The health care reform debate in the United States is defined by the choice between free market reform and a government-administered single payer alternative. Nearly half the population receives access to health care through government directed programs (e.g. Medicare) while the remainder is covered by private insurers. In spite of the current mix of allocation mechanisms advocates on both sides of the debate have argued for the superiority of one form over the other in controlling costs and constraining aggregate demand. Precisely because allocation is the focus of the debate, "health care" is conceived of as a cost incurred by businesses, individuals and/or the government. A miserly attitude prevails. This dissertation aims at developing a new discursive context in which to politicize health care reform. I have used qualitative research techniques to explore the spaces in which health care is produced, allocated and consumed. The concept of the diverse/community economy, developed by J. K Gibson-Graham and the Community Economies Collective, provides us with a language for differentiating the economic landscape. This typology not only allows us to recognize the importance of informal caregivers in the economy of care but also to recognize the different organizational forms, processes of exchange, ethical commitments in health care's "market sector." A common theme has emerged from my interviews with informal care providers, physicians, community based health care institution administrators and alternative practitioners. All of these people spoke of their ethical commitment to care, how the practice of caregiving is deeply affecting. Interviewees recognized that caregiving was at moments a source of profound meaning while, at other times, it was a threat to their emotional and physical wellbeing. This dissertation concludes with an argument for thinking of health care "reform" as a process of development that focuses on the affective intensity of care and the ethical commitment of care providers. The aim of this development project is to produce supportive conditions for caregivers operating in both the formal and informal settings to be ethically engaged subjects.

<p> Abstract not available.</p>

<p> Issues of food accessibility and food insecurity receive high attention in the United States, due to evidence of disparities in the location and level of accessibility to nutritious food sources amongst neighborhoods of different economic classifications identified in several studies. However, most studies focus on grocery stores or convenience stores without considering other options available for food insecure residents. This research examined the different economic classes of neighborhoods in the Triple Cities of Broome County, New York and their proximity to grocery stores, food pantries and convenience stores, to establish the level of accessibility to food sources for residents of these different neighborhoods using ESRI ArcGIS for spatial analysis and Chi-Square for statistical analysis. The Findings reveal a positive relationship between the location and density of grocery stores, convenience stores and food pantries to low-income populations. Moreover, high-income neighborhoods are more disadvantaged in terms of physical access to food stores by distance. However, there exists an over-concentration of convenience stores in low-income neighborhoods compared to grocery stores and can have a negative impact on their diet choices and expenses on food.</p><p>

Thesis (M.A.)--Georgia State University, 2005. / Title from title screen. Jeremy Crampton, committee chair; Michael Eriksen, Dona Stewart, committee members. Electronic text (94 p. : ill., maps (some col.)) : digital, PDF file. Description based on contents viewed July 10, 2007. Includes bibliographical references (p. 88-94).

This dissertation consisting of three case studies, examines how the intersection of biomedicine and indigenous medicine in South Africa has formed and reformed indigenous medical practice over the past century. South Africa, like many other countries, has emerged from colonialism with the need to reassert its indigenous practices. In the case of medicine, this reformation is of particular importance because the last several decades have seen the development of the HIV/AIDS pandemic. Yet the contemporary discourses and policies surrounding indigenous medicine have much in common with their colonial predecessors. This research is interested in the way medicine has been constituted in a post-colonial context. In particular, how has the intersection of indigenous and biomedicine reconfigured and respatialized medicine in South Africa?The ways the colonial government acted to regulate indigenous medicine in essence simplified the practice and divided it into subcategories- `natural' medicine (e.g. herbs), `modern' medicine (e.g. stethoscopes) and `supernatural,' (e.g. throwing bones). The natural was the only category of practice legal in the country. Even as the government structure changed, and the previously disadvantaged eventually came to lead the country, these categories still persisted. As such, when a crisis like HIV/AIDS strikes and the need to enroll the help of the indigenous healers becomes clear, calls for their regulation, as a way to gain their assistance, are made. Although the current call does not aim to limit the number of healers, there are similar public health goals of rooting out the `bad' indigenous healers.Overall three major findings emerged: First, colonial regulations are re-introduced in a post-colonial context as discourses, which are then reinstated as policies; second, policy over the past century tends to view indigenous medicine in a simplified form (i.e. as plant-based and natural); and third, there is a constant tension between biomedicine and indigenous medicine where biomedicine works to extend its spaces of practice into the indigenous realm.

Made available in DSpace on 2014-06-11T19:28:25Z (GMT). No. of bitstreams: 0 Previous issue date: 2011-05-09Bitstream added on 2014-06-13T20:58:09Z : No. of bitstreams: 1 catao_rc_me_prud.pdf: 3195701 bytes, checksum: 407675649dada8ff4471a0d5022d59de (MD5) / Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / As inúmeras transformações socioespaciais advindas da expansão e consolidação desigual do Meio Técnico-Científico-Informacional desde o fim da Segunda Guerra Mundial tiveram efeito em todo o globo. Devido a essas transformações, o dengue se modificou, adaptando-se a esse novo meio. O aumento do número e do tamanho das cidades, que ocorreu de forma perversa, o rápido e intenso fluxo de pessoas e materiais e a degradação da saúde pública em todo mundo contribuíram para que essa doença se tornasse uma pandemia global em meados do século XX. No Brasil, ela retornou após 60 anos depois de erradicada, causando muitos problemas e a morte de várias pessoas. A hipótese do trabalho é que a distribuição e a incidência do dengue no Brasil foram, e estão sendo afetadas pelas transformações socioespaciais advindas da consolidação desigual do meio atual, que propiciou sua reemergência no território nacional e a emergência do dengue hemorrágico como um grande problema de saúde pública. O objetivo principal constitui em analisar a reemergência do dengue no Brasil e sua relação com as mudanças socioespaciais advindas da expansão desigual do Meio Técnico-Científico-Informacional e os processos de globalização no país, comparando diversas escalas geográficas. Também foi analisado os principais determinantes em escala nacional, bem como uma proposta de tipologia do dengue no Brasil, elecando as principais variáveis explicativas da doença no território / The several socio-spatial transformations brought by the uneven expansion and consolidation of the technical-scientific-information environment since the Second World War had an effect in the whole world. Due to these transformations, dengue has changed to adapt to this new environment. The disease's etiological agent is a virus, and the main vector is an urban mosquito with preference of human blood and extremely adapt to the social space. The perverse way that the growth of cities occurred, in both, number and size, the intense and fast flow of peoples and goods and the degradation of public health in whole world contributed to make that this disease became pandemic worldwide in the middle of the twenty century. In Brazil, it returns sixty years after been eradicated, causing many problems and the death of several people. The work hypothesis is that distribution and incidence of dengue was, and still is been affecting by socio-spatial transformations brought by the uneven consolidation of the actual environment, that has provided it's re-emergency in national territory. The main objective is to analyze the re-emergency of dengue in Brazil and its relations with the socio-spatial changes brought by the uneven expansion of the technical-scientific-information environment and the globalization's process in the country, comparing several geographical scales

Em 1996, a Organização Mundial da Saúde declarava a tuberculose em estado de emergência no mundo, maior causa de morte por doença infecciosa em adultos. A Organização estima que em 2007, ocorreram aproximadamente 9,27 milhões de casos novos (139 casos por 100.000 habitantes) no mundo, sendo 14,8% (1,37 milhão) co-infectados pelo HIV. Em 2005, a tuberculose foi a 9ª causa de hospitalização e a 4ª causa de mortalidade por doenças infecciosas no Brasil. A tuberculose é uma doença que expressa forte relação com a pobreza. Assim, se existe forte relação entre tuberculose e pobreza, a produção do espaço urbano deve proporcionar as condições necessárias para a permanência e alta incidência da tuberculose em alguns municípios brasileiros. Para investigar tal relação, elegeu-se o município de Guarulhos, no estado de São Paulo, o segundo mais populoso do estado, com 1.299.283 habitantes. Em Guarulhos, a forma de ocupação e a redistribuição dos habitantes nos territórios do município vêm agravando os processos de exclusão social. O objetivo deste trabalho foi identificar o padrão espacial dos casos novos notificados de tuberculose no município de Guarulhos, de 1998 a 2009, e investigar a influência de algumas variáveis socioeconômicas na distribuição da doença. Para isso foram realizadas análises estatísticas espaciais para verificação do padrão de distribuição espacial da doença, em duas unidades de agregação (grandes bairros e setores censitários). Também foram elaborados mapas da distribuição espacial de variáveis socioeconômicas consideradas relevantes para a transmissão e ocorrência da doença. No período que compreendeu os anos de 1998 a 2009, foram notificados 4.524 casos novos de tuberculose em Guarulhos, de pacientes residentes no município. Os resultados da 7 análise puramente espacial para detecção de agrupamentos altos e baixos efetuada por meio do programa SaTscan mostraram que no período estudado, a incidência média anual foi de 35,2/100 mil habitantes. A análise dos agrupamentos espaciais por bairro mostrou-se inadequada para o estudo da distribuição da tuberculose em Guarulhos, pois não permitem analisar as condições intrabairro. Os bairros são por demais heterogêneos internamente. A análise de correlação entre o risco relativo e os setores censitários permite observar que o risco relativo de tuberculose em Guarulhos apresenta associação significativa com algumas variáveis: (1) relação direta com o percentual de domicílios particulares permanentes com mais de sete moradores; (2) relação inversa com o percentual de domicílios coletivos; (3) relação direta com o percentual de domicílios particulares permanentes com banheiro e acesso a esgoto e, (4) relação inversa com a densidade demográfica. Embora exista um padrão espacial e coincidência de condições precárias e a doença, os casos novos notificados em Guarulhos não são somente determinados pelas condições socioeconômicas. A identificação das áreas de mais alto risco de adoecer de tuberculose constitui instrumento útil para a estruturação de um sistema de vigilância com base territorial, identificando grupos populacionais prioritários. / In 1996, the World Health Organization declared that tuberculosis in state of alert in the world. The disease was the lead cause of mortality by infeccious diseases in adults. The Organization estimates that in 2007, it occurred about 9.27 million new cases (139 cases by 100,000 people) in the world, of those, 14.8% (1.37 million) coinfected by HIV. In 2005, TB was the 9th cause of hospitalization and the 4th cause of mortality by infectious diseases in Brazil. From the geographical perspective, TB is a very interesting disease due to its strong association with the poverty. Thus, if there is strong association between TB and poverty, the production of the urban space must provide the conditions to the mantainement of high incidence of TB in some Brazilian municipalities. To investigate this relationship, the municipality of Guarulhos, SP, the second most populated in the state of São Paulo, was chosen. In Guarulhos, the spatial occupation and the redistribution of the inhabitants in the municipality has been agravating the processes of social exclusion. The main objective of this study was to identify the spatial pattern of the new cases of tuberculosis in Guarulhos, from 1998 to 2009, and, to investigate the influence of some socioeconomic variables in the disease distribution. Several statistical analyses were performed to verify the spatial pattern of the disease in two spatial unities of agregation (by bairros - Brazilian administrative division and by census tract). Maps of the distribution of socioeconomic variables were elaborated. In the study period, 4,524 new cases were notified in Guarulhos. Results of the spatial analysis to detection of high and low clusters performed by SaTscan software showed that the mean annual incidence was 35.2/100,000 inhabitants. The analyses by bairro showed inadequate to this study due to the internal hetorogeneity of this unity of analysis. The correlation between census tracts and relative risk allows to 9 observe that the relative risk in Guarulhos presents significant association with some variables: (1) direct relation with the percentage of households with more than seven people; (2) inverse relation with percentage of colective households; (3) direct relation with the percentage of households with bathroom and access to sewing, (4) inverse relation with demographic density. Although, there is a spatial pattern and coincidence of poor conditions and the disease, the new cases are not exclusively (or mainly) determined by socioeconomic conditions. The identification of high risk areas constitutes a usefool tool to the settlement of um surveillance system with territorial basis, identifying priority populational groups.

No description available.

Made available in DSpace on 2014-06-11T19:33:35Z (GMT). No. of bitstreams: 0 Previous issue date: 2008-12-17Bitstream added on 2014-06-13T20:25:18Z : No. of bitstreams: 1 almeida_alj_dr_prud.pdf: 1955312 bytes, checksum: cfcc325f336a0e681fecc65766a59dde (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / O presente trabalho visa compreender a produção do lugar social por meio das práticas dos fisioterapeutas em seu espaço de trabalho. As práticas tradicionais dos fisioterapeutas têm demonstrado que o exercício profissional está caracterizado por ações fragmentadas e descontextualizadas. Assim, na perspectiva de buscar um entendimento teórico sobre essas questões, a Geografia contribuiu com o entendimento das relações construídas no espaço das práticas. O material empírico utilizado foi 89 entrevistas com fisioterapeutas, dados do I Censo de Fisioterapeutas do Estado de São Paulo e dados do Ministério da Educação sobre a trajetória dos cursos de graduação em Fisioterapia. As análises dessas informações mostraram que o lugar social do fisioterapeuta está fortemente ligado à reabilitação, identificado com o ideário liberal privatista, com as instituições formadoras, predominantemente vinculadas ao ensino privado e concentradas na região sudeste, principalmente no Estado de São Paulo. As entrevistas e os dados analisados sustentam as evidências de uma prática profissional fragmentada e reducionista, resultando em um processo de alienação dos fisioterapeutas... / This thesis aims to understand the production of social place through the practice of physical therapists at their work place. The traditional work of physical therapy as exercised by professional tends to be characterized by actions both fragmented and decontextualized. In an effort to explain this situation, geography offers theoretical perspectives useful for understanding how workplaces are constructed. This empirical research used includes 89 interviews with physical therapists, data from the “First São Paulo State Physical Therapists Census” and Brazil’s Ministry of Education studies on the trajectory of undergraduate physical therapy programs. Most of these programs are located in private colleges, that are regionally concentrated in southeast of Brazil, especially the state of São Paulo. The analysis of this information demonstrated that the workplace of the physical therapist is built around rehabilitation services that are tightly linked to the individualist, own private and liberal ideal. On the one hand, the interviews and data sustain the argument that traditional professional practice is fragmented and reductionist, resulting in a process that alienates physical therapists... (Complete abstract click electronic access below)

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No. of bitstreams: 1 dias_ls_dr_prud.pdf: 9993553 bytes, checksum: 9c6241981e0f993b18a8ee216ee9ca96 (MD5) Previous issue date: 2016-04-09 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Levantamentos de moscas sinantrópicas foram realizados para verificar a composição e abundância das famílias Calliphoridae e Muscidae, considerando a interferência antrópica em quatro ambientes (centro urbano, área florestal, assentamento rural e área canavieira) na região do Pontal do Paranapenama, São Paulo. Essas moscas são de grande interesse médico-sanitário, pois são vetores mecânicos de agentes patogênicos (vírus, bactérias, ovos de helmintos, cistos de protozoários), frequentam diversos ambientes, alimentam-se de diversos tipos de substratos efêmeros, apresentam elevado grau de sinantropia e são consideradas indicadores da qualidade ambiental. Para a captura dos insetos, de março de 2012 a março de 2013, no município de Teodoro Sampaio – SP, foram utilizadas armadilhas confeccionadas com garrafas tipo “Pet-2L”, contendo fígado bovino e peixe (sardinha) como iscas, em cada ambiente pesquisado (centro urbano, área florestal, assentamento e canavial), no início, meio e fim de cada estação, em um período de 12 meses. Para verificar a relação entre os ambientes antropizados, alvos da pesquisa, e as moscas sinantrópicas, utilizou-se da proposta metodológica de Ross (1994). Para discussão dos resultados empregou-se os conceitos de Ross, baseado em Tricart: Unidades Ecodinâmicas de Instabilidade Potencial (Estáveis = área florestal “B”) e de Unidades Ecodinâmicas de Instabilidade Emergente (Instáveis = área urbana “A”, assentamento rural “C” e área canavieira “D”), classificadas em graus de fragilidade. Um total de 1.125 moscas foram capturadas, sendo 85,7% da família Calliphoridae e 14,3% da família Muscidae. Na cidade de Teodoro Sampaio (A) ocorreu a maior captura de califorídeos 56,2%, seguido da área florestal (B) 22,1%, assentamento (C) 14,5%, e do canavial (D) 7,2%, respectivamente. Os muscídeos 34,2%, foram mais abundantes no centro urbano (A), seguido na área florestal (B) 32,9%, no assentamento (C) 28,8%, e área canavieira (D) 4,1%. Como resultados, a análise de correlação revelou que nos ambientes urbanos (A), campesino (C) e do canavial (D) a população de califorídeos é mais alta em época de precipitação pluviométrica intensa, e, no primeiro (A) e no último (D), ressaltou-se as condições de umidade relativa do ar para sua proliferação. Em contraste, no ambiente florestal não foram observadas correlações entre variáveis indicadoras de condições de umidade decorrente de precipitação e populações de moscas, notando-se negativa de correlação entre temperatura e população de moscas. Observou-se influência diferenciada das condições climáticas para cada ambiente, oscilando entre temperatura e umidade, para os califorídeos. Para os muscídeos, não se observou correlação entre variáveis climáticas e número de captura, exceto a umidade relativa do ar com correlação negativa no ambiente florestal, sugerindo que essas moscas sejam mais estáveis pela melhor adaptação às condições geoclimáticas. O estudo identificou estreitas associações das moscas sinantrópicas com os seres humanos e sua capacidade de transmitir patógenos na região do Pontal do Paranapanema. Trouxe informação relevante que pode auxiliar no desenvolvimento de programas de controle e de educação ambiental e saúde, com ênfase na importância do saneamento para a gestão de moscas sinantrópicas nessa área em particular. / Surveys of synanthropic flies were performed to verify the composition and abundance of Calliphoridae and Muscidae families, with the anthropic interference in four environments (urban center, forestry, rural settlement and sugarcane area) in the region of Pontal do Paranapenama, São Paulo. These flies are of great medical and health interest since they are mechanical vectors of pathogens (viruses, bacteria, helminth eggs, protozoan cysts). Furthermore they are found at various environments, feed on various types of ephemeral substrates, have a high level of synanthropy and are considered indicators of environmental quality. In order to capture those insects from March 2012 to March 2013 in the municipality of Teodoro Sampaio - SP, traps made with bottles type "Pet-2L" containing beef liver and fish (sardines) were used as baits in each researched environment (urban center, forestry, settlement and sugarcane), at the beginning, middle and end of each season, in a period of 12 months. To verify the relationship between anthropogenic environments, targeted research, and synanthropic flies, the methodological proposal of Ross was used. To discuss the results the Ross concepts were used, based on Tricart: Ecodinamic Units of Potential Instability (Stable = forest area “B”) and Ecodinamic Units of Emergent Instability (Unstable = urban area “A” rural settlement “C” and sugarcane area “D”, classified in degrees of fragility. A total of 1,125 flies were captured, and 85.7% of the Calliphoridae family and 14.3% of Muscidae. In the city of Teodoro Sampaio (A) was the largest capture, calliphorid 56.2%, followed by forestry 22.1%, settlement (C) 14.5% and cane field (D) 7.2% respectively. The muscídeos 34.2% were more abundant in the urban center (A), followed by the forest area (B) 32.9%, the settlement (C) 28.8% and the sugarcane area ( D) 4.1%. As a result, the correlation analysis revealed that in urban environments (A), campesino (C) and sugarcane (D) the population of blowflies is higher in times of intense rainfall, and in the first (A) and last (D), it was noticed that proliferation was due to the conditions of relative humidity of the air. In contrast, in the forest environment correlations between variables indicating humidity conditions resulting from precipitation and fly populations were not observed, therefore a negative correlation between temperature and population of flies. There was different influence of climatic conditions for each environment, ranging from temperature and humidity, for blowflies. For muscídeos there was no correlation between climatic variables and capture number, except the relative humidity of the air with negative correlation in the forest environment, suggesting that these flies are more stable for the best adaptation to geo-climatic conditions. The study identified close associations with synanthropic flies and humans and their ability to transmit pathogens in the Pontal do Paranapanema region. Also it provided relevant information that may assist in the development of control, environmental education and health programs, focusing on the importance of sanitation for the management of synanthropic flies in this particular area.