Canada has a long history of investing in agricultural research, with public funds playing a dominant role for most crops up until recently. With the advent of biotechnology in the 1980s, the research industry underwent significant transformations. Crops more amenable to the application of DNA modification techniques (e.g., canola) gained considerable attention by the private sector and experienced an influx of private R&D investment and proliferation of intellectual property rights (IPRs). IPRs have changed the nature of knowledge from being non-excludable to being excludable, thus affecting the nature of research benefits and research incentives. The advantages and disadvantages of a stronger IPR system in Canadian agriculture are currently hotly debated in policy circles. <p> This thesis develops a theoretical model that describes the incentives for innovation and the distribution of benefits from research when such innovations are protected by Plant Breeders' Rights (PBRs) versus patents. Specifically, the research industry is modeled as a monopolistic seed company undertaking research, developing a new variety and selling it to heterogeneous farmers. The difference between PBRs and patents is embodied in the farmers' decision that incorporates the possibility of seed saving envisioned by PBRs, but not by patents. The simulation results show that under certain conditions PBRs can be as effective as patents in encouraging R&D activity, and that the share of farmers in total benefits is generally smaller under patents than under PBRs. The benefits under patenting regime, however, are not necessarily smaller in absolute terms. <P>This dissertation also develops a game theoretic model to study the impact of IPRs on the sharing of research inputs. The results reveal that when two private firms compete in a differentiated product market, they will have an incentive to protect their technologies and maintain exclusive rights. Therefore, sharing within private industry may be a challenge. As IPRs proliferate, however, a lack of incentive to share/cross-license may not be confined to private industry. IPRs may also impact the propensity of public researchers to protect or share their technologies. <P>To address the issue of sharing and assess the efficiency of the current IP protection system in the Canadian plant breeding industry, interviews with wheat and canola breeders were conducted. The responses suggest that, in general, patents have become more prevalent in both industries over the last decade, which has, in turn, reduced germplasm and information flows and increased secrecy. There is also evidence that patents undermine R&D efforts in some potentially promising areas of research and make freedom to operate in the breeding industry a concern.

Canada has a long history of investing in agricultural research, with public funds playing a dominant role for most crops up until recently. With the advent of biotechnology in the 1980s, the research industry underwent significant transformations. Crops more amenable to the application of DNA modification techniques (e.g., canola) gained considerable attention by the private sector and experienced an influx of private R&D investment and proliferation of intellectual property rights (IPRs). IPRs have changed the nature of knowledge from being non-excludable to being excludable, thus affecting the nature of research benefits and research incentives. The advantages and disadvantages of a stronger IPR system in Canadian agriculture are currently hotly debated in policy circles. <p> This thesis develops a theoretical model that describes the incentives for innovation and the distribution of benefits from research when such innovations are protected by Plant Breeders' Rights (PBRs) versus patents. Specifically, the research industry is modeled as a monopolistic seed company undertaking research, developing a new variety and selling it to heterogeneous farmers. The difference between PBRs and patents is embodied in the farmers' decision that incorporates the possibility of seed saving envisioned by PBRs, but not by patents. The simulation results show that under certain conditions PBRs can be as effective as patents in encouraging R&D activity, and that the share of farmers in total benefits is generally smaller under patents than under PBRs. The benefits under patenting regime, however, are not necessarily smaller in absolute terms. <P>This dissertation also develops a game theoretic model to study the impact of IPRs on the sharing of research inputs. The results reveal that when two private firms compete in a differentiated product market, they will have an incentive to protect their technologies and maintain exclusive rights. Therefore, sharing within private industry may be a challenge. As IPRs proliferate, however, a lack of incentive to share/cross-license may not be confined to private industry. IPRs may also impact the propensity of public researchers to protect or share their technologies. <P>To address the issue of sharing and assess the efficiency of the current IP protection system in the Canadian plant breeding industry, interviews with wheat and canola breeders were conducted. The responses suggest that, in general, patents have become more prevalent in both industries over the last decade, which has, in turn, reduced germplasm and information flows and increased secrecy. There is also evidence that patents undermine R&D efforts in some potentially promising areas of research and make freedom to operate in the breeding industry a concern.

Trata-se de pesquisa empírica cujo objeto são os indicadores do Índice Paulista de Responsabilidade Social (IPRS). À luz deste índice, se analisa educação e desenvolvimento nos municípios do noroeste paulista, buscando compreender que fatores levam aos bons resultados nos indicadores de escolaridade, obtidos por um grupo de municípios com baixos níveis de riqueza, denominados de grupo 3 do IPRS. O trabalho busca, por meio de um olhar crítico da composição das variáveis do IPRS, analisar a capacidade destas expressarem a realidade do ambiente educacional dos municípios e, ao mesmo tempo, serem úteis na definição de políticas visando fortalecer as dinâmicas de desenvolvimento dos mesmos. Com isso objetiva contribuir com o debate sobre a formulação de indicadores educacionais mais adequados à análise do desenvolvimento na atualidade. Parte-se da constatação da relevância da educação nas atuais dinâmicas de desenvolvimento, não mais compreendido como sinônimo de crescimento econômico, ressaltando a inclusão da dimensão educacional nos instrumentos de mensuração do desenvolvimento humano. São discutidos os conceitos de desenvolvimento como liberdade e de capital social como parâmetros para se compreender o surgimento de uma nova geração de indicadores de desenvolvimento dentre os quais o índice paulista. Estes conceitos são abordados com base nas referências teóricas fornecidas por Sen, Putnam, Bourdieu e Coleman, objetivando analisar a capacidade do IPRS em incorporar estes conceitos nas suas dimensões. Paralelamente a isso se apresenta e analisa os indicadores do IPRS no estado de São Paulo e nos municípios da região noroeste, buscando compreender o que leva a emergência de um grupo expressivo de municípios pobres em termos de riqueza mas com indicadores sociais satisfatórios. Para tanto são utilizados os dados secundários do banco de dados do IPRS da Fundação Seade. Com isso se constata dois aspectos: a relevância da dimensão escolaridade nos bons resultados sociais obtidos por estes municípios e a insuficiência dos indicadores educacionais do índice paulista, especialmente no que se refere a incorporar outras variáveis quantitativas relacionadas ao ambiente educacional disponível quanto variáveis referentes à qualidade dos processos educativos desenvolvidos. As seguintes considerações finais são apresentadas: o IPRS é um indicador que avança na sua estruturação e capacidade de retratar a realidade do desenvolvimento dos municípios, fugindo da padronização dos indicadores sintéticos, contudo, ainda apresenta limitações no que tange a capacidade de analisar o ambiente educacional e a qualidade da educação ofertada e, conseqüentemente, contribuir de maneira efetiva como instrumento de monitoramento e avaliação das políticas que visam fortalecer as dinâmicas de desenvolvimento dos municípios paulistas. / The following study is an empirical research, having as its object the indicators of the Índice Paulista de Responsabilidade Social (São Paulo Index of Social Responsibility, here referred as IPRS). Having this Index as reference, we analyze education and development of the cities located in the Northwest of São Paulo State, aiming to understand which factors lead to the good results in schooling indicators obtained by a group of low income cities, rated in group 3 in the IPRS. The study?s purpose is to analyze (through a detailed and critical look at the variables that compose the IPRS) its capacity of expressing the reality of the educational environment in the cities as well as being useful in the definition of policies that would aim to strengthen its development actions. Considering this, we intend to contribute to the debate on the creation of educational indicators that would be more adequate to the analysis of development nowadays. We take as a premise the relevance of education in the current development actions, not seen as a synonym to economical growth anymore, stressing the inclusion of the educational dimension in the measuring instruments of human development. We address the concepts of development seen as freedom and social capital as a guideline to understand the advent of a new generation of development indicators among which is the São Paulo index. These concepts are approached based on the references of theories given by Sen, Putnam, Bourdieu and Coleman, purposing to analyze the capacity of IPRS to encompass all these concepts within its boundaries. Concurrently, we present and examine the IPRS indicators in São Paulo State and in the cities of the Northwestern region, attempting to understand what leads to the appearance of an expressive number of low income cities with satisfactory social indicators. In order to do that we use the secondary data of the IPRS database from Fundação Seade. Considering this, two aspects are evidenced: the relevance of the schooling dimension in the good social results obtained by these cities and the inadequacy of the educational indicators in the São Paulo index, especially in taking into consideration other quantitative variables related to the educational environment available and to the quality of the educational processes developed. The following final points are then presented: the IPRS is an indicator that moves towards to its organization and capacity of depicting the reality of the cities development, distancing itself from the standardization of synthetic indicators, though still presenting some limitation regarding the ability to analyze the educational environment and the education quality offered, and thus effectively collaborate as an instrument of monitoring and assessment of the policies that aim the strengthening of the development actions for São Paulo cities.

Trata-se de pesquisa empírica cujo objeto são os indicadores do Índice Paulista de Responsabilidade Social (IPRS). À luz deste índice, se analisa educação e desenvolvimento nos municípios do noroeste paulista, buscando compreender que fatores levam aos bons resultados nos indicadores de escolaridade, obtidos por um grupo de municípios com baixos níveis de riqueza, denominados de grupo 3 do IPRS. O trabalho busca, por meio de um olhar crítico da composição das variáveis do IPRS, analisar a capacidade destas expressarem a realidade do ambiente educacional dos municípios e, ao mesmo tempo, serem úteis na definição de políticas visando fortalecer as dinâmicas de desenvolvimento dos mesmos. Com isso objetiva contribuir com o debate sobre a formulação de indicadores educacionais mais adequados à análise do desenvolvimento na atualidade. Parte-se da constatação da relevância da educação nas atuais dinâmicas de desenvolvimento, não mais compreendido como sinônimo de crescimento econômico, ressaltando a inclusão da dimensão educacional nos instrumentos de mensuração do desenvolvimento humano. São discutidos os conceitos de desenvolvimento como liberdade e de capital social como parâmetros para se compreender o surgimento de uma nova geração de indicadores de desenvolvimento dentre os quais o índice paulista. Estes conceitos são abordados com base nas referências teóricas fornecidas por Sen, Putnam, Bourdieu e Coleman, objetivando analisar a capacidade do IPRS em incorporar estes conceitos nas suas dimensões. Paralelamente a isso se apresenta e analisa os indicadores do IPRS no estado de São Paulo e nos municípios da região noroeste, buscando compreender o que leva a emergência de um grupo expressivo de municípios pobres em termos de riqueza mas com indicadores sociais satisfatórios. Para tanto são utilizados os dados secundários do banco de dados do IPRS da Fundação Seade. Com isso se constata dois aspectos: a relevância da dimensão escolaridade nos bons resultados sociais obtidos por estes municípios e a insuficiência dos indicadores educacionais do índice paulista, especialmente no que se refere a incorporar outras variáveis quantitativas relacionadas ao ambiente educacional disponível quanto variáveis referentes à qualidade dos processos educativos desenvolvidos. As seguintes considerações finais são apresentadas: o IPRS é um indicador que avança na sua estruturação e capacidade de retratar a realidade do desenvolvimento dos municípios, fugindo da padronização dos indicadores sintéticos, contudo, ainda apresenta limitações no que tange a capacidade de analisar o ambiente educacional e a qualidade da educação ofertada e, conseqüentemente, contribuir de maneira efetiva como instrumento de monitoramento e avaliação das políticas que visam fortalecer as dinâmicas de desenvolvimento dos municípios paulistas. / The following study is an empirical research, having as its object the indicators of the Índice Paulista de Responsabilidade Social (São Paulo Index of Social Responsibility, here referred as IPRS). Having this Index as reference, we analyze education and development of the cities located in the Northwest of São Paulo State, aiming to understand which factors lead to the good results in schooling indicators obtained by a group of low income cities, rated in group 3 in the IPRS. The study?s purpose is to analyze (through a detailed and critical look at the variables that compose the IPRS) its capacity of expressing the reality of the educational environment in the cities as well as being useful in the definition of policies that would aim to strengthen its development actions. Considering this, we intend to contribute to the debate on the creation of educational indicators that would be more adequate to the analysis of development nowadays. We take as a premise the relevance of education in the current development actions, not seen as a synonym to economical growth anymore, stressing the inclusion of the educational dimension in the measuring instruments of human development. We address the concepts of development seen as freedom and social capital as a guideline to understand the advent of a new generation of development indicators among which is the São Paulo index. These concepts are approached based on the references of theories given by Sen, Putnam, Bourdieu and Coleman, purposing to analyze the capacity of IPRS to encompass all these concepts within its boundaries. Concurrently, we present and examine the IPRS indicators in São Paulo State and in the cities of the Northwestern region, attempting to understand what leads to the appearance of an expressive number of low income cities with satisfactory social indicators. In order to do that we use the secondary data of the IPRS database from Fundação Seade. Considering this, two aspects are evidenced: the relevance of the schooling dimension in the good social results obtained by these cities and the inadequacy of the educational indicators in the São Paulo index, especially in taking into consideration other quantitative variables related to the educational environment available and to the quality of the educational processes developed. The following final points are then presented: the IPRS is an indicator that moves towards to its organization and capacity of depicting the reality of the cities development, distancing itself from the standardization of synthetic indicators, though still presenting some limitation regarding the ability to analyze the educational environment and the education quality offered, and thus effectively collaborate as an instrument of monitoring and assessment of the policies that aim the strengthening of the development actions for São Paulo cities.

The principal purpose of this study is to provide a refined empirical investigation concerning country-specific determinants of horizontal and vertical intra-industry trade (IIT,) in relation to South Africa using the gravity model of trade in a panel data setting. Prior to investigating the case of South Africa's intra-industry trade a critical review of the relevant theoretical, methodologcal, and empirical literature is provided. The study operationalises the theoretical dstinction between horizontal and vertical IIT using the latest methodology of decomposing total IIT into horizontal intra-industry trade (HIIq and vertical intra-industry trade (WIT,). Thts study makes several advances on earlier empirical studies of intra-industry trade determinants. These include the introduction of new countq-specific determinants of intraindustry trade that previous studies have not examined. Furthermore, it is the first empirical study that traces the relationshp between intra-industry trade flows and intellectual property rights (IPRs). Moreover, to ensure the sensitivity and robustness of the results, several econometric approaches have been used in estimating the gravity model of South Africa's intra-industry trade: the consistent coefficient approach, the fixed effects approach, the random effects approach, and the between effects approach. The econometric results are generally satisfactory in terms of economic interpretation and statistical significance and thus offer new empirical validation to the theoretical explanatory variables. The key findngs suggest the following: the volume of South Africa's IIT has increased during the study period and its WIT exceeds its HIIT. The latter result reflects the nature of South Africa's trade as it imports high valued added products and exports primary and mineral products. South Africa's intra-industry trade and its two components are positively related to market size and standard of living, and negatively related to geographcal distance. Furthermore, separately, the IPRs and the imitation ability of South Africa's tradmg partners are not important factors in determining IIT flows; however, the interaction between them is an important factor. Thts study also reveals South Africa should pursue its intra-industry trade with rest of world concentrating on local industries that produce most competitive varieties, absorbing labor and other resources from the production of other varieties.

La tesi ha ad oggetto le forme di tutela dei diritti di proprietà industriale sulle invenzioni aventi ad oggetto piante. La prima parte del lavoro è dedicata ad un’analisi delle linee evolutive degli strumenti specifici di protezione delle nuove varietà vegetali introdotti, dapprima, nell’ordinamento giuridico statunitense e, qualche tempo dopo, in quelli dei Paesi aderenti alla Convenzione UPOV. L’autore pone a confronto le suddette discipline ad hoc con la normativa brevettuale classica, evidenziandone le differenze sia sul piano dei rispettivi requisiti d’accesso che su quello del contenuto e della portata della tutela. Viene, dunque, valutato l’impatto prodotto dall’avvento delle moderne biotecnologie sui sistemi normativi vigenti in Europa e negli Stati Uniti in materia di protezione dell’innovazione conseguita in campo agricolo. Attraverso lo studio dei principali arresti giurisprudenziali e delle iniziative legislative succedutisi negli ultimi anni, vengono delineati i tratti caratteristici degli approcci adottati, rispettivamente, oltre-Atlantico e nel vecchio continente al fine di fornire risposta alle questioni determinate dalla rivoluzione biotecnologica, con particolare riguardo ai problemi di interfaccia fra tutela varietale e tutela brevettuale che quest’ultima ha determinato. L’autore ritiene che le vie seguite negli Stati Uniti ed in Europa, per quanto diverse tra loro sul piano formale, non siano poi così distanti nella sostanza e, de jure condendo, suggerisce di ridefinire in Europa le interrelazioni fra tutela varietale e tutela brevettuale, abrogando il divieto di brevettazione delle nuove varietà vegetali, vero elemento differenziale fra il contesto normativo europeo e quello statunitense. / Intellectual property rights on plant-related inventions are the subject matter of this thesis. In the first part of this work, the author analyzes the evolution of the specific means of protection for new plant varieties first introduced in the United States of America and then in the member States of the UPOV Convention. The author makes a comparison between these ad hoc means of protection and the patent protection, by pointing out the differences in respect to the conditions for protection and the scope of protection. After that, an assessment of the impact of modern biotechnology on the existent European and American plant-related invention systems of protection is made. The author investigates the approaches which were chosen in Europe and in the United States of America in order to address the issues related to the biotechnological revolution, with particular focus on the interface problems between plant variety protection and patent protection, by means of a study of the principal case law and regulatory interventions adopted during the last years. The author believes that American and European approaches are not so different in substance and, de jure condendo, suggests redefining the relationship between plant variety protection and patent protection in Europe through the elimination of the ban on patent protection for plant varieties, which is the real differential factor between European and American normative contexts.

La contrefaçon est un phénomène de dimension internationale qui constitue aujourd’hui plus qu’hier un véritable fléau. Il apparaît que les principaux pays de provenance des contrefaçons saisies dans l’Union Européenne sont les pays d’Asie,notamment la Thaïlande. Cette recherche a pour but d'étudier les problèmes juridiques relatifs à la contrefaçon des droits de propriété intellectuelle. Ceci nous amène à poursuivre la recherche suivant deux axes. La première partie a pour but de mettre en évidence la comparaison de la définition de la contrefaçon en France et en Thaïlande. Elle se décompose en deux sous-parties, la première s'attachant à décrire la qualification de l’atteinte constitutive de contrefaçon selon les droits concernés (le terme « contrefaçon » en lui-même, tant en France qu’en Thaïlande, désignant différentes formes d’atteintes à un droit patrimonial de propriété intellectuelle). Pour identifier les atteintes constitutives de contrefaçon, notamment l’élément matériel, nous mettons l’accent sur 4 points: l’existence de la création, la diffusion de la création, l’usage de la création et la participation à l’action contrefaisante. S’agissant de l’élément intentionnel de contrefaçon, il semble présenter de multiples facettes. La seconde définit la preuve de la contrefaçon. On observe alors les moyens de preuve de la contrefaçon : la loi prévoit deux séries de mesures principales que nous pouvons regrouper en moyens de preuve en matière civile et pénale. Par ailleurs, il y a des moyens de preuve alternatifs entre les deux régimes. Ce sont des procédures douanières.La seconde partie a pour objet la prise en considération de la répression par les juridictions civiles et pénales. Elle se décompose donc en deux sous-parties : la première concerne les sanctions prononcées par les juridictions pénales. Nous avons déjà étudié la procédure pénale et les sanctions applicables à la contrefaçon. Il se trouve que la situation en Thaïlande est totalement différente de la situation française, notamment concernant la jurisprudence en matière pénale. Il semblerait que la majorité des décisions soient des sanctions prononcées par les juridictions pénales. La seconde sous-partie concerne quant à elle la réparation des atteintes à la propriété intellectuelle. Nous constatons que le préjudice subi, en France tout comme en Thaïlande constitue en un gain manqué . En outre l’évaluation du préjudice en France et en Thaïlande est difficile (préjudice subi en matière de marque, préjudice moral et fixation de l’indemnisation de peine privée). / Counterfeiting is an international problem. It appears that the main countries of origin of counterfeit goods seized in the European Union are the Asian countries, including Thailand. The research explains concisely the entire key factors to this whole problem. The research is divided into two parts; in the first place, I will outline pointly the definition of Intellectual Property Rights law (IPRs law) infringement between French and Thailand. Firstly, we focus on the structure of IPRs infringement. The term "counterfeit" in himself both in France and Thailand indicating different forms of an intellectual property rights liability conception. To identify violations constitute infringements, including the material element, we focus on four points, the existence of the creation, dissemination of the creation, use of creation, participation in the infringing action . With regard to the intentional element of infringement, iconcerned the intention of counterfeiter by the civil and criminal aspects as well as the objectives of my research would analysis on two components. First, the application of substantive issues embodies in the civil action. The second is the criminal action. The intention of counterfeiter are also intersect into two parts of action. The secondly,, we research to the proof of infringement. There provides two measures of proof in civil matters and evidence incriminal matters. In addition, there are a customs procedures as an alternative measure of proof . In the second place, we mainly concerned the IPRs law enforcement: Firstly we concerns the penalties imposed by criminal courts. We have already studied the criminal proceedings. In addition, we studied the penaltiesfor counterfeiting. We find that the criminal proceedings in Thailand is totally different from the criminal proceedings in France. In addition, we studied the penalization of IPRs law. We find that the situation in Thailand is totally different from a France, especially in criminal jurisprudence. It seems that the majority of decisions are the penalties imposed by criminal courts. Secondly were search about categories of damages and criteria for proof of damages. We find that the damages, in France as well as in Thailand, is the recovery of profit. Also the difficulty of assessing the damage, in France as well as in Thailand, are the damage of Trademark law, moral right damage and punitive damage.

Ainda que limitadas enquanto expressão dos eventos ligados à saúde e apesar das deficiências em relação à cobertura e à qualidade dos dados, as estatísticas de mortalidade constituem um dos mais importantes subsídios para o planejamento e avaliação dos serviços de saúde. Tradicionalmente, a mortalidade de uma determinada população tem sido aferida por meio das taxas brutas e específicas de mortalidade. Porém, esses índices consideram apenas a magnitude das causas de óbito, sem qualificar o peso resultante dessas mortes para a sociedade. Neste sentido, tem-se enfatizado cada vez mais a importância da mortalidade prematura enquanto expressão social do valor da morte, pois esta, quando ocorre numa idade de altas criatividade e produtividade não só afeta o indivíduo e o grupo social que convive diretamente com ele, mas a sociedade como um todo, que é privada do seu potencial econômico e intelectual (REICHENHEIM; WERNECK, 1994). \"O indicador Anos Potenciais de Vida Perdidos (APVP), ao combinar a magnitude das mortes com a idade em que ocorreram os óbitos, qualifica essas mortes\" (KERR-PONTES; ROUQUAYROL, 1999 apud SAUER; WAGNER, 2003, p. 1520). Este estudo pretendeu avaliar a evolução dos APVPs nos municípios e regionais de saúde do Estado de São Paulo, no período de 2003 a 2013, para a população total. Pretendeu, também, analisar a evolução retrospectiva das 15 causas de óbito com as maiores taxas de APVP em 2013, para a população total do Estado de São Paulo. Para tanto, foi elaborada uma base de dados a partir dos óbitos de residentes do Estado de São Paulo ocorridos no período de 2003 a 2013 e processados pelo SIM (Sistema de Informação sobre Mortalidade), sendo as causas de morte classificadas de acordo com a Décima Revisão da Classificação Internacional de Doenças (CID 10). O cálculo dos APVPs foi realizado com base numa proposta feita por Romeder e McWhinnie (1988) e, após elaborados os dados, foram confeccionados cartogramas utilizando o programa Tabwin para visualização da evolução dos APVPs nas regionais de saúde do Estado. Foram construídos gráficos de linha para a observação da evolução das 15 causas de óbito com as maiores taxas de APVP de 2003 a 2013. Posteriormente, foram analisadas as Taxa de Mortalidade Geral (TMG), Taxa de Mortalidade Infantil (TMI) e Taxa de Mortalidade Materna (TMM) para os anos de 7 2003 a 2013 para o Estado de São Paulo. E, finalmente, foram avaliados: as dimensões escolaridade, longevidade e riqueza do Índice Paulista de Responsabilidade Social (IPRS) em cada um de seus grupos; frequência absoluta e relativa do IPRS em cada um de seus grupos; relação do IPRS segundo Redes Regionais de Atenção à Saúde (RRAS); relação IPRS segundo Grupos Populacionais; TAPVP por grupos de IPRS; TAPVP por Grupos Populacionais; TAPVP por RRAS; IPRS na sua dimensão Riqueza por TAPVP; IPRS na sua dimensão Longevidade por TAPVP; IPRS na sua dimensão Escolaridade por TAPVP; Correlação entre as dimensões do IPRS e TAPVP. Todas estas avaliações são válidas para o Estado de São Paulo para o ano de 2012 e foram obtidas utilizando-se o aplicativo Stata 9.0. A Taxa de Mortalidade Geral (TMG) para o Estado de São Paulo para o período de 2003 a 2013 em comparação com a do Brasil mostrou-se desfavorável, o mesmo acontecendo com a Taxa de Mortalidade Infantil (TMI), cujo predomínio, no Estado, foi do componente Pós-Neonatal. Já a Taxa de Mortalidade Materna (TMM) demonstrou boa assistência ao pré-natal, parto e puerpério no Estado no período citado. Observando-se a evolução das TAPVP nos cartogramas do Estado de São Paulo no período de 2003 a 2013 as RRAS onde as TAPVP foram maiores foram: 6, 7, 9, 10, 11, 12, 13 e 17. Das quinze maiores causas de óbito segundo TAPVP para o Estado no período, nove são passíveis de prevenção na atenção primária. Citou-se ainda o subregistro e a tripla carga de doenças. A maioria dos 645 municípios do Estado de São Paulo, no ano de 2012 apresentaram um IPRS de grupo 4. Houve 95% de probabilidade de que a maior TAPVP ocorreu para o IPRS 4 com um IC de 17.325,04 a 18.424,20. O Teste de Anova, com 4 gl mostrou diferença significativa (p<0,05) na TAPVP por grupos de IPRS. Com 5 graus de liberdade, o Teste de Kruskal-Wallis foi significativo (p<0,05) indicando que houve diferença entre os Grupos Populacionais quanto à TAPVP. Com 16 graus de liberdade, o Teste de Kruskal-Wallis foi significativo (p<0,05) indicando que existiu diferença entre as RRAS quanto às TAPVP. À medida que aumentou a riqueza do IPRS, diminuiu, ainda que discretamente, a TAPVP. Longevidade e TAPVP mantiveram-se estáveis. Conforme aumentou a escolaridade, aumentou a TAPVP. Por existir uma correlação positiva entre riqueza e longevidade e escolaridade, à medida que aumentou a riqueza, aumentaram a longevidade e escolaridade. Com relação a TAPVP e riqueza e longevidade, o coeficiente de correlação foi negativo, significando que à medida que aumentaram a riqueza e 8 longevidade, diminuiu a TAPVP. Porém, com relação à escolaridade, o coeficiente de correlação entre o mesmo e a TAPVP foi positivo, indicando que à medida que aumentou a escolaridade, aumentou a TAPVP. Por fim, essa dissertação poderia ser apresentada às autoridades de saúde do Estado como um projeto para redução da mortalidade prematura, com foco em melhoria da educação básica, instalação de mais serviços de saúde de qualidade e adequação dos serviços de segurança pública. / Although limited as an expression of health-related events and despite problems concerning the coverage and quality of available data, mortality estimates are among the most important foundations for the planning and evaluation of health services. Traditionally, mortality has been estimated according to the gross and specific mortality rates in a given population. However, these indicators consider the impact of death causes alone, without qualifying the burden resulting from deaths to society. The importance of premature mortality as a social expression of the burden of death has therefore received increasing attention, as it occurs at an age range of high creativity and productivity and affects not only the individual and his direct social group, but society as a whole, whose economic and intellectual potential is affected (REICHENHEIM; WERNECK, 1994). The estimate of potential years of life lost (PYLL) provides a more detailed assessment of mortality by combining death rates and the age when death occurs (KERR-PONTES; ROUQUAYROL, 1999 apud SAUER; WAGNER, 2003, p. 1520). Our study was aimed at assessing the evolution of PYLL rates in the total population of cities and health districts in the State of São Paulo, Brazil, between 2003 and 2013. We also assessed the retrospective evolution of the 15 death causes with the greatest PYLL rates in 2013 for the total population of the State of São Paulo. In order to achieve this, we created a database with information on deaths occurred in the state between 2003 and 2013 which were processed by the Mortality Information System (MIS), with death causes classified according to the 10th revision of the International Classification of Diseases (ICD-10). PYLL rates were calculated according to the method proposed by Romeder and McWhinnie (1988) and data charts 9 were created in TabWin to display the evolution of PYLL rates in the health districts of the state. Line graphs were created to display the evolution of the 15 death causes with the highest PYLL rates between 2003 and 2013. We further assessed the general mortality rate (GMR), child mortality rates (CMR), and mother mortality rates (MMR). Finally, we assessed the education, longevity, and wealth dimensions of the São Paulo Index of Social Responsibility (SPISR) in each of its groups; absolute and relative frequency of the SPISR in each of its groups; relationship of the SPISR according to the Regional Health Care Networks (RHCN); SPISR relationship according to population groups; PYLL rates by SPISR group; PYLL rates by population groups; PYLL rates by RHCN; SPISR dimension \'wealth\' by PYLL rates; SPISR dimension \'longevity\' by PYLL rates; SPISR dimension \'education\' by PYLL rates; and correlations between SPISR dimensions and PYLL rates. All the analyses are valid for the State of São Paulo in the year of 2012 and were made using the Stata 9.0 software. The GMR in the State of São Paulo for the period of 2003-2013 was worse compared to Brazil, and so was the CMR, with a predominance of the post-neonatal component in the State. The MMR indicated the availability of adequate prenatal, delivery, and postpartum assistance in the State during the period. The data charts displaying the evolution of PYLL rates in the State of São Paulo show that the RHCNs with the highest PYLL rates were 6, 7, 9, 10, 11, 12, 13, and 17. From the main 15 death causes according to PYLL rates in the period, 9 can be prevented in primary care. Under-recording and the triple load of diseases were also detected. The SPISR of most of the 645 municipalities in the State of São Paulo in the year 2012 was 4. The probability that the highest PYLL rate was associated with a SPISR of 4 was 95%, with a confidence interval between 17325.04 and 18424.20. An ANOVA with 4 degrees of freedom showed significant differences (p<0.05) in PYLL rates by SPISR group. With 5 degrees of freedom, the test of Kruskal-Wallis provided significant results (p<0.05), indicating the existence of differences between population groups in respect to PYLL rates. With 16 degrees of freedom, the Kruskal-Wallis test indicated the existence of significant differences between the RHCNs in terms of PYLL rates. PYLL rates decreased, although subtly, with the increase of wealth in the SPISR. Longevity and PYLL rates remained stable. As education increased, PYLL rates also increased. Since there was a positive correlation between wealth, longevity, and education, increased wealth was associated 10 with increased longevity and education as well. Concerning the relationship between PYLL rates and wealth and longevity, we found a negative correlation coefficient, indicating that as wealth and longevity increased, PYLL rates decreased. In respect to education, however, the correlation with PYLL rates was positive, indicating that increases in education were associated with increases in PYLL rates. Finally, this dissertation could be presented to the health authorities of the State of São Paulo as a project to reduce early mortality, focused on improvements in basic education, expansion of high-quality health services, and improvements in public security

Ainda que limitadas enquanto expressão dos eventos ligados à saúde e apesar das deficiências em relação à cobertura e à qualidade dos dados, as estatísticas de mortalidade constituem um dos mais importantes subsídios para o planejamento e avaliação dos serviços de saúde. Tradicionalmente, a mortalidade de uma determinada população tem sido aferida por meio das taxas brutas e específicas de mortalidade. Porém, esses índices consideram apenas a magnitude das causas de óbito, sem qualificar o peso resultante dessas mortes para a sociedade. Neste sentido, tem-se enfatizado cada vez mais a importância da mortalidade prematura enquanto expressão social do valor da morte, pois esta, quando ocorre numa idade de altas criatividade e produtividade não só afeta o indivíduo e o grupo social que convive diretamente com ele, mas a sociedade como um todo, que é privada do seu potencial econômico e intelectual (REICHENHEIM; WERNECK, 1994). \"O indicador Anos Potenciais de Vida Perdidos (APVP), ao combinar a magnitude das mortes com a idade em que ocorreram os óbitos, qualifica essas mortes\" (KERR-PONTES; ROUQUAYROL, 1999 apud SAUER; WAGNER, 2003, p. 1520). Este estudo pretendeu avaliar a evolução dos APVPs nos municípios e regionais de saúde do Estado de São Paulo, no período de 2003 a 2013, para a população total. Pretendeu, também, analisar a evolução retrospectiva das 15 causas de óbito com as maiores taxas de APVP em 2013, para a população total do Estado de São Paulo. Para tanto, foi elaborada uma base de dados a partir dos óbitos de residentes do Estado de São Paulo ocorridos no período de 2003 a 2013 e processados pelo SIM (Sistema de Informação sobre Mortalidade), sendo as causas de morte classificadas de acordo com a Décima Revisão da Classificação Internacional de Doenças (CID 10). O cálculo dos APVPs foi realizado com base numa proposta feita por Romeder e McWhinnie (1988) e, após elaborados os dados, foram confeccionados cartogramas utilizando o programa Tabwin para visualização da evolução dos APVPs nas regionais de saúde do Estado. Foram construídos gráficos de linha para a observação da evolução das 15 causas de óbito com as maiores taxas de APVP de 2003 a 2013. Posteriormente, foram analisadas as Taxa de Mortalidade Geral (TMG), Taxa de Mortalidade Infantil (TMI) e Taxa de Mortalidade Materna (TMM) para os anos de 7 2003 a 2013 para o Estado de São Paulo. E, finalmente, foram avaliados: as dimensões escolaridade, longevidade e riqueza do Índice Paulista de Responsabilidade Social (IPRS) em cada um de seus grupos; frequência absoluta e relativa do IPRS em cada um de seus grupos; relação do IPRS segundo Redes Regionais de Atenção à Saúde (RRAS); relação IPRS segundo Grupos Populacionais; TAPVP por grupos de IPRS; TAPVP por Grupos Populacionais; TAPVP por RRAS; IPRS na sua dimensão Riqueza por TAPVP; IPRS na sua dimensão Longevidade por TAPVP; IPRS na sua dimensão Escolaridade por TAPVP; Correlação entre as dimensões do IPRS e TAPVP. Todas estas avaliações são válidas para o Estado de São Paulo para o ano de 2012 e foram obtidas utilizando-se o aplicativo Stata 9.0. A Taxa de Mortalidade Geral (TMG) para o Estado de São Paulo para o período de 2003 a 2013 em comparação com a do Brasil mostrou-se desfavorável, o mesmo acontecendo com a Taxa de Mortalidade Infantil (TMI), cujo predomínio, no Estado, foi do componente Pós-Neonatal. Já a Taxa de Mortalidade Materna (TMM) demonstrou boa assistência ao pré-natal, parto e puerpério no Estado no período citado. Observando-se a evolução das TAPVP nos cartogramas do Estado de São Paulo no período de 2003 a 2013 as RRAS onde as TAPVP foram maiores foram: 6, 7, 9, 10, 11, 12, 13 e 17. Das quinze maiores causas de óbito segundo TAPVP para o Estado no período, nove são passíveis de prevenção na atenção primária. Citou-se ainda o subregistro e a tripla carga de doenças. A maioria dos 645 municípios do Estado de São Paulo, no ano de 2012 apresentaram um IPRS de grupo 4. Houve 95% de probabilidade de que a maior TAPVP ocorreu para o IPRS 4 com um IC de 17.325,04 a 18.424,20. O Teste de Anova, com 4 gl mostrou diferença significativa (p<0,05) na TAPVP por grupos de IPRS. Com 5 graus de liberdade, o Teste de Kruskal-Wallis foi significativo (p<0,05) indicando que houve diferença entre os Grupos Populacionais quanto à TAPVP. Com 16 graus de liberdade, o Teste de Kruskal-Wallis foi significativo (p<0,05) indicando que existiu diferença entre as RRAS quanto às TAPVP. À medida que aumentou a riqueza do IPRS, diminuiu, ainda que discretamente, a TAPVP. Longevidade e TAPVP mantiveram-se estáveis. Conforme aumentou a escolaridade, aumentou a TAPVP. Por existir uma correlação positiva entre riqueza e longevidade e escolaridade, à medida que aumentou a riqueza, aumentaram a longevidade e escolaridade. Com relação a TAPVP e riqueza e longevidade, o coeficiente de correlação foi negativo, significando que à medida que aumentaram a riqueza e 8 longevidade, diminuiu a TAPVP. Porém, com relação à escolaridade, o coeficiente de correlação entre o mesmo e a TAPVP foi positivo, indicando que à medida que aumentou a escolaridade, aumentou a TAPVP. Por fim, essa dissertação poderia ser apresentada às autoridades de saúde do Estado como um projeto para redução da mortalidade prematura, com foco em melhoria da educação básica, instalação de mais serviços de saúde de qualidade e adequação dos serviços de segurança pública. / Although limited as an expression of health-related events and despite problems concerning the coverage and quality of available data, mortality estimates are among the most important foundations for the planning and evaluation of health services. Traditionally, mortality has been estimated according to the gross and specific mortality rates in a given population. However, these indicators consider the impact of death causes alone, without qualifying the burden resulting from deaths to society. The importance of premature mortality as a social expression of the burden of death has therefore received increasing attention, as it occurs at an age range of high creativity and productivity and affects not only the individual and his direct social group, but society as a whole, whose economic and intellectual potential is affected (REICHENHEIM; WERNECK, 1994). The estimate of potential years of life lost (PYLL) provides a more detailed assessment of mortality by combining death rates and the age when death occurs (KERR-PONTES; ROUQUAYROL, 1999 apud SAUER; WAGNER, 2003, p. 1520). Our study was aimed at assessing the evolution of PYLL rates in the total population of cities and health districts in the State of São Paulo, Brazil, between 2003 and 2013. We also assessed the retrospective evolution of the 15 death causes with the greatest PYLL rates in 2013 for the total population of the State of São Paulo. In order to achieve this, we created a database with information on deaths occurred in the state between 2003 and 2013 which were processed by the Mortality Information System (MIS), with death causes classified according to the 10th revision of the International Classification of Diseases (ICD-10). PYLL rates were calculated according to the method proposed by Romeder and McWhinnie (1988) and data charts 9 were created in TabWin to display the evolution of PYLL rates in the health districts of the state. Line graphs were created to display the evolution of the 15 death causes with the highest PYLL rates between 2003 and 2013. We further assessed the general mortality rate (GMR), child mortality rates (CMR), and mother mortality rates (MMR). Finally, we assessed the education, longevity, and wealth dimensions of the São Paulo Index of Social Responsibility (SPISR) in each of its groups; absolute and relative frequency of the SPISR in each of its groups; relationship of the SPISR according to the Regional Health Care Networks (RHCN); SPISR relationship according to population groups; PYLL rates by SPISR group; PYLL rates by population groups; PYLL rates by RHCN; SPISR dimension \'wealth\' by PYLL rates; SPISR dimension \'longevity\' by PYLL rates; SPISR dimension \'education\' by PYLL rates; and correlations between SPISR dimensions and PYLL rates. All the analyses are valid for the State of São Paulo in the year of 2012 and were made using the Stata 9.0 software. The GMR in the State of São Paulo for the period of 2003-2013 was worse compared to Brazil, and so was the CMR, with a predominance of the post-neonatal component in the State. The MMR indicated the availability of adequate prenatal, delivery, and postpartum assistance in the State during the period. The data charts displaying the evolution of PYLL rates in the State of São Paulo show that the RHCNs with the highest PYLL rates were 6, 7, 9, 10, 11, 12, 13, and 17. From the main 15 death causes according to PYLL rates in the period, 9 can be prevented in primary care. Under-recording and the triple load of diseases were also detected. The SPISR of most of the 645 municipalities in the State of São Paulo in the year 2012 was 4. The probability that the highest PYLL rate was associated with a SPISR of 4 was 95%, with a confidence interval between 17325.04 and 18424.20. An ANOVA with 4 degrees of freedom showed significant differences (p<0.05) in PYLL rates by SPISR group. With 5 degrees of freedom, the test of Kruskal-Wallis provided significant results (p<0.05), indicating the existence of differences between population groups in respect to PYLL rates. With 16 degrees of freedom, the Kruskal-Wallis test indicated the existence of significant differences between the RHCNs in terms of PYLL rates. PYLL rates decreased, although subtly, with the increase of wealth in the SPISR. Longevity and PYLL rates remained stable. As education increased, PYLL rates also increased. Since there was a positive correlation between wealth, longevity, and education, increased wealth was associated 10 with increased longevity and education as well. Concerning the relationship between PYLL rates and wealth and longevity, we found a negative correlation coefficient, indicating that as wealth and longevity increased, PYLL rates decreased. In respect to education, however, the correlation with PYLL rates was positive, indicating that increases in education were associated with increases in PYLL rates. Finally, this dissertation could be presented to the health authorities of the State of São Paulo as a project to reduce early mortality, focused on improvements in basic education, expansion of high-quality health services, and improvements in public security