O Multilateralismo Amazônico, entre êxitos geopolíticos e entraves executivos: trajetória do processo de cooperação de 1978 a 2012 / The Multilateralism Amazon, and Barriers Between Successes Geopolitical Executive: Path of Cooperation Process 1978-2012

Este trabalho apresenta uma análise detalhada sobre o processo de cooperação entre os países da região amazônica, com base em elementos contextuais, políticos e institucionais. O período que se estende da assinatura do Tratado de Cooperação Amazônica (TCA), em 1978, até os dias atuais, caracteriza-se pela alternância de fases de inatividade com fases de declarada renovação do compromisso político. Os fatores explicativos identificados relacionam-se a questões domésticas, regionais e do contexto internacional. Esta trajetória compreende cinco períodos distintos: de 1978 a 1989, fase defensivo-protecionista; de 1989 a 1994, fase de incentivo e fortalecimento político; de 1995 a 2002, amadurecimento institucional; de 2002 a 2009, marcada pela intensificação dos contatos entre os países amazônicos, porém seguida de uma crise institucional; e, de 2009 a 2014: fase de “relançamento da OTCA”, pautada nas diretrizes da Agenda Estratégica de Cooperação Amazônica. Após a análise deste processo de cooperação que completa 35 anos, concluímos o texto evidenciando os principais resultados alcançados pelos países amazônicos e as principais dificuldades persistentes para a consecução dos objetivos regionais comuns. ABSTRACTThis paper analyzes the multilateral cooperation process between the countries of the Amazon region, focusing on three degrees: the contextual; the political; and the institutional. We start from the analysis of the negotiation process of the Amazon Cooperation Treaty (ACT), in 1978, and its developments until 2002, when has been created the Amazon Cooperation Treaty Organization (ACTO). The trajectory was divided into five phases that were called: defensive (1978-1989); political strengthening (1989-1994); institutional maturation (1995-2002); diplomatic intensification (2002-2009); and relaunch of the Amazon Cooperation Treaty Organization (2009-2014). The reasons founded in our analysis are related to domestic, regional and international issues that had influence in the cooperation process. After the historical analysis, we make an overview of the main results and difficulties that marks the cooperation process between the countries that has sovereignty over the Amazon basin.

O Multilateralismo Amazônico, entre êxitos geopolíticos e entraves executivos: trajetória do processo de cooperação de 1978 a 2012 / The Multilateralism Amazon, and Barriers Between Successes Geopolitical Executive: Path of Cooperation Process 1978-2012

Este trabalho apresenta uma análise detalhada sobre o processo de cooperação entre os países da região amazônica, com base em elementos contextuais, políticos e institucionais. O período que se estende da assinatura do Tratado de Cooperação Amazônica (TCA), em 1978, até os dias atuais, caracteriza-se pela alternância de fases de inatividade com fases de declarada renovação do compromisso político. Os fatores explicativos identificados relacionam-se a questões domésticas, regionais e do contexto internacional. Esta trajetória compreende cinco períodos distintos: de 1978 a 1989, fase defensivo-protecionista; de 1989 a 1994, fase de incentivo e fortalecimento político; de 1995 a 2002, amadurecimento institucional; de 2002 a 2009, marcada pela intensificação dos contatos entre os países amazônicos, porém seguida de uma crise institucional; e, de 2009 a 2014: fase de “relançamento da OTCA”, pautada nas diretrizes da Agenda Estratégica de Cooperação Amazônica. Após a análise deste processo de cooperação que completa 35 anos, concluímos o texto evidenciando os principais resultados alcançados pelos países amazônicos e as principais dificuldades persistentes para a consecução dos objetivos regionais comuns. ABSTRACTThis paper analyzes the multilateral cooperation process between the countries of the Amazon region, focusing on three degrees: the contextual; the political; and the institutional. We start from the analysis of the negotiation process of the Amazon Cooperation Treaty (ACT), in 1978, and its developments until 2002, when has been created the Amazon Cooperation Treaty Organization (ACTO). The trajectory was divided into five phases that were called: defensive (1978-1989); political strengthening (1989-1994); institutional maturation (1995-2002); diplomatic intensification (2002-2009); and relaunch of the Amazon Cooperation Treaty Organization (2009-2014). The reasons founded in our analysis are related to domestic, regional and international issues that had influence in the cooperation process. After the historical analysis, we make an overview of the main results and difficulties that marks the cooperation process between the countries that has sovereignty over the Amazon basin.

Delayed colorectal cancer care during covid-19 pandemic (decor-19). Global perspective from an international survey

Background The widespread nature of coronavirus disease 2019 (COVID-19) has been unprecedented. We sought to analyze its global impact with a survey on colorectal cancer (CRC) care during the pandemic. Methods The impact of COVID-19 on preoperative assessment, elective surgery, and postoperative management of CRC patients was explored by a 35-item survey, which was distributed worldwide to members of surgical societies with an interest in CRC care. Respondents were divided into two comparator groups: 1) ‘delay’ group: CRC care affected by the pandemic; 2) ‘no delay’ group: unaltered CRC practice. Results A total of 1,051 respondents from 84 countries completed the survey. No substantial differences in demographics were found between the ‘delay’ (745, 70.9%) and ‘no delay’ (306, 29.1%) groups. Suspension of multidisciplinary team meetings, staff members quarantined or relocated to COVID-19 units, units fully dedicated to COVID-19 care, personal protective equipment not readily available were factors significantly associated to delays in endoscopy, radiology, surgery, histopathology and prolonged chemoradiation therapy-to-surgery intervals. In the ‘delay’ group, 48.9% of respondents reported a change in the initial surgical plan and 26.3% reported a shift from elective to urgent operations. Recovery of CRC care was associated with the status of the outbreak. Practicing in COVID-free units, no change in operative slots and staff members not relocated to COVID-19 units were statistically associated with unaltered CRC care in the ‘no delay’ group, while the geographical distribution was not. Conclusions Global changes in diagnostic and therapeutic CRC practices were evident. Changes were associated with differences in health-care delivery systems, hospital’s preparedness, resources availability, and local COVID-19 prevalence rather than geographical factors. Strategic planning is required to optimize CRC care