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Das press es às ousadias: o confronto entre a descentraliza o tutelada e a gest o em rede no SUS From pressure to boldness: the conflict between decentralization and network management in SUS
Leonardo Trevisan
Revista de Administra??o Pública , 2007, DOI: 10.1590/s0034-76122007000200004
Abstract: Vista no tempo, a implanta o do SUS vem enfrentando descompassos gerenciais. Primeiro, as press es, sempre maiores, por reforma do Estado que minimalize custos, afetam a proposta de atendimento universal do sistema. Depois, a difícil convivência entre o princípio da descentraliza o com o conceito de rede, aqui entendida n o só como liga o entre esferas diferenciadas de gest o, mas como o modo pelo qual o acesso a um direito é exercido em rede, desde o planejamento. Por outro lado, decis es operacionais sobre a saúde foram descentralizadas, mas o processo de repasse das verbas para efetivar tais decis es n o foi. No aspecto administrativo, a descentraliza o da gest o de saúde sofreu solu o de continuidade com a edi o da Norma Operacional de Assistência à Saúde no 01/2001. No aspecto gerencial, a implanta o do conceito de rede, a arma mais eficiente para enfrentar a verticaliza o de estruturas decisórias, enfrenta "gargalos" operacionais e financeiros (implanta o do "cart o eletr nico") que impedem os atores das diferentes organiza es de falarem a mesma "linguagem", o meio mais eficaz para gerar "vínculos" interorganizacionais. Taken into perspective, the implementation of the Unified Health System (SUS) has been facing managerial problems. First, because the increasing pressures for state reforms that will minimize costs affect the system's concept of universal care. Second, it is hard to balance the decentralization principle with the network concept, understood here not only as the link between different management spheres but also as how one can exercise his or her right in a network, from the planning stage on. On the other hand, operational decisions on healthcare were decentralized but the fund flow was not. Administratively speaking, the decentralization of healthcare management suffered an interruption when the Healthcare Operational Guideline n. 01/2001 came into effect. From the managerial standpoint, the introduction of the network concept, the strongest weapon against verticalization of the decision making process, faces operational and financial constraints (the implementation of electronic tokens) that keep the different organizations from 'speaking the same language', which is the most effective way to create inter-organizational 'bonds'.
Les enfants de la guerre : Le Grand Cahier d’Agota Kristof
Carine Trevisan
Amnis , 2006, DOI: 10.4000/amnis.952
Abstract: On examine, à partir de l’étude du Grand Cahier, d’Agota Kristof, la fa on dont l’état de guerre expulse souvent brutalement l’enfant de sa position d’enfant, lui assignant une place problématique, notamment dans la succession des générations. Non seulement témoin mais aussi souvent victime de la sauvagerie des adultes, il peut néanmoins s’ identifier à l’agresseur et devenir à son tour meurtrier. Donnant fictivement la parole à des enfants qui font l’épreuve de la brutalisation des comportements des hommes et femmes en état de guerre, Le Grand Cahier, par le choix d’une écriture glacée – on a qualifié ce livre d’ exercice de cruauté –, conduit à son extrême limite cette représentation de l’enfance dévastée, au point qu’elle en devient inquiétante : abolition de toute faculté à rêver, à imaginer, anesthésie de la vie émotive, destruction de tout ce qui peut faire lien avec autrui, d’où insensibilité à la mort, re ue ou donnée. Cette chute hors de l’humain peut cependant être considérée comme une technique, certes mutilante, de survie. En el estudio de El gran cuaderno de Agota Kristof se analiza cómo el estado de guerra expulsa, a menudo brutalmente, al ni o de su posición de ni o y le asigna una plaza problemática, en particular en la sucesión de las generaciones. A pesar de que el ni o no sea solamente testigo sino también víctima de la bestialidad de los adultos, puede sin embargo identificarse con el agresor y convertirse en un asesino. Al dar de manera ficticia la palabra a ni os que han sufrido la brutalidad de los comportamientos de los hombres y mujeres en tiempos de guerra, El gran cuaderno, a través de una escritura insensible – se ha utilizado para hablar de este libro la expresión ejercicio de crueldad –, representa con todas sus consecuencias una ni ez destrozada, hasta el punto de convertirla en algo inquietante: eliminación de cualquier capacidad para so ar e imaginar, anestesia de la vida emotiva, destrucción de todo aquello que permite establecer un vínculo con el otro, de donde se entiende la insensibilidad ante la muerte, recibida o dada. Esta caída fuera de lo humano puede sin embargo ser considerada como una técnica, desde luego mutiladora, de supervivencia. Starting with the study of The Notebook by Agota Kristof, this paper examines the way the state of war expels often brutally the child of its child's position, assigning him(her) a problematic place, particularly in the succession of generations. Not only witness but also often victim of the brutality of the adults, the child can nevertheless “be identified with the at
Avant-propos
Carine Trevisan
Amnis , 2010,
Abstract: Ce neuvième numéro d’Amnis examine les manières dont, dans un environnement socialement ou historiquement hostile, s’inventent des stratégies de résistance ou de survie inédites. Il met en relief la fa on dont la contrainte, l’empêchement à penser, l’exposition à la violence extrême peuvent être paradoxalement sources de création.Celle-ci prend des formes multiples : depuis le refus, face à la menace génocidaire (Janine Altounian) ou au risque d’anéantissement psychique dans les camps soviéti...
Consumo pós crise do subprime. Novos tempos na internacionaliza o da economia brasileira
Leonardo Trevisan
Comunica??o, Mídia e Consumo , 2010,
Abstract: A preocupa o com o futuro da economia brasileira já chegou aos poetas e às revistas internacionais. Os efeitos da crise do subprime fazem parte dessa preocupa o. Alguns desafios, como a internacionaliza o das empresas brasileiras, a atualiza o tecnológica da produ o e as expectativas de consumo no País ganharam destaque nesse processo. A reuni o do G-20, no entanto, mostrou que há diferentes métodos de lidar com a crise, preservando-se a maior influência do modo norte-americano de “fazer negócio”. A inser o brasileira na economia internacional, porém, acompanha mais o novo perfil das economias emergentes, que se desenvolve independentemente da crise. Nesse caminho, a maior dificuldade para a inser o internacional eficiente do Brasil, com manuten o da mobilidade social e da tendência de alta no consumo, continua a ser a frágil rela ointerna entre educa o e competitividade.
BV-regularity for the Malliavin Derivative of the Maximum of the Wiener Process
Dario Trevisan
Mathematics , 2013,
Abstract: We prove that, on the classical Wiener space, the random variable $\sup_{0\le t \le T} W_t$ admits a measure as second Malliavin derivative, whose total variation measure is finite and singular w.r.t.\ the Wiener measure.
Zero noise limits using local times
Dario Trevisan
Mathematics , 2013,
Abstract: We consider a well-known family of SDEs with irregular drifts and the correspondent zero noise limits. Using (mollified) local times, we show which trajectories are selected. The approach is completely probabilistic and relies on elementary stochastic calculus only.
A short proof of Stein's universal multiplier theorem
Dario Trevisan
Mathematics , 2014,
Abstract: We give a short proof of Stein's universal multiplier theorem, purely by probabilistic methods, thus avoiding any use of harmonic analysis techniques (complex interpolation or transference methods).
Pseudorandomness and Combinatorial Constructions
Luca Trevisan
Mathematics , 2006,
Abstract: In combinatorics, the probabilistic method is a very powerful tool to prove the existence of combinatorial objects with interesting and useful properties. Explicit constructions of objects with such properties are often very difficult, or unknown. In computer science, probabilistic algorithms are sometimes simpler and more efficient than the best known deterministic algorithms for the same problem. Despite this evidence for the power of random choices, the computational theory of pseudorandomness shows that, under certain complexity-theoretic assumptions, every probabilistic algorithm has an efficient deterministic simulation and a large class of applications of the the probabilistic method can be converted into explicit constructions. In this survey paper we describe connections between the conditional ``derandomization'' results of the computational theory of pseudorandomness and unconditional explicit constructions of certain combinatorial objects such as error-correcting codes and ``randomness extractors.''
BV-capacities on Wiener Spaces and Regularity of the Maximum of the Wiener Process
Dario Trevisan
Mathematics , 2012,
Abstract: We define a capacity C on abstract Wiener spaces and prove that, for any u with bounded variation, the total variation measure |Du| is absolutely continuous with respect to C: this enables us to extend the usual rules of calculus in many cases dealing with BV functions. As an application, we show that, on the classical Wiener space, the random variable sup_{0\leqt\leqT} W_t admits a measure as second derivative, whose total variation measure is singular w.r.t. the Wiener measure.
Well-posedness of Multidimensional Diffusion Processes with Weakly Differentiable Coefficients
Dario Trevisan
Mathematics , 2015,
Abstract: We investigate well-posedness for martingale solutions of stochastic differential equations, under low regularity assumptions on their coefficients, widely extending some results first obtained by A. Figalli. Our main results are a very general equivalence between different descriptions for multidimensional diffusion processes, such as Fokker-Planck equations and martingale problems, under minimal regularity and integrability assumptions, and new existence and uniqueness results for diffusions having weakly differentiable coefficients, by means of energy estimates and commutator inequalities. Our approach relies upon techniques recently developed, jointly with L. Ambrosio, to address well-posedness for ordinary differential equations in metric measure spaces: in particular, we employ in a systematic way new representations and inequalities for commutators between smoothing operators and diffusion generators.
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