The role of the State and the quality of the public sector

Includes bibliography

The role of the State and the quality of the public sector

Sectoral policies make explicit and implicit assumptions about the behaviour and capabilities of the agents (such as dynamic responses to market signals, demand-led assistance, collaborative efforts, participation in financing); which we consider to be rather unrealistic. Because of this lack of realism, policies that aim to be neutral often turn out to be highly exclusive. They fail to give sufficient importance to the special features of the sector -with its high climatic, biological and commercial risks and its slow adaptation- or to the fact that those who take decisions in agriculture are now mostly in an inferior position because of their incomes below the poverty line, their inadequate training, their traditions based on centuries of living in precarious conditions, and their geographical location in marginal areas, far from infrastructure and with only a minimum of services and sources of information. These people have only scanty and imperfect access to the markets which, according to the prevailing model, should govern decisions and the (re);distribution of the factors of production. In our opinion, this explains the patchy and lower-than-expected growth registered by the sector after the reforms to promote the liberalization of markets and external openness in the region. In view of the results of the application of the new model, it may be wondered whether Latin America can afford a form of development which excludes over half of its agricultural producers; what the alternatives are; and what costs and benefits each of them offers in terms of production and monetary, social, spatial and other aspects. The article outlines the changes in policies and their results at the aggregate level, summarizes the arguments usually put forward to explain agricultural performance in the region, and proposes a second set of explanations based on a description of the agents and the responses that may be expected from them, contrasting the latter with the supposedly neutral nature of the policies.

Sanitary quality of the public groundwater supply for the municipality of Belém in northern Brazil

Neste estudo, a qualidade da água foi verificada no manancial de abastecimento Água Preta, do município de Belém (PA). Houve seis amostragens em seis pontos de coleta e a concentração de coliformes foi verificada através da Técnica de Fermentação em Tubos Múltiplos para a determinação do NMP. Os isolados de Escherichia coli obtidos foram submetidos ao teste de sensibilidade aos seguintes antimicrobianos: cefoxitina, ampicilina, imipenem, gentamicina e amicacina. Além disso, foi investigado genes codificadores de fatores de virulência relacionados às variedades diarreiogênicas de E. coli. Não houve ocorrência de genes relacionados à patogenicidade, e as concentrações de coliformes termotolerantes apresentaram-se dentro dos padrões para mananciais de superfície usados para fins de abastecimento público. Contudo, as maiores concentrações de coliformes totais e termotolerantes foram observadas no ponto de coleta próximo à captação no rio Guamá e na área de maior adensamento populacional no entorno do lago. O teste de suscetibilidade dos isolados E. coli indicou uma alta porcentagem de resistência a ampicilina, a presença de seis perfis fenotípicos e a ocorrência de multiresistência. Assim, os resultados reforçam a necessidade do monitoramento sistemático deste manancial, visando a implementação de políticas de preservação e proteção dos mananciais utilizados para fins de abastecimento público, assim como a prevenção de doenças veiculadas pela água.

Evaluation of quality of life in severely obese patients after bariatric surgery carried out in the public healthcare system

Objectives: To assess QoL of obese patients in the Brazilian public healthcare system, before and after bariatric surgery, and to determine the appropriateness of the Moorehead-Ardelt Questionnaire II (M-A-QoLQII) compared with the Short-Form Health Survey (SF-36). Subjects and methods: Forty-one severe obese patients in a waiting-list, and 84 patients who underwent bariatric surgery were included. Correlations were tested and reliability determined by the Cronbach's coefficient. Results: BMI differed between the pre- and post-surgery groups (52.3 +/- 8.3 kg/m(2) vs. 32.5 +/- 6.4 kg/m(2), p < 0.001). The latter showed better scores in the SF-36 domains than in the pre-surgery. SF-36 and M-A-QoLQII categories were correlated (r = 0.53, 0.49 and 0.47, for vitality, mental health, and general health domains, p < 0.001). In the logistic regression, age, previous BMI, and loss of excess weight were associated with functional capacity. Conclusions:The outcomes of bariatric surgery obtained in a Brazilian public healthcare center were successful. M-A-QoLII represents a useful tool to assess surgery outcomes, including QoL. Arq Bras Endocrinol Metab. 2012;56(1):33-8

THE EVALUATION OF PUBLIC HEALTH COMPONENTS OF INTERNATIONAL DISASTER RELIEF OPERATIONS: INDOCHINESE REFUGEES IN THAILAND, 1979-1982

Refugee populations suffer poor health status and yet the activities of refugee relief agencies in the public health sector have not been subjected previously to comprehensive evaluation. The purpose of this study was to examine the effectiveness and cost of the major public health service inputs of the international relief operation for Indochinese refugees in Thailand coordinated by the United Nations High Commissioner for Refugees (UNHCR). The investigator collected data from surveillance reports and agency records pertaining to 11 old refugee camps administered by the Government of Thailand Ministry of Interior (MOI) since an earlier refugee influx, and five new Khmer holding centers administered directly by UNHCR, from November, 1979, to March, 1982.^ Generous international funding permitted UNHCR to maintain a higher level of public health service inputs than refugees usually enjoyed in their countries of origin or than Thais around them enjoyed. Annual per capita expenditure for public health inputs averaged approximately US$151. Indochinese refugees in Thailand, for the most part, had access to adequate general food rations, to supplementary feeding programs, and to preventive health measures, and enjoyed high-quality medical services. Old refugee camps administered by MOI consistently received public health inputs of lower quantity and quality compared with new UNHCR-administered holding centers, despite comparable per capita expenditure after both types of camps had stabilized (static phase).^ Mortality and morbidity rates among new Khmer refugees were catastrophic during the emergency and transition phases of camp development. Health status in the refugee population during the static phase, however, was similar to, or better than, health status in the refugees' countries of origin or the Thai communities surrounding the camps. During the static phase, mortality and morbidity generally remained stable at roughly the same low levels in both types of camps.^ Furthermore, the results of multiple regression analyses demonstrated that combined public health inputs accounted for from one to 23 per cent of the variation in refugee mortality and morbidity. The direction of associations between some public health inputs and specific health outcome variables demonstrated no clear pattern. ^

Comparing the quality of three models of postabortion care in public hospitals in Mexico City

artículo publicado en la revista Int Fam Plan Perspect. 2003 Sep;29(3):112-20

New QR Survey Methodologies to Analyze User Perception of Service Quality in Public Transport: The Experience of Madrid

Customer Satisfaction Surveys (CSS) have become an important tool for public transport planners, as improvements in the perceived quality of service lead to greater use of public transport and lower traffic pollution. Until now, Intelligent Transportation System (ITS) enhancements in public transport have traditionally included fleet management systems based on Automatic Vehicle Location (AVL) technologies, which can be used to optimize routing and scheduling, and to feed real-time information into passenger information channels. However, surveys of public transport users could also benefit from the new information technologies. As most customers carry their smartphones when traveling, Quick Response (QR) codes open up the possibility of conducting these surveys at a lower cost.This paper contributes to the limited existing literature by developing the analysis of QR codes applied to CSS in public transport and highlighting their importance in reducing the cost of data collection and processing. The added value of this research is that it provides the first assessment of a real case study in Madrid (Spain) using QR codes for this purpose. This pilot experience was part of a research project analyzing bus service quality in the same case study, so the QR code survey (155 valid questionnaires) was validated using a conventional face-to-face survey (520 valid questionnaires). The results show clearly that, after overcoming a few teething troubles, this QR code application will ultimately provide transport management with a useful tool to reduce survey costs

The Illinois long-term care and chronic disease facilities plan : [rule 3B] / prepared by the Illinois Department of Public Health, Office of Health Facilities and Quality of Care ; approved and adopted by the Illinois Health Facilities Planning Board.

Effective July 21, 1977.

CPA audit quality : status of actions taken to improve auditing and financial reporting of public companies : report to the chairman, Oversight and Investigations Subcommittee, Committee on Energy and Commerce, House of Representatives /

"B-233641"-- P. [1].

The eutrophication in the river Vouga basin: impacts on the quality of water for public supply

The aim of this paper is to make a characterization of water quality problems, in the river Vouga, regarding its use for public water supply. The river Vouga basin is located in a mountainous area, draining to the coastal lagoon of the Ria de Aveiro. Other medium size rivers also contribute to the load of pollution entering the estuarine system of the Ria de Aveiro. Two major impacts of the pollution in the river Vouga basin were identified. One is the eutrophication process of the lower reach of the river, including the Ria de Aveiro; the other is the occasional deterioration in the quality of the water abstracted from the medium reach of river Vouga. The causes of this deterioration are related to the enrichment of the river water with organic material. To improve the river water quality, both urban wastewater and agriculture related sources, must be controlled.

Smart and sustainable public transport systems through improving level and quality of service

Buses are considered a slow, low comfort and low reliability transport system, thus its negative and por image. In the framework of the 3iBS project (2012), several examples of innovative and/or effective solutions regarding the Level of Service (LoS) were analysed aiming to provide operators, practitioners and policy makers with a set of Good Practice Guidelines to strengthen the competitiveness of the bus in the urban environment. The identification of the key indicators regarding vehicles, infrastructure and operation was possible through the analysis of a set of case studies -among which Barcelona (Spain), Cagliari (Italy), London (United Kingdom), Paris and Nantes (France). A cross comparison between the case studies was carried out for contrasting the level of achievement of the different criteria considered. The information provided on Regulatory, Financial and Technical issues allows the identification of a number of specific factors influencing the implementation of a high quality transport scheme, and set the basis for the elaboration of a set of Guidelines for the implementation of an intelligent, innovative and integrated bus system, including the main barriers to be tackled.