Abstract Within the justice system, asymmetrical power relations make the testimonies of women/victims of harassment and sexual and domestic violence appear unconvincing to courts and judges. Based on an analysis of an action for protection and two court rulings, this article reveals a framework of epistemic (contextual) and hermeneutic (interpretative) injustice. The testimonies of the victims of gender-based violence were listened to with scepticism and were not understood. The rulings reveal three common elements that run through Ecuador’s justice system: 1) despite the facts of violence and the proven involvement of the aggressors, the interpretation is inadequate, and the harm caused to the victim is not confronted; 2) the application of the law favours men over women; 3) in the courts, the understanding of the harm to the victim is often not approached from a gender-based violence perspective.

Resumen Dentro del sistema de administración de justicia, las relaciones de poder asimétricas hacen que los testimonios de las mujeres-víctimas de acoso y de violencia sexual e intrafamiliar parezcan poco convincentes para tribunales y jueces. A partir del análisis de una acción de protección y dos sentencias, este artículo revela un marco de injusticia epistémica (contextual) y hermenéutica (de interpretación). Los testimonios de las víctimas de violencia basada en género fueron escuchados con escepticismo y no fueron comprendidos. Las sentencias revelan tres elementos comunes que atraviesan el sistema de justicia de Ecuador: 1) pese a los hechos de violencia y la participación comprobada de los agresores, la interpretación es inadecuada y no se confrontan los daños ocasionados en la víctima; 2) la aplicación de la norma favorece a los hombres antes que las mujeres; 3) en los tribunales, la comprensión del daño hacia la víctima no suele abordarse desde el enfoque de la violencia de género.

Objetivo: Este estudio tuvo como objetivo investigar el impacto de las sesiones mediúnicas, especialmente los mensajes evidenciales, en el proceso de duelo y analizar las percepciones de los enlutados, lo médium y los colaboradores involucrados en el evento. Metodología: La investigación adoptó un enfoque metodológico mixto, combinando técnicas cualitativas y cuantitativas, y se llevó a cabo en tres fases: (1) aplicación de un cuestionario cerrado a 105 enlutados en la fila de espera para las sesiones mediúnicas; (2) aplicación de cuestionarios semiabiertos al médium y a seis colaboradores; (3) aplicación de cuestionarios abiertos a 12 enlutados que recibieron mensajes evidenciales. El análisis cuantitativo utilizó estadísticas descriptivas e inferenciales, mientras que el análisis cualitativo siguió la técnica de Análisis de Contenido. Resultados: Los mensajes mediúnicos evidenciales contribuyeron al alivio emocional y a la sensación de reconexión con los seres queridos fallecidos, a pesar de la incomodidad inicial en la fila de espera. La percepción del médium y los colaboradores sobre el impacto del evento fue positiva, aunque la imprevisibilidad de los mensajes limita la adopción de esta práctica como una terapia estructurada. Conclusión: Las sesiones mediúnicas pueden desempeñar un papel importante en la adaptación de individuos con duelo prolongado, ofreciendo consuelo espiritual y promoviendo la resignificación de la pérdida, destacando la importancia de la integración entre el apoyo clínico y espiritual.

Objective: This study aimed to investigate the impact of mediumistic sessions, particularly evidential messages, on the grieving process and analyze the perceptions of mourners, medium, and collaborators involved in the event. Methodology: The research adopted a mixed-methods approach, combining qualitative and quantitative techniques, and was conducted in three phases: (1) the administration of a closed-ended questionnaire to 105 mourners in the waiting line for mediumistic sessions; (2) the administration of semi-structured questionnaires to the medium and six collaborators; (3) the administration of open-ended questionnaires to 12 mourners who received evidential messages. The quantitative analysis used descriptive and inferential statistics, while the qualitative analysis followed the Content Analysis technique. Results: The evidential mediumistic messages contributed to emotional relief and a sense of reconnection with the deceased loved ones, despite the initial discomfort in the waiting line. The perception of the medium and collaborators regarding the event's impact was positive, although the unpredictability of the messages limits the adoption of this practice as a structured therapy. Conclusion: Mediumistic sessions can play an important role in the adaptation of individuals with prolonged grief, offering spiritual comfort and promoting the re-signification of loss, highlighting the importance of integrating clinical and spiritual support.

Objetivo: Este estudo teve como objetivo investigar o impacto das sessões mediúnicas, especialmente das mensagens evidenciais, no processo de luto e analisar as percepções de enlutados, médium e colaboradores envolvidos no evento. Metodologia: A pesquisa adotou uma abordagem metodológica mista, combinando técnicas qualitativas e quantitativas, e foi conduzida em três fases: (1) aplicação de questionário fechado a 105 enlutados na fila de espera para sessões mediúnicas; (2) aplicação de questionários semiabertos ao médium e a seis colaboradores; (3) aplicação de questionários abertos a 12 enlutados que receberam mensagens evidenciais. A análise quantitativa utilizou estatísticas descritivas e inferenciais, enquanto a análise qualitativa seguiu a técnica de Análise de Conteúdo. Resultados: As mensagens mediúnicas evidenciais contribuíram para alívio emocional e sensação de reconexão com os entes falecidos, apesar do desconforto inicial na fila de espera. A percepção do médium e dos colaboradores sobre o impacto do evento foi positiva, embora a imprevisibilidade das mensagens limite a adoção dessa prática como uma terapia estruturada. Conclusão: As sessões mediúnicas podem desempenhar um papel importante na adaptação de indivíduos com luto prolongado, oferecendo consolo espiritual e promovendo a ressignificação da perda, destacando a importância da integração entre suporte clínico e espiritual.

Universities face the challenges of substantial reforms such as new managerialism, corporatism, neoliberalism, McDonaldisation, entrepreneurialism, massification, decolonisation, and many other approaches, philosophies, and practices that influence the original idea of the university. In competitive environments, new managerialism in the public sector can be a means of achieving more efficient, flexible, and adaptable management, thus, the permeation and manifestation of new managerialism in public higher education engender business practices and private-sector ideas. Furthermore, these transformations include globalisation and internationalisation, mass participation and vocational credentialing; business-like administration and internal product and performance regimes; quasi-market competition between institutions; and the part marketisation of teaching and research and services. These managerialist ideas, embedded in a neo-liberal conception of globalisation, have specific implications for higher education in the sense that they have the potential to limit contribution to future public administration research and graduate products to serve as public servants. Compounding the situation is academic capitalism, academic entrepreneurs, entrepreneurial academics and the commodification and commoditisation of a public good (education). Furthermore, even research universities seem to be giving way to entrepreneurial universities and are associated with the emergence of corporate universities. The university's entrepreneurial behaviour is seen in professors' perspectives on the university's role in knowledge dissemination -innovation agents being entrepreneurial academics and academic entrepreneurs - the former resembles innovative university members, while the latter resembles a typical start-up entrepreneur. This "Stalinist plan or new managerialism or new functionalism" and entrepreneurialism represents a healthy capitalist enterprise and propel thinking about whether or not universities pursue epistemologies, ontological scholarship, research and curriculum to improve public administration. This conceptual paper identifies complexities in propelling universities to a higher fitness landscape in producing public administration research and graduates. This is because a public university now fends for itself as it influences distinctive segments of the economy and militates against origins of public administration.

BACKGROUND. Anaesthetic drug wastage negatively impacts the already constrained economy in developing countries such as South Africa (SA). However, safe anaesthetic drug administration during both elective and emergency surgeries can be achieved without increasing wastage or costs. Drugs frequently wasted include those required in emergencies. Cost-reduction strategies, particularly in drug wastage, represent a potential area for short-term savings in hospital drug budgets. Increasing clinician awareness of drug wastage can help modify practices, leading to reduced waste while maintaining high-quality patient care. OBJECTIVE. To evaluate wastage of commonly administered anaesthetic drugs, and to evaluate preventable and routine drug wastage and its cost. METHODS. A prospective observational study was conducted in the operating theatre of Chris Hani Baragwanath Academic Hospital, a tertiary hospital in SA. Prospective data were collected for all patients who presented for elective and emergency surgical procedures at this institution over a 2-week period. Drug preparation and administration were determined by the treating anaesthesiologist. The amount of remaining drug in syringes and opened ampoules was considered as wasted. Routine drug wastage was defined as the remaining drug after the required dose was administered, while preventable drug wastage referred to drugs drawn but not administered to the patient. RESULTS. Data were collected from 373 participants, of whom 58% were undergoing elective surgery. The average drug wastage was 29.7%, comprising 21.3% routine wastage and 8.4% preventable wastage, with an effect size of 0.47 (p<0.001). Propofol accounted for the highest frequency of routine drug wastage, while preventable wastage was predominantly attributed to adrenaline, atropine and suxamethonium (emergency pharmacological agents). The average cost of routine wastage was ZAR3.85, significantly higher than the ZAR1.32 for preventable drug wastage (p<0.001). Multivariate regression analysis revealed a significant association between paediatric surgical cases and increased anaesthetic drug wastage (p=0.004). CONCLUSION. The cost and wastage of anaesthetic drugs pose significant challenges in healthcare institutions, particularly in developing countries with limited resources. Implementing cost-effective strategies, such as using smaller ampoules and prefilled syringes, has been demonstrated to reduce drug wastage without compromising patient care.

In the global context, where virtuality transversalizes the areas of knowledge, it is essential to approach and trace the processes of adaptation, where the study of the implications within the legal system is considered critical. The objective of the study was to analyze the impact of virtual hearings on the principles of fairness and immediacy in civil and criminal courts in Peru, 2024. The approach was based on the socio-legal paradigm. The research assumed a non-experimental, analytical and mixed design, comprising a sample of 147 legal operators of civil and criminal courts; the survey technique was applied. The results showed that virtual hearings presented limitations that compromise the principles of fairness and immediacy, especially in restrictions related to the interpretation of non-verbal communication and emerging technical difficulties that affect both the interaction between the parties and the ability of judges to make accurate assessments of the credibility of witnesses. It is concluded that the transition to virtual hearings in Peru requires a comprehensive reform of the judicial system to preserve fairness, immediacy and access to justice in the digital environment.

No contexto global, onde a virtualidade atravessa as áreas do conhecimento, é essencial abordar e rastrear os processos de adaptação, onde o estudo das implicações dentro do sistema jurídico é considerado crítico. O objetivo do estudo foi analisar o impacto das audiências virtuais sobre os princípios de justiça e imediatismo nos tribunais civis e criminais no Peru, em 2024. A abordagem foi baseada no paradigma sociojurídico. A pesquisa assumiu um desenho não experimental, analítico e misto, compreendendo uma amostra de 147 operadores jurídicos em tribunais civis e criminais; foi aplicada a técnica de pesquisa. Os resultados mostraram que as audiências virtuais apresentam limitações que comprometem os princípios da imparcialidade e do imediatismo, especialmente nas restrições ligadas à interpretação da comunicação não verbal e nas dificuldades técnicas emergentes que afetam tanto a interação entre as partes quanto a capacidade dos juízes de fazer avaliações precisas da credibilidade das testemunhas. Conclui-se que a transição para as audiências virtuais no Peru exige uma reforma abrangente do sistema judicial para preservar a equidade, o imediatismo e o acesso à justiça no ambiente digital.

En el contexto global, donde la virtualidad transversaliza las áreas del conocimiento, resulta fundamental el abordaje y trazabilidad de los procesos de adecuación, donde el estudio sobre las implicancias dentro del sistema jurídico se concibe como crítico. El objetivo del estudio fue analizar la incidencia de las audiencias virtuales sobre los principios de equidad e inmediación en tribunales civiles y penales en Perú, 2024. El enfoque se inscribió en el paradigma socio jurídico. La investigación asumió un diseño no experimental, analítico y mixto, conformada por una muestra de 147 operadores jurídicos de tribunales civiles y penales; se aplicó la técnica de la encuesta. Los resultados evidenciaron que las audiencias virtuales presentaron limitaciones que comprometen los principios de equidad e inmediación, sobre todo en restricciones vinculadas con la interpretación de la comunicación no verbal y con dificultades técnicas emergentes que afectan tanto la interacción entre las partes como la capacidad de los jueces para realizar evaluaciones precisas de la credibilidad de los testigos. Se concluye que la transición a audiencias virtuales en Perú demanda una reforma integral del sistema judicial para preservar la equidad, inmediación y el acceso a la justicia en el entorno digital.

ABSTRACT Purpose This study aimed to adapt the Montreal Cognitive Assessment Hearing Impaired (MoCA-H) into Brazilian Portuguese (BP). Methods This was a descriptive, cross-sectional, quantitative, and qualitative study involving participants selected by convenience. The instrument was adapted from its original version, in a six-stage process consisting of the following: Stage 1 - Translation and back translation of the MoCA-H; Stage 2 - Stimulus analysis and selection; Stage 3 - Semantic analysis of stimuli; Stage 4 - Analysis by non-expert judges, part 1; Stage 5 - Analysis by non-expert judges, part 2; Stage 6 - Pilot study. The following statistical methods were used in this study: parametric T-test, Gwet’s first-order Agreement Coefficient (AC1), and the Content Validity Ratio (CVR). Results Cultural and linguistic adaptations were made to the instrument as well as changes to administration procedures to improve respondent comprehension. Participants with and without hearing loss had some comprehension difficulties in the visualspatial/executive domain task. This was observed not only in Stage 6 but also from the beginning of the adaptation process. Conclusion The adaptation process yielded an instrument with satisfactory content validity.

Abstract In this study, we investigated the cerebroprotective effects of fenchone (FEN) against brain ischemia through in silico and in vivo approaches, focusing on the inhibition of nitric oxide synthase (NOS) and the modulation of oxidative stress markers. Molecular docking revealed the potential binding affinity of FEN for the NOS active site, with a binding energy of -6.6 kcal/mol. This was validated through molecular dynamics simulations over a 100 ns time frame, demonstrating stability and favorable interaction profiles. Wistar albino rats underwent bilateral common carotid artery occlusion/reperfusion (BCCAO/R) followed by FEN administration at doses of 100 and 200 mg/kg. Our results indicated a significant reduction in cerebral infarction size and improvements in electroencephalography (EEG) signal magnitude with FEN treatment. Additionally, FEN restored the activity of antioxidant enzymes (catalase and superoxide dismutase) and decreased malondialdehyde (MDA) and nitric oxide (NO) levels and infarct size compared to those in untreated ischemic rats. Histological analysis further corroborated the neuroprotective effects of FEN, demonstrating the structural preservation of neurons in the hippocampal CA1 region. Overall, the results suggest that FEN plays a neuroprotective role in brain ischemia, potentially through the inhibition of NOS, reduction of oxidative stress, and modulation of antioxidants, highlighting the potential of FEN as a therapeutic candidate for ischemic stroke management.

ABSTRACT Good governance practices seek to prevent corrupt behavior among public officials by implementing management models that improve administration and establish criteria for hiring public employees. This study analyzes how the Brazilian public administration has been selecting and hiring personnel throughout history and the impact of these practices on public employees’ loyalty. The research is based on a bibliographical review of aspects related to management models and the recruitment of public employees, as well as data collected from official Brazilian government websites. The findings suggest that the discourses and normative changes adopted have not significantly contributed to strengthening public governance based on criteria that consider morality and integrity.

RESUMO As práticas de boa governança buscam evitar que as condutas dos ocupantes de cargos públicos se deem de maneira corrupta. Para tanto, modelos de gestão são elaborados com vistas ao aprimoramento da administração, o que envolve critérios relacionados ao ingresso dos ocupantes dessas funções. Tendo isso em vista, este artigo faz uma análise sobre as maneiras pelas quais se deram as seleções de pessoas ao longo da história brasileira e o que isso revela acerca da lealdade por elas prestada. O estudo baseia-se em uma revisão bibliográfica sobre os aspectos relacionados a modelos de gestão e ingresso de pessoas na administração pública, bem como no levantamento de dados em sítios eletrônicos oficiais do governo brasileiro. Os achados sugerem que os discursos e alterações normativas adotados não foram capazes de contribuir, de modo significativo, para o fortalecimento de uma governança pública pautada em critérios afetos à moralidade e à integridade.

RESUMEN Las prácticas de buen gobierno tratan de evitar comportamientos corruptos por parte de los titulares de cargos públicos. Para ello, se elaboran modelos de gestión con vistas a mejorar la administración, lo que implica criterios relacionados con el ingreso de quienes ocupan estos cargos. Teniendo esto en cuenta, este artículo analiza las formas de selección de las personas a lo largo de la historia de Brasil y lo que esto revela sobre su lealtad. El estudio se basa en una revisión bibliográfica de aspectos relacionados con los modelos de gestión y el ingreso de personas a la administración pública, así como en un estudio de datos en sitios web oficiales del gobierno brasileño. Los resultados sugieren que los discursos y cambios normativos adoptados no han podido contribuir significativamente a fortalecer la gobernanza pública basada en criterios relacionados con la moralidad y la integridad.

ABSTRACT Purpose: To evaluate the effect of the topical application of the ethanol extract (EESL) and the hydroethanolic fraction (HFSL) of ripe Solanum lycocarpum fruit on the healing of experimentally-induced wounds in mice. Methods: The EESL and HFSL obtained from ripe fruit of the species S. lycocarpum were obtained by percolation with ethanol. They were tested in the healing of excisional wounds in mice, which were induced in anesthetized animals using a 7-mm dermatological punch. They were divided according to the treatment period and group, n = 6, and received topical application of the EESL or HFSL daily or saline solution for one, five, seven, or 21 days. At the end of this period, the animals were euthanized, and the lesions were subjected to histopathological processing and analysis to evaluate macroscopic area of the wound and microscopic analysis by morphometry of the number of leukocytes, mast cells, fibroblasts, re-epithelialization, and matrix deposition. Results: The application of the EESL and HFSL reduced the number of leukocytes after one, five, and seven days of treatment. EESL improved re-epithelialization and tissue proliferation in wound healing from day 7. Conclusion: The study demonstrated that daily administration of EESL and HFSL exhibit wound healing activity, with this effect being more pronounced by EESL. To our knowledge, this is the first report of the anti-inflammatory and healing activity of this species through topical application.

Resumo A administração Macri (2015-2019) veio ao governo com a promessa de reduzir os direitos de exportação a zero para commodities em geral e para commodities agrícolas em particular, o que lhe rendeu o apoio da grande maioria do empreendedorismo rural. Contudo, a política de direitos de exportação sobre produtos agrícolas, depois de uma redução inicial revelou-se semelhante à que historicamente prevaleceu na Argentina. Este trabalho descreve os altos e baixos da referida administração no que diz respeito à política agrícola em geral e aos direitos de exportação em particular, debatendo as razões para antecedentes que impediram o governo de cumprir o seu compromisso. A análise expõe os limites do privilégio da burguesia sociedade agrária e os proprietários de terras como fração de classe na aliança que apoiou Cambiemos e as restrições estruturais do processo político que o Macrismo incorporou.

Abstract The Macri administration (2015-2019) came into government with the promise of reducing to zero export duties for commodities in general and agricultural commodities in particular, which earned him the support of the majority of rural entrepreneurs. However, the policy of export duties on agricultural commodities, after an initial reduction, turned out to be similar to the one that was historically governed in Argentina. This work describes the ups and downs of the administration in terms of agrarian policy in general, and export rights in particular, debating the underlying reasons that prevented the government from carrying out its commitment. The analysis exposes the limits to the privilege of the agrarian bourgeoisie and the landowners as a class fraction in the alliance that supported Cambiemos and the structural restrictions of the political process that macrismo embodied.

Resumen La administración Macri (2015-2019) llegó al gobierno con la promesa de reducir a cero los derechos de exportación para commodities en general y para commodities agrícolas en particular, lo que le valió el apoyo de la amplia mayoría del empresariado rural. Sin embargo, la política de derechos de exportación sobre commodities agrícolas, luego de una reducción inicial, resultó ser similar a la que históricamente rigió en Argentina. Este trabajo describe los vaivenes de dicha administración en materia de política agraria en general y derechos de exportación en particular, debatiendo los motivos de fondo que impidieron al gobierno llevar a cabo su compromiso. El análisis expone los límites al privilegio de la burguesía agraria y los terratenientes en tanto fracción de clase en la alianza que sustentó a Cambiemos y las restricciones estructurales del proceso político que el macrismo encarnó.

Abstract This study aims to analyze the existence of information about deprescription in the leaflets of proton pump inhibitor (PPI) medications. The leaflets available on the Brazilian Health Regulatory Agency (ANVISA) and Food and Drug Administration (FDA) websites for the following medications were analyzed: omeprazole, esomeprazole, lansoprazole, dexlansoprazole, pantoprazole, and rabeprazole. The variables collected in each leaflet were the existence: a) about deprescribing; b) of guidance on the deprescription process; c) maximum recommended time for use; and d) risk of prolonged use. This information was analyzed in accordance with the PPI deprescription guideline, from Canada. Regarding the medication leaflets, 83.33 % from ANVISA and 100 % from the FDA did not present explicit and systematic guidance on deprescribing. Regarding the maximum time of use, 100 % of the leaflets from both agencies contained this information. Regarding the risks of prolonged use of the medication, 33.33 % of the ANVISA leaflets and 33.3 % of the FDA leaflets did not report the increased risks described in the guideline. The results highlight a large gap in information about deprescribing in PPI leaflets; this highlighting is necessary to contribute to the promotion of the rational use of medicines.

Resumo: O objetivo foi identificar as competências necessárias para que os gestores de atenção primária à saúde desempenhem efetivamente suas funções. A revisão sistemática foi realizada de acordo com as recomendações PRISMA nas bases de dados PubMed, Scopus, Web of Science e CINAHL, considerando publicações dos últimos 10 anos até maio de 2023. Os critérios de inclusão foram: estudos quantitativos, qualitativos ou mistos que avaliaram as competências necessárias para gestores de atenção primária à saúde e publicados em inglês, espanhol ou português. A qualidade metodológica foi avaliada utilizando o Instrumento de Avaliação de Métodos Mistos. Foram identificados 171 estudos, sendo que seis foram analisados. Destacou-se a importância da liderança, do trabalho em equipe e da comunicação. Além da necessidade de formação disciplinar na área da saúde, foi ressaltado o conhecimento em administração e gestão de indicadores, assim como uma atitude autônoma e flexível diante dos desafios que surgem em seu trabalho. A avaliação da qualidade metodológica apresentou, de modo geral, um bom desempenho, exceto por alguns estudos que não fornecem informações suficientes para determinar a representatividade das amostras. Os gestores de atenção primária à saúde devem possuir competências específicas para desempenhar suas funções de forma eficaz, dada a relevância do nível primário nos sistemas de saúde de cada país. Este estudo oferece um quadro geral das competências necessárias para as responsabilidades gerenciais nesta área; no entanto, é necessário considerar as particularidades e os contextos locais de cada centro para desenvolver perfis gerenciais adaptados às suas necessidades específicas.

Abstract: This study aimed to identify the competencies required by primary health care managers for the effective performance of their functions. A systematic review was conducted according to PRISMA, in the databases PubMed, Scopus, Web of Science, and CINAHL, up to May 2023, in the last 10 years. The inclusion criteria were quantitative, qualitative, or mixed studies that evaluated the competencies required for primary health care managers and published in English, Spanish, or Portuguese. Methodological quality was assessed using the Mixed Methods Appraisal Tool. This article identified 171 studies, including six to the analysis. The importance of leadership, teamwork, and communication was highlighted. Furthermore, the need for disciplinary training in the health area, knowledge in administration, and use of management indicators, as well as an autonomous and flexible attitude to challenges were highlighted. The evaluation of methodological quality showed an overall good performance, except for some studies that do not report sufficient information to determine sample representativeness. Primary health care managers must possess specific competencies to effectively perform their roles, given the relevance of primary care in each country’s health system. This study provides a general framework of the required competencies for managerial responsibilities in this area. However, it is necessary to consider the particularities and local contexts of each center to develop managerial profiles adapted to their specific needs.

Resumen: El objetivo de este estudio fue identificar las competencias necesarias para que los gestores de atención primaria de salud puedan desempeñar eficazmente sus funciones. La revisión sistemática se realizó de acuerdo con las recomendaciones de PRISMA en las bases de datos PubMed, Scopus, Web of Science y CINAHL, considerando publicaciones de los últimos 10 años hasta mayo de 2023. Los criterios de inclusión fueron los siguientes: estudios cuantitativos, cualitativos o mixtos que evaluaron las competencias requeridas para los gestores de atención primaria de salud y que estaban publicados en inglés, español o portugués. La calidad metodológica se evaluó utilizando el Instrumento de Evaluación de Métodos Mixtos. Se encontraron 171 estudios; y seis se agregaron al análisis. Se destacaron la importancia del liderazgo, del trabajo en equipo y de la comunicación. Es necesaria una formación disciplinaria en el área de salud, además de conocimiento en la administración y gestión de indicadores, así como una actitud autónoma y flexible frente a los desafíos que se presentan en su trabajo. La evaluación de la calidad metodológica presentó, en general, un buen desempeño, a excepción de algunos estudios que no aportan información suficiente para determinar la representatividad de las muestras. Los gestores de atención primaria de salud deben contar con competencias específicas para desempeñar sus funciones de manera efectiva, dada la relevancia del nivel primario en los sistemas de salud de cada país. Este estudio proporciona una visión general de las competencias requeridas para las responsabilidades gerenciales en esta área; sin embargo, es necesario considerar las particularidades y contextos locales de cada centro para desarrollar perfiles gerenciales adaptados a sus necesidades específicas.

RESUMO O estudo teve como objetivo avaliar a aplicabilidade da associação de duas classes de fármacos. Foram utilizados 10 gatos hígidos, que foram submetidos à avaliação ecocardiográfica e aferição da pressão arterial sistêmica no momento basal e após a administração da dexmedetomidina, na dose de (10mcg/kg), e o butorfanol, na dose de (0,4mg/kg), por via intramuscular. Nos resultados obtidos, houve diminuição de 12% na espessura da parede livre na diástole no modo M (P = 0,017), além da diminuição em 47% da frequência cardíaca (P < 0,0001) e do aumento em 30% na pressão arterial sistêmica (P < 0,0001) após a sedação. O índice TEI aumentou (P < 0,0001) e houve impacto significativo na função sistólica dos gatos sedados, com a diminuição da fração de encurtamento (P < 0,0001), do débito cardíaco (P = 0,003), da onda S’ (P = 0,007) e o aumento do diâmetro do ventrículo esquerdo na sístole em modo M (P = 0,0003). Além desses resultados, diminuíram as velocidades máximas dos fluxos da artéria aorta (P = 0,015) e da artéria pulmonar (P < 0,0001), bem como houve promoção das alterações compatíveis com hipertensão da artéria pulmonar. A associação promove sedação, porém diminui a função sistólica, o débito cardíaco e a frequência cardíaca e aumenta a pós-carga, portanto não é adequada para avaliação ecocardiográfica.

ABSTRACT The study aimed to evaluate the applicability of the association of two classes of drugs. Ten healthy cats were used, who underwent echocardiographic evaluation and measurement of systemic blood pressure at baseline and after administration of dexmedetomidine at a dose of (10 mcg/kg) and butorphanol at a dose of (0.4mg/kg) intramuscularly. In the results obtained, there was a 12% decrease in free wall thickness in diastole in M mode (p=0.017), in addition to a 47% decrease in heart rate (p< 0.0001) and a 30% increase in systemic blood pressure (p<0.0001) after sedation. The TEI index increased (p<0.0001) and there was a significant impact on the systolic function of sedated cats, with a decrease in shortening fraction (p<0.0001), cardiac output (p = 20.003), S' wave (p = 0.007) and increased left ventricular diameter in M-mode systole (p = 0.0003). And the maximum velocities of the aorta (p = 0.015) and pulmonary artery (p < 0.0001) flows decreased, in addition to promoting alterations compatible with pulmonary artery hypertension. The association promotes sedation, but decreases systolic function, cardiac output and heart rate and increases afterload, therefore it is not suitable for echocardiographic evaluation.

Abstract: The work presented here is part of the doctoral thesis and had as its objective the appraisal of records carried out from the perspective of the documentary form as opposed to the appraisal of records from the perspective of “subjects”, in the context of the Brazilian state Executive Branch. The objective was to conceptualize and analyze appraisal as an archival function applied to archival records, based on the documentary form and the subject, carrying out an in-depth study on the methods and ways of using each type of approach, aiming to obtain as a result the definition of which one has the most potential based on a defined reality. The study was carried out from the perspective of the analysis implemented in the schedule dispositions produced within the scope of the Records Management Programs of the States of Rio de Janeiro and Minas Gerais. The choice to assess the use of management instruments in these two perspectives is due to the need to contribute to the public archives of the state Executive Branch and to archivists, with regard to the importance of deciding on an applicable methodology, already at the moment of conception. of management instruments, especially the document temporality table. A comparative case study was adopted aiming, based on comparable elements, to obtain data on the characteristics of the appraisal process in each of the files selected for the research. The documentary form used as a parameter to define the series demonstrated its ability to contribute to an appraisal process closer to objectivity, especially when compared to the “subject”.

Resumo: O trabalho ora apresentado faz parte da tese de doutoramento e teve como objeto a avaliação de documentos realizada sob a perspectiva do tipo documental em contraponto à avaliação de documentos sob a perspectiva dos “assuntos”, no contexto do Poder Executivo estadual brasileiro. Objetivou-se conceituar e analisar a avaliação como função arquivística aplicada aos documentos de arquivo, tendo como base o tipo documental e o assunto, realizando um estudo sobre os métodos e as formas de utilização de cada tipo de abordagem, visando obter como resultado a definição de qual deles possui mais potencialidades a partir de uma realidade definida. O estudo foi realizado na perspectiva da análise implementada nas tabelas de temporalidade e destinação de documentos produzidas no âmbito dos Programas de Gestão de Documentos dos Estados do Rio de Janeiro e Minas Gerais. A escolha de aferir a utilização dos instrumentos de gestão nessas duas perspectivas se dá pela necessidade de contribuir para os arquivos públicos do Poder Executivo estadual e para os arquivistas, no que se refere à importância de decidir por uma metodologia aplicável, já no momento de concepção dos instrumentos de gestão, especialmente a tabela de temporalidade de documentos. Adotou-se o estudo de caso comparado visando, a partir de elementos comparáveis, obter dados sobre as características do processo avaliativo em cada um dos arquivos selecionados para a pesquisa. O tipo documental utilizado como parâmetro de definição da série demonstrou sua capacidade de contribuir para um processo avaliativo mais próximo da objetividade, principalmente quando comparado ao “assunto”.

ABSTRACT The article examines the impact of Ordinance GM/MS No. 1,262, published in September 2023, which links financial incentives to measurable outcomes in liver transplant programs in Brazil. The initiative, which considers the number of transplants performed and 30-day and 1-year survival rates, is viewed as progress toward greater accountability and improved patient care. However, the author highlights significant flaws in the current classification system that may undermine the principles of equity, universality, and decentralization of the Unified Health System [Sistema Único de Saúde (SUS)]. The payment model in use is outdated, does not cover the actual costs of transplants, and ends up using financial incentives to fill budgetary gaps rather than reward excellence in outcomes. Furthermore, the emphasis on the absolute volume of transplants disadvantages centers in smaller and less populated regions, making it harder for them to compete with large centers in more populous states. This exacerbates regional inequalities and encourages the centralization of transplant operations, contravening the SUS’s principle of decentralization. The author proposes adjustments to the system, such as updating the base payment to reflect actual costs, enabling all centers to operate with financial stability. It is also suggested that financial incentives reward excellence in outcomes and that the scoring system assigns greater weight to one-year survival rates, creating a fairer and results-oriented model. Proportional measures based on population size and redistributive funding for lower-ranked centers are recommended to promote equity and stability in transplant access. Ordinance GM/MS No. 1,262 is recognized as an initial milestone, but adjustments are needed to align quality and efficiency with the fundamental principles of the SUS, ensuring that all patients receive high-quality care, regardless of where they are treated.

RESUMO O artigo analisa a influência da Portaria GM/MS Nº 1.262, publicada em setembro de 2023, que vincula incentivos financeiros a resultados mensuráveis nos programas de transplante de fígado no Brasil. Considerando as taxas de sobrevida de 30 dias e 1 ano, bem como o número de transplantes realizados, essa iniciativa representa um progresso em direção a maior responsabilidade e melhor tratamento aos pacientes. No entanto, o autor chama atenção para falhas importantes no sistema atual de classificação que podem comprometer os valores de justiça, universalidade e descentralização do Sistema Único de Saúde (SUS). O modelo de pagamento atual é antiquado, não cobre os custos reais dos transplantes e acaba utilizando os incentivos financeiros para suprir déficits orçamentários, em vez de recompensar a excelência nos resultados. Além disso, o foco no número absoluto de transplantes prejudica os centros em áreas menores e menos habitadas, tornando mais difícil a competição com grandes centros em estados mais populosos. Isso agrava as desigualdades regionais e incentiva a centralização das operações de transplante, contrariando o princípio descentralizador do SUS. O autor sugere mudanças no sistema, como a atualização do pagamento base para refletir os custos reais, permitindo que todos os centros operem com estabilidade financeira. Também são recomendados incentivos financeiros que recompensem a excelência nos resultados e um modelo mais justo e orientado por resultados, com o sistema de pontuação atribuindo maior peso às taxas de sobrevida de 1 ano. Para promover equidade e consistência no acesso ao transplante, são aconselhadas medidas proporcionais ao tamanho da população e financiamento redistributivo para hospitais com menor classificação. Embora a Portaria GM/MS Nº 1.262 seja reconhecida como um marco inicial, mudanças são necessárias para alinhar eficiência e qualidade com os valores fundamentais do SUS, garantindo que todos os pacientes recebam um tratamento de excelência, independentemente de onde sejam atendidos.