Post-disaster reconstruction projects : a logical framework for community participation

In a post-disaster environment, housing reconstruction projects frequently face enormous difficulties due to the various, often apparently ill-considered, internal and external factors. Non-Governmental Organisations (NGOs) operating in post-disaster settings such as in Afghanistan continue to face blame over the failure of reconstruction projects, and worse, they are sometimes even viewed as being corrupt entities. While it is not always possible for NGOs to eliminate or reduce the impact of factors that are outside their control, they certainly can increase the chances of project success by placing considerable emphasis on working more effectively with the affected communities. To achieve maximum community participation in reconstruction projects , this research develops a specific logical framework to guide the process of community participation in post-disaster housing reconstruction in Afghanistan.

Community engagement for disaster resilience : flood risk management in Jakarta, Indonesia

Understanding dynamics of interactions between community groups and government agencies is crucial to improve community resilience for flood risk reduction through effective community engagement strategies. Overall, a variety of approaches are available, however they are limited in their application. Based on research of a case study in Kampung Melayu Village in Jakarta, further complexity in engaging community emerges in planning policy which requires the relocation of households living in floodplains. This complexity arises in decision-making processes due to barriers to communication. This obstacle highlights the need for a simplified approach for an effective flood risk management which will be further explored in this paper. Qualitative analyses will be undertaken following semi-structured interviews conducted with key actors within government agencies, non-governmental organisations (NGOs), and representatives of communities. The analyses involve investigation of barriers and constraints on community engagement in flood risk management, particularly relevant to collaboration mechanism, perception of risk, and technical literacy to flood risk. These analyses result in potential redirection of community consultation strategies to lead to a more effective collaboration among stakeholders in the decision-making processes. As a result, greater effectiveness in plan implementation of flood risk management potentially improves disaster resilience in the future.

Community wide interventions for increasing physical activity

Background Multi-strategic community wide interventions for physical activity are increasingly popular but their ability to achieve population level improvements is unknown. Objectives To evaluate the effects of community wide, multi-strategic interventions upon population levels of physical activity. Search methods We searched the Cochrane Public Health Group Segment of the Cochrane Register of Studies,The Cochrane Library, MEDLINE, MEDLINE in Process, EMBASE, CINAHL, LILACS, PsycINFO, ASSIA, the British Nursing Index, Chinese CNKI databases, EPPI Centre (DoPHER, TRoPHI), ERIC, HMIC, Sociological Abstracts, SPORTDiscus, Transport Database and Web of Science (Science Citation Index, Social Sciences Citation Index, Conference Proceedings Citation Index). We also scanned websites of the EU Platform on Diet, Physical Activity and Health; Health-Evidence.org; the International Union for Health Promotion and Education; the NIHR Coordinating Centre for Health Technology (NCCHTA); the US Centre for Disease Control and Prevention (CDC) and NICE and SIGN guidelines. Reference lists of all relevant systematic reviews, guidelines and primary studies were searched and we contacted experts in the field. The searches were updated to 16 January 2014, unrestricted by language or publication status. Selection criteria Cluster randomised controlled trials, randomised controlled trials, quasi-experimental designs which used a control population for comparison, interrupted time-series studies, and prospective controlled cohort studies were included. Only studies with a minimum six-month follow up from the start of the intervention to measurement of outcomes were included. Community wide interventions had to comprise at least two broad strategies aimed at physical activity for the whole population. Studies which randomised individuals from the same community were excluded. Data collection and analysis At least two review authors independently extracted the data and assessed the risk of bias. Each study was assessed for the setting, the number of included components and their intensity. The primary outcome measures were grouped according to whether they were dichotomous (per cent physically active, per cent physically active during leisure time, and per cent physically inactive) or continuous (leisure time physical activity time (time spent)), walking (time spent), energy expenditure (as metabolic equivalents or METS)). For dichotomous measures we calculated the unadjusted and adjusted risk difference, and the unadjusted and adjusted relative risk. For continuous measures we calculated percentage change from baseline, unadjusted and adjusted. Main results After the selection process had been completed, 33 studies were included. A total of 267 communities were included in the review (populations between 500 and 1.9 million). Of the included studies, 25 were set in high income countries and eight were in low income countries. The interventions varied by the number of strategies included and their intensity. Almost all of the interventions included a component of building partnerships with local governments or non-governmental organisations (NGOs) (29 studies). None of the studies provided results by socio-economic disadvantage or other markers of equity. However, of those included studies undertaken in high income countries, 14 studies were described as being provided to deprived, disadvantaged or low socio-economic communities. Nineteen studies were identified as having a high risk of bias, 10 studies were unclear, and four studies had a low risk of bias. Selection bias was a major concern with these studies, with only five studies using randomisation to allocate communities. Four studies were judged as being at low risk of selection bias although 19 studies were considered to have an unclear risk of bias. Twelve studies had a high risk of detection bias, 13 an unclear risk and four a low risk of bias. Generally, the better designed studies showed no improvement in the primary outcome measure of physical activity at a population level. All four of the newly included, and judged to be at low risk of bias, studies (conducted in Japan, United Kingdom and USA) used randomisation to allocate the intervention to the communities. Three studies used a cluster randomised design and one study used a stepped wedge design. The approach to measuring the primary outcome of physical activity was better in these four studies than in many of the earlier studies. One study obtained objective population representative measurements of physical activity by accelerometers, while the remaining three low-risk studies used validated self-reported measures. The study using accelerometry, conducted in low income, high crime communities of USA, emphasised social marketing, partnership with police and environmental improvements. No change in the seven-day average daily minutes of moderate to vigorous physical activity was observed during the two years of operation. Some program level effect was observed with more people walking in the intervention community, however this result was not evident in the whole community. Similarly, the two studies conducted in the United Kingdom (one in rural villages and the other in urban London; both using communication, partnership and environmental strategies) found no improvement in the mean levels of energy expenditure per person per week, measured from one to four years from baseline. None of the three low risk studies reporting a dichotomous outcome of physical activity found improvements associated with the intervention. Overall, there was a noticeable absence of reporting of benefit in physical activity for community wide interventions in the included studies. However, as a group, the interventions undertaken in China appeared to have the greatest possibility of success with high participation rates reported. Reporting bias was evident with two studies failing to report physical activity measured at follow up. No adverse events were reported.The data pertaining to cost and sustainability of the interventions were limited and varied. Authors' conclusions Although numerous studies have been undertaken, there is a noticeable inconsistency of the findings in the available studies and this is confounded by serious methodological issues within the included studies. The body of evidence in this review does not support the hypothesis that the multi-component community wide interventions studied effectively increased physical activity for the population, although some studies with environmental components observed more people walking. Plain language summary Community wide interventions for increasing physical activity Not having enough physical activity leads to poorer health. Regular physical activity can reduce the risk of chronic disease and improve one's health and wellbeing. The lack of physical activity is a common and in some cases a growing health problem. To address this, 33 studies have used improvement activities directed at communities, using more than one approach in a single program. When we first looked at the available research in 2011 we observed that there was a lack of good studies which could show whether this approach was beneficial or not. Some studies claimed that community wide programs improved physical activities and other studies did not. In this update we found four new studies that were of good quality; however none of these four studies increased physical activity levels for the population. Some studies reported program level effects such as observing more people walking, however the population level of physical activity had not increased. This review found that community wide interventions are very difficult to undertake, and it appears that they usually fail to provide a measurable benefit in physical activity for a population. It is apparent that many of the interventions failed to reach a substantial portion of the community, and we speculate that some single strategies included in the combination may lack individual effectiveness. Laički sažetak Intervencije u zajednici za povećanje tjelesne aktivnosti Nedostatna tjelesna aktivnost povezana je s lošijim zdravljem.Redovita tjelesna aktivnost može umanjiti rizik od kroničnih bolesti te poboljšati zdravlje i kvalitetu života pojedinca.Manjak tjelesne aktivnosti čest je problem, a učestalost tog problema se povećava.Cochrane sustavni pregled je analizirao 33 studije koje su istražile programe za povećanje tjelesne aktivnosti u zajednici, u kojima se koristilo više od jednog pristupa.Kad su prvi put pregledani dokazi iz istraživanja koja su bila dostupna 2011. godine, utvrđeno je da nema dovoljno dobrih studija koje bi mogle pokazati je li takav pristup koristan ili ne.Primjerice, neke studije tvrde da programi za povećanje tjelesne aktivnosti u zajednici poboljšavaju tjelesnu aktivnost pojedinaca u zajednici, a druge studije tvrde suprotno.U ovom obnovljenom sustavnom pregledu pronađene su 4 nove studije koje su bile visoke kvalitete, ail nijedna od tih studija nije pokazala da je istraživana intervencija dovela do povećanja tjelesne aktivnosti u zajednici.Neke su studije opisale učinak na način da je opisano da je uočeno da više ljudi u zajednici hoda, međutim, ukupna razina tjelesne aktivnosti u promatranoj populaciji nije se povećala.Ovaj sustavni pregled je utvrdio da je intervencije za povećanje tjelesne aktivnosti u zajednici teško provesti i čini se da one obično ne uspijevaju u svojoj namjeri da na mjerljiv način povećaju tjelesnu aktivnost u populaciji.Čini se da mnoge intervencije nisu uspjele doseći veći broj stanovnika u zajednici pa se može smatrati da neke od strategija uključene u analizirane kombinacije nisu zasebno učinkovite.

Kestävä kehitys globaalin ajan hyvinvointiyhteiskunnan haasteena

The objective of the dissertation was to determine the concept of sustainable development according to current understanding and to analyze the structuration of sustainable daily life and how it varies between different groups. The present dissertation is both a literature-based theoretical study and data-based empirical research. The theoretical framework of the study was a greated model of the Structuration of Sustainability in Everyday Life. The model is based on a synthesis of Giddens Theory of Structuration (1984), Spaargaren JA van Vliet's Theory of Consumption as Social Practices (2000) and principles of sustainable development. According to the model created, sustainable everyday life is generated in a context of internal and external factors compromising the interests of ecosystems, society and business. The literature used in the thesis included international and national statements on sustainable development and research into sustainability and the transition to sustainable societies. The data were collected at Helsinki Metropolia University of Applied Sciences. The discretionary sample consisted of students of social services (n = 210) and were collected using the semantic differential technique. The data were analyzed using quantitative and qualitative methods. The results showed that the value placed on ecological, economic and social sustainability increased with age. Activity in non governmental organizations was associated with the acceptance of sustainable development as a whole and especially with global responsibility. Women's everyday life promoted sustainability more than men´s. People living in Helsinki had more sustainable ways of living than those living in the surrounding municipalities because of greater recycling and the low importance given to ownership. Prefering vegetarian food turned out to be a real opportunity for a more sustainable way of living because there were few barriers identified. Contradictory human behavior occurred when advanced sustainable consumer were ready to risk their health. The importance of communality was high and it was considered an aspect of health. The most significant obstacles to sustainable development in daily life were high costs, lack of knowledge and busyness. Similar attitudes towards sustainable development translate into different people´s behavior, which indicates complexities of the behaviour change in the context of sustainable development. The role of non governmental organizations is significant in increasing global responsibility. Education presents an opportunity to increase sustainability, but there are challenges to face from system thinking and in understanding entities in a state of transition towards sustainable everyday life. The responsibility of policy makers is paramount because high costs create a barrier to a sustainable way of living. The implementation of the concept of sustainable development should be focused on the planetary ethics which cover humans, animals, plants and ecosystems. Keywords: Sustainable development, sustainable thinking, behaviour change  

Realities on the ground: Human trafficking constructs in Thailand and the implications on NGO anti-trafficking prevention strategies

This thesis is a qualitative study that examines how participating staff from Thai based non-governmental organisations interpret and construct the notion of human trafficking; and how this impacts prevention methods. The research examined the impact of different socio-cultural, political and religious ideologies on anti-trafficking prevention and programme implementation. Findings highlighted that while a 'raid and rescue' approach to human trafficking was widely recognised by donors and the media; it was not suitable or complementary to sustainable and community focused anti-trafficking models. Rather, a holistic approach that considers contextual factors and inter-agency collaboration is essential for effective anti-trafficking prevention strategies.

World parliament – fact or fiction? On the feasibility of world parliamentary models

Cosmopolitan ideals have been on the philosophical agenda for several millennia but the end of the Cold War started a new discussion on state sovereignty, global democracy, the role of international law and global institutions. The Westphalian state system in practice since the 17th century is transforming and the democracy deficit needs new solutions. An impetus has been the fact that in the present world, an international body representing global citizens does not exist. In this Master’s thesis, the possibility of establishing a world parliament is examined. In a case analysis, 17 models on world parliament from two journals, a volume of essays and two other publications are discussed. Based on general observations, the models are divided into four thematic groups. The models are analyzed with an emphasis on feasible and probable elements. Further, a new scenario with a time frame of thirty years is proposed based on the methodology of normative futures studies, taking special interest in causal relationships and actions leading to change. The scenario presents three gradual steps that each need to be realized before a sustainable world parliament is established. The theoretical framework is based on social constructivism, and changes in international and multi-level governance are examined with the concepts of globalization, democracy and sovereignty. A feasible, desirable and credible world parliament is constituted gradually by implying electoral, democratic and legal measures for members initially from exclusively democratic states, parliamentarians, non-governmental organizations and other groups. The parliament should be located outside the United Nations context, since a new body avoids the problem of inefficiency currently prevailing in the UN. The main objectives of the world parliament are to safeguard peace and international law and to offer legal advice in cases when international law has been violated. A feasible world parliament is advisory in the beginning but it is granted legislative powers in the future. The number of members in the world parliament could also be extended following the example of the EU enlargement process.

Basic Income Grant in Namibia, a Viewpoint on the Proposal and on the Work of the BIG Coalition

This thesis studies the basic income grant proposal in Namibia. The proposal suggests a monthly grant of N$100 (approximately 10€) to all those Namibian citizens who do not receive the state pension. This thesis concentrates on the Basic Income Grant (BIG) Coalition and on its work. The formation and transformation of the coalition during the time period between 2003 and 2009 is analyzed with the help of data collected during two field work periods in 2008 and 2009. The data includes interviews, newspaper articles, observations and other background material. The analysis of this material is mainly conducted from organizational viewpoint. The final part of the thesis applies the results to the theory of Mosse, whose propositions about policy and practice will be discussed in relation to the basic income grant pilot project. The thesis argues that social legitimacy has been a vital resource for the work of the BIG Coalition and it has sought for it in various ways. The concept of social legitimacy originates from the resource dependence perspective of Pfeffer and Salancik, who propose that organizations are dependent on their environments, and on the resources provided by the surrounding environment. This thesis studies the concept of social legitimacy in the context of resource dependence theory. Social legitimacy is analyzed in the relations between the coalition and its environment, in the formation of the coalition, in the responses towards criticism, and finally in relation to the propositions concerning policy and practice. The work of the coalition in the pilot project will be analyzed through the propositions of Mosse concerning policy and practice. The results will describe and analyze key events in the formation of the BIG Coalition from the South African proposal until the end of the basic income pilot project. This BIG pilot project conducted in 2008-2009 is one of the most well-known activities of the coalition. The clashes between the coalition and its environment will be analyzed through four case studies. It will be shown that the project has been conducted in order to gain more legitimacy to the basic income grant proposal. The conclusion questions the legitimacy of the BIG Coalition as a research and development organization, and requests for more transparent research on the basic income proposal in Namibia.

The India MPA Workshop Proceedings. Social Dimensions of Marine Protected Areas Implementation in India: do Fishing Communities Benefit? 21-22 January 2009, IMAGE Auditorium, Chennai, India

In the current context of natural resource management, marine protected areas (MPAs) are being widely propagated as an important tool for the conservation of marine and fisheries resources. The International Collective in Support of Fishworkers (ICSF) recently undertook a series of studies on MPAs in India to highlight the various legal, institutional, policy and livelihoods issues that confront fishing and coastal communities. In order to discuss the findings of these case studies and to suggest proposals for livelihood-sensitive conservation and management of coastal and fisheries resources through participatory processes, ICSF organized a two-day workshop on ‘Social Dimensions of Marine Protected Area Implementation in India: Do Fishing Communities Benefit?’ at Chennai on 21-22 January 2009. This publication—the India MPA Workshop Proceedings—contains the prospectus of the workshop, a report of the proceedings and the consensus statement that was reached by organizations and individuals who particapated in the workshop. This publication will be useful for fishworkers, non-governmental organizations, policymakers, trade unions, researchers and others interested in natural resource management and coastal and fishing communities.

The State of Coral Reef Ecosystems of the United States and Pacific Freely Associated States: 2005

Executive Summary: For over three decades, scientists have been documenting the decline of coral reef ecosystems, amid increasing recognition of their value in supporting high biological diversity and their many benefits to human society. Coral reef ecosystems are recognized for their benefits on many levels, such as supporting economies by nurturing fisheries and providing for recreational and tourism opportunities, providing substances useful for medical purposes, performing essential ecosystem services that protect against coastal erosion, and provid-ing a diversity of other, more intangible contributions to many cultures. In the past decade, the increased awareness regarding coral reefs has prompted action by governmental and non-governmental organizations, including increased funding from the U.S. Congress for conservation of these important ecosystems and creation of the U.S. Coral Reef Task Force (USCRTF) to coordinate activities and implement conservation measures [Presidential Executive Order 13089]. Numerous partnerships forged among Federal agencies and state, local, non-governmental, academic and private partners support activities that range from basic science to systematic monitoring of ecosystem com-ponents and are conducted by government agencies, non-governmental organizations, universities, and the private sector. This report shares the results of many of these efforts in the framework of a broad assessment of the condition of coral reef ecosystems across 14 U.S. jurisdictions and Pacific Freely Associated States. This report relies heavily on quantitative, spatially-explicit data that has been collected in the recent past and comparisons with historical data, where possible. The success of this effort can be attributed to the dedication of over 160 report contributors who comprised the expert writing teams for each jurisdiction. The content of the report chapters are the result of their considerable collaborative efforts. The writing teams, which were organized by jurisdiction and comprised of experts from numerous research and management institutions, were provided a basic chapter outline and a length limit, but the content of each chapter was left entirely to their discretion. Each jurisdictional chapter in the report is structured to: 1) describe how each of the primary threats identified in the National Coral Reef Action Strategy (NCRAS) has manifested in the jurisdiction; 2) introduce ongoing monitoring and assessment activities relative to three major categories of inquiry – water quality, benthic habitats, and associated biological communities – and provide summary results in a data-rich format; and 3) highlight recent management activities that promote conservation of coral reef ecosystems.

Fisheries management

These Guidelines have been produced to support the implementation of Article 7 of the Code of Conduct for Responsible Fisheries, with some reference to Article 12. They are addressed primarily to the decision-makers within fisheries management authorities and other interest groups, including fishing companies, fishers' organizations, concerned non-governmental organizations and others. The Guidelines provide a background to the need for fisheries management and an introduction to the activities encompassed by fisheries management. They introduce the major constraints experienced in fisheries and fisheries management and some of the fundamental concepts related to these. Biological, environmental, technological, socio-cultural and economic constraints and concepts are examined. Information is fundamental to responsible fisheries management and these Guidelines put emphasis on the range of data required for informed decisionmaking and examine aspects of the collection and interpretation of these data. Data are discussed in terms of three suggested scales in fisheries management: fisheries policy and development planning, formulation of management plans and implementation of management action. The range of possible management actions is outlined. This includes technical measures, such as gear restrictions, and more direct approaches in the form of direct catch limitation or effort limitation. The problems associated with open access fisheries are explained and comments made on the means to limit access and obstacles which may be encountered in this process. Finally, the Guidelines examine the management process. This section covers the process of agreeing on a management plan for a fishery, including the need for consultation and, where appropriate, cooperative decision-making. The need for periodic review of management plans is stressed. The importance of an effective legal framework, institutional and administrative structures and monitoring control and surveillance are described. (PDF contains 91 pages)

Direito Desportivo Internacional: a influência das normas e das decisões jusdesportivas internacionais no ordenamento jurídico brasileiro

Este trabalho tem como escopo analisar as influências das normas e das decisões jusdesportivas internacionais no ordenamento jurídico brasileiro. Para isso, alinharam-se as predileções do autor por Esporte, Direito Internacional e Relações Internacionais, assim como por outras ciências, como Geografia. Indubitável a importância do tema para a conjuntura atual, sendo o Brasil sede dos dois principais megaeventos esportivos em 2014 e 2016, a Copa do Mundo Fifa e os Jogos da XXXI Olimpíadas, os Jogos Olímpicos. Essa dissertação foi dividida em quatro capítulos. O primeiro trata da relação entre Esporte, Globalização e Geopolítica, e o segundo capítulo versa sobre o Esporte sob a perspectiva dos Direitos Humanos. Após estudar o Esporte sob a perspectiva do Estado e do Homem, analisam-se as fontes do Direito Desportivo Internacional e o ordenamento jusdesportivo. Os Estados não são os únicos produtores de normas jurídicas. Entidades privadas são capazes de produzir normas, em cooperação ou em conflito com o Estado. Admite-se, portanto, pluralidade de produção normativa. No caso do Direito Desportivo Internacional, optou-se por abordar quatro organizações esportivas internacionais: COI, Wada, Fifa e TAS/CAS, tema do derradeiro capítulo. A influência de seus regulamentos e de seus estatutos se mostrará não apenas nos estatutos e nos regulamentos de suas afiliadas, mas também na legislação nacional. Essas organizações não governamentais de alcance transnacional/internacional têm sua natureza jurídica de acordo com seus estatutos constitutivos. A tentativa de unificação de sistemas jurídicos deve ser abandonada, dando lugar à concepção de harmonização. A dificuldade de harmonização é causada pela pluralidade de Estados e de atores privados que tentam normatizar as relações jurídicas que envolvem o esporte. Desse modo, as influências dessas normas internacionais de caráter privado são marcantes no ordenamento jurídico pátrio. Analisa-se como ocorrem essas influências e de que forma cada produtor de norma jurídica poderia atuar para que prevaleça a cooperação entre eles no âmbito jusdesportivo.

Biocombustíveis, governança global e comércio internacional: Rumo a um novo paradigma energético?

Considerando-se este importante momento de transição em que as tradicionais matrizes energéticas são paulatinamente substituídas por um conjunto de fontes renováveis, das quais os biocombustíves sobressaem-se pela capacidade de contribuir para o meio ambiente, trazendo igualmente benefícios econômicos e sociais a seus produtores; o presente trabalho visa contribuir para o panorama energético global que se começa a se delinear. Diante da impotência do Estado em lidar hodiernamente com determinadas questões, testemunha-se a participação de atores privados (organizações não governamentais, empresas transnacionais e sociedade civil, entre outros) atuando como vetores na transmissão de compromissos internacionais junto a estruturas nacionais para a solução de problemas comuns da humanidade. A essa nova arquitetura jurídica e política convencionou-se designar de governança global. Diante da inexistência de uma governança energética global que opere no interesse de países importadores, exportadores e investidores do setor de energia, agindo também como promotora de desenvolvimento social e econômico junto a países em desenvolvimento; e, por fim, em face da ausência de uma regulação internacional exclusiva na área energética, o presente estudo se dedica a investigar as possibilidades de disciplinamento do comércio internacional dos biocombustíveis. Admitindo-se o relevante desempenho que o Brasil detém na produção e exportação deste produto, inclusive na área tecnológica, a presente tese busca identificar o foro adequado, condições justas de produção, investimento, concessão de subsídios, adoção de medidas técnicas, de compra e venda, concorrência entre outros itens que o tema relaciona.

Organizações não-governamentais: perspectivas de mercado de trabalho do serviço social

Este trabalho tem como finalidade analisar se as ONGs constituem-se um desdobramento do mercado de trabalho para o Serviço Social e quais as implicações diante da reforma neoliberal do Estado brasileiro. Nossa análise parte da compreensão de que o reordenamento do Estado, as dinâmicas que determinam o enxugamento e o desmantelamento das políticas sociais públicas num contexto de reestruturação produtiva, recaem sobre a profissão, refletindo-se nas condições e relações de trabalho do assistente social em suas diversas áreas de atuação. Frente a essas alterações no campo do trabalho, nas últimas décadas, é necessário um debate aprofundado sobre as possibilidades de novos campos de trabalho para o Serviço Social. Partindo dessas considerações, indagamos: as Organizações Não-Governamentais podem representar um possível mercado em expansão para os assistentes sociais? Visando contribuir com o debate junto aos profissionais de Serviço Social e com pesquisadores dessa temática, realizamos uma pesquisa empírica junto as ONGs na Cidade do Rio de Janeiro, coletando dados junto aos gestores e assistentes sociais inseridos nas organizações, para verificarmos as perspectivas de mercado de trabalho para o Serviço Social, tendo como foco as ONGs.

A behavior model for blood donors and marketing strategies to retain and attract them

Objective: analyze and propose a theoretical model that describes blood donor decisions to help staff working in blood banks (nurses and others) in their efforts to capture and retain donors. Methods: analysis of several studies on the motivations to give blood in Spain over the last six years, as well as past literature on the topic, the authors' experiences in the last 25 years in over 15 Non Governmental Organizations with different levels of responsibilities, their experiences as blood donors and the informal interviews developed during those 25 years. Results: a model is proposed with different internal and external factors that influence blood donation, as well as the different stages of the decision-making process. Conclusion: the knowledge of the donation process permits the development of marketing strategies that help to increase donors and donations.

A Residência Médica: articulações entre a prática e o ensino

O objetivo desta tese de doutorado é o estudo da residência médica e de suas articulações com o campo educacional e o da saúde. Propõe-se uma análise histórico - dialética, tomando como ponto de partida a articulação da medicina e da educação na estrutura social. Parte-se da concepção segundo a qual a prática e o saber no campo educacional e na saúde estão ligados à transformação histórica do processo de produção econômica. Essa compreensão remete à chamada determinação em última instância: a estrutura econômica determina o lugar e a forma de articulação da medicina e da educação na estrutura social. Para compreender a peculiaridades do ensino e da residência médica no Brasil faz-se uma caracterização da assistência médica, sobretudo do papel assumido pelo Estado na configuração do campo: primeiro, a adoção de um sistema em que compete ao Estado a responsabilidade pela universalização da atenção básica, através de serviços próprios ou em parceria com organizações não governamentais; segundo, a atenção especializada, com maior incorporação tecnológica, seria prestada pelo setor privado, mediante incentivos concedidos pelo Estado. Dessa divisão, resulta, no desenho atual, ao invés de um único sistema, a conformação de dois ou mais sistemas de saúde, em que a segmentação da assistência implica em práticas diferenciadas. O efeito desta divisão no mercado de trabalho repercute na escola e na residência médicas. A residência, em particular, por suas características de treinamento em serviço, responde diretamente aos condicionantes do mundo do trabalho, reproduzindo o modelo de prática hegemônica.