Global, regional, and national levels and causes of maternal mortality during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013

BACKGROUND: The fifth Millennium Development Goal (MDG 5) established the goal of a 75% reduction in the maternal mortality ratio (MMR; number of maternal deaths per 100,000 livebirths) between 1990 and 2015. We aimed to measure levels and track trends in maternal mortality, the key causes contributing to maternal death, and timing of maternal death with respect to delivery. METHODS: We used robust statistical methods including the Cause of Death Ensemble model (CODEm) to analyse a database of data for 7065 site-years and estimate the number of maternal deaths from all causes in 188 countries between 1990 and 2013. We estimated the number of pregnancy-related deaths caused by HIV on the basis of a systematic review of the relative risk of dying during pregnancy for HIV-positive women compared with HIV-negative women. We also estimated the fraction of these deaths aggravated by pregnancy on the basis of a systematic review. To estimate the numbers of maternal deaths due to nine different causes, we identified 61 sources from a systematic review and 943 site-years of vital registration data. We also did a systematic review of reports about the timing of maternal death, identifying 142 sources to use in our analysis. We developed estimates for each country for 1990-2013 using Bayesian meta-regression. We estimated 95% uncertainty intervals (UIs) for all values. FINDINGS: 292,982 (95% UI 261,017-327,792) maternal deaths occurred in 2013, compared with 376,034 (343,483-407,574) in 1990. The global annual rate of change in the MMR was -0·3% (-1·1 to 0·6) from 1990 to 2003, and -2·7% (-3·9 to -1·5) from 2003 to 2013, with evidence of continued acceleration. MMRs reduced consistently in south, east, and southeast Asia between 1990 and 2013, but maternal deaths increased in much of sub-Saharan Africa during the 1990s. 2070 (1290-2866) maternal deaths were related to HIV in 2013, 0·4% (0·2-0·6) of the global total. MMR was highest in the oldest age groups in both 1990 and 2013. In 2013, most deaths occurred intrapartum or postpartum. Causes varied by region and between 1990 and 2013. We recorded substantial variation in the MMR by country in 2013, from 956·8 (685·1-1262·8) in South Sudan to 2·4 (1·6-3·6) in Iceland. INTERPRETATION: Global rates of change suggest that only 16 countries will achieve the MDG 5 target by 2015. Accelerated reductions since the Millennium Declaration in 2000 coincide with increased development assistance for maternal, newborn, and child health. Setting of targets and associated interventions for after 2015 will need careful consideration of regions that are making slow progress, such as west and central Africa. FUNDING: Bill & Melinda Gates Foundation.

Spectacle and publics: Ava Gardner in Australia 1959

Ava Gardner’s famous line about Melbourne being the right place to film a story about the end of the world was part of the spectacle created by the print media to capitalise on her presence here to film, On the Beach in 1959. Gardner’s refusal to appear in public created different responses from the Australian print media the most interesting of which was Melbourne’s The Truth. With the help of a fledgling paparazzi, Truth used Gardner’s non-appearance to create a fictitious image of her which was mediated to create extremes of public opinion in order to generate sales. This paper examines The Truth ’s response to Gardner in the context of the creation and manipulation of public spectacle.

Metade Sul : uma análise das políticas públicas para o desenvolvimento regional no Rio Grande do Sul

A Metade Sul do Rio Grande do Sul, considerando sua extensão territorial e a persistência secular de seu declínio econômico, configura-se como uma das questões de maior complexidade na área regional. Nos últimos anos, diversos estudos foram realizados para compreender os motivos desse baixo dinamismo econômico. Ao mesmo tempo, pressões de políticos locais e da opinião pública motivaram a formulação de diversas ações governamentais desenhadas especificamente com o objetivo de reverter essa situação. O presente trabalho teve como objetivo central destacar e analisar, do ponto de vista da administração pública, os principais programas econômicos concebidos nas últimas duas décadas, direcionados a recuperar economicamente essa região. Baseado nos conceitos teóricos das recentes contribuições no campo da economia regional e utilizando o instrumental de análise de políticas públicas, tornou-se possível compreender a concepção central das políticas adotadas e apresentar novas perspectivas de ação.

Um desafio para a regulação do mercado de assistência à saúde no Brasil: a escolha do consumidor de planos de saúde

The objective of this dissertation is to discover and to analyze the way how the consumer uses his/her perception to decide contracting a health plan, to supply elements that can serve to subsidize the State, the market and the consumers, in relation to the knowledge on the process of choice of the consumer and the decisions of purchase and contracting services of private health. The estimated one is to evidence that the brand of health plan is an important variable and decisive to the consumer contracting the service of a company that operates in these sector, because mean for the consumer security about the product, through the symbolism that the same one represents, despite the consumer not knowing to the certainty what is contracting in quality and amount. The theoretical construction is carried through using literature of anthropology of the consumption, theory of modernity, theory of the regulation, economic utilitarism, and marketing. Moreover, referential specific theoretician on the regulation of the market of health plans in Brazil. The health plan market in Brazil is anti-symmetrical and the consumer doesn¿t have knowledge technician who makes possible it to form judgment and to carry through rationality choices. Than the consumer uses to his/her decision symbolic elements that are available to his/her and supply to his/her the security that is look likes in the consumption of this kind of good. These symbolic elements related the confidence and security and are into the strong brands of the companies and are transmitted to the consumer through the mass media. In this dissertation are used as sources of data some information of the regulatory agency of the sector ¿ ANS -, a research of public opinion with health plans users and the results of the application of proper questionnaires for this research.

Futebol e política: a criação do Campeonato Nacional de Clubes de Futebol

A presente dissertação busca analisar como o Campeonato Brasileiro de Clubes de Futebol – desde sua gênese - está correlacionado com o projeto político do governo militar que chegou ao poder através do golpe civil-militar de 1964. A criação do mesmo está intimamente relacionada à busca de legitimidade do regime, através do crescimento econômico e da formulação de uma intensa propaganda ufanista. A compreensão do cenário político das décadas de 1960 e 1970 é fundamental, uma vez que este tem ligações diretas com as estratégias escolhidas pelos atores envolvidos no processo de criação e consolidação do Campeonato Brasileiro, além de abrir caminhos para questionamentos sobre a relação entre eventos esportivos e seus usos por políticos, já que envolve o entendimento de fenômenos de representação . Com a falência do modelo econômico posto em prática até então, e o consequente início do projeto de distensão, eram necessários novos mecanismos de legitimação do regime, ampliando-se a participação política da população. Nestes dois momentos portanto, – de auge do crescimento econômico e de crise do regime - de forma diferenciada, o Campeonato Nacional pode ser usado para analisar tentativas de cooptação da opinião pública ou mesmo de votos. Como veremos, nem sempre esta tentativa foi bem sucedida.

Extra! Extra!: os jornaleiros e as bancas de jornais como espaço de disputas pelo controle da distribuição da imprensa e da economia política dos meios

Parafraseando Robert Ezra Park, os jornaleiros têm uma história; mas os jornaleiros têm, ainda, uma história natural. A evolução do modelo de distribuição e comercialização de publicações impressas, que culmina nas modernas bancas de jornais, aponta para o tratamento de licenças e concessões para a operacionalização de uma atividade comercial em espaço público urbano. As bancas se constituem, portanto, em um espaço regulado pelo poder público e operacionalizado por iniciativa privada, a título precário. Por que se chegou a este modelo e quais as suas implicações é uma das principais questões abordadas por este trabalho. Entre outros pontos, esta tese tem como objetivo compreender (1) em que medida políticos e homens públicos são capazes de atuar na regulação da liberdade de imprensa através do controle e fiscalização sobre as bancas de jornais; (2) como se dão as articulações dos profissionais vendedores e distribuidores de jornais e revistas diante destas regulações, quais são suas reivindicações comuns e como é construída sua memória em torno destas ações; (3) em que circunstâncias se desenvolvem as negociações entre jornaleiros e homens de imprensa e como estas relações são capazes de ampliar a penetração de determinados impressos junto ao público, atuando de maneira decisiva na conformação da opinião pública; e, finalmente, (4) qual a importância dos jornaleiros e das bancas de jornais e revistas no processo histórico de construção política da opinião sobre a notícia e na apreensão social da informação nas grandes cidades. Nesse sentido, embora evidenciado pelo modelo atual de distribuição adotado pelas principais cidades do país, o papel dos jornaleiros como agentes de fundamental relevância cultural e política na cadeia produtiva dos periódicos impressos tem sido subjugado ante a análises que se concentram nas técnicas ou no discurso jornalístico, quando muito nas cercanias dos estudos de recepção e na apropriação da cultura popular – jamais na investigação sobre esta instituição que silenciosamente tem ocupado nosso imaginário por todos esses anos: as bancas de jornais e revistas.

Domestic violence in Brazil: social problems and legislative interventions

Recent statistical data confirms that domestic violence is a structural problem of exceptional gravity. We analyze the frequent legislative changes in Brazil since 2000 as a result of social pressure for protection of abused women. Only the Law 11.340 of 2006 was well received by lawyers, judges and the public opinion. We present the innovations and peculiarities of this statute and the allegations on unconstitutionality. We discuss cases of judicial review of this law and reject the arguments of unconstitutionality. That notwithstanding, we argue that penalization decisions is the wrong way from a criminological point of view because they do not take into consideration the desires and needs of the victims.

Sacredness of the constitutional text and interpretative heresy: the Brazilian Supreme Court decision on same-sex civil unions

The paper provides a close lecture of the arguments and methods of legal construction, employed in the extensive individual opinions written by the Justices of the Brazilian Supreme Court in the case which authorized the same sex civil union. After tracing an outline of the legal problem and his possible solutions, we analyze the individual opinions, showing their methodological syncretism, the use of legal methods and arguments in a contradictory way as well the deficiencies in the reasoning. The Justices use legal arguments, but do not meet the requirements of rationality in the decision-making. We have a rhetorical attempt that aims to satisfy the public opinion than to offer a comprehensive and coherent solution according the normative elements of the Brazilian Federal Constitution of 1988.

An exploratory study on how to improve the economy of American Samoa

Deep in the South Pacific region about 2,300 miles southwest of the Hawaiian islands1 lies a United States territory that many Americans have never heard of nor known anything about. However, some famous Americans such as Troy Polamalu of the Pittsburgh Steelers, semi retired professional wrestler Dwayne “The Rock” Johnson, and Hawaii Congresswoman Tulsi Gabbard have genealogical roots there. More importantly, many of the Territory’s sons and daughters have served and lost their lives for the United States flag and the cause of freedom around the world. This place is called American Samoa, a collection of seven islands that if glued together would have a total landmass of approximately 76 square miles, just a tad bigger than the capital city of the United States. According to the United States Census Bureau, there were 55,519 residents of American Samoa in 2010.1 The majority of them are ethnic Samoans, a Polynesian sect that traces its history back to early migrants from Southeast Asia who settled the islands around 1500 B.C.2 3 The climate is warm all year long and the forests along the mountains are ripe with vegetation. The main island is Tutuila with its beautiful and coveted landlocked harbor that was used as a coaling station by the United States naval ships during World War II. In fact, it was the Pago Pago Harbor that diminished the impact of the 2009 Tsunami that devastated the Samoan islands by channeling the waters of the Pacific Ocean towards the end of the harbor instead of flooding many other villages surrounding the Pago Pago Bay area. Lives and property were destroyed near the end of the Harbor but it could have been worse for the entire Bay area. Locally grown foods include coconut, taro, banana, guava, sugar cane, papaya, yam, pineapple, and breadfruit. It is completely surrounded by the Pacific Ocean from which the locals obtain a variety of seafood. There is a popular saying in Samoa that goes, “In Samoa, it is impossible to starve 1 American Samoa Department of Commerce, 2012 Statistical Yearbook, http://www.doc.as/wpcontent/uploads/2011/06/2012-Statistical-Yearbook-1.pdf 2 U.S. Census Bureau News, U.S. Census Bureau Releases 2010 Census Population Counts for American Samoa, http://www.census.gov/2010census/news/releases/operations/cb11-cn177.html (Aug. 24, 2011). 3 3 J. Robert Shaffer, American Samoa: 100 Years Under the United States Flag (Honolulu, Hawaii: Island Heritage Publishing, 2000), 34. 4 because people live off of the land’s and the ocean’s abundant resources.” To the west of American Samoa lies a larger group of four islands that make up the Sovereign State of Samoa, which became independent from New Zealand in 1962. Samoa and American Samoa share the same language, culture, and religion but are divided by government and political systems. The focus of this study will be on American Samoa, which became a United States territory in 1900 when the principal chiefs of Tutuila (the largest island in American Samoa) ceded the islands to the United States.

A intervenção estatal sobre o mercado bancário no Brasil por meio dos bancos públicos: a tentativa de redução dos spreads em 2012

As taxas de juros cobradas pelos bancos têm sido alvo constante de críticas por parte da opinião pública e de preocupação por parte do governo. Uma das razões para essas altas taxas, além do nível elevado da taxa básica de juros SELIC, são os altos spreads cobrados pelos bancos. Uma das formas para tentar diminuir esse nível é aumentar a competitividade entre os bancos. Entretanto, uma suposta dificuldade para se atingir um maior nível de competição é o grau de concentração bancária existente hoje no Brasil. Nesse sentido, o governo brasileiro pressionou o mercado bancário para reduzir seus spreads e taxas durante o primeiro semestre de 2012, um período de aparente estabilidade macroeconômica e de forte queda da taxa SELIC. A pressão exercida pelo governo surtiu efeito, inicialmente sobre os bancos públicos, e, posteriormente, sobre os bancos privados, que anunciaram publicamente a redução de taxas para diversas operações. Este trabalho buscou entender as dimensões e origens dos efeitos desse posicionamento do governo sobre os spreads e a rentabilidade dos maiores bancos brasileiros. Como resultado, observou-se a efetividade da atuação governamental na redução do spread ex post, da rentabilidade das operações de crédito (proxy da taxa) e da rentabilidade geral dos bancos públicos e privados. Apesar disso, houve recuo por parte dos bancos privados na concessão de crédito apontando para o poder de mercado dessas instituições e levantando dúvidas sobre a real capacidade da utilização dos bancos públicos para fomentar maior competitividade em um ambiente de incerteza econômica.

Imagens e contra-imagens do estado": considerações sobre a sociedade civil em Gramsci e Habermas

The theme of civil society has resonated significantly in the analysis of social science studies and has long been the center of public opinion, applied to a vast range of contexts, significances and political ideological connotations. Starting with such an unstable theoretical scenario, our research proposal scrutinized two civil society analysis traditions. Embodied by Antonio Gramsci and Jürgen Habermas, these politically conceptual differences are significantly divided into distinct interpretations of the relationship between the state and civil society. On one side, in Gramsci's work, we observe civil society as historically constituted through "molecular expansion of the state", organizing itself during its obligatory constitutive moment. On the other, Habermas shows us a civil society instituted from the structural differentiation process of society developed due to the contradiction existing between the different ways the state administration is organized, the economy and daily social interaction (in which it is found). As a consequence, civil society is no longer seen as a political arena and the hegemonic catalyst of the state, but as a social arrangement destined to increase the viability of the ethical and dialogical reconstruction of social life. It follows that the understanding of the distinctions between both models of civil society become crucial in the measure that they are divided in relation to the delineation of acting agents, fighting strategies, and to the objective of their actions.Despite the existence of analytical dissonance, we intend to outline the common points between both these civil society analysis traditions whose conflicting political action models lead us to a greater understanding of our contemporary political scene. This will be done starting with the systematization of both selected authors' principal categories, and through the introduction of the "contra-hegemonic public sphere" concept

A trajetória dos movimentos socioambientais em Sergipe : personagens, instituições e estratégias de comunicação

The research aimed to study the emergence, role, and the possibilities of environmental movements in Sergipe, running through an analysis of the period between 1983 and 2011. This goal has been guided by the core issue of research, which was to analyze the relationship between the mission, structure and action of environmental organizations in Sergipe. The research arose from the need to map and critically evaluate the environmental movement in Sergipe. The methodological procedures focused on the literature search, survey papers in Sergipe a time gap of 28 years, detailed analysis of nine "movements" and selected in-depth interviews, semi-structured interviews with dozens of social actors involved in the area. In conclusion, we observed that environmentalism in Sergipe, from its inception, was associated with recovery of consciousness regarding the environment, to combat local problems of degradation, and the search for legitimacy of public opinion. Although the environmental movement have been, at times, the attention of mass media, the movement failed to leave the niche and achieve a more representative portion of society. You can still see the deep relationship between the profile of environmental leaders, capital strength and the practical results of the environmental actions and finally, it was observed that the action of the movements has much stronger bond with the relationship of the organization and its main leaders with the other "environmentalist," than with the structure and mission of the institution

Estudo da desidratação osmótica da cenoura (Daucus carota) em fatias

In the area of food dehydration, drying of vegetables has a very representative position, it has the objective to preserve the surplus of crops and began with sun drying. Among the vegetable is the carrot, which had its origin in Southeast Asia and in Brazil is a vegetable cultivated enough. The principal objective of this works is to find alternative ways for the conservation of carrot slices by osmotic dehydration with additional drying in heart. Were initially defined the best conditions of pre-osmotic dehydration (temperature, immersion time, type of osmotic solution) based on the results of humidity loss, solid gain, weight reduction and efficiency ratio of predehydrated carrots slices. The osmotic solutions used were composed by NaCl (10%) and sucrose (50 ° Brix) named DO1 and sucrose (50 ° Brix) called DO2. Was made experiment of pre-osmotic dehydration of carrot slices in two temperature levels, with complementary drying in heart with air circulation at 70 º C. Sensory analysis was performed and the study of slices dehydration osmotically and the slices without osmotic treatment. The best results were obtained with the solution DO1 60°C with immersion time of 60 min. The drying of carrot slices presented period of constant rate and decreasing rate. The osmotic pre-treatment reduced the initial humidity of carrot slices, reducing the time to the product to reach the same humidity content. Fick's model, considering the shrinkage, and the Page s model, adapt satisfactorily to experimental datas, allowing the determination of effective diffusion coefficients, consistent with the references. The results of sensory analysis of dry product, showed greater acceptance of sliced carrots with osmotic treatment

Intelectuais e imprensa: a configuração de uma rede hispano-americana no espaço atlântico

Este artigo trata da configuração de uma rede intelectual de dimensão internacional que uniu a América Latina e a Península Ibérica, a partir de meados do século XIX. Objetivamos analisar o papel dos intelectuais e órgãos de imprensa na formação dessa rede e discutir suas idéias e projetos, à luz do contexto político e do debate cultural. Consideramos que a ação dos intelectuais e da imprensa contribuiu para a configuração de um espaço singular de circulação de idéias e de formação de uma opinião pública ibero-americana.