Small-area variation in health care affecting the choice of cesarean delivery: the case of a Colombian health insurer

In the midst of health care reform, Colombia has succeeded in increasing health insurance coverage and the quality of health care. In spite of this, efficiency continues to be a matter of concern, and small-area variations in health care are one of the plausible causes of such inefficiencies. In order to understand this issue, we use individual data of all births from a Contributory-Regimen insurer in Colombia. We perform two different specifications of a multilevel logistic regression model. Our results reveal that hospitals account for 20% of variation on the probability of performing cesarean sections. Geographic area only explains 1/3 of the variance attributable to the hospital. Furthermore, some variables from both demand and supply sides are found to be also relevant on the probability of undergoing cesarean sections. This paper contributes to previous research by using a hierarchical model and by defining hospitals as cluster. Moreover, we also include clinical and supply induced demand variables.

Esencialismo psicológico: Herramienta conceptual para estudiar la discriminación de la mujer en Colombia.

El esencialismo psicológico es una teoría legal concerniente a la naturaleza de los grupos humanos, y se presenta como la tendencia a creer que los miembros de un grupo tienen una esencia o naturaleza subyacente que define su identidad. El esencialismo psicológico plantea a partir de determinismos causales, diferencias entre grupos y categorías sociales. Para identificar la presencia de creencias esencialistas sobre el género en el discurso de hombres y mujeres colombianos, se realizó un análisis de contenido de cuatro grupos focales, dos de los cuales estaban conformados por hombres y dos por mujeres, discutiendo alrededor de una temática común: las posibles implicaciones sociales de ser mujer en Colombia. La información fue registrada en medio audio y el análisis cualitativo se realizó con la ayuda del software Atlas-Ti, versión 7.0. El proceso de codificación inicial estuvo informado por la revisión de literatura que generó categorías orientadoras. Posteriormente se identificaron categorías emergentes, y se procedió a contrastar la información de los dos tipos de categorías (teóricas y empíricas), para finalmente reflexionar acerca del pensamiento esencialista y la discriminación de género enfocado en la mujer. Se identificó que tanto hombres como mujeres, recurrieron a explicaciones esencialistas, como determinantes culturales, sociales y biológicos para explicar o justificar las desigualdades en el poder social entre los grupos. Sin embargo, se identificaron también ideas no esencialistas contrarias al sistema de creencias esencialistas, en cuanto a la percepción de cambio social de la situación de la mujer en el país.

Representaciones sociales de la medicina complementaria y alternativa (MCA) para el cáncer en estudiantes universitarios de carreras de ciencias de la salud

Se realizó un estudio cualitativo exploratorio con estudiantes de carreras de Ciencias de la Salud con el objetivo de comprender las representaciones sociales que tienen acerca de la Medicina Complementaria y Alternativa (MCA) para el cáncer. Se desarrollaron grupos focales y la información obtenida fue analizada a través del Análisis Temático e interpretada con base en la Teoría de las Representaciones Sociales. Se encontraron diversas representaciones sociales asociadas con la definición, los objetivos, los tratamientos, la eficacia, las fuentes de información y el origen de la MCA. En conclusión se evidenció una alta tendencia a la aceptación y a la manifestación de una actitud positiva, aunque ambivalente frente a la MCA, además de un desconocimiento por la diferenciación conceptual entre este tipo de Medicina y la Medicina Popular. La cultura y las creencias sociales predominan en las representaciones sociales que tienen los estudiantes de la MCA para el cáncer, pese a su formación académica.

Oscar and Arabella hot hot hot.

No hay hielo, no hay nieve. Es un verano caluroso de la última glaciación que crea dificultades a los lanudos mamuts Oscar y Arabella. Siendo tan lanudos parece que nada pueden hacer para refrescarse hasta que Oscar toma rápidamente una drástica decisión para mantenerse frescos.

From Kaiser to Führer : Germany 1940-45 for Edexcel.

Su contenido ha sido aprobado por Edexcel y se adapta a los temas de las especificaciones AS y A2. Examina la sociedad y el gobierno durante el Segundo Reich, el experimento democrático de 1919 a 1929, el ascenso de los nazis y la vida durante la Segunda Guerra Mundial.

Migrarte ciencia y arte visual, un di??logo identitario bilateral

Resumen basado en el de la publicaci??n

Les tècniques científiques integrades del grau de ciencies ambientals: una experiència de pràctiques basades en un disseny per competències

En el marc del nou disseny dels plans d’estudis del primer curs dels graus de la Facultat de Ciències de la UdG, el curs 2009/10 es varen començar a impartir unes assignatures sota el nom de Tècniques Científiques Integrades (TCI). Les TCI’s suposen una transformació absoluta del model de pràctiques que es desenvolupaven a les antigues llicenciatures. La nova organització ha eliminat les pràctiques de laboratori i camp clàssiques realitzades dins de les assignatures de primer per substituir-les per unes activitats integradores lligades a les competències.

Building wood debris piles benefits avian seed dispersers in burned and logged Mediterranean pine forests

Salvage logging is a common practice carried out in burned forests worldwide, and intended to mitigate the economic losses caused by wildfires. Logging implies an additional disturbance occurring shortly after fire, although its ecological effects can be somewhat mitigated by leaving wood debris on site. The composition of the bird community and its capacity to provide ecosystem services such as seed dispersal of fleshy-fruited plants have been shown to be affected by postfire logging. We assessed the effects of the habitat structure resulting from different postfire management practices on the bird community, in three burned pine forests in Catalonia (western Mediterranean). For this purpose, we focused on the group of species that is responsible for seed dispersal, a process which takes place primarily during the winter in the Mediterranean basin. In addition, we assessed microhabitat selection by seed disperser birds in such environments in relation to management practices. Our results showed a significant, positive relationship between the density of wood debris piles and the abundance of seed disperser birds. Furthermore, such piles were the preferred microhabitat of these species. This reveals an important effect of forest management on seed disperser birds, which is likely to affect the dynamics of bird-dependent seed dispersal. Thus, building wood debris piles can be a useful practice for the conservation of both the species and their ecosystem services, while also being compatible with timber harvesting

Can salvage logging affect seed dispersal by birds into burned forests?

The recovery of vegetation in Mediterranean ecosystems after wildfire is mostly a result of direct regeneration, since the same species existing before the fire regenerate on-site by seeding or resprouting. However, the possibility of plant colonization by dispersal of seeds from unburned areas remains poorly studied. We addressed the role of the frugivorous, bird-dependent seed dispersal (seed rain) of fleshy-fruited plants in a burned and managed forest in the second winter after a fire, before on-site fruit production had begun. We also assessed the effect on seed rain of different microhabitats resulting from salvage logging (erosion barriers, standing snags, open areas), as well as the microhabitats of unlogged patches and an unburned control forest, taking account of the importance of perches as seed rain sites. We found considerable seed rain by birds in the burned area. Seeds, mostly from Olive trees Olea europaea and Evergreen pistaches Pistacia lentiscus, belonged to plants fruiting only in surrounding unburned areas. Seed rain was heterogeneous, and depended on microhabitat, with the highest seed density in the unburned control forest but closely followed by the wood piles of erosion barriers. In contrast, very low densities were found under perches of standing snags. Furthermore, frugivorous bird richness seemed to be higher in the erosion barriers than elsewhere. Our results highlight the importance of this specific post-fire management in bird-dependent seed rain and also may suggest a consequent heterogeneous distribution of fleshy-fruited plants in burned and managed areas. However, there needs to be more study of the establishment success of dispersed seeds before an accurate assessment can be made of the role of bird-mediated seed dispersal in post-fire regeneration

La migració primaveral d'ocells als Aiguamolls de l'Empordà (Girona): primer anellament de Becadell Gros (Gallinago Media) a la Península Ibèrica

En aquest treball s'exposen els resultats obtinguts en la campanya 1994 d'anellament d'ocells inclosa dins del projecte italià Piccole Isole. Es demostra que el factor meteorològic afecta directament la fenologia migratòria de diferents espècies d'ocells. Es pretén també estudiar la influència dels diferents hàbitats en el nombre i en la diversitat de captures. Es recullen també en aquest treball les principals espècies visualitzades durant la campanya, com també l'elevat nombre de controls estrangers recuperats. Dintre de les captures i l'anellament posterior, destaca sobretot la d'un becadell gros (Gallinago media) fets per primera vegada a la peninsula Ibèrica

Antropologia, Filosofia e Direito: para uma mudança de paradigma

Várias questões se põem na interseção entre a Filosofia e as Ciências Sociais e Humanas para a definição do Lugar do Outro no pensamento jurídico-político e no sentido de definir o que se entende por «natureza humana». Uma perspetiva antropológica se impõe no contexto do próprio pensamento político.

La educación laica y el proyecto educativo velasquista en el Ecuador, 1930-1950 (Estudios)

Este estudio analiza la política educativa de Velasco Ibarra durante sus dos primeros gobiernos 0934-1935 y 1944-1947) Y las tensiones que mantuvo con la educación laica, instituida décadas atrás por la Revolución Liberal. Con este propósito, el artículo examina la función que la educación tuvo en el ideario velasquista, empeñado en la reconstitución del orden moral de la sociedad. El ensayo interroga el proyecto de despolitización de la educación y de respaldo a la educación confesional que Velasco Ibarra impulsó. Examina, además, el desarrollo de una oferta educativa estratificada, contraria a los principios más democratizadores de la educación liberal.

Modelling habitat selection and distribution of the critically endangered Jerdon's courser Rhinoptilus bitorquatus in scrub jungle: an application of a new tracking method

1. Jerdon's courser Rhinoptilus bitorquatus is a nocturnally active cursorial bird that is only known to occur in a small area of scrub jungle in Andhra Pradesh, India, and is listed as critically endangered by the IUCN. Information on its habitat requirements is needed urgently to underpin conservation measures. We quantified the habitat features that correlated with the use of different areas of scrub jungle by Jerdon's coursers, and developed a model to map potentially suitable habitat over large areas from satellite imagery and facilitate the design of surveys of Jerdon's courser distribution. 2. We used 11 arrays of 5-m long tracking strips consisting of smoothed fine soil to detect the footprints of Jerdon's coursers, and measured tracking rates (tracking events per strip night). We counted the number of bushes and trees, and described other attributes of vegetation and substrate in a 10-m square plot centred on each strip. We obtained reflectance data from Landsat 7 satellite imagery for the pixel within which each strip lay. 3. We used logistic regression models to describe the relationship between tracking rate by Jerdon's coursers and characteristics of the habitat around the strips, using ground-based survey data and satellite imagery. 4. Jerdon's coursers were most likely to occur where the density of large (>2 m tall) bushes was in the range 300-700 ha(-1) and where the density of smaller bushes was less than 1000 ha(-1). This habitat was detectable using satellite imagery. 5. Synthesis and applications. The occurrence of Jerdon's courser is strongly correlated with the density of bushes and trees, and is in turn affected by grazing with domestic livestock, woodcutting and mechanical clearance of bushes to create pasture, orchards and farmland. It is likely that there is an optimal level of grazing and woodcutting that would maintain or create suitable conditions for the species. Knowledge of the species' distribution is incomplete and there is considerable pressure from human use of apparently suitable habitats. Hence, distribution mapping is a high conservation priority. A two-step procedure is proposed, involving the use of ground surveys of bush density to calibrate satellite image-based mapping of potential habitat. These maps could then be used to select priority areas for Jerdon's courser surveys. The use of tracking strips to study habitat selection and distribution has potential in studies of other scarce and secretive species.