Depuis 2006, le Programme Hors Normes (PHN) dicte une nouvelle marche à suivre que doivent privilégier les équipes de santé au travail (SAT) lorsque des travailleurs sont exposés à des concentrations environnementales de produits chimiques supérieures aux valeurs d’exposition admissibles, c’est-à-dire à des « hors normes ». Le PHN encadre les activités de signalements des hors normes aux instances concernées et demande des suivis plus rigoureux en établissements. Ce faisant, il redéfinit les rôles des infirmières et des membres des équipes SAT. Dans le but de mieux comprendre l’implication des infirmières dans le cadre du PHN, sept entretiens individuels semi-dirigés ont été réalisés afin d’explorer et de décrire leurs représentations. L’analyse qualitative de ces représentations, par catégorisation et comparaisons constantes des discours, révèle que les infirmières se représentent de diverses façons leur pratique dans le cadre du PHN. En effet, les résultats de l’étude montrent qu’afin de comprendre l’implication des infirmières dans ce programme d’intervention, il importe de considérer les quatre éléments suivants : l’organisation du travail, les aspects relationnels (dynamique de relations), les cibles d’intervention et l’utilité du travail des infirmières (sens donné au travail). Afin de faciliter leur participation dans les programmes d’intervention et d’encourager la collaboration, tant intersectorielle qu’interprofessionnelle, il est suggéré en premier lieu de favoriser l’implication des infirmières dans les processus d’élaboration et d’implantation de programmes d’intervention. En second lieu, il est proposé de mettre en place une formation continue interprofessionnelle permettant une meilleure harmonisation des pratiques professionnelles. / Since 2006, the Programme Hors Normes (PHN) (Standards Non-compliance Program) of the “Direction de santé publique de Montréal ”, has set new guidelines for Occupational Health Teams with regard to workers who have been exposed to environmental concentrations of chemical agents that exceed permissible exposure levels, in other words, that are “standards non-compliant.” The PHN oversees the reporting of non-compliance to the relevant authorities and ensures that employers conduct rigorous follow-up. In doing so, the program has redefined the roles of occupational health team nurses. This exploratory study aims to describe the representations of these nurses with regard to the PHN and to better understand how they represent their practice into the PHN. Individual semi-directed interviews were conducted among seven nurses. Qualitative analysis of the data, through categorization and consistent comparison of narratives, reveals the various ways nurses represent their practice in the PHN. Their representations of their practice appear to derive from four elements: work organization, work relationships, intervention target, and work satisfaction. To increase nurses’empowerment, to take into account the ways in which he PHN has prompted them to reflect on their practice, and to promote cross-sector and cross-professional cooperation, the study suggests that nurses should participate in the planning and implementation of intervention programs and that on-going training should be provided in order to further harmonize professional practice.

O objeto de estudo desta pesquisa qualitativa são as práticas dos trabalhadores de um Centro de Atenção Picossocial III - CAPS III. A finalidade é contribuir para a compreensão das práticas em saúde mental produzidas no CAPS III, por meio da perspectiva crítica e colaborar com a consolidação da Reforma Psiquiátrica brasileira. Tem como objetivos: descrever as práticas de saúde mental dos trabalhadores do CAPS III; verificar se as práticas se articulam às diretrizes da Reforma Psiquiátrica brasileira e analisar os processos de trabalho desenvolvidos pelos trabalhadores nos seus elementos constitutivos, da perspectiva do campo psicossocial. O cenário de estudo é Núcleo de Atenção Psicossocial I da Secretaria Municipal de Saúde de Santo André. Participaram deste estudo 11 (onze) trabalhadores, um de cada categoria profissional, de nível médio e superior. Os dados empíricos foram obtidos por meio de entrevista individual semi-estruturada e para a caracterização do cenário de estudo, o Instrumento de Captação da Realidade Objetiva, método proposto pela Teoria de Intervenção Práxica em Enfermagem em Saúde Coletiva. O material empírico foi analisado de acordo com a orientação de Minayo, baseada na hermenêutica-dialética. A análise dos dados deu origem às categorias: a) o CAPS III e a rede de atenção à saúde mental; b) Organização interna do CAPS III; c) as práticas em saúde mental no CAPS III e as diretrizes da Reforma Psiquiátrica brasileira; d) os processos de trabalho no CAPS III. Os resultados indicam que, no plano descritivo, as práticas de saúde mental dos trabalhadores do CAPS III articulam-se às diretrizes da Reforma Psiquiátrica. A análise dos elementos constitutivos dos processos de trabalho evidencia contradições. Pode-se constatar atitudes coerentes com o quadro teórico de referência adotado, o campo psicossocial, embora estas não se articulem a um projeto coletivo institucional, revelando práxis espontâneas e reiterativas. A consolidação da Reforma Psiquiátrica requer processos de trabalho que se traduzam em práxis criativas, capazes de produzir transformações concretas na vida dos usuários dos serviços. Identifica-se a necessidade de formação dos trabalhadores com relação ao projeto coletivo institucional, visando qualificar a força de trabalho dos Centros de Atenção Psicossocial, dada a função social destes equipamentos, considerados estratégicos na reorientação do modelo de atenção à saúde mental. O material empírico evidencia uma crise na organização do serviço, revelando o sofrimento dos trabalhadores e a precarização da assistência prestada aos usuários do serviço. É necessário que o serviço possa colocar-se em crise para que esta necessidade possa ser tomada pelo poder local, visando transformar essa realidade / The object of study of this qualitative research are practices of the workers of a Pshychosocial Attention Center III (CAPS III). The purpose of this study is to contribute to the understanding of the mental heath practices produced in the Pshychosocial Attention Center III, through a critical perspective, to cooperate with the consolidation of the Brazilian Psychiatric Reform. Objectives are: describe the mental heath practices of the workers of a CAPS III; verify if the mental health practices are related to the references of the Brazilian Psychiatric Reform and; analyze the processes of work developed by the workers of the CAPS III, in its constitutive elements, form a the perspective of the Pshychosocial Field. The scenery of this study is the Núcleo de Atenção Psicossocial I of the Health Department of Santo André. 11 (eleven) workers participated in the study; one form each professional category, medium level and higher education level workers. The empirical data were gathered through individual interviews with the workers and the characterization of the scenery of the study, according to the Method of Praxis Intervention of Nursing in Collective Heath. The empirical data are analyzed according to Minayo´s propose, based in dialectical-hermeneutic. The data provided the categories: a) CAPS III and the mental health care net; b) Internal organization of CAPS III; c) mental heath practices in CAPS III and the references of the Brazilian Psychiatric Reform; d) processes of work in CAPS III. The results indicate that, in a descriptive view, the mental health practices of the workers of CAPS III, correspond to the Brazilian Psychiatric Reform´s references. The analyzes of processes of work demonstrate contradictions. It is possible to recognize attitudes according to the theoretical references, the Pshychosocial Field, even though these attitudes are not related to a collective project, revealing spontaneous and reiterative praxis. The consolidation of the Brazilian Psychiatric Reform requires processes of work that constitutes creative praxis, capable to produce concrete transformation in user’s life. It is identified the need to develop the formation of the workers related to the collective project, aiming to qualify the work strength of the Pshychosocial Attention Center, considering the social function of this equipment, considered strategic in reorientation of the Mental Heath care model. The empirical data indicate crises in the internal organization of the service, revealing workers\' suffer and the loss on the quality of the assistance, which makes it necessary to the service to put its self in crises to be assumed by the local government instances

Made available in DSpace on 2016-04-29T13:31:09Z (GMT). No. of bitstreams: 1 Julia Hatakeyama Joia.pdf: 2173399 bytes, checksum: c450bdeaa534aaeaccb25dc46237ca81 (MD5) Previous issue date: 2014-03-18 / Conselho Nacional de Desenvolvimento Científico e Tecnológico / The following research is based on the relations between the fields of mental health, rights of children and adolescents, and the judicial system. Throughout this work psychiatry internment of children and adolescents in situation of vulnerability were examined, particularly those who attend the specialized services on treatment of people who use drugs . At first, the study contextualizes governmental measures aimed at people in street situation in the center of Sao Paulo during the period of 2012-2013, by highlighting the Sufoco operation, the implementation of a judicial addendum at the CRATOD (Reference Center for Alcohol, Tabaco, and other drugs) and the enforcement of the services to drug addicts at the CAISM (Center of Integrated Support for Mental Health) Philippe Pinel. Secondly, the study seeks to analyze the psychiatry internment of a specialized service, which was created to attend initially people who live on the streets - SAID (Service of Integral Support to Addicts), later referred to as UNAD (Unit of Services to Addicts). In order to do so, a consultation was carried out among the institutional services and data of the clinic prompt-books, which sought to evidence the institutional path of the service users. The patterns of internment were identified, underscoring the flux and characteristics of the users, as well as identifying the major situations of compulsory internment which occur under the health and the judiciary systems. The study follows with the problematization of the systems put in action by the psychiatry internment, which is characterized by isolation and punitive functions, many times going beyond its therapeutical function, which should instead build up care networks and methods to reduce vulnerabilities of children and adolescents. Even if the psychiatric reform had the non-institucionalization as a motto of its mental health policy, which was based on the disconnection between unsound mind, dangerousness, and segregation, under the perspective of guaranteeing the rights of users, some step backs were identified. In the fields of childhood and youth it has been present a trend of psyquiatrization of social conflicts, which evidence the renewal of strategies of dangerousness policy . The thematic of drug consumption, reduced to the diagnosis of chemical dependency has been lately an important factor that drives the psyquiatric internment, particularly compulsory ones, reaffirming the systems of isolation and tutorship / A presente pesquisa localiza-se na interface dos campos da saúde mental, dos direitos da infância e juventude e do sistema de justiça. Investigaram-se as internações psiquiátricas de crianças e adolescentes em situação de vulnerabilidade social, em um serviço especializado no tratamento de dependentes químicos . Em um primeiro momento, contextualizam-se as ações do poder público para pessoas em situação de rua no centro de São Paulo, no período 2012-2013, dando especial destaque à Operação Sufoco, à implantação de um anexo judiciário no CRATOD (Centro de Referência de Álcool, Tabaco e Outras Drogas) e à imposição do atendimento de dependentes químicos no CAISM (Centro de Atenção Integrada em Saúde Mental) Philippe Pinel. O segundo momento é reservado à análise das internações psiquiátricas de um serviço especializado, criado para atender, inicialmente, a população de rua - SAID (Serviço de Atenção Integral ao Dependente), depois chamado UNAD (Unidade de Atendimento ao Dependente). Para isso, foi realizada consulta a censos institucionais no serviço e a dados de prontuários, a fim de evidenciar as trajetórias institucionais dos usuários. Traça-se um perfil das internações, destacando fluxos e características dos usuários, e identificam-se as principais compulsoriedades nas relações da rede de saúde com o Poder Judiciário. Posteriormente, problematizam-se os circuitos acionados pela internação psiquiátrica, em que funções asilares e punitivas aparecem muitas vezes sobrepondo-se à função terapêutica, à articulação de redes territoriais de cuidados e à busca de diminuição das vulnerabilidades das crianças e adolescentes. Ainda que a Reforma Psiquiátrica tenha a desinstitucionalização como norteadora das políticas de saúde mental, fundamentada na desvinculação entre loucura, periculosidade e segregação, e na perspectiva da garantia dos direitos aos usuários, identificam-se também retrocessos. O campo da infância e juventude apresenta uma tendência crescente à psiquiatrização dos conflitos sociais, que evidenciam a renovação de estratégias de gestão da periculosidade . A temática do consumo de drogas, reduzida ao diagnóstico dependência química , vem sendo, atualmente, um importante vetor que aciona a internação psiquiátrica, em especial nas suas compulsoriedades, reafirmando circuitos asilares e tutelares

Made available in DSpace on 2016-04-27T18:12:43Z (GMT). No. of bitstreams: 1 ADRIANA SOARES ALVES.pdf: 924579 bytes, checksum: 2f204404494bf32fb7678a29fc64cb3e (MD5) Previous issue date: 2010-02-11 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Introduction: Continuous exposition to high levels of sonorant pressure can cause a noise induced hearing loss (NIAL) and consequently provoque negative effects on the individual quality of life. Objective: Analysing the hearing handicap auto-perception on textile industry employees with and without noise induced hearing loss. Method: The transversal type of the epidemiological study sample was constituted by 83 employees, being 54 from the Normal Group and 29 from the NIAL group. The age group varyed from 23 to 62 years old. All the employees had been exposed to an occupational noise above 85dB(A) at least for two years. A brief question protocol and the questionnaire about hearing handicap auto-perception named Hearing Handicap Inventory for Adults (HHIA) have been used. Results: 27.8% of the Normal Group employees presented an audiometric notch in one ear at least. The highest frequency was 6kHz. In the NIAL Group the hearing losses were from 3kHz to 8kHz in the right ear, and from 2kHz to 8kHz in the left ear. 24.1% of the NIAL group presented a light / moderate handicap. The Normal Group employees did not present hearing handicap. There was a statiscally significant association between an auto-reporting hearing loss and being part of the NIAL group.Conclusion: Despite the low rate of handicap in the HHIA, the high occurrence of hearing complaints indicates the importance of the studies about noise effects, independently of the hearing loss presence / Introdução: A exposição continuada a elevados níveis de pressão sonora pode ocasionar uma perda auditiva induzida por ruído (PAIR) e, conseqüentemente, provocar efeitos na qualidade de vida do indivíduo. Objetivo: analisar a auto-percepção do handicap auditivo em trabalhadores de uma indústria têxtil com e sem a presença de perda auditiva induzida por ruído. Método: A amostra do estudo epidemiológico do tipo transversal foi composta por 83 funcionários, sendo 54 do grupo Normal e 29 do grupo PAIR. A faixa etária variou de 23 a 62 anos. Todos os trabalhadores estavam expostos a ruído ocupacional acima de 85 dB(A) há, no mínimo, dois anos. Foram utilizados um breve protocolo de anamnese e o questionário de auto-percepção de handicap auditivo denominado Hearing Handicap Inventory for Adults ( HHIA). Resultados: No Grupo Normal, 27,8% apresentaram entalhe audiométrico em pelo menos uma orelha. A freqüência mais acometido foi 6 kHz. No Grupo PAIR, as perdas auditivas foram entre 3 kHz a 8 kHz na orelha direita e entre 2 kHz e 8 kHz na orelha esquerda. Foi identificado handicap de grau leve/moderado em 24,1% do Grupo PAIR. Os trabalhadores do Grupo Normal não apresentaram handicap auditivo. Houve associação estatisticamente significante entre auto-referir perda auditiva e pertencer ao Grupo PAIR. Conclusão: Apesar do baixo índice de handicap no HHIA, a alta ocorrência de queixas auditivas indica a importância de estudos sobre os efeitos do ruído, independente da presença de perda auditiva

"Image and Text" focuses on the consequences of multi-media interaction on the concept of a work's meaning(s) in three distinct publishing trends in nineteenth-century Britain: graphic satire, the literary annuals, and book illustration. The graphic satire of engravers James Gillray and George Cruikshank is replete with textual components that rely on the interaction of media for the overall satirical impact. Literary annuals combine engravings with the ekphrastic poetry of writers including William Wordsworth, Samuel Taylor Coleridge, Robert Southey, and Letitia Elizabeth Landon. Book illustrations provided writers Sir Walter Scott and Alfred, Lord Tennyson a means to recycle previously published works as "new" texts; the engravings promote an illusion of textual originality and reality by imparting visual meanings onto the text. In turn, the close proximity of text to image changes visual meanings by making the images susceptible to textual meanings. Many of the theoretical implications resulting from the pairing of media resound in modern film adaptations, which often provide commentary about nineteenth-century visual culture and the self-reflexivity of media. The critical heritage that has responded to the pairing of media in nineteenth-century print culture often expresses uneasiness with the relationship between text and mechanically produced images, and this uneasiness has often resulted in the treatment of text and image as separate components of multi-media works. "Image and Text" recovers the dialogue between media in nineteenth-century print forms often overlooked in critical commentary that favors the study of an elusive and sometimes fictional concept of an original work; each chapter acknowledges the collaborative nature of the production of multi-media works and their ability to promote textual newness, originality (or the illusion of originality), and (un)reality. Multi-media works challenge critical conventions regarding artistic and authorial originality, and they enter into battles over fidelity of meaning. By recognizing multi-media works as part of a diverse genre it becomes possible to expand critical dialogue about such works past fidelity studies. Text and image cannot faithfully represent the other; what they can do is engage in dialogue: with each other, with their historical and cultural moments, and with their successors and predecessors.

Depuis 2006, le Programme Hors Normes (PHN) dicte une nouvelle marche à suivre que doivent privilégier les équipes de santé au travail (SAT) lorsque des travailleurs sont exposés à des concentrations environnementales de produits chimiques supérieures aux valeurs d’exposition admissibles, c’est-à-dire à des « hors normes ». Le PHN encadre les activités de signalements des hors normes aux instances concernées et demande des suivis plus rigoureux en établissements. Ce faisant, il redéfinit les rôles des infirmières et des membres des équipes SAT. Dans le but de mieux comprendre l’implication des infirmières dans le cadre du PHN, sept entretiens individuels semi-dirigés ont été réalisés afin d’explorer et de décrire leurs représentations. L’analyse qualitative de ces représentations, par catégorisation et comparaisons constantes des discours, révèle que les infirmières se représentent de diverses façons leur pratique dans le cadre du PHN. En effet, les résultats de l’étude montrent qu’afin de comprendre l’implication des infirmières dans ce programme d’intervention, il importe de considérer les quatre éléments suivants : l’organisation du travail, les aspects relationnels (dynamique de relations), les cibles d’intervention et l’utilité du travail des infirmières (sens donné au travail). Afin de faciliter leur participation dans les programmes d’intervention et d’encourager la collaboration, tant intersectorielle qu’interprofessionnelle, il est suggéré en premier lieu de favoriser l’implication des infirmières dans les processus d’élaboration et d’implantation de programmes d’intervention. En second lieu, il est proposé de mettre en place une formation continue interprofessionnelle permettant une meilleure harmonisation des pratiques professionnelles. / Since 2006, the Programme Hors Normes (PHN) (Standards Non-compliance Program) of the “Direction de santé publique de Montréal ”, has set new guidelines for Occupational Health Teams with regard to workers who have been exposed to environmental concentrations of chemical agents that exceed permissible exposure levels, in other words, that are “standards non-compliant.” The PHN oversees the reporting of non-compliance to the relevant authorities and ensures that employers conduct rigorous follow-up. In doing so, the program has redefined the roles of occupational health team nurses. This exploratory study aims to describe the representations of these nurses with regard to the PHN and to better understand how they represent their practice into the PHN. Individual semi-directed interviews were conducted among seven nurses. Qualitative analysis of the data, through categorization and consistent comparison of narratives, reveals the various ways nurses represent their practice in the PHN. Their representations of their practice appear to derive from four elements: work organization, work relationships, intervention target, and work satisfaction. To increase nurses’empowerment, to take into account the ways in which he PHN has prompted them to reflect on their practice, and to promote cross-sector and cross-professional cooperation, the study suggests that nurses should participate in the planning and implementation of intervention programs and that on-going training should be provided in order to further harmonize professional practice.

Diss. (sammanfattning) Stockholm : Handelshögskolan, 2008 Sammanfattning jämte 3 uppsatser

Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro / Esta dissertação tem como objetivo estudar a relação entre propriedade intelectual, inovação e saúde pública, com foco na análise do consórcio farmacêutico para desenvolvimento do medicamento combinação em dose fixa artesunato-mefloquina (ASMQ) contra a malária. A concepção dessa iniciativa se insere num momento histórico, final dos anos 1990 e início dos anos 2000, em que estudos apontaram a insuficiência da pesquisa e desenvolvimento para as doenças negligenciadas. Na época, o cenário da malária era particularmente preocupante, dada a disseminação de resistência aos medicamentos disponíveis e à falta de perspectiva do lançamento de novos produtos contra a doença. Para proteger a última classe de antimaláricos eficazes, a saber,os derivados a base de artemisinina, uma estratégia encontrada foi a do recurso à terapia combinada a base de artemisinina (artemisinin based combination therapy ACT). Contudo, dos 4 ACTs recomendados pela OMS em 2001, apenas 1 se encontrava disponível no mercado. O projeto FACT foi então criado, em 2002, com o propósito de desenvolver dois novos ACTs artesunato-mefloquina e artesunato-amodiaquina. O consórcio do ASMQ, por suas especificidades, em particular a produção de inovação por um laboratório público do Sul e a circulação Sul-Sul de conhecimentos e tecnologias , o tornam de interesse para estudos nos campos da bioética e da saúde pública; tendo sido, por isso, escolhido como objeto desta dissertação. O estudo se apoiou em pesquisa bibliográfica, de fundamental relevância para a compreensão dos problemas de acesso e de disponibilidade de novos produtos para doenças negligenciadas, decorrentes de um modelo de inovação farmacêutica sustentado em patentes. De forma complementar, foram feitos: i) trabalho de observação durante a 65a Assembleia Mundial da Saúde, da Organização Mundial da Saúdem, evento de importância para os debates sobre propriedade intelectual e interesse público; e ii) entrevistas com integrantes de equipes das duas principais instituições participantes do consórcio FACT (Farmanguinhos/Fiocruz e DNDi). / This thesis aims to study the relationship between intellectual property, innovation and public health, considering the case of the consortium for the development of the fixed-dose combination artesunate-mefloquine (ASMQ) for the treatment of malaria. The genesis of this initiative is part of a historical moment (late 1990s and early 2000s), when studies highlighted the crisis on R&D for neglected diseases. At that time, the scenario of malaria was particularly worrying, given the spread of drug resistance and also the fact that there was no expectation for launching new antimalarials in the market. A strategy was then developed to protect the last class of effective antimalarials (artemisinin derivatives) by establishment of the artemisin-based combination therapies (ACTs). Nevertheless, only one of the four ACTs recommended by WHO in 2001 was available. The FACT project was then created in 2002 with the purpose of developing two new ACTs - artesunate-mefloquine and artesunateamodiaquine. The ASMQ Consortium, due to its specific features (production of an innovation by a public laboratory located in the South and South-South knowledge circulation), may interest the studies in the fields of Bioethics and Public Health, and was chosen to integrate this thesis. Besides the analysis of specialized literature, which was of fundamental importance for understanding the problems of access and availability that arises from the current model of innovation adopted by the pharmaceutical industry, an observation work was conducted during the 65th World Health Assembly, World Health Organization, held in Geneva during May 2012, which was of valuable importance for the debates regarding intellectual property and public interest. Also we conducted interviews with actors belonging to the two institutions participants of the consortium FACT (Farmanguinhos / Fiocruz and DNDi) in order to better understand the initiative.

Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro / Esta dissertação tem como objetivo estudar a relação entre propriedade intelectual, inovação e saúde pública, com foco na análise do consórcio farmacêutico para desenvolvimento do medicamento combinação em dose fixa artesunato-mefloquina (ASMQ) contra a malária. A concepção dessa iniciativa se insere num momento histórico, final dos anos 1990 e início dos anos 2000, em que estudos apontaram a insuficiência da pesquisa e desenvolvimento para as doenças negligenciadas. Na época, o cenário da malária era particularmente preocupante, dada a disseminação de resistência aos medicamentos disponíveis e à falta de perspectiva do lançamento de novos produtos contra a doença. Para proteger a última classe de antimaláricos eficazes, a saber,os derivados a base de artemisinina, uma estratégia encontrada foi a do recurso à terapia combinada a base de artemisinina (artemisinin based combination therapy ACT). Contudo, dos 4 ACTs recomendados pela OMS em 2001, apenas 1 se encontrava disponível no mercado. O projeto FACT foi então criado, em 2002, com o propósito de desenvolver dois novos ACTs artesunato-mefloquina e artesunato-amodiaquina. O consórcio do ASMQ, por suas especificidades, em particular a produção de inovação por um laboratório público do Sul e a circulação Sul-Sul de conhecimentos e tecnologias , o tornam de interesse para estudos nos campos da bioética e da saúde pública; tendo sido, por isso, escolhido como objeto desta dissertação. O estudo se apoiou em pesquisa bibliográfica, de fundamental relevância para a compreensão dos problemas de acesso e de disponibilidade de novos produtos para doenças negligenciadas, decorrentes de um modelo de inovação farmacêutica sustentado em patentes. De forma complementar, foram feitos: i) trabalho de observação durante a 65a Assembleia Mundial da Saúde, da Organização Mundial da Saúdem, evento de importância para os debates sobre propriedade intelectual e interesse público; e ii) entrevistas com integrantes de equipes das duas principais instituições participantes do consórcio FACT (Farmanguinhos/Fiocruz e DNDi). / This thesis aims to study the relationship between intellectual property, innovation and public health, considering the case of the consortium for the development of the fixed-dose combination artesunate-mefloquine (ASMQ) for the treatment of malaria. The genesis of this initiative is part of a historical moment (late 1990s and early 2000s), when studies highlighted the crisis on R&D for neglected diseases. At that time, the scenario of malaria was particularly worrying, given the spread of drug resistance and also the fact that there was no expectation for launching new antimalarials in the market. A strategy was then developed to protect the last class of effective antimalarials (artemisinin derivatives) by establishment of the artemisin-based combination therapies (ACTs). Nevertheless, only one of the four ACTs recommended by WHO in 2001 was available. The FACT project was then created in 2002 with the purpose of developing two new ACTs - artesunate-mefloquine and artesunateamodiaquine. The ASMQ Consortium, due to its specific features (production of an innovation by a public laboratory located in the South and South-South knowledge circulation), may interest the studies in the fields of Bioethics and Public Health, and was chosen to integrate this thesis. Besides the analysis of specialized literature, which was of fundamental importance for understanding the problems of access and availability that arises from the current model of innovation adopted by the pharmaceutical industry, an observation work was conducted during the 65th World Health Assembly, World Health Organization, held in Geneva during May 2012, which was of valuable importance for the debates regarding intellectual property and public interest. Also we conducted interviews with actors belonging to the two institutions participants of the consortium FACT (Farmanguinhos / Fiocruz and DNDi) in order to better understand the initiative.

The associations between coping styles, measured by COPE Test, dispositional version (Carver,Scheier and Weintraub, 1989), and Health Status inferred through a performance status, measured by Karnofsky's Index of Behavioral Performance are examined. The study focuses upon 28 oncological in patients. Positive moderate Pearson's correlations were found between these two variables in this correlational-descriptive study. These were interpreted in the following sense: the larger use of the style, the less health status among the scales suppression of competent activities, procrastination of coping, instrumental social support, focusing and releasing of emotions and behavioral disengagement. The active coping scale presented a negative correlationwith regard to Performance Status as a health measure. / Se estudian las asociaciones entre estilos de afrontamiento medidos a través del Test de Estimación del Afrontamiento COPE-versión disposicional (Carver, Scheier y Weintraub. 1989) y Estado de Salud inferido a través del Estatus Performance, medido a través del Índice de EjecuciónConductual de Karnofsky, en un grupo de 28 pacientes oncológicos hospitalizados de ambos sexos. La investigación alcanza el nivel descriptivo-correlacional, y se encontraron asociaciones entre ambas variables expresadas en correlaciones Pearson positivas y moderadas interpretadas en el siguiente sentido: a mayor empleo del estilo, menor estatus de salud entre las escalas supresión de actividades competentes, postergación del afrontamiento, apoyo social instrumental, enfocar y liberar emociones y desentendimiento conductual. La escala afrontamiento activo, presentó una correlación negativa respecto al Estatus Performance como medida de salud.