Avaliação de operadoras de saúde por usuários pelo método Analytic Hierarchy Process

OBJETIVO: Analisar a qualidade dos serviços oferecidos por empresas operadoras de planos de saúde, segundo a percepção de usuários. MÉTODOS: Estudo transversal com 360 usuários de sete operadoras de planos de saúde da cidade de Curitiba, PR, e região metropolitana em 2008. Foi aplicado questionário sobre as preferências dos usuários em relação a seis atributos (localização dos pontos de atendimento; efetividade da ação dos médicos, clínicas e hospitais; rapidez e amabilidade no atendimento; facilidade na liberação de guias; preço; abrangência da rede credenciada) de cada uma das empresas operadoras. Para a análise das respostas foi utilizado o método Analytic Hierarchy Process (AHP, ou Processo Analítico de Hierarquia), ferramenta de análise de decisão e planejamento de múltiplos critérios. RESULTADOS: O atributo mais valorizado pelos usuários foi "preço". As empresas foram agrupadas em dois conjuntos de preferências em relação aos atributos: dos sete planos de saúde, dois apresentaram menor preferência (entre 23% e 19%) e cinco, maior preferência (em torno de 10%). CONCLUSÕES: Com esse tipo de pesquisa, as empresas operadoras de planos de saúde poderiam reformular suas estruturas, processos, preços e redes credenciadas com o objetivo de melhorar seu posicionamento no mercado.

Oviposition preference hierarchy in Ceratitis capitata (Diptera, Tephritidae): influence of female age and experience

The influence of two factors, age and previous experience, on the oviposition hierarchy preference of Ceratitis capitata (Wiedemann, 1824) females was studied. Two populations were analyzed: one reared in laboratory during 17 years and the other captured in nature. In the first experiment the oviposition preference for four fruits, papaya, orange, banana and apple was tested at the beginning of oviposition period and 20 days past. The results showed that the wild females as much the laboratory ones had an oviposition preference hierarchy at the beginning of peak period of oviposition. However this hierarchic preference disappeared in a later phase of life. In the second experiment the females were previously exposed to fruits of different hierarchic positions and afterwards their choice was tested in respect to the oviposition preference for those fruits. The results showed that there was an influence of the previous experience on the posterior choice of fruits to oviposition when the females were exposed to fruits of lower hierarchic position.

Understanding the hierarchy governance choice of some wineries in Brazil - case study of 3 Brazilian wineries

ABSTRACT This study aims to contribute towards understanding the multiple factors, which influence firm's governance decisions. To identify some of these factors, three cases in the Brazilian wine industry were analyzed: Miolo located in Vale dos Vinhedos (South of Brazil) and in Vale do Rio São Francisco (Northeast of Brazil); Don Laurindo located in Vale dos Vinhedos; and ViniBrasil located in Vale do Rio São Francisco. For the most part, all three firms procure the grapes they use for their wine production in-house. Only Miolo purchases an insignificant amount of grapes outside of its production. By Brazilian standards, these regions have a long tradition of grape production and it is not difficult to purchase sufficient quantity of grapes to produce wine. However, the wineries are concerned also about the quality of the grapes they use and purchasing high-quality grapes might be critical issue. On the other hand, the quality of grapes is easily measured and the cost to buy in the market is cheaper than producing in-house. Furthermore, also the level of asset specificity present in the grape-grower-wine-producer transaction seems, by itself, insufficient to justify the use of hierarchical governance forms. Then, the aim of the article is to analyze the reasons why these wineries largely rely on hierarchy governance forms to procure their grape-inputs. What explains their use of hierarchy governance, given that both asset specificity and measurement problems appear to be relatively low?

Knowledge hierarchy and professional knowledge

The aim of this article is to substantiate, in the sociological point of view, the distinction between the social and cognitive processes that produce knowledge in knowledge abstract systems - KAS - to generate cultural inequality and the micro processes of knowledge usage, which build local and cultural knowledge from common sense. It is circumscribed to this aim a problematization of knowledge usage developed by middle class salaried professional groups, rich in cultural capital but without equivalent symbolical capital, in a capitalist society at risk. In order to achieve this goal, the classical contributions of Pierre Bourdieu, Boaventura Sousa Santos, Donald Schön and Basil Bernstein (among others) are taken as a basis regarding the limitation of critical and reflexive thinking and the virtues of professional knowledge to support an epistemology of professional practice.

Modelos quantitativos de apoio as decisões: II

O sucesso da aplicação de técnicas de Análise das Decisões como apoio em problemas com um único objetivo predominante abriu caminho para estudos de problemas mais ambiciosos como os de decisões com multicritérios e decisões e de grupo (estes dois tipos utilizam metodologias muito semelhantes). Como evolução natural da Análise das Decisões, resultou a metodologia MAUT (Multi-Attribute Utility Theory). Seu rigorismo teórico torna as aplicações difíceis para um analista menos preparado. Como conseqüência, surgiu a metodologia AHP (Analytic Hierarchy Process) de utilização extremamente simples. A crítica ao AHP veio da escola européia que criou uma série de métodos conhecidos pela abreviação comum: MCDA (Multicriteria Decision Aid).

A blockmodel study of managerial hierarchies, verbal networks, and organizational culture in four hospitals

This study demonstrates and applies a social network methodology for studying the dynamics of hierarchies in organizations. Social network (blockmodel) analysis of verbal networks in four hospitals contrasted hierarchical and structurally equivalent partitions of the sociomatrices of frequent ties and perceptions of organizational culture. It was found that the verbal networks in these organizations follow a center periphery pattern rather than a hierarchical logic and that perceptions of culture vary more by verbal network than by formal hierarchy. The perceptions of culture of central groups in one organization are much like those of peripheral groups in another. In all four hospitals, structurally equivalent social networks are more important in predicting subcultures than are hierarchical groupings and hierarchy has a limited impact on the development of verbal networks. These findings suggest the value of an amoeba rather than a pyramid metaphor in interpreting the cultures and relational structures of organizations.

SPATIOTEMPORAL TRENDS OF CASES OF PANDEMIC INFLUENZA A(H1N1)PDM09 IN ARGENTINA, 2009-2012

The aim of this paper was to analyze the spatiotemporal variations of cases of influenza A(H1N1)pdm09 in Argentina. A space-time permutation scan statistic was performed to test the non-randomness in the interaction between space and time in reported influenza A(H1N1)pdm09 cases. In 2009, two clusters were recorded in the east of Buenos Aires Province (May and June) and in the central and northern part of Argentina (July and August). Between 2011 and 2012, clusters near areas bordering other countries were registered. Within the clusters, in 2009, the high notification rates were first observed in the school-age population and then extended to the older population (15-59 years). From 2011 onwards, higher rates of reported cases of influenza A(H1N1)pdm09 occurred in children under five years in center of the country. Two stages of transmission of influenza A(H1N1)pdm09 can be characterized. The first stage had high rates of notification and a possible interaction with individuals from other countries in the major cities of Argentina (pattern of hierarchy), and the second stage had an increased interaction in some border areas without a clear pattern of hierarchy. These results suggest the need for greater coordination in the Southern Cone countries, in order to implement joint prevention and vaccination policies.

Aceitação e preferência de frutos para oviposição em duas populações de Ceratitis capitata (Diptera, Tephritidae)

The influence of four host fruits, orange (Citrus sinensis L.), papaya (Carica papaya L.), mango (Mangifera indica L.) and apple (Malus domestica Borkh) on oviposition behavior of Ceratitis capitata (Wiedemann, 1824) was evaluated. Experiments were carried out on two C. capitata laboratory-reared populations: one with artificial diet for 10 years with periodic introduction of wild flies and other reared with artificial diet for 20 years without wild flies introduction. In acceptance experiments two pieces of a single fruit type were exposed to a group of 10 females; after 48 hours, these were changed by two new pieces of the same fruit type, and, in the end of the fourth day, the experiments were concluded. In preference experiments, two pieces of different fruits were offered to the females. These experiments were driven under the same conditions of the acceptance ones. Acceptance and preference experiments for both populations showed the following choice hierarchy: papaya > mango > orange > apple. The acceptance experiments showed no differences in the number of eggs/female/day laid in the first 48 hours and in the last 48 hours of the experiments. The amount of eggs in the two pieces of fruits offered to the females was similar. In spite of the two populations present similar behavior in relation to host hierarchy, the number of laid eggs was different, being larger for the population reared without wild flies introduction.

Sharing competences in strategic alliances: a case study of the Cosan and Shell biofuel venture

In a competitive world, the way a firm establishes its organizational arrangements may determine the enhancement of its core competences and the possibility of reaching new markets. Firms that find their skills to be applicable in just one type of market encounter constraints in expanding their markets, and through alliances may find a competitive form of value capture. Hybrid forms of organization appear primarily as an alternative to capturing value and managing joint assets when the market and hierarchy modes do not present any yields for the firm's competitiveness. As a result, this form may present other challenging issues, such as the allocation of rights and principal-agent problems. The biofuel market has presented a strong pattern of changes over the last 10 years. New intra-firm arrangements have appeared as a path to participate or survive among global competition. Given the need for capital to achieve better results, there has been a consistent movement of mergers and acquisitions in the Biofuel sector, especially since the 2008 financial crisis. In 2011 there were five major groups in Brazil with a grinding capacity of more than 15 million tons per year: Raízen (joint venture formed by Cosan and Shell), Louis Dreyfus, Tereos Petrobras, ETH, and Bunge. Major oil companies have implemented the strategy of diversification as a hedge against the rising cost of oil. Using the alliance of Cosan and Shell in the Brazilian biofuel market as a case study, this paper analyses the governance mode and challenging issues raised by strategic alliances when firms aim to reach new markets through the sharing of core competences with local firms. The article is based on documentary research and interviews with Cosan's Investor Relations staff, and examines the main questions involving hybrid forms through the lens of the Transaction Cost Economics (TCE), Agency Theory, Resource Based View (RBV), and dynamic capabilities theoretical approaches. One focal point is knowledge "appropriability" and the specific assets originated by the joint venture. Once the alliance is formed, it is expected that competences will be shared and new capabilities will expand the limits of the firm. In the case studied, Cosan and Shell shared a number of strategic assets related to their competences. Raízen was formed with economizing incentives, as well to continue marshalling internal resources to enhance the company's presence in the world energy sector. Therefore, some challenges might be related to the control and monitoring agents' behavior, considering the two-part organism formed by distinctive organizational culture, tacit knowledge, and long-term incentives. The case study analyzed illustrates the hybrid arrangement as a middle form for organizing the transaction: neither in the market nor in the hierarchy mode, but rather a more flexible commitment agreement with a strategic central authority. The corporate governance devices are also a challenge, since the alignment between the parent companies in the joint ventures is far more complex. These characteristics have led to an organism with bilateral dependence, offering favorable conditions for developing dynamic capabilities. However, these conditions might rely on the partners' long-term interest in the joint venture.

Women working at university restaurants: life and work conditions and gender-based violence

This is an exploratory and descriptive study with a quantitative approach that aimed to understand the social production and reproduction processes of women working at university restaurants and the occurrence and the magnitude of gender-based violence committed against them by their intimate partners. The data were collected through semi-structured interviews. The analysis categories used were social production and reproduction, gender and gender-based violence. The interviewees held a subordinate social position during the productive and reproductive periods of their lives. Approximately 70% reported having experienced gender-based violence from an intimate partner (66% psychological violence, 36.3% physical violence and 28.6% sexual violence). Most of the health problems resulting from violence were related to mental health. The results indicate that the situation requires immediate interventions, mostly guided by the instrumentalization of these women and the support by the state and the university as appropriate to address violence.

Scientific production on the applicability of phenytoin in wound healing

Phenytoin is an anticonvulsant that has been used in wound healing. The objectives of this study were to describe how the scientific production presents the use ofphenytoinas a healing agent and to discuss its applicability in wounds. A literature review and hierarchy analysis of evidence-based practices was performed. Eighteen articles were analyzed that tested the intervention in wounds such as leprosy ulcers, leg ulcers, diabetic foot ulcers, pressure ulcers, trophic ulcers, war wounds, burns, preparation of recipient graft area, radiodermatitis and post-extraction of melanocytic nevi. Systemic use ofphenytoinin the treatment of fistulas and the hypothesis of topical use in the treatment of vitiligo were found. In conclusion, topical use ofphenytoinis scientifically evidenced. However robust research is needed that supports a protocol for the use ofphenytoinas another option of a healing agent in clinical practice.

More than one inseminated female in colonies of the independent-founding wasp Mischocyttarus cassununga von Ihering (Hymenoptera, Vespidae)

In the primitively eusocial wasps, especially Polistini and Mischocyttarini tribes, the physiological condition of each individual is strongly associated with its dominance status in the colonial hierarchy. As a rule, in independent-founding wasps, female wasps are all morphologically alike, and their role is apparently quite flexible even as adults. However, some studies have shown that differences in body size can exist between reproductive and non-reproductive females. Thus, the present study aimed at detecting differences between reproductive (inseminated) and non-reproductive (uninseminated) individuals based on morphological and physiological parameters. We tape-recorded the daily behavioural repertory of six colonies of Mischocyttarus cassununga for determining the hierarchical dominance in the field, and then collected these colonies (in different cycle stages) for measuring 13 set characters, and assessing the physiological condition of each individual by inspecting their fat bodies and ovaries. Our results revealed that inseminated and uninseminated females are not significantly different in relation to body size, in spite of first group shows higher average than second in almost all measured parts. The physiological evaluation of each individual demonstrated more than one inseminated female per colony during all stages of the colony cycle, suggesting a strategic condition of this species against difficulties (predation and parasitism of the colony) in nature.

Residence advantage in heterospecific territorial disputes of Erythrodiplax Brauer species (Odonata, Libellulidae)

Residence advantage in heterospecific territorial disputes of Erythrodiplax Brauer species (Odonata, Libellulidae). Territories are the outcome of interactions determining where and how long individuals settle. To odonate species, aggressive disputes are not so common since the outcome can be predetermined by advantages such as residency, age, and body size. However, it is possible to predict that at heterospecific disputes, larger body-sized or more aggressive species have some profits overcoming these individual advantages, generating patterns of species hierarchy. Here, I studied the aggressiveness of five Erythrodiplax species (Odonata, Libellulidae) during territorial disputes and verified if larger body-sized species are more aggressive than smaller ones or if the residence advantage prevails on the heterospecific disputes. Larger species were not more aggressive than smaller ones and winners of intra- and interspecific territorial disputes were defined mainly by the residence. So, the residence advantage between heterospecific opponents appears to prevail over any other asymmetry among these species. This pattern may occur because, despite the territorial behaviour in dragonfly males, heterospecific disputes may not increment male reproductive success because it may not increase their access to females.

Definição de áreas prioritárias ao uso público no parque estadual da Cachoeira da Fumaça - ES, utilizando geoprocessamento

O Parque Estadual da Cachoeira da Fumaça (PECF) está localizado entre os municípios de Alegre e Ibitirama, no sul do Estado do Espírito Santo, possuindo área aproximada de 162,50 hectares. Levando-se em consideração a importância ambiental do PECF para o Estado do Espírito Santo, a necessidade de proteção dos ecossistemas da Mata Atlântica e suas formações associadas, bem como o aprimoramento das técnicas de gestão, este trabalho teve por objetivo propor subsídios aos gestores, através da geração de um mapa de adequabilidade com áreas prioritárias ao uso público, utilizando análise multicritério e lógica fuzzy. Os materiais utilizados foram: Ortofoto do ES, mapa de curvas de nível obtido do Geobases e para coleta de dados em campo utilizou-se GPS diferencial. Os fatores relevantes para avaliação dos aspectos relacionados ao ecoturismo que foram utilizados para produzir os mapas de adequabilidade, seguindo uma ordem de prioridade estabelecida pelo método Analytic Hierarchy Process (AHP) foram: fator cachoeira, uso dos solos, massa de água (contendo os rios), trilhas, locais de acessos, estruturas e declividade. Após a combinação dos fatores, foi gerado o mapa de adequabilidade para uso público, com superfície de adequabilidade mostrando a aptidão e representando o zoneamento da área do PECF para o objetivo proposto. A partir do zoneamento da Unidade de Conservação foi possível mostrar as áreas com diferentes graus de aptidão ao ecoturismo de acordo com suas distâncias da cachoeira, trilhas, e da área de Mata Atlântica.