863 resultados para Government implementation strategies
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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.
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Dissertação Apresentada à Escola Superior de Educação de Lisboa para obtenção de grau de mestre em Ciências da Educação - Especialidade Supervisão em Educação
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Cancer is a national and international health care concern. It’s important to find strategies for early diagnosis as well as for the optimization of the various therapeutic options currently existing in Portugal. Cancer is the second leading cause of death in Portugal, the choice of this study, is due to the importance of radiotherapy approach in cancer treatment and because is the therapy used in 40% of oncology patients. Radiation therapy has evolve data technological level, that allows new treatment techniques that are more efficient and that also promotes greater professional satisfaction. The hadrons are charged particles, used in cancer therapy. These particles can bring a paradigm shift regarding the therapeutic approach in radiotherapy. The technique used is proton therapy, that reveal to be more accurate, efficacious and less toxic to surrounding tissue. Proton therapy may be a promising development in the field of oncology and how the treatment is given in radiotherapy. Although there is awareness of the benefits of proton therapy in oncology it’s also important to take in consideration the costs of these therapy, because they are considerably higher than conventional treatments of radiotherapy. Given the lack of a proton therapy service in Portugal, this study aims to be a documentary analysis of clinical records that will achieve the following objectives: to identify the number of cancer patients diagnosed in 2010 in Portugal and to calculate the estimated number of patients that could have been treated with proton therapy according to the Health Council of the Netherlands registration document.
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ABSTRACT OBJECTIVE To analyze Government strategies for reducing prices of antiretroviral medicines for HIV in Brazil. METHODS Analysis of Ministry of Health purchases of antiretroviral medicines, from 2005 to 2013. Expenditures and costs of the treatment per year were analyzed and compared to international prices of atazanavir. Price reductions were estimated based on the terms of a voluntary license of patent rights and technology transfer in the Partnership for Productive Development Agreement for atazanavir. RESULTS Atazanavir, a patented medicine, represented a significant share of the expenditures on antiretrovirals purchased from the private sector. Prices in Brazil were higher than international references, and no evidence was found of a relationship between purchase volume and price paid by the Ministry of Health. Concerning the latest strategy to reduce prices, involving local production of the 200 mg capsule, the price reduction was greater than the estimated reduction. As for the 300 mg capsule, the amounts paid in the first two years after the Partnership for Productive Development Agreement were close to the estimated values. Prices in nominal values for both dosage forms remained virtually constant between 2011 (the signature of the Partnership for Productive Development Agreement), 2012 and 2013 (after the establishment of the Partnership). CONCLUSIONS Price reduction of medicines is complex in limited-competition environments. The use of a Partnership for Productive Development Agreement as a strategy to increase the capacity of local production and to reduce prices raises issues regarding its effectiveness in reducing prices and to overcome patent barriers. Investments in research and development that can stimulate technological accumulation should be considered by the Government to strengthen its bargaining power to negotiate medicines prices under a monopoly situation.
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The scope and coverage of the Brazilian Immunization Program can be compared with those in developed countries because it provides a large number of vaccines and has a considerable coverage. The increasing complexity of the program brings challenges regarding its development, high coverage levels, access equality, and safety. The Immunization Information System, with nominal data, is an innovative tool that can more accurately monitor these indicators and allows the evaluation of the impact of new vaccination strategies. The main difficulties for such a system are in its implementation process, training of professionals, mastering its use, its constant maintenance needs and ensuring the information contained remain confidential. Therefore, encouraging the development of this tool should be part of public health policies and should also be involved in the three spheres of government as well as the public and private vaccination services.
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Dissertação apresentada ao Instituto Politécnico do Porto - Instituto Superior de Contabilidade e Administração do Porto, para obtenção do Grau de Mestre em Assessoria e Administração de Organizações, sob orientação de Anabela Mesquita, PhD
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RESUMO: O instrumento de avaliação de sistemas de saúde mental da organização mundial de saúde (WHO-AIMS)foi usado para a recolha de informações sobre o Programa Nacional de Saúde Mental de Moçambique. O presente estudo tem como objectivo melhorar o Programa Nacional de Saúde Mental e fornecer um ponto de partida para a monitorização das mudanças. Os resultados do estudo permitirão a Moçambique fortalecer a sua capacidade para desenvolver planos de saúde mental baseados em informações com pontos de partida e metas bem definidos. O relatório será também útil para a monitorização do progresso da implementação de reformas nas políticas de saúde mental, na disponibilização de serviços de base comunitária, e no envolvimento dos utentes, seus familiares e outros actores na promoção, prevenção,cuidados e reabilitação em saúde mental. Tendo em conta os antecedentes históricos da saúde mental em Moçambique, a realidade actual clama por reformas profundas voltadas para uma intervenção mais humanizada e com enfoque nos cuidados primários. É nesse contexto que o estudo realizado apresenta resultados relacionados com as políticas, legislação, estratégias e planos de acção e financiamento para a saúde mental; serviços de saúde mental;cuidados primários; recursos humanos e ligação com outros sectores chave. A saúde mental foi avaliada desde o sistema de gestão até ao nível comunitário. Relativamente aos órgãos de gestão, a principal constatação é que existem instrumentos legais para sustentar as iniciativas desta área e influenciar os meios políticos em prol da saúde mental. Todavia, o caminho a percorrer ainda é longo uma vez que não está ainda aprovada nenhuma lei de saúde mental e os financiamentos para a área não permitem a implementação das reformas necessárias. Os serviços ao nível clínico debatem-se com a problemática dos recursos humanos (constituídos principalmente por técnicos de psiquiatria) e disponibilidade de psicofármacos. O modelo biopsicossocial ainda não é implementado integralmente uma vez que são poucos os serviços que oferecem apoio psicossocial (que inclui a reabilitação e reintegração) para além da intervenção farmacológica. Esta pode ser considerada uma das principais causas de recaídas identificadas em todas as províncias. Há uma necessidade urgente de se realizarem pesquisas e levantamentos epidemiológicos que possam servir de suporte para a advocacia em saúde mental com vista a melhoria dos cuidados a prestar aos pacientes e comunidade. Os instrumentos de recolha de informação de rotina não são adequados limitando a fidelidade dos dados recolhidos e a possibilidade de uma gestão dos serviços de saúde mental que responda as reais necessidades da população. Em suma, os resultados aqui apresentados mostram que Moçambique tem uma base que pode ser considerada uma mais valia para a reforma do sistema de saúde mental. Existem, ainda que escassos, recursos como humanos, infra-estruturas e legislação para a prestação dos serviços clínicos. É preciso investir na saúde mental para que os recursos existentes sejam melhorados e expandidos, apostando na criação de equipas multidisciplinares e qualificação das equipas de gestão e equipas clínicas. --------ABSTRACT: The World Health Organization Assessment Instrument for Mental Health Services (WHO-AIMS) was used to collect information about the National Mental Health Program of Mozambique. The present study aims to improve the National Mental Health Program and provide a starting point for monitoring change. The study results will allow Mozambique to strengthen its capacity to develop mental health plans based on information with starting points and well-defined goals. The report will also be useful for monitoring the progress of implementation of reforms in mental health policies, the provision of community-based services, and involvement of users, their families and other stakeholders in the promotion, prevention, care and rehabilitation in mental health. Given the historical background of mental health in Mozambique, the current situation calls for reforms aimed at a more humane intervention focused on primary care. In this context, the study presents results related to policies, legislation, strategies and action plans and funding for mental health; mental health services; primary care; human resources and liaison with other key sectors. Mental health was assessed from the management system to the community level. With regard to the management, the main observation is that there are legal instruments to support the initiatives in this area and to influence the political means on behalf of mental health. However, the pathway is still long as it is not yet approved any Mental Health Law and the funding for the area do not allow the implementation of necessary reforms. Services at the clinical level are struggling with the issue of human resources (consisting primarily of psychiatrist technicians) and availability of psychotropic drugs. The biopsychosocial model is not yet fully implemented since there are few services providing psychosocial support (including rehabilitation and reintegration) in addition to pharmacological intervention. This can be considered a major cause of relapse identified in all provinces. There is an urgent need to conduct research and epidemiological surveys which could provide support for advocacy in mental health in order to improve the mental health car for the patients and community. The routine data collection instruments are not appropriate limiting the fidelity of the data collected and the possibility of a management of mental health services that meets the real needs of the population. In summary, the results presented here show that Mozambique has a groundwork that can be considered an asset for the reform of mental health system. There are, though scarce, human resources, infrastructure and legislation for the provision of clinical services. It’s necessary to invest in mental health so that existing resources are improved and expanded, and to invest on the creation of multidisciplinary teams and qualification of management teams and clinical teams.
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An overwhelming problem in Math Curriculums in Higher Education Institutions (HEI), we are daily facing in the last decade, is the substantial differences in Math background of our students. When you try to transmit, engage and teach subjects/contents that your “audience” is unable to respond to and/or even understand what we are trying to convey, it is somehow frustrating. In this sense, the Math projects and other didactic strategies, developed through Learning Management System Moodle, which include an array of activities that combine higher order thinking skills with math subjects and technology, for students of HE, appear as remedial but important, proactive and innovative measures in order to face and try to overcome these considerable problems. In this paper we will present some of these strategies, developed in some organic units of the Polytechnic Institute of Porto (IPP). But, how “fruitful” are the endless number of hours teachers spent in developing and implementing these platforms? Do students react to them as we would expect? Do they embrace this opportunity to overcome their difficulties? How do they use/interact individually with LMS platforms? Can this environment that provides the teacher with many interesting tools to improve the teaching – learning process, encourages students to reinforce their abilities and knowledge? In what way do they use each available material – videos, interactive tasks, texts, among others? What is the best way to assess student’s performance in these online learning environments? Learning Analytics tools provides us a huge amount of data, but how can we extract “good” and helpful information from them? These and many other questions still remain unanswered but we look forward to get some help in, at least, “get some drafts” for them because we feel that this “learning analysis”, that tackles the path from the objectives to the actual results, is perhaps the only way we have to move forward in the “best” learning and teaching direction.
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Dissertation submitted in partial fulfillment of the requirements for the Degree of Master of Science in Geospatial Technologies.
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Dissertation submitted in partial fulfillment of the requirements for the Degree of Master of Science in Geospatial Technologies.
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A Work Project, presented as part of the requirements for the Award of a Masters Degree in Management from the NOVA – School of Business and Economics
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Dissertation presented to obtain the Master Degree in Molecular, Genetics and Biomedicine
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Dissertação para obtenção do Grau de Mestre em Engenharia do Ambiente, perfil Gestão e Sistemas Ambientais
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RESUMO: A reprogramação celular permite que uma célula somática seja reprogramada para outra célula diferente através da expressão forçada de factores de transcrição (FTs) específicos de determinada linhagem celular, e constitui uma área de investigação emergente nos últimos anos. As células somáticas podem ser experimentalmente manipuladas de modo a obter células estaminais pluripotentes induzidas (CEPi), ou convertidas directamente noutro tipo de célula somática. Estas descobertas inovadoras oferecem oportunidades promissoras para o desenvolvimento de novas terapias de substituição celular e modelos de doença, funcionando também como ferramentas valiosas para o estudo dos mecanismos moleculares que estabelecem a identidade celular e regulam os processos de desenvolvimento. Existem várias doenças degenerativas hereditárias e adquiridas da retina que causam deficiência visual devido a uma disfunção no tecido de suporte da retina, o epitélio pigmentar da retina (EPR). Uma destas doenças é a Coroideremia (CHM), uma doença hereditária monogénica ligada ao cromossoma X causada por mutações que implicam a perda de função duma proteína com funções importantes na regulação do tráfico intracelular. A CHM é caracterizada pela degenerescência progressiva do EPR, assim como dos foto-receptores e da coróide. Resultados experimentais sugerem que o EPR desempenha um papel importante na patogénese da CHM, o que parece indicar uma possível vantagem terapêutica na substituição do EPR nos doentes com CHM. Por outro lado, existe uma lacuna em termos de modelos in vitro de EPR para estudar a CHM, o que pode explicar o ainda desconhecimento dos mecanismos moleculares que explicam a patogénese desta doença. Assim, este trabalho focou-se principalmente na exploração das potencialidades das técnicas de reprogramação celular no contexto das doenças de degenerescência da retina, em particular no caso da CHM. Células de murganho de estirpe selvagem, bem como células derivadas de um ratinho modelo de knockout condicional de Chm, foram convertidos com sucesso em CEPi recorrendo a um sistema lentiviral induzido que permite a expressão forçada dos 4 factores clássicos de reprogramação, a saber Oct4, Sox2, Klf4 e c-Myc. Estas células mostraram ter equivalência morfológica, molecular e funcional a células estaminais embrionárias (CES). As CEPi obtidas foram seguidamente submetidas a protocolos de diferenciação com o objectivo final de obter células do EPR. Os resultados promissores obtidos revelam a possibilidade de gerar um valioso modelo de EPR-CHM para estudos in vitro. Em alternativa, a conversão directa de linhagens partindo de fibroblastos para obter células do EPR foi também abordada. Uma vasta gama de ferramentas moleculares foi gerada de modo a implementar uma estratégia mediada por FTs-chave, seleccionados devido ao seu papel fundamental no desenvolvimento embrionário e especificação do EPR. Conjuntos de 10 ou menos FTs foram usados para transduzir fibroblastos, que adquiriram morfologia pigmentada e expressão de alguns marcadores específicos do EPR. Adicionalmente, observou-se a activação de regiões promotoras de genes específicos de EPR, indicando que a identidade transcricional das células foi alterada no sentido pretendido. Em conclusão, avanços significativos foram atingidos no sentido da implementação de tecnologias de reprogramação celular já estabelecidas, bem como na concepção de novas estratégias inovadoras. Metodologias de reprogramação, quer para pluripotência, quer via conversão directa, foram aplicadas com o objectivo final de gerar células do EPR. O trabalho aqui descrito abre novos caminhos para o estabelecimento de terapias de substituição celular e, de uma maneira mais directa, levanta a possibilidade de modelar doenças degenerativas da retina com disfunção do EPR numa placa de petri, em particular no caso da CHM.---------------ABSTRACT: Cellular reprogramming is an emerging research field in which a somatic cell is reprogrammed into a different cell type by forcing the expression of lineage-specific transcription factors (TFs). Cellular identities can be manipulated using experimental techniques with the attainment of pluripotency properties and the generation of induced Pluripotent Stem (iPS) cells, or the direct conversion of one somatic cell into another somatic cell type. These pioneering discoveries offer new unprecedented opportunities for the establishment of novel cell-based therapies and disease models, as well as serving as valuable tools for the study of molecular mechanisms governing cell fate establishment and developmental processes. Several retinal degenerative disorders, inherited and acquired, lead to visual impairment due to an underlying dysfunction of the support cells of the retina, the retinal pigment epithelium (RPE). Choroideremia (CHM), an X-linked monogenic disease caused by a loss of function mutation in a key regulator of intracellular trafficking, is characterized by a progressive degeneration of the RPE and other components of the retina, such as the photoreceptors and the choroid. Evidence suggest that RPE plays an important role in CHM pathogenesis, thus implying that regenerative approaches aiming at rescuing RPE function may be of great benefit for CHM patients. Additionally, lack of appropriate in vitro models has contributed to the still poorly-characterized molecular events in the base of CHM degenerative process. Therefore, the main focus of this work was to explore the potential applications of cellular reprogramming technology in the context of RPE-related retinal degenerations. The generation of mouse iPS cells was established and optimized using an inducible lentiviral system to force the expression of the classic set of TFs, namely Oct4, Sox2, Klf4 and c-Myc. Wild-type cells, as well as cells derived from a conditional knockout (KO) mouse model of Chm, were successfully converted into a pluripotent state, that displayed morphology, molecular and functional equivalence to Embryonic Stem (ES) cells. Generated iPS cells were then subjected to differentiation protocols towards the attainment of a RPE cell fate, with promising results highlighting the possibility of generating a valuable Chm-RPE in vitro model. In alternative, direct lineage conversion of fibroblasts into RPE-like cells was also tackled. A TF-mediated approach was implemented after the generation of a panoply of molecular tools needed for such studies. After transduction with pools of 10 or less TFs, selected for their key role on RPE developmental process and specification, fibroblasts acquired a pigmented morphology and expression of some RPE-specific markers. Additionally, promoter regions of RPE-specific genes were activated indicating that the transcriptional identity of the cells was being altered into the pursued cell fate. In conclusion, highly significant progress was made towards the implementation of already established cellular reprogramming technologies, as well as the designing of new innovative ones. Reprogramming into pluripotency and lineage conversion methodologies were applied to ultimately generate RPE cells. These studies open new avenues for the establishment of cell replacement therapies and, more straightforwardly,raise the possibility of modelling retinal degenerations with underlying RPE defects in apetri dish, particularly CHM.
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This marketing plan project is a culmination of extensive strategies with the use of experiential marketing to address issues confronting the Kenyan tourism industry in order to have a sustainable tourism sector. Following the terrorist attack carried out by Islamist militants’ belonging to al-Shabaab terrorist organization on Nairobi’s Westgate shopping mall in September 2013, tourist forecast has gone down sharply with an average of 20% fall in tourists’ arrivals which is likely to have an impact on the tourism sector in Kenya. Even before the deadly attack on Westgate, the most lethal attack by Islamist terrorists in 15 years in Kenya, the government through the Kenya tourist board had announced that in 2013 tourist arrivals were down by 12%, at 495,978, according to an October 2013 report by Bloomberg. Tourism revenues were also down by 7.4%, over FY12/13 (July-June) to reach KES96.24bn, according to a September 2013 report on the local Capital FM website. Beyond 2013, much will depend on how quickly the Kenya tourist board can regain control of the situation. The Kenyan government believes that the Westgate mall attack was a 'one-off' incident, with a low probability of a similar event happening again over the short term period. Germany, United States, United Kingdom, Australia, Italy, France and Canada continue to be the key source market however; the Kenya tourist board can make continued growth stronger from new emerging markets in order to increase new arrivals into the country. The marketing plan outlines the objectives to be implemented and provides the implementation strategy, activity plans, monitoring and evaluation plans, financial requirements projections and proposes a new structure of experiential marketing. A number of regional forces are identified that will impact tourism into the country including global, social and economic forces, emerging trends in visitor motivations and behavior, emerging forces in experiential marketing. A major component of the strategy identifies target markets for Kenya to commensurate with the level of resources that will be available for marketing and promotion, in keeping with the forces and trends identified and the nature of the Kenya tourism environment. The agreed upon target market segments are: generic/mass travel, experiential travel, creative travel, adventure seeking travel, senior/extended/long stay travel, and business related travel. The strategy phases the development of the target markets over the years of the marketing strategies in order to yield the best opportunity for results. A core activity in developing a marketing strategy is determining the nature of experiences Kenya offers in tourism. The strategy’s experience development process will continue to develop within the context of the products identified which will be promoted regionally: culture/heritage, nature, community-based. Each county in the country has a significant number of attractions and experiences and the challenge of the country is to bring these together in a creative and innovative way in order to encourage tourists to visit more than one county in Kenya.