Developing a complex intervention to reduce time to presentation with symptoms of lung cancer

Background - Lung cancer is the commonest cause of cancer in Scotland and is usually advanced at diagnosis. Median time between symptom onset and consultation is 14 weeks, so an intervention to prompt earlier presentation could support earlier diagnosis and enable curative treatment in more cases. Aim - To develop and optimise an intervention to reduce the time between onset and first consultation with symptoms that might indicate lung cancer. Design and setting - Iterative development of complex healthcare intervention according to the MRC Framework conducted in Northeast Scotland. Method - The study produced a complex intervention to promote early presentation of lung cancer symptoms. An expert multidisciplinary group developed the first draft of the intervention based on theory and existing evidence. This was refined following focus groups with health professionals and high-risk patients. Results - First draft intervention components included: information communicated persuasively, demonstrations of early consultation and its benefits, behaviour change techniques, and involvement of spouses/partners. Focus groups identified patient engagement, achieving behavioural change, and conflict at the patient–general practice interface as challenges and measures were incorporated to tackle these. Final intervention delivery included a detailed self-help manual and extended consultation with a trained research nurse at which specific action plans were devised. Conclusion -The study has developed an intervention that appeals to patients and health professionals and has theoretical potential for benefit. Now it requires evaluation.

Disabling a family? Emotional dilemmas experienced in becoming a parent of a child with learning disabilities

Becoming the parent of a child diagnosed with learning disabilities can have a dramatic impact. Chrissie Rogers, the author of this article, is both a lecturer in education studies at Keele University and the mother of a daughter who has learning disabilities. She argues here that the pressures on mothers to produce ‘perfect’ babies and to meet all their needs are immense. These pressures arise from both internalised norms and societal expectations and, in the face of these pressures, parents may feel shock, loss and disappointment. These feelings may lead, in turn, to denial, anxiety and conflict affecting both the parents and the professionals involved with the family. Drawing on a series of in-depth interviews and personal narratives, Chrissie Rogers makes a powerful case for the importance of support, whether that support is formal or informal. She suggests that, without the right levels of support and understanding, having a child with a diagnosis of learning disability can disable the whole family.

Institutional complexity in Thai state-owned enterprises:the implementation of performance measurement systems

This study explores institutional complexity in Thai State-Owned Enterprises (SOEs). In doing so, a qualitative approach has been employed in this study in order to identify institutional logics in the field of Thai SOEs and to understand organisational and individual perceptions of institutional complexity in the implementation of performance measurement systems (PMS) and how they respond to the complexity. To achieve this goal, two Thai SOEs were studied, both of which faced challenges in the implementation of Economic Value Management (EVM) and Balance Scorecard (BSC) as well as difficulties in linking their individual BSC and incentive systems. The qualitative data were collected from semi-structured interviews and document reviews. The empirical aspects of this study reveal that the institutional logics in the field of Thai SOEs are the logic of bureaucracy, commercial operations, social activities, seniority and unity. Regarding the multiple institutional logics embedded, SOEs experienced the institutional complexity in the implementation of PMS. The results suggest that the organisations have decoupled the EVM and loosely coupled the BSC from organisational practices to cope with institutional complexity and conflict institutional demands. Also, the evidence shows that the institutional logics influence SOEs’ actions towards resisting changes incentive systems and the relationship between individual BSC and incentives.

The Mismanagement of Environmental Conflicts

During the Communist regime, companies' conflicts with the public were hidden. The public did not have the right to express their objection. Recent Hungarian law, however, supports people's right to influence decisions that have an impact on their lives, but attitudes change slowly. In this article, I show the typical methods of companies' mismanagement of environmental conflicts. The first part of the article concentrates on strategic issues, and the second one emphasizes mistakes in communication with local communities. There are signs that Hungarian companies have already started to learn their lesson, but they also need help to face the new situation of the post-Communist era. Conflict theory and conflict resolution techniques may help them to deal with communication problems and to reach win-win solutions. Although not unknown, facilitation is not a common technique in Hungary yet. This means that there is potential for its development.

The Use of the Military for Law Enforcement Activities in Central America

Faced with the violence, criminality and insecurity now threatening peace and democratic governance in Central America, the region’s governments have decided to use the Armed Forces to carry out actions in response to criminal actions, looking to improve their performance. Although public demand for including the Armed Forces in these functions takes place within a legally legitimate framework, it is motivated by tangible circumstances such as increased levels of violence, delinquency and crime. Despite being coupled with the perception of institutional weakness within the security and judicial system (particularly police) and the recognition of prestige, efficiency, discipline and severity in fulfilling the Armed Forces’ missions, these arguments are insufficient to legitimize the use of the military as a police force. Within this context, this paper reflects on the implications or consequences of the use of the Armed Forces in duties traditionally assigned to the police in the Central American region with the goal of contributing to the debate on this topic taking place in the Americas. To achieve this end, first we will focus on understanding the actual context in which a decision is made to involve the Armed Forces in security duties in the region. Second, we will examine the effects and implications of this decision on the Armed Forces’ relations within their respective societies. Third and finally, considering this is already a reality in the region, this paper will provide recommendations. The main findings of this research, resulting from the application of an analyticaldescriptive and historically based study, are organized in three dimensions: the political dimension, by implication referring to the relationship between the ultimate political authority and the Armed Forces; the social dimension, by implication the opinion of citizens; and other implications not only affecting the structural and cultural organization of armies and police but also the complementary operational framework within a context of comprehensive response by the State. As a main conclusion, it poses there is an environment conducive to the use of the Armed Forces in citizen’s security, in view of the impact of threats provoked by criminal structures of a military nature currently operating in Central America. However, this participation creates an inevitable social and political impact if implemented in isolation or given a political leading role and/or operational autonomy. This participation poses risks to the institutions of the Armed Forces and the police as well. Finally, this paper identifies an urgent need for the Armed Forces’ role to be more clearly defined with regard to security matters, limiting it to threats that impact States’ governability and existence. Nonetheless, Central American States should seek a COMPREHENSIVE response to current crime and violence, using all necessary institutions to confront these challenges, but with defined roles and responsibilities for each and dynamic coordination to complement their actions.

Bolivia's Uncertain Future

Edited by former LACC Director, Eduardo Gamarra, this issue asked prominent Bolivian journalists and social scientists to critically analyze the first year and a half of Evo Morales’ government. Popularly elected in December 2005, Morales promised to conduct a revolution in democracy. In this collection of essays, the objective is to show a different view than the image of Morales as the Bolivian Nelson Mandela who freed his indigenous brethren from repression. The essays gathered here tell the story about how Bolivia’s first indigenous president has attempted to change Bolivia. These essays show that Morales’ first 18 months in office have been filled with promise, controversy, and conflict.

O papel dos quintais urbanos na segurança alimentar, bem estar e conservação da biodiversidade

Residential homegardens have environmental and social roles in the urban environment. These green spaces can potentially minimize the impacts caused by the growth of cities, being an alternative to connect fragmented areas or offer refuge to wildlife and therefore support the conservation of biodiversity. In addition, the homegardens demonstrate a leading role in increasing human well-being by promoting socialization opportunities, contact with nature, local culture as well as improvements in food security for the urban families. Nevertheless, it is still unclear what specific characteristics of homegardens can act effectively in the conservation of the biodiversity, as well as in the construction of food security and well being of the homegardeners and their families. The first chapter of this thesis analyzed the diversity of plant species (native and exotic) and assessed the contribution of different types of urban gardens (ornamental and forest gardens alike) in the presence of wildlife such as birds, monkeys and lizards. In the second chapter we evaluated the contribution of those gardens to the welfare and food security of their owners. In order to do this, 41 gardens were visited in Pium, a southern coastal town in the northeastern Brazil, which also happens to be in a periurban region undergoing rapid urban expansion and pressure from the real estate market. We surveyed the planned biodiversity and fauna associated with homegardens. The data related to food security and welfare were sampled through interviews with the person in charge of taking care of the gardens. These interviews covered issues on the supply of food from the garden and absence of chemical products, as well as aspects of the GNH indicator (Gross National Happiness). The results showed that these homegardens generally contribute little to the maintenance of native plant species (native species = 29/ total = 187). From its main features, the gardens were classified as ornamental, forest gardens and forest farms. These groups had a different effect on the presence of the animals studied and the last two contained most of the sampled native species. The diversity of plants and trees was a good predictor of the presence of birds and monkeys. Thus, the contribution of yards for the conservation of biodiversity depends on the type of garden: some even can have negative effects on conservation. These results can direct new approaches to detailed understanding of gardens and also of public policies applied to urban planning. The results of the second chapter showed that the two types of forest gardens contributed to household food security, for providing food and medicinal herbs, which mostly did not have pesticides and chemical 12 fertilizers. But the three groups of gardens are important components for the well being of their stakeholders. Gardens help promote the transmission of knowledge on agriculture, socialization, contact with nature and bring up feelings related to peace and harmony. Thus, forest gardens can be considered important means to get through public projects and policies designed to encourage biodiversity and promote food security and well-being in urban areas

Les droits réels et personnels sur les titres détenus auprès d'un intermédiaire : analyse comparative en droit québécois interne et international privé

Les transactions sur les valeurs mobilières ainsi que leur mise en garantie se font bien au-delà des frontières nationales. Elles impliquent une multitude d’intervenants, tels que l’émetteur, un grand nombre d’intermédiaires disposés en structure pyramidale, un ou des investisseurs et, bien évidemment, les bénéficiaires desdites valeurs mobilières ou garanties. On peut aussi signaler l’existence de nombreux portefeuilles diversifiés contenant des titres émis par plusieurs émetteurs situés dans plusieurs états. Toute la difficulté d’une telle diversité d’acteurs, de composantes financières et juridiques, réside dans l’application de règles divergentes et souvent conflictuelles provenant de systèmes juridiques d’origines diverses (Common Law et civiliste). De nombreux juristes, de toutes nationalités confondues, ont pu constater ces dernières années que les règles de création, d’opposabilité et de réalisation des sûretés, ainsi que les règles de conflit de lois qui aident à déterminer la loi applicable à ces différentes questions, ne répondaient plus adéquatement aux exigences juridiques nationales dans un marché financier global, exponentiel et sans réelles frontières administratives. Afin de résoudre cette situation et accommoder le marché financier, de nombreux textes de loi ont été révisés et adaptés. Notre analyse du droit québécois est effectuée en fonction du droit américain et canadien, principales sources du législateur québécois, mais aussi du droit suisse qui est le plus proche de la tradition civiliste québécoise, le tout à la lueur de la 36e Convention de La Haye du 5 juillet 2006 sur la loi applicable à certains droits sur des titres détenus auprès d'un intermédiaire. Par exemple, les articles 8 et 9 du Uniform Commercial Code (UCC) américain ont proposé des solutions modernes et révolutionnaires qui s’éloignent considérablement des règles traditionnelles connues en matière de bien, de propriété, de sûreté et de conflits de lois. Plusieurs autres projets et instruments juridiques dédiés à ces sujets ont été adoptés, tels que : la Loi uniforme sur le transfert des valeurs mobilières (LUTVM) canadienne, qui a été intégrée au Québec par le biais de la Loi sur le transfert de valeurs mobilières et l’obtention de titres intermédiés, RLRQ, c.T-11.002 (LTVMQ) ; la 36e Convention de La Haye du 5 juillet 2006 sur la loi applicable à certains droits sur des titres détenus auprès d'un intermédiaire; la Loi fédérale sur le droit international privé (LDIP) suisse, ainsi que la Loi fédérale sur les titres intermédiés (LTI) suisse. L’analyse de ces textes de loi nous a permis de proposer une nouvelle version des règles de conflit de lois en matière de sûretés et de transfert des titres intermédiés en droit québécois. Cette étude devrait susciter une réflexion profonde du point de vue d’un juriste civiliste, sur l’efficacité des nouvelles règles québécoises de sûretés et de conflit de lois en matière de titres intermédiés, totalement inspirées des règles américaines de Common Law. Un choix qui semble totalement ignorer un pan du système juridique civiliste et sociétal.

Relaciones de poder y guerra

Este artículo introduce los conceptos de relaciones de poder analizados por Michel Foucault, haciendo hincapié en el vínculo del ejercicio del poder en las relaciones internacionales. Por ello, se analizan el marco de relaciones que el ejercicio de dicho poder genera, así como las tipologías de relaciones entre Estados, que igualmente genera el poder. El artículo presenta los paradigmas de las relaciones internacionales y su evolución en el tiempo, estableciendo puentes con las consideraciones de Foucault con respecto al poder, la guerra, la represión o las razas. En este sentido, el concepto de guerra de razas se antoja fundamental para identificar dicha noción como la versión más extrema del paradigma realista. Dicha guerra de razas no constituye una categoría que integre necesariamente el concepto biológico, sino que se refiere al proceso de imposición de la identidad del grupo dominante, la cual puede contener aspectos étnicos, socioculturales y políticos. No obstante, ni el realismo ni su visión extrema son los únicos paradigmas existentes, ya que la evolución de los paradigmas alternativos ha conllevado la génesis del reflectivismo como alternativa al realismo.

Antropología de la Conservación en España. Balance y perspectivas

En este artículo presentamos un balance de la Antropología de la Conservación en el Estado español. Durante las últimas décadas, la protección de los espacios naturales ha aumentado de una manera exponencial en todo el mundo. A la vez que se extendía esta patrimonialización de la naturaleza, los trabajos etnográficos sobre las áreas protegidas han ido ganando terreno dentro de la disciplina y, en particular, en el campo de la Antropología Ambiental. La mencionada bibliografía ha puesto de relieve los múltiples aspectos derivados de las nuevas políticas territoriales de regulación, apropiación y mercantilización de la ‘naturaleza’. En este trabajo realizamos una revisión exhaustiva de la producción generada a raíz de este interés por las áreas protegidas en nuestro país subrayando sus principales aportaciones, características y debilidades. De este modo pretendemos reflexionar acerca de su continuidad, con el fin de evitar la mera reiteración y favorecer el avance en sus resultados.

¿Fue la crisis política del Occidente musulmán del siglo XIII debida a un cambio climático? Una aproximación histórica al fin del Periodo Cálido Medieval

Durante el siglo XIII se produjo una sucesión de revueltas que supuso la desaparición del Imperio almohade y su sustitución por poderes regionales en al-Andalus, el Magreb y el Magreb al-Aqsà. La historiografía ha presentado el surgimiento y pugna entre estos poderes como un fenómeno social, político e, incluso, cultural y religioso, con el que se ha podido explicar su aniquilación o marginalización. Este trabajo pretende contextualizar los hechos desde una perspectiva medioambiental, de forma que la desintegración del califato almohade, el surgimiento de aquellos poderes y la progresión de los reinos cristianos en la península ibérica puedan entenderse desde una visión global de cambio climático y una posible crisis agrícola.

Linguas en contacto na escrita electrónica galega

La escritura electrónica es en la actualidad una modalidad gráfica de gran éxito que en los últimos años comenzó a ser albo de diversas investigaciones lingüísticas. Sin embargo, un análisis exclusivamente gramatical, desvinculado del medio social en el que se utiliza, parece insuficiente para entender un fenómeno de tal complejidad. Consecuentemente, analizamos sus características en base a los condicionamientos sociolingüísticos presentes en el caso gallego. Así, examinamos las implicaciones de la situación de contacto y conflicto lingüístico entre el gallego y el español, señalamos las motivaciones de la alternancia de código y de las interferencias lingüísticas –que no siempre coinciden con las que operan en la lengua común- y observamos que estas prácticas son consecuencia de la confluencia de factores sociolingüísticos con otros de naturaleza pragmática.

La felicidad del mal

En el presente artículo se aspira a poner de relieve cómo Tucídides, al describir la guerra de Corcira y extraer las consecuencias morales de la misma, pone bajo el foco de su análisis incluso los bajos fondos de naturaleza humana, esa dimensión de la psique que permanece oculta o es negada cuando las sociedades viven en paz y con cierto grado de prosperidad. El resultado es la aparición del mal en toda su apoteosis existencial. Es decir, no ya el mal que infligimos unas veces sin querer y otras por necesidad, o por seguridad, o por miedo, etc. El mal que ahí aparece como constitutivo del ser humano es el que se inflige cuando han desaparecido todas las condiciones que lo volvían explicable y hasta necesario, el mal gratuito, el mal que ha aislado a su ejecutor de todo contexto, que ha transformado la voluntad del mismo en siervo suyo y que, a cambio, le procura éxtasis de felicidad que sólo él procura.

Konflikter, ogräs eller frön? : Arbetsplatskonflikter utifrån ett ledarskapsperspektiv

Det gemensamma intresset för konflikter grundade idén att studera väl ansedda ledares perspektiv på arbetsplatskonflikter och hur dessa ledare löser konflikter konstruktivt. I grunden finns en undran om väl ansedda ledare har förmågor som gör att de löser konflikter mer konstruktivt. Konflikter utgör en stor del av en ledares arbetstid. Konflikter kan förmodligen inte undvikas men hur konflikter hanteras är avgörande för att en organisation och dess anställda skall mogna och utvecklas. Det har utövats forskning inom konflikthantering utifrån ett ledarskapsperspektiv men de studierna har haft en kvantitativ ansats. Studiens syfte är att undersöka hur väl ansedda chefer ser på arbetsplatskonflikter och hur dessa chefer hanterar konflikter. Ett delsyfte är att erhålla kunskap om vilka metoder ansedda ledare använder i konflikthantering. För att besvara syftet har följande frågeställningar använts: Vilka typer av arbetsplatskonflikter uppstår i en organisation? Vad är avgörande om konflikter blir konstruktiva eller destruktiva? Vad har ledarskapet för inverkan på konflikthantering och hur ska ledaren ta sig an konflikter? Vilka förmågor och egenskaper har ledare som hanterar konflikter effektivt? Studien grundar sig på en kvalitativ ansats med semistrukturerade intervjuer som insamlingsmetod. Det införskaffade materialet kodades och tematiserades. Resultaten analyserades med hjälp av teoriramen. Slutligen användes Rahims (2002) teori om conflict management i diskussion då det i resultatet framkom stöd för modellen, dock med en utveckling vilket presenteras i slutsatsen. I studiens analys framkom att ledare som hanterar konflikter konstruktivt behärskar tre huvudområden. Dessa förmågor är människoorienterad, uppgiftsorienterad och lärande- och kulturorienterad. Väl ansedda ledare manövrerar emellan dessa förmågor beroende på situation. I studiens resultat framkom också att undvikande och dominant ledarskapsbeteende skapar barriärer i konflikthantering.