Potencialidades e alcances do monitoramento como ferramenta de gestão da saúde

No Brasil, a construção bem como as mudanças nos mais de vinte anos do Sistema Único de Saúde (SUS) tem demandado um crescente interesse em estratégias que valorizem o uso da informação em saúde. Cada vez mais as incertezas entre a complexidade deste sistema e as intervenções necessárias para atender os seus preceitos e as necessidades da população precisam de respostas ágeis e efetivas. A efetividade dos serviços e a equidade em sua prestação são cruciais na atenção à saúde e mostram-se como desafio frente à dificuldade de avaliação dos resultados das ações pela demora no impacto nos indicadores epidemiológicos clássicos. O monitoramento é uma prática que pode ser destacada pela agilidade nas respostas, porém é nítido o quanto a discussão sobre o assunto é pouco estabelecida na literatura disponível. Se apresenta como uma prática interativa e proativa que utiliza informações disponíveis com o potencial de organizar e divulgar rapidamente as descobertas feitas, gerar um aprendizado organizacional e apoiar o processo decisório. A proposta deste estudo considerou o Painel de Monitoramento da Secretaria Municipal da Saúde de São Paulo como ponto de partida para pesquisar sobre as potencialidades do monitoramento na gestão. Uma pesquisa de métodos mistos foi a opção metodológica para este trabalho que buscou aprofundar o marco referencial teórico sobre monitoramento, descrever e analisar criticamente as referências técnicas utilizadas para a construção da proposta e realizar um estudo de caso único em território descentralizado do município de São Paulo sobre a rotina local na sua utilização e com isso analisar as potencialidades e os alcances desta experiência na gestão municipal. Concluiu-se que o monitoramento por meio de indicadores selecionados a partir de dados secundários é uma estratégia oportuna de acompanhar a tendência de determinadas ações possibilitando assim a emissão de juízo de valor e tomada de decisão com rapidez. O aplicativo propicia aos gestores e técnicos informações relevantes que apoiam o processo decisório, além de possibilitar a sua utilização em diferentes contextos da gestão e portes territoriais. Por outro lado, a prática cotidiana é pautada por prioridades normativas, onde a precisão do registro, a coerência das fontes e a quantidade apontada sobrepõem-se à informação em si, o seu significado e as ações necessárias para o enfrentamento dos problemas. O uso da informação é cultura em construção e o Painel de Monitoramento traz a possibilidade de organizar, qualificar e difundir dados secundários dos diferentes sistemas de informação do Sistema Único de Saúde (SUS). Além disso, tem contribuído também no papel de fomentar as discussões sobre os diferentes temas que envolvem as prioridades de uma gestão em todos os níveis do sistema de saúde do município de São Paulo.

Avaliação de impacto do Proagro Mais: um estudo de caso

Esta pesquisa avalia o impacto do \"Programa de Garantia da Atividade Agropecuária\" para agricultores familiares, conhecido como Proagro Mais. A relevância do trabalho fundamenta-se no considerável tamanho do Programa dentro do contexto das políticas de gestão de risco agrícola no Brasil. Além disso, é a primeira pesquisa desse tipo na literatura científica do país. A amostra é formada por produtores de milho do Estado do Paraná, tendo como linha base o ano de 2003, uma vez que é o ano anterior ao lançamento do Proagro Mais, e o ano de 2005 como ano de impacto. A base de dados utilizada neste estudo foi fornecida pelo Tribunal de Contas da União (TCU), cujas variáveis relevantes incluem características da cultura e dos agricultores familiares, como área financiada, atividades agrícolas complementares, educação e rendimento esperado. Adicionalmente, a partir de outras fontes públicas, foram adicionadas variáveis meteorológicas e regionais para controlar a localização da fazenda. O objetivo da pesquisa é avaliar o impacto do Proagro Mais sobre o montante de crédito por hectare concedido aos beneficiários do Programa. As metodologias usadas incluem o Propensity Score Matching (PSM), a Diferença das Diferenças (DID) e dois estimadores condicionais do DID com PSM usando dados em painel e repeated cross-section. As estimativas econométricas mostram que o Efeito Médio do Tratamento nos Tratados (EMTT) teve sinal negativo na maioria dos modelos revelando que, após o período de perda de rendimento, o grupo de controle teve um valor médio mais elevado de crédito por hectare do que os beneficiários do Proagro Mais. Os resultados sugerem a existência de mecanismos que poderiam complementar ou substituir o Proagro Mais como instrumento de gestão de risco agrícola, mas também podem sugerir que o Programa avaliado não cubra todos os riscos do setor.

Las sociologías del tiempo y las Tecnologías Avanzadas al servicio de la comunicación de los Pacientes UCI. Diseño, desarrollo y validación de un Sistema Interactivo de Comunicación para el entorno hospitalario

Introducción: El ingreso en UCI dificulta significativamente la interrelación familia-paciente. El aislamiento del paciente tiene repercusiones para todo su entorno e influye también en la relación con el personal sanitario. El aumento de la ansiedad dentro de la estructura UCI genera en este microsistema social una situación compleja en la que el equipo sanitario, el paciente y su familia deben manejarse. Se ha producido una reflexión significativa en relación con las políticas de gestión UCI-paciente-familia que ha permitido sugerir cambios de enfoque en la organización hospitalaria de los cuidados intensivos. Sin embargo, no se ha conseguido definir el modo en que la implementación de esos cambios puede articularse y se alerta recurrentemente sobre la ausencia de soluciones prácticas que ayuden a impulsar su introducción. Material y métodos: El proyecto MELIADE parte del análisis sociosistémico de este contexto mediante la aplicación de las metodologías de investigación de la Teoría Fundamentada y profundiza en el estudio de las variables que afectan a este complejo proceso relacional para comprender el porqué de la dificultad de introducir los cambios propuestos hasta el momento por los teóricos e identificar alternativas que los promuevan limitando el conflicto interno. Resultados: Como resultado, se sugieren nuevas alternativas basadas en las tecnologías avanzadas de la comunicación que permitan mejorar la percepción de la calidad asistencial para, superando las actuales dificultades, contribuir a rebajar la tensión de este entorno. El sistema MELIADE de comunicación familia-paciente cuenta ya con su primera versión software y sus características se presentan en este artículo.

Data and Documentation

The primary aims of this survey were to assess household waste management practices; participation in waste diversion practices; knowledge of local waste management politics; willingness to participate in local decision making regarding the development of a local waste processing facility; attitudes and perceptions of waste, waste management policies, and waste management technologies.

How to get out of the crisis without reforms? The Belarusian authorities confront growing economic problems. OSW Commentary NUMBER 202/21.03.2016

2015 saw a drop in Belarus’s GDP for the first time in almost 20 years, which is primarily the result of a significant reduction in levels of production and export. As a consequence, there was also a serious depletion of the country’s foreign exchange reserves, as well as a progressive weakening of the Belarusian rouble. The macroeconomic figures from January and February 2016 show that these trends are not only continuing, but they are also becoming even more severe, which confirms that Belarus now finds itself in a prolonged economic crisis. On one hand, the reason for this state of affairs is the protracted economic recession in Russia, which is Belarus’s main economic partner, together with the drastic global decline in prices for fuel, which is a key Belarusian export. On the other hand, meanwhile, an equally important reason for the current crisis is the failure of the Belarusian economic model. President Aleksandr Lukashenko, out of fear that his authoritarian system of government will be dismantled and that public discontent will rise, has categorically rejected the proposals for even partial reforms put forward by some of his entourage, who are aware of the need for the immediate transformation of the country’s anachronistic and very costly economic model, based as it still is on quasi-Soviet management policies.

Fiji mapped mangrove ecosystem service rankings in GeoJSON format

Incorporating the values of the services that ecosystems provide into decision making is becoming increasingly common in nature conservation and resource management policies, both locally and globally. Yet with limited funds for conservation of threatened species and ecosystems there is a desire to identify priority areas where investment efficiently conserves multiple ecosystem services. We mapped four mangrove ecosystems services (coastal protection, fisheries, biodiversity, and carbon storage) across Fiji. Using a cost-effectiveness analysis, we prioritised mangrove areas for each service, where the effectiveness was a function of the benefits provided to the local communities, and the costs were associated with restricting specific uses of mangroves. We demonstrate that, although priority mangrove areas (top 20%) for each service can be managed at relatively low opportunity costs (ranging from 4.5 to 11.3% of overall opportunity costs), prioritising for a single service yields relatively low co-benefits due to limited geographical overlap with priority areas for other services. None-the-less, prioritisation of mangrove areas provides greater overlap of benefits than if sites were selected randomly for most ecosystem services. We discuss deficiencies in the mapping of ecosystems services in data poor regions and how this may impact upon the equity of managing mangroves for particular services across the urban-rural divide in developing countries. Finally we discuss how our maps may aid decision-makers to direct funding for mangrove management from various sources to localities that best meet funding objectives, as well as how this knowledge can aid in creating a national mangrove zoning scheme.

First report on prospects for additional networks /

Issued Jan. 1980-

O IMPACTO DAS POLÍTICAS E PRÁTICAS DE RECURSOS HUMANOS SOBRE OS COMPORTAMENTOS DE CIDADANIA ORGANIZACIONAL

O objetivo deste estudo é investigar se as políticas e práticas de recursos humanos (PPRH) impactam os comportamentos de cidadania organizacional (CCO), a fim de proporcionar aos gestores uma compreensão de como os indivíduos, tão diferentes entre si, comportam-se dentro e fora da organização diante daquilo que lhes é estabelecido pela área de recursos humanos. No campo teórico, foram consideradas as obras de Milkovich e Boudreau (1994), Dessler (2002), Demo et al. (2012) entre outros para abordar a questão de PPRH e os trabalhos de Handy (1978), Organ (1990), Siqueira (2003) entre outros para a temática CCO. A metodologia utilizada nesse estudo trata-se de uma pesquisa quantitativa entre 156 trabalhadores de empresas públicas, privadas e mistas localizadas no Estado de São Paulo, sendo que para a captação dos dados foram aplicados questionários de autopreenchimento, composto por duas escalas, sendo uma voltada a PPRH (DEMO et al., 2012) e outra cujas questões são relacionadas a CCO (BASTOS et al., 2014). Como resultados, identificou-se que PPRH impacta de forma significativa CCO e que a política de envolvimento, que trata da criação de um vínculo afetivo entre a organização e seus colaboradores, contribuindo para o seu bem-estar em termos de reconhecimento, relacionamento, participação e comunicação (Demo et al., 2012, p.38), é a única que impacta de forma significativa CCO, se comparados aos impactos causados pelas políticas de recrutamento e seleção, treinamento e desenvolvimento, condições de trabalho, avaliação de desempenho e remuneração e recompensas. Conclui-se também que o conjunto de PPRH impacta com maior significância os fatores de CCO denominados divulgação da imagem organizacional e sugestões criativas. Não houve impacto significativo entre PPRH e o fator cooperação com os colegas.

O PIONEIRISMO DAS POLÍTICAS PÚBLICAS MUNICIPAIS PARA ALFABETIZAÇÃO DE JOVENS E ADULTOS EM DIADEMA/SP: AVANÇOS E DESAFIOS

Esta pesquisa localiza os diferentes aspectos na trajetória pioneira das políticas públicas municipais, em Diadema (SP), para a educação de jovens e adultos (EJA), especificamente no programa para alfabetização. Atualiza as características do programa e aborda o - Relatório Final da Pesquisa Qualitativa Etnográfica Perfil do Aluno do Serviço de Educação de Jovens e Adultos -, conduzida entre 1993 e 1995, importante avaliação do serviço. Propõe uma atualização baseada em resultados apresentados naquela pesquisa, utilizando-os para confrontar o desenvolvimento das políticas de educação de jovens e adultos no município e nas mais recentes políticas na Região do ABCDMRR (Santo André, São Bernardo do Campo, São Caetano do Sul, Diadema, Mauá, Ribeirão Pires e Rio Grande da Serra), no estado de São Paulo e no Brasil, para esse segmento populacional. Também procura reatualizar as mensurações e avaliações qualitativas angariadas naquela pesquisa para compor esta dissertação de mestrado.

Cadburys' new factory system, 1879-1919

This thesis examines the reasons for Cadburys' move from a city centre site to a greenfield site in Bournville in 1879 and the subsequent development of the factory and the Bournville community. The founding of the Bournville Village Trust by George Cadbury is discussed in relation to the Garden City movement. The welfare and personnel management policies which Cadburys adopted in the 1900s are considered in relation to welfarism in general, especially in the United States. The extent to which the idea of a `Quaker employer' can explain Cadburys policies is questioned both methodologically and empirically. The early use of scientific management at Bournville is described and related to Edward Cadbury's writings on the subject. Finally, the institution of a Works Council Scheme in 1918 is described and its uses are discussed. It is concluded that Cadburys instituted a new factory system in this period which consisted of a synthesis of ideas borrowed from elsewhere and that for a variety of reasons Cadburys was an appropriate site for their implementation.

Managing diversity in organizations:an integrative model and agenda for future research

The literature on policies, procedures, and practices of diversity management in organizations is currently fragmented and often contradictory in highlighting what is effective diversity management, and which organizational and societal factors facilitate or hinder its implementation. In order to provide a comprehensive and cohesive view of diversity management in organizations, we develop a multilevel model informed by the social identity approach that explains, on the basis of a work motivation logic, the processes by, and the conditions under which employee dissimilarity within diverse work groups is related to innovation, effectiveness, and well-being. Building on this new model, we then identify those work group factors (e.g., climate for inclusion and supervisory leadership), organizational factors (e.g., diversity management policies and procedures, and top management's diversity beliefs), and societal factors (e.g., legislation, socioeconomic situation, and culture) that are likely to contribute to the effective management of diversity in organizations. In our discussion of the theoretical implications of the proposed model, we offer a set of propositions to serve as a guide for future research. We conclude with a discussion of possible limitations of the model and practical implications for managing diversity in organizations. © 2014 Taylor & Francis.

Rubric-Q:adding quality-related elements to the GEOSS clearinghouse datasets

Geospatial data have become a crucial input for the scientific community for understanding the environment and developing environmental management policies. The Global Earth Observation System of Systems (GEOSS) Clearinghouse is a catalogue and search engine that provides access to the Earth Observation metadata. However, metadata are often not easily understood by users, especially when presented in ISO XML encoding. Data quality included in the metadata is basic for users to select datasets suitable for them. This work aims to help users to understand the quality information held in metadata records and to provide the results to geospatial users in an understandable and comparable way. Thus, we have developed an enhanced tool (Rubric-Q) for visually assessing the metadata quality information and quantifying the degree of metadata population. Rubric-Q is an extension of a previous NOAA Rubric tool used as a metadata training and improvement instrument. The paper also presents a thorough assessment of the quality information by applying the Rubric-Q to all dataset metadata records available in the GEOSS Clearinghouse. The results reveal that just 8.7% of the datasets have some quality element described in the metadata, 63.4% have some lineage element documented, and merely 1.2% has some usage element described. © 2013 IEEE.

Control of MNC environmental performance and the challenges of subsidiary network dimensions

The trend of green consumerism and increased standardization of environmental regulations has driven multinational corporations (MNCs) to seek standardization of environmental practices or at least seek to be associated with such behavior. In fact, many firms are seeking to free ride on this global green movement, without having the actual ecological footprint to substantiate their environmental claims. While scholars have articulated the benefits from such optimization of uniform global green operations, the challenges for MNCs to control and implement such operations are understudied. For firms to translate environmental commitment to actual performance, the obstacles are substantial, particularly for the MNC. This is attributed to headquarters' (HQ) control challenges (1) in managing core elements of the corporate environmental management (CEM) process and specifically matching verbal commitment and policy with ecological performance and by (2) the fact that the MNC operates in multiple markets and the HQ is required to implement policy across complex subsidiary networks consisting of diverse and distant units. Drawing from the literature on HQ challenges of MNC management and control, this study examines (1) how core components of the CEM process impact optimization of global environmental performance (GEP) and then uses network theory to examine how (2) a subsidiary network's dimensions can present challenges to the implementation of green management policies. It presents a framework for CEM which includes (1) MNCs' Verbal environmental commitment, (2) green policy Management which guides standards for operations, (3) actual environmental Performance reflected in a firm's ecological footprint and (4) corporate environmental Reputation (VMPR). Then it explains how an MNC's key subsidiary network dimensions (density, diversity, and dispersion) create challenges that hinder the relationship between green policy management and actual environmental performance. It combines content analysis, multiple regression, and post-hoc hierarchal cluster analysis to study US manufacturing MNCs. The findings support a positive significant effect of verbal environmental commitment and green policy management on actual global environmental performance and environmental reputation, as well as a direct impact of verbal environmental commitment on green policy management. Unexpectedly, network dimensions were not found to moderate the relationship between green management policy and GEP.

Impact of Late Holocene climate variability and anthropogenic activities on Biscayne Bay (Florida, U.S.A.): Evidence from diatoms

Shallow marine ecosystems are experiencing significant environmental alterations as a result of changing climate and increasing human activities along coasts. Intensive urbanization of the southeast Florida coast and intensification of climate change over the last few centuries changed the character of coastal ecosystems in the semi-enclosed Biscayne Bay, Florida. In order to develop management policies for the Bay, it is vital to obtain reliable scientific evidence of past ecological conditions. The long-term records of subfossil diatoms obtained from No Name Bank and Featherbed Bank in the Central Biscayne Bay, and from the Card Sound Bank in the neighboring Card Sound, were used to study the magnitude of the environmental change caused by climate variability and water management over the last ~ 600 yr. Analyses of these records revealed that the major shifts in the diatom assemblage structures at No Name Bank occurred in 1956, at Featherbed Bank in 1966, and at Card Sound Bank in 1957. Smaller magnitude shifts were also recorded at Featherbed Bank in 1893, 1942, 1974 and 1983. Most of these changes coincided with severe drought periods that developed during the cold phases of El Niño Southern Oscillation (ENSO), Atlantic Multidecadal Oscillation (AMO) and Pacific Decadal Oscillation (PDO), or when AMO was in warm phase and PDO was in the cold phase. Only the 1983 change coincided with an unusually wet period that developed during the warm phases of ENSO and PDO. Quantitative reconstructions of salinity using the weighted averaging partial least squares (WA-PLS) diatom-based salinity model revealed a gradual increase in salinity at the three coring locations over the last ~ 600 yr, which was primarily caused by continuously rising sea level and in the last several decades also by the reduction of the amount of freshwater inflow from the mainland. Concentration of sediment total nitrogen (TN), total phosphorus (TP) and total organic carbon (TOC) increased in the second half of the 20th century, which coincided with the construction of canals, landfills, marinas and water treatment plants along the western margin of Biscayne Bay. Increased magnitude and rate of the diatom assemblage restructuring in the mid- and late-1900s, suggest that large environmental changes are occurring more rapidly now than in the past.

Impact of Late Holocene Climate Variability and Anthropogenic Activities on Biscayne Bay (Florida, U.S.A.): Evidence From Diatoms

Shallow marine ecosystems are experiencing significant environmental alterations as a result of changing climate and increasing human activities along coasts. Intensive urbanization of the southeast Florida coast and intensification of climate change over the last few centuries changed the character of coastal ecosystems in the semi-enclosed Biscayne Bay, Florida. In order to develop management policies for the Bay, it is vital to obtain reliable scientific evidence of past ecological conditions. The long-term records of subfossil diatoms obtained from No Name Bank and Featherbed Bank in the Central Biscayne Bay, and from the Card Sound Bank in the neighboring Card Sound, were used to study the magnitude of the environmental change caused by climate variability and water management over the last ~ 600 yr. Analyses of these records revealed that the major shifts in the diatom assemblage structures at No Name Bank occurred in 1956, at Featherbed Bank in 1966, and at Card Sound Bank in 1957. Smaller magnitude shifts were also recorded at Featherbed Bank in 1893, 1942, 1974 and 1983. Most of these changes coincided with severe drought periods that developed during the cold phases of El Niño Southern Oscillation (ENSO), Atlantic Multidecadal Oscillation (AMO) and Pacific Decadal Oscillation (PDO), or when AMO was in warm phase and PDO was in the cold phase. Only the 1983 change coincided with an unusually wet period that developed during the warm phases of ENSO and PDO. Quantitative reconstructions of salinity using the weighted averaging partial least squares (WA-PLS) diatom-based salinity model revealed a gradual increase in salinity at the three coring locations over the last ~ 600 yr, which was primarily caused by continuously rising sea level and in the last several decades also by the reduction of the amount of freshwater inflow from the mainland. Concentration of sediment total nitrogen (TN), total phosphorus (TP) and total organic carbon (TOC) increased in the second half of the 20th century, which coincided with the construction of canals, landfills, marinas and water treatment plants along the western margin of Biscayne Bay. Increased magnitude and rate of the diatom assemblage restructuring in the mid- and late-1900s, suggest that large environmental changes are occurring more rapidly now than in the past.