Política de desenvolvimento e estruturação do espaço regional da área da Bodoquena em Mato Grosso do Sul

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

Social movement, public policy changes and partnerships building for local development

O artigo discute a influência do movimento social rural sobre as mudanças na política de apoio ao pequeno produtor rural e para a criação de parcerias entre o Governo e as Organizações Locais para o desenvolvimento local na Amazônia, em particular no estado do Pará. O objetivo do artigo é examinar a parceria como um resultado de um processo interativo entre as mudanças nas políticas públicas e as demandas dos movimentos sociais. O artigo mostra que embora os movimentos sociais façam parte de uma relação conflituosa entre o Estado e a sociedade civil, tais movimentos no estado do Pará foram uma pré-condição para mudanças na política pública, estrutura de financiamento e prioridades das agencias regionais que resultaram em proposições para cooperação entre o Governo e as Organizações Locais em nível municipal.

Hidrovia e desenvolvimento regional: estudo dos projetos de desenvolvimento dos vales do Tietê e Paraná no Estado de São Paulo

"This paper aims to examine three regional development plans proposed for the region of the valleys of rivers Tietê and Paraná: Rail Project (ISCO, 1994), the Development Plan (CESP, 1996) and Máster Plan (ADTP, 1996). The interest in conducting the study relies on the possibility that it may contribute to the debate on the reshaping of public policy and style necessary to establish a new pattern of regional development in the country"

A comparative analysis of caries and fluorosis among cities with and without public water supply fluoridation in São Paulo State, Brazil

Purpose: This population-based, cross-sectional study aimed to record the DMFT index for 12 year-old children with dental caries and fluorosis levels in cities with and without public water supply fluoridation. Methods: From the 101 municipalities belonging to the Health Regional Department XV (DRSXV-SJRP) of the São Paulo state in the Southeast region of Brazil, 85 cities were selected after exclusion of those with incomplete data and less than ten years of fluoridation treatment in 2004. The criteria adopted for the assessment of dental caries and fluorosis levels were based on the guidelines published in the WHO Manual 4th edition. The data were analyzed using Fisher’s exact tests at a significance level of 5%. Results: The prevalence of caries in 12 year-old children had no significant association with fluoridated water, and was considered “moderate” and “high” in cities without fluoridation and “low” and “moderate” in cities with fluoridation. A significant association was found between water fluoridation and fluorosis (P=0.001), but not between water fluoridation and the DMFT index (P=0.119). Conclusion: The prevalence of fluorosis was related to water fluoridation in this study. However, fluorosis was also observed in non-fluoridated cities, which may result from fluoride intake through other sources.

Participação de gambás e cães domiciliados como reservatórios de Leishmania infantum e Trypanosoma cruzi georreferenciados nos municípios da Regional de Saúde de Três Lagoas - MS

Pós-graduação em Doenças Tropicais - FMB

A nova política nacional de desenvolvimento regional: uma análise sobre as estratégias de desenvolvimento territorial para o Brasil

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Hydrogeologic Setting and Ground-Water Flow Simulations of the Eastern High Plains Regional Study Area, Nebraska

The transport of anthropogenic and natural contaminants to public-supply wells was evaluated in a part of the High Plains aquifer near York, Nebraska, as part of the U.S. Geological Survey National Water-Quality Assessment Program. The aquifer in the Eastern High Plains regional study area is composed of Quaternary alluvial deposits typical of the High Plains aquifer in eastern Nebraska and Kansas, is an important water source for agricultural irrigation and public water supply, and is susceptible and vulnerable to contamination. A six-layer, steady-state ground-water flow model of the High Plains aquifer near York, Nebraska, was constructed and calibrated to average conditions for the time period from 1997 to 2001. The calibrated model and advective particle-tracking simulations were used to compute areas contributing recharge and travel times from recharge areas to selected public-supply wells. Model results indicate recharge from agricultural irrigation return flow and precipitation (about 89 percent of inflow) provides most of the ground-water inflow, whereas the majority of ground-water discharge is to pumping wells (about 78 percent of outflow). Particle-tracking results indicate areas contributing recharge to public-supply wells extend northwest because of the natural ground-water gradient from the northwest to the southeast across the study area. Particle-tracking simulations indicate most ground-water travel times from areas contributing recharge range from 20 to more than 100 years but that some ground water, especially that in the lower confined unit, originates at the upgradient model boundary instead of at the water table in the study area and has travel times of thousands of years.

Hydrogeology, Chemical Characteristics, and Transport Processes in the Zone of Contribution of a Public-Supply Well in York, Nebraska

In 2001, the U.S. Geological Survey, as part of the National Water Quality Assessment (NAWQA) Program, initiated a topical study of Transport of Anthropogenic and Natural Contaminants (TANC) to PSW (public-supply wells). Local-scale and regional-scale TANC study areas were delineated within selected NAWQA study units for intensive study of processes effecting transport of contaminants to PSWs. This report describes results from a local-scale TANC study area at York, Nebraska, within the High Plains aquifer, including the hydrogeology and geochemistry of a 108-square-kilometer study area that contains the zone of contribution to a PSW selected for study (study PSW), and describes factors controlling the transport of selected anthropogenic and natural contaminants to PSWs.

Simulations of Ground-Water Flow, Transport, Age, and Particle Tracking near York, Nebraska, for a Study of Transport of Anthropogenic and Natural Contaminants (TANC) to Public-Supply Wells

The U.S. Geological Survey (USGS) is committed to providing the Nation with credible scientific information that helps to enhance and protect the overall quality of life and that facilitates effective management of water, biological, energy, and mineral resources (http://www.usgs.gov/). Information on the Nation’s water resources is critical to ensuring long-term availability of water that is safe for drinking and recreation and is suitable for industry, irrigation, and fish and wildlife. Population growth and increasing demands for water make the availability of that water, now measured in terms of quantity and quality, even more essential to the long-term sustainability of our communities and ecosystems. The USGS implemented the National Water-Quality Assessment (NAWQA) Program in 1991 to support national, regional, State, and local information needs and decisions related to water-quality management and policy (http://water.usgs.gov/nawqa). The NAWQA Program is designed to answer: What is the condition of our Nation’s streams and ground water? How are conditions changing over time? How do natural features and human activities affect the quality of streams and ground water, and where are those effects most pronounced? By combining information on water chemistry, physical characteristics, stream habitat, and aquatic life, the NAWQA Program aims to provide science-based insights for current and emerging water issues and priorities. From 1991-2001, the NAWQA Program completed interdisciplinary assessments and established a baseline understanding of water-quality conditions in 51 of the Nation’s river basins and aquifers, referred to as Study Units (http://water.usgs.gov/nawqa/studyu.html).

Metropolitan and regional health planning: dilemmas of the Pact for Health in the Baixada Santista Metropolitan Area, Sao Paulo State, Brazil

This paper focuses on the relationship between metropolitan and regional health planning based on the processes of regionalization and the Pact for Health in the Baixada Santista Metropolitan Area, Sao Paulo State, Brazil. The method used was a case study in two stages, namely during initial implementation of the Pact for Health (2007) and the Regional Administration Committees (CGR) and in 2010. Municipal and regional health systems managers and the director of the Metropolitan Agency were interviewed, and records were analyzed from ten years of meetings of the Regional Inter-Administration Committee and the Regional Development Council. Four issues emerged: financing and infrastructure; health services utilization; inefficiency of the Regional Health Administration's instruments and decision-making levels; and the relationship between different levels in the Administration. Metropolitan health management remained as an underlying issue, appearing only incidentally or tangentially to regional management. Despite some limitations, the CGR has been legitimized as a space for regional health management.

Regional and socioeconomic distribution of household food availability in Brazil, in 2008-2009

OBJECTIVE: To describe the regional and socioeconomic distribution of household food availability in Brazil. METHODS: Data from the 2008-2009 Household Budget Survey on food and beverage acquisition for household consumption, conducted by the Instituto Brasileiro de Geografia e Estatistica (Brazilian Institute of Geography and Statistics), were analyzed. The amounts of foods, recorded during seven consecutive days in the 55,970 sample households, were converted into calories and nutrients. Food quality indicators were constructed and analyzed according to the regional and socioeconomic strata of the Brazilian population. RESULTS: The amount of energy from protein was adequate in all regional and socioeconomic strata. On the other hand, an excess of free sugars and fats was observed in all regions of the country, especially in the Southern and Southeastern regions. The proportion of saturated fats was high in urban areas and consistent with the greater contribution of animal-derived products. Limited availability of fruits and vegetables was found in all regions. An increase in the fat content and reduction in carbohydrate content of the diet were observed with the increase in income. CONCLUSIONS: The negative characteristics of the Brazilian diet observed at the end of the first decade of the 21(st) century indicate the need to prioritize public policies for the promotion of healthy eating.

TITANS OF CAPITALISM IN THE MODERNIZATION OF BRAZILIAN TERRITORY: URBAN AND AWARDS PUBLIC ASSISTANCE DURING THE FIRST REPUBLIC (1889-1930)

In Brazil, the newly created Republic expressed interests of the elite increasingly committed to foreign capital. The Rio de Janeiro saw accumulate vast resources in trade and finance, deriving for industrial applications. The city appears as articulator of Brazilian territory and mediation between it and the international market. In the capital of the Republic, the conservative plan would sweep the old city and inaugurate images copied from Europe and installed in the tropics with civilizing purpose. This materialized with infrastructure financing and loans to entrepreneurs in Europe and North America, awarded public service concessions. The project relied on strong support of mayors (members or representatives of the companies involved in the reforms). This work aims to address the relationship between the mayors of Rio de Janeiro during the First Republic and international capital, focusing on strategies for the production of new spaces in motion the modernization of Brazil and its international image.

Regional differences in clinical care among patients with type 1 diabetes in Brazil: Brazilian Type 1 Diabetes Study Group

Background To determine the characteristics of clinical care offered to type 1 diabetic patients across the four distinct regions of Brazil, with geographic and contrasting socioeconomic differences. Glycemic control, prevalence of cardiovascular risk factors, screening for chronic complications and the frequency that the recommended treatment goals were met using the American Diabetes Association guidelines were evaluated. Methods This was a cross-sectional, multicenter study conducted from December 2008 to December 2010 in 28 secondary and tertiary care public clinics in 20 Brazilian cities in north/northeast, mid-west, southeast and south regions. The data were obtained from 3,591 patients (56.0% females and 57.1% Caucasians) aged 21.2 ± 11.7 years with a disease duration of 9.6 ± 8.1 years (<1 to 50 years). Results Overall, 18.4% patients had HbA1c levels <7.0%, and 47.5% patients had HbA1c levels ≥ 9%. HbA1c levels were associated with lower economic status, female gender, age and the daily frequency of self-blood glucose monitoring (SBGM) but not with insulin regimen and geographic region. Hypertension was more frequent in the mid-west (32%) and north/northeast (25%) than in the southeast (19%) and south (17%) regions (p<0.001). More patients from the southeast region achieved LDL cholesterol goals and were treated with statins (p<0.001). Fewer patients from the north/northeast and mid-west regions were screened for retinopathy and nephropathy, compared with patients from the south and southeast. Patients from the south/southeast regions had more intensive insulin regimens than patients from the north/northeast and mid-west regions (p<0.001). The most common insulin therapy combination was intermediate-acting with regular human insulin, mainly in the north/northeast region (p<0.001). The combination of insulin glargine with lispro and glulisine was more frequently used in the mid-west region (p<0.001). Patients from the north/northeast region were younger, non-Caucasian, from lower economic status, used less continuous subcutaneous insulin infusion, performed less SBGM and were less overweight/obese (p<0.001). Conclusions A majority of patients, mainly in the north/northeast and mid-west regions, did not meet metabolic control goals and were not screened for diabetes-related chronic complications. These results should guide governmental health policy decisions, specific to each geographic region, to improve diabetes care and decrease the negative impact diabetes has on the public health system.

Tradition, Change and Variation : Past and Present Trends in Public Old-age Care

The general aim of this dissertation is to describe and analyse how public old-age care in Sweden has developed and changed during the last century. The study applies a provider perspective on how care has been planned and professionally carried out. A broader social policy perspective, studying old-age care at central/national as well as local/municipal level, is also developed. A special focus is directed at the large local variation in care and services for the elderly. The empirical base is comprised of official documents and other public sources, survey data from interviews with elderly recipients of public old-age care, and official statistics on publicly financed and controlled old-age care and services. Study I addresses the development of old-age care in Sweden during the twentieth century by studying an important occupation in this field – the supervisors and their professional roles, tasks and working conditions. Throughout, the roles of supervisors have followed the prevailing official policy on the proper way to provide care for elderly people in Sweden; from poor relief at the beginning of the 1900s, via a generous level of services in the 1960s and 1970s, to today’s restricted and economy-controlled mode of operation. Study II describes and compares two main forms of public old-age care in Sweden today, home help services and institutional care. The care-load found in home-based care was comparable to and sometimes even larger than in service-homes and other institutions, indicating that large care needs among elderly people in Sweden today can be met in their homes as well as in institutional settings. Studies III and IV analyse the local variation in public old-age care in Sweden. During the last decades there has been an overall decline in home help services. The coverage of home help for elderly people shows large differences between municipalities throughout this period, and the relative variation has increased. The local disparity seems to depend more on historical factors, e.g., previous coverage rates, than on the present municipal situation in levels of need or local economy and politics. In an introductory part the four papers are linked together by an outline of the demographic situation and the social policy model for old-age care in Sweden. Trends that have been apparent over time, e.g. professionalisation and market orientation, are traced and discussed. Conflicts between prevailing ideologies are analysed, in regards to for instance home-based and institution-based care, social and medical culture, and local and central levels of decision-making. ’Welfare municipality’, ‘path dependency’, and ‘decentralisation’ are suggested as a conceptual framework for describing the large and increasing local variations in old-age care. Finally, implications of the four studies with regard to old-age care policy and further research are discussed.

Le società pubbliche a partecipazione regionale e locale operanti nei settori dei servizi pubblici locali e dei servizi “strumentali” e quelle con scopo lucrativo: la recente evoluzione legislativa, gli ambiti di attività ed i relativi limiti, le prospettive future.

Con la prima parte, si intende fornire un quadro pressoché esaustivo delle principali disposizioni in materia di società a partecipazione pubblica regionale e locale operanti nel campo dei servizi pubblici locali e della loro interpretazione giurisprudenziale e dottrinale, prendendo le mosse dagli ultimi interventi legislativo. Nella seconda parte, si affronta, invece, il tema dei limiti legislativi alla capacità di azione delle società a partecipazione pubblica e dei connessi dubbi interpretativi, anche alla luce degli orientamenti giurisprudenziali e dottrinali. In particolare, l’analisi riguarda l’art. 13 del decreto”Bersani” e il comma 9 dell’art. 23 bis (ora pedissequamente trasfuso nel comma 33 dell’art. 4 del d.l. n. 138/2011), ossia le principali disposizioni che definiscono, rispettivamente, la capacità di azione delle società (a partecipazione pubblica) strumentali e di quelle operanti nel campo dei servizi pubblici locali titolari di affidamenti diretti (assentiti con modalità diverse dall’evidenza pubblica). Vengono forniti cenni di inquadramento in relazione al cd. procedimento di riordino delle partecipazioni societarie pubbliche previsto dalla legge finanziaria del 2008 (art. 3, commi 27 – 32). Dal combinato disposto delle suddette norme, così come interpretate dalla giurisprudenza costituzionale ed amministrativa, si ricavano, poi, utili indicazioni in ordine alla possibilità, per gli enti pubblici territoriali, di costituire società con scopo meramente lucrativo (ossia, soggetti societari privi del rapporto di strumentalità con gli enti costituenti o partecipanti, chiamati ad operare, in regime di concorrenza, in settori completamente liberalizzati) e società cd. multiutilities (aventi oggetto sociale complesso, la cui attività si estrinseca tanto nel campo dei servizi strumentali, quanto in quello dei servizi pubblici locali), nonché in relazione alla disciplina applicabile all’attività di detti soggetti societari. La finalità ultima del contributo consiste nell'individuazione delle linee guida finalizzate alla classificazione delle società pubbliche in funzione della loro attività.