Health care benefits under close scrutiny.

Mode of access: Internet.

End games: Euthanasia under interminable scrutiny

It is increasingly asserted that the disagreements of abstract principle between adversaries in the euthanasia debate fail to account for the complex, particular and ambiguous experiences of people at the end of their lives. A greater research effort into experiences, meaning, connection, vulnerability and motivation is advocated, during which the euthanasia 'question' should remain open. I argue that this is a normative strategy, which is felicitous to the status quo and further medicalises the end of life, but which masquerades as a value-neutral assertion about needing more knowledge.

That's the name of the scrutiny game

The Audit Commission should leave naming and shaming behind and find a more positive style

The European Parliament and the Future of Comitology after Lisbon: Lessons to be drawn from the Regulatory Procedure with Scrutiny for Delegated Acts

The history of comitology – the system of implementation committees that control the Commission in the execution of delegated powers – has been characterised by institutional tensions. The crux of these tensions has often been the role of the European Parliament and its quest to be granted powers equal to those of the Council. Over time this tension has been resolved through a series of inter-institutional agreements and Comitology Decisions, essentially giving the Parliament incremental increases in power. This process came to a head with the 2006 Comitology reform and the introduction of the regulatory procedure with scrutiny (RPS). After just over three years of experience with the RPS procedure, and having revised the entire acquis communautaire, the Treaty of Lisbon made has made it redundant through the creation of Delegated Acts (Article 290 TFEU), which gives the Parliament equal rights of oversight. This article aims to evaluate the practical implications that Delegated Acts will entail for the Parliament, principally by using the four years of experience with the RPS to better understand the challenges ahead. This analysis will be of interest to those following the study of comitology, formal and informal interinstitutional relations, and also to practitioners who will have to work with Delegated Acts in the future.

[strategies For Integration Of Health Care Practices And Sanitary Surveillance In The Context Of The Implementation Of Rede Cegonha - A Brazilian Mother And Infant Health Care Network].

Mother and infant mortality has been the scope of analysis throughout the history of public health in Brazil and various strategies to tackle the issue have been proposed to date. The Ministry of Health has been working on this and the Rede Cegonha strategy is the most recent policy in this context. Given the principle of comprehensive health care and the structure of the Unified Health System in care networks, it is necessary to ensure the integration of health care practices, among which are the sanitary surveillance actions (SSA). Considering that the integration of health care practices and SSA can contribute to reduce mother and infant mortality rates, this article is a result of qualitative research that analyzed the integration of these actions in four cities in the State of São Paulo/Brazil: Campinas, Indaiatuba, Jaguariúna and Santa Bárbara D'Oeste. The research was conducted through interviews with SSA and maternal health managers, and the data were evaluated using thematic analysis. The results converge with other studies, identifying the isolation of health care practices and SSA. The insertion of SSA in collectively-managed areas appears to be a potential strategy for health planning and implementation of actions in the context under scrutiny.

Circuitos de uso de crack na região central da cidade de São Paulo (SP, Brasil)

Apesar de o uso de drogas ser uma prática presente desde os primórdios da humanidade, atualmente o seu abuso adquiriu dimensões preocupantes, configurando-se como um problema de saúde pública. O surgimento do crack, droga derivada da pasta de coca, agravou esse quadro ao aumentar os danos sociais e à saúde dos usuários. Visando conhecer o impacto de sua inserção no cotidiano dos usuários, foi realizado um estudo etnográfico em locais de venda e uso de crack na região central da cidade de São Paulo (SP, Brasil). Foi utilizado um diário de campo para registrar as observações e os diálogos informais efetuados com as pessoas que circulavam no local estudado. Os resultados apontaram os circuitos percorridos pelos usuários, suas dinâmicas e as relações que estabelecem com outros atores sociais, as quais são permeadas por permanente tensão, envolvendo a prática de atos violentos nos quais os usuários são tanto agressores quanto vítimas. O estudo também sugere a importância de outros fatores como a história da região pesquisada, as políticas públicas, questões econômicas e ausência de investimentos sociais e em saúde pública. Sugere-se que o alto grau de degradação da região pesquisada não seria consequência apenas das pessoas e atividades exercidas no local, mas principalmente do processo urbano que gerou tal quadro social.

A procedure to evaluate environmental rehabilitation in limestone quarries

A procedure to evaluate mine rehabilitation practices during the operational phase was developed and validated. It is based on a comparison of actually observed or documented practices with internationally recommended best practices (BP). A set of 150 BP statements was derived from international guides in order to establish the benchmark. The statements are arranged in six rehabilitation programs under three categories: (1) planning (2) operational and (3) management, corresponding to the adoption of the plan-do-check-act management systems model to mine rehabilitation. The procedure consists of (i) performing technical inspections guided by a series of field forms containing BP statements; (ii) classifying evidences in five categories; and (iii) calculating conformity indexes and levels. For testing and calibration purposes, the procedure was applied to nine limestone quarries and conformity indexes were calculated for the rehabilitation programs in each quarry. Most quarries featured poor planning practices, operational practices reached high conformity levels in 50% of the cases and management practices scored moderate conformity. Despite all quarries being ISO 14001 certified, their management systems pay low attention to issues pertaining to land rehabilitation and biodiversity. The best results were achieved by a quarry whose expansion was recently submitted to the environmental impact assessment process, suggesting that public scrutiny may play a positive role in enhancing rehabilitation practices. Conformity indexes and levels can be used to chart the evolution of rehabilitation practices at regular intervals, to establish corporate goals and for communication with stakeholders. (C) 2010 Elsevier Ltd. All rights reserved.

Targeted! Population segmentation, electronic surveillance and governing the unemployed in Australia

Targeting is increasingly used to manage people. It operates by segmenting populations and providing different levels of opportunities and services to these groups. Each group is subject to different levels of surveillance and scrutiny. This article examines the deployment of targeting in Australian social security. Three case studies of targeting are presented in Australia's management of benefit overpayment and fraud, the distribution of employment services and the application of workfare. In conceptualizing surveillance as governance, the analysis examines the rationalities, technologies and practices that make targeting thinkable, practicable and achievable. In the case studies, targeting is variously conceptualized and justified by calculative risk discourses, moral discourses of obligation and notions of welfare dependency Advanced information technologies are also seen as particularly important in giving rise to the capacity to think about and act on population segments.

The usefulness of acetic acid wash and chemiluminescent illumination (Vizilite) in the visualization of oral mucosal white lesions

A diligent and careful examination of the mouth and oral structures has been historically deficient in revealing premalignant and malignant oral lesions. Conventional screening practice for oral neoplastic lesions involves visual scrutiny of the oral tissues with the naked eye under projected incandescent or halogen illumination. Visualization is the principal strategy used to find patients with lesions at risk for malignant transformation; hence, any procedure which highlights neoplastic lesions should aid the clinician. This pilot study examined the usefulness of acetic acid wash and chemiluminescent light (Vizilite) in enhancing visualization of oral mucosal white lesions, and its ability to highlight malignant and potentially malignant lesions. Fifty five patients referred for assessment of a white lesion, were prospectively screened with Vizilite, and an incisional biopsy performed for a definitive diagnosis. The age, sex, and smoking status of all patients were recorded, and all lesions were photographed. The visibility, location, size, border, and presence of satellite lesions, were also recorded. The Vizilite tool enhanced intraoral visualization of 26 white lesions, but it could not distinguish between epithelial hyperplasia, dysplasia, or carcinoma. Indeed, all lesions appeared ‘‘aceto-white’’, regardless of the definitive diagnosis. On one occasion, Vizilite aided in the identification of a satellite lesion that was not observed by routine visual inspection. Vizilite appears to be a useful visualization tool, but it does not aid in the identification of malignant and potentially malignant lesions of the oral mucosa.

Modelling basin level allocation of water in the Murray-Darling Basin in a world of uncertainty, Murray-Darling Program Working Papers WPM05-1, Risk and Sustainable Management Group, 8 February 2005

Abstract: The Murray-Darling Basin comprises over 1 million km2; it lies within four states and one territory; and over 12, 800 GL of irrigation water is used to produce over 40% of the nation's gross value of agricultural production. This production is used by a diverse collection of some-times mutually exclusive commodities (e.g. pasture; stone fruit; grapes; cotton and field crops). The supply of water for irrigation is subject to climatic and policy uncertainty. Variable inflows mean that water property rights do not provide a guaranteed supply. With increasing public scrutiny and environmental issues facing irrigators, greater pressure is being placed on this finite resource. The uncertainty of the water supply, water quality (salinity), combined with where water is utilised, while attempting to maximising return for investment makes for an interesting research field. The utilisation and comparison of a GAMS and Excel based modelling approach has been used to ask: where should we allocate water?; amongst what commodities?; and how does this affect both the quantity of water and the quality of water along the Murray-Darling river system?

An audit tool for intellectual property management: IP management in the Queensland Department of Primary Industries

Smart State is a Queensland Government initiative that recognises the central role of knowledge-based economic growth. In this context, the management of intellectual property (IP) within Queensland and Australian government research and development agencies has changed dramatically over recent years. Increasing expectations have been placed on utilising public sector IP to both underpin economic development and augment taxes by generating new revenues. Public sector research and development (R&D) management has come under greater scrutiny to commercialise and/or corporatise their activities. In a study of IP management issues in the Queensland Public Sector we developed a framework to facilitate a holistic audit of IP management in government agencies. In this paper we describe this framework as it pertains to one large public sector Agriculture R&D Agency, the Queensland Department of Primary Industries (QDPI). The four overlapping domains of the framework are: IP Generation; IP Rights; IP Uptake; and Corporate IP Support. The audit within QDPI, conducted in 2000 near the outset of Smart State, highlighted some well developed IP management practices within QDPI's traditional areas of focus of innovation (IP Generation) and IP ownership and licensing (IP Rights). However, further management practice developments are required to improve the domains of IP Uptake and Corporate IP Support.

Desenvolvimento sustent??vel: o desafio da admininstra????o p??blica brasileira nas dimens??es da relev??ncia social, da prud??ncia ecol??gica e da viabilidade econ??mica

Partindo do conceito de bem-estar social, definido em lei como de responsabilidade da administra????o p??blica, especialmente no que diz respeito ?? preserva????o dos recursos naturais para a manuten????o da decente qualidade de vida dos cidad??os, o artigo foi estruturado a partir do relat??rio de pesquisa de inicia????o cient??fica financiada pela Funda????o de Amparo ?? Pesquisa do Estado de S??o Paulo (Fapesp) e desenvolvido na Universidade Estadual de S??o Paulo (Unesp). Tal relat??rio objetivou investigar os par??metros de regularidade da administra????o p??blica, analisando-se a jurisprud??ncia dos tribunais. Foram evidenciadas irregularidades na atua????o da administra????o p??blica, constatando a desarticula????o da gest??o p??blica ao gerir as tr??s dimens??es que definem o desenvolvimento sustent??vel: a relev??ncia social, a viabilidade econ??mica e a prud??ncia ecol??gica. Foi poss??vel constatar com esta pesquisa que a administra????o p??blica brasileira d?? mais import??ncia para a quest??o econ??mica que ??s quest??es sociais e ambientais. Pudemos perceber que enquanto o meio ambiente ?? degradado e a sociedade prejudicada com a piora da qualidade de vida, o econ??mico vem sendo privilegiado constantemente. Sendo assim, evidenciaremos esse descaso propondo algumas mudan??as para a melhora da gest??o das tr??s dimens??es do desenvolvimento sustent??vel; por??m, em contrapartida, mostraremos a seriedade na atua????o dos ??rg??os colegiados ambientais e institui????es do poder p??blico, tais como o Minist??rio P??blico, que hoje atuam em parceria com a popula????o, crescentemente envolvida no processo mediante a pr??tica de den??ncias e reclama????es.

Gest??o de pessoas no setor p??blico e a reprodu????o do discurso do setor privado

O objetivo deste estudo ?? o de estabelecer uma an??lise cr??tica do discurso contempor??neo em gest??o de pessoas, verificando como discurso e pr??tica gerencialistas se reproduzem no setor p??blico, sem que haja a devida an??lise do fator ideol??gico que permeia a gest??o privada. No contexto da idealiza????o de modelos gerenciais, gestores p??blicos s??o ??vidos em implementar modelos do setor privado, que t??m uma l??gica diferente da gest??o do setor p??blico. O artigo estabelece, dessa forma, a an??lise cr??tica desse processo, definindo elementos que possam inspirar a gest??o de organiza????es p??blicas e respeitar as suas especificidades.

EU Commission participation in the Troika mission: is there a European Union price to pay?

The article is intended to debate two questions regarding the involvement of the Commission in the Troika's action: firstly, considering the nature of financial assistance programs, it aims to discuss the effect of the Commission's participation in Troika negotiations on the balance of power of the EU institutions; and secondly, the article raises the issue of the Commission's liability for the results achieved by the financial assistance program, taking into account the extent of the conditions imposed, as well as the intensity of scrutiny by the Troika.