Caraterização da tomada de decisão em organizações hospitalares : impacto do estatuto jurídico

RESUMO - O decisor hospitalar tem como função decidir os recursos de uma organização de saúde, sejam estes financeiros, materiais ou humanos, sendo decisivo o conhecimento e informação que o apoiem na aplicabilidade nas tomadas de decisão e na solução dos problemas. As tomadas de decisão suportam-se em modelos reproduzidos pelos decisores, em processos, modelos, e em princípios, que podem ou não assumir intuição, objetividade, racionalidade e ética, bem como de técnicas várias que podem ser limitativas ou condicionadas, por força de fatores vários, como: a falta de informação inerente de uma multidisciplinaridade do processo; de condicionalismos organizacionais, internos ou externos, associados à envolvente e cultura organizacional e influências políticas e macroeconómicas; ao fator tempo; a tecnologia; a estrutura e desenho organizacional; a autoridade/poder e a autonomia para decidir; a liderança, e do estatuto jurídico que o hospital possui. Este último ponto será esmiuçado, mais profundamente, neste estudo. Iremos, através do estudo, compreender se os elementos componentes das decisões tomadas nos hospitais, são ou não adaptadas em consonância com diferentes políticas de governação hospitalar, em contextos e dinâmicas organizacionais diferenciadas, por diferentes Estatutos Jurídicos Hospitalares - EPE, SPA, PPP e Privados. Foi realizado um estudo de caráter exploratório, descritivo-correlacional e transversal, baseou-se num questionário aplicado a decisores hospitalares, incidindo nos dois vetores centrais do estudo, na tomada de decisão e no estatuto jurídico hospitalar. A decisão é então, um valiosíssimo veículo na persecução das estratégias e planos formulados pelo hospital, esperando-se destes produzir consequentes resultados eficientes, eficazes e efetivos na sua aplicação.

How effective is dog culling in controlling zoonotic visceral leishmaniasis? a critical evaluation of the science, politics and ethics behind this public health policy

INTRODUCTION: Zoonotic kala-azar, a lethal disease caused by protozoa of the genus Leishmania is considered out of control in parts of the world, particularly in Brazil, where transmission has spread to cities throughout most of the territory and mortality presents an increasing trend. Although a highly debatable measure, the Brazilian government regularly culls seropositive dogs to control the disease. Since control is failing, critical analysis concerning the actions focused on the canine reservoir was conducted. METHODS: In a review of the literature, a historical perspective focusing mainly on comparisons between the successful Chinese and Soviet strategies and the Brazilian approach is presented. In addition, analyses of the principal studies regarding the role of dogs as risk factors to humans and of the main intervention studies regarding the efficacy of the dog killing strategy were undertaken. Brazilian political reaction to a recently published systematic review that concluded that the dog culling program lacked efficiency and its effect on public policy were also reviewed. RESULTS: No firm evidence of the risk conferred by the presence of dogs to humans was verified; on the contrary, a lack of scientific support for the policy of killing dogs was confirmed. A bias for distorting scientific data towards maintaining the policy of culling animals was observed. CONCLUSIONS: Since there is no evidence that dog culling diminishes visceral leishmaniasis transmission, it should be abandoned as a control measure. Ethical considerations have been raised regarding distorting scientific results and the killing of animals despite minimal or absent scientific evidence

Tool for spatial and dynamic representation of artistic performances

This proposal aims to explore the use of available technologies for video representation of sets and performers in order to serve as support for composition processes and artistic performer rehearsals, while focusing in representing the performer’s body and its movements, and its relation with objects belonging to the three-dimensional space of their performances. This project’s main goal is to design and develop a system that can spatially represent the performer and its movements, by means of capturing processes and reconstruction using a camera device, as well as enhance the three-dimensional space where the performance occurs by allowing interaction with virtual objects and by adding a video component, either for documentary purposes, or for live performances effects (for example, using video mapping video techniques in captured video or projection during a performance).

Responsabilidade social em saúde pública

RESUMO - A Responsabilidade Social é actuar de modo justo, digno e responsável com todos os stakeholders. Por outro lado a Saúde Pública tem como principal objectivo promover a saúde dos indivíduos, comunidades e sociedades como um todo, incidindo nos determinantes de saúde. As empresas têm adoptado inúmeras acções e politicas socialmente responsáveis que contribuem para o aumento da concretização dos objectivos a longo prazo. As empresas criam códigos de ética e de conduta, redigem relatórios sociais, aderem a normas e certificações internacionais, promovem auditorias internas e externas, desenvolvem políticas laborais para evitar problemas e escândalos que afectem a reputação da empresa, apoiam cada vez mais causas sociais, preocupamse com o bem-estar e as condições de trabalho dos colaboradores e com o ambiente. Todos os esforços e investimentos parecem ser poucos quando se observa a possibilidade de maior reconhecimento e retorno financeiro. Existem diversas concepções para o que é ser-se socialmente responsável e de como a empresa deve agir enquanto cidadã. Ao mesmo tempo, são muitas as actividades que podem ser desenvolvidas no que diz respeito à responsabilidade social das empresas na área da promoção da saúde pública. Este estudo pretende criar uma ligação entre o conceito de Responsabilidade Social das Empresas e de Saúde Pública e, nesse sentido, procurar associar os objectivos das acções desenvolvidas pelas empresas estudadas com os objectivos prosseguidos pela Saúde Pública.

Epidemiological aspects of human and canine visceral leishmaniasis in Montes Claros, State of Minas Gerais, Brazil, between 2007 and 2009

INTRODUCTION: Visceral leishmaniasis (VL) is an expanding zoonosis in Brazil and is becoming urbanized in several Brazilian regions. This study aims to describe the epidemiological features of human and canine VL in the municipality of Montes Claros, State of Minas Gerais, by focusing on their spatial distribution. METHODS: Data concerning human cases and reactive dogs for VL from 2007 to 2009 were obtained from the Information System for Disease Notification (SINAN) and from reports of the local Centro de Controle de Zoonoses (CCZ), respectively. The addresses of human and canine cases have been georeferenced and localized in thematic maps, allowing their spatial visualization as well as the identification of areas at risk of VL transmission. RESULTS: Ninety-five cases of human VL were reported in the period. The 0-9-year-old age group (48.4%) was the most affected, within which the majority consisted of male patients (64%). Of the samples collected for the canine serological survey, 2,919 (6.3%) were reactive to VL. The spatial localization of these cases shows that the disease was scattered in the urban area of the municipality. Areas showing a higher dissemination risk were concentrated in the central, northwestern, and southern regions of the city. CONCLUSIONS: Identifying the areas most at risk in urban Montes Claros may help guide actions toward local epidemiological vigilance and control.

Utopia III or an Ambiguous Humanist Utopia for the Second Millenium

Portuguese literature does not have many examples of successful and renowned utopias, though the considerable amount of published utopias written in foreign languages and translated to Portuguese language being quite relevant. However, in the last quarter of the twentieth century, almost at the eve of the second millennium an important Portuguese utopia was published: Utopia III, written by Pina Martins (1998). This long novel is structured as being the sequel of More’s Utopia, presenting the history and actual status of the mother of all literary utopias. The question at the basis of the whole novel is, “What would More’s Utopia be like today?” The main goal of this text will be to presente a literary analysis of Utopia III, focusing on the humanist principles and their adaptation to contemporary society, the search for a harmonious relationship between city and nature, the defence of a Portuguese identity and the appeal to a humanist renewal.

Self-initiation expatriation: A focus on Italian and Portuguese students

The purpose of this work project is to analyze the phenomenon of self-initiated expatriation (SIE) through its link to the Protean Career and Career Capital theories, focusing in particular on Italian and Portuguese students attending a Master in the business area. The main research questions are to understand the reasons driving the intention to expatriate, after the conclusion of the academic path, using three main categories (Adventure Motivation, Work Characteristic Motivation and instrumental Motivation) and the intention to repatriate. A sample of Italian and Portuguese students was obtained. Italians show a higher intention to expatriate relative to Portuguese; nevertheless, no other significant differences were found among the two populations, because of the similar cultural background and economic situation. Additionally, several heterogeneities were observed considering other clusters defined by Gender, Teaching Language of the Master and Past International Experiences, across the two nationalities. Furthermore, possible future researches and practical implications were discussed.

How to monitor and improve Unilever JM Supply Chain processes to become the best of Portugal’s sector in 2015?

Unilever Jerónimo Martins is a Portuguese joint-venture leading firm in what concerns the supply chain industry of fast-moving consumer goods in Portugal. The scope of analysis of this Work Project is focusing on Unilever-JM operations and services in the Portuguese market regarding quality, efficiency and effectiveness over B2B customers. It will be analysed the possibility of development and implementation of a performance measurement system, Tableau de Bord, which will be crucial for the identification of potential opportunities of improvement with impact in the supply chain processes. This will be completed through the establishment of KPI’s to monitor and manage periodically logistics, planning and customer service processes’ performance, which are the ones where the bottlenecks are impacting more in the supply chain. In this work project the nexus causality for the problems will also be discussed and some recommendations will be prepared to tackle the inefficiencies found through the monitoring of the previous core processes, in order to improve efficacy and quality service of the supply chain.

Product relatedness role on driving industrial policy success

This thesis aims to study how product relatedness to the current pattern of specialization influences the success of industrial policies in underdeveloped sectors. Drawing from Hausmann and Klinger (2006), this work extends the existing literature on the importance of proximity spillovers to explain economic development by focusing on underdeveloped sectors. We find that investment's success in an underdeveloped sector is more likely if it is highly related to the current pattern of specialization. However, heterogeneity amongst sectors is remarkable. Moreover, industrial policy cases are sometimes successful despite the bad odds provided by this criterion, suggesting further factors should be considered.

O uso da força no Direito Internacional = Use of force in Public International Law

Versão online da Revista Brasileira de Estudos Políticos, Belo Horizonte, nº 107, pp. 149-200, jul./dez.2013

O emprego de uma força de segurança de natureza militar nas missões de paz

The conflicts currently taking place around the world demand that the international intervention fits the intensity and extent of the threat. This is particularly important in post-conflict scenarios, leading to a greater participation of the Security Forces in those scenarios, in order to foster lasting peace, enforce the order and improve law enforcement services in those regions. The transition from armed conflict to peacekeeping may entail high risk situations and greater instability periods, so-called “intermediate situations”. Accordingly, in the face of persisting high volatility, a robust response is still required post-conflict. Therefore, it is appropriate to deploy Security Forces with military nature and status, the gendarmeries, which have training and response capabilities similar to Armed Forces in peacekeeping operations. Their double facet as police and military forces enables them to perform police duties in high risk and unsafe environments. In light of these features, the Portuguese gendarmerie, Guarda Nacional Republicana (GNR), is able to carry out tasks in these scenarios, which it has been doing through individual operatives or larger units. This dissertation focuses on the use of Security Forces of military nature in peacekeeping missions, in particular the Portuguese GNR, relying mostly on the inductive approach and using literature research, document analysis, interviews and statistics. After a brief description of international peacekeeping missions, we describe the contribution of Security Forces of a military nature in such operations. Then we introduce and analyse the GNR, focusing on its deployment in different kinds of peacekeeping operations, from its first participation in 1995 until today. We also report some reactions to the performance of GNR. Finally, we discuss whether there is indeed a unique role for this type of forces in international peacekeeping missions.

A regulação da atividade espacial

The technological evolution of the past fifty years has provided Humanity the contact with the last frontier of knowledge: space. An unknown world, explored by a small group of nations, which has become crucial to understanding who we are and where we come from. Space assets in recent years have opened the way to a digital society, shaped by the rapid exchange of information, whose means are mostly in space. A place of fascination and curiosity, restricted to a few people in these decades, which may soon be changing. This essay addresses some legal issues concerning the private exploration of space. Liability on space tourism is the core of this investigation, focusing on the comprehension of the international legal framework and its connection with the states national law. In particular, the study of the main international treaties, the U.S. legal system of space law and the developments in Europe are the fundamental tools of the current analysis, not forgetting the point of view of a possible international harmonization. Besides the needed theoretical context on the evolution of space law and a brief approach of the technical matters of the current aerospace engineering, the goal is to examine the characteristics of international space law and its relation with the new private actors, responsible for providing suborbital flights, operating in a near future. Within these circumstances, given the economic potential of the growing private space industry, it is essential to discuss the legal aspects of a spatial regulation. Being liability, undoubtedly, the emerging issue in the legal debate on this topic, it is important to safeguard the interests of the operators, States and, above all, future space tourists.

Quality of life of patients with hepatitis C

INTRODUCTION: Self-report on the quality of life (QOL) is increasingly studied in the evaluation of various diseases, especially in chronic ones. However, there are few data in the literature focusing the QOL of patients living with chronic hepatitis C. The objective of this study was to evaluate the QOL in patients with hepatitis C assessed by the World Health Organization Quality of Life Assessment (WHOQOL)-bref scale. METHODS: One hundred and eight hepatitis C patients attending the Outpatient Healthcare Medical Specialties in Tubarão, State of Santa Catarina, Brazil, were contacted from May 2010 to February 2011. Patients answered the WHOQOL-bref scale and a questionnaire about their treatment and risk factors to hepatitis C virus (VHC) infection. RESULTS: Although most of patients with chronic hepatitis C considered their QoL good or very good (58.1%), 47 (44.8%) patients were poorly or very poorly satisfied with their health. About the WHOQOL answers, the environment domain had the highest score (25.15 + 5.77), while the lowest score was the social relationships domain (9.19 + 2.5). There was statistically significant association between household income and quality of life in all domains (p<0.001) and statistically significant association between education and the physical, psychological and social domains of quality of life (p<0.05). CONCLUSIONS: Based on the answers given in WHOQOL-bref, patients with chronic hepatitis C have a generally poor QOL, especially in social relationship domain. Household income and educational level were factors that interfered significantly with patients' QOL assessment.

Relatório de estágio no Centro de Arbitragem Comercial da Câmara de Comércio e Indústria Portuguesa

This report is the outcome of an internship that took place in Centro de Arbitragem Comercial da Câmara de Comércio e Indústria Portuguesa and its completion is an essential part of the path towards obtaining the Master’s Degree in Faculdade de Direito da Universidade Nova de Lisboa. This report has been structured in two stages – firstly, the presentation of the Centro de Arbitragem Comercial, focusing on its field of expertise, organic structure, principles and advantages. Then, the description of the activities developed within the Secretariat over the several stages of the arbitration procedure – since the reception of the arbitration requirement in institutional proceedings, terms of reference in ad hoc procedures, through the monitoring of the arbitral tribunal sessions (preliminary hearings, submission of evidence and final allegations) and the notification of the arbitration award. The second stage of this report is related to the description of the functions and powers of the President of Centro de Arbitragem Comercial. Firstly, it defines those powers by analyzing the statutes and rules of proceedings of the Centro de Arbitragem, drawing comparisons between the above mention and the rules of proceedings of others arbitral institutional centres, some of them are international references. The report assesses and describes the presidential powers, such as: configuration and composition of the arbitral tribunal (including arbitrator’s replacements, excuses and refusals); deadline extensions; determination of procedural rules and decision-making on any procedural incidents which arise before the constitution of the arbitral tribunal; definition of arbitration costs and fees; joinder of parties and consolidation of proceedings admission; and appointment of an emergency arbitrator. Lastly, this report analyzes some decisions delivered by the President in the respective institutional procedures which took place in the Centre.

Reactive electron scattering from biomolecules and technologically relevant molecules

The role of a set of gases relevant within the context of biomolecules and technologically relevant molecules under the interaction of low-energy electrons was studied in an effort to contribute to the understanding of the underlying processes yielding negative ion formation. The results are relevant within the context of damage to living material exposed to energetic radiation, to the role of dopants in the ion-molecule chemistry processes, to Electron Beam Induced Deposition (EBID) and Ion Beam Induced Deposition (IBID) techniques. The research described in this thesis addresses dissociative electron attachment (DEA) and electron transfer studies involving experimental setups from the University of Innsbruck, Austria and Universidade Nova de Lisboa, Portugal, respectively. This thesis presents DEA studies, obtained by a double focusing mass spectrometer, of dimethyl disulphide (C2H6S2), two isomers, enflurane and isoflurane (C3F5Cl5) and two chlorinated ethanes, pentachloroethane (C2HCl5) and hexachloroethane (C2Cl6), along with quantum chemical calculations providing information on the molecular orbitals as well as thermochemical thresholds of anion formation for enflurane, isoflurane, pentachloroethane and hexachloroethane. The experiments represent the most accurate DEA studies to these molecules, with significant differences from previous work reported in the literature. As far as electron transfer studies are concerned, negative ion formation in collisions of neutral potassium atoms with N1 and N3 methylated pyrimidine molecules were obtained by time-of-flight mass spectrometry (TOF). The results obtained allowed to propose concerted mechanisms for site and bond selective excision of bonds.