856 resultados para Integrality and psichiatric reform
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This paper proposes a methodology to achieve integrated planning and projects for secondary distribution circuits. The planning model is formulated as a mixed integer nonlinear programming problem (MINLP). In order to resolve this problem, a tabu search (TS) algorithm is used, with a neighborhood structure developed to explore the physical characteristics of specific geographies included in the planning and expansion of secondary networks, thus obtaining effective solutions as well as low operating costs and investments. The project stage of secondary circuits consists of calculating the mechanical efforts to determine the support structures of the primary and secondary distribution systems and determining the types of structures that should be used in the system according to topological and electrical parameters of the network and, therefore, accurately assessing the costs involved in the construction and/or reform of secondary systems. A constructive heuristic based on information of the electrical and topological conditions between the medium voltage and low voltage systems is used to connect the primary systems and secondary circuits. The results obtained from planning and design simulations of a real secondary system of electric energy distribution are presented.
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Introduction The social agenda is long-term in nature, in the sense that poverty alleviation along with a better distribution of income, wealth and opportunities are long-term goals. A sound macroeconomic policy, on the other hand, has to do largely with the consistent management of short-term policy instruments pursuing a sustainable and predictable pace for aggregate economic variables and major prices (wages, inflation, interest rates and exchange rates). In spite of the different arena and rationale in which they play, there are strong links between the two. First and most obvious, macroeconomic adjustment and structural reform are more likely to be sustainable when they are equitable. Second, social intervention —i.e., policies, programmes and reforms aimed at improving social performance in the long run—, needs stable funding which is not always available in view of macroeconomic constraints. Third, macroeconomic instability —especially episodes of recession or hyperinflation— increases poverty and inequality, while restoring macroeconomic equilibrium does not restore previous social balances. Finally, there is no unique macroeconomic policy mix to tackle a given situation, and the policy options may not be neutral from a social standpoint. Monetary, fiscal and exchange rate policies, together with structural reform, have major consequences for the social wellbeing of societies, not only in terms of protection against shocks and crises but also in terms of equity. Many, if not all, of the necessary social policies are of a domestic nature. This report thus concentrates on domestic strategies aimed at maximizing the linkages between consistent macroeconomic policies and social progress. Pursuing them, however, depends to a considerable extent on the international enabling environment in which the global financial system, the unsettled debt crisis and increasing ODA flows play a significant role. Countries operate in a world economy where market players everywhere immediately scrutinize domestic monetary, financial or fiscal policy decisions and the performance of exchange rate regimes of individual countries. Under these conditions, the room for manoeuvre of policymakers has become considerably constrained. Consequently, it is becoming increasingly complex to incorporate the social dimensions into such policy decisions, to the extent that external analysts consider that authorities are sacrificing sound macroeconomic policies. The main message of the report is that the expediency of short-term economic efficiency as embedded in much of the advice on macroeconomic stability needs to be tempered by long-term development objectives. The report starts with a short historical background which describes the ascendancy of macroeconomic policies over social development policies (chapter I). It continues with an evaluation of the relation between macroeconomic consistency and social effort (chapter II), and the importance of sustainable and stable growth for social progress (chapter III). The report then turns to the need for an equity-enhancing growth strategy (chapter IV) and an analysis of the priorities of social policies in an integrated approach to growth (chapter V). The final chapter adds some final institutional remarks.
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The Brazilian Network for Continuous Monitoring of GNSS - RBMC is a national network of continuously operating reference GNSS stations. Since its establishment in December of 1996, it has been playing an essential role for the maintenance and user access of the fundamental geodetic frame in the country. In order to provide better services for RBMC, the Brazilian Institute of Geography and Statistics - IBGE and the National Institute of Colonization and Land Reform - INCRA are both partners involved in the National Geospatial Framework Project - PIGN. This paper provides an overview of the recent modernization phases the RBMC network has undergone highlighting its future steps. These steps involve the installation of new equipment, provide real time data from a group of core stations and compute real-time DGPS corrections, based on CDGPS (The real-time Canada-Wide DGPS Service) (The Real-Time Canada-Wide DGPS Service. http://www.cdgps.com/ 2009a). In addition to this, a post-mission Precise Point Positioning (PPP) service has been established based on the current Geodetic Survey Division of NRCan (CSRS-PPP) service. This service is operational since April 2009 and is in large use in the country. All activities mentioned before are based on a cooperation signed at the end of 2004 with the University of New Brunswick, supported by the Canadian International Development Agency and the Brazilian Cooperation Agency. The Geodetic Survey Division of NRCan is also participating in this modernization effort under the same project. This infrastructure of 66 GNSS stations, the real time, post processing services and the potentiality of providing Wide Area DGPS corrections in the future show that the RBMC system is comparable to those available in USA and Europe. © Springer-Verlag Berlin Heidelberg 2012.
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Pós-graduação em Odontologia Preventiva e Social - FOA
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Reformers want history education to help students learn to engage in historical inquiry, read critically across conflicting sources, and engage in civil discussion of controversial issues. How can we help teachers and students shift the roles, norms, and activity in history classrooms to achieve these aims? An activity-theoretical framework suggests the value of explicitly attending to multiple aspects of human activity when designing and presenting reform-oriented pedagogies or curricula. Such attention increases the odds that teachers who implement new approaches or curriculum will achieve significant shifts in the means and ends of history education.
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In the current climate of escalating health care costs, defining value and accurately measuring it are two critical issues affecting not only the future of cancer care in particular but also the future of health care in general. Specifically, measuring and improving value in cancer-related health care are critical for continued advancements in research, management, and overall delivery of care. However, in oncology, most of this research has focused on value as it relates to insurance industry and payment reform, with little attention paid to value as the output of clinical interventions that encompass integrated clinical teams focusing on the entire cycle of care and measuring objective outcomes that are most relevant to patients. ^ In this study, patient-centered value was defined as health outcomes achieved per dollar spent, and calculated using objective functional outcomes and total care costs. The analytic sample comprised patients diagnosed with three common head and neck cancers—cancer of the larynx, oral cavity, and oropharynx—who were treated in an integrated tertiary care center over an approximately 10-year period. The results of this study provide initial empirical data that can be used to assess and ultimately to help improve the quality and value of head and neck cancer care, and more importantly they can be used by patients and clinicians to make better-informed decisions about care, particularly what therapeutic services and outcomes matter the most to patients.^
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Apart from threats to its national security and territorial integrity, Ukraine faces serious economic challenges. These result from the slow pace of economic and institutional reform in the previous two decades, the populist policies of the Yanukovych era and the consequences of the conflict with Russia. The new Ukrainian authorities have made pro-reform declarations, but these do not seem to be supported sufficiently by concrete policy measures, especially in the critical areas of fiscal, balance-of-payment and structural adjustment. Also, the international financial aid package granted to Ukraine has not been accompanied by sufficiently strong policy conditionality. Ukraine urgently needs a complex programme of far-reaching economic and institutional reform, which will include both short-term fiscal and macroeconomic adjustment measures and medium- to long-term structural and institutional changes. Energy subsidies and the low retirement age are the two critical policy areas that require adjustment to avoid sovereign default and a balance-of-payments crisis.
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After coming to power in September 2009, the Alliance for European Integration (AIE)1 coalition began implementing a wide-ranging programme of reforms, with a view to bringing Moldova closer to the European Union, and ultimately to ensure the country’s full membership of the EU. Today, Moldova is considered a clear leader in European integration among the members of the EU’s Eastern Partnership programme. This, however, has less to do with the concrete reforms introduced by the Moldovan government, and more to do with, on the one hand, Chișinău’s excellent public relations with Brussels, achieved through effective diplomacy; and on the other hand, the growing disillusionment with the lack of progress in other Eastern Partnership countries, particularly in Ukraine. Attempts to evaluate Moldova’s reforms have proven rather problematic. On the one hand, the ruling coalition has managed to make significant progress in the areas of civil liberties, human rights and electoral reform. The government has also successfully implemented regulations which have brought Moldova closer to signing a Deep and Comprehensive Free Trade Agreement (DCFTA) with the EU, and it has made headway in talks on visa liberalisation with Brussels. On the other hand, Chișinău has still not carried out the structural and economic reforms without which real change in the country will be impossible. No reforms have been introduced in the Ministry of the Interior, the Moldovan police force, or the judiciary. The AIE has also failed to decentralise governance and has had no real success in reducing corruption; its attempts to rebuild the country’s financial institutions have proved equally unsuccessful. The main reasons for this poor performance include mutual mistrust and conflicting interests among the coalition members, a shortage of financial resources, strong resistance to change by public administration staff, and significant pressure from those political and business groups whose interests could suffer as a result of the proposed reforms. It should also be noted that since the AIE took power, the international context of the reform efforts has undergone significant changes. On the one hand, the EU has been facing an economic crisis, which has had a negative impact on Moldovan exports and contributed to the worsening of the economic situation in the country; and on the other hand, Moldova has been offered membership of the Customs Union as a viable alternative to EU membership.