Depuis les dernières décennies, un nouveau consensus des matières premières s'est formé en Amérique latine, réactivant un modèle de développement extractiviste. Parallèlement, des mouvements socio-environnementaux ont émergé à partir d'une diversité d'organisations populaires paysannes, autochtones, afro-descendantes, féministes, de droits humains, etc. Dans de nombreux pays, les politiques publiques et les projets extractifs et énergétiques ont fait de plus en plus l'objet de conflits entre les mouvements socio-environnementaux, les firmes nationales et transnationales exploitant les ressources naturelles et les autorités publiques. À maintes reprises, les institutions étatiques ont répondu à ces conflits par la criminalisation des actions collectives et la répression des militants mobilisés, occasionnant une augmentation des violences et des violations des droits humains. Pourtant peu étudié, le Honduras constitue un cas extrême de ces tendances latino-américaines, ayant parmi les plus hauts taux d'homicides de défenseurs de l'environnement et de la terre. Partant de ce constat empirique, cette thèse s'interroge sur un paradoxe. Face à un risque aussi élevé de violence, pourquoi certaines personnes décident-elles de s'engager, de se mobiliser et de prendre la parole publiquement dans le cadre des conflits socio-environnementaux? La thèse souligne les limites de la littérature sur les conflits socio-environnementaux en Amérique latine qui se centre quasi exclusivement sur l'étude des causes de ces violences au détriment de l'étude de leurs effets sur l'engagement, la mobilisation collective et les prises de parole publiques. En dialogue critique avec les études sur la répression, l'activisme en contexte de risque élevé et l'anthropologie de la violence, la thèse procède plutôt à une analyse des effets de la violence sur l'activisme dans une perspective nouvelle s'inspirant des écrits du philosophe Cornelius Castoriadis sur les imaginaires sociaux et des travaux sur le processus de subjectivation politique tel qu'ont pu le théoriser Michel Foucault, Judith Butler et Jacques Rancière. Dans une démarche d'analyse du discours, la thèse démontre qu'à travers des luttes se jouant autour des actes de véridiction et de juridiction, les discours militants contestent l'imaginaire sécuritaire véhiculé par les institutions policières, militaires, judiciaires et gouvernementales dans les journaux conservateurs et captent la légitimité de l'imaginaire des droits humains circulant au sein des systèmes internationaux de protection de ces droits tout en y introduisant de nouvelles significations, afin de faire reconnaître ces violences comme des violations de droits. Ces luttes de sens, en mettant en circulation un nouvel imaginaire, contribuent à former des communautés discursives malgré la diversité des groupes et des mouvements sociaux, et permettent aux activistes de vérifier leur égalité face à des torts partagés, en particulier l'exposition à une mort violente en toute impunité, bref l'abandon. En rassemblant des luttes hétérogènes au sein de coalitions multisectorielles et en incitant les militants et militantes à adopter une éthique de la parrêsia, ce processus de subjectivation politique influence la décision des activistes et des membres de communautés de s'engager, de se mobiliser collectivement et de dire-le-vrai et dire-le-juste sur les violences malgré les risques encourus. L'une des contributions de la thèse est ainsi de démontrer comment la violence est devenue, à travers les luttes pour dire-le-vrai et dire-le-juste, un objet central de litiges au sein des conflits socio-environnementaux, transformant les dynamiques d'engagement, de mobilisation et de prise de parole, pratiques qui persistent au risque de subir de nouvelles violences en raison de leur défense de la vie.

Isotopic assays, including stable carbon, stable oxygen, and radiogenic strontium were measured for 37 individuals from the Talgua cave ossuaries to understand human movement and mortuary practice during Formative Period Honduras. Likelihood assignment models demonstrated that the individuals had diverse childhood geographic origins within the surrounding valleys. This shows that different kin or ethnic groups from diverse geographic origins were utilizing the ossuaries. Five possible ‘non-local’ individuals were identified from the radiogenic strontium and stable oxygen isotope datasets, suggesting minimal human movement into northeast Honduras from outside Lower Central America. The low number of ‘non-local’ individuals at Talgua Caves also suggests that trade items were acquired by down-the-line exchange processes rather than through a long-distance trade connection. This type of trade network and bioarchaeological evidence of limited ‘non-local’ individuals at Talgua Caves suggests the surrounding region was culturally distinct from Mesoamerica during the Formative Period.

Tegucigalpa, the capital of Honduras, has experienced an unsatisfied water demand during the last three decades. The state owned water utility in charge of the water supply of the country, SANAA, has faced this deficit by providing an intermittent water supply. The intermittent water supply has increased the gap between the rich and the poor, who cannot afford water storage facilities. Theories explain water scarcity either by low precipitation or by lack of investment in water structures. This thesis investigates the applicability of both explanations by quantifying the annual precipitation in the sub catchments with water supply potential for Tegucigalpa, and identifying the problems which caused the lack of investment into the water infrastructure. The analysis concluded that even if the annual precipitation is abundant, it is not evenly distributed in time and in space. Furthermore, it is argued that the financial limitations which hindered the lack of investment in water structures originated in the low tariffs imposed, and to the practices of the patronage system. / QC 20111207

No description available.

Det övergripande syftet med denna C-uppsats är att få en generell förståelse för hur religion kan influera på folkhälsofrågor. Vi spenderade två och en halv månad i Honduras med syftet att få en förståelse för hur religion kan påverka folkhälsofrågor och folkhälsoarbete. I det specifika fallet Honduras är syftet att diskutera hur katolska kyrkan influerar på den reproduktiva hälsan i Honduras. Studien är kvalitativ till sin karaktär och resultatet baseras på information från personliga intervjuer. För att ta reda på hur katolska kyrkan influerar den reproduktiva hälsan i landet intervjuade vi personal som arbetar på de största aktörerna involverade i arbetet med reproduktiv hälsa. Vi intervjuade även två katolska organisationer. Det finns en konflikt mellan katolska kyrkan och de icke-katolska organisationerna som arbetar med reproduktiv hälsa. En majoritet av de icke-katolska organisationerna ser katolska kyrkan, i synnerhet de två katolska organisationerna Pro Vida och Opus Dei, som ett hinder i arbetet med att förbättra den reproduktiva hälsan hos befolkningen. Sett från ett maktperspektiv blir slutsatsen att det existerar en synlig konflikt mellan katolska kyrkans intressen och den honduranska befolkningens intressen och att katolska kyrkan utövar makt över den honduranska befolkningen i den bemärkelsen att de inkräktar på deras reproduktiva rättigheter. Hur katolska kyrkan influerar på den reproduktiva hälsan behöver dock mer omfattande undersökas. / The overall objective of this essay is to provide a general understanding of how religion can influence on public health issues. We spent two and a half month in Honduras with the goal to achieve an understanding of the influence of religion on public health issues and public health work. In the particular case of Honduras the purpose is to discuss how the Catholic Church influences reproductive health in Honduras. It is a qualitative study and the result is based on information gathered in one-on-one interviews. As a way to find out how the Catholic Church influences reproductive health in the country we interviewed the staff of the main actors involved in the work with reproductive health, as well as two Catholic organizations. There is a conflict between the Catholic Church and the Non-Catholic organizations working with reproductive health. Almost all of the Non-Catholic organizations view the Catholic Church, with focus on the two Catholic organizations, Pro Vida and Opus Dei, as an obstacle in the work with improving the reproductive health in the population. From a power theory perspective we reach the conclusion that there is a visible conflict between the interests of the Catholic Church and the interests of the Honduran population and that the Catholic Church exercises power over the population by intruding on their reproductive rights. However, how the Catholic Church influences reproductive health matters needs to be further investigated.

Predictive models based in symptomatology of suspected dengue patients seeking medical care in Honduras. The models based on logistic regression models predicted the outcomes of dengue fever/ severe dengue. Sensitivity and specificity are discussed. It also describe the level of agreement between Honduran classification of severe dengue and the ones based on World Health Organization guidelines of 1997 and 2009. / Introduction: Dengue is a major public health problem in tropical and subtropical countries but its clinical presentation may be similar to many febrile illnesses. Since in endemic countries laboratory confirmation is frequently delayed, the majority of dengue cases are diagnosed based on patient’s symptomatology. This can often lead to misdiagnosis and potential serious health complications. The objective of this study was to identify clinical, hematological and demographical parameters that could be used as predictors of dengue fever among patients with febrile illness. Methods: We conducted a retrospective cohort study of 548 patients presenting with febrile syndrome to the largest public hospitals in Honduras. Patients’ clinical, laboratory, and demographical data as well as dengue laboratory confirmation by either serology or viral isolation were used to build a predictive statistical model to identify dengue cases. Results: Of 548 patients, 390 were confirmed with dengue infection while 158 had negative results. Univariable analysis revealed seven variables associated with dengue: male sex, petechiae, skin rash, myalgia, retro-ocular pain, positive tourniquet test, and bleeding gums. In multivariable logistic regression analysis, retro-ocular pain petechiae and bleeding gums were associated with increased risk, while epistaxis and paleness of skin were associated with reduced risk of dengue. Using a value of 0.6 (i.e., 60% probability for a case to be positive based on the equation values), our model had a sensitivity of 86.2%, a specificity of 27.2%, and an overall accuracy of 69.2%; allowing for the diagnosis of dengue to be ruled out and for other febrile conditions to be investigated. Conclusions: The application of predictive models can be valuable when laboratory confirmation is delayed. Among Honduran patients presenting with febrile illness, our data reveal key symptoms associated with dengue fever, however the overall accuracy of our model is still low and specificity remains a concern. Our model requires validation in other populations with similar pattern of dengue transmission. Key Words: Dengue, fever, Predictive model, symptoms, Honduras / Thesis / Doctor of Philosophy (PhD) / Predictive models based in symptomatology of suspected dengue patients seeking medical care in Honduras. The models based on logistic regression models predicted the outcomes of dengue fever/ severe dengue. Sensitivity and specificity are discussed. It also describe the level of agreement between Honduran classification of severe dengue and the ones based on World Health Organization guidelines of 1997 and 2009.

No description available.

Since the 1800's, technological advances have extended the foundation on which telemedicine could build. With its evolution, telemedicine has proven to be a means of offering effective health care interventions, from a multitude of disciplines. Teledermatology, a specialty application of telemedicine, offers great potential in improving the standard of dermatologic care by bridging the gap between the expert opinion of dermatologists and those without access to basic dermatologic care, particularly in developing nations, where skin disease continues to be a major public health problem. In Honduras, the setting for this study, and other developing nations, technology to support telemedicine is available. Dermatologic disease is among the most common disease presentations in the developing world, which left untreated due to a lack of access to adequate medical care, can progress causing increased morbidity or even death. A potential but untested solution is teledermatology. Teledermatology offers great potential in improving the standard of dermatologic care by bridging the gap between the expert opinion of dermatologists and those without access to basic dermatologic care. The purpose of this study was to evaluate the prevalence and types of dermatologic conditions and the feasibility of a store-and-forward teledermatology system in an underserved area of Honduras, so as to potentially provide more timely diagnosis and treatment, implementation of preventative measures, and offer long term solutions.so as The justification and significance of this study was the potential of store-and-forward teledermatology to improve the standard of dermatologic care by improving access of populations in underserved areas to dermatology specialists through affordable technology. The methodology of this study was primarily case study descriptive. This study was conducted at a public primary care clinic (JMA Clinic) and satellite sites in underserved areas of Francisco Morazán, Honduras. During a four week period in Spring 2011, patients with dermatologic conditions were examined and photos taken of condition. The patient information was sent to 3 U.S. board certified dermatologists, who provided diagnosis and treatment within 24 hours, which allowed the clinic physician sufficient time to review recommendations before patient follow-up. Patients would receive follow-up within 48 hours of initial visit. Diagnostic agreement, image quality, and user satisfaction were evaluated. IRB forms were submitted and clearance given. The data was analyzed with SPSS using descriptive statistics. The primary findings were the types of dermatologic conditions, interobserver agreement, image quality, and patient and physician satisfaction. The findings of this study substantiate the need for dermatologic care, as approximately 1 out of every 5 patients of the JMA Clinic presented with a dermatologic condition. The majority of these patients were children or women in their late 20s and early 30s; many of whom had their condition for more than a year and most had not received prior therapy. The types of dermatologic conditions observed were typical of that seen at a dermatology clinic in the U.S., yet inclusive of tropical and regional differences. Dermatitis, infectious and pigmentary conditions were the most common presentations. The interobserver diagnostic agreement achieved was 78%, and improved when considering differential diagnoses. Image quality received high ratings. Patients and physicians recorded a high level of overall satisfaction. Physicians indicated improved knowledge of teledermatology. Because of the unique environment and circumstances, the results are limited to the setting in which the study occurs. This project was a pilot study limited to 4 weeks of data collection and will be limited in significance by its duration and small sample size with respect to the conclusions that can be drawn about the prevalence and types of dermatologic conditions. This study illustrates that teledermatology is a viable means of providing dermatologic care to those in an underserved area of Honduras, where a lack of or limited access to general healthcare or specialty dermatologic care exists. The data offers insights to draw conclusions and recommendations on the potential for similar models to be implemented in underserved areas throughout Honduras and other similar regions. / Ph. D.

There is a need to counteract economic injustice in the world. As an architect, as a creator, it is my responsibility to make the world a better place. I want to help people to help themselves by concentrating their efforts in a constructive way. I desire to create a prototypical solution for a village in an area with high unemployment and desperate poverty as a means to give work to people and to serve as an example for other groups of people wanting to do the same. The site I've chosen to illustrate this concept of self-help housing is a 300 x 500 meter plateau in Tegucigalpa, Honduras. / Master of Architecture

La cooperación internacional para el desarrollo (CID) se ha convertido en un ámbito importante de la política internacional. Los cambios acontecidos en el orden internacional se han reflejado en la arquitectura de la CID. Durante los últimos años, nuevos actores y dinámicas han caracterizado dicha arquitectura. La predominancia que tenían la Cooperación Norte-Sur (CNS), los países desarrollados y sus instituciones ha sido puesta en cuestión por actores del Sur que han empezado a posicionarse como oferentes de CID mediante la modalidad de cooperación Sur-Sur (CSS). Este cambio ha abierto el espacio para que países latinoamericanos como el Perú empiecen a desempeñar un rol como oferentes de CID. Pese a la relevancia del tema, en la academia y en la práctica, los estudios de casos como el Perú son escasos. La presente investigación se enmarca en la corriente de literatura que busca indagar cuáles son las motivaciones que tienen los Estados para proveer CID a determinados países. Específicamente, se analizará la oferta de CID peruana para Honduras. Esto debido a que el Perú desempeña exclusivamente el rol de oferente y que, en términos cuantitativos, es uno de los países con los que más proyectos se han desarrollado. Con el objetivo de determinar dichas motivaciones se empleará un marco teórico constructivista y una metodología cualitativa, basada principalmente en entrevistas y otras fuentes primarias. La hipótesis principal plantea que las ideas de los principales tomadores de decisiones acerca del rol que el Perú debería ocupar en la arena internacional son la motivación principal. Una hipótesis alternativa enfatiza motivaciones de carácter económico y comercial. Se concluye que las motivaciones de los Estados son de carácter muy diverso, que las concepciones de los tomadores de decisiones tienen un rol central y que es necesario desarrollar más investigación empírica para el caso peruano.