A partir de la revisión de dos ámbitos de la relación Estado/pueblos indígenas —esto es, territorialidad y autonomía, proyectos minero energéticosy consulta previa—, se pretende analizar los avances, retrocesos y vaciamientos vividos en esta relación durante el período 1990-2013, con el fin de aportar a la discusión de esta problemática en los demás países que viven circunstancias semejantes enAmérica Latina. Especial importancia tienen para el caso ecuatoriano las constituciones de 1998 y 2008, en las cuales se reconoció el carácter pluricultural y pluriétnico del Estado ecuatoriano en la primera, yel carácter plurinacional e intercultural en la segunda. Asimismo, el movimiento indígena, desde su surgimiento como actor en la política nacional desde 1990, no solo ha sido pionero y referente en la región, sino que ha sido impugnador del proceso de extractivismo llevado adelante por el Estado. / From the review of two areas of relative state / indigenous peoples, territoriality, mining and energy projects and consultation, is to analyze the progress, setbacks and dissections lived in this relationshipduring the period 1990-2013, to contribute to the discussion of this problem in other countries experiencing similar circumstancesin Latin America. Of particular importance is the case of Ecuador to the constitutions of 1998 and 2008, in which the multiethnic and multicultural nature of the Ecuadorian State acknowledged at the first, and the plurinational and intercultural character in the second. Likewise, the indigenous movement since its emergence as an actor in national politics since 1990, has not only been a pioneer and leader in the region, but has been challenger extractivismo process carried outby the state.

A presente Tese procura examinar como os espaços alternativos aos mecanismos convencionais da democracia representativa influenciam na extensão e fortalecimento da democracia participativa em Cabo Verde. Para a consecução desse objetivo, foram selecionados três Conselhos de Políticas Públicas – criados a partir do período democrático iniciado no início dos anos 1990 e respaldados pelo novo Texto Constitucional aprovado em 1992. Os Conselhos selecionados – quais sejam: o Conselho de Concertação Social (CCS), o Conselho Nacional de Saúde (CNS) e a Comissão Nacional para os Direitos Humanos e a Cidadania (CNDHC) além de constituírem três áreas diferentes e possuírem uma abrangência nacional, integram a estrutura político-administrativa do Estado, estando, pois vinculados às orgânicas dos diferentes departamentos governamentais responsáveis pela área do trabalho, salário e seguridade social, da saúde e dos direitos humanos e justiça. Dado esse objeto de estudo, a metodologia usada foi a qualitativa assente na coleta de uma variedade de materiais empíricos relacionados com os conselhos aqui considerados. Implícito a esta metodologia foi priorizado o método comparado centrado na comparação das variáveis e dos conselhos, individualmente considerados, quanto à sua influência no modelo da democracia participativa. Os resultados alcançados com o desenvolvimento da pesquisa sinalizam para o fato de eles não representarem impacto considerável no modelo da democracia participativa em Cabo Verde, sendo a sua existência e funcionamento representar apenas um apêndice da manutenção do modelo da democracia representativa sem que houvesse ocorrência de qualquer transformação nos pressupostos basilares deste modelo. Assim sendo, entre as diversas sugestões apresentadas com o desfecho da pesquisa para a extensão e fortalecimento da democracia participativa, esta Tese propõe a alteração dos arranjos institucionais de modo a que eles possam conferir maior capacidade participativa e deliberativa aos conselhos. / This thesis seek to examine how alternative mechanisms of representative democracy impact into extending and strengthening participatory democracy in Cape Verde. Aiming to reach this goal, three Public Policy Councils were selected – all them created in the beginning of 1990s and supported by the new constitutional text approved in 1992 –, these are Council for Social Consultation (CCS), National Health Council (CNS) and National Commission for Human Rights and Citizenship (CNDHC). These three areas also, are part of the political and administrative structure of the state and are related to the different government organic departments responsible for labor, wage and social security, health and human rights and justice. Methodologically, this study is qualitative based on collecting a variety of empirical materials relating to the advice considered here. Inside this method, was also prioritized comparative approach that focused on comparison of variables of councils individually and their influence on the model of participatory democracy. The results of the study point out of non-existence of considerable impact on participatory democracy model in Cape Verde, and its existence and functioning represent only an appendage of maintenance of representative democracy model without their occurrence of any transformation in the basic assumptions of this model. Thus, among the many tips given to the outcome of the research for the extending and strengthening of participatory democracy, this thesis proposes changing in the institutional arrangements so that they can give more participatory and deliberative capacity to advice.

A regulação de consultas especializadas tem se mostrado como uma das áreas mais problemáticas do Sistema Único de Saúde (SUS) no Brasil. Cabe aos gestores de saúde nos municípios, estados, e governo federal, estabelecerem mecanismos de regulação coerentes com o volume de recursos disponíveis e com o contingente populacional a atender. Diversas centrais de regulação para atendimentos especializados foram implantadas nas secretarias municipais de saúde e sistemas de informação foram criados como ferramentas para apoio a estas centrais. Seu escopo tem sido progressivamente ampliado, de maneira a incluir uma visão crítica das necessidades da população em relação à capacidade de atendimento dos prestadores de serviço. No processo de regulação de consultas especializadas, duas questões têm-se destacado: (1) para um dado caso, quais pacientes têm maior prioridade de atendimento, e (2) quais prestadores de serviço podem resolver melhor o caso? Fundamentado nestas duas questões, e a partir da consideração dos requisitos legitimados na área da assistência à saúde, este trabalho propõe um sistema para apoio à decisão de agendamento de consultas especializadas para servir às centrais de regulação. O sistema proposto integra análise de decisão multi-critério e programação linear para o agendamento das consultas, onde a alocação dos pacientes é definida em função da relevância relativa de um conjunto de critérios relacionados à noção de efetividade da assistência médica especializada e da capacidade de atendimento das unidades de assistência credenciadas. Da integração destes modelos resulta uma representação que leva em conta simultaneamente os aspectos relacionados ao diagnóstico médico e suas conseqüências na vida do paciente, os aspectos relacionados às instalações e processos disponíveis nas unidades assistenciais credenciadas, e os aspectos relacionados à dificuldade de acesso do paciente a estas unidades. O uso do sistema permite que as informações pessoais e médicas do paciente, assim como as informações sobre as unidades assistenciais, sejam incorporadas em um modelo de programação linear de maneira a maximizar a efetividade do conjunto de solicitações para cada especialidade. Os modelos foram implementados em um sistema informatizado, e aplicados em uma parcela dos serviços da Secretaria Municipal de Saúde de Porto Alegre para as especialidades de cardiologia e cirurgia vascular. O sistema e os resultados obtidos foram validados por um grupo de peritos, que confirmou a viabilidade do uso deste modelo como uma ferramenta para a otimização da alocação de recursos no atendimento especializado pelo SUS. / The regulation of specialized medical consultations has been one of the most problematic areas of the Government Unified Health System (SUS) in Brazil. It is the role of health managers from cities, states and federal government to establish coherent mechanisms of regulation with the amount of available resources and the population contingent to be assisted. Many regulation centers for specialized consultations had been created in public city health departments, and many information systems were developed to support these centers. Its target has been gradually extended, in a way to include a critical vision of the necessities of the population in relation to the capacity of attendance of the service rendering. On the specialized consultations regulatory process, two questions arise: (1) for a random situation, which patient has priority to be assisted? (2) Which health providers can better solve this problem? Based on these two questions, and from the consideration of the legitimated requirements in health care, this work considers a decision support system for the scheduling process of specialized consultations into regulation central offices. The considered system integrates multi-criteria analysis and linear programming for the scheduling process, where the allocation of the patients is defined in function of the relative relevance of a set of criteria related to the notion of effectiveness of the specialized medical assistance and the capacity of assistance of the credential service providers. By the integration of these models, a representation results that simultaneously takes in account the related aspects to the medical diagnosis and its consequences in the patient’s life, the aspects related to the installations and available processes in the credential assistance units, and the aspects related to the difficulty of access of the patient to these units. The use of the system allows that the personal and medical information of the patient, as well as the information on the assistance units, are incorporated in a model of linear programming in a way to maximize the effectiveness of the set of requests for each specialty. The models had been implemented in a decision support system, and applied in a parcel of the services of the Porto Alegre City Health Department for cardiology and vascular surgery. The information system and the outgoing results were validated by a group of experts, which confirmed the model viability for using as a tool to improve the resource distribution at the SUS's specialized assistance.

Em 2011, a Agência Nacional de Vigilância Sanitária inseriu como eixo estratégico de sua gestão o envolvimento com as macro políticas sociais brasileiras, especialmente as relacionadas ao desenvolvimento social, com foco na erradicação da extrema pobreza e no avanço da formalização das atividades econômicas relacionadas a produtos e serviços sujeitos à vigilância sanitária. Em 2013 a Agencia publicou uma regulação específica para o microempreendedor individual, para o empreendimento familiar rural e para o empreendimento econômico solidário (RDC n° 49) intitulada de \"Inclusão produtiva com segurança sanitária\". A construção da norma contou com a participação da sociedade, por meio da consulta pública n°37. Objetivos: Analisar criticamente a percepção e as expectativas dos atores sociais participantes da consulta sobre os impactos esperados acerca da RDC e discutir as possíveis convergências dessas expectativas com as ações propostas no I Plano Nacional de Segurança Alimentar e Nutricional (2012/2015). Metodologia: Trata-se de um estudo qualitativo que utilizou os métodos de análise documental e análise de conteúdo temática para analisar os dados secundários da consulta pública °37. Resultados: A partir da descrição das categorias identificadas, os atores sociais foram divididos entre \"grupo a favor\" e \"grupo contrário\", explicitando o caráter antagônico das expectativas dos participantes acerca dos impactos da norma. Além disso, a analise mostrou que existem vários pontos de convergência entre os impactos esperados pelos participantes e as ações propostas no I Plano de Segurança Alimentar e Nutricional (2012-2015). Conclusão: O tema \"Inclusão produtiva com Segurança Sanitária\" provocou uma discussão rica e complexa mostrando que é necessário haver um equilíbrio para que as normas sanitárias sejam coerentes com as especificidades existentes na pequena produção, garantindo, contudo, a segurança sanitária dos alimentos. / In 2011, the National Sanitary Surveillance Agency inserted as a strategic axis of its management the involvement with macro social policies in Brazil, especially those related with social development, focusing on eradication of extreme poverty and on advancing formalization for economic activities related to products and services subject to health surveillance. In 2013 the Agency published a specific regulation for individual microentrepreneur, family farmer and solidarity economic enterprise (RDC n°49) entitled \"Productive Inclusion with Health Security\". The construction of the standard was attended by civil society, through the public consultation n° 37. Objectives: To critically analyze perception and expectations of social actors participants of the consultation on expected impacts of RDC and to discuss the possible convergences of these expectations with the actions proposed in the 1st National Plan for Food and Nutrition Security (2012/2015). Methodology: This is a qualitative study that used the methods of document analysis and the analysis of thematic content to analyze the secondary data of the public consultation n° 37. Results: From the description of categories identified, the social actors were divided between \"favor group\" and \"opposing group\", clarifying the antagonistic character of participants\' expectations about impacts of the norm. In addition, the analysis showed there are several points of convergence between the expected impacts of participants and actions proposed in the I Food and Nutrition Security Plan (2012-2015). Conclusion: The theme \"Productive Inclusion with Sanitary Safety\" has provoked a rich and complex discussion, showing that a balance needs to be struck in order to ensure that health standards are consistent with the specificities of small production, while guaranteeing food safety.

This thesis explores the role and effectiveness of police authorities in connecting policing and the citizen and in increasing the citizen's involvement in the delivery of their policing service. The thesis examines: police authorities in the context of citizenship and in relation to accountability; and whether the operational function of law enforcement, the original charge of Keeping the Kings Peace and policing by consent - can work homogenously within a system characterised by both active and passive citizenry. Individual chapters discuss whether police authorities have sufficient power, whether the home secretary and chief constable have too much power, and the propensity of police authorities to demand answers and call the police service to account. As history shows, it is possible to have a police service carrying out policing functions in the absence of a police authority performing a scrutiny function; but it would be impossible to have a police authority without a police service. Therefore, the thesis argues that the added value, the relevance and the effectiveness of police authorities needs to be unambiguous.

No description available.

In the Department of Correctional Services (DCS), as the role of workers in the workplace changed after demilitarisation in 1996, the needs of the employees also changed. The changing work environment placed different demands on them, unlike those that they had been used to in the past. Because of the growth of personal problems at the workplace, the EAP was introduced in the DCS in the late 1990’s. The EAP in the DCS has been formally in existence since 2000 and has not been formally evaluated according to the EAPA SA standards. The EAPA SA standards are the benchmark against which all EAPs in South Africa could be measured. This research attempts to ascertain whether the EAP in the DCS has been implemented according the prescripts of the EAPA SA standards. The research approach involved both the qualitative as well as the quantitative approaches. The qualitative approach was used in documenting the processes followed in the conceptualisation, introduction and creation of the EAP in DCS. The quantitative approach was used to evaluate the EAP in DCS using the EAPA SA standards as a benchmark. In the first chapter a general orientation to the study as well as the researcher’s rationale and structure for the research is provided. The literature review in chapter two took a retrospective look at the developments in the EAP industry by focussing on the most modern interventions in the EAP field initially and moving to the origins of the EAP later. Chapter three focussed on the evaluation of the EAP in the DCS which included a systematic collection of information about that programme. In chapter four each standard as it appears in the standards document and brief comment on each standard was presented. The standards were also reviewed in relation to recent literature on the subject. The empirical analysis in the following chapter included a quantitative analysis followed by a qualitative analysis of the responses. The first phase included the development of a questionnaire based on the standards. The distribution and completion of the questionnaire were part of phase two. In the final phase the questionnaire was analysed by the Department of Statistics at the University of Pretoria, under the leadership of Professor Smith and Dr. Mike van der Linde. In the final chapter a consolidation of all the chapters as well as recommendations for further research is presented. The formulated problem was addressed through the choice of different approaches, strategy and design during the research process. The researcher was able to combine the research approaches to compare and subsequently verify the findings. Based on the findings the following conclusions can be made: firstly that the DCS does not comply fully with many of the standards as set out by EAPA SA, secondly that the DCS is understaffed when attempting to deliver EAP services and finally that there is a resounding plea for EAP services in the DCS. In addition to the proposals a revised standards document has also been integrated into the findings. / Thesis (PhD)--University of Pretoria, 2010. / Social Work and Criminology / unrestricted

Sammanfattning Bakgrund: Forskning visar att ätstörningar hos skolelever blir alltmer vanligt både nationellt och internationellt. Det förekommer mest hos flickor men ökar även hos pojkar. Uppskattningsvis har 10 % ätstörningssymtom. Ca 4-5% av alla flickor har någon gång insjuknat i en allvarlig ätstörning i Sverige. Det är av vikt att upptäcka dessa skolelever då konsekvenserna kan medföra allvarliga hälsoproblem med långdraget, ibland kroniskt förlopp och i värsta fall död. Syfte: Beskriva skolsköterskors erfarenheter av att upptäcka ätstörning hos skolelever. Metod: Tio semistrukturerade intervjuer genomfördes med skolsköterskor. Intervjuerna analyserades utifrån en kvalitativ innehållsanalys med induktiv ansats. Resultat: Skolsköterskan upptäcker ätstörningar genom sitt hälsofrämjande arbete i både de planerade och spontana hälsobesöken, men också genom att vara uppmärksam på risksignaler hos skolelever som avvikande beteende samt ha ett könssperspektiv. Skolsköterskan är beroende av andras information, såsom pedagoger, kompisar, extern personal, föräldrar och skoleleven själv för att upptäcka ätstörning. Skolsköterskorna har goda kunskaper om ätstörning men ingen stor erfarenhet av att upptäcka detta. Utbildning och tydliga riktlinjer eftersöks då osäkerhet upplevs. Slutsats: Elevhälsovården saknade riktlinjer och arbetsrutiner för att upptäcka ätstörning. Därför är det viktigt att utveckla och modernisera tydliga riktlinjer, vilket skulle kunna bidra till tidig upptäckt av ätstörningar hos skolelever.   Nyckelord: Elevhälsa, hälsobesök, hälsofrämjande, hälsosamtal, information, kroppsuppfattning. / abstract Background: Research shows that eating disorders among school students are becoming increasingly common both nationally and internationally. It occurs most in girls but is also increasing among boys. Estimately 10% suffers from eating disorder symptoms. About 4-5% of girls have ever suffered from a serious eating disorder in Sweden. It is important to discover these schoolchildren as the consequences can lead to serious health problems with the longevity, sometimes chronic progression and in worst case death. Purpose: Describe the school nurse's experience of detecting eating disorders among school students. Method: Ten semistructured interviews were conducted with school nurses. The interviews were analyzed based on a qualitative content analysis with an inductive approach. Result: The school nurse detects eating disorders through his health promotion work in both planned and spontaneous health visits, but also by paying attention to the risk signals of school students as deviating behavior meanwhile having a gender perspective. The nurse was dependent on other people's information, such as educators, friends, external staff, parents and the actual school student to detect eating disorders. School nurses have good knowledge but no experience detecting it. Education and clear guidelines were sought sines uncertainty was experienced in detecting eating disorders. Conclusion: Student health care lacked guidelines and work routines to detect eating disorders. Therefore, it is important to develop and modernize clear guidelines, which would mean that school nurses would discover more schoolchildren and thereby reduce suffering. Keyword: Body perception, health consultation, health promotion, health visit, information, student health.

Background: Effective information exchange is an asset to effective lung cancer care. Although a considerable body of evidence informs the approaches to ‘diagnostic bad news delivery’, the exchange of information that takes place between patients with cancer and professionals with whom they interact thereafter is less well documented. Information exchange has an influential role throughout the lung cancer care continuum, providing patients and professionals with details relative to the cancer diagnosis and the subsequent choices to be made in its management. Information on disease extent, treatment and related side-effects, rehabilitation and prognosis are judged by patients as the most prominent for them. Despite awareness of the specific categories relevant to information exchange needs, there is little evidence available exploring the information exchange process, per se, within cancer generally and even less within the lung cancer context. Aim: To investigate information exchange processes during lung cancer consultations, specifically exploring information content which is both exchanged and not exchanged. Design: Qualitative, multiple case study design. Methods: A case centred on a patient with lung cancer. Within the case were the patients, the health professionals they consulted with and accompanying companions. Seven cases were recruited, which included 12 companions. Data were collected in outpatient clinics between 2010 and 2011. Data were digital recordings of consultations; debrief interviews immediately post-consultation and later in-depth patient interviews. All interviews were transcribed and analysed for pattern matching and coding. Findings: Analysis of categorical data indicated cases were typical of the Scottish lung cancer population across all demographic domains, accept age and performance status. The preliminary analysis showed across cases, almost universal satisfaction with the level and content of information exchange for the main a priori categories of diagnosis, treatment and treatment outcome. Substantive analysis revealed that information content across the a priori categories was influenced by the presence of the accompanying companion. Within the clinical consultation, companion influence on information exchange was shown to be mediating, moderating or neutral. A key finding which emerged showed companion accompaniment to be a negotiated process, with three identifying levels of accompaniment. Non-negotiated companion presence at the clinic was associated with influential and expert companions who significantly moderated the content, direction and flow of information exchange, using the constructs of companion control, companion agenda and companion as expert. Persuasive influences further shaped non-negotiated accompaniment and were identified as demographic characteristics and relationship alliances. Patient and professional perspective regarding companion accompaniment was shown to be discordant. Conclusions: The level of negotiated companion presence at lung cancer clinics has direct implications for clinical care. There needs to be greater understanding among professionals of ways in which information exchange can be influenced by companions.

Många av Sveriges kommuner har idag svårt att få deltagare till medborgardialoger som angår nya planprojekt. Det är av stor vikt att dialogerna mellan kommuner och medborgare fungerar på ett bra sätt eftersom en bristfällig dialog kan leda till svårigheter i demokratin. För att kunna stärka demokratin och locka fler medborgare till dialogerna, framförallt yngre, finns olika verktyg som kommuner kan använda för att att illustrera de olika planförslagen. I denna studie undersöks frågor om virtuell verklighetsteknik (VR) är ett verktyg som skulle kunna locka fler till medborgardialoger samt om VR ökar förståelsen för kommunens olika illustrationer. VR är en tredimensionell visualisering med speciella skärmar och rörelse utrustning. Virtuella verklighetsillustrationer presenteras med en huvudmonterad display där du blir placerad i en miljö och kan röra dig fritt. För att studera dessa frågor utfördes ett experiment där deltagarna fick titta på två områden från en illustrationsplan, 3D-visualisering, samt använda VR. Deltagarna fick på en enkät ringa in upp till två svar för hur de upplevde området. För att enkelt tolka resultatet i denna studie användes värderosor. Med hjälp av dessa framkom resultatet att VR förbättrar förståelsen för illustrationsplaner och 3D-visualiseringar. Experimentet gav även svar på att VR kan locka personer till att medverka i medborgardialoger. Studien visade att VR bör användas som ett komplement till kommunens illustrationer för att fler medborgare ska lockas till medborgardialoger. Genom att jämföra resultatet går det tydligt att se stora skillnader på hur personer uppfattar de olika illustrationsverktygen. Den ökade förståelsen ger möjlighet för fler att lämna synpunkter till planprojekt. / Many of Sweden's municipalities have a hard time attracting participants to public consultation events about new planning projects. Good communication between municipalities and citizens is vital because to the planning process and a well functioning democracy. In order to strengthen democracy and attract more citizens to planning consultations, especially younger people, municipalities can use a variety of different illustrations and presentation tools. This study examined whether virtual reality (VR) is a useful tool for attracting the public and if VR increases the publics understanding of planning proposals. In order to examine these questions an experiment was conducted where participants looked at two different areas on an illustration map using 3D-visualizations and VR. The participants then answered two questions about how they experienced the environment. A radar chart was used to to interpret the results. The results indicate that VR enhanced the understanding of Illustration maps and 3D-visualizations. The experiment also suggests that VR can attract more people to public consultations. The study also showed that VR could be used as a complement to conventional illustrations and to enhance the public´s understanding of and opportunities to contribute opinions about planning projects.