Fortalecimiento institucional al municipio de Santa Cruz de la Sierra, Bolivia

El programa de Apoyo para la Implementación de los Planes Nacionales de Acción SINPA (Support for Implementation of National Plans of Action) surge para dar cumplimiento a las políticas y directrices proclamadas durante la Conferencia de las Naciones Unidas para los Asentamientos Humanos - HABITAT II (Estambul 1996) (UNCHS 1997) en tres ciudades de diferentes países. En Bolivia, SINPA materializa el fortalecimiento del Gobierno Municipal de Santa Cruz de la Sierra, ciudad tropical prometedora y de grandes contrastes (motor del desarrollo económico, concentra los mayores índices de pobreza absoluta del país), se rige por un convenio suscrito entre el gobierno municipal el Instituto de Estudios de Vivienda y Desarrollo Urbano IHS (Holanda) y dos universidades locales. El país de fuerte tradición centralista y con bajo nivel de relacionamiento y articulación entre los estamentos político y civil, introduce a partir de 1994 drásticas reformas al Estado una de las cuales es la descentralización que se da como municipalización. Con este surgimiento se presentan e identifican una serie de debilidades en los gobiernos locales para enfrentar las nuevas responsabilidades y competencias. SINPA es un intento de subsanar esta realidad desarrollando capacidades de gestión desde el interior del gobierno municipal, enfatizando la planificación desde cuatro pilares: gestión ambiental, fortalecimiento institucional, participación ciudadana y desarrollo económico local

Participatory Budgeting in the Municipality of Santo André, Brazil: The challenges in linking short-term action and long-term strategic planning

This report is addressed to professionals and urban practitioners who are interested in participatory planning processes and in the establishment of organised priority setting mechanisms and decision-making involving government and communities on the allocation of public investments. Those who work in the public sector or with public policies at the local government level will benefit from the findings of the research particularly if their interest lies on the establishment of government-community management of public funds. The findings of the research will be instrumental for NGO’s and CBO’s that are engaged in partnerships with local governments. The primary objective of the research is to analyse and describe the experience of the municipality of Santo André with participatory budgeting hereinafter called OP ( Orçamento Participativo) depicted from interviews and observations of key actors and stakeholders directly involved in the OP, and from the analysis of internal documents of the municipality. The research also makes a first attempt to unveil issues underlying the integration of the participatory budgeting (OP) as a short-term planning activity and the recently started strategic planning process hereinafter called CF (Cidade Futuro) as a long-term development planning process. The research makes use of participants’ observations and qualitative methods and intends not only to analyse and describe in detail the OP and CF in Santo André but also questions to what extent this peculiar participatory process can be replicated in other municipalities seeking direct citizen involvement in municipal affairs. The authors attempt to look at the lessons learned from these experiences in order to depict issues, processes and methodologies that can be replicated in Bolivian municipalities and particularly in Santa Cruz de la Sierra. The authors look at this possibility against the enactment of legislation (Law of Popular Participation, Law on Municipalities, Sustainable Municipal Development Plan-SMDP) that seems to have created a conducive environment for genuine civil participation in urban management in Bolivian local governments. The Spanish report pays a particular attention to this dimension

Raleio químico de macieiras "Fuji Mishima" em porta-enxerto semivigoroso cultivadas sob tela antigranizo preta.

O raleio de frutos é a principal ferramenta para regularizar a produção e melhorar a qualidade de frutos de macieiras. A presença de tela antigranizo, especialmente de coloração preta, impõem algumas modificações ambientais que são desfavoráveis à frutificação efetiva de macieira e que podem afetar o raleio químico. O objetivo desse trabalho foi avaliar a efetividade de programas de raleio com combinação de diversos reguladores de crescimento e épocas de aplicação em um pomar de macieiras, sob cobertura com tela antigranizo de cor preta

The validity and reliability of the Portuguese versions of three tools used to diagnose delirium in critically ill patients

OBJECTIVES: The objectives of this study are to compare the sensitivity and specificity of three diagnostic tools for delirium (the Intensive Care Delirium Screening Checklist, the Confusion Assessment Method for Intensive Care Units and the Confusion Assessment Method for Intensive Care Units Flowsheet) in a mixed population of critically ill patients, and to validate the Brazilian Portuguese Confusion Assessment Method for Intensive Care Units. METHODS: The study was conducted in four intensive care units in Brazil. Patients were screened for delirium by a psychiatrist or neurologist using the Diagnostic and Statistical Manual of Mental Disorders. Patients were subsequently screened by an intensivist using Portuguese translations of the three tools. RESULTS: One hundred and nineteen patients were evaluated and 38.6% were diagnosed with delirium by the reference rater. The Confusion Assessment Method for Intensive Care Units had a sensitivity of 72.5% and a specificity of 96.2%; the Confusion Assessment Method for Intensive Care Units Flowsheet had a sensitivity of 72.5% and a specificity of 96.2%; the Intensive Care Delirium Screening Checklist had a sensitivity of 96.0% and a specificity of 72.4%. There was strong agreement between the Confusion Assessment Method for Intensive Care Units and the Confusion Assessment Method for Intensive Care Units Flowsheet (kappa coefficient = 0.96) CONCLUSION: All three instruments are effective diagnostic tools in critically ill intensive care unit patients. In addition, the Brazilian Portuguese version of the Confusion Assessment Method for Intensive Care Units is a valid and reliable instrument for the assessment of delirium among critically ill patients

The posttraumatic stress disorder project in Brazil: neuropsychological, structural and molecular neuroimaging studies in victims of urban violence

<p>Abstract</p> <p>Background</p> <p>Life trauma is highly prevalent in the general population and posttraumatic stress disorder is among the most prevalent psychiatric consequences of trauma exposure. Brazil has a unique environment to conduct translational research about psychological trauma and posttraumatic stress disorder, since urban violence became a Brazilian phenomenon, being particularly related to the rapid population growth of its cities. This research involves three case-control studies: a neuropsychological, a structural neuroimaging and a molecular neuroimaging study, each focusing on different objectives but providing complementary information. First, it aims to examine cognitive functioning of PTSD subjects and its relationships with symptomatology. The second objective is to evaluate neurostructural integrity of orbitofrontal cortex and hippocampus in PTSD subjects. The third aim is to evaluate if patients with PTSD have decreased dopamine transporter density in the basal ganglia as compared to resilient controls subjects. This paper shows the research rationale and design for these three case-control studies.</p> <p>Methods and design</p> <p>Cases and controls will be identified through an epidemiologic survey conducted in the city of São Paulo. Subjects exposed to traumatic life experiences resulting in posttraumatic stress disorder (cases) will be compared to resilient victims of traumatic life experiences without PTSD (controls) aiming to identify biological variables that might protect or predispose to PTSD. In the neuropsychological case-control study, 100 patients with PTSD, will be compared with 100 victims of trauma without posttraumatic stress disorder, age- and sex-matched controls. Similarly, 50 cases and 50 controls will be enrolled for the structural study and 25 cases and 25 controls in the functional neuroimaging study. All individuals from the three studies will complete psychometrics and a structured clinical interview (the Structured Clinical Interview for DSM-IV and the Clinician-Administered PTSD Scale, Beck Anxiety Inventory, Beck Depression Inventory, Global Assessment of Function, The Social Adjustment Scale, Medical Outcomes Study 36-Item Short-Form Health Survey, Early Trauma Inventory, Clinical global Impressions, and Peritraumatic Dissociative Experiences Questionnaire). A broad neuropsychological battery will be administered for all participants of the neuropsychological study. Magnetic resonance scans will be performed to acquire structural neuroimaging data. Single photon emission computerized tomography with [(99m)Tc]-TRODAT-1 brain scans will be performed to evaluate dopamine transporters.</p> <p>Discussion</p> <p>This study protocol will be informative for researchers and clinicians interested in considering, designing and/or conducting translational research in the field of trauma and posttraumatic stress disorder.</p

Squatter settlements and slums and sustainable development

Squatter settlement is defined as a low residential area, which has developed without legal right to the land or permission from the concerned authorities to build, and as a result, of their illegal status, infrastructure and services are usually inadequate (UN-Habitat 2003). On the other hand, slums are contiguous settlements where inhabitants are characterized by insecure residential status, inadequate access to safe water, inadequate access to sanitation and other basic infrastructure and services, poor housing quality, and overcrowding (UN-Habitat 2003). Both are form of informal settlements that are not formally planned

ICAR: endoscopic skull‐base surgery

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