Rehabilitative management of swallowing and oral-motor movements in patients with tetanus of a public service in Brazil

When looking at developing countries, the prolonged intensive medical and nursing care required by many patients places extra demands on an already stretched healthcare budget. The purpose of this study was to verify the effectiveness of a systematic rehabilitative program for swallowing and oral-motor movements in intensive care unit patients with the diagnosis of tetanus. Forty-five patients who were clinically diagnosed with tetanus were included in the study. Participants were divided in two groups: Cl - consisted of 18 tetanus patients who were consecutively admitted to the infectious disease ICU from January 2002 to December 2005, prior to the existence of a systematic swallowing and oral-motor intervention: GII - consisted of 27 tetanus patients who were consecutively admitted to the infectious disease ICU from January 2006 to December 2009 and were submitted to a specific rehabilitative management of swallowing and of the oral-motor movements. Results indicate that the proposed rehabilitative program reduced by approximately 50% the time patients remained in the ICU. The significant improvement observed in patients with tetanus who were submitted to the rehabilitative program for swallowing and oral-motor movements occurred in conjunction with a reduction in the amount of time necessary to reintroduce oral feeding, to decannulate and to remove the feeding tubes. In conclusion, swallowing/muscle exercise, in patients with severe/very severe tetanus, seem to promote the remission of muscle tension and seem to maximize functional swallowing. (C) 2012 Elsevier B.V. All rights reserved.

Experiences of spanish public administration in requirements management and acquisition management processes

This paper shows the main contributions of the 1st Symposium on Improvement Process Models and Software Quality of Public Administrations. The obtained results expose the need to promote the implementation of Software Maturity Models and show possible advantages of its application in software processes of Public Administrations. Specifically, it was analyzed the current status in two process areas: Requirements Management and Subcontracting Management.

Pension legislation for federal public servants in Brazil

This paper addresses the creation of pension funds for federal civil servants in Brazil, analyzing the existing legislation and regulation on this issue. To this end, it takes off based on the genesis of the Brazilian private pension plans, logging the emergence of private funds as well as the existence of various laws and constitutional amendments prior to Law 12.618/2012, which provided for the pension funds system for Brazilian federal public servants. It also identifies proponents and opponents to the Foundation for Pension Funds of Federal Civil Servants (FUNPRESP), signaling the discursive construction of the pension fund schemes as central character in contemporary welfare capitalism. Finally, presents controversial aspects of the new pension fund law developments in Brazil.

High genetic diversity among Pseudomonas aeruginosa and Acinetobacter spp. isolated in a public hospital in Brazil

In Brazil and other regions of the world, Pseudomonas aeruginosa and Acinetobacter spp. have emerged as important agents of nosocomial infection and are commonly involved in outbreaks. The main objective of the present study was to evaluate the genetic relationship among P. aeruginosa and Acinetobacter spp. isolated from patients in a public university hospital in northwestern Parana, Brazil, and report their antimicrobial resistance profile. A total of 75 P. aeruginosa and 94 Acinetobacter spp. isolates were phenotypically identified and tested for antibiotic susceptibility using automated methodology. Polymyxin B was tested by disk diffusion for P. aeruginosa. Metallo-beta-lactamase (MBL) was detected using a disk approximation test. Genotyping was performed using enterobacterial repetitive intergenic consensus polymerase chain reaction (ERIC-PCR). Approximately 55% of the P. aeruginosa isolates and 92% of the Acinetobacter spp. isolates were multiresistant, but none were MBL-producers. ERIC-PCR revealed the presence of small clusters of carbapenem-resistant Acinetobacter spp., most likely OXA-type carbapenemase producers. Furthermore, high genetic diversity in P. aeruginosa and Acinetobacter spp. clinical isolates was observed, suggesting that cross-transmission is not very frequent in the studied hospital.

Healthcare-associated infections: challenges to public health in Brazil

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Endovascular repair of a juxtarenal saccular aneurysm using the Multilayer Flow Modulator: report of the first case performed in a Public Hospital in Brazil

Endovascular aortic aneurysm repair (EVAR) involving renal and visceral arteries remains a great challenge. Several techniques have been developed over the time to treat juxtarenal, pararenal and thoracoabdominal aneurysms, highlighting the fenestrated and branched endografts, parallel prostheses as Chimney, Periscope and Sandwich Techniques and the use of flow modulation by multilayer stent. We report a case of saccular juxtarenal aortic aneurysm with high surgical risk for complex airway access due to a history of radical laryngectomy for laryngeal neoplasm. Due to chronic aorto-iliac obstructive disease, ostial stenosis of renal artery and limited diameter of the suprarenal aorta, we discarded options involving fenestrated/branched endografts and involving parallel prostheses techniques. We present this case as a therapeutic challenge and a successful treatment option in the short-term evaluation.

Terminal report [to the International Cooperation Administration] on the contract concerning public administration in the University of San Andrés.

Mode of access: Internet.

Report of a meeting on technical cooperation in public administration in dependent territories, New York, N.Y., 20 May 1954.

Mode of access: Internet.

Public administration in an age of austerity:the future of the discipline

Reflecting changes in the nature of governance, some have questioned whether Public Administration is now an historical anachronism. While a legitimate debate exists between sceptics and optimists, this special issue demonstrates grounds for optimism by indicating the continuing diversity and adaptability of the field of Public Administration. In this introduction, we first sketch the variety of intellectual traditions which comprise the field of modern Public Administration. We then consider institutional challenges facing the subject given considerable pressures towards disciplinary fragmentation, and ideological challenges arising from a new distrust of public provision in the UK. Despite these challenges, Public Administration continues to provide a framework to analyse the practice of government and governance, governing institutions and traditions, and their wider sociological context. It can also directly inform policy reform - even if this endeavour can have its own pitfalls and pratfalls for the 'engaged' academic. We further suggest that, rather than lacking theoretical rigour, new approaches are developing that recognise the structural and political nature of the determinants of public administration. Finally, we highlight the richness of modern comparative work in Public Administration. Researchers can usefully look beyond the Atlantic relationship for theoretical enhancement and also consider more seriously the recursive and complex nature of international pressures on public administration. © The Author(s) 2012 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Co-ordination and public administration in a global economy — A Hungarian point of view

The purpose of social co-ordination mechanisms is to co-ordinate the activities of individuals and organisations specialised in the distribution of work. The paper reviews five basic types of mechanisms: market, bureaucratic, ethical, aggressive and co-operative co-ordination. Today’s world operates on the basis of a duality: international cooperation is based on nation states, in which the public administrations work according to bureaucratic coordination. However, the increasingly globalised market responds to the logic of market coordination. The article argues that in terms of understanding the working of public administration, the various coordination mechanisms are of crucial importance, especially where various mechanisms meet, such as the relationship between nation states and multinational corporations.

New methodologies for risk assessment of GMOs: an experiment of public consultation in Brazil.

2008

O controle externo sobre as agências reguladoras de Estado : limites e (im)possibilidades

Com a criação das primeiras entidades reguladoras de infraestrutura, década de 90, surgiu uma nova maneira estratégica de o Estado atuar com intuito de melhorar a governança pública. O Estado brasileiro, que era responsável direto pelo desenvolvimento econômico e social, buscou se redefinir frente ao modelo de entidades reguladoras que emergia. Em decorrência dessa nova fisionomia estatal, a descentralização funcional ganhou ênfase resultando no aparecimento de estruturas mais flexíveis e autônomas sob a natureza de direito público com a finalidade de atuar em setores típicos de Estado. Assim, foram criadas as primeiras agências reguladoras brasileiras com objetivo de normatizar, incentivar e regular setores essenciais à sociedade. Por consequência de tais inovações, diversas áreas administrativas tiveram de serem adaptadas, sobretudo as relacionadas à atividade de controle no âmbito administrativo. Para tanto, tornou-se necessário conciliar, dentro de um escopo sistematizado, mecanismos capazes de atender as demandas oriundas do recente Estado regulador brasileiro. Com efeito, a função controle adquire relevo no sentido de evitar que tais agências reguladoras apartem-se de limites impostos por lei ou de que divirjam de suas missões institucionais. Assim, o presente trabalho investiga a atuação do controle externo exercido pelo Tribunal de Contas da União (TCU) no desempenho das agências reguladoras de Estado. Diante de o assunto permear várias áreas epistemológicas, entende-se que abordá-lo sob o enfoque interdisciplinar pode estender em contribuições sobre o objeto investigado. Nesse contexto, esta dissertação visa incorporar, também, outras áreas de conhecimento. Longe de defender um isomorfismo para o arranjo regulatório brasileiro ou de promover uma saída paradigmática, esta pesquisa busca, com amparo na metodologia qualitativa e sob os enfoques exploratórios e descritivos, reunir conhecimentos e constatações no sentido de propiciar maior aproximação acerca do assunto e concorrer para o delineamento de diretrizes futuras do controle externo sobre a regulação brasileira. Destaca-se que tanto a regulação como o controle sobre o ambiente regulatório são assuntos que se encontram em desenvolvimento no contexto brasileiro, o que enseja a pertinência desta pesquisa. Em face do exposto, esta dissertação visa investigar o estado atual do controle exercido pelo TCU sobre o desempenho nas agências reguladoras de Estado – infraestrutura - com intuito de analisar e promover um debate sobre limites e (im)possibilidades dessa atuação.