Pregnant Adolescents in Vietnam : Social context and health care needs

Background: The number of childbearing adolescents in Vietnam is relatively low but they are more prone to experience adverse outcome than adult women. Reports of increasing rates of abortion and prevalence of STIs including HIV among youth indicate a need to improve services and counselling for these groups. Midwives are key persons in the promotion of young people’s sexual and reproductive health in Vietnam. Aim: The overall aim of this thesis is to describe the prevalence and outcome of adolescent pregnancies in Vietnam (I), to explore the social context and health care seeking behavior of pregnant adolescents (II), as well as to explore the perspectives of health care providers and midwifery students regarding adolescent sexuality and reproductive health service needs (III, IV). Methods: The studies were conducted from 2002 to 2005, combining qualitative and quantitative research methods. A population based prospective survey was used to estimate rates and outcomes of adolescent pregnancies (I). Pregnant and newly delivered adolescents’ experiences of childbearing and their encounters with health care providers were studied using qualitative interviews (II). Health care providers’ perspective on adolescent sexual and reproductive health (ASRH) and views on how to improve the quality of abortion care was explored in focus group discussions (FGD). The values and attitudes of midwifery students about ASRH were investigated using questionnaires and interviews (IV). Descriptive statistics was used to analyse quantitative data (I, IV) and content analysis were applied for qualitative data (II, III, and IV). Findings: Adolescent birth rate was similar to previously reported in Vietnam but lower when compared to other Asian countries. The incidence of stillborn among adolescents was higher than for women in higher reproductive ages. The proportion of preterm deliveries was 20 % of all births, higher than previous findings from Vietnam. About 2 % of the deliveries were home deliveries, more common among women with low education, belonging to ethnic minority and/or living in mountainous areas (I). Ambivalence facing motherhood, pride and happiness but also worries and lack of self-confidence emerged as themes from the interviews; and experience of ‘being in the hands of others’ in a positive, caring sense but also in a sense of subordination in relation to husband, family and health care providers (II). Health care providers at abortion clinics and midwifery students generally disapproved of pre-marital sex, but had a pragmatic view on the need for contraceptive services and counselling to reduce the burden of unwanted pregnancies and abortions for young women. Providers and midwifery students expressed a need for training on ASRH issues (III, IV). Conclusion: Cultural norms and gender inequity make pregnant adolescent women in Vietnam vulnerable to sexual and reproductive health risks. Health care providers experience ethical dilemmas while counselling unmarried adolescents who come for abortion and this has a negative impact on the quality of care. Integrated ASRH in education and training programmes for health care providers, including midwives, as well as continued in-service training on these issues are suggested to improve reproductive health care services in Vietnam.

Utformningen hos toppuniversitets logotyper : en visuell innehållsanalys

Föreliggande studie syftar till att genom en visuell innehållsanalys kartlägga gemensamma drag i 120 universitetslogotypers visuella utformning, samt undersöka samband mellan dessa karaktärsdrag och universitetens internationella rankningsposition.Med utgångspunkt från topprankningslistan Times Higher Education World University Rankings med 400 internationella universitet, indelade i fyra grupper i intervaller om 100 (d.v.s. rankningsposition 1–100, 101–200 etc.), valdes 30 universitet ut per grupp genom ett obundet slumpmässigt urval. Logotyperna för universiteten inhämtades främst från deras grafiska manualer.I studien presenteras förekomsten av generella drag med avseende på färg, typografi, typologi, detaljrikedom samt innehåll och form. Resultatet visade på tydliga gemensamma drag med i regel en till två dominerande karaktärsdrag per kategori. Resultaten tyder dock inte på att universitetens rakningsposition påverkar den visuella utformningen.

To achieve safe and respectful maternity care in tertiary level hospitals in Nepal, relatives are a valued addition to the provision of maternity care

Introduction: The White Ribbon Alliance for safe motherhood believes respectful maternity care is the universal right of every childbearing woman. Methods: NHRC in 2012 approved an inquiry of respectful care at facility-based childbirth. Individual-, focus group interviews and content analysis was used for gathering and analysis of data. Findings: The participating women and the SBAs shared similar views, and this was that together the SBAs and relatives ensured the women remained within the comfort and safety zone when giving birth in a tertiary level maternity unit. Conclusion: The SBAs strategy of having relatives provides basic care alongside the provision of medical care by the SBAs is a strategy that Nepal could use to improve the quality of its maternity care without any additional costs. Clinical implication: Prenatal classes might contribute to preparing relatives. Further Research: Further research could evaluate such a strategy in order to determine its effectiveness in reduction of morbidity and mortality.

User perspectives on the Swedish Maternal Health Care Register

Background: Established in 1999, the Swedish Maternal Health Care Register (MHCR) collects data on pregnancy, birth, and the postpartum period for most pregnant women in Sweden. Antenatal care (ANC) midwives manually enter data into the Web-application that is designed for MHCR. The aim of this study was to investigate midwives? experiences, opinions and use of the MHCR. Method: A national, cross-sectional, questionnaire survey, addressing all Swedish midwives working in ANC, was conducted January to March 2012. The questionnaire included demographic data, preformed statements with six response options ranging from zero to five (0 = totally disagree and 5 = totally agree), and opportunities to add information or further clarification in the form of free text comments. Parametric and non-parametric methods and logistic regression analyses were applied, and content analysis was used for free text comments. Results: The estimated response rate was 53.1%. Most participants were positive towards the Web-application and the included variables in the MHCR. Midwives exclusively engaged in patient-related work tasks perceived the register as burdensome (70.3%) and 44.2% questioned the benefit of the register. The corresponding figures for midwives also engaged in administrative supervision were 37.8% and 18.5%, respectively. Direct electronic transfer of data from the medical records to the MHCR was emphasised as significant future improvement. In addition, the midwives suggested that new variables of interest should be included in the MHCR ? e.g., infertility, outcomes of previous pregnancy and birth, and complications of the index pregnancy. Conclusions: In general, the MHCR was valued positively, although perceived as burdensome. Direct electronic transfer of data from the medical records to the MHCR is a prioritized issue to facilitate the working situation for midwives. Finally, the data suggest that the MHCR is an underused source for operational planning and quality assessment in local ANC centres.

Automatically Adapting Source Code to Document Provenance

Being able to ask questions about the provenance of some data requires documentation on each influence on that data's existence and content. Much software exists, and is being developed, for which there is no provenance-awareness, i.e. at best, the data it outputs can be connected to its inputs, but with no record of intermediate processing. Further, where some record of processing does exist, e.g. as logs, it is not in a form easily connected with that of other processes. We would like to enable compiled software to record useful documentation without requiring prior manual adaptation. In this paper, we present an approach to adapting source code from its original form without manual manipulation, to record information on data provenance during execution.

The Human Figure in Drawing and Sculpture

My project as a Senior Scholar has been the study of the human figure through drawing and sculpture. I have worked directly from the model in order to understand the form and structure of the human body. The result of this concentrated study has been a sharpened sense of vision and an increased confidence in the use of materials for both two and three-dimensional representation.

Responsabilidade corporativa: entre o social e o regulado estudo de um setor da siderurgia brasileira

Este trabalho teve como objetivo analisar as dimensões de responsabilidade corporativa "regulada" e a responsabilidade corporativa "social", explorando o conceito de responsabilidade social em relação às práticas de responsabilidade social e regulada, bem como sua aplicação no ramo siderúrgico brasileiro, especificamente nas seguintes empresas: Companhia Siderúrgica Nacional, CSN e Companhia Siderúrgica Paulista, COSIP A. Em linhas gerais, os resultados chamaram a atenção para o fato de que, em grande parte, o que se vem chamando de responsabilidade social, não passa do cumprimento às determinações legais. Dessa forma, entender a responsabilidade que as empresas têm para o desenvolvimento de uma sociedade requer verificar em que medida as organizações estão contribuindo para um desenvolvimento econômico e social, que leve em conta noções de sustentabilidade e que vão além das determinações pautadas pela legislação vigente. No tratamento dos dados coletados nas entrevistas utilizou-se análise do discurso como uma forma de entender as relações intertextuais e interdiscursivas, ou seja, compreender as disfuncionalidades entre o que se diz e o que se faz. Além disso, serviram de suporte para análise pesquisas documental e bibliográfica do tema em questão.

Princípio republicano, cargo em comissão e clientelismo político nos municípios do estado do Rio de Janeiro: reflexões sobre a profissionalização da função pública no Brasil

A origem do comportamento orientado para a conquista de cargos públicos no Brasil remonta à formação dos primeiros povoados e vilas durante o período colonial. O nepotismo e o clientelismo político perpassam toda a história do País. Tendo como fio condutor o princípio republicano, buscou-se verificar até que ponto são os cargos em comissão utilizados no âmbito dos Municípios do Estado do Rio de Janeiro como estratégia para manter e atualizar práticas clientelísticas como o empreguismo e o nepotismo. A utilização de métodos e técnicas de análise documental e de conteúdo, em dispositivos legais produzidos pelos municípios estudados e em Relatórios de Inspeções Ordinárias neles realizadas pelo Tribunal de Contas do Estado do Rio de Janeiro, permitiu não só o proceder de uma análise qualitativa como o uso de técnicas quantitativas e representações gráficas dos achados, possibilitando uma leitura mais amena àqueles que têm pouco contato com a matéria. Essa complementaridade de métodos permitiu depreender que as ações empreendidas pelos gestores públicos, no que tange à utilização da livre nomeação, encontram-se na contramão da prática da cidadania, do igualitarismo, do respeito ao servir público. A pesquisa atestou que a quase totalidade dos municípios estudados se utiliza dos cargos em comissão de forma totalmente avessa à prevista constitucionalmente, servindo tais cargos, na verdade, para dar ingresso no serviço público a pessoas das relações do administrador, não para assessorá-lo, mas para aumentar renda familiar, cumprir compromissos de campanha e, até mesmo, para, em troca de votos, exercerem funções que por suas características deveriam ser oferecidas em concurso a toda sociedade. O estudo sugere, ao fim, um conjunto de medidas, baseadas em critérios fundamentados em princípios científicos de gestão, visando à valorização do servidor público, à redução do grau de politização da direção da administração pública e da apropriação patrimonialista dos postos de trabalho, à aceleração da profissionalização das funções públicas e a restringir o livre provimento de cargos em comissão, bem como a impingir sanções, por improbidade administrativa, aos que as desrespeitarem. Em que pese à importância de medidas preventivas, orientadas para o desenvolvimento de uma postura no sentido de um autêntico servir público, a tendência à permissividade precisa ser urgentemente afastada.

Valores organizacionais: uma análise no contexto educacional

This research¿s main goal was to analyze the existing relationship between both environmental and organizational values from three State Schools located in the city of Curitiba. These are: Protásio de Carvalho School, Guaíra School and Rio Branco School. At a theoretical empirical reference, an environmental approach has been performed, followed by aspects regarding organizational values, including the discussion on the theme of organizational culture, and, finally, a study on the prevalent values in public educational institutions. The method that best features this research is a comparative case report, with the use of multiple sources of evidence. Secondary data in order to identify the environmental values has been obtained through references of two of the most important newspapers in the State of Paraná, reports published by the State¿s Secretary of Education, publications from the State¿s Teachers Union and through the Educational Legislation in both Federal and State levels. The organizational values have been identified from primary data obtained through semi-structured interviews, performed with the School Principals and through questionnaires distributed to the School Principals and Teachers. The analysis over this data has been carried out in a descriptive-qualitative way by using both documentary and content analysis techniques. The database revealed that there are a few consistencies between environmental and organizational values, in a way that certain values identified in society and in the Government are, several times, more congruent with the values identified in the group of School Principals, whereas the values identified in the Teacher¿s Union have a higher consistency with the prevalent values in the group of teachers. At schools, mainly in the group of teachers, there¿s a noticeable refraction towards actions promoted by the government, and a certain skepticism towards actions promoted by the Teacher¿s Union. The student¿s education is given a higher value than one¿s cognitive education, in the work atmosphere as much as in the organizations; the Society has been gradually taking the responsibility regarding public education, with the support of school boards, teachers, and even of the Government, at a time when teachers, unlike the Society and the Government, appear to give very little value to their own profession.

Models of complexity in Robert Coover's John's wife and the adventures of Lucky Pierre

This doctoral dissertation analyzes two novels by the American novelist Robert Coover as examples of hypertextual writing on the book bound page, as tokens of hyperfiction. The complexity displayed in the novels, John's Wife and The Adventures of Lucky Pierre, integrates the cultural elements that characterize the contemporary condition of capitalism and technologized practices that have fostered a different subjectivity evidenced in hypertextual writing and reading, the posthuman subjectivity. The models that account for the complexity of each novel are drawn from the concept of strange attractors in Chaos Theory and from the concept of rhizome in Nomadology. The transformations the characters undergo in the degree of their corporeality sets the plane on which to discuss turbulence and posthumanity. The notions of dynamic patterns and strange attractors, along with the concept of the Body without Organs and Rhizome are interpreted, leading to the revision of narratology and to analytical categories appropriate to the study of the novels. The reading exercised throughout this dissertation enacts Daniel Punday's corporeal reading. The changes in the characters' degree of materiality are associated with the stages of order, turbulence and chaos in the story, bearing on the constitution of subjectivity within and along the reading process. Coover's inscription of planes of consistency to counter linearity and accommodate hypertextual features to the paper supported narratives describes the characters' trajectory as rhizomatic. The study led to the conclusion that narrative today stands more as a regime in a rhizomatic relation with other regimes in cultural practice than as an exclusively literary form and genre. Besides this, posthuman subjectivity emerges as class identity, holding hypertextual novels as their literary form of choice.

A contribuição do Sistema Integrado de Administração Financeira do Governo Federal (SIAFI) para a promoção da accountability: a percepção dos usuários

Este estudo investiga qual a contribuição do Sistema Integrado de Administração Financeira do Governo Federal (SIAFI) na promoção da accountability da Administração Pública Federal no Brasil, com base na pesquisa documental e na percepção dos usuários do sistema. O modelo de análise da accountability ocorre a partir da investigação das suas definições e dimensões, segundo levantamento do referencial teórico abrangendo o campo da administração pública e da previsão na legislação brasileira. São definidas três dimensões para descrição da accountability: transparência, prestação de contas e responsabilização. Na condução da metodologia, inicialmente essas dimensões foram tratadas pela pesquisa documental, por meio da investigação no SIAFI – Manual Web da existência de mecanismos de accountability, com a aplicação de técnicas voltadas a levantar as expressões e instrumentos do sistema que possibilitam a promoção da accountability. O resultado dessa análise evidenciou funcionalidades, que foram posteriormente escritas na forma de questões de avaliação, segundo escala Likert de 4 pontos, a fim de identificar a eficácia percebida por quatro grupos de usuários do sistema: gestor, operador, agente de controle e agente de investigação. O questionário foi aplicado via internet aos usuários de 128 órgãos do Governo Federal, tendo retornado 287 formulários respondidos. O tratamento e análise dos resultados permitiram observar que o sistema é percebido como eficaz na promoção da accountability, apesar da necessita de melhorias e de treinamento de seus usuários. Além disso, foram identificadas divergências estatisticamente significativas nas respostas dos perfis de usuários, apontando uma não uniformidade nessa percepção segundo a origem do usuário e finalidade de sua relação com o sistema.

Equipes de trabalho na administração municipal: a captação de recursos para o desenvolvimento no município de Natividade/RJ

This thesis aims to identify how teams of at job municipality Natividade influence in raising funds through projects. Was employed research descriptive, explanatory literature and content analysis focused on a qualitative approach, which led to the interpretation of elements detected in field research, aligning them with researched theoretical material . The survey results indicate that the municipal administrators in their departments work of non-integrated form, complicating and compromising the execution of agreements and contracts and causing delays in the progress of processes. It was found that it is necessary investment in technical training, preventive actions and daily monitoring, targeting the correct fulfillment of the requirements for capturing public resources. It is essential to adopt the merit of legitimacy organizational as a mechanism to be able to retain, develop, attract and motivate city officials to work in Project Teams. The main contributions of this study are to provoke reflections on the dynamics of raising public resources for development projects and programs. Was identified a lack of trained technicians and municipal managers to present suitable projects, to identify problems in the implementation of agreements and correct irregularities pointed out in the Ancillary Service Information for Voluntary Transfers - Cauc. It was found that managerial failure causes impacts both in teams of job, as in the progress of the municipality. Keywords: work teams, fundraising, projects.

Controles sobre o Judiciário geram governança e eficiência? Estudo sobre o CNJ e a Justiça Estadual

O objetivo desta tese é investigar a atuação do órgão de controle judicial no Poder Judiciário, focando na dimensão “Desempenho Administrativo Judicial”. Esta tese visa complementar o modelo de Taylor (2008) adicionando o CNJ como um elemento da melhoria do desempenho dos tribunais, por meio da implantação de ferramentas gerenciais e ocasionando impactos políticos e institucionais. O estudo se apoia no contexto político e organizacional do Judiciário para apresentar um complemento ao entendimento vigente sobre os mecanismos de mensuração de desempenho. Os impactos do CNJ foram analisados a partir de sete aspectos do processo de Reforma do Judiciário: 1. Padronização das estruturas; 2. Sistemas de gerenciamento centralizados; 3. Padronização de procedimentos internos; 4. Centralização orçamentária; 5. Financiamento de unidades judiciais; 6. Procedimentos disciplinar contra irregularidades e más condutas de magistrados; 7. Critérios meritocráticos e promoção de magistrados. Os dados foram coletados por meio de entrevistas estruturadas com ex-conselheiros e conselheiros atuais do CNJ e considerou os dez anos de existência do CNJ (2004-2013), fornecendo uma perspectiva longitudinal. A análise temática ou categorial foi escolhida como a principal da técnica de análise de conteúdo. Os dados foram segmentados por questões, por categorias prévias e por categorias estabelecidas posteriormente. Foi evidenciado que o CNJ apresenta um efeito direto de atuação no “Desempenho Administrativo Judicial”: i) usando ferramentas de gestão que permitem os tribunais aprimorar a organização interna e elevar o nível de maturidade de governança; ii) moralizando e fiscalizando os Tribunais por meio de inspeções frequentes realizadas pela Corregedoria Nacional de Justiça que objetiva a resolução das irregularidades e o afastamento dos magistrados com más condutas no exercício do cargo. As evidências identificaram também impactos indiretos: i) o CNJ como um coordenador de ações do Judiciário, articulando melhor as relações com os representantes do Executivo e do Legislativo na obtenção de mais recursos orçamentários e financeiros para os tribunais; ii) o CNJ aumenta a autonomia do Judiciário reconhecendo os esforços de gestão dos tribunais e compartilhando as melhores práticas com os outros tribunais, com impactos na melhoria de infraestrutura e no desempenho. O aumento de controle promovido pelo CNJ reforçou a governança e a eficiência dos tribunais, mas com perca de autonomia num primeiro momento. Por outro lado, num segundo momento, possibilitou uma mudança de perfil nas indicações de seus conselheiros numa tentativa de enfraquecer o controle e aumentar autonomia dos tribunais.

Alasdair Gray`s 1982 Janine (1984): a postmodernist scottish novel

Alasdair Gray is now an established figure in the Scottish literary scene and has numerous claims to be considered an important voice writing in English. First Lanark: A Life in Four Books (1981) and then 1982 Janine (1984) contributed to the recognition of Gray as one of the founding fathers of the new Scottish writing and as a figure of importance in international contemporary fiction due to his innovative, experimental and postmodernist novels. As the title of this dissertation - “Alasdair Gray’s 1982 Janine (1984): A Postmodernist Scottish Novel” - suggests, it aims at analysing the author’s second novel, 1982 Janine (1984), in a thematic and formal perspective, in order to justify the choice of the terms - Postmodernist and Scottish - to classify this novel. 1982 Janine projects a world through Jock McLeish’s mind and is a powerful stream-of-consciousness narrative. Jock is an alcoholic who lives a personal crisis and, therefore, tries to escape from his depressing reality through sexual fantasies and political diatribes. During a single night in a Scottish hotel room, he drinks and dreams, and spends the whole night alone with his fantasies and fears, his memories and hopes. In Chapter 11, the most daring experimental section of the novel, Jock attempts to commit suicide by taking an overdose of tablets with alcohol but fails. Following this, he decides to review his life and make for a new beginning; the novel thus closing with an optimistic note. Also, the narrative is based on a constant interweaving of sex fantasy with political satire, that is, it is through his protagonist that Gray manages to convey the state of Scotland as well as the concerns and aspirations of the Scottish people and then, proceed to a political and social critique. This dissertation appears structured in three chapters. In Chapter I - “Alasdair Gray: A Postmodernist Scottish Writer” - I present Gray as a powerful postmodernist writer who also sees himself as a Scottish author, and more particularly as a Glaswegian, who concentrates on Scottish subject matter in his literary work. In a first section, I offer a brief survey of the Scottish literary scene from the fourteenth to the twentieth century, in order to understand Gray’s choice of setting and themes and to check his influence or indebtedness to previous Scottish authors. As 1982 Janine is also a good example of selfconscious experimental writing, in a second section, I present various seminal fictional works that introduced and developed experimentalism in British fiction, in order to evaluate the influence of modernist developments in form and technique on recent experimental writing. The third section consists of an introduction to Gray’s work for he is not only a novelist, but also an artist, a playwright, a poet, an activist and a scholar. Chapter II - “Postmodernist Features in 1982 Janine” - aims at listing and examining the postmodernist devices that the novel includes, in what content and form are concerned. On the one hand, the use of a developed type of the modernist stream of consciousness, the presence of a protagonist who feels entrapped in a specific system, the quest for freedom, the incoherence and fragmentation of time, the nonchronological order of the narrative, the blending of fantasy and “reality”, as well as the importance of the Scottish material are definitely current aspects within postmodernist literature that can be found in Gray’s novel. On the other hand, the handling of literary self-conscious devices, such as typographical experimentation, presence of metafiction and intertextuality, and inclusion of an Epilogue, are likewise among recurrent postmodernist features. As the title - “A Narratological Analysis of 1982 Janine” - evidences, Chapter III offers a description of the mechanics of the narrative and its functioning in order to better understand the narrative technique of postmodernist fiction. This study is based primarily on Gérard Genette’s theoretical framework and terminology, presented in Narrative Discourse: An Essay in Method, an analytical tool that allows me to provide a more objective and scientific analysis. Hence, I follow the Genettian division of narrative discourse in Time, Mood and Voice while examining the novel. Finally, I proceed to a description of the intertextual relationships 1982 Janine establishes with other texts.

Ação pública na formação e transformação do destino turístico de Porto de Galinhas: um estudo dos referenciais no período de 1970 a 2010

The central interest of this thesis is to comprehend how the public action impels the formation and transformation of the tourist destinies. The research was based on the premise that the public actions are the result of the mediation process of state and non-state actors considered important in a section, which interact aiming for prevailing their interests and world visions above the others. The case of Porto de Galinhas beach, in Pernambuco, locus of the investigation of this thesis, allowed the analysis of a multiplicity of actors on the formation and implementation of local actions toward the development of the tourism between the years 1970 and 2010, as well as permitted the comprehension of the construction of the referential on the interventions made. This thesis, of a qualitative nature, has as theoretical support the cognitive approach of analysis of the public policies developed in France, and it has as main exponents the authors Bruno Jobert and Pierre Muller. This choice was made by the emphasis on the cognitive and normative factors of the politics, which aspects are not very explored in the studies of public policies in Brazil. As the source of the data collection, documental, bibliographic and field researches were utilized to the (re)constitution of the formation and transformation in the site concerned. The analysis techniques applied were the content and the documental analysis. To trace the public action referential, it started by the characterization of the touristic section frontiers and the creation of images by the main international body: the World Tourism Organization, of which analysis of the minutes of the meetings underscored guidelines to the member countries, including Brazil, which compounds the global-sectorial reference of the section. As from the analysis of the evolution of the tourism in the country, was identified that public policies in Brazil passed by transformations in their organization over the years, indicating changes in the referential that guided the interventions. These guidelines and transformations were identified in the construction of the tourist destination of Porto de Galinhas, of which data was systematized and presented in four historical periods, in which were discussed the values, the standard, the algorithms, the images and the important mediators. It has been revealed that the State worked in different roles in the decades analyzed in local tourism. From the 1990s, however, new actors were inserted in the formulation and implementation of policies developed, especially for local hotelkeepers. These, through their association, establishes a leadership relation in the local touristic section, thereby, they could set their hegemony and spread their own interest. The leadership acquired by a group of actors, in the case of Porto de Galinhas, does not mean that trade within the industry were neutralized, but that there is a cognitive framework that confronts the actors involved. In spite of the advances achieved by the work of the mediators in the last decades, that resulted in an amplification and diversification of the activity in the area, as well as the consolidation at the beach, as a tourist destiny of national standout, the position of the place is instable, concerned to the competitiveness, once that there is an situation of social and environmental unsustainability