"As you receive with one hand, so should you give with the other": the mutual-help practices of Cape Verdeans on the Lisbon periphery”

Rural Cape Verdeans employ a number of mutual-help practices to mitigate the uncertainties surrounding activities fundamental to their subsistence. One of these practices is djunta mon (‘to work together’), a loosely planned, non-monetized system of allocating labor at peak intervals during the growing season. By means of djunta mon, neighbors or family members work in each other’s fields until the tasks of every landowning participant are complete. Alongside djunta mon in rural Cape Verde exist a number of other non-remunerated mutual-help practices, such as djuda mutua (‘mutual help’) and laja kaza (‘to add concrete to one’s house’). While less visible than djunta mon, they are nonetheless important in completing tasks essential to rural life in the islands. In this thesis, I will attempt to show how Cape Verdean immigrants in Lisbon have adapted the mutual-help practices of rural Cape Verde to a new, transnational context. The iterations of these practices in Lisbon differ from their rural counterparts in that they involve fewer people, occur on a year-round basis, and are concerned primarily with domestic work. They also help people find employment, access childcare, secure interest-free credit, and construct or repair houses. I will argue that extensive mutual-help ties ensure Cape Verdean migrants in Lisbon a sufficient pool of family and friends upon which they can rely for support and assistance. An additional element I will explore is the perception among Cape Verdean immigrants that these mutual-help practices seem to be occurring with less frequency. While this shift is in part due to the availability of other means of support, I will contend that the changing attitude of Cape Verdeans towards mutual help is also due to their encountering neoliberal notions of ‘self-accountability.’ Thus, Cape Verdeans perceive that their mutual-help practices are in decline, while simultaneously needing the material support that they provide.

Pay-as-you-go social security and the distribution of bequests

This paper studies the impact of an unfunded social security system on the distribution of bequests in a framework where savings are due both by life cycle and by random altruistic motivations. We show that the impact of social security on the distribution of bequests depends crucially on the importance of the bequest motive in explaining savings behavior. If the bequest motive is strong, then an increase in the social security tax raises the bequests left by altruistic parents. On the other hand, when the importance of bequests in motivating savings is sufficiently low, theincrease in the social security tax could result in a reduction of the bequests left by altruistic parents under some conditions on the attitude of individuals toward risk and on the relative returns associated with private saving and social security. Some implications concerning the transitional effects of introducing an unfunded social security scheme are also discussed.

Health correlates of overweight and obesity in adults aged 50 years and over: results from the Survey of Health, Ageing and Retirement in Europe (SHARE)

QUESTIONS UNDER STUDY: To examine the association between overweight/obesity and several self-reported chronic diseases, symptoms and disability measures. METHODS: Data from eleven European countries participating in the Survey of Health, Ageing and Retirement in Europe were used. 18,584 non-institutionalised individuals aged 50 years and over with BMI > or = 18.5 (kg/m2) were included. BMI was categorized into normal weight (BMI 18.5-24.9), overweight (BMI 25.0-29.9) and obesity (BMI > or = 30). Dependent variables were 13 diagnosed chronic conditions, 11 health complaints, subjective health and physical disability measures. For both genders, multiple logistic regressions were performed adjusting for age, socioeconomic status and behaviour risks. RESULTS: The odds ratios for high blood pressure, high cholesterol, diabetes, arthritis, joint pain and swollen legs were significantly increased for overweight and obese adults. Compared to normal-weight individuals, the odds ratio (OR) for reporting > or = 2 chronic diseases was 2.4 (95% CI 1.9-2.9) for obese men and 2.7 (95% CI 2.2-3.1) for obese women. Overweight and obese women were more likely to report health symptoms. Obesity in men (OR 0.5, 95% CI 0.4-0.6), and overweight (OR 0.5, 95% CI 0.4-0.6) and obesity (OR 0.4, 95% CI 0.3-0.5) in women, were associated with poorer subjective health (i.e. a decreased risk of reporting excellent, very good or good subjective health). Disability outcomes were those showing the greatest differences in strength of association across BMI categories, and between genders. For example, the OR for any difficulty in walking 100 metres was non-significant at 0.8 for overweight men, at 1.9 (95% CI 1.3-2.7) for obese men, at 1.4 (95% CI 1.1-1.8) for overweight women, and at 3.5 (95% CI 2.6-4.7) for obese women. CONCLUSIONS: These results highlight the impact of increased BMI on morbidity and disability. Healthcare stakeholders of the participating countries should be aware of the substantial burden that obesity places on the general health and autonomy of adults aged over 50.

Epidémiologie et prévention du mélanome cutané en Suisse. [Epidemiology and prevention of melanoma in Switzerland].

[Quintessence] - L'incidence du mélanome malin augmente rapidement depuis plus de 50 ans. - La Suisse, avec 1700 nouveaux cas diagnostiqués par an, est, avec la Norvège, le pays d'Europe le plus touché par le mélanome. - Des différences régionales sont récemment apparues avec une incidence plus élevée dans les cantons romands. - Les changements observés en Suisse dans l'attitude et le comportement face au soleil sont trop récents et modestes pour influencer l'incidence. - La détection précoce effectuée depuis près de 20 ans a permis d'augmenter la survie et le taux de mélanomes fins sans toutefois altérer l'incidence des lésions épaisses. - La mortalité associée au mélanome malin a récemment diminué, d'abord chez les femmes. L'efficacité de la prévention devrait se confirmer à terme si les efforts entrepris se poursuivent. [Auteurs] [Summary] - The incidence of malignant melanoma has steadily increased in Caucasian populations over the last 50 years. - With some 1700 new cases per year, Switzerland has, with Norway, the highest rate of melanoma in Europe. - Regional differences within Switzerland are emerging, with a higher incidence in western (French-speaking) cantons. - Observed changes in sun protection attitudes and knowledge in the Swiss population have yet to impact on the incidence trend. - Early detection, as pursued since the mid-1980s in Switzerland, has led to a substantial increase in survival and rates of thin melanoma, without major change in rates of thick melanoma. - Mortality from melanoma has recently decreased, initially in women. The effectiveness of prevention campaigns should eventually be confirmed if current efforts persist. [Authors]

Does risk aversion or attraction depend on income? An experiment

Does risk attitude (aversion or attraction) vary with the level of the income at risk? About half of our subjects chose to insure all levels, whereas another half chose instead not to insure low levels, but to insure high levels.

Unemployment duration and workers' wage aspirations in Spain

This paper examines unemployed workers' declared willingness to work for a wage lower than the one warranted by their qualification. We analyze which personal and economic characteristics determine thiswillingness and how it changes as unemployment spells lengthen. Moreover, we also study the influence of this willingness on unemployment duration. The main results are: (i) Young workers, those less educated and those living in regions with high unemployment show a more positive attitude towards accepting lower wages while married women with a working husband show more negative attitudes; (ii) The exhaustion of unemployment benefits has positive effects in the transition probability of the attitude from negative to positive; (iii) The effect of this attitude on the unemployment hazard rate is positive but only marginally significant which may be showing that this willingness is not only reflecting the worker's reservation wage but also some unobserved heterogeneity; (iv) The negative duration dependence of the unemployment hazard rate is substantially reduced when unobserved heterogeneity is controlled for.

Country effects in ISSP-1993 environmental data: Comparison of SEM approaches

Structural equation models (SEM) are commonly used to analyze the relationship between variables some of which may be latent, such as individual ``attitude'' to and ``behavior'' concerning specific issues. A number of difficulties arise when we want to compare a large number of groups, each with large sample size, and the manifest variables are distinctly non-normally distributed. Using an specific data set, we evaluate the appropriateness of the following alternative SEM approaches: multiple group versus MIMIC models, continuous versus ordinal variables estimation methods, and normal theory versus non-normal estimation methods. The approaches are applied to the ISSP-1993 Environmental data set, with the purpose of exploring variation in the mean level of variables of ``attitude'' to and ``behavior''concerning environmental issues and their mutual relationship across countries. Issues of both theoretical and practical relevance arise in the course of this application.

Attitudes towards morphine use among Swiss nurses and physicians

Background: There is little information regarding risk perception and attitudes on morphine use in Switzerland. Objectives: We aimed at assessing such attitudes in a sample of health professionals in the French-speaking part of Switzerland. Study design: Cross-sectional study. Setting: five non-university hospitals of the French-speaking canton of Valais, Switzerland. Methods: 431 nurses and 40 physicians (age range: 20-63). Risk perception and attitudes towards morphine use were assessed using a validated questionnaire. Results: Over half of participants showed a negative attitude regarding most adverse events related to morphine, while less than one third showed a similar attitude regarding other statements. On bivariate analyses, participants working in geriatrics showed a more negative attitude towards use of morphine than participants working in medicine and surgery. Non-Swiss participants also showed a more negative attitude than Swiss regarding use of morphine. Conversely, no differences were found between genders, profession (nurses or physicians), years of experience (<=14 and >14) and religion (catholic vs. others/no religion). These findings were further confirmed by multivariate adjustment. Limitations: possible selection bias due to responders only. Results limited to French speaking participants. Conclusion: Attitudes regarding morphine uses are mainly driven by its potential adverse effects and vary according to specialty and nationality. Educational measures directed at health professionals working in geriatrics or coming from abroad might reduce the high morphinophobia levels observed in these groups.

Analyse pharmacoéconomique et pharmacothérapeutique de l'efficacité des cercles de qualité médecins-pharmaciens pour la prescription médicamenteuse entre 1999 et 2009

IntroductionUn cercle de qualité médecins-pharmaciens (CQ) pour la prescription médicamenteuse repose sur une démarche systémique coordonnée par des pharmaciens d'officine visant l'amélioration continue de la sécurité et de l'efficience des prescriptions de médecins de premier recours. Les trois éléments clés de ce concept collaboratif sont 1) le travail en réseau au niveau local ; 2) les données de prescription médicale et le retour d'informations (feedback) décrivant de manière comparative les coûts, le choix et la fréquence des médicaments prescrits ; 3) le matériel standardisé de formation continue interdisciplinaire.L'objectif de la présente étude est d'évaluer sur une période de onze ans (1999-2009) l'impact pharmacoéconomique et pharmacothérapeutique de six CQs pionniers (24 médecins et 6 pharmaciens), localisés dans le canton de Fribourg.Méthode: L'étude mesure notamment l'impact sur les coûts globaux de prescription des médecins des CQs en comparaison avec un groupe contrôle de médecins omnipraticiens travaillant hors CQ entre 1999-2009. La maîtrise des coûts engendrée est détaillée pour cinq index thérapeutiques de la classe des médicaments cardiovasculaires, y compris le pourcentage des génériques et celui des emballages de sartans dans la classe dite des antihypertenseurs. Les données sont issues des données de facturation fournies par la Coopérative professionnelle pour les pharmaciens suisses (OFAC).Résultats: Concernant la maîtrise des coûts annuels des médicaments par patient, la différence cumulée entre les CQs et le groupe contrôle est en 2009 de 43% en faveur des cercles (cf. Fig. 1). Ceci représente pour 2009 uniquement une économie de 245'000 CHF par médecin. Ces résultats s'expliquent par un profil de prescription médicale plus efficient, une meilleure pénétration des génériques (cf. Fig. 2), une attitude plus pondérée vis-à-vis des stratégies marketing, une formation continue interdisciplinaire spécialisée à propos de l'usage rationnel des médicaments, une meilleure application des recommandations nationales ou internationales.Conclusion: Cette évaluation a confirmé l'intérêt des CQs comme réseau local de collaboration en médecine de premier recours. Les médecins travaillant avec les pharmaciens modifient leurs prescriptions de manière claire et durable. Ce projet interdisciplinaire de qualité des soins montre que la maîtrise des coûts médicamenteux est obtenue sans concession à la qualité des traitements.

Independent Living Program, Vol. 1, 2008

The Iowa Department for the Blind is the state agency that serves Iowans with vision loss. Services are free, confidential and available statewide. "There are no limitations to what you can do with training and a positive attitude." (All quotes in this newsletter are from former training participants). At the Iowa Department for the Blind, we believe in a positive approach to blindness. Vision loss alone should not prevent anyone from being independent. For this reason, we offer a wide variety of opportunities to obtain the skills necessary for independence.

Independent Living Program, Vol. 2, 2008

The Iowa Department for the Blind is the state agency that serves Iowans with vision loss. Services are free, confidential and available statewide. "There are no limitations to what you can do with training and a positive attitude." (All quotes in this newsletter are from former training participants). At the Iowa Department for the Blind, we believe in a positive approach to blindness. Vision loss alone should not prevent anyone from being independent. For this reason, we offer a wide variety of opportunities to obtain the skills necessary for independence.

Independent Living Program, Vol. 3, 2008

The Iowa Department for the Blind is the state agency that serves Iowans with vision loss. Services are free, confidential and available statewide. "There are no limitations to what you can do with training and a positive attitude." (All quotes in this newsletter are from former training participants). At the Iowa Department for the Blind, we believe in a positive approach to blindness. Vision loss alone should not prevent anyone from being independent. For this reason, we offer a wide variety of opportunities to obtain the skills necessary for independence.

Multi-dimensional approach to bullying

RÉSUMÉ : Le bullying est un type de comportement agressif qu'un élève (ou plusieurs) fait subir à un autre et qui se manifeste par des agressions verbales, physiques et/ou psychologiques. Les caractéristiques du bullying sont la répétitivité d'actions négatives sur le long terme et une relation de pouvoir asymétrique. Pour la victime, ce type de comportement peut avoir des conséquences graves telles qu'échec scolaire, dépression, troubles alimentaires, ou idées suicidaires. De plus, les auteurs de bullying commettent plus de comportements déviants au sein de l'école ou à l'extérieur de cette dernière. La mise en place d'actions ciblées auprès des auteurs de bullying pourrait donc non seulement prévenir une victimisation, mais aussi réduire les actes de délinquance en général. Hormis quelques études locales ou cantonales, aucune recherche nationale auprès d'adolescents n'existait dans le domaine. Ce travail propose de combler cette lacune afin d'obtenir une compréhension suffisante du phénomène qui permet de donner des pistes pour définir des mesures de prévention appropriées. Afin d'appréhender la problématique du bullying dans les écoles secondaires suisses, deux sondages de délinquance juvénile autoreportée ont été effectués. Le premier a eu lieu entre 2003 et 2005 dans le canton de Vaud auprès de plus de 4500 écoliers. Le second a été administré en 2006 dans toute la Suisse et environ 3600 jeunes y ont participé. Les jeunes ont répondu au sondage soit en classe (questionnaire papier) soit en salle d'informatique (questionnaire en ligne). Les jeunes ayant répondu avoir sérieusement harcelé un autre élève est d'environ 7% dans le canton de Vaud et de 4% dans l'échantillon national. Les analyses statistiques ont permis tout d'abord de sélectionner les variables les plus fortement liées au bullying. Les résultats montrent que les jeunes avec un bas niveau d'autocontrôle et ayant une attitude positive envers la violence sont plus susceptibles de commettre des actes de bullying. L'importance des variables environnementales a aussi été démontrée: plus le jeune est supervisé et encadré par des adultes, plus les autorités (école, voisinage) jouent leur rôle de contrôle social en faisant respecter les règles et en intervenant de manière impartiale, moins le jeune risque de commettre des actes de bullying. De plus, l'utilisation d'analyses multiniveaux a permis de montrer l'existence d'effets de l'école sur le bullying. En particulier, le taux de bullying dans une école donnée augmente lorsque les avis des jeunes divergent par rapport à leur perception du climat scolaire. Un autre constat que l'on peut mettre en évidence est que la réaction des enseignants lors de bagarres a une influence différente sur le taux de bullying en fonction de l'établissement scolaire. ABSTRACT : Bullying is the intentional, repetitive or persistent hurting of one pupil by another (or several), where the relationship involves an imbalance of power. Bullying is a type of aggressive behaviour and the act can be verbal, physical and/or psychological. The consequences on the victims are serious: school failure, depressive symptomatology, eating disorders, or suicidal ideation. Moreover, the authors of bullying display more delinquent behaviour within or outside the school. Thus, preventive programmes targeting bullying could not only prevent victimisation, but also reduce delinquency in general. Very little data concerning bullying had been collected in Switzerland and, except some local or cantonal studies, no national research among teenagers existed in the field. This work intends to fill the gap in order to provide sufficient understanding of the phenomenon and to suggest some tracks for defining appropriate measures of prevention. In order to understand the problems of bullying in Swiss secondary schools better, two surveys of self-reported juvenile delinquency were carried out. The first one took place between 2003 and 2005 in the canton Vaud among more than 4500 pupils, the second in 2006 across Switzerland with about 3600 youths taking part. The pupils answered to the survey either in the classroom (paper questionnaire) or in the computer room (online questionnaire). The youths that answered having seriously bullied another pupil are about 7% in canton Vaud and 4% in the national sample. Statistical analyses have selected the variables most strongly related to bullying. The results show that the youths with a low level of self-control and adopting a positive attitude towards violence are more likely to bully others. The importance of the environmental variables was also shown: the more that youth is supervised and monitored by adults, and the more the authorities (school, neighbourhood) play their role of social control by making the rules be respected through intervening in an impartial way, the less the youth bully. Moreover, the use of multilevel analyses permitted to show the existence of effects of the school on bullying. In particular, the rate of bullying in a given school increases when there is a wide variation among students of the same school in their perception of their school climate. Another important aspect concerns teachers' reactions when pupils fight: this variable does not influence the bullying rate to the same extent, and depends on the school.

Ecole et construction du sens

Peut-on continuer à invoquer la neutralité abstentionniste de l'État pour proscrire un enseignement sur la religion à l'école ? Cet argument qui a eu sa légitimité historique vaut-il encore aujourd'hui ? En d'autres termes, l'existence d'un tel enseignement ne pourrait-il pas s'avérer compatible avec un régime de séparation Églises-État ? Qu'en pensent les acteurs directement concernés ? Refusant de rejeter la religion du côté du privé, les enseignants en nombre croissant déplorent le peu de place accordé à la « spiritualité » en classe. Quant aux élèves, reflétant l'attitude incertaine de leurs parents quant aux valeurs à transmettre, ils expriment des besoins plus difficiles à déchiffrer. Mais derrière ce débat relatif à l'inscription d'une case religieuse dans les programmes scolaires, ne s'en cache-t-il pas un autre touchant directement aux objectifs du système éducatif et au rôle des enseignants ?

The response of a Swiss university hospital's palliative care consult team to assisted suicide within the institution.

In January 2006 the Centre Hospitalier Universitaire Vaudois (CHUV), a large university hospital in Lausanne, Switzerland, became the first hospital in Switzerland to allow assisted suicide (AS) in exceptional cases within its walls. However, euthanasia is illegal. This decision has posed several ethical and practical dilemmas for the hospital's palliative care consult service. To address these, the team embarked on a formal process of open dialogue amongst its members with the goal of identifying a collective response and position. This process involved meetings every 4 to 6 weeks over the course of 10 months. An iterative process unfolded. One of the principal dilemmas relates to finding a balance between the team's position against AS and the patient's autonomy and the institution's directive. Although all team members expressed opposition to AS, there were mixed opinions as to whether or not the team members should be present during the act if requested so by patients. Some thought this could be misinterpreted as complicity in the act and could send out mixed messages to the public and other health professionals about palliative care. Others felt that the team's commitment to nonabandonment obliged them to be present even if they did not provide the drug or give any advice or assistance. The implications of nonabandonment are explored, as are several other questions such as whether or not the teams are obliged to provide detailed information on AS when requested by patients.