Brazilian Congress Research Articles

Unraveling Environmental Impact Assessment Practitioners in Brazil: Profile, Education and Perception of EIA Practice among CBAI Participants

Environmental Impact Assessment (EIA) practice demands interactions between different actors, and its effectiveness depends on how they respond to their own expectations, as well as the expectations of other actors and legal standards. Thus, EIA practitioners play an important role in improving this process. This study examines the profile of Brazilian EIA practitioners who participated in at least one edition of the Congresso Brasileiro de Avaliação de Impacto (CBAI - Brazilian Congress on Impact Assessment in English), as well as their perception of EIA practice within the country. It is a quantitative and qualitative research based on the premise that EIA practitioners would have participated in at least one of the first five congresses (CBAI) promoted by the Associação Brasileira de Avaliação de Impacto (ABAI - Brazilian Association for Impact Assessment in English). Data collection involved distributing an online questionnaire, available between September 26th and November 1st, 2022, to all 794 contacts registered at ABAI. A total of 217 responses were obtained, with participants comprising 48% men and 52% women, with the majority falling between 25 and 45 years of age. All respondents had studied EIA (through undergraduate or postgraduate courses, or in other contexts). Most participants had more than 10 years of experience working with EIA, primarily in consultancy and academia. Perceptions regarding the quality, problems, strengths and opportunities of Brazilian EIA practice generally aligned with the literature. Respondents tended to disagree with streamlining EIA and Environmental Licensing procedures and to agree with the necessity of implementing Strategic Environmental Assessment in Brazil. The results are important to understand who Brazilian EIA practitioners are and what this portion of EIA practitioners think.

Women's Performance in Conferences and Their Publications: A Critical Analysis

Abstract Introduction Gender inequality occurs in all spheres of society, which is no different in the medical field. Abstract presentations in congress are the vanguard of scientific knowledge, an integral part of topic discussion, and, ideally, culminate in the publication of these works as complete manuscripts. Objective The objective of this study is to evaluate the role played by women in the presentation of scientific works at the Brazilian Society of Coloproctology congress and in the works published from these presentations. Methods The bibliometric evaluation of the presented abstracts in the editions from 2015 to 2018 of the Brazilian Congress of Coloproctology was used, along with the works later published from these presentations. Gender identification data was extracted from the authors of the abstracts through their names and research for conference on the Lattes and Google Scholar platforms. The collected data was on the number of female participants and their order of authorship of abstracts and publications, evaluating possible changes when publication occurs. Results A total of 1,336 abstracts were analyzed, with 91.6% of female authors. When publication occurs, women's presence dropped to 75.2% and suffered a change of order in the position of authorship to one of lesser relevance in 38.1%. Conclusion Women's participation occurs in most abstracts. However, this proportion undergoes unfavorable changes when these works are published, either by changing the order of authorship, when women leave main positions and become coauthors, or are removed from the complete manuscript's publication.

Associação Brasileira de Fisioterapia Neurofunctional: Best Abstract Awards.

The Journal of Neurologic Physical Therapy is pleased to publish the 4 most outstanding abstracts presented at the 7th Brazilian Congress of Neurofunctional Physical Therapy held in Fortaleza, Ceara, Brazil, September 6 to 9, 2023.

Máquina homogeneizadora: a Frente Parlamentar da Agropecuária e sua construção de convergência de votos no Congresso Nacional

Abstract Dissensions among private leaders of agricultural commodity chains have drawn attention in Brazil, particularly concerning climate-related issues. However, these divisions have not manifested in the National Congress, where the agribusiness caucus usually builds a highly homogeneous voting base in matters connected with these issues. This article analyses this contrast by means of an ethnography of the complex movements involved in constructing this homogeneity. To do this, the work followed a legislative measure related to the Forest Code as it moved through Congress. The research triangulated data obtained from long-term participant observation in Congress and the Instituto Pensar Agropecuária, corporate and state documents and interviews with politicians and heads of business associations. The results evidence a political machine that produces voting convergence linked with agribusiness agendas in the Legislative branch.

Expanding Global Surgery Education in Brazil: Perspectives after the 35th Brazilian Surgical Congress.

The 35th Brazilian Congress of Surgery marked a turning point for surgical education in the country. For the first time, the Brazilian College of Surgeons included Global Surgery on the main congressional agenda, providing a unique opportunity to rethink how surgical skills are taught from a public health perspective. This discussion prompts us to consider why and how Global Surgery education should be expanded in Brazil. Although Brazilian researchers and institutions have contributed to the fields expansion since 2015, Global Surgery education initiatives are still incipient in our country. Relying on successful strategies can be a starting point to promote the area among national surgical practitioners. In this editorial, we discuss potential strategies to expand Global Surgery education opportunities and propose a series of recommendations at the national level.

Expanding Global Surgery Education in Brazil: Perspectives after the 35th Brazilian Surgical Congress

RESUMO O 35º Congresso Brasileiro de Cirurgia foi marcado por discussões inovadoras para a educação cirúrgica no país. Pela primeira vez, o Colégio Brasileiro de Cirurgiões incluiu a Cirurgia Global na pauta principal do congresso, proporcionando uma oportunidade única de repensar como as habilidades cirúrgicas são ensinadas a partir de uma perspectiva de saúde pública. Essa discussão nos leva a considerar por que e como o ensino da Cirurgia Global deve ser expandido no Brasil. Embora pesquisadores e instituições brasileiras tenham contribuído para a expansão do campo desde 2015, as iniciativas de educação em Cirurgia Global ainda são incipientes em nosso país. Basear-se em estratégias bem-sucedidas pode ser um ponto de partida para promover a área entre os profissionais de cirurgia nacionais. Neste editorial, discutimos potenciais estratégias para expandir as oportunidades de educação em Cirurgia Global e propomos uma série de recomendações a nível nacional.

Abstracts - XIV Brazilian Congress of Pediatric Neurosurgery

The XIV Congress of SBNPED, held at the Clarion Hotel, part of the Órion complex in Goiânia, from August 2 to 5, 2023, was truly a significant comeback for in-person events in the field of pediatric neurosurgery. This reunion was characterized by a high scientific standard and also filled with emotion. This edition of the event brought a novelty, as for the first time in Brazil, the ISPN – International Society for Pediatrics Neurosurgery was present with the ISPN Educational Course included in the event's schedule.

Brazilian National Network of Alternative Methods (RENAMA) 10th Anniversary: Meeting of the Associated Laboratories, May 2022.

The Brazilian National Network of Alternative Methods (RENAMA), which is linked to the Ministry of Science, Technology and Innovation, is currently comprised of 51 laboratories from CROs, academia, industry and government. RENAMA's aim is to develop and validate new approach methodologies (NAMs), as well as train researchers and disseminate information on their use - thus reducing Brazilian, and consequently Latin American, dependence on external technology. Moreover, it promotes the adoption of NAMs by educators and trained researchers, as well as the implementation of good laboratory practice (GLP) and the use of certified products. The RENAMA network started its activities in 2012, and was originally comprised of three central laboratories - the National Institute of Metrology, Quality and Technology (INMETRO); the National Institute of Quality Control in Health (INCQS); and the National Brazilian Biosciences Laboratory (LNBio) - and ten associated laboratories. In 2022, RENAMA celebrated its 10th anniversary, a milestone commemorated by the organisation of a meeting attended by different stakeholders, including the RENAMA-associated laboratories, academia, non-governmental organisations and industry. Ninety-six participants attended the meeting, held on 26 May 2022 in Balneário Camboriú, SC, Brazil, as part of the programme of the XXIII Brazilian Congress of Toxicology 2022. Significant moments of the RENAMA were remembered, and new goals and discussion themes were established. The lectures highlighted recent innovations in the toxicological sciences that have translated into the assessment of consumer product safety through the use of human-relevant NAMs instead of the use of existing animal-based approaches. The challenges and opportunities in accepting such practices for regulatory purposes were also presented and discussed.

Assessing the Level of Evidence of Presented Studies at the Brazilian Congress of Coloproctology

Abstract Introduction Scientific studies in Brazil grew around 10.7% compared to previous years. However, the level of quality of evidence has been decreasing. The aim in our study is to examine the meeting abstracts of the Brazilian congress of coloproctology and analyze the level of evidence in trends and variables. Methods A descriptive bibliometric study, working with secondary data to review scientific abstracts in the annals of the coloproctology congress from 2015 to 2019. Results A total of 1756 abstracts of the Brazilian Congress of Coloproctology were analyzed for 5 years (2015-2019). There was a higher trend of abstracts presented with lower levels of evidence (level of evidence 5: 52.3% and 3: 30%), being the majority composed of case reports (49.4%) and retrospective studies (30.4%). The last two years analyzed (2018: 55.2% and 2019: 59.3%) had a predominance above average of case reports. From 2017 to 2019 there was a significant decrease in the number of level 2 evidence studies (18.10%,11.80% and 5.50%), while the number of studies with level 5 evidence showed an increase (45.60%, 56.60% and 61.40%). Statistical analysis occurred in only 17%, with an important decrease for the last two years (2018: 13.6%; 2019: 12.1%). Conclusions Although the data of this study is from the Brazilian coloproctology point of view, they are important for the global scientific community, as they allow a quantitative evaluation of the relative contribution from the level of evidence of Brazilian coloproctology researchers to the scientific scenario.

Preface

11th Brazilian Congress on Metrology (Metrologia 2021) The Metrology 2021 congress was held from October 18th to 21st, 2021. It was a remote event, with all activities done in virtual rooms. The general president of Metrology 2021 was Americo Bernardes, president of the Brazilian Society of Metrology and professor at the Federal University of Ouro Preto.Metrology 2021 Magna session was the lecture Dr. Claire M. Saundry (NIST) gave on the first day, October 18th. Dr. Saundry spoke about the main activities of the Interamerican Metrology System (or “Sistema Interamericano de Metrologia” – SIM) regarding capacity building and knowledge transfer.Following the Magna session, on the morning of October 18th, the work began with the plenary lecture given by Dr. Daniel Varela Magalhães from the Mechanical Engineering Department at USP. The speaker gave a general outline of the new edition of the International Vocabulary of Metrology (VIM).Further after, on the afternoon of October 18th, two virtual rooms were held in parallel with the sessions related to CBM (general metrology) and CBMRI (ionizing radiations). CBMRI sessions also featured four thematic discussions on specific topics of interest.The second day of the congress, October 19th, started with the lecture of Dr. Thomas Hartung from the Johns Hopkins Bloomberg School of Public Health. He spoke about assessing the health effects of drugs and chemicals, which is considered a scientific revolution and a critical application of Metrology in the Health Area. Continuing in the Health area, Dr. Cameron Miller from NIST presented his lecture on documentary standards and the development of measurement methods for UV disinfection technologies. The plenary lectures were closed by Dr. Renato Garcia from UFSC, who spoke about quality programs in medical equipment used in primary health care, specifically about post-market safety and performance trials.Later, on the afternoon of October 19th, two virtual rooms were held in parallel sessions related to CBM (general metrology) and CBMO (optical metrology).The third day of the congress started with an exciting round table about female researchers’ presence in ionizing radiations. A plenary lecture by Stephane Solve from the “Bureau International de Poids et Mesures” (BIPM) Radiometry-Photometry group followed. The main subject was an extension of the BIPM on-site primary voltage standards comparisons to AC voltages, an important topic in Electrical Metrology. Further on, the morning works ended with a round table about Metrology in Health, featuring Renata Souza from FIOCRUZ and Roberto Macoto Ichinose from the Biomedical Engineering of COPPE/UFRJ.The afternoon of the third day started with two virtual rooms that held parallel sessions related to SEMETRO (electrical metrology) and to CIMMEC (mechanical metrology). Later on, there was another round table about Metrology in Health, specifically about metrological traceability of laboratory tests, with lectures by Dr. Marcelo Medeiros from INMETRO, Debora Michele Morone D’Aiuto from FIOCRUZ, Rafael Monsores from the company CONTROLLAB and MD Luisane Maria Falci Vieira, manager of the laboratory Álvaro Apoio.The event’s last day, October 21st, started with a plenary lecture by Dr. Jim Huggett from National Measurement Laboratory (NML), talking about the role of measurement science in supporting a molecular diagnosis of SARS-COV-2, a very current and hot topic. A vivid discussion on Metrology Education followed the plenary lecture.The afternoon of the last day started with two virtual rooms that held parallel sessions related to REMEQ (chemical metrology) and CBM (general metrology). Later, round tables were held in the two parallel virtual rooms, discussing hot topics such as metrological traceability, quality control on COVID-19 diagnostics, alternative methods applied to toxicology, and a web app developed for the performance evaluation of laboratories.Metrologia 2021 disclosed about 170 articles. After the second round of revision, the editorial committee selected the best 35 to be published by IOP JPCS.Metrology 2021 had sponsors from the industrial sector (Fluke Calibration and Sartorius do Brasil (Gold sponsors) and institutional support (ARBB Consultoria em Metrologia e Qualidade, RMMG, Canal Metrologia, REDE, SBLUZ and GM Metrologia). The event’s next edition will be face-to-face in 2023, from 28th to 30th November, in Itaipava, a gorgeous area belonging to the “Imperial City” of Petrópolis, Rio de Janeiro state. You are all welcome to join us! Rio de Janeiro, RJ, Brasil, August 28th, 2023. List of Editorial committee, Organizing committee are available in this Pdf.

Discrepancies of Abstracts Presented in Coloproctology Congresses and Later Publish as Full Manuscripts. A Brazilian Perspective

Abstract Introduction The purpose of this retrospective bibliometric study was to assess the discrepancies between coloproctology surgery meeting abstracts and subsequent full-length manuscript publications. Methods Abstracts presented at the Brazilian Congress of Coloproctology Surgery from 2015 to 2019 were compared with matching manuscript publications. Discrepancies between the abstract and therefore the subsequent manuscript were categorized as major (changes within the purpose, methods, study design, sample size, statistical analysis, results, and conclusions) and minor (changes within the title, authorship, and number of female authors) variations. Results The conversion rate of abstracts in published manuscripts was 6,9% (121 abstracts). There were inconsistencies between the study title (66,1%), authorship (69,5%), study design (3,3%), sample size (39,2%), statistical analysis (24,8%), results (25,6%), and conclusions (12,4%) of manuscripts compared with their corresponding meeting abstracts. Conclusion As changes occur before manuscript publication of coloproctology surgery meeting abstracts, caution should be exercised in referencing abstracts or altering surgical practices based on abstracts content.

An American and Brazilian Perspective on Abstracts Presented in Coloproctology Conferences Converted into Published Manuscripts

Abstract Introduction The presentation of abstracts in a congress is an important step for the dissemination of scientific information. The American Congress of Coloproctology is promoted by the American Society of Colon & Rectal Surgeons (ASCRS), and it is the largest in number of participants within the specialty, followed by the Brazilian Congress of Coloproctology. The present study aims to evaluate variables related to the quality of the scientific production of the abstracts presented in these two events and their conversion rate to published manuscripts. Materials and Methods The present bibliometric study assesses secondary data from the review of abstracts presented in these 2 important conferences in 2016, followed by a research of the publications from these congress presentations. Results The total number of abstracts evaluated was 854. The rate of articles containing statistical analyses was of 73.7% in the American congress, and of 34.1% in the Brazilian congress. Multicentric studies were more prevalent in the American congress (23.1%). Regarding study design, the most common were case reports in the Brazilian (44.8%) congress and retrospective studies in the American congress (67.7%). As for the works presented, the rate of conversion into full manuscripts in the American congress was of 24.2% compared with 10.6% in the Brazilian congress. Most papers from the American congress (93.7%) have citations compared with 68.6% of the other event evaluated. Conclusion The scientific performance demonstrated by the conversion rate of abstracts into publications is below ideal, mainly in relation to the Brazilian meeting; yet, there were significant differences between the two events in terms of the profile of the presentations and several variables analyzed.

Increased Perirolandic Cortical Excitability May Facilitate Sensory Motor Mapping in Children (P13-1.003)

<h3>Objective:</h3> We are hereby describing a case of refractory pediatric epilepsy where resection of perirolandic seizure foci was performed successfully under neurophysiologic guidance. <h3>Background:</h3> Pediatric neurophysiologic sensory-motor mapping is frequently unsuccessful, due to inability to localize central sulcus (CS) and primary motor cortex (M1). These shortcomings result from poor somatosensory evoked potentials (SSEP) and high M1 depolarization thresholds respectively, both reflections of the immaturity of the central nervous system. <h3>Design/Methods:</h3> Case report <h3>Results:</h3> An 8-year-old boy with developmental delay, debilitating focal epilepsy and epileptic encephalopathy underwent phase 2 video EEG monitoring. The recordings showed seizures with early involvement of several depth electrodes located within the right parieto-frontal regions, and an early motor semiology involving the left arm. The patient underwent neurophysiologically guided resection of the seizure foci under general anesthesia. Pre-resection electrocorticography (ECoG) via a 64 contact grid showed abundant perirolandic epileptiform discharges (ED), maximal postcentrally. Cortical recordings of high amplitude median SSEP and a low depolarization threshold led to successful CS localization and identification of M1, respectively. A subdural strip electrode placed over the precentral gyrus and secured in position, allowed simultaneous ECoG and motor monitoring during the resection of the postcentral foci. Initially, ECoG showed near continuous runs of ED, unchanged by cortical electrical stimulation. Under steady state anesthesia, at a constant propofol infusion rate, this activity decreased in frequency and stopped altogether towards the end stages of the resection, as the M1 threshold increased by 7 mA. Post-resection fronto-parietal ECoG recordings were quiet. Post-operatively, the patient became seizure free, showed cognitive improvement and no motor deficits. <h3>Conclusions:</h3> Increased cortical excitability may lead to successful functional mapping in children. Under steady anesthetic conditions, increases in the M1 threshold during resection of nearby epileptic foci may be an early sign of decrease in the abnormal regional cortical excitability. <b>Disclosure:</b> Dr. Alzahrany has nothing to disclose. Dr. Simon has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Risk Management Foundation of the Harvard Institutions Incorporated. Dr. Simon has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for MCIC Vermont. Dr. Simon has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Aaronson, Rappaport, Feinstein&amp; Deutch. Dr. Simon has received publishing royalties from a publication relating to health care. Dr. Simon has received personal compensation in the range of $0-$499 for serving as a Speaker with American Clinical Neurophysiology Society . Dr. Simon has a non-compensated relationship as a Speaker with International Society of Intraoperative Neurophysiology that is relevant to AAN interests or activities. Dr. Simon has a non-compensated relationship as a Speaker with Brazilian Congress of Neurology that is relevant to AAN interests or activities.

Conflicts of Interest of Sponsors and Promoters in Research

The development of health technologies by transnational pharmaceutical industries has been considered the most profitable industrial activity on the planet. This economic power facilitates the favoring of the interests of those who are the biggest sponsors and promoters of research in their relationships with researchers, institutions and associations of patients. In developed countries, about 90% of clinical trials are conducted by large pharmaceutical industries, in developing countries it varies between 100 and 95%. That is, in the reality of countries like Brazil and Angola there is a clear dependency due to the low research capacity. There are some differences in the rigor with which the concept of conflict of interest has been defined. We will work with the International Council of Science Editors’ definition that has been used by most of the highest impact scientific journals. In this definition, any financial relationship or other types of advantages offered by sponsors and promoters to researchers and research institutions already characterizes a factual and not just potential conflict of interest. We will try to demonstrate the most common practices these conflicts appear through the hiring of medical consultants, injection of resources in journals, medical associations and organizations of patients, payments or advantages to institutions, researchers, research participants and ethics committees, as well as in funding of scientific events. We will finally present some results of a recent publication conducted by me and a graduate student in Bioethics on conflicts of interest between sponsors of Brazilian national specialty congresses and researchers and the results of clinical trials for drugs presented.

Abstracts from the World Congress of Cardiology/Brazilian Congress of Cardiology 2022

These are the abstracts from the combined 77^th Brazilian Congress of Cardiology, together with the World Congress of Cardiology, held in October 2022. From 1950 to today, the World Heart Federation’s World Congress of Cardiology (WCC) has been a key event on the cardiovascular calendar, offering a global perspective on cardiovascular health and bringing together thousands of cardiology professionals from all over the world with one common goal: to reduce the global burden of cardiovascular disease and help people live longer, healthier lives.

Cultural Adaptation and Validation of the Ostomy Skin Tool to the Brazilian Portuguese.

To adapt the Ostomy Skin Tool (discoloration, erosion, and tissue overgrowth) to the Brazilian culture and to analyze psychometric properties of the adapted version. Psychometric (methodologic) evaluation of the instrument. Three ostomy/enterostomal therapy nurses evaluated the extent and severity of peristomal skin conditions in a sample of 109 adults 18 years or older with peristomal skin complications. These participants were receiving care in an ambulatory care center in outpatient health services in Sao Paulo and Curitiba, Brazil. In addition, interobserver reliability was measured using a group of 129 nurse participants who attended the Brazilian Congress of Stomatherapy held from November 12 to 15, 2017, in Belo Horizonte, a city located in the state of Minas Gerais, Brazil. Nurse participants assessed the descriptions of peristomal skin complications of the Portuguese version, using the same photographs used in the original DET score, purposely placed out of original order. The study was performed in 2 stages. The instrument was translated into Brazilian Portuguese by 2 bilingual translators, and back-translated into English. The back-translated version was sent to one of the developers of the instrument for additional evaluation. During stage 2, content validity was evaluated by 7 nurses with expertise in ostomy and peristomal skin care. Convergent validity was evaluated by correlating the severity of peristomal skin complications to pain intensity. Discriminant validity was evaluated based on type and time of ostomy creation, presence of retraction, and preoperative stoma site marking. Finally, interrater reliability was evaluated using standardized photograph evaluation reproduced in the same sequence as the original English language version of the instrument, along with paired scores from assessment of adults living with an ostomy generated by an investigator and nurse data collectors. The Content Validity Index for the Ostomy Skin Tool was 0.83. Levels of mild agreements were obtained for the nurses' observations in the evaluation of peristomal skin complications using standardized photographs (κ= 0.314). In contrast, moderate to almost perfect agreements were obtained when scores were compared in the clinical setting (κ= 0.48-0.93, according to the domains). Positive correlations between the instrument and pain intensity (r = 0.44; P = .001) indicate convergent validity of the adapted version of the Ostomy Skin Tool. In contrast, analysis of discriminant validity was mixed and definitive conclusions about this form of construct validity cannot be made based on this study. This study supports convergent validity and interrater reliability of the adapted version of the Ostomy Skin Tool.

Bibliometric analysis and conversion rate of abstracts presented at the Brazilian Congress of Coloproctology into publication of full articles.

the presentation of research at a congress is an interesting means for scientific dissemination, but only with publication in an indexed journal does the data become accessible and disseminated. The conversion rate in published articles of abstracts presented at congresses is an indicator to assess the scientific quality of those events. The aim of this study is to evaluate bibliometric characteristics of abstracts presented at the Brazilian Congress of Coloproctology and to determine the factors that affect publication rates. Retrospective evaluation of all abstracts presented at the Brazilian Congresses of Coloproctology from 2015 to 2019. Multiple databases were analyzed to estimate the conversion rate of the presented papers, as well as variables associated with the conversion of abstracts into full manuscripts through bivariate analysis and multivariate variables of these predictors. 1756 abstracts were analyzed. Most studies are retrospective, series or case reports, and even personal experience. The conversion rate was 6.9%. The presence of statistical analysis was twice as high for published abstracts as for unpublished ones. the data presented demonstrate a low scientific productivity of the specialty, since the research carried out is, for the most part, not published as complete manuscripts. The predictors of publication of abstracts were: multicenter studies, studies with statistical analysis, study designs with a higher level of evidence and studies awarded by the congress.

The 9th Brazilian Congress of Social and Human Sciences in Health of Abrasco: betting on the emancipatory power of plural and inclusive exchanges

The 9th Brazilian Congress of Social and Human Sciences in Health of Abrasco: betting on the emancipatory power of plural and inclusive exchanges

The 9th Brazilian Congress of Social and Human Sciences in Health of Abrasco: betting on the emancipatory power of plural and inclusive exchanges

The 9th Brazilian Congress of Social and Human Sciences in Health of Abrasco: betting on the emancipatory power of plural and inclusive exchanges

Propostas para a área de gestão do trabalho e educação na saúde para o fortalecimento do SUS

Abstract This propositional document was outlined within the scope of the 13th Brazilian Congress on Collective Health, held in November 2022. The event brought together 6,800 people imbued with hope for the election of a progressive and democratic government, as well as a spirit of articulation, integration, and defense of rights. The document was designed with the objective of contributing to formulating necessary solutions for problems faced by the Brazilian society, presenting proposals to the federal government’s transition commission that are dear to the work management and education in the healthcare field and move towards a strong and egalitarian Brazilian National Health System.