Congenital hypothyroidism (CH), a pediatric endocrine condition that results in early thyroid hormone (TH) insufficiency, is associated with visuospatial dysfunction suggestive of selective dorsal visual stream impairment. However, the ventral visual stream has not been adequately investigated in this population and so the effect of early TH insufficiency on development of the two streams had not been clearly established. This thesis used a comprehensive set of neuropsychological and experimental tests to assess higher-order visual functions in children and adolescents with CH compared with typically developing individuals. The results show that while CH is associated with poorer performance on tasks tapping into dorsal stream functions such as judgment of line orientation, spatial localization, three-dimensional block and two-dimensional mental construction, judgment of object location, and mental rotation, performance on typical ventral stream tasks such as identity discrimination, including abstract shapes, faces, and buildings, is relatively unimpaired. Thus this thesis establishes that the dorsal visual stream is selectively vulnerable to TH insufficiency. In addition to the investigating the nature of the higher-order visual problems in CH, this thesis explores the mechanism underlying these problems and assesses whether they result from organizational effects by early TH or activational effects by current TH levels. The data support the organizational mechanism and suggest that prenatal TH insufficiency results in irreversible changes to the dorsal visual stream due to the timing of dorsal stream development, which occurs earlier than ventral stream development and is thus more vulnerable to insult.

Congenital hypothyroidism (CH), a pediatric endocrine condition that results in early thyroid hormone (TH) insufficiency, is associated with visuospatial dysfunction suggestive of selective dorsal visual stream impairment. However, the ventral visual stream has not been adequately investigated in this population and so the effect of early TH insufficiency on development of the two streams had not been clearly established. This thesis used a comprehensive set of neuropsychological and experimental tests to assess higher-order visual functions in children and adolescents with CH compared with typically developing individuals. The results show that while CH is associated with poorer performance on tasks tapping into dorsal stream functions such as judgment of line orientation, spatial localization, three-dimensional block and two-dimensional mental construction, judgment of object location, and mental rotation, performance on typical ventral stream tasks such as identity discrimination, including abstract shapes, faces, and buildings, is relatively unimpaired. Thus this thesis establishes that the dorsal visual stream is selectively vulnerable to TH insufficiency. In addition to the investigating the nature of the higher-order visual problems in CH, this thesis explores the mechanism underlying these problems and assesses whether they result from organizational effects by early TH or activational effects by current TH levels. The data support the organizational mechanism and suggest that prenatal TH insufficiency results in irreversible changes to the dorsal visual stream due to the timing of dorsal stream development, which occurs earlier than ventral stream development and is thus more vulnerable to insult.

The possible impacts of the level of formal education on different aspects of disaster management, prevention, alarm, emergency, or postdisaster activities, were studied in a comparative perspective for three countries with a comparable exposure to hurricane hazards but different capacities for preventing harm. The study focused on the role of formal education in reducing vulnerability operating through a long-term learning process and put particular emphasis on the education of women. The comparative statistical analysis of the three countries was complemented through qualitative studies in Cuba and the Dominican Republic collected in 2010-2011. We also analyzed to what degree targeted efforts to reduce vulnerability were interconnected with other policy domains, including education and science, health, national defense, regional development, and cultural factors. We found that better education in the population had clear short-term effects on reducing vulnerability through awareness about crucial information, faster and more efficient responses to alerts, and better postdisaster recuperation. However, there were also important longer term effects of educational efforts to reduce social vulnerability through the empowerment of women, its effect on the quality of institutions and social networks for mutual assistance creating a general culture of safety and preparedness. Not surprisingly, on all three accounts Cuba clearly did the best; whereas Haiti was worst, and the Dominican Republic took an intermediate position. (authors' abstract)

This dissertation has two primary objectives. First, through an analysis of empirical data, it presents a systematic, in-depth analysis of how rural populations react and adjust to adversity within specific socio-economic and institutional contexts. The analysis applies a vulnerability framework to understand the complex relationships between households, communities, and larger environmental, socio-economic, and political factors and how they influence drought impacts on the population. Using a combination of quantitative and qualitative data to look at issues of overall well-being, resource access, and livelihood and risk management strategies, the results provide insights into why most households are unable to successfully mitigate the impacts of drought. The analytical framework also provides a mechanism for making policy-relevant recommendations. In this vein, the dissertation explores the need for a new approach to the status quo of public policy making and presents an applied model for participatory planning to reduce drought vulnerability in Ceará. The pilot program, Projeto MAPLAN, is an effort, based on an empirical understanding of the public and private sides of vulnerability, to redefine the way that politics as usual are carried out. It challenges the way in which decisions are made by stimulating public participation and providing tools for accountability. On the public side it works to institutionalize effective participation through citizen input and governmental recognition of that input. On the private side the model works to increase the availability of resources and improve access to resources in order to expand the range of opportunities and strategies and to help households flourish in a semi-arid region.

The concept of food deserts, as a measure of low-income neighborhoods with limited access to affordable and healthy produce, can be helpful as a tool to quantify and compare food vulnerabilities, as many recent studies have demonstrated. However, the term masks the role that systems of racism and capitalism have played in producing food vulnerabilities. To explore this gap in the literature, this dissertation addresses two central research questions. The first central research question asks, what are the influential demographic and spatial patterns that have shaped supermarket access in low-income neighborhoods across Atlanta from 1980 to 2010? This study addresses this question using geo-spatial and quantitative analytical methods. The second research question asks, how have the movement of capital, the influence of urban political regimes, and community-based organizations shaped food environments in historically black neighborhoods in Atlanta from 1980 to 2010? These relationships are explored through a qualitative analysis of community redevelopment plans for two case study neighborhoods. The study reveals several findings. First, race, poverty, and population density spatially overlap with shifts in Atlanta's supermarket locations. Atlanta has a clear racial and income dividing line that splits the city into higher-income and majority white neighborhoods to the north and low-income/poor and majority black neighborhoods to the south, which has intensified over the thirty-year study period. Second, racial segregation and the concentration of poverty reinforce the vulnerability experienced by low-income neighborhoods, and produces limited access to supermarkets and other neighborhood retail outlets. Third, even though neighborhood redevelopment plans contained resident's concerns about limited supermarket access, the plans' visions often required both the public sector and private investment. Fourth, the concept of food deserts is too limited. Instead, a new conceptual understanding is needed to identify processes and structures that have produced whole communities of people that have been food deserted.

Touching a sensibility will attempt to locate the exchange when the living body physically touches the world. Exploration into the emotive response that the lived body creates as it moves through the world, both as a passive receptor and as an active initiator, will be explored where a relationship between the touched and the toucher is formed. This project will use photographic processes in an attempt to facilitate the viewer to engage in the work with their own personal sensibility. The emotional tension created, within an individual when their desire to physically touch something in the world is forbidden, impossible or illicit, will be investigated. This tension manifests itself in the form of apprehension, vulnerability, anticipation, romanticism and the sensibility of possible unpredicted connection. Photographic portrayal will be used to articulate this research and bring into fruition ideas which sit around the haptic.

Arthur’s Pass township, located close to the Main Divide of the central Southern Alps, is highly exposed to natural hazards and has been affected by hazard events since it was founded in 1906. The village is a small alpine township, with a permanent resident population of approximately 54. Its location within the Arthur’s Pass National Park and on the main road between the east and west coasts of the South Island makes it popular with tourists, trampers, climbers and skiers, which can expand the local population to up to 500 people. Its position on the Bealey River floodplain within a highly dynamic tectonic and geomorphic environment makes it vulnerable to earthquakes, landslides, rockfalls, debris flows, heavy rain and snow, river flooding and riverbed erosion. Previous investigations on natural hazards in the area are limited to the Otira Gorge and State Highway 73, with little focus on hazards affecting the village area. Natural hazard events are persistent and frequent in the Arthur’s Pass region and the village is susceptible to being isolated from external resources during and after a disaster, making it necessary for the village to be self-sufficient during a large-scale disaster. The hazards were identified and analysed using aerial photographs and satellite images, historical data, supported by in-field reconnaissance at various times of the year to record seasonal changes. Hazard mapping used the same methods to illustrate the spatial and volumetric hazard changes over a range of time scales; >2% annual probability of occurrence (0-50 years recurrence interval), 2%-0.2% annual probability of occurrence (50-500 years recurrence interval) and <0.2% annual probability of occurrence (500+ years recurrence interval). The hazard maps show that that most hazards are not restricted to a specific temporal or spatial scale, and that they are often interdependent. It is difficult to determine the precise effects that climate change and global warming will have on natural hazards, but they are expected to increase the unpredictability of hazard events and alter weather patterns significantly in the long-term. A visitor questionnaire undertaken in the village indicated that many visitors do not regard the hazards as severe enough to represent a legitimate threat; hence the public perceptions of natural hazards are affecting the vulnerability of the village. Additionally, many people do not feel confident that they would know what to do if a disaster did occur in the village. This level of awareness can be improved by providing more information to visitors and displaying details on emergency procedures. The village does not currently have an emergency plan that specifies particular preparedness and response procedures; it relies heavily on a plan adapted from Mt. Cook/Aoraki village. Current emergency management in the village could be improved by the production of an emergency plan specifically for the region, the use of education schemes and information sessions, and the installation of warning signs. The provision of this detailed hazard investigation and hazard maps is intended to assist emergency managers to identify, prioritise, mitigate the hazards to reduce the vulnerability of the village to natural hazards in the short- and long-terms.

Submitted by Suelen Reis (suziy.ellen@gmail.com) on 2013-04-03T18:32:54Z No. of bitstreams: 1 Lucineide%20Silva.pdf: 531899 bytes, checksum: f4534bc1e91394986eede68ceec14723 (MD5) / Approved for entry into archive by Rodrigo Meirelles(rodrigomei@ufba.br) on 2013-04-05T14:47:42Z (GMT) No. of bitstreams: 1 Lucineide%20Silva.pdf: 531899 bytes, checksum: f4534bc1e91394986eede68ceec14723 (MD5) / Made available in DSpace on 2013-04-05T14:47:42Z (GMT). No. of bitstreams: 1 Lucineide%20Silva.pdf: 531899 bytes, checksum: f4534bc1e91394986eede68ceec14723 (MD5) Previous issue date: 2006 / A Síndrome da Imunodeficiência Adquirida (aids) tem acometido progressivamente homens e mulheres que estão na faixa etária de 50 a 59 anos. Neste sentido, é importante conhecer as representações sociais dessas pessoas, para melhor compreender suas vulnerabilidades à infecção pelo HIV e o modo como agem diante desta epidemia. Este estudo pautou-se nos seguintes objetivos: identificar situações de vulnerabilidade em relação ao HIV/aids entre homens e mulheres de 50 a 59 anos, soropositivos(as) e soronegativos(as); apreender as representações sociais desses sujeitos sobre aids e, conhecer as implicações das representações sociais para aids na vulnerabilidade desses indivíduos. O estudo é quantiqualitativo, com abordagem multimétodos, fundamentado na Teoria das Representações Sociais, gênero, geração e no conceito de vulnerabilidade proposto por Mann. A pesquisa foi desenvolvida em Salvador/BA, tendo como sujeitos 85 homens e mulheres com 50 a 59 anos, soropositivos(as) e soronegativos(as) para o HIV, que compareceram entre os meses de dezembro/2005 a abril/2006 ao Centro de Referência Estadual em IST e aids. Os dados foram coletados através do Teste de Associação Livre de Palavras (TALP) e da entrevista semiestruturada, sendo os mesmos submetidos a análise fatorial de correspondência (AFC) e a análise de conteúdo temática, respectivamente. Para o TALP foram utilizados cinco estímulos indutores: aids, sexo, sexualidade, práticas sexuais e vulnerabilidade ao HIV/aids. As respostas foram processadas no software Tri-Deux-Mots, com as seguintes variáveis: sexo, opção sexual, escolaridade, idade, religião e condição sorológica para o HIV. A AFC demonstrou que só houve significância na oposição de respostas para as variáveis sexo e opção sexual. Na análise, evidenciou-se que os homens destacaram um aspecto social relacionado a aids (“preconceito”), enquanto que as mulheres enfatizaram os desconfortos orgânico e psicológico (“doença contagiosa” e “doença ruim”). Para os indivíduos que se declararam homossexuais e bissexuais, a aids remete aos aspectos negativos da doença, uma vez que esta é uma “doença contagiosa”, “incurável”, “ruim” e que causa “preocupação”. Os condicionantes de gênero e geracionais foram identificados nas representações sociais para o sexo, sexualidade e práticas sexuais, sendo estes representados por elas como “normal” e para eles como “prazer”. A soropositividade para o HIV representa para as mulheres o fim das atividades sexuais, entretanto, para os homens, não traz muitas repercussões na esfera da sexualidade. Grande parte dos sujeitos reconheceu o risco do “sexo desprotegido” e a importância da utilização da “camisinha”. Constatou-se que a maioria dos soronegativos não se percebe vulnerável ao HIV/aids, sobretudo, por considerar que esta é uma “doença de jovens”. As principais situações de vulnerabilidade ao HIV identificadas pelos sujeitos foram o excesso de confiança no(a) parceiro(a), a dificuldade de inserir o preservativo nas relações estáveis, relações sexuais desprotegidas com a “mulher da rua” e/ou com a “mulher de rua” e a participação em orgias. Diante dos achados, reafirma-se a importância das implicações das representações sociais na vulnerabilidade dos indivíduos que se encontram com idade entre 50 a 59 anos, sobretudo, para subsidiar atividades educativas e a formulação de políticas públicas para a prevenção e o controle da epidemia de HIV/aids nessa faixa etária. / Salvador

FundaÃÃo Cearense de Apoio ao Desenvolvimento Cientifico e TecnolÃgico / As definiÃÃes de vulnerabilidade englobam a vulnerabilidade social, programÃtica e individual. Neste trabalho, objetivou-se analisar a vulnerabilidade social, programÃtica e individual de crianÃas no contexto de famÃlias que vivem com HIV/aids. Estudo transversal, quantitativo, realizado em unidades de referÃncia para HIV/aids em Fortaleza-CE. Participaram 231 famÃlias, as quais possuÃam 271 crianÃas com atà 12 anos de idade, distribuÃdas em dois grupos: sem HIV (219) e HIV+ (52). Conduziram-se entrevistas com cuidadores, cujos dados foram analisados de acordo com as dimensÃes da vulnerabilidade social (condiÃÃes socioeconÃmicas, sociodemogrÃficas dos cuidadores, condiÃÃes ambientais e apoio sociofamiliar); vulnerabilidade programÃtica (acessibilidade ao serviÃo) e vulnerabilidade individual (transmissÃo vertical e condiÃÃes de saÃde). Os dados foram tratados no STATA v.11 e foram analisadas as dimensÃes de vulnerabilidade, discriminadas em blocos, mediante um modelo hierarquizado. Em nÃvel distal, permaneceu a dimensÃo social; em nÃvel intermediÃrio, a dimensÃo programÃtica e, em nÃvel proximal, a dimensÃo individual. Definiu-se o diagnÃstico da infecÃÃo pelo HIV como variÃvel dependente e a idade e o sexo da crianÃa como potenciais fatores confundidores e de ajuste do modelo final. Utilizaram-se anÃlises bivariadas para identificar diferenÃas proporcionais entre as variÃveis selecionadas e o diagnÃstico de HIV para cada dimensÃo da vulnerabilidade, mediante aplicaÃÃo dos Testes Qui quadrado de Pearson e o Exato de Fischer. Para as tendÃncias proporcionais entre as variÃveis do tipo ordinal e o diagnÃstico, utilizou-se o Teste Qui quadrado de TendÃncia Linear. Para estimar a magnitude das associaÃÃes, utilizou-se a RazÃo de PrevalÃncia (RP) e intervalos de confianÃa a 95%. Em relaÃÃo à vulnerabilidade social, houve diferenÃa significativa (p=0,021) quanto à principal fonte de renda dos domicÃlios. A mÃe à a principal cuidadora das crianÃas em 80% das famÃlias. Dos cuidadores das crianÃas, observaram-se diferenÃas significantes quanto à faixa etÃria (p=0,000) e situaÃÃo conjugal (p=0,011). Em relaÃÃo ao apoio sociofamiliar, houve diferenÃa significativa em relaÃÃo à orfandade (p=0,003); destaca-se que 46,1% das crianÃas HIV+ sÃo ÃrfÃs. Na vulnerabilidade programÃtica, observaram-se diferenÃas significativas entre os grupos de variÃveis: tipo de parto (p=0,000); profilaxia pelo AZT na gestaÃÃo (p=0,000); uso do Bactrim (p=0,000) e inÃcio da profilaxia do AZT para a crianÃa (p=0,00). Na vulnerabilidade individual, houve diferenÃa significativa nas variÃveis: aleitamento materno (p=0,000); idade que levou a crianÃa ao serviÃo para acompanhamento do HIV (p=0,000) e administraÃÃo do AZT para a crianÃa (p=0,015). Postula-se que a ocorrÃncia do HIV+ esteja associada Ãs causas estruturais ou bÃsicas, representadas pelas condiÃÃes socioeconÃmicas dos indivÃduos, portanto, as caracterÃsticas sociais (distais) influenciam negativamente as demais dimensÃes e ratificam que condiÃÃes precÃrias de sobrevivÃncia potencializam o diagnÃstico HIV+ e privam estas famÃlias na vigÃncia do HIV. Portanto, o modelo final com as dimensÃes social + programÃtica + individual + idade da crianÃa + sexo + interaÃÃo entre a idade e o sexo, somados, contribuÃram para explicar 31,0% dos casos de crianÃas HIV+. Diante do apresentado, urge integrar diferentes Ãreas para cumprir as medidas de prevenÃÃo da TransmissÃo Vertical, em virtude de as crianÃas expostas ao HIV/aids estarem inseridas em ambientes vulnerÃveis. Portanto, à preciso garantir-lhes acessibilidade aos serviÃos de saÃde mediante a descentralizaÃÃo dos serviÃos de atendimento, bem como ampliar os serviÃos especializados, a fim de minimizar a vulnerabilidade social, programÃtica e individual que cinge esta populaÃÃo. / The definitions of vulnerability include social, programmatic and individual vulnerability. In this study, the objective was to analyze the social, program and individual vulnerability of children in the context of families living with HIV/aids. This cross-sectional, quantitative study was undertaken at referral units for HIV/aids in Fortaleza-CE. Participants were 231 families with 271 children of up to 12 years of age, distributed in two groups: without HIV (219) and HIV+ (52). Interviews were held with caregivers, whose data were analyzed in accordance with the dimensions of social vulnerability (socioeconomic and sociodemographic conditions of the caregivers, environmental conditions and social-familial support); programmatic vulnerability (service access) and individual vulnerability (vertical transmission and health conditions). The data were processed in STATA v.11 and the vulnerability dimensions, distinguished in blocks, were analyzed using a hierarchical model. The social dimension was located at the distal end, the programmatic dimension at the intermediary level, and the individual dimension at the proximal end. The HIV diagnosis was defined as the dependent variable and the childâs age and sex as potentially confounding and adjustment factors in the final model. Bivariate analyses were used to identify proportional differences between the selected variables and the HIV diagnosis for each vulnerability dimension through the application of Pearsonâs Chi-squared and Fisherâs Exact Tests. For the proportional trends between the ordinal variables and the diagnosis, the Chi-squared Test for Linear Trend was used. To estimate the magnitude of the associations, the Prevalence Ratio (PR) and 95% confidence intervals were used. As regards the social vulnerability, a significant difference was found (p=0.021) in the residencesâ main source of income. The mother is the childrenâs main caregiver in 80% of the families. Concerning the childrenâs caregivers, significant differences were observed in the age range (p=0.000) and marital situation (p=0.011). What the social-familial support is concerned, a significant difference was found in orphanhood (p=0.003); it is highlighted that 46.1% of the HIV+ children are orphans. In the programmatic vulnerability, significant differences were observed between the groups of variables: delivery type (p=0.000); AZT prophylaxis during pregnancy (p=0.000); use of Bactrim (p=0.000) and start of the AZT prophylaxis for the child (p=0.00). In the individual vulnerability, a significant difference was found in the variables: breastfeeding (p=0.000); at what age the child was taken to the service for HIV monitoring (p=0.000) and administration of AZT to the child (p=0.015). It is postulated that the occurrence of HIV+ is associated with structural or basic causes, represented by the individualsâ socioeconomic conditions. Therefore, the social (distal) characteristics have a negative influence on the other dimensions and ratify that precarious survival conditions leverage the HIV+ diagnosis and deprive these families with HIV. Hence, the final model with the social + programmatic + individual dimensions + childâs age + sex + interaction between age and sex combined contributed to explain 31.0% of the cases of HIV+ children. In view of the above, it is urgent to integrate different areas in order to comply with the prevention measures of Vertical Transmission, considering that the children exposed to HIV/aids are inserted in vulnerable environments. Therefore, they need to be guaranteed access to the health services through the decentralization of the care services. Also, the specialized services need to be expanded in order to minimize the social, programmatic and individual vulnerability that affects this population.

Due to persistent and serious threats from natural disasters around the globe, many have turned to resilience and vulnerability research to guide disaster preparation, recovery, and adaptation decisions. In response, scholars and practitioners have put forth a variety of disaster indices, based on quantifiable metrics, to gauge levels of resilience and vulnerability. However, few indices are empirically validated using observed disaster impacts and, as a result, it is often unclear which index should be preferred for each decision at hand. Thus, we compare and empirically validate five of the top U.S. disaster indices, including three resilience indices and two vulnerability indices. We use observed disaster losses, fatalities, and disaster declarations from the southeastern United States to empirically validate each index. We find that disaster indices, though thoughtfully substantiated by literature and theoretically persuasive, are not all created equal. While four of the five indices perform as predicted in explaining damages, only three explain fatalities and only two explain disaster declarations as expected by theory. These results highlight the need for disaster indices to clearly state index objectives and structure underlying metrics to support validation of the results based on these goals. Further, policymakers should use index results carefully when developing regional policy or investing in resilience and vulnerability improvement projects.