Are marginalized women being left behind? A population-based study of institutional deliveries in Karnataka, India

Background While India has made significant progress in reducing maternal mortality, attaining further declines will require increased skilled birth attendance and institutional delivery among marginalized and difficult to reach populations. Methods A population-based survey was carried out among 16 randomly selected rural villages in rural Mysore District in Karnataka, India between August and September 2008. All households in selected villages were enumerated and women with children 6 years of age or younger underwent an interviewer-administered questionnaire on antenatal care and institutional delivery. Results Institutional deliveries in rural areas of Mysore District increased from 51% to 70% between 2002 and 2008. While increasing numbers of women were accessing antenatal care and delivering in hospitals, large disparities were found in uptake of these services among different castes. Mothers belonging to general castes were almost twice as likely to have an institutional birth as compared to scheduled castes and tribes. Mothers belonging to other backward caste or general castes had 1.8 times higher odds (95% CI: 1.21, 2.89) of having an institutional delivery as compared to scheduled castes and tribes. In multivariable analysis, which adjusted for inter- and intra-village variance, Below Poverty Line status, caste, and receiving antenatal care were all associated with institutional delivery. Conclusion The results of the study suggest that while the Indian Government has made significant progress in increasing antenatal care and institutional deliveries among rural populations, further success in lowering maternal mortality will likely hinge on the success of NRHM programs focused on serving marginalized groups. Health interventions which target SC/ST may also have to address both perceived and actual stigma and discrimination, in addition to providing needed services. Strategies for overcoming these barriers may include sensitization of healthcare workers, targeted health education and outreach, and culturally appropriate community-level interventions. Addressing the needs of these communities will be critical to achieving Millennium Development Goal Five by 2015.

Le feld-maréchal Erich von Manstein : un officier prussien à l'ombre de l'image de la Wehrmacht : étude critique de l'homme et du soldat

Thèse numérisée par la Direction des bibliothèques de l'Université de Montréal.

The Political Economy of Ethnic Empowerment in India

This dissertation consists of three papers, which together examine whether policies meant to address inequality, succeed in mitigating the impact of traditional institutions such as caste and enable ethnic minorities to claim their rights. Using experimental and quasi-experimental methods with data from a variety of primary and secondary sources, this dissertation analyzes whether policies meant to empower vulnerable groups in India have succeeded in doing so. The findings suggest that while legislations in the form of mandated political representation or freedom of information laws are necessary in terms of increasing the accountability of government towards citizens, they may not be sufficient in ensuring adequate and uniform delivery of public services, especially to citizens belonging to marginalized groups. Further, empowering citizens – especially those belonging to groups that have faced historic discrimination – to actively participate in civic and political life may require more active and intensive policy and programmatic interventions.

Le feld-maréchal Erich von Manstein : un officier prussien à l'ombre de l'image de la Wehrmacht : étude critique de l'homme et du soldat

Thèse numérisée par la Direction des bibliothèques de l'Université de Montréal.

The glass coffin, to be or no to be Snow White

We can widen the notion of « end of life » by including lives that are out of the race/circuit, excluded from “active life” and economic usefulness, and which entered this other major area of life we usually consider as the garbage of existence. We could compare this space to the glass coffin where the dwarves secluded Snow White, neither alive nor dead, but in end of life. This “end of life” starts very early in institutions or for those who live in the streets. Our society reinstated, without noticing, a caste of “untouchables” with whom we don’t know anymore how to relate. Accompaniment of the end of life actually appears closely bound to accompaniment of these lives finished, considered as “obsoletes”, expendable, disturbing… It gradually appeared to me that my workshops with homeless people or people deeply damaged by addictions were closer to palliative care than to “psychotherapy”.

What is this thing called Historical Archaeology?

Historical archaeology, in its narrow temporal sense -as an archaeology of the emergence and subsequent evolution of the Modern world- is steadily taking pace in Spanish academia. This paper aims at provoking a more robust debate through understanding how Spanish historical archaeology is placed in the international scene and some of its more relevant particularities. In so doing, the paper also stresses the strong links that have united historical and prehistorical archaeology since its inception, both in relation to the ontological, epistemological and methodological definition of the first as to the influence of socio-political issues in the latter. Such reflection is partly a situated reflection from prehistory as one of the paper’s authors has been a prehistorian for most of her professional life.

Does mode of follow-up influence contraceptive use after medical abortion in a low-resource setting? Secondary outcome analysis of a non-inferiority randomized controlled trial

BACKGROUND: Post-abortion contraceptive use in India is low and the use of modern methods of contraception is rare, especially in rural areas. This study primarily compares contraceptive use among women whose abortion outcome was assessed in-clinic with women who assessed their abortion outcome at home, in a low-resource, primary health care setting. Moreover, it investigates how background characteristics and abortion service provision influences contraceptive use post-abortion. METHODS: A randomized controlled, non-inferiority, trial (RCT) compared clinic follow-up with home-assessment of abortion outcome at 2 weeks post-abortion. Additionally, contraceptive-use at 3 months post-abortion was investigated through a cross-sectional follow-up interview with a largely urban sub-sample of women from the RCT. Women seeking abortion with a gestational age of up to 9 weeks and who agreed to a 2-week follow-up were included (n = 731). Women with known contraindications to medical abortions, Hb < 85 mg/l and aged below 18 were excluded. Data were collected between April 2013 and August 2014 in six primary health-care clinics in Rajasthan. A computerised random number generator created the randomisation sequence (1:1) in blocks of six. Contraceptive use was measured at 2 weeks among women successfully followed-up (n = 623) and 3 months in the sub-set of women who were included if they were recruited at one of the urban study sites, owned a phone and agreed to a 3-month follow-up (n = 114). RESULTS: There were no differences between contraceptive use and continuation between study groups at 3 months (76 % clinic follow-up, 77 % home-assessment), however women in the clinic follow-up group were most likely to adopt a contraceptive method at 2 weeks (62 ± 12 %), while women in the home-assessment group were most likely to adopt a method after next menstruation (60 ± 13 %). Fifty-two per cent of women who initiated a method at 2 weeks chose the 3-month injection or the copper intrauterine device. Only 4 % of women preferred sterilization. Caste, educational attainment, or type of residence did not influence contraceptive use. CONCLUSIONS: Simplified follow-up after early medical abortion will not change women's opportunities to access contraception in a low-resource setting, if contraceptive services are provided as intra-abortion services as early as on day one. Women's postabortion contraceptive use at 3 months is unlikely to be affected by mode of followup after medical abortion, also in a low-resource setting. Clinical guidelines need to encourage intra-abortion contraception, offering the full spectrum of evidence-based methods, especially long-acting reversible methods. TRIAL REGISTRATION: Clinicaltrials.gov NCT01827995.

Da casta ao terroir

Pela importância atual – e crescente – que o vinho tem na economia portuguesa, pela margem existente para a apresentação de temas de reflexão que acrescentem valor ao posicionamento do setor, pela experiência pessoal e paixão pela área, decidi elaborar a minha dissertação numa temática enquadrável no setor do vinho, em particular no vinho Alvarinho proveniente do terroir que representa a Denominação de Origem Vinho Verde Sub-região de Monção e Melgaço. A estrutura deste estudo assenta em duas dimensões: a primeira, numa perspetiva local, assente na recente decisão de alargar a Denominação Origem Vinho Verde Alvarinho a todas as sub-regiões que integram a Região dos Vinhos Verdes, com efeitos em 2021. Pelo que se procurará mostrar a importância da relação desta casta com o seu terroir de origem e, perante esta interligação, qual o fator mais importante a utilizar na comunicação do vinho. A segunda prende-se com a dimensão internacional que se pretende para o Alvarinho no mercado dos grandes vinhos brancos mundiais, onde encontramos castas brancas de renome como a Chardonnay e a Riesling, face a esta exposição e à crescente aposta na casta a nível mundial, como agir perante a potencial ameaça que representa a entrada dos países do “Novo Mundo”. Posto isto, é neste contexto que se coloca a questão que está na génese desta dissertação: de que forma o terroir contribui como fator de diferenciação e de vantagem competitiva do Alvarinho produzido na Denominação de Origem Vinho Verde Sub-região Monção e Melgaço no mercado dos grandes vinhos brancos mundiais? Cuja resposta poderá em grande parte estar, no meu entendimento, na análise de um caso de sucesso, que nesta dissertação é representada pelo trabalho realizado em torno do Rieseling produzido no Vale de Mosel e que contribuiu para que este tivesse conquistado a sua reputação.

La noblesse montréalaise devant les tribunaux (1750-1793)

Entre la fin du régime français et l’adoption de l’Acte constitutionnel par le Parlement de Londres en 1791, le rapport que la noblesse canadienne entretient avec le système judiciaire civil de la colonie change de façon majeure. Les Canadiens doivent s’adapter au nouveau système mis en place par l’administration britannique de la colonie. En Nouvelle-France, les nobles présentaient leurs différends juridiques civils devant le Tribunal royal, régi par la Coutume de Paris ; à partir de la Cession (1763), ce sont officiellement les lois britanniques qui s’appliquent jusqu’au retour des lois civiles françaises en 1774. Après quelques adaptations, la Cour des Plaidoyers communs devient la cour de prédilection des Canadiens, et par conséquent, de l’ancienne élite militaire. Le système judiciaire constitue un élément important de l’étude de l’évolution de la colonie, car l’attitude de la caste élitaire face aux tribunaux est un indicateur de sa capacité d’adaptation et de son degré d’implication dans la vie sociale.

La noblesse montréalaise devant les tribunaux (1750-1793)

Entre la fin du régime français et l’adoption de l’Acte constitutionnel par le Parlement de Londres en 1791, le rapport que la noblesse canadienne entretient avec le système judiciaire civil de la colonie change de façon majeure. Les Canadiens doivent s’adapter au nouveau système mis en place par l’administration britannique de la colonie. En Nouvelle-France, les nobles présentaient leurs différends juridiques civils devant le Tribunal royal, régi par la Coutume de Paris ; à partir de la Cession (1763), ce sont officiellement les lois britanniques qui s’appliquent jusqu’au retour des lois civiles françaises en 1774. Après quelques adaptations, la Cour des Plaidoyers communs devient la cour de prédilection des Canadiens, et par conséquent, de l’ancienne élite militaire. Le système judiciaire constitue un élément important de l’étude de l’évolution de la colonie, car l’attitude de la caste élitaire face aux tribunaux est un indicateur de sa capacité d’adaptation et de son degré d’implication dans la vie sociale.

Efeitos da dança criativa em mulheres idosas

Objectivo: Verificar os efeitos da prática da Dança Criativa (DC) em mulheres idosas, no peso (P), altura (A), índice de massa corporal (IMC), perímetro abdominal (PA), força, resistência e flexibilidade dos membros superiores e inferiores (F, R, FL-MS/MI), mobilidade física (MF) [agilidade (AG), velocidade (V), equilíbrio dinâmico (ED)], resistência aeróbia (RA) e satisfação com a vida (SV). Método: A amostra foi de 57 mulheres, entre os 65 e os 80 anos, tendo sido distribuídas aleatoriamente pelo grupo de controlo (GC) (n=25) e pelo grupo experimental (GE) (n=32). Este último frequentou aulas de DC durante 6 meses, 3 vezes por semana, com a duração de 50'. A análise estatística foi efectuada através do SPSS 17, b:mdo sido utilizadas técnicas não paramétricas. As variáveis funcionais foram avaliadas através da bateria funcional Fitness Test (Rikli & Jones, 1999) - Idosos e a SV através da Satisfaction with Live Scale (SWLS), (Diener, Larsen and Gri1fin, 1985). Resultados: Os resultados demonstraram diferenças significativas, para melhor, em todas as variáveis, excepto no P, no PA e na FLMS, entre o início e os 3 meses e entre o início E os 6 meses. No P e no PA foram observadas diferenças entre os 3 e os 15 meses. Na FRMS ambos os grupos apresentaram diferenças significativas, para melhor, e na FLMS só o GC apresentou diferenças significativas para pior. Não havia diferenças significativas entre o GE e o GC no início do estudo, excepto na RA. Conclusões: A DC promove melhorias no P; A; IMC; PA; F, R, FL-MI; MF; RA e SV em mulheres idosas. ABSTRACT: Objective: To test and verify the effects of the practice of Creative Dance in the weight, height, body mass, abdominal perimeter, strength, resistance and flexibility of the lower and upper limbs, as well as physical mobility (agility, velocity, dynamic balance), aerobic resistance and life satisfaction in elderly women. Method: 57 females constituted the sample analyzed within the ages of 65 and 80 years old randomly divided between the control group (25) and the experimental group (32). The experimental group attended 50 minutes’ classes prepared and orientated to the target core of this study during six months. The statistical analysis was processed with SPSS 17 software under non-parametric techniques. The functional battery Fitness Test (Rikli & Jones, 1999) was used to evaluate the functional variables and life satisfaction was accessed trough the Satisfaction with Live Scale (SWLS), (Diener, Larsen and Griffin, 1985). Results: The results defined positive significant differences in all variables evaluated, except weigh, abdominal perimeter and flexibility of the upper limbs between the beginning and the 3-month and the beginning and the 6- month. Differences were observed in weight and abdominal perimeter between the 3 and 6 months. 8oth groups showed considerable positive differences in the strength and resistance of the upper limbs and only the control group showed negative differences in flexibility of the upper limbs. At the beginning of the study there were no significant differences between the two groups, except in the aerobic resistance. Conclusions: Creative Dance promotes the improvement of weight, height, body mass index, abdominal perimeter, strength, resistance, flexibility of both upper and lower limbs in elderly women.