Inventory and perspectives of chronic disease management programs in Switzerland: an exploratory survey.

OBJECTIVE: To describe chronic disease management programs active in Switzerland in 2007, using an exploratory survey. METHODS: We searched the internet (Swiss official websites and Swiss web-pages, using Google), a medical electronic database (Medline), reference lists of pertinent articles, and contacted key informants. Programs met our operational definition of chronic disease management if their interventions targeted a chronic disease, included a multidisciplinary team (>/=2 healthcare professionals), lasted at least six months, and had already been implemented and were active in December 2007. We developed an extraction grid and collected data pertaining to eight domains (patient population, intervention recipient, intervention content, delivery personnel, method of communication, intensity and complexity, environment, clinical outcomes). RESULTS: We identified seven programs fulfilling our operational definition of chronic disease management. Programs targeted patients with diabetes, hypertension, heart failure, obesity, psychosis and breast cancer. Interventions were multifaceted; all included education and half considered planned follow-ups. The recipients of the interventions were patients, and healthcare professionals involved were physicians, nurses, social workers, psychologists and case managers of various backgrounds. CONCLUSIONS: In Switzerland, a country with universal healthcare insurance coverage and little incentive to develop new healthcare strategies, chronic disease management programs are scarce. For future developments, appropriate evaluations of existing programs, involvement of all healthcare stakeholders, strong leadership and political will are, at least, desirable.

Sumak Kawsay, or the concept of living well, and perceptions about natural, urban and rural areas: the case of Cuenca (Ecuador)

This research explores critical environmental concepts from the standpoint of political ecology. It contrasts the Ecuadorian Kichua indigenous concept of Sumak Kawsay (i.e., living well), with discourses about natural, urban and rural areas. Sumak Kawsay was included in Ecuador’s 2008 constitution as an alternative to the neoclassical idea of development. This work reveals interesting insights from a variety of social and political viewpoints from both rural and urban areas. The research is based on the medium sized city of Cuenca, which is located in the southern Ecuadorian Andes. We used an adaptation of the Q Method to investigate stakeholders’ perceptions. Four remarkably well-defined viewpoints were revealed. Although these views contrast strongly with Sumak Kawsay, it is possible to transform this paradigm in the foundation of Cuenca’s public policies and institutional structure.

Climate change, anthropogenic disturbance and the northward range expansion of Lactuca serriola (Asteraceae)

The distribution range of Lactuca serriola, a species native to the summer-dry mediterranean climate, has expanded northwards during the last 250 years. This paper assesses the influence of climate on the range expansion of this species and highlights the importance of anthropogenic disturbance to its spread. Location Central and Northern Europe. Methods Data on the geographic distribution of L. serriola were assembled through a literature search as well as through floristic and herbarium surveys. Maps of the spread of L. serriola in Central and Northern Europe were prepared based on herbarium data. The spread was assessed more precisely in Germany, Austria and Great Britain by pooling herbarium and literature data. We modelled the bioclimatic niche of the species using occurrence and climatic data covering the last century to generate projections of suitable habitats under the climatic conditions of five time periods. We tested whether the observed distribution of L. serriola could be explained for each time period, assuming that the climatic niche of the species was conserved across time. Results The species has spread northwards since the beginning of the 19th century. We show that climate warming in Europe increased the number of sites suitable for the species at northern latitudes. Until the late 1970s, the distribution of the species corresponded to the climatically suitable sites available. For the last two decades, however, we could not show any significant relationship between the increase in suitable sites and the distributional range change of L. serriola. However, we highlight potential areas the species could spread to in the future (Great Britain, southern Scandinavia and the Swedish coast). It is predominantly non-climatic influences of global change that have contributed to its rapid spread. Main conclusions The observation that colonizing species are not filling their climatically suitable range might imply that, potentially, other ruderal species could expand far beyond their current range. Our work highlights the importance of historical floristic and herbarium data for understanding the expansion of a species. Such historical distributional data can provide valuable information for those planning the management of contemporary environmental problems, such as species responses to environmental change.

Administració pública electronica i immigracio: una nova oportunitat per una societat xarxa catalana inclusiva

Aquest projecte explora dues dinàmiques socials interrelacionades: a) L'increment de la diversitat cultural al territori català i la necessitat d'implementar polítiques públiques per millorar la convivència i la cohesió social. b) El desenvolupament de la societat xarxa catalana mitjançant la disseminació de les noves tecnologies de la informació i la comunicació en I'espai de I'administració pública. Mes en concret, el projecte aborda la qüestió de la participació de les persones immigrades en la societat xarxa catalana mitjançant una metodologia que combina la investigació online i offline. Es posa un especial èmfasi en I'estudi de I ‘accés i ús dels serveis oferts per I'administració pública electrònica de les persones immigrades a Catalunya. Els nous usuaris i usuàries dels serveis públics presenten condicionants i necessitats particulars que depenen del seu origen cultural i de la seva situació administrativa. Aquest projecte estudia el grau d'adequació de la e-Administració a les demandes i necessitats especifiques d'aquest grup de població. En aquest sentit, I'estudi explora les possibilitats per a poder promoure la cohesió social mitjançant el desenvolupament d'una administració pública electronica mes inclusiva i interactiva a Catalunya. L’anàlisi de I'adaptació i adopció de I'administració electrònica catalana en el context de la població immigrada s'ha fet des d'un doble camí metodològic. D' una banda, s'ha realitzat una incursió en com I'administració pública catalana, tant local com autonòmica, s'ha adaptat a la diversitat dels seus usuaris mitjançant I'observació de webs i entrevistes a responsables tècnics i polítics. D'altra banda, s'han fet entrevistes amb persones immigrades amb perfils socio-culturals diversos. podem apuntar que I'administració pública electrònica a Catalunya es una realitat per a moltes persones immigrades que ja han provat de fer-la servir per a usos socialment importants. Existeixen, però, impediments tant des de la pròpia dinàmica de I'administració, que no ha posat aquesta qüestió en un lloc prioritari, com des de les persones que desconfien dels seus propis coneixements i no sempre troben allò que busquen. Amb tot, ens trobem amb un espai que obre expectatives de futur molt amplies. Un espai molt idoni per a repensar les formes que exigeixen els reptes de la nova ciutadania

The “Death of environmentalism” debates: forging links between SEA and civil society discourses

Social and environmental accounting (SEA) is currently going through a period of critical selfanalysis.Challenging questions are being raised about how SEA should be defined, who should be doing the defining, and what the agenda should be. We attempt to engage and enrich these debates from both a process and content perspective by drawing on the political philosophy of agonistic pluralism and a set of debates within the environmental movement – “the death of environmentalism” debates. The contribution of the paper is twofold: to set forth the death of environmentalism debates in the accounting literature and, in doing so, to contextualize and theorize the contested nature of SEA using agonistic pluralism. In contrast to consensually oriented approaches to SEA, the desired outcome is not necessarily resolution of ideological differences but to imagine, develop, and support democratic processes wherein these differences can be recognized and engaged. We construe the “Death” debates as illustrative of the contestable practical and political issues facing both SEA and progressive social movements generally, demonstrating the context and content of the deliberations necessary in contemplating effective programs of engagement. The SEA community, and civil society groups, can benefit from the more overtly political perspective provided by agonistic pluralism. By surfacing and engaging with various antagonisms in this wider contested civic sphere, SEA can more effectively respond to, and move beyond, traditional politically conservative, managerialist approaches to sustainability.

Temporary and circular labour migration : reassessing established public policies

Today, Temporary Labour Migration is a fundamental course of action promoted by relevant economic and political agents, such as EC, the GCIM, or the OECD. Based on a specific empirical case study of Temporary and Circular Labour Migration in the Catalonian agrarian sector, which has been distinguished as a particularly successful formula, we identify a new area of interest: the emergence of a new empirical migrant category, the Circular Labour Migrant, which remains theoretically unnamed and lacks public recognition. We argue that, until now, there have been two historical phases regarding temporary labour migration: one of total deregulation and another of partial regulation, led by private actors with support from public institutions, and featuring circularity. IN a developed Welfare State context, it would be normatively pertinent to except a step towards a third phase, one involving the institutionalization of this new mobility category through the elaboration of a public policy.

The Nationalism of stateless nations and Europe. The Catalan case

This paper analyzes how the ideas and concepts of Europe have developed in Catalonia, under the conditions of a decentralizing “nation-state” (Spain) on one hand, and the European integration process on the other. It analyzes the programmes, manifestations of political leaders, and political actions of the Catalan political parties, specially the nationalists, from the setting up of the Spanish state of autonomies (1977-1982) until today. The paper tries to show how, in multilevel governance, holistic and enthusiastic visions of an economically and political integrating Europe as a “natural ally” of a Catalan nationalism were partially replaced by more pragmatic and even more critical assessments.