Accounting and the “Doctor-Manager Relationship”

The adoption of the “new public management” in the hospital sector brought about greater presence and power to professional managers in hospitals, thus increasing the risk of conflict in the doctor-manager relationship. Aiming to enrich the discussion on the factors that could be the bases for this conflict and considering the role of accounting, the study presented here corresponds, basically, to what we call “content analysis” of qualitative studies. The results demonstrate that the Portuguese doctors as the sample studied accept, in essence, the principles of enterprise management and recognize the use of accounting information in the scope of their functions as long as they are called to participate as legitimate actors, and authorities respect their desires to preserve a practice which they consider of quality.

Capital Intelectual: sua divulgação no setor bancário em Portugal

The importance of intangible resources has increased dramatically in recent years comparing to tangible ones. The economy in which we live is the result of competitive pressures that have imposed the implementation of business at an international level as well as a requirement in the application of sophisticated technologies that allow us to follow this fast evolution. In this age of information and innovation organizations will only survive if they are inserted in a global network of strategic relations, generically called as the network economy by Lev (2003). The service sector has stood out against the more traditional sectors of the economy. The intensive use of knowledge and a strong customer orientation created a new reality in today’s organizations: a growing importance attached to innovation, to the quality of products and services offered, to the information and communication technologies adopted, and to the creativity and particular abilities of human resources. The concept of intangible assets is more common in an accounting language and intellectual capital is most often applied in the context of management, being associated with a more comprehensive, multidimensional approach, representing all the knowledge that the institution owns and that it applies in the form of expertise, the creativity and organizational competencies that lead to innovation and to the sustained attainment of future economic benefits. An analysis of the scope of intellectual capital is fundamental to take more appropriate management decisions so that a more appropriate accounting treatment could be given by the accounting standardization organizations. This study intends to analyse the practices of information disclosure of the intellectual capital in the banking sector in Portugal, complementing the analysis of the disclosure of intangible assets in the context of accounting standards with the disclosure of intellectual capital in the context of organizational management. In particular, our main aims are to identify the extent of disclosure of intellectual capital made by banks in Portugal and also to identify the factors that determine such a disclosure. The disclosure in the context of accounting standards will be studied by checking the disclosure of intangible assets through the items listed in the International Accounting Standard 38 developed by the International Accounting Standards Board. The context of management was analysed by means of creating a voluntary disclosure index based on assumptions of the model Intellectus, developed by the Centro de Investigación sobre la Sociedad del Conocimiento – Instituto de Administración de Empresas (CIC-IADE) of the Universidad Autónoma of Madrid, and of the model Intellectual Capital Statement (made in Europe) (InCaS), both promoted by the European Commission and that we have adapted to the banking sector. When analysing the disclosure of intangible assets based on the context of accounting standards and the voluntary disclosure of intellectual capital, this study has tried to raise awareness about the importance of issuing reports on the intellectual capital as an alternative tool to take management decisions in the existing organizations and reflects the transparency and legitimacy that these institutions seek through a more extensive and more detailed information disclosure of their intellectual capital. Based on a complimentarily of economic theories, together with social and political theories, we tried to check the extent, evolution and tendencies of the compulsory disclosure of intangible assets and of the voluntary disclosure of the intellectual capital analysed in the period 2001-2011. Banks characteristics were also analysed in order to deduce those factors that determine or promote a larger disclosure in this sector. Based on these objectives, we adopted a longitudinal approach to explore the extent and the development of the disclosure of intangible assets as well as the factors that have determined it. Furthermore, we sought to assess the impact of the adoption of IAS 38 in the financial statements of the organizations in this sector. The disclosure index created on the basis of the disclosure requirements stated in IAS 38 from IASB was applied to the consolidated financial statements of the seventeen banks that rendered their statements in Portugal from 2001 to 2009. Since the information disclosed in the context of accounting standards may not have an important role as a management tool once it was not able to reflect what really contributes to the competitiveness and organizational growth, the voluntary disclosure of the intellectual capital was analysed according to the information obtained from the 2010 annual individual reports of the banks operating in Portugal in that year and from their respective websites in 2011. We tried to analyse the extent of the voluntary disclosure of the intellectual capital and of each of its components, human capital, structural capital and relational capital. The comparative analysis of their annual reports and their web pages allowed us to assess the incidence of the disclosure and discover what channel the banking sector focuses on when disclosing their intellectual capital. Also in this analysis the study of the disclosure determinants has allowed us to conclude about the influence of particular characteristics in the voluntary disclosure of the intellectual capital. The results of the analysis to the extent of the disclosure of intangible assets in the consolidated financial statements of the banking groups in Portugal in the period 2001-2009 have shown an average information disclosure of 0.24. This information disclosure evolved from an average value of 0.1940 in 2001 to 0.2778 in 2009. The average value is 0.8286 if it is only considered the disclosure of the intangible assets that the banks possessed. The evolution of this index means an increase in the average disclosure from 0.7852 in 2001 to 0.8788 in 2009. From the first results that are related to the extent of the disclosure of intangible assets in the financial statements, we can verify that the banking groups present a low disclosure level of these resources. However, when considering the disclosure of only the intangible assets that each institution owns, the disclosure level appears to be in compliance with the disclosure requirements for this sector. An evolution in the disclosure of intangible assets for the period considered was confirmed, showing an increase in the information disclosure of intangible assets in 2005, the year in which the accounting rules for intangible assets changed. The analysis that focused on the disclosure in the context of management tried to understand the extent, the incidence and the determinants of the voluntary information disclosure of intellectual capital in the annual reports of 2010 and on their web pages in 2011, studying the 32 banks operating in Portugal in this period. The average voluntary disclosure of the intellectual capital in the 2010 annual reports is 0.4342 while that in web pages is 0.2907. A review of the components of the intellectual capital allowed us to assess the importance that the banks confer to each of these components. The data obtained show that the relational capital, and more specifically the business capital, is the most disclosed component by banks in Portugal both in the annual reports and in their institutional web pages, followed by the structural capital and, finally, by the human capital. The disclosure of the human capital and the structural capital is higher in the annual reports than that in the websites, while the relational capital is more disclosed in the websites than in the annual reports. The results have also shown that the banks make a complementary use of both sources when disclosing information about their structural capital and relational capital but they do not show any information about their human capital in their websites. We tried to prove the influence of factors that could determine the accounting disclosure and the voluntary disclosure of the intellectual capital in this sector. The change in the IASB accounting rules as from January 1st 2005 gave a greater disclosure of accounting information of intangible assets in the financial statements of banks. The bank size and corporate governance measures have statistically proved to have an influence on the extent of the accounting disclosure of intangible assets and on the voluntary disclosure of the intellectual capital. Economic and financial variables such as profitability, operating efficiency or solvency were not determinants of information disclosure. The instability that the banking sector has experienced in economic and financial indicators in recent years as a result of the global financial markets imbalance has worsen indicators such as profitability, efficiency and solvency and caused major discrepancies in the economic situation between banks in Portugal. This empirical analysis has contributed to confront the disclosure required by accounting rules performed in the financial statements of organizations with that performed in the main disclosure media which is available for entities and which is increasingly requested in the process of taking management decisions. It also allowed us to verify whether there is homogeneity between institutions in the fulfilment of the requirements for information disclosure of intangible assets. However, as for voluntary disclosure of intellectual capital, there are large disparities in the disclosure extent between organizations. Regardless of this sector specific characteristics, the voluntary disclosure of intellectual capital made by banks in Portugal follows the trends in other sectors and the practices adopted in other countries, namely regarding the amount of information disclosed, the incidence of the disclosure on the indicators of relational capital and the importance of variables such as size as determinants of disclosure of intellectual capital. For a further knowledge in this field, we created a specific index for the banking sector, considering appropriate indicators for an incisive, comprehensive analysis in order to consider the most relevant indicators of intellectual capital components. Besides, confronting the analysis of disclosure in the context of accounting standards with the study of voluntary disclosure brought a new analysis approach to the research on intellectual capital disclosure. With this study, we have also intended to raise greater awareness of the need for harmonization in the intellectual capital disclosure on the part of the regulatory banking authority by means of a demanding, consistent and transparent report of intellectual capital with simple, clear, objective indicators so that those interested in disclosing intellectual capital information in the organizations in this sector may obtain more harmonized and comparable information. A research on the disclosure quality of intellectual capital, together with the application of other analysis methodologies in this sector, might be a promising approach for future research. Applying the voluntary disclosure index to the same sector in other countries may also contribute to the knowledge of disclosure practices in different geographical environments. We highlight the relevance of further studies contributing to the harmonization and consistency in the presentation of an intellectual capital report so as to enable organizations to disclose the resources that contribute most to their competitiveness and growth.

Determinant factors of the implementation of the balanced scorecard in Portugal: empirical evidence in public and private organizations

In this article we aim to identify and analyze a set of variables that can potentially influence the adoption of the Balanced Scorecard (BSC)in Portugal. Hypotheses were tested using data obtained from a questionnaire sent to 591 publicly-owned organizations (local governments, municipal corporations and hospitals) and 549 privately-owned organizations (large companies and small and medium enterprises) in Portugal, with an overall response rate of 31.3%. The results allow us to conclude that although the majority of respondents claimed to know the BSC, its use in Portugal is still limited and very recent, particularly in the public sector organizations. However, it should be noted that its use has increased in Portugal in recent years. Using as theoretical framework the contingency and institutional theories, we found that decentralization, vertical differentiation and the degree of higher education are associated with the implementation of the BSC.

Conceptual design of a mechatronic system for supporting basic quality of life of bedridden elderly people

Ambient Assisted Living is an important subject to be explored and developed, especially in developed countries, due to the increasing number of aged people. In this context the development of mechatronic support systems for bedridden elderly people (BEP) living in their homes is essential in order to support independence, autonomy and improve their quality of life. Some basic tasks as eating, taking a bath and/or hygiene cares become difficult to execute, regarding that often the main caregiver is the other element of the aged couple (husband or wife). This paper presents the conceptual design of a mechanical system especially devoted to assist the caregiver in the handling and repositioning of the BEP. Issues as reducing the number of caregivers, to only one, and reducing the system's handling complexity (because most of the time it will be used by an aged person) are considered. The expertise obtained from the visits to rehabilitation centers and hospitals, and from working meetings, are considered in the development of the proposed mechatronic system.

A HIPÓTESE INTEGRADORA DA GOVERNANÇA CORPORATIVA E DA RESPONSABILIDADE SOCIAL CORPORATIVA SOB O ENFOQUE DOS DIREITOS HUMANOS

A governança corporativa e a responsabilidade social corporativa são dois instrumentos que têm o caráter de atingir a excelência da organização empresarial. Por sua vez, os mesmos foram instrumentalizados como meio de proteção dos interesses dos agentes privados com vista à potencialização da sociedade empresarial, motivados pela desconfiança dos processos decisórios dos administradores societários. Posteriormente, evoluiram sob a forma de códigos de condutas, ditados pelos organismos de controle empresarial, sempre conservando o caráter voluntário de sua aceitação. Alguns objetivos sequer foram incluídos nos seus processos internos de excelência, como por exemplo os direitos humanos de determinados stakeholders. Esse ponto é o objeto principal desta investigação, que busca evidenciar a hipótese de integração da governança corporativa e da responsabilidade social corporativa sob o enfoque dos direitos humanos. § The Corporate governance and corporate social responsibility are two instruments that have the character to achieve excellence in business organization. On the other hand, they have been exploited as a way of protecting the interests of private agents for enhancement of corporate society, motivated by the distrust of the decision-making process of corporate managers. Later, it evolved in the form of codes of conduct, dictated by the bodies of corporate control, always preserving the voluntary nature of their acceptance. Some objectives were not even included in its internal process of excellence, such as the human rights of certain stakeholders. This point is the main object of this research, which seeks to demonstrate the possibility of integration of corporate governance and corporate social responsibility in the human rights perspective.

Use of Performance Measurement in the Public Sector: the case of the police service

Many public organisations have been under great pressure in recent years to increase the efficiency and transparency of outputs, to rationalise the use of public resources, and to increase the quality of service delivery. In this context, public organisations were encouraged to introduce the New Public Management reforms with the goal of improving the efficiency and effectiveness of the performance organisation through a new public management model. This new public management model is based on measurement by outputs and outcomes, a clear definition of responsibilities, the transparency and accountability of governmental activities, and on a greater value for citizens. What type of performance measurement systems are used in police services? Based on the literature, we see that multidimensional models, such as the Balanced Scorecard, are important in many public organisations, like municipalities, universities, and hospitals. Police services are characterised by complex, diverse objectives and stakeholders. Therefore, performance measurement of these public services calls for a specific analysis. Based on a nationwide survey of all police chiefs of the Portuguese police force, we find that employee performance measurement is the main form of measurement. Also, we propose a strategic map for the Portuguese police service.

Organisational and professional commitments: the influence in nurses´organizational citizenship behaviours

The way an employee behaves in his work can be influenced by the organisational and professional commitment. Nurses are professionals who are guided by organisational and professional goals and values. Among nurses, professional commitment may be an important antecedent of organisational citizenship behaviours. The study shows how organisational and professional commitment is related with nurses’ organisational citizenship behaviours. Data from a sample of 420 nurses working in two hospitals --- the Hospital of St. Marcos, Braga and the Hospital Centre of Alto Ave, Guimarães and Fafe units were collected. The main findings are as follows: (a) organisational commitment and professional commitment contribute to the explanation of nurses’ organisational citizenship behaviours, (b) affective organisational commitment, continuance organisational commitment --- personal sacrifice, affective professional commitment and continuance professional commitment explain 28.6% of variance of organisational citizenship behaviours. © 2013 Instituto Politécnico do Cávado e do Ave (IPCA). Published by Elsevier España, S.L.U. All rights reserved.

Social Work in the Portuguese empire Health Services

Muitos historiadores, particularmente estrangeiros, que vêem Portugal “de fora”, têm-se mostrado críticos do mau desempenho do império colonial português.Aintolerância religiosa, uso excessivo de força para conseguir o monopólio de especiarias, são alguns aspectos que mereceram críticas mais duras [Devo admitir que fui eu um destes críticos!] mas quase sempre bem fundamentadas e difíceis de rejeitar. Mas é preciso admitir que a história colonial portuguesa é também feita de elementos positivos e menos violentos. Os portugueses devem ser considerados pioneiros de assistência social através das suas políticas inovadoras que providenciaram cuidados para os doentes e desgraçados, embora estas políticas não abrangessem os sujeitos não-Cristãos do império.

Assessment of a strategy for the control of respiratory diseases in children

A programme for the control of respiratory diseases in children was conceived for the State of S. Paulo, Brazil, in 1986. Its progress thereafter and the epidemiology of the diseases concerned are examined. Apart from an inquiry into the 64 existing State local health authorities, a sample of 18,255 cases of children assisted by the programme at different levels, including both in-patient and outpatient care, is analysed. Each case record included information about identification (child, doctor and health facility), reasons for calling, diagnoses made and outcome of treatment. Further data were also sought from hospitals and from State mortality records. The programme was found to be poorly implemented in the State but, where implemented, it showed itself capable of resolving problems (only 0.5% of the cases could not be handled) as also of changing ongoing trends (more than 50% reduction in hospital admission rates). Individual assessment of each item of the programme indicated its bottlenecks. Regarding the epidemiology of respiratory diseases, it is observed that the major burden to health services comes from children aged less than five, and that the most important diseases are wheezing illnesses and pneumonia. Morevoer, they were found to be significantly associated (p = 0.000) so that a child in the community presenting wheezing diseases is 5 times more likely to develop pneumonia than a child with any other respiratory diagnosis. Similarly, among the under five deaths it was found that the risk for pneumonia is 3 times greater for children who died presenting wheezing diseases than it is for children with any other sort of diagnosis. In conclusion, the programme is deemed to be efficient and effective but its efficacy is marred by administrative flaws. The successful control of respiratory problems in childhood is related to a proper appreciation of the importance of wheezing diseases.

Effects of exposure to formaldehyde and tobacco smoking on genotoxicity biomarkers

Formaldehyde (FA) is a colour less gas widely used in the industry and hospitals as an aqueous solution, formalin. It is extremely reactive and induces various genotoxic effects in proliferating cultured mammalian cells. Tobacco smoke has been epidemiologically associated to a higher risk of development of cancer, especially in the oral cavity, larynx and lungs, as these are places of direct contact with many carcinogenic tobacco’s compounds. Approximately 90% of human cancers originate from epithelial cells. Therefore, it could be argued that oral epithelial cells represent a preferred target site for early genotoxic events induced by carcinogenic agents entering the body via inhalation and ingestion. The cytokinesis-blocked micronucleus assay (CBMN) in human lymphocytes is one of the most commonly used methods for measuring DNA damage, namely the detection of micronucleus, nucleoplasmic bridges, and nuclear buds.

Evaluation of the influence of the ADH3 ILE349VAL polymorphism in the frequency of genotoxicity biomarkers in workers exposed to formaldehyde and tobacco smoking

Formaldehyde (FA) is a colourless gas widely used in the industry and hospitals as an aqueous solution, formalin. It is extremely reactive and induces various genotoxic effects in proliferating cultured mammalian cells. Tobacco smoke has been epidemiologically associated to a higher risk of development of cancer, especially in the oral cavity, larynx and lungs, as these are places of direct contact with many carcinogenic tobacco’s compounds. Genetic polymorphisms in enzymes involved in the metabolism are very important and can make changes in the individual susceptibility to disease. Alcohol dehydrogenase class 3 (ADH3), also known as formaldehyde dehydrogenase dependent of glutathione, is the major enzyme involved in the formaldehyde oxidation, especially in the buccal mucosa. The polymorphism in study is a substitution of an isoleucine for a valine in codon 349. The cytokinesis-blocked micronucleus assay (CBMN) in human lymphocytes is one of the most commonly used methods for measuring DNA damage, namely the detection of micronucleus, nucleoplasmic bridges, and nuclear buds, classified as genotoxicity biomarkers.

Mortality among patients with non-affective functional psychoses in a metropolitan area of South-Eastern Brazil

High mortality rates among those suffering from schizophrenia and related psychoses have been consistently described in developed societies. However, to date there is a lack of data on this matter in Brazil. In order to examine this issue, a prospective 2-year follow-up study was carried out in S. Paulo. The sample consisted of 120 consecutive admissions to psychiatric hospitals in a defined catchment area, aged 18 to 44 years old, with clinical diagnoses of non-affective functional psychoses according to the ICD-9. After 2 years, 116 (96.7%) subjects were traced. During the study period there were 7 deaths (6.0% of those traced), 5 (4.3%) due to suicide. All but one of the suicides occurred in the first year after discharge from hospital. Age and sex Standardised Mortality Ratios (relative to rates for the population of the city of Sao Paulo) were 8.4 for overall mortality (95% confidence interval: 4.0-15.9) and 317.9 for deaths due to suicide (95% confidence interval: 125.2-668.3). These results are in agreement with previous studies, and show that in Brazil non-affective functional psychoses are life-threatening illnesses, which need adequate care, particularly when patients go back to live in the community after hospital discharge.

Demographic profile and health conditions of the elderly in a community in an urban area of Southeastern Brazil

Some specific characteristics of the aging of the Brazilian population in different areas, states and communities all over the country, have shown significant variations. Historical series of demographic and health indicators for the population in their sixties and over in Brazil, state of S. Paulo and in the municipal district of Araraquara are listed as follows: level of education and urban population growth rate, income distribution, mortality rates and main causes of death. In 1991 the aged constituled were 7,8% of the Brazilian population and 9,7% in Araraquara community. The elderly population (of 70 years of aged and above) as a proportion of the whole, has increased and already stands for 40%. The same trend holds good for both the proportion of aged within the urban population and their level of education wich increased to 90% in 1991. The main causes of death are chronic degenerative diseases which have replaced the infectious illness: firts, the diseases of the circulatory sistem (which account for more than 40% of all deaths) and the neoplasms (which let to 15% of the deaths). On the basis of these health and demographic data relating to people of 60 years of age and over, this study suggests some procedures for the improvement of the quality of the assistance given to the target population: a) the assistance give to the aged should be improved by providing gerontological training for general physicians and nurses, both of public and private clinics; b) the already exixting educational activities for the aged, for health workers and for teachers of secundary education should be further developed; c) the number of day-hospitals should be increased for the purpose of avoiding unnecessary confinement so as maintain the low rate of institutionalization in homes for the elderly (0,7% in Araraquara). It is reported that at least 35% of the aged population in this area is entitled to private health assistance, wich brings out the importance of including such services in the local health programs for this group.

Revestimento vinílico em pavimentos: características, execução e patologia

O desenvolvimento industrial, tecnológico e económico, conduziu ao aparecimento de soluções construtivas e de revestimentos disponíveis no mercado da construção, cada vez mais eficientes e economicamente vantajosas. Uma dessas soluções é o revestimento vinílico em pavimentos, utilizado a nível mundial principalmente em escritórios, hospitais e escolas. A sua resistência ao tráfego pedonal e facilidade de aplicação e manutenção fazem dele um revestimento de eleição. No entanto esta aparente versatilidade acaba por colocar dificuldades aos profissionais do projecto, da construção e da reabilitação de edifícios, em particular na escolha das melhores soluções para cada tipo de utilização. É pois importante que estes profissionais disponham de orientações práticas para que façam as suas escolhas de um modo objectivo. O presente trabalho propõe o desenvolvimento de uma análise aprofundada deste tipo de material, onde são abordadas as suas exigências funcionais, modo de aplicação e patologia associada, tentando evitar-se deste modo a ocorrência de eventuais erros sistemáticos e recorrentes.

Risk factors for perinatal mortality in an urban area of Southern Brazil, 1993

INTRODUCTION: Although there was a considerable reduction in infant mortality in Pelotas, Rio Grande do Sul in the last decade, its perinatal causes were reduced only by 28%. The associated factors of these causes were analised. MATERIAL AND METHOD: All hospital births and perinatal deaths were assessed by daily visits to all the maternity hospitals in the city, throughout 1993 and including the first week of 1994. RESULTS: The perinatal mortality rate was 22.1 per thousand births. The multivariate analysis showed the following risk factors: low socioeconomic level, male sex and maternal age above 35 years . Among multigravidae women, the fetal mortality rate was significantly increased for mothers with a previously low birthweight and a previous stillbirth. For early neonatal mortality the risk was significantly increased by a smaller number of antenatal visits than 5 and low birthweight. CONCLUSIONS: Main risk factors for perinatal mortality: low socioeconomic level, maternal age above 35 years and male sex. For early neonatal mortality the risk was significantly increased by a smaller number of antenatal visits than 5 and low birthweight.