Education system institutions and educational inequalities in Uruguay

This article shows how certain aspects at the secondary level of Uruguay’s public school system produce inequalities in student achievement. The 2006 edition of the Programme for International Student Assessment (pisa) (oecd, 2006a) points to three key aspects of the institutions that regulate secondary education that play a part in reproducing inequalities of origin, hindering the equalizing role that guides the education system. First, the teacher assignment mechanism has the dual effect of sending a revolving door of young and inexperienced teachers to schools in unfavourable sociocultural contexts as well as concentrating teachers with more experience in schools in favourable contexts. Second, the geography-based system for assigning students to schools reproduces the residential segregation process. Lastly, the centralized system for supplying educational and technological materials is inadequate to the needs of the schools.

Notificação da violência como estratégia de vigilância em saúde: perfil de uma metrópole do Brasil

A violência é um problema de saúde pública e sua notificação é fundamental para a vigilância epidemiológica e para a definição de políticas públicas de prevenção e promoção de saúde. O estudo objetivou caracterizar a ocorrência de violência doméstica, sexual e de outras, a partir das informações do banco de dados do Sistema Informação de Agravos de Notificação (SINAN), das fichas de notificação de violência da cidade de Belém (PA), no período de janeiro de 2009 a dezembro de 2011. Foram sistematizadas 3.267 notificações, representando um aumento de 240% de 2009 a 2011. Em relação ao sexo das vítimas, observou-se que, em média, 83,2% dos casos atingiram as mulheres, proporção esta semelhante nos três anos analisados. A violência sexual foi a mais presente com 41,8%; seguida da violência psicológica com 26,3% e da violência física com 24,0%. Os resultados demonstram a importância do conhecimento do perfil das violências para intervenção e elaboração de políticas públicas intersetoriais que promovam a saúde e a qualidade de vida nesta região do Brasil.

O transporte urbano e a circulação na abordagem espacial: análise do transporte coletivo urbano da região do ABCD, grande São Paulo

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Lugar de cadeirante é em casa?: Mobilidade, acessibilidade no transporte coletivo e o espaço da diferença em São Luís

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Uso de aparelho de amplificação sonora individual por idosos: estudo SABE - saúde, bem- estar e envelhecimento

PURPOSE: Describe hearing aid use by the elderly population in the city of São Paulo and identify associated factors. METHODS: A cross-sectional, descriptive, quantitative study integrated with the SABE (health, well-being and aging) project developed in 2006. A total of 1.115 individuals aged 65 or over were interviewed. Sample selection occurred in two stages, with replacement and probabilities proportional to the population to complement those aged 75 or over. Structured questionnaires and validated instruments were used. The data were weighted, the Rao-Scott test was used for univariate analysis and backward stepwise logistic regression was used for multivariate analysis, performed on Stata 10® software. RESULTS: Three hundred and seventy-seven subjects (30.4%) were classified as hearing impaired and 10.1% of these reported using hearing aids. To acquire the devices, 78.8% used their own resources and 16.9% acquired them through the Brazilian public health system (SUS). Among non-users of hearing aids, 16.6% reported prior indication; however, 8.6% were unable to adapt to the device and 8.0% could not afford to acquire one. Hearing aid use was associated with lower prevalence of probable dementia. CONCLUSION: The low number of hearing aid users indicates the difficulties elderly people face in acquiring them and/or that the health services face in effectively helping them to adapt. These findings may influence the quality of life of elderly with hearing impairment, given the association with probable dementia revealed by this study.

Análise de equilíbrio corporal submetido á esforços de aceleração e desaceleração na direção antero-posterior: estudo transversal

Pós-graduação em Engenharia Mecânica - FEG

O transporte coletivo intermunicipal no Estado de São Paulo: as linhas suburbanas

Esse trabalho tem por objetivo, mostrar a evolução do sistema de transporte coletivo intermunicipal do Estado de São Paulo. Nesse sentido, partimos do processo de industrialização e nacionalização da indústria automobilística. Procuramos também mostrar a evolução do Departamento de Estradas e Rodagem [DER], no papel de direcionador e gerenciador do sistema. Nesse processo, detalhamos o papel de todos os governos do Estado de São Paulo, na implantação de sistema viário estadual [1950-2006]. Também procuramos demonstrar o surgimento dos principais grupos que monopolizam cada vez mais o setor dos transportes coletivo intermunicipal. Assim, vamos comprovar a tese de que as empresas do transporte coletivo intermunicipal estão utilizando as linhas suburbanas para fazer frente ao grande avanço do transporte clandestino intermunicipal no Estado de São Paulo.

Challenges in the therapy of visceral leishmaniasis in Brazil: a public health perspective

Over 3,000 yearly cases of Visceral Leishmaniasis (VL) are reported in Brazil. Brazilian Public Health System provides universal free access to antileishmania therapeutic options: Meglumine Antimoniate, Amphotericin B deoxycholate, and Liposomal Amphotericin B. Even though Amphotericin formulations have been advised for severe disease, this recommendation is mostly based on the opinion of experts and on analogy with studies conducted in other countries. Presently, there are two ongoing multicenter clinical trials comparing the efficacy and safety of the available therapeutic options. Some other issues require further clarification, such as severity markers and the approach to VL/AIDS coinfection. Brazil is facing the challenge of providing access to diagnosis and adequate treatment, in order to avoid VL-related deaths.

Electroconvulsive Therapy in Brazil After the "Psychiatric Reform" A Public Health Problem-Example From a University Service

Objectives: The Brazilian public health system does not provide electroconvulsive therapy (ECT), which is limited to a few academic services. National mental health policies are against ECT. Our objectives were to analyze critically the public policies toward ECT and present the current situation using statistics from the Institute of Psychiatry of the University of Sao Paulo (IPq-HCFMUSP) and summary data from the other 13 ECT services identified in the country. Methods: Data regarding ECT treatment at the IPq-HCFMUSP were collected from January 2009 to June 2010 (demographical, number of sessions, and diagnoses). All the data were analyzed using SPSS 19, Epic Info 2000, and Excel. Results: During this period, 331 patients were treated at IPq-HCFMUSP: 221 (67%) were from Sao Paulo city, 50 (15.2%) from Sao Paulo's metropolitan area, 39 (11.8%) from Sao Paulo's countryside, and 20 (6.1%) from other states; 7352 ECT treatments were delivered-63.0% (4629) devoted entirely via the public health system (although not funded by the federal government); the main diagnoses were a mood disorder in 86.4% and schizophrenia in 7.3% of the cases. Conclusions: There is an important lack of public assistance for ECT, affecting mainly the poor and severely ill patients. The university services are overcrowded and cannot handle all the referrals. The authors press for changes in the mental health policies.

Contributions of ergonomics to the construction of bus drivers health and excellence in public transport and at work

This article is the product of research that analyzed the work of bus drivers of a public transportation company that is considered a benchmark reference in its field of operations, in which it strives to achieve operating excellence. Within this context, the authors sought to understand how such a company has managed to maintain a policy that is capable of reconciling quality public transport while also providing working conditions compatible with the professional development, comfort and health of its workers. Ergonomic work analysis and activity analysis were the guiding elements used in this study. Initial analyses indicate that the activity of drivers includes serving a population and providing mobility for it, which depends on driving the vehicle itself and on relationships with colleagues, users, pedestrians, drivers and others.

The implementation of the Medical Regulation Office and Mobile Emergency Attendance System and its impact on the gravity profile of non-traumatic afflictions treated in a University Hospital: a research study

Abstract Background The public health system of Brazil is structured by a network of increasing complexity, but the low resolution of emergency care at pre-hospital units and the lack of organization of patient flow overloaded the hospitals, mainly the ones of higher complexity. The knowledge of this phenomenon induced Ribeirão Preto to implement the Medical Regulation Office and the Mobile Emergency Attendance System. The objective of this study was to analyze the impact of these services on the gravity profile of non-traumatic afflictions in a University Hospital. Methods The study conducted a retrospective analysis of the medical records of 906 patients older than 13 years of age who entered the Emergency Care Unit of the Hospital of the University of São Paulo School of Medicine at Ribeirão Preto. All presented acute non-traumatic afflictions and were admitted to the Internal Medicine, Surgery or Neurology Departments during two study periods: May 1996 (prior to) and May 2001 (after the implementation of the Medical Regulation Office and Mobile Emergency Attendance System). Demographics and mortality risk levels calculated by Acute Physiology and Chronic Health Evaluation II (APACHE II) were determined. Results From 1996 to 2001, the mean age increased from 49 ± 0.9 to 52 ± 0.9 (P = 0.021), as did the percentage of co-morbidities, from 66.6 to 77.0 (P = 0.0001), the number of in-hospital complications from 260 to 284 (P = 0.0001), the mean calculated APACHE II mortality risk increased from 12.0 ± 0.5 to 14.8 ± 0.6 (P = 0.0008) and mortality rate from 6.1 to 12.2 (P = 0.002). The differences were more significant for patients admitted to the Internal Medicine Department. Conclusion The implementation of the Medical Regulation and Mobile Emergency Attendance System contributed to directing patients with higher gravity scores to the Emergency Care Unit, demonstrating the potential of these services for hierarchical structuring of pre-hospital networks and referrals.

Multi-Sensor people counting

[EN]An accurate estimation of the number of people entering / leaving a controlled area is an interesting capability for automatic surveil- lance systems. Potential applications where this technology can be ap- plied include those related to security, safety, energy saving or fraud control. In this paper we present a novel con guration of a multi-sensor system combining both visual and range data specially suited for trou- blesome scenarios such as public transportation. The approach applies probabilistic estimation lters on raw sensor data to create intermediate level hypothesis that are later fused using a certainty-based integration stage. Promising results have been obtained in several tests performed on a realistic test bed scenario under variable lightning conditions.

Decrescita sostenibile applicata alla mobilità nelle aree urbane.

La mobilità nelle aree urbane di medie e grandi dimensioni risente di molte criticità e spesso è causa di numerose discussioni. L'utilizzo sempre crescente del mezzo di trasporto privato ha prodotto conseguenze negative: l'aumento del traffico e degli incidenti stradali, dell'inquinamento atmosferico e del rumore sono accompagnati da un forte spreco energetico. Dall'altra parte, il trasporto pubblico locale (TPL) non è riuscito a costruirsi canali preferenziali all'interno dell'immaginario cittadino, poiché sottomesso da un modello economico e un mercato fortemente dipendenti dall'automobile. Una via d'uscita dalla mobilità non sostenibile basata sull'utilizzo di combustibili fossili porta a concepire un trasporto pubblico locale gratuito, fruibile dal cittadino in qualsiasi momento della giornata. Attraverso un'analisi dell'azienda del trasporto pubblico bolognese (ATC) e dei dati provenienti dalla sanità regionale, questa tesi intende mostrare che vi sarà un miglioramento della qualità di vita in aree urbane nel momento in cui la teoria della decrescita venga condivisa da tutti i cittadini. Così sarà possibile liberare i centri urbani dai mezzi privati e quindi dagli alti livelli di inquinamento acustico e atmosferico, e dare ai cittadini la vera libertà di movimento. Mobility in medium and large sized urban areas is critical and often a cause for numerous debates. The use of private transport is in constant increase and has generated negative consequences: congestion and road accidents, air and noise pollutio as well as a considerable waste of energy. On the other hand, the local public transport (LPT) has not succeeded in representing the preferred choice by citizens in the urban imaginary. Its potential has been subdued by economic models and markets that are largely dependant on the production of vehicles. An alternative to the current non sustainable mobility based on the combustion of fossil fuels could be the provision of a free local transport network available to the citizen from anywhere at any time. This dissertation's objective is to show how an improvement of the quality of life in urban areas is connected to a collective awareness on the degrowth theory. I intend to achieve this by analysing thoroughly the system of the public transportation agency in Bologna (ATC) and considering data from the local health department. Only then we will be able to limit private vehicles from city centres and as a result of that drastically decrease air and noise pollution whilst providing a true service for a free moving citizen.

Operational research applied to regional healthcare system

In this thesis we focus on optimization and simulation techniques applied to solve strategic, tactical and operational problems rising in the healthcare sector. At first we present three applications to Emilia-Romagna Public Health System (SSR) developed in collaboration with Agenzia Sanitaria e Sociale dell'Emilia-Romagna (ASSR), a regional center for innovation and improvement in health. Agenzia launched a strategic campaign aimed at introducing Operations Research techniques as decision making tools to support technological and organizational innovations. The three applications focus on forecast and fund allocation of medical specialty positions, breast screening program extension and operating theater planning. The case studies exploit the potential of combinatorial optimization, discrete event simulation and system dynamics techniques to solve resource constrained problem arising within Emilia-Romagna territory. We then present an application in collaboration with Dipartimento di Epidemiologia del Lazio that focuses on population demand of service allocation to regional emergency departments. Finally, a simulation-optimization approach, developed in collaboration with INESC TECH center of Porto, to evaluate matching policies for the kidney exchange problem is discussed.

Decomposition Methods and Network Design Problems

Decomposition based approaches are recalled from primal and dual point of view. The possibility of building partially disaggregated reduced master problems is investigated. This extends the idea of aggregated-versus-disaggregated formulation to a gradual choice of alternative level of aggregation. Partial aggregation is applied to the linear multicommodity minimum cost flow problem. The possibility of having only partially aggregated bundles opens a wide range of alternatives with different trade-offs between the number of iterations and the required computation for solving it. This trade-off is explored for several sets of instances and the results are compared with the ones obtained by directly solving the natural node-arc formulation. An iterative solution process to the route assignment problem is proposed, based on the well-known Frank Wolfe algorithm. In order to provide a first feasible solution to the Frank Wolfe algorithm, a linear multicommodity min-cost flow problem is solved to optimality by using the decomposition techniques mentioned above. Solutions of this problem are useful for network orientation and design, especially in relation with public transportation systems as the Personal Rapid Transit. A single-commodity robust network design problem is addressed. In this, an undirected graph with edge costs is given together with a discrete set of balance matrices, representing different supply/demand scenarios. The goal is to determine the minimum cost installation of capacities on the edges such that the flow exchange is feasible for every scenario. A set of new instances that are computationally hard for the natural flow formulation are solved by means of a new heuristic algorithm. Finally, an efficient decomposition-based heuristic approach for a large scale stochastic unit commitment problem is presented. The addressed real-world stochastic problem employs at its core a deterministic unit commitment planning model developed by the California Independent System Operator (ISO).