lt;p align="justify"gt; Este trabalho visa propor uma simulação do instrumento da cobrança pelo uso dos recursos hídricos na bacia hidrográfica do rio Piracicaba no Estado de Minas Gerais. Nesta bacia destacam-se como principais segmentos de usuários, o setor de mineração no alto e médio Piracicaba e o setor de siderurgia que representa o maior complexo siderúrgico da América Latina, com suas plantas instaladas na porção do baixo curso do rio Piracicaba, na região conhecida como Vale do Aço. Inicialmente foram apresentadas as legislações de recursos hídricos a nível federal e estadual, particularmente a do Estado de Minas Gerais, destacando seus avanços em relação à federal. Posteriormente foi caracterizada a bacia hidrográfica considerando aspectos físicos e sócio-econômicos, bem como o levantamento dos principais usos dos recursos hídricos para o ano de 2006. Utilizou-se como principal referencia para a simulação da cobrança pelo uso da água na bacia do rio Piracicaba, a metodologia de cobrança aplicada na bacia do rio Paraíba do Sul, (CEIVAP). A partir dos valores dos parâmetros utilizados naquela bacia estimou-se o valor a ser arrecadado com a cobrança na bacia hidrográfica do rio Piracicaba. Recomenda-se a necessidade de reavaliação da metodologia utilizada quando o Comitê IX da Bacia optar pela implantação da cobrança na bacia do rio Piracicaba podendo ser utilizada a nova fórmula de cobrança do CEIVAP que define novos critérios e valores para a cobrança a partir de 2007. Por fim concluiu-se que de uma forma geral a cobrança pelo uso de recursos hídricos na bacia atende os objetivos da legislação federal e estadual de recursos hídricos.lt;/pgt; / lt;p align="justify"gt; This work seeks to simulate the implementation of the management instrument of water use charge in the Piracicaba river basin in the State of Minas Gerais. In this watershed, those which stand out as main user segments are the mining sector, in the upper and medium Piracicaba basin, where the largest minerary complex of the world is located; and the metallurgy sector, that has its largest metallurgical complex in Latin America installed mainly in the lower Piracicaba basin, in the area known as Steel Valley. Initially, the legislation of water resources was presented at federal and state level, particularly of the State of Minas Gerais, detaching its progresses in relation to the norms of federal ambit. Then it was presented a description of the river basin considering physical, climatic and socioeconomic aspects, as well as the survey of the main uses of the water resources in the basin in the year of 2006. It was presented the volume of water granted in the basin for superficial and underground abstractions, per user sector. For the simulation of the water use charge in the basin, it was used the methodology of CEIVAP for the charge in the Paraíba do Sul watershed. From the values of the parameters used in that basin, it was estimated the value to be collected with the charge in the Piracicaba watershed. Then, recommendations were presented for the reevaluation of this methodology when the Basin Committee decides to implement the charge, once the current formula used by CEIVAP for water use charge will be reformulated by 2007. Finally it was concluded that, in a general way, the water use charge in the basin attains the objectives of the federal legislation - the "Water Law", as Law nº 9.433/97 is known -, once it recognizes the economical value of water and gives dimension of its real value to the user; works as an incentive for the user for the rationalization of its use and propitiates the means to obtain funds, what makes possible the financing of programs and interventions foreseen in Water Resources Plans.lt;/pgt;

Health is a fundamental human right. Access to health care, which includes providing a population with safe, effective, good quality drugs at the least possible cost, is a prerequisite to realising that right. Drugs or medicines play a fundamental role in the effectiveness, efficiency and responsiveness of health care systems. Drugs also constitute a major recurrent expense in both state-run and private sector health care. To ensure that health care workers prescribe the most cost-effective drugs through the essential drugs list, training, as well as evaluation and monitoring systems must be regarded as important elements of containing costs. Pharmaceutical benefit management programmes such as pharmacoeconomics, drug utilisation review (DUR), evidence-based medicine and disease management have emerged as tools to ensure cost-effective selection and use of drugs, particularly for chronic diseases. These managed care tools are often investigated to determine whether new technologies or interventions are appropriate and have "value". Affordable prices of medicines, on their own, however, do not ensure access to medicines. Also important are reliable procurement, distribution and storage systems, and appropriately trained personnel to manage these components of drug management. Poorly regulated drug supply systems can have serious consequences such as antibiotic resistance, problems with safety or quality and most importantly wastage, as it is believed that a significant proportion of drugs purchased by the state in South Africa find their way into the private sector market through a "grey market". The general objective of this study was to review and analyse the cost and medicine usage of the "top twenty" pharmaceutical products according to the monthly pharmaceutical purchasing reports of the Department of Health in the North West Province. The research can be classified as retrospective and quantitative. The data used for the analysis were obtained over a two-year study period (1 Apr 2000 - 28 Feb 2002) from the private provider operating the medical stores in the North West Province. The results of the empirical investigation, showed the total number of "top twenty" products appearing during the study period amounted to 460 different products having a total purchasing cost of R 66,263,674.51 representing 37.2% (n = R 178,163,061.50) of all pharmaceutical products purchased during the two-year period. Through analysis it was found, when classified according the Anatomical Therapeutic Chemical (ATC) therapeutic main group, antihypertensives had the highest quantity purchased for year one (20.69%; n = 134,515,640) with cough and cold preparations revealing the highest purchasing quantity for year two (40.55%; n = 103,567,031) of all "top twenty" pharmaceuticals during the study period. Antibacterials for systemic use presented with the highest cost percentages for both years, representing 20.68% (n = R35, 568,221.31) and 16.72% (n = R 31,370,435.51) respectively. Hydrochlorothiazide presented with the highest purchasing quantity for both years when classified according to chemical substance with, Methyldopa having the highest purchasing cost for year one followed by vaccine Hib-DTP 10 dose vial (Haemophilus influenzae type B vaccine-diphtheria, pertusis and tetanus vaccine) for year two. Furthermore it was also found that the majority of the "top twenty" products were in the oral dosage form. Finally it was concluded that drugs used in the treatment of hypertension and cardiac failure were the most utilised in comparison to other "top twenty" products during the study period. Possible misappropriation based on the defined daily dose of the "top twenty" products might have occurred. In completion of this study, recommendations for future research were made. / Thesis (M.Pharm.)--North-West University, Potchefstroom Campus, 2004.

Health is a fundamental human right. Access to health care, which includes providing a population with safe, effective, good quality drugs at the least possible cost, is a prerequisite to realising that right. Drugs or medicines play a fundamental role in the effectiveness, efficiency and responsiveness of health care systems. Drugs also constitute a major recurrent expense in both state-run and private sector health care. To ensure that health care workers prescribe the most cost-effective drugs through the essential drugs list, training, as well as evaluation and monitoring systems must be regarded as important elements of containing costs. Pharmaceutical benefit management programmes such as pharmacoeconomics, drug utilisation review (DUR), evidence-based medicine and disease management have emerged as tools to ensure cost-effective selection and use of drugs, particularly for chronic diseases. These managed care tools are often investigated to determine whether new technologies or interventions are appropriate and have "value". Affordable prices of medicines, on their own, however, do not ensure access to medicines. Also important are reliable procurement, distribution and storage systems, and appropriately trained personnel to manage these components of drug management. Poorly regulated drug supply systems can have serious consequences such as antibiotic resistance, problems with safety or quality and most importantly wastage, as it is believed that a significant proportion of drugs purchased by the state in South Africa find their way into the private sector market through a "grey market". The general objective of this study was to review and analyse the cost and medicine usage of the "top twenty" pharmaceutical products according to the monthly pharmaceutical purchasing reports of the Department of Health in the North West Province. The research can be classified as retrospective and quantitative. The data used for the analysis were obtained over a two-year study period (1 Apr 2000 - 28 Feb 2002) from the private provider operating the medical stores in the North West Province. The results of the empirical investigation, showed the total number of "top twenty" products appearing during the study period amounted to 460 different products having a total purchasing cost of R 66,263,674.51 representing 37.2% (n = R 178,163,061.50) of all pharmaceutical products purchased during the two-year period. Through analysis it was found, when classified according the Anatomical Therapeutic Chemical (ATC) therapeutic main group, antihypertensives had the highest quantity purchased for year one (20.69%; n = 134,515,640) with cough and cold preparations revealing the highest purchasing quantity for year two (40.55%; n = 103,567,031) of all "top twenty" pharmaceuticals during the study period. Antibacterials for systemic use presented with the highest cost percentages for both years, representing 20.68% (n = R35, 568,221.31) and 16.72% (n = R 31,370,435.51) respectively. Hydrochlorothiazide presented with the highest purchasing quantity for both years when classified according to chemical substance with, Methyldopa having the highest purchasing cost for year one followed by vaccine Hib-DTP 10 dose vial (Haemophilus influenzae type B vaccine-diphtheria, pertusis and tetanus vaccine) for year two. Furthermore it was also found that the majority of the "top twenty" products were in the oral dosage form. Finally it was concluded that drugs used in the treatment of hypertension and cardiac failure were the most utilised in comparison to other "top twenty" products during the study period. Possible misappropriation based on the defined daily dose of the "top twenty" products might have occurred. In completion of this study, recommendations for future research were made. / Thesis (M.Pharm.)--North-West University, Potchefstroom Campus, 2004.

Cette thèse interroge les effets de l’intégration de l’impératif participatif dans les organismes HLM à partir de trois terrains de recherche complémentaires : les discours des dirigeants du « Mouvement HLM », les dispositifs de « concertation locative » et les actions de « développement social ». Nous mettons tout d’abord en évidence la manière dont les dispositifs participatifs viennent accompagner le tournant néolibéral de l’action publique à partir de la fin des années 1970 et montrons ce faisant l’ancienneté de la coexistence entre deux formes de participation - la première mettant l’accent sur l’évaluation du service rendu et la seconde sur l’accompagnement social des locataires. Le regard est ensuite porté sur les pratiques actuelles des organismes HLM, étudiées à partir d’une enquête menée au sein d’un organisme HLM dans le cadre d’une convention industrielle de formation par la recherche (CIFRE). En caractérisant les attendus attachés aux dispositifs, les conditions de leur mise en en œuvre et leurs effets sur le système d’acteurs, la démonstration met en lumière le sens donné à la participation dans le milieu HLM, caractérisé par la coexistence de logiques patrimoniale, entrepreneuriale et sociale. Ce faisant, elle enrichit la compréhension des logiques qui président à la formalisation et à la diffusion de dispositifs participatifs dans les sociétés contemporaines d’une part, de leurs effets sur les pratiques professionnelles et les relations entre institutions et individus d’autre part. Cette thèse entend ainsi contribuer à l’analyse des transformations systémiques produites par l’intégration de la participation dans les structures sociales. / This thesis examines the effects of the integration of the participatory imperative in social housing organizations. It is grounded in three complementary fieldworks: "Mouvement HLM"’s speeches, the "rental consultation" settings and "social development"’s actions. This work first demonstrates how participatory mechanisms support the neoliberal turn in public action that started in the late 1970s. In so doing, it shows the historical coexistence between two forms of participation. The first form emphasizes on the evaluation of service delivery. The second insists on social assistance for tenants. The analysis then focuses on social housing organizations’ contemporary practices and is based on a survey conducted in a social housing organization under an Industrial Research Training Convention (CIFRE). Looking at the participatory settings’ expected outcomes, their implementation’s prerequisites and their effects on the system of actors, the demonstration highlights the meaning of "participation" in social housing organizations which are characterized by the coexistence of patrimonial, entrepreneurial and social logics. On the one hand, this thesis broadens the understanding of the logics that govern the formalization and the propagation of participatory settings in contemporary society. On the other hand, it deepens the comprehension of participatory setting’s effects on professional practices and relationships between individuals and institutions. Therefore, this thesis aims to contribute to the analysis of systemic transformations produced by the integration of participation in social structures.