El impacto de las características socieconómicas de los municipios en la implementación de las transferencias en efectivo condicionadas : un estudio del Programa Bolsa Familia en Brasil

Tesis inédita de la Universidad Complutense de Madrid, Facultad de Ciencias Políticas y Sociología, leída el 24-09-2015¿Es realmente importante para la implementacio¿n de poli¿ticas que la jurisdiccio¿n ejecutora sea rica o pobre? Este estudio se centra en contestar esta pregunta y en entender mejor co¿mo las caracteri¿sticas socioecono¿micas locales pueden influir en la implementacio¿n de las poli¿ticas, particularmente en las poli¿ticas para aliviar la pobreza, como por ejemplo las transferencias monetarias condicionadas, que son en gran parte aplicadas en a¿reas pobres. Au¿n cuando la influencia de las caracteri¿sticas socioecono¿micas en el desempen¿o es ampliamente reconocida en la literatura sobre implementacio¿n de poli¿ticas, los marcos teo¿ricos existentes so¿lo ofrecen un examen superficial y limitado sobre el rol de las caracteri¿sticas socioecono¿micas en el proceso de implementacio¿n. Dada esta laguna en la literatura, la primera parte de esta tesis esta¿ dedicada a desarrollar un marco teo¿rico que explique la relacio¿n entre las caracteri¿sticas socioecono¿micas y la ejecucio¿n de poli¿ticas. Este marco teo¿rico ofrece un camino para analizar la interaccio¿n entre caracteri¿sticas socioecono¿micas locales y otros seis grupos de variables que influyen en la ejecucio¿n, e¿stas son: el objetivo de la poli¿tica, los recursos de la poli¿tica, las condiciones poli¿ticas, la capacidad de la agencia ejecutora, la disposicio¿n de los implementadores y las relaciones intergubernamentales. La segunda parte de este trabajo investiga empi¿ricamente estas relaciones en el contexto del Programa Bolsa Fami¿lia, un programa de transferencias monetarias condicionadas en Brasil que beneficia a ma¿s de 13 millones de familias con transferencias de dinero mensuales, vinculadas al cumplimento de condicionalidades de salud y educacio¿n. La implementacio¿n descentralizada de Bolsa Fami¿lia ofrece un espacio ideal para el estudio de variacio¿n de desempen¿o entre las 5.565 municipalidades que implementan este programa federal. Haciendo un ana¿lisis comparativo subnacional, este estudio aplica una combinacio¿n de investigacio¿n cuantitativa con amplia muestra e investigacio¿n cualitativa contextualizada, y compara el desempen¿o de municipios que implementan el Programa Bolsa Fami¿lia y sus caracteri¿sticas socioecono¿micas, particularmente sus niveles de ingreso y desarrollo. El ana¿lisis cuantitativo de datos de desempen¿o de todos los municipios que implementan Bolsa Fami¿lia demuestra que, contrariamente al sentido comu¿n, los municipios ma¿s pobres y menos desarrollados tienen un mejor desempen¿o que aquellos ma¿s ricos o ma¿s desarrollados. ¿Por que¿ sucede esto? Una investigacio¿n ma¿s profunda utilizando te¿cnicas cualitativas sugiere que esto se da porque la importancia relativa del Programa Bolsa Fami¿lia para los municipios vari¿a de acuerdo a su situacio¿n socioecono¿mica: el programa es de extrema importancia para los municipios pobres, y tan solo marginalmente importante para los ricos. Esto, por su parte, influye en el nivel de apoyo y en los recursos disponibles a la hora de ejecutar el programa en dichas a¿reas. Los municipios ricos han fracasado en movilizar recursos locales existentes para apoyar la implementacio¿n, mientras que los municipios pobres se han beneficiado de fondos federales relacionados con desempen¿o, para prepararse para llevar a cabo la implementacio¿n del programa. En suma, los municipios pobres tienden a tener tanto la motivacio¿n como la capacidad de implementar el Programa Bolsa Fami¿lia, mientras que los municipios ricos, en la mayori¿a de los casos, carecen de ambas. Las conclusiones de este estudio desafi¿an la creencia ampliamente aceptada de que ma¿s recursos y capacidad a nivel local conllevan invariablemente a un mejor desempen¿o en la implementacio¿n de poli¿ticas, y proponen una revisio¿n de estrategias de implementacio¿n descentralizada y de desarrollo de capacidades en a¿reas pobres.Fac. de Ciencias Políticas y SociologíaTRUEunpu

Cost-Effectiveness of Rotavirus Vaccination in France-Accounting for Indirect Protection.

BACKGROUND: Vaccination against rotavirus has shown great potential for reducing the primary cause of severe childhood gastroenteritis. Previous economic evaluations of rotavirus vaccination in France have not modeled the potential impact of vaccines on disease burden via reduced transmission. OBJECTIVE: To determine the cost-effectiveness of the introduction of pentavalent rotavirus vaccination into the French infant vaccination schedule. METHODS: We developed an age-structured model of rotavirus transmission calibrated to 6 years of French gastroenteritis incidence and vaccine clinical trial data. We evaluated the cost-effectiveness of pentavalent rotavirus vaccination considering that 75% of infants would receive the three-dose vaccine course. RESULTS: Our model predicts that rotavirus vaccination will decrease rotavirus gastroenteritis incidence and associated clinical outcomes in vaccinated and unvaccinated individuals, delay the seasonal peak of infection, and increase the age of infection. From the societal perspective, our base-case scenario predicts that vaccination coverage would be cost-effective at €115 or €135 per vaccine course at €28,500 and €39,500/quality-adjusted life-year (QALY) gained, respectively, and suggests that almost 95% of the financial benefits will be recouped within the first 5 years following vaccination implementation. From the third-party payer perspective, incremental cost-effectiveness ratios ranged from €12,500 to €20,000/QALY, respectively. Our uncertainty analysis suggests that findings were sensitive to various assumptions including the number of hospitalizations, outpatient visits, and the extent of QALY losses per rotavirus episode. CONCLUSIONS: Introducing pentavalent rotavirus vaccination into the French infant vaccination schedule would significantly reduce the burden of rotavirus disease in children, and could be cost-effective under plausible conditions

Spatial heterogeneity in projected leprosy trends in India

Background: Leprosy is caused by infection with Mycobacterium leprae and is characterized by peripheral nerve damage and skin lesions. The disease is classified into paucibacillary (PB) and multibacillary (MB) leprosy. The 2012 London Declaration formulated the following targets for leprosy control: (1) global interruption of transmission or elimination by 2020, and (2) reduction of grade-2 disabilities in newly detected cases to below 1 per million population at a global level by 2020. Leprosy is treatable, but diagnosis, access to treatment and treatment adherence (all necessary to curtail transmission) represent major challenges. Globally, new case detection rates for leprosy have remained fairly stable in the past decade, with India responsible for more than half of cases reported annually. Methods: We analyzed publicly available data from the Indian Ministry of Health and Family Welfare, and fit linear mixed-effects regression models to leprosy case detection trends reported at the district level. We assessed correlation of the new district-level case detection rate for leprosy with several state-level regressors: TB incidence, BCG coverage, fraction of cases exhibiting grade 2 disability at diagnosis, fraction of cases in children, and fraction multibacillary. Results: Our analyses suggest an endemic disease in very slow decline, with substantial spatial heterogeneity at both district and state levels. Enhanced active case finding was associated with a higher case detection rate. Conclusions: Trend analysis of reported new detection rates from India does not support a thesis of rapid progress in leprosy control

Data analysis of Permanent GPS networks in Italy and surrounding region: application of a distributed processing approach

We describe the procedures used to combine into a uniform velocity solution the observations of more than 80 continuous GPS stations operating in the central Mediterranean in the 1998-2004 time interval. We used a distributed processing approach, which makes efficient use of computer resources, while producing velocity estimates for all stations in one common reference frame, allowing for an effective merging of all the observations into a self-consistent network solution. We describe the CGPS data archiving and processing procedures, and provide main results in terms of position time-series and velocities for all stations that observed more than three years. We computed horizontal and vertical velocities accounting for the seasonal (annual and semi-annual) signals, and considering the off-sets in the coordinate time-series caused by station equipment changes. Weighted post-fit RMS of the north, east and vertical velocity components are in the range of 1.57-2.08 mm, 1.31-3.28 mm, and 3.60-7.24 mm, respectively, which are reduced by solving for seasonal signals in the velocity estimates. The annual and semi-annual signals in the height components, with amplitudes up to 4.8 mm, are much stronger than those in the horizontal components. The mean amplitudes of annual and semi-annual signals are within 0.18-0.47 mm, 0.23-0.52 mm and 0.55-1.92 mm in the north, east and vertical components, respectively

Direct and indirect effects of rotavirus vaccination: Comparing predictions from transmission dynamic models

Early observations from countries that have introduced rotavirus vaccination suggest that there may be indirect protection for unvaccinated individuals, but it is unclear whether these benefits will extend to the long term. Transmission dynamic models have attempted to quantify the indirect protection that might be expected from rotavirus vaccination in developed countries, but results have varied. To better understand the magnitude and sources of variability in model projections, we undertook a comparative analysis of transmission dynamic models for rotavirus. We fit five models to reported rotavirus gastroenteritis (RVGE) data from England and Wales, and evaluated outcomes for short- and long-term vaccination effects. All of our models reproduced the important features of rotavirus epidemics in England and Wales. Models predicted that during the initial year after vaccine introduction, incidence of severe RVGE would be reduced 1.8-2.9 times more than expected from the direct effects of the vaccine alone (28-50% at 90% coverage), but over a 5-year period following vaccine introduction severe RVGE would be reduced only by 1.1-1.7 times more than expected from the direct effects (54-90% at 90% coverage). Projections for the long-term reduction of severe RVGE ranged from a 55% reduction at full coverage to elimination with at least 80% coverage. Our models predicted short-term reductions in the incidence of RVGE that exceeded estimates of the direct effects, consistent with observations from the United States and other countries. Some of the models predicted that the short-term indirect benefits may be offset by a partial shifting of the burden of RVGE to older unvaccinated individuals. Nonetheless, even when such a shift occurs, the overall reduction in severe RVGE is considerable. Discrepancies among model predictions reflect uncertainties about age variation in the risk and reporting of RVGE, and the duration of natural and vaccine-induced immunity, highlighting important questions for future research

Composição florística e fauna associada das ilhas flutuantes livres, Rio Paraguai, Corumbá, MS.

As ilhas flutuantes livres englobam várias espécies vegetais tais como camalotes e gramíneas. Nas folhas e raízes destas plantas encontra-se uma diversidade de organismos. Este trabalho teve como objetivo fazer o levantamento das espécies vegetais componentes das ilhas flutuantes livres e conhecer os organismos associados e seus hábitos alimentares. Free floating islands include several species such as water hyacinth and grasses. In leaves and roots of these plants there are a diversity of organisms. This study aimed to survey the plant species of these free floating islands and recognize the associated organisms and its food habits

Aplicação localizada de herbicidas para controle de alecrim-do-campo (Vernonia nudiflora) em pastagem natural.

Resumo: Para avaliar o controle de alecrim-do-campo (Vernonia nudiflora) com aplicação de herbicidas de contato, foi conduzido durante 353 dias, um experimento com delineamento de parcelas subdivididas, dispostas em blocos ao acaso, com três repetições em um arranjo fatorial (5x3)+1, sendo cinco herbicidas em três doses mais a testemunha. As parcelas corresponderam aos herbicidas, com doses de 1,5; 3,0 e 4,5 L ha-1 de Tordon, Aminol 806, Garlon, Grazon e Plenum. A abundância de V. nudiflora foi avaliada antes da aplicação e 60 e 353 dias após. A aplicação foi feita com ?roçadeira química? tratorizada, consistindo em uma plataforma com bandejas com altura regulável, que entra em contato somente com as plantas alvo. Os herbicidas não diferiram quanto à redução na abundância do alecrim e todos reduziram significativamente mais que a testemunha. Os tratamentos não interferiram na frequência na composição de espécies desejáveis no campo nativo. O uso do aplicador químico é eficaz para o controle, mesmo com baixas concentrações de herbicidas, tendo eficácia na redução do alecrim-do-campo e preservando as espécies desejáveis para a produção animal. [Located herbicide application to control alecrim-do-campo (Vernonia nudiflora) in natural grassland]. Abstract: To evaluate the control of alecrim-do-campo (Vernonia nudiflora) with contact herbicides, an experiment was conducted during 353 days, following a split plot block design, with three replicates in a (5x3)+1 factorial arrangement, being five herbicides in three doses and the control. The plots corresponded to the herbicides, with doses of 1.5, 3.0 and 4.5 L ha-1 of Tordon, Aminol 806, Garlon, Grazon e Plenum. The presence of V. nudiflora was evaluated prior to application and 60 and 353 days after. The application was made using a chemical applicator, which consists of a platform of adjustable height that contacts only the target plant. The herbicides did not differ in reducing the abundance of V. nudiflora and all of them reduced significantly more than the control. The chemical applicator was effective to control alecrim-do-campo, even with low herbicide concentrations, reducing the Vernonia abundance and not being harmful to the native desirable species