Technologies of birth and models of midwifery care

This article is based on a study of a reform in the organisation of maternity services in the United Kingdom, which aimed towards developing a more woman-centred model of care. After decades of fragmentation and depersonalisation of care, associated with the shift of birth to a hospital setting, pressure by midwives and mothers prompted government review and a relatively radical turnaround in policy. However, the emergent model of care has been profoundly influenced by concepts and technologies of monitoring. The use of such technologies as ultrasound scans, electronic foetal monitoring and oxytocic augmentation of labour, generally supported by epidural anaesthesia for pain relief, have accompanied the development of a particular ecological model of birth – often called active management –, which is oriented towards the idea of an obstetric norm. Drawing on analysis of women’s narrative accounts of labour and birth, this article discusses the impact on women’s embodiment in birth, and the sources of information they use about the status of their own bodies, their labour and that of the child. It also illustrates how the impact on women’s experiences of birth may be mediated by a relational model of support, through the provision of caseload midwifery care.

Asset pricing implications of benchmarking: A two-factor CAPM

In this paper we consider the equilibrium effects of an institutionalinvestor whose performance is benchmarked to an index. In a partialequilibrium setting, the objective of the institutional investor is modeledas the maximization of expected utility (an increasing and concave function,in order to accommodate risk aversion) of final wealth minus a benchmark.In equilibrium this optimal strategy gives rise to the two-beta CAPM inBrennan (1993): together with the market beta a new risk-factor (that wecall active management risk) is brought into the analysis. This new betais deffined as the normalized (to the benchmark's variance) covariancebetween the asset excess return and the excess return of the market overthe benchmark index. Different to Brennan, the empirical test supports themodel's predictions. The cross-section return on the active management riskis positive and signifficant especially after 1990, when institutionalinvestors have become the representative agent of the market.

Réhabilitation accélérée multimodate postcésarienne, la somme de toutes les astuces [Fast-track multimodal rehabilitation after cesarean, the sum of all tricks].

Fast-track multimodal rehabilitation after cesarean, the sum of all tricks Fast-track multimodal rehabilitation after caesarean is an interdisciplinary concept allowing an accelerated return to normal physiology. Fast-track rehabilitation combines minimising surgical trauma, regional anaesthesia and active management of pain control, minimally invasive postoperative care while promoting return to autonomy.

Gestión del bosque mediterráneo y conservación de la avifauna: el caso de los alcornocales

Se presentan los resultados de los diversos estudios de poblaciones de aves realizados en los alcornocales catalanes, especialmente en cuanto a la riqueza específica de los mismos. Dado que los estudios publicados hasta el momento en esta materia eran referidos a la estación reproductora (primavera), se señalan los datos recogidos en los alcornocales de les Gavarres (NE peninsular), durante la estación invernal. Asimismo, se analizan las diversas tipologías de alcornocales que se encuentran en Catalunya, bosques en gestión activa, y por tanto sin sotobosque, y bosques abandonados en los que la biomasa del sotobosque es máxi-ma, y se exponen los resultados de la comparativa entre ambas tipologías de explotación cuando se aplica un índice de conservación de la avifauna, basado en la riqueza de cada una de las especies registradas, la presencia de especies amenazadas según los criterios de la UICN (SPEC) y su categoría de amenaza (non-SPEC, SPEC 4, SPEC 3, SPEC 2 y SPEC 1). Los resultados obtenidos muestran como las explotaciones abandonadas tienen un índice de conservación de avifauna más elevado que los bosques en explotación activa. Se discuten es-tos resultados en el contexto de la gestión forestal y las ayudas recibidas por parte de las ad-ministraciones para llevar a cabo estas prácticas de gestión

Joukkoliikenteen koontikannan prosessien kehittäminen

Vuoden 2009 lopulla voimaan astuneet EU:n palvelusopimusasetus (PSA) ja kansallinen joukkoliikennelaki (869/2009) pakottavat avaamaan joukkoliikenteen markkinat kilpailulle koko Suomen alueella. Tästä johtuen Liikenne- ja viestintäministeriö on velvoittanut Liikenneviraston hankkimaan riittävän informaatiopohjan joukkoliikenteen kilpailutusten pohjaksi. Tämä pakottaa viraston uudistamaan bussipysäkkitiedon hallintansa ja -prosessinsa lähes kokonaan. Tämän työn tavoitteena oli selvittää, millaiset prosessit Liikenneviraston tulisi muodostaa, jotta tiedot jokaisen Suomen kunnan ja kaupungin katuverkon bussipysäkeistä saataisiin siirrettyä uuteen, kansalliseen joukkoliikenteen koontitietokantaan. Työssä tutkitaan, tarkastellaan ja kategorisoidaan Suomen kunnat ja kaupungit pysäkkitiedon hallinnoijan näkökulmasta. Tämän perusteella kehitetään vanhoja pysäkkitiedon prosesseja sekä luodaan uusia prosessimalleja pysäkkitiedon siirrolle ja päivitykselle. Jaottelun apuna käytetään kyselytutkimusta ja puhelinhaastatteluja. Kirjallisuusosa sisältää yleistä teoriaa prosesseista, niiden vaiheista ja kehittämisestä. Työn keskeisempänä tuloksena ovat prosessimallit siitä, miten pysäkkitiedon tulisi jatkossa siirtyä eri joukkoliikenneviranomaisilta Liikenneviraston kansalliseen koontikantaan. Lisäksi työssä huomattiin, että aktiivinen johtaminen ja yhteydenpito Liikenneviraston suunnalta ovat tärkeimmät edellytykset sille, että pysäkkitieto liikkuu ja tiedonsiirto paranee eri toimijoiden välillä.

The Performance of European Small Cap Equity Funds

The thesis examines the risk-adjusted performance of European small cap equity funds between 2008 and 2013. The performance is measured using several measures including Sharpe ratio, Treynor ratio, Modigliani measure, Jensen alpha, 3-factor alpha and 4-factor alpha. The thesis also addresses the issue of persistence in mutual fund performance. Thirdly, the relationship between the activity of fund managers and fund performance is investigated. The managerial activity is measured using tracking error and R-squared obtained from a 4-factor asset pricing model. The issues are investigated using Spearman rank correlation test, cross-sectional regression analysis and ranked portfolio tests. Monthly return data was provided by Morningstar and consists of 88 mutual funds. Results show that small cap funds earn back a significant amount of their expenses, but on average loose to their benchmark index. The evidence of performance persistence over 12-month time period is weak. Managerial activity is shown to positively contribute to fund performance

Recent patterns of change in vegetation structure and tree composition of British broadleaved woodland: evidence from large-scale surveys

Evidence is presented of widespread changes in structure and species composition between the 1980s and 2003–2004 from surveys of 249 British broadleaved woodlands. Structural components examined include canopy cover, vertical vegetation profiles, field-layer cover and deadwood abundance. Woods were located in 13 geographical localities and the patterns of change were examined for each locality as well as across all woods. Changes were not uniform throughout the localities; overall, there were significant decreases in canopy cover and increases in sub-canopy (2–10 m) cover. Changes in 0.5–2 m vegetation cover showed strong geographic patterns, increasing in western localities, but declining or showing no change in eastern localities. There were significant increases in canopy ash Fraxinus excelsior and decreases in oak Quercus robur/petraea. Shrub layer ash and honeysuckle Lonicera periclymenum increased while birch Betula spp. hawthorn Crataegus monogyna and hazel Corylus avellana declined. Within the field layer, both bracken Pteridium aquilinum and herbs increased. Overall, deadwood generally increased. Changes were consistent with reductions in active woodland management and changes in grazing and browsing pressure. These findings have important implications for sustainable active management of British broadleaved woodlands to meet silvicultural and biodiversity objectives.

Indexing stock portfolios in Brazil: tracking the IBOVESPA and the FGV 100

Indexing is a passive investment strategy in which the investor weights bis portfolio to match the performance of a broad-based indexo Since severaI studies showed that indexed portfolios have consistently outperformed active management strategies over the last decades, an increasing number of investors has become interested in indexing portfolios IateIy. Brazilian financiaI institutions do not offer indexed portfolios to their clients at this point in time. In this work we propose the use of indexed portfolios to track the performance oftwo ofthe most important Brazilian stock indexes: the mOVESPA and the FGVIOO. We test the tracking performance of our modeI by a historical simulation. We applied several statistical tests to the data to verify how many stocks should be used to controI the portfolio tracking error within user specified bounds.

Brazilian equity mutual funds: A general outlook based on performance

This dissertation main goal is to overview the Brazilian equity mutual funds returns. We find that active management is not effective for Ibovespa index, since Ibovespa active funds do not outperform the Ibovespa referenced funds. However, for IBrX index, active management do outperform the passive strategy. We found that Sustainable funds returns do not outperform the market, Endowment funds show poor performance, which could indicate strong regulation imposition over endowment funds portfolios. The size of a fund shows positive correlation to mean average returns and alphas. A fund’s lifetime is positively correlated to returns and to alphas, which could be related to more risk-taking by younger managers in order to pursue higher expected returns and, consequently, bigger inflows. Younger funds tend to have lower performance probably because, in taking more risks, they do not perform as expected. In addition, we find that the decreasing trend of the alpha evolution along the time is a sign of the industry decreasing returns of scale, which entails that managers have more difficulties to beat the market portfolio. Top 10s rankings show that funds appear more than once on the top 10s, which shows persistence of funds’ performance. Finally, concerning the deciles and quartiles rankings, the frequency of appearances changes among performance measures. There are measures which, when compared to others, strongly change the top and bottom for the decile and quartile members.

Intervenções benéficas durante o parto para a prevenção da mortalidade materna

O caráter multifatorial das complicações e da mortalidade materna torna difícil e demorada a tarefa de seu controle a longo prazo. A atenção profissional à mulher gestante e/ou parturiente representa seguramente elemento chave para a obtenção de bons resultados, tanto maternos quanto perinatais. Partindo-se do pressuposto de que atenção médica profissional ao parto de maneira adequada tem a capacidade de diminuir a ocorrência de complicações associadas à morbidade e mortalidade materna, são apresentadas resumidamente as evidências sobre algumas intervenções incluídas nesta atenção. São enfocadas as evidências derivadas de estudos realizados com extremo rigor metodológico e científico, os ensaios controlados randomizados, sobre intervenções capazes de reduzir as complicações e a mortalidade materna. Estas principais intervenções referem-se basicamente a: atenção institucional ao parto, atendimento profissional capacitado, utilização de parteiras tradicionais em determinados contextos, uso de tecnologias apropriadas incluindo o partograma, local do parto, posição para o parto, uso de episiotomia, tipo de parto, uso de ocitócicos na fase ativa do parto, realização de esforços de puxo no período expulsivo, manejo da dequitação e profilaxia da hemorragia puerperal. Ainda que o efeito de prevenir mortes seja difícil de ser avaliado pela baixa freqüência, sua utilização de forma racional e padronizada, por meio de manuais e normatizações de condutas de serviços, tem um efeito positivo sobre a qualidade da atenção ao nascimento. Isso faz parte do contexto técnico e humano do direito que toda mulher tem ao melhor atendimento possível nesse momento tão especial de sua vida.

Global trade, food production and ecosystem support : Making the interactions visible

Modern food production is a complex, globalized system in which what we eat and how it is produced are increasingly disconnected. This thesis examines some of the ways in which global trade has changed the mix of inputs to food and feed, and how this affects food security and our perceptions of sustainability. One useful indicator of the ecological impact of trade in food and feed products is the Appropriated Ecosystem Areas (ArEAs), which estimates the terrestrial and aquatic areas needed to produce all the inputs to particular products. The method is introduced in Paper I and used to calculate and track changes in imported subsidies to Swedish agriculture over the period 1962-1994. In 1994, Swedish consumers needed agricultural areas outside their national borders to satisfy more than a third of their food consumption needs. The method is then applied to Swedish meat production in Paper II to show that the term “Made in Sweden” is often a misnomer. In 1999, almost 80% of manufactured feed for Swedish pigs, cattle and chickens was dependent on imported inputs, mainly from Europe, Southeast Asia and South America. Paper III examines ecosystem subsidies to intensive aquaculture in two nations: shrimp production in Thailand and salmon production in Norway. In both countries, aquaculture was shown to rely increasingly on imported subsidies. The rapid expansion of aquaculture turned these countries from fishmeal net exporters to fishmeal net importers, increasingly using inputs from the Southeastern Pacific Ocean. As the examined agricultural and aquacultural production systems became globalized, levels of dependence on other nations’ ecosystems, the number of external supply sources, and the distance to these sources steadily increased. Dependence on other nations is not problematic, as long as we are able to acknowledge these links and sustainably manage resources both at home and abroad. However, ecosystem subsidies are seldom recognized or made explicit in national policy or economic accounts. Economic systems are generally not designed to receive feedbacks when the status of remote ecosystems changes, much less to respond in an ecologically sensitive manner. Papers IV and V discuss the problem of “masking” of the true environmental costs of production for trade. One of our conclusions is that, while the ArEAs approach is a useful tool for illuminating environmentally-based subsidies in the policy arena, it does not reflect all of the costs. Current agricultural and aquacultural production methods have generated substantial increases in production levels, but if policy continues to support the focus on yield and production increases alone, taking the work of ecosystems for granted, vulnerability can result. Thus, a challenge is to develop a set of complementary tools that can be used in economic accounting at national and international scales that address ecosystem support and performance. We conclude that future resilience in food production systems will require more explicit links between consumers and the work of supporting ecosystems, locally and in other regions of the world, and that food security planning will require active management of the capacity of all involved ecosystems to sustain food production.

The role of proactive coping strategies and perceived health status for Social well-being and life-project in old age.

The latter part of the 20th century was a period characterized by a fundamental demographic transition of western society. This substantial and structural demographic change proposes several challenges to contemporary society and fosters the emergence of new issues and challenges. Among these, none is more crucial than the comprehension of the mechanisms and the processes that lead people to positive aging. Rowe and Kahn’s model of successful aging highlights the interplay between social engagement with life, health, and functioning for a positive aging experience. Other systemic models of successful aging (Kahana et al., 1996; 2003; Stevernik et al., 2006) emphasize the role of internal and external resources for attaining positive aging. Among these, the proactive coping strategies are indicated as important active strategies for avoiding the depletion of resources, counterbalancing the declines and maintaining social and civic involvement. The study has analyzed the role of proactive coping strategies for two facets of positive aging, the experience of a high social well-being and the presence of personal projects in fundamental life domains. As expected, the proactive coping strategies, referred to as the active management of the environment, the accumulation of resources and the actualization of human potentials are confirmed as positive predictors of high level of social well-being and of many personal projects focused on family, culture, leisure time, civic and social participation. Perceived health status give a significant contribution only to the possession of many personal projects. Gender and level of school education give also a significant contribution to these two dimensions of positive aging, highlighting how positive aging is rooted not only in the possession of personal resources, but also in historical models of education and in positive longitudinal chains related to early development.

Castanea sativa in Europe: distribution, habitat, usage and threats

The sweet chestnut (Castanea sativa Mill.) is the only native species of the genus in Europe. The broad diffusion and active management by man resulted in the establishment of the species at the limits of its potential ecological range, which makes it difficult to trace its original natural area. The present distribution ranges from North-Western Africa (e.g. Morocco) to North-Western Europe (southern England, Belgium) and from south-western Asia (e.g. Turkey) to Eastern Europe (e.g. Romania), the Caucasus (Georgia, Armenia) and the Caspian Sea. In Europe the main chestnut forests are concentrated in a few countries such as Italy, France and the Iberian Peninsula. The sweet chestnut has a remarkable multipurpose character, and may be managed for timber production (coppice and high forest) as well as for fruit production (traditional orchards), including a broad range of secondary products and ecosystem services.

Avaliação do efeito de escala no cálculo da perigosidade de incêndio florestal

Dissertação apresentada à Escola Superior Agrária do Instituto Politécnico de Castelo Branco para cumprimento dos requisitos necessários à obtenção do grau de Mestre em Sistemas de Informação Geográfica - Recursos Agro-Florestais e Ambientais.