Primary health care. Neoliberal continuities in “person-centered care”

This paper analyzes the document on primary health care (PHC) published by the World Health Organization (WHO) in 2008, held to mark the thirtieth anniversary of the Declaration of Alma-Ata on PHC (1). Objective: to investigate in depth the assumptions outlined in the report, in order to problematize the notion of APS and universal access to health that are made in this proposal. Methodology: using documentary analysis examines the health proposal prepared by the international body and subjected to criticism from the following areas: a) conception of health as aright or as a service. b) Criteria commodified healthcare. Results: emphasize the permanence of a neoliberal perspective on the proposals WHO health reform in this document, which needs to be discussed in contexts where neoliberalism was intense processes of inequality and exclusion, as in the case of Latin America.

Las Jarretaderas, Nayarit, Mexico: a Social Interstice in Touristic Zona Metropolitana of Sun and Sand

The objective of the present article is to illustrate the social interstice (Las Jarretaderas) existing between the municipalities Bahía de Banderas, Nayarit and Puerto Vallarta, Jalisco. The researched community is an outstanding case-study providing an in-depth analysis of a number of social process mostly related to the chiapaneca migration. The text is divided into two sections. The first one deals with the urbanization process of the metropolitan area of Puerto Vallarta. The second and longer section defines the concept of social interstice and explains how the researched locality falls under under that previously-defined concept according to the processes analyzed.

The municipality and neighborhood associative entities in argentine cities: its resignification after the decentralization of the ‘80s A case study: The municipality of Río Cuarto and their neighborhood associations

In Argentina, the restructuring of the State initially raised as a public policy in the 1980s and in-depth in the ‘ 90s under the neoliberal model accentuated - between other processes, of the administrative  decentralization, which also resulted in new roles awarded to municipalities. That’s how various actors in society charged leadership. The local and urban were the subject of renewed interpretations,  scenarios where practices more fully participatory citizen could be settled. In the neighborhoods  of cities, grass-roots organizations cultivated his role as space intermediation. This article discusses  and reflects on these new roles that launched from the changes in articulation with the municipality  since the mid-’ 80s and ‘ 90s, and problematizes particularly about the contents and scope of participatory practices inside and outside of organizations of civil society in the neo-liberal situation.

Short Term Health Shocks and School Attendance: The Case of a Dengue Fever Outbreak in Colombia.

This paper makes use of a short, sharp, unexpected health shock in the form of the 2010 Colombian Dengue outbreak to examine the direct and indirect impact of negative health shocks on behaviour of households in affected areas. Our analysis combines data from several sources in order to obtain a comprehensive picture of the influence of the outbreak, and furthermore to understand the underlying mechanisms driving the effects. Our initial analysis indicates that the outbreak had a substantial negative effect on the health status of adults and adversely affected their ability to function as usual in their daily lives. In our aggregated school data, in areas with high levels of haemorrhagic Dengue we observe a reduction innational exam attendance (last year of secondary school) and on enrolment rates in primary education. Further analysis aims to exploit detailed individual level data to gain a more in depth understanding of the precise channels through which this disease influenced the behaviour and outcomes of the poor in Colombia.

Enhanced fault recovery methods for protected traffic services in GMPLS networks

Les noves tecnologies a la xarxa ens permeten transportar, cada cop més, grans volums d' informació i trànsit de xarxa amb diferents nivells de prioritat. En aquest escenari, on s'ofereix una millor qualitat de servei, les conseqüències d'una fallada en un enllaç o en un node esdevenen més importants. Multiprotocol Lavel Switching (MPLS), juntament amb l'extensió a MPLS generalitzat (GMPLS), proporcionen mecanismes ràpids de recuperació de fallada establint camins, Label Switch Path (LSPs), redundants per ser utilitzats com a camins alternatius. En cas de fallada podrem utilitzar aquests camins per redireccionar el trànsit. El principal objectiu d'aquesta tesi ha estat millorar alguns dels actuals mecanismes de recuperació de fallades MPLS/GMPLS, amb l'objectiu de suportar els requeriments de protecció dels serveis proporcionats per la nova Internet. Per tal de fer aquesta avaluació s'han tingut en compte alguns paràmetres de qualitat de protecció com els temps de recuperació de fallada, les pèrdues de paquets o el consum de recursos. En aquesta tesi presentem una completa revisió i comparació dels principals mètodes de recuperació de fallada basats en MPLS. Aquest anàlisi inclou els mètodes de protecció del camí (backups globals, backups inversos i protecció 1+1), els mètodes de protecció locals i els mètodes de protecció de segments. També s'ha tingut en compte l'extensió d'aquests mecanismes a les xarxes òptiques mitjançant el pla de control proporcionat per GMPLS. En una primera fase d'aquest treball, cada mètode de recuperació de fallades és analitzat sense tenir en compte restriccions de recursos o de topologia. Aquest anàlisi ens dóna una primera classificació dels millors mecanismes de protecció en termes de pèrdues de paquets i temps de recuperació. Aquest primer anàlisi no és aplicable a xarxes reals. Per tal de tenir en compte aquest nou escenari, en una segona fase, s'analitzen els algorismes d'encaminament on sí tindrem en compte aquestes limitacions i restriccions de la xarxa. Es presenten alguns dels principals algorismes d'encaminament amb qualitat de servei i alguna de les principals propostes d'encaminament per xarxes MPLS. La majoria dels actual algorismes d'encaminament no tenen en compte l'establiment de rutes alternatives o utilitzen els mateixos objectius per seleccionar els camins de treball i els de protecció. Per millorar el nivell de protecció introduïm i formalitzem dos nous conceptes: la Probabilitat de fallada de la xarxa i l'Impacte de fallada. Un anàlisi de la xarxa a nivell físic proporciona un primer element per avaluar el nivell de protecció en termes de fiabilitat i disponibilitat de la xarxa. Formalitzem l'impacte d'una fallada, quant a la degradació de la qualitat de servei (en termes de retard i pèrdues de paquets). Expliquem la nostra proposta per reduir la probabilitat de fallada i l'impacte de fallada. Per últim fem una nova definició i classificació dels serveis de xarxa segons els valors requerits de probabilitat de fallada i impacte. Un dels aspectes que destaquem dels resultats d'aquesta tesi és que els mecanismes de protecció global del camí maximitzen la fiabilitat de la xarxa, mentre que les tècniques de protecció local o de segments de xarxa minimitzen l'impacte de fallada. Per tant podem assolir mínim impacte i màxima fiabilitat aplicant protecció local a tota la xarxa, però no és una proposta escalable en termes de consum de recursos. Nosaltres proposem un mecanisme intermig, aplicant protecció de segments combinat amb el nostre model d'avaluació de la probabilitat de fallada. Resumint, aquesta tesi presenta diversos mecanismes per l'anàlisi del nivell de protecció de la xarxa. Els resultats dels models i mecanismes proposats milloren la fiabilitat i minimitzen l'impacte d'una fallada en la xarxa.

Resilience in rail engineering work

This paper discusses an ongoing project that aims at improving the potential for resilience of a system responsible for the planning of rail engineering work delivery. This is being addressed by means of a methodology based on the observation and analysis of “real” planning activities, using resilience engineering concepts as a background. Interviews with planners have been carried out to provide an overview of the planning process and steer more in-depth investigation. Analysis of historic information and observation of planners’ main activities is underway. Given the nature of the process under study, information flows and communication issues have been given particular attention throughout the data collection and analysis stages. Initial data confirms that the planning process is greatly reliant on the capability of people using their knowledge and skills to communicate in a dynamic informational environment. Evidence was found of communication breakdowns at the boundaries of different planning levels and teams. The fact that the process is divided amongst several different areas of the organisation, often with different goals and needs, creates potential sources of conflict and tension.

Current infection control trends in audiology

The purpose of this study was to provide an in-depth assessment of current infection control practice trends in a group of practicing audiologists. The study investigated the extent to which Universal Precautions are applied in the clinical settings, the percentages of respondents familiar with general infection control nomenclature, and the future educational directives.

Living up to the value agenda: the empirical realities of through-life value creation in construction

Current research agendas are increasingly encouraging the construction industry to operate on the basis of 'added value'. Such debates echo the established concept of 'high value manufacturing' and associated trends towards servitization. Within construction, the so-called 'value agenda' draws heavily from the notion of integrated solutions. This is held to be especially appropriate in the context of PFI projects. Also relevant is the concept of service-led projects whereby the project rationale is driven by the client's objectives for delivering an enhanced service to its own customers. Such ideas are contextualized by a consideration of broader trends of privatization and outsourcing within and across the construction industry's client base. The current emphasis on integrated solutions reflects long-term trends within privatized client organizations towards the outsourcing of asset management capabilities. However, such trends are by no means uniform or consistent. An in-depth case study of three operating divisions within a major construction company illustrates that firms are unlikely to reorientate their business in response to the 'value agenda'. In the case of PFI, the tendency has been to establish specialist units for the purposes of winning work. Meanwhile, institutionally embedded operating routines within the rest of the business remain broadly unaffected.

Isolating the 'farmer' effect as a component of the advantage of growing genetically modified varieties in developing countries: a Bt cotton case study from Jalgaon, India

The present paper explores the 'farmer' effect in economic advantages often claimed for Bt cotton varieties (those with the endotoxin gene from Bacillus thuringiensis conferring resistance to some insect pests) compared to non-Bt varieties. Critics claim that much of the yield advantage of Bt cotton could be due to the fact that farmers adopting the technology are in a better position to provide inputs and management and so much of any claimed Bt advantage is an artefact rather than reflecting a real advantage of the variety per se. The present paper provides an in-depth analysis of 63 non-adopting and 94 adopting households of Bt cotton in Jalgaon, Maharashtra State, India, spanning the seasons 2002 and 2003. Results suggest that Bt adopters are indeed different from non-adopters in a number of ways. Adopters appear to specialize more on cotton (at least in terms of the land area they devote to the crop), spend more money on irrigation and grow well-performing non-Bt varieties of cotton (Bunny). Taking gross margin as the basis for comparison, Bt plots had 2.5 times the gross margin of non-Bt plots in both seasons. If only adopters are considered then the gross margin advantage of Bt plots reduces to 1.6 times that of non-Bt plots. This is still a significant advantage and could well explain the popularity of Bt in Maharashtra. However, it is clear that great care needs to be taken with such comparative studies.

"The past is still right here in the present": second-generation Bajan-Brit transnational migrants' views on issues relating to race and colour class

This paper deals with second-generation Barbadians or 'Bajan-Brits', who have decided to,return' to the birthplace of their parents, focusing on their reactions to matters relating to race relations and racialised identities. The importance of race and the operation of the 'colour-class' system in the Caribbean are established at the outset. Based on fifty-two qualitative in-depth interviews, the paper initially considers the positive things that the second-generation migrants report about living in a majority black country and the salience of such racial affirmation as part of their migration process. The paper then presents an analysis of the narratives provided by the Bajan-Brits concerning their reactions to issues relating to race relations in Barbadian society. The impressions of the young returnees provide clear commentaries on what are regarded as (i) the 'acceptance of white hegemony' within Barbadian society, (ii) the occurrence of de facto 'racial segregation, (iii) perceptions of the 'existence of apartheid, and (iv) 'the continuation of slavery'. The account then turns to the contemporary operation of the colour-class system. It is concluded that, despite academic arguments that the colour-class dimension has to be put to one side as the principal dimension of social stratification in the contemporary Caribbean, the second-generation migrants are acutely aware of the continued existence and salience of such gradations within society. Thus, the analysis not only serves to emphasise the continued importance of racial-based stratification in the contemporary Caribbean, but also speaks of the 'hybrid' and 'in-between' racialised identities of the second-generation migrants.

Young caregivers in the context of the HIV/AIDS pandemic in sub-Saharan Africa

Against a background of rising adult mortality and morbidity in the context of the HIV/AIDS pandemic in sub-Saharan Africa, this paper provides both quantitative and qualitative evidence for the existence of a largely neglected group of young people with increased responsibility for caregiving. Using questionnaire surveys, focus groups, storyboards and in-depth interviews in three studies across Southern and Eastern Africa some young people in Lesotho, Tanzania and Zimbabwe are found to devote considerable time and energy to caring for sick members of their households. Examination of the tasks carried out by these youngsters finds them to be burdened beyond usual familial and societal expectations of children's 'normal' contributions to the reproduction of households via domestic chores and suchlike. It is concluded that these young people can be described as 'young carers'. The three studies are presented to illuminate different sociospatial aspects of caregiving by young people. First, using qualitative data from Lesotho the range of caring tasks young caregivers; perform for care recipients - usually a grandmother, parent, or sibling - is identified. Second, the impact caregiving responsibilities have on children's primary school attendance is examined using survey data from Tanzania. Third, the wider negative and positive impacts of caregiving including loss of friends and gaining of emotional maturity for young carers and their households is explored with in-depth individual interviews from Zimbabwe. Finally, suggestions are made for further research to deepen understanding of the geographies of caring within the context of the population geographies of the HIV/AIDS pandemic in sub-Saharan Africa and beyond. Copyright (c) 2006 John Wiley & Sons, Ltd.

Financial protection in the UK building industry: bonds, retentions and guarantees

Financial Protection in the UK Building Industry provides comprehensive treatment of a complex aspect of construction management which is increasingly important in modern construction contracts. The term 'Financial Protection' refers to refers to the various mechanisms by which funds are made available to ensure the due performance of a partys contractual obligations. This book is based on material written for a research project funded by the Reading Construction Forum. Financial Protection in the UK Building Industry looks at the legal and economic background to the problem of providing financial protection to clients to guard against poor performance and or the insolvency of contractors, consultants and sub-contractors. The inclusion of practical guidance notes and summaries makes this a valuable guide for the construction professional as well as for the researcher. * provides in-depth analysis of financial protection measures * explores the ways in which financial protection can increase efficiency in the industry * financial protection in construction is beset with problems - this book points toward practical solutions

Contemporary organizational theory in the management of construction projects

The level of insolvencies in the construction industry is high, when compared to other industry sectors. Given the management expertise and experience that is available to the construction industry, it seems strange that, according to the literature, the major causes of failure are lack of financial control and poor management. This indicates that with a good cash flow management, companies could be kept operating and financially healthy. It is possible to prevent failure. Although there are financial models that can be used to predict failure, they are based on company accounts, which have been shown to be an unreliable source of data. There are models available for cash flow management and forecasting and these could be used as a starting point for managers in rethinking their cash flow management practices. The research reported here has reached the stage of formulating researchable questions for an in-depth study including issues such as how contractors manage their cash flow, how payment practices can be managed without damaging others in the supply chain and the relationships between companies" financial structures and the payment regimes to which they are subjected.

Cash flow management in construction firms

The level of insolvencies in the construction industry is high, when compared to other industry sectors. Given the management expertise and experience that is available to the construction industry, it seems strange that, according to the literature, the major causes of failure are lack of financial control and poor management. This indicates that with a good cash flow management, companies could be kept operating and financially healthy. It is possible to prevent failure. Although there are financial models that can be used to predict failure, they are based on company accounts, which have been shown to be an unreliable source of data. There are models available for cash flow management and forecasting and these could be used as a starting point for managers in rethinking their cash flow management practices. The research reported here has reached the stage of formulating researchable questions for an in-depth study including issues such as how contractors manage their cash flow, how payment practices can be managed without damaging others in the supply chain and the relationships between companies’ financial structures and the payment regimes to which they are subjected.

Young caregiving and HIV in the UK: caring relationships and mobilities in African migrant families

Recent research in Sub-Saharan Africa has revealed the importance of children’s caring roles in families affected by HIV and AIDS. However, few studies have explored young caregiving in the context of HIV in the UK, where recently arrived African migrant and refugee families are adversely affected by the global epidemic. This paper explores young people’s socio-spatial experiences of caring for a parent with HIV, based on qualitative research with 37 respondents in London and other urban areas in England. In-depth semi-structured interviews were conducted with young people with caring responsibilities and mothers with HIV, who were predominantly African migrants, as well as with service providers. Drawing on their perspectives, the paper discusses the ways that young people and mothers negotiate the boundaries of young people’s care work within and beyond homespace, according to norms of age, gender, generational relations and cultural constructions of childhood. Despite close attachments within the family, the emotional effects of living with a highly stigmatised life-limiting illness, pressures associated with insecure immigration status, transnational migration and low income undermined African mothers’ and young people’s sense of security and belonging to homespace. These factors also restricted their mobility and social participation in school/college and neighbourhood spaces. While young people and mothers valued supportive safe spaces within the community, the stigma surrounding HIV significantly affected their ability to seek support. The article identifies security, privacy, independence and social mobility as key dimensions of African young people’s and mothers’ imagined futures of ‘home’ and ‘family’.