[Role of coronary artery bypass grafting in the treatment of coronary artery disease - a well-balanced information of the patients and objective decision making are welcome]

Most recently discussion about the optimal treatment for different subsets of patients suffering from coronary artery disease has re-emerged, mainly because of the uncertainty caused by doctors and patients regarding the phenomenon of unpredictable early and late stent thrombosis. Surgical revascularization using multiple arterial bypass grafts has repeatedly proven its superiority compared to percutaneous intervention techniques, especially in patients suffering from left main stem disease and coronary 3-vessels disease. Several prospective randomized multicenter studies comparing early and mid-term results following PCI and CABG have been really restrictive, with respect to patient enrollment, with less than 5% of all patients treated during the same time period been enrolled. Coronary artery bypass grafting allows the most complete revascularization in one session, because all target coronary vessels larger than 1 mm can be bypassed in their distal segments. Once the patient has been turn-off for surgery, surgeons have to consider the most complete arterial revascularization in order to decrease the long-term necessity for re-revascularization; for instance patency rate of the left internal thoracic artery grafted to the distal part left anterior descending artery may be as high as 90-95% after 10 to 15 years. Early mortality following isolated CABG operation has been as low as 0.6 to 1% in the most recent period (reports from the University Hospital Berne and the University Hospital of Zurich); beside these excellent results, the CABG option seems to be less expensive than PCI with time, since the necessity for additional PCI is rather high following initial PCI, and the price of stent devices is still very high, particularly in Switzerland. Patients, insurance and experts in health care should be better and more honestly informed concerning the risk and costs of PCI and CABG procedures as well as about the much higher rate of subsequent interventions following PCI. Team approach for all patients in whom both options could be offered seems mandatory to avoid unbalanced information of the patients. Looking at the recent developments in transcatheter valve treatments, the revival of cardiological-cardiosurgical conferences seems to a good option to optimize the cooperation between the two medical specialties: cardiology and cardiac surgery.

Transformation of local medicinal knowledge in the Andean Highlands: Case studies from Peru and Bolivia

In the Andean highlands, indigenous environmental knowledge is currently undergoing major changes as a result of various external and internal factors. As in other parts of the world, an overall process of erosion of local knowledge can be observed. In response to this trend, some initiatives that adopt a biocultural approach aim at actively strengthening local identities and revalorizing indigenous environmental knowledge and practices, assuming that such practices can contribute to more sustainable management of biodiversity. However, these initiatives usually lack a sound research basis, as few studies have focused on the dynamics of indigenous environmental knowledge in the Andes and on its links with biodiversity management. Against this background, the general objective of this research project was to contribute to the understanding of the dynamics of indigenous environmental knowledge in the Andean highlands of Peru and Bolivia by investigating how local medicinal knowledge is socially differentiated within rural communities, how it is transformed, and which external and internal factors influence these transformation processes. The project adopted an actor-oriented perspective and emphasized the concept of knowledge dialogue by analyzing the integration of traditional and formal medicinal systems within family therapeutic strategies. It also aimed at grasping some of the links between the dynamics of medicinal knowledge and the types of land use systems and biodiversity management. Research was conducted in two case study areas of the Andes, both Quechua-speaking and situated in comparable agro-ecological production belts - Pitumarca District, Department of Cusco (Southern Peruvian Highlands) and the Tunari National Park, Department of Cochabamba (Bolivian inner-Andean valleys). In each case study area, the land use systems and strategies of 18 families from two rural communities, their environmental knowledge related to medicine and to the local therapeutic flora, and an appreciation of the dynamics of this knowledge were assessed. Data were collected through a combination of disciplinary and participatory action-research methods. It was mostly analyzed using qualitative methods, though some quantitative ethnobotanical methods were also used. In both case studies, traditional medicine still constitutes the preferred option for the families interviewed, independently of their age, education level, economic status, religion, or migration status. Surprisingly and contrary to general assertions among local NGOs and researchers, results show that there is a revival of Andean medicine within the younger generation, who have greater knowledge of medicinal plants than the previous one, value this knowledge as an important element of their way of life and relationship with “Mother Earth” (Pachamama), and, at least in the Bolivian case, prefer to consult the traditional healer rather than go to the health post. Migration to the urban centres and the Amazon lowlands, commonly thought to be an important factor of local medicinal knowledge loss, only affects people’s knowledge in the case of families who migrate over half of the year or permanently. Migration does not influence the knowledge of medicinal plants or the therapeutic strategies of families who migrate temporarily for shorter periods of time. Finally, economic status influences neither the status of people’s medicinal knowledge, nor families’ therapeutic strategies, even though the financial factor is often mentioned by practitioners and local people as the main reason for not using the formal health system. The influence of the formal health system on traditional medicinal knowledge varies in each case study area. In the Bolivian case, where it was only introduced in the 1990s and access to it is still very limited, the main impact was to give local communities access to contraceptive methods and to vaccination. In the Peruvian case, the formal system had a much greater impact on families’ health practices, due to local and national policies that, for instance, practically prohibit some traditional practices such as home birth. But in both cases, biomedicine is not considered capable of responding to cultural illnesses such as “fear” (susto), “bad air” (malviento), or “anger” (colerina). As a consequence, Andean farmers integrate the traditional medicinal system and the formal one within their multiple therapeutic strategies, reflecting an inter-ontological dialogue between different conceptions of health and illness. These findings reflect a more general trend in the Andes, where indigenous communities are currently actively revalorizing their knowledge and taking up traditional practices, thus strengthening their indigenous collective identities in a process of cultural resistance.

Valorization of agrobiodiversity products and strengthening of local identities in the Peruvian Andes: Experiences from the BioAndes Programme

In the Peruvian Andes, a long history of interaction between the local populations and their natural environment has led to extraordinary levels of agrobiodiversity. However, in sharp contrast with this biological wealth, Andean indigenous populations live under most precarious conditions. Moreover, natural resources are undergoing severe degradation processes and local knowledge about biodiversity management is under serious pressure. Against this background, the BioAndes Programme is developing initiatives based on a biocultural approach that aim at fostering biodiversity through the enhancement of cultural processes. On the basis of intercultural dialogue, joint learning and capacity development, and transdisciplinary action-research, indigenous communities, development practitioners, and researchers strive for the creation of innovative ways to contribute to more sustainable economic, socio-cultural, and political valorization of Andean biodiversity. Project activities are diverse and range from the cultivation, transformation, and commercialization of organic Andean fruits in San Marcos, Cajamarca Department, to the recuperation of natural dying techniques for alpaca wool and traditional weaving in Pitumarca, Cusco Department, and the promotion of responsible ecotourism in both regions. Based on the projects’ first two-years of experience, the following lessons learnt will be presented and discussed: 1. The economic valorization and commercialization of local products can be a powerful tool for the revival and innovation of eroded know-how; at the same time it contributes to the strengthening of local identities, in parallel with the empowerment of marginalized groups such as smallholders and women. 2. Such initiatives are only successful when they are embedded within activities that go beyond the focus on local products and seek the valorization of the entire natural and cultural landscape (e.g. through the promotion of agrotourism and local gastronomy, more sustainable management of local resources including the restoration of ecosystems, and the realization of inventories of local agrobiodiversity and the knowledge related to it). 3. The sustainability of these initiatives, which are often externally induced, is conditioned by the ability of local actors to acquire ownership of projects and access to the knowledge required to carry them out, which also means developing the personal and institutional capacities for handling the whole chain from production to commercialization. 4. The confrontation of different economic rationalities and their underlying worldviews that occur when local or indigenous people integrate into the market economy implies the need for a dialogical co-production of knowledge and collective action by local people, experts from NGOs, and political authorities in order to better control the conditions relating to the market economy. The valorization of local agrobiodiversity shows much potential for enhancing natural and cultural diversity in Southern countries, but only when local communities can participate in the shaping of the conditions under which this happens. Such activities should be designed in the mid- to long-term as part of social learning processes that are carefully embedded in the local context. Supporting institutions play a crucial role in these processes, but should see themselves only as facilitators, while ensuring that control and ownership remain with the local actors.

Hilarión Eslava and the Renaissance of the Renaissance in Spain

Hilarión Eslava war der einflussreichste Musikpädagoge und Musikhistoriker der Mitte des 19. Jhs. in Spanien. Die Musikhistoriographie hat seine Leistung jedoch nicht gebührend zur Kenntnis genommen, da sie auf ideologische und historiographische Grundlagen fusst, des späten 20. Jhs. nicht kompatibel war.

Towards an Application of Globalization Paradigms to Modern Folk Music Revivals

This chapter maps out central globalizing perspectives that have influenced discourses on revival and related transformational processes of traditional forms of musical expression. Focusing on the Latvian groups Skandinieki and Iļģi and on electric folk in England, the chapter analyzes the extent to which meta-perspectives can help elucidate the impact of global flows on music revivals. As Held et al.’s 2003 globalization study indicates, revival situations can be interpreted from different meta-perspectives. Equating globalization with homogenization, a sceptic perspective perceives revival as an important means of preservation. A hyperglobal approach regards globalization not as a threat, but as a possible access to Western market structures. A transformationalist perspective perceives increasingly dense global networks as the basis for developing new structures, approached from an open perspective. Although supporting a transformationalist perspective, this chapter argues that an adequate modern approach toward revival requires the combination of all three perspectives.

Germanic Mythology in Music: Cultural Memory and Conflict within the Framework of Modern Globalization

The multi-layered enactment of a national past in music has been strongly intertwined with the usage of mythological elements. Having often been compiled as a coherent narrative during the emergence of the European nation-states (like the Finnish Kalevala), the mythological material has often been perceived as a form of historical truth and national justification. This focal role is also apparent in various music genres ranging from folk revival to metal in post-1989 Europe. Within the globalized context, however, local-national interpretations can collide with earlier nationalist appropriations. This complex and sometimes politically conflicting situation becomes particularly evident with groups falling back on symbols and narrations that had previously been employed by Nazi-Germany. While Nazi-Germany had, among others, tried replace the Christmas tradition with elements and songs from Germanic (and other) mythological sources, modern Neo-Nazi music groups often employ central mythological names (like Odin or Tyr) and iconic elements (like Vikings and warriors) in song lyrics and CD cover designs. However, while many covers and lyrics are legally forbidden in Germany, Scandinavian and Baltic groups (like the Faroese Viking metal group Tyr and the Latvian pagan metal band Skyforger) employ similar elements of Norse mythology, which are often combined with traditional material. Discussing selected case studies, this paper highlights central discursive points of colliding historical-national associations and individual interpretations of the mythological elements in musical contexts. How far can the material be disassociated from the earlier historical political usage and instrumentalization? Is this necessary ? And how can the specific global-local conflict points be approached by a theoretical framework ?

Religion and Ethnicity in Mongolian Societies. Historical and Contemporary Perspectives

This volume about religion and ethnicity in Mongolian societies is the outcome of an international seminar organized in Switzerland in 2009. Ten contributions explore the interplay of religion and ethnicity in the Mongolian and Buryat-Mongolian regions, covering four hundred years of Mongolian and Buryat history. Drawing on methods of diverse scholarly disciplines, including religious studies, Tibetan and Mongolian studies, social anthropology and history, the issues addressed include Mongolian identity formations in the light of the Tibeto-Mongolian interface in the 17th century, Buryat religious survival in the colonial setting of 18th and 19th century Russia, the interplay of religion and politics in Buryatia, a case study of the famous “Imperishable Body” of Khambo Lama Itigelov, an analysis of the religious politics of the Buryat Traditional Sangha in today’s Republic of Buryatia, the role of Shamanism in the identity practices of Modern Buryatia, as well as the revival of “traditional” religions like Buddhism and Shamanism in Mongolia and the emergence of new religions, especially Christianity. Furthermore, two contributions provide in-depth analyses of the dominant theoretical approaches that inform Russian and Anglophone scholarship dealing with these questions.

The phylogenetic position of the Dura Language of Nepal

The precise phylogenetic propinquity of Dura within the Tibeto-Burman or Trans-Himalayan language family has hitherto been indeterminate. In the absence of compelling comparative evidence, the language has previously been assigned to a subgroup in its own right within the linguistic phylum as a whole. Meanwhile, the Dura language is effectively extinct, although attempts at revival may be undertaken by well-intentioned members of Dura ethnicity. On the basis of a comprehensive study and analysis of all of the extant Dura language material, the phylogenetic position of the language within the family will be clarified. Comparative evidence from the Dura lexicon, its nominal and verbal morphology as well as from syntactic and phonological properties is adduced to determine the phylogenetic position of Dura. Moreover, this result will help explain some of the sociocultural realities associated with the Dura language community in Lamjung, Nepal

Racing against Time: Varying Patterns of Social Mobilization in Serbia and Georgia

After the collapse of the Soviet Union and Yugoslavia, a number of actors started to engage in the power struggle for the opportunities to shape the new order in successive nation-states. In Serbia and Georgia historically hegemonic Orthodox Christian churches were among the firsts in the frontlines for political and economic power. More than a decade has passed since the so-called Coloured Revolutions in Georgia and Serbia, and the Orthodox churches still remain participants of an ongoing socio-political transition of these states. The revival of public role of religion appeared temporary in Serbia followed by a gradual decline of an influence of the Orthodox Church over political life and legal process. However, in Georgia the public and political role of religion increased rather than declined albeit changed shape. Examining the degree to which the two Orthodox churches can influence the political agenda in Serbia and Georgia, the paper attempts to understand how church-State relations work in practice. By bringing rich empirical data from the field (70 interviews with (arch)bishops, priests and religious clerics in Georgia and Serbia added to field observations), the paper reflects on the themes under which the two Orthodox churches mobilize public protest in Serbia and Georgia. The paper further looks at varying State responses and their broader implication for church-state problematique.

Heiligenspielrezeption in der Schweiz 1929: Das Bruderklausenspiel von Oskar Eberle

Based on Hansjürgen Linke’s study about the history of the reception of religious and secular medieval plays in twentieth-century Germany, the paper examines the respective situation in Switzerland. It focusses on the Bruderklausenspiel (1929), written and staged by Oskar Eberle. The director and scholar Oskar Eberle, and the Schweizerische Gesellschaft für Theaterkultur (SGTK) were the most influential supporters of the reception of religious plays in twentieth-century Switzerland. While in Germany the revival of medieval theatre emphasized a Renaissance of a former national importance, in Switzerland, the situation was very different. The revival of religious plays had a certain confessional background, and the political idea was to strengthen national self-confidence, and to confirm the nation’s historical neutrality concerning foreign affairs.

Great Himalaya: Tourism and the dynamics of change in Nepal

Based on extensive field work and years of personal experience, the authors discuss the development of tourism in the Great Himalaya of Nepal from the early days of mountaineering to present-day trekking. Tourism and its potentials, drawbacks, and risks are illustrated with a focus on the Khumbu/Everest and Annapurna regions, the most popular mountain destinations in the country. The themes addressed include: growth and expansion of mountain tourism; employment and income generation; wealth, poverty, and livelihood as reflected in statistics and personal accounts by local people; the revival of trade with Tibet; tourism and the role of women; the crucial role played by institutions, policies and political stability; and environmental issues such as forest degradation, garbage management, and trail damage. With its numerous illustrations, text boxes and quotes, the book is intended for a broad readership of policy- and decision-makers in tourism and development, scholars, and tourists and mountaineers who take an interest in mountain development in the Great Himalaya and elsewhere.