Risk adjustment for hospital use using social security data: cross sectional small area analysis

Objectives: To identify demographic and socioeconomic determinants of need for acute hospital treatment at small area level. To establish whether there is a relation between poverty and use of inpatient services. To devise a risk adjustment formula for distributing public funds for hospital services using, as far as possible, variables that can be updated between censuses. Design: Cross sectional analysis. Spatial interactive modelling was used to quantify the proximity of the population to health service facilities. Two stage weighted least squares regression was used to model use against supply of hospital and community services and a wide range of potential needs drivers including health, socioeconomic census variables, uptake of income support and family credit, and religious denomination. Setting: Northern Ireland. Main outcome measure: Intensity of use of inpatient services. Results: After endogeneity of supply and use was taken into account, a statistical model was produced that predicted use based on five variables: income support, family credit, elderly people living alone, all ages standardised mortality ratio, and low birth weight. The main effect of the formula produced is to move resources from urban to rural areas. Conclusions: This work has produced a population risk adjustment formula for acute hospital treatment in which four of the five variables can be updated annually rather than relying on census derived data. Inclusion of the social security data makes a substantial difference to the model and to the results produced by the formula.

Cultural policy models and cultural facilities models: from national to local models. Analysis of Barcelona’s case

The development of cultural policy analysis by social science has been produced a theorization about cultural policy models from sociology and political science. This analysis shows the influence of the national model of cultural policy on the forms of governance and management of cultural facilities. However, in this paper we will defend that currently the local model of cultural policy decisively influences the model of cultural institutions. This is explained by the growing importance of culture in local development strategies. In order to demonstrate this we will analyze the case of the Barcelona Model of local development and cultural policy, that is characterized for the level of local government leadership, multilevel governance, the use of culture in urban planning processes and a tendency to use public-private partnership in public management. This Model influences the genesis and development of the cultural facilities and it produces a singular and relatively successful model.

Cultural assets and sustainable development: the economic significance of Cultural Heritage

This article assesses the condition of the Cultural Heritage as a form of capital that gives rise to a significant flow of economic returns widely outweighing the effort it takes to preserve it. More specifically, the data related to Spain is provided from the perspective of aggregate demand drawing up an estimation of both the direct and indirect economic impacts arising from the Cultural Heritage valuation. The results highlight again the relevance of cultural tourism in the delivery of these economic returns and as a catalyst of activities leading to the sustainable socioeconomic devel-opment of multiple territories.

The proposal of democratic citizenship in Hannah Arendt

The main purpose of this paper is to analyze Hannah Arendt’s citizenship proposal. The central thesis is that this proposal is possible in contemporary democracies, and it is adequate for developing and strengthening of political action. The work is divided in five sections. In the first, we develop a brief introduction on the studied issue. In the second and third section, we analyze, respec-tively, political and moral conditions that enable democratic citizenship, and the conditions that hinder the exercise of the same, according to Arendt. Then, we reflect critically on Arendt’s citizenship proposal. Finally, we conclude and we propose a set of civic challenges relate to current democracies in light of the above proposal.

Discourses on Modernization in the Employment Public Services: Towards a New Form of Governance?

The “crisis of the social issue” in the EU has led to a certain consensus in the need to renew the organizational and institutional model of public administration. The core of the reform implies important administrative changes in most of the European welfare states. Those changes are inspired on theories such as the new public management, management by objectives or partnership. Such changes involve both semantic (“sharing responsibilities”, “effective costs”, or the substitution of “citizen under an administration” by “consumer”) and political (predominance of scattered forms of power and the individualization of responsibilities) transformations which operate in the framework of individuals and State relations. The paradigms of activation and flexicurity have been central in this public administration modernization project. This commitment with new forms of governance of social issues has important consequences for the political and moral foundations of social cohesion, and the Spanish case is not an exception. This paper aims at looking at those representations of “modernization” (as they appear in debates about the employment services restructuring policies) in detail as well as providing references to the trajectory of such reforms of public services since the early eighties to the beginning of the crisis.

The “re-socialization” of Gypsy women in the literacy courses aimed to the recipients of the Social Integration Revenue Policy of the Region of Madrid

This article studies the gender values that are promoted both in the literacy courses for gypsy women beneficiaries of the Social Integration Revenue Policy of the Region of Madrid and in the events that are organized for this group by public institutions and NGOs. The process of “socialization” that occurs in the educative groups for Gypsy women is focused on constructing an image of what it is to be a “Gypsy modern woman”. Through multiple mechanisms and discursive techniques a specific conception of gender equality is transmitted in these educative spaces. In addition to this, Gypsy women are continually urged to assume certain values and social practices (of gender identity, of "citizenship", of parenting, etc..), while an archetype of "Gypsy Woman" which condenses powerful stereotypes and prejudices about the "Gypsy culture" and the gender relations characteristics of this group is constructed.

The (in)visible scar. Representation of the body in blogs by women with breast cancer

In this paper we analyze the representation of the body in blogs by women with breast cancer. Taking into account both texts and images, we study the representation of the body on the basis of the body problems proposed by Frank (1995): control, body-relatedness, other-relatedness and desire. In the blogs studied we find a desiring and dyadic body, which is understood as part of a network of affection and care. The diagnosis of cancer can generate both dissociation, when the body is experienced as a threat, and association, a wish to be connected to it. In relation to control, a clear will of predictability is observed but traces of assumption of contingency also appear.

The reform of Welfare Regimes in Costa Rica, Chile, Argentina, Brazil and Uruguay

The aim of this article is to analyze the social policy in Latin America in a context of emerging welfare states. To understand the changes one takes into consideration the theories about institutional reform and the transformations produced in the XX century and the beginning of the XXI to substitute a social security regime mainly based on segmentation of benefi ts and on programs to fi ght poverty by another with an institutional and redistributive nature. The paper pays attention in particular to the path of the most developed welfare states of Latin America: Costa Rica, Chile, Argentina, Brasil y Uruguay.

Pension structural reforms, re-reforms and their effects on social welfare: The case of Chile

This article fi rst summarizes the structural reforms of pensions (total or partial privatization) in Latin America and Central and Eastern Europe, identifying their advantages and disadvantages, and does the same with the international process of re-reforms of pensions with a greater role of the state. Second, chooses Chile as a case study, as a world pioneer in both types of reforms; describes their characteristics and effects on social welfare of the structural reform of 1981 and the re-reform of 2008. Such effects are evaluated based on ten basic principles of social security from the International Labour Offi ce (ILO): 1) social dialogue to approve the reforms, 2) universal coverage of the population, 3) equal treatment of insured persons, 4) social solidarity, 5) gender equity, 6) suffi ciency of benefi ts, 7) effi ciency and reasonable administrative cost, 8) social participation in the management of the system, 9) role of the state and supervision, and 10) fi nancial sustainability. Third, it summarizes the advantages and disadvantages-challenges of the re-reform and informs on the current debate for further reforms.

Welfare Regimes and “progressive” governments in Latin America: The cases of Venezuela, Ecuador and Bolivia

Several authors have applied the concept of Welfare Regimens for studying social policy in Latin America (Esping-Andersen, 1993 and 2000). Among others, Martínez Franzoni (2007) develops a typology, with fi eld work is at the turn of the millennium, and establishes three categories: State-productivist regime, state-protectionist and family orientated. Most countries in the region are placed in the latter category. The hypothesis of this article argues that with the emergence of governments considered “left” or “progressive” in several countries of the region from the late ‘90s and, more decisively, in 2000’, the map of welfare regimes models could have mutated substantively. The nationally transformative experiences are different (various socio-economic realities and political action in which they are located exists) but they have several contact points that can be summarized in a greater state intervention in different areas previously closed to their operating and recovery of important functions of welfare and care of the population by the government. The paper discusses with an exploratory and descriptive approach the welfare schemes that would shape in three countries that have constitutionalized the change from the neoliberal paradigm: Venezuela, Bolivia and Ecuador.

Conditional cash transfer programs and the representations of poverty in Bolivia and Peru

Bolivia and Peru adopted the same instruments of social policy —conditional cash transfer programs— to solve the same public problems under different political regimes. By means of the qualitative methodology of discourse analysis, this paper studies the representations of poverty and State made by key actors of those social programs. Underlying more differences than similarities, one demonstrates that the same social policy is linked to opposite social representations of poverty and the State role in every country. The main explanation for this is, far from being imposed by international organizations, those programs are adopted and adapted by each political regime.

Bolsa Familia Program and school enrolment: An analysis of the 2010 Brazilian demographic census

The Bolsa Família Program goal is to promote social development and poverty reduction, through the direct transfer of conditional cash, in association with other social programs. This study aims to analyze whether Bolsa Família had an association with children’s school attendance, which is one of the educational conditions of the program. Our main hypothesis is that children living in households receiving Bolsa Família had greater chances of attending school. Data from the Ministry of Social Development and Combating Famine indicated that children living in households with Bolsa Família had greater school enrolment levels. By using data from the 2010 Demographic Census, collected by the Brazilian Institute of Geography and Statistics (IBGE), some descriptive analyzes and binary logistic regression models were performed for different thresholds of household per capita income. These estimates were made by comparing children who lived in households receiving Bolsa Família to those children not receiving the program. We took into consideration characteristics about the household, mothers, and children. The results were clustered by the municipality of residence of the child. In all income thresholds, children benefi ting from Bolsa Família were more likely to be enrolled in school, compared to children not receiving the benefi t.

Places making: participatory construction of scientifi c culture cities

In the framework of the European project Platform of Local Authorities and Communicators Engaged in Science (PLACES), we analyse the articulations between scientifi c communication, public perception of science, processes of citizen participation and apropiation of space, based on a case study of the inhabitants of Teruel city, Autonomous Community of Aragon, Spain. On the interrelationships between these issues, there are a number of contradictions, such as the difference between a high interest for information about science and technology and a low level of recognition and interaction with local institutions involved in those activities, the complex conceptualization of scientifi c space in relation to the “public-private” pair, or an articulation of a claiming civic rethoric and an insuffi cient co-responsibility. We conclude that, in a local context, the dimension of territoriality and, in particular, the identifi cation with the town, is a central mediation for activating citizen participation as part of processes of appropriation of space for setting up cities of scientifi c culture.

Unraveling EU Policies: the ““Common Basic Principles”” and the ““European Integration Fund”” as a technology of government

this paper is about EU “soft policies” on immigrant integration. It analyzes the “Common Basic Principles” (CBPs) and the “European Integration Fund” (EIF), two devices that have been recently established within this framework. It adopts the theoretical perspective of the “anthropology of policy” and “governmentality studies”. It shows the context of birth of the aforementioned devices, as well as their functioning and the assessment done by the actors implied in the elaboration/implementation/evaluation of the related policies. It is based both on documentary research as well as direct observation and interviews done to the actors implied. It concludes that the PBC and the EIF should be considered as a “technology of government”, that strives to align the conduct of the actors with the governmental aims, as well as it produces specific practices and knowledge. It also underlines an intrinsic feature of many policies: their “congenital failure”, since they are (often) disputed and resignified by situated actors, who are embedded in asymmetrical power relations.

Dynamic analysis of employment trajectories through the concept of fl exicurity

The paper presents a dynamic study of the Spanish labour market which tries to determine if it matches the characteristics of transitional labour markets from a fl exicurity approach. Employment trajectories of Spanish workers during the years 2007-2010 are studied using the Continuous Sample of Working Lives. This period covers the end of the expansion of the Spanish economy and the beginning of the current employment crisis. From the combination of the chosen topic, the approach, and the database used, this is a novel perspective in our country. The article shows evidence of the evolution of the employment and unemployment spells, the Spanish labour market turnover degree, and the diffi culties of some groups for carrying out transition between employment and unemployment. The results obtained show a labour market in which a) transitions have come to a halt, and b) there is high job insecurity.