La Salud Pública frente a un Estado centralizado : establecimientos y servicios asistenciales en la provincia de Mendoza durante el primer peronismo

La presente investigación analiza la acción del Estado en materia de salud pública durante el primer peronismo e incursiona sobre algunos factores que condicionaron el éxito o fracaso de las políticas a nivel provincial. El trabajo remite además, a través de algunos ejemplos concretos, a unidades territoriales más reducidas como son los municipios, en tanto ámbitos de aplicación de las políticas públicas o bien ejecutores de las mismas. Algunas de las preguntas que se intentaron responder fueron ¿En qué medida los nuevos cambios en la estructura del Estado fueron acompañados de acciones concretas que incidieran en las condiciones de vida de la población? ¿Qué obstáculos limitaron la acción gubernamental? Se incluirá en este análisis la realización de obra pública por parte del Estado, personal a cargo, como así también las inversiones en otros recursos necesarios para una adecuada atención médica.

Un desafío a la justicia social peronista : La hidatidosis en la provincia de Buenos Aires, 1946-1952

Analiza las políticas sanitarias del gobierno de Domingo Alfredo Mercante (1946-1952) -mano derecha de Juan Domingo Perón- en la provincia de Buenos Aires, Argentina, atendiendo a lo que fue una de sus más instigantes líneas de intervención: la erradicación de la hidatidosis. Visibilizando un problema largamente olvidado por la historiografía, especificaremos de qué modo el gobierno mercantiano colocó a la hidatidosis en la agenda estatal a través de una legitimación estadística, socioeconómica y simbólica. Luego, especificaremos las estrategias de esta gestión: sanción de leyes regulatorias contra la endemia, creación de instituciones específicas antihidatídicas estatales, generación de espacios de información y educación interdisciplinaria, interministerial y hasta supranacionales con el fin de alcanzar el mayor conocimiento sobre la enfermedad e intercambiar experiencias que enriquecieran su propia práctica y, finalmente, la definición de acciones enfocadas en el relevo, tratamiento y profilaxis de animales y personas

La Salud Pública frente a un Estado centralizado : establecimientos y servicios asistenciales en la provincia de Mendoza durante el primer peronismo

La presente investigación analiza la acción del Estado en materia de salud pública durante el primer peronismo e incursiona sobre algunos factores que condicionaron el éxito o fracaso de las políticas a nivel provincial. El trabajo remite además, a través de algunos ejemplos concretos, a unidades territoriales más reducidas como son los municipios, en tanto ámbitos de aplicación de las políticas públicas o bien ejecutores de las mismas. Algunas de las preguntas que se intentaron responder fueron ¿En qué medida los nuevos cambios en la estructura del Estado fueron acompañados de acciones concretas que incidieran en las condiciones de vida de la población? ¿Qué obstáculos limitaron la acción gubernamental? Se incluirá en este análisis la realización de obra pública por parte del Estado, personal a cargo, como así también las inversiones en otros recursos necesarios para una adecuada atención médica.

Un desafío a la justicia social peronista : La hidatidosis en la provincia de Buenos Aires, 1946-1952

Analiza las políticas sanitarias del gobierno de Domingo Alfredo Mercante (1946-1952) -mano derecha de Juan Domingo Perón- en la provincia de Buenos Aires, Argentina, atendiendo a lo que fue una de sus más instigantes líneas de intervención: la erradicación de la hidatidosis. Visibilizando un problema largamente olvidado por la historiografía, especificaremos de qué modo el gobierno mercantiano colocó a la hidatidosis en la agenda estatal a través de una legitimación estadística, socioeconómica y simbólica. Luego, especificaremos las estrategias de esta gestión: sanción de leyes regulatorias contra la endemia, creación de instituciones específicas antihidatídicas estatales, generación de espacios de información y educación interdisciplinaria, interministerial y hasta supranacionales con el fin de alcanzar el mayor conocimiento sobre la enfermedad e intercambiar experiencias que enriquecieran su propia práctica y, finalmente, la definición de acciones enfocadas en el relevo, tratamiento y profilaxis de animales y personas

The European Union Foreign Policy in the Caucasus and Central Asia: The Limitations of the Opening towards the East

This article intends to study the evolution of the European Union foreign policy in the Southern Caucasus and Central Area throughout the Post-Cold War era. The aim is to analyze Brussels’ fundamental interests and limitations in the area, the strategies it has implemented in the last few years, and the extent to which the EU has been able to undermine the regional hegemons’ traditional supremacy. As will be highlighted, the Community’s chronic weaknesses, the local determination to preserve sovereignty and an increasing international geopolitical competition undermine any European aspiration to become a pre-eminent actor at the heart of the Eurasian continent in the near future.

Tourism in Albarracín and Region. Local Public Action and dynamics in recent key sustainable tourism development

Spanish tourist destinations in rural areas have been established over more than two decades of implementation of various public policy instruments (mainly tourism and rural development policies). These convey complementary objectives in theory but provoke distant results in practice. The intervention of these instruments produces in the region of Sierra de Albarracín (Teruel) two types of destination whose sustainability is committed: the historical urban site of Albarracín as a consolidated cultural tourism destination based on heritage and the Sierra as a generic and incipient destination of rural tourism. It is discussed how the deployment of the local public action causes a fragmented territory in two models of management and tourism development. Cooperation is presented as a key element for the necessary rethinking of tourism development in the region.

Responsibility and Well-Being: Resource Integration Under Responsibilization in Expert Services

Responsibilization, or the shift of functions and risks from providers and producers to consumers, has become an increasingly common policy in service systems and marketplaces (e.g., financial, health, governmental). As responsibilization is often considered synonymous with consumer agency and well-being, the authors take a transformative service research perspective and draw on resource integration literature to investigate whether responsibilization is truly associated with well-being. The authors focus on expert services, for which responsibilization concerns are particularly salient, and question whether this expanding policy is in the public interest. In the process, they develop a conceptualization of resource integration under responsibilization that includes three levels of actors (consumer, provider, and service system), the identification of structural tensions to resource integration, and three categories of resource integration practices (access, appropriation, and management) necessary to negotiate responsibilization. The findings have important implications for health care providers, public and institutional policy makers, and other service systems, all of which must pay more active attention to the challenges consumers face in negotiating responsibilization and the resulting well-being outcomes.

Responsibility and Well-being: Resource Integration under Responsibilization in Expert Services

Responsibilization, or the shift in functions and risks from providers and producers to the consumer, has become an increasingly common policy in service systems and marketplaces (e.g., financial, health, governmental). Responsibilization is often presented as synonymous with consumer agency and well-being. We take a transformative service research perspective and utilize the resource integration framework to investigate whether responsibilization is truly associated with well-being. We focus on expert services, where responsibilization concerns are particularly salient, and question whether this expanding policy is in the public interest. In the process, we develop a conceptualization of resource integration under responsibilization that includes three levels of actors (consumer, provider and service system), the identification of structural tensions to resource integration and three categories of resource integration practices (access, appropriation and management) necessary to negotiate responsibilization. Our findings have important implications for health care providers, public policy makers, and other service systems, all of which must pay more active attention to the challenges consumers face in negotiating responsibilization and the resulting well-being outcomes.

Does the European Union have a reverse gear? Policy dismantling in a hyperconsensual polity

The financial crisis has triggered demands to halt and even reverse the expansion of European Union (EU) policies. But have these and previous demands actually resulted in policy dismantling? The existing literature has charted the rise of dismantling discourses such as subsidiarity and better regulation, but has not examined the net effect on the acquis. For the first time, this contribution addresses this gap in the literature through an empirical study of policy change between 1992 and 2014. It is guided by a coding framework which captures the direction of policy change. It reveals that, despite its disposition towards consensualism, the EU has become a new locus of policy dismantling. However, not all policies targeted have been cut; many have stayed the same and some have even expanded. It concludes by identifying new directions for research on a topic that has continually fallen into the analytical blind spot of EU scholars.

La Salud Pública frente a un Estado centralizado : establecimientos y servicios asistenciales en la provincia de Mendoza durante el primer peronismo

La presente investigación analiza la acción del Estado en materia de salud pública durante el primer peronismo e incursiona sobre algunos factores que condicionaron el éxito o fracaso de las políticas a nivel provincial. El trabajo remite además, a través de algunos ejemplos concretos, a unidades territoriales más reducidas como son los municipios, en tanto ámbitos de aplicación de las políticas públicas o bien ejecutores de las mismas. Algunas de las preguntas que se intentaron responder fueron ¿En qué medida los nuevos cambios en la estructura del Estado fueron acompañados de acciones concretas que incidieran en las condiciones de vida de la población? ¿Qué obstáculos limitaron la acción gubernamental? Se incluirá en este análisis la realización de obra pública por parte del Estado, personal a cargo, como así también las inversiones en otros recursos necesarios para una adecuada atención médica.

Health Survey Northern Ireland First Results 2014/15

Statistics and research for the Department of Health, Social Services and Public Safety is provided by Information Analysis Directorate (IAD). This report presents results from the 2014/15 Health Survey Northern Ireland. It includes information on general health, mental health and wellbeing, diet and nutrition, breastfeeding, oral health, medicines, obesity, smoking, and sexual health. Only differences that are statistically significant at the 95% confidence level are reported. The fieldwork for this survey was conducted between April 2014 and March 2015. Results are based on responses from 4,144 individuals, with a response rate of 64% achieved.

Power relations and good governance: a social network analysis of the evolution of the integrity in public office act in the Commonwealth of Dominica

La Banque mondiale propose la bonne gouvernance comme la stratégie visant à corriger les maux de la mauvaise gouvernance et de faciliter le développement dans les pays en développement (Carayannis, Pirzadeh, Popescu & 2012; & Hilyard Wilks 1998; Leftwich 1993; Banque mondiale, 1989). Dans cette perspective, la réforme institutionnelle et une arène de la politique publique plus inclusive sont deux stratégies critiques qui visent à établir la bonne gouvernance, selon la Banque et d’autres institutions de Bretton Woods. Le problème, c’est que beaucoup de ces pays en voie de développement ne possèdent pas l’architecture institutionnelle préalable à ces nouvelles mesures. Cette thèse étudie et explique comment un état en voie de développement, le Commonwealth de la Dominique, s’est lancé dans un projet de loi visant l’intégrité dans la fonction publique. Cette loi, la Loi sur l’intégrité dans la fonction publique (IPO) a été adoptée en 2003 et mis en œuvre en 2008. Cette thèse analyse les relations de pouvoir entre les acteurs dominants autour de évolution de la loi et donc, elle emploie une combinaison de technique de l’analyse des réseaux sociaux et de la recherche qualitative pour répondre à la question principale: Pourquoi l’État a-t-il développé et mis en œuvre la conception actuelle de la IPO (2003)? Cette question est d’autant plus significative quand nous considérons que contrairement à la recherche existante sur le sujet, l’IPO dominiquaise diverge considérablement dans la structure du l’IPO type idéal. Nous affirmons que les acteurs "rationnels," conscients de leur position structurelle dans un réseau d’acteurs, ont utilisé leurs ressources de pouvoir pour façonner l’institution afin qu’elle serve leurs intérêts et ceux et leurs alliés. De plus, nous émettons l’hypothèse que: d’abord, le choix d’une agence spécialisée contre la corruption et la conception ultérieure de cette institution reflètent les préférences des acteurs dominants qui ont participé à la création de ladite institution et la seconde, notre hypothèse rivale, les caractéristiques des modèles alternatifs d’institutions de l’intégrité publique sont celles des acteurs non dominants. Nos résultats sont mitigés. Le jeu de pouvoir a été limité à un petit groupe d’acteurs dominants qui ont cherché à utiliser la création de la loi pour assurer leur légitimité et la survie politique. Sans surprise, aucun acteur n’a avancé un modèle alternatif. Nous avons conclu donc que la loi est la conséquence d’un jeu de pouvoir partisan. Cette recherche répond à la pénurie de recherche sur la conception des institutions de l’intégrité publique, qui semblent privilégier en grande partie un biais organisationnel et structurel. De plus, en étudiant le sujet du point de vue des relations de pouvoir (le pouvoir, lui-même, vu sous l’angle actanciel et structurel), la thèse apporte de la rigueur conceptuelle, méthodologique, et analytique au discours sur la création de ces institutions par l’étude de leur genèse des perspectives tant actancielles que structurelles. En outre, les résultats renforcent notre capacité de prédire quand et avec quelle intensité un acteur déploierait ses ressources de pouvoir.

Avaliação da política de segurança alimentar implementada através dos restaurantes populares do Rio Grande do Norte

This survey has to general objective to evaluate the Food Safety Policy implemented by Restaurantes Populares do Rio Grande do Norte. The survey is qualitative of type exploratory and descriptive. The universe of survey is all Units of Food and Nutrition (UAN) of the Restaurantes Populares do Rio Grande do Norte. To collects of data were used two instruments: interview and form. The interviews were intended to analyze the four axes of the Food Safety: access, food quality, production and marketing of food and organizational arrangement. The form was used to check the quality of nutrition and sanitary-hygienic food served. We used two types of forms: a spreadsheet with the weekly menu and the portions served to verify that the meals serve the nutritional needs proposed by the program; and the check-list of ANVISA to verify the sanitary-hygienic conditions in each unit. Through the survey data and analyses made observe that the access category have some problems such as lack of registration, lack of advertising of Restaurants and wastage of public resources, making policy that should be of included in a policy of exclusion. In the nutritional aspect there is neglect on the daily nutritional goal, because it is not accomplished nutritional analysis of menu offered, the nutritionists do not know what should be the nutritional value of meals served; in the hygienic-health aspect trough the problems identified is concludes that there is no guarantee of food quality hygienic-sanitary, committing the program as a Food Safety Program. About the production and marketing of food is observed some problems as: the goal of sale of meals is not achieved in full, the purchase of genres does not stimulate the local economy, nor generates jobs and income, and inefficient performance of the MEIOS's supervision. In the analysis of organizational arrangement is concluded that the partnerships are beneficial, despite some negative points, therefore, are these partnerships the problems of non-compliance, as both the MEIOS and Nutriti of important criteria established in the partnership. Therefore, it is understood that the Programa Restaurantes Populares in its original formulation is proposed to be a food safety policy, but has some problems that impossible to meet its goal, making it unprofitable like Food Safety Policy

Resident perceptions of natural resources between cities and across scales in the Pacific Northwest

As the global population becomes increasingly urban, research is needed to explore how local culture, land use, and policy will influence urban natural resource management. We used a broad-scale comparative approach and survey of residents within the Portland (Oregon)-Vancouver (Washington) metropolitan areas, USA, two states with similar geographical and ecological characteristics, but different approaches to land-use planning, to explore resident perceptions about natural resources at three scales of analysis: property level (“at or near my house”), neighborhood (“within a 20-minute walk from my house”), and metro level (“across the metro area”). At the metro-level scale, nonmetric multidimensional scaling revealed that the two cities were quite similar. However, affinity for particular landscape characteristics existed within each city with the greatest difference generally at the property-level scale. Portland respondents expressed affinity for large mature trees, tree-lined streets, public transportation, and proximity to stores and services. Vancouver respondents expressed affinity for plentiful accessible parking. We suggest three explanations that likely are not mutually exclusive. First, respondents are segmented based on preferences for particular amenities, such as convenience versus commuter needs. Second, historical land-use and tax policy legacies may influence individual decisions. Third, more environmentally attuned worldviews may influence an individual’s desire to produce environmentally friendly outcomes. Our findings highlight the importance of acknowledging variations in residents’ affinities for landscape characteristics across different scales and locations because these differences may influence future land-use policies about urban natural resources.

Evaluating a School Community Linked Physical Activity Intervention Programme: a Multi-level Analysis.

Previous research has highlighted the importance of positive physical activity (PA) behaviors during childhood to promote sustained active lifestyles throughout the lifespan (Telama et al. 2005; 2014). It is in this context that the role of schools and teachers in facilitating PA education is promoted. Research suggests that teachers play an important role in the attitudes of children towards PA (Figley 1985) and schools may be an efficient vehicle for PA provision and promotion (McGinnis, Kanner and DeGraw, 1991; Wechsler, Deveraux, Davis and Collins, 2000). Yet despite consensus that schools represent an ideal setting from which to ‘reach’ young people (Department of Health and Human Services, UK, 2012) there remains conceptual (e.g. multi-component intervention) and methodological (e.g. duration, intensity, family involvement) ambiguity regarding the mechanisms of change claimed by PA intervention programmes. This may, in part, contribute to research findings that suggest that PA interventions have had limited impact on children’s overall activity levels and thereby limited impact in reducing children’s metabolic health (Metcalf, Henley & Wilkin, 2012). A marked criticism of the health promotion field has been the focus on behavioural change while failing to acknowledge the impact of context in influencing health outcomes (Golden & Earp, 2011). For years, the trans-theoretical model of behaviour change has been ‘the dominant model for health behaviour change’ (Armitage, 2009); this model focusses primarily on the individual and the psychology of the change process. Arguably, this model is limited by the individual’s decision-making ability and degree of self-efficacy in order to achieve sustained behavioural change and does not take account of external factors that may hinder their ability to realise change. Similar to the trans-theoretical model, socio-ecological models identify the individual at the focal point of change but also emphasises the importance of connecting multiple impacting variables, in particular, the connections between the social environment, the physical environment and public policy in facilitating behavioural change (REF). In this research, a social-ecological framework was used to connect the ways a PA intervention programme had an impact (or not) on participants, and to make explicit the foundational features of the programme that facilitated positive change. In this study, we examined the evaluation of a multi-agency approach to a PA intervention programme which aimed to increase physical activity, and awareness of the importance of physical activity to key stage 2 (age 7-12) pupils in three UK primary schools. The agencies involved were the local health authority, a community based charitable organisation, a local health administrative agency, and the city school district. In examining the impact of the intervention, we adopted a process evaluation model in order to better understand the mechanisms and context that facilitated change. Therefore, the aim of this evaluation was to describe the provision, process and impact of the intervention by 1) assessing changes in physical activity levels 2) assessing changes in the student’s attitudes towards physical activity, 3) examining student’s perceptions of the child size fitness equipment in school and their likelihood of using the equipment outside of school and 4) exploring staff perceptions, specifically the challenges and benefits, of facilitating equipment based exercise sessions in the school environment. Methodology, Methods, Research Instruments or Sources Used Evaluation of the intervention was designed as a matched-control study and was undertaken over a seven-month period. The school-based intervention involved 3 intervention schools (n =436; 224 boys) and one control school (n=123; 70 boys) in a low socioeconomic and multicultural urban setting. The PA intervention was separated into two phases: a motivation DVD and 10 days of circuit based exercise sessions (Phase 1) followed by a maintenance phase (Phase 2) that incorporated a PA reward program and the use of specialist kid’s gym equipment located at each school for a period of 4 wk. Outcome measures were measured at baseline (January) and endpoint (July; end of academic school year) using reliable and valid self-report measures. The children’s attitudes towards PA were assessed using the Children’s Attitudes towards Physical Activity (CATPA) questionnaire. The Physical Activity Questionnaire for Children (PAQ-C), a 7-day recall questionnaire, was used to assess PA levels over a school week. A standardised test battery (Fitnessgram®) was used to assess cardiovascular fitness, body composition, muscular strength and endurance, and flexibility. After the 4 wk period, similar kid’s equipment was available for general access at local community facilities. The control school did not receive any of the interventions. All physical fitness tests and PA questionnaires were administered and collected prior to the start of the intervention (January) and following the intervention period (July) by an independent evaluation team. Evaluation testing took place at the individual schools over 2-3 consecutive days (depending on the number of children to be tested at the school). Staff (n=19) and student perceptions (n = 436) of the child sized fitness equipment were assessed via questionnaires post-intervention. Students completed a questionnaire to assess enjoyment, usage, ease of use and equipment assess and usage in the community. A questionnaire assessed staff perceptions on the delivery of the exercise sessions, classroom engagement and student perceptions. Conclusions, Expected Outcomes or Findings Findings showed that both the intervention (16.4%) and control groups increased their PAQ-C score by post-intervention (p < 0.05); with the intervention (17.8%) and control (21.3%) boys showing the greatest increase in physical activity levels. At post-intervention, there was a 5.5% decline in the intervention girls’ attitudes toward PA in the aesthetic subdomains (p = 0.009); whereas the control boys had an increase in positive attitudes in the health domain (p = 0.003). No significant differences in attitudes towards physical activity were observed in any other domain for either group at post-intervention (p > 0.05). The results of the equipment questionnaire, 96% of the children stated they enjoyed using the equipment and would like to use the equipment again in the future; however at post-intervention only 27% reported using the equipment outside of school in the last 7 days. Students identified the ski walker (34%) and cycle (32%) as their favorite pieces of equipment; with the single joint exercises such as leg extension and bicep/tricep machine (<3%) as their least favorite. Key themes from staff were that the equipment sessions were enjoyable, a novel activity, children felt very grown-up, and the activity was linked to a real fitness experience. They also expressed the need for more support to deliver the sessions and more time required for each session. Findings from this study suggest that a more integrated approach within the various agencies is required, particularly more support to increase teachers pedagogical content knowledge in physical activity instruction which is age appropriate. Future recommendations for successful implementation include sufficient time period for all students to access and engage with the equipment; increased access and marketing of facilities to parents within the local community, and professional teacher support strategies to facilitate the exercise sessions.