AN ECONOMIC ANALYSIS OF THE DEMAND FOR CARE IN A FREE-STANDING EMERGENCY CENTER

Free-standing emergency centers (FECs) represent a new approach to the delivery of health care which are competing for patients with more conventional forms of ambulatory care in many parts of the U.S. Currently, little is known about these centers and their patient populations. The purpose of this study, therefore, was to describe the patients who visited two commonly-owned FECs, and determine the reasons for their visits. An economic model of the demand for FEC care was developed to test its ability to predict the economic and sociodemographic factors of use. Demand analysis of other forms of ambulatory services, such as a regular source of care (RSOC), was also conducted to examine the issues of substitution and complementarity.^ A systematic random sample was chosen from all private patients who used the clinics between July 1 and December 31, 1981. Data were obtained by means of a telephone interview and from clinic records. Five hundred fifty-one patients participated in the study.^ The typical FEC patient was a 26 year old white male with a minimum of a high school education, and a family income exceeding $25,000 a year. He had lived in the area for at least twenty years, and was a professional or a clerical worker. The patients made an average of 1.26 visits to the FECs in 1981. The majority of the visits involved a medical complaint; injuries and preventive care were the next most common reasons for visits.^ The analytic results revealed that time played a relatively important role in the demand for FEC care. As waiting time at the patients' regular source of care increased, the demand for FEC care increased, indicating that the clinic serves as a substitute for the patients' usual means of care. Age and education were inversely related to the demand for FEC care, while those with a RSOC frequented the clinics less than those lacking such a source.^ The patients used the familiar forms of ambulatory care, such as a private physician or an emergency room in a more typical fashion. These visits were directly related to the age and education of the patients, existence of a regular source of care, and disability days, which is a measure of health status. ^

La presse d'extreme droite face au revisionnisme en France 1978-1990

Between 1978 and 1990 five newspapers close to Jean-Marie Le Pen's Front National had the choice of defining their stand on so-called révisionnisme which in its extreme form denied the existence of the Shoah, considering it to be the fabrication of a Jewish conspiracy. Within révisionnisme, a négationniste discourse affirmed that the gas chambers never existed, while a relativiste discourse denied that the Shoah was an act of genocide. However, most of the extreme-right newspapers did not adopt the cause of révisionnisme, even if they sometimes evinced an indulgence towards it. Only the weekly Rivarol and the militant François Brigneau who worked for Minute, Présent and National Hebdo and wrote the most on the subject openly espoused révisionnisme. The reasons for their stance included neo-fascist views, belief in a Jewish conspiracy. Their stance was in keeping with ideas commonly expressed in French neo-fascist circles that made for a révisionnisme of exculpation. On the other hand, the French Catholic intégriste milieu close to the Front National, which is represented by the newspapers Présent and Aspects de la France, was not generally révisionniste, notwithstanding the occasionnal expressions of relativisme by persons in the schismatic lefebvriste movement or close to Présent. This rejection of révisionnisme by Catholics on the extreme right was conditioned by various factors: the nature of Maurras's nationalisme intégral and anti-Semitism transmitted by I' Action française; the Catholic Church's modified position on the Jews; and the (offensive) atheism of the upholders of révisionnisme. This same révisionnisme extended beyond latter-day Nazi sympathisers. In its French version, it served to unite elements of the extreme right and the extreme left, as witness the role played by La Vieille Taupe, the extreme left group which was (and is) the leading publisher in France of tracts favouring révisionnisme.

Las penas de encierro perpetuo desde una perspectiva histórica

Son pocos los trabajos publicados sobre la historia de las penas privativas de libertad, por lo cual llevo un tiempo dedicada a intentar llenar este vacío. En esta ocasión he querido explicar cuál ha sido el desarrollo de las sanciones de encierro perpetuo en los sucesivos Códigos Penales españoles, poniendo énfasis en el contexto político en el que se aprueban estos Códigos y las reformas de los mismos, así como también en las teorías de la pena y en las razones político-criminales que han contribuido a su justificación o crítica.

Acões motrizes e representações sociais no jogo do laço no vale do Itabapoana

Universidade Estadual de Campinas . Faculdade de Educação Física

Ressignificação existencial do pretérito e longevidade humana

Existem, atualmente, mais de 300 hipóteses relativas à caracterização, função e mecanismos do envelhecimento, possivelmente devido ao aumento de idosos no mundo. Embora se avente uma função social à velhice humana, as transformações da sociedade impuseram uma cultura de descarte, incluindo pessoas como os idosos. Tal exclusão, que se associa à tristeza, depressão e morte desse grupo, é contraditória ao aumento do tempo de vida dos idosos constatado atualmente. O presente trabalho tentou determinar os aspectos ambientais envolvidos na longevidade usando uma técnica de metodologia qualitativa denominada grounded theory (ou teoria fundamentada nos dados) em dados fornecidos por ex-ferroviários longevos. Constatou-se que as representações dos ex-ferroviários confluem para a categoria central: desolação pelo aniquilamento da vida e do ambiente, no presente, devido à continuada negligência do Estado e da Sociedade na promoção e preservação das coisas boas para a vida que havia no passado. Observou-se ainda que, paralelamente à hipervalorização genérica das coisas do passado, há constatação recente de que suas existências fizeram parte da epopeia que promoveu o desenvolvimento econômico e social do interior paulista e possibilitou uma ressignificação existencial do passado, sugerindo ser um potente mecanismo de defesa que culmina em longevidade. Tal achado se insere na hipótese de que a função da longevidade seria a de preservar um contingente social com conhecimentos de um modo de vida que deu certo por ser socialmente vantajoso

Africanized honey bees more efficiently convert protein diets into hemolymph protein than do Carniolan bees (Apis mellifera carnica)

The superiority of Africanized over European honey bees in tropical and subtropical regions of the New World is both well documented and poorly understood. As part of an effort to try to understand the process by which the displacement of European bees occurred, we examined the ability of these two types of bees and of hybrids between the two to convert natural and artificial diets into usable protein. Newly emerged bees from colonies of tropically adapted Africanized and temperate-origin Carniolan bees and first-generation hybrids between the two were caged and fed artificial and natural protein diets for six days to determine whether there were differences in their ability to use these diets. The Africanized bees developed significantly higher protein levels in the hemolymph than did the Carniolan bees. The difference was 31% when the bees were fed bee bread (37.5 and 28.56 mu g protein/mu L hemolymph, respectively). The hybrids developed protein levels intermediate between the two parental types. These were approximately 10 times the levels found in bees fed with sucrose alone. Superior food conversion efficiency of the Africanized bees may be one of the reasons for their superiority both in the wild and for beekeeping in tropical and subtropical Latin America.

The Las Campanas/AAT rich cluster survey - I. Precision and reliability of the photometric catalogue

The Las Campanas Observatory and Anglo-Australian Telescope Rich Cluster Survey (LARCS) is a panoramic imaging and spectroscopic survey of an X-ray luminosity-selected sample of 21 clusters of galaxies at 0.07 < z < 0.16. Charge-coupled device (CCD) imaging was obtained in B and R of typically 2 degrees wide regions centred on the 21 clusters, and the galaxy sample selected from the imaging is being used for an on-going spectroscopic survey of the clusters with the 2dF spectrograph on the Anglo-Australian Telescope. This paper presents the reduction of the imaging data and the photometric analysis used in the survey. Based on an overlapping area of 12.3 deg(2) we compare the CCD-based LARCS catalogue with the photographic-based galaxy catalogue used for the input to the 2dF Galaxy Redshift Survey (2dFGRS) from the APM, to the completeness of the GRS/APM catalogue, b(J) = 19.45. This comparison confirms the reliability of the photometry across our mosaics and between the clusters in our survey. This comparison also provides useful information concerning the properties of the GRS/APM. The stellar contamination in the GRS/APM galaxy catalogue is confirmed as around 5-10 per cent, as originally estimated. However, using the superior sensitivity and spatial resolution in the LARCS survey evidence is found for four distinct populations of galaxies that are systematically omitted from the GRS/APM catalogue. The characteristics of the 'missing' galaxy populations are described, reasons for their absence examined and the impact they will have on the conclusions drawn from the 2dF Galaxy Redshift Survey are discussed.

'The utility of human security': Which humans? What security? A reply to Thomas & Tow

Thomas & Tow's evaluation of the utility of human security is an important contribution to an ongoing debate about what security is and for whom security should be provided. In particular, the authors' engagement with the human security agenda is important given the centrality of this approach to recent attempts to rethink security. This article argues, however, that Thomas & Tow's approach to the human security agenda is problematic for two central reasons. First, their attempt to narrow security to make this approach amenable to state policymakers risks reifying the sources of insecurity for individuals everywhere. Second, the conception of human security they put forward appears largely inconsistent with the normative concerns inherent in the human security agenda.

O sentido de ser educadora das/ nas brinquedotecas do hospital infantil de Vitória/ ES: um estudo a partir dos conceitos de experiência, narrativa e cuidado

O ato de brincar tem sido considerado como vital à saúde mental, emocional, física e intelectual do ser humano. Todos esses elementos são vividos no brincar de modo indissociado. A brinquedoteca Hospitalar possibilita melhores condições para a recuperação da criança internada, minimizando situações traumatizantes e tornando a sua estadia no hospital mais alegre. Este trabalho propõe um estudo de inspiração fenomenológico existencial OBJETIVANDO: desvelar - o sentido de ser educadora nas brinquedotecas do Hospital Infantil de Vitória/ ES, focando as experiências delas narradas e cuidadosamente vividas (e ou experienciadas) nos modos subjetivos delas serem no mundo objetivo, vivências que serão narradas por elas nesse espaço-tempo de ludicidade que se presta à Pedagogia Hospitalar nas suas vertentes de atendimentos escolares (Educação Especial numa perspectiva inclusiva) e não-escolares donde a Pedagogia hospitalar compõe um ramo da Pedagogia Social, oferecendo assim atendimentos às crianças e jovens especialmente, mas não só (podendo abarcar adultos e idosos). MARCO TEÓRICO: o termo teórico central do nosso marco teórico é Cuidado (SORGE), como em BOFF (2012) e WALDOW(1993; 1998; 2006) e Experiência em PINEL (2004;2006) de ser (ter sido) de alguma forma criadora desse espaço-tempo de brincar ( e de estudar) no hospital, confabulando tanto uma Educação Não Escolar (Pedagogia Social) e Escolar (Pedagogia Escolar). A angústia de ser educadora das brinquedotecas pareceu-nos que se constituirá em uma característica imprescindível para a compreensão da sua existência do ser no ofício, bem como sua interação consigo mesmo, com o outro e com o mundo das Brinquedotecas Hospitalares. Entendemos os sentidos da alegria, calma e alegria, coragem e profissionalismo, transform(ação), direito e escolaridade e humanização e dor como elementos que compuseram o complexo mosaico de Cuidado (Sorge) – próprios daquele que se propõe cuidar de si, do outro e das coisas do mundo pelo viés de cuidar.

IDENTIFYING ETHICAL DILEMMAS OF PORTUGUESE CHARTERED ACCOUNTANTS

The way professionals deal with ethical dilemmas and the decisions they make may be guided by a personal and individual ideology, but it is also strongly influenced by their professional group and society. This paper focuses in real situations as they are experienced by individuals in their day-to-day professional life. The data were collected using opened-end interviews. Respondents were asked to identify the ethical dilemmas they had been faced with during their professional life. Qualitative analysis shows that main dilemmas are about how to deal with “informal economy”, “false invoices” and “tax evasion”. This study aims to contribute to the discussion of ethical issues faced by Portuguese Chartered Account (TOC), thus promoting a large debate about the way the TOC can help to create a better society and consequently legitimating their existence as a professional organization of public interest. More than ever, understanding professionals’ behavior in their real context is essential for to build a culture conducive to the ethical development of society, and to ensure, at the same time, the desirable business sustainability. This study gives a broaden description of ethics dilemmas faced by chartered accounts and shows some inefficiency in the ethical control system made by professional bodies.

IDENTIFYING ETHICAL DILEMMAS OF TOC/CHARTERED ACCOUNTANTS

The way professionals deal with ethical dilemmas and the decisions they make may be guided by a personal and individual ideology, but these are also strongly influenced by their professional group and society. The focus in this paper is on situations as experienced by individuals in their day-to-day professional life. The data were collected with opened-end interviews. Respondents were asked to identify the ethical dilemmas they had been faced with during their professional life. Qualitative analysis shows that main dilemmas are about how to deal with “informal economy”, “false invoices” and “tax evasion”. This study aims to contribute to the discussion of ethical issues faced by TOC, thus promoting a large debate about the way TOC can help create a better society and consequently legitimating their existence as a professional organization of public interest.

Derivative-free optimization and filter methods to solve nonlinear constrained problems

In real optimization problems, usually the analytical expression of the objective function is not known, nor its derivatives, or they are complex. In these cases it becomes essential to use optimization methods where the calculation of the derivatives, or the verification of their existence, is not necessary: the Direct Search Methods or Derivative-free Methods are one solution. When the problem has constraints, penalty functions are often used. Unfortunately the choice of the penalty parameters is, frequently, very difficult, because most strategies for choosing it are heuristics strategies. As an alternative to penalty function appeared the filter methods. A filter algorithm introduces a function that aggregates the constrained violations and constructs a biobjective problem. In this problem the step is accepted if it either reduces the objective function or the constrained violation. This implies that the filter methods are less parameter dependent than a penalty function. In this work, we present a new direct search method, based on simplex methods, for general constrained optimization that combines the features of the simplex method and filter methods. This method does not compute or approximate any derivatives, penalty constants or Lagrange multipliers. The basic idea of simplex filter algorithm is to construct an initial simplex and use the simplex to drive the search. We illustrate the behavior of our algorithm through some examples. The proposed methods were implemented in Java.

Derivative-free nonlinear optimization filter simplex

The filter method is a technique for solving nonlinear programming problems. The filter algorithm has two phases in each iteration. The first one reduces a measure of infeasibility, while in the second the objective function value is reduced. In real optimization problems, usually the objective function is not differentiable or its derivatives are unknown. In these cases it becomes essential to use optimization methods where the calculation of the derivatives or the verification of their existence is not necessary: direct search methods or derivative-free methods are examples of such techniques. In this work we present a new direct search method, based on simplex methods, for general constrained optimization that combines the features of simplex and filter methods. This method neither computes nor approximates derivatives, penalty constants or Lagrange multipliers.

Titularização: inovação financeira, gestão de crédito e Normas Internacionais de Contabilidade

Mestrado em Auditoria

Impacto dos benefícios fiscais, em sede de IRS, em Portugal e a sua evolução no período de 2001-2010

Mestrado em Contabilidade