Indications For In Vitro Fertilization At A Public Center For Reproductive Health In Campinas, Brazil.

To assess the sociodemographic profile and gynecologic and obstetric characteristics of women referred to a public reference center in Campinas, Brazil, for in vitro fertilization (IVF). Women referred between April 1, 2008, and October 31, 2009, were eligible for inclusion in a cross-sectional study. Participants were interviewed about sociodemographic characteristics, obstetric and gynecologic history, and etiologic factors resulting in the referral. Preliminary clinical examinations performed elsewhere were evaluated. A total of 176 women were included, of whom 129 (73.3%) presented with tubal factor infertility. Tubal ligation had been performed in 66 (37.5%) women. Overall, 121 (68.8%) women were aged 30 years old or less, 110 (62.5%) had received more than 8 years of schooling, 123 (69.6%) had had infertility for up to 5 years, and 99 (56.3%) did not have any children. Moreover, 25 (14.2%) women had endometriosis and 25 (14.2%) had a male factor issue. A previous ectopic pregnancy was reported for 20 (11.4%) women and pelvic inflammatory disease for 49 (27.8%). Tubal factor infertility was the most common indication for IVF. Preventive measures are required, in addition to policies that ensure access to high-complexity treatments in the public sector.

Employee adjustment to large-scale organisational change

The present study was designed to test the utility of a stress-coping model of employee adjustment to organisational change. Specifically, it was proposed that employee adjustment to this type of work stress would be influenced by the characteristics of the change situation, employees' appraisals of the situation, their coping strategies, and the extent of their personal resources. Data were collected from 140 middle managers and supervisors involved in a large-scale public sector integration. The results of the research provided some support for the proposed model: high levels of psychological distress were related to a reliance on informal sources of information, high appraised stress, low appraised certainty, and the use of avoidant rather than problem-focused strategies, whereas poor social functioning was associated with low self-esteem, high levels or disruption across the period of change, a reliance on informal sources of information, and the use of avoidant coping strategies. There was no evidence that coping strategies mediated the effects of the event characteristics, situational appraisals, and personal resources on adjustment; however, there was some evidence linking these variables to coping strategies, in particular, problem-focused coping. There was also some evidence to indicate that the experience of organisational change was different for managers and supervisors: levels of threat were higher for the managers than the supervisors, but there was no difference between the groups of employees in terms of adjustment.

Linking client and employee perceptions of the organization: A study of client satisfaction with health care services

Client satisfaction with health care sen ices has usually been researched in terms of socio-demographic and predispositional characteristics associated with the client. The present study included organizational characteristics as predictors of client satisfaction with health care services. Participants in the research were clients and employees of an Australian public-sector health care organization who responded to separate client and employee questionnaires. Hierarchical regression analyses indicated that, after controlling for a number of client characteristics, organizational characteristics, as perceived by employees, accounted for a significant proportion of additional variance in client satisfaction with health care services. Results of the present study provided some support for the proposition that employee perceptions of the working environment should be considered in a more comprehensive understanding of client satisfaction with health care services. Limitations of the study highlight practical difficulties in the assessment of client outcomes and methodological complexities in linking individual and organizational processes.

Production efficiency and financing of public health: an analysis of small municipalities in the state of Sao Paulo - Brazil

This paper measured the variations in performance of small municipalities in the State of Sao Paulo, Brazil, regarding the technical efficiency in the use of public funds in public primary health care actions concerning the funding profile, in a scenario of fiscal federalism. Technical efficiency is one of the parameters of evaluation of public sector performance and was measured by means of Data Envelopment Analysis (DEA). The correlation analysis of DEA score was used to verify possible associations between technical efficiency and the funding profile of expenses with health care. The results showed that 6.41% of the municipalities were considered efficient. They also showed that the level of municipality dependence to inter-governmental general purpose grants and the national health funding specific purpose grants have negative correlation with efficiency scores.

A moderniza????o do estado e a ger??ncia p??blica

O artigo analisa a problem??tica da moderniza????o do Estado vista como um processo de constitui????o de cidadania e de otimiza????o dos recursos p??blicos. Os autores focalizam, por um lado, o atendimento aos usu??rios, a qualidade dos servi??os e a transpar??ncia. Por outro lado, a incorpora????o de t??cnicas de gest??o avan??adas ?? considerada indispens??vel para o aumento da efic??cia e da efici??ncia no setor p??blico. Os principais problemas discutidos no artigo incluem: racionalidade do setor p??blico racionalidade das empresas privadas; incentivos e motiva????o dos servidores p??blicos; rigidez dos procedimentos administrativos; margem de decis??o dos gestores; sistemas de acesso a informa????o; import??ncia da gest??o de pessoal e da valoriza????o do trabalho no setor p??blico; papel dos gerentes na moderniza????o das institui????es p??blicas; cargos de carreira, cargos de confian??a; mecanismos de recrutamento e reten????o e sistemas de capacita????o dos servidores p??blicos. Os autores concluem que, devido ??s inova????es constantes em mat??ria de ger??ncia p??blica, n??o existe hoje um perfil gerencial definitivo como resposta ??s necessidades do Estado. Pelo contr??rio, o que se observa ?? uma crescente complexidade da gest??o p??blica que continuar?? oscilando entre a pol??tica e a tecnocracia, entre a maior flexibilidade e as exig??ncias de controle, entre a ado????o das t??cnicas de gest??o e a recupera????o da tradi????o administrativa e a cultura da fun????o p??blica.

Uma breve compara????o entre os mercados de trabalho do setor p??blico e privado

Este artigo apresenta diversas caracter??sticas dos mercados de trabalho do setor p??blico e privado, ressaltando as disparidades entre ambos e, mais especificamente, as distor????es observadas no setor p??blico, a fim de demonstrar o grau de segmenta????o entre ambos. As compara????es se d??o em torno do comportamento do emprego, do perfil dos trabalhadores e da din??mica das remunera????es. A an??lise evidencia que a crise fiscal e a rigidez da legisla????o s??o determinantes fundamentais das caracter??sticas e distor????es (e conseq??entemente da segmenta????o) observadas no setor p??blico e que a flexibiliza????o das regras atuais, assim como as reformas constitucionais em curso, constituem importante condi????o para a aproxima????o entre os dois mercados e a melhoria da gest??o de recursos humanos na administra????o p??blica.

Centros de Servi??os Compartilhados: da experi??ncia brit??nica ??s perspectivas de inova????o na gest??o p??blica brasileira

O presente artigo toma como ponto de partida a revis??o do estado da arte sobre os centros de servi??os compartilhados (CSC). Arranjos de servi??os compartilhados est??o ganhando import??ncia na gest??o p??blica como meio para reduzir despesas e elevar a qualidade dos servi??os. Os objetivos da pesquisa foram investigar as determinantes do surgimento dos CSC na gest??o p??blica, os principais problemas em sua implanta????o e as tend??ncias futuras dos CSC. Al??m da publica????o cient??fica e t??cnica sobre o tema, a metodologia se assenta no estudo da experi??ncia brit??nica de compartilhamento de servi??os entre diferentes esferas de governo. Uma das conclus??es relevantes da pesquisa ?? que o Brasil, embora tenha poucas experi??ncias de servi??os compartilhados na administra????o p??blica, poder?? obter significativos benef??cios financeiros e na qualidade dos servi??os p??blicos.

An e-marketplace of healthcare and social care services: the perceived interest

Purpose – The health and social care sector is receiving growing attention due to the increased life expectancy and to the public demand for a better quality of life and better health services. New cost-efficient approaches are required, and the paper aims to present and discuss the main results of a study undertaken in a Portuguese municipality on the perceived relevance of an e-marketplace of social and healthcare services for the inhabitants in general, and for people with special needs in particular, and the identification of the most relevant services to be offered through this platform. Design/methodology/approach – A wide survey was undertaken to identify the needs of potential users and their expectancies with relation to the proposed platform. The results of the study are a support for the project promoters to understand the viability of the solution and the requirements to the deployment of the pilot experiment, as well as to drive the selection of domains of activities/classes of services to be offered by the platform. Findings – Services such as information about healthcare services, home monitoring/accompanying services 24 hours per day, and personal hygiene services provided at home are the ones recognized by the inquired citizens as the most important, which indicates that the potential users will be mostly people with special needs or their family or caregivers. Originality/value – While still at a preliminary development phase, the project represents a good opportunity to develop a totally innovative service with high potential impact for the senior population and for individuals with special needs.

Determining factors of environmental management practices in portuguese local entities

Purpose: The aim of this paper is to analyse the development of environmental management practices by Portuguese local entities and their determining factors. Design/methodology/approach: The data were collected by sending a postal questionnaire. In order to measure the degree of development of environmental management practices an index of environmental management practices (EMPI) was developed, which reflects the extent to which a set of 16 environmental management practices have been implemented by the entities included in the sample. Four variables are considered in this study as possible factors that drive the development of environmental management practices by local entities, namely type of entity, size, proactive environmental strategy and Local Agenda 21 Findings: Results indicate the degree of development of environmental management practices in Portuguese local entities is low. Additionally, entity size, the adoption of proactive environmental strategies and the implementation of Local Agenda 21 are explaining factors of the degree of development of such practices. Originality/value: This study adds to the international research on environmental management in public sector by providing empirical data from a country, Portugal, where empirical evidence is still relatively limited.

Determining factors of environmental management practices in portuguese local entities

Purpose – The purpose of this paper is to analyse the development of environmental management practices by Portuguese local entities and their determining factors. Design/methodology/approach – The data were collected by sending a postal questionnaire. In order to measure the degree of development of environmental management practices, an index of environmental management practices (EMPI) was developed, which reflects the extent to which a set of 16 environmental management practices have been implemented by the entities included in the sample. In total, four variables are considered in this study as possible factors that drive the development of environmental management practices by local entities: type of entity; size; proactive environmental strategy; and Local Agenda 21. Findings – Results indicate the degree of development of environmental management practices in Portuguese local entities is low. Additionally, entity size, the adoption of proactive environmental strategies and the implementation of Local Agenda 21 are explaining factors of the degree of development of such practices. Originality/value – The paper adds to the international research on environmental management in the public sector by providing empirical data from a country, Portugal, where empirical evidence is still relatively limited.

Portugal’s Minho-Lima region as a tourist destination: tourism operators’ attitudes towards its management and promotion

The success of tourism development depends on the capacity of a region’s tourism agents to establish and sustain networks, involving both private-sector companies and the public sector. Creating an attractive destination able to compete with others that are better positioned and consolidated requires cooperative behaviour among the various agents involved. This behaviour will facilitate both external and internal competition, which in turn will assure better product quality, continuous product renewal, a strong offer of unique experiences and the efficient use of endogenous resources. In this paper, the authors discuss the results of a survey of restaurant owners and of interviews conducted with the main institutional agents concerned with tourism promotion and the economic development of the Minho–Lima region. Such an approach, the authors argue, can be valuable in identifying the strengths and weaknesses of the area in question with regard to future tourism development. The authors work from the premise that the commitment of tourism agents constitutes a precondition for the success of the strategy to be defined. This is especially applicable to Minho–Lima, which to date has suffered from an absence of commitment and coordination on the part of those agents.

Determinant factors of the implementation of the balanced scorecard in Portugal: empirical evidence in public and private organizations

In this article we aim to identify and analyze a set of variables that can potentially influence the adoption of the Balanced Scorecard (BSC)in Portugal. Hypotheses were tested using data obtained from a questionnaire sent to 591 publicly-owned organizations (local governments, municipal corporations and hospitals) and 549 privately-owned organizations (large companies and small and medium enterprises) in Portugal, with an overall response rate of 31.3%. The results allow us to conclude that although the majority of respondents claimed to know the BSC, its use in Portugal is still limited and very recent, particularly in the public sector organizations. However, it should be noted that its use has increased in Portugal in recent years. Using as theoretical framework the contingency and institutional theories, we found that decentralization, vertical differentiation and the degree of higher education are associated with the implementation of the BSC.