Bio + Region = BIOREGION? Ein Workshop im Rahmen der Wissenschaftstagung

Das Konzept der "Bioregion" als Verbindung nachhaltiger regionaler Entwicklung und biologischer Landwirtschaft gewinnt zunehmend an Bedeutung. In den Medien erscheinen immer wieder Berichte über neue Initiativen zur Errichtung von Bioregionen in allen Teilen Österreichs. Was allerdings darunter im allgemeinen zu verstehen ist, ist nicht immer klar

How can new forms of food governance contribute to creating alternative economic spaces for the revitalisation of rural areas?

In a context of recurrent economic crisis, lasting distrust towards the incumbent agrifood system and withdrawal of state institutions from core regulatory tasks, new initiatives are emerging throughout Europe. Diverse stakeholders forge new alliances with partners in order to develop or maintain the quality of food, the sustainability of agriculture and the agrifood economy as well as lively rural areas. At the same time mainstream actors incorporate similar arguments and appropriate values like seasonality, rare breeds and varieties, traceability, localness, or short circuits for their ends. However, there are other mainstream market actors, some producer cooperatives for instance, who adapt their activities and contribute to an enhanced resilience of agrifood systems. New forms of long-term partnerships and networks between food chain actors emerge, which are built on shared sets of values. These find expression in the products as well as in the relationships between partners along the supply chain. Some of these arrangements seem to make the growth of a ‘values-based food network’ possible, which may benefit the livelihoods of rural regions. Such new forms of food governance establish themselves on different levels and scales, oriented vertically along supply chains or territorially within regions, market oriented or policy driven. Working group 2b examines the emergence and impact of these new forms of governance in rural space

The UK quality and outcomes framework pay-for-performance scheme and spirometry: rewarding quality or just quantity? A cross-sectional study in Rotherham, UK

Background: Accurate spirometry is important in the management of COPD. The UK Quality and Outcomes Framework pay-for-performance scheme for general practitioners includes spirometry related indicators within its COPD domain. It is not known whether high achievement against QOF spirometry indicators is associated with spirometry to BTS standards. Methods: Data were obtained from the records of 3,217 patients randomly sampled from 5,649 patients with COPD in 38 general practices in Rotherham, UK. Severity of airflow obstruction was categorised by FEV1 (% predicted) according to NICE guidelines. This was compared with clinician recorded COPD severity. The proportion of patients whose spirometry met BTS standards was calculated in each practice using a random sub-sample of 761 patients. The Spearman rank correlation between practice level QOF spirometry achievement and performance against BTS spirometry standards was calculated. Results: Spirometry as assessed by clinical records was to BTS standards in 31% of cases (range at practice level 0% to 74%). The categorisation of airflow obstruction according to the most recent spirometry results did not agree well with the clinical categorisation of COPD recorded in the notes (Cohen's kappa = 0.34, 0.30 - 0.38). 12% of patients on COPD registers had FEV1 (% predicted) results recorded that did not support the diagnosis of COPD. There was no association between quality, as measured by adherence to BTS spirometry standards, and either QOF COPD9 achievement (Spearman's rho = -0.11), or QOF COPD10 achievement (rho = 0.01). Conclusion: The UK Quality and Outcomes Framework currently assesses the quantity, but not the quality of spirometry

Should Doctors Offer Biomarker Testing to Those Afraid to Develop Alzheimer’s Dementia?:Applying the Method of Reflective Equilibrium for a Clinical Dilemma

An increasing number of people seek medical attention for mild cognitive symptoms at older age, worried that they might develop Alzheimer’s disease. Some clinical practice guidelines suggest offering biomarker testing in such cases, using a brain scan or a lumbar puncture, to improve diagnostic certainty about Alzheimer’s disease and enable an earlier diagnosis. Critics, on the other hand, point out that there is no effective Alzheimer treatment available and argue that biomarker tests lack clinical validity. The debate on the ethical desirability of biomarker testing is currently polarized; advocates and opponents tend to focus on their own line of arguments. In this paper, we show how the method of reflective equilibrium (RE) can be used to systematically weigh the relevant arguments on both sides of the debate to decide whether to offer Alzheimer biomarker testing. In the tradition of RE, we reflect upon these arguments in light of their coherence with other argumentative elements, including relevant facts (e.g. on the clinical validity of the test), ethical principles, and theories on societal ideals or relevant concepts, such as autonomy. Our stance in the debate therefore rests upon previously set out in-depth arguments and reflects a wide societal perspective.</p

The Framing of "alzheimer's Disease":Differences between Scientific and Lay Literature and Their Ethical Implications

Background and Objectives: The meaning of Alzheimer's disease (AD) is changing in research. It now refers to a pathophysiological process, regardless of whether clinical symptoms are present. In the lay literature, on the other hand, AD is understood as a form of dementia. This raises the question of whether researchers and the lay audience are still talking about the same thing. If not, how will these different understandings of AD shape perspectives on (societal) needs for people with AD? Research Design and Methods: We use framing analysis to retrieve the understandings of the term AD that are upheld in the research literature and in national Dutch newspaper articles. We make explicit how the framings of AD steer our normative attitudes toward the disease. Results: In the analyzed research articles, AD is framed as a pathological cascade, reflected by biomarkers, starting in cognitively healthy people and ending, inevitably, in dementia. In the lay literature, AD is used as a synonym for dementia, and an AD diagnosis is understood as an incentive to enjoy "the time that is left."Discussion and Implications: The two different uses of the term AD in research and in the lay literature may result in misunderstandings, especially those research framings that falsely imply that people with AD biomarkers will inevitably develop dementia. Adoption of the research understanding of AD in clinical practice will have normative implications for our view on priority setting in health care. For example, it legitimizes biomarker testing in people without dementia as improving "diagnostic"certainty. </p

Entwicklung, Bedeutung und Erfolgsfaktoren von Bio- Vermarktungsinitiativen in der Schweiz, Österreich und Deutschland

Problemstellung/Ziele: In Rahmen des EU Projektes "Organic Marketing Initiatives and Rural Development" (OMIaRD; QLK5-2000-01124) wurden in neun verschiedenen Ländern Untersuchungen zur Bedeutung von Vermarktungsprojekten für die Entwicklung des Biomarktes und des ländlichen Raums durchgeführt. Die entsprechenden Projektergebnisse aus den deutschsprachigen Ländern (DE, AT, CH) sollen in diesem Beitrag vorgestellt werden. Fazit: Die Untersuchung zeigt, dass Bio-Vermarktungsinitiativen erfolgreich am Markt operieren können und dies auch bei unterschiedlichem Grad äusserer Benachteiligung (Klima, Boden, Topographie, Marktferne). Als wichtige Faktoren wurden eine strategische und straffe Unternehmensführung, kompetentes Management, eine qualitäts-orientierte Produktpolitik, eine solide und angemessene Finanzstrategie vor allem auch eine vertrauensvolle Kooperation und Koordination mit den Marktpartnern, herausgearbeitet

Motivations to Pursue the Doctoral Degree in Counselor Education and Supervision

Pursuing a doctoral degree in Counselor Education and Supervision (CES) requires a significant commitment. Although there is research on motivations to pursue a doctorate in general, there has not been a specific examination of motivations among those who have pursued a doctorate in CES, which warrants investigation given the diversity of training and potential career paths offered by the degree. In this Q methodology study, 35 students, counselor educators, and practitioners sorted statements pertaining to their motivation for doctoral studies in CES. The sorted statements were correlated and factor analyzed, resulted in four distinct motivations. The motivations are described and implications for CES are discussed