Gestão Social do Desenvolvimento: O Desafio da Articulação de Atores Sociais no Programa Territórios da Cidadania Norte-RJ

This study analyzes how far the design and implementation of the Programa Territórios da Cidadania in the North Region of Rio de Janeiro State increa­se pluralism, especially including business representatives. It was realized semi-structured interviews, which were complemented by a documentary analysis and treated by analysis of content with combined graph developed based on the habermasian concept of deliberative citizenship. The design of this policy indicates hesitant incentive to include businessmen, such that specific politic aspects of inter­sectorial partnership are briefly pointed out. Besides that, the processes of territory construction valorizes the family farming; the civil society groups rejects to include businessmen in territorial collegiate body; and the analysis process of territorial pro­jects encumbers the propose of innovate projects articulated with businessmen. In conclusion, the social management experience analyzed was not capable to promote the concertation of dynamic social forces presents in the territory.Este trabalho analisa em que medida o desenho e implementação do Programa Territórios da Cidadania no Norte-RJ valorizam o pluralismo, especificamen­te quanto à inclusão dos representantes dos empresários no âmbito desta política. Foram realizadas entrevistas semiestruturadas, complementadas por análise documental, e tratadas por meio de análise de conteúdo com grade mista elaborada com base no conceito de cidadania deliberativa habermasiano. O desenho da política revela o incentivo hesitante à inclusão dos empresários, de tal sorte que aspectos de natureza política das parcerias intersetoriais são brevemente apontados. Além disso, o processo de formação do território valoriza os agricultores familiares; os representantes da sociedade civil opõem-se à inclusão dos empresários no colegiado territorial; e o processo de avaliação dos projetos territoriais dificulta a propositura de iniciativas inovadoras articuladas com os empresários. Resta claro que a experiência de gestão social analisada não conseguiu promover a concertação das forças sociais dinâmicas presentes no território

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Avaliação da implementação do Programa Nacional de Fortalecimento da Agricultura Familiar - novas perspectivas de análise

Este trabalho apresenta os resultados da avaliação da implementação do Programa Nacional de Fortalecimento da Agricultura Familiar (Pronaf) desenhada a partir dos eixos conteúdo, contexto, capacidade, compromisso e clientes/coalizões. Além de análise documental, foram realizadas entrevistas e grupos focais. Os resultados corroboram a necessidade de convergência entre as vertentes top-down e bottomup para a análise da implementação de políticas públicas e pontuam como entrave mais significativo ao êxito do programa as deficiências do sistema de assistência técnica. Por outro lado, observam-se expressivos avanços quanto à estrutura de governança, que possibilita o equacionamento das demandas portadas pelos diferentes atores e que fomenta atualizações constantes no escopo do programa, podendo assegurar a manutenção da qualidade operacional alcançada

APLs e Desenvolvimento Territorial: um Estudo sobre o Programa Território da Cidadania Norte do Rio de Janeiro

The aim of this paper is to analyze the implications of the Local Productive Arrangement of oil in the North Fluminense on regional governance and the process of formation of the Território da Cidadania North-RJ. It starts from the assumption that the unequal distribution of the benefits of oil production chain compromises the territorial development policy, especially concerning the delimitation of the territories, which would have consequences for the practice of social management. By taking the country as unit of management of public policies, the actions to be performed require the involvement and cooperation between different social actors through the establishment of democratic governance in building a common project for development of the territory. Added to this, the territorial delimitation process that necessarily must follow aspects of identity and social cohesion in order to promote the building of joint actions between the various actors for development. The methodological steps contemplated in this study bibliographic, documental and field. Interviews were conducted semi-structured interviews with representatives of business, civil society and government. The research results indicate that the cluster of oil contributes to segregate the municipalities in the North-RJ, which impacts the process of formation of the Programa Territórios da Cidadania in the region and could undermine the social management, due to the limited diversity of actors in decision-making and the difficulty in building consensus needed for dynamic participatory

Spatial distribution of Schistosoma mansoni infection before and after chemotherapy with two praziquantel doses in a community of Pernambuco, Brazil

Praziquantel chemotherapy has been the focus of the Schistosomiasis Control Program in Brazil for the past two decades. Nevertheless, information on the impact of selective chemotherapy against Schistosoma mansoni infection under the conditions confronted by the health teams in endemic municipalities remains scarce. This paper compares the spatial pattern of infection before and after treatment with either a 40 mg/kg or 60 mg/kg dose of praziquantel by determining the intensity of spatial cluster among patients at 180 and 360 days after treatment. The spatial-temporal distribution of egg-positive patients was analysed in a Geographic Information System using the kernel smoothing technique. While all patients became egg-negative after 21 days, 17.9% and 30.9% reverted to an egg-positive condition after 180 and 360 days, respectively. Both the prevalence and intensity of infection after treatment were significantly lower in the 60 mg/kg than in the 40 mg/kg treatment group. The higher intensity of the kernel in the 40 mg/kg group compared to the 60 mg/kg group, at both 180 and 360 days, ref lects the higher number of reverted cases in the lower dose group. Auxiliary, preventive measures to control transmission should be integrated with chemotherapy to achieve a more enduring impact