Resumo A publicação da lei que criou a titulação de organização social foi precedida de debates sobre o consensualismo no âmbito da Administração Pública, uma corrente interpretativa do direito administrativo que advoga movimentos de horizontalidade entre poder público e privado. Para avaliar a implementação de políticas públicas relacionadas à execução dos direitos humanos – no caso deste artigo, o direito humano à saúde –, realizamos uma pesquisa documental com análise dos 30 contratos de gestão firmados entre organizações sociais de saúde e a Secretaria Municipal de Saúde de São Paulo (SMS-SP), vigentes até 2014. A análise permitiu verificar que o modelo é fortemente influenciado pelas diretrizes do Sistema Único de Saúde (SUS). No caso das relações público-privadas, foi possível concluir que o modelo não é aplicado aos serviços de saúde de maneira idêntica se inserido em maior ou menor grau na política de saúde a depender da escolha do gestor. Por fim, a estrutura homogênea de parte dos contratos, invariável mesmo com relação aos objetos contratados, permitiu descartar a hipótese de que esses instrumentos contam com maior consenso entre o poder público e o parceiro privado. Não havia grande margem de negociação de cláusulas entre os contratados.

Abstract The social organization creation law was preceded by debates about consensualism inside the Public Administration, an interpretative school of thought of administrative law that advocates horizontal movements between Public and Private sector. In order to evaluate the implementation of public policies related to the execution of human rights – in the case of this research, the right to health –, we conducted a documentary research with an analysis of the 30 management contracts signed between social health organizations and the Municipal Health Office of São Paulo from 2006 to 2014. The analysis showed that the model is strongly influenced by SUS guidelines. In the case of public-private relations, it was possible to conclude that the model is not applied to health services in an identical way, inserted to a greater or lesser extent in health policy depending on the manager’s choice. Finally, the homogeneous structure of part of the contracts, which is invariable even in relation to the contracted objects, allowed us to discard the hypothesis that these instruments have a greater consensus between the Government and the private partner. There was not much scope for negotiating clauses between contractors.

Resumo: Este artigo traz reflexões a respeito da deficiência como uma das expressões da questão social, de forma a considerar que as desvantagens sociais são geradas como consequência das noções de quais são os corpos produtivos e úteis à produção capitalista. Refletiu-se sobre como o processo da contradição das Políticas Sociais garante direitos sociais, permite a reprodução desse sistema e cria o sujeito ideal beneficiário.

Abstract: This article brings reflections on disability as one of the expressions of the social issue, in order to consider that social disadvantages are generated as a consequence of the notions of which are the productive and useful bodies of capitalist production. It reflected on how the process of contradiction of Social Policies guarantees social rights, allows the reproduction of this system and creates the ideal beneficiary subject.

Resumo Objetivos: avaliar a atenção ao pré-natal na Atenção Básica identificando os aspectos que influenciam a adequação estrutural e operacional. Métodos: pesquisa avaliativa com análise de 4.059 municípios que aderiram ao 2° ciclo do Programa de Melhoria do Acesso e da Qualidade na Atenção Básica em 2013-2014. O modelo avaliativo composto por 19 indicadores agrupados nas dimensões aspectos estruturais e aspectos operacionais foi validado em conferência de consenso. A análise de dados foi descritiva, com emissão de juízo de valor. Resultados: nos aspectos estruturais 32,6% dos municípios apresentaram adequação e nos operacionais, apenas 24,1%. Na avaliação geral do pré-natal menos de um quarto (24,6%) dos municípios ficaram adequados, àqueles com até 10 mil habitantes apresentaram maior percentual de adequação (41,6%). A região Sul apresentou adequação de 33,8%, considerando todos os portes. Conclusões: a maior parte dos municípios apresentou baixa adequação na atenção ao pré-natal, com melhor desempenho dos aspectos estruturais. Municípios de menor porte apresentaram melhores resultados em todos os itens analisados. Destaque para a região Sul nos aspectos estruturais e na avaliação geral do pré-natal. Uma adequada atenção ao pré-natal precisa ser integral e equânime, com fortalecimento das redes regionais voltadas para a inclusão social.

Abstract Objectives: to evaluate prenatal care in Primary Care by identifying the aspects that influence structural and operational adequacy. Methods: evaluation research with analysis of 4,059 municipalities that joined the 2nd cycle of the Program for Improving Access and Quality in Primary Care in 2013-2014. The evaluative model composed of 19 indicators grouped in structural aspects and operational aspects dimensions was validated in a consensus conference. Data analysis was descriptive, with the issuance of value judgment. Results: in structural aspects, 32.6% of the municipalities presented adequacy, whilst in operational ones, only 24.1%. In the general prenatal evaluation, less than a quarter (24.6%) of the municipalities was adequate, those with up to 10 thousand inhabitants had a higher percentage of adequacy (41.6%). The South region presented adequacy of 33.8%, considering all sizes. Conclusions: most municipalities presented low adequacy in prenatal care, with better performance of structural aspects. Smaller municipalities presented better results in all analyzed items. Structural aspects and general evaluation of prenatal care are highlighted in the South region. Adequate attention to prenatal care needs to be comprehensive and equitable, with the strengthening of regional networks geared towards social inclusion.

ABSTRACT: Mechanical harvesting leaves in its wake a considerable amount of straw in the field, which can be effectively utilized to improve the soil condition and sugarcane yield. However, there is no specific information as to the quantity of straw mulch required to achieve such effects and as to whether it can be used in other sectors for bioelectricity and ethanol production. The aim of this research was to evaluate the effect of removing different amounts of straw from the field and its impact on the yield and industrial quality of sugarcane ratoons. The experiment was carried out on Rhodic soil where six treatments were evaluated including 0 %, 25 % (5 Mg ha−1), 50 % (10 Mg ha−1), 75 % (15 Mg ha−1), 100 % (20 Mg ha−1) straw on the soil surface and burned sugarcane (where 100 % of the straw was burned). The influence on yield and industrial quality was calculated using total soluble solids, Pol (Apparent sucrose content), apparent purity, total sugars, reducing sugars and fiber. Shifting the harvesting system from burned cane to growing under straw mulch improved crop yield as well as favoring sugar contents during water deficit conditions. The straw left on the soil did not affect industrial quality in any way during the trials; however, under drought conditions, treatments with 50 and 75 % of straw resulted in a 76 % higher yield compared to burned sugarcane, and 29 % more than the 0 %, 25 % to 100 % treatments of straw mulch thus favoring higher sugar production. The removal of 50 % of the straw caused no damage to the sugarcane crop.

Abstract INTRODUCTION: The occurrence of leprosy reactions, a common event during treatment, may be mostly related to the action of multidrug therapy on Mycobacterium leprae. The clinical and laboratory monitoring of patients with reactions is important, since collecting data that assists in predicting the risk of reactions may help to prevent disability. METHODS: This was a sectional study, in order to correlate clinical and laboratory diagnosis with the number of reactions during treatment. Spearman's correlation was used to verify the degree of association between the assessed variables. RESULTS: This study was conducted with 211 patients with leprosy reactions during treatment of M. leprae. The borderline tuberculoid group was the most prevalent clinical form (74/211; 35.1%) and the type one reaction showed the highest frequency (136/211; 64.5%). It was observed that 73.5% (155/211) of reactions occurred within 3 months of the initiation of multidrug therapy. The diagnostic values, including the bacterial indices (BIs) of dermal smears (r = 0.21, p < 0.05) and skin biopsies (r = 0.20; p < 0.05), showed a positive correlation with the number of reactions during treatment. CONCLUSIONS: This research showed a positive correlation between bacillary load markers and the number of leprosy reactions. This study provided scientific support to future research aiming to elucidate the influence of antigenic load on the number of leprosy reactions during treatment.

Resumo: O objetivo deste trabalho foi avaliar o efeito de diferentes quantidades de palhada sobre o sistema radicular e a produtividade da cana-de-açúcar (Saccharum officinarum), de primeira e segunda soqueiras, em Latossolo Vermelho eutroférrico. Seis tratamentos foram avaliados : 0, 5 (25%), 10 (50%), 15 (75%) e 20 Mg ha-1 (100%) de palhada e cana-queimada, na primeira e segunda soqueiras. Utilizou-se a cana-de-açúcar 'SP80-1816'. Avaliou-se a massa de raízes a 0,45 e 0,75 m de distância da linha de plantio, até 0,60 m de profundidade. Na primeira soqueira, os tratamentos com 50, 75 e 100% de palhada proporcionaram maior massa radicular até 0,20 m de profundidade, em comparação aos tratamentos cana-queimada, 0 e 5 Mg ha-1 (25%) de palhada. Os tratamentos com 50 e 75% de palhada proporcionaram produtividades 43% maiores do que a da cana-queimada (110 Mg ha-1). O tratamento com 10 Mg ha-1 (50%) foi suficiente para proporcionar aumento da massa radicular e da produtividade da cana-de-açúcar. O sistema radicular e a produtividade da cana-de-açúcar são favorecidos pela mudança do sistema de colheita de cana-queimada para o de cana sob palhada.

Abstract: The objective of this work was to evaluate the effect of different amounts of straw on the root system and productivity of sugarcane (Saccharum officinarum), of first and second ratoons, in an Oxisol. Six treatments were evaluated: 0, 5 (25%), 10 (50%), 15 (75%), and 20 Mg ha-1 (100%) straw and burned sugarcane of the first and second ratoons. 'SP80-1816' sugarcane was used. Root mass at 0.45 and 0.75 m away from the row, and up to 0.60 m deep was evaluated. In the first ratoon, treatments with 50, 75 and 100% straw provided greater root mass up to 0.20-m depth, in comparison to treatments of burned sugarcane, and 0 and 5 Mg ha-1 (25%) straw. The treatments with 50 and 75% straw had 43% higher yields than burned sugarcane (110 Mg ha-1). The treatment with 10 Mg ha-1 straw (50%) was sufficient to provide increased root mass and productivity of sugarcane. The root system and the productivity of sugarcane are favored by the change of burned-sugarcane harvesting system to sugarcane under straw.

This cross-sectional retrospective study evaluated 440 leprosy patients; 57% (251/440) had leprosy reactions during and/or after multidrug therapy, 80.5% (202/251) of whom presented with multibacillary leprosy. At diagnosis, positive bacterial index (BI) [odds ratio (OR) = 6.39; 95% confidence interval (CI): 4.1-10.1)] or polymerase chain reaction (PCR) (OR = 9.15; 95% CI: 5.4-15.5) in skin smears, anti-phenolic glycolipid-1 (anti-PGL-1) ELISA (OR = 4.77; 95% CI: 2.9-7.9), leucocytosis (OR = 9.97; 95% CI: 3.9-25.7), thrombocytopenia (OR = 5.72; 95% CI: 2.3-14.0) and elevated lactate dehydrogenase (OR = 2.38; 95% CI: 1.4-4.0) were potential markers for the development of reactions during treatment. After treatment, positive BI (OR = 8.47; 95% CI: 4.7-15.3) and PCR (OR = 6.46; 95% CI: 3.4-12.3) in skin smears, anti-PGL-1 ELISA (OR = 2.25; 95% CI: 1.3-3.9), anaemia (OR = 2.36; 95% CI: 1.2-4.5), leucocytosis (OR = 4.14; 95% CI: 1.5-11.6) and thrombocytopenia (OR = 3.70; 95% CI: 1.3-2.2) were risk factors for the occurrence of reactions during the study period. The identification of groups with an increased risk for developing reactions will allow for the timely development of a treatment plan to prevent nerve damage and, therefore, the appearance of the disabling sequelae associated with the stigma of leprosy.