Continuidade dos cuidados de saúde às crianças e jovens com Diabetes - articulação interinstitucional

A efetiva articulação entre os Cuidados de Saúde Primários e Hospitalares apresenta-se como uma estratégia para aumentar os ganhos em saúde, racionalizando os recursos financeiros, a eficiência dos serviços e a satisfação dos utentes. Com o presente projeto, pretendeu-se promover a comunicação entre as equipas de Saúde Escolar do Agrupamento de Centros de Saúde da Arrábida e a Consulta de Diabetes Juvenil do Centro Hospitalar de Setúbal, através da implementação de um protocolo de articulação, com o objetivo de assegurar o continuum dos cuidados de saúde às crianças e jovens acompanhadas na consulta de Diabetes Juvenil. Partindo das necessidades identificadas pelos e com os diversos profissionais de saúde envolvidos pretendeu-se garantir um plano assistencial integrado e desenvolver uma prática de complementaridade com a de outros profissionais de saúde e parceiros comunitários. Adotou-se a metodologia do planeamento em saúde e delinearam-se intervenções que envolveram os diferentes profissionais de saúde, conduzindo à reflexão e discussão sobre o tema, apontando para a mudança nas práticas, consubstanciado por etapas de conhecimento, motivação, apreciação, experimentação e finalmente de adoção; ABSTRACT: Effective coordination between Primary Health Care and Hospital presents itself as a strategy to increase health gains, streamlining financial resources, the efficiency of services and user satisfaction. With this project, the aim was to promote communication between the School Health Team of the Grouping Arrabida Health Centers and Juvenil e Diabetes Consultation of Setúbal Hospital Centre, through the implementation of a joint protocol with the objective of ensure the continuum of health care to children and young people accompanied the Juvenile Diabetes consultation. Starting from the needs identified by and with the various health professionals involved was intended to ensure an integrated care plan and develop a practice of complementarity with other health professionals and community partners. Adopted the planning methodology in health and outlined by interventions involving different health professionals, leading to reflection and discussion on the topic, pointing to the change in practice, embodied by stages of knowledge, motivation, appreciation, experimentation and finally adoption.

Agriculture, Environmental Incentive Payments, and Water Quality in the Chesapeake Bay

Nonpoint sources (NPS) pollution from agriculture is the leading source of water quality impairment in U.S. rivers and streams, and a major contributor to lakes, wetlands, estuaries and coastal waters (U.S. EPA 2016). Using data from a survey of farmers in Maryland, this dissertation examines the effects of a cost sharing policy designed to encourage adoption of conservation practices that reduce NPS pollution in the Chesapeake Bay watershed. This watershed is the site of the largest Total Maximum Daily Load (TMDL) implemented to date, making it an important setting in the U.S. for water quality policy. I study two main questions related to the reduction of NPS pollution from agriculture. First, I examine the issue of additionality of cost sharing payments by estimating the direct effect of cover crop cost sharing on the acres of cover crops, and the indirect effect of cover crop cost sharing on the acres of two other practices: conservation tillage and contour/strip cropping. A two-stage simultaneous equation approach is used to correct for voluntary self-selection into cost sharing programs and account for substitution effects among conservation practices. Quasi-random Halton sequences are employed to solve the system of equations for conservation practice acreage and to minimize the computational burden involved. By considering patterns of agronomic complementarity or substitution among conservation practices (Blum et al., 1997; USDA SARE, 2012), this analysis estimates water quality impacts of the crowding-in or crowding-out of private investment in conservation due to public incentive payments. Second, I connect the econometric behavioral results with model parameters from the EPA’s Chesapeake Bay Program to conduct a policy simulation on water quality effects. I expand the econometric model to also consider the potential loss of vegetative cover due to cropland incentive payments, or slippage (Lichtenberg and Smith-Ramirez, 2011). Econometric results are linked with the Chesapeake Bay Program watershed model to estimate the change in abatement levels and costs for nitrogen, phosphorus and sediment under various behavioral scenarios. Finally, I use inverse sampling weights to derive statewide abatement quantities and costs for each of these pollutants, comparing these with TMDL targets for agriculture in Maryland.

Caractérisation du fonctionnement d'une hydrolienne à membrane ondulante pour la récupération de l'énergie des courants marins

This manuscript presents three approaches : analytical, experimental and numerical, to study the behaviour of a flexible membrane tidal energy converter. This technology, developed by the EEL Energy company, is based on periodic deformations of a pre-stressed flexible structure. Energy converters, located on each side of the device, are set into motion by the wave-like motion. In the analytical model, the membrane is represented by a linear beam model at one dimension and the flow by a 3 dimensions potential fluid. The fluid forces are evaluated by the elongated body theory. Energy is dissipated all over the length of the membrane. A 20th scale experimental prototype has been designed with micro-dampers to simulate the power take-off. Trials have allowed to validate the undulating membrane energy converter concept. A numerical model has been developed. Each element of the device is represented and the energy dissipation is done by dampers element with a damping law linear to damper velocity. Comparison of the three approaches validates their ability to represent the membrane behaviour without damping. The energy dissipation applied with the analytical model is clearly different from the two other models because of the location (where the energy is dissipated) and damping law. The two others show a similar behaviour and the same order of power take off repartition but value of power take off are underestimated by the numerical model. This three approaches have allowed to put forward key-parameters on which depend the behaviour of the membrane and the parametric study highlights the complementarity and the advantage of developing three approaches in parallel to answer industrial optimization problems. To make the link between trials in flume tank and sea trials, a 1/6th prototype has been built. To do so, the change of scale was studied. The behaviour of both prototypes is compared and differences could be explained by differences of boundary conditions and confinement effects. To evaluated membrane long-term behaviour at sea, a method of ageing accelerated by temperature and fatigue tests have been carried out on prototype materials samples submerged in sea water.

O Ofício das Rezadeiras: um estudo antropológico sobre as práticas terapêuticas e a comunhão de crenças em Cruzeta/RN

The present Master´s dissertation aims to study the practices of the rezadeiras, Brazilian women healers, through an anthropological perspective. Special attention will be given to the understanding of these practices as a dynamic process in relation to those women who heal in Cruzeta (Seridó, Rio Grande do Norte), where is located our ethnographic research. For this research, twenty four rezadeiras were contacted and colaborated with our work plan. Among them, two were pentecostal rezadeiras and another one was member of the Jurema cult, an afro-brazilian religious cult. Similarities among these women healers were perceived in the research process, mostly in terms of their learning process and the use of certain objects and ritual techniques. However, apparent differences among them gave us the chance for understanding and reflecting on the actual heterogeneity of this world of specialists. Furthermore, i tried to capture the relations between the rezadeiras and the therapeutic practices from health professionals or the religious practices of religious leaders (Catholic, pentecostal, etc). It is possible to ascertain about the complementarity between therapeutic practices from different cultural logics. This complementarity is also perceived through the religious interchanges and transits among different healers, including those who have different religious beliefs. In this work, rituals are also described and they are a crucial factor to the understanding of this particular religious and therapeutic practice conducted by women. Following these ideas, our basic aim is to understand how the rezadeiras make interpretations about health and illness, specially those ones which are particular associated with their practices, the so called "doenças de rezadeiras"

Standardized environmental management systems as an internal management tool

In a principal-agent model we analyze the firm’s decision to adopt an informal or a standardized Environmental Management System (EMS). Our results are consistent with empirical evidence in several respects. A standardized EMS increases the internal control at the cost of introducing some degree of rigidity that entails an endogenous setup cost. Standardized systems are more prone to be adopted by big and well established firms and under tougher environmental policies. Firms with standardized EMS tend to devote more effort to abatement although this effort results in lower pollution only if public incentives are strong enough, suggesting a complementarity relationship between standardized EMS and public policies. Emission charges have both a marginal effect on abatement and a qualitative effect on the adoption decision that may induce a conflict between private and public interests. As a result of the combination of these two effects it can be optimal for the government to distort the tax in a specific way in order to push the firm to choose the socially optimal EMS. The introduction of standardized systems can result in win-win situations where firms, society and the environment get better off.

Segurança pública e privada

A presente investigação teve como objetivo analisar o carácter subsidiário e complementar dos serviços de segurança privada, face à atividade desenvolvida pelas forças e serviços de segurança. Centrada nos espetáculos desportivos, procurou mostrar de que forma se materializa a complementaridade e subsidiariedade entre serviços de segurança privada e as forças e serviços de segurança. Através de uma estratégia de investigação qualitativa, concretizada a partir de uma pesquisa documental e um inquérito por entrevista semiestruturada, cujos dados foram alvo de análise de conteúdo, pretendeu-se recolher informação que permita à GNR melhorar a sua atuação na segurança dos espetáculos desportivos. No âmbito da segurança interna, a segurança privada assume um papel fundamental no garante da segurança, a par das atividades desenvolvidas pelas forças e serviços de segurança. Nos espetáculos desportivos, esta relação simbiótica é evidente, sendo um claro exemplo de uma abordagem integrada a este direito fundamental. Conclui-se que a relação, prevista legalmente como complementar e subsidiária, entre serviços de segurança privada e forças e serviços de segurança, se materializa pela adoção e normalização de diversos mecanismos de coordenação e articulação, mas principalmente pela partilha de um fim último comum: a segurança de todos os cidadãos. Abstract: Inserted in the CEMC 2015-16, this work aims to analyze the alternative and complementary nature of private security services, due to the activity carried out by Police Forces. Focusing on sports events, this research sought to show how materializes complementarity and subsidiarity between private security services and Police forces. Through a qualitative research strategy, implemented from documental research and a survey by semi-structured interviews, whose data were subjected to content analysis, we intended to collect information to the GNR improve their performance in the safety of sports events. In the context of internal security, private agents play a key role in security guarantees, along with the activities carried out by security forces and services. In sports events, this symbiotic relationship is too obvious, being a clear example of an integrated approach to this fundamental right. It was concluded that the relationship provided legally as complementary and subsidiarity between private security companies and security forces and services, materializes the adoption and standardization of various mechanisms for coordination and articulation, but mostly by sharing an end last common: the safety of all citizens.

The Westerly Index as complementary indicator of the North Atlantic oscillation in explaining drought variability across Europe

This paper analyses the influence of different atmospheric circulation indices on the multi-scalar drought variability across Europe by using the Standardized Precipitation Evapotranspiration Index (SPEI). The monthly circulation indices used in this study include the North Atlantic oscillation (NAO), the East Atlantic (EA), the Scandinavian (SCAN) and the East Atlantic-Western Russia (EA-WR) patterns, as well as the recently published Westerly Index (WI), defined as the persistence of westerly winds over the eastern north Atlantic region. The results indicate that European drought variability is better explained by the station-based NAO index and the WI than by any other combination of circulation indices. In northern and central Europe the variability of drought severity for different seasons and time-scales is strongly associated with the WI. On the contrary, the influence of the NAO on southern Europe droughts is stronger than that exerted by the WI. The correlation patterns of the NAO and WI with the SPEI show a spatial complementarity in shaping drought variability across Europe. Lagged correlations of the NAO and WI with the SPEI also indicate enough skill of both indices to anticipate drought severity several months in advance. As long as instrumental series of the NAO and WI are available, their combined use would allow inferring European drought variability for the last two centuries and improve the calibration and interpretation of paleoclimatic proxies associated with drought.

Estabelecimento de prioridades para a conservação dos vertebrados terrestres do Parque Natural da Ria Formosa e selecção de áreas para a sua protecção

Dissertação de mest. em Gestão e Conservação da Natureza, Faculdade de Ciências do Mar e do Ambiente, Univ. do Algarve, 2004

A representação social do microempreendedor individual na publicidade do Sebrae

Dissertação (mestrado)—Universidade de Brasília, Faculdade de Comunicação, Programa de Pós-Graduação em Comunicação, 2015.

Principios de la cosmovisión andina relacionados con el uso de plantas medicinales en la parroquia de Sayausí, cantón Cuenca

Antecedentes: Sayausí, pese a su urbanización en los últimos 20 años aún mantiene costumbres ancestrales andinas, como el uso de plantas medicinales: recurso preventivo y terapéutico en salud. Objetivo: Conocer el manejo de las plantas medicinales en Sayausí, según los principios de la cosmovisión andina. Materiales y Métodos: Investigación con enfoque cualitativo e intercultural. Estudia el uso de plantas medicinales bajo los postulados de la cosmovisión andina, con los sabios de la comunidad. Fundamento teórico para el análisis de los datos: el diseño narrativo, generando conceptos e interpretaciones a partir de la información obtenida de los sabios. Técnicas utilizadas: entrevistas. Instrumentos: formularios con preguntas abiertas, grabaciones y fotografías. Las entrevistas se redactaron utilizando citas, códigos y memos, procesadas con el programa Atlas ti; las categorías principales agrupadas según taxonomías; la información complementada con tablas y figuras. Resultados: los Yachak explicaron con sus propias palabras y vivencias los cinco principios: relacionalidad, reciprocidad, correspondencia, complementariedad y paridad. En su racionalidad todo funciona como proceso holístico, involucra a todos los componentes del universo. El sanar con montes constituye un verdadero ritual: incluye los principios, las plantas, el cuerpo y el espíritu. En el proceso formativo de los sabios intervienen: aprendizaje, don y necesidad. Las plantas tienen tres funciones principales: sanación, alimentación y elemento sagrado. Las formas para clasificar las plantas fueron: género, forma, color, y estado térmico. La recolección del monte, su preparación y la administración son los tres momentos del proceso de curación

O Hoshin Kanri como instrumento de alinhamento estratégico : Estudo de caso : Serviços sociais da Guarda Nacional Republicana

O presente trabalho de investigação aplicado é subordinado à área de conhecimento de Gestão Estratégica e intitulado “O Hoshin Kanri como Instrumento de Alinhamento Estratégico. Estudo de Caso: Serviços Sociais da Guarda Nacional Republicana”. Apesar de se tratar de um modelo bastante recente, sem exploração académica ou exemplos de aplicação em outras instituições de natureza pública, identificamos de forma prévia o modo como o Hoshin Kanri, quando em complemento do Balanced Scorecard, pode contribuir para potenciar a gestão organizacional e, numa segunda fase, perspetivar a sua aplicação aos Serviços Sociais da Guarda Nacional Republicana. Na investigação que conduzimos, utilizámos o método hipotético-dedutivo e o método inquisitivo, tivemos em conta três fases distintas, embora complementares: exploratória, analítica e conclusiva. Ao longo destas fases, recorreu-se à análise documental, entrevistas, inquéritos por questionários na recolha e análise de informação. Desta forma, verificou-se que as chefias de topo dos Serviços Sociais da Guarda Nacional Republicana vêm uma oportunidade na implementação do Hoshin Kanri, enquanto modelo com grandes potencialidades que permite o desdobramento da estratégia conceptualizada pelo Balanced Scorecard e, consequentemente, um alinhamento mais estreito entre os vários níveis de gestão, privilegiando o acompanhamento e controlo necessário à adoção atempada de medidas corretivas. O estudo realizado permitiu ainda perceber que a sua implementação depende essencialmente da dinâmica interna daquele Serviço e não de condicionantes externas, o que constitui um indicador bastante positivo se considerarmos a sua introdução prioritária. Resulta da simbiose entre o Balanced Scorecard e o Hoshin Kanri a definição da rota estratégica e a sua execução prática, o que permite perspetivar uma melhoria dos resultados alcançados. Desta interação e complementaridade poderá advir a necessidade de ajustamento ou revisão da estratégia organizacional alavancando a performance institucional. Nesse desiderato, construímos e apresentamos um modelo conceptual resultante da aplicação do Balanced Scorecard e do Hoshin Kanri à realidade da Instituição.

Hacia un enfoque epistemológico pluralista en los estudios de comunicación y cambio: humanismo, ciencia y ecologismo

El artículo propone una aproximación epistemológica pluralista a la investigación de las relaciones entre comunicación y cambio social. A tal fin, se parte de la propuesta de fusión epistemológica realizada por Johan Galtung para los Estudios para la Paz, tomando en cuenta, además, las particularidades del fenómeno de la comunicación. Según Galtung, la combinación del cartesianismo, del verum-factum (Vico) y del taoísmo permitiría contrarrestar los riesgos del monismo epistemológico y superar sus limitaciones. En este mismo sentido, el artículo plantea ampliar cada una de estas epistemologías en un nivel más general y abarcador (ciencia, humanidades, ecologismo holista-dialéctico), y describir su recorrido histórico para identificar las posibilidades de complementariedad y su valor para el estudio de la comunicación y el cambio.

Análisis de las variables de marketing que afectan al valor del cliente. La permanencia como variable controlable

To know how marketing variables affect customer value is essential for a company in order to be market and customer oriented, and to improve investment efficiency in both attracting and retaining customers. Thus, the assessment of the influence of marketing variables in customer value is of prime importance. This is recognized in many empirical studies of these variables, which address the impact of a single variable (or sets of a few variables) on customer value. A comprehensive, integrated assessment of all marketing variables and their interdependencies is an arduous and complex task for researchers and marketing managers. This research proposes a theoretical model of customer value that takes into account all significant marketing variables that have been partially addressed in empirical investigations of other researchers. These marketing variables include brand and reputation, point of sale, employees, price, termination fee commitment, discounts, complementarity of products, experiences, emotions, perceived value, quality, satisfaction, switching costs, and loyalty. The model incorporates the relationship between each variable with retention and with customer value as well as the relationships between them. A special focus is placed on the empirical analysis of the termination fee commitment and its relationship with customer value. This variable is widely used in the telecommunication’s industry for its influence on customer retention from the moment of purchase. However, there is strikingly little research in this topic. A large customer database of a telecommunications company containing five years information about 63.165 customers is used for this purpose. Multivariate linear regression and ANOVA method are applied...

The use of digital educational resources : the contribution of research in the supervised teaching practice in basic education

This article aims to reflect on the impact of Information and Communication Technologies (ICT) in the educational context, focusing on the potential contributions of the use of Digital Educational Resources (RED) in the process of teaching and learning. For this purpose, the results of the use of the RED will be presented:. Digital Classroom - The World's 1st Year Carochinha The study was accomplished in a class of the 1st grade of the 1st CEB, composed of 27 students, aged 6-7 years in Castelo Branco City Schools Group within the Supervised Teaching Practice. The results obtained after the analysis and processing of the data showed that when using this RED students show they have acquired the content covered by the fact that they enhanced levels of greater interest, commitment, motivation, commitment and initiative in the course of activities proposals. But, perhaps because they are students of 1st year of the 1st CEB, do not neglect the presence and monitoring of the teacher and the use of paper-based resources. This means that there should be a complementarity that reconciles the human factor (teacher), with the use of digital media resources and paper support resources (Manual).

Does international trade produce convergence?

In spite of increasing globalization around the world, the effects of international trade on economic growth are not very clear. I consider an endogenous economic growth model in an open economy with the Home Market Effect (HME) and non-homothetic preferences in order to identify some determinants of the different results in this relationship. The model shows how trade between similar countries leads to convergence in economic growth when knowledge spillovers are present, while trade between very asymmetric countries produces divergence and may become trade in a poverty or growth trap. The results for welfare move in the same direction as economic growth since convergence implies increases in welfare for both countries, while divergence leads to increases in welfare for the largest country and the opposite for its commercial partner in the absence of knowledge spillovers. International trade does not implicate greater welfare as is usual in a static context under CES preferences.