Behind the veil of agricultural modernization : gendered dynamics of rural change in the Saïss, Morocco

The Moroccan countryside is marked by rapidly changing rural realities. The Moroccan government frames and promotes these changes as linear development towards modernity and progress for all thereby only focusing on the experiences of some audacious men – ‘entrepreneurs’ and ‘modernizing farmers’. The aim of the study is to unveil Morocco’s agricultural modernization plan by illustrating how agrarian processes in the agricultural plain of the Saïss are not a logical, self-evident or smooth transition to a higher stage of development or modernity. They are a form of globalizing capitalist development which is messy and contradictory, and which is marked by, and re-produces existing gender social hierarchies. By putting the experiences that often “fall away” from agrarian analysis at the heart of my study I am to explore how gender and social differences come to matter in process of agrarian change and are intimately linked.</p

Behind the veil of agricultural modernization : gendered dynamics of rural change in the Saïss, Morocco

The Moroccan countryside is marked by rapidly changing rural realities. The Moroccan government frames and promotes these changes as linear development towards modernity and progress for all thereby only focusing on the experiences of some audacious men – ‘entrepreneurs’ and ‘modernizing farmers’. The aim of the study is to unveil Morocco’s agricultural modernization plan by illustrating how agrarian processes in the agricultural plain of the Saïss are not a logical, self-evident or smooth transition to a higher stage of development or modernity. They are a form of globalizing capitalist development which is messy and contradictory, and which is marked by, and re-produces existing gender social hierarchies. By putting the experiences that often “fall away” from agrarian analysis at the heart of my study I am to explore how gender and social differences come to matter in process of agrarian change and are intimately linked.</p

Irrigation Management in the Pamirs in Tajikistan: A Man's Domain?

Families living in Gorno-Badakhshan—situated in the Pamir Mountains in Tajikistan—depend on irrigated agriculture to meet their subsistence needs. Because men predominate, and are most visible in, the operation and management of irrigation systems in this region, water-related activities are often labeled as masculine. Yet women historically played an important role in on-farm irrigation activities and even formed the majority of the agricultural workforce during the Soviet period. Today women are still responsible for the bulk of farming activities, including irrigation. This is partly a consequence of the difficulty of depending on farming alone for making a living, which leads many men to migrate elsewhere in search of employment. Drawing on 6 months of fieldwork in 2 villages in different irrigation systems, this article argues that although formal water rights and power are vested in men, this does not mean that women lack agency, nor is it necessarily a reflection of wider gender inequities. Understanding the power and equity implications of formal distributions of rights and powers among men and women requires an analysis that links formal rights to actual irrigation and farming practices and places them in broader historical and livelihood contexts

Aligning Medical Student Curriculum with Practice Quality Goals: Impacts on Quality Metrics and Practice Capacity for Students

The practice of medicine occurs primarily in the ambulatory environment where providers have many competing demands, including health record documentation and patient volume expectations. Subsequently, medical student education has not been a priority for providers, health systems, or community practices. Yet, accrediting and professional organizations, such as the Association of American Medical Colleges, American Academy of Family Physicians, Ambulatory Pediatric Association, Society of General Internal Medicine, and the Liaison Committee on Medical Education, recommend education in ambulatory settings

Students Adding Value: Improving Patient Care Measures While Learning Valuable Population Health Skills

Medical students are potential resources for ambulatory primary care practices if learning goals can align with clinical needs. The authors introduced a quality improvement (QI) curriculum in the ambulatory clinical rotation that matched student learning expectations with practice needs. In 2016-2017, 128 students were assigned to academic, university affiliated, community health, and private practices. Student project measures were matched with appropriate outcome measures on monthly practice dashboards. Binomial mixed effects models were used to model QI measures. For university collaborative practices with student involvement, the estimated odds of a patient being screened for breast cancer in March 2017 was approximately 2 times greater than in 2016. This odds ratio was 36.2% greater than the comparable odds ratio for collaborative practices without student involvement (95% confidence interval = 22.7% to 51.2% greater). When student curriculum and assignments align with practice needs, practice metrics improve and students contribute to improvements in real-world settings

Transformations to groundwater sustainability: from individuals and pumps to communities and aquifers

If the success of agricultural intensification continues to rely on the depletion of aquifers and exploitation of (female) labour, transformations to groundwater sustainability will be impossible to achieve. Hence, the development of new groundwater imaginaries, based on alternative ways of organizing society-water relations is highly important. This paper argues that a comparative documentation of grass-roots initiatives to care for, share or recharge aquifers in places with acute resource pressures provides an important source of inspiration. Using a grounded anti-colonial and feminist approach, we combine an ethnographic documentation of groundwater practices with hydrogeological and engineering insights to enunciate, normatively assess and jointly learn from the knowledges, technologies and institutions that characterize such initiatives. Doing this usefully shifts the focus of planned efforts to regulate and govern groundwater away from government efforts to control individual pumping behaviours, to the identification of possibilities to anchor transformations to sustainability in collective action

Recognition and diagnosis of sleep disorders in Parkinson's disease

Contains fulltext : 109296.pdf (publisher's version ) (Open Access)Sleep disturbances are among the most frequent and incapacitating non-motor symptoms of Parkinson's disease (PD), and are increasingly recognized as an important determinant of impaired quality of life. Here we review several recent developments regarding the recognition and diagnosis of sleep disorders in PD. In addition, we provide a practical and easily applicable approach to the diagnostic process as a basis for tailored therapeutic interventions. This includes a stepwise scheme that guides the clinical interview and subsequent ancillary investigations. In this scheme, the various possible sleep disorders are arranged not in order of prevalence, but in a 'differential diagnostic' order. We also provide recommendations for the use of sleep registrations such as polysomnography. Furthermore, we point out when a sleep specialist could be consulted to provide additional diagnostic and therapeutic input. This structured approach facilitates early detection of sleep disturbances in PD, so treatment can be initiated promptly

Frequent sputum production is associated with disturbed night's rest and impaired sleep quality in patients with COPD

Purpose In this study, we measured night's rest parameters measured with an accelerometer and sleep quality in mild to very severe patients with COPD. Furthermore, our aim was to investigate the association between night's rest parameters and clinical variables and the association between sleep quality and quality of life or health status. Methods Mild to very severe COPD patients were recruited from general practitioners and outpatient clinics of general hospitals to participate in a cross-sectional study on physical activity in patients with COPD. A total of 103 patients (mean age 65 years, 67 % male) wore the accelerometer during night's rest for at least four nights and were included in the analyses. Results No significant associations were found between objectively measured body movements during night's rest or subjective sleep quality and lung function, dyspnoea severity, body composition and physical activity during the day. Patients with frequent sputum production during the day had a higher number of sitting transitions during the night (5.3 vs 4.3 sitting transitions) and more frequently got out of bed compared to patients who hardly ever produced sputum during the day (1.0 vs 0.8 times per night). Furthermore, these patients also reported worse sleep quality (Pittsburgh sleep quality index (PSQI) score 4 vs 3). Conclusions Our results indicate that objectively measured body movements during night's rest like body postures and transitions are not related to sleep quality in patients with COPD. We did find an association between frequent sputum production and disturbances during night's rest and sleep quality. Future studies should investigate whether the treatment of mucus hypersecretion leads to improved night's rest