India's senior citizen's policy and an examination of the life of senior citizens in North Delhi

The paper investigates the ageing situation in India and the development of the government initiatives for the welfare of senior citizens. It also presents the initial results of a survey that the author conducted in 2011 in North Delhi. The main features related to ageing in India are 'feminisation', 'rurality' and 'poverty'. The survey in North Delhi reveals the differences between the male and the female senior citizens, and the vulnerability of the latter, in particular. The social security coverage such as pensions and health insurance was found quite limited among the respondents.

La ruralidad del 15-M. Iniciativas desde el movimiento agroecológico alicantino

La principal imagen del movimiento 15-M viene simbolizada por las acampadas en las plazas de numerosas ciudades españolas, es decir, su apariencia urbana. No obstante, el derecho a la alimentación sana, el consumo responsable, el acceso a la tierra, la conservación de ecosistemas agrarios y la despoblación del medio rural han sido algunas de las temáticas debatidas en el seno del movimiento. Ello demuestra una sustancial preocupación por la cuestión tanto ambiental como agraria, para las cuales se reclaman alternativas desde una perspectiva propiamente rural. Como se pretende hacer ver en este artículo, en el seno del movimiento 15-M las cuestiones urbanas y rurales son indisociables. Entre ellas destaca la reivindicación de la soberanía alimentaria y de la agroecología como horizontes de una transformación en la organización del territorio. En este artículo se sintetizan los aspectos de ruralidad del movimiento 15-M y sus reivindicaciones de carácter social, ambiental y territorial. De manera particular, se consideran las características propias de iniciativas incipientes que se están llevando a cabo en la provincia de Alicante, en el sureste del Estado español, así como de sus interrelaciones con movimientos rurales en el ámbito regional, nacional e internacional.

Cardiovascular disease in Switzerland - health care, mortality and geographical pattern

SUMMARY Switzerland is facing an aging population and a growing amount of patients with chronic diseases. It is crucial to display health care processes and pathways, to identify inequalities and obstacles, and to point out possibilities for improvements of the Swiss health care system (e.g. increase efficiency). The introductory part of the thesis presents a brief description of the Swiss health care system, health services research and regional variation as well as an introduction of CVD and its epidemiological key figures, aetiology and treatments. This is followed by the description of the utilized methods and data, and the objectives of this thesis. The subsequent sections present the four articles included in this thesis. The first article focuses on a small area analysis on regional variation of avoidable hospitalisations in Switzerland including density of primary care physicians and specialists, rurality and hospital supply factors as explanatory variables in the analysis. Lower rates of avoidable hospitalisations were found in areas with very high supply of primary care physicians, increased avoidable hospitalisation rates in areas with more specialists and in areas with higher proportion of rural residents. The second article aims to examine whether emergency patients with acute ST-segment elevation myocardial infarction were adequately treated, i.e. according to the treatment guidelines, in Switzerland. Results show that older and female patients were less likely to receive revascularization which suggests that the treatment guidelines may not be uniformly applied in Switzerland. Similar to the first article, also in the third article a small area analysis was performed but this time investigating regional variation in costs at the end of life. Strongest associations of cost was found with cause of death, age and language region of the decedents. The strong spatial variation of costs could only partly be explained by the included covariates. Article four aims to examine the relationship of distance to different hospital types and mortality from AMI or stroke. We found that AMI mortality in the Swiss population 30 and older and stroke mortality in those 65 and above increased with distance to central and university hospitals, while adjusting for sociodemographic and economic characteristics of the population. The presentation of the four articles is followed by a discussion, which summarizes the main findings and the strengths and limitations of the presented articles. The thesis concludes with a discussion about the challenges for policy, practice and future research.

Comparing Patient-Centered Medical Home Implementation in Urban and Rural VHA Clinics: Results from the Patient Aligned Care Team (PACT) Initiative

Thesis (Master's)--University of Washington, 2016-06

Correlates of depressive symptoms in a representative sample of young Australian women

This paper presents a descriptive analysis of the prevalence of depressive symptoms among a national cohort of young Australian women, and the characteristics of those who experience them. It explores the associations between demographic and health-related variables and depressive symptoms in a representative sample of 9333 Australian women aged 22-27 years, from the Australian Longitudinal Study on Women's Health. Approximately 30% of these young women indicated that they were experiencing depressive symptoms, as indicated by the Center for Epidemiological Studies Depression Scale (CESD-10). After adjusting for age and rurality of residence, depressive symptoms were related to the following demographic variables: low income, low educational qualifications, a history of unemployment, not being in a relationship, and living arrangements other than living with a partner. Those health-related variables that were significantly associated with depressive symptoms included frequent visits to doctors and medical specialists, and a higher number of physical symptoms experienced and diagnoses made. More illicit drug use, higher use of cigarettes and alcohol, and lower exercise status were also significantly associated with depressive symptoms. This analysis supports the view that depression is one aspect of a multifactorial cluster of negative conditions across several domains of functioning, including physical ill-health, risky behaviours, and marginal social status. The complex interactions between these conditions, of which depression is only one, underscore the difficulties that arise in the treatment of depression and support the value of preventive interventions as an important public health strategy.

Menopause, rurlity, and obesity in rural African American women

In the US, one in every eight deaths is due to an obesity-related chronic health condition (ORCHC). More than half of African American women (AAW) 20 years old or older are obese or morbidly obese, as are 63% of menopausal AAW. Many have ORCHC that increase their morbidity and mortality and increase health care costs. In 2013, 42.6 percent of AAs living in South Carolina (SC) were obese. The purpose of this cross-sectional study was to identify the cognitive, behavioral, biological, and demographic factors that influence health outcomes (BMI, and ORCHC) of AAW living in rural SC. A sample of 200 AAW (50 in each of the 4 groups of rurality by menopausal status), 18-64 years, completed the: Menopausal Rating Scale (symptoms); Body Image Assessment for Obesity (self-perception of body); Mental Health Inventory; Block Food Frequency Questionnaire; Eating Behaviors and Chronic Conditions, Traditional Food Habits, and Food Preparation Technique questionnaires — and measures for Body Mass Index. Most rural, and premenopausal AAW were single and not living with a partner. Premenopausal women had significantly higher educational levels. Sixty percent of AAW had between 1 and 5 ORCHC. Most AAW used salt based seasonings, ate deep fried foods 1 to 3 times a week, and ate outside the home 1 to 3 times a month. Few AAW knew the correct daily serving for grains and dairy, and most consumed less than the recommended daily serving of fruits, vegetables and dairy. Morbidly obese AAW used more traditional food preparation techniques than obese and normal-weight AAW. Rural, and menopausal AAW had significantly higher morbid obesity levels, consumed larger portions of meats and vegetables, and reported more body image dissatisfaction than very rural AAW, and premenopausal AAW, respectively. Controlling for socioeconomic factors the relationships between perceptions of body images, psychological distress, and psychological wellbeing remained significant for numbers of ORCHC^

A organização da educação no território federal do Amapá: do "ideal" ao real, do liberal ao conservador (1943-1958)

The present study on “organization education on Amapá’s Federal Territory (1943-1958)”, looked forward to answering the following questions: Was there an educational policy, in a systemic way, on the former Amapá’s federal territory? On the other hand, what were the main initiatives of the first intervenors for the education dissemination? After facing these questions, we established, as hypothesis, that the developed actions in the education’s scope on that territory back in the 40’s and 50’s were not able to implant an educational project in Amapá, since there was no preoccupation to understanding the sociocultural reality of Amapá’s population. Given this hypothesis, we analyzed the relation between the political practices developed by the first intervenor on the territory and the brazilian political scenario, from the legal-administrative nature of the federal entities and political conjuncture of the “New State” (1937-1945). To achieve that, we sought some similarities between Janary Gentil Nunes’s ways of governing and Getúlio Vargas’s political actions. To make this happen, it was necessary to check official documents out, as well as unofficial ones, especially the old articles published by “Amapá”, the local newspaper, official press tool back then, which disseminated the beliefs and values of the constituted authorities, with the purpose of “strengthen” the “modernization” ideal on the people. Such practice was based on the attempt of breaking off sociocultural economic backwardness of the territory, hiding out the reality of the Amapá’s population, marked by poverty, a high illiteracy rate and the typical tropical diseases from Amazon (Malaria). During the rupture’s process between the old and the modern, the education takes on a major role in the official speech, being used as political advertisement and as essential element to the modernization and to the development of a “new man”: now “civilized”. However, the investigation on the expansion of the elementary education in Amapá, showed us the presence of a significant number of rural schools, in contradiction to the disseminated urban modernization promise around there. In this sense, we can affirm that educational policy on Amapá’s territory failed by reasons of being based on the “transplantation” of the Federal District’s educational project, and it is important to recall that, back then, the brazilian Federal District was Rio de Janeiro. Despite the public agents had established uncountable schools on rural areas, these were not carried out from a more systemic process, this is, considering the reality of the Amazon’s "cabloco". So, we observed the existence of the separation between the modern speech and the maintenance of old oligarchic practices by that time.

La institucionalidad rural en Colombia : Reflexiones para su análisis y fortalecimiento

La cuestión rural constituye uno de los grandes desafíos para la institucionalidad en Colombia. La discusión respecto a la eficiencia y eficacia institucional para el sector rural debe adelantarse fundamentada en aspectos coyunturales que a su vez median en la dinámica social, política, cultural, ambiental, económica y productiva en el agro colombiano, entre los cuales se incluyen los tratados comerciales y un eventual posconflicto. La nueva ruralidad, como enfoque para el desarrollo rural, plantea una visión distinta en torno a la temática: concibe lo rural como un espacio multisectorial y multidimensional, lo cual constituye el punto de partida desde el cual surgen los elementos de análisis que permiten adelantar un debate institucional amplio y participativo de cara a la transformación estructural de la realidad rural.

La institucionalidad rural en Colombia : Reflexiones para su análisis y fortalecimiento

La cuestión rural constituye uno de los grandes desafíos para la institucionalidad en Colombia. La discusión respecto a la eficiencia y eficacia institucional para el sector rural debe adelantarse fundamentada en aspectos coyunturales que a su vez median en la dinámica social, política, cultural, ambiental, económica y productiva en el agro colombiano, entre los cuales se incluyen los tratados comerciales y un eventual posconflicto. La nueva ruralidad, como enfoque para el desarrollo rural, plantea una visión distinta en torno a la temática: concibe lo rural como un espacio multisectorial y multidimensional, lo cual constituye el punto de partida desde el cual surgen los elementos de análisis que permiten adelantar un debate institucional amplio y participativo de cara a la transformación estructural de la realidad rural.

La institucionalidad rural en Colombia : Reflexiones para su análisis y fortalecimiento

La cuestión rural constituye uno de los grandes desafíos para la institucionalidad en Colombia. La discusión respecto a la eficiencia y eficacia institucional para el sector rural debe adelantarse fundamentada en aspectos coyunturales que a su vez median en la dinámica social, política, cultural, ambiental, económica y productiva en el agro colombiano, entre los cuales se incluyen los tratados comerciales y un eventual posconflicto. La nueva ruralidad, como enfoque para el desarrollo rural, plantea una visión distinta en torno a la temática: concibe lo rural como un espacio multisectorial y multidimensional, lo cual constituye el punto de partida desde el cual surgen los elementos de análisis que permiten adelantar un debate institucional amplio y participativo de cara a la transformación estructural de la realidad rural.

Teenage motherhood: where you live is also important. A prospective cohort study of 14,000 women

The United Kingdom has among the highest rates of teenage motherhood (TM) in Western Europe. The relationship to individual social and material disadvantage is well established but the influence of area of residence is unclear. We tested for additional TM risks in deprived areas or in cities. The Northern Ireland Longitudinal Study was used to identify 14,055 nulliparous females (15-18). TM risk was measured using multilevel logistic regression, adjusting for health status, religion, family structure, socio-economic status, rurality and employment-based area deprivation. Most variation in TM was driven by individual, household and socioeconomic factors with the greatest proportion of mothers in low value or social rented accommodation. Living in an area with fewer employment opportunities was associated with elevated TM risk (most vs. least deprived, ORadj = 1.98 [1.49, 2.63]), as was urban dwelling (urban vs. intermediate, ORadj = 1.42 [1.13, 1.78]). We conclude that area of residence is a significant independent risk factor for TM. Interventions should be targeted towards the most deprived and urban areas and to those in the lowest value housing.

[The France of margins: a very small population or significance?]

International audience

Ciríaco de Cardoso e O burro do Sr. Alcaide : percursos de formação de um compositor de comédia musical no Portugal finissecular

O principal objetivo deste estudo foi compreender as etapas do percurso artístico do compositor portuense Ciríaco de Cardoso (1846 – 1900) e os discursos em torno de uma das suas obras mais célebres: O burro do Sr. Alcaide (1891). No primeiro capítulo procurou-se identificar e discutir os critérios que estiveram na base das opções profissionais tomadas por Ciríaco. O decurso da sua carreira leva a crer que possuía uma noção profunda das atividades que, no espaço lusófono, apresentavam maior potencial de aquisição quer de capital económico, quer de capital simbólico. É por isso que, mobilizando recursos das suas redes de sociabilidade, circula por instituições no Porto e em Lisboa mas, também, pelo lucrativo mercado teatral do Rio de Janeiro, assim como em Paris. Concentra-se no popular teatro musical – principal fonte de sustento – em paralelo com a atividade concertística e operática – forma de distinção atendendo à competitividade no mercado musico-teatral. Percebe também que a maximização do seu poder simbólico depende da legitimação alcançada pela sua associação às elites socioculturais locais, pelo que fomenta o estabelecimento de sociabilidades que se estendem inclusive às casas reais portuguesa e brasileira. Paradoxalmente, as edes mais próximas de Ciríaco estavam vinculadas a um idealismo republicano, relacionamento que exponencial proliferação de discursos dessa índole pelos media lusófonos (sobretudo a partir do tricentenário camoniano de 1880) e, por outro, pela aparente inexistência de registos que associem inequivocamente o artista ao ativismo republicano. Não obstante, é provável que Ciríaco de Cardoso tenha explorado o filão antimonárquico na programação da temporada de 1891 do Teatro da Avenida. O segundo capítulo explora a produção de O burro do Sr. Alcaide, através da análise da sua estrutura e das relações da obra com a realidade portuguesa da última década do século XIX. Embora respeite o modelo da opereta francesa, apresenta também características que poderão levar a que seja interpretada como transmissora de uma portugalidade idealizada, em linha com o nacionalismo português do último quartel do século. A ação decorre em Lisboa, cenário de interação entre personagens-tipo e caricaturas de personalidades concretas da elite sociopolítica portuguesa. Através de referências ao sebastianismo, satiriza-se o comportamento dessas elites, assim como as instituições da monarquia constitucional e a prevalência de uma visão messiânica dos governantes por parte da sociedade em geral. Faz-se a apologia da ruralidade através de tópicos musicais e de quadros onde se constrói uma imagem da música tradicional, correspondendo a uma idealização da nação – notada e enfatizada na receção pela crítica. Utiliza também outros tópicos pertencentes à paisagem sonora do público burguês, completando a expressão da urbanidade de um país onde essas duas realidades não eram ainda completamente dissociáveis. Contudo, ao não propor alterações efetivas à hierarquia da sociedade portuguesa finissecular, o desfecho da obra leva a concluir que esta terá consistido numa forma de propaganda o que, por um lado, explica o seu mediatismo e, por outro, vincula os seus autores – mais ou menos conscientes disso – às lutas políticas em curso aquando do ano da sua estreia.

Arquitectura e turismo

Dissertação para obtenção do grau de Mestre em Arquitetura, apresentada na Universidade de Lisboa - Faculdade de Arquitetura.