967 resultados para State policies
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The expansion of agrofuel crops challenges us to rethink policies, territories, human agency, and the paradigms used to explain them. In Brazil, policies supporting the expansion of agrofuel crops and the intensification of agrofuel production are reorganising rural land use and undermining some forms of participation in the capitalist and family modes of production. To reflect on this new reality, we study peasant movement reactions, proposals, and territorial disputes with agribusiness. Using the Pontal do Paranapanema region of São Paulo state as a case in point, the paper analyses territorial disputes between expanding sugarcane plantations and agrarian reform settlements as well as biodiesel production projects developed by the Landless Workers Movement (MST) and the Western São Paulo Federation of Settlement and Family Farmer Associations (FAAFOP). It also analyses the agrofuel policies of other peasant organisations, including Via Campesina. The production of agrofuels has changed the processes of land acquisition and use by both agribusiness and the peasantry, provoking new insights into the nature of territorial conflicts and thereby stimulating the need to revise perspectives on the agrarian question in Brazil.
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CONTEXTO: No Brasil, a incidência e prevalência populacionais das doenças inflamatórias intestinais são desconhecidas. OBJETIVO: Neste trabalho, estimou-se esses parâmetros na área que abrange a antiga região de saúde DIR 11, no centro-oeste do Estado de São Paulo. MÉTODOS: Usou-se um registro sequencial de 115 pacientes (>15 anos de idade) com doenças inflamatórias intestinais, residindo na área de estudo, atendidos durante período de 20 anos (1986-2005) em hospital de referência. Estimou-se, para quatro períodos consecutivos de 5 anos, as incidências e prevalências de acordo com os tipos de doença e do sexo de doentes. As suas inter-relações foram analisadas utilizando o modelo de regressão linear de Poisson. RESULTADOS: Na região, as doenças inflamatórias intestinais foram predominantes em mulheres jovens, da raça branca, residindo na zona urbana.A incidência da retocolite foi maior que a da doença de Crohn e das colites não classificadas, e diferentemente dessas duas ultimas, mostrou decréscimo no último período (2001-2005). Neste mesmo período, a taxa da incidência para a retocolite foi de 4,48 casos/100.000 habitantes, para a doença de Crohn atingiu 3,50 casos/100.000 habitantes e a das colites não classificadas foi de 1,75 casos/100.000 habitantes. As prevalências atingiram os valores de 14,81 casos/100.000 habitantes para a retocolite, 5,65 casos/100.000 habitantes para a doenças de Crohn e 2,14 casos/100.000 habitantes. Considerando todas as doenças inflamatórias a prevalência atingiu o valor de 22,61 casos/100.000 habitantes. CONCLUSÃO:A incidência dessas doenças inflamatórias intestinais nessa região é baixa, igualando-se aos países da América Latina e do sul da Europa e sua crescente prevalência justifica políticas de saúde para as suas abordagens.
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Continuing developments in science and technology that affect many dimensions of human life, especially those related to longevity, require responses from social policies and programmes to enable quality-of-life improvements in every sector, including leisure. To contribute to research in this area, this qualitative study sought to identify the perceptions of and meanings attached to participation in (active outdoor) leisure by a group of elderly citizens of Araras, São Paulo State, Brazil. Data were collected via questionnaires administered to a mixed-gender sample of 100 persons, aged between 60 and 80 years, after they had participated in an outdoor adventure/leisure programme. The data were subjected to thematic content analysis. The study revealed that the participants identified positive emotional effects as a result of their participation, relating to their sense of belonging to a group, to their increased quality of life and to their ability to remain physically active.
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The inappropriate use of antimicrobials in hospitals presents a negative impact on patient outcome and is associated with the emergence and spread of multidrug-resistant microorganisms. Antimicrobial stewardship programs (ASPs) have been instituted in order to improve the quality of prescriptions in hospitals. In this setting, the identification of patterns of inappropriate antimicrobial prescription is a valuable tool that allows ASPs to identify priorities for directing educative/restrictive policies. With this purpose, a study was conducted in the Bauru State Hospital, a teaching hospital with 285 beds affiliated to the Botucatu Medical School, São Paulo State University. The hospital maintains an active ASP since it was opened, in 2002. We selected 25% of the requests for parenteral antimicrobials (RPAs) from 2005 for analysis. Prescriptions for prophylactic purposes were excluded. All other RPAs were classified according to a modified Kunin and Jones categories. Univariate and multivariable analyses were performed to identify predictors of general inappropriateness and of specific prescription errors. Prescriptions classified as "appropriate'' or "probably appropriate" were selected as controls in all stages of the study. Among 963 RPAs included in our study, 34.6% were inappropriate. General predictors of inappropriateness were: prescription on weekends/holidays (OR = 1.67, 95% CI = 1.20-2.28, p = 0.002), patient from intensive care unit (OR = 1.57, 95% CI = 1.11-2.23, p = 0.01), peritoneal (OR = 2.15, 95% CI = 1.27-3.65, p = 0.004) or urinary tract infection (OR = 1.89, 95% CI = 1.25-2.87, p = 0.002), combined therapy with two or more antimicrobials (OR = 1.72, 95% CI = 1.15-2.57, p = 0.008) and prescriptions including penicillin (OR = 2.12, 95% CI = 1.39-3.25, p = 0.001) or first-generation cephalosporins (OR = 1.74, 95% CI = 1.01-3.00, p = 0.048). Previous consultation with an infectious diseases (ID) specialist had a protective effect against inappropriate prescription (OR = 0.34, 95% CI = 0.24-0.50, p < 0.001). Factors independently associated with specific prescription errors varied. However, consultation with an ID specialist was protective against both unnecessary antimicrobial use (OR = 0.04, 95% CI = 0.01-0.26, p = 0.001) and requests for agents with insufficient spectrum (OR = 0.14, 95% CI = 0.03-0.30, p = 0.01). In conclusion, the analysis of factors predictive of inappropriateness in antimicrobial prescription allowed us to identify issues requiring intervention. Also, it provided a positive feedback of the ASP efficacy, demonstrating the importance of previous consultation with an ID specialist to assure the quality of antimicrobial prescriptions.
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This article reviews the main anti-poverty policies implemented in Brazil from the early 1990s to the early 2000s. These include focused and universal policies - such as education and health care - as well as the rural development, a 'middle ground' policy. Though the inter-municipal consortium, a new institutional arrangement gathering municipalities together, has emerged as a promising policy implementation tool, anti-poverty policies have faced implementation difficulties. Lack of coordination between different programs, even within the same policy area, has impaired their effectiveness. As a consequence, compensatory programs, based on monetary transfers to poor families, which face fewer implementation problems, have become the dominant type of anti-poverty policies in Brazil. Despite these shortcomings, a small Brazilian state, Santa Catarina, was able to reduce by 46 percent the number of individuals living in poverty in just ten years. This is a sign that fighting poverty can, after all, be a feasible endeavor. © 2004 IIAS, SAGE Publications (London, Thousand Oaks, CA and New Delhi).
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