Health financing changes in the context of health care decentralization: the case of three Latin American countries

OBJECTIVE: The results of an evaluative longitudinal study, which identified the effects of health care decentralization on health financing in Mexico, Nicaragua and Peru are presented in this article. METHODS: The methodology had two main phases. In the first, secondary sources of data and documents were analyzed with the following variables: type of decentralization implemented, source of financing, funds for financing, providers, final use of resources, mechanisms for resource allocation. In the second phase, primary data were collected by a survey of key personnel in the health sector. RESULTS: Results of the comparative analysis are presented, showing the changes implemented in the three countries, as well as the strengths and weaknesses of each country in matters of financing and decentralization. CONCLUSIONS: The main financing changes implemented and quantitative trends with respect to the five financing indicators are presented as a methodological tool to implement corrections and adjustments in health financing.

O piano (bem) informado : processos de interiorização e crescimento

Este livro debruça-se sobre questões ligadas à metodologia do piano, incluindo aspectos técnicos, musicais e artísticos, num enquadramento que engloba algumas das principais reflexões éticas, estéticas e filosóficas de referência. O objetivo deste trabalho é a partilha de uma visão baseada na experiência pessoal e profissional na área do piano. Este texto assume uma certa continuidade com as grandes contribuições de autores tais como Ludwig Deppe, Matthay Tobias, Grigory Kogan, Heinrich Neuhaus e George Kochevitsky publicado. Ao mesmo tempo que se integra e complementa alguma dessa literatura especializada, aponta ideias, sugestões e pontos de vista caracterizados pela inovação e aplicabilidade racional e científica.

The (well) informed piano : internalization and growth process

The subject matter of this book is about piano methodology, including technical, musical, artistic, ethical and philosophical issues and reflections. The purpose of this work is to share a personal professional experience insight in the field of piano performance. This text assumes a certain continuity to the major contributions of artists like Ludwig Deppe, Tobias Matthay, Grigory Kogan, Heinrich Neuhaus and George Kochevitsky. At the same time, it tries to integrate and complement this selected literature, bringing new ideas and hints to specific professional issues.

Should the U.S. adapt to the world? The first debate on american exceptionalism and its impact on the founding of the United States

This paper aims at putting into perspective the recent, post 9/11 debate on the United States‘ alleged exceptionalism and its impact on the definition of American foreign policy. It reminds the readers that the United States was born as a result of a similar debate, at a time when a crucial choice for its future was to be made. Indeed, the Founding Fathers discarded the revolutionary idea that America was altogether different from other (European) nations and, as such, could succeed in saving republicanism and concentrate on domestic affairs. As Gordon Wood and Harvey Mansfield have shown, the 1787 version of republicanism stood as a departure from its earlier version, and such a change was necessary to the creation of a full-fledged federation, therefore paving the way to the current powerful Federal Republic. The early failure of the exceptionalist creed did not cause its disappearance, as the contemporary form of exceptionalism demonstrates, but created conditions that made an enduring and powerful influence very difficult.

Leitura à primeira vista ao piano: relatório de estágio

A frequência de um Estágio de Ensino Especializado proporciona uma oportunidade de proximidade entre futuro docente e aluno. A observação de metodologias e o envolvimento com a música e contexto musical das escolas e alunos é algo fundamental para a formação correcta de docentes. Devido ao carácter prático do ensino de um instrumento, esta interacção demonstra-se fundamental para a experiência pedagógica. Neste estágio pretendeu-se aumentar o grau de qualidade de ensino e o número de ferramentas pedagógicas, comparando-as com ferramentas aprendidas e articuladas por experiência pré-adquirida como docente. A pedagogia de ensino de piano tem vindo a sofrer várias modificações e adaptações, como reflexo do meio e dos recursos disponíveis. A existência de conservatórios onde os alunos podem frequentar um grande número de disciplinas trouxe vantagens significativas para a sua cultura musical. Embora o estudo do instrumento continue a ser a prática principal, a diminuição nos horários de estudo obriga a uma selecção criteriosa dos conteúdos programáticos deste instrumento, de modo a não por em causa o desenvolvimento técnico dos alunos. Uma área raramente encontrada nestes conteúdos é a leitura à primeira vista. A investigação aqui apresentada pretendeu compreender como se realiza a leitura à primeira vista de uma partitura ao piano e como se pode desenvolver esta competência. Recorrendo a fontes bibliográficas consultadas e à análise de métodos de ensino representativos, foram alvo de investigação a forma como um leitor lê à primeira vista uma partitura, qual a importância do tacto e da visão, e até que ponto esta competência pode ser estudada e desenvolvida. Quais são os factores-chave da leitura à primeira vista? Até que ponto a prática ao instrumento pode influenciar esta capacidade? Embora a leitura à primeira vista tenha sido retirada como disciplina e forma de avaliação em vários estabelecimentos de ensino, a realização de alguns inquéritos pretendeu avaliar a importância dada a esta disciplina, entre professores e alunos.

Work, malaise, and well-being in Spanish and Latin-American doctors

ABSTRACT OBJECTIVE To analyze the relations between the meanings of working and the levels of doctors work well-being in the context of their working conditions. METHOD The research combined the qualitative methodology of textual analysis and the quantitative one of correspondence factor analysis. A convenience, intentional, and stratified sample composed of 305 Spanish and Latin American doctors completed an extensive questionnaire on the topics of the research. RESULTS The general meaning of working for the group located in the quartile of malaise included perceptions of discomfort, frustration, and exhaustion. However, those showing higher levels of well-being, located on the opposite quartile, associated their working experience with good conditions and the development of their professional and personal competences. CONCLUSIONS The study provides empirical evidence of the relationship between contextual factors and the meanings of working for participants with higher levels of malaise, and of the importance granted both to intrinsic and extrinsic factors by those who scored highest on well-being.

Synthesis and structural characterization of new Piano-stool Ruthenium(II) complexes bearing 1-Butylimidazole heteroaromatic ligand

New cationic ruthenium(II) complexes with the formula [Ru(eta(5)-C5H5)(LL)(1-BuIm)] [Z], with (LL) = 2PPh(3) or DPPE, and Z = CF3SO3-, PF6-, BPh4-, have been synthesized and fully characterized. Spectroscopic and electrochemical studies revealed that the electronic properties of the coordinated 1-butylimidazole were clearly influenced by the nature of the phosphane coligands (LL) and also by the different counter ions. The solid state structures of the six complexes determined by X-ray crystallographic studies, confirmed the expected distorted three-legged piano stool structure. However the geometry of the 1-butylimidazole ligand was found considerably different in all six compounds, being governed by the stereochemistry of the mono and bidentate coligands (PPh3 or DPPE).

American trypanosomiasis (Chagas' disease) in conventional and germfree rats and mice

Germfree (GF) and conventional (CV) CFW (LOB) mice and Wistar and Sprague-Dawley rats were infected with Trypanosoma cruzi. The disease was more severe in the GF than in the CV animals as revealed by: (1) an earlier and more intense parasitemia; (2) a more precocious mortality; (3) a twice enlarged spleen: (4) a more intense cell and tissue parasitism; (5) visceral signs of cardiac failure.

Ecological aspects of American cutaneous leishmaniasis: 6. Man-biting sandfly fauna of a patch of residual forest in the middle and north-eastern region of the São Paulo State, Brazil

This report shows the phlebotomine vectorial role in the endemic cutaneous leishmaniasis situated in the middle and north-eastern region of the São Paulo, Brazil. Analysis of information encloses a sandfly man-biting fauna of four different patches of residual forest. So, using the human-bait and Shannon trap for a period of one year we have caught 16,869 sandflies. The predominance of Lutzomyia intermedia (85,6%) was clear. Moreover, the low density of Lutzomyia whitmani and Lutzomyia pessoai and their epidemiological implications at present and in the past are discussed. Information about the daily activity of some species is given and we emphasize for the first time, the diurnal activity of Lutzomyia firmatoi in the São Paulo State.

A improvisação como ferramenta pedagógica no ensino vocacional de piano

Resumo I - A frequência do Estágio do Ensino Especializado proporcionou uma oportunidade de observar o ensino de piano numa das escolas mais importantes do ensino da música em Portugal, acompanhando alunos do Curso Básico e do Curso Secundário, que frequentaram a Escola de Música do Conservatório Nacional no regime integrado. O processo de observação de aulas que decorreu deste estágio possibilitou-nos assistir às aulas de piano de uma professora experiente, permitindo a observação de metodologias consolidadas e assistir de perto à forma como estas são postas em prática. Por outro lado, através da leccionação de aulas observadas, foi dada a oportunidade de testar e reflectir sobre o próprio desempenho docente, procurando estratégias e ferramentas pedagógicas que possam vir a acrescentar qualidade à prática pedagógica. O ensino especializado da música em Portugal tem experimentado mudanças importantes, o que leva a que haja uma adaptação das escolas às mudanças, continuando a leccionar um ensino de qualidade, que se quer cada vez mais eficaz, inovador, e com professores cada vez melhor fundamentados e preparados.

Desenvolvimento da autonomia dos alunos na aprendizagem de piano: relatório de estágio

Resumo I - O presente Relatório tem como objetivo dar a conhecer a experiência da estagiária, inserida no âmbito do Mestrado em Ensino da Música, da Escola Superior de Música de Lisboa – IPL. O Estágio decorreu no Instituto Gregoriano de Lisboa, no ano letivo de 2014/2015. Foram selecionados três alunos de níveis diferentes para avaliar a atividade da estagiária enquanto docente de piano. Com este intuito, foi feita a caraterização da escola e dos alunos envolvidos no Estágio, assim como a descrição das práticas educativas desenvolvidas. Para cada um dos alunos integrados no contexto deste Estágio foram elaborados planos de aulas semanais e planificações anuais. Por fim, foi elaborada uma análise crítica da atividade docente desenvolvida e a descrição das conclusões resultantes desta prática.

Towards Active Course Marks for Autonomous Sailing Competitions

This paper describes the environmental monitoring / regatta beacon buoy under development at the Laboratory of Autonomous Systems (LSA) of the Polytechnic Institute of Porto. On the one hand, environmentalmonitoring of open water bodies in real or deferred time is essential to assess and make sensible decisions and, on the other hand, the broadcast in real time of position, water and wind related parameters allows autonomous boats to optimise their regatta performance. This proposal, rather than restraining the boats autonomy, fosters the development of intelligent behaviour by allowing the boats to focus on regatta strategy and tactics. The Nautical and Telemetric Application (NAUTA) buoy is a dual mode reconfigurable system that includes communications, control, data logging, sensing, storage and power subsystems. In environmental monitoring mode, the buoy gathers and stores data from several underwater and above water sensors and, in regatta mode, the buoy becomes an active course mark for the autonomous sailing boats in the vicinity. During a race, the buoy broadcasts its position, together with the wind and the water current local conditions, allowing autonomous boats to navigate towards and round the mark successfully. This project started with the specification of the requirements of the dual mode operation, followed by the design and building of the buoy structure. The research is currently focussed on the development of the modular, reconfigurable, open source-based control system. The NAUTA buoy is innovative, extensible and optimises the on board platform resources.

Leishmania braziliensis: isolation of carbohydrate-containing antigen and possibility of its use in the immunodiagnosis of American Cutaneous Leishmaniasis

Leishmania braziliensis is a causative agent of American Cutaneous Leishmaniasis (ACL). The 034-JCG strain, isolated from a patient from the northern region of Paraná State, Brazil, was cultivated in Blood Agar Base medium, lyophilized and submitted to phenol-water extraction. The extract was treated with RNase I. The carbohydrate containing-antigen (Ag-CHO) was immunogenic to rabbits and showed at least a fraction with some negative charge at pH 8.2. This antigen showed cross-reactivity with the phenol-water extract of the growth medium used for the culture of promastigotes and with the surface antigens of promastigotes. Its composition is: 24.3% of total sugars, from which 11.2% of galactose, 7.5% of mannose and 5.6% of ribose. Protein content was 5.4% and phosphate 18.5%. The antigenic activity was maintained after: repeated freezing-thawing; lyophilization; heating at 100ºC for 30 minutes; treatment with RNase, trichloroacetic acid and sodium metaperiodate. The precipitin line obtained is Periodic Acid Schiff positive. The application of the Ag-CHO in counterimmunoelectrophoresis reaction for the immunodiagnosis of ACL showed 60% sensitivity, and no cross-reaction with the five sera of Chagas' disease patients tested. The use of this antigen in a more sensitive technique, with more samples of sera, may improve these results.

RESTAVEC – from haitian slave child to middle-class american

Trabalho de Projeto apresentado ao Instituto de Contabilidade e Administração do Porto para a obtenção do grau de Mestre em Tradução e Interpretação Especializadas, sob orientação da Doutora Clara Sarmento