Federal Council

Background: Effective pharmacotherapy for Cocaine Use Disorder is needed. The Cocacrack-2 study showed that homeopathic fifty-millesimal potencies of Opium and Erythroxylum coca were more effective than a placebo in reducing cocaine/crack use. However, the study experienced high dropout rates, which are common in the study population but could introduce bias. Therefore, further research is needed, focusing on strategies to ensure trial patient retention. The Cocacrack-3 study protocol initially aimed to improve retention through home visits from Primary Care. However, due to the COVID-19 pandemic, we revised the protocol to utilize specialized facilities with network support and telemedicine follow-up to enhance retention. Objectives: 1) Assess the effectiveness and safety of sequential administration of homeopathic potencies (LM2, LM4, LM6) of Opium and Erythroxylum coca in reducing cocaine use. 2) Evaluate the effectiveness of telemedicine and support networks in enhancing treatment retention. Setting: Psychosocial Attention Centers for Alcohol and other Drugs (CAPS-AD) in Florianópolis, São José, and Palhoça, Brazil. Study center: Research Laboratory for the History of Nursing and Health Knowledge at the Federal University of Santa Catarina. Methods: Randomized, placebo-controlled, double-blind, crossover clinical trial (six weeks per participant). Hypothesis: H0: No significant difference between homeopathic potencies and placebo. H1: Significant difference between homeopathic potencies and placebo. Inclusion criteria: Men and women aged 18-70, patients at CAPS-AD, with a support network. Exclusion criteria: Remission of cocaine use > two weeks, inability to participate virtually. Sample size: 120 participants, randomized 1:1 to verum or placebo sequences. Interventions: LM2, LM4, LM6 potencies of Opium and Erythroxylum coca, or placebo. Primary measure: Percentage of cocaine use days at week 3. Secondary measures: Cocaine use days, craving, progression, concomitant medications, adverse events, treatment adherence, and participant retention.

BackgroundInfertility is an underrecognized disease which affects over 17% of the reproductive age population worldwide. However, availability of, and access to, assisted reproductive technology (ART) is variable across countries. There are significant challenges relating to awareness, financial and other barriers to care, cultural considerations, and the level of support provided to people undergoing care. Previous studies have explored these challenges, but less attention has been given to the policy implications. As the need for fertility care rises, we investigate the evidence that policy changes can be implemented to improve access to ART treatment.MethodsA review of literature was conducted on fertility policy challenges and developments, covering fertility recognition and awareness; cultural and religious considerations; and access to ART treatment, psycho-social care, and supplementary care. Nine medical and academic experts were invited to validate secondary research findings and provide their perspectives on policy implications. The experts covered different specialties and geographic expertise. Experts participated in individual 60-minute interviews, then a half-day Policy Forum discussion was held virtually in May 2023.ResultsLack of recognition of infertility as a disease, low financial coverage of fertility services, limited psychosocial support, and cultural considerations are substantial barriers to fertility services access. Some countries have limited reimbursement of services or offer only private care, significantly limiting treatment access. Others restrict reimbursement based on age, gender and family status, which creates access inequities. Policy action is needed to mitigate these challenges and to ensure timely and equitable access to fertility care. Decision-makers need to collectively recognize infertility as a disease, rather than just a social issue. Equity of access to infertility services should be ensured by expanding the availability of public funding, along with review and rationalisation of criteria for treatment reimbursement. To improve engagement in treatment and support through the fertility journey, access to psychosocial care should be expanded and included as a core service.ConclusionMajor obstacles to accessing ART treatment have been identified across regions globally, highlighting the urgent need for national policy action to enhance care quality by reviewing current legislation, improving patient and physician education, refining reimbursement procedures, and expanding psychosocial support services.

Background and objectiveTelemedicine holds promise for older adults with chronic and complex conditions, particularly those in need of palliative care. However, more information is needed about the perceptions of patients and their caregivers regarding this technology for providing care. Therefore, this study aims to explore the experience of non-oncologic older adult patients in palliative care with telemedicine.MethodsWe followed Arksey and O'Malley's five-stage scoping review approach and conducted searches in Medline, Scopus, and Web of Science databases. Key concepts included: "telemedicine" or "telehealth"; "elderly" or "old age" or "geriatric"; "palliative care" and NO "cancer" and were included articles written in English or Portuguese from the last five years.ResultsEighteen articles were included out of 137 abstracts selected. Most studies focused on elderly individuals in homebound settings, nursing homes, or long-term care facilities. The experiences reported in many articles were positive, with patients and caregivers expressing a willingness to use telemedicine. It was particularly convenient for patients in rural areas. However, several barriers were identified, such as difficulties in using and accessing technology and concerns about privacy, influencing the willingness to use telemedicine.ConclusionsTelemedicine can be beneficial in the care of older adults with non-oncologic chronic disease, multimorbidity, and life-threatening conditions. Nevertheless, understanding this barrier and searching for solutions from the patients' perspectives is essential for integrating telemedicine into their care. More studies involving older adults palliative care patients are needed to explore this area further.

Abstract On 2 February 1932, Alan Don, chaplain to the Archbishop of Canterbury Cosmo Gordan Lang, recorded in his diary the simple entry: ‘Church Assembly – not very invigorating’.1 This has been the tenor of the relationship between the English and the governing bodies of the church for centuries. This article seeks to describe the role of synodality at the regional level2 by reference to the General Synod of the Church of England, with a brief comparative study of the tikanga system in New Zealand, and asks the question whether the procedures meet the expectation of synodality.

The trends of recent years show that aquaculture products have already outstripped the products of industrial fisheries. The situation is understandable – the growing population of the Earth requires the production and consumption of more and more different types of food. And here fish products and seafood play an important role as sources of animal protein necessary for a full life of every person. FAO forecasts an increase in aquaculture production to 201 million tons by 2030, with most of the increase coming from developing countries.

VALORAÇÃO DO PASSIVO AMBIENTAL EM ÁREAS SOB RESTRIÇÃO ECOLÓGICA DE IMÓVEIS RURAIS DECRETADOS DEODATO DO NASCIMENTO AQUINO1 1 Perito Federal Territorial, Engenheiro Agrônomo – Doutor em Engenharia Agrícola, Instituto Nacional de Colonização e Reforma Agrária – INCRA, Rua Monsenhor Furtado, 2397 - Panamericano, Fortaleza - CE, 60441-750. ORCID 0000-0002-2736-5136, deodato.aquino@incra.gov.br. RESUMO: A valoração econômica de passivos ambientais, constitui-se em um conjunto de métodos e técnicas cuja finalidade é estimar valores monetários dos recursos vegetais suprimidos ilegalmente por atividades antrópicas. O objetivo deste trabalho é apresentar uma proposta metodológica, com uso de geoprocessamento, para estimar a valoração do passivo ambiental sobreposto em áreas de Reserva Legal e de Preservação Permanente nos imóveis rurais desapropriados, por interesse social, para fins de reforma agrária e/ou regularização de territórios quilombolas. A área estudada compreende um imóvel rural abrangido por Território Quilombola no município de Pacajus, Ceará. Utilizou-se dados topográficos planialtimétricos, obtidos junto a missão SRTM para o cálculo da declividade do terreno. Na estimativa do passivo ambiental, empregou-se ferramentas de sensoriamento remoto, imagens vetoriais do projeto MapBiomas e geoprocessamento, no software livre Q.GIS. A proposta metodológica demonstrou ser de fácil operacionalidade, além de praticidade e eficiência na estimativa do valor do passivo ambiental sobreposto em áreas de Reserva Legal e de Preservação Permanente de imóveis rurais avaliados para reforma agrária e/ou regularização de territórios quilombolas. Palavras-chaves: reforma agrária, engenharia de avaliações, geotecnologias. VALUATION OF ENVIRONMENTAL LIABILITIES IN AREAS UNDER ECOLOGICAL RESTRICTIONS OF DECREED RURAL PROPERTIES ABSTRACT: The economic valuation of environmental liabilities consists of a set of methods and techniques whose purpose is to estimate the monetary value of plant resources illegally suppressed by human activities. The objective of this work is to present a methodological proposal, using geoprocessing, to estimate the valuation of environmental liabilities overlapping in areas of Legal Reserve and Permanent Preservation in rural properties expropriated, for social interest, for the purposes of agrarian reform and/or regularization of quilombola territories. The area studied comprises rural property covered by Quilombola Territory in the municipality of Pacajus, Ceará. Planialtimetric topographic data obtained from the SRTM mission were used to calculate the slope of the terrain. In the estimation of environmental liabilities, remote sensing tools, vector images from the MapBiomas project and geoprocessing in the free software Q.GIS were used. The methodological proposal proved easy to implement, in addition to being practical and efficient in estimating the value of the environmental liability overlapping in areas of Legal Reserve and Permanent Preservation of rural properties evaluated for agrarian reform and/or regularization of quilombola territories. Keywords: agrarian reform, assessment engineering, geotechnologies.

Журнал Уголь, угольная промышленность, угольная отрасль, итоги работы угольной отрасли, итоги работы угольной промышленности, горная, горные, горное, горная техника, горная экономика, горные машины, горные выставки, история горного дела, перспективы угольной промышленности, топливно-знергетический, подземные работы, открытые работы, шахтный транспорт, шахтное строительство, охрана труда, промышленная безопасность, реструктуризация, дегазация, рынок угля, переработка угля, качество угля, геология

Ouverture de la PMA aux couples de femmes : une (r)évolution qui s'imposeAlors que le projet de mariage pour tous et toutes semble sur le point d'être accepté par les Chambres fédérales, la question de l'accès à la procréation médicalement assistée (PMA) pour les couples de femmes est, quant à elle, beaucoup plus controversée.Dans cette contribution, l'auteure examine dans quelle mesure l'exclusion des couples de femmes des techniques de procréation médicalement assistée est conforme au principe de non-discrimination consacré par la CEDH.

We develop and apply a new theoretical framework for assessing the transformative capability of transparency in environmental governance. Our framework suggests that as norms related to transparency are recognized and translated into accountability mechanisms, and as these mechanisms are complied with, effects cascade and substantially influence the ability of transparency to transform relationships of inequality. Utilizing the case of climate finance in the United Nations Framework Convention on Climate Change, we find that while a variety of norms underpinning transparency are recognized within the governance architecture, their translation into accountability mechanisms has been weak, and information disclosed by countries is often opaque. This suggests that a focus on enhanced transparency is unlikely to be sufficient for realizing a climate regime that is adequate and equitable. Moreover, transparency should be seen as a terrain of political conflict over the conditions of inequality, employed differently by various coalitions to benefit their respective interests.

Resumo Diante da falta de legislação federal, as técnicas reprodutivas assistidas (RA) aplicadas no Brasil são regidas desde 1992 por normas éticas, e as partes envolvidas – médico e paciente – em processo de procriação artificial contam com resoluções do Conselho Federal de Medicina (CFM). Recentemente houve importantes inovações quanto à abrangência de RA e quanto às normas orientadoras, a exemplo da nova Resolução CFM 2.121/2015 e dos Provimentos 21/2015-CGJ-PE e CNJ 52/2016 sobre o registro de crianças geradas por RA. Este último exige identificação dos doadores do material genético. Objetiva-se demonstrar avanços para atender ao melhor interesse das crianças havidas por RA e seus pais, e à igualdade entre filhos na emissão da certidão de registro civil em cartório no Brasil, independente de ação judicial, apontando violação do sigilo médico e do direito ao anonimato do doador no provimento nacional.