Brazilian Process Research Articles

Transitional justice in Brazil and the jurisprudence of the inter-American court of human rights: a difficult dialogue with the Brazilian judiciary

O artigo aborda a justiça de transição no Brasil, considerando os objetivos defendidos pela sua teoria geral. A principal proposta é fazer uma análise jurídica do processo de transição noBrasil com base na relação entre o direito constitucional brasileiro e o Sistema Interamericano deDireitos Humanos. É sugerida uma reflexão sobre os caminhhos de diálogo entre os dois sistemas de proteção dos direitos humanos (interamericano e constitucional) propostos por algumasteorias contemporâneas. Como conclusão, algumas reflexões sobre como essa situação contribuipara a atual crise política brasileira, especialmente para certa popularização do autoritarismocomo solução política.

Potential increase of legal deforestation in Brazilian Amazon after Forest Act revision

The Brazilian Amazon rainforest is protected largely by command and control regulation of public and private land. The Brazilian Forest Act requires private landholders within the Amazon to set aside 80% of their land as legal reserves for nature protection, but this requirement can be reduced to 50% if more than 65% of a state’s territory is protected public land (for example, public conservation units and indigenous reserves). In the ongoing land designation process in Brazil, some Amazonian states may cross this 65% threshold. We assess the potential reduction in the legal reserve requirement from 80% to 50%, through spatially explicit modelling of scenarios concerning land tenure consolidation, employing up-to-date databases on land ownership. Depending on the outcome of land designation processes and political priorities, some 6.5–15.4 million hectares of private land previously protected as legal reserves may become available for legal deforestation. While protection of public land is crucial for safeguarding the Amazon, revisions of federal and state legislation may be needed to avoid the further extension of protected public land triggering increased legal deforestation on private lands. Zero-deforestation commitments and other initiatives may mitigate impacts in the absence of such revision.

Environmental Configuration and Innovation: Different Impacts in the Measurement of the Innovative Process in Brazil and in its States

This article aims to demonstrate that environmental variables can assume differentiated values over a given period and associate themselves to form configurations of different contexts. Knowing the possible configurations of the organizational environment, we are able to identify which indicators are most appropriate to measure innovation, thus meeting the basic condition to manage innovation: to measure accurately the phenomenon under analysis. Thus, with the empirical data analysis from Brazil and the states of Sao Paulo, Parana and Sergipe, we are able to highlight and characterize the different environmental configurations and their reflexes for the innovation measurement process. It should be emphasized that the environmental configuration appears as a relevant factor that must be considered in the process of measurement and management of innovation aiming at competitiveness.

Objetos paradoxais desiguais

Ancorado na Análise de Discurso Materialista, de Michel Pêcheux, proponho trabalhar a desigualdade constitutiva da relação entre diferentes objetos paradoxais, especificamente na política institucionalizada. Procedo mobilizando a noção de objetos paradoxais desiguais, formulada a partir de meu encontro com determinados objetos. O percurso que seguirei retoma, primeiramente, análises que desenvolvi apontando os sentidos de revolução no fim da Primeira República Brasileira. Em um segundo momento, analiso os sentidos de mudança no segundo turno das eleições de 2014, no Brasil. Em uma terceira parte, aponto possíveis relações entre revolução e mudança na constituição dos objetos paradoxais desiguais.

Knowledge Among University Students in Rio de Janeiro Regarding Transplant Organ Donation

IntroductionOrgan transplantation is often the only possible treatment to save the lives of patients with end-stage organ failure. Limiting factors include failure to notify in cases of patients with brain death, the inefficient procurement and distribution of organs, the lack of specific educational policies for health care professionals, lack of knowledge on the organ transplantation process, and family refusal for organ donation. ObjectiveTo evaluate the knowledge of students enrolled in different undergraduate university courses in Rio de Janeiro on the regulations and strategies governing transplant organ donation in Brazil. MethodsThis qualitative, observational study used a 10-item questionnaire aimed at obtaining data on respondents' general knowledge regarding organ donation and transplantation. The questionnaire was applied using either a printed or an electronic version developed on Google Forms and was completed anonymously. ResultsOverall, 587 questionnaires were completed. The participants were divided into 3 groups according to their field of study: 256 (43.6%) from courses related to arts and humanities, 159 (27.1%) from science and technology-related courses, and 172 (29.3%) from the biomedical field. Most respondents (396; 67.5%) were unaware of the criteria required to be an organ transplant donor. ConclusionThere is a significant lack of knowledge among university students on issues related to the organ donation and transplantation process in Brazil.

Dialogues on the work process in oral health in Brazil: an analysis based on the PMAQ-AB survey

The study aimed to: (1) describe the work process in Brazil's oral health teams, based on the essential attributes of primary health care, according to geographic region, type of team, and the municipality's socioeconomic characteristics and (2) verify whether the data in the work process of the oral health teams in the Brazilian National Program to Improve Access and Quality in primary health (PMAQ-AB) were capable of measuring such attributes. This was a nationwide ecological study with data from cycle I of PMAQ-AB. The study included descriptive, exploratory factor, and confirmatory factor analyses (α = 5%). Constructs were analyzed in light of the essential attributes of primary health care (first contact, coordination of care, comprehensiveness, and continuity). The first three constructs and a fourth factor were formed, called dental prosthesis actions. However, the continuity attribute was not formed. The models' goodness-of-fit measures were satisfactory. Factor loads were greater than 0.5, except for the two variables in factor 3. The actions most frequently performed by the oral health teams (> 60%) were in first contact, and the least frequent were those in comprehensiveness, highlighting referrals to specialties (7.6%). There were differences in the work process in oral health teams between regions of the country, type of team, and certification strata (p < 0.05). In conclusion, data on the work process in oral health teams from cycle primary health care in the services' work routine. Further research is recommended on continuity of care. In addition, the oral health teams participating in cycle I of PMAQ-AB should make further progress in actions related to comprehensiveness and coordination of care.

HT2 - The Introduction of Health Technology Assessment in Japan; Lessons Learned from Three Other New HTA Markets (Brazil, Poland and South Korea)

The introduction of Health Technology Assessment (HTA) is currently being trialled in Japan on a number of products with expected results in April 2018. The government plans to implement a full-scale HTA system for reimbursement and pricing decisions. This research aims to inform successful HTA implementation based on the experience of other relatively new HTA markets. The evolution of the HTA systems and processes in Brazil, Poland and South Korea were analysed based on publically available information. These three countries were chosen because of their relatively new introduction of HTA and recognition as leaders in their respective region. Brazil introduced HTA in 2006 and strengthened its role with the National Committee for Health Technology Incorporation (CONITEC) in 2011. Poland created the Agency for Health Technology Assessment (AOMTiT) in 2005. South Korea has required HTA via the Health Insurance Review and Assessment (HIRA) since 2007. Despite differences in HTA implementation, the role of HTA in the decision-making process has increased in the three markets, with the number of assessments performed rising. However, HTA implementation first slowed down the adoption of innovative technologies and changes or exemptions were introduced over time to improve patient access. In all three countries, the HTA process has evolved substantially with the introduction of methodological guidelines, clarification of the process and enhanced transparency. The experiences in Brazil, Poland and South Korea, where limited resources are available, have demonstrated the interest of introducing HTA in reimbursement and pricing decision-making. However it seems that a stepwise, transparent approach is necessary to guarantee success, as well as the establishment of clear guidelines adapted to local context. Certain therapies might benefit from special consideration as cost-effectiveness thresholds are often inappropriate for rare diseases or conditions with short life expectancy, resulting in reduced patient access in those areas.

Gasification of Brazilian coal-chars with CO2: effect of samples’ properties on reactivity and kinetic modeling

The gasification of coals obtained from important coalfields in Brazil was investigated in 1.0 bar of CO2 using a thermogravimetric analyzer. Tests were carried out in two sequential steps: pyrolysis under N2 at 1213 K and isothermal gasification under CO2 in the temperature range of 1113–1213 K. The kinetic study was performed in the kinetically controlled regime and three gas-solid models were fitted to the experimental data. According to the results, subbituminous coal-chars presented higher reactivities than bituminous types, with maceral and ash compositions playing a key role in the overall process. The reaction rates increased with increasing temperature, with maximum values found in the conversion range of 10–60%. The random pore model that predicts a maximum point of reactivity over the reaction course suitably described the gasification kinetics. Values of activation energy between 146.63(±0.03) kJ/mol and 215.09(±0.05) kJ/mol were found, which are consistent to literature data of coals gasified worldwide. Despite the relatively high ash content (32–45%), the Brazilian coals appeared to be sufficiently reactive to be gasified, thus indicating the significance of this study to the development of gasification process in Brazil.

Aging in Brazil: the building of a healthcare model.

The article discusses the development of a health care model for the elderly, seeking to add to the discussion about the aging of the population in the context of a new epidemiological and demographic scenario. Considering that the aging process in Brazil is relatively recent, more relevant social movements have been described in the construction of health policies directed towards the elderly. After an initial description of the main milestones, we present the model of care considered most appropriate for the best care of the elderly. Based on a critical analysis of health care models for the elderly, the article proposes an approach to care for this age group, focusing on health promotion and prevention, in order to avoid overloading the health system. Integrated care models aim to solve the problem of fragmented and poorly coordinated care in current health systems. The more the healthcare professional knows the history of his patient, the better the results; this is how contemporary and resolutive models of care should work, and it is these that are recommended by the most important national and international health agencies. This article is particularly concerned with a care model that is of higher quality, and is more resolutive and cost-effective.

A cor da mestiçagem: o pardo e a produção de subjetividades negras no Brasil contemporâneo

This paper problematizes the positions occupied by color/race in Brazilian ethnic-racial dynamics and relates them with the black subjectivity process in Brazil. After an historiographical analysis of the XIX and XX centuries and of black women’s narratives posted on the blog Blogueiras Negras, we highlighted a change in the use of the word pardo. Working with some of the tool-concepts of Michel Foucault, we show that the changes identified interfere in the production of black subjectivity and are important for rethinking contemporaneous education.

THE MARRAKESH TREATY RATIFICATION IN BRAZIL: IMMEDIATE EFFECTS

This paper willpresent the ratification process of the Marrakesh Treaty in Brazil, its place within the legal system and the likely effects on copyright limitations. We structure the paper in two parts. First we show how the Brazilian Constitution governs the reception of human rights international treaties and conventions and expose their effects throughout the system. We follow by the presentation of the Marrakesh Treaty’s ratification process in Brazil, concentrating on the justifications and results of the legislative procedures. Finally, we consider the likely and possible effects on public policy, legal change and the judicial interpretation of the limitations. We choose to use primary official sources to present the questions for analyses. Our method of choice is inductive, since we extensively use legislative records to elaborate on the political processes and legal rationales behind it.

THE MARRAKESH TREATY RATIFICATION IN BRAZIL: IMMEDIATE EFFECTS

This paper willpresent the ratification process of the Marrakesh Treaty in Brazil, its place within the legal system and the likely effects on copyright limitations. We structure the paper in two parts. First we show how the Brazilian Constitution governs the reception of human rights international treaties and conventions and expose their effects throughout the system. We follow by the presentation of the Marrakesh Treaty’s ratification process in Brazil, concentrating on the justifications and results of the legislative procedures. Finally, we consider the likely and possible effects on public policy, legal change and the judicial interpretation of the limitations. We choose to use primary official sources to present the questions for analyses. Our method of choice is inductive, since we extensively use legislative records to elaborate on the political processes and legal rationales behind it.

THE MARRAKESH TREATY RATIFICATION IN BRAZIL: IMMEDIATE EFFECTS

This paper willpresent the ratification process of the Marrakesh Treaty in Brazil, its place within the legal system and the likely effects on copyright limitations. We structure the paper in two parts. First we show how the Brazilian Constitution governs the reception of human rights international treaties and conventions and expose their effects throughout the system. We follow by the presentation of the Marrakesh Treaty’s ratification process in Brazil, concentrating on the justifications and results of the legislative procedures. Finally, we consider the likely and possible effects on public policy, legal change and the judicial interpretation of the limitations. We choose to use primary official sources to present the questions for analyses. Our method of choice is inductive, since we extensively use legislative records to elaborate on the political processes and legal rationales behind it.

Seleção de indicadores de paisagem para as áreas ambientais em assentamento rural

Os Assentamentos Rurais (ARs) são a materialização do processo de reforma agrária no Brasil, sendo caracterizados pela sua multifuncionalidade. Com relação à função ambiental, os ARs devem respeitar os dispositivos legais da Política Nacional do Meio Ambiente (PNMA), com a conservação das áreas de preservação permanente (PP) e de reserva legal (RL); áreas ambientais do AR. Desta forma, é de extrema importância a seleção e a utilização de indicadores para auxiliar na avaliação e monitoramento destas áreas em ARs, associando-se a Sistema de Informação Geográfica (SIG). Neste contexto, o objetivo deste estudo é selecionar indicadores de paisagens para as áreas ambientais em ARs, exemplificado no AR Rosa Luxemburgo II, em São Cristovão, Sergipe. Após revisão bibliográfica, definiu-se oito indicadores de paisagem da categoria 'Uso da Terra', associando-se a utilização de ferramentas de processamento digital de imagens e plataforma SIG. Como principais resultados, têm-se que, no AR estudado, na fase de ordenamento espacial do AR, existe significativa omissão das áreas de PP; cerca de 61% e 48% das áreas ambientais e de RL, respectivamente, estão efetivamente ocupadas com vegetação nativa, necessitando a recomposição florestal das demais áreas ambientais, para a plena disponibilidade dos serviços ecossistêmicos; e, a existência da Assessoria Técnica, Social e Ambiental à Reforma Agrária (ATES) não representou ações ambientais de conservação e de proteção das áreas de PP e RL. Como conclusões, tem-se que os indicadores de paisagem, no modelo DPSIR, são importantes para a avaliação e o monitoramento das áreas ambientais em ARs, mostrando-se uma ferramenta efetiva para o planejamento e a gestão ambiental de ARs.

Institutional violence during the parturition process in Brazil: integrative review.

To identify the types of institutional violence of childbirth reported by the woman, the birth companion and health professionals. Integrative review that analyzed 33 articles in the LILACS, BDENF, INDEXPSI, regional SciELO, Scopus, Web Of Science and PubMed databases. Women were the main violence rapporteur, with predominance of the psychological type. Precarious infrastructure and the imposition of professional decisions were identified by the companion as violence. For health professionals, performing procedures without consent does not characterize violence, but guarantees childbirth security. Final considerations: The most common types of violence in Brazilian maternity hospitals are psychological, physical and structural. Most of the time, violence is reported by women, although professionals also perceive and admit its perpetuation.

Environmental licensing of large projects of infrastructure: is there a tendency towards judicialization?

Os licenciamentos ambientais no Brasil, particularmente os que envolvem grandes empreendimentos de infraestrutura e diversidade de atores e interesses, como o setor modal portuário, têm ganhado os holofotes públicos e midiáticos, tendo em vista as disputas travadas nesses processos e os conflitos e as contradições que emergem destes. Como consequência dessa complexidade, muitas decisões sobre a concessão ou não das licenças, embora originalmente endereçadas a apenas um órgão ambiental do Poder Executivo, são submetidas ao crivo judicial. Essa complexidade é explorada neste artigo, que traz resultados de um estudo sobre a judicialização do licenciamento da expansão do Porto Público de São Sebastião, litoral norte de São Paulo. O artigo retoma a cronologia do conflito que emerge desse processo e discute um conjunto de variáveis críticas que pesaram na judicialização do licenciamento do porto. Argumentamos que, para além das causas explícitas nas ações judiciais, outras variáveis – as chamadas causas implícitas da judicialização – permearam a dinâmica político-social que levou o conflito para o Poder Judiciário. Argumentamos ainda que a identificação dessas causas expõe as raízes das limitações que o licenciamento ambiental enfrenta na prática.

A Study on continuous and intermittent THAI™ processes in Brazil's Northeastern Region

ABSTRACTToe-to-Heel Air Injection – THAI™ is an enhanced oil recovery technique that employs in situ combustion combined with technologies for horizontal well drilling, which is unprecedented in Brazilian oilfields. Motivated by this context, this research is intended to studying the application of the THAI™ process in a semisynthetic reservoir, with characteristics similar to those found in Brazil's Northeastern region. At the end, it was demonstrated that the intermittent air injection increased the oil recovery, when compared to the continuous injection, what reinforce the need for further research turned to ongoing and future projects in mature oilfields.

Empreendedorismo e inovação: a evolução dos fatores que influenciam o empreendedorismo corporativo

This article aims to show the evolution of factors that influence corporate entrepreneurship through the analysis of variables (eg. entrepreneurial activity, perceived opportunity and perceived capacity) that interfere in the process of innovation and entrepreneurship in Brazil. In order to do so, the factors influencing the innovation process and corporate entrepreneurship were identified in the literature, the relationship between these factors was described. Then, based on data collected by the Global Entrepreneurship Monitor (GEM), the factors which determine the national levels of entrepreneurial activity were defined; variables related to innovation were determined; the variables in the period from 2001 to 2015 were presented; and finally, the variables were related to the influence factors. The main results demonstrate relations between factors such as perception of opportunities and capacities, aspirations of growth and innovation, perceived capacity and leadership. They also present the relation between some factors that influence business development and the innovation process in Brazil.

PP105 Applying Horizon Scanning To Decision Making: The Case of Tafamidis

Introduction:Horizon scanning (HS) is an important tool for guiding health policy formulation and the decision-making process in Brazil. In 2016, the Ministry of Health started to draft Brazilian clinical practice guidelines for transthyretin familial amyloid polyneuropathy (TTR-FAP), which is a rare disease caused by a mutation of the transthyretin gene. An initial HS report was conducted that provided information about new and emerging technologies for TTR-FAP. The HS identified five drugs that were based on two mechanisms of action: transthyretin stabilization (diflunisal, tafamidis, and tolcapone) and gene silencing (ALN-TTR02 and ISIS-TTR-Rx). At that time in Brazil there were no drugs registered for the treatment of TTR-FAP. However, a few months later tafamidis was licensed in Brazil. In early 2017 the manufacturer submitted an application to the National Committee for Health Technology Incorporation (CONITEC), with the aim of incorporating tafamidis into the Brazilian health system. As a result the HS report was updated to support the assessment by CONITEC. This study aims to show how HS is being used to support CONITEC in this issue.Methods:As per the EuroScan toolkit, we performed a reassessment of the technologies included in the initial HS report. We searched clinical trial registers, the websites of pharmaceutical companies, conference proceedings, scientific journals, HS databases, and regulatory websites for further information. The data were synthesized and a reformulated landscape of the technological environment for TTR-FAP therapy was presented to the CONITEC Plenary.Results:The main difference between the initial and final HS output was that tafamidis was approved for use in Brazil, making it the only registered drug for TTR-FAP. Another difference was related to the start of a new clinical trial with diflunisal for TTR-FAP, indicating that this drug could be a potential competitor for tafamidis. It was also possible to add published positive results from a clinical trial with ISIS-TTR-Rx, which were unavailable when the first report was written. Beyond that, it appears that there are two promising gene silencers on the horizon that could represent potential competitors for tafamidis.Conclusions:The analysis of tafamidis for incorporation into the Brazilian health system is ongoing, but HS was able to deliver strategic information that could affect the final recommendation of CONITEC.

PNM-03 Sexual Reassignment Surgery - Initial Experience

Transsexuality is classified as a sexual identity disorder characterised as a desire to live and to be accepted as a person of the opposite sex, and the need to undergo surgery and/or hormonal treatment in order to make the body as close to the desired sex as possible. In 2013, the Ministry of Health expanded the Specialised Care of the Transsexual Process in Brazil. To demonstrate the initial experience of a sexual reassignment surgery service and the incidence of the primary complications. From April 2015 to March 2017, 17 patients diagnosed with male-to-female transsexuality underwent sexual reassignment surgery. They had a mean age of 30 years (21-42 years) and the mean follow-up time was 12 months. No post-operative complications were recorded in 11 patients (65%). Only one patient (5.8%) had an operative wound infection; another two (11.7%) developed urethral meatus stenosis and were treated with meatoplasty. In one case (5.8%), partial stenosis of the vaginal canal occurred, and this patient was followed-up with sessions of physical therapy and vaginal dilation exercises, and no further surgical intervention was necessary. There were no urinary or rectal fistulas. Two patients (11.7%) reported sporadic episodes of urinary loss on exertion, treated with pelvic floor physiotherapy. One patient required early re-operation due to bleeding from the urethral border, and another two patients underwent late procedures to improve vulvar aesthetics.