Research on Ethical Governance of "BRAIN Initiative" in the United States / 中国医学伦理学

With the implementation of the "BRAIN initiative" in various countries, neuroethical governance has become an important concern of the international community. After ten years of development, the "BRAIN initiative" in the United States has formed a relatively complete ethical governance system. By interpreting the strategic report of the "BRAIN initiative" in the United States, analyzing its basic framework of ethical governance, dissecting its governance practice mechanism, and conducting research from the aspects of top-level design and construction, regulatory model innovation, promoting public participation, enhancing international dialogue, and improving soft and hard regulations, this paper provided some reference and thoughts for the ethical governance of the "BRAIN initiative" in China.

Mechanism and enlightenment of public participation in the NICE health technology assessment in England / 中国药房

OBJECTIVE To analyze the public participation mechanism of National Institute for Health and Care Excellence （NICE） health technology assessment in England and to provide experience for the dynamic adjustment of Chinese medical insurance catalog. METHODS By retrieving related literature and official websites， types and mechanisms of public participation （management organization， selection method， participation mode， evaluation feedback） in NICE health technology assessment were analyzed comprehensively； and based on this， suggestions were put forward to adjust the public participation in Chinese medical insurance catalog. RESULTS & CONCLUSIONS The current public participation types of NICE health technology assessment were patient and carer organizations， HTA committee lay members， patient expert and public observers. At the management level， NICE has set up a public participation team and made guidelines on public participation matters. For different public participation types， NICE has established different selection procedures， such as expression of interest， NICE invitation， open recruitment， nomination， NICE decision， etc. The public participation types are various and in the whole assessing process from the initial determination of the scope of the health technology assessment to the final appeal. Also， NICE has established a flexible and dynamic evaluation feedback system to optimize the way of public participation and the health technology assessment process； NICE has undertaken extensive international cooperation and exchanges to promote public participation at the national and international levels. It is suggested that our country should combine the national conditions， clarify the channel of public participation in health technology evaluation， set up a working group of public participation affairs， strengthen patients’ participation in evaluation and feedback， improve decision-making transparency， and improve the public participation mechanism of health technology evaluation from the aspects of channel opening， management mechanism， evaluation feedback， information disclosure and so on.

Participação social e educação popular em saúde: espaços possíveis de diálogo na forma de uma ouvidoria coletiva / Public participation and popular health education: potential spaces for dialogue in the form of a collective ombudsman / Participación social y educación popular en salud: espacios posibles de diálogo en la forma de una defensoría colectiva

Este trabalho relata a experiência de um projeto de pesquisa e extensão no âmbito da participação social e da educação popular em saúde, realizado na comunidade de Roda de Fogo, Recife, PE, entre 2019 e 2021. Tem como objetivo descrever como se deu essa experiência, apontar seus resultados e identificar suas potencialidades e desafios. Para a sistematização dos dados, utilizamos gravações, cadernos de campo e atas de reunião do projeto. Ao revisitar todo o material, foi possível ratificar o importante trabalho realizado pela ouvidoria coletiva no âmbito da formação dos estudantes, da participação dos moradores e da interlocução com diversos setores da máquina pública, que, juntos, visaram uma maior compreensão dos inúmeros desafios enfrentados pelos territórios mais empobrecidos. Entretanto, verificamos que as discussões no âmbito do projeto tenderam a se encaminhar para necessidades imediatas, o que comprometeu o sentido político da participação social.(AU)

This article recounts the experiences of a research and extension project in the area of public participation and popular health education developed between 2019 and 2021 in a community called Roda de Fogo in Recife, the capital of the state of Pernambuco, Brazil. We describe the experiences, outline the main results and identify strengths and challenges. The data were collected using recordings, field diaries and project meeting minutes. The findings reveal the importance of the work carried out by the collective ombudsman for student training, community participation and engagement with various sectors of the public sector apparatus, which together aimed to promote better understanding of the numerous challenges faced in poor areas. However, we found that project discussions tended to focus on immediate need, compromising the political meaning of public participation.(AU)

Este trabajo relata la experiencia de un proyecto de investigación y extensión en el ámbito de la participación social y de la educación popular en salud, realizado en la comunidad Roda de Fogo/Recife/Estado de Pernambuco, entre 2019 y 2021. Su objetivo es describir cómo se realizó esa experiencia, señalar sus resultados e identificar sus potencialidades y desafíos. Para la sistematización de los datos utilizamos grabaciones, cuadernos de campo y actas de reunión del proyecto. Al revisitar todo el material, fue posible ratificar el importante trabajo realizado por la defensoría colectiva en el ámbito de la formación de los estudiantes, de la participación de los moradores y de la interlocución con diversos sectores de la máquina pública que, en conjunto, tuvieron como objetivo una mayor comprensión de los innumerables desafíos enfrentados por los territorios más empobrecidos. No obstante, verificamos que las discusiones en el ámbito del proyecto tendieron a dirigirse hacia necesidades inmediatas, lo que comprometió el sentido político de la participación social.(AU)

Moradores de áreas rurais de municípios mineiros endêmicos para a doença de Chagas: ideias e concepções sobre a doença, os vetores e os serviços de saúde / Residents of rural areas in municipalities of Minas Gerais endemic for Chagas disease: their ideas and conceptions about the disease, vector, and health services

Resumo Introdução A vigilância da doença de Chagas (DC), baseada na participação popular, ocorre por meio da detecção e notificação de insetos suspeitos de serem vetores da DC aos Postos de Informação de Triatomíneos (PITs). Objetivo Compreender as ideias e concepções dos moradores em áreas rurais dos municípios da Microrregião de Saúde de Itaúna (MSI) em relação a aspectos relacionados à DC, seus vetores e serviços de saúde. Método Em 2016, foram realizados quatro grupos focais nos municípios da MSI. Esses grupos focais foram gravados, transcritos e analisados utilizando a técnica de análise de conteúdo. Neste processo, identificamos e categorizamos unidades de análise tanto dentro de cada grupo focal quanto entre eles. Resultados Descobrimos que há compreensão por parte de alguns moradores sobre a natureza da transmissão da DC, as características morfológicas e hábitos dos vetores, o encaminhamento do vetor para os PITs e o diagnóstico da DC. Também encontramos relatos da ausência de intervenções educacionais e de saúde relacionadas à DC. Conclusão Compreender as concepções e ideias sobre a DC das populações em áreas endêmicas é fundamental para desenvolver futuras estratégias envolvendo a participação popular.

Abstract Background The surveillance of Chagas disease (CD) based on public participation is carried out through the detection and notification of insects suspected of being vectors of CD to Triatomine Information Posts (TIPs). Objective To understand the ideas and conceptions of residents in rural areas of the municipalities of the Micro-region of Health de Itaúna (MHI) regarding aspects related to CD, its vectors, and health services. Method In 2016, four focus groups were conducted in the municipalities of MHI. These focus groups were recorded, transcribed, and analyzed using the content analysis technique. In this process, units of analysis, both within each focus group and between them, were identified and categorized. Results It was found that some residents have a good understanding of the nature of CD transmission and of the morphological characteristics and habits of the vectors, in addition to an understanding of the forwarding of the vector to TIPs, and the diagnosis of CD. Reports of the absence of education and health interventions related to CD were also found. Conclusion Understanding the conceptions and ideas about CD of populations in endemic areas is fundamental to developing future strategies involving public participation.

Circulação cotidiana e uma práxis terapêutico-ocupacional social / Circulación cotidiana y una praxis terapéutico-ocupacional social / Everyday circulation and social occupational therapy praxis

Há uma ampla análise marxista sobre a vida cotidiana como núcleo da práxis humana. Um aspecto substancial do cotidiano é a circulação, movimento que promove o trânsito pelos territórios sociopolíticos, constituindo o que denominamos como "circulação cotidiana". Essa dimensão da vida acontece na dialética social e pode ser compulsória (reduzida aos mecanismos de manutenção da opressão e do status quo) ou emancipatória (ligada ao desejo, à autonomia, ao alargamento das alternativas e à democratização da sociedade e de seus bens sociais). Defende-se que o terapeuta ocupacional social faça uso teórico-metodológico desses conceitos, desenvolvendo estratégias para a promoção da circulação cotidiana emancipatória junto a sujeitos, individuais e coletivos, cujas vidas são perpassadas por barreiras materiais e imateriais, favorecendo a experiência e o acesso dos mesmos aos territórios de vida, contemplando criação, prazer e consciência - ampliando a cidadania e a participação social. (AU)

Hay un amplio análisis marxista sobre la vida cotidiana como núcleo de la praxis humana. Un aspecto substancial del cotidiano es la circulación, movimiento que promueve el tránsito por los territorios sociopolíticos, constituyendo lo que denominamos de "circulación cotidiana". Esa dimensión de la vida sucede en la dialéctica social y puede ser obligatoria (reducida a los mecanismos de mantenimiento de la opresión y del statu quo) o emancipadora (vinculada al deseo, a la autonomía, al ensanchamiento de las alternativas y a la democratización de la sociedad y de sus bienes sociales). Se defiende que el terapeuta ocupacional social haga un uso teórico-metodológico de esos conceptos, desarrollando estrategias para la promoción de la circulación cotidiana emancipadora con sujetos, individuales y colectivos, cuyas vidas están atravesadas por barreras materiales e inmateriales que favorecen la experiencia y el acceso de ellos a los territorios de la vida, incluyendo creación, placer y conciencia, ampliando la ciudadanía y la participación social. (AU)

Marx provides a wide-ranging analysis of everyday life as the core of human praxis. An important aspect of everyday life is circulation, movement that promotes transit through sociopolitical territories, constituting what we call "everyday circulation". This aspect of life is played out within the social dialectic and can be compulsory (reduced to mechanisms that maintain oppression and the status quo) or emancipatory (linked to desire, autonomy, broadening alternatives and the democratization of society and social goods). We defend that social occupational therapists make theoretical and methodological use of these concepts, developing strategies to promote emancipatory everyday circulation with subjects, individuals and groups whose lives are pervaded by material and immaterial barriers, facilitating the experience of and access to territories of life, encompassing creation, pleasure and awareness - thus strengthening citizenship and public participation. (AU)

A mineração de urânio em questão: análise da comunicação pública das Indústrias Nucleares do Brasil (INB) em Caetité, Bahia / Questioning uranium mining: an analysis of the public communication stated by Indústrias Nucleares do Brasil (INB) in Caetité, Bahia / La minería de uranio en cuestión: un análisis de la comunicación pública transmitida por la INB (Indústrias Nucleares do Brasil) en Caetité, Bahia

O objetivo deste artigo é discutir, através de análise de conteúdo, as estratégias de comunicação pública adotadas pelas Indústrias Nucleares do Brasil no 'Espaço INB', um centro de informações localizado na cidade baiana de Caetité, onde a empresa realiza a mineração e o beneficiamento de urânio. Desde que foram iniciadas, essas atividades levantaram inúmeras suspeitas de danos ambientais e problemas de saúde pública. Diante disso, buscamos compreender como a INB se posiciona diante dessas suspeitas e se relaciona com as populações atingidas por suas atividades. De acordo com nosso argumento, ao adotar uma postura que denominamos tecnoentusiasta e tecnocrática, a empresa dificulta um debate público aberto e descentralizado sobre as controvérsias em torno da mineração de urânio

This article aims to use the content analysis to discuss the public communication stated by the 'Espaço INB', an information center managed by Indústrias Nucleares do Brasil located in the city of Caetité ­ BA, where the company mines and processes uranium. Since INB started its activities in Caetité, several suspicions of environmental damage and public health problems emerged. Thus, we analyze how INB responds to these suspicions and relates to the populations affected by its activities. We argue that INB adopts an attitude that we call techno-enthusiastic and technocratic, hindering an open public and decentralized debate about the controversies surrounding uranium mining.

El objetivo de este artículo es discutir, a través del análisis de contenido, la comunicación pública transmitida por el 'Espaço INB', un centro de información administrado por Indústrias Nucleares do Brasil ubicado en la ciudad de Caetité/Bahia, donde la empresa hace la mínería y el procesamiento del uranio. Desde que comenzaron, estas actividades han generado numerosas sospechas de daños ambientales y problemas de salud pública. Por eso, analizamos como el INB contesta estas sospechas y se relaciona con las poblaciones afectadas por sus actividades. Argumentamos que el INB adopta una actitud que llamamos tecno-entusiasta y tecnocrática, lo que dificulta un debate público abierto y descentralizado sobre las controversias respecto a la minería de uranio.

The value and realization path of public participation in national public health emergency management system / 预防医学

@#Public participation is an indispensable link in the public health emergency management system, as well as a dynamic factor and a cornerstone. It undertakes the functions of early warning, emergency response and publicness maintenance, so that it values in improving the effectiveness of public health emergency management. The main paths to realize the value of public participation in the public health emergency management system are to be the gatekeepers of public health early warning and surveillance, the participants of the management and support of public health emergency prevention and control. It is a complex system to establish and improve the national public health system. Our society should pay attention to and give full play to the value of public participation.@*@#@*@#

Participación ciudadana en los comités éticos institucionales de investigación clínica y asistenciales de Cataluña / Participation of civilians in Catalonian clinical research and health care institutional ethical review committees / Participação dos cidadãos na pesquisa clínica institucional das comissões éticas e cuidado na Catalunha

Resumen: Objetivo: Conocer el nivel de participación de pacientes, usuarios y ciudadanos en los comités de ética de la investigación (CEI) y los comités de ética asistencial (CEA) acreditados en Cataluña. Material y métodos: Estudio descriptivo transversal en una muestra oportunista de 30 CEI y CEA. Se administró un cuestionario dirigido a los presidentes y al representante de los usuarios o ciudadanos (miembro lego). Para la interpretación de los resultados se analizó medias y desviación estándar. Las respuestas a las preguntas de texto abierto se analizaron mediante un análisis cualitativo del contenido. Resultados: Del total de los 30 comités de ética (CEI y CEA) contactados, 12 (40%) aceptaron participar. En total se realizaron 15 entrevistas (9 miembros de CEI y 6 miembros de CEA): 8 presenciales, 4 telefónicamente y 3 contestadas por correo electrónico. Resultados de los CEI: del total de 7 CEI entrevistados, 2 tenían representación ciudadana en su comité. El perfil correspondía a una mujer, de profesión administrativa y a un hombre de profesión auditor contable, ambos de más de 50 años. Resultados de los CEA: de los 5 CEA que participaron, 2 declararon tener representación de la ciudanía. El perfil correspondía a una mujer, de profesión administrativa y a un hombre de profesión profesor, ambos de más de 50 años. Discusión: Actualmente hay poca representación de la ciudadanía/pacientes en los comités éticos institucionales. Constituye un tema actual de debate la necesidad de incorporar el punto de vista del ciudadano/paciente, habiendo, sin embargo, un desconocimiento sobre el perfil más idóneo y en discusión su representatividad.

Abstract: Aim: To know the level of participation of patients, users and civilians in scientific ethical review committees (SERC) and health care ethical review committees (HCERC) accredited in Catalonian. Materials and methods: Descriptive transversal study using an opportunistic sample of 30 SERC and HCERC. A questionnaire was filled out addressed to presidents and consumer or civilian (lay member) representatives. For the interpretation of results means and standard deviations were analyzed. Answers to open texts questions were analyzed using qualitative content analysis. Results: 12 committees (40%) accepted to participate; 15 interviews were carried out (9 SERC members and 6 HCERC members): 8 person to person, 4 by phone and 3 by email. SERC Results: Of 7 SERC interviewed, 2 have a civilian representative in the committee. The profile was a woman of administrative profession and an auditor accountant man, both older than 50 years. HCERC Results: Of 5 HCERC participating, 2 declared having a civilian representative. The profile was a woman of administrative profession and a man teacher, both older than 50 years. Discussion: Currently, there is low civilian/patient representation in institutional ethical review committees. Today, the need to incorporate the point of view of the civilian/patient is a debatable issue, being unknown the suitable profile and their representativeness is under discussion.

Resumo: Objetivo: Conhecer o nível de participação de pacientes, usuários e cidadãos em comitês de ética de pesquisa (CEI) e as comissões de ética de cuidados de saúde (CEA) acreditados na Catalunha. Material e métodos: Estudo descritivo, transversal em uma amostra oportunista de 30 CEI e CEA. Um questionário dirigido aos presidentes e representante dos usuários ou cidadãos (membro de leigo) foi administrado. Para a interpretação dos resultados foi feita uma análise que incluiu as médias e o desvio-padrão. Analisaram-se as respostas às perguntas do texto aberto com uma análise qualitativa do conteúdo. Resultados: Do total dos 30 comitês de ética (CEI e CEA) contatados, 12 (40%) concordaram em participar. No total foram realizadas 15 entrevistas (9 membros do CEI e 6 membros da CEA). De todas as entrevistas realizadas, 8 foram presenciais, 4 foram realizadas por telefone e 3 foram respondidas por e-mail. Resultados da CEI: do total de 7 entrevistados da CEI, 2 tinham representação cidadã na sua Comissão. O perfil correspondia a uma mulher, de carreira administrativa e a um home de profissão auditor contábil, ambos com mais de 50 anos. Resultados da CEA: dos 5 CEA que participaram, 2 declararam ter representação cidadã. O perfil correspondente era de uma mulher, de carreira administrativa e a um homem professor, ambos com mais de 50 anos. Discussão: Atualmente há pouca representação dos cidadãos/pacientes em comitês de ética institucionais. A necessidade de incorporar o ponto de vista do cidadão/paciente constitui um tema atual de discussão, no entanto, falta conhecimento sobre o perfil mais adequado e discussão sua representatividade.

Citizen science participation in research in the environmental sciences: key factors related to projects' success and longevity

ABSTRACT The potential impacts of citizen science initiatives are increasing across the globe, albeit in an imbalanced manner. In general, there is a strong element of trial and error in most projects, and the comparison of best practices and project structure between different initiatives remains difficult. In Brazil, the participation of volunteers in environmental research is limited. Identifying the factors related to citizen science projects' success and longevity within a global perspective can contribute for consolidating such practices in the country. In this study, we explore past and present projects, including a case study in Brazil, to identify the spatial and temporal trends of citizen science programs as well as their best practices and challenges. We performed a bibliographic search using Google Scholar and considered results from 2005-2014. Although these results are subjective due to the Google Scholar's algorithm and ranking criteria, we highlighted factors to compare projects across geographical and disciplinary areas and identified key matches between project proponents and participants, project goals and local priorities, participant profiles and engagement, scientific methods and funding. This approach is a useful starting point for future citizen science projects, allowing for a systematic analysis of potential inconsistencies and shortcomings in this emerging field.

Factors Affecting the Insured Organizations Participation in Decision Making Process in Health Insurance Policy Committee / 보건행정학회지

BACKGROUND: Due to the asymmetry of information and knowledge and the power of bureaucrats and medical professionals, it is not easy for citizens to participate in health care policy making. This study analyzes the case of the insured organization participating in the Health Insurance Policy Committee (HIPC) and provides a basis for discussing methods and conditions for better public participation. METHODS: Qualitative analysis was conducted using the in-depth interviews with the participants and document data such as materials for HIPC meetings. Semi-structured interviews were conducted with purposively sampled six participants from organizations representing the insured in HIPC. The meanings related to the factors affecting participation were found and categorized into major categories. RESULTS: The main factors affecting participating in the decision making process were trust and cooperation among the participants, structure and procedure of governance, representation and expertise of participants, and contents of issues. Due to limited cooperation, participants lacked influence in important decisions. There was an imbalance in power due to unreasonable procedures and criteria for governance. As the materials for meetings were provided inappropriate manner, it was difficult for participants to understand the contents and comments on the meeting. Due to weak accountability structure, opinions from external stakeholders have not been well received. The participation was made depending on the expertise of individual members. The degree of influence was different depending on the contents of the issues. CONCLUSION: In order to meet the values of democracy and realize the participation that the insured can demonstrate influence, it is necessary to have a fair and reasonable procedure and a sufficient learning environment. More deliberative structure which reflects citizen's public perspective is required, rather than current negotiating structure of HIPC.

Democracia no SUS, como estamos? Um debate sobre a participação social a partir da literatura recente / Democracy at SUS (Sistema Único de Saúde - Unified Health System); how are we doing? A debate on social participation based on recent literature

O Sistema Único de Saúde (SUS) é forjado em meio ao paradigma de abertura democrática no Brasil na década de 80, no contexto de uma sociedade capitalista em transformação. Dentre os princípios organizativos do SUS, a participação da população consolida a expressão da manifestação democrática de um sistema de saúde, que tem sua construção em disputa desde meados da década de 1970. O referencial teórico da Democracia orientou esta pesquisa, que propõem, a partir de uma revisão sistemática da literatura, descrever e analisar o estado da arte da produção de conhecimento, ou seja, as práticas e discussões atuais acerca das experiências de participação social e Democracia nos espaços do Sistema Único de Saúde. Os estudos analisados demonstraram avanços na consolidação de práticas democráticas, nas instituições participativas do SUS, mas, também, apontaram uma série de desafios para que se alcance a efetiva atuação dos atores nos espaços de participação popular. Destaca-se, ainda, que os estudos têm se concentrado nas instituições participativas, com a ausência de produção sobre outras formas de participação popular. Observou-se, por fim, que a área da saúde tem incorporado poucas referências de outras áreas de conhecimento na análise sobre a participação social e a Democracia. (AU)

The Sistema Único de Saúde (SUS) (Unified Health System) is forged amid the paradigm of the democratic opening up in Brazil in the 1980s, in the context of a capitalist society undergoing transformation. Among the organizing principles of SUS, the participation of the people is the one that consolidates the expression of the democratic manifestation of a health system whose construction has been disputed since the 1970s. The theoretical background of democracy has oriented this research. The proposition with this article is to describe and analyze the state of the art in the production of knowledge based on a systematic review of literature, i.e., the current practices and discussions on the experiences of social participation and democracy in the platforms of the Unified Health System. The analyzed studies have shown progress in the consolidation of democratic practices in the participatory institutions of SUS, but have also indicated a series of challenges for the achievement of an effective performance by the players in the platforms of public participation. It is also to be noted that studies have been concentrating on the participatory institutions, with an absence of production on other forms of social participation. Also to be noted is the fact that the area of health has incorporated few of the references of other areas of knowledge in the analysis of social participation and democracy.(AU)

Analisando audiências públicas no licenciamento ambiental: quem são e o que dizem os participantes sobre projetos de usinas de cana-de-açúcar / Analyzing public hearings in environmental licensing: who are and what say the participants about sugarcane mill projects

Resumo Audiências públicas são o principal mecanismo para participação em processos de licenciamento ambiental no Brasil. Criadas para informar e ouvir o público, as audiências são criticadas por sua baixa capacidade de influenciar decisões, atribuída, entre outros fatores, à realização tardia no processo de licenciamento. Buscando explorar essa temática em um setor no qual a participação pública é pouco estudada, foi realizada análise documental de 25 audiências públicas de processos de licenciamento ambiental para implantação ou ampliação de usinas de cana-de-açúcar em São Paulo. A maioria dos 62 participantes que fizeram uso da palavra são cidadãos, seguidos de representantes do Poder Executivo e de representantes de entidades da sociedade civil. Quanto às características das falas, 50,9% foram afirmações/comentários, 15,2% ressaltaram aspectos positivos do projeto/empresa, 11,2% apresentaram questionamentos, 9,4% destacaram aspectos negativos, 5,4% apresentaram sugestões, 6,5% foram de endosso ao projeto e 1,4% de oposição. Quanto aos temas abordados, geração de emprego e renda e a reputação da empresa são os mais frequentes, destacados majoritariamente em seus aspectos positivos. Estes temas diferem daqueles destacados na literatura como relevantes para discutir os impactos da expansão da cana-de-açúcar, mostrando a diferença entre a apreciação popular e a técnico-científica dos impactos socioambientais.

Abstract Public hearings are the primary mechanism for public participation in Brazilian environmental licensing. Created to inform and listen to the public, the hearings are criticized for their low influence on decision-making, resulting, among other reasons, from its late occurrence in the licensing process. Seeking to explore the theme in a sector where public participation is not usually researched, this paper presents an analysis of 25 public hearings about the process of environmental licensing of sugarcane mills in the state of São Paulo, Brazil. Most of the 62 participants are citizens, followed by representatives of local governments and representatives of civil society organizations. Regarding the characteristics of speeches, 50.9% were statements/comments, 15.2% highlighted positive aspects of the project/company, 11.2% were questions, 9.4% highlighted negative aspects, 5.4% were suggestions; 6.5% were for endorsing the project, and 1.4% for opposing. As for themes, employment and income generation and the company's reputation are the most frequent, highlighted mainly for its positive aspects. These themes differ from those discussed in the literature as relevant for sugarcane expansion impact, showing a marked difference between citizens' and scientists' perspectives about its social and environmental consequences.

A Educação Ambiental como estratégia de mobilização social para o enfrentamento da escassez de água / Environmental Education as a social mobilization strategy to face water scarcity

Resumo O artigo 225 da Constituição Brasileira estabelece que todos os brasileiros têm direito ao meio ambiente ecologicamente equilibrado, como um bem de uso comum do povo e essencial à qualidade de vida saudável, impondo-se ao poder público e à coletividade o dever de defendê-lo e preservá-lo para as presentes e futuras gerações. Este artigo objetiva apresentar uma metodologia de mobilização para o enfrentamento da escassez dos recursos hídricos, tendo como pressuposto o Programa de Educação Ambiental e Mobilização Social em Saneamento (PEAMSS). Trata-se de um estudo orientado pelo método qualitativo do tipo bibliográfico documental, com caráter de pesquisa-ação, tendo a educação como propulsora da participação, mobilização e controle social sobre os recursos hídricos. Inicia-se pela abordagem teórica, a partir dos pressupostos da Educação Ambiental, continuamente com a apresentação do PEAMSS. Comentados e seguidos pela proposição do plano de ação. Conclui-se que o alcance e universalização dos direitos humanos à água e ao saneamento se darão somente com a gestão de águas de modo democrático e participativo. A partir deste estudo observou-se que são necessárias ações para avaliar o alcance do PEAMSS e para traçar novos caminhos para implementação do programa.

Abstract Article 225 of the Brazilian Constitution establishes that all citizens have the right to an ecologically balanced environment, as a common good that is essential for a healthy life, and that the government and society have the duty to protect and preserve the environment for present and future generations. This article outlines a methodology for promoting social mobilization to address water scarcity developed under the National Environmental Education and Social Mobilization for Sanitation Program (PEAMSS, acronym in Portuguese). The main aim of this article is to show the importance of education as a driving force for empowerment for water resources management. It outlines the main concepts of emancipatory environmental education and then goes on to describe the elaboration of a PEAMMS action plan. It concludes that the universalization of the right to safe and clean drinking water and access to sanitation is only possible through democratic and participatory water resources management. Actions are necessary to evaluate the reach of the PEAMSS and define the way ahead for the program.

Problems and Countermeasures of Public Participation in the Food and Drug Safety Administration in Chi-na / 中国药房

OBJECTIVE:To perfect public participation system of food and drug safety in China and establish“society multi-governance”of food and drug safety. METHODS:The problems of public participation in food and drug safety administration were analyzed in China. Referring to the experience of USA,Japan,South Korea and other developed countries in stage of food and drug safety legislative decision-making,regulation and enforcement and dispute settlement,the countermeasures were put forward to perfect public participation system of food and drug safety. RESULTS & CONCLUSIONS:The public is in a passive position and shows weak right of speech in legislative decision-making stage;the public is not active and shows weak awareness of partici-pating in management in regulation and enforcement stage;public interest litigation system in dispute settlement stage has not been established. Those problems impede the generation of“society multi-governance”of food and drug safety in China. In United States,Japan,South Korea and other developed countries,the position and right of the public participation can be guaranteed com-pletely through establishing complete legal system,strengthening government information transparency,improving complaints sys-tem and public interest litigation system,etc. Our country can perfect the system of public participation in the food and drug safety and promote the generation of“society multi-governance”of food and drug safety by detailing the regulations in legislative deci-sion-making,emphasizing the information opening and feedback,strengthening the propaganda of public responsibility conscious-ness,setting up scientific food and drug safety complaint and reparting system and establishing public interest litigation system.

Deliberative democracy in health care: current challenges and future prospects

Background: There is a vast body of literature on deliberative, participative, or engaged democracy. In the area of health care there is a rapidly expanding literature on deliberative democracy as embodied in various notions of public engagement, shared decision-making (SDM), patient-centered care, and patient/care provider autonomy over the past few decades. It is useful to review such literature to get a sense of the challenges and prospects of introducing deliberative democracy in health care. Objective: This paper reviews the key literature on deliberative democracy and SDM in health care settings with a focus on identifying the main challenges of promoting this approach in health care, and recognizing its progress so far for mapping out its future prospects in the context of advanced countries. Method: Several databases were searched to identify the literature pertinent to the subject of this study. A total of 56 key studies in English were identified and reviewed carefully for indications and evidence of challenges and/or promising avenues of promoting deliberative democracy in health care. Results: Time pressure, lack of financial motivation, entrenched professional interests, informational imbalance, practical feasibility, cost, diversity of decisions, and contextual factors are noted as the main challenges. As for the prospects, greater clarity on conception of public engagement and policy objectives, real commitment of the authorities to public input, documenting evidence of the effectiveness of public involvement, development of patient decision supports, training of health professionals in SDM, and use of multiple and flexible methods of engagement leadership suited to specific contexts are the main findings in the reviewed literature. Conclusion: Seeking deliberative democracy in health care is both challenging and rewarding. The challenges have been more or less identified. However, its prospects are potentially significant. Such prospects are more likely to materialize if deliberative democracy is pursued more systematically in the broader sociopolitical domains. (AU)

Participação popular na formação do comitê de equidade em saúde na cidade de Goiás, Goiás / Popular participation in the formation of health equity committee in the city of Goiás, Goiás / La participación popular en la formación del comité para la equidad en salud en la ciudad de Goiás, Goiás

A pesquisa teve por objetivos analisar a participação no processo de implementação dos Comitês de Equidade do SUS, após a roda de diálogos, na Cidade de Goiás, no Estado de Goiás, e verificar se a participação pode ser critério para o empoderamento dos sujeitos. Por meio de estudo de caso, a pesquisa buscou compreender como vem se constituindo a participação a partir da experiência desenvolvida no Projeto de Extensão 'Saberes, Fazeres e Sabores: práticas integrativas da Política Nacional de Educação Popular em Saúde e articulações no Centro-Oeste'. Foi realizada grupo focal com os participantes da Roda de Conversa. Os resultados indicam que a concepção de participação está relacionada à ideia de reunião de pessoas com interesses comuns e contribui para o exercício do direito à saúde. Entretanto, as características históricas e culturais do Estado de Goiás e da Cidade de Goiás foram apontadas como elementos limitantes para o desenvolvimento da participação popular e para o processo de constituição do Comitê de Equidade. Nesse sentido, a Roda de Conversa foi apontada como importante para o avanço da participação popular, por ser um espaço de aquisição de conhecimentos e informações e, portanto, adquire característica de espaço de formação sobre as questões relacionadas à saúde.

This research aimed to examine the participation in the implementation of the SUS ́s Equity Committees in the City of Goiás, in the state of Goiás, and verify if this participation can be criteria for the empowerment of individuals. Through a case study, the research sought to understand how the improvement of participation from the experience developed in the Extension Project "Knowledge, Doings and Flavors: integrating practices from the National Public Education in Health and relations in the Midwest". A focal group was conducted with participants through a round-table session. The results indicate that the concept of participation is related to the idea of meeting people with common interests and contribute to the exercise of the right to health. However, the historical and cultural characteristics of the state of Goiás and the City of Goiás were identified as limiting elements for the development of public participation and the process of establishment of the Equity Committee. In this sense, the round-table was identified as important to advancement of public participation, for being a moment of acquiring knowledge and information and thus securing discussions on training issues related to health.

Esta investigación tuvo como objetivo examinar la participación en la implementación de los Comités de renta variable del SUS en la ciudad de Goiás, en el Estado de Goiás que pudo verificar que la participación puede ser un criterio para el empoderamiento de los individuos. A través del estudio de casos, la investigación trató de entender cómo llegar a la participación de la experiencia desarrollada en el Proyecto de Extensión " de conocimiento, hechos y Sabores: prácticas integradoras de la Educación Popular en Salud y articulaciones en el Medio Oeste". Fue hecho un grupo focal con los participantes por ruedas de conversación. Los resultados indican que el concepto de la participación se relaciona con la idea de conocer a personas con intereses comunes y que esa participación puede mejorar al ejercicio del derecho a la salud. Sin embargo, las características históricas y culturales del estado de Goiás y de la Ciudad de Goiás fueron identificadas como limitantes para el desarrollo de la participación popular y el proceso de establecimiento de los miembros del Comité de Equidad. En este sentido, la charla dentro de la rueda fue identificada como importante para avanzar en la participación popular, siendo un sitio de adquisición de conocimientos e información y por lo tanto un espacio para la formación en temas de salud.

Experimentação animal e seus limites: core set e participação pública / Animal experimentation and its limits: core set and public participation

As controvérsias em ciência e tecnologia são cada vez mais reconhecidas como questões éticas e morais, e não somente técnicas. É o caso da experimentação animal, foco deste trabalho. Visando clarificar quais grupos tiveram seus interesses e reivindicações atendidos e quais foram ignorados, foi efetuada uma análise da legislação do estado de São Paulo sobre o assunto, a partir do referencial teórico dos Estudos Sociais da Ciência e Tecnologia. O estudo abordou aspectos como a relação entre a comunidade científica, a camada política e o público leigo, a autoridade da ciência e as estratégias para inclusão/exclusão de grupos. Concluiu-se que, apesar dos crescentes questionamentos sobre as consequências sociais, éticas e morais da prática científica, a ciência ainda desempenha um papel central na resolução de controvérsias, ocupando um lugar privilegiado dentro do core set...

Controversies in science and technology are increasingly recognized as ethical and moral issues, not just technical. It is the case of animal experimentation, the central issue of this work. Using the theoretical framework of Social Studies of Science and Technology, the work analyses the law of the State of São Paulo, Brazil, about animal experimentation, aiming to clarify which groups had their interests and demands met, and which were ignored. The study addressed issues such as the relationship between the scientific community, the lay public and the policy layer, the authority of science and the strategies for inclusion/exclusion of groups. It was concluded that, despite the growing doubts about the social, moral and ethical consequences of scientific practice, science still plays a central role in the resolution of controversies, occupying a privileged place within the core set...

Public Participation in the Process of Local Public Health Policy, Using Policy Network Analysis / 예방의학회지

OBJECTIVES: To assess the current public participation in-local health policy and its implications through the analysis of policy networks in health center programs. METHODS: We examined the decision-making process in sub-health center installations and the implementation process in metabolic syndrome management program cases in two districts ('gu's) of Seoul. Participants of the policy network were selected by the snowballing method and completed self-administered questionnaires. Actors, the interactions among actors, and the characteristics of the network were analyzed by Netminer. RESULTS: The results showed that the public is not yet actively participating in the local public health policy processes of decision-making and implementation. In the decision-making process, most of the network actors were in the public sector, while the private sector was a minor actor and participated in only a limited number of issues after the major decisions were made. In the implementation process, the program was led by the health center, while other actors participated passively. CONCLUSIONS: Public participation in Korean public health policy is not yet well activated. Preliminary discussions with various stakeholders, including civil society, are needed before making important local public health policy decisions. In addition, efforts to include local institutions and residents in the implementation process with the public officials are necessary to improve the situation.

Aspectos públicos da formação e da identidade do analista / Public aspects of the formation and identity of the analyst / Aspectos públicos de la formación y de la identidad del analista

A formação psicanalítica pode ser pensada através da relação entre seus aspectos privados, sobretudo análise didática e supervisão, e seus aspectos públicos, representadas pelos seminários teóricos e clínicos (Giovannetti, 2010). A participação político institucional também tem sido elencada como fator constituinte da formação, em seus aspectos públicos. O artigo reflete sobre uma possível ampliação da noção desta participação político institucional no polo público da formação. O texto analisa de que forma a participação do analista nas questões da pólis, da comunidade também fazem parte de sua formação. Em que medida, nós analistas, mostramos "nossa cara", parafraseando a música Brasil, de Cazuza, citada no texto.

Psychoanalytic training could be considered through the relationship between its private aspects, especially training analysis and supervision, and its public aspects represented by the theoretical and clinical seminars (Giovannetti, 2010). The institutional political participation has also been considered as a constituent factor of the analytical training in its public field. The article reflects about a possible extension of the notion of public field during the training process. The text examines how the analyst participation in the polis, in the community matters, also makes part of his training. To what extent analysts "show their faces" paraphrasing the song Brasil, by Cazuza, also cited in the text.

La formación psicoanalítica se puede considerar a través de la relación entre sus aspectos particulares, principalmente el análisis didáctico y la supervisión, y sus aspectos públicos, representados por los seminarios teóricos y clínicos (Giovannetti, 2010). La participación político-institucional también ha sido considerada como un factor constituyente de la formación en su aspecto público. El artículo reflexiona sobre una posible ampliación de la noción de esta participación político-institucional en el polo público de la formación. El texto analiza cómo la participación del analista en asuntos de la polis, de la comunidad, también hace parte de su formación. Cuestiona en qué medida los analistas "muestran su cara", parafraseando la canción Brasil, de Cazuza, citada en el texto.

Iniciativas de Apropiación Social de la Ciencia y la Tecnología en Colombia: tendencias y retos para una comprensión más amplia de estas dinámicas / Colombian initiatives in the Social Appropriation of Science and Technology: tendencies and challenges for a broader understanding of these dynamics

Pretende ampliar la comprensión que en Colombia se ha tenido sobre la Apropiación Social de la Ciencia y la Tecnología (ASCyT), particularmente en lo que refiere al tipo de actores que promueven iniciativas en ese sentido. Apoyándose en una metodología de rastreo por vínculos, se identificaron y documentaron cien iniciativas de ASCyT en el país, promovidas desde la sociedad civil, el estado, la empresa, las comunidades de investigadores y los escenarios mediadores. El artículo analiza estas iniciativas y señala los desafíos que presentan para descolocar y volver más participativo el enfoque que se le ha dado a la ASCyT en el país.

Is aimed at broadening Colombia's understanding of the social appropriation of science and technology, particularly the types of actors who promote initiatives in this sphere. Using a chain referral sampling methodology, a hundred such initiatives in Colombia were identified and documented, which were promoted by civil society, the State, business, the research community and mediators. The article further analyzes these iniciatives and indicates the challenges they represent, especially in breaking down the traditional approach to the social appropriation of science and technology in Colombia and replacing it with more participative strategies.