Complementary and conventional medicine in Switzerland: comparing characteristics of general practitioners

OBJECTIVES: Do structural characteristics of general practitioners (GPs) who practice complementary medicine (CAM) differ from those GPs who do not? Assessed characteristics included experience and professional integration of general practitioners (GPs), workload, medical activities, and personal and technical resources of practices. The investigated CAM disciplines were anthroposophic medicine, homoeopathy, traditional Chinese medicine, neural therapy and herbal medicine. MATERIAL AND METHODS: We designed a cross-sectional study with convenience and stratified samples of GPs providing conventional (COM) and/or complementary primary care in Switzerland. The samples were taken from the database of the Swiss medical association (FMH) and from CAM societies. Data were collected using a postal questionnaire. RESULTS: Of the 650 practitioners who were included in the study, 191 were COM, 167 noncertified CAM and 292 certified CAM physicians. The proportion of females was higher in the population of CAM physicians. Gender-adjusted age did not differ between CAM and COM physicians. Nearly twice as many CAM physicians work part-time. Differences were also seen for the majority of structural characteristics such as qualification of physicians, type of practice, type of staff, and presence of technical equipment. CONCLUSION: The study results show that structural characteristics of primary health care do differ between CAM and COM practitioners. We assumed that the activities of GPs are defined essentially by analyzed structures. The results are to be considered for evaluations in primary health care, particularly when quality of health care is assessed.

Buffer capacity: capturing a dimension of resilience to climate change in African smallholder agriculture

Building resilience to climate change in agricultural production can ensure the functioning of agricultural-based livelihoods and reduce their vulnerability to climate change impacts. This paper thus explores how buffer capacity, a characteristic feature of resilience, can be conceptualised and used for assessing the resilience of smallholder agriculture to climate change. It uses the case of conservation agriculture farmers in a Kenyan region and examines how their practices contribute to buffer capacity. Surveys were used to collect data from 41 purposely selected conservation agriculture farmers in the Laikipia region of Kenya. Besides descriptive statistics, factor analysis was used to identify the key dimensions that characterise buffer capacity in the study context. The cluster of practices characterising buffer capacity in conservation agriculture include soil protection, adapted crops, intensification/irrigation, mechanisation and livelihood diversification. Various conservation practices increase buffer capacity, evaluated by farmers in economic, social, ecological and other dimensions. Through conservation agriculture, most farmers improved their productivity and incomes despite drought, improved their environment and social relations. Better-off farmers also reduced their need for labour, but this resulted in lesser income-earning opportunities for the poorer farmers, thus reducing the buffer capacity and resilience of the latter.

Recovery of large carnivores in Europe's modern human-dominated landscapes.

The conservation of large carnivores is a formidable challenge for biodiversity conservation. Using a data set on the past and current status of brown bears (Ursus arctos), Eurasian lynx (Lynx lynx), gray wolves (Canis lupus), and wolverines (Gulo gulo) in European countries, we show that roughly one-third of mainland Europe hosts at least one large carnivore species, with stable or increasing abundance in most cases in 21st-century records. The reasons for this overall conservation success include protective legislation, supportive public opinion, and a variety of practices making coexistence between large carnivores and people possible. The European situation reveals that large carnivores and people can share the same landscape.

Spaces of the Past, Histories of the Present: An Interview with Stuart Elden and Derek Gregory

The ontologies of space and territory, our experience of them and the techniques we use to govern them, the very conception of the socio-spatial formations that we inhabit, are all historically specific: they depend on a genealogy of practices, knowledges, discourses, regulations, performances and representations articulated in a way that is extremely complex yet nevertheless legible over time. In this interview we look at the logic and the patterns that intertwine space and time — both as objects and tools of inquiry — though a cross-disciplinary dialogue. The discussion with Stuart Elden and Derek Gregory covers the place of history in socio-spatial theory and in their own work, old and new ways of thinking about the intersection between history and territory, space and time, the implications of geography and history for thinking about contemporary politics, and the challenges now faced by critical thought and academic work in the current neo-liberal attack on public universities and the welfare state

Understanding the Leadership Capacity and Practice of Assistant Principals

The purpose of this study was to explore the leadership capacities and practices of assistant principals. The research also sought to determine what relationships existed between capacity and practice and to see if there was a difference based on experience, context and personal characteristics. Since the majority of principals first serve as assistant principals, their work and experiences as assistant principals will have significant consequences (Kwan, 2009). The literature has long held and continues to challenge the notion that the role of assistant principal is adequate preparation for the principalship (Chan, Webb, & Bowen, 2003; Harris, Muijs, & Crawford, 2003; Kwan, 2009; Mertz, 2000; Webb & Vulliamy, 1995). Based on empirical findings, this study has affirmed the need to further research and refine the role of the assistant principal. The results indicate that in addition to strengths, there are explicit gaps and missed opportunities in the leadership practices of assistant principals that impact the potential for building a leadership pipeline within schools. The work of the assistant principal is characterized by a proliferation of duties rather than a strategic set of practices that support distributed leadership and sustainability.

A Meta-Analytic Review of Mindfulness-Based Interventions on Symptom Reduction: A Critique and Guide for Future Investigation.

Over the past decade, mindfulness practices have been used with increasing frequency as therapeutic components within cognitive behavioral treatment regimens. As is standard practice, prescriptive uses of mindfulness intervention are incorporated to improve end-state functioning by ameliorating problematic symptoms and conditions. Common change-targets include the control of cognitive and emotional content for purposes of enhancing psychological self-regulation and physical well-being. The term mindfulness applies to a heterogeneous range of practices, methods, and techniques. While there is no singular agreed upon definition for mindfulness, as a process concept, the term connotes an immediate, non-thetic access to events, wherein each occasioning event is experienced in toto within the broader contextual event-field, and distinct from intervening conceptual themes being noticed. Training in mindfulness practices may be conducted using individual, group, or small class formats. The current paper provides a meta-analytic review of 44 treatment outcome studies (extracted 1982 through 2006), which examines the clinical utility of mindfulness as the primary therapeutic approach. Results indicated that average effect sizes for mindfulness based interventions fell within the medium range for construct category variables examined (d = .56). These findings suggest that mindfulness training is a cost-effective treatment for a wide array of contemporary psychological problems and diagnoses, in addition to fostering positive psychology attributes such as quality and satisfaction with life. A critique of the research and recommendations for future research, including a need to examine the role of mindfulness as a tool for cultivating increased psychological acceptance and life satisfaction, is presented.

Governmentality and 'fearless speech': framing the education of asylum seeker and refugee children in Australia

This paper considers the educational provision for, and general treatment of, refugee and asylum seeker children in Australia, using a framework of governmentality. The paper describes the regimes of practices which govern refugees and asylum seekers in Australia, including mandatory detention and a complex set of visa categorisations, and considers their consequences for the educational provision for children. It addresses three questions: How is it possible that the rights of children have been rendered invisible in and by a democratic state? How are repressive and even violent practices normalised in a liberal state, so that ordinary citizens show so little concern about them? And what should our response be as educators and intellectuals? In conclusion, it explores Foucault's notions of ethics and fearless speech (parrhesia) as a basis for an ethics of engagement in education.

Being fit and looking healthy: Young women's and men's constructions of health and fitness

We drew on Foucault's notion of 'practices of the self' to examine how young people take up, negotiate, and resist the imperatives of a public health discourse concerned with the relationships between health, fitness, and the body. We did this through a discussion of the ways young women and men talk about their own and others' bodies, in the context of a number of in-depth interviews conducted for the Life Activity Project, a study of the place and meaning of physical activity in young people's lives, funded by an Australian Research Council Grant. We found that the young women and men in the study engaged the health/fitness discourse very differently: for the young men, health conflated with fitness as an embodied capacity to do physical work; and for the young women, health was a much more difficult and complex project associated with managing and monitoring practices associated with eating and exercise to maintain an 'appropriate' body shape.

Career management practices in India:an empirical study

This paper examines and discusses the developments in the field of career management, bringing in the international perspective. In particular, the paper explores career management practices in 108 Indian organizations. A factor analysis procedure suggested five groups of practices: formal planning, formal active management, developmental, career stages and assessment. These are found to be associated with certain organizational and cultural characteristics. The research has both theoretical and practical implications.

Its in her eyes? A barometer for EU accession through female perceptions of role portrayals in advertising:a cross-cultural study of Ukraine and Turkey?

This article examines female response to gender role portrayals in advertising for Ukraine and Turkey. Being both new potential EU candidates, we argue that gender stereotype could also be used as a \u2018barometer\u2019 of progress and closure towards a more generally accepted EU behaviour against women. While their history remains different, both from a political and society values point of views, constraints are currently being faced that require convergence or justification of practices and understanding. Principal components analysis is employed over 290 questionnaires to identify the underlying dimensions. Results indicate overall similarities in perceptions, fragmentation within groups, but seem to provide divergence regarding thresholds.

Bilingualism and educational achievement:a study of young bilinguals in Birmingham schools and colleges

This study aimed firstly to investigate current patterns of language use amongst young bilinguals in Birmingham and secondly to examine the relationship between this language use and educational achievement. The research then focussed on various practices, customs and attitudes which would favour the attrition or survival of minority languages in the British situation. The data necessary to address this question was provided by a sample of three hundred and seventy-four 16-19 year olds, studying in Birmingham schools and colleges during the period 1987-1990 and drawn from the main linguistic minority communities in Birmingham. The research methods chosen were both quantitative and qualitative. The study found evidence of ethnolinguistic vitality amongst many of the linguistic minority communities in Birmingham: a number of practices and a range of attitudes indicate that linguistic diversity may continue and that a stable diglossic situation may develop in some instances, particularly where demographical and religious factors lead to closeness of association. Where language attrition is occurring it is often because of the move from a less prestigious minority language or dialect to a more prestigious minority language in addition to pressures from English. The educational experience of the sample indicates that literacy and formal language study are of key importance if personal bilingualism is to be experienced as an asset; high levels of oral proficiency in the L1 and L2 do not, on their own, necessarily correlate with positive educational benefit. The intervening variable associated with educational achievement appears to be the formal language learning process and literacy. A number of attitudes and practices, including the very close associations maintained with some of the countries of origin of the families, were seen to aid or hinder first language maintenance and second language acquisition.

Control of antibiotic prescribing in UK NHS hosptials. Available in 2 volumes.

This thesis is an evaluation of practices to control antibiotic prescribing in UK NHS hospitals. Within the past ten years there has been increasing international concern about escalating antibiotic resistance, and the UK has issued several policy documents for pmdent antibiotic prescribing. Chief Pharmacists in 253 UK NHS hospitals were surveyed about the availability and nature of documents to control antibiotic prescribing (formularies, policies and guidelines), and the role of pharmacists and medical microbiologists in monitoring prescribers' compliance with the recommendations of such documents. Although 235 hospitals had at least one document, only 60% had both an antibiotic formulary and guidelines, and only about one-half planned an annual revision of document(s). Pharmacists were reported as mostly checking antibiotic prescribing on every ward whilst medical microbiologists mostly visited selected units only. Response to a similar questionnaire was obtained from the Chief Medical Microbiologists in 131 UK NHS hospitals. Comparisons of the questionnaires indicated areas of apparent disagreement about the roles of pharmacists and medical microbiologists. Eighty three paired-responses received from pharmacists and medical microbiologists in the same hospital revealed poor agreement and awareness about controls. A total of 205 institutional prescribing guidelines were analysed for recommendations for the empirical antibiotic prescribing of Community-Acquired Pneumonia (CAP). Variation was observed in recommendations and agreement with national guidance from the British Thoracic Society (BTS). A questionnaire was subsequently sent to 235 Chief Pharmacists to investigate their awareness of this new guidance from the BTS, and subsequent revision of institutional guidelines. Documents had been revised in only about one-half of hospitals where pharmacists were aware of the new guidance. An audit of empirical antibiotic prescribing practices for CAP was performed at one hospital. Although problems were experienced with retrieval of medical records, diagnostic criteria were poorly recorded, and only 57% of prescribing for non-severe CAP was compliant with institutional guidelines. A survey of clinicians at the same hospital identified that almost one-half used the institutional guidelines and most found them useful. However, areas for improvement concernmg awareness of the guidelines and ease of access were identified. It is important that hospitals are equipped to react to changes in the hospital environment including frequent movement of junior doctors between institutions, the employment of specialist "infectious diseases pharmacists" and the increasing benefits offered by information technology. Recommendations for policy have been suggested.

Mathematical modelling of patient risks in a hospital environment, using multiple regression analysis

The aim of this research work was primarily to examine the relevance of patient parameters, ward structures, procedures and practices, in respect of the potential hazards of wound cross-infection and nasal colonisation with multiple resistant strains of Staphylococcus aureus, which it is thought might provide a useful indication of a patient's general susceptibility to wound infection. Information from a large cross-sectional survey involving 12,000 patients from some 41 hospitals and 375 wards was collected over a five-year period from 1967-72, and its validity checked before any subsequent analysis was carried out. Many environmental factors and procedures which had previously been thought (but never conclusively proved) to have an influence on wound infection or nasal colonisation rates, were assessed, and subsequently dismissed as not being significant, provided that the standard of the current range of practices and procedures is maintained and not allowed to deteriorate. Retrospective analysis revealed that the probability of wound infection was influenced by the patient's age, duration of pre-operative hospitalisation, sex, type of wound, presence and type of drain, number of patients in ward, and other special risk factors, whilst nasal colonisation was found to be influenced by the patient's age, total duration of hospitalisation, sex, antibiotics, proportion of occupied beds in the ward, average distance between bed centres and special risk factors. A multi-variate regression analysis technique was used to develop statistical models, consisting of variable patient and environmental factors which were found to have a significant influence on the risks pertaining to wound infection and nasal colonisation. A relationship between wound infection and nasal colonisation was then established and this led to the development of a more advanced model for predicting wound infections, taking advantage of the additional knowledge of the patient's state of nasal colonisation prior to operation.

Theorizing accounting and other [calculative] practices in private equity:Experimenting with Schatzki’s ‘site’ ontology

This thesis contributes to social studies of finance and accounting (Vollmer, Mennicken, & Preda, 2009) and the practice theory literatures (Feldman & Orlikowski, 2011) by experimenting (Baxter & Chua, 2008) with concepts developed by Theodore Schatzki and demonstrating their relevance and usefulness in theorizing and explaining accounting and other organizational phenomena. Influenced by Schatzki, I have undertaken a sociological investigation of the practices, arrangements, and nexuses forming (part of) the social ‘site’ of private equity (PE). I have examined and explained the organization of practices within the PE industry. More specifically, I have sought to throw light on the practice organizations animating various PE practices. I have problematized a particular aspect of Schatzki’s practice organization framework: ‘general understanding’, which has so far been poorly understood and taken for granted in the accounting literature. I have tried to further explore the concept to clarify important definitional issues surrounding its empirical application. In investigating the forms of accounting and control practices in PE firms and how they link with other practices forming part of the ‘site’, I have sought to explain how the ‘situated functionality’ of accounting is ‘prefigured’ by its ‘dispersed’ nature. In doing so, this thesis addresses the recent calls for research on accounting and control practices within financial services firms. This thesis contributes to the social studies of finance and accounting literature also by opening the blackbox of investment [e]valuation practices prevalent in the PE industry. I theorize the due diligence of PE funds as a complex of linked calculative practices and bring to fore the important aspects of ‘practical intelligibility’ of the investment professionals undertaking investment evaluation. I also identify and differentiate the ‘causal’ and ‘prefigurational’ relations between investment evaluation practices and the material entities ‘constituting’ those practices. Moreover, I demonstrate the role of practice memory in those practices. Finally, the thesis also contributes to the practice theory literature by identifying and attempting to clarify and/or improve the poorly defined and/or underdeveloped concepts of Schatzki’s ‘site’ ontology framework.