Commodification of health care systems: The Catalan case

Commodification of the public healthcare system has been a growing process in recent decades, especially in universal healthcare systems and in high-income countries like Spain.  There are substantial differences in the healthcare systems of each autonomous region of Spain, among which Catalonia is characterized by having a mixed healthcare system with complex partnerships and interactions between the public and private healthcare sectors.  Using a narrative review approach, this article addresses various aspects of the Catalan healthcare system, characterizing the privatization and commodification of health processes in Catalonia from a historical perspective with particular attention to recent legislative changes and austerity measures.  The article approximates, the eventual effects that commodification and austerity measures will have on the health of the population and on the structure, accessibility, effectiveness, equity and quality of healthcare services.

Looking for Determinants of Ontological Security in the Spain of the Crisis

The concept of ontological security has a remarkable echo in the current sociology to describe emotional status of men of late modernity. However, the concept created by Giddens in the eighties has been little used in empirical research covering various sources of risk or uncertainty. In this paper, a scale for ontological security is proposed. To do this, we start from the results of a research focused on the relationship between risk, uncertainty and vulnerability in the context of the economic crisis in Spain. These results were produced through nine focus groups and a telephone survey with standardized questionnaire applied to a national sample of 2,408 individuals over 18 years. This work is divided into three main sections. In the fi rst, a scale has been built from the results of the application of different items present in the questionnaire used. The second part explores the relationships of the scale obtained with the variables further approximate the emotional dimensions of individuals. The third part observes the variables that contribute to changes in the scale: These variables show the structural feature of the ontological security.

W. E. B. Du Bois, Black Agency and the Slaves' Civil War

This article reviews the historical literature on slave self-activity during the US Civil War, taking account of recent developments in historiography. Attempting to move beyond the debate between those who argue for 'slave self-emancipation' and others who emphasize the role of high politics, this article suggests that while slaves played a central role in re-directing the war into an assault on slavery, there were severe constraints on their activity as well. Northern military advances played a critical role in opening up the Confederate South to slave self-assertion.

Nazi Wireless Propaganda: Lord Haw-Haw and British Public Opinion in the Second World War

This is the first book devoted exclusively to the analysis of the Nazis' radio effort against the United Kingdom during the Second World War. It traces the development of the German propaganda service and looks to erode the myth surrounding Lord Haw-Haw -the 'superpropagandist'. Propaganda is presented in context: the purposes behind it, the changing patterns, themes, styles, and techniques employed, and the impact upon the target audience and its morale. An analysis of the Nazi wireless broadcasts to Britain for the whole of the Second World War reveals a sophisticated and intelligent propaganda assault on the social and economic fabric of British society. In the end the British failed to succumb to the stupefying effects of Nazi propaganda and they traditionally congratulate themselves upon the national unity which immunised them against it. The author argues that this traditional view disguises a more complex, less appealing reality. Free CD Includes a CD of 24 German wartime broadcasts to Britain Key Features: *Exposition of organisational structure of Nazi wireless for the UK *Detailed analysis of style and content of propaganda broadcasts *Careful and critical re-appraisal of British domestic morale and national unity *CD insert of 24 recordings of Nazi broadcasters including William Joyce, John Amery, Edward Dietze, Norman Baillie-Stewart, Edward Bowlby and 'Black' propaganda broadcasts

Exploring Forensic Nursing Ethics and Practice: Roles, Loyalties and Photodocumentation Practices

Thesis (Ph.D.)--University of Washington, 2016-08

Neoliberal and Neoconservative Immiseration Capitalism in England: Policies and Impacts on Society and on Education

In this article we firstly set out the facts about the current stage of capitalism, the Immiseration stage of neoliberal capitalism in England. We note its relationship with conservatism and neo-conservatism. We identify increased societal inequalities, the assault by the capitalist state on its opponents, and proceed to describe and analyse what neoliberalism and neo-conservatism have done and are doing to education in England- in the schools, further education, and university sectors. We present two testimonies about the impacts of neoliberalism/ neo-conservatism, one from the school sector, one from the further / vocational education sector, as a means of describing, analysing, and then theorising the parameters of the neoliberal/ neoconservative restructuring education and its impacts. We conclude by further theorising this. With the election of a Conservative majority in the 7 May 2015 general election in the UK, the policies and processes of neoliberalisation and neoconservatisation are being intensified.

Neutrophil Chemotaxis in Multiple Chemoattractant Gradients

Chemotaxis, the phenomenon in which cells move in response to extracellular chemical gradients, plays a prominent role in the mammalian immune response. During this process, a number of chemical signals, called chemoattractants, are produced at or proximal to sites of infection and diffuse into the surrounding tissue. Immune cells sense these chemoattractants and move in the direction where their concentration is greatest, thereby locating the source of attractants and their associated targets. Leading the assault against new infections is a specialized class of leukocytes (white blood cells) known as neutrophils, which normally circulate in the bloodstream. Upon activation, these cells emigrate out of the vasculature and navigate through interstitial tissues toward target sites. There they phagocytose bacteria and release a number of proteases and reactive oxygen intermediates with antimicrobial activity. Neutrophils recruited by infected tissue in vivo are likely confronted by complex chemical environments consisting of a number of different chemoattractant species. These signals may include end target chemicals produced in the vicinity of the infectious agents, and endogenous chemicals released by local host tissues during the inflammatory response. To successfully locate their pathogenic targets within these chemically diverse and heterogeneous settings, activated neutrophils must be capable of distinguishing between the different signals and employing some sort of logic to prioritize among them. This ability to simultaneously process and interpret mulitple signals is thought to be essential for efficient navigation of the cells to target areas. In particular, aberrant cell signaling and defects in this functionality are known to contribute to medical conditions such as chronic inflammation, asthma and rheumatoid arthritis. To elucidate the biomolecular mechanisms underlying the neutrophil response to different chemoattractants, a number of efforts have been made toward understanding how cells respond to different combinations of chemicals. Most notably, recent investigations have shown that in the presence of both end target and endogenous chemoattractant variants, the cells migrate preferentially toward the former type, even in very low relative concentrations of the latter. Interestingly, however, when the cells are exposed to two different endogenous chemical species, they exhibit a combinatorial response in which distant sources are favored over proximal sources. Some additional results also suggest that cells located between two endogenous chemoattractant sources will respond to the vectorial sum of the combined gradients. In the long run, this peculiar behavior could result in oscillatory cell trajectories between the two sources. To further explore the significance of these and other observations, particularly in the context of physiological conditions, we introduce in this work a simplified phenomenological model of neutrophil chemotaxis. In particular, this model incorporates a trait commonly known as directional persistence - the tendency for migrating neutrophils to continue moving in the same direction (much like momentum) - while also accounting for the dose-response characteristics of cells to different chemical species. Simulations based on this model suggest that the efficiency of cell migration in complex chemical environments depends significantly on the degree of directional persistence. In particular, with appropriate values for this parameter, cells can improve their odds of locating end targets by drifting through a network of attractant sources in a loosely-guided fashion. This corroborates the prediction that neutrophils randomly migrate from one chemoattractant source to the next while searching for their end targets. These cells may thus use persistence as a general mechanism to avoid being trapped near sources of endogenous chemoattractants - the mathematical analogue of local maxima in a global optimization problem. Moreover, this general foraging strategy may apply to other biological processes involving multiple signals and long-range navigation.

Crime and prejudice: The influence of appearance on blame amongst perpetrators and victims

Stereotypes based on characteristics such as age, race, and gender influence opinions in a criminal context. Yet, to date research has largely assessed whether perpetrators, rather than victims, are judged differently. Furthermore, although facial features can be a source of unconscious bias, research has failed to assess whether perceptions based on facial features affect the criminal context. To better understand the relationship between stereotypic facial features and gender, and whether this varies across perpetrators and victims, participants were asked to answer questions about an aggravated assault scenario after viewing an image of a person described as the victim or the alleged perpetrator. Images varied in gender and in presence or absence of tattoos or gothic makeup. Participants sympathized with the victim regardless of gender, but discrepancies were stronger if the victim was female than male. Neutral and tattooed faces were judged more harshly than faces with gothic makeup, regardless of gender.

REPORTING OF SEXUAL VIOLENCE AGAINST WOMEN IN BRAZIL

Objetivo: Apresentar o quadro de violência sexual contra a mulher no Brasil, com base nas notificações realizadas no Sistema de Informação de Agravos de Notificação (SINAN). Métodos: Trata-se de um estudo descritivo, com abordagem quantitativa, que analisou informações referentes às notificações de violência sexual contra a mulher, no período de 2009 a 2013, considerando a unidade da federação, perfil das mulheres, características da ocorrência e encaminhamentos realizados pelo setor saúde. Os dados foram analisados por meio da estatística descritiva, sendo apresentados números absolutos e relativos derivados das notificações. Resultados: No Brasil, foram registradas 21.871 notificações no período estudado. Observaram-se maiores taxas de registros no ano de 2013 e na região Norte. Predominou o ciclo de vida de 10 a 19 anos (10.806/49,4%), as raças branca (8.894/40,7%) e parda (8.535/39,0%), e a escolaridade ensino fundamental incompleto (5.444/24,9%). Os casos de violência sexual ocorreram com maior frequência na residência da mulher (13.259/60,6%), com agressor conhecido (5.649/25,8%) e sem suspeita do uso de álcool (9.249/42,3%). A maior parte do atendimento no setor saúde foi de nível ambulatorial (15.842/72,6%), e os casos evoluíram para alta (16.879/77,2%). Conclusão: As notificações cresceram progressivamente no período estudado, e a violência sexual contra a mulher no país, registrada pelo setor saúde, atingiu, principalmente, adolescentes, no ambiente doméstico e com agressor conhecido.

The Issue with Issues Management: An Engagement Approach to Integrate Gender and Emotion into Issues Management

Using sexual assault on college campuses as a context for interrogating issues management, this study offers a normative model for inclusive issues management through an engagement approach that can better account for the gendered and emotional dimensions of issues. Because public relations literature and research have offered little theoretical or practical guidance for how issues managers can most effectively deal with issues such as sexual assault, this study represents a promising step forward. Results for this study were obtained through 32 in-depth interviews with university issues managers, six focus groups with student populations, and approximately 92 hours of participant observation. By focusing on inclusion, this revised model works to have utility for an array of issues that have previously fallen outside of the dominant masculine and rationale spheres that have worked to silence marginalized publics’ experiences. Through adapting previous issues management models to focus on inclusion at the heart of a strategic process, and engagement as the strategy for achieving this, this study offers a framework for ensuring more voices are heard—which enables organizations to more effectively communicate with their publics. Additionally, findings from this research may also help practitioners at different types of organizations develop better, and proactive, communication strategies for handling emotional and gendered issues as to avoid negative media attention and work to change organizational culture.

Criminal Case Processing of Sexual Assaults in Alaska

Discretion plays a role in nearly every facet of the American criminal justice system. It is widely regarded as necessary to do justice but is not without criticisms – especially when it leads to unfavorable or disparate treatment. The role of discretion in sexual assault cases has been particularly scrutinized. Since the majority of sexual assaults do not fit stereotypic beliefs about what constitutes a “real rape” and “genuine victim,” criminal justice officials use their discretion to filter these cases out of the justice system. This study explored this issue by examining two stages of the criminal justice process: the police decision to refer cases for prosecution and the prosecutorial decision to accept referred cases. In doing so, it contributes to this body of literature in three ways. First, it included sexual assault cases that involve Alaska Native victims and suspects. Second, it addressed a gap in the theoretical scholarship by examining the downstream nature of police decision-making. And finally, it examined the formal reasons prosecutors give for charge dispositions. This study found a significant amount of attrition of sexual assault cases as they progressed through the criminal justice system. Moreover, a combination of legally relevant and extralegal factors was found to be important, but not consistently across all types of sexual assaults. Among legal factors, the number of victim injuries was the most consistent predictor. Among extralegal factors, cases that involved Alaska Native suspects had significantly higher odds of case referral and case acceptance compared to white suspects. The effect of suspect race was particularly pronounced in cases with a white victim. Additionally, the findings suggest that not only are Native American defendants more likely to have their cases referred by police, but once referred, they are also more likely to have them accepted for prosecution. Contrary to expectations, victim-suspect relationship, specifically non-stranger assaults, increased the odds of police referral compared to stranger cases. However, the opposite appears to be true for the decision to prosecute cases. Once referred, prosecutors were five times more likely to accept sexual assaults perpetrated by strangers. The implications of these findings are also discussed.

Identificação e caracterização fisiológica do soldado nas operações em áreas edificadas

No âmbito do Trabalho de Investigação Aplicada foi elaborada uma caracterização fisiológica do soldado nas operações em áreas edificadas, tendo como objetivo geral contribuir para o quadro teórico e prático na área da motricidade humana, relativamente às aptidões fisiológicas, designadamente: a Frequência Cardíaca, o Consumo de Oxigénio máximo (VO2max) e o Lactato Sanguíneo. Neste estudo foi executada uma pista de combate em áreas edificadas, com o nível de dificuldade crescente, inicialmente sem e com carga (colete balístico) de seguida com o inimigo armado com airsoft e para finalizar, a esquadra de assalto com armas de airsoft. A pista desenrolou-se na Aldeia de Camões em Mafra. Para medição dos parâmetros em estudo, utilizou os monitores cardíacos Garmin Forerunner 310XT, que fornecem os valores das Frequências Cardíacas e o Lactete Plus, que nos dão os valores dos níveis de Lactato Sanguíneo. Verificou-se que não existe uma doutrina de referência que evidencie o treino físico orientado para o combate em áreas edificadas nos dias de hoje. Da análise dos resultados obtidos verificámos que a intensidade do esforço, durante a execução das pistas de combate, foi predominantemente realizada no regime anaeróbio. Com os resultados alcançados durante a realização da pista de combate, identificámos algumas das tarefas mais críticas na sua execução. Apurámos através dos níveis de lactato que a função do comandante de esquadra é de uma intensidade de esforço físico superior a exigida na restante esquadra de assalto.

Blood alcohol and injury in Bhutan: targeted surveillance in a national referral hospital emergency department

Bhutan is a low-middle-income country with poor roads, rapidly increasing motor vehicle use and heavy alcohol consumption. We estimated the proportion of emergency department patients presenting with injury who had positive blood alcohol. We sought to breathalyse and interview all adult patients (≥18 years) presenting with injury at the Jigme Dorji Wangchuck National Referral Hospital in the capital city Thimphu, from April to October 2015. Breath tests and interviews were conducted with 339 (91%) of 374 eligible adult patients. A third (34%) were alcohol-positive and 22% had blood alcohol concentrations >0.08 g/dL. The highest alcohol-positive fractions were for assault (71%), falls (31%) and traffic crashes (30%). Over a third (36%) of patients had a delay of >2 h between injury and breath test. The results underestimate blood alcohol concentrations at the time of injury so the true prevalence of pre-injury alcohol impairment is greater than our estimates suggest. Countermeasures are urgently needed, particularly roadside random breath testing and alcohol controls.

Loose Ends

Loose Ends is a collection of lyric and narrative poems that explores the multiple terrains of identity—individual, cultural, and historical. The poems embrace the essential incoherence of the self, resisting monolithic identity in favor of a multi-faceted, historically complex, imagistic rendering of the inner life. At its heart, the collection seeks to grapple with the gravitas of living: the continual assault of history and nature on human agency, the staggering context of the universe as a backdrop for communal and individual struggle. While single poems may only touch briefly or incompletely on these themes, the collection as a whole presents an admittedly inchoate picture of contemporary American identity.

High-performance liquid chromatography (HPLC) and high-performance liquid chromatography mass spectrometry (HPLC/MS) for the analysis of date rape drugs

The drugs studied in this work have been reportedly used to commit drug-facilitated sexual assault (DFSA), commonly known as "date rape". Detection of the drugs was performed using high-performance liquid chromatography with ultraviolet detection (HPLC/UV) and identified with high performance-liquid chromatography mass spectrometry (HPLC/MS) using selected ion monitoring (SIM). The objective of this study was to develop a single HPLC method for the simultaneous detection, identification and quantitation of these drugs. The following drugs were simultaneously analyzed: Gamma-hydroxybutyrate (GHB), scopolamine, lysergic acid diethylamide, ketamine, flunitrazepam, and diphenhydramine. The results showed increased sensitivity with electrospray (ES) ionization versus atmospheric pressure chemical ionization (APCI) using HPLC/MS. HPLC/ES/MS was approximately six times more sensitive than HPLC/APCI/MS and about fifty times more sensitive than HPLC/UV. A limit of detection (LOD) of 100 ppb was achieved for drug analysis using this method. The average linear regression coefficient of correlation squared (r2) was 0.933 for HPLC/UV and 0.998 for HPLC/ES/MS. The detection limits achieved by this method allowed for the detection of drug dosages used in beverage tampering. This method can be used to screen beverages suspected of drug tampering. The results of this study demonstrated that solid phase microextraction (SPME) did not improve sensitivity as an extraction technique when compared to direct injections of the drug standards.