Small Cities, Neoliberal Governance and Sustainable Development in the Global South : A Conceptual Framework and Research Agenda

Development and environmental issues of small cities in developing countries have largely been overlooked although these settlements are of global demographic importance and often face a "triple challenge"; that is, they have limited financial and human resources to address growing environmental problems that are related to both development (e.g., pollution) and under-development (e.g., inadequate water supply). Neoliberal policy has arguably aggravated this challenge as public investments in infrastructure generally declined while the focus shifted to the metropolitan "economic growth machines". This paper develops a conceptual framework and agenda for the study of small cities in the global south, their environmental dynamics, governance and politics in the current neoliberal context. While small cities are governed in a neoliberal policy context, they are not central to neoliberalism, and their (environmental) governance therefore seems to differ from that of global cities. Furthermore, "actually existing" neoliberal governance of small cities is shaped by the interplay of regional and local politics and environmental situations. The approach of urban political ecology and the concept of rural-urban linkages are used to consider these socio-ecological processes. The conceptual framework and research agenda are illustrated in the case of India, where the agency of small cities in regard to environmental governance seems to remain limited despite formal political decentralization.

Le Soutien psychiatrique Intensif dans le Milieu (SIM) à Lausanne: un projet pilote [Intensive Psychiatric Support at the Setting in Lausanne: a pilot project]

While the hospital remains an important element of the psychiatric health-care system, the fact that it is always the best place to treat acute psychotic episodes is still debated. After a brief review of the literature relative to the main existing community care models, the authors describe the development in the Department Universitaire de Psychiatrie Adulte (DUPA), of an alternative to hospitalisation for patient going through a severe acute psychiatric episode. They present three clinical situations and the aims of the research project, which will follow this pilot phase.

Management and prognosis of status epilepticus according to hospital setting: a prospective study.

BACKGROUND: The treatment of status epilepticus (SE) is based on relatively little evidence although several guidelines have been published. A recent study reported a worse SE prognosis in a large urban setting as compared to a peripheral hospital, postulating better management in the latter. The aim of this study was to analyse SE episodes occurring in different settings and address possible explanatory variables regarding outcome, including treatment quality. METHODS: Over six months we prospectively recorded consecutive adults with SE (fit lasting five or more minutes) at the Centre Hospitalier Universitaire Vaudois (CHUV) and in six peripheral hospitals (PH) in the same region. Demographical, historical and clinical variables were collected, including SE severity estimation (STESS score) and adherence to Swiss SE treatment guidelines. Outcome at discharge was categorised as "good" (return to baseline), or "poor" (persistent neurological sequelae or death). RESULTS: Of 54 patients (CHUV: 36; PH 18), 33% had a poor outcome. Whilst age, SE severity, percentage of SE episodes lasting less than 30 minutes and total SE duration were similar, fewer patients had a good outcome at the CHUV (61% vs 83%; OR 3.57; 95% CI 0.8-22.1). Mortality was 14% at the CHUV and 5% at the PH. Most treatments were in agreement with national guidelines, although less often in PH (78% vs 97%, P = 0.04). CONCLUSION: Although not statistically significant, we observed a slightly worse SE prognosis in a large academic centre as compared to smaller hospitals. Since SE severity was similar in the two settings but adherence to national treatment guidelines was higher in the academic centre, further investigation on the prognostic role of SE treatment and outcome determinants is required.

Recommendations for raloxifene use in daily clinical practice in the Swiss setting.

BACKGROUND/AIM: Raloxifene is the first selective estrogen receptor modulator that has been approved for the treatment and prevention of osteoporosis in postmenopausal women in Europe and in the US. Although raloxifene reduces the risk of invasive breast cancer in postmenopausal women with osteoporosis and in postmenopausal women at high risk for invasive breast cancer, it is approved in that indication in the US but not in the EU. The aim was to characterize the clinical profiles of postmenopausal women expected to benefit most from therapy with raloxifene based on published scientific evidence to date. METHODS: Key individual patient characteristics relevant to the prescription of raloxifene in daily practice were defined by a board of Swiss experts in the fields of menopause and metabolic bone diseases and linked to published scientific evidence. Consensus was reached about translating these insights into daily practice. RESULTS: Through estrogen agonistic effects on bone, raloxifene reduces biochemical markers of bone turnover to premenopausal levels, increases bone mineral density (BMD) at the lumbar spine, proximal femur, and total body, and reduces vertebral fracture risk in women with osteopenia or osteoporosis with and without prevalent vertebral fracture. Through estrogen antagonistic effects on breast tissue, raloxifene reduces the risk of invasive estrogen-receptor positive breast cancer in postmenopausal women with osteoporosis and in postmenopausal women at high risk for invasive breast cancer. Finally, raloxifene increases the incidence of hot flushes, the risk of venous thromboembolic events, and the risk of fatal stroke in postmenopausal women at increased risk for coronary heart disease. Postmenopausal women in whom the use of raloxifene is considered can be categorized in a 2 × 2 matrix reflecting their bone status (osteopenic or osteoporotic based on their BMD T-score by dual energy X-ray absorptiometry) and their breast cancer risk (low or high based on the modified Gail model). Women at high risk of breast cancer should be considered for treatment with raloxifene. CONCLUSION: Postmenopausal women between 50 and 70 years of age without climacteric symptoms with either osteopenia or osteoporosis should be evaluated with regard to their breast cancer risk and considered for treatment with raloxifene within the framework of its contraindications and precautions.

Achievement goals in educational contexts: A social psychology perspective

Research on achievement goals usually defines mastery goals as the desire to acquire knowledge, and performance goals as the desire to outperform (or not to underperform) others. Educational contexts are most of the time social contexts, involving various persons and groups, of various hierarchical positions, and various cultural and ideological contexts. Surprisingly, most research in the achievement goal field has been conducted at an individual level of analysis. In the present paper, we will review the social consequences and antecedents of goal endorsement. This research indicates that goals strongly affect the way one behaves with co-learners. Moreover, it suggests that more than merely individual dispositions, goals reflect the social relation students have with other persons, institutions, and with the society to which they belong. We conclude this paper by setting an agenda for future achievement goal research.

Educação, cidadania e competividade: questões em torno de uma nova agenda

Há alguns anos tem-se firmado o debate em torno de uma agenda política e teórica que procura defender e sustentar uma articulação possível entre a procura de competitividade das economias e a manutenção e desenvolvimento dos direitos, nomeadamente sociais, que viabilizam e constituem condições de cidadania. Neste debate, que é atravessado por distintas posições, argumentos e propostas, a educação e formação são apontadas como eixos decisivos daquela articulação. A nossa argumentação vai no sentido de mobilizar análises e investigações em Ciências Sociais, trazendo para o centro da discussão questões e problemas que freqüentemente têm sido omitidos. Defendemos que, pelo contrário, é do confronto dessas questões e problemas que depende a possibilidade de constituir uma agenda política e teórica merecedora de crédito para uma via de desenvolvimento humana, social e ecologicamente sustentável.

Leadership Agenda and Strategic Progress Report, 2007-2008

Early Childhood Iowa (ECI) is an alliance of stakeholders in early care, health, and education that affect children age zero to five in the State of Iowa. Its purpose is to support a comprehensive, integrated early care, health and education system for Iowa. All activities of the system are aligned around a common vision for Iowa: Every child, beginning at birth, will be healthy and successful.Membership is voluntary and open to anyone self-identifying as a “stakeholder” in Iowa’s early care, health, and education system. The process for membership will be with as few barriers or constraints as possible. Individuals seeking membership should agree to the vision for an early care, health, and education system in Iowa and to the principles and core beliefs of the ECI Stakeholders. The structure of ECI includes six system component groups that describe the necessary elements of an effective and comprehensive early care, health, and education system, as well as a State Agency Liaison group and a Co-chairs group. Membership in each component group is open to anyone with an interest in the unique responsibilities of a implementing an early care, health and education system.

Después de los 90: agenda de cuestiones educativas

El artículo propone una agenda de "cuestiones educativas" orientada a la reconstitución del lazo entre educación y democracia después de las reformas implementadas en los años 90. Construye previamente un estado de situación caracterizado por la presencia de tres procesos: a. un proceso de des-institucionalización escolar que se expresa tanto en la dificultad de la escuela para sostener un marco normativo sancionado socialmente, como en la crisis de identidad por la que atraviesan las instituciones; b. un proceso de fragmentación del sistema educativo que se diferencia de la tradicional segmentación de los sistemas; c. el agotamiento del instrumental teórico-conceptual con el que tradicionalmente nos hemos propuesto organizar y dar sentido a los fenómenos de la realidad. En este marco el artículo propone: 1. discutir los limites de la modernidad educativa en países periféricos como el nuestro y, en este marco, los de la pedagogía moderna para superar las problemáticas de discriminación y exclusión educativa; 2. rediscutir el concepto de ciudadanía y el papel de la escuela en la formación ciudadana; 3. repensar y discutir el papel del conocimiento y la investigación en la modificación de las practicas políticas y pedagógicas.

O renovado conservadorismo da agenda pós-moderna

O artigo tem como objetivo discutir aspectos da agenda pós-moderna e a permanência de sua vitalidade nos dias de hoje. Seu ponto de partida são as idéias desenvolvidas pela autora em artigos anteriores, nos quais privilegia a crítica às principais propostas das tendências "pós": o relativismo epistemológico, a suspeita em relação ao conhecimento objetivo e ao caráter estruturado das coisas e do mundo. Na primeira parte, retomam-se os textos de 1996 e 1998, que apresentam, ainda que rapidamente, as origens da "agenda pós" e indicam alguns de seus desdobramentos, notadamente a virada lingüística e a supressão das fronteiras entre História e Literatura; na segunda, recuperam-se as idéias expostas nos textos de 1998 e 2003, com vistas a mostrar algumas características do pensamento neopragmático de Richard Rorty. Finalmente, assinalam-se as principais repercussões desta ampla agenda na pesquisa e em práticas educacionais.

Promotion de l'activité physique au cabinet médical: où en sommes- nous en Suisse [Promotion of physical activity in the primary care setting: what is the situation in Switzerland?]

If many harmful effects of a sedentary lifestyle on health are well known, we still need to better understand how effectively promoting regular physical activity in the general population. Among the currently explored strategies, screening for sedentary lifestyle and promoting physical activity in the primary care setting seem promising. Despite recommendations from governmental agencies and professional associations in favor of physical activity counseling, this approach has not been widely adopted so far. This article summarizes the steps taken in Switzerland with an aim of developing physical activity counseling in the primary care setting. It describes how the early implication of primary care physicians influenced in a concrete way the development of a project dedicated to that task.

Combate ao sexismo em livros didáticos: construção da agenda e sua crítica

O artigo tem por objetivo descrever e problematizar a construção da agenda sobre "sexismo no livro didático" em cenário internacional e nacional. Para tanto, efetua uma revisão crítica da literatura desde a década de 1960 até a contemporaneidade, dando especial ênfase a permanências e mudanças, bem como a tensões detectadas na implementação de políticas que visam o combate ao "sexismo" nos livros didáticos.

Preimplantation genetic diagnosis (PGD) for HLA typing: bases for setting up an open international collaboration when PGD is not available.

In severe forms of Diamond-Blackfan anemia, preimplantation genetic diagnosis (PGD) of histocompatibility leukocyte antigen-compatible embryos for enabling the next sibling in the family to be a stem-cell transplantation donor constitutes the sole lasting cure capable of terminating the enduring need for iterative transfusions. We report here an open collaboration between two renowned institutions to provide a family desiring this treatment even though they resided where the preimplantation genetic diagnosis procedure is banned.