A presente dissertação objetiva demonstrar a aplicabilidade dos conceitos relativos à arquitetura organizacional à criação de entidade de autogestão em saúde. Para atingir este propósito agregamos à revisão bibliográfica de trabalhos versando sobre a nova teoria da firma e sobre o mercado de saúde suplementar brasileiro informações coletadas a partir da experiência profissional do autor e de colaboradores atuantes no setor em questão. A fundamentàção teórica agrupando os conceitos econômicos utilizados no trabalho conjugada com a realização de retrospectiva histórica do setor, bem como a contextualização de seu cenário atual, possibilitaram a construção de proposta para constituição de entidade de autogestão . em saúde do tipo patrocinada.Desse modo, podemos concluir que a correta leitura do ambiente de negócios ao qual se vincula, traduzida na elaboração de estratégia viabilizadora das aspirações da entidade, possibilita estruturar a firma sob o critério de melhor uso do conhecimento específico disperso entre os empregados. Para tanto, deve-se definir uma política de delegação de poder para tomada de decisões aos colaboradores conjuntamente com a formulação de sistemas de incentivos e avaliação e monitoramento de performance como alternativa eficiente na busca pela maximização do resultado da instituição. / The present dissertation objective to demonstrate the applicability of the relative concepts to the organizacional architecture to the creation of entity of self management in health. To reach this intention we add to the bibliographical revision of works turning on the new theory of the firm and on the brazilian market of suplemental health the information collected from the professional experience of the author and of operating collaborators in the sector in questiono The theoretical recital grouping the used economic concepts in the work conjugated with the accomplishment of historical retrospect of the sector, as well as the contextualization of its current scene, makes possible the construction of proposal for constitution of entity of self management in health of the sponsored type. In this manner, we can conclude that the correct business-oriented reading of the environment which if ties, translated in the elaboration of strategy of the aspirations of the entity, makes possible to structuralize the firm under the criterion of better use of the dispersed specific knowledge between the employees. For in such a way, one politics of delegation of jointly being able for taking of decisions to the collaborators with the formularization of systems of incentives and evaluation and monitoring of efficient performance as alternative in the search for the maximization of the result of the institution must be defined.

La présente thèse a pour but d'effectuer une étude des effets de la réélection immédiate sur les exécutifs des unités sous-nationales de l'Argentine, le Brésil et l'Uruguay entre 1983-2006. À partir de ce travail on prétend constater quels sont les effets véritablement appréciables de ce mécanisme sur les systèmes politiques sousnationaux. On part de l'hypothèse que cette modalité de réélection provoque des effets les niveaux de concurrence du système de partis, sur la permanence du parti de gouvernement, et dans l'interne de ce. Cette recherche essaye d'approfondir dans la discussion (présent dans une vaste littérature) des effets et les règles électorales sur les systèmes politiques et en particulier de la réélection immédiate aujourd'hui adoptée par quelques pays latino-americains et en débat dans plusieurs de d'eux au niveau présidentiel. L'objectif final de ce travail n'est pas de prononcer à faveur - ou dans contre - de la réélection immédiate, ni s'agit d'un débat élémentairement normatif, mais essaye de présenter quelques questions ponctuelles qu'ils peuvent servir à améliorer le niveau de discussion sur cette dernière. / The present thesis must as objective make a study of the effects of the immediate re-election on the executives of the subnational units of Argentina, Brazil and Uruguay between 1983-2006. From this work it is tried to state as they are the truely appreciable effects of this mechanism on the subnational political systems. Part of the hypothesis that this modality of re-election causes effects in the levels of competition of the system of parties, in the permanence of the government party, and in the internal one of this. This investigation tries to deepen in the discussion (present in a vast Literature) of the effects and the electoral rules on the political systems and in individual of the reelection immediate today adopted by some Latin American countries and in debate in several of them to presidential level. The final mission of this work is not to pronounce itself to favor - or in against of the immediate re-election, nor is an elementarily normative debate, but that tries to present/display some precise questions that can serve to improve the discussion level about the same one. / La presente tesis tiene como objetivo realizar un estudio de los efectos de la reelección inmediata sobre los ejecutivos de las unidades subnacionales de Argentina, Brasil y Uruguay entre 1982-2007. A partir de este trabajo se pretende constatar cuales son los efectos verdaderamente apreciables de este mecanismo sobre los sistemas políticos subnacionales. Se parte de la hipótesis de que esta modalidad de reelección provoca efectos en los niveles de competencia del sistema de partidos, en la permanencia del partido de gobierno, y en la interna de este. Esta investigación intenta profundizar en la discusión (presente en una vasta literatura) sobre los efectos de las reglas electorales sobre los sistemas políticos y en particular de la reelección inmediata hoy adoptada por algunos países latinoamericanos y en debate en varios de ellos a nivel presidencial. El objetivo final de este trabajo no es pronunciarse a favor -o en contra- de la reelección inmediata, ni se trata de un debate elementalmente normativo, sino que intenta presentar algunas cuestiones puntuales que pueden servir para mejorar el nivel de discusión acerca de la misma.

Text in English / The aim of the study was to describe the competencies of midwives during the provision of immediate postnatal care (PNC) with the intention of adapting and linking international best practice guidelines as well as a conceptual framework for the implementation of PNC in Swaziland. A quantitative cross-sectional design study was conducted to investigate the competencies of midwives during the provision of immediate postnatal care services to mothers and their infants. A systematic random sampling technique was used to select eighty-eight (88) midwives and six (6) senior midwives to participate in the study. Data collection was done using structured questionnaires. Quantitative data was complemented by data that was generated from open-ended questions at the end of the questionnaires. Data analysis was conducted using IBM SPSS Statistics version 22.0 software. The study highlighted that all the midwives who participated in this study had the relevant qualification. Of the respondents, 70.5% were state-certified midwives with a second registered certificate, 27.3% had bachelor’s degrees, while 2.3% had an advanced midwifery certificate. The study found no difference between the type of qualification of midwives and the knowledge of PNC interventions to be offered to mothers immediately post-delivery across different qualifications held by the midwives (Kruskal-Wallis test: x2=5.498, df=2, p=0.064). Gaps were identified in their knowledge and practices. There were discrepancies in the level of knowledge and practices regarding maternal vital sign assessment immediately after delivery (within 30 minutes). It was noted that these vital signs, i.e. blood pressure (12.5%), temperature (50.0%), pulse (54.5%), respiration (63.6%) were not taken after delivery. It was also noted that 15.0%, 58.0%, 64.8% of the respondents were not aware of the importance of assessing newborns for APGAR, skin-to-skin contact and drying the neonate. The study found that there were no postnatal care guidelines in Swaziland. The findings of the study led to the adaption and linkage of the latest international evidence-based guidelines and a conceptual framework for the implementation of immediate PNC to mothers and their infants in Swaziland. / Health Studies / D. Litt. et Phil. (Health Studies)

The aim of the current study was to determine the occurrence and effects of corporal punishment in the South African environment. Special attention was paid to themes that were derived from the literature. These themes were immediate compliance, aggression and the parental influence of corporal punishment. This was a quantitative study which utilised a survey developed by the researcher using previous literature on the topic of corporal punishment. The sample was taken from four different schools in the Johannesburg area. The sample consisted of one hundred and twenty one children within middle childhood (N=121). It was found that corporal punishment is occurring in South African homes. It was also found that children do not feel indifferent about the use of corporal punishment. When it came to the use of corporal punishment and socio-economic status, it was found that there is a significant correlation between the two. / Social Work / M.Diac (Play therapy)

CIS/SOCS (cytokine-inducible SH2 protein/suppressor of cytokine signaling) are a family of proteins that are thought to act as negative regulators of signaling by erythropoetin, interleukin-6 and other cytokines whose receptors are related to the growth hormone receptor (GHR), and like growth hormone (GH), signal through the JAK/STAT pathway. We examined the possibility that CIS/SOCS proteins may also be involved in GH signaling, in particular, in termination of the transient insulin-like effects of GH. mRNAs for CIS, SOCS3, and to a lesser extent SOCS1 were detectable by Northern blot analysis of rat adipocyte total RNA, and the expression of CIS and SOCS3 was markedly increased 30 min after incubation with 500 ng/ml hGH. Both CIS and SOCS3 were detected in adipocyte extracts by immunoprecipitation and immunoblotting with their corresponding antisera. GH stimulated the tyrosine phosphorylation of a 120 kDa protein (p120) that was co-precipitated from adipocyte extracts along with αCIS and detected in Western blots with phospho-tyrosine antibodies. However, no tyrosine phosphorylated proteins in these cell extracts were immunoprecipitated with antibodies to CIS3/SOCS3. p120 was later identified as the GHR based on the observations that two GHR antibodies recognized p120 in scale-up experiments and that p120 and the GHR share several characteristics, including their molecular weights, tyrosine phosphorylation upon GH stimulation, interaction with CIS, similar extent of glycosylation as judged by electrophoretic mobility shift after Endo F digestion, comparable mobility shifts upon thrombin digestion, and N-terminal histidine-tagging. The findings, however, do not rule out the possibility that there might be other tyrosine phosphorylated 120 kDa protein(s) that interact with CIS and contribute to the p120 signal, as well as the GHR. Further studies of the association of CIS with the GHR revealed that CIS might selectively interact with multiply tyrosine phosphorylated forms of the GHR, and these tyrosines are likely located near the carboxyl end of the GHR. Overexpression of CIS partially inhibited GH-induced STAT5 phosphorylation in CHO cells. Studies in freshly isolated and GH-deprived (sensitive) adipocytes revealed that the abundance of CIS does not correlate with the termination of the insulin-like effects of GH or the emergence of refractoriness. Neither the association of CIS with the GHR nor the tyrosine phosphorylation status of the GHR, JAK2 and STAT5 appear responsible for refractoriness in adipocytes. These data imply that some negative regulators other than CIS might contribute to the termination of GH-induced insulin-like effects in adipocytes.

A presente dissertação objetiva demonstrar a aplicabilidade dos conceitos relativos à arquitetura organizacional à criação de entidade de autogestão em saúde. Para atingir este propósito agregamos à revisão bibliográfica de trabalhos versando sobre a nova teoria da firma e sobre o mercado de saúde suplementar brasileiro informações coletadas a partir da experiência profissional do autor e de colaboradores atuantes no setor em questão. A fundamentàção teórica agrupando os conceitos econômicos utilizados no trabalho conjugada com a realização de retrospectiva histórica do setor, bem como a contextualização de seu cenário atual, possibilitaram a construção de proposta para constituição de entidade de autogestão . em saúde do tipo patrocinada.Desse modo, podemos concluir que a correta leitura do ambiente de negócios ao qual se vincula, traduzida na elaboração de estratégia viabilizadora das aspirações da entidade, possibilita estruturar a firma sob o critério de melhor uso do conhecimento específico disperso entre os empregados. Para tanto, deve-se definir uma política de delegação de poder para tomada de decisões aos colaboradores conjuntamente com a formulação de sistemas de incentivos e avaliação e monitoramento de performance como alternativa eficiente na busca pela maximização do resultado da instituição. / The present dissertation objective to demonstrate the applicability of the relative concepts to the organizacional architecture to the creation of entity of self management in health. To reach this intention we add to the bibliographical revision of works turning on the new theory of the firm and on the brazilian market of suplemental health the information collected from the professional experience of the author and of operating collaborators in the sector in questiono The theoretical recital grouping the used economic concepts in the work conjugated with the accomplishment of historical retrospect of the sector, as well as the contextualization of its current scene, makes possible the construction of proposal for constitution of entity of self management in health of the sponsored type. In this manner, we can conclude that the correct business-oriented reading of the environment which if ties, translated in the elaboration of strategy of the aspirations of the entity, makes possible to structuralize the firm under the criterion of better use of the dispersed specific knowledge between the employees. For in such a way, one politics of delegation of jointly being able for taking of decisions to the collaborators with the formularization of systems of incentives and evaluation and monitoring of efficient performance as alternative in the search for the maximization of the result of the institution must be defined.

La présente thèse a pour but d'effectuer une étude des effets de la réélection immédiate sur les exécutifs des unités sous-nationales de l'Argentine, le Brésil et l'Uruguay entre 1983-2006. À partir de ce travail on prétend constater quels sont les effets véritablement appréciables de ce mécanisme sur les systèmes politiques sousnationaux. On part de l'hypothèse que cette modalité de réélection provoque des effets les niveaux de concurrence du système de partis, sur la permanence du parti de gouvernement, et dans l'interne de ce. Cette recherche essaye d'approfondir dans la discussion (présent dans une vaste littérature) des effets et les règles électorales sur les systèmes politiques et en particulier de la réélection immédiate aujourd'hui adoptée par quelques pays latino-americains et en débat dans plusieurs de d'eux au niveau présidentiel. L'objectif final de ce travail n'est pas de prononcer à faveur - ou dans contre - de la réélection immédiate, ni s'agit d'un débat élémentairement normatif, mais essaye de présenter quelques questions ponctuelles qu'ils peuvent servir à améliorer le niveau de discussion sur cette dernière. / The present thesis must as objective make a study of the effects of the immediate re-election on the executives of the subnational units of Argentina, Brazil and Uruguay between 1983-2006. From this work it is tried to state as they are the truely appreciable effects of this mechanism on the subnational political systems. Part of the hypothesis that this modality of re-election causes effects in the levels of competition of the system of parties, in the permanence of the government party, and in the internal one of this. This investigation tries to deepen in the discussion (present in a vast Literature) of the effects and the electoral rules on the political systems and in individual of the reelection immediate today adopted by some Latin American countries and in debate in several of them to presidential level. The final mission of this work is not to pronounce itself to favor - or in against of the immediate re-election, nor is an elementarily normative debate, but that tries to present/display some precise questions that can serve to improve the discussion level about the same one. / La presente tesis tiene como objetivo realizar un estudio de los efectos de la reelección inmediata sobre los ejecutivos de las unidades subnacionales de Argentina, Brasil y Uruguay entre 1982-2007. A partir de este trabajo se pretende constatar cuales son los efectos verdaderamente apreciables de este mecanismo sobre los sistemas políticos subnacionales. Se parte de la hipótesis de que esta modalidad de reelección provoca efectos en los niveles de competencia del sistema de partidos, en la permanencia del partido de gobierno, y en la interna de este. Esta investigación intenta profundizar en la discusión (presente en una vasta literatura) sobre los efectos de las reglas electorales sobre los sistemas políticos y en particular de la reelección inmediata hoy adoptada por algunos países latinoamericanos y en debate en varios de ellos a nivel presidencial. El objetivo final de este trabajo no es pronunciarse a favor -o en contra- de la reelección inmediata, ni se trata de un debate elementalmente normativo, sino que intenta presentar algunas cuestiones puntuales que pueden servir para mejorar el nivel de discusión acerca de la misma.

Propósito: O objetivo deste estudo foi avaliar a estabilidade primária com análise de freqüência de ressonância e a resposta óssea por histomorfometria em implantes sob tratamento com carga imediata e carga precoce. Material e método: Foram colocados três implantes Replace Select (Nobel Biocare, Suécia) em cada lado da mandíbula de 8 cães, totalizando 48 implantes no estudo. Um par de implantes foi selecionado para o protocolo de carga imediata (CI). Após sete dias, o segundo par de implantes recebeu as próteses para o protocolo de carga precoce (CP). Catorze dias após a colocação dos implantes, o terceiro par de implantes recebeu as próteses para o protocolo de carga precoce tardia (CPT). Em cada período foi medida a estabilidade dos implantes por freqüência de ressonância. Após o período total de doze semanas da colocação das próteses os animais foram sacrificados e os espécimes foram preparados para análise histomorfométrica. As diferenças entre os tempos de carregamento para os seguintes parâmetros: estabilidade, contato ossoimplante (COI), densidade óssea (DO) e perda da crista óssea (PCO) foram avaliadas usando ANOVA. Resultados: Os valores iniciais de estabilidade (ISQ) dos implantes foram: 77,88 ± 4,61 para CI, 79,73 ± 3,55 para CP e 79,64 ± 3,00 para CPT, sem diferença estatisticamente significante (p=0,30). Os valores finais de estabilidade foram 80,46 ± 4,23 para CI, 81,88 ± 3,55 para CP e 81,88 ± 3,42 para CPT, também sem diferença estatística (p=0,47). Para avaliar a estabilidade dos implantes em função do tempo, foi realizada ANOVA para amostras repetidas e para cada grupo foi detectado aumento significativo da estabilidade ao final do experimento (p=0,003). A interação método de carregamento versus tempo não foi significativa (p=0,97). A porcentagem de COI para CI foi 77,9 ± 1,71%, para CP foi 79,25 ± 2,11% e para CPT foi 79,42 ± 1,49%. A porcentagem de DO para CI foi 69,97 ± 3,81%, para CP foi 69,23 ± 5,68% e para CPT foi 69,19 ± 2,90%. A PCO para CI foi 1,57 ± 0,22 mm, para CP foi 1,23 ± 0,19 mm e para CPT foi 1,17 ± 0,32 mm. Não foi observada diferença estatística para nenhum dos parâmetros avaliados (p>0,05). Conclusão: Considerando a estabilidade primária, contato osso-implante, densidade óssea ao redor do implante e perda da crista óssea em cães, conclui-se que não existem diferenças estatisticamente significantes num prazo de até 12 semanas para implantes submetidos à ativação imediata, em 7 dias ou 14 dias após a cirurgia. / Purpose: The aim of this study was to evaluate the implant stability through frequency resonance analysis and the effect that different loading time will have on the bone response around implants through a histomorphometric analysis. Material and Methods: Three Replace Select implants were placed on each side of the mandible in 8 dogs totaling 48 implants in the study. One pair of implants was selected for immediate loading protocol (IL). After seven days the second pair of implants received the prostheses for the early loading protocol (EL). In each period, the implant stability measurements were performed by means of resonance frequency. After 12 weeks, a new reading of the implant stability was performed. Fourteen days after the implant placement the third pair of implants received the prostheses for the advanced early loading (AEL). Following a period totaling twelve weeks of prosthetics, the animals were sacrificed and the specimens were prepared for histomorphometric analysis. The differences between loading time in the following parameters: bone-to-implant contact (BIC), bone density (BD) and crestal bone loss (CBL) were evaluated through ANOVA. Results: The mean values of initial stability (ISQ) in different loading times were 77.88 ± 4.61 (IL), 79.73 ± 3.55 (EL) and 79.64 ± 3.00 (AEL). The data were subject to ANOVA and a significant difference was not detected (p = 0.30). The mean values of final stability in different loading times were 80.46 ± 4.23 (IL), 81.88 ± 3.55 (EL) and 81.88 ± 3.42 (AEL). The data were subject to ANOVA and a significant difference was not detected (p = 0.47). To evaluate the implant stability in function of time, a variance analysis for repeated samples was performed, and there was significant difference (p = 0.003), indicating, for each group, a significant increase in stability at the end of the experiment. The time versus method interaction did not show significant difference (p = 0.97), indicating that the variations are similar in the studied groups. The percentage of BIC for IL was 77.9 ± 1.71%, for EL was 79.25 ± 2.11% and for AEL was 79.42 ± 1.49%. The percentage of BD for IL was 69.97 ± 3.81%, for EL was 69.23 ± 5.68% and for AEL was 69.19 ± 2.90%. The CBL for IL was 1.57 ± 0.22mm, for EL was 1.23 ± 0.19mm and for AEL was 1.17 ± 0.32mm. There was no statistical difference for any of the parameters evaluated (p>0.05). Conclusion: Considering primary stability, bone-to-implant contact, bone density around the implants and crestal bone loss, there are no significant differences until 12 weeks after surgery for the stability of immediate, 7 or 14 days after placement activated implants.

A presente dissertação objetiva demonstrar a aplicabilidade dos conceitos relativos à arquitetura organizacional à criação de entidade de autogestão em saúde. Para atingir este propósito agregamos à revisão bibliográfica de trabalhos versando sobre a nova teoria da firma e sobre o mercado de saúde suplementar brasileiro informações coletadas a partir da experiência profissional do autor e de colaboradores atuantes no setor em questão. A fundamentàção teórica agrupando os conceitos econômicos utilizados no trabalho conjugada com a realização de retrospectiva histórica do setor, bem como a contextualização de seu cenário atual, possibilitaram a construção de proposta para constituição de entidade de autogestão . em saúde do tipo patrocinada.Desse modo, podemos concluir que a correta leitura do ambiente de negócios ao qual se vincula, traduzida na elaboração de estratégia viabilizadora das aspirações da entidade, possibilita estruturar a firma sob o critério de melhor uso do conhecimento específico disperso entre os empregados. Para tanto, deve-se definir uma política de delegação de poder para tomada de decisões aos colaboradores conjuntamente com a formulação de sistemas de incentivos e avaliação e monitoramento de performance como alternativa eficiente na busca pela maximização do resultado da instituição. / The present dissertation objective to demonstrate the applicability of the relative concepts to the organizacional architecture to the creation of entity of self management in health. To reach this intention we add to the bibliographical revision of works turning on the new theory of the firm and on the brazilian market of suplemental health the information collected from the professional experience of the author and of operating collaborators in the sector in questiono The theoretical recital grouping the used economic concepts in the work conjugated with the accomplishment of historical retrospect of the sector, as well as the contextualization of its current scene, makes possible the construction of proposal for constitution of entity of self management in health of the sponsored type. In this manner, we can conclude that the correct business-oriented reading of the environment which if ties, translated in the elaboration of strategy of the aspirations of the entity, makes possible to structuralize the firm under the criterion of better use of the dispersed specific knowledge between the employees. For in such a way, one politics of delegation of jointly being able for taking of decisions to the collaborators with the formularization of systems of incentives and evaluation and monitoring of efficient performance as alternative in the search for the maximization of the result of the institution must be defined.

La présente thèse a pour but d'effectuer une étude des effets de la réélection immédiate sur les exécutifs des unités sous-nationales de l'Argentine, le Brésil et l'Uruguay entre 1983-2006. À partir de ce travail on prétend constater quels sont les effets véritablement appréciables de ce mécanisme sur les systèmes politiques sousnationaux. On part de l'hypothèse que cette modalité de réélection provoque des effets les niveaux de concurrence du système de partis, sur la permanence du parti de gouvernement, et dans l'interne de ce. Cette recherche essaye d'approfondir dans la discussion (présent dans une vaste littérature) des effets et les règles électorales sur les systèmes politiques et en particulier de la réélection immédiate aujourd'hui adoptée par quelques pays latino-americains et en débat dans plusieurs de d'eux au niveau présidentiel. L'objectif final de ce travail n'est pas de prononcer à faveur - ou dans contre - de la réélection immédiate, ni s'agit d'un débat élémentairement normatif, mais essaye de présenter quelques questions ponctuelles qu'ils peuvent servir à améliorer le niveau de discussion sur cette dernière. / The present thesis must as objective make a study of the effects of the immediate re-election on the executives of the subnational units of Argentina, Brazil and Uruguay between 1983-2006. From this work it is tried to state as they are the truely appreciable effects of this mechanism on the subnational political systems. Part of the hypothesis that this modality of re-election causes effects in the levels of competition of the system of parties, in the permanence of the government party, and in the internal one of this. This investigation tries to deepen in the discussion (present in a vast Literature) of the effects and the electoral rules on the political systems and in individual of the reelection immediate today adopted by some Latin American countries and in debate in several of them to presidential level. The final mission of this work is not to pronounce itself to favor - or in against of the immediate re-election, nor is an elementarily normative debate, but that tries to present/display some precise questions that can serve to improve the discussion level about the same one. / La presente tesis tiene como objetivo realizar un estudio de los efectos de la reelección inmediata sobre los ejecutivos de las unidades subnacionales de Argentina, Brasil y Uruguay entre 1982-2007. A partir de este trabajo se pretende constatar cuales son los efectos verdaderamente apreciables de este mecanismo sobre los sistemas políticos subnacionales. Se parte de la hipótesis de que esta modalidad de reelección provoca efectos en los niveles de competencia del sistema de partidos, en la permanencia del partido de gobierno, y en la interna de este. Esta investigación intenta profundizar en la discusión (presente en una vasta literatura) sobre los efectos de las reglas electorales sobre los sistemas políticos y en particular de la reelección inmediata hoy adoptada por algunos países latinoamericanos y en debate en varios de ellos a nivel presidencial. El objetivo final de este trabajo no es pronunciarse a favor -o en contra- de la reelección inmediata, ni se trata de un debate elementalmente normativo, sino que intenta presentar algunas cuestiones puntuales que pueden servir para mejorar el nivel de discusión acerca de la misma.