9 resultados para demand-side management

em Scielo Saúde Pública - SP


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The Dutch disease is a major market failure originated in the existence of cheap and abundant natural or human resources that keep overvalued the currency of a country for an undetermined period of time, thus turning non profitable the production of tradable goods using technology in the state-of-the-art. It is an obstacle to growth on the demand side, because it limits investment opportunities. The severity of the Dutch disease varies according to the extent of the Ricardian rents involved, i.e., according to the difference between two exchange rate equilibriums: the ‘current’ or market rate and the ‘industrial’ rate - the one that make viable efficient tradable industries. Its main symptoms, besides overvalued currency, are low rates of growth of the manufacturing industry, artificially high real wages, and unemployment. Its neutralization requires managing the exchange rate. The principal instrument for that is a sales or export tax on the commodities that give origin to the Dutch disease. In order to neutralize it policymakers face major political obstacles since it involves taxing exports and reducing wages. Finally, this papers argues that there is an extended concept of Dutch disease: besides having its origin in natural resources, it may arise from cheap labor provided that the ‘wage spread’ in the developing country is considerably larger than in the developed one - a condition that is usually present.

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The Brazilian economy pulled by the aggregate demand. This article aims to present the demand-led growth theory and some empirical evidences for a demand-led growth regime in Brazil. First of all, we will do a brief review of the theory of demand led-growth, based in the seminal work of Kaldor (1988), for whom long-run growth is determined by the growth rate of consumption expenditures and the growth rate of exports. Based in the empirical methodology developed by Atesoglu (2002), we run some econometric tests for the hypothesis of demand-led growth for Brazilian economy. The results of such tests shown that near of 85% of GDP growth in Brazil in the period 1991-2005 is explained by variables at the demand side of the economy. Besides that, based in the methodology developed by Ledesma and Thirwall (2002), we shown that natural rate of growth for Brazilian economy is endogenous, increasing during boom times. This means that appears to be no restrictions in the supply side of the economy for a faster growth of Brazilian economy. Finally, we argue that a necessary condition for a sustained growth of Brazilian economy is the adoption of a export-led growth model. For such it is necessary to put an end on the actual over-valuation of real exchange rate.

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This is a personal account of the definition of "new developmentalism" - a national development strategy alternative to the Washington consensus -, and of a "structuralist development macroeconomics": the sum of models that justifies theoretically that strategy. It is personal account of a collective work involving Keynesian, institutionalist and structuralist economists in Brazil that are forming a new school of thought in Brazil: a Keynesian-structuralist school. It is Keynesian because it emphasizes the demand side or the investment opportunities' side of economic growth. It is institutionalist because institutions obviously matter in achieving growth and stability. It is structuralist because it defines economic development as a structural change from low to high value added per capita industries and because it is based on two structural tendencies that limit investment opportunities: the tendency of wages to grow below productivity and the tendency to the cyclical overvaluation of the exchange rate.

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Objective To analyse the provision of health care actions and services for people living with AIDS and receiving specialised care in Ribeirão Preto, SP. Method A descriptive, exploratory, survey-type study that consisted of interviews with structured questionnaires and data analysis using descriptive statistics. Results The provision of health care actions and services is perceived as fair. For the 301 subjects, routine care provided by the reference team, laboratory tests and the availability of antiretroviral drugs, vaccines and condoms obtained satisfactory evaluations. The provision of tests for the prevention and diagnosis of comorbidities was assessed as fair, whereas the provisions of specialised care by other professionals, psychosocial support groups and medicines for the prevention of antiretroviral side effects were assessed as unsatisfactory. Conclusion Shortcomings were observed in follow-up and care management along with a predominantly biological, doctor-centred focus in which clinical control and access to antiretroviral therapy comprise the essential focus of the care provided.


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The objective of this work was to evaluate the effect of pond management on fish feed, growth, yield, survival, and water and effluent quality, during tambaqui (Colossoma macropomum) juvenile production. Fish were distributed in nine 600 m² earthen ponds, at a density of 8 fish per m²; the rearing period was 60 days. Three different pond management were applied: limed and fertilized (LimFer), limed (Lim), and natural (Nat). Fish were fed with a commercial ration containing 34% crude protein three times daily. There were no significant differences in fish growth or yield. Three main items found in tambaqui stomach were insect, zooplankton and ration, without a significant difference among treatments in proportion. Alkalinity, hardness, and CO2 were greater in LimFer and Lim ponds. Chlorophyll a, transparency, ammonia, nitrite, temperature, and dissolved oxygen of pond water were not significantly different among treatments. Biochemical oxygen demand, total phosphorus, orthophosphate, ammonia, and nitrite were significantly greater in effluents from LimFer ponds. Pond fertilization should be avoided, because growth and yield were similar among the three pond management systems tested; besides, it produces a more impacting effluent.

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The increasing demand for water resources accentuates the need to reduce water waste through a more appropriate irrigation management. In the particular case of irrigated coffee planting, which in recent years presented growth with the predominance of drip irrigation, the improvement of drip irrigation management techniques is a necessity. The proper management of drip irrigation depends on the knowledge of the spatial pattern of soil moisture distribution inside the wetted strip formed under the irrigation lines. In this study, grids of 24 tensiometers were used to determine the water storage within the wetted strip formed under drippers, with a 3.78 L h-1 discharge, evenly spaced by 0.4 m, subjected to two different management criteria (fixed irrigation interval and 60 kPa tension). Estimates of storage based on a one-dimensional analysis, that only considers depth variations, were compared with two-dimensional estimates. The results indicate that for high-frequency irrigation the one-dimensional analysis is not appropriate. However, under less frequent irrigation, the two-dimensional analysis is dispensable, being the one-dimensional sufficient for calculating the water volume stored in the wetted strip.

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Citrus orchards are very important in Brazil, especially in São Paulo State, where occupy an area of 600,000 ha approximately. To identify sustainability degree of citrus production system, an energy analysis allows evaluating efficiency of direct and indirect applied inputs. Thus, this study aimed to evaluate citrus production system under energetic point of view, in which invested energy is paid back with citrus production; being compared within three scenarios for operational field efficiency. As result, by sensitivity analysis was determined that fuel was the main energy demander, followed by pesticides and fertilizers. In operational work capacity analysis, all combinations between efficiency (minimum, typical and maximum) and yield levels became positive in the seventh year, except for the combination minimum efficiency and 10 % less yield, positive in the eighth year. The best combination (maximum efficiency and 10 % more yield) has promoted investment payoff around the sixth and seventh year. By this study, it is possible to determine the total energy demand to produce citrus and indentify the applied inputs that need more attention by the decision-makers. Labor and seedlings can be ommited for further studies with citrus, since they were irrelevant. Management of agricultural machinery may pose an important role on decreasing environmental impact of citrus production.

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Sympathetic ganglion block (SGB) or intravenous regional block (IVRB) has been recommended for pain management in patients with complex regional pain syndrome type I (CRPS-I). Forty-five patients were initially selected but only 43 were accepted for the study. The present study evaluated the efficacy of IVRB produced by combining 70 mg lidocaine with 30 µg clonidine (14 patients, 1 male/13 females, age range: 27-50 years) versus SGB produced by the injection of 70 mg lidocaine alone (14 patients, 1 male/13 females, age range: 27-54 years) or combined with 30 µg clonidine (15 patients, 1 male/14 females, age range: 25-50 years) into the stellate ganglion for pain management in patients with upper extremity CRPS-I. Each procedure was repeated five times at 7-day intervals, and pain intensity and duration were measured using a visual analog scale immediately before each procedure. A progressive and significant reduction in pain scores and a significant increase in the duration of analgesia were observed in all groups following the first three blocks, but no further improvement was obtained following the last two blocks. Drowsiness, the most frequent side effect, and dry mouth occurred only in patients submitted to SGB with lidocaine combined with clonidine. The three methods were similar regarding changes in pain intensity and duration of analgesia. However, IVRB seems to be preferable to SGB due to its easier execution and lower risk of undesirable effects.

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Sucrose solution is recommended as relevant pain relief management in neonates during acute painful procedures; however, only a few studies have analyzed the potentially adverse effects of sucrose administration to preterm neonates. The goal of this study was to examine the potential side effects of sucrose for pain relief in preterm infants, assessing feeding and weight gain during hospitalization and their feeding patterns postdischarge. The study sample consisted of 43 preterm neonates divided into two groups: a sucrose group (SG, n=18) and a control group (CG, n=25) in which no sucrose was administered. The SG received 0.5 mL/kg 25% oral sucrose for 2 min prior to all acute painful procedures during three consecutive days. A prospective review of medical charts was performed for all samples. The study was done prior to implementation of the institutional sucrose guidelines as a routine service, and followed all ethical requirements. There were no statistically significant differences between groups in terms of weight gain, length of stay with orogastric tubes, and parenteral feeding. Postdischarge, infant nutritional intake included feeding human milk to 67% of the SG and 74% of the CG. There were no statistically significant differences between groups regarding human milk feeding patterns postdischarge. Neonate feeding patterns and weight gain were unaffected following the short-term use of sucrose for pain relief.