946 resultados para Municipal health financial resources


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A capacidade adaptativa às enchentes diz respeito à capacidade inerente de indivíduos ou de um sistema de se ajustar aos efeitos desse evento e lidar com ele, de modo a moderar seus danos potenciais. A cidade de São Paulo é particularmente vulnerável às enchentes devido ao seu histórico de uso e ocupação do solo. O objetivo deste trabalho é analisar a capacidade adaptativa a partir da realidade local de moradores do Jardim Pantanal, localizado na zona leste do município de São Paulo às várzeas do rio Tietê, a fim de propor ações que possam contribuir na construção dessa capacidade. A pesquisa foi desenvolvida por meio de levantamento documental e bibliográfico, entrevistas semiestruturadas, análise das transcrições, codificação, e categorização dos dados. As capacidades adaptativas genérica e específica nos níveis organizacionais individual e de sistema são baixas, e entre os determinantes da capacidade adaptativa às enchentes os recursos financeiros, a vulnerabilidade urbana e as estratégias de enfrentamento foram considerados os mais importantes, em nível individual. A falta de recursos, a irregularidade de rendimentos e a ausência de diversificação na fonte de renda limitam as opções disponíveis de moradia em áreas regulares e dificultam a mobilização de recursos para a adoção de medidas preventivas e de recuperação pós-evento. A vulnerabilidade urbana expressa-se pela ocupação em área irregular, onde não são realizados investimentos em medidas de infraestrutura por parte dos moradores, que poderiam reduzir a exposição aos impactos das enchentes, pois não se sabe até quando poderão permanecer na área. As estratégias de enfrentamento demonstram ter caráter apenas reativo sem qualquer planejamento, sendo decididas e tomadas reativamente quando a água sobe. Tendo em vista os aspectos observados, a construção da capacidade adaptativa às enchentes no Jardim Pantanal requer: a) entrosamento entre as medidas de adaptação autônomas (do indivíduo) e as planejadas (do sistema); b) ações de adaptação antecipatórias, mais do que responsivas; e c) medidas de adaptação de curto e longo prazos que considerem as vulnerabilidades que surgiram durante o período de adaptação.

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No Brasil, a construção bem como as mudanças nos mais de vinte anos do Sistema Único de Saúde (SUS) tem demandado um crescente interesse em estratégias que valorizem o uso da informação em saúde. Cada vez mais as incertezas entre a complexidade deste sistema e as intervenções necessárias para atender os seus preceitos e as necessidades da população precisam de respostas ágeis e efetivas. A efetividade dos serviços e a equidade em sua prestação são cruciais na atenção à saúde e mostram-se como desafio frente à dificuldade de avaliação dos resultados das ações pela demora no impacto nos indicadores epidemiológicos clássicos. O monitoramento é uma prática que pode ser destacada pela agilidade nas respostas, porém é nítido o quanto a discussão sobre o assunto é pouco estabelecida na literatura disponível. Se apresenta como uma prática interativa e proativa que utiliza informações disponíveis com o potencial de organizar e divulgar rapidamente as descobertas feitas, gerar um aprendizado organizacional e apoiar o processo decisório. A proposta deste estudo considerou o Painel de Monitoramento da Secretaria Municipal da Saúde de São Paulo como ponto de partida para pesquisar sobre as potencialidades do monitoramento na gestão. Uma pesquisa de métodos mistos foi a opção metodológica para este trabalho que buscou aprofundar o marco referencial teórico sobre monitoramento, descrever e analisar criticamente as referências técnicas utilizadas para a construção da proposta e realizar um estudo de caso único em território descentralizado do município de São Paulo sobre a rotina local na sua utilização e com isso analisar as potencialidades e os alcances desta experiência na gestão municipal. Concluiu-se que o monitoramento por meio de indicadores selecionados a partir de dados secundários é uma estratégia oportuna de acompanhar a tendência de determinadas ações possibilitando assim a emissão de juízo de valor e tomada de decisão com rapidez. O aplicativo propicia aos gestores e técnicos informações relevantes que apoiam o processo decisório, além de possibilitar a sua utilização em diferentes contextos da gestão e portes territoriais. Por outro lado, a prática cotidiana é pautada por prioridades normativas, onde a precisão do registro, a coerência das fontes e a quantidade apontada sobrepõem-se à informação em si, o seu significado e as ações necessárias para o enfrentamento dos problemas. O uso da informação é cultura em construção e o Painel de Monitoramento traz a possibilidade de organizar, qualificar e difundir dados secundários dos diferentes sistemas de informação do Sistema Único de Saúde (SUS). Além disso, tem contribuído também no papel de fomentar as discussões sobre os diferentes temas que envolvem as prioridades de uma gestão em todos os níveis do sistema de saúde do município de São Paulo.

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Trata-se da meta-avaliação de um processo avaliativo desenvolvido por secretários e assessores técnicos municipais de uma região de saúde do estado de São Paulo, com foco nos critérios de utilidade e participação. É uma pesquisa qualitativa, cuja base empírica foi 1) o material produzido em sete oficinas realizadas com os representantes municipais, com vistas à avaliação de um aspecto da linha de cuidados em saúde sob a ótica da integralidade; e 2) as entrevistas semiestruturadas realizadas com os mesmos atores após a finalização do processo avaliativo. Para a avaliação do critério de utilidade, utilizou-se principalmente o referencial de KIRKHART (2000), com o objetivo de ampliar a análise para além do uso instrumental dos achados avaliativos e focá-la na identificação de influências múltiplas exercidas por um fenômeno complexo como um processo avaliativo. A análise do critério participação se deu com base no referencial de COUSINS e WHITMORE (1998), buscando a identificação no material empírico de decisões ou aspectos contextuais que fizeram com que a opção participativa fosse aprofundada ou limitada no processo em foco. O trabalho destaca a importância de explicitar pressupostos que baseiam a metodologia da avaliação/ meta-avaliação escolhida, e a necessidade de se buscar referenciais teóricos de análise compatíveis com a opção realizada, frisando a inexistência de posturas neutras ou estudos totalmente objetivos; e a importância de capacitar avaliadores a acompanharem a demanda dos participantes de um processo participativo com a flexibilidade necessária para conferir-lhe o maior aproveitamento possível. Conclui-se pela viabilidade, com vantagens, da realização de processos participativos locais com gestores na Saúde Pública, destacando a possibilidade de ganhos em formação e o enriquecimento dos processos de negociação em nível do território, de forma coerente à política de construção das regiões de saúde no SUS.

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In the 29 years following \"Our Common Future\" by the United Nations, there is considerable debate among governments, civil society, interest groups and business organisations about what constitutes sustainable development, which constitutes evidence for a contested discourse concerning sustainability. The purpose of this study is to understand this debate in the developing economic context of Brazil, and in particular, to understand and critique the social and environmental accounting [SEA] discursive constructions relating to the State-owned, Petrobras as well as to understand the Brazilian literature on SEA. The discourse theory [DT]-based analysis employs rhetorical redescription to analyse twenty-two reports from Petrobras from 2004-2013. I investigate the political notions by employing the methodological framework of the Logics of Critical Explanation [LCE]. LCE engenders five methodological steps: problematisation, retroduction, logics (social, political and fantasmatic), articulation and critique. The empirical discussion suggests that the hegemony of economic development operates to obfuscate, rhetorically, the development of sustainability, so as to maintain the core business of Petrobras conceived as capital accumulation. Equally, these articulations also illustrate how the constructions of SEA operate to serve the company\'s purpose with few (none) profound changes in integration of sustainability. The Brazilian literature on SEA sustains the status quo of neo-liberal market policies that operate to protect the dominant business case approach to maintain an agenda of wealth-creation in relation to social and environmental needs. The articulations of the case manifested in policies regarding, for example, corruption, which involved over-payments for contracts and unsustainable practices relating to the use of fossil fuels and demonstrated that there was antagonism between action and disclosure. The corruption scandal that emerged after SEA disclosures highlighted the rhetorical nature of disclosure when financial resources were subtracted from the company for political parties and engineering contractors hid facts through incomplete disclosures. The articulations of SEA misrepresent a broader context of the meanings associated with sustainability, which restricted the constructions of SEA to principally serve and represent the intention of the most powerful groups. The significance of SEA, then is narrowed to represent particular interests. The study argues for more critical studies as limited Brazilian literature concerning SEA kept a \'safe distance\' from substantively critiquing the constructions of SEA and its articulations in the Brazilian context. The literature review and the Petrobras\' case illustrate a variety of naming, instituting and articulatory practices that endeavour to maintain the current hegemony of development in an emerging economy, which allows Petrobras to continue to exercise significant profit at the expense of the social and environmental. The constructed idea of development in Petrobras\' discourses emphasises a rhetoric of wider development, but, in reality, these discourses were the antithesis of political, social and ethical developmental issues. These constructions aim to hide struggles between social inequalities and exploitation of natural resources and constitute excuses about a fanciful notion of rhetorical and hegemonic neo-liberal development. In summary, this thesis contributes to the prior literature in five ways: (i) the addition of DT to the analysis of SEA enhances the discussion of political elements such as hegemony, antagonism, logic of equivalence/difference, ideology and articulation; (ii) the analysis of an emerging economy such as Brazil incorporates a new perspective of the discussion of the discourses of SEA and development; (iii) this thesis includes a focus on rhetoric to discuss the maintenance of the status quo; (iv) the holistic structure of the LCE approach enlarges the understanding of the social, political and fantasmatic logics of SEA studies and; (v) this thesis combines an analysis of the literature and the case of Petrobras to characterise and critique the state of the Brazilian academy and its impacts and reflections on the significance of SEA. This thesis, therefore, argues for more critical studies in the Brazilian academy due to the persistence of idea of SEA and development that takes-for-granted deep exclusions and contradictions and provide little space for critiques.

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O crescimento de uma empresa pode ser apoiado com recursos de terceiros provenientes do mercado de crédito ou do mercado de capitais. Credores ou potenciais investidores disponibilizam recursos a partir de um processo de avaliação de indicadores de performance. Para as PMEs que consideram o crescimento, conhecer como os indicadores relevantes se comportam ao longo de um ciclo de crescimento é uma questão estratégica. Fatores como tamanho, lucratividade, oportunidades de crescimento, composição de ativos das empresas, risco inerente aos resultados, têm sido vinculados a determinantes de uma estrutura de capital. Assim sendo, este trabalho busca verificar quais indicadores podem nortear o desempenho empresarial de PMEs ao longo de um ciclo de crescimento. Como contribuição original, este trabalho apresenta um painel com indicadores em diferentes estágios de crescimento que resultam na geração de valor para os proprietários e potenciais investidores do mercado de capitais. A amostra inicial é composta por 1.610 empresas para o período de 2010 a 2014. Entretanto, considerando a disponibilidade de informações, a amostra final é composta por 28 empresas de porte médio/grande, 387 empresas grandes e 138 empresas listadas na BM&FBOVESPA, totalizando 553 empresas. A metodologia adotada envolve a classificação de porte de empresa do BNDES como critério para definir ciclo de crescimento, e testes de estatística descritiva, análise fatorial, análise de correlação, regressão múltipla linear e montagem de painel. Como resultado, verificou-se que as variáveis tamanho, composição de ativos e lucratividade são fatores que explicam o endividamento de curto prazo para o estágio médias/grandes empresas. Ainda, que esses fatores explicam o endividamento de longo prazo para os estágios grandes e empresas listadas na BM&FBOVESPA. Tais resultados estão de acordo com estudos prévios, mas as variáveis relacionadas a volatilidade e crescimento não foram significantes nos modelos para os estágios de empresas. O painel montado a partir das variáveis de composição de ativos e lucratividade indicou que endividamento de curto prazo, endividamento de longo prazo, receita líquida, retorno sobre o patrimônio líquido e lucros antes de juros, impostos, depreciação e amortização (EBITDA) sinalizam empresas, em cada estágio de ciclo de crescimento do estudo, que buscam o crescimento com rentabilidade acima da média e atendem a critérios valorizados pelo investidor do mercado de capitais. Estes indicadores podem sinalizar o desempenho empresarial de PMEs ao longo de um ciclo de crescimento

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While the topic of climate change is controversial, the world needs to take a precautionary approach to reduce carbon dioxide emissions. With growing populations and increasing energy demands, solutions to cleaner energy need to be developed and implemented. In order to successfully reduce carbon dioxide emissions, a global carbon pricing policy needs to be developed that includes all countries and allows each region to utilize the best clean energy technology options along with economic incentives that will be the most effective. The research conducted in this project validates the hypothesis that placing a monetary price on carbon will allow natural, technological, and financial resources to come together to implement a feasible energy solution that will reduce global carbon dioxide emissions.

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Paper submitted to the 42nd Congress of ERSA, Dortmund, August 27th–31st 2002.

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Los autores de este trabajo toman como marco de estudio e interacción el espacio físico, social y cultural mediterráneo para, en primer lugar, analizar descriptiva y comparativamente los logros obtenidos en educación, salud, recursos económicos e igualdad de género que indican su nivel de desarrollo socio-cultural y de bienestar humano, y que unen y separan a sus poblaciones. En segundo lugar, se verifica la existencia en los distintos países mediterráneos de profundos desequilibrios demográficos y de desiguales niveles de desarrollo y bienestar que son algunos de los factores que favorecen, aunque no de forma única, los movimientos migratorios.

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The development of expertise for two groups of rhythmic gymnasts was studied where a group of elite (Olympic) gymnasts was compared to a group of sub‐elite (International) gymnasts. Structured interviews were used to collect retrospective information about the gymnasts’ health, training resources, level and ranking, and hours spent in training activities. The gymnasts rated practice activities during the last period of their development (age 16 and older) with respect to their perceived physical effort, mental concentration, and fun. The Olympic gymnasts were involved in significantly fewer activities and sports throughout their development compared to the International gymnasts. All gymnasts reported engaging in five practice activities of warm‐up, ballet, technique training, routines, and conditioning in their rhythmic gymnastics training. Olympic gymnasts allocated substantially more time to the practice activities of ballet, technique, routines, and conditioning, compared to the International gymnasts. Olympic gymnasts also rated their health as lower than the International gymnasts. All gymnasts reported that the practice activities of technique and routine training required more physical effort and mental concentration than warm‐up, ballet, and conditioning. The Olympic gymnasts reported experiencing less fun in their participation overall. The findings of this study provide a comprehensive description of early activity involvement, training activities, training resources, and health and injury ratings of expert level rhythmic gymnasts and help to further the understanding of how to assess sport expertise development

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Over 90% of the external relations budget of the EU is processed through its external financial instruments. With the Lisbon Treaty and the creation of the new European External Action Service (EEAS), the institutional architecture of these instruments was significantly reformed. This contribution analyses strategic programming both pre- and post-Lisbon, identifies ‘winners’ and ‘losers’, and examines the potential of the new provisions to increase the coherence of EU external action. The examination shows that the instruments can be categorised into three groupings: ‘the big three’ comprising the bulk of funding characterised by joint programming and responsibilities; the ‘Commission-only’ instruments where all powers remain with the Commission; and the ‘EEAS-led rest’ in which the High Representative and the EEAS play a strong role but only have limited financial resources available. The new system calls for strong coordination of all involved actors in order to make it work. Findings of a case study on the Instrument for Stability reveal, however, that so far the establishment of the EEAS has not made a substantial impact on strategic programming in its first two years.

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A key element of Russia’s policy towards the new government of Ukraine concerns demands for a constitutional reform that would transform the country from a unitary into a federal state in a way that would considerably privilege the eastern and southern regions. Such a change to Ukraine’s administrative system would enable Moscow to put pressure on Ukraine’s central government via the regions. In order to achieve its objectives, Russia has been pressuring Kyiv to establish a constitutional assembly in a form that would guarantee the endorsement of solutions dictated by Russia. In other words, Russia has been demanding, in what is practically an ultimatum, that Ukraine give up one of the fundamental sovereign rights of a state, the right to freely determine its system of government. Transforming Ukraine into a federal state is an unacceptable idea, primarily because the intention behind Russia’s demands is to undermine Ukraine’s sovereignty, both through the content of the proposed changes and the way in which they are to be implemented. However, keeping in place the current, centralist model of state governance is not a feasible alternative. Ukraine will have to grant its regions broad self-governance powers, including the power to hold local referendums, and to transfer a considerable portion of the prerogatives currently held by the state to the local self-governments, along with adequate financial resources. That is because decentralisation along these lines is the only way forward towards a modern democracy in Ukraine. Russia’s policy has forced Kyiv to undertake legislative work on constitutional reform as a matter of urgency, rather than waiting until a new parliament is elected in which the new, post-Maidan balance of political power will be reflected, as political logic would require. The first draft of the constitutional amendments (of which no details are known at this stage) is to be presented in mid-May, and is expected to come into force in early autumn. However, whether these plans can be put into practice depends on further developments in the eastern part of Ukraine, because (among other reasons) if a state of emergency is introduced, the constitutional amendment process will have to be suspended.

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After coming to power in September 2009, the Alliance for European Integration (AIE)1 coalition began implementing a wide-ranging programme of reforms, with a view to bringing Moldova closer to the European Union, and ultimately to ensure the country’s full membership of the EU. Today, Moldova is considered a clear leader in European integration among the members of the EU’s Eastern Partnership programme. This, however, has less to do with the concrete reforms introduced by the Moldovan government, and more to do with, on the one hand, Chișinău’s excellent public relations with Brussels, achieved through effective diplomacy; and on the other hand, the growing disillusionment with the lack of progress in other Eastern Partnership countries, particularly in Ukraine. Attempts to evaluate Moldova’s reforms have proven rather problematic. On the one hand, the ruling coalition has managed to make significant progress in the areas of civil liberties, human rights and electoral reform. The government has also successfully implemented regulations which have brought Moldova closer to signing a Deep and Comprehensive Free Trade Agreement (DCFTA) with the EU, and it has made headway in talks on visa liberalisation with Brussels. On the other hand, Chișinău has still not carried out the structural and economic reforms without which real change in the country will be impossible. No reforms have been introduced in the Ministry of the Interior, the Moldovan police force, or the judiciary. The AIE has also failed to decentralise governance and has had no real success in reducing corruption; its attempts to rebuild the country’s financial institutions have proved equally unsuccessful. The main reasons for this poor performance include mutual mistrust and conflicting interests among the coalition members, a shortage of financial resources, strong resistance to change by public administration staff, and significant pressure from those political and business groups whose interests could suffer as a result of the proposed reforms. It should also be noted that since the AIE took power, the international context of the reform efforts has undergone significant changes. On the one hand, the EU has been facing an economic crisis, which has had a negative impact on Moldovan exports and contributed to the worsening of the economic situation in the country; and on the other hand, Moldova has been offered membership of the Customs Union as a viable alternative to EU membership.

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One million signatures from at least seven European Member States: Fulfilling the conditions of the European Citizens’ Initiative requires a communication campaign, which manages to reach and touch the citizens, as well as to encourage them to act. This empirical study analyses, which methods in this regard are successful or rather counterproductive. It comes to the conclusion that a variety of factors are decisive, and that these factors can differ in their manifestation – such as the availability of financial resources, the emotional potential of the issue or a sophisticated network of supporters.

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The Treaty of Lisbon (2009) explicitly added - in Article 3 of the Treaty on the European Union (TEU) and Article 174 of the Treaty on the Functioning of the European Union (TFEU) - the principle of territorial cohesion to the already existing principles of social and economic cohesion between the EU Member States. To concretely reach the objective of territorial cohesion, the EU created – on the one hand - the legal instrument of the “European Grouping for Territorial Cooperation” adopted through regulation n. 1082/2006 (EGTC). This allows cross-border cooperation between local and regional authorities. On the other hand, in 2009 a new form of European transnational cooperation has been introduced, the so called Macro Regional Strategy (MRS). This was firstly applied to the Baltic Sea Region in order to give to this cross - border geographical area a coordinated framework in specific policy fields, such as the environment and the infrastructures. Both concepts - EGTC and MRS - are based on the fundamental idea of supporting the territorial and cross - border cooperation between local, regional and national authorities and other stakeholders. Despite this common aspect, the two instruments differ profoundly in terms of form, structure and content. While the MRS is to be considered as a political integrated framework without its own financial resources, the instrument of the EGTC is based on a stable legal basis. To this extent, the alpine region - a large geographic area in the heart of Europe with a longstanding tradition in crossborder cooperation - represents an interesting practical example with regard to the implementation of these two forms of cooperation across borders. In fact, the countries and regions in the Alpine area are unified through the Alps and face, therefore, common challenges: that is why this “region” is ideally suited to be the ground for experiments regarding transnational tools and strategies.

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To increase our understanding of the formation of students' intentions to found an own firm, research needs to systematically integrate theory of planned behavior, resource-based view, and family business literature. To date, however, an explicit and systematic integration of these perspectives cannot be found. We attempt to close this gap by explicitly investigating founding intentions of students with family business background. More specifically, we examine how the provision of human, social, and financial resources by the family affects students' desirability and feasibility perceptions, and ultimately founding intentions. Our analysis based on a sample of 14'290 students from 26 countries reveals that both desirability and feasibility perceptions mediate the relationships between all three types of resources and founding intentions. Interestingly, the provision of financial resources is negatively related to both desirability and feasibility perceptions. These findings illustrate the research potential of a combination of theory of planned behavior with the resource-based view, especially in the family business context. Our study thus offers valuable contributions to literature on career choices, theory of planned behavior, and family business, as well as to practice.