IMPASSES DA ACCOUNTABILITY: DILEMAS E ALTERNATIVAS DA REPRESENTAÇÃO POLÍTICA

Um elemento crucial das democracias eleitorais é a accountability, que garantiria o vínculo entre representantes e representados. Mas as esperanças depositadas nela não encontram mais do que uma pálida efetivação na prática política. A capacidade de supervisão dos constituintes sobre seus representantes é reduzida, devido a fatores que incluem a complexidade das questões públicas, o fraco incentivo à qualificação política e o controle sobre a agenda. Diante dessa situação, surgem propostas de transformação radical dos mecanismos representativos, que resgatam a idéia de “representação descritiva” e enfraquecem ou mesmo abolem a accountability. É o caso, notadamente, da representação de grupos e da substituição das eleições por sorteios. Embora prescindindo de instrumentos formais de  responsividade dos governantes em relação aos governados, as formas propostas gerariam um corpo de representantes mais assemelhado ao conjunto da população e ampliariam a rotatividade nos cargos decisórios. O presente artigo analisa as propostas de representação descritiva sob o ângulo da relação entre representantes e representados. Embora muitas vezes padeçam de sérias fragilidades e pareçam inviáveis para implementação efetiva, essas propostas incorporam críticas importantes e que merecem ser levadas em consideração, a respeito do funcionamento da representação eleitoral e, em particular, da accountability

Capital político e carreira eleitoral: algumas variáveis na eleição para o Congresso brasileiro

O artigo discute a estruturação da carreira política no Brasil, com atenção especial para os meios de comunicação de massa. Na medida em que se tornou uma fonte crucial de produção de capital político, os meios de comunicação geram "atalhos" na carreira política, permitindo que outsiders ganhem posições que, numa carreira fechada, só seriam acessíveis a integrantes experientes do campo político, com ampla vivência em cargos de menor importância. À luz dessa discussão, é examinada a trajetória dos deputados federais eleitos em quatro legislaturas, observando a força - e as limitações - da influência dos meios de comunicação, analisando-se mais atentamente aqueles deputados eleitos pela primeira vez e sem experiência eleitoral e administrativa prévia. O artigo conclui que, de modo geral, a exposição nos meios de comunicação é uma variável importante, ainda que a atividade profissional originária dos candidatos também seja uma variável a considerar. Abstract This article looks at the way political careers are structured in Brazil, paying special attention to mass communications. To the extent that they have become a crucial source for the production of political capital, the mass media create "shortcuts" in a political career, enabling outsiders access to positions that, in a more closed race, would only be open to experienced members of the political field who are making their way up from wide experience in minor positions. In light of this discussion, we examine the trajectory of federal representatives elected in four legislatures, observing the strength - and the limitations - of the influence of mass media, paying closest attention to those who have been elected for the first time and without previous electoral and administrative experience. The article concludes that, generally speaking, exposure through mass communications is an important variable, although the candidates' original professional activity is also an important variable to consider. Résumé L'article discute la structure de la carrière politique au Brésil et met en relief le rôle des moyens de communications massives. Comme les médias sont devenus une source cruciale de production de capital politique, ils favorisent des «raccourcis» dans la carrière politique et permettent que outsiders aient des positions qui ne seraient accessibles dans une carrière fermée qu'aux membres avertis du cadre politique et ayant une large expérience dans des postes de moindre importance. Cette discussion nous aide à examiner la trajectoire des députés nationaux élus à quatre reprises: on observe la force - et les limites - de l'influence des moyens de communication et on analyse avec attention les députés élus pour la première fois et sans expérience électorale et administrative. L'article conclut que souvent l'exposition aux moyens de communications est une variable importante, bien que l'activité professionnelle d'origine des candidats soit aussi une variable à être prise en compte

O TERCEIRO GOVERNO LULA: limites e perspectivas

The paper presents some reflections on the first sixmonths of the new government, taking into accountthe evolution of the conjuncture in this shortperiod. In particular, it highlights its institutionaldifficulties in relation to a parliament that is mostlyfrom the neoliberal right and extreme right, andwith a strong physiological connotation – whichcharacterizes Brazilian “coalition presidentialism”and prohibits any type of structural change thatreduces social inequality. And he points outthat the confrontation and overcoming of thesedifficulties, even if partial, cannot rely solely onLula’s negotiation capacity at the institutional level;without popular mobilization, which expresses inthe streets the effective desire for structural changesas explicitly done in the electoral campaign, thecorrelation of forces will not become, fundamentally,more favourable.L’article présente quelques réflexions sur les sixpremiers mois du nouveau gouvernement, entenant compte de l’évolution de la conjoncturedans cette courte période. Il met notammenten lumière ses difficultés institutionnelles parrapport à un parlement majoritairement issu dela droite et de l’extrême droite néolibérales, et àforte connotation physiologique – qui caractérisele « présidentialisme de coalition » brésilien etinterdit tout type de changement structurel quiréduise les inégalités sociales. Et il rappelle que laconfrontation et le dépassement de ces difficultés,même partiels, ne peuvent reposer uniquementsur la capacité de négociation de Lula au niveauinstitutionnel; sans mobilisation populaire, quiexprime dans la rue le désir effectif de changementsstructurels comme cela s’est fait explicitementdans la campagne électorale, le rapport de forces nedeviendra pas, fondamentalement, plus favorable.O artigo traz algumas reflexões sobre os primeiros seis meses do novo governo, tendo por contexto a evolução da conjuntura nesse pequeno período. Em particular, destaca as suas dificuldades institucionais na relação com um parlamento majoritariamente de direita neoliberal e extrema-direita, e com forte conotação fisiológica – que caracteriza o “presidencialismo de coalização” brasileiro e interdita qualquer tipo de mudança estrutural que reduza a desigualdade social. E aponta que o enfrentamento e a superação dessas dificuldades, mesmo que parcial, não poderão se apoiar apenas na capacidade de negociação de Lula no plano institucional; sem a mobilização popular, que expresse nas ruas o desejo efetivo de mudanças estruturais tal como feito explicitamente na campanha eleitoral, a correlação de forças não se tornará, no fundamental, mais favorável

Caso 4/19: “Uma lição de esperança”

Caso relatado na Reunião de Discussão de Casos Clínicos do Hospital Universitário Prof. Polydoro Ernani de São Thiago, iniciada pelos Profs. Jorge Dias de Matos, Marisa Helena César Coral e Rosemeri Maurici da Silva, em julho de 2017. No dia 12 de setembro de 2019, no bloco do curso de medicina, realizou-se a apresentação e discussão do caso cujo registro é apresentado a seguir: um paciente masculino de 36 anos desenvolve grave e insidiosa doença, que se caracteriza por emagrecimento, fadiga e esplenomegalia volumosa. Qual é o diagnóstico? Quais são as perspectivas de tratamento? E como paciente e médico viveram essa relação com a doença? Este relato de caso, baseado em entrevistas pessoais, é escrito na perspectiva principal do paciente, com inserções explicativas de caráter técnico, formuladas pelos autores. Pretende trazer um novo estilo para a apresentação de casos clínicos, tendo como público alvo os alunos iniciantes na graduação e o público leigo

Caracterização da função TIC/Informática nas câmaras municipais portuguesas

[Extrato] Ao longo dos últimos anos as Tecnologias da Informação e Comunicação (TIC) e os Sistemas de Informação (SI) têm vindo a desempenhar um papel fundamental nas organizações, assumindo-se como um fator determinante no desenvolvimento e na transformação da economia e das sociedades. O setor público, em geral, e as câmaras municipais, em particular, não constituem exceção a este fenómeno. Com efeito, as crescentes expetativas dos cidadãos face aos serviços públicos, têm vindo a exigir uma constante modernização administrativa, no sentido de agilizar processos, reduzir custos, fornecer informação e prestar serviços de forma mais amigável e ágil a toda a sociedade, o que consequentemente, proporcionará uma melhor qualidade de vida aos seus cidadãos.[...

Design of a charge regulator for application in an isolated micro grid with photovoltaic generation

This paper presents the design of a charge regulator operating in an isolated micro grid with photovoltaic generation. The converter selected for this application is a SEPIC with a MPPT algorithm for the cases in which the energy demand is greater than the energy available. The algorithm is able to modify its point of maximum power, in order to perform the recharging and supply of power to the battery bank of the system (isolated microgrid) and a group of charges set at a level of determined of voltage. Finally, the results of the tests carried out are presented and the conclusions are given.This paper presents the design of a charge regulator operating in an isolated micro grid with photovoltaic generation. The converter selected for this application is a SEPIC with a MPPT algorithm for the cases in which the energy demand is greater than the energy available. The algorithm is able to modify its point of maximum power, in order to perform the recharging and supply of power to the battery bank of the system (isolated microgrid) and a group of charges set at a level of determined of voltage. Finally, the results of the tests carried out are presented and the conclusions are given

Design of a charge regulator for application in an isolated micro grid with photovoltaic generation

This paper presents the design of a charge regulator operating in an isolated micro grid with photovoltaic generation. The converter selected for this application is a SEPIC with a MPPT algorithm for the cases in which the energy demand is greater than the energy available. The algorithm is able to modify its point of maximum power, in order to perform the recharging and supply of power to the battery bank of the system (isolated microgrid) and a group of charges set at a level of determined of voltage. Finally, the results of the tests carried out are presented and the conclusions are given.This paper presents the design of a charge regulator operating in an isolated micro grid with photovoltaic generation. The converter selected for this application is a SEPIC with a MPPT algorithm for the cases in which the energy demand is greater than the energy available. The algorithm is able to modify its point of maximum power, in order to perform the recharging and supply of power to the battery bank of the system (isolated microgrid) and a group of charges set at a level of determined of voltage. Finally, the results of the tests carried out are presented and the conclusions are given

Predictive model for atrial fibrillation in hypertensive diabetic patients

Background: Several scores to identify patients at high risk of suffering atrial fibrillation have been developed. Their applicability in hypertensive diabetic patients, however, remains uncertain. Our aim is to develop and validate a diagnostic predictive model to calculate the risk of developing atrial fibrillation at five years in a hypertensive diabetic population. Methods: The derivation cohort consisted of patients with both hypertension and diabetes attended in any of the 52 primary healthcare centres of Barcelona; the validation cohort came from the 11 primary healthcare centres of Terres de l'Ebre (Catalonia South) from January 2013 to December 2017. Multivariable Cox regression identified clinical risk factors associated with the development of atrial fibrillation. The overall performance, discrimination and calibration of the model were carried out. Results: The derivation data set comprised 54 575 patients. The atrial fibrillation rate incidence was 15.3 per 1000 person/year. A 5-year predictive model included age, male gender, overweight, heart failure, valvular heart disease, peripheral vascular disease, chronic kidney disease, number of antihypertensive drugs, systolic and diastolic blood pressure, heart rate, thromboembolism, stroke and previous history of myocardial infarction. The discrimination of the model was good (c-index = 0.692; 95% confidence interval, 0.684-0.700), and calibration was adequate. In the validation cohort, the discrimination was lower (c-index = 0.670). Conclusions: The model accurately predicts future atrial fibrillation in a population with both diabetes and hypertension. Early detection allows the prevention of possible complications arising from this disease

Prognostic Value of Serum Paraprotein Response Kinetics in Patients With Newly Diagnosed Multiple Myeloma

Response kinetics is not well-established as a prognostic marker in multiple myeloma (MM). We developed a mathematical model to assess the prognostic value of serum monoclonal component (MC) response kinetics during 6 induction cycles in 373 newly diagnosed MM patients. The model calculated a resistance parameter that reflects the stagnation in the response after an initial descent, dividing the patients into two kinetics categories with significantly different progression-free survival (PFS). Introduction: Response kinetics is a well-established prognostic marker in acute lymphoblastic leukemia. The situation is not clear in multiple myeloma (MM) despite having a biomarker for response monitoring (monoclonal component [MC]). Materials and Methods: We developed a mathematical model to assess the prognostic value of serum MC response kinetics during 6 induction cycles, in 373 NDMM transplanted patients treated in the GEM2012Menos65 clinical trial. The model calculated a resistance parameter that reflects the stagnation in the response after an initial descent. Results: Two patient subgroups were defined based on low and high resistance, that respectively captured sensitive and refractory kinetics, with progression-free survival (PFS) at 5 years of 72% and 59% (HR 0.64, 95% CI 0.44-0.93; P =.02). Resistance significantly correlated with depth of response measured after consolidation (80.9% CR and 68.4% minimal residual disease negativity in patients with sensitive vs. 31% and 20% in those with refractory kinetics). Furthermore, it modulated the impact of reaching CR after consolidation; thus, within CR patients those with refractory kinetics had significantly shorter PFS than those with sensitive kinetics (median 54 months vs. NR; P =.02). Minimal residual disease negativity abrogated this effect. Our study also questions the benefit of rapid responders compared to late responders (5-year PFS 59.7% vs. 76.5%, respectively [P <.002]). Of note, 85% of patients considered as late responders were classified as having sensitive kinetics. Conclusion: This semi-mechanistic modeling of M-component kinetics could be of great value to identify patients at risk of early treatment failure, who may benefit from early rescue intervention strategies. (C) 2022 The Authors. Published by Elsevier Inc