O Programa Nova EJA do Estado do Rio de Janeiro na perspectiva dos seus sujeitos

O presente estudo propõe analisar a nova matriz curricular da Educação de Jovens e Adultos do Estado do Rio de Janeiro, que foi aprovada pelo CEE/RJ através da Deliberação CEE N 320/2011. Tal programa derivou das novas diretrizes curriculares apresentadas pelo Plano de Metas do Estado do Rio de Janeiro (PME/RJ- 2011), atribuído como uma das frentes de atuação governamental adotadas pelo Governo Sergio Cabral. Nesse sentido, propomos pesquisar as implicações formativas na formação de Jovens e Adultos decorrentes da implantação do currículo mínimo na EJA, tendo como arcabouço teórico metodológico a Filosofia da Práxis de Gramsci, norteado pela concepção de Escola e educação que deriva de seu pensamento. Para tal, busca-se a partir de uma práxis filosófica que se revela comprometida com a realidade, contribuir com estudos que possam oferecer uma perspectiva de análise à sociedade. Para Gramsci, é no campo das experiências concretas, na análise crítica sobre a cultura e a política que se chegará, progressivamente, a uma concepção singular de mundo atrelada a visão da totalidade que vincula política e história como elementos indissociáveis no processo de emancipação das classes subalternas. Daí o interesse em investigar nos espaços de tensão, os embates históricos dos modelos de formação do Estado em confronto com as demandas da educação popular, através das ações históricas coletivas, que evidenciam como principais protagonistas os movimentos sociais.

Saúde como direito social na pauta sindical de professores da rede básica de ensino

A pesquisa tem como objeto as bases ético-políticas da organização coletiva dos professores pela sua saúde e, como objetivo, analisar como a questão da saúde dos trabalhadores foi incorporada na pauta sindical dos professores da rede básica de ensino no Brasil, a fim de desvendar concepções sobre saúde que sustentam tais reivindicações. A pergunta orientadora é: a saúde dos trabalhadores da educação tem sido incorporada na pauta sindical dos professores nos limites da reprodução da força de trabalho ou amplia-se para o plano dos direitos? Delimitou-se como campo de pesquisa a Confederação Nacional dos Trabalhadores em Educação (CNTE) por esta entidade sindical ser representativa de mais de dois milhões de trabalhadores da educação da rede básica e pública de ensino no país. Os resultados encontrados possibilitaram reconstruir historicamente o objeto, no sentido de identificar como, quando e por quais meios a entidade sindical iniciou a problematização da questão saúde/adoecimento docente como uma questão coletiva, bem como identificar o papel que a CNTE foi assimilando para si ao longo desse processo e que relações a entidade sindical percebe entre condições e trabalho dos professores e adoecimento. A classificação dos temas em saúde, quanto à sua natureza econômico-corporativa ou ético-política, apreendeu-se que concepções de saúde se fazem presentes nas fontes pesquisadas. Identificou-se que a concepção de saúde ampliada se faz presente na pauta sindical, evidenciada por um conjunto de temas considerados como pertinentes a uma natureza ético-política, notadamente, aqueles presentes na pauta que estão orientados para a defesa do Sistema Único de Saúde e a garantia da saúde por meio de políticas públicas. Contudo, os resultados também mostram que, no âmbito das necessidades provenientes das bases sindicais, ainda prevalecem reivindicações pertinentes a uma natureza econômico-corporativa, que necessárias para os trabalhadores da educação, se configuram a partir de concepções de saúde restritas, predominantemente baseadas em reivindicações por assistência médica, por meio de instituições próprias ao funcionalismo público ou planos de saúde. Neste último sentido, embora importantes, não ampliam o debate sindical no sentido de defender a saúde como direito social. A tese que se defende é que o momento ético-político, no qual se insere a luta pelos direitos sociais, tem relações imediatas com a dimensão ontológica do ser social, assim, tendo como pressuposto de que o trabalho é fundante de todas as determinações do ser social, considera-se que é na dimensão ético-política do processo saúde-doença que se deve introduzir a discussão política da saúde, e nela, a saúde dos trabalhadores a fim de se construir uma pauta contra o entendimento da saúde como uma mercadoria

How smokers may react to cigarette taxes and price increases in Brazil: data from a national survey

Background: Despite being the third largest tobacco producer in the world, Brazil has developed a comprehensive tobacco control policy that includes a broad restriction on both advertising and smoking in indoor public places, compulsory pictorial warning labels, and a menthol cigarette ban. However, tax and pricing policies have been developed slowly and only very recently were stronger measures implemented. This study investigated the expected responses of smokers to hypothetical price increases in Brazil.Methods: We analyzed smokers' responses to hypothetical future price increases according to sociodemographic characteristics and smoking conditions in a multistage sample of Brazilian current cigarette smokers aged >= 14 years (n = 500). Logistic regression analysis was used to examine the relationship between possible responses and different predictors.Results: in most subgroups investigated, smokers most frequently said they would react to a hypothetical price increase by taking up alternatives that might have a positive impact on health, i.e., they would try to stop smoking (52.3%) or smoke fewer cigarettes (46.8%). However, a considerable percentage responded that they would use alternatives that would reduce the effect of price increases, such as the same brand with lower cost (48.1%). After controlling for sex age group (14-19, 20-39, 40-59, and >= 60 years), schooling level (>= 9 versus <= 9 years), number of cigarettes per day (>20 versus <= 20), and stage of change for smoking cessation (precontemplation, contemplation, and preparation), lower levels of dependence were positively associated with the response I would try to stop smoking (odds ratio [OR], 2.19). Young age was associated with I would decrease the number of cigarettes (OR, 3.44). A low schooling level was strongly associated with all responses.Conclusions: Taxes and prices increases have great potential to stimulate cessation or reduction of cigarette consumption further among two important vulnerable populations of smokers in Brazil: young smokers and those of low educational level. the results from the present study also suggest that seeking illegal products may reduce the impact of increased taxes, but does not eliminate it.

Constructing Universities as Organizations: University Reforms in Poland in the Light of Institutional Theory

This chapter shows that apart from changes at the systemic and institutional levels, successful reform implementation struggles with a gradual change in academic beliefs, attitudes and behaviours. Currently, visions of the university proposed by the Polish academic community and visions of it proposed by Polish reformers and policymakers (within ongoing reforms) are worlds apart. I shall study recent reforms in the context of specific academic self--protective narratives being produced in the last two decades (at the collective level of the academic profession) and in the context of the Ivory Tower university ideals predominant at the individual level (as studied comparatively through a large--scale European survey of the academic profession). Institutions change both swiftly, radically – and slowly, gradually. Research literature on institutional change until recently was focused almost exclusively on the role of radical changes caused by external shocks, leading to radical institutional reconfigurations. And research literature about the gradual, incremental institutional change have been emergent for about a decade and a half now (Mahoney and Thelen 2010; Streeck and Thelen 2005, 2009; Thelen 2003). Polish higher education provides interesting empirical grounds to test institutional theories. Both types of transformations (radical and gradual) may lead to equally permanent changes in the functioning of institutions, equally deep transformations of their fundamental rules, norms and operating procedures. Questions about institutional change are questions about characteristics of institutions undergoing changes. Endogenous institutional change is as important as exogenous change (Mahoney and Thelen 2010: 3). Moments in which there emerge opportunities of performing deep institutional reforms are short (in Poland these moments occurred in 2009-2012), and between them there are long periods of institutional stasis and stability (Pierson 2004: 134-135). The premises of theories of institutional change can be applied systematically to a system of higher education which shows an unprecedented rate of change and which is exposed to broad, fundamental reform programmes. There are many ways to discuss the Kudrycka reforms - and "constructing Polish universities as organizations" (rather than traditional academic "institutions") is one of more promising. In this account, Polish universities are under construction as organizations, and under siege as institutions. They are being rationalized as organizations, following instrumental rather than institutional logics. Polish academics in their views and attitudes are still following an institutional logic, while Polish reforms are following the new (New Public Management-led) instrumental logics. Both are on a collision course about basic values. Reforms and reformees seem to be worlds apart. I am discussing the the two contrasting visions of the university and describing the Kudrycka reforms as the reistitutionalization of the research mission of Polish universities. The core of reforms is a new level of funding and governance - the intermediary one (and no longer the state one), with four new peer-run institutions, with the KEJN, PKA and NCN in the lead. Poland has been beginning to follow the "global rules of the academic game" since 2009. I am also discussing two academic self-protection modes agains reforms: (Polish) "national academic traditions" and "institutional exceptionalism" (of Polish HE). Both discourses prevailed for two decades, none seems socially (and politically) acceptable any more. Old myths do not seem to fit new realities. In this context I am discussing briefly and through large-scale empirical data the low connectedness to the outside world of Polish HE institutions, low influence of the government on HE policies and the low level of academic entrepreneurialism, as seen through the EUROAC/CAP micro-level data. The conclusion is that the Kudrycka reforms are an imporant first step only - Poland is too slow in reforms, and reforms are both underfunded and inconsistent. Poland is still accumulating disadvantages as public funding and university reforms have not reached a critical point. Ever more efforts lead to ever less results, as macro-level data show. Consequently, it may be useful to construct universities as organizations in Poland to a higher degree than elsewhere in Europe, and especially in Western Europe.

Thomas Davis's education policies: theory and practice

This thesis explores the education policies of Thomas Davis. On the eve of the Great Famine Ireland was economically impoverished and politically dependent. The Irish people had a subservient mentality, were mainly uneducated and were unaware of their potential. He believed that education would develop a self-reliant, self-sufficient people; it would create a new generation of leaders and citizens necessary to transform Ireland into a prosperous, independent nation. This thesis explores his education philosophy which was political in orientation; he called for reform of university education so that it would educate leaders who were knowledgeable, patriotic and responsible. He formulated a curriculum which consisted of knowledge that would have direct use and application in public life; his curriculum included moral philosophy, oratory, philological studies and history. His contribution to the debate on the Queens Colleges bill, 1845, is explored including his public disagreement with Daniel O’Connell on the principle of multi-denominational education. This work also examines his policies on learning methodologies and teaching methods. It provides details of his thoughts on learning by experience, by observation, book learning and learning in the home. It focuses on the deficiencies evident in the system of teaching and learning that operated in Trinity College Dublin and it provides an analysis of his preferred method of instruction: Lyceum teaching. This thesis also explores his national curriculum in history and Irish culture which was designed to forge a sense of national identity, to win support for repeal and to develop the principle of nationality. He formulated a national curriculum to counteract the absence of national knowledge in the state schools, to provide the people with a positive self-image and ultimately to empower them to reclaim Ireland and to develop it. Davis knew the power of education and he used it as an instrument of political and social change.

The effects of copayment policies on adherence to prescription medicines in publicly insured populations

Introduction: Copayments for prescriptions are associated with decreased adherence to medicines resulting in increased health service utilisation, morbidity and mortality. In October 2010 a 50c copayment per prescription item was introduced on the General Medical Services (GMS) scheme in Ireland, the national public health insurance programme for low-income and older people. The copayment was increased to €1.50 per prescription item in January 2013. To date, the impact of these copayments on adherence to prescription medicines on the GMS scheme has not been assessed. Given that the GMS population comprises more than 40% of the Irish population, this presents an important public health problem. The aim of this thesis was to assess the impact of two prescription copayments, 50c and €1.50, on adherence to medicines.Methods: In Chapter 2 the published literature was systematically reviewed with meta-analysis to a) develop evidence on cost-sharing for prescriptions and adherence to medicines and b) develop evidence for an alternative policy option; removal of copayments. The core research question of this thesis was addressed by a large before and after longitudinal study, with comparator group, using the national pharmacy claims database. New users of essential and less-essential medicines were included in the study with sample sizes ranging from 7,007 to 136,111 individuals in different medication groups. Segmented regression was used with generalised estimating equations to allow for correlations between repeated monthly measurements of adherence. A qualitative study involving 24 individuals was conducted to assess patient attitudes towards the 50c copayment policy. The qualitative and quantitative findings were integrated in the discussion chapter of the thesis. The vast majority of the literature on this topic area is generated in North America, therefore a test of generalisability was carried out in Chapter 5 by comparing the impact of two similar copayment interventions on adherence, one in the U.S. and one in Ireland. The method used to measure adherence in Chapters 3 and 5 was validated in Chapter 6. Results: The systematic review with meta-analysis demonstrated an 11% (95% CI 1.09 to 1.14) increased odds of non-adherence when publicly insured populations were exposed to copayments. The second systematic review found moderate but variable improvements in adherence after removal/reduction of copayments in a general population. The core paper of this thesis found that both the 50c and €1.50 copayments on the GMS scheme were associated with larger reductions in adherence to less-essential medicines than essential medicines directly after the implementation of policies. An important exception to this pattern was observed; adherence to anti-depressant medications declined by a larger extent than adherence to other essential medicines after both copayments. The cross country comparison indicated that North American evidence on cost-sharing for prescriptions is not automatically generalisable to the Irish setting. Irish patients had greater immediate decreases of -5.3% (95% CI -6.9 to -3.7) and -2.8% (95% CI -4.9 to -0.7) in adherence to anti-hypertensives and anti-hyperlipidaemic medicines, respectively, directly after the policy changes, relative to their U.S. counterparts. In the long term, however, the U.S. and Irish populations had similar behaviours. The concordance study highlighted the possibility of a measurement bias occurring for the measurement of adherence to non-steroidal anti-inflammatory drugs in Chapter 3. Conclusions: This thesis has presented two reviews of international cost-sharing policies, an assessment of the generalisability of international evidence and both qualitative and quantitative examinations of cost-sharing policies for prescription medicines on the GMS scheme in Ireland. It was found that the introduction of a 50c copayment and its subsequent increase to €1.50 on the GMS scheme had a larger impact on adherence to less-essential medicines relative to essential medicines, with the exception of anti-depressant medications. This is in line with policy objectives to reduce moral hazard and is therefore demonstrative of the value of such policies. There are however some caveats. The copayment now stands at €2.50 per prescription item. The impact of this increase in copayment has yet to be assessed which is an obvious point for future research. Careful monitoring for adverse effects in socio-economically disadvantaged groups within the GMS population is also warranted. International evidence can be applied to the Irish setting to aid in future decision making in this area, but not without placing it in the local context first. Patients accepted the introduction of the 50c charge, however did voice concerns over a rising price. The challenge for policymakers is to find the ‘optimal copayment’ – whereby moral hazard is decreased, but access to essential chronic disease medicines that provide advantages at the population level is not deterred. This evidence presented in this thesis will be utilisable for future policy-making in Ireland.

Are State legislatures responding to public opinion when allocating funds for tobacco control programs?

This study explored the factors associated with state-level allocations to tobacco-control programs. The primary research question was whether public sentiment regarding tobacco control was a significant factor in the states' 2001 budget decisions. In addition to public opinion, several additional political and economic measures were considered. Significant associations were found between our outcome, state-level tobacco-control funding per capita, and key variables of interest including public opinion, amount of tobacco settlement received, the party affiliation of the governor, the state's smoking rate, excise tax revenue received, and whether the state was a major producer of tobacco. The findings from this study supported our hypothesis that states with citizens who favor more restrictive indoor air policies allocate more to tobacco control. Effective public education to change public opinion and the cultural norms surrounding smoking may affect political decisions and, in turn, increase funding for crucial public health programs.

Education and Poverty: Confronting the Evidence

Current U.S. policy initiatives to improve the U.S. education system, including No Child Left Behind, test-based evaluation of teachers, and the promotion of competition are misguided because they either deny or set to the side a basic body of evidence documenting that students from disadvantaged households on average perform less well in school than those from more advantaged families. Because these policy initiatives do not directly address the educational challenges experienced by disadvantaged students, they have contributed little-and are not likely to contribute much in the future-to raising overall student achievement or to reducing achievement and educational attainment gaps between advantaged and disadvantaged students. Moreover, such policies have the potential to do serious harm. Addressing the educational challenges faced by children from disadvantaged families will require a broader and bolder approach to education policy than the recent efforts to reform schools. © 2012 by the Association for Public Policy Analysis and Management.

The Design and Implementation of an Educational Computer Game and Its Study as a Motivational Tool for Middle School ESOL Students

Gemstone Team ILL (Interactive Language Learning)

PARTAKE survey of public knowledge and perceptions of clinical research in India.

BACKGROUND: A public that is an informed partner in clinical research is important for ethical, methodological, and operational reasons. There are indications that the public is unaware or misinformed, and not sufficiently engaged in clinical research but studies on the topic are lacking. PARTAKE - Public Awareness of Research for Therapeutic Advancements through Knowledge and Empowerment is a program aimed at increasing public awareness and partnership in clinical research. The PARTAKE Survey is a component of the program. OBJECTIVE: To study public knowledge and perceptions of clinical research. METHODS: A 40-item questionnaire combining multiple-choice and open-ended questions was administered to 175 English- or Hindi-speaking individuals in 8 public locations representing various socioeconomic strata in New Delhi, India. RESULTS: Interviewees were 18-84 old (mean: 39.6, SD ± 16.6), 23.6% female, 68.6% employed, 7.3% illiterate, 26.3% had heard of research, 2.9% had participated and 58.9% expressed willingness to participate in clinical research. The following perceptions were reported (% true/% false/% not aware): 'research benefits society' (94.1%/3.5%/2.3%), 'the government protects against unethical clinical research' (56.7%/26.3%/16.9%), 'research hospitals provide better care' (67.2%/8.7%/23.9%), 'confidentiality is adequately protected' (54.1%/12.3%/33.5%), 'participation in research is voluntary' (85.3%/5.8%/8.7%); 'participants treated like 'guinea pigs'' (20.7%/53.2%/26.0%), and 'compensation for participation is adequate' (24.7%/12.9%/62.3%). CONCLUSIONS: Results suggest the Indian public is aware of some key features of clinical research (e.g., purpose, value, voluntary nature of participation), and supports clinical research in general but is unaware of other key features (e.g., compensation, confidentiality, protection of human participants) and exhibits some distrust in the conduct and reporting of clinical trials. Larger, cross-cultural surveys are required to inform educational programs addressing these issues.

Aspects of care 5: the continuing educational needs of midwives

This is the fifth in a series of six papers presenting key findings from a national study that was undertaken to investigate the role and responsibilities of midwives and to identify continuing educational need. The background to the study and the titles of the other papers in the series have been outlined in the first paper. This paper focuses on the methods used to identify the continuing educational needs of midwives, and provides an overview of the findings related to midwives' perceived confidence/competence to practice and their continuing educational needs.

Aspects of care 6: continuing educational needs of midwives 2

This is the last in a series of six papers presenting key findings from a national study that was undertaken to investigate the role and responsibilities of midwives in England and to identify and address continuing educational needs. The background to the study and the titles of other papers in the series have been outlined in the first paper. The first five papers have provided an overview of the main research findings that have been used to determine the continuing educational needs of midwives. This paper provides a more detailed picture of the issues that were identified in relation to educational need, and an overview of the way in which an educational package was developed on the basis of the research findings for use by midwives nationally.

Public-public partnerships (PUPs) in water

Water operators need to be efficient, accountable, honest public institutions providing a universal service. Many water services however lack the institutional strength, the human resources, the technical expertise and equipment, or the financial or managerial capacity to provide these services. They need support to develop these capacities. The vast majority of water operators in the world are in the public sector – 90% of all major cities are served by such bodies. This means that the largest pool of experience and expertise, and the great majority of examples of good practice and sound institutions, are to be found in existing public sector water operators. Because they are public sector, however, they do not have any natural commercial incentive to provide international support. Their incentive stems from solidarity, not profit. Since 1990, however, the policies of donors and development banks have focussed on the private companies and their incentives. The vast resources of the public sector have been overlooked, even blocked by pro-private policies. Out of sight of these global policy-makers, however, a growing number of public sector water companies have been engaged, in a great variety of ways, in helping others develop the capacity to be effective and accountable public services. These supportive arrangements are now called 'public-public partnerships' (PUPs). A public-public partnership (PUP) is simply a collaboration between two or more public authorities or organisations, based on solidarity, to improve the capacity and effectiveness of one partner in providing public water or sanitation services. They have been described as: “a peer relationship forged around common values and objectives, which exclude profit-seeking”.1 Neither partner expects a commercial profit, directly or indirectly. This makes PUPs very different from the public–private partnerships (PPPs) which have been promoted by the international financial institutions (IFIs) like the World Bank. The problems of PPPs have been examined in a number of reports. A great advantage of PUPs is that they avoid the risks of such partnerships: transaction costs, contract failure, renegotiation, the complexities of regulation, commercial opportunism, monopoly pricing, commercial secrecy, currency risk, and lack of public legitimacy.2 PUPs are not merely an abstract concept. The list in the annexe to this paper includes over 130 PUPs in around 70 countries. This means that far more countries have hosted PUPs than host PPPs in water – according to a report from PPIAF in December 2008, there are only 44 countries with private participation in water. These PUPs cover a period of over 20 years, and been used in all regions of the world. The earliest date to the 1980s, when the Yokohama Waterworks Bureau first started partnerships to help train staff in other Asian countries. Many of the PUP projects have been initiated in the last few years, a result of the growing recognition of PUPs as a tool for achieving improvements in public water management. This paper attempts to provide an overview of the typical objectives of PUPs; the different forms of PUPs and partners involved; a series of case studies of actual PUPs; and an examination of the recent WOPs initiative. It then offers recommendations for future development of PUPs.

Developing “middle leaders” in the public services? The realities of management and leadership development for public managers

Purpose – This paper aims to assess the actual contribution to organisational change of management and leadership development (MLD) activity for middle managers (MMs) in public service organisations (PSOs). Design/methodology/approach – Using the case study approach, the paper compares the content and outcomes of management and leadership training interventions for MMs in two large PSOs. The organisations, a fire brigade and a train operating company, are leaders in their sectors with respect to management development and “modernisation” of their services. Findings – The paper demonstrates how, in one case, MM development was largely an exercise in regulatory compliance, with little effect on individual MMs' performance or organisational outcomes. The second case demonstrates how MMs were effectively trained to enforce specific human resource policies which contributed to the successful implementation of top-down strategy yet paid little attention to the potential leadership role of MMs. Research limitations/implications – The paper highlights the need for further contextualised research at organisational level into the outcomes of MLD, especially in terms of different public service contexts. Practical implications – The paper demonstrates the dangers of designing and implementing development programmes without sufficient regard to professional practice and the realities of managerial discretion in PSOs. Originality/value – The paper provides an in-depth and contextualised insight into the conditions for success and failure in management development interventions in PSOs.

Public sector pay in the UK: has the historic pattern of public/private sector pay movements been broken?

The historic pattern of public sector pay movements in the UK has been counter-cyclical with private sector pay growth. Periods of relative decline in public sector pay against private sector movements have been followed by periods of ‘catch-up’ as Government controls are eased to remedy skill shortages or deal with industrial unrest among public servants. Public sector ‘catch up’ increases have therefore come at awkward times for Government, often coinciding with economic downturn in the private sector (Trinder 1994, White 1996, Bach 2002). Several such epochs of public sector pay policy can be identified since the 1970s. The question is whether the current limits on public sector pay being imposed by the UK Government fit this historic pattern or whether the pattern has been broken and, if so, how and why? This paper takes a historical approach in considering the context to public sector pay determination in the UK. In particular the paper seeks to review the period since Labour came into office (White and Hatchett 2003) and the various pay ‘modernisation’ exercises that have been in process over the last decade (White 2004). The paper draws on national statistics on public sector employment and pay levels to chart changes in public sector pay policy and draws on secondary literature to consider both Government policy intentions and the impact of these policies for public servants.