Burnout em profissionais da saúde portugueses: Uma análise a nível nacional

Introdução: O burnout é uma síndrome psicológica, caracterizada por elevada exaustão emocional, elevada despersonalização e baixa realização profissional, que conduz à erosão dos valores pessoais, profissionais e de saúde. Este estudo reporta a prevalência do burnout em profissionais de saúde Portugueses. Material e Métodos: Os níveis de burnout foram estimados pelo Maslach Burnout Inventory - Human Services Survey numa escala ordinal de zero (nunca) a seis (sempre) pontos. A amostra foi constituída por 1 262 enfermeiros e 466 médicos com médias de idade de 36,8 anos (DP = 12,2) e 38,7 (DP = 11,0), respetivamente. Os participantes foram provenientes de todos os distritos nacionais (35% Lisboa; 18% Porto; 6% Aveiro, 6% Setúbal, 5% Coimbra; 5% regiões autónomas), com atuação em meio hospitalar (54%), centros de saúde (Unidade de Saúde Familiar - 30%; Unidades de Cuidados de Saúde Primários - 8%) e outras instituições públicas/privadas (8%). Resultados: A análise dos níveis de burnout revelou que ambas as categorias profissionais apresentaram níveis moderados a elevados de burnout (M = 3,0; DP = 1,7) não sendo significativas as diferenças entre as duas profissões. Vila Real (M = 3,8; SD = 1,7) e a Madeira (M = 2,5; DP = 1,5) são as regiões onde os níveis de burnout são mais e menos elevados, respetivamente. Os níveis de burnout não diferiram significativamente entre Hospitais, Unidades de Cuidados de Saúde Personalizados e Unidades de Saúde Familiares. Os profissionais com maior tempo na função são menos acometidos por burnout (r = -0,15) não ocorrendo associação significativa com a duração da jornada de trabalho (r = 0,04). A má qualidade das condições de trabalho foi o melhor preditor do burnout (r = -0,35). Discussão: A ocorrência da síndrome de burnout em profissionais de saúde portugueses é frequente, estando associada à percepção de más condições de trabalho e à menor duração do tempo de serviço. A incidência de burnout apresenta diferenças regionais que podem estar associadas ao aumento do stress imposto pelo exercício da profissão em condições sub-ótimas para a prestação dos cuidados de saúde. Os resultados alertam para a necessidade de intervenções para melhorar as condições de trabalho e formação inicial dos profissionais de saúde de forma a garantir a qualidade do serviço prestado aos utentes e o bem-estar pessoal destes profissionais. Conclusões: A nível nacional, entre 2011 e 2013, 21,6% dos profissionais de saúde apresentaram burnout moderado e 47,8% burnout elevado. A perceção de más condições de trabalho foi o principal preditor da ocorrência de burnout nos profissionais de saúde Portugueses.

HISTORIA Y EVOLUCIÓN DE LOS SISTEMAS DE INFORMACIÓN GEOGRÁFICA EN COSTA RICA

Este trabajo presenta un estudio retrospectivo de los orígenes y evolución de la aplicación de Sistemas de  Información Geográfca  (SIG) y Teledetección  (TD) en nuestro país. Se  inicia por el  rol desempeñado del Profesor Merrill Lyew dentro de  la Escuela de Ciencias Geográfcas de la Universidad Nacional, pasando luego por una breve descripción del proceso de implementación de SIG y TD en los centros de enseñanza superior estatales.En esta breve descripción se analiza cómo diferentes unidades académicas han ido incorporando la tecnología SIG y TD en sus planes de estudio.Posteriormente, se presenta una aproximación de la situación actual SIG y TD en las instituciones públicas y privadas y cómo ellas han venido incorporando estas tecnologías en su quehacer diario. Se hace alusión a diferentes eventos que se han llevado en Costa Rica con el objetivo de compartir experiencias en las más diversas aplicaciones.De la misma manera se citan algunas de las principales empresas privadas que se dedican a la venta de insumos, aplicaciones, capacitaciones y software en el campo SIG y TD. En el camino óptimo se visualizan dos opciones por seguir:  la consolidación ofcial de un organismo, comisión o secretaría que tenga bajo su responsabilidad la organización de la Infraestructura Nacional de Datos Geoespaciales. La segunda versa sobre el esfuerzo realizado por las Escuelas de Geografía de la Universidad de Costa Rica y Universidad Nacional para ofrecer a partir del 2008 el Programa de Maestría Profesional en Sistemas de Información Geográfca y Teledetección. Palabras claves: Sistemas de Información Geográfca (SIG), Teledetección, Evolución, Historia, Costa Rica.Abstract This work is a retrospective study of the origins and evolution of the applications of Geographic Information Systems (GIS) and Remote Sensing in our country. It begins with the work of Prof. Merryl Lyew of the School of Geographic Sciences at Universidad Nacional and continues with a brief description of the GIS and Remote Sensing implementation process at state centers of higher education.It  also  analyzes  how  different  academic  departments  have  incorporated GIS  and Remote Sensing technology in their courses of study.Subsequently, this work presents an approximation of the actual situation regarding GIS and remote sensing  in public and private  institutions and how  these  technologies have become incorporated in their daily work. It also refers to the different events that have been carried on in Costa Rica with the objective of sharing experiences in the most diverse applications. In the same way, this work cites some of the principal private businesses dedicated to the sale of supplies, applications, training and software in the feld of GIS and remote sensing. Two options are seen as the best way to pursue the offcial consolidation of an agency, commission  or  administrative  department  to  have  under  its  responsibility  organization  of  the National Infrastructure of Geospatial Data. The second deals with the successful effort by the School of Geographic Sciences at Universidad Nacional of Costa Rica as of 2008 to offer the Professional Master’s program in Geographic Information Systems and Remote Sensing.KEyWordS: Geographic Information Systems (GIS), Remote Sensing, Origin, Evolution, Costa Rica, Universidad Nacional

Shiva's dance: Crisis, local institutions and private firms

The uneven spatial distribution of start-ups and their respective survival may reflect comparative advantages resulting from the local institutional background. For the first time, we explore this idea using Data Envelopment Analysis (DEA) to assess the relative efficiency of Portuguese municipalities in this specific context. We depart from the related literature where expenditure is perceived as a desirable input by choosing a measure of fiscal responsibility and infrastructural variables in the first stage. Comparing results for 2006 and 2010, we find that mean performance decreased substantially 1) with the effects of the Global Financial Crisis, 2) as municipal population increases and 3) as financial independence decreases. A second stage is then performed employing a double-bootstrap procedure to evaluate how the regional context outside the control of local authorities (e.g. demographic characteristics and political preferences) impacts on efficiency.

Hegemony, Private Actors, and International Institutions: Transnational Corporations as the agents of transformation of the trade regime from GATT to the WTO

Diese Dissertation hat das Ziel, zum einen die Transformation des Handelssystems von der GATT zur Welthandelsorganisation (WTO) im Kontext einer veränderten Weltordnung und zum anderen die Rollen von transnationalen Unternehmen im Rahmen dieser Transformation zu untersuchen und zu verstehen. Die Arbeit wird theoretisch vom Neogramscianismus angeleitet, da die etablierten Ansätzen in den Internationalen Beziehungen und der International Politischen Ökonomie nur unzureichend die intersubjektive Natur von Regimen und nicht-staatlichen Akteuren darstellen. Für Anhänger des Neogramscianismus sind internationale Regime intersubjektive Einheiten, deren Zusammenspiel von Ideen und Machtkonfigurationen historische Strukturen prägen. Die Hegemonie ist ein Konzept, das soziale Einflüsse als Agenten historischen Wandels in international Regimen und der Weltordnung zusammenbindet. Mit dem Konzept der Hegemonie wird eine Machtsituation beschrieben, in der politische Macht in legitime Autorität übersetzt wird, indem die Zustimmung subalterner Akteure eingeholt wird. Hegemonie beinhaltet die konsensuellen Aspekte von Machtausübung in einer jeweiligen Weltordnung. Diese Dissertation argumentiert vor allem, dass die Transformation des Handelssystems als hegemonisch bezeichnet werden kann, da sie parallel mit der Transformation der Weltordnung von einer von den USA dominierten Nachkriegszeit zu einer neoliberalen Hegemonie stattfand. Mit der Transformation zur Welthandlungsorganisation wird der legale Rahmen des Handelssystems neu strukturiert und ihre normative Grundlagen neu definiert, wodurch der ethische Rahmen des Neoliberalismus reflektiert wird. Diese Änderungen werden in der neuartigen Anerkennung der legitimen Autorität des Marktes gegenüber Nationalstaaten und der Anerkennung von der Notwendigkeit von bindenden Disziplinen, die Regierungen übergeordnet sind, reflektiert. Diese Dissertation analysiert zwei Fälle, um die Rolle von transnationalen Unternehmen innerhalb diese Transformationsprozesses zu erklären. Dabei wird der Fokus vor allem auf die Aktivitäten und Fähigkeiten der Unternehmen gerichtet, die Ausrichtung des Handelsregimes zu bestimmen. Die erste Studie untersucht die Eingliederung von Dienstleistungen in das GATT Regime vor und während der Uruguay-Runde (1986 – 1994) und argumentiert, dass diese Eingliederung zu einer Neudefinierung von Liberalisierung und Normen der Nichtdiskriminierung führte. Die zweite Studie analysiert den gescheiterten Versuch, ausländische Direktinvestitionen noch bevor und während der 2001 begonnenen Doha Runde in die Welthandelsorganisation zu integrieren. Letztendlich wird in dieser Dissertation argumentiert, dass transnationale Unternehmen, die in den Vereinigten Staaten ansässig sind, hegemonische Agenten der Regimetransformation waren und eine wichtige Rolle dabei gespielt haben, Dienstleistungen in das GATT einzubinden. Und zwar gelang ihnen dies durch eine in den späten 1970er Jahren begonnenen Kampagne. Auf der einen Seite war die Kampagne darin erfolgreich, etablierte Denkstrukturen zu Handelsthemen systematisch im Sinne des Neoliberalismus zu verändern – und zwar sowohl hinsichtlich der normativen Inhalte als auch der intersubjektiven Bedeutungen des Regimes. Auf der anderen Seite deutet der Fall des Investitionsabkommens die Grenzen der hegemonischen Ideen, Institutionen, und Strömungen seit den frühen 90er Jahren an. Transnationale Unternehmen, die in Europa ansässig waren, sind mit ihren Bemühungen gescheitert, das Regime weiter zu transformieren und das Thema Investitionen in die legalen und normativen Rahmenbedingungen der WTO zu integrieren. Die Prioritäten und Strategien der transnationalen Unternehmen, die Agenda der WTO zu beeinflussen, waren beschränkt und wurden im Kontext einer angefochtenen neoliberalen Hegemonie geformt, die wiederum von dem Widerstand und anti-hegemonischen Kampagnen der Zivilgesellschaft beeinflusst wurden. Die Analyse in dieser Dissertation wurde durch eine qualitative Diskursanalyse von Sekundär- und Primärquellen durchgeführt: Regierungsvorschläge, Verhandlungstexte, Konferenzzusammenfassungen und Statements von Unternehmen.

Credit for marginal groups; a study of the principal private sector credit institutions providing loans to marginal groups in the countries of the Dominican Republic, Chile, Ecuador, Colombia, and Guatemala.

"Sponsored by: Pan American Development Foundation, in cooperation with: CUNA International, Inc. [and others]"

Directory of private homes and institutions in Wisconsin caring for aged or chronically ill persons.

"January 26, 1951."

Directory of private homes and institutions in Wisconsin caring for aged or chronically ill persons, July 1949.

Caption title.

Directory of private homes and institutions in Wisconsin caring for aged or chronically ill persons, July 1948.

Caption title.

Degree programs at private higher education institutions in Illinois.

"July 1980."

Child welfare work in Colorado; a study of public and private agencies and institutions and conditions of service, in the care of dependent, delinquent and defective children,

Mode of access: Internet.

Innovative and entrepreneurial activity in the public sector : the changing face of public sector institutions

This paper investigates the elements which support innovative and entrepreneurial activity in New Zealand’s state owned enterprises (SOEs). An inductive case study design, involving interview data, textual analysis, and observation, was applied to three SOEs. Findings reveal that those aspects typically associated with entrepreneurship, such as innovation, risk acceptance, pro-activeness and growth, are often supported by a number of unexpected elements within the public sector. These elements include culture, branding, operational excellence, cost efficiency, and knowledge transfer. The implications are twofold. First, that innovative and entrepreneurial activity in the public sector can go beyond policy-making, with SOEs representing an important policy decision and sector of the New Zealand Government. And second, that the impact of several SOEs on international markets suggests competition on the global stage will increasingly come from both public and private sector organizations.

Private Ancillary Funds (PAFs)

PAFs are trusts to which taxpayers can make tax deductible donations.1 The term private ancillary fund is defined in the taxation legislation and has some similarities with the US private family foundation. This new arrangement allows families, businesses and individuals to create a tax effective closely held charitable trust which was not possible prior to the initiative. The sole purpose of a PAF must be to provide money, property or benefits to funds, authorities or institutions, which are deductible gift recipients (DGRs).

Supermarkets and private standards : unintended consequences of the audit ritual

Recent scholarship has considered the implications of the rise of voluntary private standards in food and the role of private actors in a rapidly evolving, de-facto ‘mandatory’ sphere of governance. Standards are an important element of this globalising private sphere, but are an element that has been relatively peripheral in analyses of power in agri-food systems. Sociological thought has countered orthodox views of standards as simple tools of measurement, instead understanding their function as a governance mechanism that transforms many things, and people, during processes of standardisation. In a case study of the Australian retail supermarket duopoly and the proprietary standards required for market access this paper foregrounds retailers as standard owners and their role in third-party auditing and certification. Interview data from primary research into Australia’s food standards captures the multifaceted role supermarkets play as standard-owners, who are found to impinge on the independence of third-party certification while enforcing rigorous audit practices. We show how standard owners, in attempting to standardize the audit process, generate tensions within certification practices in a unique example of ritualism around audit. In examining standards to understand power in contemporary food governance, it is shown that retailers are drawn beyond standard-setting into certification and enforcement, that is characterized by a web of institutions and actors whose power to influence outcomes is uneven.

Public private partnership infrastructure delivery: Benefits and costs for society

This research provides additional knowledge on the benefits and costs to society, in particular of road transport procured through Public-Private Partnership (PPP) arrangements. Currently, the public sector comparator (PSC) and cost-benefit analysis (CBA) used to evaluate and measure the benefits and costs of PPP are limited in their capacity to predict and forecast long-term events. PPP is attractive to governments due to the non-upfront payment, perceived value for money, and risk allocation and transfer to the private investor. However, public sector remains the guarantor, and under-writer of the private investor's loan from financial institutions and other voluntary risks which are unlimited to future compensatory claims. The new knowledge from this research is the introduction of a framework capable of evaluating, and measuring the associated PPP benefits, as well as the costs, effects, and impacts to society which are protracted and sporadic by nature.