Este ensaio analisa conflitos e potencialidades das Ciências Sociais e Humanas em Saúde (CSHS) no campo da Saúde Coletiva e os desafios de atuar em uma área interdisciplinar. Inicialmente, apresentamos algumas particularidades das CSHS, dialogando com tensões internas. Em seguida, as metodologias qualitativas e seus usos nas pesquisas em Saúde Coletiva são problematizadas, mantendo um diálogo com as demais áreas. Por fim, apresentamos uma reflexão sobre as perspectivas futuras das CSHS e possíveis caminhos teórico-metodológicos que aprofundariam a transversalidade da área. Repensar as relações entre as áreas provoca uma reflexão sobre uma possível e oportuna reconfiguração da própria Saúde Coletiva. Os desafios nos colocam a necessidade de repensar a noção de CSHS; e de indagar sobre a linguagem que estamos construindo e sobre o que podemos fazer.

Este ensayo analiza conflictos y potencialidades de las Ciencia Sociales y Humanas en Salud (CSHS) en el campo de la Salud Colectiva y los desafíos de actuar en un área interdisciplinaria. Inicialmente, presentamos algunas particularidades de las CSHS, dialogando con tensiones internas. A continuación, las metodologías cualitativas y sus usos en las investigaciones de Salud Colectiva se problematizan, manteniendo un diálogo con las demás áreas. Finalmente, presentamos una reflexión sobre las perspectivas futuras de las CSHS y posibles caminos teóricos-metodológicos que profundizarían la transversalidad del área. Repensar las relaciones entre las áreas provoca una reflexión sobre una posible y oportuna reconfiguración de la propia Salud Colectiva. Los desafíos nos plantean la oportunidad de repensar la noción de CSHS, de indagar sobre el lenguaje que estamos construyendo y sobre lo que queremos hacer.

This essay analyzes the conflicts and potential of social sciences and humanities in health (SSHH) in the field of public health and the challenges of acting in an interdisciplinary area. We present some of the particularities of SSHH, dialoguing with internal tensions and then go on to problematize qualitative methodologies and their use in public health research, maintaining a dialogue with the other areas. Finally, we reflect upon the outlook for SSHH and possible theoretical and methodological pathways that would broaden the cross-cutting nature of the area. Rethinking relations between areas prompts reflection on a possible and timely reconfiguration of public health. The challenges give rise to the need to rethink the notion of SSHH, question the language we are constructing, and ask what we can do.

This essay analyzes the conflicts and potential of social sciences and humanities in health (SSHH) in the field of public health and the challenges of acting in an interdisciplinary area. We present some of the particularities of SSHH, dialoguing with internal tensions and then go on to problematize qualitative methodologies and their use in public health research, maintaining a dialogue with the other areas. Finally, we reflect upon the outlook for SSHH and possible theoretical and methodological pathways that would broaden the cross-cutting nature of the area. Rethinking relations between areas prompts reflection on a possible and timely reconfiguration of public health. The challenges give rise to the need to rethink the notion of SSHH, question the language we are constructing, and ask what we can do.

Este ensaio analisa conflitos e potencialidades das Ciências Sociais e Humanas em Saúde (CSHS) no campo da Saúde Coletiva e os desafios de atuar em uma área interdisciplinar. Inicialmente, apresentamos algumas particularidades das CSHS, dialogando com tensões internas. Em seguida, as metodologias qualitativas e seus usos nas pesquisas em Saúde Coletiva são problematizadas, mantendo um diálogo com as demais áreas. Por fim, apresentamos uma reflexão sobre as perspectivas futuras das CSHS e possíveis caminhos teórico-metodológicos que aprofundariam a transversalidade da área. Repensar as relações entre as áreas provoca uma reflexão sobre uma possível e oportuna reconfiguração da própria Saúde Coletiva. Os desafios nos colocam a necessidade de repensar a noção de CSHS; e de indagar sobre a linguagem que estamos construindo e sobre o que podemos fazer.

Este ensayo analiza conflictos y potencialidades de las Ciencia Sociales y Humanas en Salud (CSHS) en el campo de la Salud Colectiva y los desafíos de actuar en un área interdisciplinaria. Inicialmente, presentamos algunas particularidades de las CSHS, dialogando con tensiones internas. A continuación, las metodologías cualitativas y sus usos en las investigaciones de Salud Colectiva se problematizan, manteniendo un diálogo con las demás áreas. Finalmente, presentamos una reflexión sobre las perspectivas futuras de las CSHS y posibles caminos teóricos-metodológicos que profundizarían la transversalidad del área. Repensar las relaciones entre las áreas provoca una reflexión sobre una posible y oportuna reconfiguración de la propia Salud Colectiva. Los desafíos nos plantean la oportunidad de repensar la noción de CSHS, de indagar sobre el lenguaje que estamos construyendo y sobre lo que queremos hacer.

An inert atmosphere is, in some cases, important for the performing of experiments where substances are toxic and/or sensitive to oxygen. However, the high cost and accessibility of an equipment to work under these conditions, results in the fact that most laboratories do not have this kind of equipment. In this paper, we present a simple and efficient project to build a cheap glove box for processes that require an inert atmosphere. The proposed glove box is made using medium density fiberboard (MDF), an acrylic lid, hinges, air valves, PVC gloves and other materials that can be found easily in local stores or on the internet. Tests to verify the quality of the nitrogen atmosphere were performed using the lighter test and niobium pentachloride (NbCl5), which is a moisture/ oxygen sensitive material. The results demonstrated that the equipment is able to maintain an inert atmosphere for several hours, does not permit lighter to function and maintains the NbCl5 stable.

Abstract The objective of this research is to investigate the determinants of public spending on education in the Brazilian cities of Mato Grosso do Sul, in the period 2010-2018. The sample included the 79 municipalities analyzed using regression with data in a fixed effects panel. The data revealed a deviation in the distribution of enrollments in relation to the population, as well as the disproportionate distribution of Gross Domestic Product (GDP) and spending among municipalities. The analysis showed that spending on education is determined by population size, GDP per capita, and municipal election year. However, contrary to what the literature shows, the variables general electoral year and the number of enrollments did not influence the spending on education, revealing limitations in the financing of education in smaller municipalities due to the lesser capacity to obtain own resources, parliamentary amendments, and central decentralization. Among these evidences, the research presents implications for public managers, organized society and researchers.

Resumo Essa pesquisa teve o objetivo de investigar os determinantes do gasto público em Educação das cidades Sul Mato-Grossenses, no período de 2010-2018. A amostra contou com os 79 municípios analisados por meio de regressão com dados em painel de efeitos fixos. Os dados revelaram um desvio na distribuição das matrículas em relação ao quadro populacional, bem como a distribuição desproporcional do Produto Interno Bruto (PIB) e dos gastos entre municípios. A análise evidenciou que o gasto em Educação é determinado pelo tamanho da população, pelo PIB per capita, e pelo ano eleitoral municipal. No entanto, distinto do fundamentado na literatura, as variáveis ano eleitoral geral e o quantitativo de matrículas não demonstraram influências no gasto em Educação, revelando limitações no financiamento da Educação em municípios menores devido à menor capacidade de obter recursos próprios, emendas parlamentares e descentralização central. Entre essas evidências, a pesquisa apresenta implicações para os gestores públicos, para a sociedade organizada e para os pesquisadores.

Resumen Esta investigación tuvo como objetivo investigar los determinantes del gasto público en educación en las ciudades de Mato Grosso do Sul - Brasil, en el período 2010-2018. La muestra incluyó los 79 municipios analizados mediante regresión con datos en un panel de efectos fijos. Los datos revelaron una desviación en la distribución de las matrículas en relación con la población, así como la distribución desproporcionada del Producto Interno Bruto (PIB) y el gasto entre municipios. El análisis mostró que el gasto en educación está determinado por el tamaño de la población, por el PIB per cápita y por el año electoral municipal. Sin embargo, a diferencia de lo que se basa en la literatura, las variables año electoral general y el número de matrículas no mostraron ninguna influencia en el gasto en educación, revelando limitaciones en el financiamiento de la educación en municipios más pequeños debido a una menor capacidad para obtener recursos propios, enmiendas parlamentarias y descentralización central. Entre estas evidencias, la investigación tiene implicaciones para los administradores públicos, para la sociedad organizada y para los investigadores.

Circular chemistry (CC) is an approach for establishing chemical processes to become truly circular and sustainable. It adopts the principles of circular economy (CE), employing life cycle approaches and systems thinking, which help to understand and address the sustainability issues of chemical processes and products. Within this whole context, it is possible to identify some problems of the current lifestyle, such as plastic waste disposal, CO2 emission, e-waste, among others, which need to be addressed accordingly. The reuse provided, well-structured within the context of circular chemistry, can bring benefits in all spheres: social, environmental and economic. Thus, the purpose of this revision is to present CE and CC as the pillars for a sustainable development, bringing discussions about: CE and CC systems; sustainable chemistry; and chemistry 4.0, which embeds digitization, sustainability, and circular economy in industrial chemical processes. Through the knowledge of chemistry, both CC and CE can contribute with innovative methods and processes which maximize benefits, eliminating, or, at least, reducing adverse impacts, thus contributing to construct a mutually beneficial relationship between science and society, its surroundings, and the environment. Therefore, implementing this new model is an opportunity that challenges the human imagination in building a better world.

ABSTRACT The objective was to evaluate the quality of sunflower seeds classified according to their thickness and passed through the seeder-fertilizer dosing system under variation of the travel speed. A lot of M734 was classified by thickness passing the seeds through a set of oblong-hole sieves and two thicknesses were selected. A portion of the seeds with only the commercial classification was also reserved, named as non-classified. The biometric evaluation was done and the sowing was carried out at 5.0, 6.5, 8.0, 9.5 and 11.0 km h-1. The quality of the seeds was evaluated through: germination and first germination count, average time and percentage of emergence in sand, accelerated aging and tetrazolium test. The classification by thickness reduce the coefficient of variation of the length, width, thickness, and mass but seeds classification does not affect seed vigor and viability after sowing under speed variation. In the higher studied speed, the passage of seeds through the dosing mechanism reduces germination. The vigor is affected at 6.5 km h-1 speed by the accelerated aging test. According to the emergence in sand and tetrazolium test, speed variation does not affect the vigor and viability of sunflower seeds.

Abstract This article aims to reflect on the current health challenges of lesbians, gays, bisexuals, transgenders, intersex, and other sexual and gender minorities (LGBTI+) within the Brazilian scenario. This study adopted a triangulation approach, based on two studies developed in the Southeast and South of Brazil, which included policy analysis and qualitative research on the perceptions of key actors from the Brazilian Unified Health System (SUS) - LGBTI+ users, workers, and managers. All data were analyzed by an interdisciplinary team of researchers. The main problems faced by the LGBTI+ population were registered, indicating some of the necessary progress. Some of these challenges include: access of the LGBTI+ population to SUS; the need to train health professionals; the decentralization of health services sensitive to the LGBTI+ population; the distinct forms of violence and discrimination; the lack of research in health care conducted with specific groups, such as lesbians, bisexuals, intersex, and other sexual minorities. The results reinforce the urgency for the complete implementation of the “National Policy for the Comprehensive Health of LGBT”. The recognition of the LGBTI+ health needs will aid in achieving the principles which are the guiding principles of SUS.

Resumo Este artigo objetiva refletir sobre os desafios da saúde de pessoas lésbicas, gays, bissexuais, travestis, transexuais, intersexuais e outras minorias sexuais e de gênero (LGBTI+) no cenário brasileiro atual. Baseado no método de triangulação, incluiu análise de políticas, pesquisa qualitativa sobre percepções de atores-chave do Sistema Único de Saúde (SUS) - pessoas usuárias LGBTI+, profissionais e gestores(as) - a partir de dois projetos desenvolvidos no Sudeste e Sul do Brasil, analisados por equipe interdisciplinar de pesquisadores(as). Foram elencados os principais problemas enfrentados pela população LGBTI+, sinalizando alguns dos avanços necessários. Alguns desses desafios incluem: o acesso de LGBTI+ ao SUS; a necessidade de capacitação de profissionais; a interiorização e descentralização de serviços sensíveis à LGBTI+; as distintas formas de violências e discriminação; lacunas de pesquisas em saúde de segmentos específicos, como de lésbicas, bissexuais, intersexos e outras minorias sexuais. Os resultados corroboram a urgência da implementação plena da “Política Nacional de Saúde Integral de LGBT”. O reconhecimento das demandas dessa população contribui para alcançar os princípios que norteiam o SUS.

Abstract This article aims to reflect on the current health challenges of lesbians, gays, bisexuals, transgenders, intersex, and other sexual and gender minorities (LGBTI+) within the Brazilian scenario. This study adopted a triangulation approach, based on two studies developed in the Southeast and South of Brazil, which included policy analysis and qualitative research on the perceptions of key actors from the Brazilian Unified Health System (SUS) - LGBTI+ users, workers, and managers. All data were analyzed by an interdisciplinary team of researchers. The main problems faced by the LGBTI+ population were registered, indicating some of the necessary progress. Some of these challenges include: access of the LGBTI+ population to SUS; the need to train health professionals; the decentralization of health services sensitive to the LGBTI+ population; the distinct forms of violence and discrimination; the lack of research in health care conducted with specific groups, such as lesbians, bisexuals, intersex, and other sexual minorities. The results reinforce the urgency for the complete implementation of the “National Policy for the Comprehensive Health of LGBT”. The recognition of the LGBTI+ health needs will aid in achieving the principles which are the guiding principles of SUS.

Resumo Este artigo objetiva refletir sobre os desafios da saúde de pessoas lésbicas, gays, bissexuais, travestis, transexuais, intersexuais e outras minorias sexuais e de gênero (LGBTI+) no cenário brasileiro atual. Baseado no método de triangulação, incluiu análise de políticas, pesquisa qualitativa sobre percepções de atores-chave do Sistema Único de Saúde (SUS) - pessoas usuárias LGBTI+, profissionais e gestores(as) - a partir de dois projetos desenvolvidos no Sudeste e Sul do Brasil, analisados por equipe interdisciplinar de pesquisadores(as). Foram elencados os principais problemas enfrentados pela população LGBTI+, sinalizando alguns dos avanços necessários. Alguns desses desafios incluem: o acesso de LGBTI+ ao SUS; a necessidade de capacitação de profissionais; a interiorização e descentralização de serviços sensíveis à LGBTI+; as distintas formas de violências e discriminação; lacunas de pesquisas em saúde de segmentos específicos, como de lésbicas, bissexuais, intersexos e outras minorias sexuais. Os resultados corroboram a urgência da implementação plena da “Política Nacional de Saúde Integral de LGBT”. O reconhecimento das demandas dessa população contribui para alcançar os princípios que norteiam o SUS.

ABSTRACT Introduction: Central vein catheterization (CVC) is one of the main risk factors for central vein stenosis (CVS) occurrence in the hemodialysis population. In this work we aimed to evaluate previous central venous manipulation, clinical presentation, and complications in hemodialysis patients with proved CVS. Material and Methods: We retrospectively reviewed all venous angiographies in patients attending our public hospital center for hemodialysis treatment from 2013 to 2018 (n=209). In patients with confirmed CVS (n=29, 14%), we evaluated history of prior CVC and cardiac rhythm devices (CDR), as well as demographics and cardiovascular risk factors. Results: We identified 31 CVS in 29 patients who underwent venous angiography. Most of these patients, 75.9% (n=22), had at least one CVC (ipsilateral or not); at least one previous ipsilateral short-term CVC was found in 34.4% (n=10) of patients and at least one previous ipsilateral long-term CVC was found in 41.4% (n=12) of patients. All patients who had a prior CRD (n=4, 13.8%), had developed an ipsilateral CVS. Conclusion: Prevalence of detected CVS in our population was significant and is likely underestimated. A high percentage of patients with CVS had an history of previous ipsilateral CVC. The number of patients with previous short-term CVC was similar to that of previous long-term CVC, hinting an important role of short-term CVC as a risk factor do CVS.

ABSTRACT Encapsulating peritoneal sclerosis (EPS) is a rare complication of peritoneal dialysis which mortality can reach 50%. The usual treatment involves suspension of the technique, medical treatment, and surgical enterolysis. We report the case of a 36-year-old female who undergone continuous ambulatory peritoneal dialysis without complications for 10 years. She presented at the emergency department with abdominal pain and a diagnosis of peritonitis was assumed. The patient developed a systemic inflammatory response, and her abdominal computer tomography (CT) scan showed multiple parietal calcifications. After multiple broad-spectrum antibiotics, an undetermined febrile syndrome persisted, and parenteral nutrition was started. An EPS diagnosis was established and treatment with tamoxifen was proposed. Exploratory laparoscopy was decided, and the intraoperative findings were consistent with EPS. The patient was submitted to extensive enterolysis. A clinical improvement led to a discharge after 60 days of hospitalization. After more than 30 months with tamoxifen, she remains on hemodialysis and doing well. There are no randomized controlled trials to guide EPS management and the following procedures are more difficult to decide, who makes these reports important to the reflection. We describe a case of successful treatment of EPS, with a very severe presentation. The management with enterolysis and tamoxifen contributed decisively to this outcome.

SUMMARY OBJECTIVE: The objective of this study was to evaluate whether a single measurement of vascular endothelial growth factor could distinguish between intrauterine pregnancy and ectopic pregnancy and to correlate the levels of vascular endothelial growth factor with serum levels of progesterone andβ-human chorionic gonadotropin in each subgroup. METHODS: Ninety patients with a positive human chorionic gonadotropin test and either abdominal pain or vaginal bleeding were selected; pregnancies were singletons, spontaneously conceived, 42–56 days of gestational age. All patients had a transvaginal ultrasound examination and were divided into three subgroups: abnormal intrauterine pregnancy, tubal pregnancy, and normal intrauterine pregnancy. Tubal pregnancies were surgically treated and histologically confirmed. Blood samples were collected for the determination of β-human chorionic gonadotropin, progesterone, and vascular endothelial growth factor and their concentrations were compared in each subgroup. Receiver operating characteristic curve was calculated by comparing the subgroup of tubal pregnancy to the other groups. A Fisher discriminant function analysis was performed. The level of significance was 5%. RESULTS: One-way analysis of variance revealed a significant correlation between the different subgroups and β-human chorionic gonadotropin, progesterone, and vascular endothelial growth factor serum levels (p<0.001). Vascular endothelial growth factor concentration was significantly higher for patients with tubal pregnancy than for other subgroups (p<0.05). β-Human chorionic gonadotropin and progesterone levels were higher in the subgroup with normal intrauterine pregnancies compared with the subgroups with tubal and abnormal intrauterine pregnancies (p<0.05). Serum vascular endothelial growth factor level >188.7 ng/mL predicted tubal pregnancy with 96.7% sensitivity, 95.0% specificity, 90.6% positive predictive value, and 98.3% negative predictive value. CONCLUSIONS: Serum vascular endothelial growth factor could be a marker in discriminating intrauterine pregnancy from tubal pregnancy; its levels are increased in women with ectopic pregnancy compared with women with normal and abnormal intrauterine pregnancies.

Abstract: Social policy constitutes a half-open door to the ideology of the Iberian dictatorial regimes. During the 1930s and 1940s, Salazar and Franco presented themselves to their respective countries as a guarantee of a new political order, articulating the discourse around social issues. This article studies how the regimes, through the construction of social assistance, achieved some loyalty of the masses in return, due to their dependence on the State and, above all, due to its imposition. However, Salazarism and Francoism reserved a different relevance for their welfare policies.

Resumo: A política social constitui-se numa porta entreaberta para ideário dos regimes ditatoriais ibéricos. No decurso dos anos de 1930 e 1940, Salazar e Franco apresentaram-se aos respetivos países como garantia de uma nova ordem política, articulando o discurso em torno das questões sociais. Este artigo estuda como os regimes, através da construção de uma assistência social, conseguiram alguma fidelização das massas em retorno, por dependência perante o Estado e, sobretudo, por imposição do mesmo. Contudo, Salazarismo e Franquismo reservaram diferente relevância para as suas políticas assistencialistas.

Abstract This article aims to identify and analyze how health professionals working in primary care in the city of São Paulo undertand LGBTI+ people access to health. The research covered the six administrative regions of the city and this paper analyses in depth interviews with specialists of the administrative regions, and also with managers, physicians, nurses and nursing technicians/assistants in Basic Health Clinics trying to understand how they see the access of this segment of people into primary care. The access of LGBTI+ people to primary care tends to prioritize those visually recognizable and whose health demands can be understood in the frame of health centered on illness. This keeps many segments and health demands without attention. The results of the investigation point toward the need of switching the visual frame for a listening strategy to promote access of LGBTI+ people to integral health.

Resumo Este artigo tem como objetivo identificar e analisar como os profissionais de saúde, que atuam na atenção básica na cidade de São Paulo, percebem o acesso à saúde de pessoas LGBTI+. A pesquisa abrangeu as seis regionais de saúde paulistanas e o artigo centra-se na análise das entrevistas em profundidade com especialistas nas regionais, além de gerentes, médicos, enfermeiros e técnicos/auxiliares de enfermagem nas Unidades Básicas de Saúde (UBSs) focando na forma como os profissionais veem a entrada desse segmento na atenção básica. Conclui-se que a forma atual de acolhimento tende a priorizar aquelas e aqueles reconhecíveis visualmente e cujas demandas envolvem uma concepção de saúde centrada na doença, o que mantém vários segmentos e demandas de saúde sem atenção. Sugere-se que a superação do enquadramento visual por uma estratégia de escuta poderia contribuir para o acesso das pessoas LGBTI+ à saúde integral.

Abstract: More than half of the Integrative and Complementary Practices (PICs) offered in the SUS are foreign. Imported from other continents, they were shaped in different cultures with different conceptions of body, health, disease and healing. In the flow of these therapies, Anthroposophy presents a transnationality that, a priori, absorbed European therapeutic practices, adapting them to cultural and climatic issues, but also produced and exported therapies originally Brazilian to Europe, in an opposite movement, from the South to the Global North. Promoter of a bildung in individuals, Anthroposophy seeks to forge itself as a therapeutic motto. This article reflects on this therapeutic transnationality that carries a bildung project and whether it would be decolonial, breaking with European logic and prestige

Resumo: Mais da metade das Práticas Integrativas e Complementares (PICs) oferecidas no SUS são estrangeiras. Importadas de outros continentes, elas foram moldadas em diferentes culturas com distintas concepções de corpo, saúde, doença e cura. No fluxo dessas terapias, a Antroposofia apresenta uma transnacionalidade que, a priori, absorvia as práticas terapêuticas europeias, adaptando-as às questões culturais e climáticas, mas também produzia e exportava terapias originalmente brasileiras para a Europa, em um movimento contrário, do Sul para o Norte Global. Promotora de uma bildung nos indivíduos, a Antroposofia busca um forjar a si mesmo como um mote terapêutico. Este artigo reflete sobre essa transnacionalidade terapêutica portadora de um projeto de bildung e se este seria decolonial, rompendo com a lógica e o prestígio europeu.