Gestão de políticas públicas intersetoriais : uma análise da política nacional de promoção da saúde

Mestrado (dissertação)—Universidade de Brasília, Faculdade de Ciências da Saúde, Programa de Pós-Graduação em Saúde Coletiva, 2015.

A Retrospective-Longitudinal Examination of the Relationship between Apportionment of Seat Time in Community-College Algebra Courses and Student Academic Performance

During the past decade, there has been a dramatic increase by postsecondary institutions in providing academic programs and course offerings in a multitude of formats and venues (Biemiller, 2009; Kucsera & Zimmaro, 2010; Lang, 2009; Mangan, 2008). Strategies pertaining to reapportionment of course-delivery seat time have been a major facet of these institutional initiatives; most notably, within many open-door 2-year colleges. Often, these enrollment-management decisions are driven by the desire to increase market-share, optimize the usage of finite facility capacity, and contain costs, especially during these economically turbulent times. So, while enrollments have surged to the point where nearly one in three 18-to-24 year-old U.S. undergraduates are community college students (Pew Research Center, 2009), graduation rates, on average, still remain distressingly low (Complete College America, 2011). Among the learning-theory constructs related to seat-time reapportionment efforts is the cognitive phenomenon commonly referred to as the spacing effect, the degree to which learning is enhanced by a series of shorter, separated sessions as opposed to fewer, more massed episodes. This ex post facto study explored whether seat time in a postsecondary developmental-level algebra course is significantly related to: course success; course-enrollment persistence; and, longitudinally, the time to successfully complete a general-education-level mathematics course. Hierarchical logistic regression and discrete-time survival analysis were used to perform a multi-level, multivariable analysis of a student cohort (N = 3,284) enrolled at a large, multi-campus, urban community college. The subjects were retrospectively tracked over a 2-year longitudinal period. The study found that students in long seat-time classes tended to withdraw earlier and more often than did their peers in short seat-time classes (p < .05). Additionally, a model comprised of nine statistically significant covariates (all with p-values less than .01) was constructed. However, no longitudinal seat-time group differences were detected nor was there sufficient statistical evidence to conclude that seat time was predictive of developmental-level course success. A principal aim of this study was to demonstrate—to educational leaders, researchers, and institutional-research/business-intelligence professionals—the advantages and computational practicability of survival analysis, an underused but more powerful way to investigate changes in students over time.

Network Construction and Graph Theoretical Analysis of Functional Language Networks in Pediatric Epilepsy

This dissertation introduces a new approach for assessing the effects of pediatric epilepsy on the language connectome. Two novel data-driven network construction approaches are presented. These methods rely on connecting different brain regions using either extent or intensity of language related activations as identified by independent component analysis of fMRI data. An auditory description decision task (ADDT) paradigm was used to activate the language network for 29 patients and 30 controls recruited from three major pediatric hospitals. Empirical evaluations illustrated that pediatric epilepsy can cause, or is associated with, a network efficiency reduction. Patients showed a propensity to inefficiently employ the whole brain network to perform the ADDT language task; on the contrary, controls seemed to efficiently use smaller segregated network components to achieve the same task. To explain the causes of the decreased efficiency, graph theoretical analysis was carried out. The analysis revealed no substantial global network feature differences between the patient and control groups. It also showed that for both subject groups the language network exhibited small-world characteristics; however, the patient’s extent of activation network showed a tendency towards more random networks. It was also shown that the intensity of activation network displayed ipsilateral hub reorganization on the local level. The left hemispheric hubs displayed greater centrality values for patients, whereas the right hemispheric hubs displayed greater centrality values for controls. This hub hemispheric disparity was not correlated with a right atypical language laterality found in six patients. Finally it was shown that a multi-level unsupervised clustering scheme based on self-organizing maps, a type of artificial neural network, and k-means was able to fairly and blindly separate the subjects into their respective patient or control groups. The clustering was initiated using the local nodal centrality measurements only. Compared to the extent of activation network, the intensity of activation network clustering demonstrated better precision. This outcome supports the assertion that the local centrality differences presented by the intensity of activation network can be associated with focal epilepsy.

HRM and innovation:looking across levels

Studies are starting to explore the role of HRM in fostering organizational innovation but empirical evidence remains contradictory and theory fragmented. This is partly because extant literature by and large adopts a unitary level of analysis, rather than reflecting on the multi-level demands that innovation presents. Building on an emergent literature focused on HRM’s role in shaping innovation, we shed light on the question of whether, and how, HRM might influence employees’ innovative behaviours in the direction of strategically important goals. Drawing upon institutional theory, our contributions are three-fold: to bring out the effect of two discrete HRM configurations- one underpinned by a control and the other by an entrepreneurial ethos, on attitudes and behaviours at the individual level; to reflect the way in which employee innovative behaviours arising from these HRM configurations coalesce to shape higher-level phenomena, such as organizational-level innovation; and to bring out two distinct patterns of bottom-up emergence, one driven primarily by composition and the other by both composition and compilation.

Effectiveness of Depression-Suicidal Behaviour Gatekeeper training among police officers in three European regions: outcomes of the Optimising Suicide Prevention Programmes and their Implementation in Europe (OSPI-Europe) study

Background: Gatekeeper training for community facilitators, to identify and respond to those at risk of suicide, forms an important part of multi-level community-based suicide prevention programmes. Aims: This study examined the effects of gatekeeper training on attitudes, knowledge and confidence of police officers in dealing with persons at risk of suicide. Methods: A total of 828 police officers across three European regions participated in a 4-hour training programme which addressed the epidemiology of depression and suicidal behaviour, symptoms of depression, warning signs and risk factors associated with suicidal behaviour, motivating help-seeking behaviour, dealing with acute suicidal crisis and informing bereaved relatives. Participants completed internationally validated questionnaires assessing stigmatising attitudes, knowledge about depression and confidence in dealing with suicidal persons pre- and post-training. Results: There were significant differences among countries in terms of previous exposure to suicidal persons and extent of previous training. Post-training evaluation demonstrated significant improvements in stigmatising attitudes, knowledge and confidence in all three countries. Conclusion: The consistently positive effects of gatekeeper training of police officers across different regions support inclusion of this type of training as a fundamental part of multi-level community-based suicide prevention programmes and roll-out, nationally and internationally.

Talking about quality: exploring how ‘quality’ is conceptualized in European hospitals and healthcare systems

BACKGROUND: Conceptualization of quality of care - in terms of what individuals, groups and organizations include in their meaning of quality, is an unexplored research area. It is important to understand how quality is conceptualised as a means to successfully implement improvement efforts and bridge potential disconnect in language about quality between system levels, professions, and clinical services. The aim is therefore to explore and compare conceptualization of quality among national bodies (macro level), senior hospital managers (meso level), and professional groups within clinical micro systems (micro level) in a cross-national study. METHODS: This cross-national multi-level case study combines analysis of national policy documents and regulations at the macro level with semi-structured interviews (383) and non-participant observation (803 hours) of key meetings and shadowing of staff at the meso and micro levels in ten purposively sampled European hospitals (England, the Netherlands, Portugal, Sweden, and Norway). Fieldwork at the meso and micro levels was undertaken over a 12-month period (2011-2012) and different types of micro systems were included (maternity, oncology, orthopaedics, elderly care, intensive care, and geriatrics). RESULTS: The three quality dimensions clinical effectiveness, patient safety, and patient experience were incorporated in macro level policies in all countries. Senior hospital managers adopted a similar conceptualization, but also included efficiency and costs in their conceptualization of quality. 'Quality' in the forms of measuring indicators and performance management were dominant among senior hospital managers (with clinical and non-clinical background). The differential emphasis on the three quality dimensions was strongly linked to professional roles, personal ideas, and beliefs at the micro level. Clinical effectiveness was dominant among physicians (evidence-based approach), while patient experience was dominant among nurses (patient-centered care, enough time to talk with patients). Conceptualization varied between micro systems depending on the type of services provided. CONCLUSION: The quality conceptualization differed across system levels (macro-meso-micro), among professional groups (nurses, doctors, managers), and between the studied micro systems in our ten sampled European hospitals. This entails a managerial alignment challenge translating macro level quality definitions into different local contexts.

EU-North Africa relations in cross-border law enforcement: new legal challenges for the EU in the post-Lisbon and post-Stockholm era

The Stockholm Programme, allied to the Lisbon Treaty, heralds a new era of development of the EU provisions on cross-border law enforcement. The focus is shifting from the ongoing internal EU developments to the external relations of the EU. Many North African countries have had long legal relationships with the EU through the Euro-Mediterranean Partnerships. A number of these partnership agreements make express references, at the political level, to the development of cross-border law enforcement provision, as is the case of Morocco and Algeria with regard to drug trafficking and manufacture, or the lengthy references by Egypt to many of the crimes of interest to the EU’s own law enforcement legal framework. Algeria is currently focusing on modernising their own police forces, with both Algeria and Tunisia, reforming their criminal judicial frameworks. Another key player, Libya, currently has no legal agreements with the EU, and at least until the recent conflict, maintained an observer status in the Euro-Mediterranean process. At a practitioner level, the European Police College (CEPOL) is currently involved in the Euromed Police II programme. Clearly momentum is developing, both within the EU and from a number of Euro-Med North African countries to develop closer law enforcement co-operation. This may well develop further with the recent changes in governments of a number of North African countries. The EU approach in the Police and Judicial Cooperation in Criminal Matters (PJCCM) policy area is to develop a legal framework upon which EU cross-border law enforcement will be based. The current EU cross-border law enforcement framework is the product of many years of multi-level negotiations. Challenges will arise as new countries from different legal and policing traditions will attempt to engage with already highly detailed legal and practice frameworks. The shared European legal traditions will not necessarily be reflected in the North African countries. This chapter critically analyses, from an EU legal perspective the problems and issues that will be encountered as the EU’s North African partner countries attempt to articulate into the existing, and still developing EU cross-border law enforcement framework.

Los mecanismos de influencia en el liderazgo: dos estudios de caso

Este trabajo investigativo busca aportar a la literatura sobre las tácticas de influencia en el liderazgo. Surge como una aplicación, a dos casos específicos, del proyecto de investigación “Los mecanismos de influencia en la relación de liderazgo”, desarrollado por el profesor Juan Javier Saavedra Mayorga e inscrito en la línea de investigación en Estudios Organizacionales del Grupo de Investigación en Dirección y Gerencia. La investigación tiene como objetivo fundamental identificar las tácticas de influencia que utilizan dos líderes organizacionales en su trato cotidiano con sus colaboradores, así como la reacción de estos últimos ante dichas tácticas. El proyecto parte de una revisión teórica sobre tres elementos: el liderazgo, la influencia y el poder, y las reacciones de los colaboradores frente a las tácticas de influencia utilizadas por el líder. La estrategia metodológica empleada es el estudio de caso. El trabajo de campo se desarrolló en dos organizaciones: Microscopios y Equipos Especiales S.A.S. y Tecniespectro S.A.S. La técnica de recolección de información es la entrevista semi estructurada, y el método de análisis de información es el análisis de contenido temático.

Los mecanismos de influencia en el liderazgo

Este trabajo tiene como objetivo fundamental identificar las tácticas de influencia que utiliza el señor Carlos Pérez, gerente y socio principal de G. & M., en su trato cotidiano con sus colaboradores, así como la reacción de estos últimos ante dichas tácticas.

A complexity-based diagnostic on the democratic unity roundtable mud: problems and alternatives (2008-2016)

Este trabajo exploratorio estudia al movimiento político Mesa de la Unidad Democrática (MUD), creada con el fin de oponerse la Gobierno socialista existente en venezuela. La crítica que este documento realiza, parte desde el punto de vista de la Ciencia de la Complejidad. Algunos conceptos clave de sistemas complejos han sido utilizados para explicar el funcionamiento y organización de la MUD, esto con el objetivo de generar un diagnóstico integral de los problemas que enfrenta, y evidenciar las nuevas percepciones sobre comportamientos perjudiciales que el partido tiene actualmente. Con el enfoque de la complejidad se pretende ayudar a comprender mejor el contexto que enmarca al partido y, para, finalmente aportar una serie de soluciones a los problemas de cohesión que presen

Liderazgo Responsable: Una revisión de la literatura

El objetivo del presente artículo es profundizar en los conceptos de liderazgo responsable y responsabilidad social empresarial, basándose en un marco referencial y bibliográfico pertinente para la investigación. Para ello, se realizó una exhaustiva búsqueda de referencias bibliográficas, tales como artículos científicos, publicaciones académicas y estudios de caso, que ayudaron a dar un acercamiento conceptual al tema principal. Se encontraron diferentes aproximaciones conceptuales sobre el liderazgo responsable y la importancia que tiene en términos de responsabilidad social, algunas teorías del liderazgo, estilos de liderazgo responsable, la satisfacción laboral y por ultimo una serie de casos empresariales que ponen estos conceptos en práctica.

Modern viticulture in southern Europe: Vulnerabilities and strategies for adaptation to water scarcity

Water is now considered the most important but vulnerable resource in the Mediterranean region. Nev ertheless, irrigation expanded fast in the region (e.g. South Portugal and Spain) to mitigate environmental stress and to guarantee stable grape yield and quality. Sustainable wine production depends on sustain able water use in the wine’s supply chain, from the vine to the bottle. Better understanding of grapevine stress physiology (e.g. water relations, temperature regulation, water use efficiency), more robust crop monitoring/phenotyping and implementation of best water management practices will help to mitigate climate effects and will enable significant water savings in the vineyard and winery. In this paper, we focused on the major vulnerabilities and opportunities of South European Mediterranean viticulture (e.g. in Portugal and Spain) and present a multi-level strategy (from plant to the consumer) to overcome region’s weaknesses and support strategies for adaptation to water scarcity, promote sustainable water use and minimize the environmental impact of the sector.

Modern viticulture in southern Europe: vulnerabilities and strategies for adaptation to water scarcity

Water is now considered the most important but vulnerable resource in the Mediterranean region. Nevertheless, irrigation expanded fast in the region (e.g. South Portugal and Spain) to mitigate environmental stress and to guarantee stable grape yield and quality. Sustainable wine production depends on sustainable water use in the wine’s supply chain, from the vine to the bottle. Better understanding of grapevine stress physiology (e.g. water relations, temperature regulation, water use efficiency), more robust crop monitoring/phenotyping and implementation of best water management practices will help to mitigate climate effects and will enable significant water savings in the vineyard and winery. In this paper, we focused on the major vulnerabilities and opportunities of South European Mediterranean viticulture (e.g. in Portugal and Spain) and present a multi-level strategy (from plant to the consumer) to overcome region’s weaknesses and support strategies for adaptation to water scarcity, promote sustainable water use and minimize the environmental impact of the sector.

Biomimetic surfaces for greener coastal infrastructures: an analysis of factors that contribute to make artificial structures more “natural”

The growing ecological awareness of Ocean Sprawl impacts is promoting the adoption of eco-engineering strategies to enhance the ecological performance of coastal infrastructures. Biomimicry, as an eco-engineering tool, aims to design infrastructure more suitable for wildlife by manipulating structural factors to mimic natural habitats. However, little is known about the extent to which natural and artificial substrates differ in their structure and to what extent such differences affect the biota. To fill these knowledge gaps and consequently design biomimetic surfaces, I initially explored how much physical structure diverges between various types of natural and artificial substrates and tested to what extent differences in physical structure and material composition affect the epibenthic communities. By mean of an in-field mensurative experiment and a systematic review coupled with a meta-analysis, I found that, although communities tended to differ between natural and artificial coastal habitats, both physical structure and material composition reported an overall mild effect on epibenthic communities. However, an informed choice of building material and an appropriate combination of multiple structural manipulations can promote ecological benefits at multiple levels, from increasing the ecological performance in situ to reducing the impacts during the production process. Thus, I combined my findings in a final experiment, still in progress, where I am testing the combined role of shape, brightness and inclination of biomimetic surfaces I have designed in producing benefits at multiple levels. Overall, I suggest that biomimicry has the potential to increase the ecological value of artificial habitats especially when a wide range of aspects is simultaneously considered. Indeed, none of the structural factors, individually, can fully mimic the “natural conditions” to effectively improve the ecological performance of the artificial substrates. This emphasizes the need to include in future works a multi-level perspective to fully achieve the great potential of biomimicry.

Comparison Between Single-Diode Low-Level Laser Therapy (LLLT) and LED Multi-Diode (Cluster) Therapy (LEDT) Applications Before High-Intensity Exercise

Background Data and Objective: There is anecdotal evidence that low-level laser therapy (LLLT) may affect the development of muscular fatigue, minor muscle damage, and recovery after heavy exercises. Although manufacturers claim that cluster probes (LEDT) maybe more effective than single-diode lasers in clinical settings, there is a lack of head-to-head comparisons in controlled trials. This study was designed to compare the effect of single-diode LLLT and cluster LEDT before heavy exercise. Materials and Methods: This was a randomized, placebo-controlled, double-blind cross-over study. Young male volleyball players (n = 8) were enrolled and asked to perform three Wingate cycle tests after 4 x 30 sec LLLT or LEDT pretreatment of the rectus femoris muscle with either (1) an active LEDT cluster-probe (660/850 nm, 10/30mW), (2) a placebo cluster-probe with no output, and (3) a single-diode 810-nm 200-mW laser. Results: The active LEDT group had significantly decreased post-exercise creatine kinase (CK) levels (-18.88 +/- 41.48U/L), compared to the placebo cluster group (26.88 +/- 15.18U/L) (p < 0.05) and the active single-diode laser group (43.38 +/- 32.90U/L) (p<0.01). None of the pre-exercise LLLT or LEDT protocols enhanced performance on the Wingate tests or reduced post-exercise blood lactate levels. However, a non-significant tendency toward lower post-exercise blood lactate levels in the treated groups should be explored further. Conclusion: In this experimental set-up, only the active LEDT probe decreased post-exercise CK levels after the Wingate cycle test. Neither performance nor blood lactate levels were significantly affected by this protocol of pre-exercise LEDT or LLLT.