Floods of the Upper Danube River and Its Tributaries and Their Impact on Urban Economies (c. 1350–1600): The Examples of the Towns of Krems/Stein and Wels (Austria)

This paper examines the impact of disastrous and ‘ordinary’ floods on human societies in what is now Austria. The focus is on urban areas and their neighbourhoods. Examining institutional sources such as accounts of the bridge masters, charters, statutes and official petitions, it can be shown that city communities were well acquainted with this permanent risk: in fact, an office was established for the restoration of bridges and the maintenance of water defences and large depots for timber and water pipes ensured that the reconstruction of bridges and the system of water supply could start immediately after the floods had subsided. Carpenters and similar groups gained 10 to 20 per cent of their income from the repair of bridges and other flood damage. The construction of houses in endangered zones was adapted in order to survive the worst case experiences. Thus, we may describe those communities living along the central European rivers as ‘cultures of flood management’. This special knowledge vanished, however, from the mid-nineteenth century onwards, when river regulations gave the people a false feeling of security.

The burnout syndrome among nurses in an urban acute care hospital

Three hundred fifty-four registered nurses from an urban acute care hospital were examined through self-report questionnaires. Nurses from trauma care, critical care and non-critical care nursing specialties participated in the study. The study focuses were (1) whether sociodemographic characteristics were significantly related to burnout; (2) what was the prevalence estimate of burnout among the population; (3) whether burnout levels differed depending upon nursing specialties and; (4) whether burnout as related to nursing stress, work environment, and work relations was mediated by sociodemographic characteristics.^ Race, age, marital status, education, seniority, rank, nursing education, and birthplace were significantly related to one or more aspects of burnout in the total population. With emotional exhaustion alone the prevalence of burnout was 62%. Using emotional exhaustion and depersonalization combined with reduced sense of personal accomplishment as a measure of burnout, thirty-four percent of the nurses were either in the pre-burnout phase or burned out. The relative importance of sociodemographic characteristics indicated that experience and race were highly significant risk factors.^ Burnout levels differed significantly depending upon nursing specialty. Specifically, levels of emotional exhaustion and depersonalization differed significantly between trauma care and critical care, and trauma care and non-critical care. Personal accomplishment did not differ depending upon nursing specialty. Critical care nurses did not differ significantly from non-critical care nurses on aspect of burnout.^ Race, marital status, education, seniority and rank were significant mediators of emotional exhaustion and depersonalization. The study offers possible explanations for the mediating effect of sociodemographic characteristics on nursing stress, work environment, work relations, emotional exhaustion and depersonalization. ^

Patient satisfaction and nursing staff work satisfaction in an urban public teaching hospital

This study examined the level of patient satisfaction and nursing staff work satisfaction at an urban public hospital in the Southwestern United States. The primary objectives of this study were to determine: (1) the level of overall patient satisfaction and satisfaction with specific dimensions of hospital care; (2) the differences in patient satisfaction according to demographic characteristics (age, gender, ethnicity, and education completed) and predispositional factors (perceived health status, perceived level of pain, prior contact with the hospital, and hospital image) and the relative importance of each variable on patient satisfaction; (3) the level of overall work satisfaction and satisfaction with specific dimensions of work experienced by the medical/surgical nursing staff; (4) the differences in work satisfaction experienced by the nursing staff based on demographic variables (age, gender, ethnicity, and marital status) and professional factors (education completed, staff position, the number of years employed with the hospital, and number of years employed in nursing) and the relative importance of each variable on work satisfaction; and (5) to determine the effect of the nursing work milieu on patient and staff satisfaction.^ The study findings showed that patients experienced a moderate to low level of satisfaction with the dimensions of hospital care (admission process, daily care, information, nursing care, physician care, other hospital staff, living arrangements, and overall care). Of the eight dimensions of care, patients reported a relatively positive level of satisfaction (75 percent or better) with only one dimension: physician care. Ethnicity, perceived health status, and hospital image were significantly related to patient satisfaction. Hispanic patients, those who were in good health, and those who felt the hospital had a good image in their community were most satisfied with hospital care. Patients also reported areas of hospital care that needed the most improvement. Responses included: rude staff, better nursing care, and better communication.^ Findings from the nursing satisfaction survey indicated a low level of satisfaction with the dimensions of work (autonomy, pay, professional status, interaction, task requirements, and organizational policies). Only one dimension of work, professional status, received a mean satisfaction score in the positive range. Additionally, staff members were unanimously dissatisfied with their salaries. Frequently mentioned work-related problems reported by the staff included: staffing shortages, heavy patient loads. and excessive paperwork.^ The nursing milieu appeared to have had a significant effect on the satisfaction levels of patients nursing staff employees. The nursing staff were often short staffed, which increased the patient-to-nurse ratio. Consequently, patients did not receive the amount of attention and care they expected from the nursing staff. Crowded patient rooms allowed for little personal space and privacy. Dissatisfaction with living conditions served to influence patients' attitudes and satisfaction levels. These frustrations were often directed toward their primary caregivers, the nursing staff. Consequently, the nursing milieu appeared to directly affect and influence the satisfaction levels of both patients and staff. (Abstract shortened by UMI). ^

Fostering sustainable urban development in Nakuru, Kenya Rift Valley

The town of Nakuru—Kenya's fourth largest town—lies in a unique setting in the Great Rift Valley. Recent developments on the Menengai Crater, the Mau Escarpment, and the Bahati Highlands exemplify the impacts of poorly planned urban growth on mountain ecosystems. The Nakuru Local Urban Observatory (LUO) project was initiated by the Municipal Council of Nakuru in January 2003, in collaboration with the Centre for Development and Environment (CDE) of the University of Berne and the Intermediate Technology Development Group (ITDG), and with funding from the Swiss Agency for Development and Cooperation (SDC). The project aims to provide a framework for sustainable urban development practices by building technical skills and improving participation by local stakeholders in decision-making processes. The potentials of information technology (IT) are being tapped to provide up-to-date information to decision-makers and democratize access to information, in order to improve public participation. The overall objective is to find ways of achieving better urban management in order to mitigate non-sustainable development trends in the town and its surroundings.

Decision-Support tools for assessing land degradation and realising sustainable land management, Study Case of El Mkhachbiya Catchment, Northwest of Tunisia

Land degradation is intrinsically complex and involves decisions by many agencies and individuals, land degradation map- ping should be used as a learning tool through which managers, experts and stakeholders can re-examine their views within a wider semantic context. In this paper, we introduce an analytical framework for mapping land degradation, developed by World Overview for Conservation Approaches and technologies (WOCAT) programs, which aims to develop some thematic maps that serve as an useful tool and including effective information on land degradation and conservation status. Consequently, this methodology would provide an important background for decision-making in order to launch rehabilitation/remediation actions in high-priority intervention areas. As land degradation mapping is a problem-solving task that aims to provide clear information, this study entails the implementation of WOCAT mapping tool, which integrate a set of indicators to appraise the severity of land degradation across a representative watershed. So this work focuses on the use of the most relevant indicators for measuring impacts of different degradation processes in El Mkhachbiya catchment, situated in Northwest of Tunisia and those actions taken to deal with them based on the analysis of operating modes and issues of degradation in different land use systems. This study aims to provide a database for surveillance and monitoring of land degradation, in order to support stakeholders in making appropriate choices and judge guidelines and possible suitable recommendations to remedy the situation in order to promote sustainable development. The approach is illustrated through a case study of an urban watershed in Northwest of Tunisia. Results showed that the main land degradation drivers in the study area were related to natural processes, which were exacerbated by human activities. So the output of this analytical framework enabled a better communication of land degradation issues and concerns in a way relevant for policymakers.

Contractual Difficulties in Environmental Management and the Protection of Biodiversity: The Case of Conservation and Mitigation Banking

This paper offers a principal-agent model of feasible private contracting in mitigation and conservation banking aimed at the protection of natural habitat and bio-diversity of US wetlands and uplands. It is shown that while it is straightforward to design an incentive contract, such a contract may not achieve the federally mandated objective of no net loss of habitat. This is because the minimum payment required as an economic incentive to private agents may be greater than what they should receive for the habitat values that they actually created in the field. This possible problem is shown to derive from nonconvexity in the production possibility set between the biological value of land as natural habitat and in non-habitat uses such as in urban development. The paper concludes with a consideration of several institutional devises that may promote the convergence of private contracting and the attainment of no net loss. These include the payment of subsidies, greater accuracy in the identification of actual quality by the principal, and the use of several incentive alignment devises.

An empirical model to estimate the demand for primary care in urban settings

Objective. To measure the demand for primary care and its associated factors by building and estimating a demand model of primary care in urban settings.^ Data source. Secondary data from 2005 California Health Interview Survey (CHIS 2005), a population-based random-digit dial telephone survey, conducted by the UCLA Center for Health Policy Research in collaboration with the California Department of Health Services, and the Public Health Institute between July 2005 and April 2006.^ Study design. A literature review was done to specify the demand model by identifying relevant predictors and indicators. CHIS 2005 data was utilized for demand estimation.^ Analytical methods. The probit regression was used to estimate the use/non-use equation and the negative binomial regression was applied to the utilization equation with the non-negative integer dependent variable.^ Results. The model included two equations in which the use/non-use equation explained the probability of making a doctor visit in the past twelve months, and the utilization equation estimated the demand for primary conditional on at least one visit. Among independent variables, wage rate and income did not affect the primary care demand whereas age had a negative effect on demand. People with college and graduate educational level were associated with 1.03 (p < 0.05) and 1.58 (p < 0.01) more visits, respectively, compared to those with no formal education. Insurance was significantly and positively related to the demand for primary care (p < 0.01). Need for care variables exhibited positive effects on demand (p < 0.01). Existence of chronic disease was associated with 0.63 more visits, disability status was associated with 1.05 more visits, and people with poor health status had 4.24 more visits than those with excellent health status. ^ Conclusions. The average probability of visiting doctors in the past twelve months was 85% and the average number of visits was 3.45. The study emphasized the importance of need variables in explaining healthcare utilization, as well as the impact of insurance, employment and education on demand. The two-equation model of decision-making, and the probit and negative binomial regression methods, was a useful approach to demand estimation for primary care in urban settings.^

Comparison of financial trends in small rural and urban hospitals in Texas, 1983--1985

The purpose of this study was to compare the financial performance of small rural hospitals to that of small urban hospitals in Texas. Hospital-specific and environmental factors were studied as control variables.^ Small rural hospitals were found to be financially stronger on measures of liquidity but weaker on measures of profitability. Small urban hospitals performed better on measures of profitability and long-range solvency. When all measures in the five dimensions of financial performance were analyzed, no significant difference was found between the two groups of hospitals. None of the control variables included in the study was significantly associated with financial performance both for rural and urban hospitals. Conclusions were that small rural hospitals in Texas are experiencing a deterioration in financial condition but small, rural hospitals are not doing any worse than small urban hospitals; and that the financial hardship which rural hospitals suffer may be inherent in the nature of the institutions themselves, and not as a result of their smallness nor their rural settings. ^

Implementing and evaluating a Web -based close call reporting system at an urban hospital

Medical errors and close calls are pervasive in health care. It is hypothesized that the causes of close calls are the same as for medical errors; therefore learning about close calls can help prevent errors and increase patient safety. Yet despite efforts to encourage close call reporting, close calls as well as medical errors are under-reported in health care. The purpose of this dissertation was to implement and evaluate a web-based anonymous close call reporting system in three units at an urban hospital. ^ The study participants were physicians, nurses and medical technicians (N = 187) who care for patients in the Medical Intermediate Care Unit, the Surgical Intermediate Care Unit, and the Coronary Catheterization Laboratory in the hospital. We provided educational information to the participants on how to use the system and e-mailed and delivered paper reminders to report to the participants throughout the 19-month project. We surveyed the participants at the beginning and at the end of the study to assess their attitudes and beliefs regarding incident reporting. We found that the majority of the health care providers in our study are supportive of incident reporting in general but in practice very few had actually reported an error or a close call, semi-structured interview 20 weeks after we made the close call reporting system available. The purpose of the interviews was to further assess the participants' attitudes regarding incident reporting and the reporting system. Our findings suggest that the health care providers are supportive of medical error reporting in general, but are not convinced of the benefit of reporting close calls. Barriers to close call reporting cited include lack of time, heavy workloads, preferring to take care of close calls "on the spot", and not seeing the benefits of close call reporting. Consequently only two = close calls were reported via the system by two separate caregivers during the project. ^ The findings suggest that future efforts to increase close call reporting must address barriers to reporting, especially the belief among care givers that it is not worth taking time from their already busy schedules to report close calls. ^

Los recursos visuales en el ordenamiento territorial : I- Potrerillos (Mendoza, Argentina)

Se presenta la primera etapa del relevamiento de los recursos paisajísticos de la provincia de Mendoza, con el ajuste metodológico efectuado mediante una prueba piloto desarrollada sobre la Ruta Nac. N° 7, desde el Acceso sur en Luján de Cuyo (límite este) hasta Potrerillos inclusive (límite oeste). Los límites norte y sur están abarcados por el horizonte observable desde la ruta que atraviesa el área en sentido este-oeste. Se seleccionaron los puntos representativos mediante dos tipos de muestreo: sistemático y discrecional. En base a la catalogación de los recursos visuales se diseña una zonificación referencial general con miras al ordenamiento territorial y uso del suelo en distintas actividades de desarrollo futuro: turístico, reservas, residencial, agrícola, industrial. Se valora la calidad estética del paisaje aplicando, además, índices valorativos de la vulnerabilidad de los espacios a las actividades humanas (Índice de Naturalidad e Índice de Fragilidad), para obtener valores de la Calidad Visual Vulnerable del paisaje. Estos valores se grafican en planos que representan las distintas calidades alcanzadas y se complementa con una descripción de los puntos analizados, recomendaciones para el mejoramiento paisajístico a través de introducción o conducción de vegetación y fotografías documentales de las vistas analizadas.

Diagnóstico de sistema integrado de transporte de passageiros com uso de sistema de informação geográfica : o caso da cidade de Macaé – RJ – Brasil : resultados preliminares

O Sistema Integrado de Transporte Coletivo do município de Macaé – RJ tem sido alvo de diversas críticas atualmente e reflete a dificuldade dos gestores urbanos em acompanhar as rápidas transformações da “capital nacional do petróleo", levantando a necessidade de métodos de diagnósticos eficientes em sistemas de transporte de passageiros. Desta forma, o objetivo do trabalho é diagnosticar o sistema de transporte público de Macaé - RJ e analisar o uso de Sistema de Informação Geográfica, tendo em vista a eficiência do diagnóstico. A metodologia se baseia em dados operacionais do sistema de transporte, confecção de mapas e análises espaciais com uso do software Transcad 4.5 Full. Os resultados apontam dificuldades estruturais no sistema como, por exemplo, a localização indevida de 2 Terminais, a sobrecarga de linhas alimentadoras com necessidade demasiada de transbordo, a falta de atendimento direto de importantes linhas de desejo, a desestabilidade na operação, etc. A utilização do SIG demonstrou expressivo ganho de tempo na gestão e análise de informações de forma integrada, devendo-se ponderar, em alguns casos, o método de mapeamento e a relação tempo de trabalho x ganho de conhecimento, assim como a necessidade de integração com informações operacionais do sistema de transporte.

El ordenamiento territorial en Argentina : editorial

La Revista Proyección dedica este número a presentar estudios realizados en distintas provincias argentinas luego de la crisis económica del año 2001. Muestran el estado de situación actual y plantean la necesidad del Ordenamiento Territorial para poder superar algunos de los efectos que provoca el modelo neoliberal instaurado a principios de los ’90: desequilibrios territoriales, crecimiento urbano sin control, pérdida permanente y progresiva de capital natural, cultural y social, conflictos sociales.

Seguridad humana : necesidad de innovar enfoques a partir del ordenamiento territorial

La inseguridad es uno de los mayores desafíos al que se enfrentan los gobernantes en América Latina. Este problema avanza desde una visión sectorial en los años ochenta hacia una visión transversal a partir de los noventa. Esto implica una evolución de su concepto; desde su consideración como una cuestión de seguridad de Estado de competencia policial y militar hacia la “seguridad humana", concepto multidimensional que contempla el desarrollo humano y la satisfacción de necesidades. En Argentina la inseguridad se agrava desde la crisis social y económica y es parte de la agenda política debido a los constantes reclamos de la sociedad. Sin embargo, con el transcurrir de los años se puede observar la imposibilidad de las gestiones gubernamentales de hacerle frente. Es por ello que en este trabajo se plantea la relación entre la seguridad humana y el Ordenamiento Territorial a través de la evaluación de la habitabilidad, enfoque que permite operacionalizar el concepto de seguridad de forma integradora y transversal. Para el desarrollo del trabajo se utiliza un caso de estudio: el piedemonte del Gran Mendoza. Se parte de la construcción de una metodología de análisis que permite espacializar los datos y de un sistema de variables e indicadores para medir la habitabilidad en términos de la seguridad humana.

Territorial approaches for rural development in Latin America : a case study in Chile

Una reciente transición en el campo del desarrollo rural es el movimiento desde un enfoque reducido del sector agrícola hasta uno que adopta una visión territorial más amplia. Este pasaje intenta interpretar las interacciones entre los mundos urbano y rural de una manera más comprensiva. Esta perspectiva teórica relativamente nueva interesa particularmente a los académicos y los políticos en los países latinoamericanos donde, a partir de la mitad de los años noventa, el concepto de una nueva ruralidad se ha visto como la fuente de un nuevo enfoque para el desarrollo rural. Por lo tanto, el propósito teórico de esta investigación es explicitar los indicadores analíticos del nuevo enfoque de la ruralidad en América Latina e identificar las diferencias entre los acercamientos sectoriales y territoriales, considerando los aspectos socio-económicos, institucionales y medioambientales involucrados. La transición del enfoque sectorial a uno territorial significa también, desde un punto de vista operativo, el reconocimiento de la existencia de áreas homogéneas a partir de las cuales pueden proponerse estrategias de desarrollo rural. El propósito operativo de esta investigación consiste en proponer una metodología para identificar estas áreas con una aplicación a la Región del Maule en Chile. La conclusión subraya algunos elementos críticos que se deben considerar en la definición de estrategias del desarrollo rural territorial.