Self-assessment of the outcome of early medical abortion versus clinic follow-up in India : a randomised, controlled, non-inferiority trial

Background: The need for multiple clinical visits remains a barrier to women accessing safe legal medical abortion services. Alternatives to routine clinic follow-up visits have not been assessed in rural low-resource settings. We compared the effectiveness of standard clinic follow-up versus home assessment of outcome of medical abortion in a low-resource setting. Methods: This randomised, controlled, non-inferiority trial was done in six health centres (three rural, three urban) in Rajasthan, India. Women seeking early medical abortion up to 9 weeks of gestation were randomly assigned (1:1) to either routine clinic follow-up or self-assessment at home. Randomisation was done with a computer-generated randomisation sequence, with a block size of six. The study was not blinded. Women in the home-assessment group were advised to use a pictorial instruction sheet and take a low-sensitivity urine pregnancy test at home, 10-14 days after intake of mifepristone, and were contacted by a home visit or telephone call to record the outcome of the abortion. The primary (non-inferiority) outcome was complete abortion without continuing pregnancy or need for surgical evacuation or additional mifepristone and misoprostol. The non-inferiority margin for the risk difference was 5%. All participants with a reported primary outcome and who followed the clinical protocol were included in the analysis. This study is registered with ClinicalTrials.gov, number NCT01827995. Findings: Between April 23, 2013, and May 15, 2014, 731 women were recruited and assigned to clinic follow-up (n=366) or home assessment (n=365), of whom 700 were analysed for the main outcomes (n=336 and n=364, respectively). Complete abortion without continuing pregnancy, surgical intervention, or additional mifepristone and misoprostol was reported in 313 (93%) of 336 women in the clinic follow-up group and 347 (95%) of 364 women in the home-assessment group (difference -2.2%, 95% CI -5.9 to 1.6). One case of haemorrhage occurred in each group (rate of adverse events 0.3% in each group); no other adverse events were noted. Interpretation Home assessment of medical abortion outcome with a low-sensitivity urine pregnancy test is non-inferior to clinic follow-up, and could be introduced instead of a clinic follow-up visit in a low-resource setting.

The importance of considering the evidence in the MTP 2014 Amendment debate in India - unsubstantiated arguments should not impede improved access to safe abortion

With the objective to improve access to safe abortion services in India, the Ministry of Health and Welfare, with approval of the Law Ministry, published draft amendments of the MTP Act on October 29, 2014. Instead of the expected support, the amendments created a heated debate within professional medical associations of India. In this commentary, we review the evidence in response to the current discourse with regard to the amendments. It would be unfortunate if unsubstantiated one-sided arguments would impede the intention of improving access to safe abortion care in India.

Decent work and the informal sector in Brazil

Brazil has a substantial share – about 60% by some measures - of its employees working without labor registry and 62% of its private sector workers not contributing to social security. Informality is important because its job precaurioness, social desprotection consequences, and it is also very correlated with poverty and other social welfare concepts measured at a family level. 58% of the country population that is found below the indigent line live in families headed by informal workers. The complexity of the informal sector is derived from the multiple relevant dimensions of jobs quality. The basis used for guiding policy interventions depends on which effect of informality one is interested such: as lowering job precaurioness, increasing occupational risks, increasing the degree of protection against adverse shocks, allowing that good oportunities to be taken by the credit provision, improving informal workers families living conditions, implementing afirmative actions, reducing tax evasion etc. This report gauges various aspects of the informal sector activities in Brazil over the last decades. Our artistic constraint are the available sources of information. The final purpose is to help the design of policies aimed to assist those that hold “indecent” jobs

Mobilidades Urbanas - Indovation: A middle-class consumption ethic in India

Em uma conjuntura de expansão urbana, intensificação do consumo, mudança climática e escassez de petróleo, o tema das mobilidades assume inquestionável importância econômica, social e ambiental. O seminário internacional "Mobilidades Urbanas: Alicerces para Pesquisas Transnacionais" volta-se, por um lado, para a fomentação do debate em torno do paradigma das novas mobilidades - envolvendo mobilidade espacial e socioeconômica, entre outras - e de sua aplicabilidade no contexto brasileiro; por outro, para a capacitação de pesquisadores cujas investigações tematizam os processos de mobilidade social e espacial a partir de perspectivas comparativas e transnacionais.

Labor legislation and the size of informal sector in Brazil

This paper studies the increase in the rate of informal workers in the Brazilian economy that occurred between 1985 and 1999. We develop an overlapping generations model with incomplete markets in which agents are ex-post heterogeneous. We calibrate it to match some features of the Brazilian economy for 1985. We conduct a policy experiment which reproduces the 1988 constitution reforms that increased the retirement benefits and labor costs in the formal sector. We show that these reforms can explain the increase in informal labor. Then, we conduct a policy experiment and analyze its impact on the Brazilian economy.

Assesment of port governance in Brazil: a managerial perspective on the port of Santos

The role of maritime transportation within international trade was drastically revamped during the inception of the globalization process, which enhanced the contribution of ports in world economy as main logistics gateways for global production and trade. As a result, the relationship between ports and governments has changed. Devolution ideologies that had been applied in other industries decades ago were now being considered by governments for the port industry. Many central governments sought to extract themselves from commercial activities of ports and devolving this responsibility to local governments, communities or private entities. The institution of devolution programs also changed the governance structures of ports further influencing port performance. Consequently, the recent worldwide trend towards devolution in the port industry has spawned considerable variety of governance models that are now set in place around the world. While some countries opt for more decentralized structures others prefer to retain a centralization of powers. In this way some governments consider local features and national integration more than others, which ultimately influence the success of a port reform implementation. Nevertheless, the prime intent of governments is now to maximize the efficiency and performance of their domestic ports. This issue intends to examine the changed port governance environment in Brazil by determining how and why imposed port reforms of the Brazilian federal government have been affecting the overall performance of the national port system, over the last decades, using the Port of Santos as a sample upon an exploratory study. For that, the study will use a contingency theory-based framework – the Matching Framework - that views port performance as a function of the fit among the dimensions of external operating environment, strategy and structure of a port organization. In essence, the greater the fit among these dimensions the better the expected performance of a port will be, and vice-versa. Port managers, government officials and academics alike shall be interested in this document.

Development of technological capabilities in an extremely volatile economy. The industrial sector in Argentina

Includes bibliography

Feminization of the informal sector in Latin America and the Caribbean?

Includes bibliography

Supply Chain Management practices in the electro-electronics sector in Brazil: Evolutionary approach, information technology adoption and management actions

This paper examines the current level of adoption of Supply Chain Management (SCM) practices in the electro-electronic sector in Brazil and aims to identify the management and Information Technology (IT) actions that have been implemented to support the adoption of those practices. An e-mail survey was conducted. Descriptive statistics techniques were employed for data analysis. This study makes contributions to the electro-electronics sector and to the topics related to SCM, such as identifi cation and level of adoption of SCM practices. Another contribution of this research is the investigation of whether approaches such as Enterprise Resources Planning (ERP), Workshop with Customers, Electronic Data Interchange (EDI), Workshop with Suppliers and electronic Kanban are commonly used to support SCM practices. So far, this is the fi rst research on SCM practices in the electro-electronics sector in Brazil. Copyright © 2012 Inderscience Enterprises Ltd.

The rural sector in the socio-economic context of Brazil

Includes bibliography

Globalization and restructuring the energy sector in Latin America

Includes bibliography

Production structure of the services sector in countries at different development levels

Includes bibliography