O Trabalho do Médico no Brasil na Perspectiva da Constituição de 1988 e do Direito Social ao Trabalho

MEDICAL WORK IN BRAZIL IN THE PERSPECTIVE OF 1998´S CONSTITUTION AND THE SOCIAL RIGHT TO WORK O presente artigo tem como objetivo discutir a relação de trabalho em que se inserem historicamente os médicos brasileiros, bem como compreender como essas relações influenciam o papel do médico, sob o ponto de vista da cidadania, utilizando-se de uma análise qualitativa-descritiva do fenômeno estudado. São consideradas as normas jurídicas de caráter constitucional e do direito social do trabalho que se aplicam à relação em destaque, notadamente as concernentes aos direitos fundamentais e ao requisito legal de subordinação inserto na Consolidação das Leis do Trabalho. Matrizes de pensamento sócio-histórico são visitadas, a partir das interpretações fundantes de K. Marx, N. Bobbio e H. Arendt. Por fim, o artigo aponta para algumas reflexões críticas necessárias, no sentido de transformar e construir um novo paradigma nas relações de trabalho médico, e sugere uma proposta para a carreira médica nos moldes de carreiras como a magistratura, a defensoria pública e a advocacia geral da união, como também uma relação mais equilibrada dos médicos com os planos e seguradoras de saúde no Brasil. PALAVRAS-CHAVE: Relação de trabalho; direitos fundamentais; sociologia do trabalho; trabalho médico; medicina. ABSTRACT This paper aims to discuss the historical labour relationship of brazilian physicians as well as to understand how this relationship influence the physician's role from the point of view of citizenship, using a qualitative descriptive analysis of the phenomenon studied. Some legal and constitutional rules are considered to understand the character of social labor law that apply to this specific relationship, notably those concerning the fundamental rights and the legal requirement to insert in the Consolidation of Labor Laws . Socio-historical thought are examined, from interpretation of K. Marx , N. Bobbio and H. Arendt . Finally , the article points to some critical thinking necessary to transform and build a new paradigm in relations of medical work , and suggests a proposal for a medical career in the terms of similar careers magistrates, public defenders and public attorneys, as well as a more balanced relationship with the medical plans and health insurers in Brazil . KEYWORDS: Employment relationship; fundamental rights; work´s sociology; medical work; medicine. Data da Submissão: 18/04/2014 Data da Aceitação: 27/05/201

A critical assessment of the pairing symmetry in NaxCoO2.yH2O

We examine each of the symmetry-allowed pairing states of NaxCoO2.yH2O and compare their properties to what is experimentally and theoretically established about the compound. In this way, we can eliminate the vast majority of states that are technically allowed and narrow the field to two, both of f-wave type states. We discuss the expected features of these states and suggest experiments that can distinguish between them. We also discuss odd-frequency gap pairing and how it relates to available experimental evidence

Rainfall and sentinel chicken seroconversions predict human cases of Murray Valley encephalitis in the north of Western Australia

Background Murray Valley encephalitis virus (MVEV) is a flavivirus that occurs in Australia and New Guinea. While clinical cases are uncommon, MVEV can cause severe encephalitis with high mortality. Sentinel chicken surveillance is used at many sites around Australia to provide an early warning system for risk of human infection in areas that have low population density and geographical remoteness. MVEV in Western Australia occurs in areas of low population density and geographical remoteness, resulting in logistical challenges with surveillance systems and few human cases. While epidemiological data has suggested an association between rainfall and MVEV activity in outbreak years, it has not been quantified, and the association between rainfall and sporadic cases is less clear. In this study we analysed 22 years of sentinel chicken and human case data from Western Australia in order to evaluate the effectiveness of sentinel chicken surveillance for MVEV and assess the association between rainfall and MVEV activity. Methods Sentinel chicken seroconversion, human case and rainfall data from the Kimberley and Pilbara regions of Western Australia from 1990 to 2011 were analysed using negative binomial regression. Sentinel chicken seroconversion and human cases were used as dependent variables in the model. The model was then tested against sentinel chicken and rainfall data from 2012 and 2013.Results Sentinel chicken seroconversion preceded all human cases except two in March 1993. Rainfall in the prior three months was significantly associated with both sentinel chicken seroconversion and human cases across the regions of interest. Sentinel chicken seroconversion was also predictive of human cases in the models. The model predicted sentinel chicken seroconversion in the Kimberley but not in the Pilbara, where seroconversions early in 2012 were not predicted. The latter may be due to localised MVEV activity in isolated foci at dams, which do not reflect broader virus activity in the region. Conclusions We showed that rainfall and sentinel chickens provide a useful early warning of MVEV risk to humans across endemic and epidemic areas, and that a combination of the two indicators improves the ability to assess MVEV risk and inform risk management measures

The long-term prediction of return to work following serious accidental injuries: A follow up study

Background Considerable indirect costs are incurred by time taken off work following accidental injuries. The aim of this study was to predict return to work following serious accidental injuries. Method 121 severely injured patients were included in the study. Complete follow-up data were available for 85 patients. Two weeks post trauma (T1), patients rated their appraisal of the injury severity and their ability to cope with the injury and its job-related consequences. Time off work was assessed at one (T2) and three years (T3) post accident. The main outcome was the number of days of sick leave taken due to the accidental injury. Results The patients' appraisals a) of the injury severity and b) of their coping abilities regarding the accidental injury and its job-related consequences were significant predictors of the number of sick-leave days taken. Injury severity (ISS), type of accident, age and gender did not contribute significantly to the prediction. Conclusions Return to work in the long term is best predicted by the patients' own appraisal of both their injury severity and the ability to cope with the accidental injury

Preparation, structural characterisation and antibacterial properties of Ga-doped sol-gel phosphate-based glass

A sol-gel preparation of Ga-doped phosphate-based glass with potential application in antimicrobial devices has been developed. Samples of composition (CaO)(0.30)(Na2O)(0.20-x) (Ga2O3) (x) (P2O5)(0.50) where x = 0 and 0.03 were prepared, and the structure and properties of the gallium-doped sample compared with those of the sample containing no gallium. Analysis of the P-31 MAS NMR data demonstrated that addition of gallium to the sol-gel reaction increases the connectivity of the phosphate network at the expense of hydroxyl groups. This premise is supported by the results of the elemental analysis, which showed that the gallium-free sample contains significantly more hydrogen and by FTIR spectroscopy, which revealed a higher concentration of -OH groups in that sample. Ga K-edge extended X-ray absorption fine structure and X-ray absorption near-edge structure data revealed that the gallium ions are coordinated by six oxygen atoms. In agreement with the X-ray absorption data, the high-energy XRD results also suggest that the Ga3+ ions are octahedrally coordinated with respect to oxygen. Antimicrobial studies demonstrated that the sample containing Ga3+ ions had significant activity against Staphylococcus aureus compared to the control

Diagnostic value of harmonic transthoracic echocardiography in native valve infective endocarditis: comparison with transesophageal echocardiography

<p>Abstract</p> <p>Background</p> <p>Although echocardiography has been incorporated into the diagnostic algorithm of patients with suspected infective endocarditis (IE), systematic usage in clinical practice remains ill defined. To determine the diagnostic accuracy of detecting vegetations using harmonic transthoracic echocardiography (hTTE) as compared to transesophageal echocardiography (TEE) in patients with an intermediate likelihood of native valve IE.</p> <p>Methods</p> <p>Between 2004 and 2005, 36 consecutive inpatients with an intermediate likelihood of disease were prospectively evaluated by hTTE and TEE.</p> <p>Results</p> <p>Of 36 patients (21 males with a mean age of 57 ± 15 years, range 32 to 86 years), 19 patients had definite IE by TEE. The sensitivity for the detection of vegetations by hTTE was 84%, specificity of 88%, positive predictive value (PPV) of 89% and negative predictive value (NPV) of 82%. The association between hTTE and TTE interpretation for the presence and absence of vegetations were high (kappa = 0.90 and 0.85 respectively).</p> <p>Conclusion</p> <p>In patients with an intermediate likelihood of native valve IE, TTE with harmonic imaging provides diagnostic quality images in the majority of cases, has excellent concordance with TEE and should be recommended as the first line test.</p

Mechanical Activation of Al-Oxyhydroxide Minerals – Physicochemical Changes, Reactivity and Relevance to Bayer Process

Overview of our research on ‘structure and reactivity’ of gibbsite and boehmite under varied conditions of mechanical activation, e.g. milling energy and presence of a second phase is presented. Bulk and surface changes induced in the solids by milling are characterized in terms of morphology, particle size distribution, specific surface area and nature of porosity, crystallite size and zeta potential. Results on enhanced amorphisation of gibbsite in presence of a second phase (quartz, hematite etc), changes in zeta potential of gibbsite due to loss of texture during milling and anomalous decrease in surface area of boehmite during milling are reported. Reactivity of the activated solids in sodium hydroxide and variation in thermal transformation temperatures is correlated with physicochemical characteristics of the samples and plausible explanation for the observed correlations presented. Significance of the results with specific reference to bauxite and alumina processing in Bayer process is highlighted

The Changing Epidemiology of Murray Valley Encephalitis in Australia: The 2011 Outbreak and a Review of the Literature

Murray Valley encephalitis virus (MVEV) is the most serious of the endemic arboviruses in Australia. It was responsible for six known large outbreaks of encephalitis in south-eastern Australia in the 1900s, with the last comprising 58 cases in 1974. Since then MVEV clinical cases have been largely confined to the western and central parts of northern Australia. In 2011, high-level MVEV activity occurred in south-eastern Australia for the first time since 1974, accompanied by unusually heavy seasonal MVEV activity in northern Australia. This resulted in 17 confirmed cases of MVEV disease across Australia. Record wet season rainfall was recorded in many areas of Australia in the summer and autumn of 2011. This was associated with significant flooding and increased numbers of the mosquito vector and subsequent MVEV activity. This paper documents the outbreak and adds to our knowledge about disease outcomes, epidemiology of disease and the link between the MVEV activity and environmental factors. Clinical and demographic information from the 17 reported cases was obtained. Cases or family members were interviewed about their activities and location during the incubation period. In contrast to outbreaks prior to 2000, the majority of cases were non-Aboriginal adults, and almost half (40%) of the cases acquired MVEV outside their area of residence. All but two cases occurred in areas of known MVEV activity.This outbreak continues to reflect a change in the demographic pattern of human cases of encephalitic MVEV over the last 20 years. In northern Australia, this is associated with the increasing numbers of non-Aboriginal workers and tourists living and travelling in endemic and epidemic areas, and also identifies an association with activities that lead to high mosquito exposure. This outbreak demonstrates that there is an ongoing risk of MVEV encephalitis to the heavily populated areas of south-eastern Australia