A regionalização como instrumento de governança pública em saúde no estado do Paraná: análise dos vazios assistenciais como subsídio à ação do estado

Everyone has a right to health and the State’s duty is to provide it. SUS (unified health system) main principles are universalization, integrality and equality which are based on the decentralization, regionalization and hierarchization directives and shows the importance of a territorial perspective for planning healthcare actions. Decentralization was the strategy chosen to implant SUS, since municipalities were in charge of providing and organizing the municipal healthcare services. Nevertheless regionalization, that’s to say service, institution and practice integration, was not performed satisfactorily, thus jeopardizing the health system decision making process and causing disputes between municipalities over financial resources instead of developing an interdependent and cooperative net. This way, it is important to analyze if health regionalization has a good potential for being used as public governance tool. The present study aims at giving answers to the following research problem: What are the contributions of regionalism to the State of Paraná public governance applied to health? Besides that, it also aims at assessing the State of Parana health regionalization to identify healthcare gaps and help the State actions through public governance principles applied to healthcare. Therefore, the study used a quantitative-qualitative, exploratory and descriptive research, plus secondary data concerning bibliographic and documental research. The present study analyzed the current hospital bed distribution by compared to the ideal distribution allowing the identification of healthcare gaps in the regional healthcare centers, besides considering medical specialties in the State of Paraná. The study conclusion is that health regionalization is an important tool for reducing healthcare gaps concerning hospital beds permitting the use of seven to ten public governance principles applied to healthcare, as established in the present study, and shows health regionalization is an important pubic governance tool.

La démocratie et ses institutions : comment les institutions perçoivent et transforment les questions de politiques publiques

Cette thèse porte sur les fondements philosophiques des institutions démocratiques canadiennes et analyse comment leur conception réelle contribue à les atteindre. Pour passer de la théorie à la pratique, la démocratie doit être institutionnalisée. Les institutions ne sont pas que de simples contraintes sur les actions du gouvernement. Elles incarnent des normes démocratiques. Cependant, les théories démocratiques contemporaines sont souvent abstraites et désincarnées. Alors qu’elles étudient les fondements normatifs de la démocratie en général, elles réfléchissent rarement sur les mécanismes permettant d’atteindre l’idéal démocratique. À l’inverse, la science politique tente de tracer l’ensemble du paysage institutionnel entourant l’action de l’État. Mais l’approche de la science politique a une faiblesse majeure : elle n’offre aucune justification épistémologique ou morale des institutions démocratiques. Cette dichotomie entre les principes et les institutions est trompeuse. Les principes de la démocratie libérale sont incarnés par les institutions. En se concentrant sur les fondements philosophiques des institutions démocratiques et libérales, cette thèse fait revivre une longue tradition d’Aristote à John Stuart Mill et réunissant des penseurs comme Montesquieu et James Madison. Actuellement, la recherche universitaire se détourne encore des questions institutionnelles, sous prétexte qu’elles ne seraient pas assez philosophiques. Cependant, le design institutionnel est une question philosophique. Cette thèse propose des améliorations pour que les institutions démocratiques remplissent leur rôle philosophique de manière plus adéquate. Le suicide médicalement assisté est utilisé comme un exemple de l’influence des institutions sur la démocratie.

Turkish Security Policymaking on Nuclear Issues: Conceptualizing Advanced Cooperative Security Strategies

Turkey is a non-nuclear member of a nuclear alliance in a region where nuclear proliferation is of particular concern. As the only North Atlantic Treaty Organization (NATO) member that has a border with the Middle East, Turkish officials argue that Turkey cannot solely rely on NATO guarantees in addressing the regional security challenges. However, Turkey has not been able to formulate a security policy that reconciles its quest for independence, its NATO membership, the bilateral relationship with the United States, and regional engagement in the Middle East. This dissertation assesses the strategic implications of Turkey’s perceptions of the U.S./NATO nuclear and conventional deterrence on nuclear issues. It explores three case studies by the process tracing of Turkish policymakers’ nuclear-related decisions on U.S. tactical nuclear weapons deployed in Europe, national air and missile defense, and Iran’s nuclear program. The study finds that the principles of Turkish security policymaking do not incorporate a fundamentally different reasoning on nuclear issues than conventional deterrence. Nuclear weapons and their delivery systems do not have a defining role in Turkish security and defense strategy. The decisions are mainly guided by non-nuclear considerations such as Alliance politics, modernization of the domestic defense industry, and regional influence. The dissertation argues that Turkey could formulate more effective and less risky security policies on nuclear issues by emphasizing the cooperative security approaches within the NATO Alliance over confrontational measures. The findings of this dissertation reveal that a major transformation of Turkish security policymaking is required to end the crisis of confidence with NATO, redefinition of the strategic partnership with the US, and a more cautious approach toward the Middle East. The dissertation argues that Turkey should promote proactive measures to reduce, contain, and counter risks before they develop into real threats, as well as contribute to developing consensual confidence-building measures to reduce uncertainty.

Tensões e contradições do processo de construção das diretrizes para a politica pública de educação infantil do campo

Tese (doutorado)—Universidade de Brasília, Faculdade de Educação, Programa de Pós-Graduação em Educação, 2016.

O descompasso de uma experiência: avaliação do Programa Habitar Brasil na Comunidade África-Natal/RN

This research deals with the evaluation of the Programa do Governo Federal para Urbanização de Favelas Habitar Brasil(1993) carried out in the Africa slum - Redinha neighbourhood in Natal-Rn. This study carried out in period from 2005 to 2006 searches to identify the effects of the actions proposed by Program in 1993-1994 about the current urbanistic configuration of the Africa community. It analyzes the effectiveness in the process of achievement of the considered objectives to habitation, communitity equipments, infrastructure and agrarian regularization. On the evaluation process, it has been as reference the works developed by Adauto Cardoso (2004), Blaine Worthen (2004), Ronaldo Garcia (2001) and Rosângela Paz (2006). About the Habitational Policy with approach to the Urbanistic Right and the right to the housing, the reflections by Raquel Rolnik, Nabil Bonduki, Ermínia Maricato, Saule Júnior, Betânia de Moraes Alfonsin and Edésio Fernandes are main references. To gauge the execution of the objectives proposed by Habitar Brasil in 1993, it has searched in the documentary data of the time and in information gotten in interviews with technicians that had participated of the program, consistent references on what was considered, what was executed and the process of the intervention of Habitar Brasil in the Africa community. The area analysis in 2005-2006 has developed on the base of the urbanistic survey of the current situation from the four performance lines of the Program: habitation, infrastructure, community equipments and agrarian regularization, with a current urbanistic evaluation of Africa considering the intervention carried out in 1993 and 1994. The study points out the context of Brazilian Habitational Policy where the Programa Habitar Brasil was launched, explaining the main principles of the Program. In terms of local, it empahsizes the administrative-political factors that had contributed so that Natal-Rn city has been pioneering in the resources captation of Habitar Brazil (1993). Considering Habitar Brazil in Africa, the work argues and presents the intervention diagnosis and the proposal, developed by Program in 1993 evidencing the local problem of the time. After that, it makes a current reading of the area, identifying in 2006 representative elements of Habitar Brasil (1993-1994) for the Africa community. It identifies significant advances in the constitution of the institucional apparatus of the plaining system of Habitation of Social Interest for the city of Natal and points the fragilities in the implementation of the urban infrastructure actions and above all in the achievement of the objectives of the agrarian regularization

Pesky Pests of the Great Lakes State: Is Public Participation Influenced by Geographic Differences?

In Michigan, environmental issues, such as invasive species, are not geographically constrained, affecting citizens throughout the state. Regulations and management plans organized by scientists and officials are intended to address issues statewide, but these policies may not adequately tackle the threat from invasive species as it impacts different parts of the state at different times. Participation and contributions from citizens can offer insight into the impacts and changes non-native species have on the local ecosystem. However, chances to participate and contribute may be influenced by geographic location in the state. To understand if this was the case, this research studied publicly available documents and completed participant observations and semistructured interviews with participants, leaders, and officials included in invasive species management. Between the two study locations, Metro Detroit and the Western Upper Peninsula of Michigan, locational differences had some impact on opportunities to contribute to invasive species management. Population and the differences in the type of advertising used to alert citizens about events influenced access to participation opportunities. This research also revealed that this public policy issue lacks public involvement and contributions. Between the two locations, more involvement opportunities and organizations were present in Metro Detroit. However, it was the organizations themselves and their limited political involvement, and not geographic location, which had a greater impact on citizens' lack of participation in invasive species management.

Disentangling patient and public involvement in healthcare decisions:why the difference matters

Patient and public involvement has become an integral aspect of many developed health systems and is judged to be an essential driver for reform. However, little attention has been paid to the distinctions between patients and the public, and the views of patients are often seen to encompass those of the general public. Using an ideal-type approach, we analyse crucial distinctions between patient involvement and public involvement using examples from Sweden and England. We highlight that patients have sectional interests as health service users in contrast to citizens who engage as a public policy agent reflecting societal interests. Patients draw on experiential knowledge and focus on output legitimacy and performance accountability, aim at typical representativeness, and a direct responsiveness to individual needs and preferences. In contrast, the public contributes with collective perspectives generated from diversity, centres on input legitimacy achieved through statistical representativeness, democratic accountability and indirect responsiveness to general citizen preferences. Thus, using patients as proxies for the public fails to achieve intended goals and benefits of involvement. We conclude that understanding and measuring the impact of patient and public involvement can only develop with the application of a clearer comprehension of the differences.

La influencia de la religión en la formación de la nación, estudio de caso: el budismo en Bután

El Reino de Bután es el único Estado de la cordillera del Himalaya cuya población es en su mayoría practicante del Budismo Mahayana Tántrico y cuyo desempeño tanto en la arena internacional como en su administración interna está estrechamente vinculado con los valores y principios budistas de reciprocidad, felicidad, solidaridad, vida familiar, cooperación, entre otros. Ejemplo de esto es la creación del Índice de Felicidad Nacional Bruta y la iniciativa del Nuevo Paradigma de Desarrollo. El presente artículo analiza los factores nacionales fundamentales que han permitido el desarrollo de la nación hacia las mencionadas políticas; y explica la influencia del Budismo en la formación de la Nación butanesa, para lo cual se hace un análisis cualitativo de fuentes, biografías, documentos oficiales y encuestas nacionales. Lo anterior permitirá explicar la estrecha relación ente el budismo y la nación butanesa actual, así como la importancia del Nuevo Paradigma del Desarrollo.

Revisión sistemática de la literatura de las intervenciones diseñadas para el comportamiento de automedicación no responsable

La automedicación no responsable se ha convertido en un problema de salud pública global en las últimas décadas, por sus consecuencias individuales (por ejemplo, la intoxicación) y colectivas (por ejemplo, la resistencia microbiana a los antibióticos). Las intervenciones orientadas a este comportamiento han sido aisladas y muy diferentes. Aunque se tiene evidencia de que su aplicación puede traer beneficios en diferentes poblaciones, no se halló en la literatura una compilación sistemática de dichas intervenciones. El objetivo de la presente revisión es sistematizar la literatura científica sobre las diferentes alternativas de intervención del comportamiento individual de automedicación no responsable. En cuanto al método, la revisión de literatura involucró la búsqueda sistemática de “automedicación” e “intervención” en las bases de datos académicas internacionales con contenidos de psicología, suscritas por la Biblioteca de la Universidad del Rosario. Como resultado se encontró que las intervenciones orientadas al comportamiento de automedicación no responsable se pueden clasificar en dos grandes grupos: (a) intervenciones regulatorias, con dirección “arriba hacia abajo”, que suponen una acción de los Estados nacionales por medio de sus legislaciones o de entidades internacionales (por ejemplo, Organización Mundial de la Salud); y (b) intervenciones educativas, con dirección “abajo hacia arriba”, que suponen acciones con individuos y comunidades con el fin de enseñar acerca del uso adecuado de los medicamentos. Se concluye acerca de la necesidad de complementar ambos tipos de intervención, los cuales, si bien demuestran resultados positivos, aisladamente son insuficientes para contrarrestar integralmente este fenómeno creciente y complejo.

Urban public policies: towards the improvement of landscape ecological system. The case-study of the city of Évora, Portugal.

The Charter of European Planning 2013 presents a Vision for the future of European cities and regions, highlighting the sustainability of cities and the preservation of urban ecosystems, integrating the man-made environment with the natural ecosystems and contribute to the well-being and quality of life of their inhabitants and other stakeholders. Thus, urban public policies are crucial to the improvement of the landscape ecological system, achievable by city planning and design. The paper aims to analyse if public urban policies in Portugal have been integrating strategies and/or guidelines to enhance the ecological system of the landscape. Then, which new perspectives are possible, framed by the recently approved law Bases of Public Policy of Soils, Land Management and Urban Planning (2014). This new law, in contrast with the previous ones, don’t allow reserving land to urbanize, in municipal master plans. Moreover, it is possible to revert land classified for urban purposes in those plans into rustic soils (when it is not yet infra-structured or built). It allows creating new planning and design dynamics, convert several areas and including them in the urban ecological structure, essential to the enhancement of landscape ecological system. This is a filed of work where landscape architecture has huge responsibilities, by associating and harmonize man-made environment with natural systems, enlightening sustainability consistent with conservation and improvement of Nature while contributing to the well-being and quality of life of Man. A sustainability that is ethical, aesthetic, ecological and cultural. The study is supported by a case study – the city of Évora. The ultimate goal is to propose measures to promote larger and better integration of ecological component in urban public policies, framed by the new territorial management law, taking into account and highlighting the specificities of the landscape system – Man and Nature – at the local level.

“Who Gets Public Support to Innovation? Evidence from the Portuguese Alentejo Region”

The aim of the study is to assess which factors influence the policymaking decisions to financially support an innovative investment project. Based on the case study of the Portuguese Innovation Incentive System in the Alentejo region, we estimated an econometric model based on firms’ and application’ characteristics, controlling for macroeconomic environment. The results indicate that the selection process is more focused on the expected project impact than on firms’ past performance. Furthermore, we found that government preference for promoting employment and exportation are shown to be higher than the impact on firm productivity.

“Productivity and Employment in Firm’s Acess to Public Funding to Support Innovation”

Innovation is at the heart of the Europe 2020 Strategy, in order to promote higher levels of employment and productivity. Special attention is given to increasing the effectiveness of innovation policy instruments, mainly as some authors found evidence that productivity could be negatively affected by subsidies. The aim of the study is to assess how the expected impact on firm productivity and employment is taken into account, when firms apply for public funding for innovation. The analysis is based on the case study of the Portuguese Innovation Incentive System in the Alentejo region. In order to understand which factors influence the public decision to financially support private investment, we estimated a logit model based on firms’ and applications’ characteristics, controlling for the macroeconomic environment. The results indicate that government preferences for promoting exports, exploiting firms R&D results and stimulating the level of qualified employment are shown to be more relevant than the impact on firm productivity. Furthermore, the cost to the government of new jobs created, measured at least by exemption of interest and financial charges on the loan, is almost twice as much for non-SMEs as for SMEs.

Interface Between Intellectual Disability And Mental Health: Hermeneutic Review.

A literature review was conducted aiming to understand the interface between the Intellectual Disability and Mental Health fields and to contribute to mitigating the path of institutionalizing individuals with intellectual deficiencies. The so-called dual diagnosis phenomenon remains underestimated in Brazil but is the object of research and specific public policy internationally. This phenomenon alerts us to the prevalence of mental health problems in those with intellectual disabilities, limiting their social inclusion. The findings reinforce the importance of this theme and indicate possible diagnostic invisibility of the development of mental illness in those with intellectual disabilities in Brazil, which may contribute to sustaining psychiatric institutionalization of this population. 

Educação a distância e efeitos em cadeia

This article is divided into two parts. The first presents two abstract arguments that constitute the starting point for the development of the second part, which is directed towards discussing some aspects of the distance learning policies, i.e., the role of public authorities in encouraging and shaping this type of education. First of all, it is intended to establish some assumptions to understand the emergence of this phenomenon and some of its conditioning factors and consequences; then to suggest some analytical tools to allow us to reflect on public policy in this area.

As conferências nacionais do esporte na configuração da política esportiva e de lazer no governo Lula (2003-2010)

Universidade Estadual de Campinas . Faculdade de Educação Física