A inter-relação trabalho-saúde mental: um estudo de caso

A autora, após sintetizar algumas das vertentes de estudo e conceitos atuais na temática da inter-relação trabalho-saúde mental, apresenta um estudo de caso individual. Trata-se do caso de um mecânico industrial do setor siderúrgico que desenvolveu um quadro psicopatol6gico. A evolução de manifestações de fadiga crônica e desencadeamento de uma crise mental aguda são examinadas em suas correlações ao hist6rico de vida e trabalho e a dinâmicas referidas às condições e à organização do trabalho no emprego atual.

Contemporary issues in the government and administration of Latin American megacities

This paper is the first to systematically analyze and compare the structures of city governance and administration for seven major cities in Latin America, four of which are megacities (population of over 10 million), and three others are large national capitals. U.S. and U. K. models of city administration are reviewed as baseline models against which differences in Latin American may be explored. Structures of Government in Latin America show several important features and trends: 1) the lack of metropolitan (cross jurisdictional) authority; 2) the existence of strong mayors and weak councils"; 3) high levels of partisanship; 4) overlapping rather than interlocking bureaucracies; 5) pressures towards the privatization of city services, but continuing tension over the desirability of public versus private control; 6) greater fiscal responsibility and autonomy; and 7), a continuing marginalization of public participation in megacity governance.In spite of these features, many cities throughout the region (regardless of whether they are megacity size or national capitals), are actively intensifying their efforts to develop more effective, accountable and democratic governance structures.

COMPARATIVE ANALYSIS OF AMERICAN AND SPANISH CRUISE PASSENGERS' BEHAVIORAL INTENTIONS

ABSTRACT Earlier studies of cross-national differences in consumer behavior in different consumption sectors have verified that cultural differences have a strong influence on consumers. Despite the importance of cross-national analysis, no studies in the literature examine the moderating effects of nationality on the construction of behavioral intentions and their antecedents among cruise line passengers. This study investigates the moderating effects of nationality on the relationships between perceived value, satisfaction, trust and behavioral intentions among Spanish and (U.S.) American passengers of cruise lines that use Barcelona as home port and port-of-call. A theoretical model was tested with a total of 968 surveys. Structural equation models (SEMs) were used, by means of a multigroup analysis. Results of this study indicated that Spaniards showed stronger relationships between trust and behavioral intentions, and between emotional value and satisfaction. Americans presented stronger relationships between service quality and satisfaction, and between service quality and behavioral intentions.

The convergence of the Central American countries to International Accounting Standards

Abstract: In the last few decades, Central American countries are making a significant effort in order to modernize their governments' legislation both on financial management and systems of financial information. In this sense, these countries aim to enhance the quality of public financial information in order to improve decision-making processes, decrease the level of corruption, and keep citizens informed. In this context, the purpose of this paper is twofold. Firstly, to assess the degree of similarity of the financial information that is being developed by Central American governments with regard to the recommendations set up by Ipsas, and secondly, to analyse the efforts and the strategies that those countries are carrying out in the process of implementing those standards. To determine the differences in the information containing the annual financial statements issued by national public authorities and the recommendations set up by Ipsas we conducted a deductive content analysis. In view of the results we can say that the quality of annual financial statements presented by the countries in Central America, in comparison to the recommendations by the Ipsas concerning Ifac information, is not enough. Hence, in order to operate significant changes, it is still necessary to create new strategies for the implementation of the Ipsas.

An appraisal of the health planning method proposed by the Pan-American Health Organization for Latin America

A brief description of the main features of the health planning technique developed by the "Centro de Estudios del Desarrollo" (CENDES) in Venezuela, and proposed by the Pan-American Health Organization for use in Latin America, is presented. This presentation is followed by an appraisal of the planning method which includes comments both upon its positive aspects and upon its negative points. Comments are also made referring to other recent publications of the WHO/PAHO on health planning. In conclusion, the CENDES technique is considered a health planning method of great potential for use especially in underdeveloped areas, the success of its application depending upon the hability of the health planners to introduce the necessary modifications to adapt to the local circunstamces.

The right to medical care and its economic consequences: an American dilemma

The concepts of "rights" and of "right to health care" including its evolution in modern times are discussed. The consequences of implementing this right are discussed in economic terms, regarding the situation in the United States of America. A discussion is also included on the limitations of the role of Health Insurance as a measure to solve the problem of providing health care for all individuals.

Os eventos vitais: aspectos de seus registros e inter-relação da legislação vigente com as estatísticas de saúde

Foram estudados os registros civis desde as suas origens, salientando aspectos legislativos do Brasil, chamando a atenção para algumas implicações que a legislação a eles referente trazem às estatísticas vitais e suas repercussões em planejamento de saúde e epidemiologia. Relativamente ao nascimento foram abordados alguns tópicos, com ênfase no problema do registro por local de ocorrência, fato que influe enormemente em programações de saúde materno-infantil. Foram salientados também alguns aspectos do sub-registro de nascimento, citando dados para São Paulo. Quanto aos óbitos foram analisados o registro por local de ocorrência, o prazo para registro, o problema das causas de morte e o relativo ao sub-registro. Com referência aos nascidos mortos, foi apresentada a conceituação de nascido vivo e nascido morto da Organização Mundial da Saúde e indicado o fato de sua não aplicação prática repercutir nos campos do Direito e da Estatística Vital. Foram feitas algumas recomendações no sentido de um maior entrosamento entre os vários profissionais - legisladores, médicos, oficiais de cartório, estaticistas de saúde - que, de uma maneira ou de outra, têm relação com os eventos vitais.

Ecological aspects of American cutaneous leishmaniasis: 4. Observations on the endophilic behavior of the sandfly and the vectorial role of Psychodopygus intermedius in the Ribeira Valley region of the S.Paulo State, Brazil

The invasive tendency of Psychodopygus intermedius in the home environment, observed initially by Forattini et al. (1976), has now been confirmed by the demonstration of its high endophilic ability and by the use of human residences for shelter. Populations such as Lutzomyia migonei and Pintomyia fischeri were also present in that environment, though their low densities registered during this investigation could be an indication of their poor ability to overcome the barriers raised by the artificial environment. An objective epidemiological analysis based on the variables here given showed that human infection takes place in the extraforest environment, and the principal vectorial function falls, without doubt, on P. intermedius.

Health financing changes in the context of health care decentralization: the case of three Latin American countries

OBJECTIVE: The results of an evaluative longitudinal study, which identified the effects of health care decentralization on health financing in Mexico, Nicaragua and Peru are presented in this article. METHODS: The methodology had two main phases. In the first, secondary sources of data and documents were analyzed with the following variables: type of decentralization implemented, source of financing, funds for financing, providers, final use of resources, mechanisms for resource allocation. In the second phase, primary data were collected by a survey of key personnel in the health sector. RESULTS: Results of the comparative analysis are presented, showing the changes implemented in the three countries, as well as the strengths and weaknesses of each country in matters of financing and decentralization. CONCLUSIONS: The main financing changes implemented and quantitative trends with respect to the five financing indicators are presented as a methodological tool to implement corrections and adjustments in health financing.

Medidas de morbidade referida e inter-relações com dimensões de saúde

OBJETIVO: Analisar as inter-relações entre auto-avaliação de saúde, percepção de doença de longa duração e diagnóstico de doenças crônicas. MÉTODOS: Na Pesquisa Mundial de Saúde, realizada no Brasil em 2003, foram entrevistados 5.000 indivíduos com 18 anos ou mais, selecionados a partir de amostra estratificada em três estágios. Foi utilizado o questionário original adaptado ao contexto brasileiro, abordando a presença de doença de longa duração ou incapacidade, a auto-avaliação de saúde (geral e dos vários domínios) e o diagnóstico de seis doenças crônicas (artrite, angina, asma, depressão, esquizofrenia e diabetes mellitus). Para comparar as relações entre a auto-avaliação de saúde, percepção de doença de longa duração e as doenças crônicas avaliadas foram utilizados teste estatístico de homogeneidade de proporções e modelos de regressão logística múltipla. RESULTADOS: A auto-avaliação de saúde "não boa" e a percepção de ser portador de doença de longa duração foram significativamente mais freqüentes entre mulheres, indivíduos com 50 anos ou mais e aqueles com alguma das doenças pesquisadas. Os entrevistados com diagnóstico de diabetes mellitus apresentaram as piores avaliações de saúde: 70,9% referiram doença de longa duração e 79,3% avaliaram sua saúde como "não boa". Verificou-se pior avaliação de saúde com a associação de duas ou mais doenças. O efeito da auto-avaliação de saúde sobre a percepção de doença de longa duração foi maior que o número de doenças. CONCLUSÕES: As três formas de aferição da morbidade mostraram inter-relações significativas. A auto-avaliação de saúde "não boa" apresentou efeito mais importante para a percepção de doença de longa duração, sugerindo que as medidas subjetivas do estado de saúde possam ser mais sensíveis para estabelecer e monitorar o bem-estar do indivíduo.

Content validity and reliability of test of gross motor development in Chilean children

ABSTRACT OBJECTIVE To validate a Spanish version of the Test of Gross Motor Development (TGMD-2) for the Chilean population. METHODS Descriptive, transversal, non-experimental validity and reliability study. Four translators, three experts and 92 Chilean children, from five to 10 years, students from a primary school in Santiago, Chile, have participated. The Committee of Experts has carried out translation, back-translation and revision processes to determine the translinguistic equivalence and content validity of the test, using the content validity index in 2013. In addition, a pilot implementation was achieved to determine test reliability in Spanish, by using the intraclass correlation coefficient and Bland-Altman method. We evaluated whether the results presented significant differences by replacing the bat with a racket, using T-test. RESULTS We obtained a content validity index higher than 0.80 for language clarity and relevance of the TGMD-2 for children. There were significant differences in the object control subtest when comparing the results with bat and racket. The intraclass correlation coefficient for reliability inter-rater, intra-rater and test-retest reliability was greater than 0.80 in all cases. CONCLUSIONS The TGMD-2 has appropriate content validity to be applied in the Chilean population. The reliability of this test is within the appropriate parameters and its use could be recommended in this population after the establishment of normative data, setting a further precedent for the validation in other Latin American countries.

Work, malaise, and well-being in Spanish and Latin-American doctors

ABSTRACT OBJECTIVE To analyze the relations between the meanings of working and the levels of doctors work well-being in the context of their working conditions. METHOD The research combined the qualitative methodology of textual analysis and the quantitative one of correspondence factor analysis. A convenience, intentional, and stratified sample composed of 305 Spanish and Latin American doctors completed an extensive questionnaire on the topics of the research. RESULTS The general meaning of working for the group located in the quartile of malaise included perceptions of discomfort, frustration, and exhaustion. However, those showing higher levels of well-being, located on the opposite quartile, associated their working experience with good conditions and the development of their professional and personal competences. CONCLUSIONS The study provides empirical evidence of the relationship between contextual factors and the meanings of working for participants with higher levels of malaise, and of the importance granted both to intrinsic and extrinsic factors by those who scored highest on well-being.

American trypanosomiasis (Chagas' disease) in conventional and germfree rats and mice

Germfree (GF) and conventional (CV) CFW (LOB) mice and Wistar and Sprague-Dawley rats were infected with Trypanosoma cruzi. The disease was more severe in the GF than in the CV animals as revealed by: (1) an earlier and more intense parasitemia; (2) a more precocious mortality; (3) a twice enlarged spleen: (4) a more intense cell and tissue parasitism; (5) visceral signs of cardiac failure.

Ecological aspects of American cutaneous leishmaniasis: 6. Man-biting sandfly fauna of a patch of residual forest in the middle and north-eastern region of the São Paulo State, Brazil

This report shows the phlebotomine vectorial role in the endemic cutaneous leishmaniasis situated in the middle and north-eastern region of the São Paulo, Brazil. Analysis of information encloses a sandfly man-biting fauna of four different patches of residual forest. So, using the human-bait and Shannon trap for a period of one year we have caught 16,869 sandflies. The predominance of Lutzomyia intermedia (85,6%) was clear. Moreover, the low density of Lutzomyia whitmani and Lutzomyia pessoai and their epidemiological implications at present and in the past are discussed. Information about the daily activity of some species is given and we emphasize for the first time, the diurnal activity of Lutzomyia firmatoi in the São Paulo State.