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

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

O enredo prisional em Angola: soberanias duais na disciplina do corpo colonial

A análise das estruturas de aprisionamento necessita de atender ao quadro institucional no qual se encontra enquadrado. A compreensão das finalidades às quais reporta apenas pode ser captada na alusão a um quadro teórico e conceptual que não se cinja à apreensão restrita das suas mais evidentes manifestações. O enredo da Angola colonial, no qual nos focamos, imprime a necessidade de nos afastarmos dos recorrentes estudos que tendem a evidenciar a brutalidade da prática repressiva no interior das prisões, menosprezando, por iminência, uma análise que capte as características longitudinais que ditam as estruturas administrativas das suas bases materiais. Assente na defesa de um alargamento conceptual das práticas de confinamento, pretende esta investigação contribuir para os estudos que atendem à necessidade destes estabelecimentos serem analisados à luz de outras instâncias, nomeadamente o trabalho forçado e o incipiente poder infraestrutural do estado colonial. De forma a alcançar tal propósito esta dissertação concebe uma análise que contrapõe às finalidades impressas nos códigos legais dos estatutos criminais coloniais os relatórios arquivísticos. Estes dão conta da prática que regia o modus operandi destes estabelecimentos e atestam a debilidade morfológica do poder estatal colonial. É face a tal que se apresenta, numa última análise, as instâncias que nos permitem pensar o enredo edificado pelas empresas concessionárias no território colonial numa relação de analogia com a prisão colonial. Tal comparação é aqui edificada pelo recurso ao estudo de caso da Companhia de Diamantes de Angola, problematizando-se o modo como esta empresa substituía o poder do estado colonial ao implementar políticas públicas de gestão e controlo das massas trabalhadoras que se encontravam sob a sua alçada.

Opa e fusão

Control of a public company can be obtained through several ways, of which the tender offer and the merger are only two. We attempt to understand what are the risks involved in the appearance of a control position. Such underlying risks justify the rationality of the mandatory bid rule, as well as the consequences of said rule. Finally, we attempt to understand if the interests of the minority shareholders are duly defended in the case of control being acquired through merger, since that is the understanding of the legislator.

Effect of Emotion and Personality on Deviation from Purely Rational Decision-Making

Human decision-making has consistently demonstrated deviation from "pure" rationality. Emotions are a primary driver of human actions and the current study investigates how perceived emotions and personality traits may affect decision-making during the Ultimatum Game (UG). We manipulated emotions by showing images with emotional connotation while participants decided how to split money with a second player. Event-related potentials (ERPs) from scalp electrodes were recorded during the whole decision-making process. We observed significant differences in the activity of central and frontal areas when participants offered money with respect to when they accepted or rejected an offer. We found that participants were more likely to offer a higher amount of money when making their decision in association with negative emotions. Furthermore, participants were more likely to accept offers when making their decision in association with positive emotions. Honest, conscientious, and introverted participants were more likely to accept offers. Our results suggest that factors others than a rational strategy may predict economic decision-making in the UG.

Aspectos hidrológicos en el fondo marino peruano asociados a la Extensión Sur de la Corriente Cromwell (ESCC) entre 3° y 7°S

Para determinar la variabilidad estacional y espacial en el fondo marino del norte peruano, durante los últimos 30 años (1980-2009), se estudió la temperatura y el oxígeno disuelto entre las latitudes 3°-7°S. Se halló una mayor proyección latitudinal del oxígeno disuelto (OD), superior a 1,0 mL/L en la estación de otoño, delimitada por la isoterma de 15 °C al borde de la plataforma. Esta proyección estaría asociada a los flujos subsuperficiales hacia el sur, que constituyen la Extensión Sur de la Corriente de Cromwell (ESCC), a profundidades de 90-180 m. La oxigenación estaría influenciada por el incremento o repliegue de la ESCC presente en el área. La variación media de oxígeno registra valores de 0,7-1,3 mL/L en verano y 0,8-1,6 mL/L en otoño. Paita (5°S) presenta valores promedio de 1,0 mL/L en verano y de 1,4 mL/L en otoño. Los mayores valores de OD se asocian a latitudes menores en ambas estaciones; la estación de otoño presenta los mayores tenores de oxígeno, asociados a una mayor intensidad de la ESCC.

Caracterización de la Zona de Mínimo de Oxígeno (ZMO) frente a la costa peruana entre 3°N y 14°S, 1999 - 2009

Se analizaron datos de oxígeno disuelto, frente a las costas del Perú, para comprender las variaciones de la ZMO, caracterizadas por: a) el espesor de esa zona, limitada por las isolíneas de oxígeno de 0,5 mL.L-1; y b) la profundidad de su límite superior en la franja marino costera. Se muestran los resultados de las evaluaciones en la columna de agua, en la bahía de Callao en el periodo 1999 – 2009, y además en enero - febrero 2009 en un estudio de la ZMO, durante el Crucero Meteor 77-4 0901-02: Interacción en el Océano Tropical, Biogeoquímica y Clima. En la zona costera del Callao (12°S) se acentúa la hipoxia; la ZMO se ve restringida por la plataforma y su límite superior más superficial se ubicó a los 2,5 m de profundidad. A partir de la información obtenida en enero–febrero 2009 (Crucero 0901-02) se analizó la variabilidad espacial de la ZMO, en donde se halló un espesor de ~637,8 m, en la sección Punta Falsa (6°S). Se analizó la dinámica de la ZMO y su límite superior, debido al gran interés que ha tomado, por el posible incremento de su espesor, en el contexto de cambio climático, con grandes repercusiones sobre los recursos pesqueros.

Nietzsche's eternal recurrence of the same : the effect of logic abridgement, contradictions and inconsistencies

I will argue that the doctrine of eternal recurrence of the same no better interprets cosmology than pink elephants interpret zoology. I will also argue that the eternal-reiurn-of-the-same doctrine as what Magnus calls "existential imperative" is without possibility of application and thus futile. To facilitate those arguments, the validity of the doctrine of the eternal recurrence of the same will be tested under distinct rubrics. Although each rubric will stand alone, one per chapter, as an evaluation of some specific aspect of eternal recurrence, the rubric sequence has been selected to accommodate the identification of what I shall be calling logic abridgments. The conclusions to be extracted from each rubric are grouped under the heading CONCLUSION and appear immediately following rubric ten. Then, or if, at the end of a rubric a reader is inclined to wonder which rubric or topic is next, and why, the answer can be found at the top of the following page. The question is usually answered in the very first sentence, but always answered in the first paragraph. The first rubric has been placed in order by chronological entitlement in that it deals with the evolution of the idea of eternal recurrence from the time of the ancient Greeks to Nietzsche's August, 1881 inspiration. This much-recommended technique is also known as starting at the beginning. Rubric 1 also deals with 20th. Century philosophers' assessments of the relationship between Nietzsche and ancient Greek thought. The only experience of E-R, Zarathustra's mountain vision, is second only because it sets the scene alluded to in following rubrics. The third rubric explores .ii?.ih T jc,i -I'w Nietzsche's evaluation of rationality so that his thought processes will be understood appropriately. The actual mechanism of E-R is tested in rubric four...The scientific proof Nietzsche assembled in support of E-R is assessed by contemporary philosophers in rubric five. E-R's function as an ethical imperative is debated in rubrics six and seven.. .The extent to which E-R fulfills its purpose in overcoming nihilism is measured against the comfort assured by major world religions in rubric eight. Whether E-R also serves as a redemption for revenge is questioned in rubric nine. Rubric ten assures that E-R refers to return of the identically same and not merely the similar. In addition to assemblage and evaluation of all ten rubrics, at the end of each rubric a brief recapitulation of its principal points concludes the chapter. In this essay I will assess the theoretical conditions under which the doctrine cannot be applicable and will show what contradictions and inconsistencies follow if the doctrine is taken to be operable. Harold Alderman in his book Nietzsche's Gift wrote, the "doctrine of eternal recurrence gives us a problem not in Platonic cosmology, but in Socratic selfreflection." ^ I will illustrate that the recurrence doctrine's cosmogony is unworkable and that if it were workable, it would negate self-reflection on the grounds that selfreflection cannot find its cause in eternal recurrence of the same. Thus, when the cosmology is shown to be impossible, any expected ensuing results or benefits will be rendered also impossible. The so-called "heaviest burden" will be exposed as complex, engrossing "what if speculations deserving no linkings to reality. To identify ^Alderman p. 84 abridgments of logic, contradictions and inconsistencies in Nietzsche's doctrine of eternal recurrence of the same, I. will examine the subject under the following schedule. In Chapter 1 the ancient origins of recurrence theories will be introduced. ..This chapter is intended to establish the boundaries within which the subsequent chapters, except Chapter 10, will be confined. Chapter 2, Zarathustra's vision of E-R, assesses the sections of Thus Spoke Zarathustra in which the phenomenon of recurrence of the same is reported. ..Nihilism as a psychological difficulty is introduced in this rubric, but that subject will be studied in detail in Chapter 8. In Chapter 2 the symbols of eternal recurrence of the same will be considered. Whether the recurrence image should be of a closed ring or as a coil will be of significance in many sections of my essay. I will argue that neither symbolic configuration can accommodate Nietzsche's supposed intention. Chapter 3 defends the description of E-R given by Zarathustra. Chapter 4, the cosmological mechanics of E-R, speculates on the seriousness with which Nietzsche might have intended the doctrine of eternal recurrence to be taken. My essay reports, and then assesses, the argument of those who suppose the doctrine to have been merely exploratory musings by Nietzsche on cosmological hypotheses...The cosmogony of E-R is examined. In Chapter 5, cosmological proofs tested, the proofs for Nietzsche's doctrine of return of the same are evaluated. This chapter features the position taken by Martin ' Heidegger. My essay suggests that while Heidegger's argument that recurrence of the same is a genuine cosmic agenda is admirable, it is not at all persuasive. Chapter 6, E-R is an ethical imperative, is in essence the reporting of a debate between two scholars regarding the possibility of an imperative in the doctrine of recurrence. Their debate polarizes the arguments I intend to develop. Chapter 7, does E-R of the same preclude alteration of attitudes, is a continuation of the debate presented in Chapter 6 with the focus shifted to the psychological from the cosmological aspects of eternal recurrence of the same. Chapter 8, Can E-R Overcome Nihilism?, is divided into two parts. In the first, nihilism as it applies to Nietzsche's theory is discussed. ..In part 2, the broader consequences, sources and definitions of nihilism are outlined. My essay argues that Nietzsche's doctrine is more nihilistic than are the world's major religions. Chapter 9, Is E-R a redemption for revenge?, examines the suggestion extracted from Thus Spoke Zarathustra that the doctrine of eternal recurrence is intended, among other purposes, as a redemption for mankind from the destructiveness of revenge. Chapter 10, E-R of the similar refuted, analyses a position that an element of chance can influence the doctrine of recurrence. This view appears to allow, not for recurrence of the same, but recurrence of the similar. A summary will recount briefly the various significant logic abridgments, contradictions, and inconsistencies associated with Nietzsche's doctrine of eternal recurrence of the same. In the 'conclusion' section of my essay my own opinions and observations will be assembled from the body of the essay.

Sediment genotoxicity and its relationship to the frequency of chironomid labial plate deformities

Sediment samples were taken from seven locations in the WeIland River in December 1986 and April 1987. The DMSO extracts of these sediment samples showed a significant (pbounded by an industrialized area were slightly toxic according to -the alkaline phosphatase inhib_ii~ion component of the 50S chromotest analyses. The toxicity of these samples was only evident once they had been activated by the 59 (liver extract) mixture.

Geochemistry and petrogenesis of the McElroy and Larder Lake assemblages, Abitibi Greenstone Belt, Northeastern Ontario

The McElroy and Larder Lake assemblages, located in the southern Abitibi Greenstone Belt are two late Archean metavolcanic sequences having markedly contrasting physical characteristics arid are separated from one another by a regional fault. An assemblage is an informal term which describes stratified volcanic and/or sedimentary rock units built during a specific time period in a similar depositional or volcanic setting and are commonly bounded by faults, unconformities or intrusions. The petrology and petrogenesis of these assemblages have been investigated to determine if a genetic link exists between the two adjacent assemblages. The McElroy assemblage is homoclinal sequence of evolved massive and pillowed fl.ows, which except for the basal unit represents a progressively fractionated volcanic pile. From the base to the top of the assemblage the lithologies include Fe-tholeiitic, dendritic flows; komatiite basaltic, ultramafic flows; Mg-tholeiitic, leucogabbro; Mg-tholeiitic, massive flows and Fe-tholeiitic, pillowed flows. Massive flows range from coarse grained to aphanitic and are commonly plagioclase glomerophyric. The Larder Lake assemblage consists of komatiitic, Mg-rich and Fe-rich tholeiitic basalts, structurally disrupted by folds and faults. Tholeiitic rocks in the Larder Lake assemblage range from aphanitic to coarse grained massive and pillowed flows. Komatiitic flows contain both spinifex and massive textures. Geochemical variability within both assemblages is attributed to different petrogenetic histories. The lithologies of the McElroy assemblage were derived by partial melting of a primitive mantle source followed by various degrees of crystal fractionation. Partial melting of a primitive mantle source generated the ultramafic flows and possibly other flows in the assemblage. Fractionation of ultramafic flows may have also produced the more evolved McElroy lithologies. The highly evolved, basal, dendritic flow may represent the upper unit 3 of a missing volcanic pile in which continued magmatism generated the remaining McElroy lithologies. Alternatively, the dendritic flows may represent a primary lava derived from a low degree (10-15%) partial melt of a primitive mantle source which was followed by continued partial melting to generate the ultramafic flows. The Larder Lake lithologies were derived by partial melting of a komatiitic source followed by gabbroic fractionation. The tectonic environment for both assemblages is interpreted to be an oceanic arc setting. The McElroy assemblage lavas were generated in a mature back arc setting whereas the Larder Lake lithologies were produced during the early stages of komatiitc crust subduction. This setting is consistent with previous models involving plate tectonic processes for the generation of other metavolcanic assemblages in the Abitibi Greenstone Belt.

Grant of Permission for lease of military lands from Sir Robert Prescott to Thomas Clark, 1798-1801.

Transcript (original spelling and grammar retained): By His Excellency Robert Prescott Esquire, Captain General and Governor in Chief in and over His Majestys Provinces of Upper and Lower Canada, General and Commander in Chief of all His Majesty’s forces in the Provinces of Upper and Lower Canada, Nova Scotia, New Brunswick and their several Dependencies and in the Island of Newfoundland &ca. &ca. &ca. I do hereby authorise and permit Thomas Clark of Queenstown in the County of Lincoln in the Province of Upper Canada merchant to take possession of all that Lot, piece and parcel of Land (being part of the land reserved by his Majesty for Military purposes) situate, lying and being at Queenstown in the Township of Newark, in the Home District in the said Province of Upper Canada, bounded and abutted as follows, that is to say beginning at the Distance of two Chains and ninety links from the South East End of his Majesty’s Store House, the said distance being measured along the Bank up Stream, thence South thirty nine degrees and an half West one Chain and fifty links thence south fifty degrees and an half East one Chain and thirty links thence North thirty nine degrees and an half East to the Edge of the Bank and from thence along the Bank to the place of beginning, containing thirty one perches and one hundred and twenty five square links and to occupy and hold the said Lot, piece and parcel of Land during pleasure subject nevertheless to the provisoes and Conditions herein after contained, that is to say. First on condition that it shall and may be lawful to and for His Majesty his Heirs and Successors and to and for the Commander in Chief of His Majesty Forces for the time being and to and for the Officer commanding his Majesty’s Forces in Upper Canada for the time being and to and for either of them to determine and make void this present permission to occupy during pleasure the said Lot, Piece or Parcel of Land above described at any time hereafter whenever he or they shall see fit so to do without any compensation or indemnification to the said Thomas Clark or any other Person or Persons whosoever for any Loss Injury or Damage which he the said Thomas Clark or any other Person or Persons whosoever may thereby sustain. Secondly on this further Condition that it shall and may be lawful to and for His Majesty his Heirs and Successors and to and for his and their Officers, Soldiers and Servants at any time hereafter by order of the Commander in Chief of His Majesty’s Forces for the time being or by order of the Officer commanding his Majesty’s forces in Upper Canada for the time being or by order of the Officer of His Majesty’s Corps of Royal Engineers commanding in the said Province of Upper Canada for the time being to enter upon the said Lot Piece and parcel of Land which the said Thomas Clark is hereby permitted to occupy during pleasure or upon any part thereof and to take down and from the said Lot piece and parcel of Land or from any part thereof to remove any dwelling House Store or other Buildings on the said Lot, piece or Parcel of Land or any part thereof erected and to remove any goods or Chattels on the said Lot piece and parcel of Land or on any part thereof or on any such dwelling House Store or other building found or being and that His Majesty his Heirs and Successors or any other Person or Persons whosoever shall not be liable or responsible to the said Thomas Clark or to any other Person or Persons whosoever for any Loss, Injury or Damage which he or they shall or may in such case sustain. Thirdly on this further Condition that the said Thomas Clark shall not erect on the said Lot Piece or Parcel of Land which the said Thomas Clark is hereby permitted to occupy during pleasure or upon any part thereof at any time or times hereafter any dwelling House store or other Building whatsoever of Stone or brick or of any other materials wood only exccepted and that if any dwelling House or Store or other building of Stone or brick or of any other materials except wood shall at any time be erected on the said Lot, piece or parcel of Land or upon any part thereof, then and in such case, this present permission and every Clause and Article thereof shall from thenceforth cease and determine and be absolutely and entirely null and void. And lastly on this further Condition that the said Thomas Clark or any other Person whosoever shall not assign this permission to occupy the said Lot, Piece or Parcel of Land above described to any Person of Persons whosoever, and if any such assignment shall be made by the said Thomas Clark or by any other Person in his right, or on his behalf, that then and in such case such assignment and this permission to occupy during pleasure the said Lot piece and parcel of Land above described, and every Clause and Article thereof shall from thenceforth cease and determine and be absolutely and entirely null and void. Given under my hand at the Castle of St. Lewis in the City of Quebec in the Province of Lower Canada this Ninth day of July in the year of our Lord one thousand seven hundred and ninety eight and in the thirty eighth year of His Majesty’s Reign. [Signed here by Robert Prescott] By Order of the Commander in Chief [Signed here by James Green (Illegible signature)] I the said Thomas Clark above named do hereby accept the above written Permission to occupy during pleasure the said Lot piece and parcel of Land above described upon and subject to the several Provisioes and Conditions above written and each and every of them severally and respectively. In witness whereof I have hereunto set my hand the Sixteenth day of August in the year of our Lord one thousand seven hundred and ninety eight and in the thirty eighth year of His Majesty’s Reign. [Signed here by Thomas Clark] Signed in the presence of [Illegible signature – looks like J. M Donell Lt. Col.] [Illegible – looks like 2d. Battn R. C. Sm?] [Signed here by C. Anderson] Whereas Inconveniences did arise from the peculiar situation of the Ground contiguous to the above described Lot of Land and the occupation thereof, if estimated by the above Limits would prove highly disadvantageous to Mr. Thomas Clark be it known that in consideration thereof we do permit the above Lot to extend one half Chain more in length up stream so as to comprehend the space allowed for the Road between Lots Two + Three, and we do hereby appropriate the said additional space wholly to the use of the said Thomas Clark. In witness whereof we have hereunto subscribed this Thirteenth Day of October in the Year of our Lord one thousand Eight Hundred and one. [Signed here by J. M’Donell Lt. Col] 2d. Battn. R. C. [in?] Com of Fort George + Dependencies Robt. Pilkington Captain Royal Engineers

'To do justice and judgement' : the place of passion in public life

Please consult the paper edition of this thesis to read. It is available on the 5th Floor of the Library at Call Number: Z 9999 P65 F47 2003

Indenture between The Honourable Peter Russell, His Majesty’s Receiver General and William Dickson

Indenture between The Honourable Peter Russell, His Majesty’s Receiver General and William Dickson 10 acres bounded by a Port, and a Military Reserve. This document is slightly torn and taped. This does not affect the text – instrument no. 6507, Aug. 22, 1798.

Core Retionalizability in Two-Agent Exchange Economies.

We provide a characterization of selection correspondences in two-person exchange economies that can be core rationalized in the sense that there exists a preference profile with some standard properties that generates the observed choices as the set of core elements of the economy for any given initial endowment vector. The approach followed in this paper deviates from the standard rational choice model in that a rationalization in terms of a profile of individual orderings rather than in terms of a single individual or social preference relation is analyzed.

Non-Deteriorating Choice

We analyze an alternative to the standard rationalizability requirement for observed choices by considering non-deteriorating selections. A selection function is a generalization of a choice function where selected alternatives may depend on a reference (or status quo) alternative in addition to the set of feasible options. A selection function is non-deteriorating if there exists an ordering over the universal set of alternatives such that the selected alternatives are at least as good as the reference option. We characterize non-deteriorating selection functions in an abstract framework and in an economic environment.

Some Implications of the Zero Lower Bound on Interest Rates for the Term Structure and Monetary Policy

In an economy where cash can be stored costlessly (in nominal terms), the nominal interest rate is bounded below by zero. This paper derives the implications of this nonnegativity constraint for the term structure and shows that it induces a nonlinear and convex relation between short- and long-term interest rates. As a result, the long-term rate responds asymmetrically to changes in the short-term rate, and by less than predicted by a benchmark linear model. In particular, a decrease in the short-term rate leads to a decrease in the long-term rate that is smaller in magnitude than the increase in the long-term rate associated with an increase in the short-term rate of the same size. Up to the extent that monetary policy acts by affecting long-term rates through the term structure, its power is considerably reduced at low interest rates. The empirical predictions of the model are examined using data from Japan.