Health intervention and decline in infant mortality rates. Milk depots in Spain (1900-1936)

The role of public health has been a central topic on the classical debate about the historical mortality decline in Europe. One of these health initiatives were the Milk Depots. Spain set up those centres from the late 19th century until the beginning of the Civil War. The goal of this paper is to evaluate the effect of this health intervention on the infant mortality decline during this period. This study works out three kinds of sources: Statistical Yearbooks, Official documents and local records produced by the same Milk Depot. It analyses data available for all the country and one local case such as the Barcelona’s Milk Depot (1904-1935). The main methodological issue deals with the measurement of the effect of the Milk Depot activities on the pattern of changes of infant mortality. Results suggest that Milk Depots have a positive but quite moderate effect on the improving of overall levels of child survival.

La formació permanent en el context de l'Espai Europeu de la Formació Permanent

La importància de la formació permanent és indiscutible en qualsevol context laboral i molt especialment en les actuals circumstàncies de crisi econòmica mundial. Però en l'actual espai europeu d'educació superior (EEES), les tendències i els plans de formació contínua adquireixen una dimensió global, que supera o, millor dit, hauria de superar els plantejaments reduccionistes. Per això, la construcció i el desenvolupament de l'espai europeu de formació permanent, EEFP (Comissió de les Comunitats Europees, 2001a), ha d'entendre's com un procés que està immers en un teixit més ampli. Es tracta d'una acció en xarxa on és necessària la implicació de molts agents actius professionals i on la convergència, el reconeixement i la cohesió han de ser els seus màxims elements qualitatius

Managers' perspective on continuous health education in a region of São Paulo State

OBJECTIVEAnalysing the concepts of Continuous Health Education - CHE (EPS - in Portuguese), operated by municipal managers and translated into official documents.METHODQualitative research with the use of official documents and semi-structured interviews with the Municipal Health Secretaries or Coordinators of Primary Health Care in the Northeast Region of São Paulo State, and thematic analysis of empirical material.RESULTSResults indicate difficulties in the municipalities problematizing their management practices, services and health care; EPS tools presented are insufficient and unsatisfactory for amending the array of problems raised and are still far from the routine of Primary Care services.CONCLUSIONDespite efforts to implement EPS actions for the strengthening of primary care, the process appears to be incipient.

The EU strategy of policy convergence with its neighbours in the area of trade

The objective of this paper is to ascertain whether the EU is seeking policy convergence with its neighbours in the area of trade by means of EU regulations. For each trade- related topic, we carried out a content analysis of the available official documents to identify the model of relations that has been established between the EU and four neighbouring countries (Morocco, Algeria, Ukraine and Georgia). The findings indicate that Europeanization is the EU strategy in most cases. However, adaptation to European regulations is only a long-term aim. When international regulations exist in a specific area, the EU usually demands the internationalization of a country¿s regulations as a first step. When there are no international regulations, the convergence process is established on the basis of bilaterally developed norms. EU strategy also varies depending on the country. Its relations with Algeria are the most particular. We conclude that the EU is promoting policy convergence with its neighbours in the area of trade mainly on the basis of international and bilaterally-developed regulations.

The EU strategy of policy convergence with its neighbours in the area of trade

The objective of this paper is to ascertain whether the EU is seeking policy convergence with its neighbours in the area of trade by means of EU regulations. For each trade- related topic, we carried out a content analysis of the available official documents to identify the model of relations that has been established between the EU and four neighbouring countries (Morocco, Algeria, Ukraine and Georgia). The findings indicate that Europeanization is the EU strategy in most cases. However, adaptation to European regulations is only a long-term aim. When international regulations exist in a specific area, the EU usually demands the internationalization of a country¿s regulations as a first step. When there are no international regulations, the convergence process is established on the basis of bilaterally developed norms. EU strategy also varies depending on the country. Its relations with Algeria are the most particular. We conclude that the EU is promoting policy convergence with its neighbours in the area of trade mainly on the basis of international and bilaterally-developed regulations.

The empirical assessment of agency accountability: A regime approach and an application to the German Bundesnetzagentur

Regulation has in many cases been delegated to independent agencies, which has led to the question of how democratic accountability of these agencies is ensured. There are few empirical approaches to agency accountability. We offer such an approach, resting upon three propositions. First, we scrutinize agency accountability both de jure (accountability is ensured by formal rights of accountability 'fora' to receive information and impose consequences) and de facto (the capability of fora to use these rights depends on resources and decision costs that affect the credibility of their sanctioning capacity). Second, accountability must be evaluated separately at political, operational and managerial levels. And third, at each level accountability is enacted by a system of several (partially) interdependent fora, forming together an accountability regime. The proposed framework is applied to the case of the German Bundesnetzagentur's accountability regime, which shows its suitability for empirical purposes. Regulatory agencies are often considered as independent, yet accountable. This article provides a realistic framework for the study of accountability 'regimes' in which they are embedded. It emphasizes the need to identify the various actors (accountability fora) to which agencies are formally accountable (parliamentary committees, auditing bodies, courts, and so on) and to consider possible relationships between them. It argues that formal accountability 'on paper', as defined in official documents, does not fully account for de facto accountability, which depends on the resources possessed by the fora (mainly information-processing and decision-making capacities) and the credibility of their sanctioning capacities. The article applies this framework to the German Bundesnetzagentur.

Rural Food System Change in Tanzania during the Post-Ujamaa Era. A Case Study from Western Bagamoyo District

Food systems in Sub-Saharan Africa have been rapidly transforming during the recent decades with diverse outcomes on human development and environment. This study explores the food system change in rural villages in eastern Tanzania where subsistence agriculture has traditionally been the main source of livelihood. The focus is on the salient changes in the spatial dimensions and structural composition of the food system in the context of economic liberalization that has taken place after the end of the socialist ujamaa era in the mid-1980s. In addition, the linkages of the changes are examined in relation to food security, socio-economic situation, livelihoods, and local environment. The approach of the study is geographical, but also involves various multi-disciplinary elements, particularly from development studies. The research methods included thematic and questionnaire interviews, participatory tools, and the analysis of land use/ cover data and official documents. Several earlier studies that were made in the area during the late 1970s and 1980s provided an important reference base. The study shows that subsistence farming has lost its dominant role in food provisioning due to the declining productivity of land, livestock losses, and the increasing shift of labour to non-farm sectors. Also rapid population growth has added to the pressure on land and other natural resources. Despite the increasing need for money for buying marketed foods and other necessities, the nutritional situation shows improvement and severe malnutrition has diminished. However, the long-term sustainability of this transformation raises concerns. Firstly, the food security situation continues to be fragile and prone to shocks such as adverse climatic conditions, crop failures and price hikes. Secondly, the commodification of the food system and livelihoods in general is linked to rapid environmental degradation in the area, particularly the loss of soil fertility and deforestation. The situation calls for efforts that take more determined and holistic approaches towards sustainable development of the rural food system with particular focus on the role and viability of small-scale farming.

Mountain biodiversity in Brazil

The high species richness and diversity found in tropical montane habitats are often related to: 1) an effect of climatic and geological history on biotic evolution; 2) the various environmental impacts on species adaptation mechanisms; and 3) the continuous dispersal of fauna and flora in time. However, little is known about how these factors shaped species richness in Brazilian mountains. Official documents on biodiversity in Brazil make no explicit reference to mountains, even though there is a mountain work programme of the Convention on Biological Diversity, which Brazil is a signatory of. This paper discusses the importance of mountain ecosystems in Brazil to show the urgent need to include mountain biodiversity in the national agenda of biodiversity research and conservation.

Practices and ethical concerns regarding preimplantation diagnosis. Who regulates preimplantation genetic diagnosis in Brazil?

Preimplantation genetic diagnosis (PGD) was originally developed to diagnose embryo-related genetic abnormalities for couples who present a high risk of a specific inherited disorder. Because this technology involves embryo selection, the medical, bioethical, and legal implications of the technique have been debated, particularly when it is used to select features that are not related to serious diseases. Although several initiatives have attempted to achieve regulatory harmonization, the diversity of healthcare services available and the presence of cultural differences have hampered attempts to achieve this goal. Thus, in different countries, the provision of PGD and regulatory frameworks reflect the perceptions of scientific groups, legislators, and society regarding this technology. In Brazil, several texts have been analyzed by the National Congress to regulate the use of assisted reproduction technologies. Legislative debates, however, are not conclusive, and limited information has been published on how PGD is specifically regulated. The country requires the development of new regulatory standards to ensure adequate access to this technology and to guarantee its safe practice. This study examined official documents published on PGD regulation in Brazil and demonstrated how little direct oversight of PGD currently exists. It provides relevant information to encourage reflection on a particular regulation model in a Brazilian context, and should serve as part of the basis to enable further reform of the clinical practice of PGD in the country.

A crisis of social democracy : organized labour and the NDP in an era of neoliberalism

The NDP was founded out of the ashes of the Co-Operative Commonwealth Federation to cooperate with the Canadian Labour Congress to become the 'political arm of organized labour' in Canada. The NDP has long claimed they are the party which represents the policy goals of organized labour in Canada: that the NDP alone will fight for trade union rights, and will fight for Canadian workers. Divergent Paths is an examination of the links between the labour movement and the ND P in an era ofneo-liberalism. Provincial NDP governments have become increasingly neoliberal in their ideological orientation, and have often proved to be no friend to the labour movement when they hold office. The Federal party has never held power, nor have they ever formed the Official Opposition. This thesis charts the progress of the federal NDP as they become more neoliberal from 1988 to 2006, and shows how this trend effects the links between the NDP and labour. Divergent Paths studies each federal election from 1988 to 2006, looking at the interactions between Labour and the NDP during these elections. Elections provide critical junctions to study discourse - party platforms, speeches, and other official documents can be used to examine discourse. Extensive newspaper searches were used to follow campaign events and policy speeches. Studying the party's discourse can be used to determine the ideological orientation of the party itself: the fact that the party's discourse has become neoliberal is a sure sign that the party itself is neoliberal. The NDP continues to drive towards the centre of the political spectrum in an attempt to gain multi-class support. The NDP seems more interested in gaining seats at any cost, rather then promoting the agenda of Labour. As the party attempts to open up to more multi-class support, Labour becomes increasingly marginalised in the party. A rift which arguably started well before the 1988 election was exacerbated during that election; labour encouraged the NDP to campaign solely on the issue of Free Trade, and the NDP did not. The 1993 election saw the rift between the two grow even further as the Federal NDP suffered major blowbacks from the actions of the Ontario NDP. The 1997 and 2000 elections saw the NDP make a deliberate move to the centre of the political spectrum which increasingly marginalised labour. In the 2004 election, Jack Layton made no attempt to move the party back to the left; and in 2006 the link between labour and the NDP was perhaps irreparably damaged when the CAW endorsed the Liberal party in a strategic voting strategy, and the CLC did not endorse the NDP. The NDP is no longer a reliable ally of organized labour. The Canadian labour movement must decide wether the NDP can be 'salvaged' or if the labour movement should end their alliance with the NDP and engage in a new political project.

Naval Occurrences of the Late War Between Great Britain and the United States of America- 1817

Full title is "A Full and Correct Account of the Chief Naval Occurrences of the Late War Between Great Britain and the United States of America; preceded by a Cursory Examination of the American Accounts of their Naval Actions Fought Previous to that Period: to Which is Added an Appendix; with Plates" This is an expanded version of author William James' pamphlet "An Inquiry into the Merits of the Principal Naval Actions between Great Britain and the United States." (Halifax, Nova Scotia, 1816) In this work he discussed how American ships, during the War of 1812, were larger and more heavily armed and manned than those of the British. He therefore, stated that American victories were due only to their greater numerical force and not their superior seamanship. Naval Occurrences is a thorough documentation of the naval operations from the British perspective that addresses contradictions and inconsistencies within the American official documents as well as political and media accounts. This is perhaps his motivation for the words "Corrected Account" within the title. James' sentiments towards the US most likely sprouted from being held prisoner while visiting in 1812. (He was falsely accused of being a renegade seeking revenge on the US.) In 1813, he escaped to Halifax where he began writing on various naval topics. James became one of the leading authorities on British Naval History.

The War Vol. 1, No. 20- November 7, 1812

This newspaper was published bi-weekly from June 1812 to September 1814 by S. Woodworth and Co. in New York. Editor Samuel Woodworth formed the content of the newspaper using official documents from both the American and British side with the intention to report the events of the war. Article topics in this issue include: Page 1: Letter from Maj. Gen. Van Rensselaer to Maj. Gen. Henry Dearborn describing in detail the battle of Queenston; Page 2: Letter from Maj. Gen. Van Rensselaer to Maj. Gen. Henry Dearborn describing in detail the battle of Queenston; report of U.S. war sloop Wasp capturing the British war ship Frolic and the subsequent capture of the Wasp by another British war ship, Poictiers; copy of statement by U.S. President James Madison detailing battles in Detroit, Queenston, and his plans for the war; Page 3: copy of statement by U.S. President James Madison detailing battles in Detroit, Queenston, and his plans for the war; Page 4: copy of statement by U.S. President James Madison detailing battles in Detroit, Queenston, and his plans for the war; U.S. President James Madison promotes Capt. Z. Taylor to rank of Major for his part in defense of Ft. Harrison; report of various Naval movements;

Évaluer la téléréadaptation : la synthèse des effets et l’analyse des changements cliniques et organisationnels

La téléréadaptation, tout comme d’autres champs en télésanté, est de plus en plus interpelée pour la prestation de services. Le but de ce projet de thèse est d’enrichir l’évaluation de la téléréadaptation afin que les connaissances qui en découlent puissent venir soutenir la prise de décision d’acteurs impliqués à différents niveaux en téléréadaptation. Le premier article présente une revue systématique dont l’objectif était de faire synthèse critique des études en téléréadaptation. La revue rassemble 28 études en téléréadaptation, qui confirment l’efficacité de la téléréadaptation pour diverses clientèles dans différents milieux. Certaines des études suggèrent également des bénéfices en termes de coûts, mais ces résultats demeurent préliminaires. Cette synthèse critique est utile pour soutenir la décision d’introduire la téléréadaptation pour combler un besoin. Par contre, les décideurs bénéficieraient aussi de connaissances par rapport aux changements cliniques et organisationnels qui sont associés à la téléréadaptation lorsqu’elle est introduite en milieu clinique. Les deux autres articles traitent d’une étude de cas unique qui a examiné un projet clinique de téléréadaptation dans l’est de la province de Québec, au Canada. Le cadre conceptuel qui sous-tend l’étude de cas découle de la théorie de structuration de Giddens et des modèles de structuration de la technologie, en particulier de l’interaction entre la structure, l’agent et la technologie. Les données ont été recueillies à partir de plusieurs sources (groupes de discussion, entrevues individuelles, documents officiels et observation d’enregistrements) suivi d’une analyse qualitative. Le deuxième article de la thèse porte sur le lien entre la structure, l’agent et la culture organisationnelle dans l’utilisation de la téléréadaptation. Les résultats indiquent que les différences de culture organisationnelle entre les milieux sont plus évidentes avec l’utilisation de la téléréadaptation, entraînant des situations de conflits ainsi que des occasions de changement. De plus, la culture organisationnelle joue un rôle au niveau des croyances liées à la technologie. Les résultats indiquent aussi que la téléréadaptation pourrait contribuer à changer les cultures organisationnelles. Le troisième article examine l’intégration de la téléréadaptation dans les pratiques cliniques existantes, ainsi que les nouvelles routines cliniques qu’elle permet de soutenir et la pérennisation de la téléréadaptation. Les résultats indiquent qu’il y a effectivement certaines activités de téléréadaptation qui se sont intégrées aux routines des intervenants, principalement pour les plans d’intervention interdisciplinaire, tandis que pour les consultations et le suivi des patients, l’utilisation de la téléréadaptation n’a pas été intégrée aux routines. Plusieurs facteurs en lien avec la structure et l’agent ont contraint et facilité l’intégration aux routines cliniques, dont les croyances partagées, la visibilité de la téléréadaptation, le leadership clinique et organisationnel, la disponibilité des ressources, et l’existence de liens de collaboration. La pérennité de la téléréadaptation a aussi pu être observée à partir de la généralisation des activités et le développement de nouvelles applications et collaborations en téléréadaptation, et ce, uniquement pour les activités qui s’étaient intégrées aux routines des intervenants. Les résultats démontrent donc que lorsque la téléréadaptation n’est pas intégrée aux routines cliniques, elle n’est pas utilisée. Par contre, la téléréadaptation peut démontrée certains signes de pérennité lorsque les activités, qui sont reproduites, deviennent intégrées aux routines quotidiennes des utilisateurs. Ensemble, ces études font ressortir des résultats utiles pour la mise en place de la téléréadaptation et permettent de dégager des pistes pour enrichir le champ de l’évaluation de la téléréadaptation, afin que celui-ci devienne plus pertinent et complet, et puisse mieux soutenir les prises de décision d’acteurs impliqués à différents niveaux en téléréadaptation.

La pronunciación de ELE en los alumnos quebequenses : dificultades concretas y pautas de corrección

Mon sujet de recherche traite sur la prononciation de l'espagnol comme langue étrangère chez les élèves québécois, sur leurs difficultés concrètes et lignes de correction qui peuvent leur être attribuées. Dans une première partie plus générale, nous traiterons sur l'enseignement de la prononciation, de la place qu'elle occupe dans l'enseignement d'une langue étrangère. Nous croyons que la prononciation est un aspect de la langue qui a été mis de côté pour mettre en valeur la communication. Si une "mauvaise" prononciation n'entrave pas à la compréhension ou à la communication, elle n'est pas corrigée ni travaillée. Nous pouvons donc nous retrouver avec des étudiants ayant un haut niveau d'espagnol mais dont la prononciation connaît certaines lacunes. Nous déterminerons également ce que nous entendons par "meilleure" ou "mauvaise" prononciation, nous nous interrogerons également sur la pertinence de l'enseignement de la phonétique. Nous nous poserons aussi la question sur la place de la prononciation selon la méthodologie didactique utilisée, et analyserons la quantité et qualité des exercices de prononciation présents ou pas dans les manuels scolaires, et s'ils correspondent aux exigences des documents officiels tels le Cadre commun européenne de référence, ou le Plan curricular de l'institut Cervantès. Dans une deuxième partie nous nous questionnons sur les facteurs qui conditionnent l'apprentissage d'une langue et le perfectionnement de la prononciation dans une langue étrangère, car nous croyons que peut importe l'âge de l'étudiant, il y a toujours place à l'amélioration dans la prononciation. Nous nous interrogeons ensuite sur les tendances générales des francophones lors de leur prononciation de l'espagnol, nous ferons une étude contrastive des phonèmes espagnols et français, puis nous étudierons plus en détail les tendances des élèves québécois, car nous croyons que ces derniers sont dotés de certains atouts en comparaison à d'autres francophones. Dans une troisième partie, nous proposons des exercices visant à améliorer la prononciation chez nos élèves, et afin de vérifier l'efficacité de ces exercices, nous enregistrerons des étudiants ayant bénéficié de ces exercices, et d'autres qui n'y auront pas eu droit. Cette étude comparative cherche à prouver que ces exercices aident réellement et qu'ils, ou d'autres exercices de ce genre, devraient être inclus dans l'enseignement. Le questionnaire dont il s'agit s'attarde principalement au phénomène du [r], que nous croyons être un, ou le son le plus difficile à prononcer en espagnol (autant la vibrante simple comme multiple). Bien entendu, une partie de ce chapitre sera consacrée à l'analyse de résultats.

Évolution des discours publics des autorités de santé au Québec en matière de gestion du poids

L’augmentation observée de la prévalence du surpoids et de l’obésité au Québec comme ailleurs en Occident inquiète tant les gouvernements que les autorités médicales. Afin de contenir ce phénomène qui est désormais décrit comme une pandémie d’obésité, ces organisations y sont allées de différentes initiatives et recommandations, dans un contexte d’inefficacité avérée des interventions de gestion de poids à caractère clinique et d’émergence de stratégies de prévention dont l’efficacité et la sécurité à long terme restent encore à démontrer. Méthode : L’objet de cette recherche a été de décrire l’évolution du discours des organismes officiels de santé au Québec en matière de gestion du poids par l’analyse de contenu. Cette analyse a eu recours à une grille de plus de 160 documents produits au cours des 60 dernières années par les gouvernements, les autorités professionnelles et les médias québécois. Résultats et discussion : L’analyse révèle que l’évolution du discours de ces organisations s’inscrit dans trois continuums : le pathologique (une évolution, une gradation, une inflation étymologique du sens qui est donné au poids problématique); la surveillance (avec l’établissement de critères rationnels, la surveillance d’abord individuelle est devenue collective et s’est institutionnalisée); la responsabilisation (la responsabilité du poids s’est déplacée de l’individu vers le collectif puis vers le social). Ces continuums illustrent un déplacement de la manière de conceptualiser le poids de la sphère privée vers la sphère publique. Cette analyse révèle aussi qu’il y a à l’œuvre un exercice disciplinaire propre à une moralisation qui s’appuie sur la prémisse que l’augmentation de la prévalence touche toute la population de manière égale. Or, il n’en est rien.