A wave of maternity unit closure is sweeping through the North Atlantic zone, leaving rural communities without the care they crucially need. In its wake resistance grows, mobilizing against closures in the face of a discourse of economic efficiency and neoliberal austerity. To understand the issue, research on maternity care and geography offer useful insights on the particular costs and consequences of losing access to care but is less useful for engaging the causes behind them. Not suffering from a lack of critical engagement, Marxist theory enables the wave to be understood in terms of changing political incentives and the ways these have come about. The present essay brings the two fields together in an effort to aid local resistance in rural communities, concluding that regionalization does not operate on a logic of its own as is otherwise stated but on the logic of markets, imposed on governments by the neoliberalization of the Western world and beyond. The essay aims to provide the political-economic framework needed to confrontt he logic of markets, neoliberalism, and the capitalist political-economic system that underline the closures.

Departing from the ongoing regionalization processes in Europe and other parts of the world, this thesis aims to study the premises and conditions of regional citizenship in contemporary state restructuring. As globalization is viewed to challenge the sovereignty and capacity of nation states, subnational regions have gained authority and interest as key actors to compete on globalized markets of capital in order to ensure future development. This alteration in the balance between the regional and the national raises questions on how aspects of citizenship become negotiated in relation to regions as emphasized political communities. The study therefore develops and applies a productive analysis of regional citizenship based on citizenship theory and poststructuralist discourse theory. The attempts to reform the administrative region of Värmland, Sweden, between the years 2007 and 2011 functions as a case study in the dissertation.  In relation to this process a variety of materials has been collected in order to shed light on articulatory practices related to the reform: media material, public documents and assessment reports, observations of public dialog meetings and focus groups. Through a discourse analysis of the material the study focuses on the discursive production of regional communities and regional citizens in relation to regional reform. Three different but related articulations of the region emerge in the analysis: the region as a cultural landscape, as a welfare system and as a growth machine.   The study shows how the understanding of the region as a growth machine holds a hegemonic position in relation to the other articulations. The growth machine is based on a neoliberal notion of development, where competiveness and commodification function as premises to the intrinsic understanding of regional citizens – as well as welfare and culture - as capital that can, and should, be used to facilitate economic growth. / Runt om i världen byggs större och starkare regioner. Regioner betraktas som i delar en arvtagare till uppgifter som nationalstaterna inte längre anses kunna hantera i en globaliserad värld. Därför har regionerna fått större grad av självständighet från de nationella staterna, frisläppta för att på bästa sätt hitta sätt att locka till sig olika former av globalt rörligt kapital. Kapital som anses utgöra grunden för att kunna bygga ett gott samhälle.   I den här avhandlingen studeras samtida regionalisering ur ett medborgarskapsperspektiv. Vad innebär det för relationen mellan människor och gemenskap att regionen intar en framskjuten position i samhällsbyggandet? Vilka band knyts mellan regionen och regionmedborgaren i en tid som kännetecknas av globalisering och konkurrens? Hur fördelas rättigheter och skyldigheter mellan regionen och medborgarna, och vad innebär det att vara en god regionmedborgare? Genom en svensk fallstudie analyseras hur regionen och regionala medborgare görs meningsfulla i anslutning till att regionens framtid förhandlas. Materialet består av pressmaterial, utredningsmaterial, observerade offentliga möten samt fokusgrupper med regionmedborgare. Studien visar hur myten om regionen som en tillväxtmaskin intar en dominerande ställning och hur globala marknadslogiker fungerar som villkor för det regionala medborgarskapet.

Le développement portuaire est mis en perspective à partir des ports de Calcutta, la troisième métropole de l’Inde par sa population. L’objet d’analyse est le phénomène de régionalisation portuaire en Inde, défini par une gouvernance portuaire qui lui est propre. La recherche articule géographie portuaire, géographie régionale et géographie économique dans une démarche qui permet d’appréhender la gouvernance portuaire en Inde, ainsi que la relation métropole-port. Elle interroge ainsi deux notions en géographie portuaire : la régionalisation et la gouvernance portuaires en Inde. La thèse montre que la régionalisation portuaire s’insère dans les évolutions de la gouvernance portuaire qui caractérise Calcutta. Elle souligne la pertinence de la notion de gouvernance portuaire comme catégorie analytique du phénomène de régionalisation portuaire, comme processus et comme enjeu politico-socio-économique. Par ailleurs, le rôle joué par la gouvernance portuaire dans le rapport métropole-port est mis en évidence par l’étude des choix économiques ouvertement néolibéraux en opposition aux couleurs politiques du gouvernement du Bengale occidental, communiste depuis 1977. Dans ce contexte spécifique au Bengale occidental, la régionalisation portuaire évolue à travers une succession d’étapes marquées par l’initiation de réformes faisant progressivement appel à la participation des capitaux privés. En Inde, les décisions prises en matière de réformes portuaires, souvent au détriment des populations les plus vulnérables (paysans), ne sont pas sans poser de problèmes sociaux, qui ont déjà évolué vers de graves conflits entre ces populations et les acteurs impliqués dans la question portuaire. A Calcutta, les enjeux du développement portuaire régional posent la question de la place de ses ports comme outil de développement pour cette région de l’Inde, pays d’Asie du Sud devenu puissance émergente sur la scène internationale. / Port development is put into perspective from the ports of Calcutta, the third metropolis by population in India. The object of analysis is the port regionalization phenomenon in India, defined by a port governance of its own. The research focuses port geography, economic geography and regional geography in a process that allows us to understand the port governance in India, as well as the city-port relationship. It thus interrogates two concepts in harbor geography regionalization and port governance in India. The thesis shows that the port regionalization fits into the evolution of port governance that characterizes Calcutta. It stresses the relevance of the concept of port governance as an analytical category of port regionalization phenomenon as a process and as political, social and economic issue. Moreover, the role of governance in the port city harbor report is highlighted by the study of economic choices openly in opposition to neoliberal policies colors of the Government of West Bengal Communist since 1977. In this specific context in West Bengal port regionalization evolves through a succession of stages marked by the initiation of reforms gradually involving the participation of private capital. In India, decisions on port reforms, often at the expense of the most vulnerable populations (farmers) are not without social problems, which have evolved into serious conflicts between indigenous people and other actors involved in the port question. In Calcutta, the challenges of regional port development raises the question of the place of its ports as a development tool for this region of India, South Asia become an emerging power on the international stage.

O Sistema Único de Saúde orienta-se pelos princípios da universalidade, equidade e integralidade; e pelas diretrizes da descentralização, regionalização, hierarquização e participação social. No Sistema Federativo Brasileiro o poder é compartilhado entre o governo central e governos regionais, mas a capacidade da assunção da autonomia pelos entes subnacionais tem sido desigual e solitária, em vários momentos históricos. No processo de regionalização foram conformados territórios denominados Regiões de Saúde e a organização da atenção ancorada em Redes de Atenção à Saúde com enfoque na integralidade do cuidado. Em São Paulo organizou-se, sob a lógica da suficiência de serviços regionalizados, as Redes Regionais de Atenção à Saúde, compostos por uma ou mais Regiões de Saúde. A atenção ao parto foi organizada na Rede Cegonha contemplando a assistência materna e infantil. Um desafio atual é repensar o hospital no contexto de redes regionalizadas, com políticas de fomento à atenção hospitalar. Analisou-se o quanto as políticas de regionalização, que orientam a conformação e governança das Regiões de Saúde; a implantação das redes temáticas, priorizando a Rede Cegonha; e os incentivos para a rede hospitalar, qualificaram a atenção hospitalar no Estado. Trata-se de estudo descritivo e avaliativo, embasado em informações e dados quantitativos, de 2010 a 2016. Utilizou-se o acesso ao parto para análise da ampliação do acesso em âmbito regional. Levantou-se os Planos de Ação da Rede Cegonha, identificando as transferências financeiras, analisou-se a capacidade instalada de leitos relacionados à Rede e os fluxos de internações para partos, segundo risco. Os dados foram provenientes dos sistemas de informações, cadastros gerais e produção de serviços de saúde do SUS. Os dados foram comparados e analisados considerando os desenhos regionais estabelecidos nas políticas do Estado, utilizou-se o tabulador Tabwin para extração e construção de mapas cartográficos, e ferramenta Excel para organização, construção de tabelas, gráficos, cálculo do índice de dependência, análises exploratórias, de tendências e correlações. A implantação da Rede Cegonha relacionou-se mais à capacidade de gestores locais que às necessidades de saúde ou de uma coordenação estadual, pouco reduziu iniquidades e nem sempre agregou equilibradamente os diferentes equipamentos necessários ao cuidado. Manteve-se prioridade no investimento em serviços mais complexos, em detrimento daqueles de maior capilaridade, prevalecendo a lógica dos prestadores. Houve redução de leitos obstétricos e aumento do referenciamento entre as Regiões de Saúde para os partos de risco habitual, embora mais restritos à macrorregião de saúde; houve maior acesso aos serviços e partos de alto risco e redução proporcional desses referenciamentos. Na Região Metropolitana de São Paulo houve associação entre as transferências financeiras federais e menores referenciamentos para partos de alto risco. Foram ainda escassas as transformações no sentido das grandes apostas da Rede Cegonha como os centros de parto normal e o método canguru. Conclui-se que as políticas de incentivo ao processo de regionalização e qualificação da atenção hospitalar contribuíram pouco para o avanço da integralidade e equidade no SUS considerando os deslocamentos para atenção ao parto nas regiões de saúde do estado de São Paulo. / The Single Health System (SUS) orients itself through the principles of universality, equity and integrality as well as through the guidelines of decentralization, regionalization, hierarchy and social participation. In the Brazilian Federative System, the power is divided between the central government and regional governments, but the subnational entity\'s ability to exercise autonomy has been unequal and solitary throughout history. During the regionalization process, territories called Health Regions were formed and the organization of healthcare was anchored to Care Networks, with a focus on integrality of care. In São Paulo, Regional Healthcare Networks, composed of multiple Health Regions, were organized, under the logic of regionalized sufficiency. Childbirth care was organized in Rede Cegonha, a network that contemplates child and maternal care. One current challenge is how to rethink hospitals in the context of regionalized networks, with hospital care development policies. To what extent the regionalization policies, that guide the conformation and governance of the Health Regions; the implantation of the thematic networks, giving priority to the Rede Cegonha; and the incentives to the hospital network, improved the state\'s hospital care was analyzed. It is a descriptive and evaluative study, based on information and quantitative data from 2010 to 2016. Access to childbirth care was used to analyze the amplification of access in the regional scope. The Rede Cegonha\'s action plans were verified to identify financial transfers. The bed installed capacity related to Rede Cegonha and the flow of hospitalization for childbirth, based on risk, were analyzed. The data was extracted from national information systems, general registrations and SUS\'s service production systems. The data was compared and analyzed considering the regional mapping established in the State policies, the tabulator Tabwin was used to extract and construct cartographic maps, and the tool Excel was used for organization, table creation, graphs, calculation of dependency ratio, and exploratory, trend and correlation analysis. The implantation of Rede Cegonha was related more to the capability of the local managers than to the health needs or state coordination, barely reduced iniquities and did not always prioritized the different equipment needed for care in a balanced manner. Priority was given to investments on more complex services, in the detriment of those with higher demand, prevailing the provider\'s logic. There was a reduction in obstetric beds and an increase of referencing between Health Regions for usual risk deliveries, although more restricted to the health macroregion; there was higher access to high-risk services and deliveries and proportional reduction in referencing. In the São Paulo Metropolitan Region there was an association between federal financial transfers and a decrease in referencing for high-risk deliveries. The transformations towards the Rede Cegonha big wagers, like the normal delivery centers and the kangaroo method, were meager so far. Concludes that the incentive to the regionalization process policies and improvements in hospital care contributed little to the advance of integrality and equity on SUS considering the displacement for childbirth care in the Health Regions of São Paulo state.

A regionalização emergiu dentro das diretrizes organizativas do Sistema Único de Saúde como ordenadora das ações e serviços de saúde a fim de qualificar e fortalecer a descentralização com o escopo de garantir o direito à saúde da população, reduzindo as desigualdades sociais e territoriais por meio da identificação e do reconhecimento das regiões de saúde, promovendo a integralidade de atenção e equidade das ações e serviços. Esta pesquisa tem como objetivo analisar a regionalização das ações e serviços a partir da construção de redes de saúde interfederativas da mesorregião do Bico do Papagaio, Rede TOPAMA, e da região do Vale do médio do São Francisco, Rede PEBA, fundamentadas no pacto pela saúde. Tendo a temática investigativa ancorada em uma nova estratégia de organização dos serviços de saúde, foi realizada uma pesquisa documental, com análise de conteúdo, tendo os documentos do Subprojeto QualiSUS-Rede da Rede TOPAMA e da Rede PEBA como foco de análise. Utilizaram-se, como aporte bibliográfico, os preceitos constitucionais à construção do SUS e autores brasileiros da saúde pública. Os resultados revelaram que a Região TOPAMA ainda não está dotada de elementos necessários para o pleno funcionamento com integração das ações e serviços para atender às demandas da população. O mapa de saúde da rede e elaboração do COAP ainda permanece em construção, não ocorrendo organização dos fluxos interestaduais. Verificaram-se, ainda, conflitos acerca da alocação de recursos entre os estados. No que tange à região PEBA, a rede demonstra-se articulada e hierarquizada, com fluxos interestaduais pré-definidos, contudo, com a necessidade de definir novas estratégias a fim de superar os desafios frente às barreiras geográficas para garantia da assistência e acesso às ações e serviços de saúde. Conclui-se que, para garantir assistência à saúde integralizada e equânime com gestão compartilhada, as federações devem caminhar articuladas e em sintonia para garantir o desenvolvimento regional, os entes federados devem estar despidos de interesses próprios, partidos políticos e conformar uma gestão unificada de forma participativa, solidária e cooperativa, proporcionando o bem comum em beneficio do usuário e não apenas relações entre governos. / The regionalization emerged within organizational guidelines of the Unified Health System as ordering of actions and health services in order to qualify and strengthen decentralization with the aim of ensuring the right to health of the population, reducing social and regional inequalities by identifying and recognition of health regions, promoting the full attention and fairness of procedures and services. This research aims to analyze the actions and regionalization of services from building networks of health interfederativas from the middle region of the Parrots Beak, TOPAMA Network, and Valley of the middle São Francisco, PEBA Network region, based on health pact . Having the investigative theme anchored on a new strategy for the organization of health services, documentary research was carried out, with content analysis, and documents Subproject QualiSUS TOPAMA Network-Network and Network PEBA analytical focus. We used as bibliographic contribution, the constitutional construction of SUS Brazilian authors and public health principles. The results revealed that the TOPAMA Region is not yet endowed with elements necessary for full operation with integration of programs and services to meet the demands of the population. The map of network health and development of the COAP is still under construction, not occurring organization of interstate flows. Still, there were disputes about the allocation of resources among states. Regarding the PEBA region, the network is demonstrated articulated and hierarchical, with predefined interstate flows, however, with the need to define new strategies to overcome the challenges facing the geographical barriers to care and ensuring access to actions and health services. It is concluded that, to ensure assistance to fully paid health and equitable shared with management, federations must walk articulated and in tune to ensure regional development, federal agencies must be stripped of their own interests and political parties shape a unified management so participatory, supportive and cooperative, providing the common good for the benefit of the user and not just relations between governments.

The development of regional flood-frequency equations is a key component of engineering infrastructure design and flood risk assessment at ungauged sites. These equations are constructed based on regression analysis techniques to study the connection between peak flow observations and different explanatory variables. However, many regions of the world remain poorly gauged or have experienced dramatic changes in land use or climate that make past observations less useful. To remedy this situation, we need to interpret and construct these regional equations based on physical principles of water movement and general knowledge of the geographic and geomorphologic setting of the upstream catchment at the location of interest. Several studies have examined these regional equations through the scaling theory of floods, making physical interpretations of the equation parameters (or scaling parameters) with respect to rainfall properties and geomorphologic variables. However, despite the advances of these previous works, the scaling theory of floods must be concerted with different, well-known problems in statistical hydrology for a proper engineering application in flood regionalization. These problems can vary from limitations in peak flow observations (sampling errors) to selection of an inadequate model structure of peak flows (epistemic errors). I present a series of studies based on hydrologic simulations and peak flow observations that illustrate several aspects related to the application and use of the scaling theory of floods, which include the following: (1) description of spatial patterns of scaling parameters; (2) inclusion of river network descriptors in flood frequency equations; and (3) evaluation of sampling errors and epistemic errors in the construction of flood frequency equations. The results presented in this dissertation contribute to the development of a more complete regional flood frequency analysis framework that leverages the physics of peak flow scaling and river network descriptors.

abstract: The WNT signaling pathway plays numerous roles in development and maintenance of adult homeostasis. In concordance with it’s numerous roles, dysfunction of WNT signaling leads to a variety of human diseases ranging from developmental disorders to cancer. WNT signaling is composed of a family of 19 WNT soluble secreted glycoproteins, which are evolutionarily conserved across all phyla of the animal kingdom. WNT ligands interact most commonly with a family of receptors known as frizzled (FZ) receptors, composed of 10 independent genes. Specific interactions between WNT proteins and FZ receptors are not well characterized and are known to be promiscuous, Traditionally canonical WNT signaling is described as a binary system in which WNT signaling is either off or on. In the ‘off’ state, in the absence of a WNT ligand, cytoplasmic β-catenin is continuously degraded by the action of the APC/Axin/GSK-3β destruction complex. In the ‘on’ state, when WNT binds to its Frizzled (Fz) receptor and LRP coreceptor, this protein destruction complex is disrupted, allowing β-catenin to translocate into the nucleus where it interacts with the DNA-bound T cell factor/lymphoid factor (TCF/LEF) family of proteins to regulate target gene expression. However in a variety of systems in development and disease canonical WNT signaling acts in a gradient fashion, suggesting more complex regulation of β-catenin transcriptional activity. As such, the traditional ‘binary’ view of WNT signaling does not clearly explain how this graded signal is transmitted intracellularly to control concentration-dependent changes in gene expression and cell identity. I have developed an in vitro human pluripotent stem cell (hPSC)-based model that recapitulates the same in vivo developmental effects of the WNT signaling gradient on the anterior-posterior (A/P) patterning of the neural tube observed during early development. Using RNA-seq and ChIP-seq I have characterized β-catenin binding at different levels of WNT signaling and identified different classes of β-catenin peaks that bind cis-regulatory elements to influence neural cell fate. This work expands the traditional binary view of canonical WNT signaling and illuminates WNT/β-catenin activity in other developmental and diseased contexts. / Dissertation/Thesis / Doctoral Dissertation Biomedical Engineering 2019

Micro-regions have gained an increasing awareness of their potential in global politics, an illogical development that have yet to be explained. In this study, we hypothesize that there is a trend where regions attempt to lobby EU-policy, and explore the role of regions, and their channels to Brussels: how they look today, and how they have changed over time. In this exploration, we conducted a comparative case study where the Swedish regions’ channels to Brussels were compared over time by a theoretical framework built on new regionalism ideas. To collect data, we interviewed representation office officials, and supported this data with a content analysis. We then compared our results to a similar study from 2007.We found that the representation offices today lobby as a daily activity, and that monitoring is often emphasized to be pro-active in policy influencing. Money is still experienced as the prime logic for regional representation in Brussels, but possibilities for financial gain may incentive regional interest to contribute to the EU policy framework. The representation offices favor the European Commission as a channel, but this depends on where in the process the office enters, while informal networks are given an increased value for several reasons.

Finland and Estonia, the two peripheral states of the European Union’s north-eastern corner have steadily converged since the fall of the Soviet Union, both bilaterally and in a multilateral European context. The co-operation is significant and covers multiple sectors of society. Now the two countries have set out on a project to join their two capitals by building a fixed link under the Gulf of Finland forming the symbolic twin-capital of Talsinki. This case-study sets out to analyse what motivations there are in creation of the twin-capital, and what relevance does the fixed link have on the regionalization process.The qualitative analysis of policy and spatial-economic documentation triangulated with media sources shows that the incentives are mainly economic, and the process is mainly driven by state- and regional level politicians motivated by regional development. The study also indicates that the rising influence of China and other global actors has an effect on the regional politics of peripheral Europe.

The thesis is focused on the analysis of national party organizational adaptation to political decentralization, specifically of internal change in the Labour Party. The main aim of this case study is to find the degree to which the devolution influence Labour party internal organization and strengthen the role of Welsh Labour. The thesis assumes a certain shift in the position of the Welsh Labour Party within the party structures, this change is placed in context of decentralization reform in Great Britain. Based on the defined factors, which are set out in the introduction, the thesis examines the changes in the party internal structure and the transfer of powers towards its regional branch - the Welsh Labour. The aim of the thesis is not only to find whether the decentralization reform had an impact on the internal party organization, but also to present other possible factors of this change and outline further possible research.