A promoção da autonomia numa sala do movimento da escola moderna

Relatório da Prática Profissional Supervisionada Mestrado em Educação Pré-Escolar

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.

Challenges of converting nonprofit in for-profit-reasons decision making and key success factores of a conversion

Due to external constraints (opposed by the market and legal system) and internal changes nonprofit organizations have been converting to for-profit entities combining commercial revenue and social value creation. To create an understanding of the conversion process considering its challenges, the reasons, the decision-making process and key success factors of a conversion are examined. Therefore, a two-step research procedure is used combining literature research and a multiple case study approach based on expert interviews with known companies. The outcome is a helpful guideline (including a decision matrix) for social entrepreneurs that might face a conversion.

Interlinkages and forecasting made possible by the use of the DECOIN analytical tool kit

This technical report is a document prepared as a deliverable [D4.3 Report of the Interlinkages and forecasting prototype tool] of a EU project – DECOIN Project No. 044428 - FP6-2005-SSP-5A. The text is divided into 4 sections: (1) this short introductory section explains the purpose of the report; (2) the second section provides a general discussion of a systemic problem found in existing quantitative analysis of sustainability. It addresses the epistemological implications of complexity, which entails the need of dealing with the existence of Multiple-Scales and non-equivalent narratives (multiple dimensions/attributes) to be used to define sustainability issues. There is an unavoidable tension between a “steady-state view” (= the perception of what is going on now – reflecting a PAST --& PRESENT view of the reality) versus an “evolutionary view” (= the unknown transformation that we have to expect in the process of becoming of the observed reality and in the observer – reflecting a PRESENT --& FUTURE view of the reality). The section ends by listing the implications of these points on the choice of integrated packages of sustainability indicators; (3) the third section illustrates the potentiality of the DECOIN toolkit for the study of sustainability trade-offs and linkages across indicators using quantitative examples taken from cases study of another EU project (SMILE). In particular, this section starts by addressing the existence of internal constraints to sustainability (economic versus social aspects). The narrative chosen for this discussion focuses on the dark side of ageing and immigration on the economic viability of social systems. Then the section continues by exploring external constraints to sustainability (economic development vs the environment). The narrative chosen for this discussion focuses on the dark side of current strategy of economic development based on externalization and the “bubbles-disease”; (4) the last section presents a critical appraisal of the quality of energy data found in energy statistics. It starts with a discussion of the general goal of statistical accounting. Then it introduces the concept of multipurpose grammars. The second part uses the experience made in the activities of the DECOIN project to answer the question: how useful are EUROSTAT energy statistics? The answer starts with an analysis of basic epistemological problems associated with accounting of energy. This discussion leads to the acknowledgment of an important epistemological problem: the unavoidable bifurcations in the mechanism of accounting needed to generate energy statistics. By using numerical example the text deals with the following issues: (i) the pitfalls of the actual system of accounting in energy statistics; (ii) a critical appraisal of the actual system of accounting in BP statistics; (iii) a critical appraisal of the actual system of accounting in Eurostat statistics. The section ends by proposing an innovative method to represent energy statistics which can result more useful for those willing develop sustainability indicators.

Assessing the quality of alternative energy sources: Energy Return On the Investment (EROI), the metabolic pattern of societies and energy statistics

This paper presents an initial challenge to tackle the every so "tricky" points encountered when dealing with energy accounting, and thereafter illustrates how such a system of accounting can be used when assessing for the metabolic changes in societies. The paper is divided in four main sections. The first three, present a general discussion on the main issues encountered when conducting energy analyses. The last section, subsequently, combines this heuristic approach to the actual formalization of it, in quantitative terms, for the analysis of possible energy scenarios. Section one covers the broader issue of how to account for the relevant categories used when accounting for Joules of energy; emphasizing on the clear distinction between Primary Energy Sources (PES) (which are the physical exploited entities that are used to derive useable energy forms (energy carriers)) and Energy Carriers (EC) (the actual useful energy that is transmitted for the appropriate end uses within a society). Section two sheds light on the concept of Energy Return on Investment (EROI). Here, it is emphasized that, there must already be a certain amount of energy carriers available to be able to extract/exploit Primary Energy Sources to thereafter generate a net supply of energy carriers. It is pointed out that this current trend of intense energy supply has only been possible to the great use and dependence on fossil energy. Section three follows up on the discussion of EROI, indicating that a single numeric indicator such as an output/input ratio is not sufficient in assessing for the performance of energetic systems. Rather an integrated approach that incorporates (i) how big the net supply of Joules of EC can be, given an amount of extracted PES (the external constraints); (ii) how much EC needs to be invested to extract an amount of PES; and (iii) the power level that it takes for both processes to succeed, is underlined. Section four, ultimately, puts the theoretical concepts at play, assessing for how the metabolic performances of societies can be accounted for within this analytical framework.

Can the impact of bed closure in intensive care units be reliably monitored?

OBJECTIVE: To assess the properties of various indicators aimed at monitoring the impact on the activity and patient outcome of a bed closure in a surgical intensive care unit (ICU). DESIGN: Comparison before and after the intervention. SETTING: A surgical ICU at a university hospital. PATIENTS: All patients admitted to the unit over two periods of 10 months. INTERVENTION: Closure of one bed out of 17. MEASUREMENTS AND RESULTS: Activity and outcome indicators in the ICU and the structures upstream from it (emergency department, operative theater, recovery room) and downstream from it (intermediate care units). After the bed closure, the monthly medians of admitted patients and ICU hospital days increased from 107 (interquartile range 94-112) to 113 (106-121, P=0.07) and from 360 (325-443) to 395 (345-436, P=0.48), respectively, along with the linear trend observed in our institution. All indicators of workload, patient severity, and outcome remained stable except for SAPS II score, emergency admissions, and ICU readmissions, which increased not only transiently but also on a mid-term basis (10 months), indicating that the process of patient care delivery was no longer predictable. CONCLUSIONS: Health care systems, including ICUs, are extraordinary flexible, and can adapt to multiple external constraints without altering commonly used activity and outcome indicators. It is therefore necessary to set up multiple indicators to be able to reliably monitor the impact of external interventions and intervene rapidly when the system is no longer under control.

Estado, bloco no poder e acumulação capitalista: uma abordagem teórica

State, power block and capitalist accumulation: a theoretical approach. This article aims to elaborate a theory, based on Poulantzas, about the role of the State in a capitalist economy through a relational perspective that perceives the State as a field and a strategic process for the disputes of class fractions within the power bloc. In order to do so, it exposes the relation between State and accumulation at an abstract-formal level, emphasising the limitations of studies that use only this dimension. Next, it analyzes the role of the power bloc in mediating between the abstract and concrete levels of the State, observing that public policies are elaborated as a result of the clashes within the power bloc. Finally, it promotes a discussion on the external constraints (international system) that are affected and affect the State and, consequently, the dynamics of the power bloc.

Industrialization in Sub-Saharan Africa and import substitution policy

This article aims to contribute to the understanding of the process of import substitution in Sub-Saharan Africa. The process of industrialization in Sub-Saharan Africa occurred in two phases: a first step, even very early during the colonial regime began around the 1920s and ended in the late forties; a second phase of industrialization began in the late fifties and gained momentum in the sixties, when import substitution was implemented more widely. Although these countries were the last to embark on the strategy of import substitution, they followed the same steps of Latin American countries, and as the structural domestic and external constraints were too strong, the failure of the policy of import substitution arrived early and the negative impact on these economies had a greater magnitude.

Pourquoi et comment la médiation préventive du Ministère du travail améliore-t-elle les relations du travail dans les entreprises québécoises?

Le présent mémoire de maîtrise porte sur la médiation préventive en relations du travail. La question de recherche est la suivante : « Pourquoi et comment la médiation préventive du ministère du Travail améliore-t-elle les relations du travail dans les entreprises québécoises? ». La médiation préventive est un mode d’intervention administratif et un mécanisme de soutien additionnel à la législation québécoise offert volontairement depuis plusieurs années par le ministère du Travail aux parties patronale et syndicale qui en font la demande. La médiation préventive se réalise avec le soutien d’un médiateur ou d’une médiatrice du ministère hors de la période de la négociation collective. Son contenu appartient aux parties et les ententes s’effectuent par consensus. La médiation préventive se présente de quatre manières : diagnostic des relations du travail par consensus, diagnostic des relations du travail par entrevue, séminaire en relations du travail et comité de relations du travail. Le modèle conceptuel comporte une variable dépendante qui est les relations du travail, une variable indépendante correspondant à la médiation préventive, le changement organisationnel en tant que variable intermédiaire et une variable de contrôle se rapportant à l’environnement organisationnel. La première des trois hypothèses générales de cette recherche affirme que, toutes choses égales par ailleurs, la médiation préventive amène un changement organisationnel. La seconde hypothèse générale relate que, toutes choses égales par ailleurs, le changement organisationnel contribue à améliorer les relations du travail. La dernière hypothèse générale correspond à l’idée que, toutes choses égales par ailleurs, l’environnement organisationnel a un impact sur les relations du travail. Parmi les douze hypothèses suivantes, quatre hypothèses ont été développées à partir de la première hypothèse générale : 1) toutes choses égales par ailleurs, l’établissement d’un diagnostic des relations du travail par le médiateur va aider à la mise en place d’un plan d’action; 2) toutes choses égales par ailleurs, l'établissement d'un plan d'action par le médiateur contribue au changement organisationnel; 3) toutes choses égales par ailleurs, un suivi par le médiateur contribue au changement organisationnel; 4) toutes choses égales par ailleurs, la perception des deux parties (patronale et syndicale) que le médiateur a bien joué son rôle contribue au changement organisationnel. Les quatre hypothèses suivantes découlent de la seconde hypothèse générale : 1) toutes choses égales par ailleurs, un changement culturel dans l’organisation avec un réaménagement des points de vue de la direction contribue à améliorer les relations du travail; 2) toutes choses égales par ailleurs, un changement relationnel dans l’organisation vers des relations de coopération contribue à améliorer les relations du travail; 3) toutes choses égales par ailleurs, un changement du style de direction dans l’organisation avec l’introduction de valeurs humaines ainsi qu’un « espace de discussion » contribue à améliorer les relations du travail; 4) toutes choses égales par ailleurs, la perception des deux parties (patronale et syndicale) d’avoir bien joué leur rôle contribue à améliorer les relations du travail. Enfin, les quatre dernières hypothèses ont été réalisées à partir de la troisième hypothèse générale : 1) toutes choses égales par ailleurs, l’organisation a un impact sur les relations du travail; 2) toutes choses égales par ailleurs, l’histoire syndicale a un impact sur les relations du travail; 3) toutes choses égales par ailleurs, la perception des contraintes extérieures et des risques pour l’emploi contribue à améliorer les relations du travail; 4) toutes choses égales par ailleurs, la perception d’un équilibre dans les rapports de force entre les parties (patronale et syndicale) contribue à améliorer les relations du travail. La vérification des hypothèses s’est effectuée à l’aide d’entretiens semi-structurés auprès de neuf participants des parties patronale et syndicale d’une entreprise ayant employé une médiation préventive. Une cueillette de données secondaires a aussi eu lieu pour notamment mesurer le niveau de conflit au travail sur dix ans. L’analyse des résultats de cette étude qualitative et longitudinale a permis de confirmer l’ensemble des hypothèses puisque la médiation préventive a amené à un changement organisationnel qui a aidé à améliorer les relations du travail et où l’environnement a eu un impact sur celles-ci. Un modèle d’analyse a été développé et validé pour cette recherche afin de savoir pourquoi et comment la médiation préventive du ministère du Travail améliore les relations du travail dans les entreprises québécoises. La présente recherche démontre de manière empirique que la médiation préventive améliore les relations du travail dans les entreprises québécoises tout en expliquant comment celle-ci procède. De plus, cette recherche suggère à toutes les organisations québécoises syndiquées d’entreprendre une médiation préventive si elles sont aux prises avec de mauvaises relations du travail.

Refinement of the Clinical Scenario Evaluation Framework for Assessment of Competing Development Strategies with an Application to Multiple Sclerosis

When competing strategies for development programs, clinical trial designs, or data analysis methods exist, the alternatives need to be evaluated in a systematic way to facilitate informed decision making. Here we describe a refinement of the recently proposed clinical scenario evaluation framework for the assessment of competing strategies. The refinement is achieved by subdividing key elements previously proposed into new categories, distinguishing between quantities that can be estimated from preexisting data and those that cannot and between aspects under the control of the decision maker from those that are determined by external constraints. The refined framework is illustrated by an application to a design project for an adaptive seamless design for a clinical trial in progressive multiple sclerosis.

The language of poverty: an exploration of the narratives of the poor

Within the development discourse, the narratives of the poor are a well utilized rhetorical tool to describe poverty and its causes. However, narratives can also reveal the beliefs and ‘world-view’ of the narrators. To explore this influence, the authors applied a discursive approach, to deconstruct the narratives of 101 slum dwellers in Kibera, Nairobi. The results revealed that poverty was largely attributed to external constraints, beyond an individual's control. Despite wanting a better life, participants held low expectations for the future. Hopes and dreams were placed on their children. While risk and uncertainty was a constant theme, large differences were found between genders as to the aspirations for the future. Copyright © 2009 John Wiley & Sons, Ltd and ERP Environment.

Desenvolvimento nacional, desenvolvimento regional e moeda: notas teóricas à luz da economia política do desenvolvimento

This work analyses the ability of National States and regions have to formulations development strategies. Redeeming the initial development concept as a conflictual process, the hypothesis is that it presents internal and external constraints, as the latter have a higher preponderance, revealed the role played by money. In this case, one can point to as sub-hypothesis that the growth models with external constraint, mainly through the balance of payments, may illustrate the fact that countries are subject to international economic interactions that limit the possibility of bringing acylating strategies well successful in overcoming backwardness. For the specific case of regions, indicates that the external constraint remains an element of embarrassment for regional development, but redeems itself the center-periphery relations in this context to discuss the role of monetary and financial system as an explanation for the disparities regional income. On the domestic front, we highlight the importance of social structures of accumulation as an element of internal cohesion necessary to achieve successful development trajectories. It points also to the importance of the State in the process rescuing some of the main theoretical contributions of the political economy of development, incorporating the concept of globalization on theoretical frameworks presented. This construction where development depends on the actions of external and internal conditions, where money plays a key role as a guideline for reflections on regional development. The attempt was to transplant our considerations on the general development to address the case of regions. Finally, we conclude by greater confidence in the hypothesis and sub-hypotheses of departure, which led to propositions of economic policies

Application of a new reverse Monte Carlo algorithm to polyatomic molecular systems. I. Liquid water

Using a new reverse Monte Carlo algorithm, we present simulations that reproduce very well several structural and thermodynamic properties of liquid water. Both Monte Carlo, molecular dynamics simulations and experimental radial distribution functions used as input are accurately reproduced using a small number of molecules and no external constraints. Ad hoc energy and hydrogen bond analysis show the physical consistency and limitations of the generated RMC configurations. (C) 2001 American Institute of Physics.

Industrialization in Sub-Saharan Africa and import substitution policy

This article aims to contribute to the understanding of the process of import substitution in Sub-Saharan Africa. The process of industrialization in Sub-Saharan Africa occurred in two phases: a first step, even very early during the colonial regime began around the 1920s and ended in the late forties; a second phase of industrialization began in the late fifties and gained momentum in the sixties, when import substitution was implemented more widely. Although these countries were the last to embark on the strategy of import substitution, they followed the same steps of Latin American countries, and as the structural domestic and external constraints were too strong, the failure of the policy of import substitution arrived early and the negative impact on these economies had a greater magnitude.

Transição energética em direção à energia renovável: revisitando a questão da política industrial como instrumento de desenvolvimento tecnológico

Pós-graduação em Ciências Sociais - FFC