The network origins of aggregate fluctuations

This paper argues that in the presence of intersectoral input-output linkages, microeconomicidiosyncratic shocks may lead to aggregate fluctuations. In particular, itshows that, as the economy becomes more disaggregated, the rate at which aggregatevolatility decays is determined by the structure of the network capturing such linkages.Our main results provide a characterization of this relationship in terms of the importanceof different sectors as suppliers to their immediate customers as well as theirrole as indirect suppliers to chains of downstream sectors. Such higher-order interconnectionscapture the possibility of "cascade effects" whereby productivity shocks to asector propagate not only to its immediate downstream customers, but also indirectlyto the rest of the economy. Our results highlight that sizable aggregate volatility isobtained from sectoral idiosyncratic shocks only if there exists significant asymmetryin the roles that sectors play as suppliers to others, and that the "sparseness" of theinput-output matrix is unrelated to the nature of aggregate fluctuations.

O espaço fórum como apoio na formação da rede intersetorial regional em saúde mental: desafios e potencialidades

Pós-graduação em Psicologia - FCLAS

O cuidado em saúde mental infantil na perspectiva de profissionais, familiares e crianças

Introdução: A preocupação e a incorporação da problemática da saúde mental infantil nas políticas públicas de saúde são recentes, assim como o desenvolvimento de ações voltadas a esse cuidado. Preconiza-se que essa atenção se proceda a partir de uma rede composta por serviços atuando de modo articulado a outros setores. Objetivo: Analisar os processos e as condições de produção de cuidados em saúde mental de criança na perspectiva do modo psicossocial na Rede de Atenção Psicossocial. Método: Pesquisa qualitativa, com referencial teórico-metodológico oriundo da Análise Institucional, desenvolvida por meio de Observação Participante em (1) espaços de articulação entre serviços de saúde, (2) Unidade Básica de Saúde e (3) Centro de Atenção Psicossocial Infantojuvenil (CAPSi) no município de Mauá, São Paulo. A Observação Participante permitiu reconhecer os procedimentos de cuidados no cotidiano dos serviços. Para aprofundamento da investigação, foram realizados Grupos Focais com profissionais da Estratégia de Saúde da Família e do CAPSi, com familiares de crianças que frequentam o CAPSi e com crianças usuárias do serviço. Os dados foram analisados e interpretados a partir de conceitos advindos da psicanálise winnicottiana, do modo de atenção psicossocial e da análise institucional. Resultados e Discussão: O interesse, o investimento político e o direcionamento das ações e da organização dos serviços, coerentes com a lógica de atenção psicossocial, têm propiciado um terreno fértil para a construção de práticas transformadoras de cuidado em saúde mental. A incorporação desse cuidado na Atenção Básica, ainda que apresente desafios e tensões entre o modelo instituído (departamentalizado em especialidades) e instituinte (saúde mental integrante da saúde geral), levou a mudanças nas ações e concepções dos profissionais. Contudo, o desenvolvimento de ações intersetoriais e a construção de uma rede ampliada de atenção têm sido limitados pela escassez de serviços e profissionais da rede e por diferentes concepções que atravessam o campo. Os participantes da pesquisa expressam visão conflitante em relação à concepção acerca de problemas de saúde mental e das expectativas quanto ao cuidado, sendo observada forte presença de uma cultura psiquiátrica, que se acentua nas falas dos familiares e na articulação com outros serviços, e uma inclinação a favor da atenção psicossocial, mais presente nas expressões dos profissionais. Nos serviços de saúde, há movimentos instituintes que enfatizam a integralidade da atenção, a interdisciplinaridade do cuidado, a multideterminação do processo saúde-doença, alinhados ao modo de atenção psicossocial. O acolhimento, o vínculo, a escuta e a confiança, importantes elementos do cuidado estão presente nas ações dos serviços. As intervenções terapêuticas têm sido desenvolvidas a partir da singularidade dos casos por meio de Projetos Terapêuticos Individuais, embora sejam consideradas aquém das necessidades das crianças, limitações advindas da escassez de profissionais e serviços da rede. Considerações Finais: Embora os serviços de saúde atuem na direção do cuidado alicerçado no modo psicossocial, eles têm atuado de forma pouco articulada com outros setores. A hegemonia da cultura psiquiátrica é um desafio a ser enfrentado. São urgentes ações que possam promover mudanças nessa cultura predominante e no imaginário social no que toca aos problemas de saúde mental e aceitação das diferenças.

A rede em ação intersetorial e comunitária como espaço de formação na abordagem ao usuário de drogas

Tese (doutorado)—Universidade de Brasília, Instituto de Psicologia, Psicologia Clínica e Cultura, 2015.

Aggregate fluctuations and the network structure of intersectoral trade

This paper analyzes the flow of intermediate inputs across sectors by adopting a network perspective on sectoral interactions. I apply these tools to show how fluctuationsin aggregate economic activity can be obtained from independent shocks to individualsectors. First, I characterize the network structure of input trade in the U.S. On thedemand side, a typical sector relies on a small number of key inputs and sectors arehomogeneous in this respect. However, in their role as input-suppliers sectors do differ:many specialized input suppliers coexist alongside general purpose sectors functioningas hubs to the economy. I then develop a model of intersectoral linkages that can reproduce these connectivity features. In a standard multisector setup, I use this modelto provide analytical expressions linking aggregate volatility to the network structureof input trade. I show that the presence of sectoral hubs - by coupling productiondecisions across sectors - leads to fluctuations in aggregates.

Access, equity and social cohesion: evaluation of intersectoral strategies for people experiencing homelessness

Objective To understand and evaluate the work of intersectoral assistance on the insertion and the flow of people in situation of street with severe mental illness in public services of Mental Health. Method A case study developed from ten visits to a night shelter between March and April 2012. For data collection, the participant observation and semi-structured interviews were carried out with four sheltered individuals, as well as non-directive group interviews with five technicians of the social-assistance services. Results Were analyzed using Content Analysis and developing a Logic Model validated with the professionals involved. Conclusion The social assistance services are the main entry of this clientele in the public network of assistance services, and the Mental Health services have difficulty in responding to the specificities of the same clientele and in establishing intersectoral work.


How Do Aggregate Fluctuations Depend on the Network Structure of the Economy?

[spa] En este artículo, analizamos la volatilidad agregada de una economía estilizada donde los agentes estann conectados en redes. Si hay relaciones estratégicas entre las acciones de los agentes, choques idiosincráticos pueden generar fluctuaciones agregadas. Demonstramos que la volatilidad agregada depende de la estructura de redes de la economía de dos maneras. Por un lado, si hay más conexiones en la economía en su conjunto, la volatilidad agregada es más baja. Por otro lado, si las conexiones están más concentradas, la volatilidad agregada es más alta. Presentamos una aplicación de nuestras predicciones teóricas que utiliza datos de EEUU de conexiones intrasectoriales y de diversificación de las empresas.

How Do Aggregate Fluctuations Depend on the Network Structure of the Economy?

[spa] En este artículo, analizamos la volatilidad agregada de una economía estilizada donde los agentes estann conectados en redes. Si hay relaciones estratégicas entre las acciones de los agentes, choques idiosincráticos pueden generar fluctuaciones agregadas. Demonstramos que la volatilidad agregada depende de la estructura de redes de la economía de dos maneras. Por un lado, si hay más conexiones en la economía en su conjunto, la volatilidad agregada es más baja. Por otro lado, si las conexiones están más concentradas, la volatilidad agregada es más alta. Presentamos una aplicación de nuestras predicciones teóricas que utiliza datos de EEUU de conexiones intrasectoriales y de diversificación de las empresas.

Understanding Network Governance: A Case Study Exploration of Active Canada 20/20

Consistent with the governance shift towards network forms of governance, a number of new social movements have formed in response to the declining levels of physical activity in the Western world. One such movement is Active Canada 20/20: A Physical Activity Strategy and Change Agenda for Canada. Network governance is employed as the theoretical framework for this case study exploration of Active Canada 20/20 and the political landscape surrounding its development and implementation. Semi-structured interviews were conducted in addition to document/policy analysis and direct observations. Analysis of the data resulted in three overarching themes – the defining characteristics of network governance, the political landscape, and intersectoral linkages – that interconnect multifariously based the nature of the Canadian federal government and its relationship with the voluntary sector for physical activity. Despite progress in driving Active Canada 20/20 forward, entrenched dynamics of power need to be navigated within the political landscape surrounding network governance.

Structural Connectivity Of The Default Mode Network And Cognition In Alzheimer׳s Disease.

Disconnectivity between the Default Mode Network (DMN) nodes can cause clinical symptoms and cognitive deficits in Alzheimer׳s disease (AD). We aimed to examine the structural connectivity between DMN nodes, to verify the extent in which white matter disconnection affects cognitive performance. MRI data of 76 subjects (25 mild AD, 21 amnestic Mild Cognitive Impairment subjects and 30 controls) were acquired on a 3.0T scanner. ExploreDTI software (fractional Anisotropy threshold=0.25 and the angular threshold=60°) calculated axial, radial, and mean diffusivities, fractional anisotropy and streamline count. AD patients showed lower fractional anisotropy (P=0.01) and streamline count (P=0.029), and higher radial diffusivity (P=0.014) than controls in the cingulum. After correction for white matter atrophy, only fractional anisotropy and radial diffusivity remained significantly lower in AD compared to controls (P=0.003 and P=0.05). In the parahippocampal bundle, AD patients had lower mean and radial diffusivities (P=0.048 and P=0.013) compared to controls, from which only radial diffusivity survived for white matter adjustment (P=0.05). Regression models revealed that cognitive performance is also accounted for by white matter microstructural values. Structural connectivity within the DMN is important to the execution of high-complexity tasks, probably due to its relevant role in the integration of the network.

Can We Predict The Clinical Outcomes Of Genitourinary Trauma Patients And Offer Them An Evidence-based Support? The Case For Telemedicine Network.

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[gait Speed, Grip Strength And Self-rated Health Among The Elderly: Data From The Fibra Campinas Network, São Paulo, Brazil].

The article seeks to investigate patterns of performance and relationships between grip strength, gait speed and self-rated health, and investigate the relationships between them, considering the variables of gender, age and family income. This was conducted in a probabilistic sample of community-dwelling elderly aged 65 and over, members of a population study on frailty. A total of 689 elderly people without cognitive deficit suggestive of dementia underwent tests of gait speed and grip strength. Comparisons between groups were based on low, medium and high speed and strength. Self-related health was assessed using a 5-point scale. The males and the younger elderly individuals scored significantly higher on grip strength and gait speed than the female and oldest did; the richest scored higher than the poorest on grip strength and gait speed; females and men aged over 80 had weaker grip strength and lower gait speed; slow gait speed and low income arose as risk factors for a worse health evaluation. Lower muscular strength affects the self-rated assessment of health because it results in a reduction in functional capacity, especially in the presence of poverty and a lack of compensatory factors.

Going Beyond Seizure Control: Can Pharmacotherapy Help To Restore Cognitive Network Function?

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Whole Cortical And Default Mode Network Mean Functional Connectivity As Potential Biomarkers For Mild Alzheimer's Disease.

The search for an Alzheimer's disease (AD) biomarker is one of the most relevant contemporary research topics due to the high prevalence and social costs of the disease. Functional connectivity (FC) of the default mode network (DMN) is a plausible candidate for such a biomarker. We evaluated 22 patients with mild AD and 26 age- and gender-matched healthy controls. All subjects underwent resting functional magnetic resonance imaging (fMRI) in a 3.0 T scanner. To identify the DMN, seed-based FC of the posterior cingulate was calculated. We also measured the sensitivity/specificity of the method, and verified a correlation with cognitive performance. We found a significant difference between patients with mild AD and controls in average z-scores: DMN, whole cortical positive (WCP) and absolute values. DMN individual values showed a sensitivity of 77.3% and specificity of 70%. DMN and WCP values were correlated to global cognition and episodic memory performance. We showed that individual measures of DMN connectivity could be considered a promising method to differentiate AD, even at an early phase, from normal aging. Further studies with larger numbers of participants, as well as validation of normal values, are needed for more definitive conclusions.

[strategies For Integration Of Health Care Practices And Sanitary Surveillance In The Context Of The Implementation Of Rede Cegonha - A Brazilian Mother And Infant Health Care Network].

Mother and infant mortality has been the scope of analysis throughout the history of public health in Brazil and various strategies to tackle the issue have been proposed to date. The Ministry of Health has been working on this and the Rede Cegonha strategy is the most recent policy in this context. Given the principle of comprehensive health care and the structure of the Unified Health System in care networks, it is necessary to ensure the integration of health care practices, among which are the sanitary surveillance actions (SSA). Considering that the integration of health care practices and SSA can contribute to reduce mother and infant mortality rates, this article is a result of qualitative research that analyzed the integration of these actions in four cities in the State of São Paulo/Brazil: Campinas, Indaiatuba, Jaguariúna and Santa Bárbara D'Oeste. The research was conducted through interviews with SSA and maternal health managers, and the data were evaluated using thematic analysis. The results converge with other studies, identifying the isolation of health care practices and SSA. The insertion of SSA in collectively-managed areas appears to be a potential strategy for health planning and implementation of actions in the context under scrutiny.