Democratization of local government in Brazil : decentralisation and people's councils

This research studies two cases of implementation of alternative strategies for municipal government reform in Brazil, decentralisation and People's Councils. The aim is to answer the following general question: `Can decentralisation and People's Councils be a means for democratization of municipal government in Brazil?'. The hypothesis is that initiatives to reform Brazilian municipal governments face problems that are characteristic of the Brazilian political and administrative reality. These problems are considered obstacles for the development of those initiatives and accordingly, for democratization of municipal government in Brazil. After an introduction and outline in Chapter One, Chapter Two discusses four main theories concerning local government. Chapter Three discusses decentralisation and People's Councils are discussed in Chapter Four. Chapter Five presents a historical, political and economic overview of Brazil. Chapter Six deals with Brazilian Federalism and Municipal Government. The main aspects of the Municipal Government are presented as well as the development of municipal autonomy through the various Federal Constitutions and cases of People's Councils and decentralisation in municipalities in Brazil. Chapter Seven presents the political parties responsible for the initiatives, the PSDB (Brazilian Social Democratic Party) in the case of decentralisation, and the PT (Workers' Party) in the case of People's Councils. In Chapter Eight the research strategy and the data collection techniques are described. Chapters Nine and Ten present decentralisation implemented by the PSDB in Belo Horizonte, the Minas Gerais state capital and People's Councils introduced by the PT in the town of Ipatinga in the same state. Conclusions are presented in Chapter Eleven and include a comparison and discussion of the two cases. The thesis shows that these experiments with alternative strategies of local government face problems that are generally current in Brazilian political and administrative reality. Those problems are concerned with unwillingness to decentralise power, clientelism, low levels of participation of civil society and the `political' use of the structures implemented.

Provision of pharmaceutical care by community pharmacists:a comparison across Europe

Objective To investigate the provision of pharmaceutical care by community pharmacists across Europe and to examine the various factors that could affect its implementation. Methods A questionnaire-based survey of community pharmacies was conducted within 13 European countries. The questionnaire consisted of two sections. The first section focussed on demographic data and services provided in the pharmacy. The second section was a slightly adapted version of the Behavioral Pharmaceutical Care Scale (BPCS) which consists of three main dimensions (direct patient care activities, referral and consultation activities and instrumental activities). Results Response rates ranged from 10–71% between countries. The mean total score achieved by community pharmacists, expressed as a percentage of the total score achievable, ranged from 31.6 (Denmark) to 52.2% (Ireland). Even though different aspects of pharmaceutical care were implemented to different extents across Europe, it was noted that the lowest scores were consistently achieved in the direct patient care dimension (particularly those related to documentation, patient assessment and implementation of therapeutic objectives and monitoring plans) followed by performance evaluation and evaluation of patient satisfaction. Pharmacists who dispensed higher daily numbers of prescriptions in Ireland, Germany and Switzerland had significantly higher total BPCS scores. In addition, pharmacists in England and Ireland who were supported in their place of work by other pharmacists scored significantly higher on referral and consultation and had a higher overall provision of pharmaceutical care. Conclusion The present findings suggest that the provision of pharmaceutical care in community pharmacy is still limited within Europe. Pharmacists were routinely engaged in general activities such as patient record screening but were infrequently involved in patient centred professional activities such as the implementation of therapeutic objectives and monitoring plans, or in self-evaluation of performance.

Semantic representation for comparison of performance measurement indicators

Indicators are widely used by organizations as a way of evaluating, measuring and classifying organizational performance. As part of performance evaluation systems, indicators are often shared or compared across internal sectors or with other organizations. However, indicators can be vague and imprecise, and also can lack semantics, making comparisons with other indicators difficult. Thus, this paper presents a knowledge model based on an ontology that may be used to represent indicators semantically and generically, dealing with the imprecision and vagueness, and thus facilitating better comparison. Semantic technologies are shown to be suitable for this solution, so that it could be able to represent complex data involved in indicators comparison.