Os Centros de Saúde do Rio de Janeiro são analisados enquanto uma organização estruturada para desempenhar, na área da saúde, parte das funções do aparato burocrático do Estado brasileiro. Seu papel institucional vincula-se à emergência de novos problemas sanitários numa sociedade em processo de urbanização e de consolidação de um Estado nacional. Ao longo de usa trajetória histórica passou por situações distintas, no que se refere ao seu papel no Sistema de Saúde, articuladas a determinantes de natureza técnica e política. Enquanto fenômeno burocrático, esta organização sobreviveu às diversas conjunturas históricas interpondo resistências, que se manifestaram, principalmente, pela lentidão com que eram processadas as mudanças internas propostas. / The Health Centers in the city of Rio de Janeiro are analyzed as organizations that have been structured to execute parto of the bureaucratic duties petaining to the brazilian State, as far as health care is concerned. Their role, as institutions, is related to the solution of new problems, in their sanitary aspects, that are emerging in a society in processo f increasing urbanization and inside a process of organizing a National State. Along the course of their history, these organization have overcome various distinctive situations, dependind on technical and political determinants. As bureaucratic phenomena, this organization have survived many historical conjuntures, presenting itself as resistant to the proposed changes, mainly by slow ways of implementing these propositions.

This thesis is a study of British colonial policy in southern Afiica in the 1 gill centwy. More specifically it looks at how British imperial policy, in the period 1875 to 1881, played itself out in two British colonies in southern Africa, Wlder the direction of a British imperial agent, William Owen Lanyon. It sets Lanyon in the context of the frontiers and attempts to link the histories of the people who lived there, the Africans, Boers and British settlers on the one han~ and the histories of colonial policy on the other. In doing so it also unravels the relationship between Lanyon and his superiors in London and those in southern Africa. In 1875 Owen Lanyon arrived in Griqualand West, where his brief was to help promote a confederation policy in southern Africa. Because of the discovery of diamonds some years earlier, Lanyon's administration had to take account of the rising mining industry and the aggressive new capitalist economy. He also had to deal with Griqua and Tlhaping resistance to colonialism. Lanyon was transferred to the Transvaal in 1879, where he was confronted by another community that was dissatisfied with British rule: the Transvaal Boers. Indeed, in Pretoria he was faced with an extremely difficult situation, which he handled very poorly. Boer resistance to imperial rule eventually came to a head when war broke out and Lanyon and his officials were among those besieged in Pretoria. In February 1881 imperial troops suffered defeat at the hands of Boer commandos at Majuba and Lanyon was recalled to Britain. In both colonies Lanyon was caught up in the struggle between the imperial power and the local people and, seen in a larger context, in the conflict for white control over the land and labour of Africans and that between the old pre-mineral South Africa and the new capitalist order. He made a crucial contribution to developments in the sub-continent and it is remarkable that his role in southern Africa has thus far been neglected. / History / D.Litt. et Phil. (History)

INTRODUÇÃO: Esta tese trata da discussão em torno às perguntas necessárias para compor uma agenda política estratégica da reforma hospitalar brasileira. Buscou-se construir argumentos sobre a relevância de abordar nessas perguntas a grande insuficiência da oferta de leitos hospitalares, como indicador da falta de resposta oportuna em volume e qualidade para materializar a resposta às necessidades da população e garantir os direitos humanos e sociais à saúde, conforme os preceitos constitucionais de 1988. MÉTODOS: O estudo adotou um enfoque desde a perspectiva de política de saúde, o que nos remete ao debate sobre processo e poder, destacando os ciclos de formulação e implementação de políticas, a hierarquização desses debates como de política estratégica (High Politics) ou setorial (Low Politics) e as condições requeridas em termos de atores e espaços de decisão a considerar. Realizou-se a revisão da experiência internacional para identificar as referências do número e perfil de leitos requeridos para atender populações nacionais em seus territórios e também foram resgatados os parâmetros adotados no Brasil desde o Estado Novo. Para a análise da oferta hospitalar entre 2005 e 2014, foram utilizados os dados secundários extraídos do Cadastro Nacional de Estabelecimentos em Saúde - CNES, do Sistema de Informações Ambulatoriais e Hospitalares - SIA / SIH, da Agencia Nacional de Saúde Suplementar - ANS e do Instituto Brasileiro de Geografia e Estatística - IBGE. RESULTADOS: 1. O número e tipo de leitos necessários e o número, porte, tipo e características sistêmicas dos serviços hospitalares que os abrigariam, são temas que se consideraram relevantes para compor as perguntas para a agenda estratégica em debate. 2. A análise da política do período 2004 a 2014 permite identificar a fragmentação e descontinuidade das ações mesmo obtendo resultados pontuais de melhora, mas afastando-se da promessa estratégica de algumas agendas ensaiadas no período. 3. Ganhou destaque a diminuição continuada do estoque geral de leitos e de leitos para o SUS, alcançando níveis muito inferiores a qualquer parâmetro comparativo de outros sistemas universais de saúde, particularmente quando adotou-se o critério de leitos efetivos para examinar a oferta de leitos e seu desempenho. Na Saúde Suplementar houve aumento de leitos, porém queda no número por mil assegurados dado o crescimento das coberturas hospitalares no período. CONCLUSÕES: A crise persistente de acesso hospitalar constitui razão para construir uma agenda estratégica para a reforma hospitalar brasileira. Ao buscar o caminho para elevar o tema da crise hospitalar a um tratamento de alta política, foram mapeados: o conteúdo de política hospitalar dos planos estaduais de saúde, documentos técnicos estaduais e organogramas de coordenação da atenção hospitalar estadual, examinando-se a possibilidade dos governos estaduais liderarem no processo de regionalização a construção de uma agenda política estratégica estadual e nacional, fortalecendo o diálogo entre os entes federados, incluindo seus próprios prestadores e os prestadores não estatais particularmente os filantrópicos, além de estender o diálogo com o corpo médico e os usuários entendidos como cidadãos sujeitos de direitos. Para alicerçar este caminho possível se apresenta o processo de elaboração participativa de planos diretores de redes e hospitais por estados e suas regiões, como forma de construção de comunidades epistêmicas e suas projeções para a sustentação de uma agenda para a alta política, orientada a alcançar 4 leitos por 1000 habitantes em 20 anos de esforço sustentado / INTRODUCTION: This thesis addresses the debate on the questions that should be part of a strategic political agenda of the Brazilian hospital reform. The purpose is to develop arguments on the relevance that such questions should approach the huge insufficient supply of hospital beds, as an indicator of the lack of timely answer, in number and quality, to materialize people\'s needs, and therefore to guarantee the human and social rights to health, according to the 1988 constitutional principles. METHODS: This study adopts the approach from the health policy perspective, referring us to debates on process and power, and outlining the cycles of policy formulation and implementation, as well as the classification of these debates as strategic policy (High Politics) or sectorial policy (Low Politics), and the required conditions in terms of actors and decision-making spaces. A review of international experience was carried out to identify data on number and types of hospital beds necessary to attend national populations in their territories; moreover a review of the parameters adopted in Brazil since President Vargas\' dictatorship, known as the New State (1937-1945), was also carried out. For the analysis of the hospital supply between 2005 and 2014, we used secondary data drawn from the National Health Facilities Register - CNES, both the Ambulatory and Hospital Information Systems - SIA / SIH, National Regulatory Agency for Private Health Insurance and Plans - ANS, and Brazilian Institute of Geography and Statistics - IBGE. RESULTS: 1. The topics considered relevant to set the issues for the strategic agenda are: number and type of necessary beds; and number, size, type and systemic characteristics of the hospital services that would provide the beds. 2. The political analysis of the period between 2004 and 2014 allows us to identify fragmentation and discontinuity of actions, limited improvement, and failure to fulfil the strategic promise of some agendas that were tried out during that time frame. 3. The on-going decrease in the total number of national hospital beds and at the Unified Health System (SUS) is outlined, showing much lower levels than any comparative parameter of other universal national health systems, particularly when considering effective beds in the analysis of beds\' supply and its performance. In Private Health, there has been an increase in beds, but also a decrease in the number per 1,000 insureds in view of the increase in the insurance coverings in that period. We refer the persistent crisis of the hospital access as the reason to build a strategic agenda for the Brazilian hospital reform. CONCLUSIONS: In our effort to find a path that could elevate the hospital crisis\' topic to be addressed as a high politics, we delineated the content of hospital policy in Brazilian States\' health plans, technical documents, and organization charts of their hospital care coordination; considering the possibility of States\' governments lead, in the regionalization process, the development of both state and national strategic political agenda; as well as strengthen dialogue among the federated entities and the non-state providers, especially the philanthropic ones; and also extend the dialogue with medical professionals and service users who should be regarded as citizens-subjects endowed with rights. To pave this possible path we indicate the process of participative development of director plans of hospitals networks for the States and their regions, as a mean of developing epistemic communities and their projections to the sustainability of an agenda for high politics aimed to achieve 4 beds for 1,000 inhabitants in 20 years of sustained effort

INTRODUÇÃO: Esta tese trata da discussão em torno às perguntas necessárias para compor uma agenda política estratégica da reforma hospitalar brasileira. Buscou-se construir argumentos sobre a relevância de abordar nessas perguntas a grande insuficiência da oferta de leitos hospitalares, como indicador da falta de resposta oportuna em volume e qualidade para materializar a resposta às necessidades da população e garantir os direitos humanos e sociais à saúde, conforme os preceitos constitucionais de 1988. MÉTODOS: O estudo adotou um enfoque desde a perspectiva de política de saúde, o que nos remete ao debate sobre processo e poder, destacando os ciclos de formulação e implementação de políticas, a hierarquização desses debates como de política estratégica (High Politics) ou setorial (Low Politics) e as condições requeridas em termos de atores e espaços de decisão a considerar. Realizou-se a revisão da experiência internacional para identificar as referências do número e perfil de leitos requeridos para atender populações nacionais em seus territórios e também foram resgatados os parâmetros adotados no Brasil desde o Estado Novo. Para a análise da oferta hospitalar entre 2005 e 2014, foram utilizados os dados secundários extraídos do Cadastro Nacional de Estabelecimentos em Saúde - CNES, do Sistema de Informações Ambulatoriais e Hospitalares - SIA / SIH, da Agencia Nacional de Saúde Suplementar - ANS e do Instituto Brasileiro de Geografia e Estatística - IBGE. RESULTADOS: 1. O número e tipo de leitos necessários e o número, porte, tipo e características sistêmicas dos serviços hospitalares que os abrigariam, são temas que se consideraram relevantes para compor as perguntas para a agenda estratégica em debate. 2. A análise da política do período 2004 a 2014 permite identificar a fragmentação e descontinuidade das ações mesmo obtendo resultados pontuais de melhora, mas afastando-se da promessa estratégica de algumas agendas ensaiadas no período. 3. Ganhou destaque a diminuição continuada do estoque geral de leitos e de leitos para o SUS, alcançando níveis muito inferiores a qualquer parâmetro comparativo de outros sistemas universais de saúde, particularmente quando adotou-se o critério de leitos efetivos para examinar a oferta de leitos e seu desempenho. Na Saúde Suplementar houve aumento de leitos, porém queda no número por mil assegurados dado o crescimento das coberturas hospitalares no período. CONCLUSÕES: A crise persistente de acesso hospitalar constitui razão para construir uma agenda estratégica para a reforma hospitalar brasileira. Ao buscar o caminho para elevar o tema da crise hospitalar a um tratamento de alta política, foram mapeados: o conteúdo de política hospitalar dos planos estaduais de saúde, documentos técnicos estaduais e organogramas de coordenação da atenção hospitalar estadual, examinando-se a possibilidade dos governos estaduais liderarem no processo de regionalização a construção de uma agenda política estratégica estadual e nacional, fortalecendo o diálogo entre os entes federados, incluindo seus próprios prestadores e os prestadores não estatais particularmente os filantrópicos, além de estender o diálogo com o corpo médico e os usuários entendidos como cidadãos sujeitos de direitos. Para alicerçar este caminho possível se apresenta o processo de elaboração participativa de planos diretores de redes e hospitais por estados e suas regiões, como forma de construção de comunidades epistêmicas e suas projeções para a sustentação de uma agenda para a alta política, orientada a alcançar 4 leitos por 1000 habitantes em 20 anos de esforço sustentado / INTRODUCTION: This thesis addresses the debate on the questions that should be part of a strategic political agenda of the Brazilian hospital reform. The purpose is to develop arguments on the relevance that such questions should approach the huge insufficient supply of hospital beds, as an indicator of the lack of timely answer, in number and quality, to materialize people\'s needs, and therefore to guarantee the human and social rights to health, according to the 1988 constitutional principles. METHODS: This study adopts the approach from the health policy perspective, referring us to debates on process and power, and outlining the cycles of policy formulation and implementation, as well as the classification of these debates as strategic policy (High Politics) or sectorial policy (Low Politics), and the required conditions in terms of actors and decision-making spaces. A review of international experience was carried out to identify data on number and types of hospital beds necessary to attend national populations in their territories; moreover a review of the parameters adopted in Brazil since President Vargas\' dictatorship, known as the New State (1937-1945), was also carried out. For the analysis of the hospital supply between 2005 and 2014, we used secondary data drawn from the National Health Facilities Register - CNES, both the Ambulatory and Hospital Information Systems - SIA / SIH, National Regulatory Agency for Private Health Insurance and Plans - ANS, and Brazilian Institute of Geography and Statistics - IBGE. RESULTS: 1. The topics considered relevant to set the issues for the strategic agenda are: number and type of necessary beds; and number, size, type and systemic characteristics of the hospital services that would provide the beds. 2. The political analysis of the period between 2004 and 2014 allows us to identify fragmentation and discontinuity of actions, limited improvement, and failure to fulfil the strategic promise of some agendas that were tried out during that time frame. 3. The on-going decrease in the total number of national hospital beds and at the Unified Health System (SUS) is outlined, showing much lower levels than any comparative parameter of other universal national health systems, particularly when considering effective beds in the analysis of beds\' supply and its performance. In Private Health, there has been an increase in beds, but also a decrease in the number per 1,000 insureds in view of the increase in the insurance coverings in that period. We refer the persistent crisis of the hospital access as the reason to build a strategic agenda for the Brazilian hospital reform. CONCLUSIONS: In our effort to find a path that could elevate the hospital crisis\' topic to be addressed as a high politics, we delineated the content of hospital policy in Brazilian States\' health plans, technical documents, and organization charts of their hospital care coordination; considering the possibility of States\' governments lead, in the regionalization process, the development of both state and national strategic political agenda; as well as strengthen dialogue among the federated entities and the non-state providers, especially the philanthropic ones; and also extend the dialogue with medical professionals and service users who should be regarded as citizens-subjects endowed with rights. To pave this possible path we indicate the process of participative development of director plans of hospitals networks for the States and their regions, as a mean of developing epistemic communities and their projections to the sustainability of an agenda for high politics aimed to achieve 4 beds for 1,000 inhabitants in 20 years of sustained effort

L’objectif de l’étude consiste en l’analyse de l’organisation administrative du bureau de l’agriculture de la province d’Umma à l’époque de la Troisième Dynastie d’Ur. La comparaison avec la situation qui prévaut dans la province méridionale de Girsu-Lagaš montre que le secteur agricole d’Umma est environ cinq fois moins important que de sa voisine.<p>L’étude identifie les districts agricoles de la province d’Umma et leurs responsables. Elle définit en outre le nombre de charrues utilisées pour cultiver les terres arables de l’état ainsi que leur répartition par district.<p>Elle propose enfin dans un deuxième volume une prosopographie des administrateurs de domaines agricoles et des laboureurs. / Doctorat en Langues et lettres / info:eu-repo/semantics/nonPublished

This thesis is a study of British colonial policy in southern Afiica in the 1 gill centwy. More specifically it looks at how British imperial policy, in the period 1875 to 1881, played itself out in two British colonies in southern Africa, Wlder the direction of a British imperial agent, William Owen Lanyon. It sets Lanyon in the context of the frontiers and attempts to link the histories of the people who lived there, the Africans, Boers and British settlers on the one han~ and the histories of colonial policy on the other. In doing so it also unravels the relationship between Lanyon and his superiors in London and those in southern Africa. In 1875 Owen Lanyon arrived in Griqualand West, where his brief was to help promote a confederation policy in southern Africa. Because of the discovery of diamonds some years earlier, Lanyon's administration had to take account of the rising mining industry and the aggressive new capitalist economy. He also had to deal with Griqua and Tlhaping resistance to colonialism. Lanyon was transferred to the Transvaal in 1879, where he was confronted by another community that was dissatisfied with British rule: the Transvaal Boers. Indeed, in Pretoria he was faced with an extremely difficult situation, which he handled very poorly. Boer resistance to imperial rule eventually came to a head when war broke out and Lanyon and his officials were among those besieged in Pretoria. In February 1881 imperial troops suffered defeat at the hands of Boer commandos at Majuba and Lanyon was recalled to Britain. In both colonies Lanyon was caught up in the struggle between the imperial power and the local people and, seen in a larger context, in the conflict for white control over the land and labour of Africans and that between the old pre-mineral South Africa and the new capitalist order. He made a crucial contribution to developments in the sub-continent and it is remarkable that his role in southern Africa has thus far been neglected. / History / D.Litt. et Phil. (History)

Officier de cavalerie originaire de la noblesse picarde, Armand de Caulaincourt (1773-1827) gravit rapidement tous les échelons de la cour consulaire puis impériale, devenant en 1804 grand-écuyer de l’Empire. Mais, malgré l’importance de ses fonctions curiales, Napoléon le destine à une carrière de diplomate. Après différentes missions, il le nomme ambassadeur de France en Russie, à la fin de l’année 1807. Fervent partisan de l’alliance de Tilsit, Caulaincourt participe à toutes les grandes négociations franco-russes mais doit assister à la lente dégradation des relations entre les deux empires. À son retour à Paris en 1811, son bilan politique est maigre. Sa défense opiniâtre du tsar Alexandre, mais surtout son opposition à la campagne militaire qui se prépare, irritent Napoléon. Elles lui permettent toutefois d’acquérir une nouvelle stature après le désastre de Russie : pour ses contemporains Caulaincourt devient l’« homme de la paix ». Une image que Napoléon réutilise lorsqu’il le charge de le représenter aux congrès de Prague (1813) et de Châtillon (1814). Le duc de Vicence, devenu ministre des Relations extérieures, ne parvient pas à faire accepter la paix ; il lui faut finalement négocier l’abdication de Napoléon et renoncer, après les Cent-Jours, à toute carrière politique. Cette étude, qui s’appuie sur les archives personnelles de Caulaincourt et ses célèbres Mémoires, entend redonner toute son importance à cette figure majeure du Premier Empire, en insistant sur son action et sa pensée dans le domaine de la diplomatie. L’exemple de ce parcours devant permettre de contribuer à reconsidérer et réévaluer le rôle du personnel diplomatique napoléonien. / A cavalry officer born into Picardy's landed gentry, Armand de Caulaincourt rose rapidly through the ranks of the consular, and later the imperial court, to become in 1804 Grand Squire of the Empire. However, notwithstanding the importance of his curial functions, Napoleon destined him to a diplomatic career. After several missions, he was appointed as Ambassador of France to Russia (1807). Caulaincourt took part in all the major negotiations between France and Russia, but was forced to witness a slow breakdown in relations between the two Empires. At the time of his return to Paris in 1811, his political accomplishments were unimpressive. His stalwart defense of Tsar Alexander, and especially his opposition to the upcoming military campaign, were an irritation to Napoleon. Nevertheless, these stances allowed him to gain new stature after the disaster in Russia : in the eyes of his contemporaries, he became the “Peacemaker”, an image Napoleon used to his advantage by appointing him his representative at the congresses in Prague (1813) and in Châtillon (1814). The Duke of Vicenza, now Minister for Foreign Affairs, could not, however, broker an agreement in favour of peace : he was forced to negotiate Napoleon's abdication and to give up any hope of political career after the Hundred Days. This study, based on Caulaincourt's personal records and famous Memoirs, aims at restoring a major figure of the First French Empire to his due importance, while focusing on his action and thought in the field of diplomacy. The exemplary value of his career should also allow historians to reconsider and reevaluate the role of Napoleon's diplomatic personnel.