Abordagem histórica e institucional da mudança em contabilidade de gestão: o caso da normalização nos hospitais públicos portugueses

A teoria institucional constituiu o enquadramento no qual foi suportada a pergunta geral desta investigação: como e porquê a Normalização da Contabilidade de Gestão (NCG) nos hospitais públicos portugueses surgiu e evoluiu? O objetivo geral foi compreender de forma profunda o surgimento e a mudança nas regras de NCG dos hospitais públicos portugueses no período histórico 1954-2011. Face ao enquadramento institucional que justificou uma investigação interpretativa, foi usado como método de investigação um estudo de caso explanatório. A evidência sobre o caso da NCG nos hospitais públicos portugueses foi recolhida em documentos e através de 58 entrevistas realizadas em 47 unidades de análise (nos serviços centrais de contabilidade do Ministério da Saúde e em 46 hospitais públicos, num total de 53 existentes). Quanto aos principais resultados obtidos, no período 1954-1974, as regras criadas pelo poder político para controlo dos gastos públicos e a contabilidade orçamental de base de caixa estiveram na génese dos primeiros conceitos de Contabilidade de Gestão (CG) para os serviços públicos de saúde portugueses. A transição de um regime ditatorial para um regime democrático (25 de Abril de 1974), a criação do Plano Oficial de Contabilidade (POC/77) e a implementação de um estado social com Serviço Nacional de Saúde (SNS) criaram a conjuntura crítica necessária para o surgimento de um Plano Oficial de Contabilidade para os Serviços de Saúde (POCSS/80) que incluiu regras de CG. A primeira edição do Plano de Contabilidade Analítica dos Hospitais (PCAH), aprovada em 1996, não foi uma construção de raiz, mas antes uma adaptação para os hospitais das regras de CG incluídas no POCSS/91 que havia revisto o POCSS/80. Após o início da implementação do PCAH, em 1998, ocorreram sequências de autorreforço institucionalizadoras destas normas, no período 1998-2011, por influência de pressões isomórficas coercivas que delinearam um processo de evolução incremental cujo resultado foi uma reprodução por adaptação, num contexto de dependência de recursos. Vários agentes internos e externos pressionaram, no período 2003-2011, através de sequências reativas para a desinstitucionalização do PCAH em resposta ao persistente fenómeno de loose coupling. Mas o PCAH só foi descontinuado nos hospitais com privatização da governação e rejeição dos anteriores sistemas de informação. Ao nível da extensão da teoria, este estudo de caso adotou o institucionalismo histórico na investigação em CG, quanto se sabe pela primeira vez, que se mostra útil na interpretação dos processos e dos resultados da criação e evolução de instituições de CG num determinado contexto histórico. Na condição de dependência de recursos, as sequências de autorreforço, via isomorfismo coercivo, tendem para uma institucionalização com fenómeno de loose coupling. Como resposta a este fenómeno, ocorrem sequências reativas no sentido da desinstitucionalização. Perante as pressões (políticas, funcionais, sociais e tecnológicas) desinstitucionalizadoras, o fator governação privada acelera o processo de desinstitucionalização, enquanto o fator governação pública impede ou abranda esse processo.

Concepts and objects of awareness in Alzheimer’s disease: an updated systematic review

ABSTRACT Objectives To compare and discuss the objects of awareness in Alzheimer’s disease (AD): awareness of cognitive deficits, of functional activities, of social-emotional functioning and behavioral impairment. Methods A search in the PsycINFo, Pilots, PubMed/Medline and ISI electronic databases according to Prisma methodology was performed. We included studies about awareness in people with AD published between 2010 and 2015, with the combination of keywords: “Alzheimer AND awareness of deficits”, “Alzheimer AND anosognosia”, “Alzheimer AND insight”, “dementia AND awareness of deficits”, “dementia AND anosognosia”, “dementia AND insight”. The articles were categorized according to the specific object of awareness. Results Seven hundred and ten records were identified and, after application of the exclusion criteria, 191 studies were retrieved for potential use. After excluding the duplicates, 46 studies were included. Most studies assessed the cognitive domain of awareness, followed by the functional, social-emotional, and behavioral impairment domains. Memory deficits were not sufficient to explain impaired awareness in AD. Longitudinal studies did not find discrepancies between patients and caregivers’ reports, indicating that awareness is not related to cognition. Conflicting findings were observed, including the relation between awareness, mood, severity of disease, and personal characteristics. Conclusions The studies show lack of conceptual consensus and significant methodological differences. The inclusion of samples without differentiation of dementia etiology is associated to symptomatic differences, which affect awareness domains. Awareness in AD is a complex and multidimensional construct. Different objects elicit different levels of awareness.

Micro/nano-structured superhydrophobic surfaces in the biomedical field: part I: basic concepts and biomimetic approaches.

Inspired by natural structures, great attention has been devoted to the study and development of surfaces with extreme wettable properties. The meticulous study of natural systems revealed that the micro/nano-topography of the surface is critical to obtaining unique wettability features, including superhydrophobicity. However, the surface chemistry also has an important role in such surface characteristics. As the interaction of biomaterials with the biological milieu occurs at the surface of the materials, it is expected that synthetic substrates with extreme and controllable wettability ranging from superhydrophilic to superhydrophobic regimes could bring about the possibility of new investigations of cellâ material interactions on nonconventional surfaces and the development of alternative devices with biomedical utility. This first part of the review will describe in detail how proteins and cells interact with micro/nano-structured surfaces exhibiting extreme wettabilities.

Fundamental concepts in multibody dynamics

In this chapter, the fundamental ingredients related to formulation of the equations of motion for multibody systems are described. In particular, aspects such as degrees of freedom, types of coordinates, basic kinematics joints and types of analysis in multibody systems are briefly characterized. Illustrative examples of application are also presented to better clarify the fundamental issues for spatial rigid multibody systems, which are of crucial importance in the formulation development of mathematical models of mechanical systems, as well as its computational implementation.

Publicidade interactiva: os mundos virtuais ao serviço das marcas

Dissertação de mestrado em Ciências da Comunicação (área de especialização em Audiovisual e Multimédia)

A quantitative research about attitudes of pre-service teachers on inclusive education

In this paper we propose to characterize the inclusive philosophy in Thailand as well as to present and discuss results from a quantitative research carried out within the teacher pre-service context, viewed as one of the components that should be addressed by school systems that seek to be inclusive.

SI2ME: um serviço de informação para o trabalho no binómio monitorização-melhoria, no setor educativo não superior em Portugal

Tese de Doutoramento em Tecnologias e Sistemas de Informação.

Impact of nutritional counseling in reducing serum cholesterol in public health service patients

OBJECTIVE: To assess the impact of nutritional attention on the lipid profile and nutritional status of hypercholesterolemic patients attended in health centers of Belo Horizonte. METHODS: Using nutritional attendance patient record cards from two health units, the evolution of the lipid profile and the nutritional state (BMI) was monitored of 96 hypercholesterolemic patients who received diet. The patients were appraised at the following moments: initial (1st consultation), after 3 months (2nd consultation) and last consultation (variable for each patient). RESULTS: On the first attendance, 44,4% of the patients presented not only high total cholesterol and LDL-c, but also hypertriglyceridemia and 70.3% were overweight or obese, but most patients (75.6%) presented adequate HDL-c levels. There was significant reduction in the BMI, total cholesterol, LDL-c values (p < 0.01) and also in the triglyceride levels (p < 0.05) in the first three months, without alteration in the HDL-c levels. A significant reduction (p < 0.01) was observed in the frequency of individuals with high cholesterol (from 89.6% down to 47.9%), high and very high LDL-c (from 82.6% down to 45.7%), as well as high and very high triglyceride (from 43.6% down to 16.7%). The observed reduction in frequency of the low HDL-c was statistically meaningless. CONCLUSION: This study evidences the effect of the nutritional attention on lipid profile in hypercholesterolemic patients, reinforcing the need for a multiprofessional team to attend them at the public health services.

E-government e participação política em Portugal

Dissertação de Mestrado em MPA - Administração Pública

Mission du Service Geographique de l'Armée pour la mesure d'un arc de méridien équatorial en Amérique du Sud sous le contrôle scientifique de l'Académie des Sciences, 1899-1906

T. 10, Fasc. 1

Socially integrative customer service (SICS) : identification of a symbiotic link with corporate social responsibility

The aim of this study is to answer the research question "can customer service be revitalised through identification of a symbiotic relationship with social responsibility, linked by people-centricity?" The concept of customer service remains weak and there has been a lack of attention to the underlying purpose: "to serve". To strengthen the theory the humanistic nature of the concept should be revised. Fundamental to this argument is the question of who is a customer? To fully discover the scope of the concept requires a broader or more specifically a societal view. Herein the theme of social corporate responsibility is critical to the recognition of the customer service network (CSN). This suggestion in isolation is useful but structural. Another aspect must be identified to validate the "service" ethos. Through this reasoning the relational theme (RT) provides for a mechanism for this to be achieved. Therefore the theory of socially integrative customer service is based on broadening and deepening the customer service concept. This study is illustrated in the context of the grocery retail sector in the Republic of Ireland. Four case studies are presented, three based on company-wide and in-store research and a fourth is a cross-company study. Results across companies indicate acceptance of the research question and show evidence to validate SICS. There is scope to further develop SICS and to build on the CSN and the RT. Finally the concept of SICS provides for a diverse basis for further research. This theory does no purport to cause a paradigm shift but does add innovation to the body of knowledge. As is the hallmark of good theoretical development, the author has aimed to keep the philosophy simple.

Motivating techniques within Irish and American manufacturing and service companies in the Northwest of Ireland

In today’s world, many companies are concentrating on both their technology and human resources to provide them with their competitive advantage. Hence, understanding what motivates people is particularly important for managers in order to develop and sustain a competitive edge. As a result, numerous theories have been advanced to help our understanding of the subject matter and from these theories many motivational methods have evolved to enhance motivation within the workplace. In addition, research has been conducted on the various types of motivational techniques utilised by companies within Ireland. However, very little research has been completed within specific geographical regions in Ireland concerning the types of motivational techniques implemented at different job levels and their impact on employees work performance. Thus the objective of this research was to identify the motivational techniques utilised at different job levels within large manufacturing and service companies in the Northwest of Ireland and examine how these techniques influence the performance levels of employees. Furthermore, the study examined if these companies have changed from traditional ways of motivating employees to newer techniques. The research methodologies used to undertake the research included interviews with the HR managers and questionnaires completed by different employees at various job levels within the participating companies. Overall the conclusions were varied. Many different types of motivation techniques were found within the study’s participating companies. Irish companies are improving their motivational techniques, however most of these techniques are only used within higher job levels. In contrast to their American counterparts, a variety of motivational techniques are utilised and implemented at all job levels. On a more positive note, the majority of these motivational techniques do increase performance levels at all job levels. From the extensive primary and secondary research conducted, the thesis concludes by offering a number of recommendations to assist companies in further development of their motivational techniques for all job levels. These recommendations hope to augment the success of companies through an enhanced motivated workforce.

Quality management for education (second level schools)

Quality Management is a well-developed and widely used approach within industry to gain competitive edge and increased market share. It is a new management approach for schools who are now applying it without having the culture or experience of its evolution. Industrially based Quality management systems and excellence models have been developed. These excellence models and frameworks are based on the principles and concepts of TQM which are recognised as essential elements of high performing organisations. Schools are complex social institutions that provide a service. Like any other service industry, the customers of education are expecting and demanding a better service or else they will go elsewhere. Schools are beginning to reform and change to adapt to such demands. This has been reflected in Ireland in the Education Act, 1998. It is now the right time to develop a quality management system specifically for schools. The existing industrial excellence models have been modified for use in the private and public sector and some have been specifically tailored for education. The problem with such models is that they are still too sophisticated and the language still too industrial for schools. This Thesis develops and Excellence Model for Second Level Schools and provides guidance and school specific tools for its implementation.

An investigation into system security requirements and implementation in an Application Service Provider (ASP) environment

Although the ASP model has been around for over a decade, it has not achieved the expected high level of market uptake. This research project examines the past and present state of ASP adoption and identifies security as a primary factor influencing the uptake of the model. The early chapters of this document examine the ASP model and ASP security in particular. Specifically, the literature and technology review chapter analyses ASP literature, security technologies and best practices with respect to system security in general. Based on this investigation, a prototype to illustrate the range and types of technologies that encompass a security framework was developed and is described in detail. The latter chapters of this document evaluate the practical implementation of system security in an ASP environment. Finally, this document outlines the research outputs, including the conclusions drawn and recommendations with respect to system security in an ASP environment. The primary research output is the recommendation that by following best practices with respect to security, an ASP application can provide the same level of security one would expect from any other n-tier client-server application. In addition, a security evaluation matrix, which could be used to evaluate not only the security of ASP applications but the security of any n-tier application, was developed by the author. This thesis shows that perceptions with regard to fears of inadequate security of ASP solutions and solution data are misguided. Finally, based on the research conducted, the author recommends that ASP solutions should be developed and deployed on tried, tested and trusted infrastructure. Existing Application Programming Interfaces (APIs) should be used where possible and security best practices should be adhered to where feasible.