Caring for ageing migrants in nursing homes: 'doing diversity' while 'doing death'

The proposed paper will present first results of a research project investigating how nursing homes in Switzerland deal with migrant elders who are in intensive need of care. Focusing on the end-of-life in institutional care settings, the intention is to explore the dimensions of ‘doing death’ in Swiss nursing homes when the elderly involved are of migrant background. The focus is laid on the co-construction of end of life in interactions between residents of migrant background and professional carers involved (often of migrant background themselves), and will thereby focus on processes of ‘doing diversity’ while ‘doing death’. To do so, we chose an ethnographic approach focusing on the participant observation of everyday practices of ‘doing death’ and ‘death work’ and on interviewing staff, residents and their relatives. Caring for ageing migrants at the end of their lives is studied in different types of assisted living at the end of life: The field of research was entered by studying a group specific department for residents of so-called ‘Mediterranean’ background. It was contrasted by a department stressing the individuality of each resident but including a considerable number of residents with migrant background. We are interested in how (and if at all) specific forms of ‘doing community’ within different types of departments may also lead to specific ways of ‘doing death’, which aim at a stronger embeddedness of dying trajectories in social relations of reciprocity and exchange. Furthermore, migrant ‘doing death’ is expected to be particularly negotiable since the potential diversities of symbolic reference systems and daily practices are widened. If the respective resident is limited in his/her capacities to play an active part in negotiating about ‘good care’ and ‘good dying’ – either due to language competences, which would be migrant specific, or due to degenerative diseases, which is not migrant specific – the field of negotiations will be left up to the professionals within the organization (and to the relatives, which are, however, not constantly present). Strategies of stereotyping the ‘other’ as well as driving nurses, caring aides and other professionals of migrant background into roles of ‘cultural experts’ or ‘transcultural translators’ are expected to be common in such situations. However, the task of negotiating what would be a ‘good dying’ and what measures are appropriate is always at stake in contemporary heterogeneous societies. Therefore we would argue that studying dying processes involving migrant residents is looking at paradigmatic manifestations of doing death in recent contexts of reflexive modernity.

Patient information leaflets: informing or frightening? A focus group study exploring patients' emotional reactions and subsequent behavior towards package leaflets of commonly prescribed medications in family practices.

BACKGROUND The purpose of patient information leaflets (PILs) is to inform patients about the administration, precautions and potential side effects of their prescribed medication. Despite European Commission guidelines aiming at increasing readability and comprehension of PILs little is known about the potential risk information has on patients. This article explores patients' reactions and subsequent behavior towards risk information conveyed in PILs of commonly prescribed drugs by general practitioners (GPs) for the treatment of Type 2 diabetes, hypertension or hypercholesterolemia; the most frequent cause for consultations in family practices in Germany. METHODS We conducted six focus groups comprising 35 patients which were recruited in GP practices. Transcripts were read and coded for themes; categories were created by abstracting data and further refined into a coding framework. RESULTS Three interrelated categories are presented: (i) The vast amount of side effects and drug interactions commonly described in PILs provoke various emotional reactions in patients which (ii) lead to specific patient behavior of which (iii) consulting the GP for assistance is among the most common. Findings show that current description of potential risk information caused feelings of fear and anxiety in the reader resulting in undesirable behavioral reactions. CONCLUSIONS Future PILs need to convey potential risk information in a language that is less frightening while retaining the information content required to make informed decisions about the prescribed medication. Thus, during the production process greater emphasis needs to be placed on testing the degree of emotional arousal provoked in patients when reading risk information to allow them to undertake a benefit-risk-assessment of their medication that is based on rational rather than emotional (fearful) reactions.

An application of combinatorial optimization in the printing industry

Offset printing is a common method to produce large amounts of printed matter. We consider a real-world offset printing process that is used to imprint customer-specific designs on napkin pouches. The print- ing technology used yields a number of specific constraints. The planning problem consists of allocating designs to printing-plate slots such that the given customer demand for each design is fulfilled, all technologi- cal and organizational constraints are met and the total overproduction and setup costs are minimized. We formulate this planning problem as a mixed-binary linear program, and we develop a multi-pass matching-based savings heuristic. We report computational results for a set of problem instances devised from real-world data.

Treatment with tumor necrosis factor inhibitors in axial spondyloarthritis: comparison between private rheumatology practices and academic centers in a large observational cohort

OBJECTIVE To evaluate the initiation of and response to tumor necrosis factor (TNF) inhibitors for axial spondyloarthritis (axSpA) in private rheumatology practices versus academic centers. METHODS We compared newly initiated TNF inhibition for axSpA in 363 patients enrolled in private practices with 100 patients recruited in 6 university hospitals within the Swiss Clinical Quality Management (SCQM) cohort. RESULTS All patients had been treated with ≥ 1 nonsteroidal antiinflammatory drug and > 70% of patients had a baseline Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) ≥ 4 before anti-TNF agent initiation. The proportion of patients with nonradiographic axSpA (nr-axSpA) treated with TNF inhibitors was higher in hospitals versus private practices (30.4% vs 18.7%, p = 0.02). The burden of disease as assessed by patient-reported outcomes at baseline was slightly higher in the hospital setting. Mean levels (± SD) of the Ankylosing Spondylitis Disease Activity Score were, however, virtually identical in private practices and academic centers (3.4 ± 1.0 vs 3.4 ± 0.9, p = 0.68). An Assessment of SpondyloArthritis international Society (ASAS40) response at 1 year was reached for ankylosing spondylitis in 51.7% in private practices and 52.9% in university hospitals (p = 1.0) and for nr-axSpA in 27.5% versus 25.0%, respectively (p = 1.0). CONCLUSION With the exception of a lower proportion of patients with nr-axSpA newly treated with anti-TNF agents in private practices in comparison to academic centers, adherence to ASAS treatment recommendations for TNF inhibition was equally high, and similar response rates to TNF blockers were achieved in both clinical settings.

Exploring sustainability through stakeholders' perspectives and hybrid water in the Swiss alps

Can the concept of water as a socio-natural hybrid and the analysis of different users’ perceptions of water advance the study of water sustainability? In this article, I explore this question by empirically studying sustainability values and challenges, as well as distinct types of water as identified by members of five water user groups in a case study region in the Swiss Alps. Linking the concept of water as a socio-natural hybrid with the different water users’ perspectives provided valuable insights into the complex relations between material, cultural, and discursive practices. In particular, it provided a clearer picture of existing water sustainability challenges and the factors and processes that hinder more sustainable outcomes. However, by focusing on relational processes and individual stakeholder perspectives, only a limited knowledge could be created regarding a) what a more sustainable water future would look like and b) how current unsustainable practices can be effectively transformed into more sustainable ones. I conclude by arguing that the concept of water as a socio-natural hybrid provides an interesting analytical tool for investigating sustainability questions; however, if it is to contribute to water sustainability, it needs to be integrated into a broader transdisciplinary research perspective that understands science as part of a deliberative and reflective process of knowledge co-production and social learning between all actor groups involved.

The Lord of Heaven in the Inner Chambers: Jesuits, Women, and Domestic Christianity (ca. 1580-1690)

The study focuses on gender norms and practices in Chinese Christian communities established by Jesuit missionary activity during the long seventeenth century. It analyzes how European and Chinese gender norms and practices affected each other in the context of the Sino-Western cultural contact initiated by the missionaries. The thesis consists of two parts. First, it analyzes the ways in which European Jesuits engaged with Chinese gender relations in the course of their mission in China. The study demonstrates that the Jesuits’ adoption of the Chinese scholar-gentry’s habitus entailed a partial adaptation to Confucian gender norms. The latter placed great emphasis on gender segregation and therefore discouraged direct communication between missionaries and Chinese women. This resulted in the emergence of organizational and devotional arrangements of Christian communities specific to China. Second, the study discusses Chinese Christian women's religious culture that emerged in the absence of a strong missionary presence among female devotees. It points out that Chinese Christian women created their own ritual culture and religious sociability in the domestic context, and that they actively took part in shaping Chinese Christianity as masters of domestic rituals.

Large-scale land acquisitions in Peru: Land (re)-concentration, agrarian change and reactions from rural communities

More than 40 years after the agrarian reform, Peru is experiencing a renewed process of concentration of land ownership in the hands of large-scale investors, favoring the development of a sugar cane production cluster along the northern coast. The expansion of the agricultural frontier by means of large irrigation projects – originally developed to benefit medium- and small-scale farmers – is carried out today in order to be sold to large-scale investors for the production of export crops. In the region of Piura the increasing presence of large-scale biofuel investors puts substantial pressure on land and water resources, not only changing the use of and access to land for local communities, but also generating water shortages vis-à-vis the multiple water demands of local food producers. The changes in land relations and the agro-ecosystem, the altering food production regime as well as the increasing proletarization of smallholders, is driving many locals – even those which (initially) welcomed the investment – into resistance activities against the increasing control of land, water and other natural resources in the hands of agribusinesses. The aim of this presentation is to discuss the contemporary political, social and cultural dynamics of agrarian change along the northern Peruvian coast as well as the «reactions from below» emanating from campesino communities, landless laborers, brick producers, pastoralists as well as other marginalized groups. The different strategies, forms and practices of resistance with the goal of the «protection of the territory» shall be explored as well as the reasons for their rather scattered occurrence and the lack of alliances on the land issue. This input shall make a contribution to the on-going debate on individual and communal property rights and the question of what is best in terms of collective defense against land grabbing.

An exploratory study of screening practices and barriers for postpartum depression in Texas

Purpose. To evaluate the prevalence of Postpartum Depression (PPD) screening among practicing obstetrician-gynecologists in Texas, and to identify factors and barriers associated with routine depression screening practices.^ Subjects. One hundred and eighty-nine fellows and junior fellows of the Texas Association of Obstetricians & Gynecologists (District XI).^ Methods. A survey questionnaire was developed and sent to 2,028 obstetriciangynecologists, asking about their current screening practices related to PPD. The survey questions were related to the physician's demographics, the patient population, screening practices, barriers to screening, and perceptions about resources in the community. Responses were analyzed to determine associations between these factors and the physician's screening practices. ^ Results. The respondents (n=189) constituted 9.3% of the surveyed population, thus the findings cannot be considered representative of all practicing Ob-Gyns in Texas. However, the following trends were observed. Of the respondents, 85.4% reported routinely screening for PPD, while 14.6% did not. However, of those that screened, only 20.2% used the Edinburgh Postnatal Depression Scale and 7.6% screened with the Postpartum Depression Screening Scale, both validated screening tools. The majority (77.2%) reported using an informal patient interview to screen. For those who did not routinely screen, inadequate training and inadequate resources to screen for PPD were the top two barriers. Physician's age was associated with routine screening practice, as older physicians were less likely to screen routinely. Primary insurance coverage of the patient population was also associated with screening practice; physicians with Medicaid and uninsured patients were less likely to screen routinely. Lastly, physicians that believed that adequate resources existed in their communities for the treatment of PPD were more likely to screen than those that did not.^ Conclusions. The present study is the first attempt at assessing Postpartum Depression screening practices and barriers in Texas. Although the response rate was low, the findings related to informal screening methods and inadequate training indicated that education and training with regards to PPD screening and validated screening tools among Ob-Gyns stand to be improved. Connecting physicians to psychiatric resources may also improve screening rates. This first look at screening practices in Texas serves as a platform for future research in order to gain definitive insight into the diagnosis and treatment of PPD, and ultimately design interventions to improve detection rates and treatment.^

Reestructuración productiva y configuración territorial : Pequeña industria metalmecánica en la Ciudad de Córdoba 2002-2012

El desarrollo de esta investigación se conforma como la búsqueda de vinculaciones territoriales a escala urbana en la Ciudad de Córdoba frente a un proceso de carácter global, como es el de la reestructuración productiva. Este concreto real se aborda desde un caso, el de la pequeña industria metalmecánica, que por presencia histórica y peso en el producto bruto geográfico de la ciudad se constituye en uno de los sostenes de la economía urbana. El abordaje del proceso de reestructuración productiva se realiza desde el análisis de las prácticas de los agentes. Por un lado, las del gobierno como agente que regula las relaciones productivas a través de políticas públicas industriales en el marco de un régimen de acumulación capitalista, y por otro lado, las prácticas de las pequeñas industrias metalmecánicas como agentes que se desenvuelven en el procesos de producción en una dialéctica entre las tendencias de producción de reestructuración de escala global y un entorno inmediato de relaciones productivas con otros agentes, procesos de producción, marco regulatorio y políticas públicas. Esta dialéctica se materializa en el territorio y da lugar a una configuración territorial industrial a escala urbana, que no solo se explica por las prácticas de los agentes industriales sino además por el juego de otros agentes que producen territorio. En el período postconvertibilidad a partir del 2002, el crecimiento de las actividades productivas en su conjunto, imprimen una dinámica compleja de expansión urbana y de relaciones entre agentes de distintos sectores, con distintos intereses y poder de actuar en el campo. Aquí se avanza en comprender las dimensiones de la expansión urbana que inciden en la configuración territorial industrial. La configuración territorial como vínculo indisociable entre las prácticas de agentes (sistema de acciones) y la estructura productiva territorial (sistema de objetos) muta permanentemente en el contexto postconvertibilidad debido al intenso dinamismo que adquiere la actividad industrial, entre habitus construidos históricamente y nuevas prácticas, que se encuentran en tensión permanente. Este concreto real va conformando un campo socio económico que discurre entre viejas y nuevas prácticas y configura un territorio fragmentado y disociado. El trabajo parte de la consideración de las políticas públicas industriales y las prácticas específicas de los agentes de las pequeñas industrias para luego analizar a escala urbana la configuración territorial, en donde las dimensiones de la expansión urbana interactúan con la especificidad de las prácticas de los agentes analizados. El cambio paulatino en las políticas destinadas al sector industrial postconvertibilidad manifiesta una presencia cada vez más relevante de PyMEs. No obstante la inercia heredada del periodo anterior revela, en la gestión de las políticas industriales y las prácticas empresarias, un camino caracterizado por la desconfianza e incertidumbre de las pequeñas empresas

Reestructuración productiva y configuración territorial : Pequeña industria metalmecánica en la Ciudad de Córdoba 2002-2012

El desarrollo de esta investigación se conforma como la búsqueda de vinculaciones territoriales a escala urbana en la Ciudad de Córdoba frente a un proceso de carácter global, como es el de la reestructuración productiva. Este concreto real se aborda desde un caso, el de la pequeña industria metalmecánica, que por presencia histórica y peso en el producto bruto geográfico de la ciudad se constituye en uno de los sostenes de la economía urbana. El abordaje del proceso de reestructuración productiva se realiza desde el análisis de las prácticas de los agentes. Por un lado, las del gobierno como agente que regula las relaciones productivas a través de políticas públicas industriales en el marco de un régimen de acumulación capitalista, y por otro lado, las prácticas de las pequeñas industrias metalmecánicas como agentes que se desenvuelven en el procesos de producción en una dialéctica entre las tendencias de producción de reestructuración de escala global y un entorno inmediato de relaciones productivas con otros agentes, procesos de producción, marco regulatorio y políticas públicas. Esta dialéctica se materializa en el territorio y da lugar a una configuración territorial industrial a escala urbana, que no solo se explica por las prácticas de los agentes industriales sino además por el juego de otros agentes que producen territorio. En el período postconvertibilidad a partir del 2002, el crecimiento de las actividades productivas en su conjunto, imprimen una dinámica compleja de expansión urbana y de relaciones entre agentes de distintos sectores, con distintos intereses y poder de actuar en el campo. Aquí se avanza en comprender las dimensiones de la expansión urbana que inciden en la configuración territorial industrial. La configuración territorial como vínculo indisociable entre las prácticas de agentes (sistema de acciones) y la estructura productiva territorial (sistema de objetos) muta permanentemente en el contexto postconvertibilidad debido al intenso dinamismo que adquiere la actividad industrial, entre habitus construidos históricamente y nuevas prácticas, que se encuentran en tensión permanente. Este concreto real va conformando un campo socio económico que discurre entre viejas y nuevas prácticas y configura un territorio fragmentado y disociado. El trabajo parte de la consideración de las políticas públicas industriales y las prácticas específicas de los agentes de las pequeñas industrias para luego analizar a escala urbana la configuración territorial, en donde las dimensiones de la expansión urbana interactúan con la especificidad de las prácticas de los agentes analizados. El cambio paulatino en las políticas destinadas al sector industrial postconvertibilidad manifiesta una presencia cada vez más relevante de PyMEs. No obstante la inercia heredada del periodo anterior revela, en la gestión de las políticas industriales y las prácticas empresarias, un camino caracterizado por la desconfianza e incertidumbre de las pequeñas empresas

Reestructuración productiva y configuración territorial : Pequeña industria metalmecánica en la Ciudad de Córdoba 2002-2012

El desarrollo de esta investigación se conforma como la búsqueda de vinculaciones territoriales a escala urbana en la Ciudad de Córdoba frente a un proceso de carácter global, como es el de la reestructuración productiva. Este concreto real se aborda desde un caso, el de la pequeña industria metalmecánica, que por presencia histórica y peso en el producto bruto geográfico de la ciudad se constituye en uno de los sostenes de la economía urbana. El abordaje del proceso de reestructuración productiva se realiza desde el análisis de las prácticas de los agentes. Por un lado, las del gobierno como agente que regula las relaciones productivas a través de políticas públicas industriales en el marco de un régimen de acumulación capitalista, y por otro lado, las prácticas de las pequeñas industrias metalmecánicas como agentes que se desenvuelven en el procesos de producción en una dialéctica entre las tendencias de producción de reestructuración de escala global y un entorno inmediato de relaciones productivas con otros agentes, procesos de producción, marco regulatorio y políticas públicas. Esta dialéctica se materializa en el territorio y da lugar a una configuración territorial industrial a escala urbana, que no solo se explica por las prácticas de los agentes industriales sino además por el juego de otros agentes que producen territorio. En el período postconvertibilidad a partir del 2002, el crecimiento de las actividades productivas en su conjunto, imprimen una dinámica compleja de expansión urbana y de relaciones entre agentes de distintos sectores, con distintos intereses y poder de actuar en el campo. Aquí se avanza en comprender las dimensiones de la expansión urbana que inciden en la configuración territorial industrial. La configuración territorial como vínculo indisociable entre las prácticas de agentes (sistema de acciones) y la estructura productiva territorial (sistema de objetos) muta permanentemente en el contexto postconvertibilidad debido al intenso dinamismo que adquiere la actividad industrial, entre habitus construidos históricamente y nuevas prácticas, que se encuentran en tensión permanente. Este concreto real va conformando un campo socio económico que discurre entre viejas y nuevas prácticas y configura un territorio fragmentado y disociado. El trabajo parte de la consideración de las políticas públicas industriales y las prácticas específicas de los agentes de las pequeñas industrias para luego analizar a escala urbana la configuración territorial, en donde las dimensiones de la expansión urbana interactúan con la especificidad de las prácticas de los agentes analizados. El cambio paulatino en las políticas destinadas al sector industrial postconvertibilidad manifiesta una presencia cada vez más relevante de PyMEs. No obstante la inercia heredada del periodo anterior revela, en la gestión de las políticas industriales y las prácticas empresarias, un camino caracterizado por la desconfianza e incertidumbre de las pequeñas empresas

Reestructuración productiva y configuración territorial : Pequeña industria metalmecánica en la Ciudad de Córdoba 2002-2012

El desarrollo de esta investigación se conforma como la búsqueda de vinculaciones territoriales a escala urbana en la Ciudad de Córdoba frente a un proceso de carácter global, como es el de la reestructuración productiva. Este concreto real se aborda desde un caso, el de la pequeña industria metalmecánica, que por presencia histórica y peso en el producto bruto geográfico de la ciudad se constituye en uno de los sostenes de la economía urbana. El abordaje del proceso de reestructuración productiva se realiza desde el análisis de las prácticas de los agentes. Por un lado, las del gobierno como agente que regula las relaciones productivas a través de políticas públicas industriales en el marco de un régimen de acumulación capitalista, y por otro lado, las prácticas de las pequeñas industrias metalmecánicas como agentes que se desenvuelven en el procesos de producción en una dialéctica entre las tendencias de producción de reestructuración de escala global y un entorno inmediato de relaciones productivas con otros agentes, procesos de producción, marco regulatorio y políticas públicas. Esta dialéctica se materializa en el territorio y da lugar a una configuración territorial industrial a escala urbana, que no solo se explica por las prácticas de los agentes industriales sino además por el juego de otros agentes que producen territorio. En el período postconvertibilidad a partir del 2002, el crecimiento de las actividades productivas en su conjunto, imprimen una dinámica compleja de expansión urbana y de relaciones entre agentes de distintos sectores, con distintos intereses y poder de actuar en el campo. Aquí se avanza en comprender las dimensiones de la expansión urbana que inciden en la configuración territorial industrial. La configuración territorial como vínculo indisociable entre las prácticas de agentes (sistema de acciones) y la estructura productiva territorial (sistema de objetos) muta permanentemente en el contexto postconvertibilidad debido al intenso dinamismo que adquiere la actividad industrial, entre habitus construidos históricamente y nuevas prácticas, que se encuentran en tensión permanente. Este concreto real va conformando un campo socio económico que discurre entre viejas y nuevas prácticas y configura un territorio fragmentado y disociado. El trabajo parte de la consideración de las políticas públicas industriales y las prácticas específicas de los agentes de las pequeñas industrias para luego analizar a escala urbana la configuración territorial, en donde las dimensiones de la expansión urbana interactúan con la especificidad de las prácticas de los agentes analizados. El cambio paulatino en las políticas destinadas al sector industrial postconvertibilidad manifiesta una presencia cada vez más relevante de PyMEs. No obstante la inercia heredada del periodo anterior revela, en la gestión de las políticas industriales y las prácticas empresarias, un camino caracterizado por la desconfianza e incertidumbre de las pequeñas empresas

Reverse logistics practices for recovering mobile phones in Spain

The main objective of this article is to characterize the reverse logistics system for mobile phones in Spain. The study includes the characterization of the different actors involved in the reverse logistics system and the description of the most common logistics practices in the sector. We will also opose alternative practices for managing this complex reverse logistics system and finally, we analyse the challenges of the current reverse logistics model. Some alternatives for the current model are location of reception points for end-of-use mobiles, the need to legislate the secondhand mobile phone market, and the location of the necessary recycling centres according to current legislation.

Knowledge pipeline in freight pipeline industry: competence- based model for open innovation

There is growing concern over the challenges for innovation in Freight Pipeline industry. Since the early works of Chesbrough a decade ago, we have learned a lot about the content, context and process of open innovation. However, much more research is needed in Freight Pipeline Industry. The reality is that few corporations have institutionalized open innovation practices in ways that have enabled substantial growth or industry leadership. Based on this, we pursue the following question: How does a firm’s integration into knowledge networks depend on its ability to manage knowledge? A competence-based model for freight pipeline organizations is analysed, this model should be understood by any organization in order to be successful in motivating professionals who carry out innovations and play a main role in collaborative knowledge creation processes. This paper aims to explain how can open innovation achieve its potential in most Freight Pipeline Industries.