bluuebunny/crossref_metadata_2025 huggingface dataset:
Comprehensive Meta-Analysis Mulligan's Mobilization with Movement in Knee Osteoarthritis Immediate and Short-term Efficacy on Pain, Function, and Emotional Well-being
Authors: Qureshi Aliyah Usman , Saeed Abdullah , Hameed Muddsar , Arshad Anum , Khalid Hareem , Khawar Komal , Rehman Rana Anees Ur
Published: January 2024

Knee osteoarthritis (KOA) poses a significant global health challenge, impacting individuals' overall well-being through pain, compromised balance, and emotional distress. Mulligan's mobilization with movement (MWM) has emerged as a promising intervention, demonstrating immediate benefits in pain reduction and functional improvement. However, a comprehensive understanding of its sustained effects and potential synergies with other modalities remains limited. This meta-analysis aims to evaluate the immediate and short-term efficacy of Mulligan's MWM on pain reduction, physical function, and emotional well-being in KOA patients. Additionally, the study explores the sustained positive effects of MWM and its potential synergies with exercise programs and pharmacological interventions. A systematic literature review spanning 2017 to 2023 was conducted, selecting over 15 peer-reviewed studies from databases such as PubMed, Google Scholar, Cochrane Library, and Mendeley. The analysis focused on pain reduction using the Visual Analogue Scale, improvements in physical function through Time Up and Go Test and range of motion assessments, and emotional well-being evaluated via the Beck Depression Inventory. Longitudinal studies provided insights into sustained effects, and a comparative analysis explored synergies with other therapeutic modalities. Mulligan's MWM demonstrated consistent and substantial pain reduction, validated by Visual Analogue Scale scores. Improvements in physical function were evident through enhanced Time Up and Go Test results and increased range of motion. Emotional well-being saw a notable reduction in depression scores. Longitudinal studies indicated sustained positive effects, while a network meta-analysis suggested comparable efficacy with pharmacological interventions. This meta-analysis supports the immediate and short-term efficacy of Mulligan's MWM in addressing pain, improving physical function, and positively impacting emotional well-being in KOA patients. Sustained positive effects and potential synergies with other therapeutic modalities highlight the versatility of Mulligan's MWM, encouraging its integration into evidence-based guidelines for KOA management.
Behavior Analysis of Highway Rigid Pavement on Clay Soil with Beam on Elastic Foundation Approach
Authors: Srikandi I Gusti Ayu Santi , Sangadji Senot , Purwana Yusep Muslih
Published: January 2024

An important consideration in designing road infrastructure is the study of the behavior of rigid pavement structures and subsurface soils. Vehicle loads received by the rigid pavement are transferred to the soil which provides the required response and bearing capacity. To examine this problem the beam on elastic foundation (BoEF) approach can be used. The purpose of this research is to identify and assess the relationship between pavement stiffness and the soil that supports it. The object of this research is Solo Yogyakarta - NYIA Kulonprogo Toll Road section 1 STA 2+949 to STA 2+973. The pavement is modeled as a finite element resting on a series of springs that represent the characteristics of the subgrade soil. The structural analysis results show that the pavement should be designed with appropriate thickness and sufficient elastic modulus to withstand various traffic loads. In addition, an understanding of pavement deformation and soil response to loads is essential in minimizing road damage.
Hybrid Technique for Vibration Control using Synchronized Switch Damping on Inductor Modal Approach and Shape Memory Alloy Integration
Authors: Yakoubi Hadja , Cherif Aida , Meddad Mounir
Published: January 2024

Vibration control is a critical aspect of various engineering applications, including automotive and aerospace systems. This research paper presents a novel approach to enhance the performance of the Synchronized Switch Damping on Inductor (SSDI) technique by incorporating Shape Memory Alloys (SMAs). SSDI has proven effective in managing energy dissipation during electronic switching transitions, mitigating voltage spikes and reducing electromagnetic interference. However, the method consumes a substantial amount of energy. In this study, we propose a hybrid approach that combines the benefits of SSDI with the unique properties of SMAs to achieve improved vibration control. The integration of SMAs introduces a semi-passive element to the system, exploiting the inherent properties of these alloys to undergo reversible shape changes in response to external stimuli. By strategically placing SMAs within the vibration-prone components of the system, we aim to harness the mechanical forces generated during shape recovery to counteract and dampen vibrations. This innovative approach aims to capitalize on the efficient energy conversion capabilities of SMAs, thus minimizing the additional energy consumption associated with traditional semi-passive methods. The research involves theoretical modeling and simulation studies to assess the effectiveness of the proposed technique. Preliminary results demonstrate a significant reduction in vibration amplitudes and enhanced damping capabilities, validating the potential of the integrated SSDI-SMA system. The findings of this study not only contribute to advancements in vibration control methodologies but also provide insights into the broader applications of SMA-enhanced semi-passive techniques in improving the overall performance and efficiency of systems.
The Role of Herbal Medicine in Oxidative Stress: Prevention of Diabetes
Authors: Sankaran G. Brindha , Nari Siddulu , Admuthe Namdeo Bhagwan , Madhab Mausomi , Vasudha K. , Sreenivas A , Velammal M. , Kumar Aditya , Shrivastava Ruchita , Barwant Mukul Machhindra
Published: January 2024

The pathophysiology of diabetes mellitus is heavily influenced by oxidative stress, which is defined by an imbalance between reactive oxygen species (ROS) and antioxidant defenses. Innovative methods for managing and preventing diabetes are required given that it is a growing worldwide health concern. Herbal medicine, which has a long history of use in traditional therapeutic methods, has drawn interest for its ability to reduce the incidence of diabetes and combat oxidative stress. The processes underpinning the damage caused by ROS to cellular components and signaling pathways are revealed in this chapter as it delves into the complex interactions between oxidative stress and diabetes. The essential function of antioxidant substances in reducing oxidative stress is investigated, emphasizing the change from traditional herbal knowledge to contemporary scientific validation. The botanical substances that provide a source of inorganic antioxidants are at the center of this discussion. Fenugreek (Trigonella foenum-graecum) and Bitter Melon (Momordica charantia), two important medicinal herbs, are investigated for their strong antioxidant capacities and their capacity to modify glucose homeostasis and insulin sensitivity.Scientific studies, including in vitro experiments and clinical trials, shed light on how well herbal treatments for diabetes prevention actually work. Additionally, the beneficial effects of herbal combinations are clarified, as well as the importance of combining these interventions with lifestyle changes. The fusion of herbal medicine and conventional therapies appears as a promising route for diabetes prevention as the movement toward holistic health gains popularity. In conclusion, this chapter underscores the multifaceted potential of herbal medicine in addressing oxidative stress as a crucial factor in diabetes prevention. By embracing the wisdom of ancient traditions and leveraging contemporary scientific insights, herbal interventions offer a holistic and integrative strategy to safeguard against the escalating global burden of diabetes.
Formation Of Values as Psychological Immunity in Adolescent Children in The Conditions of Information Threat
Authors: Alievich Ergashev Eminjon , Ergashevna Yulchiboyeva Dilfuza
Published: January 2024

In the article, in the formation of psychological immunity in adolescent children in the conditions of information threats, based on the requirements of the present time, the uniqueness of the formation of values in adolescent children and the conducted researches are analyzed and the priority values are defined.
Principles of Law in the Legal System of Lithuania: Determining or Directing?
Authors: Lastauskienė Giedrė
Published: January 2024

The identification and description of the principles of Law and their place in the legal system are discussed in the article. The goal of this paper is to review the changes of perception of the principles of Law in Lithuania during the period of the paradigm change, after the restoration of the independence of Lithuania. The practice formed by the Constitutional Court of the Republic of Lithuania, with the court applying the principle of the rule of Law, is used for illustration of the present research.
Underlying Ideas of Law as General Principles of Law and Constitutional Principles
Authors: Šinkūnas Haroldas , Isokaitė-Valužė Indrė
Published: January 2024

The article aims at the analysis of the general principles of law in the international law and the constitutional law: the general principles of law in the case law of the International Court of Justice and the jurisprudence of the Constitutional Court of the Republic of Lithuania as well as their interplay. The concept of the general principles of law as underlying ideas identifiable in each legal system, as well as their types, functions and specifics are examined. Systematic and comparative research reveals the role of the general principles of law in the international law and the constitutional law of the Republic of Lithuania demonstrating their peculiarities in the said two legal systems, including the extent of coincidence and interrelation. The article emphasizes the significance of the general principles in both legal systems, including their role in construing, creating (developing) and applying law, as well as filling in gaps, recognizes their universality and commonness of their purpose and differences stipulated by the nature of each legal system. The analysis of the case law of the International Court of Justice reflects the discussion on the identification of the general principles of law and their recognition as such in the international law as well as the Court’s creativity in applying and construing them as the general principles of law, while the jurisprudence of the Constitutional Court of the Republic of Lithuania refers to both, the general principles of law and the constitutional principles, both being interconnected – although retaining their autonomy. It is highlighted that the general principles of law, reflecting the essential ideas and fundamental values of law, retain their unique significance despite their possible overlap with or reflection in other principles or rules.
The Role and Significance of the Principle of Solidarity in the Implementation of the State-Guaranteed Right to Health Protection Enshrined in the Constitution of the Republic of Lithuania
Authors: Taminskaitė-Kočiūnė Gabrielė
Published: January 2024

This article analyses the commitments of Lithuania in the field of health care and the instruments used by the State to implement these commitments. It also analyses the case law of the Constitutional Court of the Republic of Lithuania and the Court of Justice of the European Union, which is necessary to reveal the implications of the chosen measures for the rights and obligations of society and individuals. This right to health protection, as a constitutional right, and the peculiarities of its enforcement are the main subject of the analysis of this article.
Constitutional Doctrine and the (Non)-Freedom of the Interpretation of the Constitution
Authors: Birmontienė Toma
Published: January 2024

This article analyses the extent to which the Constitutional Court is free to develop the constitutional doctrine. As one of the preconditions for the formation of the constitutional doctrine, the freedom exercised by the Constitutional Court in interpreting the Constitution can be viewed as a subjective assessment of the provisions and principles of the Constitution by the justices of the Constitutional Court, which is determined by objective circumstances and is based on reasoning, in order to achieve the integrity of the Constitution, the balance of the values enshrined in it, and the viability of the legal basis of the life of society and the State. The limits to the freedom of the Constitutional Court in developing a new original constitutional doctrine (or a doctrine based on EU Law, international legal acts, or constitutional traditions of other democracies) remain a topical issue which raises debate not only on the content of such a doctrine, but also on the consistent continuity of the interpretation of the Constitution by the Constitutional Court, as the sole official interpreter of the provisions and principles of the Constitution.
Constitutionalisation of Civil Law, Civilisation of Constitutional Law and Way towards Private Constitutional Law
Authors: Didžiulis Laurynas
Published: January 2024

Due to the resourceful case law of the Lithuanian Constitutional Court and the doctrinal attitudes of its justices, during the most recent decades in the Lithuanian legal discourse, the opinion has been established that the constitutional law is the true foundation of the legal system, whereas the civil law is merely an ordinary branch of Law fully determined by the former. Even more – the acknowledgment that the Constitution is a main source of the civil law was followed by the denial of the civil law rules to be a source of the constitutional law and any reverse effects. This approach, which has become dogmatic in Lithuania, is understood as a consequential result of the constitutionalisation of the civil law. However, more detailed theoretical analysis, presented in this article, on the relationship between the constitutional law and the civil law as well as the case law of the Constitutional Court involving the application of the civil law rules in a constitutional adjudication denies such simplistic understanding. The relationship between the branches of law in question seems to be much more subtle and complex than judging superficially from the perspective of legal stratification into the constitutional law and the ordinary law. Ironically, the understanding proposed by constitutionalists where the constitutional law is a higher law to which the civil law is fully subordinated provokes a legal scholar to proceed further and discover signs of the formation of the private constitutional law. This, in turn, demands new reflection on the relationship between the constitutional law and the civil law. Hence, in the present article, by applying functional, systemic and comparative analysis, and by taking into account the case law of the Constitutional Court, the author seeks to find out the relationship between the constitutional law and the civil law which is fundamental for every legal system.
The Constitutional Principle of the Independence of the Judiciary: between the Constitutional Imperative and Reality
Authors: Jočienė Danutė
Published: January 2024

The independence of the judiciary as a fundamental constitutional imperative has expressis verbis been enshrined in Paragraph 2 of Article 109 of the Constitution of the Republic of Lithuania adopted in the Referendum of 25 October 1992. In the presently mentioned Article, it is emphasized that “When administering justice, judges and courts shall be independent.” 

The Constitutional Court has held more than once that the independence of judges and courts is one of the essential principles of a democratic State under the rule of Law: while administering justice, courts must ensure the implementation of the right embodied in the Constitution, laws and other legal acts, guarantee the supremacy of Law, and protect human rights and freedoms. 

Already in the Ruling of 6 December 1995, the Constitutional Court held that one of the fundamental distinguishing characteristics of a democratic State is the principle of the independence of the judiciary. All democratic States adhere to this principle, and, as the historical facts illustrate, the denial of this principle is an immanent feature of totalitarian and authoritarian regimes. 

The independence of judges and courts is not an end in itself: this is a necessary condition of the protection of the human rights and freedoms, not a privilege but one of the main duties of a judge and courts arising from the right of every person who believes that his rights or freedoms have been violated to an independent and impartial arbiter of the dispute, which, under the Constitution and laws, would in essence solve the dispute at law, guaranteed in the Constitution (inter alia, in Paragraph 2 of Article 109, as well as in Paragraph 1 of Article 30, in which it is prescribed that the person whose constitutional rights or freedoms are violated shall have the right to apply to court) (see, among many others, the Constitutional Court’s rulings of 6 December 1995, 1 October 1997, 8 May 2000, 4 March 2003, 17 August 2004, 29 December 2004, 28 March 2006, 9 May 2006).
Corrected Age at Bayley Assessment and Developmental Delay in Extreme Preterms
Authors: Garfinkle Jarred , Khairy May , Simard Marie-Noelle , Wong Jonathan , Shah Prakesh S. , Luu Thuy Mai , Beltempo Marc ,   Canadian Neonatal Network and Canadian Neonatal Follow-Up Network Investigators
Published: January 2024

BACKGROUND AND OBJECTIVES

Research on outcomes of prematurity frequently examines neurodevelopment in the toddler years as an end point, but the age range at examination varies. We aimed to evaluate whether the corrected age (CA) at Bayley-III assessment is associated with rates of developmental delay in extremely preterm children.

METHODS

This retrospective cohort study included children born at <29 weeks’ gestation who were admitted in the Canadian Neonatal Network between 2009 and 2017. The primary outcomes were significant developmental delay (Bayley-III score <70 in any domain) and developmental delay (Bayley-III score <85 in any domain). To assess the association between CA at Bayley-III assessment and developmental delay, we compared outcomes between 2 groups of children: those assessed at 18 to 20 months’ CA and 21–24 months.

RESULTS

Overall, 3944 infants were assessed at 18–20 months’ CA and 881 at 21–24 months. Compared with infants assessed at 18–20 months, those assessed at 21–24 months had higher odds of significant development delay (20.0% vs 12.5%; adjusted odds ratio, 1.75; 95% confidence interval [CI], 1.41–2.13) and development delays (48.9% vs 41.7%, adjusted odds ratio 1.33; 95% CI, 1.11–1.52). Bayley-III composite scores were on average 3 to 4 points lower in infants evaluated at 21–24 months’ CA (for instance, adjusted mean difference and 95% CI for language: 3.49 [2.33–4.66]). Conversely, rates of cerebral palsy were comparable (4.6% vs 4.7%) between the groups.

CONCLUSIONS

Bayley-III assessments performed at 21–24 months’ CA were more likely to diagnose a significant developmental delay compared with 18- to 20-month assessments in extremely preterm children.
СВІТ ПОВСТАНСТВА В МИСТЕЦЬКОМУ ОСМИСЛЕННІ В УКРАЇНСЬКІЙ ЛІТЕРАТУРІ 1920 – 1930 РОКІВ
Authors: Заверталюк Н.
Published: January 2024

Постановка проблеми. У час революції і громадянської війни (1917 – 1920) в Україні завирував повстанський рух: створювалися партизанські загони, пов-станські республіки як більшовицького, так і антибільшовицького спрямування. Реальні події, конкретні їх учасники стали об’єктом художньої творчості письменників, серед яких В. Еллан-Блакитний, Гр. Косинка, М. Хвильовий, В. Підмо-гильний, Ю. Яновський. Їхні твори, тематично орієнтовані на зображення повстан-ства, фактично без винятку були вилучені з літературного процесу на довгий час, а автори в той чи той спосіб репресовані. Через таку ситуацію тема повстанства в українській літературі Розстріляного відродження, осмислена на різних рівнях її художньої репрезентації, ще не була об’єктом системного вивчення.

Мета дослідження – окреслення специфіки художнього втілення теми повстанства в українській літературі Розстріляного відродження.

Методика дослідження базується на поєднанні засад системного аналізу з елементами рецептивного, текстологічного підходів до інтерпретації тексту.

Основні результати дослідження. Тема повстання знайшла художнє втілення в різних жанрах української літератури 1920 – 1930-х років: героїка селянських та робітничих повстань оприявнена в ліриці П. Тичини, В. Еллана-Блакитного; драматургічні та епічні твори Ю. Яновського, М. Хвильового, В. Підмогильного, Гр. Косинки в широкому ідеологічному та тематичному діапазоні зображують світ повстанства. Якщо в новелах Гр. Косинки («Десять», «На Золо-тих Богів») опоетизовується селянська повстанська стихія, яка бореться проти і білих, і червоних за право вільно жити на власній землі, то в оповіданнях В. Підмо-гильного, зокрема «Гайдамака», повстанська сила стихійна й несвідома. «Визволи-тельна» анархія Н. Махна в повісті «Третя революція» В. Підмогильного зображується в концептуальному полі зла, смерті, виявляє себе як жорстока диктатура. Не забуті наслідки повстанського минулого й тих, хто пізніше став відданим комуністом, як анарх із повісті «Санаторійна зона» М. Хвильового. Балансування між більшовицькими й національними ідеалами визначає силове поле роману «Чотири шаблі» Ю. Яновського, зокрема змісту сюжетної лінії героїчної боротьби повстанського війська проти армії інтервентів.

Висновки. Світ повстанства породив самобутні в художньому плані твори, у яких постала правда героїчної і трагічної боротьби українців за волю, що часом набувала ознак національної трагедії. Попри спроби радянської влади викреслити з української історії та літератури ці сторінки, вони збереглися в повернутих із забуття художніх текстах.
MILITARY FICTION FOR CHILDREN OF THE RUSSO-UKRAINIAN WAR AS A LITERARY FIELD
Authors: Кропивко І. , Буділова О.
Published: January 2024

Background. The phenomenon of military fiction for children had been on the margin of independent Ukraine’s scientific and social discourses before the outbreak of the Russo-Ukrainian war. Since 2014, writers and publishers have enhanced their activity in this area responding to the needs of the society, particularly to the necessity to explain to children in their language the processes they witness, to the desire to distract them from traumatic experiences or to use books as part of therapeutic intervention.

Purpose. To arrange the processes occurring in the Ukrainian literary space and connected with military fiction for children in 2014-2023.

Methods. The sociology of literature approaches have been utilized.

Results. To the major formants of the literary field of children’s military fiction belong social discourse and information produced by its actants: writers, publishers, literary experts and critics, literary bloggers, online literary platform teams etc., as well as all those interested (parents, children, character prototypes, scholars who help interpret literary works and ensure their appropriate psychological and emotional reception) who are related to literary product interpretation and consumption. Publishing houses’ effort towards filling free genre niches switches to active discussion of children’s books’ therapeutic and awareness-raising role under warfare (how to write it to avoid harming the traumatized child, how to better arrange the reception process, what tips to give to parents). Writers who tell the children about war update textual and receptive strategies. Literary platforms (Barabooka, Chytomo etc.) run discussions and events. Public attention is sustained via interviews with publishers and writers, literature overviews, updating on social media the information about the authors who fight, volunteer, take part in events, meet with children. Children themselves try their hand at creating book-trailers, writing reviews etc. The publishers expand young readers’ access to their products: books (ranging from regular paper books for “young adults” to graphic novels, comics, picture books, words-free books), audiobooks as well as animated movies created on their basis.

Conclusions and perspectives. Children’s war fiction has highlighted the angle of interdependence of literature and society, which is revealed in the cases of crisis and is connected with the social activity of the parties to the literary process. The use of sociology of literature techniques made it possible to analyze the impact of the literary field actants (writers, publishers, readers and all those interested) on the development of textual strategies, the interaction between literature and society, as well as to trace the match of literary texts to the social discourse and further on, to reflect on the impact of social development.
A Study on the Current Status of Education on Korean Speech Act of Greeting
Authors:   Research Institute of Education Science, Jeju National University, Lee Eun-Hee
Published: January 2024

Speech act of greeting is crucial in daily life, but Korean language learners often encounter difficulties due to the strong cultural characteristics reflected in the speech act of greeting. This study examines the characteristics of speech act of greeting, taking into account the elements of context of situation, and investigates how it is taught in Korean language education through the curriculum and textbooks.
The variables of the context of situation that are typically observed in speech act of greeting include the characteristics of the 'setting' where the conversation takes place and the 'participants' involved, which can be further divided into the 'relationship between the speaker and the listener' and the 'relationship of meeting '. This study explores the role of these variables in speech act of greeting.
By examining the position of the speech act of greeting within the Korean language education framework, focusing on the 'International Korean Standard Curriculum' and the 'Korean Standard Curriculum,' it is revealed that the speech act of greeting is presented in the first-level overarching goal, aimed at educating learners across different levels, incorporating the content of both the 'Functions and Tasks Area' and the 'Cultural Area.' However, the cultural area of speech act of greeting in the currently used textbooks, developed by the National Institute of the Korean Language, varies significantly depending on the textbook. Moreover, since it is primarily introduced at the beginner level, it may not fully align with the content prescribed in the curriculum.
A INTENSIFICAÇÃO DOS CONFLITOS DISTRIBUTIVOS NO BRASIL E O DESLOCAMENTO POLÍTICO EMPRESARIAL NO GOVERNO DILMA (2011-16)
Authors: Silva Hugo Fanton Ribeiro da , Oliveira Gabriel Nunes de
Published: January 2024

Resumo Este artigo discute o comportamento político dos empresários industriais brasileiros durante o Governo Dilma Rousseff (2011-16), a partir de dois estudos de caso de importantes setores: Construção Civil e Autopeças. Fundamentado na hipótese de que houve um deslocamento político do empresariado industrial desde o apoio em 2011 até a conformação de uma “unidade burguesa antidesenvolvimentista” em oposição ao governo, realizamos entrevistas semiestruturadas, levantamento de dados e de posicionamentos públicos. A análise corrobora a hipótese de deslocamento político no período, e aponta como uma das explicações o acirramento dos conflitos distributivos entre capital e trabalho, expresso nas declarações empresariais e nos aumentos da participação das remunerações no valor adicionado bruto e do número de greves.
ESCOLA SEM PARTIDO E O PROCESSO DE DESDEMOCRATIZAÇÃO NO BRASIL
Authors: Santos Rayani Mariano dos , Biroli Flávia
Published: January 2024

Resumo Este artigo analisa discursos pronunciados nas 31 reuniões e audiências públicas realizadas em 2017 e 2018, na Comissão Especial que apreciou o Projeto de Lei nº 7180, de 2014, conhecido como Projeto Escola Sem Partido. Nosso objetivo é verificar quais problemas são apresentados por seus defensores e como justificam as ações propostas. A análise de 265 manifestações individuais de parlamentares e convidados permitiu identificar a suposta ideia de doutrinação dos estudantes como o principal problema apontado. Nosso ponto de partida é o debate teórico sobre desdemocratização, com destaque para análises que discutem a privatização como forma de captura do público e do coletivo, assim como a expansão de formas de controle autoritário das condutas.Em diálogo com elas, analisamos as evidências empíricas, organizando os discursos em três frentes, que correspondem ao conjunto de ações apontadas pelos defensores do Escola Sem Partido (ESP) para barrar a “doutrinação”: (1) a expansão do privado em detrimento do público; (2) a censura de pautas e atores; e (3) a retração do compromisso estatal com agendas igualitárias. Concluímos que estes são elementos que constituem o processo de desdemocratização do ensino no país.
DIREITO INACESSÍVEL: PESSOAS COM DEFICIÊNCIA E ELEIÇÕES NO BRASIL
Authors: Piccolo Gustavo Martins , Mendes Enicéia Gonçalves
Published: January 2024

Resumo Este artigo realiza uma revisão teórica e uma análise empírica para investigar como se manifesta a participação das pessoas com deficiência no processo eleitoral brasileiro, desde o exercício do voto até o registro de candidaturas e ocupação de postos eletivos. Além disso, parte do suposto de que a consecução deste direito é basilar na produção de agendas públicas nacionais, que levem em conta os preceitos da inclusão como princípio inegociável. A coleta e análise dos dados se deu por meio dos números consolidados pelo Tribunal Superior Eleitoral (TSE), relacionando estes à pesquisas desenvolvidas em outros países. Por fim, destaca o caráter imperioso na criação de mecanismos que alavanquem o número de candidaturas de pessoas com deficiência como catalisador de uma sociedade justa e inclusiva.
Estado e acumulação de capital na saúde brasileira sob a ótica da Teoria Marxista da Dependência
Authors: Rodrigues Paulo Henrique de Almeida , Mattos Arthur Lobo Costa , Monteiro Nercilene Santos da Silva , Silva Roberta Dorneles Ferreira da Costa , Baldo Valentina Sofía Suárez
Published: January 2024

Resumo: O setor de saúde constitui um dos maiores campos de desenvolvimento econômico, social, científico e tecnológico do Brasil e tem sido arena de disputa entre os interesses capitalistas, que entendem a saúde como bem de mercado, e os defensores do acesso universal, que a entendem como bem essencial. No Brasil, a Constituição Federal de 1988 determinou que a saúde é direito de todos e dever do Estado, e, desde então, o país avança com a política pública, mas sofre recuos e bloqueios pela condição de país de economia periférica, historicamente subordinado aos interesses dos países centrais, que o veem como um amplo mercado consumidor. Esses interesses externos, associados à burguesia interna, têm obtido vantagens do Estado brasileiro desde a década de 1960, quando a formação de grupos empresariais se expandiu, dominando diversos segmentos da saúde, sobretudo a partir de políticas neoliberais dos anos de 1990. Esses aspectos são muito explorados nas publicações do campo da Saúde Coletiva, mas este texto busca uma nova abordagem, utilizando a Teoria Marxista da Dependência como referência para analisar, ainda que de forma preliminar, a situação de dependência política, econômica e tecnológica que tem distanciado a política de saúde dos ideais de um sistema público e universal, defendido na Reforma Sanitária brasileira.
Implementação de tecnologias em saúde no Brasil: análise de orientações federais para o sistema público de saúde
Authors: Silva Sarah Nascimento , Mello Nicole Freitas de , Ribeiro Laís Raquel , Silva Rosiana Estéfane da , Cota Gláucia
Published: January 2024

Resumo O objetivo foi identificar o arcabouço regulatório e as orientações federais que sustentam o processo de implementação de tecnologias em saúde no Sistema Único de Saúde (SUS), por meio da análise de documentos e legislações relacionados à Política Nacional de Gestão de Tecnologias de Saúde, publicados entre 2009 e 2021. Foi realizada busca e seleção dos documentos e posterior extração de dados, agrupados por três categorias: normativas estruturantes, recomendações na avaliação de tecnologias e recomendações nas diretrizes clínicas. Em 38,8% das normativas, foram identificadas citações à implementação relacionadas principalmente às diretrizes clínicas do SUS, mas nenhum documento dedicado a orientar as ações de implementação. As recomendações relacionadas às implementações foram identificadas em 27,1% dos relatórios e em 66,1% das diretrizes, mas sem padronização e, de modo geral, pouco detalhadas, com foco em recursos e ações necessárias para a disponibilização da tecnologia, ao invés de métodos e intervenções para implementação. Os resultados confirmam a existência de uma lacuna de diretrizes formais para guiar o processo de implementação no Brasil, o que se constitui em oportunidade para o desenvolvimento de modelos alinhados à realidade do SUS.
Rate and direct medical costs of cesarean sections among supplementary health plan holders living in the state of São Paulo, Brazil: 2015-2021
Authors: Silva Rildo Pinto da , Pazin-Filho Antonio
Published: January 2024

Abstract Brazil has the second largest cesarean section rate in the world. Differences in rates exist between the public and private health sectors. This study used data on admissions of supplementary health plan holders aged between 10 and 49 years living in the state of São Paulo admitted between 2015 and 2021 to determine cesarean section rates and costs in the private health sector. We conducted a partial economic analysis in health from a supplementary health perspective focusing on the direct medical costs of admissions. A total of 757,307 admissions were analyzed with total costs amounting to R$7.701 billion. The cesarean section rate over the period was 80%. Rates were lowest in young women (69%) and highest in the oldest age group (86%), exceeding 67% across all groups. The rate was 71% higher than in public services. The proportion of admissions with use of the intensive care unit was higher among cesarian deliveries. The median cost of a cesarean was 15% higher than that of a normal delivery and twice as high in insurance companies than healthcare cooperatives. There is an opportunity to apply policies that are widely used in public services to the private sector with the aim of reducing cesarean rates in private services, direct costs of admission, and the cost of supplementary health plans.
Ação política em saúde de pessoas trans em Manaus, Amazonas, Brasil
Authors: Neves André Luiz Machado das , Sívori Horacio Federico
Published: January 2024

Resumo O objetivo deste artigo é compreender o repertório de formas de ação política mobilizadas na construção das políticas públicas de saúde para travestis e transexuais em Manaus, Amazonas. A pesquisa etnográfica que sustenta este estudo combinou observação participante nos múltiplos espaços onde as políticas de saúde se gestam e entrevistas com membros de duas organizações trans existentes em Manaus, entre janeiro de 2016 e julho de 2018. Reconstruiu-se quatro formas de ação mobilizadas na luta por políticas de saúde, classificadas conforme algumas categorias nativas, a modo de tipos ideais: as de confronto, de articulação, de visibilidade e de colaboração, tendo a sociedade manauara como público e agentes do Judiciário, do Legislativo e do Executivo municipal e estadual, por vezes, como adversários, ou como aliados.
A literacia em saúde no ChatGPT: explorando o potencial de uso de inteligência artificial para a elaboração de textos acadêmicos
Authors: Peres Frederico
Published: January 2024

Resumo O presente estudo buscou conhecer as principais características das respostas geradas pela ferramenta ChatGPT a consultas sobre um tema emergente na literatura acadêmica de língua portuguesa - a literacia em saúde -, assim como discutir de que forma tais evidências podem contribuir para uma melhor compreensão sobre os limites e os desafios relacionados ao uso de Inteligência Artificial (IA) para a construção do conhecimento acadêmico. Trata-se de um estudo descritivo e exploratório, baseado em consultas ao ChatGPT, a partir de cinco perguntas disparadoras, feitas em sequência, nas línguas portuguesa (Brasil) e inglesa, com níveis de complexidade linguística crescentes. A análise dos resultados evidenciou uma ampla perspectiva para o uso de tecnologias baseadas em IA, como o ChatGPT, uma ferramenta disponibilizada de forma ampla e irrestrita, com uma interface intuitiva e simples, que se mostrou capaz de gerar textos coerentes, estruturados, em linguagem natural. Considerando o fenômeno do produtivismo acadêmico, associado a uma tendência crescente de má conduta profissional, sobretudo o plágio, coloca-se necessidade de um olhar ainda mais cuidadoso sobre o processo de produção e divulgação do conhecimento científico mediado por tecnologias de IA.
Health literacy in ChatGPT: exploring the potential of the use of artificial intelligence to produce academic text
Authors: Peres Frederico
Published: January 2024

Abstract The aim of this study was to identify and analyze the main constituent elements of text generated by ChatGPT in response to questions on an emerging topic in the academic literature in Portuguese - health literacy - and discuss how the evidence produced can contribute to improving our understanding of the limits and challenges of using artificial intelligence (AI) in academic writing. We conducted an exploratory descriptive study based on responses to five consecutive questions in Portuguese and English with increasing levels of complexity put to ChatGPT. Our findings reveal the potential of the use of widely available, unrestricted access AI-based technologies like ChatGPT for academic writing. Featuring a simple and intuitive interface, the tool generated structured and coherent text using natural-like language. Considering that academic productivism is associated with a growing trend in professional misconduct, especially plagiarism, there is a need too take a careful look at academic writing and scientific knowledge dissemination processes mediated by AI technologies.
Parturientes adolescentes em Cruzeiro do Sul, Acre, Brasil: características socioeconômicas e obstétricas
Authors: Damasceno Ana Alice de Araújo , Cardoso Marly Augusto , Cardoso Marly Augusto , Matijasevich Alicia , Lourenço Bárbara Hatzlhoffer , Abanto Jenny , Malta Maíra Barreto , Ferreira Marcelo Urbano , Neves Paulo Augusto Ribeiro , Damasceno Ana Alice , Silva Bruno Pereira da , Souza Rodrigo Medeiros de , Ladeia-Andrade Simone , Castro Márcia Caldas de
Published: January 2024

Resumo O objetivo do estudo foi investigar as características socioeconômicas e obstétricas de parturientes adolescentes e suas complicações sobre a saúde materna e neonatal. Trata-se de uma análise de dados da linha de base da coorte de nascimentos MINA-Brasil conduzida no município de Cruzeiro do Sul, estado do Acre. Utilizou-se teste qui-quadrado para comparar características das puérperas adolescentes com as adultas e modelos múltiplos de regressão de Poisson com variância robusta para avaliar fatores associados. Entre as puérperas estudadas, 26,2% (IC95%: 24,0-28,4) eram adolescentes. Os fatores associados ao parto na adolescência foram ter nove anos ou menos de estudo (RPaj:1,36; IC95%: 1,14-1,61), pertencer aos menores quartis do índice de riqueza (1° quartil: RPaj:1,40; IC95%: 1,08-1,80) (2° quartil: RPaj:1,37; IC95%: 1,08-1,74), ser primigesta (RPaj:3,69; IC95%: 2,98-4,57), baixo IMC pré-gestacional (RPaj:1,28; IC95%: 1,04-1,57), infecção urinária na gravidez (RPaj:1,25; IC95%: 1,07-1,46) e menos de seis consultas de pré-natal (RPaj:1,42; IC95%: 1,21-1,66). Pobreza, baixa escolaridade, primigestação, baixo IMC pré-gestacional, infecção urinária na gestação e menor número de consultas de pré-natal foram associados ao parto na adolescência em município da região Norte do Brasil.
Uso de prontuário eletrônico e parâmetros de acesso e acolhimento segundo dados do terceiro ciclo do PMAQ-AB
Authors: Valdes Gabriel , Souza Albert Schiaveto de
Published: January 2024

Resumo O uso de prontuários eletrônicos (PE) na atenção primária em saúde (APS) visa maior integração e qualidade dos serviços. Um dos pontos mais críticos da APS brasileira segue sendo o acesso. O objetivo deste artigo é analisar através dos dados do terceiro ciclo avaliativo do Programa de Melhoria do Acesso e Qualidade da Atenção Básica (PMAQ-AB) a relação entre o uso de prontuário eletrônico e os parâmetros de acesso e acolhimento das unidades participantes. Estudo transversal analítico com dados secundários. Foram avaliados dados provenientes de 38.865 equipes de atenção primária, 30.346 unidades de saúde e 140.444 usuários entrevistados. O uso de PE esteve associado a maior realização de atendimento à demanda espontânea (OR 1,664; IC95% 1,485-1,866), avaliação de risco e vulnerabilidade (OR 1,329; IC95% 1,122-1,574) e utilização de protocolos de conduta (OR 1,656; IC95% 1,530-1,793), além de maior possibilidade de agendamento por telefone (OR 3,179; IC95% 3,030-3,335). Serviços que utilizam PE tem maior chance de ser o primeiro contato dos pacientes (OR 1,226; IC95% 1,171-1,283) e de serem buscados quando o usuário tem problemas de urgência (OR 1,198; IC95% 1,161-1,236). Há uma possibilidade concreta de melhoria do acesso através da informatização.
Use of electronic health records and primary health care accessibility according to data from the third cycle of the PMAQ-AB
Authors: Valdes Gabriel , Souza Albert Schiaveto de
Published: January 2024

Abstract The use of electronic health records (EHR) in primary healthcare (PHC) aims for better integration of services and care quality. One of most the critical points of Brazilian PHC is access. This article aims to analyze, through data from the third evaluation cycle of the Brazilian Program for Improving Access and Quality of Primary Care (PMAQ-AB), the relationship between the use of electronic health records and the parameters of access of the participant teams. Cross-sectional analytical study with secondary data. Data from 38,865 primary care teams, 30,346 health units and 140,444 interviewed users were evaluated. The use of EHR was associated with greater care for non-programmed demands (OR 1.664; 95%CI 1.485-1.866), risk and vulnerability assessment (OR 1.329; 95%CI 1.122-1.574) and use of protocols for clinical conducts (OR 1.656; 95%CI 1.530-1.793), in addition to a greater possibility of scheduling consultation by telephone (OR 3.179; 95%CI 3.030-3.335). Services using EHR are more likely to be the patients first contact (OR 1.226; 95%CI 1.171-1.283) and to be sought when facing urgent health problem (OR 1.198; 95%CI 1.161-1.236). The results point to a concrete possibility of improving access through computerization.
Trends in the quality of child health care in the first week of life in primary care services in Brazil
Authors: Flores-Quispe María del Pilar , Duro Suele Manjourany Silva , Facchini Luiz Augusto , Barros Nicole Borba Rios , Tomasi Elaine
Published: January 2024

Abstract The aim of this study was to assess temporal trends in the quality of health care during the first-week child check-up in primary care services stratified by municipal, health team and maternal characteristics. We conducted a cross-sectional study using data from the three cycles of the National Program for the Improvement of Access and Quality (PMAQ) (2012, 2014 and 2018). Adult service users with children aged up to 2 were interviewed. The outcome was “good quality health care in the first week of life”. Descriptive and time trend analyses were performed using variance-weighted least squares regression. The frequency of good quality care during the first-week check-up was 47.9% (95%CI 46.6-49.3) in 2012, 52.5% (95%CI 51.3-53.7) in 2014 and 53.3% (95%CI 52.2-54.4) in 2018, with an annual increase of 0.73 pp (p<0.001). The annual increase was greater in the Northeast (2.06 pp) and in municipalities with very low/low HDI (1.48 pp) and 100% family health strategy coverage (0.98 pp). Trends in the frequency of good quality health care during the first-week child check-up were favorable.
Food patterns associated with overweight in 7-11-year old children: machine-learning approach
Authors: Kupek Emil , Liberali Rafaela
Published: January 2024

Abstract Longitudinal study, whose objective was to present a better strategy and statistical methods, and demonstrate its use with the data across the 2013-2015 period in schoolchildren aged 7 to 11 years, covered with the same food questionnaire (WebCAAFE) survey in Florianopolis, southern Brazil. Six meals/snacks and 32 foods/beverages yielded 192 possible combinations denominated meal/snack-Specific Food/beverage item (MSFIs). LASSO algorithm (LASSO-logistic regression) was used to determine the MSFIs predictive of overweight/obesity, and then binary (logistic) regression was used to further analyze a subset of these variables. Late breakfast, lunch and dinner were all associated with increased overweight/obesity risk, as was an anticipated lunch. Time-of-day or meal-tagged food/beverage intake result in large number of variables whose predictive patterns regarding weight status can be analyzed by machine learning such as LASSO, which in turn may identify the patterns not amenable to other popular statistical methods such as binary logistic regression.
Evolução das desigualdades na distribuição de dentistas no Brasil
Authors: Bleicher Lana , Cangussu Maria Cristina Teixeira
Published: January 2024

Resumo O objetivo deste artigo é analisar a evolução da distribuição de dentistas e cursos de graduação em odontologia no Brasil entre 1960 e 2022, a partir de dados institucionais e de sua correlação com dados econômicos e demográficos. Foram calculadas as proporções entre número de dentistas e população para as unidades federativas em diferentes períodos, e para determinar a concentração de dentistas, da população e dos cursos de graduação em odontologia,foi utilizado o índice Herfindahl-Hirschman (HHI). Para testar a correlação entre variáveis foi empregado o teste de Pearson, com um nível de significância de 95%. Entre 1960 e 2022, a proporção de dentistas por 10 mil habitantes aumentou de 3,3 para 16,9. Ainda em 2022, as unidades federativas com maior renda média domiciliar per capita estavam fortemente correlacionadas à maior concentração de dentistas (R2 = 0,90; p < 0,00). Entretanto, de 1975 a 2022, a concentração de dentistas medida pelo HHI caiu de 45,1 para 33,4. A diminuição da concentração geográfica dos cursos de odontologia foi ainda mais pronunciada, tendo o HHI passado de 39,3 em 1991 para 25,6 em 2022.