Desafios da pós-graduação em saúde humana no Brasil

Recognition for the growing role of extra-academic demands and players in the dynamics of human resource training for the market and, in particular, for research is discussed. Their synergies with the movement towards maturation of the sectoral system of healthcare innovation and with the priorities of the Sistema Único de Saúde (Brazilian National Health System) are discussed. The methodological adequacy of the process for evaluating these trends used by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (Coordination Office for Advancement of University-level Personnel) is analyzed. In a general manner, these trends mean adding new indicators for technological and social productivity to the predominantly academic criteria that already exist. The continuation and deepening of ongoing initiatives aimed at bringing in new formats for postgraduate programs and courses and new courses customized for the demands of the extra-academic market, among other markets, either of a social or technological-business nature, are discussed. In addition, the deepening of initiatives for stimulating postdoctoral training work, which is scarce in Brazil, is discussed.Se discute el reconocimiento del papel creciente de demandas y actores extra académicos en la dinámica de la formación de recursos humanos para el mercado y, en particular, para la investigación, así como la actuación en sinergia con el movimiento de madurez del sistema sectorial de innovación en salud y con las prioridades del Sistema Único de Salud de Brasil. Se analiza la adecuación de la metodología del proceso de evaluación de la Coordinación de Perfeccionamiento de Personal de Nivel Superior a tales tendencias, lo que significará, de manera general, agregar nuevos indicadores de productividad tecnológica y social a los criterios predominantemente académicos ya existentes. Discute la continuidad y la profundización de las iniciativas en curso en el sentido de admitir nuevos formatos de programas y cursos de postgrado, cursos adaptados a las demandas del mercado extra académico, entre otros, sean sociales o tecnológico-empresariales, así como la profundización de las iniciativas para estimular estudios postdoctorales, escasos en Brasil.Discute-se o reconhecimento do crescente papel de demandas e atores extra-acadêmicos na dinâmica da formação de recursos humanos para o mercado e, em particular, para a pesquisa. Sua atuação em sinergia com o movimento de amadurecimento do sistema setorial de inovação em saúde e com as prioridades do Sistema Único de Saúde também é discutida. É analisada a adequação da metodologia do processo de avaliação da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior a essas tendências. De maneira geral, isso significa agregar novos indicadores de produtividade tecnológica e social aos critérios predominantemente acadêmicos já existentes. Discute a continuidade e o aprofundamento das iniciativas em curso no sentido de admitir novos formatos de programas e cursos de pós-graduação, cursos customizados a demandas do mercado extra-acadêmico, entre outros, sejam sociais ou tecnológico-empresariais, bem como o aprofundamento das iniciativas para o estímulo aos estágios pós-doutorais, escassos no Brasil

Pesquisa em saúde no Brasil: contexto e desafios

O artigo discute as insuficiências da política brasileira de ciência e tecnologia frente aos desafios do século XXI, a despeito de alguns aspectos muito bem sucedidos. Mostra ainda a importância da pesquisa em saúde no quadro do esforço geral de ciência, tecnologia e inovação no país. Em seguida, sumariza a distribuição da pesquisa no mundo e reivindica um lugar específico para o País, junto a alguns outros, no panorama global. Discute alguns elementos necessários ao amadurecimento do sistema setorial de inovação em saúde e termina por discutir a necessidade da presença do Ministério da Saúde no panorama da pesquisa em saúde para que aquele processo de amadurecimento possa dar-se de maneira adequada.The deficiencies in Brazilian science and technology policies with regard to the challenges of the twenty-first century are discussed, while acknowledging that these policies have in some respects been very successful. The importance of health research within the framework of general endeavors in science, technology and innovation in this country is also demonstrated. The distribution of research around the world is then summarized, and a specific position is claimed for Brazil, along with some other countries, within the global panorama. Some elements needed for maturation of the sectoral system for health innovation are discussed. Finally, the need for the presence of the Ministry of Health within the panorama of health research, for this maturation process to take place adequately, is discussed

A eficácia do exame telerradiográfico de tórax como técnica de "screening" em população hospitalar

É analisada a eficácia da telerradiografía de tórax como técnica de "screening" em população hospitalar. Utilizando-se uma técnica prospectiva não concorrente, é evidenciado que pouco benefício traz ao paciente a chapa de tórax AP na internação, na primeira consulta ou no pré-operatório em geral. Para sete em cada 100 pacientes foi diagnosticado importante patologia assintomática. Nenhum paciente entre 0 e 19 anos teve anormalidade evidenciada pela chapa. Recomenda-se, para esta faixa, a eliminação do exame, e para pacientes acima de 20 anos a introdução da abreugrafia, ao invés da telerradiografia de tórax.The author analyses the efficacy of the AP chest telerradiograph as a screening technique in a Hospital - based population. It is shown that the AP chest X-Ray is of little value to the patient at the time of admission, first out-pacient visit and during pre-operatory evaluation. Only 7% of the patients studied showed a relevant assymptomatic pathology diagnosed by the examination. In patients aged 0-19 years, no abnormalities were identified by this procedure. The author suggests that AP chest X-Rays be discontinued for this age group and recommends its substitution by roentgen photography (35 mm) for older age groups

Tonsillar lymphoma in children with unilateral tonsillar enlargement

OBJECTIVE: To demonstrate the importance of a medical examination with emphasis on changes of the palatine tonsils (PT) and proper anamnesis to early identify patients with tonsillar lymphoma. CASE DESCRIPTION: Case 1 - 5-year-old girl with a muffled voice noted by her mother and a report of feeling a strange sensation in the throat for two weeks. She was previously treated in another service at the beginning of the symptoms with amoxicillin without improvement. An important increase in the right PT was noted, with smooth surface and absence of crypts. The diagnosis of non-Hodgkin lymphoma (NHL) was confirmed after surgery. On further investigation, positive mesenteric lymph nodes were noted. Case 2 - 11-year-old girl came to the emergency service to investigate a painless nodule in the left palatine tonsil with progressive growth for one year, without other complaints. She had previously undergone other medical consultations, but no importance was given to the patient's complaint. Oroscopy showed that the left PT was increased crossing the midline and with a nodule in the upper pole. Patient also had NHL. COMMENTS: A detailed examination of the oral cavity and neck is essential to identify suspicious tonsillar lymphoma. Patients with unilateral tonsillar enlargement and other findings suggestive of malignancy should undergo tonsillectomy.OBJETIVO: Demonstrar a importância do exame físico com ênfase nas alterações das tonsilas palatinas (TP) e na anamnese direcionada para a identificação precoce de pacientes com linfoma de TP. DESCRIÇÃO DO CASO: Caso 1 - Menina de cinco anos com voz abafada, observada pela mãe, e sensação de algo estranho na garganta há duas semanas. Foi atendida em outro serviço no início do quadro, sendo medicada com amoxicilina, sem melhora. Apresentava aumento importante da TP direita com superfície lisa e ausência de criptas. Após cirurgia, foi confirmado o diagnóstico de linfoma não Hodgkin (LNH). Na investigação também foi identificado acometimento dos linfonodos mesentéricos pelo linfoma. Caso 2 - Menina de 11 anos procurou o pronto-socorro para investigar nódulo em TP esquerda, indolor, de crescimento progressivo há um ano, sem outras queixas. Já havia passado por consultas médicas anteriores, não tendo sido valorizada a queixa da paciente. A TP esquerda encontrava-se aumentada, ultrapassando a linha média e com nódulo no polo superior. Também foi diagnosticado LNH após exame anatomopatológico. COMENTÁRIOS: Um exame minucioso da cavidade oral e do pescoço é essencial para identificar alterações suspeitas de linfoma tonsilar. Pacientes com assimetria tonsilar e outros achados sugestivos de malignidade devem ser submetidos à tonsilectomia.OBJETIVO: Demostrar la importancia de un examen físico con énfasis en las alteraciones de las tonsilas palatinas (TP) y en la anamnesis dirigida a la identificación temprana de pacientes con linfoma de TP. DESCRIPCIÓN DEL CASO: Caso 1 - Niña de cinco años, con voz velada, observada por la madre, y «sensación de algo extraño en la garganta» hace dos semanas. Fue atendida en otro servicio en el inicio del cuadro, siendo medicada con amoxicilina, sin mejora. Presentaba aumento importante de la TP derecha con superficie lisa y ausencia de criptas. Después de la cirugía, se confirmó el diagnóstico de linfoma no Hodgkin (LNH). En la investigación también se identificó acometimiento de los nodos linfáticos mesentéricos por el linfoma. Caso 2 - Muchacha de 11 años buscó al servicio de urgencia para investigar nódulo en TP izquierda, indolora, de crecimiento progresivo hace un año, sin otras quejas. Ya había pasado por consultas médicas anteriores, no habiendo sido valorizada la queja de la paciente. La TP izquierda se encontraba aumentada, sobrepasando la línea media y con nódulo en el polo superior de esa. También se diagnosticó LNH después de examen anatomopatológico. COMENTARIOS: Un examen minucioso de la cavidad oral y del cuello es esencial para identificar alteraciones sospechosas de linfoma tonsilar. Pacientes con asimetría tonsilar y otros hallazgos sugestivos de malignidad deben ser sometidos a tonsilectomía.28829

Scalable and customizable benchmark problems for many-objective optimization

Solving many-objective problems (MaOPs) is still a significant challenge in the multi-objective optimization (MOO) field. One way to measure algorithm performance is through the use of benchmark functions (also called test functions or test suites), which are artificial problems with a well-defined mathematical formulation, known solutions and a variety of features and difficulties. In this paper we propose a parameterized generator of scalable and customizable benchmark problems for MaOPs. It is able to generate problems that reproduce features present in other benchmarks and also problems with some new features. We propose here the concept of generative benchmarking, in which one can generate an infinite number of MOO problems, by varying parameters that control specific features that the problem should have: scalability in the number of variables and objectives, bias, deceptiveness, multimodality, robust and non-robust solutions, shape of the Pareto front, and constraints. The proposed Generalized Position-Distance (GPD) tunable benchmark generator uses the position-distance paradigm, a basic approach to building test functions, used in other benchmarks such as Deb, Thiele, Laumanns and Zitzler (DTLZ), Walking Fish Group (WFG) and others. It includes scalable problems in any number of variables and objectives and it presents Pareto fronts with different characteristics. The resulting functions are easy to understand and visualize, easy to implement, fast to compute and their Pareto optimal solutions are known.This work has been supported by the Brazilian agencies (i) National Council for Scientific and Technological Development (CNPq); (ii) Coordination for the Improvement of Higher Education (CAPES) and (iii) Foundation for Research of the State of Minas Gerais (FAPEMIG, in Portuguese)

Incorporation of region of interest in a decomposition-based multi-objective evolutionary algorithm

Preference-based Multi-Objective Evolutionary Algorithm (MOEA) restrict the search to a given region of the Pareto front preferred by the Decision Maker (DM), called the Region of Interest (ROI). In this paper, a new preference-guided MOEA is proposed. In this method, we define the ROI as a preference cone in the objective space. The preferential direction and the aperture of the cone are parameters that the DM has to provide to define the ROI. Given the preference cone, we employ a weight vector generation method that is based on a steady-state evolutionary algorithm. The main idea of our method is to evolve a population of weight vectors towards the characteristics that are desirable for a set of weight vectors in a decomposition-based MOEA framework. The main advantage is that the DM can define the number of weight vectors and thus can control the population size. Once the ROI is defined and the set of weight vectors are generated within the preference cone, we start a decomposition-based MOEA using the provided set of weights in its initialization. Therefore, this enforces the algorithm to converge to the ROI. The results show the benefit and adequacy of the preference cone MOEA/D for preference-guided many-objective optimization.This work was supported by the Brazilian funding agencies CAPES and CNPq

Primeiro comando da corrupção

Traça um paralelo entre a corrupção política e as facções criminosas que atuam no sistema prisional

Alternative Mathematical Models and Solution Approaches for Lot-Sizing and Scheduling Problems in the Brewery Industry: Analyzing Two Different Situations

This research proposes new approaches to deal with the production planning and scheduling problem in brewery facilities. Two real situations found in factories are addressed, which differ by considering (or not) the setup operations in tanks that provide liquid for bottling lines. Depending on the technology involved in the production process, the number of tank swaps is relevant (Case A) or it can be neglected (Case B). For both scenarios, new MIP (Mixed Integer Programming) formulations and heuristic solution methods based on these formulations are proposed. In order to evaluate the approach for Case A, we compare the results of a previous study with the results obtained in this paper. For the solution methods and the result analysis of Case B, we propose adaptations of Case A approaches yielding an alternative MIP formulation to represent it. Therefore, the main contributions of this article are twofold: (i) to propose alternative MIP models and solution methods for the problem in Case A, providing better results than previously reported, and (ii) to propose new MIP models and solution methods for Case B, analyzing and comparing the results and benefits for Case B considering the technology investment required