934 resultados para Multilateral system reform


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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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This study assesses the contributory pension system in Chile and offers some recommendations for reform, from the viewpoint of social rights that generate expectations of satisfaction. The primary objective of any pension system is to provide income security to the elderly, and contributory pensions must reflect the savings achieved throughout working life in order to guarantee that, for similar levels of effort, similar and proportionate protection will be obtained.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Objectives: The Brazilian public health system does not provide electroconvulsive therapy (ECT), which is limited to a few academic services. National mental health policies are against ECT. Our objectives were to analyze critically the public policies toward ECT and present the current situation using statistics from the Institute of Psychiatry of the University of Sao Paulo (IPq-HCFMUSP) and summary data from the other 13 ECT services identified in the country. Methods: Data regarding ECT treatment at the IPq-HCFMUSP were collected from January 2009 to June 2010 (demographical, number of sessions, and diagnoses). All the data were analyzed using SPSS 19, Epic Info 2000, and Excel. Results: During this period, 331 patients were treated at IPq-HCFMUSP: 221 (67%) were from Sao Paulo city, 50 (15.2%) from Sao Paulo's metropolitan area, 39 (11.8%) from Sao Paulo's countryside, and 20 (6.1%) from other states; 7352 ECT treatments were delivered-63.0% (4629) devoted entirely via the public health system (although not funded by the federal government); the main diagnoses were a mood disorder in 86.4% and schizophrenia in 7.3% of the cases. Conclusions: There is an important lack of public assistance for ECT, affecting mainly the poor and severely ill patients. The university services are overcrowded and cannot handle all the referrals. The authors press for changes in the mental health policies.

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Objective: The aim of this study was to assess re-hospitalization rates of individuals with psychosis and bipolar disorder and to study determinants of readmission. Methods: Prospective observational study, conducted in Sao Paulo, Brazil. One hundred-sixty-nine individuals with bipolar and psychotic disorder in need of hospitalization in the public mental health system were followed for 12 months after discharge. Their families were contacted by telephone and interviews were conducted at 1, 2, 6 and 12 months post-discharge to evaluate readmission rates and factors related. Results: One-year re-hospitalization rate was of 42.6%. Physical restraint during hospital stay was a risk factor (OR = 5.4-10.5) for readmission in most models. Not attending consultations after discharge was related to the 12-month point readmission (OR = 8.5, 95% CI 2.3-31.2) and to the survival model (OR = 3.2, 95% CI 1.5-7.2). Number of previous admissions was a risk factor for the survival model (OR = 6.6-11.9). Family's agreement with permanent hospitalization of individuals with mental illness was the predictor associated to readmission in all models (OR = 3.5-10.9) and resulted in shorter survival time to readmission; those readmitted were stereotyped as dangerous and unhealthy. Conclusions: Family's stigma towards mental illness might contribute to the increase in readmission rates of their relatives with psychiatric disorders. More studies should be conducted to depict mechanisms by which stigma increases re-hospitalization rates.

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The CAP reform process has been a central issue for agricultural economics research in recent years, and is gaining further attention in view of the post-2013 perspectives (Viaggi et al., 2010; Bartolini et al., 2011). Today the CAP is in the middle of a new reform process. Through the debate generated by the official proposals, published in October 2011 (COM(2011)625/3), the European Union (EU) engaged in a revision of the CAP ended on 26 June 2013 when a political agreement has been reached (IP/13/613, MEMO-13-621 and IP/13/864). In particular, in Italy the switch of the payment regime from historical to regional bases will take place. The underlying assumption is that the shift to regionalized payments changes the remuneration of inputs and has an impact on farmers’ allocation of fixed resources. In this context, farmers are expected to adjust their plans to the new policy environment as the regionalization of support is meant to create a change in incentives faced by farmers. The objective of this thesis is to provide an ex-ante analysis of the potential impact of the introduction of regionalized payments, within the post-2013 CAP reform, on the land market. Regionalized payments seem to produce differentiated effects and contribute to a general (slight) increase of land exchanges. The individual reaction to the new payments introduction would be different depending on location and specialization. These effects seem to be also strongly influenced by the difference in historical payments endowment and value, i.e. by the previous historical system of distribution of payments.

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The reconstruction of the child protection system in the post-communist period so as to meet professional standards while responding to the needs of children is an enormous task. In order to understand the features of the current stage of the development of the Romanian child protection system and to evaluate its trends towards change, Roth-Szamoskozi analysed data from scientific literature and collected statistics to document the evolution of the child-protection structure. Empirical data collection using qualitative methods (content analysis of documents and interviews with staff) were designed to reflect the degree to which child welfare laws correspond to internationally accepted regulations and to analyse the attitudes of those working in the field at different decision-making levels. An experiment with a group of 12 students showed that there have been basic changes in the legal framework of Romanian child welfare. Students could see that the required principles exist in the new Romanian child protection law, but also identified areas which are still inadequately represented. 61 staff members working in child welfare agencies (both state and non-governmental) were also interviewed, using a systematic, circular interview. Using the criteria of competence and the existence of specific social goals, professionalism in solving social problems and respect for social-work values, the 30 non-governmental organisations were divided into three categories. The first (7 organisations) are active in the area, know the law and are fairly professional, the second (5) are motivated in their work with specific problems, but with no great competence. The 18 organisations in the third group have no competence in the social field and in issues concerning children and do only charitable work. The state agencies are still dominated by routine, but there were many staff members who were developing reform and strategic roles and were actively directing the system towards change. Many staff members in both governmental and non-governmental organisations were directing the system towards a stress on intervention in the interests of the child in the context of its family. Roth-Szamoskozi found that staff members felt the need of a more accurate evaluation system which would enable them to show their results more clearly.