As startups no contexto da organização capitalista financeira e as subjetividades empreendedoras / Startups in the context of financial capitalist organization and entrepreneurial subjectivities / Startups en el contexto de la organización capitalista financiera y subjetividades emprendedoras

As startups são empresas que apresentam modelos de negócios marcados pela inovação, rapidez, flexibilidade e alta capacidade de adaptação aos mercados. Atuando em diferentes setores socioeconômicos, elas prometem criar e transformar produtos e serviços. A emergência e disseminação dessas empresas ocorrem em um momento histórico de mudanças iniciadas a partir de 1970 e marcadas pelas crises geradas com o esgotamento do paradigma da sociedade urbano industrial. No Brasil, o número desse modelo de negócio apresentou uma expansão expressiva, alcançando a marca de 13.374 nos últimos cinco anos. Atento a esse cenário, o objetivo desta pesquisa consistiu em compreender como sujeitos, grupos e instituições atribuem sentidos à experiência de trabalho nas chamadas startups. Na parte teórica, as condições sociais e econômicas que possibilitaram a emergência e disseminação das startups são analisadas em uma perspectiva crítica. A parte empírica, por sua vez, apresenta depoimentos de empreendedores relatando o contexto geral de atuação nas startups. Ao final deste artigo, conclui-se que há uma instrumentalização capitalística de componentes subjetivos específicos selecionados e colocados em circulação para fortalecer o modo de produção capitalista financeirizado.(AU)

Startups are companies that have business models characterized by innovation, speed, flexibility, and a high capacity to adapt to markets. Operating in different socioeconomic sectors, they promise to create and transform products and services. The emergence and dissemination of these companies occur at a historical moment of changes that began from 1970 and are marked by the crises generated by the exhaustion of the paradigm of industrial urban society. In Brazil, the number of businesses in this model showed a significant expansion, reaching 13,374 companies in the last five years. Attentive to this scenario, the objective of this research was to understand how subjects, groups, and institutions attribute meanings to the work experience in so-called startups. In the theoretical part, the social and economic conditions that enabled the emergence and dissemination of startups are analyzed in a critical perspective. The empirical part presents entrepreneurs reporting the general context of action in startups. At the end of this article, it is concluded that there is a capitalistic instrumentalization of specific subjective components that are selected and put into circulation to strengthen the financed capitalist production.(AU)

Las startups son empresas que tienen modelos de negocio marcados por la innovación, la velocidad, la flexibilidad y una alta capacidad de adaptación a los mercados. Desde diferentes sectores socioeconómicos, las startups prometen crear y transformar productos y servicios. La aparición y difusión de estas empresas se produce en un momento histórico de cambios que comenzó a partir de 1970 y que está marcado por crisis generadas por el agotamiento del paradigma de la sociedad urbana industrial. En Brasil, estas empresas se expandieron significativamente alcanzando la marca de 13.374 empresas en los últimos cinco años. En este escenario, el objetivo de esta investigación fue entender cómo los sujetos, grupos e instituciones atribuyen significados a la experiencia laboral en las startups. En la parte teórica, se analizan las condiciones sociales y económicas que permitieron el surgimiento y la difusión de las startups en una perspectiva crítica. La parte empírica presenta testimonios de emprendedores que informan sobre el trabajo en startups. La investigación concluye que hay una instrumentalización capitalista de componentes subjetivos específicos que se seleccionan y ponen en circulación para fortalecer el modo de producción capitalista financiero.(AU)

Vacunación canina y felina masiva en México: pobre rectoría y fallo de mercado / Massive canine and feline vaccination in Mexico: poor governance and market failure

Resume: Objetivo: Analizar la rectoría y los mecanismos de procuración de insumos en el contexto del Programa de Acción Específico de Prevención y Control de la Rabia Humana y la Semana Nacional de Vacunación Antirrábica canina y felina en México (SNVA-C). Material y métodos: La información se obtuvo mediante solicitudes al Instituto Nacional de Transparencia, Acceso a la Información y Protección de Datos Personales. Resultados: De 2009 a 2017 se aplicaron 158.9 millones de dosis de vacuna antirrábica canina y felina (VAR-CF) por un monto de compra aproximado de 1 915 MDP. Se documentó una débil rectoría que permite prácticas monopólicas y compras fragmentadas y directas. Las adquisiciones se han fincado con precios que varían entre entidades federativas y son significativamente más altos que los precios internacionales. Conclusión: Después de 30 años de operación de la SNVA-C en México, persisten pagos excesivos para la VAR-CF, los cuales son indicativos de una falla importante del mercado, caracterizada por nula competencia, información asimétrica y estructuras de incentivos desalineadas que impiden obtener un precio competitivo.

Abstract: Objective: To analyze decision-making concerning stewardship and procurement mechanisms in the context of the Program for Prevention and Control of Human Rabies and the National Canine and Feline Vaccination Week in Mexico. Materials and methods: The information was obtained through requests to the National Institute of Transparency, Access to Information and Protection of Personal Data. Results: From 2009 to 2017, 158.9 million doses of canine rabies vaccine (VAR-CF) were applied with an estimated budget of 1 915 million pesos. Our findings suggest weak stewardship and ineffective governance that allows monopolistic practices and fragmented and direct purchases. Prices for the same product vary discretionally between states and are significantly higher than those offered at international level. Conclusions: After 30 years of operation of the SNVA-C in Mexico, high prices of the VAR-CF persist, which are indicative of a significant market failure, characterized by zero competition, asymmetric information and misaligned incentive structures that precluded favorable price negotiation.

From health plan companies to international insurance companies: changes in the accumulation regime and repercussions on the healthcare system in Brazil / De las empresas médicas a las aseguradoras internacionales: cambios en el régimen de acumulación y repercusiones sobre el sistema de salud en Brasil / Das empresas médicas às seguradoras internacionais: mudanças no regime de acumulação e repercussões sobre o sistema de saúde no Brasil

Abstract: The concentration and internationalization of health plan companies in Brazil gave them a clearly financial face. Based on the need to understand the health care industry's capital accumulation patterns, the current study examines health plan companies' expansion strategies through the classification of their supply and demand characteristics by recent historical periods and an analysis of recent shareholding trends in one of the leading corporations in the Brazilian health care industry. The 1960s to 2000s witnessed changes in the scale of demands for health plans and adherence by companies to long-term accumulation strategies. Beginning in the early 21st century, changes in the shareholding structures of the largest Brazilian company, consistent with the financialization of its accumulation regime, resulted in the rapid multiplication of its capital. Deepening segmentation of the health care system in a context marked by the downturn in the national economy challenges the preservation of public subsidies for private health plans.

Resumen: La concentración e internacionalización de empresas de planes de salud en Brasil les han conferido un carácter financiero. Considerando la necesidad de comprender los padrones de acumulación de ese sector, el trabajo examina estrategias de expansión de las empresas de planes de salud, mediante la periodización de atributos de oferta y demanda y el examen de la trayectoria patrimonial reciente de uno de los grandes grupos del sector. Entre los años 1960 y 2000, se produjeron alteraciones en la escala de las demandas por parte de planes de salud y una adhesión de las empresas a estrategias de acumulación a largo plazo. A partir del siglo XXI, las alteraciones en las estructuras societarias de la mayor empresa brasileña, compatibles con el régimen de acumulación de carácter financiero, resultaron en la multiplicación de su capital en un corto intervalo de tiempo. La profundización de la segmentación del sistema de salud, en un contexto marcado por la desaceleración de la economía, cuestiona la preservación de los subsidios públicos para los planes privados.

Resumo: A concentração e internacionalização de empresas de planos de saúde no Brasil conferiram-lhes feição financeira. Considerando a necessidade de compreender os padrões de acumulação desse setor, o trabalho examina estratégias de expansão das empresas de planos de saúde por meio da periodização de atributos da oferta e demanda e exame da trajetória patrimonial recente de um dos grandes grupos do setor. Entre os anos 1960 e 2000, ocorreram alterações na escala das demandas por planos de saúde e adesão das empresas a estratégias de acumulação de longo prazo. A partir do século XXI, as alterações nas estruturas societárias da maior empresa brasileira, compatíveis com o regime de acumulação financeirizada, resultaram na multiplicação de seu capital em um curto intervalo de tempo. O aprofundamento da segmentação do sistema de saúde, em um contexto marcado pela desaceleração da economia, questiona a preservação dos subsídios públicos para os planos privados.

Impacto de la competencia económica del especialista en medicina general integral sobre el desarrollo socioeconómico de Cuba / Impact of the economic competence of the specialist in general comprehensive medicine on the Cuban social and economic development

La Economía de la Salud, con sus inicios en países desarrollados, constituye una disciplina que ha venido desarrollándose en los últimos años como una especialidad científica y cuyo objeto de estudio es la toma de decisiones en el sistema de servicios y programas sanitarios, desde un punto de vista económico; por ello se impone que el especialista en medicina general integral adquiera una adecuada competencia económica para el cabal cumplimiento de sus funciones, esencialmente en las actividades de promoción de salud, prevención de enfermedades, diagnóstico precoz, tratamiento oportuno y rehabilitación, con vistas al logro de un mayor progreso social.

Health Economy, with its emergence in developed countries, constitutes a discipline which is being developed in the last years as a scientific specialty and whose study object is the decisions making in the services system and sanitary programs, from an economic point of view; that is why it is important that the specialist in general comprehensive medicine acquires an appropriate economic competence for the precise fulfilment of his functions, essentially in the activities of health promotion, diseases prevention, early diagnosis, opportune treatment and rehabilitation, with the aim of achieving a huger social progress.

Study on restriction factors and countermeasures of influence of China medical devices competitiveness / 中国医疗器械杂志

Recent years, China medical devices industry has been a sunrise industry with widely-ranged products, high-tech innovation, and booming market demands. But with the globalization of market economy, China industry is still in the inferior position of competition. How to promote the industrial structure transition, increase scientific and technological level, speed up the updating of products, enhance the international competitiveness is one of the major tasks to maintain the healthy development of industry. This article makes a study on current situation of China medical devices industry, analyses the new opportunities, challenges and restriction factors, provides the countermeasures of strengthening industry competitiveness as well.

¿Por qué se limita la integración vertical en el sector salud en Colombia? / Por que é que se limita a integracao vertical no sector saúde na Colombia? / Why is vertical integration restricted in the Colombian health sector?

En el sector salud colombiano se busca limitar la integración vertical entre Entidades Promotoras de Salud (EPS) e Instituciones Prestadoras de Servicios de Salud (IPS), para evitar prácticas restrictivas de la competencia. Sin embargo, la evidencia empírica señala que no es concluyente el efecto de la integración vertical sobre la competencia entre aseguradoras. El trabajo plantea esta hipótesis sobre la base de la evidencia teórica y empírica, y muestra que la integración vertical no tuvo efectos sobre la competencia de las EPS del régimen contributivo en el período posterior a la aplicación de la restricción del 30% de contratación entre aseguradores y prestadores de servicios de salud...

In Colombia, the Health industry is restricted from vertically integrating the Health Management Organizations (EPS) with the Health Service Providers (IPS) in order to avoid antitrust competitive conditions. However, the empirical evidence in this regard is inconclusive. This paper analyzes this antitrust hypothesis, contrasting it to the empirical and theoretical evidence at hand, and shows that vertical integration had no effect on EPS competition in the period after the restriction on 30% contracting between both types of entities was enforced...

No sector saúde colombiano procura-se limitar a integração vertical entre Entidades Promotoras de Saúde (EPS) e Instituições Prestadoras de Serviços de Saúde (IPS) para evitar práticas restritivas da concorrência. No entanto, a evidência empírica indica que o efeito da integração vertical sobre a concorrência entre as companhias de seguros não é conclusivo. O trabalho levanta esta hipótese sobre a base da evidência teórica e empírica para mostrar que a integração vertical não teve nenhum efeito sobre a concorrência das EPS do regime contributivo no período após da aplicação da restrição de 30% de contratação entre as seguradoras e os prestadores dos serviços de saúde...

Health Care Market Deviations from the Ideal Market

A common argument in the health policy debate is that market forces allocate resources efficiently in health care, and that government intervention distorts such allocation. Rarely do those making such claims state explicitly that the market they refer to is an ideal in economic theory which can only exist under very strict conditions. This paper explores the strict conditions necessary for that ideal market in the context of health care as a means of examining the claim that market forces do allocate resources efficiently in health care

Ajustes curriculares al Programa de Especialización de Medicina General Integral en Economía de la Salud / Curriculum adjustment to the Specialization Program of Comprehensive General Medicine in Health Economy

Se realizó un estudio descriptivo y transversal de 53 especialistas de medicina general integral de los policlínicos universitarios Municipal y Ramón López Peña, desde junio de 2007 hasta mayo de 2008, para evaluar su competencia económica en el desempeño de sus funciones, a fin de elaborar una propuesta de cambios en el diseño curricular del Programa de Especialización de Medicina General Integral, específicamente en el contenido de Economía de la Salud, previa identificación de los conocimientos que poseían los profesionales de esta especialidad sobre la materia. A tales efectos se confeccionó una propuesta de ajustes curriculares al citado Programa, sometida a valoración de 16 expertos. Se utilizó la prueba de concordancia de Kendall para valorar las utilidades teórica y práctica de la propuesta. Dichos especialistas, además de tener una insuficiente competencia económica, mostraron gran desconocimiento sobre la importancia de la economía de la salud para el desarrollo de su labor profesional. La propuesta de ajustes curriculares obtuvo valores significativos según criterios de las autoridades evaluadoras.

A descriptive and cross-sectional study of 53 specialists in comprehensive general medicine of the Municipal and Ramón López Peña university polyclinics was carried out, from June, 2007 to May, 2008, to evaluate their economic competence when doing their functions, in order to make a proposal of changes in the curriculum design of the Program of Specialization of Comprehensive General Medicine, specifically in the content of Health Economy, with previous identification of the knowledge that the professionals of this specialty had on the matter. For this purpose a proposal of curricular adjustments to such program was made, subjected to 16 experts' evaluation. The Kendall agreement test was used to evaluate the theoretical and practical use of the proposal. These specialists, apart from having an inadequate economic competence, showed a great ignorance about the importance of the health economy for the development of their professional work. The proposal of curriculum adjustments obtained significant values according to approaches of evaluating authorities.

Shift Work and Health: Current Problems and Preventive Actions

The paper gives an overview of the problems to be tackled nowadays by occupational health with regards to shift work as well as the main guidelines at organizational and medical levels on how to protect workers' health and well-being. Working time organization is becoming a key factor on account of new technologies, market globalization, economic competition, and extension of social services to general populations, all of which involve more and more people in continuous assistance and control of work processes over the 24 hours in a day. The large increase of epidemiological and clinical studies on this issue document the severity of this risk factor on human health and well being, at both social and psychophysical levels, starting from a disruption of biological circadian rhythms and sleep/wake cycle and ending in several psychosomatic troubles and disorders, likely also including cancer, and extending to impairment of performance efficiency as well as family and social life. Appropriate interventions on the organization of shift schedules according to ergonomic criteria and careful health surveillance and social support for shift workers are important preventive and corrective measures that allow people to keep working without significant health impairment.

Fortalecimento das vantagens competitivas de Bio-Manguinhos no âmbito da inovação tecnológica de vacinas decorrentes da exposição à competição internacional / Strengthening the competitive advantages of Bio-Manguinhos in the technological innovation of vaccines from exposure to international competition

É importante compreender que para melhorar a questão da saúde pública é necessário produzir produtos com qualidade e em quantidade para atender às demandas públicas nacionais e internacionais. Para isso, é preciso desenvolver o complexo produtivo de bens e serviços de saúde. Diante da pressão do ambiente político e institucional em que o complexo econômico industrial da saúde está inserido, associado à necessidade de geração de novos produtos e da incerteza decorrente da globalização, a inovação tecnológica torna-se hoje elemento essencial para a obtenção de vantagem competitiva e sobrevivência das empresas. No caso de Bio-Manguinhos, o aprimoramento do controle e processos de produção da vacina febre amarela, com vista a atender os pré-requisitos necessários para a obtenção da certificação internacional, contribuiu significativamente para o fortalecimento das vantagens competitivas da organização. Em 2001, Bio-Manguinhos foi certificado pela Organização Mundial da Saúde para exportar a vacina febre amarela 5 e 50 doses. A certificação internacional foi obtida devido ao planejamento de longo prazo e à implementação de um rigoroso sistema de garantia da qualidade. Foram a melhoria e aperfeiçoamento dos processos de controle de qualidade e dos procedimentos de produção, que proporcionaram a entrada de Bio-Manguinhos no mercado externo de vacinas. Com a certificação, Bio-Manguinhos alcançou o reconhecimento mundial pela sua qualidade, garantindo com isso a sua competitividade no setor. Este trabalho teve por objetivo avaliar o ganho que a unidade obteve em função do procedimento para se obter esta certificação - processo esse chamado de pré qualificação - e o impacto da certificação internacional em inovações de processos, produtos e estrutura organizacional.

It is important to understand that in order to improve the public health system it is necessary to produce high quality products and in quantities to meet the national and international public demand. For this, we must develop and innovate in the goods andhealth services production complex.Under the pressure of political and institutional environment in which the health and economic-industrial complex is in, with the need to introduce new products and the uncertainty concerning globalization, technological innovation is nowadays essential to achieve competitive advantage and for survival of the companies. Regarding Bio-Manguinhos, the improvement of the control and production processes ofyellow fever vaccine, in order to meet the pre-requisites necessary for obtaining the international certification, contributed significantly for the strengthening of internal competitive advantages. In 2001, Bio-Manguinhos was certified by the World Health Organization to export yellow fever vaccine 5 and 50 doses. The international certification was obtained due to longterm planning and the implementation of a rigorous quality system. It was with the improvement and development of quality control and production procedures, which provided the access of Bio-Manguinhos in the global vaccine market. With the certification, Bio-Manguinhos has achieved worldwide recognition for its quality, ensuring its competitiveness in the sector. The objective of this study was to evaluate the gain that Bio-Manguinhos obtained due to the certification procedure – this process is also known as pre-qualification - and theimpact of international certification in innovating processes, products and organizational structure.

Especificidades do patenteamento no setor farmacêutico: modalidades e aspectos da proteção intelectual: [revisão] / Specificities of patent protection in the pharmaceutical industry: modalities and traits of intellectual property: [review]

As formas de proteção das invenções no setor farmacêutico apontam para estratégias de perpetuação da proteção patentária. Com base em uma revisão bibliográfica mostrou-se as especificidades do patenteamento no setor, perpassando por um breve histórico sobre a concessão de patentes farmacêuticas no Brasil, uma abordagem sobre invenções patenteáveis e não-patenteáveis, e pelas modalidades e aspectos da proteção patentária que visam à extensão do monopólio temporário conferido pela patente. Dentre essas estratégias estão as patentes direcionadas a polimorfos e isômeros ópticos de fármacos; combinações de fármacos e segundo uso médico, cada vez mais presentes nas reivindicações dos pedidos de privilégio de invenção das indústrias farmacêuticas. O objetivo do trabalho é mostrar algumas especificidades dos pedidos de patente farmacêuticas, de modo a contribuir para a formação de expertise na área e para a discussão sobre o impacto da ampliação dos escopos de proteção das patentes. Conclui-se que se por um lado a tendência de escopos de proteção mais permissivos pode desvelar oportunidades para os inventores nacionais, por outro, pode ser danosa para uma política de acesso a medicamentos.

Different forms of protection for inventions in the pharmaceutical industry point to strategies for the perpetuation of patent protection. Based on a literature review showing the specificities of patenting in the industry, the article provides a brief history of drug patents in Brazil, a discussion of patentable and non-patentable inventions, and the modalities and traits of patent protection that aim to extend the temporary monopoly granted under the patent. Such strategies include patents targeting polimorphs and optical isomers of drugs and drug combinations and specific clinical preparations, increasingly present in the drug patent claims filed by pharmaceutical companies. The study's objective is to discuss the specificities of drug patent claims in order to help develop expertise in the area and discuss the impact of expanding the scope of patent protection. In conclusion, while the tendency to expand towards more a permissive protective scope could produce opportunities for Brazilian national inventors, it could also be harmful to a policy for access to medicines.

The impact of TRIPS on innovation and exports: a case study of the pharmaceutical industry in India.

Currently, there is a debate on what impact the implementation of the Trade Related Aspects of Intellectual Property Rights (TRIPS) in India would have on its pharmaceutical industry and health care. The debate hinges primarily on two major questions. First, will the new patent regime provide an impetus for innovation in the pharmaceutical industry? Second, how far will India's pharmaceutical exports of copied versions of patented drugs to developing countries be restricted under the new regime? The first question seeks to find out if TRIPS will increase India's innovative capabilities to fill the current vacuum to develop drugs for tropical diseases. The large multinational companies (MNCs) that dominate the global pharmaceutical industry have no interest in commercial ventures that have little potential for great returns on investment. The second question attempts to find a solution to the lack of access to medicine in most developing countries. Indian manufacturers' supply of reverse-engineered drugs, which cost only a fraction of the prices charged by MNCs, may be coming to an end under the new regime. Against this backdrop, this article attempts to analyse the impact of strengthening intellectual property rights in India.

Economía de los medicamentos genéricos en América Latina / Economy of generic drugs in Latin America

In terms of economics, implementing generic drug policy is nothing other than consolidating (or even, creating) drug markets that set competitive prices, the result of which favors public access to essential drugs. This article approaches the topic of generic drugs from the economic perspective by examining various regulatory models in order to evaluate and leverage generic drug policy implementation options as a mechanism for battling some of the markets’ specific weaknesses. The conclusion is that there is no single unequivocal method for promoting the use of generic drugs, and that the most favorable way to integrate markets may be through a broad combination of alternatives. These alternatives are grouped and analyzed according to the market issues or challenges that must be overcome. Several options are then identified based on the degree of market consolidation to be obtained.

Regulación del financiamiento a hospitales: yardstick competition aplicada a los hospitales públicos en Chile / Hospital Financing regulation: yardstick competition in Chilean Public Hospitals

El financiamiento de los hospitales públicos requiere de unos incentivos adecuados para conseguir una mayor eficiencia en el uso de los recursos. El sistema de pago actual muestra insuficiencias para acotarlas tasas de crecimiento de los costos de los prestadores de atención de salud, requiere una nueva regulación y presenta riesgos de desequilibrar el financiamiento. En el artículo se propone desarrollar un modelo de competencia por comparación o “yardstick competition”, que genere incentivos al mejoramiento de la eficiencia en el tiempo basado en lo que los hospitales son, o su estructura y en lo que hacen o su casuística, medida con GRDs. El modelo provee incentivos a los hospitales para asignar mejor recursos en un contexto de un mecanismo más global, de asignación poblacional que se apliquen a los Servicios de Salud a los cuales pertenecen.

Public hospital financing requires appropriate incentives in order to improve efficiency in resources allocation. The payment mechanisms currently in place present serious defi- ciencies in the provision of health as regards cost containment; they also require a new regulation as they represent a risk of financial imbalance. We present a model of competition based on comparison, or yardstick competition intended improve efficiency in the model is based on hospital current structure and activities, measured through DRGs. As a result, the model provides incentives for a better allocation of resources within the hospital, in a wider context related to population based resource allocation to the Health Authorities, of which hospitals are a part.

Competencia y precios en el mercado farmacéutico mexicano / Competition and prices in the Mexican pharmaceutical market

Las formas que asume la competencia en el mercado definen el nivel de precios. El mercado farmacéutico contiene submercados con diferente grado de competencia; por un lado existen productos innovadores con patente y, por el otro, genéricos con marca comercial o sin ella. Por lo general, los medicamentos innovadores con patente tienen precios monopólicos, pero a su vencimiento éstos bajan al enfrentar la competencia de alternativas terapéuticas. La marca permite conservar las rentas económicas del monopolio. En México los precios de los medicamentos en el mercado privado son elevados, de acuerdo con las estimaciones agregadas y para medicamentos específicos, lo cual refleja las limitaciones de la competencia en el mercado y el poder de la marca comercial. En el segmento público se obtienen precios competitivos con la estrategia de los medicamentos esenciales de la Organización Mundial de la Salud, con base en el listado de productos del Cuadro Básico.

The forms of market competition define prices. The pharmaceutical market contains submarkets with different levels of competition; on the one hand are the innovating products with patents, and on the other, generic products with or without trade names. Innovating medicines generally have monopolistic prices, but when the patents expire prices drop because of competition from therapeutic alternatives. The trade name makes it easier to maintain monopolistic prices. In Mexico, medicine prices in the private market are high -according to aggregated estimates and prices for specific medicines- which reflect the limitations of pharmaceutical market competition and the power of the trade name. The public segment enjoys competitive prices using the WHO strategy for essential medicines on the basis of the Essential List.

Avaliação de desempenho como um instrumento de poder na gestão de pessoas / Performance evaluation systems as power instrument in the human resources management

O presente artigo apresenta resultados de uma pesquisa que enfocou a avaliação de desempenho (AD) como um instrumento de poder utilizado na gestão de pessoas. Realizou-se um estudo de caso que utilizou entrevistas individuais com 14 participantes, sendo 4 diretores e gerentes e 10 trabalhadores da área administrativa e operacional. Para análise dos dados,utilizou-se a análise gráfica do discurso de Lane (1985). A análise dos dados indicou que os participantes (diretoria) percebiam as políticas de gestão de pessoas permeadas pela ideologiadominante como uma forma de garantir a competitividade da empresa no mercado. Já os trabalhadores a percebiam como a possibilidade para o desenvolvimento profissional e a promoção. Os dados sugerem que os resultados da AD eram utilizados na gestão de pessoas apenas quandosustentavam/confirmavam as práticas e decisões da diretoria relacionadas às políticas de pessoal. Assim, a AD pode ser considerada um instrumento de poder na gestão de pessoas, porémtendo seu uso limitado a fatores externos à técnica quando subsidia as ações dos diretores.

The research focused on the system of evaluation of performance (PE) as a method for human resources (HR) management in a family business. It is a case study that used semi-structured interviews as instrument for collecting data. The interviews were carried out individually with fourteen people; four of the group being managers and directors and ten operational administrative workers. The technique for data analyses was the speech graphic analysis by Lane (1985). The data indicated that the participants (directors) perceived the human resources policies permeated by the dominant ideology, as a way of guaranteeing the competitiveness of the organization in the market. The PE were perceived by workers as a possibility for professional development and promotion. The results suggest that the PE was only used as an instrument of HR management while their results confirmed the directors’ practices and decisions concerning HR policies. The PE could be a management instrument, used limited by policies and interests outside the technique.

Changing ethics in medical practice: a Thai perspective.

The pace of social change in Thailand has seen the rise of various medical services and a global clientele. Currently, medical tourism and cosmetic surgery have an important role in medical practice here. A growing medical market offers a range of services at competitive rates and high levels of efficiency. This essay provides an overview of medical practices in Thailand and their effect on ordinary people.