Decentralization and privatization in Portuguese health reforms

ABSTRACT - The Portuguese National Health Service (SNS), a universal, centralized and public owned health care system, exhibits an extraordinary record of equalization in the access to health care and health gains in the late thirty years. However, the most recent history of the Portuguese health reform is pervaded by the influence of decentralization and privatization. Decentralization has been present in the system design since the 1976 Constitution, at least in theory. Private ownership of health care suppliers and out-ofpocket expenditures, on the financing side, both have a long tradition of relevance in the NHS mix of services. The initial aim of this study was to demonstrate expected parallelism between health reforms and public administration reforms, where a common pattern of joint decentralization and privatization was observed in many countries. Observers would be tempted to consider these two movements as common signs of new public management (NPM) developments. They have common objectives, are established around the core concepts of gains in effectiveness, efficiency, equity and quality of public services, through improved accountability. However, in practice, in Portugal, each movement was developed in a totally separated way. Besides those rooted in the NPM theory, there are few visible signs of association between decentralization and privatization. Decentralization, in the Portuguese SNS, was never intended to be followed by a privatization movement; it was seen merely as a public administration tool. Private management of health services, as stated in the most recent SNS legislation, was never intended to have decentralization as a condition or as a consequence. Paradoxically, in the Portuguese context, it has led invariably to centralized control. While presented as separate instruments for a common purpose, the association between decentralization and privatization still lacks a convincing demonstration. Many common health care management stereotypes remain to be checked out if we want to look for eventual associations between these two organizational tools.

Leadership of portuguese community schools in the East Coast of the United States and the public policies of education: a multiple case studies

The Portuguese community schools of the United States located in the areas of larger Portuguese population concentration are social organizations that come materializing throughout decades the designs of the educative policies of the Portuguese government in relation to the expansion and preservation of the language, the culture and the history of Portugal. These designs of the educative policies are enrolled in the Constitution of the Republic (1976), in the Basic Law of Educative System (1986) and, over all, in the successive legislative norms (Decree-laws and ordinances) of the successive governments. Portuguese community schools in the United States are structuralized in analogous way to schools of the Portuguese geographic space. For this qualitative study (multiple case), four directors of Portuguese schools of the East Coast of the United States were interviewed; two schools are in the state of Rhode Island and the other two are in the state of Massachusetts. Also, it was administered the questionnaire on practices of leadership “Leadership Practices Inventory” (LPI) of Kouzes and Posner (2002) to collect additional data about practices of leadership on the directors of the schools. The LPI evaluates practices of leadership classifying them in five domains: (a) Model the way; (b) Inspire a shared vision; (c) Challenge the process; (d) Enable others to act; and, (e) Encourage the heart. Results of this qualitative research indicate that the Portuguese Government has not had an educative policy stimulant, coherent and consistent of support, incentive, maintenance and diffusion of the Portuguese language and culture and the directors of the studied schools they have a proactive and serving leadership style in conducting the management of Portuguese community schools. The five practices of leadership are highly practiced by the directors of the studied schools above all the practices “Enable others to act” and “Encourage the heart”.

A HISTORY OF PORTUGUESE LANGUAGE TEACHING MANUALS IN BRAZIL, IN THEIR VARIOUS LANGUAGES

This article aims to study the historical constitution of Portuguese Language Teaching Manuals in Brazil (PLT) in Brazil. To do this, we offer firstly an overview view of research on these Teaching Manuals as used in schools and in Portuguese language classes throughout the whole time they have existed. From this extensive period we draw attention to some historical perspectives that have decisively changed the direction of PLT, its classes and the day to day life in schools. From these we shall single out the public policies regarding quality pertaining to the National Program for Teaching Manuals (NPTM) and to the National Program for Teaching Manuals for High Schools, specifically and for 2015 (NPTMHS 2015). We seek theoretical support in: Comenius (1954), Oliveira et al. (1984), Soares (1986, 1998, 2001), Bittencourt (1993), Freitag et al. (1993), Munakata (1997), Coracini (1999), Batista (2001, 2003, 2004), Batista and Costa Val (2004), Bunzen (2001, 2005, 2009), Bunzen and Rojo (2008) Rojo and Batista (2008), among others. The result of this research will give a history of PLT made up of diverse social and political factors, as well as those continually arising.

Problem-solving courts, therapeutic jurisprudence and the constitution : if two is company, is three a crowd?

Court costs, resource-intensive trials, booming prison populations and the obduracy of recidivism rates all present as ugly excesses of the criminal law adversarial paradigm. To combat these excesses, problem-solving courts have evolved with an edict to address the underlying issues that have caused an individual to commit a crime. When a judge seeks to help a problem-solving court participant deal with issues like addiction, mental health or poverty, they are performing a very different role to that of a judicial officer in the traditional court hierarchy. They are no longer the removed, independent arbiter — a problem-solving court judge steps into the ‘arena’ with the participant and makes active use of their judicial authority to assist in rehabilitation and positive behavioural change. Problem-solving court judges employing the principles of therapeutic jurisprudence appreciate that their interaction with participants can have therapeutic and anti-therapeutic consequences. This article will consider how the deployment of therapeutic measures (albeit with good intention) can lead to the behavioural manifestation of partiality and bias on the part of problem-solving court judges. Chapter III of the Commonwealth Constitution will then be analysed to highlight why the operation and functioning of problem solving courts may be deemed unconstitutional. Part IV of this article will explain how a problem-solving court judge who is not acting impartially or independently will potentially contravene the requirements of the Constitution. It will finally be suggested that judges who possess a high level of emotional intelligence will be the most successful in administering an independent and impartial problem solving court.

Socio-Spatial Approaches To Literacy Studies: Rethinking the Social Constitution and Politics of Space

Literacy studies have begun to examine the spatial dimension of literacy practices in a way that foregrounds space, and that considers space as constitutive to human relations and practices. This chapter provides an introduction to spatial literacy research, providing a guide to key theorists, themes, and studies that have shaped historical and new developments in spatial approaches to literacy practice and pedagogy. It begins by reconceptualising socio-spatial approaches to literacy research and defines terms. Intersections with related social theories are examined, with an emphasis on critical approaches and the politics of space. It clarifies the relationship between socio-spatial and socio-cultural paradigms, revisiting the spatial in seminal socio-cultural research. It covers new ground,including networks, flows, and deterritorialisation of literacy practice. The chapter concludes with challenges and recommendations for future language research and educational practice.

Design democratisation and its understandings through the meaning of the word “design” in Portuguese colonised countries

This paper explores the literature and analyses the different uses and understandings of the word “design” in Portuguese colonised countries, using Brazil as the main example. It investigates the relationship between the linguistic existence of terms to define and describe “design” as an activity and field, and the roles and perceptions of Design by the general society. It also addresses the effects that the lack of a proper translation causes on the local community from a cultural point of view. The current perception of Design in Portuguese colonies is associated to two main aspects: linguistic and historical. Both of them differentiate the countries taken into consideration from other countries that have a different background. The changes associated to the meaning of “design” throughout the years, caused a great impact on the perceptions that people have about Design. On the other hand, the development of Design has also influenced the changes on the meaning of the term, as a result of the legacy from the colonisation period and also as a characteristic of the Portuguese language. Design has developed and reached a level of excellence in Portuguese colonised countries that competes with the most traditional Design cultures in the world. However, this level of Design is enmeshed into an elite belonging to universities and specialised markets, therefore Design is not democratised. The ultimate aim of this study is to promote discussions on how to make the discourse surrounding this area more accessible to people from non-English speaking countries that do not have the word “design” in their local language.

A social licence to operate: Corporate social responsibility, local communities and the constitution of global production networks

This article contributes to the theorization of the role of informal regulation (undertaken by leading firms) in the ongoing organization of global production networks. It does so through a qualitative case study of BHP Billiton's Ravensthorpe Nickel Operation (RNO) in the rural Shire of Ravensthorpe in Western Australia. This less tangible, and to date under-researched, dimension of global production networks is foregrounded through a focus on the corporate social responsibility strategy implemented by RNO in the service of achieving and/or demonstrating a broader ‘social licence to operate’. This ‘licence’ functions – beyond the corporation – as a legitimated and legitimating multi-scalar mechanism through which to gain and maintain access to mineral resources and thus to establish viable and ongoing global production networks. Further, this informal regulation is shown to shape social relations and qualities of place conducive to competitive global mineral extraction and to facilitate the positioning of local communities and places in mineral global production networks.

Association of IL23R and ERAP1 genes with ankylosing spondylitis in a Portuguese population

Objective: Association between ankylosing spondylitis (AS) and two genes, ERAP1 and IL23R, has recently been reported in North American and British populations. The population attributable risk fraction for ERAP1 in this study was 25%, and for IL23R, 9%. Confirmation of these findings to ERAP1 in other ethnic groups has not yet been demonstrated. We sought to test the association between single nucleotide polymorphisms (SNPs) in these genes and susceptibility to AS among a Portuguese population. We also investigated the role of these genes in clinical manifestations of AS, including age of symptom onset, the Bath Ankylosing Spondylitis Disease Activity, Metrology and Functional Indices, and the modified Stoke Ankylosing Spondylitis Spinal Score. Methods: The study was conducted on 358 AS cases and 285 ethnically matched Portuguese healthy controls. AS was defined according to the modified New York Criteria. Genotyping of IL23R and ERAP1 allelic variants was carried out with TaqMan allelic discrimination assays. Association analysis was performed using the Cochrane-Armitage and linear regression tests of genotypes as implemented in PLINK for dichotomous and quantitative variables respectively. A meta-analysis for Portuguese and previously published Spanish IL23R data was performed using the StatsDirect® Statistical tools, by fixed and random effects models. Results: A total of 14 nsSNPs markers (8 for IL23R, 5 for ERAPl, 1 for LN-PEP) were analysed. Three markers (2 for IL23R and 1 for ERAP1) showed significant single-locus disease associations, confirming that the association of these genes with AS in the Portuguese population. The strongest associated SNP in IL23R was rs1004819 (OR=1.4, p=0.0049), and in ERAP1 was rs30187 (OR=1.26, p=0.035). The population attributable risk fractions in the Portuguese population for these SNPs are 11% and 9.7% respectively. No association was seen with any SNP in LN-PEP, which flanks ERAP1 and was associated with AS in the British population. No association was seen with clinical manifestations of AS. Conclusions: These results show that IL23R and ERAP1 genes are also associated with susceptibility to AS in the Portuguese population, and that they contribute a significant proportion of the population risk for this disease.

Copyright, fair use and the Australian Constitution

There has been much debate over recent years about whether Australian copyright law should adopt a fair use doctrine. In this chapter we argue by pointing to the historical record that the incorporation of the term 'copyrights' in the Australian Constitution embeds a notion of balance and fair use in Australian law and that this should be taken into account when interpreting the Australian Copyright Act 1968. English case law in the 18th and 19th centuries developed a principle that copyright infringement did not occur where a person had made a fair use of a work. Fair use was generally established where the defendant had made a productive use that did more than alter the original work for the purpose of evading liability, and where the defendant had made an original contribution to the resulting work. Additionally, fairness was shown by a use that did not supersede or prejudice the market for the original work. At the time of including the copyright power in the Constitution, the UK Parliament’s understanding of “copyrights” included the notion of fair use as it had been developed in U.K. precedent. In this chapter we argue that the work “copyrights” in the Australia Constitution takes its definition from copyright in 1900 and as it has evolved since. Importantly, the word “copyrights” is infused with a particular meaning that incorporates the principle of copyright balance. The constitutional notion of copyright, therefore, is not that of an unlimited power to prevent all copying. Rather, copyright distinguishes between infringing copying and non-infringing copying and grants to the copyright owner only the power to control the former. Non-infringing copying includes well-accepted limitations on the copyright owner’s rights, including the copying of ideas, the copying of public domain works and the copying of insubstantial parts of copyrighted works. In this chapter we argue that non-infringing copying also includes copying to make a fair use of a work. The sections that distinguish infringing copying from non-infringing copying in the Copyright Act 1968 are sections 36(1) and 101(1), which define infringement as the doing, without licence, of an “act comprised in the copyright”. An infringing copy is an act comprised the copyright, whereas a non-infringing copy is not. We argue that space for fair uses of copyrighted works is built into the Copyright Act 1968 through these sections, because a fair use will not produce an infringing copy and so is not an act comprised in the copyright.

Application to amend K.K.S.I. Constitution

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Copy of letter from Portuguese congregation, London, to K. K. S. I. regarding re-burial of dead

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Papers regarding workhouse and constitution of the American Hebrew Agricultural Association

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Notice to change constitution of K. K. S. I.

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