Contemporary issues in the government and administration of Latin American megacities

This paper is the first to systematically analyze and compare the structures of city governance and administration for seven major cities in Latin America, four of which are megacities (population of over 10 million), and three others are large national capitals. U.S. and U. K. models of city administration are reviewed as baseline models against which differences in Latin American may be explored. Structures of Government in Latin America show several important features and trends: 1) the lack of metropolitan (cross jurisdictional) authority; 2) the existence of strong mayors and weak councils"; 3) high levels of partisanship; 4) overlapping rather than interlocking bureaucracies; 5) pressures towards the privatization of city services, but continuing tension over the desirability of public versus private control; 6) greater fiscal responsibility and autonomy; and 7), a continuing marginalization of public participation in megacity governance.In spite of these features, many cities throughout the region (regardless of whether they are megacity size or national capitals), are actively intensifying their efforts to develop more effective, accountable and democratic governance structures.

The study of public administration in India, the Philippines, Canada and Australia: the universal struggle against epistemic colonization, and toward critical assimilation

The study of public administration has been characterized as a strong international focus, as both governments and scholars have sought to learn from the experience of other societies. While in a perfect world, one would expect a sort of pragmatic universalism, instead, many scholars tend to bring lessons from one country, or from a single cultural reality. This modest contribution lies in showing a series of national experiences rarely brought to the discourse about public administration in Brazil: Canada, Australia, India and the Philippines. Special emphasis will be given to the following: the origins and the development of public administration; the influence of ideology; and the complex tension between global theory and local practices.

Health financing changes in the context of health care decentralization: the case of three Latin American countries

OBJECTIVE: The results of an evaluative longitudinal study, which identified the effects of health care decentralization on health financing in Mexico, Nicaragua and Peru are presented in this article. METHODS: The methodology had two main phases. In the first, secondary sources of data and documents were analyzed with the following variables: type of decentralization implemented, source of financing, funds for financing, providers, final use of resources, mechanisms for resource allocation. In the second phase, primary data were collected by a survey of key personnel in the health sector. RESULTS: Results of the comparative analysis are presented, showing the changes implemented in the three countries, as well as the strengths and weaknesses of each country in matters of financing and decentralization. CONCLUSIONS: The main financing changes implemented and quantitative trends with respect to the five financing indicators are presented as a methodological tool to implement corrections and adjustments in health financing.

Evaluation of a program to reduce back pain in nursing personnel

OBJECTIVE: To evaluate the effectiveness of a program designed to reduce back pain in nursing aides. METHODS: Female nursing aides from a university hospital who had suffered episodes of back pain for at least six months were included in the study. Participants were randomly divided into a control group and an intervention group. The intervention program involved a set of exercises and an educational component stressing the ergonomic aspect, administered twice a week during working hours for four months. All subjects answered a structured questionnaire and the intensity of pain was assessed before and after the program using a visual analogue scale (VAS). Student's t-test or the Wilcoxon Rank Sum Test for independent samples, and Chi-square test or the Exact Fisher test for categorical analysis, were used. The McNemar test and the Wilcoxon matched pairs test were used to compare the periods before and after the program. RESULTS: There was a statistically significant decrease in the frequency of cervical pain in the last two months and in the last seven days in the intervention group. There was also a reduction in cervical pain intensity in the two periods (2 months, 7 days) and lumbar pain intensity in the last 7 days. CONCLUSIONS: The results suggest that a program of regular exercise with an emphasis on ergonomics can reduce musculoskeletal symptoms in nursing personnel.

O recurso ao outsourcing na prestação de cuidados de saúde

Nos últimos anos verificou-se uma alteração das condições e modo de funcionamento de empresas e instituições, privadas e públicas, muitas delas através da introdução de novas ferramentas de gestão. De entre elas, podemos destacar o outsourcing, que apesar de não ser um fenómeno actual, é ainda em Portugal uma ferramenta recente e pouco explorada, que pode contribuir de forma decisiva para a modernização, flexibilidade e competitividade das empresas. O presente estudo pretende abordar a contratação de serviços externos nos serviços de saúde públicos, também conhecido como outsourcing, mediante uma análise prática da realidade de uma instituição hospitalar com sete serviços em regime de outsourcing, com recolha dos dados durante o triénio 2008-2010. No Serviço de Urgência durante 2010 o principal prestador recebeu mais 104,28% acima do valor referência/hora, no Serviço de Oftalmologia no ano de 2010 o prestador recebeu um valor superior em 24,91%, no Serviço de Limpeza, Higiene e Conforto é pago ao prestador durante o ano de 2010 um valor superior em 13,85%, no Serviço de Vigilância e Segurança o prestador recebeu durante o ano de 2010 um valor superior em 27,5%, caso a instituição hospitalar optasse por contratar, para os serviços atrás referidos, profissionais para o quadro de pessoal. Ainda em relação ao Serviço de Urgência foi pago mais 21,38% acima do valor de referência publicado por Despacho governamental. Em relação aos Serviços de Lavandaria e de Tratamento de Resíduos Sólidos, não foi possível recolher os dados necessários que pudessem levar a uma conclusão válida sobre os custos pagos pela instituição hospitalar. Pode-se concluir que a contratação de prestadores externos, para os serviços de saúde, essenciais e não essenciais, em regime de outsourcing, revela-se na maioria dos casos analisados a opção menos económica, com custos bastantes elevados.

Chitosan-alginate microparticulate delivery system for an alternative route of administration of BCG vaccine

Immunisation against M. tuberculosis with current available BCG vaccine lacks efficacy in preventing adult pulmonary tuberculosis. Targeting nasal mucosa is an attractive option for a more effective immunization. The delivery of BCG via the intranasal route involves overcoming barriers such as crossing the physical barrier imposed by the mucus layer and ciliar remotion, cellular uptake and intracellular trafficking by antigen presenting cells. Due to its biodegradable, immunogenic and mucoadhesive properties, chitosan particulate delivery systems can act both as vaccine carrier and adjuvant, improving the elicited immune response. In this study, different combinations of Chitosan/Alginate/TPP microparticles with BCG were produced as vaccine systems. The developed microparticle system successfully modulates BCG surface physicochemical properties and promotes effective intracellular uptake by human macrophage cell lines Preliminary immune responses were evaluated after s.c. and intranasal immunisation of BALB/c mice. BCG vaccination successfully stimulated the segregation of IgG2a and IgG1, where intranasal immunisation with chitosan/alginate particulate system efficiently elicited a more equilibrated cellular/humoral immune response.

Surfaces contamination with 5-Fluorouracil in two Portuguese hospitals

Background - The use of antineoplastic drugs in cancer therapy is increasing due to their action in cancer cells. Carcinogenic, mutagenic and teratogenic effects. Some studies demonstrated that nurses and pharmacy personnel involved in preparation or administration are exposed to antineoplastic drugs. Aim: assess 5-Fluorouracil (5-FU) contamination on the surfaces of two Portuguese Hospitals (preparation and administration units). 5-FU is one of the most frequently antineoplastic agent used in Portuguese Hospitals and can be easily absorbed through the skin. This drug can be used as an marker of surfaces contamination and exposure and have been extensively discussed in other studies.

Antibody response to heat-inactivated hepatitis B vaccine (CLB-3mg) in hemodialysis patients and occupational risk personnel: a one year follow-up

Immune response against hepatitis B vaccine (CLB 3mg) was evaluated in 59 hemodialysis patients and 20 occupational risk personnel. Seroconversion was induced in 52.5% and 70.0% respectively. Twelve months after the first dose, 37.5% of patients and 60.0% of occupational risk personnel had detectable anti-HBs level. Antibody level was expressed in sample ratio units (SRU). Considering only the responders, in the patients group 38.7% had a low anti-HBs response (2.1-9.9 SRU) 32.3% a medium response (10-99.9 SRU) and 29.0% a high response (>100 SRU) while in occupational risk personnel these values were 14.3%, 64.3% and 21.4% respectively. The authors suggest the use of HBV vaccines with more elevated HBsAg concentration or a reinforced immunization schedule to improve the anti-HBs response not only for patients but also for healthy persons.

Performance assessment in the portuguese public administration

Apresentação realizada na Conferência "Changing Public Sevice in a Changing World" realizada em Budapeste a 24 de Abril de 2009

The portuguese public administration organization

Apresentação realizada no INA por ocasião da visita de uma delegação da República da Sérvia a Portugal.

Evaluation of portuguese public administration - institutions, managers and workers

Apresentação realizada a uma delegação da Administração pública da Bulgária, que visitou o INA em 2 de Dezembro de 2008.

Evaluation of training of public managers in the context of portuguese public administration

Comunicação apresentada na 32ª conferência anual do European Group of Public Administration (EGPA), em Toulouse.