Apoio como dispositivo: conexões, invenções e provocações à produção coletiva do cuidado e da gestão no município de São Bernardo do Campo

A transformação nos modos de organizar e produzir atenção em saúde exige a invenção de dispositivos com potência para proporcionar espaços coletivos de análise acerca da produção da gestão e do cuidado. O apoio é tecido por múltiplas relações, interesses, projetos e agenciamentos. Fabricado no encontro, é um intercessor que pode favorecer reflexões sobre a micropolítica do trabalho, sobre os encontros entre trabalhadores e usuários, entre trabalhadores e entre trabalhadores e gestão, agenciando possibilidades de análise do cotidiano e interferências sobre os modos de cuidar e de gerir. As interrogações sobre o cuidado podem abrir zonas de visibilidade aos processos de trabalho, discursos, práticas e relações de poder. A pesquisa procurou analisar o processo de fabricação do apoio na rede de atenção à saúde no município de São Bernardo do Campo e seus efeitos. O município organizou nove núcleos territoriais em saúde, cada qual com um grupo de até cinco apoiadores constituído por trabalhadores com formações variadas. Ademais, conta com uma dupla de facilitadores de educação permanente, ligados à gestão nos diferentes departamentos da Secretaria de Saúde e orientadores de educação permanente que tem a função de dar suporte aos apoiadores e facilitar os processos de educação permanente nos territórios. No desenho de São Bernardo, o apoio é uma ferramenta estratégica para a construção do cuidado em rede e para a análise das práticas de saúde. Há uma forte aposta da gestão na criação de espaços coletivos e dispositivos de conexão entre os departamentos, serviços, gestores e trabalhadores na intenção de suscitar transversalidade e combater a estrutura vertical de sua organização. O município vive uma intensa criação de dispositivos mobilizadores de encontros, propostos para a construção de redes e de gestão compartilhada do cuidado. Por meio de andanças com os apoiadores em variados territórios, conversas, afecções, registros em diário de campo, narrativas e documentos, tecemos uma cartografia: composição de cenários, de perspectivas e de analisadores, sentidos abertos, múltiplos e conectáveis. A abordagem cartográfica acompanha processos, persegue rastros e traçados, se movimenta entre linhas, sustenta problemáticas; nela, somos pesquisadores in-mundos, nos infectamos, nos misturamos, sempre implicados e em produção com os mundos pesquisados. Mesmo sendo uma aposta de governo, tensionamentos e conflitos acontecem no cotidiano, relacionados a diferentes prioridades, agendas, quebra de acordos, interrupção de projetos. As produções do apoio vêm fomentando conexões entre os serviços, contribuindo com o matriciamento de saúde mental e de outras especialidades na atenção básica e entre os trabalhadores da atenção especializada, fortalecendo redes, estimulando análises coletivas sobre o cuidado, criando estratégias e ferramentas, transformações em fluxos e na regulação. O apoio não é função somente do apoiador, pode ser agenciado por variados atores. Por fim, a auto-análise, quando acontece, potencializa o apoio como dispositivo, provisório, ativador de processos e de protagonismo coletivo.

Playas y paseos marítimos. El nuevo paisaje urbano de Benidorm (1956-1986)

Esta comunicación recorre la evolución del paisaje urbano de Benidorm, como ciudad vertical (acotado entre dos fechas clave: 1956 y 1986), con la aprobación de su PGOU, inspirado en un urbanismo funcionalista (CIAM), enfocado a un turismo de masas en aumento año tras año. Acontecimientos, turismo y planeamiento justificaban las diferentes ampliaciones urbanas de Benidorm, sometidas a constantes modificaciones y que se reflejaba en una libertad a través del análisis y relación entre el nuevo skyline vertical (de bloques y rascacielos de uso privado) y el tándem paseo marítimo-playa (de espacios urbanos de uso público). Para este seguimiento se hace necesario conocer cómo se construye la propia ciudad y, en particular, sus nuevos frentes marítimos que constituyen la postal más importante de cualquier ciudad turística litoral –su imagen–, la que se publicita como reclamo: la fachada que se extiende tras sus playas y cuyo éxito depende de la capacidad de articulación los espacios públicos que entrelazan la trama urbana con su frontera marítima.

The genus Callistethus (Coleoptera: Scarabaeidae: Rutelinae) in the Neotropics: new data and new species from Costa Rica

The species Callistethus carbo sp.n., C. flavodorsalis sp.n., C. fuscorubens sp.n., C. lativittis sp.n., C. levigatus sp.n., C. macroxantholeus sp.n., C. microxantholeus sp.n., C. multiplicatus sp.n., C. parapulcher sp.n., C. pseudocollaris sp.n. and C. stannibractea sp.n. from Costa Rica are described. Synonymy of Callistethus kolbei (Ohaus, 1897) with Callistethus specularis (Bates, 1888) is proposed. A phylogenetic analysis based on the genes 16S, COI and 28S is carried out for Costa Rican species and diagnostic morphological features for the genus are tested on it for phylogenetic signal. An identification key for Callistethus species of Costa Rica is provided. The distribution patterns of Callistethus species in Costa Rica are discussed.

Youth in trouble /

Mode of access: Internet.

A vision for change : the story of HUD's transformation.

Shipping list no.: 2001-0096-P.

Confirmatory factor analysis and psychometric properties of the Anxiety Sensitivity Index-Revised in clinical and normative populations

The present investigation aimed to critically examine the factor structure and psychometric properties of the Anxiety Sensitivity Index - Revised (ASI-R). Confirmatory factor analysis using a clinical sample of adults (N = 248) revealed that the ASI-R could be improved substantially through the removal of 15 problematic items in order to account for the most robust dimensions of anxiety sensitivity. This modified scale was renamed the 21-item Anxiety Sensitivity Index (21-item ASI) and reanalyzed with a large sample of normative adults (N = 435), revealing configural and metric invariance across groups. Further comparisons with other alternative models, using multi-sample analysis, indicated the 21-item ASI to be the best fitting model for both groups. There was also evidence of internal consistency, test-retest reliability, and construct validity for both samples suggesting that the 21-item ASI is a useful assessment device for investigating the construct of anxiety sensitivity in both clinical and normative populations.

Using nitrogen stable isotope ratios ( d15N) of macroalgae to monitor changes in the extent of sewage impacts in Moreton Bay, Australia

During the past decade the use of stable isotopes to investigate transport pathways of nutrients in aquatic ecosystems has contributed new understanding and knowledge to many aspects of ecology; from the trophic structure of food webs to the spatial extent of nutrient discharges. At the same time aquatic monitoring programs around the world have become more interested in quantifying ecosystem health rather than simply measuring the physical and chemical properties of water (nutrients, pH, temperature and turbidity). A novel technique was initiated in 1998 as part of the development of the Ecosystem Health Monitoring Program in S.E. Queensland Australia (EHMP) using changes in the 15N value of the red macroalgae Catenella nipae, to indicate regions impacted by sewage nitrogen. Sewage plume mapping, using the 15N of C. nipae, has demonstrated that over the past 5 years there has been a large reduction in the magnitude and spatial extent of 15N enrichment at sites close to sewage treatment plants (STPs) discharging into Moreton Bay. This presentation will discuss how the 15N signatures of the C. nipae in the plume at the mouth of the Brisbane River have declined since it was first sampled in 1998 and will evaluate causes that may be responsible for these variations. A series of laboratory experiments were conducted to investigate how environmental conditions influence the 15N signature of C, nipae over the incubation period. These data will be used to discuss the observed in situ decline in 15N in an attempt to determine if the reduction can be attributed solely to improvements in the wastewater discharge.

PARTICIPAÇÃO POPULAR NA ELABORAÇÃO DO PLANO DIRETOR DE JOANÓPOLIS ASPECTOS SOCIOEDUCATIVOS DO PROCESSO

Este trabalho busca descrever o processo de mobilização da população da cidade de Joanópolis - S.P., com vistas à participação na elaboração do Plano Diretor da cidade. Do mesmo modo, busca compreender os principais pressupostos teóricos necessários à elaboração de processos de educação social que garantam a construção coletiva de políticas públicas. A metodologia utilizada neste trabalho é de caráter qualitativo, que tanto permite o tratamento objetivo dos dados da ação quanto acolhe a parte ativa das tomadas de decisão. A contribuição deste trabalho reside em partilhar a elaboração de uma metodologia sócioeducativa que possa ser utilizada por agentes político-pedagógicos na elaboração de Planos Diretores,notadamente em cidades pequenas e médias.

Parceria ou mera relação social? Estudo de Caso das relações entre a BASF SA e a comunidade do seu entorno em Guaratinguetá/SP

Estudo sobre as relações comunicacionais entre a multinacional BASF e a comunidade no seu entorno na cidade de Guaratinguetá, no interior de São Paulo. O objetivo geral é analisar em que condições uma empresa multinacional e uma comunidade ao seu redor podem concretizar na prática uma parceria em busca de uma gestão socialmente mais responsável, bem como verificar qual o poder de interferência dessa comunidade em seus processos de comunicação. A metodologia utilizada foi estudo de caso por meio de análise de documentos, observação participante em reunião do Conselho Comunitário, grupo de discussão e entrevistas semiestruturadas, além de pesquisa bibliográfica. Procuramos compreender a percepção de membros do Conselho, de moradores da cidade, da mídia local e também dos profissionais de comunicação da multinacional. A principal conclusão é que o quepoderia se constituir em uma parceria de sucesso para ambos os lados, acaba se restringindo a uma mera relação social, onde os dois lados parecem se sentir bem e estão convictos de que realizam seus trabalhos da melhor maneira possível.

An exploration of pharmacy-specific reasons for non-adherence to prescribed medicines in a socioeconomically deprived, ethnically diverse UK cohort

Methods - Ethical approval for the study was granted by both the local National Health Service (NHS) Research Ethics Committee (REC) and Aston University’s REC. Seven focus groups were conducted between October and December 2011 in medical or community settings within inner-city Birmingham (UK). Discussions were guided by a theme plan which was developed from key themes identified by a literature review and piloted via a Patient Consultation Group. Each focus group had between 3 and 7 participants. The groups were digitally recorded and subsequently transcribed verbatim. The transcriptions were then subjected to thematic analysis via constant comparison in order to identify emerging themes. Results - Participants recognised the pharmacist as an expert source of advice about prescribed medicines, a source they frequently felt a need to consult as a result of the inadequate supply of medicines information from the prescriber. However, an emerging theme was a perception that pharmacists had an oblique profit motive relating to the supply of generic medicines with frequent changes to the ‘brand’ of generic supplied being attributed to profit-seeking by pharmacists. Such changes had a negative impact on the patient’s perceived efficacy of the therapy which may make non-adherence more likely. Conclusions - Whilst pharmacists were recognised as medicines experts, trust in the pharmacist was undermined by frequent changes to generic medicines. Such changes have the potential to adversely impact adherence levels. Further, quantitative research is recommended to examine if such views are generalisable to the wider population of Birmingham and to establish if such views impact on adherence levels.

Effects of roadway geometric features on run-off road crashes on the Florida State Highway System

Run-off-road (ROR) crashes have increasingly become a serious concern for transportation officials in the State of Florida. These types of crashes have increased proportionally in recent years statewide and have been the focus of the Florida Department of Transportation. The goal of this research was to develop statistical models that can be used to investigate the possible causal relationships between roadway geometric features and ROR crashes on Florida's rural and urban principal arterials. ^ In this research, Zero-Inflated Poisson (ZIP) and Zero-Inflated Negative Binomial (ZINB) Regression models were used to better model the excessive number of roadway segments with no ROR crashes. Since Florida covers a diverse area and since there are sixty-seven counties, it was divided into four geographical regions to minimize possible unobserved heterogeneity. Three years of crash data (2000–2002) encompassing those for principal arterials on the Florida State Highway System were used. Several statistical models based on the ZIP and ZINB regression methods were fitted to predict the expected number of ROR crashes on urban and rural roads for each region. Each region was further divided into urban and rural areas, resulting in a total of eight crash models. A best-fit predictive model was identified for each of these eight models in terms of AIC values. The ZINB regression was found to be appropriate for seven of the eight models and the ZIP regression was found to be more appropriate for the remaining model. To achieve model convergence, some explanatory variables that were not statistically significant were included. Therefore, strong conclusions cannot be derived from some of these models. ^ Given the complex nature of crashes, recommendations for additional research are made. The interaction of weather and human condition would be quite valuable in discerning additional causal relationships for these types of crashes. Additionally, roadside data should be considered and incorporated into future research of ROR crashes. ^

Women and development in Senegal: Microcredit and household well being

The challenging living conditions of many Senegalese families, and the absence of a providing spouse, have led women to covet new economic opportunities, such as microcredit loans. These loans offer Senegalese women the possibility to financially support their households and become active participants in their economies by starting or sustaining their micro businesses. The study takes place in Grand-Yoff, an overpopulated peri-urban area of the Senegalese capital city Dakar, where most people face daily survival issues. This research examines the impact of microcredit activities in the household of Senegalese female loan recipients in Grand-Yoff by examining socioeconomic indicators, in particular outcomes of health, education and nutrition.^ The research total sample is constituted of 166 female participants who engage in microcredit activities. The research combines both qualitative and quantitative methods. Data for the study were gathered through interviews, surveys, participant observation, focus-groups with the study participants and some of their household members, and document analysis.^ While some women in the study make steady profits from their business activities, others struggle to make ends meet from their businesses’ meager or unreliable profits. Some study participants who are impoverished have no choice but to invest their loans directly into their households’ dire needs, hence missing their business prerogative. Many women in the study end up in a vicious cycle of debt by defaulting on their loans or making late payments because they do not have the required household and socioeconomic conditions to take advantage of these loans. Therefore, microcredit does not make a significant impact in the households of the poorest female participants. The study finds that microcredit improves the household well-being - especially nutrition, health and education - of the participants who have acquired significant social capital such as a providing spouse, formal education, training, business experience, and belonging to business or social networks.^ The study finds that microcredit’s household impact is intimately tied to the female borrowers’ household conditions and social capital. It is recommended that microcredit services and programs offer their female clients assistance and additional basic services, financial guidance, lower interest rates, and flexible repayment schedules. ^

Information systems to support decision-making in *construction owner organizations: A data warehousing approach

Construction organizations typically deal with large volumes of project data containing valuable information. It is found that these organizations do not use these data effectively for planning and decision-making. There are two reasons. First, the information systems in construction organizations are designed to support day-to-day construction operations. The data stored in these systems are often non-validated, non-integrated and are available in a format that makes it difficult for decision makers to use in order to make timely decisions. Second, the organizational structure and the IT infrastructure are often not compatible with the information systems thereby resulting in higher operational costs and lower productivity. These two issues have been investigated in this research with the objective of developing systems that are structured for effective decision-making. ^ A framework was developed to guide storage and retrieval of validated and integrated data for timely decision-making and to enable construction organizations to redesign their organizational structure and IT infrastructure matched with information system capabilities. The research was focused on construction owner organizations that were continuously involved in multiple construction projects. Action research and Data warehousing techniques were used to develop the framework. ^ One hundred and sixty-three construction owner organizations were surveyed in order to assess their data needs, data management practices and extent of use of information systems in planning and decision-making. For in-depth analysis, Miami-Dade Transit (MDT) was selected which is in-charge of all transportation-related construction projects in the Miami-Dade county. A functional model and a prototype system were developed to test the framework. The results revealed significant improvements in data management and decision-support operations that were examined through various qualitative (ease in data access, data quality, response time, productivity improvement, etc.) and quantitative (time savings and operational cost savings) measures. The research results were first validated by MDT and then by a representative group of twenty construction owner organizations involved in various types of construction projects. ^

Information systems to support decision-making in construction owner organizations : a data warehousing approach

Construction organizations typically deal with large volumes of project data containing valuable information. It is found that these organizations do not use these data effectively for planning and decision-making. There are two reasons. First, the information systems in construction organizations are designed to support day-to-day construction operations. The data stored in these systems are often non-validated, nonintegrated and are available in a format that makes it difficult for decision makers to use in order to make timely decisions. Second, the organizational structure and the IT infrastructure are often not compatible with the information systems thereby resulting in higher operational costs and lower productivity. These two issues have been investigated in this research with the objective of developing systems that are structured for effective decision-making. A framework was developed to guide storage and retrieval of validated and integrated data for timely decision-making and to enable construction organizations to redesign their organizational structure and IT infrastructure matched with information system capabilities. The research was focused on construction owner organizations that were continuously involved in multiple construction projects. Action research and Data warehousing techniques were used to develop the framework. One hundred and sixty-three construction owner organizations were surveyed in order to assess their data needs, data management practices and extent of use of information systems in planning and decision-making. For in-depth analysis, Miami-Dade Transit (MDT) was selected which is in-charge of all transportation-related construction projects in the Miami-Dade county. A functional model and a prototype system were developed to test the framework. The results revealed significant improvements in data management and decision-support operations that were examined through various qualitative (ease in data access, data quality, response time, productivity improvement, etc.) and quantitative (time savings and operational cost savings) measures. The research results were first validated by MDT and then by a representative group of twenty construction owner organizations involved in various types of construction projects.