The social construction of infant mortality: From grassroots to medicalization

Infant mortality as a problematic situation has been recognized for some 130 years in one form or another. It has undergone various changes in its empirical dimensions relative to whom we study within the population, what we study--low birth-weight vs. pre-term births--and how we study it--whether demographically or medically. An analysis of the process by which the condition was raised by claims makers as an intolerable situation among America's urban residents reveals that demographic and medical data were sparse. Nonetheless, a judgement about the meaning and significance of the condition was made, and that interpretation led to the promulgation of systems to both document and address the condition as it has come to be defined.^ This investigation depicts the historical context and natural history of infant mortality as one of a number of social problems that came to be defined through the interplay among groups and individuals making claims and how their claims came to the public policy agenda as worthy of collective resources--who won, who lost and why. The process of social definition focuses attention on the claims makers and the ways they contrast the meaning, origins and remedies for this troubling condition. The historical context becomes the frame of reference for understanding the actions of the claims makers and the meaning and significance they attached to the problem.^ We purport that "context" provides a closer reality than disjoined "value free" accounts. Context provides the evidence for the definition, who participated in the process, why and by what means.^ The role of women in the definitional process reveals the differences in approaches utilized by the women of the settlement house reform movement and African-American women working at the grass-roots. Much of the work done by these two groups provided options to the problem's remedy; however, their differences paved the way to our current (principally medically-oriented) definition and its inherent limitations. ^

DEVELOPMENT OF A BEAM-SPECIFIC PLANNING TARGET VOLUME AND A ROBUST PLAN ANALYSIS TOOL FOR PROTON THERAPY

Proton therapy is growing increasingly popular due to its superior dose characteristics compared to conventional photon therapy. Protons travel a finite range in the patient body and stop, thereby delivering no dose beyond their range. However, because the range of a proton beam is heavily dependent on the tissue density along its beam path, uncertainties in patient setup position and inherent range calculation can degrade thedose distribution significantly. Despite these challenges that are unique to proton therapy, current management of the uncertainties during treatment planning of proton therapy has been similar to that of conventional photon therapy. The goal of this dissertation research was to develop a treatment planning method and a planevaluation method that address proton-specific issues regarding setup and range uncertainties. Treatment plan designing method adapted to proton therapy: Currently, for proton therapy using a scanning beam delivery system, setup uncertainties are largely accounted for by geometrically expanding a clinical target volume (CTV) to a planning target volume (PTV). However, a PTV alone cannot adequately account for range uncertainties coupled to misaligned patient anatomy in the beam path since it does not account for the change in tissue density. In order to remedy this problem, we proposed a beam-specific PTV (bsPTV) that accounts for the change in tissue density along the beam path due to the uncertainties. Our proposed method was successfully implemented, and its superiority over the conventional PTV was shown through a controlled experiment.. Furthermore, we have shown that the bsPTV concept can be incorporated into beam angle optimization for better target coverage and normal tissue sparing for a selected lung cancer patient. Treatment plan evaluation method adapted to proton therapy: The dose-volume histogram of the clinical target volume (CTV) or any other volumes of interest at the time of planning does not represent the most probable dosimetric outcome of a given plan as it does not include the uncertainties mentioned earlier. Currently, the PTV is used as a surrogate of the CTV’s worst case scenario for target dose estimation. However, because proton dose distributions are subject to change under these uncertainties, the validity of the PTV analysis method is questionable. In order to remedy this problem, we proposed the use of statistical parameters to quantify uncertainties on both the dose-volume histogram and dose distribution directly. The robust plan analysis tool was successfully implemented to compute both the expectation value and its standard deviation of dosimetric parameters of a treatment plan under the uncertainties. For 15 lung cancer patients, the proposed method was used to quantify the dosimetric difference between the nominal situation and its expected value under the uncertainties.

On a meaningful integration of web services in data-intensive biomedical environments: The DICODE approach

This paper reports on an innovative approach that aims to reduce information management costs in data-intensive and cognitively-complex biomedical environments. Recognizing the importance of prominent high-performance computing paradigms and large data processing technologies as well as collaboration support systems to remedy data-intensive issues, it adopts a hybrid approach by building on the synergy of these technologies. The proposed approach provides innovative Web-based workbenches that integrate and orchestrate a set of interoperable services that reduce the data-intensiveness and complexity overload at critical decision points to a manageable level, thus permitting stakeholders to be more productive and concentrate on creative activities.

Categorization of Anti-Patterns in Software Project Management

In the last decades, software systems have become an intrinsic element in our daily lives. Software exists in our computers, in our cars, and even in our refrigerators. Today’s world has become heavily dependent on software and yet, we still struggle to deliver quality software products, on-time and within budget. When searching for the causes of such alarming scenario, we find concurrent voices pointing to the role of the project manager. But what is project management and what makes it so challenging? Part of the answer to this question requires a deeper analysis of why software project managers have been largely ineffective. Answering this question might assist current and future software project managers in avoiding, or at least effectively mitigating, problematic scenarios that, if unresolved, will eventually lead to additional failures. This is where anti-patterns come into play and where they can be a useful tool in identifying and addressing software project management failure. Unfortunately, anti-patterns are still a fairly recent concept, and thus, available information is still scarce and loosely organized. This thesis will attempt to help remedy this scenario. The objective of this work is to help organize existing, documented software project management anti-patterns by answering our two research questions: · What are the different anti-patterns in software project management? · How can these anti-patterns be categorized?

The educational learning lifecycle and the cloud computing

Currently, student dropout rates are a matter of concern among universities. Many research studies, aimed at discovering the causes, have been carried out. However, few solutions, that could serve all students and related problems, have been proposed so far. One such problem is caused by the lack of the "knowledge chain educational links" that occurs when students move onto higher studies without mastering their basic studies. Most regulated studies imparted at universities are designed so that some basic subjects serve as support for other, more complicated, subjects, thus forming a complicated knowledge network. When a link in this chain fails, student frustration occurs as it prevents him from fully understanding the following educational links. In this proposal we try to mitigate these disasters that stem, for the most part, the student?s frustration beyond his college stay. On one hand, we make a dissertation on the student?s learning process, which we divide into a series of phases that amount to what we call the "learning lifecycle." Also, we analyze at what stage the action by the stakeholders involved in this scenario: teachers and students; is most important. On the other hand, we consider that Information and Communication Technologies ICT, such as Cloud Computing, can help develop new ways, allowing for the teaching of higher education, while easing and facilitating the student?s learning process. But, methods and processes need to be defined as to direct the use of such technologies; in the teaching process in general, and within higher education in particular; in order to achieve optimum results. Our methodology integrates, as another actor, the ICT into the "Learning Lifecycle". We stimulate students to stop being merely spectators of their own education, and encourage them to take an active part in their training process. To do this, we offer a set of useful tools to determine not only academic failure causes, (for self assessment), but also to remedy these failures (with corrective actions); "discovered the causes it is easier to determine solutions?. We believe this study will be useful for both students and teachers. Students learn from their own experience and improve their learning process, while obtaining all of the "knowledge chain educational links? required in their studies. We stand by the motto "Studying to learn instead of studying to pass". Teachers will also be benefited by detecting where and how to strengthen their teaching proposals. All of this will also result in decreasing dropout rates.

POLÍTICAS PÚBLICAS VOLTADAS PARA A FORMAÇÃO DO LEITOR: O PROJETO HORA DA LEITURA

Este trabalho tem o objetivo de analisar, a partir de uma abordagem políticoeducacional, os elementos teórico-metodológicos contidos no projeto Hora da Leitura, considerando-se os estudos de Bakhtin, Geraldi e Isabel Solé, articulandoos com o Referencial Curricular Nacional para a Educação Infantil, com os Parâmetros Curriculares Nacionais de 1ª a 4ª séries e de 5ª a 8ª séries , com a legislação referente ao projeto e com as condições administrativo-pedagógicas em que está sendo concretizado em escolas do estado de São Paulo. Tendo sido o projeto Hora da Leitura implantado em todas as escolas da rede estadual de ensino, a partir de 2005, procurou-se verificar em que medida os primeiros resultados têm mostrado ganhos para os alunos e professores. Nesse sentido, foi aplicado um questionário aos alunos de 7ª e 8ª séries, aos professores que atuam no projeto e aos professores coordenadores de quatro escolas da rede pública de ensino estadual. O resultado da pesquisa aponta para a ineficiência do projeto, no sentido de sanar o problema da incompetência leitora, em razão de sua superficialidade e também das condições em que é operacionalizado nas escolas públicas.(AU)

POLÍTICAS PÚBLICAS VOLTADAS PARA A FORMAÇÃO DO LEITOR: O PROJETO HORA DA LEITURA

Este trabalho tem o objetivo de analisar, a partir de uma abordagem políticoeducacional, os elementos teórico-metodológicos contidos no projeto Hora da Leitura, considerando-se os estudos de Bakhtin, Geraldi e Isabel Solé, articulandoos com o Referencial Curricular Nacional para a Educação Infantil, com os Parâmetros Curriculares Nacionais de 1ª a 4ª séries e de 5ª a 8ª séries , com a legislação referente ao projeto e com as condições administrativo-pedagógicas em que está sendo concretizado em escolas do estado de São Paulo. Tendo sido o projeto Hora da Leitura implantado em todas as escolas da rede estadual de ensino, a partir de 2005, procurou-se verificar em que medida os primeiros resultados têm mostrado ganhos para os alunos e professores. Nesse sentido, foi aplicado um questionário aos alunos de 7ª e 8ª séries, aos professores que atuam no projeto e aos professores coordenadores de quatro escolas da rede pública de ensino estadual. O resultado da pesquisa aponta para a ineficiência do projeto, no sentido de sanar o problema da incompetência leitora, em razão de sua superficialidade e também das condições em que é operacionalizado nas escolas públicas.(AU)

Why fisheries collapse and what to do about it.

With the collapse of fisheries in many parts of the world causing widespread economic harm, attention is focused on a possible cause and remedy of fishery collapse. Economic theory for managing a renewable resource, such as a fishery, leads to an ecologically unstable equilibrium as difficult to maintain as balancing a marble on top of a dome. A fishery should be managed for ecological stability instead--in the analogy, as easy to maintain as keeping a marble near the base of a bowl. The goal of ecological stability is achieved if the target stock is above that producing maximum sustainable yield and harvested at less than the maximum sustainable yield. The cost of managing for ecological stability, termed "natural insurance," is low if the fishery is sufficiently productive. This cost is shown to pay for itself over the long term in a variable and uncertain environment. An ecologically stable target stock may be attained either with annually variable quotas following current practice or, preferably, through a market mechanism whereby fish are taxed at dockside if caught when the stock was below target and are untaxed otherwise. In this regulatory environment, the goal of maximizing short-term revenue coincides with the goal of ecological stability, thereby also maximizing long-term revenue. This new approach to fishery management is illustrated with the recently collapsed Newfoundland fishing industry. The Newfoundland cod fishery is expected to rebuild to an ecologically stable level in about 9 years and thereafter support an annual harvest of about 75% of the 1981-1990 average.

Double Reasonableness and the Fourth Amendment

Recently the Supreme Court has placed new limits on both the substance of the Fourth Amendment and the exclusionary that serves as the principal remedy for Fourth Amendment violations. In this Article we briefly summarize these limitations and then argue that the curtailment of the exclusionary rule has the potential to ameliorate substantive Fourth Amendment doctrine. The limited reach of the modern exclusionary rule provides the Court with license to develop an expansive new substantive framework free of the specter of a correspondingly expansive remedial framework. One point on which nearly all jurists and commentators agree is that current Fourth Amendment doctrine is a mess. We argue that the Court’s exclusionary rule cases, while frustrating and ill-conceived if viewed in isolation, provide the Court with an opportunity to revisit problematic Fourth Amendment doctrine that was born under a very different remedial regime. Such an approach would allow the Court to adhere to its current view of the exclusionary rule as a remedy of last resort while creating a Fourth Amendment with teeth. The goal is a Fourth Amendment right that is more substantial and clearly defined, but a remedy that remains limited to egregious violations of clear substantive rules. The time is now to lift the Fourth Amendment fog.

La palmera datilera y la palmera canaria en la medicina tradicional de España

En la actualidad son muy pocos los usos vigentes. Aunque los dátiles son la materia utilizada con mayor frecuencia, también se han empleado la savia, el polen y el cogollo tierno o palmito. Los dátiles de Phoenix dactylifera se utilizaron como analgésico y para tratar la anemia y trastornos digestivos, o para fortalecer las encías, en el tratamiento de la disfunción eréctil y como afrodisiacos, para facilitar el parto y calmar los dolores postparto, y tratar el prolapso de la matriz o para el exceso de flujo menstrual. También se utilizaron como diuréticos, para la disuria y en trastornos de la vejiga. El uso que más claramente ha persistido es el tratamiento de diversos problemas respiratorios. En uso externo se utilizaron para tratar problemas de la piel, heridas, hemorragias y hemorroides. De la palmera de Canarias (Phoenix canariensis), especialmente en la isla de la Gomera, la savia cruda o guarapo, su concentrado o miel de palma y los resultantes de su fermentación (vino de palma) se consumen como alimento y también se utilizan como diurético, remedio de trastornos génitourinarios, digestivo, para infecciones de la cavidad bucal, expectorante, antitusígeno y para las irritaciones de garganta. En el Toledo de Al-Andalus las espatas de P. dactylifera se utilizaron, hace casi mil años, en el tratamiento de la debilidad, los dolores, nefritis, las enfermedades de la vejiga, trastornos hepáticos (también como preventivo), diarrea, trastornos digestivos, dolores en el abdomen y en el estómago, excesivo sangrado menstrual, úlceras en la piel y sarna, dolores articulares y trastornos cardiacos. La fitoterapia racional debería prestar atención a este recurso, considerar la evidencia científica disponible (farmacológica e incluso clínica) e incorporarlo a nuestro repertorio terapéutico.

Las Reales viruelas, muerte e inoculación en la Corte española

Durante el siglo XVIII, la viruela alcanzó su máxima expresión como enfermedad devastadora, y se convirtió en la primera causa de mortalidad infantil. En su deambular como azote mundial, diezmaba la población afectando a todas las clases sociales. Las monarquías europeas sufrieron la virulencia de la enfermedad, y se produjeron cambios notables en el devenir de las casas reales por el fallecimiento de reyes o príncipes herederos. La introducción de la inoculación como remedio preventivo contra la viruela fue apoyada por las monarquías, pero no se aplicó de manera sistemática, lo que redujo su impacto en las estadísticas de mortalidad. Revisamos los efectos de la viruela en la Corte española, enfermedad que llevó a la extinción de la Casa de Austria y afectó también a los borbones; de manera tardía, estos aceptaron la inoculación y contribuyeron a la propagación de la vacuna.

Una propuesta fallida para propagar la vacuna contra la viruela en Hispanoamérica (1802)

Tras la inicial propagación del método jenneriano por Inglaterra y el resto del continente europeo, se mostró un gran interés por difundirlo hacia Oriente y América. En el caso de España, los focos epidémicos que estaban ocurriendo en los territorios de ultramar movieron a las autoridades de los distintos virreinatos a solicitar a la Corona que enviara cuanto antes el nuevo remedio. La monarquía borbónica, que había introducido las expediciones científicas como elemento de progreso y dominio, aprobó el proyecto conocido como “Real Expedición Filantrópica de la Vacuna”, que partió hacia América al mando de Balmis en 1803. Relatamos una propuesta inédita anterior a esa, en la que un desconocido cirujano, Rafael de Malaguilla, se ofreció para llevar a cabo una iniciativa similar.

Conhecimento e adesão da prática de higienização das mãos dos profissionais da saúde: revisão de literatura

O presente estudo objetiva conhecer a produção científica da saúde acerca da higienização das mãos realizada pelos profissionais e relacionar o conhecimento e adesão do profissional a essa prática. Trata-se de uma revisão bibliográfica sistemática, realizado na Biblioteca Virtual de Saúde (BVS), nas bases de dados LILACS e SCIELO, com os descritores: pessoal de saúde, lavagem de mãos e adesão. Selecionou-se 13 artigos no período de 2002 a 2012, que foram analisados em categorias. Os critérios de inclusão para a seleção dos artigos foram: artigos publicados em português e estar disponível em texto completo. Os resultados da pesquisa evidenciaram que a grande maioria dos profissionais tem embasamento teórico e prático sobre higienização das mãos. Porém, no campo de trabalho temos resultados contrários, não há adesão esperada nem a técnica correta da lavagem das mãos. Por diversos motivos ainda não realizam por completo essa tarefa. Concluindo assim que as ações de educação que tem função de orientar e motivar esses profissionais devem ser discutidas e implementadas, a fim de sanar todas as dúvidas que ainda existem sobre a técnica de higienização das mãos.

Poems copied by James Diman, ca. 1730-1733

Small pamphlet-sized notebook containing handwritten transcriptions of three poems copied by James Diman, likely in the early 1730s. The notebook contains "The Catholic Remedy. to ye Tune of To all you Ladies, not at land &c.," "Father Ab--y's Will. Col. Sweeper Camb: Dec. 1731," and "The Poet's Lamentation for ye Loss of his cat, w'ch he used to call his Muse" copied from the London Magazine, November 1733. The "Catholic Remedy" begins "You Peope who desire to mend / your Desperate Estate..." and includes the note, "Made upon A--D--'s goving over to take orders. The note refers to the voyage of Addington Davenport (Harvard AB 1719) to England join the priesthood of the Church of England in 1730. "Father Ab--y's Will" begins "To my dear Wife, / My joy and Life..." and was a humorous poem published in 1731 after the death of Harvard College Sweeper Matthew Abdy, and attributed to Jonathan Seccombe (Harvard AB 1728). The "Poet's Lamentation" begins "Oppress'd with Grief, in heavy strains I mourn..." and was written by Joseph Green (Harvard AB 1726) as a parody of a psalm composed by Mather Byles (Harvard AB 1725). Pages 10-12, holding part of "Father Ab--y's Will" are missing, and pages 13-15 are no longer attached to the item.

A acção de condenação à prática de acto devido : conhecimento e prova dos pressupostos de facto do acto

A acção de condenação à prática de acto devido corresponde à concretização, com o Código de Processo nos Tribunais Administrativos, do princípio da tutela jurisdicional efectiva previsto no art. 268º/4 da Constituição da República Portuguesa, assegurando aos particulares a obtenção de uma pronúncia condenatória na prática do acto administrativo que tenha sido recusado ou omitido. Esta pronúncia sofre as limitações decorrentes do princípio da separação de poderes, entre o Administrativo e o Judicial, nos termos expressos no art. 71º/2 do Código de Processo, que determina que quando a emissão do acto pretendido envolva a formulação de valorações próprias do exercício da função administrativa (…) o tribunal não pode determinar o conteúdo do acto a praticar, mas deve explicitar as vinculações a observar (…) na emissão do acto devido. À limitação enunciada acresce outra, sem reflexo no texto do Código mas que se impõe por via do mesmo princípio, e que respeita aos poderes do tribunal no conhecimento e determinação dos pressupostos do acto devido, nos casos em que estes são questionados em juízo. A determinação dos pressupostos de facto do acto devido pelo tribunal está limitada pela natureza da actividade instrutória procedimental, pelo (in)cumprimento do ónus da prova no procedimento pelo interessado, nos casos limitados em que este tem relevância e pelo princípio da decisão prévia administrativa, nos termos do qual é à Administração que compete o conhecimento e decisão das pretensões que lhe são dirigidas e cuja competência que lhe foi determinada pela lei. Os limites enunciados não prejudicam a sindicabilidade, pelos tribunais, dos actos de recolha e valoração das provas pela Administração, que, nos casos em que configurem espaços de margem de livre decisão administrativa, são sindicáveis nos termos em que pode ser controlada a actividade autodeterminada da Administração, sem qualquer limitação quanto aos meios de prova.