Mudanças na Política de Atenção Básica à Saúde: consensos e contestações em espaços deliberativos do SUS

RESUMO A Política Nacional de Atenção Básica (PNAB), quando estabelecida em 2006, corroborou o direcionamento do modelo assistencial em conformidade com a universalização do sistema de saúde brasileiro. Contudo, alterações recentes na sua organização e financiamento demonstram inflexões. O objetivo do artigo foi analisar processos decisórios relacionados com a PNAB, em distintos espaços de deliberação do Sistema Único de Saúde (SUS), que incidiram em mudanças nessa política, no período de 2016 a 2020. Trata-se de um estudo de caso exploratório e retrospectivo, que adotou o process tracing. Foram analisadas as atas das reuniões do Conselho Nacional de Saúde (CNS) e da Comissão Intergestores Tripartite (CIT) de 2016 a 2020. As gravações de Reuniões Ordinárias da CIT, entre 2019 e 2020, também foram fontes de informações. Alterações na política deram-se sob a baixa interlocução e desaprovação da instância nacional de participação e controle social do SUS. O CNS atuou como um espaço de denúncia e resistência às mudanças, porém, com baixa capacidade de influenciar as decisões políticas. Por sua vez, o espaço intergovernamental do SUS revelou cooperação entre representantes de gestores subnacionais, com poucas tensões, no que diz respeito à agenda de mudança proposta pela União

Acetylation of Eugenol over 12-Molybdophosphoric Acid Anchored in Mesoporous Silicate Support Synthesized from Flint Kaolin

A new prepared catalyst, 12-molybdophosphoric acid (HPMo) anchored to the mesoporous aluminosilicate AlSiM, synthesized from Amazon kaolin, was characterized and used as a heterogeneous acid catalyst for the production of eugenyl acetate by acetylation of eugenol with acetic anhydride. The effect of various reaction parameters, such as catalyst concentration, eugenol/acetic anhydride molar ratio, temperature and reaction time, was studied to optimize the conditions of maximum conversion of eugenol. The kinetics studies showed that in eugenol acetylation, the substrate concentration follows a first order kinetics. The results of activation energy was 19.96 kJ mol−1 for HPMo anchored to AlSiM. The reuse of the catalyst was also studied and there was no loss of catalytic activity after four cycles of use (from 99.9% in the first cycle to 90% in the fifth cycle was confirmed), and an excellent stability of the material was observed. Based on catalytic and kinetic studies, HPMo anchored to AlSiM is considered an excellent catalyst

Bentonites Modified with Phosphomolybdic Heteropolyacid (HPMo) for Biowaste to Biofuel Production

Two bentonites from Paraíba (Northeastern Brazil) were impregnated with heteropoly phosphomolybdic H3PMo12O40 (HPMo). The materials produced were characterized by various techniques such as N2 adsorption-desorption (specific surface area, SSA), Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), Thermogravimetric analysis (TGA/DTG), Scanning Electron Microscopy (SEM) equipped with Dispersive Energy X-ray spectroscopy (EDS), ultraviolet-visible spectroscopy (UV-vis), acid-base titration analysis. The catalytic activity of these materials was tested in the esterification of a waste from palm oil deodorization and the main results obtained (about 93.3% of conversion) indicated that these materials have potential to act as heterogeneous solid acid catalysts. The prepared materials exhibited satisfactory catalytic performance even after a very simple recycling process in three reuse cycles, without significant loss of their activities

The Microcephaly Epidemic Research Group Paediatric Cohort (MERG-PC): A Cohort Profile.

This cohort profile aims to describe the ongoing follow-up of children in the Microcephaly Epidemic Research Group Paediatric Cohort (MERG-PC). The profile details the context and aims of the study, study population, methodology including assessments, and key results and publications to date. The children that make up MERG-PC were born in Recife or within 120 km of the city, in Pernambuco/Brazil, the epicentre of the microcephaly epidemic. MERG-PC includes children from four groups recruited at different stages of the ZIKV microcephaly epidemic in Pernambuco, i.e., the Outpatient Group (OG/n = 195), the Microcephaly Case-Control Study (MCCS/n = 80), the MERG Pregnant Women Cohort (MERG-PWC/n = 336), and the Control Group (CG/n = 100). We developed a comprehensive array of clinical, laboratory, and imaging assessments that were undertaken by a 'task force' of clinical specialists in a single day at 3, 6, 12, 18 months of age, and annually from 24 months. Children from MCCS and CG had their baseline assessment at birth and children from the other groups, at the first evaluation by the task force. The baseline cohort includes 711 children born between February 2015 and February 2019. Children's characteristics at baseline, excluding CG, were as follows: 32.6% (184/565) had microcephaly, 47% (263/559) had at least one physical abnormality, 29.5% (160/543) had at least one neurological abnormality, and 46.2% (257/556) had at least one ophthalmological abnormality. This ongoing cohort has contributed to the understanding of the congenital Zika syndrome (CZS) spectrum. The cohort has provided descriptions of paediatric neurodevelopment and early epilepsy, including EEG patterns and treatment response, and information on the frequency and characteristics of oropharyngeal dysphagia; cryptorchidism and its surgical findings; endocrine dysfunction; and adenoid hypertrophy in children with Zika-related microcephaly. The study protocols and questionnaires were shared across Brazilian states to enable harmonization across the different studies investigating microcephaly and CZS, providing the opportunity for the Zika Brazilian Cohorts Consortium to be formed, uniting all the ZIKV clinical cohorts in Brazil

Microwave-assisted preparation of a new esterification catalyst from wasted flint kaolin

AbstractAmazon flint kaolin, considered useless from an economic and industrial point of view, was calcined at 850 and 950°C to obtain metakaolin samples. These samples were subsequently treated with sulfuric acid (4M) by assisted heating with microwave radiation. The prepared samples were characterized by X-ray diffraction, scanning electron microscopy and N2 physisorption; the surface acidity was determined by titration with 0.2M KOH. The materials obtained were used as catalysts in the esterification of oleic acid with methanol. Metakaolin that was calcined at 850°C and activated at 400W for 15min presented a surface area of 187m2g−1, yielding acidic sites with a concentration of 4.32mmolg−1 and a conversion of 96.5% (115°C, 40min, molar ratio of oleic acid: methanol 1:60). In addition to a lower preparation time, the flint metakaolin activated by microwave radiation gave a catalytic performance equivalent or superior to the one prepared by reflux, as well as it showed considerably reduced reaction time and temperature