Using realist evaluation to assess primary healthcare teams’ responses to intimate partner violence in Spain

Objective: Few evaluations have assessed the factors triggering an adequate health care response to intimate partner violence. This article aimed to: 1) describe a realist evaluation carried out in Spain to ascertain why, how and under what circumstances primary health care teams respond to intimate partner violence, and 2) discuss the strengths and challenges of its application. Methods: We carried out a series of case studies in four steps. First, we developed an initial programme theory (PT1), based on interviews with managers. Second, we refined PT1 into PT2 by testing it in a primary healthcare team that was actively responding to violence. Third, we tested the refined PT2 by incorporating three other cases located in the same region. Qualitative and quantitative data were collected and thick descriptions were produced and analysed using a retroduction approach. Fourth, we analysed a total of 15 cases, and identified combinations of contextual factors and mechanisms that triggered an adequate response to violence by using qualitative comparative analysis. Results: There were several key mechanisms —the teams’ self-efficacy, perceived preparation, women-centred care—, and contextual factors —an enabling team environment and managerial style, the presence of motivated professionals, the use of the protocol and accumulated experience in primary health care—that should be considered to develop adequate primary health-care responses to violence. Conclusion: The full application of this realist evaluation was demanding, but also well suited to explore a complex intervention reflecting the situation in natural settings.

An ethnopharmacological and historical analysis of “Dictamnus”, a European traditional herbal medicine

Ethnopharmacological relevance and background: “Dictamnus” was a popular name for a group of medicinal herbaceous plant species of the Rutaceae and Lamiaceae, which since the 4th century have been used for gynaecological problems and other illnesses BCE and still appear in numerous ethnobotanical records. Aims: This research has as four overarching aims: Determining the historical evolution of medical preparations labelled “Dictamnus” and the different factors affecting this long-standing herbal tradition. Deciphering and differentiating those medicinal uses of “Dictamnus” which strictly correspond to Dictamnus (Rutaceae), from those of Origanum dictamnus and other Lamiaceae species. Quantitatively assessing the dependence from herbal books, and pharmaceutical tradition, of modern Dictamnus ethnobotanical records. Determining whether differences between Western and Eastern Europe exist with regards to the Dictamnus albus uses in ethnopharmacology and ethnomedicine. Methods: An exhaustive review of herbals, classical pharmacopoeias, ethnobotanical and ethnopharmacological literature was conducted. Systematic analysis of uses reported which were standardized according to International Classification of Diseases – 10 and multivariate analysis using factorial, hierarchical and neighbour joining methods was undertaken. Results and discussion: The popular concept “Dictamnus” includes Origanum dictamnus L., Ballota pseudodictamnus (L.) Benth. and B. acetabulosa (L.) Benth. (Lamiaceae), as well as Dictamnus albus L. and D. hispanicus Webb ex Willk. (Rutaceae), with 86 different types of uses. Between 1000 and 1700 CE numerous complex preparations with “Dictamnus” were used in the treatment of 35 different pathologies. On biogeographical grounds the widespread D. albus is a far more likely prototypical “Dictamnus” than the Cretan endemic Origanum dictamnus. However both form integral parts of the “Dictamnus” complex. Evidence exists for a sufficiently long and coherent tradition for D. albus and D. hispanicus, use to treat 47 different categories of diseases. Conclusions: This approach is a model for understanding the cultural history of plants and their role as resources for health care. “Dictamnus” shows how transmission of traditional knowledge about materia medica, over 26 centuries, represents remarkable levels of development and innovation. All this lead us to call attention to D. albus and D. hispanicus which are highly promising as potential herbal drug leads. The next steps of research should be to systematically analyse phytochemical, pharmacological and clinical evidence and to develop safety, pharmacology and toxicology profiles of the traditional preparations.

DEMOCRACY AND CITIZENSHIP IN NORTH AFRICA AFTER THE ARAB AWAKENING: CHALLENGES FOR EU AND US FOREIGN POLICY (EUSPRING). Arab Citizenship Review No. 6, October 2014. EGYPT. The Return to Authoritarianism and the Crisis of Citizenship Rights

Citizenship and democratic rights have been shrinking in Egypt with the rise of president Abd El Fattah El Sisi, widely popular among Egyptians who fear more violence and unrest in an increasingly volatile region. In this EU Spring Policy Brief, Moataz El Fegiery examines the political landscape in the run-up of parliamentary elections, arguing that the short term is likely to see further curtailment of acquired rights, further crackdown on the opposition and consolidation of military power. In the longer term, however, it is in the interest of Egyptian society and institutions as well as of Europe to reverse the politics of exclusion and ensure that freedoms, pluralism and participation prevent the rise of extremism and political violence.

The menace of a 'brown' Russia: Ethnically motivated xenophobia - symptoms, causes and prospects for the future. OSW Study 29/2008

This paper focuses on the ethnic dimension of xenophobia, as understood as aversion, fear or hostility vis-a-vis members of other nationalities, as well as the related radical nationalist ideas founded on the concept of the dominant (and often discriminatory) role of the Russians in the Russian Federation, with reference to racism or neo-Nazism. This text primarily presents xenophobia as an enormous social problem in today's Russia, which is not being addressed at the moment, but is instead being exploited by both the authorities and radical nationalist groups. This paper attempts to describe and understand the causes of xenophobia and the reasons for the popularity of extremely nationalist views among ethnic Russians. It also seeks to estimate the scale of the problem and the potential threat it may create in the future. The first part describes the different manifestations of xenophobia in present-day Russia. It identifies the groups most exposed to ethnically motivated violence and persecution, as well as the most xenophobic communities, and discusses the scale of the problem and its specific characteristics in the context of Russian reality. The second part looks into the underlying causes of xenophobic sentiments among Russians, while the last chapters delve into the authorities' attitude towards the problem and seek to answer the question of whether radical nationalist ideas may in future come to dominate Russia's political scene.

The Mirage of the State: Why the West has failed in Afghanistan, Iraq, Libya, Mali and Central African Republic? Jean Monnet/Robert Schuman Paper Series Vol. 14 No. 15, July 2014

The state still matters. However, the members of the Euro-Atlantic community may be misinterpreting this crucial baseline prior launching their military interventions since 2001. The latest violence and collapse of the state of Iraq after the invasion of Northern Iraq by a radical Sunni Muslim terrorist group, so-called Islamic State of Iraq and Syria (ISIS), demonstrate once again the centrality and requirement of a functioning state in order to maintain violent forces to disrupt domestic and regional stability. Since 2001, the US and its European allies have waged wars against failed-states in order to increase this security and national interests, and then have been involved in some type of state-building.1 This has been the case in Afghanistan, Iraq, Libya, Mali, and Central African Republic (CAR). France went into Mali (2012) and CAR (2013), which preceded two European Union military and civilian Common Security and Defense Policy missions (CSDP), in order to avoid the collapse of these two states. The threat of the collapse of both states was a concern for the members of the Euro-Atlantic community as it could have spread to the region and causing even greater instabilities. In Mali, the country was under radical Islamic pressures coming from the North after the collapse of Libya ensuing the 2011 Western intervention, while in CAR it was mainly an ethno-religious crisis. Failed states are a real concern, as they can rapidly become training grounds for radical groups and permitting all types of smuggling and trafficking.2 In Mali, France wanted to protect its large French population and avoid the fall of Mali in the hands of radical Islamic groups directly or indirectly linked to Al-Qaeda. A fallen Mali could have destabilized the region of the Sahel and ultimately affected the stability of Southern European borders. France wanted to avoid the development of a safe haven across the Sahel where movements of people and goods are uncontrolled and illegal.3 Since the end of the Cold War, Western powers have been involved in stabilizing neighborhoods and regions, like the Balkans, Africa, and Middle East, which at the exceptions of the Balkans, have led to failed policies. 9/11 changes everything. The US, under President George W. Bush, started to wage war against terrorism and all states link to it. This started a period of continuous Western interventions in this post-9/11 era in Afghanistan, Iraq, Libya, Mali and CAR. If history has demonstrated one thing, the members of the Euro-Atlantic community are struggling and will continue to struggle to stabilize Afghanistan, Iraq, Libya, Mali and Central African Republic (CAR) for one simple reason: no clear endgame. Is it the creation of a state à la Westphalian in order to permit these states to operate as the sole guarantor of security? Or is the reestablishment of status quo in these countries permitting to exit and end Western operations? This article seeks to analyze Western interventions in these five countries in order to reflect on the concept of the state and the erroneous starting point for each intervention.4 In the first part, the political status of each country is analyzed in order to understand the internal and regional crisis. In a second time, the concept of the state, framed into the Buzanian trinity, is discussed and applied to the cases. In the last part the European and American civilian-military doctrines are examined in accordance with their latest military interventions and in their broader spectrum.

Morocco’s illiberal regime and fragmented political society. Arab Citizenship Review No. 10, October 2015

The post-Arab Spring period in Morocco has undergone different stages of changing state-society relations with regard to democracy, citizenship and human rights. The first stage, between February 2011 and the summer of 2013, was characterised by popular protests demanding democracy and freedom. People criticised public policies related to civil, political and social rights (employment, health, education, the status of women, and the issue of Amazigh). This outburst put the state in an awkward, defensive position. If we compare Morocco with the other Arab Spring countries, the Moroccan state’s reaction was moderate in its use of violence and repression, and it was positive, in that it resulted in the implicit, yet official acceptance of the demands for democracy, citizenship and battling corruption. In his speech on 9 March 2011, the king pledged to modify the Constitution and democratise the institutions.

Ages, biostratigraphic datums, and coiling ratios of Pulleniatina in sediments from DSDP Holes 15-154A and 16-157

Pliocene and Pleistocene planktonic foraminiferal biogeography and paleoceanography have been examined in Deep Sea Drilling Project (DSDP) sites of the Panama Basin (Pacific Ocean) and Colombian and Venezuelan Basins (Atlantic Ocean) to determine the timing of the isolation of Atlantic and Pacific tropical planktonic faunas resulting from the development of the Central American isthmus. Previous studies have suggested a late Miocene to middle Pliocene occurrence of this event. The Panama Basin (DSDP site 157) and the Colombian Basin (DSDP site 154A) share two early Pliocene biogeographic events: (1) great abundance of sinistral coiling Neogloboquadrina pachyderma at 4.3 m.y. ago at site 157 and 0.7 m.y. later at site 154A, and (2) a sinistral-to-dextral change in the coiling-direction preference in Pulleniatina 3.5 m.y. ago at both locations. Identification of these events farther to the east in the Venezuelan Basin (DSDP site 148) is complicated by insufficient lower Pliocene core recovery, but abundant sinistral N. pachydcrma appear to have extended far to the east in the Caribbean 3.6 m.y. ago; perhaps the early Pliocene abundance of this form is not indicative of cool water. The coiling-direction history and stratigraphic ranges of Pulleniatina became different in the Atlantic and Pacific Oceans during the early Pliocene; this is inferred to result from geographic isolation of the assemblages. Saito (1976) used the temporary disappearance of this genus from Atlantic waters at 3.5 m.y. ago to mark the closure of the Isthmus of Panama, but I show that in the Colombian Basin (site 154A) its disappearance was closer to 3.1 m.y. ago. This suggests the possibility of surface-water communication between the Atlantic and Pacific until that time.

Trofeos.

Title from cover.

Conversaciones y lecturas familiares : sobre historia, biografía, crítica, literatura, ciencias y conocimientos útiles /

Essays.

Helia.

"Serie 1a"

Interaction of waves and currents /

This report presents an overview of wave-current interacion, including comprehensive review of references to significant U.S. and foreign literature available through December 1981. Specific topics under review are the effects of horizontally and vertically varying currents on waves, wave refraction by currents, dissipation and turbulence, small- and medium-scale currents, caustics and focusing, and wave breaking. The results of the review are then examined for engineering applications. The most appropriate general-purpose computer program to include wave-current interaction is the Dutch Rijkswaterstaat program CREDIZ, which is based on a parabolic wave equation. Further applications include wave and current forces on structures and possibly sediment transport. The report concludes with a brief state-of-the-art review of wave-current interaction and a list of topics needing further research and development.

Tritium handling : a literature search /

Included are 157 references to reports, journals, and other literature related to the problems and techniques of tritium handling. The subject scope embraces analytical and monitoring procedures and instruments, physiological effects, and safety measures and standards.

Texts and studies.

"Contributions to Biblical and patristic literature."

The girl of the period : and other social essays /

"Reprinted, by permission, from the Saturday Review."

Bibliography of early English literature.

Title from spine; each vol. has special t.p. only.