Barriers related to non-adherence in a mammography breast-screening program during the implementation period in the interior of São Paulo State, Brazil

Mammography is the best exam for early diagnosis of breast cancer. Developing countries frequently have a low income of mammography and absence of organized screening. The knowledge of vulnerable population and strategies to increase adherence are important to improve the implementation of an organized breast-screening program. A mammography regional-screening program was implemented in a place around 54.238 women, aged 40-69 years old. It was proposed to perform biannual mammography free of cost for the women. We analyze the first 2 years of the implementation of the project. Mammography was realized in 17.964 women. 42.1% of the women hadn't done de mammography in their lives and these women were principally from low socio-economic status (OR=2.99), low education (OR=3.00). The best strategies to include these women were mobile unit (OR=1.43) and Family Health Program (OR=1.79). The incidence of early breast tumors before the project was 14.5%, a fact that changed to 43.2% in this phase. Multivariate analysis showed that the association of illiterate and the mobile unit achieve more women who had not performed mammography in their lives. The strategies to increase adherence to mammography must be multiple and a large organization is necessary to overpass the barriers related to system health and education.

Barriers to green buildings at two Brazilian engineering schools

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Programa Município Verdeazul na Bacia do Pardo: avaliação dos fatores condicionantes de eficácia na fase de implementação

Pós-graduação em Planejamento e Análise de Políticas Públicas - FCHS

Acidentes de trabalho em hospital público de alta complexidade no interior paulista: estudo das concepções de segurança

Pós-graduação em Saúde Coletiva - FMB

Condições de acessibilidade na universidade: o ponto de vista de estudantes com deficiência

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

The Ethics of Implementation: Institutional Remedies and the Lawyer's Role

The issue addressed in this article is whether and to what extent a lawyer has an ethical responsibility to pursue implementation of the remedy in institutional reform litigation. Institutional reform litigation refers to cases in which an individual or class of individuals sues a large organization in order to vindicate constitutional or statutory rights. The types of cases with which this article is concerned are the "public law" type, such as school desegregation, prisoners' rights and patients' rights cases, although included under the rubric of institutional reform can be, inter alia, antitrust, reapportionment and bankruptcy cases. The implementation stage of institutional reform litigation arises after an individual or class of individuals prevails at the liability stage, or pursuant to a settlement, and a court orders the defendant organization to change in order to vindicate the plaintiffs' rights. At that point, the defendant organization, whether it be a prison, mental hospital or school district, usually has the burden of implementing the order. One conclusion drawn is that the ethical duty of the lawyer must always be consistent with the lawyer's "special responsibility for the quality of justice."

Use of Natural Vegetative Barriers to Limit Expansion of Blacktailed Prairie Dog Towns

Prairie dog (Cynomys ludovicianus) control has historically consisted of lethal methods to maintain, reduce, or eliminate populations in South Dakota and throughout the species range. Non-lethal methods of control are desired to meet changing management objectives for the black-tailed prairie dog. The use of naturally occurring buffer strips as vegetative barriers may be effective in limiting prairie dog town expansion. The objectives of this study were: 1) to evaluate effective width of vegetative barriers in limiting prairie dog towns expansion in western South Dakota; and 2) to document effect native vegetation height on expansion of prairie dog towns in western South Dakota. Five study sites were established in western South Dakota on rangelands containing prairie dog towns of adequate size. Electric fences were constructed for the purpose of excluding cattle and creating buffer strips of native grasses and shrubs. Prairie dogs were poisoned to create a prairie dog free buffer zone adjacent to active prairie dog towns. Grazing was allowed on both sides of the buffer strip. When grazing pressure was not sufficient, mowing was used to simulate grazing. Buffer strips were 100 meters long and 10, 25, and 40 meters in width. A zero meter control was included on all study sites. Quadrats (25) were randomly distributed throughout the buffer strips. Evaluation of study sites included visual obstruction, vegetation cover, vegetation frequency, vegetation height, and vegetation identification. Barrier penetration was evaluated by the presence of new active burrows behind vegetative barriers. Significant relationships were documented for both VOR and vegetation height. No significant difference was found between frequency of breakthroughs and buffer widths.

ESSAYS ON INTERNATIONAL RESEARCH AND DEVELOPMENT SPILLOVERS

The dissertation consists of three essays on international research and development spillovers. In the first essay, I investigate the degree to which differences in institutional arrangements among Sub-Saharan African countries determine the extent of benefits they derive from foreign research and development spillovers. In particular, I compare the international research and development spillovers for English common law and French civil law Sub-Saharan African countries. I show that differences in the legal origin of the company law or commercial codes in these countries may reflect the extent of barriers they place in the paths of firms that engage in the investment process. To tests this hypothesis, I constructed foreign R&D spillovers variable using imports as weights and employed the endogenous growth framework to estimate elasticities of productivity with respect to foreign R&D spillovers for a sample of 17 English common law and French Civil law Sub-Saharan African countries over the period 1980-2004. My results find support for the hypothesis. In particular, foreign R&D spillovers were higher in the English common law countries than in the French civil law countries. In the second essay, I examine the question of whether technical cooperation grants and overseas development assistance grants induce R&D knowledge spillovers in Sub-Saharan African countries. I test this hypothesis using data for 11 Sub-Saharan African countries over the period 1980-2004. I constructed foreign R&D spillovers using the technical cooperation grants and overseas development assistance grants as weights and employed the endogenous growth framework to provide quantitative estimates of foreign R&D spillover effects in 11 Sub-Saharan African countries. I find that technical cooperation grants and overseas development assistance grants are major mechanisms through which returns to R&D investments in G7 countries flows to Sub-Saharan African countries. However, their influence has declined over the years. Finally, the third essay tests the hypothesis that the relationship between a country's exporters and their foreign purchasing agents may lead to the exchange of ideas and thereby improve the manufacturing process and productivity in the exporting country. I test this hypothesis using disaggregated export data from OECD countries. The foreign R&D capital stock in this essay was constructed as exports weighted average of domestic R&D capital stock. I find empirical support for the hypothesis. In particular, capital goods exports generate more learning effects and therefore best explain productivity in OECD countries than non-capital goods exports.

Effective transport barriers in nontwist systems

In fluids and plasmas with zonal flow reversed shear, a peculiar kind of transport barrier appears in the shearless region, one that is associated with a proper route of transition to chaos. These barriers have been identified in symplectic nontwist maps that model such zonal flows. We use the so-called standard nontwist map, a paradigmatic example of nontwist systems, to analyze the parameter dependence of the transport through a broken shearless barrier. On varying a proper control parameter, we identify the onset of structures with high stickiness that give rise to an effective barrier near the broken shearless curve. Moreover, we show how these stickiness structures, and the concomitant transport reduction in the shearless region, are determined by a homoclinic tangle of the remaining dominant twin island chains. We use the finite-time rotation number, a recently proposed diagnostic, to identify transport barriers that separate different regions of stickiness. The identified barriers are comparable to those obtained by using finite-time Lyapunov exponents.

Shearless transport barriers in magnetically confined plasmas

Shearless transport barriers appear in confined plasmas due to non-monotonic radial profiles and cause localized reduction of transport even after they have been broken. In this paper we summarize our recent theoretical and experimental research on shearless transport barriers in plasmas confined in toroidal devices. In particular, we discuss shearless barriers in Lagrangian magnetic field line transport caused by non-monotonic safety factor profiles. We also discuss evidence of particle transport barriers found in the TCABR Tokamak (University of Sao Paulo) and the Texas Helimak (University of Texas at Austin) in biased discharges with non-monotonic plasma flows.

Institutional arrangements in the emerging biodiesel industry: Case studies from Minas Gerais-Brazil

Connecting (small) family farmers to the emerging biodiesel industry requires careful design of the institutional arrangements between the producers of oil crops and the processing companies. According to institutional economics theory, the design of effective and efficient arrangements depends on production and transaction characteristics, the institutional environment, and the organizational environment supporting the transaction between producers and the industry. This paper presents a comparative study on two cases in the feedstock-for-biodiesel industry in the state of Minas Gerais, Brazil. The two case studies represent the production and transaction system of soybeans (Glycine max L Merrill) and castor beans (Ricinus communis L). Important elements of effective and efficient institutional arrangements are farmer collective action, availability of technical and financial support, and farmer experience with particular crops. (C) 2011 Elsevier Ltd. All rights reserved.

Methodological contributions towards the study of health care production: lessons from a research study on barriers and access in mental health

This article presents methodological contributions and a conceptual innovation for thinking about the production of health care, stemming from a study on access and barriers in mental health carried out in the municipality of Campinas (Sao Paulo, Brazil). The study used a cartographic approach and, after an initial identification of the most complex cases (on the part of the teams of workers), adopted the users as guides to explore the different levels of production of their lives and to evaluate the possibility of forming a network of existential connections that produce life as a fundamental analyzer of access or barriers to care.

Regionalization and access to healthcare in Brazilian states: historical and political-institutional conditioning factors

This article examines the healthcare regionalization process in the Brazilian states in the period from 2007 to 2010, seeking to identify the conditions that favor or impede this process. Referential analysis of public policies and especially of historical institutionalism was used. Three dimensions sum up the conditioning factors of regionalization: context (historical-structural, political-institutional and conjunctural), directionality (ideology, object, actors, strategies and instruments) and regionalization features (institutionality and governance). The empirical research relied mainly on the analysis of official documents and interviews with key actors in 24 states. Distinct patterns of influence in the states were observed, with regionalization being marked by important gains in institutionality and governance in the period. Nevertheless, inherent difficulties of the contexts prejudice greater advances. There is a pressing need to broaden the territorial focus in government planning and to integrate sectorial policies for medium and long-term regional development in order to empower regionalization and to overcome obstacles to the access to healthcare services in Brazil.

The ethical dimension f analyst's interventions facing institutional demands of CAPS

(The ethical dimension f analyst's interventions facing institutional demands of CAPS) Considering the complexities involved in setting up clinical work in the psychosocial field, analyst must question their own contributions toward improvements in this area. This issue is presented here as a considerable challenge, due to the limitations of psychoanalytic practice and, especially, the differences between conventional clinical practice and that carried out in institutional and political settings. From this perspective, we call attention to the notion of ethics as a differentiating and guiding concept for psychoanalytic practice in its contribution toward the treatment provided at CAPS.