Integração ensino-serviço-comunidade: perspectivas do Comitê Gestor Local do Contrato Organizativo de Ação Pública Ensino-Saúde / Integración enseñanza-servicio-comunidad: perspectivas del Comité Gestor Local del Contrato Organizativo de Acción Pública Enseñanza-Salud / Teaching-service-community integration: perspectives of the Local Management Committee of the TeachingHealth Public Action Organizational Contract

Com o objetivo de compreender o desenvolvimento da integração ensino-serviço-comunidade (Iesc) no município de Bragança Paulista, São Paulo, por meio do Contrato Organizativo de Ação Pública Ensino-Saúde (Coapes), realizou-se um estudo de caso. Uma amostra intencional com dez integrantes do Comitê Gestor Local que participaram de entrevistas semiestruturadas, em ambiente virtual, gravadas e transcritas na íntegra. Os relatos passaram por análise de conteúdo na modalidade temática e os resultados indicaram que a condução da Iesc e do Coapes foi bem-sucedida. A sustentabilidade e os êxitos da contratualização estão relacionados a estratégias, como aproximação, diálogo institucional, igualdade de valor e transparência, provenientes de discussões técnicas, compreensão do processo, escolha do formato, sensibilização e engajamento dos atores. A combinação desses elementos, aliada a novos projetos e atitudes, aponta caminhos para a consolidação da Iesc no território, que apresenta desafios a serem superados.(AU)

Con el objetivo de comprender el desarrollo de la integración enseñanza-servicio-comunidad (IESC) en el municipio de Braganza Paulista (Estado de São Paulo), a partir del Contrato Organizativo de Acción Pública Enseñanza-Salud (Coapes), se realizó un estudio de caso. Una muestra intencional con diez integrantes del Comité Gestor Local participó en entrevistas semiestructuradas, realizadas en ambiente virtual, grabadas y transcritas integralmente. Los relatos pasaron por un análisis de contenido en la modalidad temática. Los resultados indicaron que la conducción de la IESC y del Coapes fue exitosa. La sostenibilidad y los éxitos de la contractualización están relacionados con estrategias tales como la aproximación, el diálogo institucional, la igualdad de valor y transparencia, provenientes de discusiones técnicas, comprensión del proceso, elección del formato, sensibilización y compromiso de los actores. La combinación de esos elementos, aliada a nuevos proyectos y actitudes, señala caminos para la consolidación de la IESC en el territorio que presenta desafíos que hay que superar.(AU)

To comprehend the evolution of education-service-community integration (ESCI) in the municipality of Bragança Paulista, SP, through the Teaching-Health Public Action Organizational Contract (Coapes), a case study was conducted. An intentional sample of ten members from the Local Management Committee participated in semi-structured interviews, conducted virtually, recorded, and transcribed in full. The narratives underwent thematic content analysis. The results indicated that the implementation of IESC and Coapes was successful. The sustainability and achievements in contractualization are related to strategies such as approaching, institutional dialogue, equal value, and transparency, resulting from technical discussions, understanding of the process, format selection, sensitization, and actor engagement. The combination of these elements, along with new projects and attitudes, points towards the consolidation of IESC in the territory, which presents challenges to be overcome.(AU)

Atenção Básica em Saúde em tempos de gestão contratualizada: desafios para sua sustentabilidade no Sistema Único de Saúde brasileiro / Basic Health Care in times of contractual management: challenges for its sustainability in the Brazilian Unified Health System

Resumo A Atenção Básica é acesso preferencial e ordenadora do cuidado na rede de serviços de saúde do Sistema Único de Saúde, sob responsabilidade da gestão municipal. Historicamente da administração direta, mas nas últimas décadas observa-se crescente transferência do seu gerenciamento por intermédio de contratualizações com instituições não governamentais. Objetivou-se analisar circunstâncias e elementos que motivaram gestores municipais a contratualizar entes privados sem fins lucrativos para gestão da Atenção Básica. Realizou-se pesquisa qualitativa por estudo de caso em seis municípios do estado de São Paulo. Procedeu-se a entrevistas virtuais semiestruturadas com 24 sujeitos, entre gestores, representantes das instituições, assessores regionais do Conselho de Secretários Municipais de Saúde e dos segmentos trabalhador e usuário dos respectivos Conselhos Municipais de Saúde, realizadas entre outubro de 2020 e fevereiro de 2021. As principais motivações são: 1) redução do impacto na folha de pagamento (lei de responsabilidade fiscal); 2) flexibilidade na administração dos recursos humanos, principalmente na contratação de médicos; e 3) agilidade na aquisição de insumos e equipamentos. Com base nesses resultados e na falta de preocupação desses sujeitos em considerar os atributos da Atenção Básica nas contratações, conclui-se que existe um risco potencial de prejuízos à consolidação dos princípios e diretrizes da Atenção Básica.

Abstract Primary Health Care (PHC), under the responsibility of the municipal manager, is the preferred gateway and ordering unit of the health services network in the Brazilian Unified National Health System. However, management is being transferred noticeably to non-governmental institutions (NGI). This article aimed to analyze circumstances and elements that would motivate municipal managers to hire NGI for PHC management. Qualitative research was carried out using a case study in six municipalities in the state of São Paulo. Semi-structured virtual interviews were developed with 24 subjects, including managers, institution representatives, COSEMS, and Social Control segments, from October 2020 to February 2021. The main motivations are 1) reduction of the impact on the payroll (fiscal responsibility law); 2) flexibility in the administration of human resources, especially hiring doctors; and 3) agility in the acquisition of inputs and equipment. Based on these results and the lack of concern on the part of these actors to impose Primary Health Care attributes in contracting, it can be concluded that there is a potential risk of harm to the consolidation of Primary Health Care principles and guidelines.

Structural Racism Operationalized via Adverse Social Events in a Single-Center Neonatal Intensive Care Unit.

OBJECTIVE: To evaluate structural racism in the neonatal intensive care unit (NICU) by determining if differences in adverse social events occur by racialized groups. STUDY DESIGN: Retrospective cohort study of 3290 infants hospitalized in a single center NICU between 2017 and 2019 in the Racial and Ethnic Justice in Outcomes in Neonatal Intensive Care (REJOICE) study. Demographics and adverse social events including infant urine toxicology screening, child protective services (CPS) referrals, behavioral contracts, and security emergency response calls were collected from electronic medical records. Logistic regression models were fit to test the association of race/ethnicity and adverse social events, adjusting for length of stay. Racial/ethnic groups were compared with a White referent group. RESULTS: There were 205 families (6.2%) that experienced an adverse social event. Black families were more likely to have experienced a CPS referral and a urine toxicology screen (OR, 3.6; 95% CI, 2.2-6.1 and OR, 2.2; 95% CI, 1.4-3.5). American Indian and Alaskan Native families were also more likely to experience CPS referrals and urine toxicology screens (OR, 15.8; 95% CI, 6.9-36.0 an OR, 7.6; 95% CI, 3.4-17.2). Black families were more likely to experience behavioral contracts and security emergency response calls. Latinx families had a similar risk of adverse events, and Asian families were less likely to experience adverse events. CONCLUSIONS: We found racial inequities in adverse social events in a single-center NICU. Investigation of generalizability is necessary to develop widespread strategies to address institutional and societal structural racism and to prevent adverse social events.

Continuous and Secure Integration Framework for Smart Contracts.

As part of agile methodologies seen in the past few years, IT organizations have continuously adopted new practices in their software delivery life-cycle to improve both efficiency and effectiveness of development teams. Two of these practices are continuous integration and continuous deployment, which are part of the DevOps cycle which has helped organizations build software effectively and efficiently. These practices must be considered for new technologies such as smart contracts, where security concerns and bugs might cost more once deployed than traditional software. This paper states the importance of using a proper DevOps routine and how it is possible to apply this practice to a smart contract build. Specifically, this paper introduces a framework to implement DevOps for smart contracts development by describing multiple DevOps tools and their applicability to smart contract development.

Caracterização do atributo acesso na Atenção Primária à Saúde nos Contratos de Gestão das Organizações Sociais de Saúde no município de São Paulo / Characterization of the attribute access in Primary Health Care in management Contracts of Social Health Organization in the city of São Paulo

O acesso aos cuidados de saúde está assegurado a todos na Constituição Federal de 1988. Para tanto, o Sistema Único de Saúde (SUS) definiu a Estratégia Saúde da Família (ESF), devido a seus atributos, como prioritária para a concretização desse objetivo. A Secretaria Municipal da Saúde de São Paulo (SMS-SP) adotou a contratualização com Organizações Sociais de Saúde (OSS) para a implementação da Atenção Primária à Saúde (APS). Este estudo visa caracterizar o atributo acesso na APS nos Contratos de Gestão entre a SMS-SP e as OSS. Foi realizada uma pesquisa de abordagem qualitativa com análise documental e de conteúdo dos Contratos de Gestão celebrados no período de 2014 a 2020. Os resultados apontam elevada frequência da dimensão disponibilidade, refletindo em oferta de serviços e recursos os mais variados. Todavia, as baixas frequências da acessibilidade e aceitabilidade fragilizam a adequação desses serviços e recursos, evidenciada pela ausência de documentos descritivos relativos aos cenários socioeconômicos dos territórios.

Access to health care is guaranteed to all in the Federal Constitution of 1988. To this end, the Unified Health System (SUS) defined the Family Health Strategy (ESF), due to its attributes, as a priority for achieving this objective. The Municipal Department of São Paulo (SMS-SP) adopted a contract with Social Health Organizations (OSS) to implement Primary Health Care (PHC). This study aims to characterize the access attribute in the APS in the Management Contracts between SMS-SP and OSS. Qualitative research was carried out with document and content analysis of the Management Contracts signed in the period from 2014 to 2020. The results point to a high frequency of the availability dimension, reflecting the most varied offer of services and resources. However, the low frequencies of accessibility and acceptability weaken the adequacy of these services and resources, evidenced by the absence of descriptive documents related to the socioeconomic scenarios of the territories.

Improving Data Security with Blockchain and Internet of Things in the Gourmet Cocoa Bean Fermentation Process.

Brazil was one of the largest cocoa producers in the world, mainly supported by the South of Bahia region. After the 1980s, the witch-broom disease demolished plantations, and farmers were forced into bankruptcy. The worldwide search for gourmet cocoa has rekindled interest in this production, whose fermentation process is a key step in obtaining fine cocoa, thanks to the fact that many processing properties and sensory attributes are developed in this phase. This article presents a blockchain-IoT-based system for the control and monitoring of these events, aiming to catalog in smart contracts valuable information for improvement of the cocoa fermentation process, and future research. Blockchain is used as a distributed database that implements an application-level security layer. A proof of concept was modeled and the performance of the emulated system was evaluated in the OMNet simulator, where a technique based on the SNMP protocol was applied to reduce the amount of data exchanged and resources served/consumed in this representation. Then, a physical platform was developed and preliminary experiments were performed on a real farm, as a way to verify the improvement of the cocoa fermentation process when using a technological approach.

Avaliação do desempenho de um contrato de gestão entre uma organização social de saúde (OSS) e prefeitura de uma cidade do interior paulista / Evaluation of the performance of a management contract between a health social organization and the mayor of a city in the interior of São Paulo

Introdução: A Organização Social de Saúde é uma entidade sem fins lucrativos que se encontra em estágio de expansão e há uma nítida divergência de opiniões quanto a sua efetividade e cumprimento das metas designadas pelo contrato de gestão proposto pelas instituições públicas. Objetivo: Analisar se há o cumprimento de metas estabelecidas pelo con-trato de gestão entre a Prefeitura Municipal de Catanduva/SP e o Hospital Psiquiátrico Espírita Mahatma Gandhi (OSS). Métodos: É um estudo descritivo e transversal. A coleta de dados foi realizada a partir do Relatório do Observatório de Saúde de Catanduva de 2019, estabelecendo uma relação comparativa com as metas propostas no Contrato de Gestão vigente. Foram analisadas as seguintes variáveis: número de consultas médicas, número de consultas de enfermagem e taxa de encaminhamento médico nas Unidades de Saúde da Família. Resultados: Em relação à taxa de encaminhamen-tos realizados durante o ano de 2019 em todas as USF, a média foi inferior ao valor de referência estabelecido no contra-to, sugerindo alta taxa de resolubilidade desses serviços. Além disso, produção médica e de enfermagem nas Unidades de Saúde da Família do município de Catanduva encontra-se, em sua maioria, acima do previsto no contrato de gestão, representando o cumprimento dos valores estabelecidos pela contratante. Conclusão: As metas atribuídas à OSS no contrato foram cumpridas pelas unidades de saúde conforme os valores pactuados pela Prefeitura Municipal (AU)

Introduction: The Social Health Organization is a non-profit entity that is in an expansion stage and there is a clear divergence of opinions regarding its effectiveness and compliance with the goals designated by the man-agement contract proposed by public institutions. Objective: To evaluate if the goals established by the manage-ment contract between the City of Catanduva / SP and the Psychiatric Hospital Spiritist Mahatma Gandhi (OSS) are met. Methods : It is an observational, descriptive and cross-sectional study. Data collection was carried out based on the 2019 Catanduva Health Observatory Report, establishing a comparative relationship with the goals proposed in the current Management Contract. The following variables were analyzed: number of medical consultations, number of nursing consultations and medical resolvability index in Family Health Units. Results: Regarding medical resolution, the average rate of referrals made during 2019 in all FHUs was lower than the reference value established in the contract, suggesting a high rate of resolution of these services. In addition, medical and nursing production in the Family Health Units in the municipality of Catanduva is mostly above that provided for in the management contract, representing compliance with the values established by the contractor. Conclusion: The targets assigned to the OSS in the contract were met by the health units in accordance with the values agreed by the City Hall (AU)

Between Justice and Money: How the Covid-19 Crisis was used to De-Differentiate Legality in Ecuador.

Legality in the Global South suffers from problems of application by convenience. Some rules are applied, and some are not, depending on certain actors, such as the State, the stakeholders, or others. This undermines legitimation as constructed by legality and due process. These problems are connected to a wider complex formed by coloniality, internal colonialism, and a form of functional differentiation that limits autonomy of the different social systems. This complex of structural properties allows States and other actors to systematically use one system against the other or-within a given system-one level of rules against the other. This was the case in Ecuador: in the initial months of quarantine due to Covid-19, the government took decisions about external state bonds following international legislation-and quite contrary ones related to local work contracts. Once again, legality followed different paths in diverse cases. Ecuadorian economic authorities accept and respect conditions on external public bonds which are protected by some complex and specific clauses to secure the payment. The same authorities have different practices towards international and national legislation that were organized in the sense of legal subsidiarity. This text will explore reasons and effects of legal de-differentiation in the Global South in times of crisis. The Ecuadorian case in time of Covid-19 helps to understand how structural problems related to the lack of autonomy of the legal system are perpetuated and lead to effects of convenient political action.

Dissemination of Consumer Law and Policy in Brazil: The Impact of EU Law.

This paper analyses the influence of European Law on Brazilian Consumer Law. It starts by describing the general features of Brazilian Consumer Protection law, including the constitutional dimension of consumer protection, and the introduction of the Brazilian Consumer Protection and Defence Code (CDC). It also highlights product liability, product safety, and product warranties. Some of these topics are illustrated by the case of the telecommunications sector.

Assessing tradeoffs in the design of climate change adaptation strategies for water utilities in Chile.

Climate change is a challenge to drinking water providers worldwide and to regulatory frameworks that consider long-term investment decisions. Coping with an unstable climate warrants adjustments in regulations and new investments. The investment required to maintain a selected service level needs to balance the potential for high regret stranded assets with the political and socioeconomic consequences of not meeting water demands. In recent years, the City of Santiago in Chile has seen drought events associated with climate change, which could worsen in the future. Chile's drinking water regulatory framework does not account for uncertainty in infrastructure design to cope with the potential impacts of such events. This work presents an adaptation option design process that considers multiple plausible climate change-impacted future scenarios, accommodating both structural and nonstructural measures. In our Santiago case study adaptation measures include extensions to the existing Chilean water market and traditional structural alternatives (e.g., storage infrastructure); all are represented in a simulation model of the water utility. We evaluate and optimize packages of efficient adaptation measures for various climate scenarios. This allows comparing different portfolios of combined institutional and infrastructure interventions via a range of stakeholder measures and comparing their tradeoffs under different plausible climate-impacted hydrological scenarios. Results showed that water supply performance without climate change adaptation is worse under climate scenarios with lower water availability, which are likely to be associated with higher GHG emission scenarios such as RCP 8.5. The optimized portfolios implement various combinations of adaptation strategies to reduce the impacts of this poor performance. Considering the uncertainty on future climate scenarios, the use of nonstructural adaptation measures such as option contracts exhibits the advantage of providing water in critical periods while avoiding large investments such as building reservoirs or the purchase of permanent water rights, which could end up underused if favorable climate scenarios manifest.

RootLogChain: Registering Log-Events in a Blockchain for Audit Issues from the Creation of the Root.

Logging system activities are required to provide credibility and confidence in the systems used by an organization. Logs in computer systems must be secured from the root user so that they are true and fair. This paper introduces RootLogChain, a blockchain-based audit mechanism that is built upon a security protocol to create both a root user in a blockchain network and the first log; from there, all root events are stored as logs within a standard blockchain mechanism. RootLogChain provides security constructs so as to be deployed in a distributed context over a hostile environment, such as the internet. We have developed a prototype based on a microservice architecture, validating it by executing different stress proofs in two scenarios: one with compliant agents and the other without. In such scenarios, several compliant and non-compliant agents try to become a root and register the events within the blockchain. Non-compliant agents simulate eavesdropper entities that do not follow the rules of the protocol. Our experiments show that the mechanism guarantees the creation of one and only one root user, integrity, and authenticity of the transactions; it also stores all events generated by the root within a blockchain. In addition, for audit issues, the traceability of the transaction logs can be consulted by the root.

Transparência nas relações público-privadas para prestação de serviços de saúde no estado de São Paulo / Transparency in public-private relations for the provision of health services in the state of São Paulo / Transparencia en las relaciones público-privadas para la prestación de servicios de salud en el estado de São Paulo

Objetivos: verificar se os instrumentos e mecanismos de inclusão e transparência disponíveis ao cidadão no estado de São Paulo permitem o exercício da democracia sanitária e o controle social das metas e resultados da contratualização da prestação de serviços de saúde. Metodologia: pesquisa documental, realizada em sistemas oficiais de informação, sobre a contratualização de entidades públicas e/ou privadas para prestação de serviços públicos de saúde pelo estado de São Paulo/ e pesquisa documental em Portais da Transparência e financeiros, de âmbito estadual, para aferição de metas e resultados dessas contratações. Resultados: as iniciativas privadas complementares ao papel do Estado atuam sob nítida dependência financeira da esfera governamental. Há um déficit significativo de informações para a construção ou padronização dos dados de performance, inviabilizando a fiscalização das políticas públicas em saúde e a aferição do custo/efetividade dos serviços de saúde prestados diretamente pela Administração Pública e pelo setor privado. Conclusão: os dados encontrados na pesquisa não aferiram uma maior eficiência dessas novas formas de coalizões e alianças com a sociedade civil, em que pese o fato do Poder Público não ter capacidade de absorver diretamente toda a assistência hoje prestada por intermédio dos entes privados e do terceiro setor. A falta de instrumentos de accountability governamental ocasiona falta de transparência no controle de metas e resultados das contratualizações.

Objectives: to verify whether the instruments and mechanisms for inclusion and transparency available to citizens in the state of São Paulo allow for the exercise of sanitary democracy and social control of the goals and results of the contractualization of the provision of health services. Methods: documentary research, conducted in official information systems, on the contracting of public and/or private entities for the provision of public health services by the state of São Paulo/ and documentary research on Transparency and financial Portals, at the state level, for measurement of goals and results of these contracts. Results: private initiatives that complement the role of the State act under a clear financial dependence on the government sphere. There is a significant deficit of information for the construction or standardization of performance data, making it impossible to monitor public health policies and to measure the cost/effectiveness of health services provided directly by the Public Administration and by private sector. Conclusion: the data found in the research did not show a greater efficiency of these new forms of coalitions and alliances with civil society, even though the Government is not able to directly absorb all the assistance currently provided through private entities and the third sector. The lack of governmental accountability instruments causes a lack of transparency in the control of contractual targets and results.

Objetivos: verificar si los instrumentos y mecanismos de inclusión y transparencia a disposición de los ciudadanos en el estado de São Paulo permiten el ejercicio de la democracia sanitaria y el control social de las metas y resultados de la contratación de la prestación de servicios de salud. Metodología: investigación documental realizada en sistemas de información oficiales sobre contratos con entidades públicas y/o privadas para la prestación de servicios de salud pública en el estado de São Paulo e investigación documental en Portales de Transparencia y financieros, a nivel estatal, para medir metas y resultados de estas contrataciones. Resultados: las iniciativas privadas que complementan el rol del Estado actúan bajo una clara dependencia financiera del ámbito gubernamental. Existe un importante déficitde información capaz de conducir a la construcción o estandarización de datos de desempeño, imposibilitando el seguimiento de las políticas de salud pública y la medición del costo/efectividad entre los servicios de salud brindados directamente por la Administración Pública y los brindados por el sector privado. Conclusión: No existe evidencia científica o empírica que asegure una mayor eficiencia en estas nuevas formas de coaliciones y alianzas con la sociedad civil, a pesar de que el Gobierno no puede absorber directamente toda la asistencia que actualmente se brinda a través de las entidades privadas y del tercer sector. Además, la falta de instrumentos gubernamentales de rendición de cuentas terminaprovocando poca transparencia en el control de metas y resultados colimados en los contratos establecidos.

Validation of Architecture Effectiveness for the Continuous Monitoring of File Integrity Stored in the Cloud Using Blockchain and Smart Contracts.

The management practicality and economy offered by the various technological solutions based on cloud computing have attracted many organizations, which have chosen to migrate services to the cloud, despite the numerous challenges arising from this migration. Cloud storage services are emerging as a relevant solution to meet the legal requirements of maintaining custody of electronic documents for long periods. However, the possibility of losses and the consequent financial damage require the permanent monitoring of this information. In a previous work named "Monitoring File Integrity Using Blockchain and Smart Contracts", the authors proposed an architecture based on blockchain, smart contract, and computational trust technologies that allows the periodic monitoring of the integrity of files stored in the cloud. However, the experiments carried out in the initial studies that validated the architecture included only small- and medium-sized files. As such, this paper presents a validation of the architecture to determine its effectiveness and efficiency when storing large files for long periods. The article provides an improved and detailed description of the proposed processes, followed by a security analysis of the architecture. The results of both the validation experiments and the implemented defense mechanism analysis confirm the security and the efficiency of the architecture in identifying corrupted files, regardless of file size and storage time.

Relação entre cumprimento das metas dos contratos de gestão e qualidade da atenção à saúde: uma revisão integrativa / Relationship between goals achievement of management contracts and quality of health care: an integrative review

RESUMO Trata-se de uma revisão sistemática integrativa da literatura realizada no portal da Biblioteca Virtual em Saúde com o objetivo de compreender se existe relação entre o cumprimento de metas e a qualidade da atenção à saúde. A estratégia de busca foi construída pelos polos: metas (fenômeno); contrato de gestão (população); e qualidade (contexto). A seleção foi feita através do protocolo Prisma por dois revisores, e a análise de dados realizada na modalidade temática, com foco na relação entre o cumprimento das metas e a qualidade. Dos 22 artigos incluídos na revisão, apenas 4 respondiam diretamente ao objeto desta pesquisa. 7 temas foram alvo de discussão nos artigos revisados: metodologia dos artigos; metas e seus cumprimentos nos contratos de gestão; tipos de contratualização; ideia de qualidade; aspectos do cumprimento do contrato de gestão; metas do contrato de gestão; e, por fim, a relação entre cumprimento das metas e qualidade. A maioria dos artigos revisados encontra-se no nível 4 de qualidade das evidências disponíveis. Com as evidências encontradas, foi possível concluir que as metas dos contratos de gestão não se relacionam com a qualidade da atenção à saúde e que faltam estudos que abordem o contexto brasileiro e do Sistema Único de Saúde (SUS).

ABSTRACT This study is a systematic integrative review was carried out on the Virtual Health Library portal to understand whether there is a relationship between the achievement of goals and the quality of health care. The search strategy was built by the poles: goals (phenomenon); management contract (population); and quality (context). The selection of publications was made through the Prisma protocol by two independent reviewers, and data analysis was carried out in the thematic mode, with focus on theme of the relationship between the achievement of goals and quality. Of the 22 articles included in the review, only 4 responded directly to the object of this research. 7 themes were discussed in the reviewed articles: methodology; goals and compliance with management contracts; types of contracting; quality idea; aspects of compliance with the management contract; management contract goals; and, finally, the relationship between achievement of goals and quality. Most of the articles reviewed refer to level 4 of quality evidence. With the evidence found, it was possible to conclude that the goals of management contracts are not related to the quality of health care and that there is a lack of studies that address the Brazilian context and the Unified Health System (SUS).

Situación laboral de odontólogos egresados de la Universidad de Antioquia antes y durante la pandemia por la COVID-19, periodo 2015(1)-2019(2) / Labor situation of dentists graduated from the Universidad de Antioquia before and during the pandemic COVID-19, period 2015(1)-2019(2)

Objetivo: reconocer y determinar las condiciones laborales de los odontólogos de la Facultad de Odontología de la Universidad de Antioquia en las cohortes de egresados del periodo 2015(1)-2019(2), antes y durante la pandemia por la COVID-19. Métodos: estudio descriptivo transversal abordado a partir de una muestra representativa de 142 odontólogos. Esta fue obtenida de las bases de datos proporcionadas por el Observatorio Estudiantil de dicha facultad. Resultados: se encontró que durante la pandemia el 13,5% de encuestados perdió su empleo, el 75% manifestó reducción en su salario y el 10,5% interrumpió su afiliación al régimen de prestaciones sociales. Conclusiones: si bien, la situación laboral de los odontólogos antes de la pandemia por la COVID-19 era precaria, esta se agravó durante la misma en los aspectos que ya venían siendo críticos en relación con temas salariales y prestacionales, en específico el tipo de contratación, los tiempos de inserción laboral, la duración de los contratos y la afiliación a la seguridad social y al régimen prestacional.

Objective: to recognize and determine the working conditions of the dentists of the Faculty of Dentistry of the University of Antioquia in the 2015(1)-2019(2) cohorts of graduates before and during the Covid-19 pandemic. Methods: cross-sectional descriptive study approached from a representative sample of 142 dentists obtained from the databases provided by the Student Observatory of that faculty. Results: it was found that during the pandemic 13.5% of respondents were unemployed, 75% reported a reduction in salary and 10,5% interrupted their affiliation to the social benefits system. Conclusions: although the employment situation of dentists before the Covid-19 pandemic was precarious, these deteriorating conditions worsened during the pandemic in aspects that were already critical in relation to salary and benefits: type of contract, time of employment, duration of contracts, affiliation to the social security and benefits system.

Bioética en los procesos de investigación y bioprospección: relaciones con pueblos indígenas y comunidades locales en Colombia

Propósito/Contexto. En este artículo se exploran los principios bioéticos de autonomía y justicia, a la luz de tres casos de uso de la biodiversidad, tanto para fines investigativos como de aprovechamiento comercial, que involucran territorios colectivos de comunidades indígenas, afrodescendientes y predios de población campesina. Metodología/Enfoque. En cada caso se examinaron sus características, los actores, las relaciones entre los actores y los beneficios contemplados para las partes. El estudio comprendió la recopilación y análisis de documentación y la realización de 10 entrevistas semiestructuradas con investigadores, representantes de instituciones, empresas y organizaciones indígenas y afrocolombianas. La investigación se realizó entre 2015 y 2017 e incluyó comunidades del Amazonas, Risaralda, Chocó y Antioquia. Resultados/Hallazgos. Se encontró que las instituciones de investigación y los investigadores tramitan y obtienen las autorizaciones reglamentarias, mientras que las entidades del Estado registran una progresiva omisión de responsabilidades que afecta los derechos de las comunidades, por ejemplo, a través de la inobservancia del derecho a la consulta previa. Adicionalmente, en los casos de estudio, las relaciones que los actores establecen con las comunidades INAPRR-CL (sigla de indígenas, negros, afrodescendientes, palenqueros, raizales, Rrom, campesinas y locales) varían en la observancia de principios bioéticos. Discusión/Conclusiones/Contribuciones. Debido a que el régimen jurídico tiene un alcance limitado para el uso de la biodiversidad en investigación o innovación tecnológica, se evalúa y se discute si la bioética podría servir de guía para el respeto de la autonomía y la participación de beneficios de las comunidades en proyectos de investigación y bioprospección.

Purpose/Context. This article explores the bioethical principles of autonomy and justice in the light of three cases of use of biodiversity, both for research purposes and for commercial use, involving collective territories of indigenous communities, afro-descendants, and proper-ties of the peasant population. Methods/Approach. In each case, we examined the characteristics, agents, relationships be-tween agents, and benefits contemplated for the parties. The study included document compilation and analysis and ten semi-structured interviews with researchers, representatives of indigenous and Afro-Colombian institutions, companies, and organizations. The research was carried out between 2015 and 2017 and involved Amazon, Risaralda, Chocó, and Antioquia communities. Results/Findings. Research institutions and researchers process and obtain regulatory authorizations, while State entities report a progressive omission of responsibilities that adversely affects communities' rights, for example, through non-observance of the right to prior con-sultation. Besides, in the study cases, the agents' relationships with the INAPRRCL (acronym in Spanish for indigenous, black people, Afro-descendants, palenqueros, raizales, Rrom, peasants, and locals) vary regarding the application of bioethical principles. Discussion/Conclusions/Contributions. Because the legal system has a limited scope on the use of biodiversity in research or technological innovation, we assessed and discussed whether bioethics could serve as a guide for respecting communities' autonomy and benefit share in research and bioprospecting projects.

Objetivo/Contexto. Neste artigo exploram-se os princípios bioéticos de autonomia e justiça, à luz de três casos de uso da biodiversidade, tanto para fins investigativos como de aproveitamento comercial, que envolvem territórios coletivos de comunidades indígenas, afrodescendentes e prédios de população camponesa. Metodologia/Abordagem. Em cada caso, foram examinadas as suas características, os intervenientes, as relações entre os intervenientes e os benefícios previstos para as partes. O estudo incluiu a coleta e análise de documentação e a realização de 10 entrevistas semiestruturadas com pesquisadores, representantes de instituições, empresas e organizações indígenas e afro-colombianas. A pesquisa foi realizada entre 2015 e 2017 e incluiu comunidades do Amazonas, Risaralda, Chocó e Antioquia. Resultados/Descobertas. Verificou-se que as instituições de investigação e os investigadores processam e obtêm as autorizações regulamentares, no entanto que as entidades do Estado registram uma progressiva omissão de responsabilidades que afeta os direitos das comunidades, por exemplo, através da inobservância do direito à consulta prévia. Adicionalmente, nos casos de estudo, as relações que os atores estabelecem com as INAPRRCL (sigla de indígenas, negros, afrodescendentes, palenqueros, raizais, Rrom, camponesas e locais) variam na observância de princípios bioéticos. Discussão/Conclusões/Contribuições. Dado que o regime jurídico tem um âmbito limitado para a utilização da biodiversidade na investigação ou inovação tecnológica, se avalia e se discute se a bioética poderia servir de guia para o respeito da autonomia e a participação de benefícios das comunidades em projetos de pesquisa e bioprospeção.

Dataset for solving a hybrid flexibility strategy on personnel scheduling problem in the retail industry.

This data article describes datasets from a home improvement retail store located in Santiago, Chile. The datasets have been developed to simultaneously solve a staffing and tour scheduling problem that incorporates flexible contracts and multiskilled staff. This Data in Brief article is related to the published article "Hybrid flexibility strategy on personnel scheduling: Retail case study" [1]. The datasets contain real, processed, and simulated data. Regarding the real and processed datasets, they are presented for three different store sizes (4, 5 or 6 departments). Real datasets include information about the employment-contract characteristics, cost parameters, and a forecast of the number of employees required in each department for each day of the week and each time period into which the operating day is divided. As regards the data processed for the case study, they include the set of skill sets considering that the employees can be trained in a maximum of two store departments. Regarding the simulated datasets, they include information about the random parameter of staff demand in each store department. The simulated data are presented in 90 text files classified by: (i) Store size (4, 5 or 6 departments). (ii) Coefficient of variation (10, 20, 30%). (iii) Instance identification number (10 instances per scenario that resulted from combining the store sizes and coefficients of variation). Researchers can use the datasets for benchmarking the performance of different approaches with the one presented by Porto et al. [1], and in consequence, they can find solutions to the same (or similar) type of personnel scheduling problem. The dataset includes an Excel workbook that can be used to randomly generate staff demand instances according to a chosen coefficient of variation.

A incompletude dos contratos de ônibus nos tempos da COVID-19 / La incompletitud de los contratos de autobús en tiempos de COVID-19 / Incomplete contracts for bus service during the COVID-19 pandemic

Resumo A pandemia da COVID-19 impõe sérios desafios ao setor de transporte público por ônibus. A queda da demanda em razão do isolamento social, a intensificação dos procedimentos de higienização, a aquisição de equipamentos de proteção individual e as restrições de lotação dos veículos ameaçam a viabilidade econômico-financeira do transporte coletivo brasileiro. A pandemia da COVID-19 pode ser caracterizada como um evento de força maior, ensejando reequilíbrio econômico-financeiro dos contratos de concessão de transporte público por ônibus. Entretanto, esta solução precisa ser buscada conjuntamente, pelo poder público e pelas empresas de transporte urbano, para garantir os interesses e as necessidades de ambas as partes. Este artigo sugere ações estratégicas para que o transporte coletivo continue operando durante a pandemia e os acordos de reequilíbrio econômico-financeiro estejam alinhados com o interesse público. A superação das incertezas e consequências causadas pela pandemia exige a criação de relações de confiança e apoio mútuo entre inciativa privada (operadores) e governo.

Resumen La pandemia de COVID-19 impone desafíos serios para el sector de transporte público por autobús. La caída de la demanda en función de las medidas de aislamiento social, la intensificación de los procedimientos de higiene, la adquisición del equipo de protección para los trabajadores y las restricciones en cuanto al número de pasajeros por vehículo amenazan la viabilidad económica-financiera del transporte colectivo brasileño. La pandemia de COVID-19 se puede caracterizar como acontecimiento de fuerza mayor que propicie el reequilibrio económico-financiero de contratos de concesión de transporte público por autobús. Sin embargo, esta solución debe buscarse en forma conjunta, por el gobierno y las empresas de transporte, para garantizar los intereses y las necesidades de ambas partes. Este artículo sugiere acciones estratégicas para que el transporte colectivo continúe funcionando durante la pandemia y los acuerdos de reequilibrio económico-financiero se alineen con el interés público. La superación de las incertidumbres y consecuencias de la pandemia requiere la creación de relaciones de confianza y apoyo mutuo entre la iniciativa privada (operadores) y los gobiernos.

Abstract The COVID-19 pandemic poses serious challenges for the public bus service. The fall in demand due to social distancing measures, the intensification of hygiene procedures, the acquisition of personal protective equipment, and restrictions on vehicle capacity threaten the financial viability of Brazilian public transportation. The COVID-19 pandemic may be characterized as a force majeure event, giving rise to an economic-financial balancing of public bus service contracts. However, this solution must be built by the public administration and transport companies to guarantee the interests and needs of both parties. Therefore, this article offers strategies to continue operating the service during the pandemic and to achieve economic and financial equilibrium protecting the public interest. Overcoming the uncertainties and consequences caused by the pandemic requires relationships of trust and mutual support between the private sector (operators) and government.

Resposta rápida: modelos de contrato e seu impacto no desempenho de profissionais de saúde / Rapid response: contract models and their impact on healthcare professionals' performance

Mensagens-chave Como diferentes modelos de contrato podem influenciar as dimensões de performance, produtividade e qualidade do trabalho de profissionais de saúde? Por que essa pergunta é relevante? → A produtividade e a performance de profissionais de saúde, bem como a qualidade da assistência prestada, são indicadores relevantes para os sistemas de saúde, todavia pouco se sabe sobre estratégias para apoiar melhoras nesses aspectos, desde o momento dos contratos. → Diferentes modelos de contratos podem trazer graus distintos de segurança e de satisfação para os profissionais de saúde, sendo necessário compreender quais os impactos esperados desses contratos na atuação profissional, de modo a não afetar negativamente o ambiente organizacional e a qualidade do trabalho. Quais informações encontramos? → Foram encontradas 29 revisões sistemáticas descrevendo fatores relacionados os diferentes modelos de contrato e seus efeitos na produtividade, performance e qualidade da assistência de profissionais de saúde. A maior parte das revisões focava no modelo de pagamento por performance e 07 focavam no contexto da atenção primária. → Há grandes incertezas sobre os efeitos de programas de pagamento por performance no desempenho, produtividade e qualidade da assistência de profissionais de saúde, em especial no contexto hospitalar. Isso se explica pela grande variedade de desenhos dos programas, pelos poucos estudos de avaliação do impacto dessa estratégia e pela baixa qualidade metodológica da maioria das pesquisas publicadas. → Outros modelos de contrato e pagamento para profissionais de saúde também não possuem respaldo nas evidências científicas. → A eventual implementação de programas de pagamento por performance deve levar em conta aspectos organizacionais e de recursos humanos, materiais e logísticos, a conscientização e o treinamento de lideranças, as possíveis resistências que os profissionais de saúde apresentem e a garantia da equidade. Também se recomenda focar em áreas onde a produtividade ou a qualidade da assistência são baixíssimas, podendo, assim, observar os melhores resultados. → Qualquer modelo de contrato adotado junto a profissionais de saúde deve ser objeto de rigorosas avaliações, para que se possa entender melhor seu funcionamento e seu impacto.

Os planos de saúde e a cobertura de home care / Health insurance and home care coverage

As solicitações de cobertura para home care estão entre as mais complexas discussões hoje existentes no universo jurídico dos planos de saúde. A partir de um estudo normativo-jurisprudencial, o presente artigo tem como objetivo examinar os serviços de saúde domiciliares à luz das coberturas dos contratos de planos de saúde. Com esta meta, passa por diversos tópicos inerentes a este assunto, incluindo determinados fenômenos jurídicos e sociais que ajudam a entendê-lo, assim como o regime jurídico que regula a matéria. Na sequência, o artigo foca os serviços domiciliares, com ênfase naqueles que, à luz das normas aplicáveis, são considerados como de cobertura obrigatória. Após, comenta também a complexidade terminológica que envolve o tema. Ao final, passa ao exame da jurisprudência existente sobre planos de saúde e cobertura para serviços domiciliares, com destaque para os recentes precedentes que, na opinião dos autores, adotam uma posição mais aceitável e razoável, capaz de representar um verdadeiro ponto de equilíbrio a esta temática tão controvertida.

Demands for home care coverage are stirring the most complex discussions currently existing in the legal universe of health insurance contracts. Based on a normative-jurisprudential study, this essay's scope examines home health care services in light of the coverage of health insurance contracts. With this goal, several topics on the subject are dealt with, including certain juridical and social phenomena that facilitate its understanding, as well as the legal regime that regulates this matter. It follows focusing on home health care services, with emphasis on those that, in light of the applicable regulatory standards, are considered to be of compulsory coverage. Next, the terminological complexity that involves this subject is also commented. At the end, the existing jurisprudence regarding health care insurances and the coverage for home health care services is examined, highlighting recent precedents that, in the authors' opinion, adopt an acceptable and reasonable position, capable of representing a true balance point for this controversial matter.