LEWIN’S CONTRIBUTION TO STUDY GROUP: A LEARNING CHALLENGE DURING COVID-19

Mudanças significativas estão ocorrendo mundialmente em contextos socioeconômicos devido à pandemia iniciada em 2019. Nunca na história da educação brasileira houve tantos momentos impactantes. O fechamento das escolas foi imposto devido ao contágio do coronavirus. Professores, gestores, alunos e seus respectivos familiares ficaram perplexos com a duração da quarentena. Quando se trata de ensino médio público na região sudeste, as diretrizes pedagógicas apoiadas pela tecnologia remota foram decisivas para o resgate do processo ensino-aprendizagem neste contexto atípico. Por isso, o sistema híbrido na educação básica foi adotado em larga escala. Diante disso, foram propostos esforços que explicassem o comportamento de jovens do ensino médio público durante a implementação da atividade grupo de estudo, sob as lentes da teoria de campo de Lewin, utilizando a abordagem descritiva qualitativa. Como as variáveis no espaço vital mudaram radicalmente devido à circunstância da pandemia, as valências negativas interferiram na resposta comportamental dos respondentes. Os sentimentos de sobrecarga juntamente com o de estudar sozinho interferiram na vontade do grupo para estudar. Simultaneamente, à medida que as valências se tornaram positivas com a implementação de uma estratégia pedagógica ativa, os respondentes apontaram que a atividade do grupo de estudo atuou como um reforço da aprendizagem, como motivador por meio do contato com os colegas e auxiliou com dúvidas e na compreensão dos conteúdos. Até hoje, o trabalho pioneiro de Lewin demonstra a influência de vários fatores interferindo no processo de aprendizagem em diferentes contextos.Se están produciendo cambios significativos en los contextos socioeconómicos de todo el mundo debido a la pandemia de covid-19 que comenzó en 2019. Nunca en la historia de la educación brasileña ha habido tantos momentos impactantes. Se impusieron cierres de escuelas debido a la propagación del coronavirus. Maestros, personal, estudiantes y sus respectivas familias quedaron perplejos por la duración de la cuarentena. Cuando se trata de la educación secundaria pública en la región sureste, los lineamientos pedagógicos apoyados en la tecnología remota fueron decisivos para el rescate del proceso de enseñanza-aprendizaje en este contexto inusual. Por lo tanto, el sistema híbrido en la educación básica se adoptó a gran escala. Frente a ello, se propusieron esfuerzos para explicar el comportamiento de los jóvenes de la escuela secundaria pública durante la implementación de la actividad del grupo de estudio, bajo la lente de la teoría de campo de Lewin, utilizando el enfoque descriptivo cualitativo. Como las variables en el espacio vital cambiaron radicalmente debido a la circunstancia de la pandemia, las valencias negativas interfirieron con la respuesta conductual del grupo. Los sentimientos de sobrecarga junto con los de estudiar solos interfirieron con la voluntad del grupo de estudiar. Al mismo tiempo, a medida que las valencias se volvieron positivas con la implementación de una estrategia pedagógica activa, los encuestados señalaron que la actividad del grupo de estudio actuó como un refuerzo del aprendizaje, como un motivador a través del contacto con los colegas, y ayudó con las dudas.Significant changes are taking place in socioeconomic contexts around the world due to the covid-19 pandemic that started in 2019. Never in the history of Brazilian education there have been so many impactful moments. Schools closures were imposed due to the spread of the coronavirus. Teachers, staff, students and their respective families were perplexed by the duration of the quarantine. When it comes to public secondary education in the southeast region, pedagogical guidelines supported by remote technology were decisive for the rescue of teaching-learning process in this unusual context. Therefore, the hybrid system in basic education was adopted on a large scale. In face of it, efforts were proposed to explain the behavior of public high school youth during the implementation of study group activity, under the lens of Lewin's field theory, using the qualitative descriptive approach. As the variables in the vital space radically changed due to the pandemic circumstance, the negative valences did interfere with the group’s behavioral response. The feelings of overload along with that of studying alone interfered with the group's willingness to study. Concurrently, as the valences became positive with the implementation of an active pedagogical strategy, the respondents pointed out that the study group activity acted as a reinforcement of learning, as a motivator through contact with colleagues, and helped with doubts, improving comprehension of the contents. To this day, the pioneering work of Lewin demonstrates the influence of several factors interfering in the learning process in different settings

LEWIN’S CONTRIBUTION TO STUDY GROUP: A LEARNING CHALLENGE DURING COVID-19

Mudanças significativas estão ocorrendo mundialmente em contextos socioeconômicos devido à pandemia iniciada em 2019. Nunca na história da educação brasileira houve tantos momentos impactantes. O fechamento das escolas foi imposto devido ao contágio do coronavirus. Professores, gestores, alunos e seus respectivos familiares ficaram perplexos com a duração da quarentena. Quando se trata de ensino médio público na região sudeste, as diretrizes pedagógicas apoiadas pela tecnologia remota foram decisivas para o resgate do processo ensino-aprendizagem neste contexto atípico. Por isso, o sistema híbrido na educação básica foi adotado em larga escala. Diante disso, foram propostos esforços que explicassem o comportamento de jovens do ensino médio público durante a implementação da atividade grupo de estudo, sob as lentes da teoria de campo de Lewin, utilizando a abordagem descritiva qualitativa. Como as variáveis no espaço vital mudaram radicalmente devido à circunstância da pandemia, as valências negativas interferiram na resposta comportamental dos respondentes. Os sentimentos de sobrecarga juntamente com o de estudar sozinho interferiram na vontade do grupo para estudar. Simultaneamente, à medida que as valências se tornaram positivas com a implementação de uma estratégia pedagógica ativa, os respondentes apontaram que a atividade do grupo de estudo atuou como um reforço da aprendizagem, como motivador por meio do contato com os colegas e auxiliou com dúvidas e na compreensão dos conteúdos. Até hoje, o trabalho pioneiro de Lewin demonstra a influência de vários fatores interferindo no processo de aprendizagem em diferentes contextos.Se están produciendo cambios significativos en los contextos socioeconómicos de todo el mundo debido a la pandemia de covid-19 que comenzó en 2019. Nunca en la historia de la educación brasileña ha habido tantos momentos impactantes. Se impusieron cierres de escuelas debido a la propagación del coronavirus. Maestros, personal, estudiantes y sus respectivas familias quedaron perplejos por la duración de la cuarentena. Cuando se trata de la educación secundaria pública en la región sureste, los lineamientos pedagógicos apoyados en la tecnología remota fueron decisivos para el rescate del proceso de enseñanza-aprendizaje en este contexto inusual. Por lo tanto, el sistema híbrido en la educación básica se adoptó a gran escala. Frente a ello, se propusieron esfuerzos para explicar el comportamiento de los jóvenes de la escuela secundaria pública durante la implementación de la actividad del grupo de estudio, bajo la lente de la teoría de campo de Lewin, utilizando el enfoque descriptivo cualitativo. Como las variables en el espacio vital cambiaron radicalmente debido a la circunstancia de la pandemia, las valencias negativas interfirieron con la respuesta conductual del grupo. Los sentimientos de sobrecarga junto con los de estudiar solos interfirieron con la voluntad del grupo de estudiar. Al mismo tiempo, a medida que las valencias se volvieron positivas con la implementación de una estrategia pedagógica activa, los encuestados señalaron que la actividad del grupo de estudio actuó como un refuerzo del aprendizaje, como un motivador a través del contacto con los colegas, y ayudó con las dudas.Significant changes are taking place in socioeconomic contexts around the world due to the covid-19 pandemic that started in 2019. Never in the history of Brazilian education there have been so many impactful moments. Schools closures were imposed due to the spread of the coronavirus. Teachers, staff, students and their respective families were perplexed by the duration of the quarantine. When it comes to public secondary education in the southeast region, pedagogical guidelines supported by remote technology were decisive for the rescue of teaching-learning process in this unusual context. Therefore, the hybrid system in basic education was adopted on a large scale. In face of it, efforts were proposed to explain the behavior of public high school youth during the implementation of study group activity, under the lens of Lewin's field theory, using the qualitative descriptive approach. As the variables in the vital space radically changed due to the pandemic circumstance, the negative valences did interfere with the group’s behavioral response. The feelings of overload along with that of studying alone interfered with the group's willingness to study. Concurrently, as the valences became positive with the implementation of an active pedagogical strategy, the respondents pointed out that the study group activity acted as a reinforcement of learning, as a motivator through contact with colleagues, and helped with doubts, improving comprehension of the contents. To this day, the pioneering work of Lewin demonstrates the influence of several factors interfering in the learning process in different settings

Measuring universal health coverage based on an index of effective coverage of health services in 204 countries and territories, 1990–2019 : A systematic analysis for the Global Burden of Disease Study 2019

Background Achieving universal health coverage (UHC) involves all people receiving the health services they need, of high quality, without experiencing financial hardship. Making progress towards UHC is a policy priority for both countries and global institutions, as highlighted by the agenda of the UN Sustainable Development Goals (SDGs) and WHO's Thirteenth General Programme of Work (GPW13). Measuring effective coverage at the health-system level is important for understanding whether health services are aligned with countries' health profiles and are of sufficient quality to produce health gains for populations of all ages. Methods Based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we assessed UHC effective coverage for 204 countries and territories from 1990 to 2019. Drawing from a measurement framework developed through WHO's GPW13 consultation, we mapped 23 effective coverage indicators to a matrix representing health service types (eg, promotion, prevention, and treatment) and five population-age groups spanning from reproductive and newborn to older adults (≥65 years). Effective coverage indicators were based on intervention coverage or outcome-based measures such as mortality-to-incidence ratios to approximate access to quality care; outcome-based measures were transformed to values on a scale of 0–100 based on the 2·5th and 97·5th percentile of location-year values. We constructed the UHC effective coverage index by weighting each effective coverage indicator relative to its associated potential health gains, as measured by disability-adjusted life-years for each location-year and population-age group. For three tests of validity (content, known-groups, and convergent), UHC effective coverage index performance was generally better than that of other UHC service coverage indices from WHO (ie, the current metric for SDG indicator 3.8.1 on UHC service coverage), the World Bank, and GBD 2017. We quantified frontiers of UHC effective coverage performance on the basis of pooled health spending per capita, representing UHC effective coverage index levels achieved in 2019 relative to country-level government health spending, prepaid private expenditures, and development assistance for health. To assess current trajectories towards the GPW13 UHC billion target—1 billion more people benefiting from UHC by 2023—we estimated additional population equivalents with UHC effective coverage from 2018 to 2023. Findings Globally, performance on the UHC effective coverage index improved from 45·8 (95% uncertainty interval 44·2–47·5) in 1990 to 60·3 (58·7–61·9) in 2019, yet country-level UHC effective coverage in 2019 still spanned from 95 or higher in Japan and Iceland to lower than 25 in Somalia and the Central African Republic. Since 2010, sub-Saharan Africa showed accelerated gains on the UHC effective coverage index (at an average increase of 2·6% [1·9–3·3] per year up to 2019); by contrast, most other GBD super-regions had slowed rates of progress in 2010–2019 relative to 1990–2010. Many countries showed lagging performance on effective coverage indicators for non-communicable diseases relative to those for communicable diseases and maternal and child health, despite non-communicable diseases accounting for a greater proportion of potential health gains in 2019, suggesting that many health systems are not keeping pace with the rising non-communicable disease burden and associated population health needs. In 2019, the UHC effective coverage index was associated with pooled health spending per capita (r=0·79), although countries across the development spectrum had much lower UHC effective coverage than is potentially achievable relative to their health spending. Under maximum efficiency of translating health spending into UHC effective coverage performance, countries would need to reach $1398 pooled health spending per capita (US$ adjusted for purchasing power parity) in order to achieve 80 on the UHC effective coverage index. From 2018 to 2023, an estimated 388·9 million (358·6–421·3) more population equivalents would have UHC effective coverage, falling well short of the GPW13 target of 1 billion more people benefiting from UHC during this time. Current projections point to an estimated 3·1 billion (3·0–3·2) population equivalents still lacking UHC effective coverage in 2023, with nearly a third (968·1 million [903·5–1040·3]) residing in south Asia. Interpretation The present study demonstrates the utility of measuring effective coverage and its role in supporting improved health outcomes for all people—the ultimate goal of UHC and its achievement. Global ambitions to accelerate progress on UHC service coverage are increasingly unlikely unless concerted action on non-communicable diseases occurs and countries can better translate health spending into improved performance. Focusing on effective coverage and accounting for the world's evolving health needs lays the groundwork for better understanding how close—or how far—all populations are in benefiting from UHC

Measuring universal health coverage based on an index of effective coverage of health services in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background Achieving universal health coverage (UHC) involves all people receiving the health services they need, of high quality, without experiencing financial hardship. Making progress towards UHC is a policy priority for both countries and global institutions, as highlighted by the agenda of the UN Sustainable Development Goals (SDGs) and WHO's Thirteenth General Programme of Work (GPW13). Measuring effective coverage at the health-system level is important for understanding whether health services are aligned with countries' health profiles and are of sufficient quality to produce health gains for populations of all ages. Methods Based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we assessed UHC effective coverage for 204 countries and territories from 1990 to 2019. Drawing from a measurement framework developed through WHO's GPW13 consultation, we mapped 23 effective coverage indicators to a matrix representing health service types (eg, promotion, prevention, and treatment) and five population-age groups spanning from reproductive and newborn to older adults (≥65 years). Effective coverage indicators were based on intervention coverage or outcome-based measures such as mortality-to-incidence ratios to approximate access to quality care; outcome-based measures were transformed to values on a scale of 0–100 based on the 2·5th and 97·5th percentile of location-year values. We constructed the UHC effective coverage index by weighting each effective coverage indicator relative to its associated potential health gains, as measured by disability-adjusted life-years for each location-year and population-age group. For three tests of validity (content, known-groups, and convergent), UHC effective coverage index performance was generally better than that of other UHC service coverage indices from WHO (ie, the current metric for SDG indicator 3.8.1 on UHC service coverage), the World Bank, and GBD 2017. We quantified frontiers of UHC effective coverage performance on the basis of pooled health spending per capita, representing UHC effective coverage index levels achieved in 2019 relative to country-level government health spending, prepaid private expenditures, and development assistance for health. To assess current trajectories towards the GPW13 UHC billion target—1 billion more people benefiting from UHC by 2023—we estimated additional population equivalents with UHC effective coverage from 2018 to 2023. Findings Globally, performance on the UHC effective coverage index improved from 45·8 (95% uncertainty interval 44·2–47·5) in 1990 to 60·3 (58·7–61·9) in 2019, yet country-level UHC effective coverage in 2019 still spanned from 95 or higher in Japan and Iceland to lower than 25 in Somalia and the Central African Republic. Since 2010, sub-Saharan Africa showed accelerated gains on the UHC effective coverage index (at an average increase of 2·6% [1·9–3·3] per year up to 2019); by contrast, most other GBD super-regions had slowed rates of progress in 2010–2019 relative to 1990–2010. Many countries showed lagging performance on effective coverage indicators for non-communicable diseases relative to those for communicable diseases and maternal and child health, despite non-communicable diseases accounting for a greater proportion of potential health gains in 2019, suggesting that many health systems are not keeping pace with the rising non-communicable disease burden and associated population health needs. In 2019, the UHC effective coverage index was associated with pooled health spending per capita (r=0·79), although countries across the development spectrum had much lower UHC effective coverage than is potentially achievable relative to their health spending. Under maximum efficiency of translating health spending into UHC effective coverage performance, countries would need to reach $1398 pooled health spending per capita (US$ adjusted for purchasing power parity) in order to achieve 80 on the UHC effective coverage index. From 2018 to 2023, an estimated 388·9 million (358·6–421·3) more population equivalents would have UHC effective coverage, falling well short of the GPW13 target of 1 billion more people benefiting from UHC during this time. Current projections point to an estimated 3·1 billion (3·0–3·2) population equivalents still lacking UHC effective coverage in 2023, with nearly a third (968·1 million [903·5–1040·3]) residing in south Asia. Interpretation The present study demonstrates the utility of measuring effective coverage and its role in supporting improved health outcomes for all people—the ultimate goal of UHC and its achievement. Global ambitions to accelerate progress on UHC service coverage are increasingly unlikely unless concerted action on non-communicable diseases occurs and countries can better translate health spending into improved performance. Focusing on effective coverage and accounting for the world's evolving health needs lays the groundwork for better understanding how close—or how far—all populations are in benefiting from UHC

Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background: In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods: GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings: Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990–2010 time period, with the greatest annualised rate of decline occurring in the 0–9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10–24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10–24 years were also in the top ten in the 25–49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50–74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation: As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and developm nt investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licens

Global, regional, and national progress towards Sustainable Development Goal 3.2 for neonatal and child health: all-cause and cause-specific mortality findings from the Global Burden of Disease Study 2019

Background Sustainable Development Goal 3.2 has targeted elimination of preventable child mortality, reduction of neonatal death to less than 12 per 1000 livebirths, and reduction of death of children younger than 5 years to less than 25 per 1000 livebirths, for each country by 2030. To understand current rates, recent trends, and potential trajectories of child mortality for the next decade, we present the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 findings for all-cause mortality and cause-specific mortality in children younger than 5 years of age, with multiple scenarios for child mortality in 2030 that include the consideration of potential effects of COVID-19, and a novel framework for quantifying optimal child survival. Methods We completed all-cause mortality and cause-specific mortality analyses from 204 countries and territories for detailed age groups separately, with aggregated mortality probabilities per 1000 livebirths computed for neonatal mortality rate (NMR) and under-5 mortality rate (USMR). Scenarios for 2030 represent different potential trajectories, notably including potential effects of the COVID-19 pandemic and the potential impact of improvements preferentially targeting neonatal survival. Optimal child survival metrics were developed by age, sex, and cause of death across all GBD location-years. The first metric is a global optimum and is based on the lowest observed mortality, and the second is a survival potential frontier that is based on stochastic frontier analysis of observed mortality and Healthcare Access and Quality Index. Findings Global U5MR decreased from 71.2 deaths per 1000 livebirths (95% uncertainty interval WI] 68.3-74-0) in 2000 to 37.1 (33.2-41.7) in 2019 while global NMR correspondingly declined more slowly from 28.0 deaths per 1000 live births (26.8-29-5) in 2000 to 17.9 (16.3-19-8) in 2019. In 2019,136 (67%) of 204 countries had a USMR at or below the SDG 3.2 threshold and 133 (65%) had an NMR at or below the SDG 3.2 threshold, and the reference scenario suggests that by 2030,154 (75%) of all countries could meet the U5MR targets, and 139 (68%) could meet the NMR targets. Deaths of children younger than 5 years totalled 9.65 million (95% UI 9.05-10.30) in 2000 and 5.05 million (4.27-6.02) in 2019, with the neonatal fraction of these deaths increasing from 39% (3.76 million 95% UI 3.53-4.021) in 2000 to 48% (2.42 million; 2.06-2.86) in 2019. NMR and U5MR were generally higher in males than in females, although there was no statistically significant difference at the global level. Neonatal disorders remained the leading cause of death in children younger than 5 years in 2019, followed by lower respiratory infections, diarrhoeal diseases, congenital birth defects, and malaria. The global optimum analysis suggests NMR could be reduced to as low as 0.80 (95% UI 0.71-0.86) deaths per 1000 livebirths and U5MR to 1.44 (95% UI 1-27-1.58) deaths per 1000 livebirths, and in 2019, there were as many as 1.87 million (95% UI 1-35-2.58; 37% 95% UI 32-43]) of 5.05 million more deaths of children younger than 5 years than the survival potential frontier. Interpretation Global child mortality declined by almost half between 2000 and 2019, but progress remains slower in neonates and 65 (32%) of 204 countries, mostly in sub-Saharan Africa and south Asia, are not on track to meet either SDG 3.2 target by 2030. Focused improvements in perinatal and newborn care, continued and expanded delivery of essential interventions such as vaccination and infection prevention, an enhanced focus on equity, continued focus on poverty reduction and education, and investment in strengthening health systems across the development spectrum have the potential to substantially improve USMR. Given the widespread effects of COVID-19, considerable effort will be required to maintain and accelerate progress. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd

Intuição e percepção no processo decisório de microempresa

From classic and contemporary studies specializing in management and decision-making is reviewed how managers of small business, make decisions in a market riddled with competition, considering the limitations imposed by the size of their organizations. For this, investigated the presence of factors of intuition and perception in decision making of managers of a small business with the headquartered is in Rio de Janeiro. The descriptive results of reflection, compared with the theoretical predictions based mainly on Silvia Pillotto (2006) and Paulo Roberto Motta (2004), allows to confirm the presence of factors in decision making in the management of these organizations, as well as the factor rationality, was mentioned as an important element in the process.A partir de estudos clássicos e contemporâneos especializados na gestão e no processo decisório é revista a forma como gestores de microempresas, tomam decisões frente a um mercado permeado pela competitividade, considerando as limitações impostas pelo porte destas organizações. Para isto, investigou-se a presença dos fatores intuição e percepção na tomada de decisão de gestores de uma empresa de pequeno porte sediada na cidade do Rio de Janeiro. Os resultados descritivos da reflexão, comparados com as fundamentações teóricas baseadas, principalmente, em Silvia Pillotto (2006) e Paulo Roberto Motta (2004), permitenos confirmar a presença dos fatores na tomada de decisão na gestão destas organizações, como também a do fator racionalidade, tendo sido mencionado como um elemento relevante ao processo

Gestão de suprimentos da farmácia hospitalar com a implantação de métodos gerenciais de insumos utilizados na manufatura

A farmácia hospitalar abriga medicamentos de alto custo, e sua gestão profissionalizada pode garantir a sobrevivência mercadológica dessas instituições e viabilizar o exercício profissional da medicina. O objetivo é apresentar uma proposta de gestão dos estoques de uma farmácia, empregando-se três métodos da manufatura: (1) Padronização, (2) Protocolos e (3) Classificação ABC Este estudo de caso quantitativo utilizou a estatística descritiva simples no processo de gestão de estoques da farmácia de uma instituição hospitalar privada da cidade de Juiz de Fora, Minas Gerais. Coletaram-se dados pré e pós-implementação dos métodos citados, entre janeiro de 2003 e outubro de 2004. Obteve-se redução de 23,07% no número de itens abrigados no estoque; entre esses 271 (32,26%), voltavam-se aos cuidados diretos com o paciente, e apenas 128 desses itens eram medicamentos. A instituição não utilizava a Classificação ABC, e esta mostrou que os produtos da classe A representaram 71 % do valor do estoque, sinalizando diferenciar sua gestão. Conclui-se que os medicamentos representam parcela relevante na composição dos custos hospitalares, o que implica emprego de processos inovadores na gestão da farmácia, com redução dos custos institucionais e democratização do acesso aos serviços de saúde