Escala de Manejo do Dinheiro na Conjugalidade (EMDC): construção e evidências de validade / Conjugality Money Managment Scale (EMDC): construction and validity evidence / Escala de Gestión del Dinero en la Conyugalidad (EMDC): construcción y evidencias de validez

O dinheiro pode ser um fator positivo e/ou negativo na conjugalidade, e a maneira como o casal gerencia os recursos influencia em diferentes aspectos da relação. Este estudo visa apresentar a construção e as propriedades psicométricas da Escala de Manejo do Dinheiro na Conjugalidade (EMDC), elaborada para avaliar os estilos de manejo de dinheiro adotado por indivíduos em relacionamentos estáveis de coabitação: Manejo Independente ou Compartilhado. Participaram 280 homens e mulheres, brasileiros, em relacionamentos estáveis coabitando há, no mínimo, seis meses, sendo 76,4% (N = 214) residentes no estado do Rio Grande do Sul. A partir das análises fatoriais confirmatórias, a escala resultou em 18 itens agrupados em quatro dimensões: Coesão financeira, Intimidade financeira, Infidelidade financeira e Partilha de bens. As análises permitiram identificar estrutura fatorial adequada e evidências de validade. A escala possui potencial para ser utilizada em pesquisa e na prática clínica no âmbito da conjugalidade. (AU)

The approach couples take to managing financial resources influences different aspects of the marital relationship, and this may correspond to a positive and/or negative factor in conjugality. This study aims to present the construction process and psychometric properties of the Conjugality Money Management Scale (CMMS), designed to evaluate the two possible approaches to money management that can be adopted by individuals in marital cohabitation relationships: Independent or Shared Management approaches. The sample size was 280 participants, including Brazilian men and women, 76.4% (N = 214) living in the state of Rio Grande do Sul. The confirmatory factorial analyzes resulted in a scale of 18 items, classified into four dimensions: Financial Cohesion, Financial Intimacy, Financial Infidelity, and Asset Sharing. The analyses indicated adequate factorial structure and validity evidence. The scale presents the potential of applicability in research and clinical practice in the context of marital relationships. (AU)

El dinero puede ser un factor positivo y / o negativo en la conyugalidad, y la manera en que una pareja administra sus recursos influye en distintos aspectos de la relación. En este estudio se buscó presentar la construcción y las propiedades psicométricas de la Escala de Gestión del Dinero en la Conyugalidad (EMDC), diseñadas para evaluar los posibles estilos de administración del dinero adoptados por individuos en relaciones estables de convivencia: Gestión Independiente o Compartida. Participaron de la muestra 280 hombres y mujeres de Brasil, en relaciones estables con un mínimo de seis meses de convivencia, con 76.4% (N = 214) con residencia en la provincia de Rio Grande do Sul. Los 18 ítems resultantes de los análisis factoriales confirmatorios fueron agrupados en cuatro dimensiones: cohesión financiera, intimidad financiera, infidelidad financiera y distribución de activos. Los análisis permitieron identificar una estructura factorial adecuada y evidencias de validez. La escala presenta potencial de aplicabilidad para ser utilizada en investigaciones y prácticas clínicas en el ámbito de las relaciones matrimoniales. (AU)

Graduate medical education funding mechanisms, challenges, and solutions: A narrative review.

BACKGROUND: With increased attention on the federal budget deficit, graduate medical education (GME) funding has in particular been targeted as a potential source of cost reduction. Reduced GME funding can further deteriorate the compensation of physicians during their residency training. METHODS: In order to understand the GME funding mechanisms and current challenges, as well as the value of the work accomplished by residents, we searched peer-reviewed, English language studies published between 2000 and 2019. RESULTS: Direct and indirect GME funding is intended to support resident reimbursement and the higher costs associated with supporting a teaching program. However, policy efforts have aimed to reduce federal funding for GME. Furthermore, evidence suggests that residents are inadequately compensated because their salaries do not reflect the number of hours worked and are not comparable to those of other medical staff. CONCLUSIONS: Our review suggests that creative solutions are needed to diversify GME funding and improve resident compensation.

Safeguarding cancer research funding by European charities amidst the COVID-19 pandemic.

The COVID-19 outbreak has affected cancer research and cancer care. European cancer charities need to reconsider strategies for safeguarding income and supporting cancer researchers, in times when sustaining cancer research funding is more crucial than ever.

A neo-institutional analysis of the hidden interaction between the Israeli Supreme Court and the Ministry of Finance: the right to healthcare services.

BACKGROUND: Under structural conditions of non-governability, most players in the policy arena in Israel turn to two main channels that have proven effective in promoting the policies they seek: the submission of petitions to the High Court of Justice and making legislative amendments through the Economic Arrangements Law initiated by the Ministry of Finance. Nevertheless, an analysis of the principal trends emerging from the High Court of Justice rulings and legislative amendments through the Economic Arrangements Law indicates that these channels are open to influence, primarily by forces that are essentially neo-liberal. Little is known about the effects of these trends on the right to healthcare services, which in Israel has not been legislated as an independent constitutional law in Basic Laws. METHODS: We use four major legal cases decided by the Supreme Court of Israel in the past 10 years where the Court reviewed new legislative initiatives proposed by the Economic Arrangements Law in the area of healthcare. We utilize an institutional approach in our analysis. RESULTS: A neo-institutional analysis of the legal cases demonstrates that petitions against the Economic Arrangements Law in the area of healthcare services have been denied, even though the Court uses strong rhetoric against that law and the government more generally in addressing issues that concern access to healthcare services and reforms in the healthcare system. This move strengthens the trend toward a neo-liberal public policy and significantly weakens the legal protection of the right to healthcare services. CONCLUSION: In deciding petitions against the Economic Arrangements Law in the area of healthcare, the Supreme Court allows the Ministry of Finance to be a dominant player in the formation of public policy. In doing so, it may be promoting a goal of strengthening its position as a political institution that aspires to increase the public's trust in the judiciary and especially in the Supreme Court itself, in addition to exercising judicial restraint and allowing more leeway to the executive and legislative branches more generally.

Gerenciamento da renda familiar por jovens casais / The management of family income for young couples

Objetivo: avaliar o gerenciamento da renda de casais heterossexuais, de classe média, com renda individual, identificando aspectos positivos e negativos e se o gerenciamento é distinto entre casais cuja maior renda é da esposa ou do marido. Participantes: oito casais com idade entre 25 a 35 anos. Instrumentos: entrevista aberta, verificando a administração financeira individual e familiar, como são tomadas decisões financeiras, conhecimento de ambos sobre a renda e gastos do parceiro. Procedimentos: Entrevista individual com cada cônjuge. Resultados: Realizou-se análise de conteúdo qualitativa e quantitativa por meio de categorias de respostas. Em três casais o homem gerencia a renda, três deles compartilham entradas e despesas financeiras e dois dividem as despesas. As mulheres foram mais propensas a cometer infidelidade financeira. A satisfação financeira relacionou-se à consulta ao cônjuge em relação aos investimentos e aquisição de bens e a insatisfação aos gastos sem planejamento.(AU)

Objective: To evaluate the management of the income of heterosexual couples, middle-class, with individual income, identifying strengths and weaknesses and the management is distinct among couples whose income is greater with the wife or husband. Participants: Eight couples aged 25 to 35 years. Instruments: open interviews, checking the individual and family financial management, such as financial decisions, knowledge of both on income and partner spending are taken. Procedures: Individual interview with each spouse. Results: An analysis of qualitative and quantitative content through categories of answers. In three couples man manages income, three of them share financial income and expenses and two share the costs. Women were more likely to commit financial infidelity. The financial satisfaction was related to consulting the spouse for investments and acquisition of goods and dissatisfaction to spending without planning.(AU)

Implantação de centro de custos como ferramenta gerencial na xi gerência regional de saúde / Implementation of cost center as a management tool in xi regional health management

O objetivo deste trabalho é implantar a gestão de custos e demonstrar a sua importância para a tomada de decisão em uma unidade administrativa da Secretaria Estadual de Saúde do Estado de Pernambuco. O foco é demonstrar, através da aplicação de um modelo de rateio de custos por departamento e por ações a importância da gestão de custos para a geração de informações úteis à tomada de decisão. O Programa Nacional de Gestão de Custos (PNGC) foi elaborado a partir da necessidade de conhecer os custos dos produtos e serviços e avaliar os respectivos resultados. Foi implantado como eficiente técnico gerencial devido à crescente complexidade das instituições de saúde integradas ao SUS fazendo parte das suas ações estratégicas. A XI Gerência Regional de Saúde está situada na cidade de Serra Talhada, Pernambuco e foi criada no ano de 2006, sendo desde o ano de 2011 sede da III Macrorregião de Saúde, integrando a VI, X e XI Geres, numa população total de 834.344 habitante. A Regional possui departamentos ligados diretamente à Gerência como: Secretaria, Ouvidoria, CPL ­ Comissão Permanente de Licitação e NAFCM ­ Núcleo de Assistência às Famílias com Microcefalia, além de 5 (cinco) coordenações, sendo Coordenação de Planejamento e Regulação, Coordenação de Atenção à Saúde, Coordenação da Vigilância em Saúde, Coordenação do Programa Mãe Coruja e Coordenação Administrativa e Financeira. A implantação de centro de custos nos órgãos/instituições visa à otimização dos recursos sem comprometer a funcionalidade e qualidade dos serviços oferecidos, e por isso deve ser um objetivo na instituição.(AU)

O superendividamento na terceira idade: um estudo de caso / Major debt in senior citizens: a case study

O objetivo deste artigo é discutir um caso de superendividamento na Terceira Idade. Procura-se mostrar em que medida essa situação se organiza como âncora simbólica, organizando o presente e projetando o futuro. Parte-se de uma discussão sobre o superendividamento como drama social na velhice. Em seguida, realiza-se a análise do caso. Ao final, apresenta-se direitos e deveres do consumidor e da pessoa idosa como fatores decisivos na precaução e na resolução de situações de superendividamento na Terceira Idade.

The main goal of the following article is to present a case study of major debt in senior citizens. It seeks to show up to what degree this situation can alter the family and social aspects of one’s life. To accomplish this, it argues that major debt in senior citizens is a social drama. Then, the analysis of case study is done, following with a presentation of fundamental consumer and senior citizens’ rights as a decisive factor in caution and in addressing major debt situations among senior citizens.

Community dental clinics: providers' perspectives.

OBJECTIVES: Not-for-profit community dental clinics attempt to address the inequities of oral health care for disadvantaged communities, but there is little information about how they operate. The objective of this article is to explain from the perspective of senior staff how five community dental clinics in British Columbia, Canada, provide services. METHODS: The mixed-methods case study included the five not-for-profit dental clinics with full-time staff who provided a wide range of dental services. We conducted open-ended interviews to saturation with eight senior administrative staff selected purposefully because of their comprehensive knowledge of the development and operation of the clinics and supplemented their information with a year's aggregated data on patients, treatments, and operating costs. RESULTS: The interview participants described the benefits of integrating dentistry with other health and social services usually within community health centres, although they doubted the sustainability of the clinics without reliable financial support from public funds. Aggregated data showed that 75% of the patients had either publically funded or no coverage for dental services, while the others had employer-sponsored dental insurance. Financial subsidies from regional health authorities allowed two of the clinics to treat only patients who are economically vulnerable and provide all services at reduced costs. Clinics without government subsidies used the fees paid by some patients to subsidize treatment for others who could not afford treatment. CONCLUSIONS: Not-for-profit dental clinics provide dental services beyond pain relief for underserved communities. Dental services are integrated with other health and community services and located in accessible locations. However, all of the participants expressed concerns about the sustainability of the clinics without reliable public revenues.

Valuing and selling a practice.

Surgeons, as they contemplate retirement, wrongly believe that their practices do not have financial value. In fact, a well-organized efficiently functioning office with an emphasis on excellent service in combination with a constant stream of patients make it financially ideal for the new surgeon. Being able to assume such a practice can be a very smart financial decision. The practice's worth can be determined by a careful analysis of the practice financials and an evaluation of the functioning of the office and employees. Purchasing such a practice can be, economically, a very smart move by a new surgeon. Payments are made over time at a rate that allows the surgeon to make a good living, leaving him with real equity once the payments are complete. The departing surgeon, who had spent years building this successful practice, gets some of this value back in the form of an income stream to supplement his retirement. This process should be considered in virtually every case. Do not just "close the door."

Comparison of the NCRA and NAACCR Strategic Management Plans.

The Strategic Management Plans of the National Cancer Registrars Association (NCRA) and the North American Association of Central Cancer Registries (NAACCR) were compared, and differences noted. No uncovered subject areas were found.

Análise dos julgamentos do Tribunal de Contas dos municípios do Estado do Ceará: um olhar sobre a prestação de contas dos Sistemas Municipais de Saúde / Analisy of the judgement of Tribunal de Contas dos Municípios do Ceará-TCM: a look about Municipal Sistem of Health accounts

O controle exercido pelo Tribunal de Contas dos Municípios do Ceará (TCM) gera frequentes desaprovações das contas da gestão municipal da saúde, o que justifica esse trabalho. Objetivos e Método: Com o objetivo central de caracterizar as causas dessas desaprovações,foi realizada análise documental em 162 processos de Prestação de Contas e 32 de Tomada de Contas da gestão municipal da saúde, exercícios de 2001 a 2004, julgadas e desaprovadas em decisão definitiva pelo TCM. O conhecimento das bases legais da administração pública ajudou na compreensão dessa realidade. Após a identificação dos municípios e a frequência das ocorrências em cada ano de exercício, uma amostra dos gestores da saúde e contadores dos municípios implicados foi entrevistada para o levantamento da opinião deles sobre as causas das desaprovações, objetivos específicos do estudo. Resultados: Do total de 184 municípios do estado do Ceará 107(58 por cento) tiveram suas contas desaprovadas em um ou mais anos. As desaprovações são mais frequentes nos municípios de pequeno porte (70,2 por cento) e a reincidência é maior nos dois primeiros anos do mandato. As irregularidades relacionadas à licitação ocupam o primeiro lugar no ranking das causas apontadas pelo TCM, seguidas por outras relacionadas ao setor de contabilidade. Os dois grupos entrevistados apontam como causas o desconhecimento, excesso de atividades, sobrecarga do gestor da saúde e a falta de integração com os demais setores da administração. Os gestores citam ainda, a falta de autonomia e ingerência alheia no setor. Os contadores acrescentam a falta de planejamento e de controle interno pelo pessoal da saúde e consideram também, que as orientações do Procurador do município podem ser descritas como incabíveis. Conclusões: As desaprovações ocorrem pela falta de...

This thesis is justified by the (Tribunal de Contas dos Municípios do Ceará-TCM) control that is responsible for frequent disapprovals of the accounts from municipal management of health. Aims and methods: To point out the reasons of these disapprovals, the documental analysis of 162 process about rendering of accounts and 32 about taking municipal management of health, years 2001 to 2004, judged and disapproved in final decision by TCM, were realized. The knowledge of the legal basis of the public management helped to understand this reality. After the cities and frequency identification of each year, a sample of health supervisors and accountants from the cities involved was interviewed in order to have a survey about their opinion about the reasons for disapprovals. Results: From the total of 184 cities in Ceará state, 107(58 per cent) had the accounts disapproved one or more years. The disapprovals are more frequent in small cities (70,2 per cent) and the more recidivists occur in the first years of mandate. The irregularities related to bidding are in the first place on the rank of reasons pointed by TCM, followed by others related to accounting sector...