Os caminhos da avaliação de desempenho do setor saúde no Brasil: os dois lados do mesmo sistema de saúde

Esta revisão de literatura é fruto de indagações sobre a mudança na postura do Estado brasileiro no que concerne à avaliação na atualidade. A temática desta pesquisa é a inserção da ferramenta da avaliação de desempenho da saúde no Brasil. Mais precisamente, o estudo traz uma análise dos índices de desempenho do subsistema público (IDSUS) e do índice elaborado pela Agência Nacional de Saúde (ANS) para avaliar o subsistema privado da saúde (IDSS). Dessa maneira, esta dissertação tem como objetivo analisar os programas de qualificação do sistema de saúde brasileiro através da avaliação do Índice de Desempenho da Saúde Suplementar (IDSS) e do Índice de Desempenho do SUS (IDSUS), considerando seus impactos na relação público-privado do setor saúde. Para dar conta desses objetivos, a pesquisa examinou os Programas de Qualificação do Sistema de Saúde Brasileiro tanto na sua face pública quanto na privada, utilizando as técnicas de análise documental e bibliográfica. A análise transcorreu a partir do levantamento de documentos oficiais e da literatura produzida sobre o tema. Além da leitura de documentos da Agência Nacional de Saúde (ANS), Ministério da Saúde (MS), Instituto de Estudos da Saúde Suplementar (IESS), Federação de Seguros (FENASEG), Associação Brasileira de Medicina de Grupos (ABRAMGE) e Instituto Brasileiro de Geografia e Estatística (IBGE), foram consultados trabalhos acadêmicos e selecionados textos jornalísticos que evidenciaram o processo de implantação e utilização do Programa de Qualificação da Saúde no Brasil. A dissertação então trouxe à tona, admitindo como base a análise do IDSUS recentemente criado e do IDSS, a necessidade de se rediscutir as finalidades das avaliações de desempenho propostas. Tanto o IDSS quanto o IDSUS são iniciativas pioneiras positivas que podem e devem ser aprimoradas, para que possam de fato instrumentalizar o controle social e o gestor na priorização e no planejamento das ações de saúde. O instrumento utilizado pela ANS foi considerado eficaz, democrático e participativo no que diz respeito ao alcance dos objetivos do Programa de Qualificação das Operadoras de Planos de Saúde. O mesmo conseguiu integrar pressupostos de modelos e instrumentos de gestão referenciados pela literatura como modernos e eficazes, como a gestão por resultados. Promoveu não só mais transparência ao subsistema privado, mas induziu, em certa medida, a concorrência do setor. Já em relação à face pública, percebeu-se que mesmo em face da jovialidade da proposta do IDSUS, o mesmo mapeou alguns pontos críticos do subsistema e apontou a necessidade de se trabalhar o setor de forma mais eficiente. Entretanto, esta pesquisa concluiu que ambos os movimentos de avaliação dos subsistemas público e privado não se completam, não dialogam como deveriam, evidenciando uma dificuldade em perceber e organizar o sistema como um todo.

Distribution and life history of two diminutive flatfishes, Citharichthys gymnorhinus and C. cornutus (Pleuronectiformes: Paralichthyidae), in the western North Atlantic

Citharichthys cornutus and C. gymnorhinus, diminutive flatfishes inhabiting continental shelves in the western Atlantic Ocean, are infrequently reported and poorly known. We identified 594 C. cornutus in 56 different field collections (68–287 m; most between 101–200 m) off the eastern United States, Bahamas, and eastern Caribbean Sea. Historical records and recently captured specimens document the northern geographic range of adults on the shelf off New Jersey (40°N, 70°W). Citharichthys cornutus measured 17.2–81.3 mm standard length (SL); males (20.0–79.1 mm SL) and females (28.0–81.3 mm SL) attain similar sizes (sex could not be determined for fish <20 mm SL). Males reach nearly 100% maturity at ≥60 mm SL. The smallest mature females are 41.5 mm SL, and by 55.1 mm SL virtually all are mature. Juveniles are found with adults on the outer shelf. Only 214 C. gymnorhinus were located in 42 different field collections (35–201 m, with 90% between 61 and 120 m) off the east coast of the United States, Bahamas, and eastern Caribbean Sea. Adults are found as far north as the shelf off Cape Hatteras, NC (35°N, 75°W). This diminutive species (to 52.4 mm SL) is among the smallest flatfishes but males (n=131; 20.3–52.4 mm SL) attain a slightly larger maximum size than that of females (n=58; 26.2–48.0 mm SL). Males begin to mature between 29 and 35 mm SL and reach 100% maturity by 35–40 mm SL. Some females are mature at 29 mm SL, and all females >35.1 mm SL are mature. Overlooked specimens in museum collections and literature enabled us to correct long-standing inaccuracies in northern distributional limits that appear in contemporary literature and electronic data bases for these species. Associated locality-data for these specimens allow for proper evaluation of distributional information for these species in relation to hypotheses regarding shifts in species ranges due to climate change effects.

As unidades prisionais do Rio de Janeiro: uma análise da ordem excludente

A presente tese se propõe a identificar a relação entre os presídios do Rio de Janeiro e o processo de exclusão e dominação, essenciais para a construção da hegemonia. Para isso, analisamos a relação da construção da ordem vigente com as unidades prisionais, desde o início do século XIX, percebendo a forma como o Estado inseriu tais unidades em sua política a fim de garantir a dominação, criminalizando os grupos subalternos. Desta forma, os presídios aparecem como rotuladores, não só de indivíduos, como também de sua identidade e espaço, além, é claro, de confirmar seu status social. Para esta investigação foram utilizados a pesquisa bibliográfica e o cruzamento de dados do Instituto Brasileiro de Geografia e Estatística (IBGE) e do Ministério da Justiça, além do material didático utilizado pelas escolas prisionais do Rio de Janeiro. Nossa análise partiu da compreensão do presídio enquanto lócus de contenção e controle do excedente excluído, encontrada nas obras de Nilo Batista e das perspectivas de David Garland e Loic Wacquant que contextualizam estas instituições pela mesma ótica na política neoliberal. Como escopo teórico principal, alicerçamos esta pesquisa na teoria do desvio, desenvolvida por Haward Becker, e no conceito de hegemonia, tal qual Antonio Gramsci o concebe. Desta forma, observamos como percepções individuais de membros de grupos dominantes podem ser incorporadas pelo seu coletivo e ingressarem no código legal social, favorecendo e garantindo a hegemonia destes sobre os grupos subalternos. As prisões aparecem neste contexto como peça imprescindível. Concluímos, portanto, que as unidades prisionais do Rio de Janeiro possuem grande importância na afirmação da dominação social na medida em que recebem o subalterno e demarcam este grupo e seu espaço, transformando sua condição marginal em condição criminosa. Ou seja, favorecendo a criminalização de sua condição social e, portanto, justificando-a.

Development and use of parasitoids (Hymenoptera : Aphidiidae & Aphelinidae) for biological control of aphids in China

A review of aphid parasitoids in China with special emphasis on their production, utilization, and conservation is presented with a brief history of Chinese biological control. Twenty genera, 99 species of Aphidiidae and two genera, 11 species of Aphelinidae were recorded in China. Each parasitoid is listed with a brief description of aphids, host plants, areas of study such as taxonomy, biology, bionomics, geographic distribution, rearing, and literature citations. Achievements, status, and problems in aphid parasitoid production, utilization, conservation, and future prospects are detailed for dominant aphid parasitoids such as Aphidius gifuensis Ashmead, A. ervi Haliday and Aphelinus mali Haldeman. Finally, opportunities and challenges of commercialization commercialization of natural enemies, especially aphid parasitoids, in China, are analyzed and discussed.

Identification of differentially expressed genes from the cross-subfamily cloned embryos derived from zebrafish nuclei and rare minnow enucleated eggs

Cross-species nuclear transfer (NT) has been used to retain the genetic viability of a species near extinction. However, unlike intra-species NT, most embryos produced by cross-species NT were unable to develop to later stages due to incompatible nucleocytoplasmic interactions between the donor nuclei and the recipient cytoplasm from different species. To study the early nucleocytoplasmic interaction in cross-species NT, two laboratory fish species (zebrafish and rare minnow) from different subfamilies were used to generate cross-subfamily NT embryos in the present study. Suppression subtractive hybridization (SSH) was performed to screen out differentially expressed genes from the forward and reverse subtractive cDNA libraries. After dot blot and real-time PCR analysis, 80 of 500 randomly selective sequences were proven to be differentially expressed in the cloned embryos. Among them, 45 sequences shared high homology with 28 zebrafish known genes, and 35 sequences were corresponding to 22 novel expressed sequence tags (ESTs). Based on functional clustering and literature mining analysis, up-and down-regulated genes in the cross-subfamily cloned embryos were mostly relevant to transcription and translation initiation, cell cycle regulation, protein binding, etc. To our knowledge, this is the first report on the determination of genes involved in the early development of cross-species NT embryos of fish. (C) 2007 Elsevier Inc. All rights reserved.

Integrating design attributes, knowledge and uncertainty in aerospace sector

The delivery of integrated product and service solutions is growing in the aerospace industry, driven by the potential of increasing profits. Such solutions require a life cycle view at the design phase in order to support the delivery of the equipment. The influence of uncertainty associated with design for services is increasingly a challenge due to information and knowledge constraints. There is a lack of frameworks that aim to define and quantify relationship between information and knowledge with uncertainty. Driven by this gap, the paper presents a framework to illustrate the link between uncertainty and knowledge within the design context for services in the aerospace industry. The paper combines industrial interaction and literature review to initially define the design attributes, the associated knowledge requirements and the uncertainties experienced. The framework is then applied in three cases through development of causal loop models (CLMs), which are validated by industrial and academic experts. The concepts and inter-linkages are developed with the intention of developing a software prototype. Future recommendations are also included. © 2014 CIRP.

Women writing woman: representations of gender and sexuality

Pykett, Lyn. 'Women writing woman: representations of gender and sexuality', In: Women and literature in Britain 1800 - 1900 (Cambridge: Cambridge University Press, 2001), pp.78-98, 2008. RAE2008

Rorty's Elective Affinities. The New Pragmatism and Postmodern Thought

The present book is devoted to "European connections of Richard Rorty's neopragmatism". The theme, chosen carefully and intentionally, is supposed to show the motivation behind the writing of the present work, as well as to show its intended extent. Let us consider briefly the first three parts of the theme, to enlighten a little our intentions. "European" is perhaps the most important description for it was precisely that thread that was most important to me, being the only context seriously taken into account, as I assumed right from the start that I would not be writing about rather more widely unknown to me - and much less fascinating (even to Rorty, the hero of the story) from my own, traditional, Continental philosophical perspective - American analytic philosophy. So accordingly I have almost totally skipped "American" connections (to use the distinction I need here) of Rorty's philosophy, that is to say, firstly, a years-long work within analytic philosophy, secondly struggles with it on its own grounds, and finally attempts to use classical American, mainly Deweyan, pragmatism for his own needs and numerous polemics associated with it - the questions that are far away from my interests and that arise limited interest among reading and writing philosophical audience in Poland, and perhaps also among Continental philosophers. It did not seem possible to me to write a book on Rorty in his American connections for they are insufficiently known to me, demanding knowledge of both post-war American analytic philosophy as well as pragmatism of its father-founders. I could see, setting to work on Richard Rorty, that a book on his American connections (leaving aside the issue that it would not be a philosophical problem but rather, let us say, the one of writing a monograph) written by a Polish philosopher in Poland and then in the USA was not a stimulating intellectual challenge but rather a thankless working task. Besides, having spent much time on Rorty's philosophy, writing extensively about him and translating his works, I already knew that the "Continental" context was extremely important to his neopragmatism, and that thinking about it could be relatively prolific (as opposed to the context potentially given by American philosophy).

Between the worlds: otherworld women as intermediaries in early Irish literature

This thesis examines the ways in which Otherworldly women acted as intermediaries between the Otherworld and mortal world in early Irish literature. First it establishes the position of women in early Ireland so that appropriate comparisons can be made between mortal and Otherworld women throughout the thesis. Also, it defines what is meant by the ‘Otherworld’ and its relevence to the early Irish. It then goes on to discuss the differing goals of various intermediaries in early Irish texts, and in what manner they interact with mortals. It briefly looks at how Otherworld male intermediaries are treated differently in the literature, and why early authors might have used women in these roles as often as they did.

Characterization and analysis of the exogenous application of selected phytohormones on C. reinhardtii metabolism

Gemstone Team Genes to Fuels

CPAG: software for leveraging pleiotropy in GWAS to reveal similarity between human traits links plasma fatty acids and intestinal inflammation.

Meta-analyses of genome-wide association studies (GWAS) have demonstrated that the same genetic variants can be associated with multiple diseases and other complex traits. We present software called CPAG (Cross-Phenotype Analysis of GWAS) to look for similarities between 700 traits, build trees with informative clusters, and highlight underlying pathways. Clusters are consistent with pre-defined groups and literature-based validation but also reveal novel connections. We report similarity between plasma palmitoleic acid and Crohn's disease and find that specific fatty acids exacerbate enterocolitis in zebrafish. CPAG will become increasingly powerful as more genetic variants are uncovered, leading to a deeper understanding of complex traits. CPAG is freely available at www.sourceforge.net/projects/CPAG/.

Witnessing Crisis in Contemporary and Golden Age Spain

In this volume, experts on the Spanish Golden Age from the United Kingdom, Ireland, and the United States offer analyses of contemporary works that have been influenced by the classics from the sixteenth and seventeenth centuries.

New Ways of Looking at the State Apparatus and the State Archive in Nineteenth Century Ireland: Curiosities from that Phonetic Museum - Royal Irish Constabulary Reports and their Political Uses, 1879-91

This essay seeks to contextualise the intelligence work of the Royal Irish Constabulary, particularly in the 1880s, in terms of the wider British and imperial practice and, as a corollary, to reflect upon aspects of the structure of the state apparatus and the state archive in Ireland since the Union. The author contrasts Irish and British police and bureaucratic work and suggests parallels between Ireland and other imperial locations, especially India. This paper also defines the narrowly political, indeed partisan, uses to which this intelligence was put, particularly during the Special Commission of 1888 on 'Parnellism and crime', when governmentheld police records were made available to counsel for The Times. By reflecting on the structure of the state apparatus and its use in this instance, the author aims to further the debate on the governance of nineteenth-century Ireland and to explore issues of colonial identity and practice. The line of argument proposed in this essay is prefigured in Margaret O'Callaghan, British high politics and a nationalist Ireland: criminality, land and the law under Forster and Balfour (Cork, 199

Bolsa Familia Program and school enrolment: An analysis of the 2010 Brazilian demographic census

The Bolsa Família Program goal is to promote social development and poverty reduction, through the direct transfer of conditional cash, in association with other social programs. This study aims to analyze whether Bolsa Família had an association with children’s school attendance, which is one of the educational conditions of the program. Our main hypothesis is that children living in households receiving Bolsa Família had greater chances of attending school. Data from the Ministry of Social Development and Combating Famine indicated that children living in households with Bolsa Família had greater school enrolment levels. By using data from the 2010 Demographic Census, collected by the Brazilian Institute of Geography and Statistics (IBGE), some descriptive analyzes and binary logistic regression models were performed for different thresholds of household per capita income. These estimates were made by comparing children who lived in households receiving Bolsa Família to those children not receiving the program. We took into consideration characteristics about the household, mothers, and children. The results were clustered by the municipality of residence of the child. In all income thresholds, children benefi ting from Bolsa Família were more likely to be enrolled in school, compared to children not receiving the benefi t.