A regulamentação do dano extrapatrimonial pela lei 13.467/2017 e a limitação trazida pelo art. 223-G, §1º da CLT

O presente trabalho tem como objetivo analisar a regulamentação do dano extrapatrimonial pela Lei n. 13.467/2017. Para tanto, será levantado o questionamento se a tarifação trazida pelo art. 223-G, §1º, que utilizou como parâmetro a gravidade da ofensa e o salário do ofendido, seria constitucional. Dessa forma, analisar-se-á inicialmente a centralidade da pessoa humana no ordenamento trabalhista, passando-se para uma análise do instituto do dano moral na esfera laboral antes e depois da reforma, a fim de buscar entender os critérios utilizados para quantificar uma indenização. Ainda, será analisado o entendimento majoritário da doutrina, que tende para a inconstitucionalidade da tarifação prevista no art. 223-G, §1º da CLT

O direito do trabalhador à desconexão: uma análise do teletrabalho no Direito Brasileiro

Os avanços tecnológicos da pós-modernidade, ao invés de poupar horas das pessoas no trabalho, têm servido para deixá-las cada vez mais conectadas ao seu empregador, sendo difícil definir um limite entre uma jornada e outra. Os notebooks, smartphones, tablets, possibilitam o trabalho a qualquer hora e lugar, impactando diretamente na organização do tempo-trabalho-lazer dos trabalhadores, sobretudo após a regulamentação do teletrabalho pelo direito brasileiro. Diante do contexto fático do teletrabalho e da supervalorização do capital, por meio de pesquisa exploratória bibliográfica, mostra-se pertinente abordar o direito fundamental à desconexão ou ao descanso, como forma de limitar a jornada de trabalho e, consequentemente, proteger a saúde, higiene e segurança do trabalhador, enunciados no art. 7º, XIII, XV, XVII e XXII da Constituição da República de 1998. Pretende-se demonstrar, portanto, que a preservação do tempo livre destinado ao lazer desconectado do controle do capital, direito ao lazer (ócio), constitucionalmente garantido ao trabalhador, é extremamente necessária à preservação da incolumidade física e mental do trabalhador

Access to medicines in the Brazilian Unified Health System's primary health care : assessment of a public policy

In 2008, the Programa Rede Farmácia de Minas (RFM, literally translated: ‘Minas Gerais Pharmacy Network’ program) was created as a strategy to expand access to medicines. Aim: Measure access to medicines in public pharmacies through comparison between municipalities that joined or not the RFM. Materials & methods: Cross-sectional, evaluative study, gathering information from a representative sample of the municipalities in Minas Gerais between July 2014 and May 2015. The Poisson regression results were obtained by calculating the prevalence ratios. Results: Adequate access to medicines in Minas Gerais was 69.9%, being 75.8% in municipalities with and 69.2% without the RFM. The municipalities with the RFM showed statistically higher percentages in the Availability, Adequacy/Accommodation, and Acceptability dimensions. Conclusion: RFM appears an efficient strategy for promoting access to medicines

Effects of preoperative feeding with a whey protein plus carbohydrate drink on the acute phase response and insulin resistance. A randomized trial

<p>Abstract</p> <p>Background</p> <p>Prolonged preoperative fasting increases insulin resistance and current evidence recommends carbohydrate (CHO) drinks 2 hours before surgery. Our hypothesis is that the addition of whey protein to a CHO-based drink not only reduces the inflammatory response but also diminish insulin resistance.</p> <p>Methods</p> <p>Seventeen patients scheduled to cholecystectomy or inguinal herniorraphy were randomized and given 474 ml and 237 ml of water (CO group) or a drink containing CHO and milk whey protein (CHO-P group) respectively, 6 and 3 hours before operation. Blood samples were collected before surgery and 24 hours afterwards for biochemical assays. The endpoints of the study were the insulin resistance (IR), the prognostic inflammatory and nutritional index (PINI) and the C-reactive protein (CRP)/albumin ratio. A 5% level for significance was established.</p> <p>Results</p> <p>There were no anesthetic or postoperative complications. The post-operative IR was lower in the CHO-P group when compared with the CO group (2.75 ± 0.72 vs 5.74 ± 1.16; p = 0.03). There was no difference between the two groups in relation to the PINI. The CHO-P group showed a decrease in the both CRP elevation and CRP/albumin ratio (p < 0.05). The proportion of patients who showed CRP/albumin ratio considered normal was significantly greater (p < 0.05) in the CHO-P group (87.5%) than in the CO group (33.3%).</p> <p>Conclusions</p> <p>Shortening the pre-operative fasting using CHO and whey protein is safe and reduces insulin resistance and postoperative acute phase response in elective moderate operations.</p> <p>Trial registration</p> <p>ClinicalTrail.gov <a href="http://www.clinicaltrials.gov/ct2/show/NCT01354249">NCT01354249</a></p

Spatial point analysis based on dengue surveys at household level in central Brazil

<p>Abstract</p> <p>Background</p> <p>Dengue virus (DENV) affects nonimunne human populations in tropical and subtropical regions. In the Americas, dengue has drastically increased in the last two decades and Brazil is considered one of the most affected countries. The high frequency of asymptomatic infection makes difficult to estimate prevalence of infection using registered cases and to locate high risk intra-urban area at population level. The goal of this spatial point analysis was to identify potential high-risk intra-urban areas of dengue, using data collected at household level from surveys.</p> <p>Methods</p> <p>Two household surveys took place in the city of Goiania (~1.1 million population), Central Brazil in the year 2001 and 2002. First survey screened 1,586 asymptomatic individuals older than 5 years of age. Second survey 2,906 asymptomatic volunteers, same age-groups, were selected by multistage sampling (census tracts; blocks; households) using available digital maps. Sera from participants were tested by dengue virus-specific IgM/IgG by EIA. A Generalized Additive Model (GAM) was used to detect the spatial varying risk over the region. Initially without any fixed covariates, to depict the overall risk map, followed by a model including the main covariates and the year, where the resulting maps show the risk associated with living place, controlled for the individual risk factors. This method has the advantage to generate smoothed risk factors maps, adjusted by socio-demographic covariates.</p> <p>Results</p> <p>The prevalence of antibody against dengue infection was 37.3% (95%CI [35.5–39.1]) in the year 2002; 7.8% increase in one-year interval. The spatial variation in risk of dengue infection significantly changed when comparing 2001 with 2002, (ORadjusted = 1.35; p < 0.001), while controlling for potential confounders using GAM model. Also increasing age and low education levels were associated with dengue infection.</p> <p>Conclusion</p> <p>This study showed spatial heterogeneity in the risk areas of dengue when using a spatial multivariate approach in a short time interval. Data from household surveys pointed out that low prevalence areas in 2001 surveys shifted to high-risk area in consecutive year. This mapping of dengue risks should give insights for control interventions in urban areas.</p

Transcription of toll-like receptors 2, 3, 4 and 9, FoxP3 and Th17 cytokines in a susceptible experimental model of canine Leishmania infantum infection

Canine leishmaniosis (CanL) due to Leishmania infantum is a chronic zoonotic systemic disease resulting from complex interactions between protozoa and the canine immune system. Toll-like receptors (TLRs) are essential components of the innate immune system and facilitate the early detection of many infections. However, the role of TLRs in CanL remains unknown and information describing TLR transcription during infection is extremely scarce. The aim of this research project was to investigate the impact of L. infantum infection on canine TLR transcription using a susceptible model. The objectives of this study were to evaluate transcription of TLRs 2, 3, 4 and 9 by means of quantitative reverse transcription polymerase chain reaction (qRT-PCR) in skin, spleen, lymph node and liver in the presence or absence of experimental L. infantum infection in Beagle dogs. These findings were compared with clinical and serological data, parasite densities in infected tissues and transcription of IL-17, IL-22 and FoxP3 in different tissues in non-infected dogs (n = 10), and at six months (n = 24) and 15 months (n = 7) post infection. Results revealed significant down regulation of transcription with disease progression in lymph node samples for TLR3, TLR4, TLR9, IL-17, IL-22 and FoxP3. In spleen samples, significant down regulation of transcription was seen in TLR4 and IL-22 when both infected groups were compared with controls. In liver samples, down regulation of transcription was evident with disease progression for IL-22. In the skin, upregulation was seen only for TLR9 and FoxP3 in the early stages of infection. Subtle changes or down regulation in TLR transcription, Th17 cytokines and FoxP3 are indicative of the silent establishment of infection that Leishmania is renowned for. These observations provide new insights about TLR transcription, Th17 cytokines and Foxp3 in the liver, spleen, lymph node and skin in CanL and highlight possible markers of disease susceptibility in this model