Cash benefits to disabled persons in Brazil: An analysis of the BPC ? Continuous Cash Benefit Programme

The paper presents an analysis of the Continuous Cash Benefit Programme (BPC, which stands for Benefício de Prestação Continuada in Portuguese), an unconditional cash transfer to the elderly or to extremely poor individuals with disabilities. The information used in the assessment stems from the study of court decisions and laws related to the programme since its implementation, an analysis based on questionnaires applied to medical experts, interviews with the programme managers, as well as a review of pre-existing studies regarding BPC. In order to contribute to the management of the programme, as well as to improvements or even implementation of similar programmes in other countries, the study gives some recommendations about the design, operation and future evaluations of the programme.BPC, Continuous Cash Benefit, Cash benefits

Histometric evaluation of bioactive glass, platelet-rich plasma and their association with guided tissue regeneration on the treatment of periodontal defects in dogs

Orientadores: Enilson Antonio Sallum, Francisco Humberto Nociti JuniorTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de PiracicabaResumo: O objetivo do presente trabalho foi avaliar histometricamente o efeito do plasma rico em plaquetas (PRP), do vidro bioativo (Perioglas?) e sua associação sobre a regeneração periodontal em defeitos intra-ósseos de 3 paredes, além de sua combinação à regeneração tecidual guiada (RTG) em defeitos de furca grau II em cães. Foram incluídos 9 cães, fêmeas, de raça indefinida e pesando aproximadamente 15Kg. Os animais tiveram os segundos e quartos pré-molares e segundos molares mandibulares extraídos. Decorridas 12 semanas das extrações, foram criados cirurgicamente 4 defeitos intra-ósseos de 3 paredes (dimensões 4x4x4mm), sendo 2 nas faces mesiais e 2 nas faces distais dos primeiros molares mandibulares. Outros 2 defeitos do tipo furca grau II (5x2mm) foram criados na face vestibular dos terceiros pré-molares mandibulares. Em todos os defeitos foram utilizados dispositivos para cronificação durante 4 semanas. Uma semana após a remoção dos dispositivos de cronificação, os animais foram então submetidos à cirurgia para tratamento dos defeitos. O lado que recebeu os tratamentos com o PRP foi inicialmente sorteado, sendo então designados aleatoriamente os respectivos tratamentos: Controle (C); Vidro Bioativo (VB); Plasma Rico em Plaquetas (PRP) e PRP+VB, para os defeitos intra-ósseos. O lado que recebeu os tratamentos PRP e VB+PRP teve o defeito de furca grau II tratado com a associação do PRP+VB+RTG, sendo o dente contra lateral tratado com VB+RTG. Decorridas 12 semanas das cirurgias de tratamento, os animais foram sacrificados. Após processamento histológico, procedeu-se com a avaliação histométrica. Não foram observadas diferenças significantes para os parâmetros avaliados nos defeitos intra-ósseos. A extensão de epitélio foi 2,24±0,58 mm, 1,94±0,37 mm, 1,97±0,37 mm e 1,81±0,61 mm para, Controle, VB, PRP e PRP + VB, respectivamente. A adaptação conjuntiva sem formação de cemento foi 0,90±0,28 mm, 0,84±0,41 mm, 1,07±0,27 mm e 1,15±0,32 mm, respectivamente. A extensão de novo cemento foi 2,63±0,70 mm, 2,56±0,36 mm, 2,37±0,38 mm e 3,10±0,47 mm, respectivamente. A extensão de novo osso foi 4,77±0,44 mm, 4,64±0,68 mm, 4,67±0,46 mm e 4,84±0,42 mm, respectivamente. A porcentagem de preenchimento do defeito foi 47% no grupo C, 50% com VB, 53% com PRP e 50% com VB+PRP. Para os defeitos de furca verificou-se diferença significante na formação de novo cemento em favor do grupo VB+PRP+RTG (p=0,035). Dento dos limites deste estudo pode-se concluir que o uso do VB e PRP de forma isolada ou associada não promoveram efeito adicional à regeneração periodontal em defeitos intra-ósseos de três paredes em cães. Entretanto, pode-se concluir também que o uso do PRP promoveu uma maior formação de cemento em defeitos de furca grau II em cães, quando associado ao VB e à RTGAbstract: The objective of the present study was to evaluate at the histological level the effect of platelet-rich plasma (PRP), bioactive glass (BG) and his association on periodontal regeneration of 3-wall intrabony defects and its combination with guided tissue regeneration (GTR) on the regeneration of class II lesions in dogs. Nine mongrel dogs with approximately 15Kg were used in the experiment. The animals had the second premolar, fourth premolar and second molar at the mandible extracted. After twelve weeks, three-wall intra-bony defects (4x4x4m) were surgically created at the mesial and distal aspect of first mandibular molar. Class II furcation lesions (5x2mm) were surgically created, bilaterally, at the buccal aspect of mandibular third premolar. All defects were exposed to plaque accumulation for 1 month. One week after to remove the cronification devices, the defects were submitted to treatments. All treatments with PRP were located at the same side. Intrabony and class II furcation defects were randomly assigned to: Control (C); BG; PRP and PRP+BG, and PRP+BG+GTR and BG+GTR, respectively. Dogs were sacrificed 90 days after the surgeries and the blocks containing the experimental specimens were processed for histological analysis. No statistically significant differences were observed in all parameters for the treatment of intrabony defects. The extension of total epithelium (sulcular and junctional epithelium) was 2.24 ??0.58 mm, 1.94 ± ?0.37 mm, 1.97 ± ?0.37 mm and 1.81 ± ?0.61 mm for, Control, BG, PRP and PRP+BG, respectively. The new connective tissue adjacent to the root without cementum formation was 0.90 ± ?0.28 mm, 0.84 ± ?0.41 mm, 1.07 ± ?0.27 mm and 1.15 ± ?0.32 mm, respectively. The extension of new cementum was 2.63 ± ?0.70 mm, 2.56 ± ?0.36 mm, 2.37 ± ?0.38 mm and 3.10 ??0.47 mm, respectively. The length of new bone was 4.77 ± ?0.44 mm, 4.64 ± ?0.68 mm, 4.67 ± ?0.46 mm and 4.84 ± ?0.42 mm, respectively. The percentage of bone filling was 47% on the control group, 50% with BG, 50% with PRP+BG and 53% with PRP. At the class II furcation, no statistically significant differences were observed in defect extension and new bone (p=0.29).The extension of new cementum was 9.64 ± ?1.53 mm and 11.00 ± ?1.05 mm (p=0.03) to GTR+BG and GTR+BG+PRP, respectively. Within the limits of this study, it can be concluded that PRP, BG and their association was not able to increase the amount of periodontal regeneration obtained to the treatment of 3-wall intrabony defects in dogs. However, it can be assumed that PRP promoted an increase of cementum regeneration when applied in association with BG and GTR for the treatment of class II furcation lesions in dogsDoutoradoPeriodontiaDoutor em Clínica Odontológic

Abortion in Brazil : a household survey using the ballot box technique

O artigo apresenta os primeiros resultados da Pesquisa Nacional de Aborto (PNA), um levantamento por amostragem aleatória de domicílios, realizado em 2010, cuja cobertura abrangeu as mulheres com idades entre 18 e 39 anos em todo o Brasil urbano. A PNA combinou duas técnicas de sondagem: a técnica de urna e questionários preenchidos por entrevistadoras. Seus resultados indicam que, ao final da vida reprodutiva, mais de uma em cada cinco mulheres já fez aborto, ocorrendo os abortos em geral nas idades que compõem o centro do período reprodutivo das mulheres, isto é, entre 18 e 29 anos. Não se observou diferenciação relevante na prática em função de crença religiosa, mas o aborto se mostrou mais comum entre mulheres de menor escolaridade. O uso de medicamentos para a indução do último aborto ocorreu em metade dos casos e a internação pós-aborto foi observada em cerca de metade dos abortos. Tais resultados levam a concluir que o aborto deve ser prioridade na agenda de saúde pública nacional. _______________________________________________________________________________ ABSTRACTThis study presents the first results of the National Abortion Survey (PNA, Pesquisa Nacional de Aborto), a household random sample survey fielded in 2010 covering urban women in Brazil aged 18 to 39 years. The PNA combined two techniques, interviewer-administered questionnaires and self-administered ballot box questionnaires. The results of PNA show that at the end of their reproductive health one in five women has performed an abortion, with abortions being more frequent in the main reproductive ages, that is, from 18 to 29 years old. No relevant differentiation was observed in the practice of abortion among religious groups, but abortion was found to be more common among people with lower education. The use of medical drugs to induce abortion occurred in half of the abortions, and post-abortion hospitalization was observed among approximately half of the women who aborted. Such results lead to conclude that abortion is a priority in the Brazilian public health agenda

Comments on the portuguese translation of the International Classification of Functioning, Disability and Health

A análise da terminologia adotada pela Organização Mundial da Saúde para deficiência mostra que a International Classification of Functioning, Disability and Health foi fortemente influenciada pelo modelo social da deficiência, um campo de pesquisas sobre deficiência das humanidades em saúde. As traduções do documento devem contemplar esse marco teórico nas escolhas terminológicas em cada idioma. No Brasil, o documento foi traduzido como Classificação Internacional de Funcionalidade, Incapacidade e Saúde. Julgamos que mais adequado que traduzir disability por “incapacidade” e impairments por “deficiências” seria usar o termo “deficiência” para disability e “lesão” para impairment. Dado o marco normativo do documento para as políticas públicas e pesquisas científicas é preciso garantir a acuidade e legitimidade dos conceitos e seus fundamentos teóricos. _________________________________________________________________________________ ABSTRACTAn analysis of the World Health Organization terminology for disability indicates the influence of the social model of disability in the International Classification of Functioning, Disability, and Health. This theoretical framework should guide any translations of the document. In Brazil, the document was translated as Classificação Internacional de Funcionalidade, Incapacidade e Saúde. We argue that more appropriate than translating disability as “incapacidade” and impairments as “deficiências” would be to use the term “deficiência” for disability and “lesão” for impairment. Considering the normative impact of a WHO document for social policy and international research, the translation should accurately reflect the concepts and their theoretical basis

Itineraries and methods of illegal abortion in five Brazilian state capitals

O artigo apresenta os resultados da etapa de entrevistas estruturadas da Pesquisa Nacional de Aborto (PNA-entrevistas), descrevendo características das mulheres que fizeram ao menos um aborto ilegal, os itinerários e os métodos. Entrevistas estruturadas feitas em 2010 e 2011 com 122 mulheres entre 18 e 39 anos que abortaram, em cinco capitais brasileiras (Belém, Brasília, Porto Alegre, Rio de Janeiro e Salvador). Amostra não probabilística controlada por seis cotas, de acordo com nível educacional e idade, refletindo a estrutura social e demográfica encontrada na PNA-urna. A maioria das mulheres entrevistadas realizou apenas um aborto, mas uma em cada quatro realizou dois abortos, e uma em cada 17 realizou três abortos. A maioria dos abortos ocorre entre jovens até 19 anos, muitas das quais já tiveram filhos. Os exames mais comuns para identificar a gravidez são o beta-HCG sérico, o teste de urina de farmácia e o ultrassom. Há uma prevalência do aborto entre mulheres negras. O principal método abortivo é uma combinação de chás e cytotec (misoprostol) com a finalização em hospitais. Parentes e companheiros auxiliam em diferentes etapas do processo. Várias mulheres relataram já ter ajudado outras mulheres a abortar após sua experiência individual. _________________________________________________________________________________ ABSTRACTThis paper presents the results of the structured interview phase of the National Abortion Survey (PNA-interviews), describing the itineraries, methods and social and demographic profile of women who had at least one illegal abortion. Structured interviews were conducted during the years 2010 and 2011 in five state capitals (Belem, Brasilia, Porto Alegre, Rio de Janeiro and Salvador) with 122 women aged between 18 and 39 who had abortions. It is a non-probabilistic sample controlled by six parameters in accordance with level of education and age to reflect the social and demographic structure found in the PNA ballot-box questionnaire phase. The majority of women interviewed had had only one abortion, but 1 in every 4 had two abortions and 1 in every 17 had a third one. The majority of abortions are among women under 19 years of age who already had children and a higher incidence is found among black women. The most common test for pregnancy is beta-HCG blood test, the pharmacy urine test and ultrassound. The prevailing method for induction is a combination of teas and misoprostol (called Cytotec in Brazil), followed by hospital assistance after induction. Women are usually helped by a relative or their partners and several women reported helping other women to have abortions

Envelhecimento e deficiência

O objetivo deste artigo é aproximar a discussão sobre envelhecimento do tema deficiência. Os estudos sobre deficiência são um campo sólido de debates pouco conhecido no Brasil. O modelo social de deficiência, uma corrente políticoteórica iniciada no Reino Unido nos anos 1960, provocou uma reviravolta nos modelos tradicionais de compreensão da deficiência ao retirar do indivíduo a origem da desigualdade e devolvê-la ao social. Com o envelhecimento crescente da população, o principal grupo de deficientes concentra-se entre os idosos, um fenômeno que torna essa aproximação teórica ainda mais urgente. O modelo social da deficiência é uma discussão extensa sobre políticas de bem-estar e de justiça social, em que a explicação médica para a desigualdade não é mais considerada suficiente. O principal argumento aqui, é que, dado o cruzamento entre deficientes e idosos, as perspectivas teóricas e políticas do modelo social da deficiência são uma fonte rica de diálogo e inspiração para políticas de bem-estar para idosos

EFFECT OF FROST ON GERMPLASM USED IN RESTORATION OF DEGRADED AREA IN THE SERRA DO ITAJAÍ NATIONAL PARK

Frosts that occur in the Southern Brazil limit the development and survival of seedlings used for restoration projects and may cause significant losses. The objectives of this study were: evaluating the effect of frosts on seedlings produced by seeds collected around a degraded area inside the Serra do Itajaí National Park (PNSI) and used to restore this area; and validating the use of polyester printed labels for marking seedlings. Planting was carried out in adapted Anderson Groups, with 25 seedlings per module. Survival rates for frost were evaluated in 750 seedlings, identified at the species level, classified according to their ecological group, and used in three areas designated as A, B and C. 80% of the seedlings were planted in sloping area and 20%, in lowland area. For the identification of the seedlings, labels printed by a laser printer were used on matte polyester film and affixed with plastic polyamide clamps. This method proved to be practical, inexpensive and resistant to the climate action (heat, humidity and precipitation). Besides, it does not suffer attacks from the local fauna. The overall survival rate was 55.87%, whereas survival rates by ecological groups were 76.67% for shadow tolerant climax, 53.75% for light demanding climax, and 55.63% for the pioneer. The highest survival rates were the ones from seedlings located on the slopes. It was possible to verify that the local germplasm is well adapted to the frosts that occur in the region.Frosts that occur in the Southern Brazil limit the development and survival of seedlings used for restoration projects and may cause significant losses. The objectives of this study were: evaluating the effect of frosts on seedlings produced by seeds collected around a degraded area inside the Serra do Itajaí National Park (PNSI) and used for the restoration of this area; and validating the use of polyester printed labels for marking seedlings. Planting was carried out in adapted Anderson Groups, with 25 seedlings per module. Survival rates for frost were evaluated in 750 seedlings, identified at the species level, classified according to their ecological group, and used in three areas designated as A, B and C, with 80% of the seedlings planted in sloping area and 20%, in lowland area. For the identification of the seedlings, labels printed by a laser printer were used on matte polyester film and affixed with plastic polyamide clamps. This method proved to be practical, inexpensive and resistant to the climate action (heat, humidity and precipitation). Besides, it does not suffer attacks from the local fauna. The overall survival rate was 55.87%, whereas survival rates by ecological groups were 76.67% for shadow tolerant climax, 53.75% for light demanding climax, and 55.63% for the pioneer. The highest survival rates were the ones from seedlings located on the slopes. It was possible to verify that the local germplasm is well adapted to the frosts that occur in the region

Which disability? Medical evaluation and social assistance in Brazil

Este artigo analisa o conceito de deficiência adotado pela principal política de transferência de renda para a população portadora de deficiência no Brasil, o Benefício de Prestação Continuada (BPC). O estudo contrasta os critérios de seleção regulamentados pelo programa aos critérios utilizados pelos médicos peritos encarregados de avaliar e selecionar os beneficiários do programa. Foi realizada uma pesquisa por amostra com 16% do total de médicos peritos no Brasil. O objetivo do questionário foi avaliar a qualidade das instruções, dos formulários e dos procedimentos relativos à elegibilidade das pessoas deficientes ao benefício. Os resultados mostram que há uma divergência entre os critérios formais que regulamentam o BPC e a prática pericial dos médicos que apontam para um alargamento do conceito de deficiência para a inclusão de beneficiários com doenças genéticas, crônicas e infecciosas graves. _________________________________________________________________________________ ABSTRACTThis article examines the concept of disability adopted by the most important cash transfer program targeting the disabled population in Brazil, the Continuous Cash Benefit (Benefício de Prestação Continuada – BPC). The study compares the eligibility criteria established by law and the criteria used by medical examiners in the beneficiary selection process. The data are from a sample survey of 16% of the medical examiners working in the program. The questionnaire aims to assess the instructions, forms, and procedures for selecting disabled beneficiaries. The results show a discrepancy between the formal program criteria and actual practice by the examiners, suggesting an expanded concept of disability aimed at including beneficiaries with genetic, chronic, and severe infectious diseases

National abortion survey 2016

Apresentamos os resultados da Pesquisa Nacional de Aborto de 2016 (PNA 2016) e os comparamos aos da PNA 2010 quanto ao perfil das mulheres e a magnitude do aborto. A pesquisa se baseou em um levantamento domiciliar que combina técnica de urna e entrevistas face-a-face com mulheres de 18 a 39 anos, com amostra representativa do Brasil urbano. Os resultados indicam que o aborto é um fenômeno frequente e persistente entre as mulheres de todas as classes sociais, grupos raciais, níveis educacionais e religiões: em 2016, quase 1 em cada 5 mulheres, aos 40 anos já realizou, pelo menos, um aborto. Em 2015, foram, aproximadamente, 416 mil mulheres. Há, no entanto, heterogeneidade dentro dos grupos sociais, com maior frequência do aborto entre mulheres de menor escolaridade, pretas, pardas e indígenas, vivendo nas regiões Norte, Nordeste e Centro-Oeste. Como já mostrado pela PNA 2010, metade das mulheres utilizou medicamentos para abortar, e quase a metade das mulheres precisou ficar internada para finalizar o aborto.We present the results of the Brazilian National Abortion Survey of 2016 (2016 PNA) and compare them to those obtained in the 2010 PNA as per the profile of women and the magnitude of abortion. The PNA is based on a random sample that combines ballot-box questionnaires with face-to-face interviews with women ages 18 to 39 in urban areas of Brazil. The results show that abortion is a common and persistent occurrence among women of all social classes, racial groups, educational levels, and religions: in 2016, almost 1 in every 5 women had undergone at least one abortion by the age of 40. In 2015, approximately 416,000 women had an abortion. There is, however, heterogeneity among the social groups, with abortions being more frequent among women of lower educational levels, women who are Black, Brown and Indigenous, and women living in the North, Northeastern and Mid-western regions of the country. In line with the 2010 PNA, half of all women took medicine to abort and almost half of them were hospitalized to complete the abortion