Assessing the context of health care utilization in Ecuador: A spatial and multilevel analysis

<p>Abstract</p> <p>Background</p> <p>There are few studies that have analyzed the context of health care utilization, particularly in Latin America. This study examines the context of utilization of health services in Ecuador; focusing on the relationship between provision of services and use of both preventive and curative services.</p> <p>Methods</p> <p>This study is cross-sectional and analyzes data from the 2004 National Demographic and Maternal & Child Health dataset. Provider variables come from the Ecuadorian System of Social Indicators (SIISE). Global Moran's I statistic is used to assess spatial autocorrelation of the provider variables. Multilevel modeling is used for the simultaneous analysis of provision of services at the province-level with use of services at the individual level.</p> <p>Results</p> <p>Spatial analysis indicates no significant differences in the density of health care providers among Ecuadorian provinces. After adjusting for various predisposing, enabling, need factors and interaction terms, density of public practice health personnel was positively associated with use of preventive care, particularly among rural households. On the other hand, density of private practice physicians was positively associated with use of curative care, particularly among urban households.</p> <p>Conclusions</p> <p>There are significant public/private, urban/rural gaps in provision of services in Ecuador; which in turn affect people's use of services. It is necessary to strengthen the public health care delivery system (which includes addressing distribution of health workers) and national health information systems. These efforts could improve access to health care, and inform the civil society and policymakers on the advances of health care reform.</p

Considerations on Genre and Gender Conventions in Translating from Old English

The Old English poem The Wife's Lament is an extremely conventional and, at the same time, original text. It portrays a female character suffering for the absence of her loved one, through the framework of the so-called 'elegiac' style and a mainly heroic vocabulary. The traditional exile theme is, thus, interwoven with the uncommon motif of love sickness. While this appraisal of the poem is the most widely accepted one, disagreement still remains about the translation of some keywords, strictly related to the exile theme, such as sīþ or wræcsīþ. The aim of this paper is to examine diverging readings and glosses of the above mentioned 'exilic/elegiac' keywords, and to show that an accurate translation should not neglect a thorough appraisal of the text in its complexity and the association with related literary patterns and imagery in other poetic and prose texts

NSC141835

The new men’s studies can be seen as a critical interrogation of unitary concepts of masculinity. Particularly gay men have been quick to point out that restrictive notions of what it means to be a man not only affect women in negative ways, but also gay men, who are discriminated against precisely because they do not conform to hegemonic concepts of masculinity. My paper will start from a consideration of the ways in which some critics of the Old English poem The Wife’s Lament have argued against the possibility of a female narrator. I attempt to show that such critical moves, which do not stop short of emending the text in an effort to exclude the female voice, are based on unitary concepts of masculinity that affect both women and men in similar ways