894 resultados para Pap test - Social aspects


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Includes bibliography

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We sought to evaluate the performance of diagnostic tools to establish an affordable setting for early detection of cervical cancer in developing countries. We compared the performance of different screening tests and their feasibility in a cohort of over 12,000 women: conventional Pap smear, liquid-based cytology, visual inspection with acetic acid (VIA), visual inspection with Iodine solution (VILI), cervicography, screening colposcopy, and high-risk human papillomavirus (HPV) testing (HR-HPV) collected by physician and by self-sampling. HR-HPV assay collected by the physician has the highest sensitivity (80 %), but high unnecessary referrals to colposcopy (15.1 %). HR-HPV test in self-sampling had a markedly lower (57.1 %) sensitivity. VIA, VILI, and cervicography had a poor sensitivity (47.4, 55, and 28.6 %, respectively). Colposcopy presented with sensitivity of 100 % in detecting CIN2+, but the lowest specificity (66.9 %). Co-testing with VIA and VILI Pap test increased the sensitivity of stand-alone Pap test from 71.6 to 87.1 % and 71.6 to 95 %, respectively, but with high number of unnecessary colposcopies. Co-testing with HR-HPV importantly increased the sensitivity of Pap test (to 86 %), but with high number of unnecessary colposcopies (17.5 %). Molecular tests adjunct to Pap test seems a realistic option to improve the detection of high-grade lesions in population-based screening programs.

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Main objective of the dissertation is to illustrate how social and educational aspects (in close interaction with other multifunctional aspects in organic agriculture) which are developed on different multifunctional organic farms in Italy and Netherlands, as well as established agricultural policy frameworks in these countries, can be compared with the situation in Croatian organics and can contribute to further developent of organic issues in the Repubic of Croatia. So, through different chapters, the dissertation describes the performance of organic agriculture sectors in Italy, Netherlands and Croatia within the national agricultural policy frameworks, it analyzes the role of national institutions and policy in Croatia in connection with Croatia's status of candidate country for enterance into EU and harmonization of legislation with the CAP, as well as analyzes what is the role of national authorities, universities, research centres, but also of private initiatives, NGOs and cooperatives in organic agriculture in Netherlands, Italy and Croatia. Its main part describes how social and educational aspects are interacting with other multifunctional aspects in organic agriculture and analyzes the benefits and contribution of multifunctional activites performed on organic farms to education, healthy nourishment, environment protection and health care. It also assess the strengths and weaknesses of organic agriculture in all researched countries. The dissertation concludes with development opportunities for multifunctional organic agriculture in Croatia, as well as giving perspectives and recommendations for different approaches on the basis of experiences learned from successful EU models accompanied with some personal ideas and proposals.

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This course, then, investigates the effects of integration on European citizens as well as the duality of the EU as a competitive and social model. It is sensitive to the involvement of social groups, protest, and domestic politics in the study of market integration. Some of the questions we explore are: What are the effects of regulatory policy-making on social actors, how do such actors’ strategies and behaviors change as a consequence, and how to they overcome their collective action problems? Why is it that the logic of integration has at times followed a logic of “permissive consensus” while at other times it has been described as a “constraining dissensus”? What is the importance of discourse in domestic politics in order to articulate and legitimate Europeanization? How do European identities change as a consequence of policymaking as well as of protest? To what extent do ordinary Europeans matter in terms of accepting and opposing the project of European integration, how do European citizens in core and peripheral EU states experience Europeanization, and how is their involvement in the integration project to be conceptualized?