819 resultados para Psychiatry reform
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In the past ten years the struggle for land in Brazil has taken the shape of invasions of private land by welI organized groups of land less squatters. It is argued in this paper that these invasions and the resulting contlicts are a direct response to the land reform program which has been adopted by the govemment since 1985. which is based on the expropriation of farms and the creation of settlement projects. The set of formal and informal institutions which compromise the land reform program are used as the background for a game-theory model of rural contlicts. T estable implications are derived trom this model with particular emphasis on the etfect of policy variables on violence. These are then tested with panel data at state levei from 1988 to 1995. - It is shown that govemment policy which has the intent of reducing the amount of violence has the opposite etfect of leading to more incentives for contlicts.
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In spite of a general agreement over the distortion imposed by the current Brazilian tax system, attempts to reform it during the last decade have faced several restrictions to its implementation. Two of these restrictions were particular binding: a) fiscal adjustment restriction (public sector debt cannot increase), b) fiscal federalist restriction (revenues from individual states and municipalities cannot decrease). This paper focuses on a specific reform that overcomes in principle the fiscal federalist restriction. Using Auerbach and Kotlikoff (1987) model calibrated for the Brazilian economy, I analyze the short and long run macroeconomic effects of this reform subject to the fiscal adjustment restriction. Finally, I look at the redistributive effects of this reform among generations as a way to infer about public opinion’s reaction to the reform. The reform consists basically of replacing indirect taxes on corporate revenues, which I show to be equivalent to a symmetric tax on labor and capital income, by a new federal VAT. The reform presented positive macroeconomic effects both in the short and long run. Despite a substantial increase in the average VAT rate in the first years after the reform, a majority of cohorts experienced an increase in their lifetime welfare, being potentially in favour of the reform.
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This dissertation investigates how credit institutions’ market power limits the effects of creditor protection rules on the interest rate and the spread of bank loans. We use the Brazilian Bankruptcy Reform of June/2005 (BBR) as a legal event affecting the institutional environment of the Brazilian credit market. The law augments creditor protection and aims to improve the access of firms to the credit market and to reduce the cost of borrowing. Either access to credit or the credit cost are also determined by bank industry competition and the market power of suppliers of credit. We derive a simple economic model to study the effect of market power interacting with cost of lending. Using an accounting and operations dataset from July/2004 to December/2007 provided by the Brazilian Central Bank, we estimate that the lack of competition in the bank lending industry hinders the potential reducing effect of the BBR on the interest rate of corporate loans by approximately 30% and on the spread by approximately 23%. We also find no statistical evidence that the BBR affected the concentration level of the Brazilian credit market. We present a brief report on bankruptcy reforms around the world, the changes in the Brazilian legislation and on some recent related articles in our introductory chapter. The second chapter presents the economic model and the testable hypothesis on how the lack of competition in the lending market limits the effects of improved creditor protection. In this chapter, we introduce our empirical strategy using a differences-in-differences model and we estimate the limiting effect of market power on the BBR’s potential to reduce interest rates and on the spread of bank loans. We use the BBR as an exogenous event that affects collateralized corporate loans (treatment group) but that does not affect clean consumer loans (control group) to identify these effects, using different concentration measures. In Chapter 3, we propose a two-stage empirical strategy to handle the H–Statistics proposed by Panzar and Rosse as a measure of market competition. We estimate the limiting effects of the lack of competition in replacing the concentration statistics by the H–Statistics. Chapter 4 presents a structural break test of the concentration index and checks if the BBR affects the dynamic evolution of the concentration index.
Regulatory reform in the brazilian railway sector and concession valuation: a preliminary assessment
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Trabalho apresentado na 4th Conference on the Regulation of Infrastructures
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Trabalho apresentado no Law and Society Annual Conference, 2015
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Escola de Direito do Rio de Janeiro da Fundação Getulio Vargas
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Population ageing is a problem that countries will have to cope with within a few years. How would changes in the social security system affect individual behaviour? We develop a multi-sectoral life-cycle model with both retirement and occupational choices to evaluate what are the macroeconomic impacts of social security reforms. We calibrate the model to match 2011 Brazilian economy and perform a counterfactual exercise of the long-run impacts of a recently adopted reform. In 2013, the Brazilian government approximated the two segregated social security schemes, imposing a ceiling on public pensions. In the benchmark equilibrium, our modelling economy is able to reproduce the early retirement claiming, the agents' stationary distribution among sectors, as well as the social security deficit and the public job application decision. In the counterfactual exercise, we find a significant reduction of 55\% in the social security deficit, an increase of 1.94\% in capital-to-output ratio, with both output and capital growing, a delay in retirement claims of public workers and a modification in the structure of agents applying to the public sector job.
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This thesis contains three chapters. The first chapter uses a general equilibrium framework to simulate and compare the long run effects of the Patient Protection and Affordable Care Act (PPACA) and of health care costs reduction policies on macroeconomic variables, government budget, and welfare of individuals. We found that all policies were able to reduce uninsured population, with the PPACA being more effective than cost reductions. The PPACA increased public deficit mainly due to the Medicaid expansion, forcing tax hikes. On the other hand, cost reductions alleviated the fiscal burden of public insurance, reducing public deficit and taxes. Regarding welfare effects, the PPACA as a whole and cost reductions are welfare improving. High welfare gains would be achieved if the U.S. medical costs followed the same trend of OECD countries. Besides, feasible cost reductions are more welfare improving than most of the PPACA components, proving to be a good alternative. The second chapter documents that life cycle general equilibrium models with heterogeneous agents have a very hard time reproducing the American wealth distribution. A common assumption made in this literature is that all young adults enter the economy with no initial assets. In this chapter, we relax this assumption – not supported by the data – and evaluate the ability of an otherwise standard life cycle model to account for the U.S. wealth inequality. The new feature of the model is that agents enter the economy with assets drawn from an initial distribution of assets. We found that heterogeneity with respect to initial wealth is key for this class of models to replicate the data. According to our results, American inequality can be explained almost entirely by the fact that some individuals are lucky enough to be born into wealth, while others are born with few or no assets. The third chapter documents that a common assumption adopted in life cycle general equilibrium models is that the population is stable at steady state, that is, its relative age distribution becomes constant over time. An open question is whether the demographic assumptions commonly adopted in these models in fact imply that the population becomes stable. In this chapter we prove the existence of a stable population in a demographic environment where both the age-specific mortality rates and the population growth rate are constant over time, the setup commonly adopted in life cycle general equilibrium models. Hence, the stability of the population do not need to be taken as assumption in these models.
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The Brazilian Psychiatric Reform based on the desinstitucionalization of the assistance, translated to the emphasis on community/territorial treatment and in the social inclusion of the mental suffering, promoted advances in the psychiatric restructuring. In the Rio Grande do Norte (RN), we can enumerate as advances of the Brazilian Psychiatric Reform the expansion of the mental health care chain and the implementation of some strategies that, together, aims to further the psychosocial attention of the individual with psych suffering and to reduce the indices of psychiatrics readmissions in the state. In the current Brazilian‟s mental health situation we were interesting in answered the following question: what the impact of the substitutes services‟ extension in the revolving door phenomenon? This search aims to analyze the revolving door phenomenon occurrences based on the news strategies of mental health care in the Rio Grande do Norte. This is a descriptive-exploratory study with a qualitative approach, oriented by the theoretical framework of critical-dialectical approach about the Brazilian Psychiatric Reform and using the thematic oral history as method of information collects. The search was realized on the Hospital João Machado (HJM), estate reference in psychiatric treatment, and the participants was 20 professionals that work on it. The collection of information had started after the approval of the UFRN Research Ethics Committee with the opinion number 216/2011 and CAAE number 0021.0.051.000-11 and was realized using the direct observation and semi-structured interview. The study‟s results were categorized in two categories and five subcategories of analysis. CATEGORY 1) Current situation of the mental health care chain in the RN, with the subcategories: 1.1 Impact of the new services of mental health care in the revolving door phenomenon in the RN; 1.2 Implications of the new services of mental health care in assisting user to the HJM; 1.3 Issues the permeate the mental health care chain in the RN. CATEORY 2) Main causes of the revolving door phenomenon in HJM, with the categories: 2.1 Family problems; 2.2 Lack of assistance after discharge from psychiatric hospital. In summary, we conclude that the extension of the mental health care chain contributed for the reduction of the psychiatrics re-hospitalization‟s indices in RN. However, we realized that territorial services of mental health care are not the only responsible for the revolving door phenomenon. Factors as family problems and the disarticulation of the assistance after the discharge from hospital influence on the perpetuation of hospitalizations and re-hospitalizations in the local scenario. To study the revolving door phenomenon that occur in the psychiatrics‟ assistance considering the news strategies of mental health care allowed us to approach the advances and challenges brought by the RPb and by the desinstitucionatization in the state, indicating the need for further discussions and problem-solving strategies of psychosocial care.
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This study aims to identify the concepts of professional nursing team on assistance in urgency and psychiatric emergencies in SAMU in Mossoró/RN, identifying the difficulties in implementing an emergency assistance to the user in psychiatric distress in this service and point strategies in pursuit of consolidation and expansion of comprehensive health care to the public. It is a descriptive research with qualitative and exploratory approach. The subjects were employees of the nursing staff of SAMU of that mentioned municipality. Semi-structured interviews are applied as tool for data collection. It was counted on the consent of the institution where the study was developed and approval by the Ethics Committee in Research of UFRN with CAAE No 17326513.0.0000.5537, besides signing the Informed Free Consent Term by the participants. Data analysis was done by means of thematic analysis proposed by Bardin. Thus , as a result of the research produced the following categories: mechanistic practice; dehumanization of care; need for qualification, barriers to assistance in urgency and psychiatric emergency and strategies in pursuit of comprehensive care, which proceeded in preparing two articles entitled "Nursing care to the emergency room and psychiatric emergencies in the mobile emergency care service" and "Barriers for emergency service and psychiatric emergencies in the mobile emergency care service". In the studied reality it was identified that nursing care offered to users in situations of urgency and psychiatric emergency is made based primarily on the use of chemical and physical restraints, as well as transportation to the general hospital, constantly using the police force support, which meets the guidelines of the Psychiatric Reform and thereby undermining the provision of an effective and humane care. This scenario is worsened by the lack of an organized network of services in mental health, where after the service the user is taken to a general hospital, considering that there is no ready or appropriate psychiatric emergency service as a Center of Psychosocial Care - CAPs III to reference it, thereby precluding the realization of a resolute and comprehensive care. Thus, it is concluded that nursing care is based on biologicist and medicine-centered model advocated by classical psychiatry, and that despite all the advances in psychiatric reform, still guides the mental health care, so the lack of service network organized in hierarchical and mental health, where the user in urgency and emergency service can be watched in full and the guidelines of the psychiatric reform can be realized in practice
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Este trabalho investiga o aspecto qualitativo da Reforma Psiquiátrica no interior do estado de São Paulo, por meio da análise dos discursos presentes no campo da Saúde Mental. Balizamo-nos no referencial da Atenção Psicossocial enquanto corpo teórico-prático e ético para transformação paradigmática em Saúde Mental. Como método, utilizamos entrevistas semi-dirigidas com coordenadores de CAPS e coordenadores municipais de Saúde Mental, e observações participantes, analisadas por meio do método dialético de análise de discurso. Foram encontradas três matrizes teóricas principais dos discursos (Psiquiatria Tradicional, Psiquiatria Preventivo-Comunitária, Atenção Psicossocial) coexistindo no espaço institucional. A vertente Preventivo-Comunitária mostrou-se bem instalada e superando técnica e teoricamente a Psiquiatria Tradicional, porém dificultando o avanço da Atenção Psicossocial em termos éticos.
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O objetivo desse artigo é caracterizar as fontes da ineficiência técnica e alocativa em um conjunto de 308 beneficiários de um programa de reforma agrária de mercado, chamado Cédula da Terra;, distribuídos em cinco estados do Nordeste brasileiro. Estudos conduzidos por Buainain et al. (2002) mostraram existem poucas diferenças entre as características de beneficiários deste programa e dos programas tradicionais de reforma agrária por expropriação e que portanto, os resultados obtidos por este trabalho permitem visualizar as dificuldades enfrentadas pelos assentamentos no Brasil. Para medir eficiência, estimou-se uma função de produção potencial segundo a metodologia de Battese e Coelli (1995) e a partir disto, procurou-se explicar as razões da ineficiência (relativa) encontrada. Os resultados apontam para a existência de ineficiência técnica e alocativa que é identificada principalmente nas situações em que a presença de produção para consumo é elevada. Tratase de um resultado que revela a pouca maturidade da maioria dos lotes dos assentados do PCT e a dificuldade de superar as limitações impostas pela condição inicial de formação dos assentamentos de reforma agrária, principalmente na região nordeste do Brasil.
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This article examines the interplay between legitimacy and context as key determinants of public sector reform outcomes. Despite the importance of variables Such as legitimacy of public institutions, levels of civic morality and socio-economic realities, reform strategies often fail to take such contextual factors into account. The article examines, first, relevant literature both conceptual and empirical, including data from the World Values Survey project. It is argued that developing countries have distinctive characteristics which require particular reform strategies. The data analysed shows that in Latin American countries, there is no clear Correlation between confidence in public institutions and civic morality. Other empirical studies show that unemployment has a negative impact on the level of civic morality, while inequality engenders corruption. This suggests that poorer and socio-economically stratified countries face greater reform challenges owing to the lack of legitimacy of public institutions. The article concludes that reforms should focus on areas of governance that impact on poverty. This will in turn help produce more stable outcomes. Copyright (C) 2008 John Wiley & Sons, Ltd.