Impacto da prevenção quaternária no envelhecimento bem sucedido

"Quaternary prevention is more than a Philosophy , it is a concrete answer and a solution to many complex problems that affect Medicine. In 1981, Illich recognized iatrogenic complications, as clinical, social and cultural. The first, gained such a dimension that has become the third leading cause of death in the U.S. , in 2000 as referred by Starfield. When you live more, much more, you want quality of life and not just life subject of increasing comorbidities, with all the parade of treatments, medications that we already know are not without riscs, far from it, we know that over five drugs per day represent the 50% probability of drug-drug interactions and seven drugs 100 %. In elderly attending the reduction of functional reserve, there is a greater risk of iatrogenic problems, adverse reactions and drug interactions, truly unpredictable , these highly medicalized societies in which are accounted diagnoses instead of investigating patterns of disease. So quaternary prevention reminds us that both preventive and curative care in excess behave as risk factors for health , reaching in the case of using preventive medications, millions of individuals who are confident in Medicine. The idea of extending the use of drugs to healthy populations, as preventive actions, expands the pharmaceutical market, which accounts simultaneously increasing profits and losses in economies around the world. Quaternary prevention itineraries in health and disease, may contribute to successful aging about witch many important authors have spoken on."

Feminismo e academia

Depois de séculos de exclusão, as mulheres conseguem no século 20 sua inserção na universidade. O ingresso no mundo acadêmico é, sem dúvida, atravessado por diversas formas de discriminação, manifestas e encobertas, que contribuem para a formatação de trajetórias universitárias diferenciadas para homens e mulheres, assim como para uma participação desigual no próprio exercício do poder acadêmico. Embora a academia feminista tenha estimulado a produção de conhecimentos científicos não sexistas, analisando e redimensionando concepções epistemológicas tradicionais, o conteúdo e a metodologia científica hegemônica continuam manifestando traços sutilmente androcêntricos. Neste sentido, os aportes dos estudos de gênero podem contribuir com seu potencial dinamizador para a exploração crítica e para a transformação do conhecimento científico atual, bem como para uma inserção mais efetiva das mulheres nos espaços acadêmicos. ____________________________________________________________________________________ ABSTRACT

Análise do impacto da estrutura organizacional de dois hospitais públicos portugueses na execução dos seus objectivos, através da percepção dos seus colaboradores

O objetivo deste trabalho de investigação é o de procurar compreender o impacto da estrutura organizacional de dois hospitais públicos portugueses com diferentes figuras jurídicas, na execução dos seus objetivos, através da perceção dos seus colaboradores. De modo a atingirmos o nosso objetivo, recorremos à metodologia do estudo de caso, efetuado a cada um dos hospitais escolhidos. O principal instrumento de recolha de dados é o questionário, efetuado a uma população que é constituída por uma amostra aleatória simples e estratificada em classes de cada um dos hospitais. Para além de não terem sido encontradas diferenças significativas, nas áreas analisadas, entre os dois hospitais, este estudo revelou-nos ainda que a sua estrutura organizacional deve ser mais orgânica, no sentido de uma estrutura matricial, mantendo, no entanto, a parte burocrática que advêm da elevada profissionalização do seu pessoal e os principais mecanismos de coordenação. Este trabalho pretende dar um contributo no conhecimento da forma como os gestores dos hospitais podem controlar e modificar a estrutura e o desenho da organização e de que forma essas modificações podem vir a influenciar a execução dos seus objetivos. ABSCTRAT: The purpose of this research work is to seek to understand the organizational structure’s impact of two portuguese public hospitals, with different legal forms, in the implementation of their objectives through its collaborators' perception. ln order to achieve our purpose, we have used the case study methodology performed in each one of the chosen hospitals. The main instrument for data collection is the questionnaire, made to a population consisting of a simple and stratified into classes random sample from each one of the hospitals. Besides not having been found any significant differences between the two hospitals, this study has also revealed to us that its organizational structure should be more organic, towards a matrix structure, although maintaining the bureaucratic part arising from the high professionalization of its personnel and the main coordination mechanisms. This work aims to contribute to the knowledge of how hospital managers can control and modify the organization's structure and design and how those modifications may come to influence the implementation of their objectives.

The passage of authority: imagining the political transformation of Australia’s Christmas Island, from sovereignty to governance

In 2012, Australia’s Christmas Island is best known as an island of immigration detention, a key component of Australia’s growing offshore border security apparatus, where interdicted boat arrivals seeking asylum are detained and processed. This article offers one account of how the Island came to be what it is, by providing two snapshots of the operable set of power relations on Christmas Island, then and now: ‘Island in the Sun’, and ‘Tropics of Governance’. Side by side, their stark contrast reveals the passage of authority through time and place, from the embodied, unified voice of the sovereignty of the British Empire to the palliative communication and bureaucratic sincerity that characterise governance. By disclosing shifting patterns of emergence and decay and showing border security’s intimate relation to governance, this article seeks to offer a deepened understanding of the current detention situation in its immanence. What can now be seen as Christmas Island’s past follies also reveals the restless work of successive political imaginations, the shifting ways and means by which an island can be translated into a solution to a political problem, and how successive solutions tend toward wreck and ruin.

The breakdown of the workplace ‘family’ and the rise of personnel management within an Australian financial institution 1950–1980

The management of its people defines the way in which an organisation develops the capabilities to successfully compete in the market environment. Since the 1950s, approaches to staff management have evolved from traditional bureaucratic foundations to strategic planning exercises. This article uses a case study approach to investigate the way in which the process of organisational learning evolved in the development of personnel management practices. It suggests that although old and new practices were often overlaid on each other, ‘bridges’ developed which allowed the progressive development of new managerial processes.

Passages inclusifs : le réseau d'organismes communautaires autochtones de Montréal

This research aims to enrich the understanding of the constitution of a sense of belonging to an aboriginal community in Montreal. It has been demonstrated that there is indeed a social cohesion in Montreal based on the collective aboriginal ethnic identity, or aboriginality. This cohesion is supported by aboriginal organizations and associations, whise approaches and engagements have a direct impact on their inclusion into the community. These institutions are considered as the source of communitarian social bond in the city. By the empowerment of a shared aboriginal identity, the representation of community interests, the integration in the urban life, the service delivery to members of the middle class and the creation of secured spaces dedicated to their cultural heritage, aboriginal associations are creating social ties to the community. On the other hand, some problems like the lack of communication between organizations, their hermetic nature, their excessive bureaucratic methods, the way women in the community monopolize the institutions, the presence of non-aboriginal people as well as the gang phenomenon are all experienced in the organizations. These problems produce harmful consequences on the member’s relations to the communitarian system and reduce their participation and attendance. Also, the social bond within the native community is weakened by various factors outside the grasp of the institutions. Some internal discriminations and stereotypes, sometimes tied to the use of administrative indicators of the Canadian Aboriginal Law, the lack of a native district in Montreal, and the different socio-economic members’ situations create divisions and affect the community spirit. This thesis focuses on the native community construction in an urban area through its institutional sphere, which differs from other studies on urban Natives. The objective is to understand the urban realities and the way the urban native communities are developing themselves.

Political Strategy, Leadership, and Policy Entrepreneurship in Japanese Defense Policy and Politics: A Comparison of Three Prime Ministerships

Since the end of the Cold War, Japan’s defense policy and politics has gone through significant changes. Throughout the post cold war period, US-Japan alliance managers, politicians with differing visions and preferences, scholars, think tanks, and the actions of foreign governments have all played significant roles in influencing these changes. Along with these actors, the Japanese prime minister has played an important, if sometimes subtle, role in the realm of defense policy and politics. Japanese prime ministers, though significantly weaker than many heads of state, nevertheless play an important role in policy by empowering different actors (bureaucratic actors, independent commissions, or civil actors), through personal diplomacy, through agenda-setting, and through symbolic acts of state. The power of the prime minister to influence policy processes, however, has frequently varied by prime minister. My dissertation investigates how different political strategies and entrepreneurial insights by the prime minister have influenced defense policy and politics since the end of the Cold War. In addition, it seeks to explain how the quality of political strategy and entrepreneurial insight employed by different prime ministers was important in the success of different approaches to defense. My dissertation employs a comparative case study approach to examine how different prime ministerial strategies have mattered in the realm of Japanese defense policy and politics. Three prime ministers have been chosen: Prime Minister Hashimoto Ryutaro (1996-1998); Prime Minister Koizumi Junichiro (2001-2006); and Prime Minister Hatoyama Yukio (2009-2010). These prime ministers have been chosen to provide maximum contrast on issues of policy preference, cabinet management, choice of partners, and overall strategy. As my dissertation finds, the quality of political strategy has been an important aspect of Japan’s defense transformation. Successful strategies have frequently used the knowledge and accumulated personal networks of bureaucrats, supplemented bureaucratic initiatives with top-down personal diplomacy, and used a revitalized US-Japan strategic relationship as a political resource for a stronger prime ministership. Though alternative approaches, such as those that have looked to displace the influence of bureaucrats and the US in defense policy, have been less successful, this dissertation also finds theoretical evidence that alternatives may exist.

Passages inclusifs : le réseau d'organismes communautaires autochtones de Montréal

This research aims to enrich the understanding of the constitution of a sense of belonging to an aboriginal community in Montreal. It has been demonstrated that there is indeed a social cohesion in Montreal based on the collective aboriginal ethnic identity, or aboriginality. This cohesion is supported by aboriginal organizations and associations, whise approaches and engagements have a direct impact on their inclusion into the community. These institutions are considered as the source of communitarian social bond in the city. By the empowerment of a shared aboriginal identity, the representation of community interests, the integration in the urban life, the service delivery to members of the middle class and the creation of secured spaces dedicated to their cultural heritage, aboriginal associations are creating social ties to the community. On the other hand, some problems like the lack of communication between organizations, their hermetic nature, their excessive bureaucratic methods, the way women in the community monopolize the institutions, the presence of non-aboriginal people as well as the gang phenomenon are all experienced in the organizations. These problems produce harmful consequences on the member’s relations to the communitarian system and reduce their participation and attendance. Also, the social bond within the native community is weakened by various factors outside the grasp of the institutions. Some internal discriminations and stereotypes, sometimes tied to the use of administrative indicators of the Canadian Aboriginal Law, the lack of a native district in Montreal, and the different socio-economic members’ situations create divisions and affect the community spirit. This thesis focuses on the native community construction in an urban area through its institutional sphere, which differs from other studies on urban Natives. The objective is to understand the urban realities and the way the urban native communities are developing themselves.

Why fly the extra mile? Latitudinal trend in migratory fuel deposition rate as driver of trans-equatorial long-distance migration.

Trans-equatorial long-distance migrations of high-latitude breeding animals have been attributed to narrow ecological niche widths. We suggest an alternative hypothesis postulating that trans-equatorial migrations result from a possible increase in the rate at which body stores to fuel migration are deposited with absolute latitude; that is, longer, migrations away from the breeding grounds surpassing the equator may actually enhance fueling rates on the nonbreeding grounds and therewith the chance of a successful, speedy and timely migration back to the breeding grounds. To this end, we first sought to confirm the existence of a latitudinal trend in fuel deposition rate in a global data set of free-living migratory shorebirds and investigated the potential factors causing this trend. We next tested two predictions on how this trend is expected to impact the migratory itineraries on northward migration under the time-minimization hypothesis, using 56 tracks of high-latitude breeding shorebirds migrating along the East Asian-Australasian Flyway. We found a strong positive effect of latitude on fuel deposition rate, which most likely relates to latitudinal variations in primary productivity and available daily foraging time. We next confirmed the resulting predictions that (1) when flying from a stopover site toward the equator, migrants use long jumps that will take them to an equivalent or higher latitude at the opposite hemisphere; and (2) that from here onward, migrants will use small steps, basically fueling only enough to make it to the next suitable staging site. These findings may explain why migrants migrate "the extra mile" across the equator during the nonbreeding season in search of better fueling conditions, ultimately providing secure and fast return migrations to the breeding grounds in the opposite hemisphere.

Spatio-temporal patterns of herbage availability and livestock movements: A cross-border analysis in the Chinese-Mongolian Altay

Due to increasing population and the recent implementation of policies to intensify the use of land and water resources, the transhumant pastoral systems in the Chinese-Mongolian Altay-Dzungarian region are rapidly changing, leading to modifications of herd size, herd composition and spatial distribution of livestock grazing. This may have major consequences for the supply and quality of rangeland biomass. Despite similar topographic settings, the socio-political framework for Chinese and Mongolian pastoralists differs significantly, leading to differences in rangeland utilization. To substantiate these claims, the long-distance transhumance routes, frequency of pasture changes, daily grazing itineraries and size of pastures were recorded by means of GPS tracking of cattle and goats on 1,535 (China) and 1,396 (Mongolia) observation days. The status quo of the main seasonal pastures was captured by measuring the herbage offer and its nutritive value in 869 sampling spots. In the Altay-Dzungarian region, small ruminant herds covered up to 412 km (Mongolia) and grazed on up to nine pastures per year (China). In Mongolia, the herds’ average duration of stay at an individual pasture was longer than in China, particularly in spring and autumn. Herbage allowance at the onset of a grazing period (kg dry matter per sheep unit and day) ranged from 34/17 to 91/95 (China/Mongolia). Comparing crude protein and phosphorous concentrations of herbage, in China, the highest concentrations were measured for spring and summer pastures, whereas in Mongolia, the highest concentrations were determined for autumn and winter pastures. Based on our data, we conclude that regulation of animal numbers and access to pastures seemingly maintained pasture productivity in China, especially at high altitudes. However, this policy may prohibit flexible adaptation to sudden environmental constraints. In contrast, high stocking densities and grazing of pastures before flowering of herbaceous plants negatively affected rangeland productivity in Mongolia, especially for spring and summer pastures.

Initiative huronne-wendat de création d’une aire protégée : Mobilisation des savoirs et affirmation territoriale

Ce mémoire traite du projet de création de l’aire protégée Ya’nienhonhndeh de la Nation huronne-wendat. À travers l’exploration de la production, de la circulation et de l’utilisation des savoirs relatifs à ce projet, nous cherchons à éclairer les dynamiques constitutives des relations entre la Nation huronne-wendat et l’État québécois dans le cadre de la gestion du territoire traditionnel huron-wendat, le Nionwentsïo. Ce mémoire vise d’abord à mettre en lumière les aspirations de la Nation huronne-wendat concernant l’avenir de son territoire ancestral ainsi qu’à documenter les types de savoirs produits pour les faire valoir. Ensuite, à partir de la cartographie du cheminement de ces savoirs, sont exposés les obstacles structurels qui entravent la réalisation de ces aspirations lorsqu’elles doivent passer par la bureaucratie québécoise. Puis, en s’appuyant sur quelques-unes des diverses utilisations qui furent faites de ces savoirs, la réflexion est élargie pour porter sur les rapports de pouvoir établis entre la Nation huronne-wendat et l’État québécois dans le cadre de questions territoriales. Mots clés : aire protégée, Hurons-Wendat, projet autochtone, aspirations autochtones, bureaucratie, institutions, rapports de pouvoir, État québécois

¿Meritocracia o presión gubernamental? una aproximación desde la sociología de las organizaciones a la burocracia de la ONU en la OESG (2015)

El interés de esta monografía es realizar una mirada crítica a la burocracia de Las Naciones Unidas, tomando como fracción representativa a aquellos funcionarios que hacen parte de la Oficina Ejecutiva del Secretario General. Para ello se toma como guía algunos conocimientos y herramientas de la sociología de las organizaciones. Este texto presenta las normas del juego relativas a la función pública de la organización; así como las prácticas organizacionales en general, y más específicamente en los aspectos del ingreso, permanencia y retiro de los funcionarios. Como resultado se conoce el aparato burocrático de Las Naciones Unidas. El ejercicio consiste en abordar la sociología de las organizaciones como meta-valor de la sociología y como esquema metodológico para el investigador social. Consecutivamente, en conocer la dimensión formal de esta organización y, no sólo su dimensión informal, sino su comportamiento cotidiano en su estructura real.

Small states and the promotion of their foreign policy agenda in the international scenario: Trinidad and Tobago and the Kyoto Protocol

Este estudio de caso busca identificar los elementos del portafolio de política exterior de Trinidad y Tobago que le permitieron promover exitosamente sus intereses en el Protocolo de Kioto. Al hacer esto, este texto analizará las limitaciones de Trinidad y Tobago en términos de vulnerabilidades de localización, burocracia y recursos. Posteriormente, una revisión del portafolio de política exterior de este Estado ilustrará el uso de estrategias de creación de capacidades y de organización como lo son el contacto con actores institucionales y no gubernamentales, la formación de coaliciones y estrategias argumentativas, entre otras. Finalmente, este artículo concluirá que dichas acciones permitieron la promoción de la agenda de política exterior de Trinidad y Tobago a través de la creación de hojas de ruta y la coordinación de la incertidumbre con el Protocolo de Kioto. Para hacer esto, este trabajo se concentrará en examinar conceptos como vulnerabilidad y priorización, asimismo contrastando diferentes artículos académicos en la materia junto con documentos oficiales de Trinidad y Tobago.

Auditoria e controlo interno no exército: Relatório de estágio

O Sector Público em Portugal atravessa um momento de viragem. O antigo modelo de gestão, burocrático e autoritário vai, aos poucos, dando lugar a um novo modelo assente no princípio dos três "E(s)"1, economia, eficiência, eficácia, ao qual se pode juntar a sustentabilidade e o respeito pelo ambiente, procura tomar os serviços públicos amigos dos cidadãos e das boas práticas. Esta metamorfose exige, contudo, uma acção concertada não só ao nível das práticas, mas também das mentalidades num trabalho conjunto de governantes gestores e auditores. É hoje indiscutível a importância que a auditoria interna tem no seio das organizações. O sector público começa agora a dar os primeiros passos nesta área procurando através da auditoria, não só evitar fraudes e detectar erros mas também apoiar a gestão através de uma actuação directa e eficaz sobre o que está a acontecer, garantindo que os recursos que são de todos, estão a ser gastos de forma adequada. No Exército já existe uma cultura de auditoria na sua vertente tradicional, ou seja, verificação do passado, efeito persuasor, verificação da legalidade detecção de erros e fraudes. A instituição só pode ganhar se nesta área for pioneira alargando o âmbito, da sua intervenção ao nível da verificação da eficácia e da eficiência melhorando e criando uma cultura de rigor e boas práticas na sua gestão. /ABSTRACT: The public sector in Portugal is at a turning point. The old management, bureaucratic and authoritarian model is gradually giving way to a new model based on the principle of the three "E (s)2”, economy, efficiency, effectiveness and, to which we can join sustainability and environmental respect. It aims at making the public service friendly for citizens and promoting better practices. This metamorphosis, however, requires a harmonized action not only at the practice level but also in the attitudes within a joint effort of governing managers and auditors. It is nowadays· indisputable the importance that internal audit has within organizations. The public sector is beginning to take the first steps in this area, seeking in the audit not only to prevent fraud and detect errors but also to support the management by working directly and effectively on what is happening, ensuring that the resources belong to everyone, and are all being spent properly. ln the Army there is already an audit culture in its traditional area, i.e., verification of the past, persuasive effect, verification of the legality, detecting errors and fraud. The institution can only win if it is pioneer in this area by expanding the scope of its intervention at the level of verification, effectiveness and efficiency, improving and creating a culture of rigor and better practices in its management. (1-Vectores chaves para o aumento da produtividade e da riqueza suporte do chamado Value for Money (VFM) - 2-Key vectors that increase the support productivity and wealth of the so called Value for Money (VFM) )

Elites e educação: itinerários escolares e percursos profissionais. Alentejo, séculos XIX e XX

A tese examina a relação entre as elites e a educação em Portugal durante a Monarquia Constitucional e na Iª República. Em primeiro lugar caracteriza o quadro europeu no qual emergiram os modernos sistemas de ensino, focando-se depois na análise dos processos de segmentação que separaram o ensino clássico do ensino técnico, passando em revista a literatura sobre o reformismo educativo português. Em segundo, analisa o processo de segmentação na cidade de Évora, capital de uma região caracterizada pela prática de uma agricultura essencialmente extensiva e comercial, na qual estavam implantadas as instituições de ensino que constituem o objeto de estudo: o Liceu e a Escola Industrial. Em terceiro, procede à caracterização dos espaços escolares; em quarto estuda as condutas públicas dos agentes educativos, em particular dos reitores e dos professores, colocando em destaque a sua intervenção pública; em quinto, caracteriza a procura a que foram sujeitos os vários institutos de ensino estudados: a ênfase foi colocada na mobilidade geográfica aferida a partir da naturalidade dos alunos e da residência dos pais; em sexto, foi efetuada a análise da extração social dos alunos e o perfil ocupacional dos pais. Finalmente, em último lugar, foram reconstituídos os percursos académicos e profissionais dos alunos liceais no arco cronológico antes enunciado; Elites and Education.School itineraries and career paths.Alentejo, 19th and 20th centuries. Abstract: The thesis examines the relation between elites and education in Portugal, during the Constitutional Monarchy and the First Republic. Firstly, it characterises the European context in which modern teaching systems emerged and it focuses on the analysis of the processes of segmentation that separate classic and technical teaching. It reviews literature on Portuguese educational reformism, centred on classic and technical teaching. Secondly, it analyses the process of segmentation in Évora, capital of a region that is characterised by agriculture, which is essentially extensive and commercial, home to the education institutions our study focuses on: the Liceu and the Industrial School. Thirdly, school facilities are characterised; then, public behaviour of educators, namely that of headmasters and teachers, highlighting their public intervention; it characterises the demand in these institutions - the emphasis is placed on geographic mobility, considering students' birthplace and their parents' residence; a study on students' backgrounds and parents' occupational profiles is carried out. Eventually, the academic and professional itineraries of Liceu students' are reconstituted, within the formerly described chronological arch.