The participation of the nutritionist in Primary Health Care in a large urban center

Nutritionists are important professionals for ensuring the implementation of health promotion, treatment and rehabilitation. However, their participation in primary healthcare from a quantitative standpoint is limited. The city of Sao Paulo has experienced an uneven urbanization process triggering new problems of insecurity in terms of food and nutrition. This article analyzes the performance of the primary healthcare nutritionist in a large urban center. It is a quantitative study that used data from the Municipal Health Department, population data of Sao Paulo and a semi-structured questionnaire applied in individual interviews. All regions of the city are found to have fewer nutritionists than the recommendation of the Federal Council of Nutritionists. There are 123 nutritionists in the basic healthcare network and 51 in the Family Health Support Nuclei (FHSN) (57.3%). Each nutritionist from the FHSN accompanies 7.1 family health strategy teams on average. The age groups corresponding to children are less frequently seen by nutritionists. Comparing the activities, the transition from a model of primary health care focused on individual care to a model that prioritizes group care was observed.

What do medical students think about their quality of life? A qualitative study

Background: Medical education can affect medical students' physical and mental health as well as their quality of life. The aim of this study was to assess medical students' perceptions of their quality of life and its relationship with medical education. Methods: First-to sixth-year students from six Brazilian medical schools were interviewed using focus groups to explore what medical student's lives are like, factors related to increases and decreases of their quality of life during medical school, and how they deal with the difficulties in their training. Results: Students reported a variety of difficulties and crises during medical school. Factors that were reported to decrease their quality of life included competition, unprepared teachers, excessive activities, and medical school schedules that demanded exclusive dedication. Contact with pain, death and suffering and harsh social realities influence their quality of life, as well as frustrations with the program and insecurity regarding their professional future. The scarcity of time for studying, leisure activities, relationships, and rest was considered the main factor of influence. Among factors that increase quality of life are good teachers, classes with good didactic approaches, active learning methodologies, contact with patients, and efficient time management. Students also reported that meaningful relationships with family members, friends, or teachers increase their quality of life. Conclusion: Quality of teachers, curricula, healthy lifestyles related to eating habits, sleep, and physical activity modify medical students' quality of life. Lack of time due to medical school obligations was a major impact factor. Students affirm their quality of life is influenced by their medical school experiences, but they also reframe their difficulties, herein represented by their poor quality of life, understood as necessary and inherent to the process of becoming doctors.

Segurança alimentar em domicílios chefiados por idosos, Brasil

A segurança alimentar nos domicílios chefiados por idosos tem uma dimensão especial no que se refere às condições de saúde e bem-estar, uma vez que parece evidente a importância de garantir a este contingente populacional a possibilidade de continuar a contribuir na sociedade de forma ativa e produtiva. OBJETIVO: Determinar a prevalência de insegurança alimentar em domicílios cujos chefes são idosos, segundo características sociodemográficas. MÉTODOS: Trata-se de estudo descritivo com domicílios cujos chefes têm 60 anos ou mais de idade declarada, selecionados da Pesquisa Nacional de Amostra de Domicílios - PNAD 2004. Empregou-se a Escala Brasileira de Insegurança Alimentar, classificando-se os domicílios em segurança alimentar e insegurança alimentar leve, moderada e grave. A análise descritiva dos dados incluiu a distribuição de frequência dos domicílios de acordo com os níveis de insegurança alimentar nos estratos das variáveis sociodemográficas, levando-se em consideração o efeito do desenho. RESULTADOS: O estudo mostrou que 29,8% dos domicílios se encontravam na condição de insegurança alimentar e que tal condição estava significativamente associada com regiões menos abastadas (Norte/Nordeste, rural), com os segmentos populacionais mais desfavorecidos (mais pobres e menos escolarizados) e, ainda com características de gênero (mulheres) e raciais (indígenas, pardos e pretos) as quais sabidamente ocupam os níveis inferiores da hierarquia social. CONCLUSÃO: A distribuição da insegurança alimentar em domicílios chefiados por idosos segue tendência similar dos domicílios brasileiros, ratificando a maior prevalência desta condição nos estratos socioeconômicos mais desfavorecidos da população ou entre características associadas à pobreza.

Las Micro-áreas marinas como modelo de gestión sostenible. Notas metodológicas para su implantación en la bahía de Gaira, Colombia

Máster Oficial en Gestión Costera

Il contratto a Tempo Determinato nel lavoro privato e pubblico. Assetti e linee di tendenza in un mercato del lavoro dinamico e globale

L’elaborato, dopo una ricostruzione della disciplina normativa presente in materia di contratto a tempo determinato in Italia e nei principali ordinamenti europei (Spagna, Francia ed Inghilterra), affronta i più rilevanti nodi problematici dell’istituto, in riferimento al settore privato e pubblico, mettendo in luce le principali querelle dottrinali e giurisprudenziali. Particolare attenzione è dedicata alle questioni insorte a seguito delle ultime modifiche normative di cui al c.d. Collegato lavoro (legge n. 183/2010), sino al decisivo intervento della Corte Costituzionale, con pronuncia n. 303 del 9 novembre 2011, che ha dichiarato legittima la disposizione introduttiva dell’indennità risarcitoria forfetizzata, aggiuntiva rispetto alla conversione del contratto. Tutte le problematiche trattate hanno evidenziato le difficoltà per le Corti Superiori, così come per i giudici comunitari e nazionali, di trovare una linea univoca e condivisa nella risoluzione delle controversie presenti in materia. L’elaborato si chiude con alcune riflessioni sui temi della flessibilità e precarietà nel mondo del lavoro, attraverso una valutazione quantitativa e qualitativa dell’istituto, nell’intento di fornire una risposta ad alcuni interrogativi: la flessibilità è necessariamente precarietà o può essere letta quale forma speciale di occupazione? Quali sono i possibili antidoti alla precarietà? In conclusione, è emerso come la flessibilità possa rappresentare un problema per le imprese e per i lavoratori soltanto nel lungo periodo. La soluzione è stata individuata nell’opportunità di investire sulla formazione. Si è così ipotizzata una nuova «flessibilità socialmente ed economicamente sostenibile», da realizzarsi tramite l’ausilio delle Regioni e, quindi, dei contributi del Fondo europeo di sviluppo regionale: al lavoratore, in tal modo, potrà essere garantita la continuità con il lavoro tramite percorsi formativi mirati e, d’altro canto, il datore di lavoro non dovrà farsi carico dei costi per la formazione dei dipendenti a tempo determinato.

Aspetti di sostenibilità in agricoltura a diverse scale spaziali e temporali. Valutazioni ambientali, economiche ed energetiche.

La Tesi analizza le relazioni tra i processi di sviluppo agricolo e l’uso delle risorse naturali, in particolare di quelle energetiche, a livello internazionale (paesi in via di sviluppo e sviluppati), nazionale (Italia), regionale (Emilia Romagna) e aziendale, con lo scopo di valutare l’eco-efficienza dei processi di sviluppo agricolo, la sua evoluzione nel tempo e le principali dinamiche in relazione anche ai problemi di dipendenza dalle risorse fossili, della sicurezza alimentare, della sostituzione tra superfici agricole dedicate all’alimentazione umana ed animale. Per i due casi studio a livello macroeconomico è stata adottata la metodologia denominata “SUMMA” SUstainability Multi-method, multi-scale Assessment (Ulgiati et al., 2006), che integra una serie di categorie d’impatto dell’analisi del ciclo di vita, LCA, valutazioni costi-benefici e la prospettiva di analisi globale della contabilità emergetica. L’analisi su larga scala è stata ulteriormente arricchita da un caso studio sulla scala locale, di una fattoria produttrice di latte e di energia elettrica rinnovabile (fotovoltaico e biogas). Lo studio condotto mediante LCA e valutazione contingente ha valutato gli effetti ambientali, economici e sociali di scenari di riduzione della dipendenza dalle fonti fossili. I casi studio a livello macroeconomico dimostrano che, nonostante le politiche di supporto all’aumento di efficienza e a forme di produzione “verdi”, l’agricoltura a livello globale continua ad evolvere con un aumento della sua dipendenza dalle fonti energetiche fossili. I primi effetti delle politiche agricole comunitarie verso una maggiore sostenibilità sembrano tuttavia intravedersi per i Paesi Europei. Nel complesso la energy footprint si mantiene alta poiché la meccanizzazione continua dei processi agricoli deve necessariamente attingere da fonti energetiche sostitutive al lavoro umano. Le terre agricole diminuiscono nei paesi europei analizzati e in Italia aumentando i rischi d’insicurezza alimentare giacché la popolazione nazionale sta invece aumentando.

Sicurezza privata e sicurezza partecipata. Le imprese private del settore sicurezza in Italia tra subalternità e sussidirietà

La ricerca esamina il ruolo delle imprese che svolgono attività di sicurezza privata in Italia (oggi definita anche "sussidiaria" o "complementare") in relazione allo sviluppo delle recenti politiche sociali che prevedono il coinvolgimento di privati nella gestione della sicurezza in una prospettiva di community safety. Nel 2008/2009 le politiche pubbliche di sicurezza legate al controllo del territorio hanno prodotto norme con nuovi poteri “di polizia” concessi agli amministratori locali e la previsione di associazione di cittadini per la segnalare eventi dannosi alla sicurezza urbana (“ronde”). Nello stesso periodo è iniziata un’importante riforma del settore della sicurezza privata, ancora in fase di attuazione, che definisce le attività svolte dalle imprese di security, individua le caratteristiche delle imprese e fissa i parametri per la formazione del personale. Il quadro teorico del lavoro esamina i concetti di sicurezza/insicurezza urbana e di società del rischio alla luce delle teorie criminologiche legate alla prevenzione situazionale e sociale e alla community policing. La ricerca sul campo si basa sull’analisi del contenuto di diverse interviste in profondità con esponenti del mondo della sicurezza privata (imprenditori, dirigenti, studiosi). Le interviste hanno fatto emergere che il ruolo della sicurezza privata in Italia risulta fortemente problematico; anche la riforma in corso sulla normativa del settore è considerata con scarso entusiasmo a causa delle difficoltà della congiuntura economica che rischia di compromettere seriamente la crescita. Il mercato della sicurezza in Italia è frastagliato e scarsamente controllato; manca un’azione di coordinamento fra le diverse anime della sicurezza (vigilanza privata, investigazione, facility/security management); persiste una condizione di subalternità e di assenza di collaborazione con il settore pubblico che rende la sicurezza privata relegata in un ruolo marginale, lontano dalle logiche di sussidiarietà.

A new global wheat marketmodel (GLOWMM) for the analysis of wheat export prices

Food commodity prices fluctuations have important impacts on poverty and food insecurity across the world. Conventional models have not provided a complete picture of recent price spikes in agricultural commodity markets, while there is an urgent need for appropriate policy responses. Perhaps new approaches are needed in order to better understand international spill-overs, the feedback between the real and the financial sectors and also the link between food and energy prices. In this paper, we present results from a new worldwide dynamic model that provides short and long-run impulse responses of wheat international prices to various real shocks.

Verhaltensphysiologische Experimente zur Erkennung und Unterscheidung menschlicher Gesichter beim Haushund (Canis familiaris)

In der vorliegenden Arbeit wurde die Fähigkeit von Hunden zur Erkennung und Unterscheidung menschlicher Gesichter untersucht. Zu diesem Zweck wurden verschiedene Verhaltensexperimente mit fünf Hunden durchgeführt. Zunächst wurden die Hunde darauf dressiert, ein einlaminiertes DIN A4 Blatt mit einem Gesicht im Zentrum in der dafür vorgesehenen Apparatur mit der Schnauze zu berühren. Bei der Dressur wurden immer zwei Folien präsentiert, wobei nur eine Wahl, nämlich die des Dressurgesichts, durch Futtergabe belohnt wurde. Nach Abschluss der Dressurphase wurden die Hunde in Generalisationstests mit neuen Gesichtern konfrontiert, die für uns Menschen wenig bis keine direkte Ähnlichkeit mit dem Dressurgesicht aufwiesen. Um herauszufinden ob Hunde sich an der Größe orientieren, wurden einige der zuvor getesteten Gesichter um die Hälfte und mehr verkleinert. All diese Veränderungen beeinträchtigten die Fähigkeit der Hunde nicht, das Dressurgesicht bevorzugt zu wählen. Diese Ergebnisse veranlassten die Versuchsleiterin zu testen, ob Hunde sich an verschiedenen Bereichen im menschlichen Gesicht orientieren oder das Gesicht als Ganzes wahrnehmen. Zur Beurteilung wurden den Hunden abgeänderte Gesichter zum Einen ohne Haare und Ohren und zum Anderen nur Haare und Ohren ohne das Gesicht (homogen graue Fläche) präsentiert. Hier hatten die Hunde deutliche Schwierigkeiten, wenn die äußeren Konturen nicht mehr vorhanden waren. Bei diesen Versuchen blieben die Wahlen der Hunde nahe dem Zufallsniveau von 50%. Das Fehlen des Gesichts als solches erwies sich als unproblematisch, da allen Hunden die äußeren Konturen, in diesem Fall Haare und Ohren ausreichten, um das Dressurgesicht mit einer Wahlhäufigkeit signifikant über 70% wiederzuerkennen. Abschließend wurde untersucht, ob sich die Hunde durch das Zusammensetzen von zwei bzw. drei unterschiedlichen Gesichtern in ihrem Wahlverhalten beeinflussen lassen. Dazu wurden zwei unterschiedlichen Haarpartien verschiedene Gesichter zugeordnet. Ähnelten sich die äußeren Konturen fiel es den Hunden in dieser Versuchsreihe schwer die Dressurhaare wieder zu erkennen. Unterschieden sich die äußeren Konturen für unser menschliches Auge deutlich, so wählten alle Hunde die Haare und Ohren des Dressurgesichts mit einer Wahlhäufigkeit signifikant über dem Schwellenwert von 70%. Somit ist zu vermuten, dass sich im Laufe der Domestikation beim Hund keine Hirnregion ausgebildet hat, die speziell für die Gesichtserkennung von Menschen verantwortlich ist. Aus den Ergebnissen dieser Arbeit zur Gesichtserkennung beim Hund wird deutlich, dass es dem Hund möglich ist, Gesichter voneinander zu unterscheiden. Allerdings orientiert sich der Hund nicht an bestimmten Gesichtsregionen, sondern nutzt die äußeren Konturen als Wiedererkennungsmerkmal. Aus diesem Grund finden sich häufig Unsicherheiten bei Hunden, wenn ihnen bekannte Menschen plötzlich mit Hut oder Mütze begegnen und eine Erkennung über den Geruchssinn und die Stimme noch nicht stattgefunden hat. Bei der Beurteilung der Ergebnisse muss beachtet werden, dass den Hunden das menschliche Gesicht in Form von Bildern präsentiert wurde und somit keine Beeinflussung durch Bewegung im Gesicht gegeben war. Da das Bewegungssehen beim Hund sehr gut ausgebildet ist, achtet er im Alltag des Menschen sehr wahrscheinlich außerordentlich gut auf Augenbewegungen und Gesichtsmuskelbewegungen, um mit dem Sozialpartner Mensch zu kommunizieren. Weiterhin wäre es interessant herauszufinden, ob die Orientierung an den äußeren Konturen eine Folge der Domestikation und somit eine Adaptation an den Menschen und sein Ökosystem ist, oder ob Wölfe auch dazu in der Lage wären.

Vulnerability to risk among small farmers in Tajikistan: results of a 2011 survey

Tajikistan is judged to be highly vulnerable to risk, including food insecurity risks and climate change risks. By some vulnerability measures it is the most vulnerable among all 28 countries in the World Bank’s Europe and Central Asia Region – ECA (World Bank 2009). The rural population, with its relatively high incidence of poverty, is particularly vulnerable. The Pilot Program for Climate Resilience (PPCR) in Tajikistan (2011) provided an opportunity to conduct a farm-level survey with the objective of assessing various dimensions of rural population’s vulnerability to risk and their perception of constraints to farming operations and livelihoods. The survey should be accordingly referred to as the 2011 PPCR survey. The rural population in Tajikistan is highly agrarian, with about 50% of family income deriving from agriculture (see Figure 4.1; also LSMS 2007 – own calculations). Tajikistan’s agriculture basically consists of two groups of producers: small household plots – the successors of Soviet “private agriculture” – and dehkan (or “peasant”) farms – new family farming structures that began to be created under relevant legislation passed after 1992 (Lerman and Sedik, 2008). The household plots manage 20% of arable land and produce 65% of gross agricultural output (GAO). Dehkan farms manage 65% of arable land and produce close to 30% of GAO. The remaining 15% of arable land is held in agricultural enterprises – the rapidly shrinking sector of corporate farms that succeeded the Soviet kolkhozes and sovkhozes and today produces less than 10% of GAO (TajStat 2011) The survey conducted in May 2011 focused on dehkan farms, as budgetary constraints precluded the inclusion of household plots. A total of 142 dehkan farms were surveyed in face-to-face interviews. They were sampled from 17 districts across all four regions – Sughd, Khatlon, RRP, and GBAO. The districts were selected so as to represent different agro-climatic zones, different vulnerability zones (based on the World Bank (2011) vulnerability assessment), and different food-insecurity zones (based on WFP/IPC assessments). Within each district, 3-4 jamoats were chosen at random and 2-3 farms were selected in each jamoat from lists provided by jamoat administration so as to maximize the variability by farm characteristics. The sample design by region/district is presented in Table A, which also shows the agro-climatic zone and the food security phase for each district. The sample districts are superimposed on a map of food security phases based on IPC April 2011.

Land use policies and practices for reducing vulnerability in rural Tajikistan

Tajikistan, with 93% of its surface area taken up by mountains and 65% of its labor force employed in agriculture, is judged to be highly vulnerable to risks, including climate change risks and food insecurity risks. The article examines a set of land use policies and practices that can be used to mitigate the vulnerability of Tajikistan’s large rural population, primarily by increasing family incomes. Empirical evidence from Tajikistan and other CIS countries suggests that families with more land and higher commercialization earn higher incomes and achieve higher well-being. The recommended policy measures that are likely to increase rural family incomes accordingly advocate expansion of smallholder farms, improvement of livestock productivity, increase of farm commercialization through improvement of farm services, and greater diversification of both income sources and the product mix. The analysis relies for supporting evidence on official statistics and recent farm surveys. Examples from local initiatives promoting sustainable land management practices and demonstrating the implementation of the proposed policy measures are presented.

The Economics and Nutritional Impacts of Food Assistance Policies and Programs

Recent evidence on malnutrition and poverty raise important questions on the role of food assistance policies and programs. In this review article, we examine evidence on the economic and nutritional impacts of international food assistance programs (FAPs) and policies. The returns on investments in FAPs are, on average, high but depend considerably on the targeting and cost structures as well as on food quality and role of complementary activities. We disaggregate findings into four classes of recipients. Returns to FAPs are highest for children under two. But, FAPs oriented towards early childhood interventions are less well funded than are interventions aimed at school-age children or at the broader, largely adult population even though available evidence indicates that these latter classes of interventions offer considerably lower average returns in economic, health, and nutrition terms. Nonetheless, FAP effectiveness in achieving any of several objectives varies with a range of key factors, including targeting, additionality, seasonality, timeliness, incentive effects, social acceptability and political economy considerations. (C) 2013 Elsevier Ltd. All rights reserved.

On The Choice and Impacts of Innovative International Food Assistance Instruments

The rise of new food assistance instruments, including local and regional procurement, cash, and vouchers, has surpassed increase in understanding of the tradeoffs among and impacts of these options relative to traditional food aid. Response choices rarely appear to result from systematic response analyses. Further, impacts along multiple dimensions-timeliness, cost-effectiveness, local market effects, recipient satisfaction, food quality, impact on smallholder suppliers, etc.-may be competing or synergistic. No single food assistance tool is always and everywhere preferable. A growing body of evidence, including the papers in this special section, nonetheless demonstrates the clear value-added of new food assistance instruments. (C) 2013 Elsevier Ltd. All rights reserved.

Swiss Alps Jungfrau Aletsch UNESCO World Heritage Site - The state of this World Heritage region as a starting point for regional monitoring

The UNESCO listing as World Heritage Site confirms the outstanding qualities of the high-mountain region around the Great Aletsch Glacier. The region of the World Heritage Site now faces the responsibility to make these qualities visible and to preserve them for future generations. Consequently the qualities of the site must not be regarded in isolation but in the context of the entire region with its dynamics and developments. Regional monitoring is the observation and evaluation of temporal changes in target variables. It is thus an obligation towards UNESCO, who demands regular reports about the state of the listed World Heritage assets. It also allows statements about sustainable regional development and can be the basis for early recognition of threats to the outstanding qualities. Monitoring programmes face three major challenges: first, great care must be taken in defining the target qualities to be monitored or the monitoring would remain vague. Secondly, the selection of ideal indicators to describe these qualities is impeded by inadequate data quality and availability, compromises are inevitable. Thirdly, there is always an element of insecurity in the interpretation of the results as to what influences and determines the changes in the target qualities. The first survey of the monitoring programme confirmed the exceptional qualities of the region and also highlighted problematic issues.

Gender and Alcohol Use in Early Modern Augsburg

The use of alcohol in early modern German society was prescribed by carefully structured cultural norms. Drinking, even to the point of drunkenness, was not a sign of insecurity and "disorder" as many historians have claimed. Rather, participation in drinking bouts helped define and enhance men's social status. Drunkenness was therefore tolerated among men as long as they lived up to both the rules and norms of tavern society and the demands of their role as householder. Public drinking was a male prerogative, and drunkenness among women was universally condemned. Nonetheless, when alcohol abuse interfered with the household, women could and did deploy public power to impose limits on men's drinking behaviour.