Recentralização/descentralização: dinâmica do regime federativo no Brasil dos anos 90

Este artigo discute a evolução das práticas e instituições federativas no Brasil dos anos recentes, enfatizando a simultaneidade de processos de recentralização e descentralização. A trajetória descentralizadora que culmina com a Constituição de 1988, a crise fiscal do estado brasileiro e os efeitos do Plano Real são discutidos a partir de um quadro de referências de tipo comparativo, que busca incorporar escritos muito recentes de Alfred Stepan.This article discusses the evolution of the federative practice and institutions in Brazil in the past few years, emphasizing the simultaneity of the decentralization processes. The decentralizing trajectory which culminates in the 1988 Constitution, the fiscal crises of the Brazilian State and the effects of Plano Real are discussed based in a set of comparative references, trying to incorporate very recent works by Alfred Stepan

Recentralization/decentralization: dynamics of the federative regime in Brazil 90's

This article discusses the evolution of the federative practice and institutions in Brazil in the past few years, emphasizing the simultaneity of the decentralization processes. The decentralizing trajectory which culminates in the 1988 Constitution, the fiscal crises of the Brazilian State and the effects of Plano Real are discussed based in a set of comparative references, trying to incorporate very recent works by Alfred Stepan.Este artigo discute a evolução das práticas e instituições federativas no Brasil dos anos recentes, enfatizando a simultaneidade de processos de recentralização e descentralização. A trajetória descentralizadora que culmina com a Constituição de 1988, a crise fiscal do estado brasileiro e os efeitos do Plano Real são discutidos a partir de um quadro de referências de tipo comparativo, que busca incorporar escritos muito recentes de Alfred Stepan

O Leviathan declinante: a crise brasileira dos anos 80

This article evalvates the Brazilian crisis in the Eighties, analysing the feedback between economic crisis and political change. Its approach emphatizes the importance of the difference between the concepts of State and political regime. These two concepts are used in a systematic way to explain the nature of the crisis and the difficulties of the transition tomards democracy. The rupture of the alliances that supported the old developmental State of the thirties in undescored, as well as the extent of the difficulties that delay the emergence of a new hegemonic pact.Este artigo faz um balanço da crise brasileira dos anos 80. Busca analisar a interação entre crise econômica e transformação política, enfatizando a importância da distinção conceituai entre Estado e regime político. Usa sistematicamente tais conceitos para explicar a natureza da crise e as dificuldades da transição para a democracia. E salientada a ruptura das alianças que sustentaram o velho Estado desenvolvimentista surgido nos anos 30 e a extensão das dificuldades que retardaram a emergência de um novo pacto hegemônico

A global action agenda for turning the tide on fatty liver disease

Background and Aims: Fatty liver disease is a major public health threat due to its very high prevalence and related morbidity and mortality. Focused and dedicated interventions are urgently needed to target disease prevention, treatment, and care. Approach and Results: We developed an aligned, prioritized action agenda for the global fatty liver disease community of practice. Following a Delphi methodology over 2 rounds, a large panel (R1 n = 344, R2 n = 288) reviewed the action priorities using Qualtrics XM, indicating agreement using a 4-point Likert-scale and providing written feedback. Priorities were revised between rounds, and in R2, panelists also ranked the priorities within 6 domains: epidemiology, treatment and care, models of care, education and awareness, patient and community perspectives, and leadership and public health policy. The consensus fatty liver disease action agenda encompasses 29 priorities. In R2, the mean percentage of “agree” responses was 82.4%, with all individual priorities having at least a super-majority of agreement (> 66.7% “agree”). The highest-ranked action priorities included collaboration between liver specialists and primary care doctors on early diagnosis, action to address the needs of people living with multiple morbidities, and the incorporation of fatty liver disease into relevant non-communicable disease strategies and guidance. Conclusions: This consensus-driven multidisciplinary fatty liver disease action agenda developed by care providers, clinical researchers, and public health and policy experts provides a path to reduce the prevalence of fatty liver disease and improve health outcomes. To implement this agenda, concerted efforts will be needed at the global, regional, and national levels.publishedVersio