25 resultados para Public service reform


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This dissertation deals with the use of the Balanced Scorecard (BSC) in the Military Police of Rio Grande do Norte (PMRN), an organization of service delivery in the area of public safety. For this purpose we sought refuge in the company's own documents, which presented the mission, vision and strategic objectives, which are items essential to the development of the instrument and its prospects. With the general objective of developing the BSC to PMRN, fitting into the methodology in a single case study, that from the desk study and according to their development, we established the classification of goals to the generic models and the BSC then adjusted according to public understanding of the corporation presented by professionals in the process of collection and in-depth interviews. Thus emerged the strategy map PMRN, based on the presentation of the causes and effects between the strategic objectives of each perspective, the value proposition to customers, internal processes needed to meet this value proposition and intangible assets, which are the basis to execute these processes

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This work aims at investigating the surgeons-dentists acceptability in the field of public health in the city of Natal, State of Rio Grande do Norte, about the possibility of medicinal plants insertion in basic attencion of health. Moreover, it searchs to know if during their professinal formation it had some theoretician-pratical basement on this subject, as well as investigating their confidence on the medicinal plants. The basic motivation for developing this study is the possibility of contributing to the insertion of a tradicional health pratical at public assistance scope, endorsed by popular use, but now scientifically proven. For in a such way, the medicinal plants use is emphasized as a way to be followed to increase basic pharmaceutical assistance, improving the acess to the medicine and diminish expenses. Following this logic, family health program constitutes the way through which this pratical will be available to the users of health services. The research was done over thirty surgeonsdentists, all ofthem pertaining to public service ofNatal, state ofRio Grande do Norte. It was used, as research instrument, semi-estructured interview associated with methodological analysis user s speeches. On this form, this work is inserted in a trend observed nowadays not only in Brazil, where the use of the medicinal plants has been stimulated and defended to be inserted at programs ofprimary attenction of health

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This work verifies the impact caused by the Emergencial Program of Reduction of Consumption of Electric Energy (energy-rationing program) in the results of the concessionary private companies of the public service of electric energy distribution localized in the Northeast Area. As the rationing invigorated from June 2001 to February 2002, its effects are diluted in the results presented by these companies in the second semester of 2001 and first quarter of 2002, with prominence for the last quarter of 2001, when the revenue of extraordinary tariff restore was instituted by the National Agency of Electric Energy (ANEEL), consequence of the so-called General Agreement of the Electric Sector made between the federal government and the companies of the electric sector. The structure of a generic electric sector and a historical review of the Brazilian electric sector from the time it was controlled by the private enterprises, including the State control period, about 1960, and returning to the control of the private enterprises in 1990, under a new regulation structure are presented. An explanation of the models of economic regulation that Brazil used for the electric sector is made, with prominence for the price cap that is the actual effective model. The process of tariff revision foreseen in the concession contracts signed by the federal government and the concessionary companies is presented, highlighting its two stages: the tariff rebalancing that defines the new price cap and the calculation of the factor X that establishes the efficiency goals for the companies. There is made a presentation of the Emergencial Program of Reduction of Consumption of Electric Energy and of the consequent General Agreement of the Electric Sector, which created the revenue of extraordinary tariff restore. A conceptual revision on reviews is presented, regarding to concepts, accomplishment and recognition. A brief review of the six companies that made part of the worked sample is also presented. Analyzing the quarters historical review and of amount of sold energy, it was possible to conclude that the energy-rationing altered the results of the studied companies significantly and that alteration was masked by the accounting process of the revenue of extraordinary tariff restore

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INTRODUCTION: Severe maternal morbidity , also known as maternal near miss , has been used as an alternative to the study of maternal mortality , since being more frequent shares the same determinants and enables the implementati on of epidem iological surveillance of cases . Since then, hospital audits ha ve been carried out to determine the rates of maternal near miss, its mai n causes and associated factors . More recently, population surveys based on self - reported morbidity have als o been presented as vi able in identifying these cases . OBJECTIVE: The aim of this study was to determine the prevalence and associated factors of maternal near miss and complications during pregnancy and puerperal period in Natal/RN. METHODS: A cross - secti onal population - based study was conducted in Natal /RN , Brazil, which has as its target population women aged 15 to 49 years who were pregnant in the last five years. It was carried out a probabilistic sam pling design based on a multi - stage complex sample , in which 60 census tracts were selected from three strata (north , south - east and west). Afterwards, domiciles were visited in order to obtain a sample of the 908 eligible women in whom a questionnaire was applied. The descriptive analyzes and bivariate ass ociations were performed using the Chi - square test and the estimate of the prevalence ratio (PR ) with 95% confidence interval (CI) and considering the weights and design effects . The Poisson regression analysis , also with 5% significance and 95% CI, was us ed for analyzes of associated factors. RESULTS: 848 women were identified and interviewed after visits in 8.227 households corresponding to a response rate of 93 . 4 %. The prevalence of maternal near miss was 41 . 1 /1 000NV, being the Intensive Care Unity stay i ng (19 . 1 /1 000 LB ) and eclampsia (13 . 5/1000LB) the most important marker s . The prevalence of complications in the puerperal peri od was 21 . 2 %, and hemorrhage (10 . 7%) and urinary tract infection (10 . 7%) the most frequently reported clinical conditions and rema in ing in the hospital for over a week after delivery the mo st frequent intervention (5.4%) . Regarding associated factors , the bivariate analysis showed an association between the increased number of complications in women of black/brown race ( PR= 1 . 23; CI95 % : 1 . 04 - 1 . 46) and lower socioeconomic status ( PR= 1 . 33; CI95%: 1 . 12 - 1 . 58) in women who had pre natal care in public service ( PR= 1 . 42; CI95%: 1 . 16 to 1 . 72 ) and that were not advised during prenatal about where they should do the d elivery (PR= 1 . 24; CI95%: 1 . 05 - 1 . 46), made the del ivery in the public service (PR= 1 . 63; CI95%: 1 . 30 - 2 . 03), had to search for more than one hospital for delivery (PR=1 . 22; CI95%: 1 . 03 - 1 . 45) and had no companion during childbirth ( PR =1 . 19; CI95%: 1 . 01 - 1 . 41) or at all times of childbirth c are - before, during and after childbirth - ( PR= 1 . 25, CI95%: 1 . 05 - 1 . 48) . Moreover, the number of days postpartum hospitalization was higher in women who had more complications (P R= 1 . 59 ; CI95%: 1 . 36 - 1 . 86). In the final regression model for both birth place (P R= 1 . 21 ; CI 95% : 1 . 02 to 1 . 44 ) and socioeconomic status (PR = 1.54 ; CI95%: 1 . 25 - 1 . 90 ) the association remained. CONCLUSION : Conducting population surveys using the pragmatic definition of near miss is feasible and may add importa nt information about this ev ent . It was possible to find the expression of health inequalities related to maternal health in the analysis of both socioeconomic conditions and on the utilization of health services.

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This study begins with a brief overview of tax immu nities in general, dealing with the concept, legal, doctrinal ratings and limits. Then enters into the reciprocal immunity, since its birth in the United States, its justifica tions, until her current developments in the Brazilian Supreme Court, which has expanded it quite considerably. That Court has extended to state owned enterprises, even if pa id by public prices or rates, or if acts somewhat away from its essential functions, es pecially if they are public services provider. Given this linkage, these are also treate d in own topic, grounded in newer doctrinal proposals and less attached to historical formalisms (see such Supremacy of Public Interest over Private one). Public services are approached in its diversity, oblivious to traditional monolithic nature and accu stomed to the modern doctrine of fundamental human rights. It deals also the princip les of free enterprise and free competition, given that the public service provider s have lived intensely in this environment, be they public or private agents. In d ialectical topic, these institutes are placed in joint discussion, all in an attempt to in vestigate their interactions and propose criteria less generic and removed from real ity, to assess the legitimacy of the mutual enjoyment of immunity by certain agents. Sev eral cases of the Court are analyzed individually, checking in each one the app lication of the proposed criteria, such logical-deductive activity and theory of pract ice approach. At the end, the conclusions refer to a reciprocal immunity less rhe torical and ideological and more pragmatic and consequentialist. It is proposed the end to the general rules or abstract formulas of subsumption, with concerns on the one h and the actual maintenance of the federal pact, and on the other by a solid econo mic order without inapt advantages to certain players, which flatly contradicts the co nstitutional premises.

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Nowadays the search for growth makes organizations seeking competitive advantages, project management shares this goal, through techniques that assist in the search for an improved management of the various fields of knowledge through a design methodology. The world is driven by projects and the search for ways to better manage activities such as time, cost and term towards the success of a particular project is something constant. A major contribution that IT can make to the health sector is the support for the management area. IT can integrate processes, optimize the interconnection between the various sectors, make hospitals have access to inside information of good quality, as well as support in the healthcare area, sharing pictures, uniting the various aspects of nursing and nursing service. The major challenge faced by the SESAP Information Technology sector at present is in project management in IT , which does not exist makes investments in the area are increasingly difficult due to this deficiency in management develop their own systems without cost additional to the State. This study seeks to build and strengthen the Project Management within the Department of Health through the implementation of a project office that will manage the final result of this work methodology based on PMBOK, and still show the functionality applied to development the state Hospital Management System that will later be installed on all Regional Health Units and proposing measures for the sustainability and development of the sector amid the difficulties of the current public service. Such action will result in a savings of more than R$ 107,000.00 (one hundred seven thousand) regarding spending private software currently used by the assignment of invested by the State of Rio Grande do Norte user licenses, representing more than 5 % of the total budget of the State Department of Public Health of the State

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It is considered that the Strategic Alignment IT is the first step within the IT Governance process for any institution. Taking as initial point the recognition that the governance corporate has an overall view of the organizations, the IT Governance takes place as a sub-set responsible for the implementation of the organization strategies in what concerns the provision of the necessary tools for the achievement of the goals set in the Institutional Development Plan. In order to do so, COBIT specifies that such Governance shall be built on the following principles: Strategic Alignment, Value Delivery, Risk Management, Performance Measurement. This paper aims at the Strategic Alignment, considered by the authors as the foundation for the development of the entire IT Governance core. By deepening the technical knowledge of the management system development, UFRN has made a decisive step towards the technical empowerment needed to the “Value Delivery”, yet, by perusing the primarily set processes to the “Strategic Alignment”, gaps that limited the IT strategic view in the implementation of the organizational goals were found. In the qualitative study that used documentary research with content analysis and interviews with the strategic and tactical managers, the view on the role of SINFO – Superintendência de Informática was mapped. The documentary research was done on public documents present on the institutional site and on TCU – Tribunal de Contas da União – documents that map the IT Governance profiles on the federal public service as a whole. As a means to obtain the documentary research results equalization, questionnaires/interviews and iGovTI indexes, quantitative tools to the standardization of the results were used, always bearing in mind the usage of the same scale elements present in the TCU analysis. This being said, similarly to what the TCU study through the IGovTI index provides, this paper advocates a particular index to the study area – SA (Strategic Alignment), calculated from the representative variables of the COBIT 4.1 domains and having the representative variables of the Strategic Alignment primary process as components. As a result, an intermediate index among the values in two adjacent surveys done by TCU in the years of 2010 and 2012 was found, which reflects the attitude and view of managers towards the IT governance: still linked to Data Processing in which a department performs its tasks according to the demand of the various departments or sectors, although there is a commission that discusses the issues related to infrastructure acquisition and systems development. With an Operational view rather than Strategic/Managerial and low attachment to the tools consecrated by the market, several processes are not contemplated in the framework COBIT defined set; this is mainly due to the inexistence of a formal strategic plan for IT; hence, the partial congruency between the organization goals and the IT goals.

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This study aims to bring reflection on the legitimacy crisis of the Brazilian representative democracy, which results in non-attendance of fundamental rights, regarding legal and social facts in light of the existing constitutional order and seeking solutions in more democratic procedures and in a more humane, critical, democratic and collaborative education. It has been an issue for some time the understanding that the authorities do not meet the basic needs of Brazilian citizens - the only way to make them autonomous and sufficiently able to conduct their lives in a competitive and globalized labor market. Such situation only worsened - as illustrated by the social movements in mid-2013 - when people took to the streets, showing a noticeable dissatisfaction with public services in general, and some other groups presenting specific complaints in those events. To find solutions or at least suggestions for the reflection of the problem found, a current approach to public authorities was necessary attempting to reveal how the constitutional order authorizes their operation and how - in fact - they act. In this endeavour, the legitimacy of power was discussed, involving the analysis of its origin, to whom it belongs and the legitimacy of deficit situations, concluding that it is only justified as it gets more democratic influence, with greater participation of people in its deliberations and decisions, with its plurality and complexity. Research carried out by official institutions was necessary to have evidence of the low level of social development of the country and the nonattendance of minimum basic rights, as well as exposure to various acts and omissions which show that all public authorities do not legitimately represent the people's interests. The competence of the Supreme Court to establish the broader scope of the remuneration policy in the public service received proper attention, presenting itself as an effective means to promote the reduction of the remuneration and structural inequality in public service and contributing to better care of fundamental rights. Also, considerations were made about the Decree 8243/2014, which established the National Policy for Social Participation (NPSP) and the National System of Social Participation (NSSP) and took other measures with the suggestion of its expansion into the legislative and judiciary powers as a way to legitimize the Brazilian democracy, considering its current stage. In conclusion, it is presented the idea expressed by the most influential and modern pedagogical trends for the creation of a participatory, solidary, non-hierarchical and critical culture since the childhood stage. This idea focuses on the resolution of questions addressed to the common good, which considers the complexity and the existing pluralism in society with a view to constant knowledge update. Knowledge update is in turn dynamic and requires such action, instilling - for the future generations - the idea that the creation of a more participatory and collaborative democracy is needed to reduce social inequality as a way to legitimize and promote social welfare, with the implementation of a policy devoted to meet the minimum fundamental rights to ensure dignity to the population.

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The Physical Rehabilitation services (PR) are of fundamental importance in combating the global epidemic of Traffic Accidents (TA). Considering the numerous physical and social consequences of the survivors, quality problems in access to PR are a hazard to recovery of victims. It is necessary to improve the management of quality of services, assessing priority dimensions and intervening in their causes, to ensure rehabilitation available in time and suitable conditions. This study aimed to identify barriers to access to rehabilitation considering the perception of TA victims and professionals. The aim is also to estimate the access to rehabilitation and their associated factors. This is a qualitative and quantitative study of exploratory nature developed in Natal / RN with semi-structured interviews with 19 health professionals and telephone survey to 155 victims of traffic accidents. To explore barriers to access the speeches were transcribed and analyzed using the Alceste software (version 4.9). During the interviews used the following guiding question: “What barriers hinder or prevent access to physical rehabilitation for victims of traffic accidents?”. The names of classes and axes resulting from Alceste was performed by ad hoc query to three external researchers with subsequent consensus of the most representative name of analysis. We conducted multivariate analysis of the influence of the variables of the accident, sociodemographic, clinical and assistance on access to rehabilitation. Associations with p <0.20 in the bivariate analysis were submitted to logistic regression, step by step, with p <0.05 and confidence interval (CI) of 95%. The main barriers identified were: “Bureaucratic regulation”, “Long time to start rehabilitation”, “No post-surgery referral” and “inefficiency of public services”. These barriers were divided into a theoretical model built from the cause-effect diagram, in which we observed that insufficient access to rehabilitation is the product of causes related to organizational structure, work processes, professional and patients. Was constructed two logistic regression models: “General access to rehabilitation” and “Access to rehabilitation to public service”. 51.6% of patients had access to rehabilitation, and 32.9% in public and 17.9% in the private sector. The regression model “General access to rehabilitation” included the variables Income (OR:3.7), Informal Employment (OR:0.11), Unemployment (OR:0.15), Perceived Need for PR (OR:10) and Referral (OR: 27.5). The model “Access to rehabilitation in the public service” was represented by the “Referral to Public Service” (OR: 23.0) and “Private Health Plan” (OR: 0.07). Despite the known influence of social determinants on access to health services, a situation difficult to control by the public administration, this study found that the organizational and bureaucratic procedures established in health care greatly determine access to rehabilitation. Access difficulties show the seriousness of the problem and the factors suggest the need for improvements in comprehensive care for TA survivors and avoid unnecessary prolongation of the suffering of the victims of this epidemic.

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Public institutions, as well as other entities, if use of various assets for development of its activities. These assets are tools that help with the generation of benefit present and future. For the assets that compound the Property, Plant and Equipament, this loss of generation of future benefits is called Depreciation and must be recognized as an expense in the period in which it occurs. This way, be considered as an expense, the depreciation has negative influence on the composition of the entity’s income, as this is the result of the confrontation between revenue and expenditure incurred in the same period. The Brazilian legislation regulates it is necessary to recognize and disclosure in the financial statements, all of the situations that interfere with the composition of economic and financial income of the public institution. The main objective of this work was to verify if the states and cities recognize and disclosure the depreciation on their Statements of Financial Position. The data were extracted from datas of the Brazilian public administration’s entities.. The sample analyzed is 100% of the States (including the Federal District) and 91% of the Brazilian cities. The research found the historical evolution of the expenditure with depreciation, evidenced in the balance sheets of the Brazilian cities, in the last 10 years, in the period 1999 to 2008. The results indicate that 10 Brazilian states (37 %) did not show the depreciation of fixed assets in the Statements of Financial Position of the year 2008. The situation is even more worrying in relation to cities, because 4,971 (98.4 %) of 5,050 municipalities not evidenced the depreciation. The evidence found in this study indicate that public entities do not recognize the expense with depreciation, which may indicate that the economic income and financial position presented in the financial statements of these public entities does not accurately reflect the actual situation of institutional performance.