2 resultados para remote rural practice
em Digital Commons at Florida International University
Resumo:
Colombia's increasingly effective efforts to mitigate the power of the FARC and other illegitimately armed groups in the country can offer important lessons for the Peruvian government as it strives to prevent a resurgence of Sendero Luminoso and other illegal non-state actors. Both countries share certain particular challenges: deep economic, social, and in the case of Peru ethnic divisions, the presence of and/or the effects of violent insurgencies, a large-scale narcotics production and trafficking, and a history of weak state presence in large tracts of isolated and scarcely-populated areas. Important differences exist, however in the nature of the insurgencies in the two countries, the government response to them and the nature of government and society that affects the applicability of Colombia's experience to Peru. The security threat to Panama from drug trafficking and Colombian insurgents --often a linked phenomenon-- are in many ways different from the drug/insurgent factor in Colombia itself and in Peru, although there are similar variables. Unlike the Colombian and Peruvian cases, the security threat in Panama is not directed against the state, there are no domestic elements seeking to overthrow the government -- as the case of the FARC and Sendero Luminoso, security problems have not spilled over from rural to urban areas in Panama, and there is no ideological component at play in driving the threat. Nor is drug cultivation a major factor in Panama as it is in Colombia and Peru. The key variable that is shared among all three cases is the threat of extra-state actors controlling remote rural areas or small towns where state presence is minimal. The central lesson learned from Colombia is the need to define and then address the key problem of a "sovereignity gap," lack of legitimate state presence in many part of the country. Colombia's success in broadening the presence of the national government between 2002 and the presence is owed to many factors, including an effective national strategy, improvements in the armed forces and police, political will on the part of government for a sustained effort, citizen buy-in to the national strategy, including the resolve of the elite to pay more in taxes to bring change about, and the adoption of a sequenced approach to consolidated development in conflicted areas. Control of territory and effective state presence improved citizen security, strengthened confidence in democracy and the legitimate state, promoted economic development, and helped mitigate the effect of illegal drugs. Peru can benefit from the Colombian experience especially in terms of the importance of legitimate state authority, improved institutions, gaining the support of local citizens, and furthering development to wean communities away from drugs. State coordinated "integration" efforts in Peru as practiced in Colombia have the potential for success if properly calibrated to Peruvian reality, coordinated within government, and provided with sufficient resources. Peru's traditionally weak political institutions and lack of public confidence in the state in many areas of the country must be overcome if this effort is to be successful.
Resumo:
In the US, one in every eight deaths is due to an obesity-related chronic health condition (ORCHC). More than half of African American women (AAW) 20 years old or older are obese or morbidly obese, as are 63% of menopausal AAW. Many have ORCHC that increase their morbidity and mortality and increase health care costs. In 2013, 42.6 percent of AAs living in South Carolina (SC) were obese. The purpose of this cross-sectional study was to identify the cognitive, behavioral, biological, and demographic factors that influence health outcomes (BMI, and ORCHC) of AAW living in rural SC. A sample of 200 AAW (50 in each of the 4 groups of rurality by menopausal status), 18-64 years, completed the: Menopausal Rating Scale (symptoms); Body Image Assessment for Obesity (self-perception of body); Mental Health Inventory; Block Food Frequency Questionnaire; Eating Behaviors and Chronic Conditions, Traditional Food Habits, and Food Preparation Technique questionnaires – and measures for Body Mass Index. Most rural, and premenopausal AAW were single and not living with a partner. Premenopausal women had significantly higher educational levels. Sixty percent of AAW had between 1 and 5 ORCHC. Most AAW used salt based seasonings, ate deep fried foods 1 to 3 times a week, and ate outside the home 1 to 3 times a month. Few AAW knew the correct daily serving for grains and dairy, and most consumed less than the recommended daily serving of fruits, vegetables and dairy. Morbidly obese AAW used more traditional food preparation techniques than obese and normal-weight AAW. Rural, and menopausal AAW had significantly higher morbid obesity levels, consumed larger portions of meats and vegetables, and reported more body image dissatisfaction than very rural AAW, and premenopausal AAW, respectively. Controlling for socioeconomic factors the relationships between perceptions of body images, psychological distress, and psychological wellbeing remained significant for numbers of ORCHC