Estratègies de cura i presa de decisions en persones grans amb dependència ingressades en una unitat geriàtrica d'atenció intermèdia : estudi descriptiu

Aquest estudi té com objectiu observar les relacions entre les estratègies de cura (formal, informal, mixta) que fan servir els cuidadors de persones grans dependents, la seva situació social i les seves motivacions per la decisió respecte a com fan la cura. L’estat del tema destaca el predomini de les cures informals sobre les formals en els models de benestar mediterranis i la rellevància de la interacció entre factors personals socioculturals i les polítiques socials en la presa de decisions individuals sobre la cura de la dependència. La llei de la dependència, de recent implementació a l’Estat espanyol, ha universalitzat l’accés als recursos formals, creant un nou paradigma d’interacció cuidadors-recursos. Es tracta d’un estudi observacional, transversal, descriptiu de tipus mixt quantitatiu/qualitatiu realitzat a partir d’entrevistes individuals als cuidadors de dependents ingressats en una unitat geriàtrica d’atenció intermèdia. Es recullen dades sobre el context sociofamiliar, l’estratègia de cura, l’autopercepció i les motivacions. Els resultats mostren que els cuidadors combinen prestacions econòmiques i serveis (públics i privats) per adaptar al màxim l’estratègia a les condicions del dependent i a les seves pròpies. Tenen la convicció generalitzada que l’atenció cal fer-la al domicili per motius de reciprocitat i respecte a la persona cuidada. El pas a l’atenció residencial és una decisió molt difícil pels cuidadors. La implantació de la llei de la dependència ha normalitzat la relació entre cuidadors i recursos formals, però la burocratització i la insuficiència de l’oferta de serveis no afavoreixen canvis substancials en la provisió de l’ajut, que continua essent majoritàriament informal. La millora en la percepció de continuïtat d’atenció entre el domicili i la residència, i també en la gestió i l’oferta de serveis formals públics es presenten com a reptes de treball importants al nostre país.

Homicide-suicide cases in Switzerland and their impact on the Swiss Weapon Law.

Homicide followed by the suicide of the offender is a well-known phenomenon. In most cases, it takes place in the context of the so-called "family tragedies." A recent series of such family tragedies in Switzerland prompted an intensive debate in the media and the Swiss government concerning the Swiss Weapon Law, in particular the requirement to keep personal army weapons at home. The present study of Homicide-Suicide cases in Switzerland, thus focuses on the role played by guns, especially military weapons, in such crimes. We investigated retrospectively 75 cases of Homicide-Suicide, comprising 172 individuals and spanning a period of 23 years in western and central Switzerland. Our results show that if guns were used in 76% of the cases, army weapons were the cause of death in 25% of the total. In 28% of the deaths caused by a gunshot, the exact type of the gun and its origin could not be determined. Thus, the majority of Homicide-Suicide cases in Switzerland involve the use of guns. The exact percentage of cases were military weapons were involved could not be defined. In our opinion, a stricter weapons law, restricting access to firearms, would be a factor of prevention of Homicide- Suicide cases in Switzerland.

Sexual Orientation Gender Indentity, and Iowa's Safe Schools Law, 2007

Another recently enacted law is the Iowa Safe Schools Law. Effective September 1, 2007, Iowa Code Chapter 280 requires both public and private schools to establish policies prohibiting harassment and bullying against students by employees, school volunteers, or other students. Sexual Orientation and Gender identity are covered under the Safe Schools Law. Students may now seek remedies under both Chapter 216 and Chapter 280.

Enhancing centralized enforcement of EU law : Pandora's toolbox ?

State compliance with EU Law is crucial to the very existence of the Union. Traditionally, it has been secured through a combination of strong "private" and of weak "centralized" enforcement. However, this arrangement is no longer perceived to be sufficient. By endowing the Union with new tools vis-à-vis its Member States - penalties, conditionality, and the like - current reforms try to complement symbolic sanctioning with real "consequences". The goal is to reinforce the authority of EU Law. In this article, we question whether the new toolbox is fit for the purpose, or whether it risks to produce adverse effects which might even go as far as upsetting the Union's constitutional template.

Accessing Legal Information in Catalonia. Open Acces to Legislation and Case Law

The article outlines free online legal resources to conduct research on Catalan and Spanish legislation and case-law. Most of these resources are primary sources made public by government bodies. The list shows how the Spanish and Catalan governments, in their attempt to promote equal access to legislation and case-law, cover the different jurisdictions. The text also mentions some resources to conduct historical legal research about legislation and case law, and some free legal private websites.

The law of impersonal transactions

Most economic interactions happen in a context of sequential exchangein which innocent third parties suffer information asymmetry with respect toprevious "originative" contracts. The law reduces transaction costs byprotecting these third parties but preserves some element of consent byproperty rightholders to avoid damaging property enforcement?e.g., it isthey, as principals, who authorize agents in originative contracts. Judicialverifiability of these originative contracts is obtained either as an automaticbyproduct of transactions or, when these would have remained private, byrequiring them to be made public. Protecting third parties produces a legalcommodity which is easy to trade impersonally, improving the allocationand specialization of resources. Historical delay in generalizing this legalcommoditization paradigm is attributed to path dependency?the law firstdeveloped for personal trade?and an unbalance in vested interests, asluddite legal professionals face weak public bureaucracies.

Impact of the Spanish smoking law on exponsure to secondhand smoke in offices and hospitality venues: before-and-after study

BACKGROUND/OBJECTIVES: A smoking law was passed by the Spanish Parliament in December 2005 and was enforced by 1 January 2006. The law bans smoking in all indoor workplaces but only in some hospitality venues, because owners are allowed to establish a smoking zone (venues>100 m2) or to allow smoking without restrictions (venues<100 m2). The objective of the study is to assess the impact of the Spanish smoking law on exposure to secondhand smoke (SHS) in enclosed workplaces, including hospitality venues. MATERIALS AND METHODS: The study design is a before-and-after evaluation. We studied workplaces and hospitality venues from eight different regions of Spain. We took repeated samples of vapor-phase nicotine concentration in 398 premises, including private offices (162), public administration offices (90), university premises (43), bars and restaurants (79), and discotheques and pubs (24). RESULTS: In the follow-up period, SHS levels were markedly reduced in indoor offices. The median decrease in nicotine concentration ranged from 60.0% in public premises to 97.4% in private areas. Nicotine concentrations were also markedly reduced in bars and restaurants that became smoke-free (96.7%) and in the no-smoking zones of venues with separate spaces for smokers (88.9%). We found no significant changes in smoking zones or in premises allowing smoking, including discotheques and pubs. CONCLUSIONS: Overall, this study shows the positive impact of the law on reducing SHS in indoor workplaces. However, SHS was substantially reduced only in bars and restaurants that became smoke-free. Most hospitality workers continue to be exposed to very high levels of SHS. Therefore, a 100% smoke-free policy for all hospitality venues is required.

Patients who attend a private practice vs a university outpatient clinic: how do they differ?

Although interpersonal continuity is commonly assumed to be essential for care, some patients prefer to attend a university outpatient clinic where physicians change regularly and interpersonal continuity of care is not ensured. The aim of this exploratory study was to evaluate the differences between patients attending a university outpatient clinic and patients frequenting a private practice, explore their patterns of care-seeking and their understanding of continued care. We conducted a cross-sectional study of patients attending the university medical outpatient clinic (OC) in Lausanne, Switzerland and ten randomly selected private general practices (PP). Eligible patients were >30 years, Swiss nationals or long term residents, with one or more chronic conditions and attending the same practice for >3 years. They were asked to complete a questionnaire on sociodemographic data, use of medical resources and reasons for choosing and remaining at the same practice. Semi-structured interviews were conducted with a randomly selected subset of 26 patients to further explore their preferences. 329 patient questionnaires were completed, 219 by PP and 110 by OC patients. OC patients tended to be of lower socioeconomic status than PP patients. The main reason for choosing a PP were personal recommendation, while a higher percentage of patients chose the OC because they could obtain a first appointment quickly. A higher percentage of PP patients accorded importance to physician communication skills and trust, whereas a higher percentage of OC patients favoured investigation facilities. Qualitative data suggested that although OC and PP patients reported different reasons for consulting, their expectations on the medical and relationship level were similar. Our study suggests that the two groups of patients belong to different social backgrounds, have different patterns of care-seeking and attach importance to different aspects of care continuity. However, patients' expectations and perceptions of the physician-patient relationship are similar.

Transnational private authority and the participation of workers' organizations in the regulatory space surrounding the employment relationship

Most corporate codes of conduct and multi-stakeholder sustainability standards guarantee workers' rights to freedom of association and collective bargaining, but many authors are sceptical about the concrete impact of codes and standards of this kind. In this paper we use Hancher and Moran's (1998) concept of 'regulatory space' to assess the potential of private transnational regulation to support the growth of trade union membership and collective bargaining relationships, drawing on some preliminary case study results from a project on the impact of the International Finance Corporation's (IFC) social conditionality on worker organization and social dialogue. One of the major effects of neoliberal economic and industrial policy has been the routine exclusion of workers' organizations from regulatory processes on the grounds that they introduce inappropriate 'political' motives into what ought to be technical decision-making processes. This, rather than any direct attack on their capacity to take action, is what seems best to explain the global decline in union influence (Cradden 2004; Howell 2007; Howe 2012). The evidence we present in the paper suggests that private labour regulation may under certain conditions contribute to a reversal of this tendency, re-establishing the legitimacy of workers' organizations within regulatory processes and by extension the legitimacy of their use of economic and social power. We argue that guarantees of freedom of association and bargaining rights within private regulation schemes are effective to the extent that they can be used by workers' organizations in support of a claim for access to the regulatory space within which the terms and conditions of the employment relationship are determined. Our case study evidence shows that certain trade unions in East Africa have indeed been able to use IFC and other private regulation schemes as levers to win recognition from employers and to establish collective bargaining relationships. Although they did not attempt to use formal procedures to make a claim for the enforcement of freedom of association rights on behalf of their members, the unions did use enterprises' adherence to private regulation schemes as a normative point of reference in argument and political exchange about worker representation. For these unions, the regulation was a useful addition to the range of arguments that they could deploy as means to justify their demand for recognition by employers. By contrast, the private regulation that helps workers' organizations to win access to regulatory processes does little to ensure that they are able to participate meaningfully, whether in terms of technical capacity or of their ability to mobilize social power as a counterweight to the economic power of employers. To the extent that our East African unions were able to make an impact on terms and conditions of employment via their participation in regulatory space it was solely on the basis of their own capacities and resources and the application of national labour law.

Swiss family physicians' perceptions and attitudes towards knowledge translation practices.

BACKGROUND: Several studies have been performed to understand the way family physicians apply knowledge from medical research in practice. However, very little is known concerning family physicians in Switzerland. In an environment in which information constantly accumulates, it is crucial to identify the major sources of scientific information that are used by family physicians to keep their medical knowledge up to date and barriers to use these sources. Our main objective was to examine medical knowledge translation (KT) practices of Swiss family physicians. METHODS: The population consisted of French- and German-speaking private practice physicians specialised in family medicine. We conducted four interviews and three focus groups (n = 25). The interview guides of the semi-structured interviews and focus groups focused on (a) ways and means used by physicians to keep updated with information relevant to clinical practice; (b) how they consider their role in translating knowledge into practice; (c) potential barriers to KT; (d) solutions proposed by physicians for effective KT. RESULTS: Family physicians find themselves rather ambivalent about the translation of knowledge based on scientific literature, but generally express much interest in KT. They often feel overwhelmed by "information floods" and perceive clinical practice guidelines and other supports to be of limited usefulness for their practice. They often combine various formal and informal information sources to keep their knowledge up to date. Swiss family physicians report considering themselves as artisans, caring for patients with complex needs. CONCLUSION: Improved performance of KT initiatives in family medicine should be tailored to actual needs and based on high quality evidence-based sources.

Estratègies de cura i presa de decisions en persones grans amb dependència ingressades en una unitat geriàtrica d'atenció intermèdia : estudi descriptiu

Aquest estudi té com objectiu observar les relacions entre les estratègies de cura (formal, informal, mixta) que fan servir els cuidadors de persones grans dependents, la seva situació social i les seves motivacions per la decisió respecte a com fan la cura. L’estat del tema destaca el predomini de les cures informals sobre les formals en els models de benestar mediterranis i la rellevància de la interacció entre factors personals socioculturals i les polítiques socials en la presa de decisions individuals sobre la cura de la dependència. La llei de la dependència, de recent implementació a l’Estat espanyol, ha universalitzat l’accés als recursos formals, creant un nou paradigma d’interacció cuidadors-recursos. Es tracta d’un estudi observacional, transversal, descriptiu de tipus mixt quantitatiu/qualitatiu realitzat a partir d’entrevistes individuals als cuidadors de dependents ingressats en una unitat geriàtrica d’atenció intermèdia. Es recullen dades sobre el context sociofamiliar, l’estratègia de cura, l’autopercepció i les motivacions. Els resultats mostren que els cuidadors combinen prestacions econòmiques i serveis (públics i privats) per adaptar al màxim l’estratègia a les condicions del dependent i a les seves pròpies. Tenen la convicció generalitzada que l’atenció cal fer-la al domicili per motius de reciprocitat i respecte a la persona cuidada. El pas a l’atenció residencial és una decisió molt difícil pels cuidadors. La implantació de la llei de la dependència ha normalitzat la relació entre cuidadors i recursos formals, però la burocratització i la insuficiència de l’oferta de serveis no afavoreixen canvis substancials en la provisió de l’ajut, que continua essent majoritàriament informal. La millora en la percepció de continuïtat d’atenció entre el domicili i la residència, i també en la gestió i l’oferta de serveis formals públics es presenten com a reptes de treball importants al nostre país.

Family ownership – a source of sustainable success in listed companies

Extant research on exchange-listed firms has acknowledged that the concentration of ownership and the identity of owners make a difference. In addition, studies indicate that firms with a dominant owner outperform firms with dispersed ownership. During the last few years, scholars have identified one group of owners, in particular, whose ownership stake in publicly listed firm is positively related to performance: the business family. While acknowledging that family firms represent a unique organizational form, scholars have identified various concepts and theories in order to understand how the family influences organizational processes and firm performance. Despite multitude of research, scholars have not been able to present clear results on how firm performance is actually impacted by the family. In other words, studies comparing the performance of listed family and other types of firms have remained descriptive in nature since they lack empirical data and confirmation from the family business representatives. What seems to be missing is a convincing theory that links the involvement and behavioral consequences. Accordingly, scholars have not yet come to a mutual understanding of what precisely constitutes a family business. The variety of different definitions and theories has made comparability of different results difficult for instance. These two issues have hampered the development of a rigorous theory of family business. The overall objective of this study is to describe and understand how the family as a dominant owner can enhance firm performance, and can act a source of sustainable success in listed companies. In more detail, in order to develop understanding of the unique factors that can act as competitive advantages for listed family firms, this study is based on a qualitative approach and aims at theory development, not theory verification. The data in this study consist of 16 thematic interviews with CEOs, members of the board, supervisory board chairs, and founders of Finnish listed-family firms. The study consists of two parts. The first part introduces the research topic, research paradigm, methods, and publications, and also discusses the overall outcomes and contributions of the publications. The second part consists of four publications that address the research questions from different viewpoints. The analyses of this study indicate that family ownership in listed companies represents a structure that differs from the traditional views of agency and stewardship, as well as from resource-based and stakeholder views. As opposed to these theories and shareholder capitalism which consider humans as individualistic, opportunistic, and self-serving, and assume that the behaviors of an investor are based on the incentives and motivations to maximize private profits, the family owners form a collective social unit that is motivated to act together toward their mutual purpose or benefit. In addition, socio-emotional and psychological elements of ownership define the family members as owners, rather than the legal and financial dimensions of ownership. That is, collective psychological ownership of family over the business (F-CPO) can be seen as a construct that comprehensively captures the fusion between the family and the business. Moreover, it captures the realized, rather than merely potential, family influence on and interaction with the business, and thereby brings more theoretical clarity of the nature of the fusion between the family and the business, and offers a solution to the problem of family business definition. This doctoral dissertation provides academics, policy-makers, family business practitioners, and the society at large with many implications considering family and business relationships.

Gendered attitudes and family planning decision-making in Honduras

This study examines gendered attitudes and family planning in the Central American country of Honduras using a feminist perspective. Specifically, this study investigates the relationships between gendered attitudes (i.e., male oriented or non-male oriented attitudes) and who makes decisions about contraceptive use and family size among married and common-law Hondurans. This study also attempts to account for social elements such as gendered attitudes, education, economics, environment and demographics that may act to limit or enhance women's agency in reproductive decisionmaking. Furthermore, gender is examined to determine whether these relationships depend on the gender of the respondents. Two national Honduran surveys from 2001 are used in a secondary analysis, specifically muUinomial logisfic regression. Findings indicate that women reporting non-male oriented attitudes are significantly more likely to indicate that they (the wives) make the contraceptive decisions. Moreover, both men and women reporting non-male oriented attitudes are significantly more likely to indicate making contraceptive decisions together. Both of these effects remain significant when other social factors included in the analyses, though part of the effect is explained by education and economics. Similar effects are found in terms of family size decisions. Limitations and directions for future research are discussed.

Grant Chapman, University of Southern California Law School graduation, 1925

Grant Chapman, University of Southern California Law School graduation, 1925.