Global processes, local strategies : migration of educated Dominicans.

The aim of this thesis is to examine migration of educated Dominicans in light of global processes. Current global developments have resulted in increasingly global movements of people, yet people tend to come from certain places in large numbers rather than others. At the same time, international migration is increasingly selective, which shows in the disproportional number of educated migrants. This study discovers individual and societal motivations that explain why young educated Dominicans decide to migrate and return. The theoretical framework of this thesis underlines that migration is a dynamic process rooted in other global developments. Migratory movements should be seen as a result of interacting macro- and microstructures, which are linked by a number of intermediate mechanisms, meso-structures. The way individuals perceive opportunity structures concretises the way global developments mediate to the micro-level. The case of the Dominican Republic shows that there is a diversity of local responses to the world system, as Dominicans have produced their own unique historical responses to global changes. The thesis explains that Dominican migration is importantly conditioned by socioeconomic and educational background. Migration is more accessible for the educated middle class, because of the availability of better resources. Educated migrants also seem less likely to rely on networks to organize their migrations. The role of networks in migration differs by socioeconomic background on the one hand, and by the specific connections each individual has to current and previous migrants on the other hand. The personal and cultural values of the migrant are also pivotal. The central argument of this thesis is that a veritable culture of migration has evolved in the Dominican Republic. The actual economic, political and social circumstances have led many Dominicans to believe that there are better opportunities elsewhere. The globalisation of certain expectations on the one hand, and the development of the specifically Dominican feeling of ‘externalism’ on the other, have for their part given rise to the Dominican culture of migration. The study also suggests that the current Dominican development model encourages migration. Besides global structures, local structures are found to ve pivotal in determining how global processes are materialised in a specific place. The research for this thesis was conducted by using qualitative methodology. The focus of this thesis was on thematic interviews that reveal the subject’s point of view and give a fuller understanding of migration and mobility of the educated. The data was mainly collected during a field research phase in Santo Domingo, the Dominican Republic in December 2009 and January 2010. The principal material consists of ten thematic interviews held with educated Dominican current or former migrants. Four expert interviews, relevant empirical data, theoretical literature and newspaper articles were also comprehensively used.

Global Processes, Local Strategies : migration of educated Dominicans.

The aim of this thesis is to examine migration of educated Dominicans in light of global processes. Current global developments have resulted in increasingly global movements of people, yet people tend to come from certain places in large numbers rather than others. At the same time, international migration is increasingly selective, which shows in the disproportional number of educated migrants. This study discovers individual and societal motivations that explain why young educated Dominicans decide to migrate and return. The theoretical framework of this thesis underlines that migration is a dynamic process rooted in other global developments. Migratory movements should be seen as a result of interacting macro- and microstructures, which are linked by a number of intermediate mechanisms, meso-structures. The way individuals perceive opportunity structures concretises the way global developments mediate to the micro-level. The case of the Dominican Republic shows that there is a diversity of local responses to the world system, as Dominicans have produced their own unique historical responses to global changes. The thesis explains that Dominican migration is importantly conditioned by socioeconomic and educational background. Migration is more accessible for the educated middle class, because of the availability of better resources. Educated migrants also seem less likely to rely on networks to organize their migrations. The role of networks in migration differs by socioeconomic background on the one hand, and by the specific connections each individual has to current and previous migrants on the other hand. The personal and cultural values of the migrant are also pivotal. The central argument of this thesis is that a veritable culture of migration has evolved in the Dominican Republic. The actual economic, political and social circumstances have led many Dominicans to believe that there are better opportunities elsewhere. The globalisation of certain expectations on the one hand, and the development of the specifically Dominican feeling of ‘externalism’ on the other, have for their part given rise to the Dominican culture of migration. The study also suggests that the current Dominican development model encourages migration. Besides global structures, local structures are found to ve pivotal in determining how global processes are materialised in a specific place. The research for this thesis was conducted by using qualitative methodology. The focus of this thesis was on thematic interviews that reveal the subject’s point of view and give a fuller understanding of migration and mobility of the educated. The data was mainly collected during a field research phase in Santo Domingo, the Dominican Republic in December 2009 and January 2010. The principal material consists of ten thematic interviews held with educated Dominican current or former migrants. Four expert interviews, relevant empirical data, theoretical literature and newspaper articles were also comprehensively used.

Profitability and the poor: corporate strategies, innovation and sustainability

Based on empirical evidence, the article looks at the implications of private sector participation (PSP) for the delivery of water supply and sanitation to the urban and peri-urban poor in developing countries, with particular reference to Africa and Latin America. More precisely, the article addresses the impact produced by multinational companies’ (MNCs) strategies, in light of the pursuit of profitability, on the extension of connections to the pipeline network. It does so by questioning the assumptions that greater private sector efficiency and innovation, together with contract design, will enable the sustainable extension of service coverage to low income dwellers. The strategies of the major water MNCs are considered both in relation to the global expansion of their operations and the adjustment of local strategies to commercial considerations. The latter might result in identifying proWtable markets, modifying contractual provisions, attempting to reduce costs and increase income, reducing risks and exiting from non-performing contracts. The evidence reviewed allows for re-assessing the relative roles of the public and private sectors in extending and delivering water services to the poor. First, the most far reaching innovative approaches to extending connections are more likely to come from communities, public authorities and political activity than from MNCs. Secondly, whenever MNCs are liable to exit from non-profitable contracts, the public sector has no other option than to deal with external risks aVecting continuity of provision. Finally, market limitations affecting MNCs’ ability to serve marginal populations and access cheap capital do not apply to well-organised, politically led public sector undertakings

Provider diversity in the English NHS: a study of recent developments in four local health economies

Objectives: The overall objective of the research was to assess the impact of provider diversity on quality and innovation in the English NHS. The aims were to map the extent of diverse provider activity, identify the differences in performance between Third Sector Organisations (TSOs), for-profit private enterprises, and incumbent organisations within the NHS, and the factors that affect the entry and growth of new private and TSOs. Methods: Case studies of four Local Health Economies (LHEs). Data included: semi-structured interviews with 48 managerial and clinical staff from NHS organizations and providers from the private and Third Sector; some documentary evidence; a focus group with service users; and routine data from the Care Quality Commission and Companies House. Data collection was mainly between November 2008 and November 2009. Results: Involvement of diverse providers in the NHS is limited. Commissioners’ local strategies influence degrees of diversity. Barriers to the entry for TSOs include lack of economies of scale in the bidding process. Private providers have greater concern to improve patient pathways and patient experience, whereas TSOs deliver quality improvements by using a more holistic approach and a greater degree of community involvement. Entry of new providers drives NHS Trusts to respond by making improvements. Information sharing diminishes as competition intensifies. Conclusions: There is scope to increase the participation of diverse providers in the NHS, but care must be taken not to damage public accountability, overall productivity, equity and NHS providers (especially acute hospitals, which are likely to remain in the NHS) in the process.

National climate policies across Europe and their impacts on cities strategies

Globally, efforts are underway to reduce anthropogenic greenhouse gas emissions and to adapt to climate change impacts at the local level. However, there is a poor understanding of the relationship between city strategies on climate change mitigation and adaptation and the relevant policies at national and European level. This paper describes a comparative study and evaluation of cross-national policy. It reports the findings of studying the climate change strategies or plans from 200 European cities from Austria, Belgium, Estonia, Finland, France, Germany, Ireland, Italy, Netherlands, Spain and the United Kingdom. The study highlights the shared responsibility of global, European, national, regional and city policies. An interpretation and illustration of the influences from international and national networks and policy makers in stimulating the development of local strategies and actions is proposed. It was found that there is no archetypical way of planning for climate change, and multiple interests and motivations are inevitable. Our research warrants the need for a multi-scale approach to climate policy in the future, mainly ensuring sufficient capacity and resource to enable local authorities to plan and respond to their specific climate change agenda for maximising the management potentials for translating environmental challenges into opportunities.

Mediators of physical activity behavior change among women with young children

Background Women with children are less likely to engage in adequate physical activity (PA) than women without children. This study aimed to evaluate the efficacy of two strategies for promoting increased PA among mothers of preschool-aged children, and to explore the mediators of any resulting change in PA behavior. Design Controlled intervention trial incorporating repeated data collection from 554 women, randomized to one of three experimental conditions. Intervention Group 1 served as a control, while women in Groups 2 and 3 were given print information about overcoming PA barriers. Women in Group 3 were also invited to discuss the development of local strategies for the promotion of PA among mothers of young children. The primary strategies included increasing partner support, social advocacy, and capacity building, and were implemented through collaboration among participants, researchers, and community organizations. Main Outcome Measures Adequate physical activity (PA), self-efficacy (SE) and partner support (PS). Results: Following the intervention, women in Group 3 were significantly more likely to meet guidelines for PA than controls (odds ratio [OR]=1.71, confidence interval [CI]=1.05–2.77)] after controlling for age and PA at baseline. After controlling for baseline PA, residualized change in SE (OR=1.86, CI=1.17–2.94) and PS (OR=2.29, CI=1.46–3.58) significantly predicted meeting guidelines. After controlling for residual change in PS and SE, the significant intervention effect was attenuated (Group 3 OR=1.40, CI=0.76–2.36), indicating that partner support and self-efficacy may be mediators of physical activity behavior change. Conclusions The findings indicate that community participation approaches that facilitate increased self-efficacy and partner support can be effective in increasing PA among mothers of young children.

Archeologia amerykańska w świetle zarządzania dziedzictwem kulturowym: geneza, prawo, praktyka

Wydział Historyczny: Instytut Archeologii

Stakeholder participation in sustainable forest management in fire-prone areas

Os incêndios florestais, associados ao abandono do espaço rural, a pequena propriedade florestal e o desinteresse e o absentismo dos proprietários florestais têm sido apontados como fatores que têm afetado a sustentabilidade das florestas em Portugal. Apesar da formulação de políticas e de instrumentos de planeamento e de gestão florestal para lidar com estes constrangimentos, são ainda escassos os progressos para uma Gestão Florestal Sustentável. A nível internacional e europeu, a participação dos agentes já representa um aspeto-chave no processo de definição e de implementação de estratégias que promovam a multifuncionalidade da floresta, mas também se adeqúem às necessidades e aos interesses dos agentes locais. A temática da tese esteve focada nesta discussão, argumentando que existe uma escassa participação dos agentes nos processos de tomada de decisão relativos ao setor florestal. O principal objetivo da investigação foi o desenvolvimento de uma metodologia participativa para a discussão e negociação de estratégias locais para a Gestão Florestal Sustentável, que maximizem o potencial produtivo e o papel sócio-ambiental das florestas, diminuam o risco de incêndio e promovam o crescente interesse e participação dos agentes locais na gestão florestal. A tese está estruturada em três partes. A primeira parte apresenta uma avaliação do sector florestal nacional, com base numa revisão bibliográfica e numa comparação de indicadores, políticas e instrumentos de planeamento e gestão florestal (Capítulo 2) e com base num estudo de perceção social desenvolvido numa área de estudo localizada na região Centro de Portugal. Este estudo analisa as perceções técnicas (decisores políticos e técnicos) e sociais (proprietários florestais e outros membros da comunidade local) sobre as florestas, a gestão florestal e os incêndios florestais (Capítulo 4). As ‘Zonas de Intervenção Florestal’, enquanto ferramenta recente para a cooperação e organização dos proprietários e produtores florestais, foram também analisadas (Capítulo 3). A segunda parte da tese é dedicada à análise de processos de participação pública, com base numa revisão bibliográfica sobre os benefícios, níveis, abordagens e métodos de participação (Capítulo 5) e numa avaliação de processos de participação pública desenvolvidos em Portugal (Capítulo 6). A terceira parte da tese foca-se no desenho e no teste da metodologia participativa proposta no âmbito desta tese (Capítulo 7) e na formulação de algumas orientações para melhoria dos processos participativos na gestão florestal (Capítulo 8). Os resultados confirmaram a centralidade dos incêndios florestais e dos fatores associados ao contexto socioeconómico (e.g. despovoamento e envelhecimento populacional, absentismo, falta de gestão florestal, estrutura fundiária) como os principais problemas que afetam a floresta na região Centro de Portugal. A organização e cooperação dos proprietários florestais emergiu como solução possível para lidar com estas ameaças e promover a multifuncionalidade da floresta, sendo essencial aumentar o conhecimento e a participação dos agentes nas decisões associadas à floresta. É proposta uma ferramenta para esta participação, centrada no contexto local e facilmente utilizável por todos os agentes. A implementação da metodologia participativa revelou o seu potencial no desenvolvimento de uma participação equitativa e inclusiva dos múltiplos agentes.

Assessing soil erosion due to land use change at the Alqueva reservoir surrounding area

Tese de doutoramento, Ciências do Mar, da Terra e do Ambiente, Faculdade de Ciências e Tecnologia, Universidade do Algarve, 2015

Reclamações dos utentes : estudo dos resultados e medidas correctivas no contexto dos Agrupamentos de Centros de Saúde de Lisboa e Vale do Tejo

RESUMO - A qualidade dos cuidados de saúde, evolui ao longo dos tempos e é agora considerada um direito e um pilar fundamental nos serviços de saúde. As reclamações dos utentes podem revelar informação acerca das experiências entre os utentes e as organizações de saúde. Desta forma as reclamações podem ser consideradas como indicadores de qualidade que permitem identificar áreas e/ou oportunidades de melhoria, e de grande representatividade no processo da melhoria contínua da qualidade na saúde. Sendo fundamental dar voz aos utentes do SNS e possibilitar a sua participação activa no processo de melhoria da prestação dos cuidados de saúde, com este trabalho pretendeu-se estudar a forma como as reclamações dos utentes nos ACES na Região de Saúde de Lisboa e Vale do Tejo, contribuem para a melhoria da qualidade nos referidos serviços de saúde. Foram reconhecidas e analisadas as principais causas de reclamação, as correspondentes medidas correctivas e as necessidades e/ou dificuldades no seu processo de implementação, bem como a respectiva avaliação dos resultados obtidos e identificação das recomendações dos Coordenadores dos Gabinetes do Utente no âmbito dos ACES da Região de Saúde de LVT. Efectuou-se a análise de revisão bibliográfica e a consulta dos dados, desagregados, das causas mais mencionadas nas reclamações no âmbito do estudo e foram realizados contactos informais com a estrutura regional e nacional do Sistema SIM-Cidadão. Foram aplicados 15 questionários aos Coordenadores Locais dos Gabinetes do Cidadão dos ACES da ARSLVT, apresentando a investigação um carácter exploratório e qualitativo. Os questionários, foram enviados e recebidos anonimamente através da plataforma para estudos estatísticos Survey Monkey. A sua análise e interpretação, foi efectuada de forma a organizar os seus dados de uma forma sistematizada e permitir categorizar a informação para permitir a sua análise. Os resultados evidenciaram que as reclamações dos utentes apresentadas nos Gabinetes do Cidadão, de certa forma, foram um contributo para o processo da melhoria da qualidade nos ACES da Região de Saúde de Lisboa e Vale do Tejo através do adopção de medidas e acções correctivas, ultrapassando algumas limitações devida à criação de estratégias locais. No entanto foi evidente que algumas limitações não foram passiveis de ser ultrapassadas, pois envolvem decisões do âmbito externo aos ACES. Os resultados alcançados e as recomendações dos Coordenadores, podem evidenciar algumas mudanças organizacionais, mas transparecem a ideia de que existe ainda um longo caminho a percorrer.

Évaluation du processus : analyse de l’évaluabilité et de la mise en œuvre d’une stratégie d’amélioration de la couverture vaccinale au Burkina Faso.

La vaccination qui est le sujet sur lequel porte cette recherche est une des questions de santé publique les plus importantes; elle fait néanmoins l’objet de nombreuses controverses. Dans le contexte de cette thèse, c’est plutôt l’accès à la vaccination qui est mis en question. La présente recherche vise à analyser une stratégie d’amélioration de la couverture vaccinale à l’aide d’une évaluation de processus extensive en trois étapes faisant suite à une documentation approfondie du contexte. En effet, la recherche analyse les perceptions et les facteurs d’influence de la couverture vaccinale avant l’intervention, les assises conceptuelles et théoriques de cette intervention, l’implantation et la réception de l’intervention et enfin les résultats et les mécanismes mis en œuvre pour les atteindre. Les résultats indiquent que la vaccination s’insère dans l’ensemble des stratégies locales de protection fondées sur des notions endogènes du risque. Ces éléments culturels associés à des facteurs socioéconomiques et aux rapports entre parents et services de santé concourent à expliquer un niveau relativement bas de couverture vaccinale complète de 50% avant l’intervention. L’analyse exploratoire de l’intervention indique que celle-ci intègre une théorie initiale implicite et une philosophie. L’intervention finale était évaluable; cependant, la validation de sa théorie a été compromise par des écarts dans l’implantation. L’approche descriptive montre des taux de réalisation d’activités assez élevés, une atteinte de plus de 95% des cibles et un niveau de réception acceptable, ce qui indique que l’intervention est une stratégie réalisable mais à améliorer. La couverture vaccinale après l’intervention est de 87%; elle est influencée positivement par les niveaux de connaissance élevés des parents et le fait pour les enfants d’être nés dans un centre de santé, et négativement par l’éloignement par rapport au site de vaccination. L’atteinte des résultats suit la procédure principale d’amélioration du niveau de connaissance des parents. Celle-ci est basée sur un mécanisme latent qui est la perception des « opportunités » que fournit la vaccination pour prévenir divers risques sanitaires, sociaux et économiques. Cependant, des approches complémentaires tentent de maximiser les effets de l’intervention en utilisant les pouvoirs conférés aux relais communautaires féminins et la coercition sociale. Cette recherche contribue à éclairer la relation entre l’évaluation du processus et l’analyse de l’évaluabilité, à conceptualiser et opérationnaliser autrement les notions de doses d’intervention administrées et de doses reçues. Sur le plan de la pratique, la recherche contribue à proposer l’amélioration des profils de personnel pour les activités de vaccination et la vulgarisation de la stratégie. Des propositions sont faites pour l’amélioration de l’intervention et l’information des institutions de financement des interventions.

La Costa Brava ante los nuevos retos del turismo

The first section of this paper summarises the most relevant charateristics of the contemporary tourist model, also called postfordist or postmodernist. In the second part the traditional tourist model developed in the Costa Brava in the past decades, is reviewed. Emphasising the saturation of tourist facilities on the coast line, expansive urban growth, thanks to a tolerant administration, poor complementary supply and concentrated demand in few markets and the proximity of Barcelona conurbation, stressed by second homes. In the third section, some strategies developed in recent years to readapt the Costa Brava to the new tendencies in tourism, are presented. Incorporation of the inland to the tourist product, new planning policics, lessening urban densities and height, and a change in mind in favour of protected natural areas, diversification of demand with new markets, specially form Eastern Europe (although this might be considered as a continuation of the traditional tourist model) and the emergence of local strategies oriented towards the creation of new tourist products based upon natural and cultural resources

Governos locais e políticas de promoção econômica: uma análise da promoção econômica nos municípios brasileiros com população acima de 50 mil habitantes

This work aims to analyze the policy of economic promotion in the Brazilian cities of medium and great size (with population above of 50.000 hab.). The objective of the research is to launch light in the debate on the regional and municipal development, presenting the recent hypotheses supplied by literature. Of complementary form, had for specific objective presents the results of the Research of Basic Information of Cities - PIM, of Brazilian Institute of Geography and Statistics (IBGE), in two surveys carried through together to the Brazilian local governments (1999 and 2009). It analyzes the instruments of economic promotion used by local governments and the influence of the development variables, as the Local Human Index of Development (HID-L) and the Local Gross Domestic Product (GDP-L). The research sample that factors as HID-L and GDP-L has significant influence in economic promotion of cities and must be taken in account in the definition of the local strategies of development

Tecendo saberes: fenomenologia do tratamento da dependência química

Esta pesquisa buscou conhecer o trabalho desenvolvido no Centro de Cuidados a Dependentes Químicos - CCDQ, localizado no município de Belém, estado do Pará, único serviço público no Brasil dentro do Sistema Único de Saúde destinado a oferecer tratamento específico para dependência química de álcool e outras drogas em regime de internação em longa duração, seguida de acompanhamento ambulatorial. A escassez de pesquisas nesta área no contexto local, fomenta a importância da discussão sobre o uso de drogas e as formas de tratamento existentes. Essa nova possibilidade de tratamento surgida das demandas sociais do município, através de dados compilados por diversas pesquisas, que levaram o governo estadual a planejar e implementar o centro, tinha por objetivo respeitar a voluntariedade do sujeito, incentivar a construção de um ambiente humanizado, pautada na lógica da reforma psiquiátrica, no que concerne à participação da família e práticas ressocializantes. Examinamos algumas contribuições da gestalt-terapia, Psicologia de base fenomenológica – existencial, que orienta minha linha de pesquisa e da Terapia Ocupacional, minha área de atuação, correlacionando-as como ciências e intervenções que dialogam no campo da interdisciplinaridade, tendo em vista o tratamento da drogadicção. A coleta de dados se deu através de questionários com questões abertas, respondidos por representantes da coordenação do centro, da equipe psicossocial e usuários do serviço. A perspectiva fenomenológica-existencial gestáltica configurou a fundamentação teórica na condução desse estudo, em que procuramos colaborar com este campo de investigação, desvelando alguns sentidos contidos nos diferentes discursos dos atores que trabalham ou se tratam no CCDQ e que colaboraram para configurar este relatório. Observamos a partir desses discursos, transformados em unidades de significação, que tanto o trabalho voltado às famílias, quanto as atividades ressocializantes estão deficitárias, sendo apontada também a necessidade de capacitação da equipe e a ausência de suporte da rede de serviços de saúde dentre outras questões. Pela especificidade dos resultados, pretendemos contribuir com a fundamentação de estratégias locais de ações preventivas e terapêuticas em drogadicção, além de possibilitar o conhecimento do que já vem sendo construído neste campo de atuação, tendo em vista ainda que novas ações terapêuticas podem ser construídas a partir da avaliação dos serviços já existentes prestados à população, bem como suscitar reflexões sobre as políticas, as ações e os seres humanos.