Horizontal Models of Conviviality or Radical Democracy in the Americas: Zapatistas, Boggs Center, Casa Pueblo

In this paper, I argue that despite their different circumstances (size, location, history, demography), the Zapatistas (Chiapas, Mexico), Boggs Center (Detroit, USA), and Casa Pueblo (Adjuntas, Puerto Rico) share common lessons that are worth considering, at a time when there is so much uncertainty and disagreement about how best to address social injustices and much disillusionment with representative democracy. After a summary of the history and accomplishments of each of these American communal activist organisations, I present the common lessons and consider some challenges and possible objections. They provide an alternative between naïve optimism and cynical passive pessimism. They practice horizontal models of conviviality and a holistic, ecological, and experimental approach to ameliorating injustices

El punto de partida de la filosofía en Risieri Frondizi y el pragmatismo

The work of Risieri Frondizi (1910-1983) is an important historical and philosophical connection between the Hispanic world and American philosophy. Frondizi shares with the classical American pragmatists, especially with John Dewey, (1) the same criticism of the starting point of modern philosophy, and (2) a defense of ‘experience’ as the proper basis for any philosophical inquiry. Moreover, (3) Frondizi can be read as making significant and original contributions to the history of doctrines such as pragmatism, which take ‘experience’ as their starting point

Geographic Data on Health Inequities: Understanding Policy Implications

Pappas discusses a new study that examines US health disparities using county-level data

Exploring ethical considerations for the use of biological and physiological markers in population-based surveys in less developed countries

BACKGROUND: The health information needs of developing countries increasingly include population-based estimates determined by biological and physiological measures. Collection of data on these biomarkers requires careful reassessment of ethical standards and procedures related to issues of safety, informed consent, reporting, and referral policies. This paper reviews the survey practices of health examination surveys that have been conducted in developed nations and discusses their application to similar types of surveys proposed for developing countries. DISCUSSION: The paper contends that a unitary set of ethical principles should be followed for surveys around the world that precludes the danger of creating double standards (and implicitly lowers standards for work done in developing countries). Global ethical standards must, however, be interpreted in the context of the unique historical and cultural context of the country in which the work is being done. Factors that influence ethical considerations, such as the relationship between investigators in developed and developing countries are also discussed. SUMMARY: The paper provides a set of conclusions reached through this discussion and recommendations for the ethical use of biomarkers in populations-based surveys in developing countries

Transformational leadership, transnational culture and political competence in globalizing health care services: a case study of Jordan's King Hussein Cancer Center

<p>Abstract</p> <p>Background</p> <p>Following the demise of Jordan's King Hussein bin Talal to cancer in 1999, the country's Al-Amal Center was transformed from a poorly perceived and ineffectual cancer care institution into a Western-style comprehensive cancer center. Renamed King Hussein Cancer Center (KHCC), it achieved improved levels of quality, expanded cancer care services and achieved Joint Commission International accreditation under new leadership over a three-year period (2002–2005).</p> <p>Methods</p> <p>An exploratory case research method was used to explain the rapid change to international standards. Sources including personal interviews, document review and on-site observations were combined to conduct a robust examination of KHCC's rapid changes.</p> <p>Results</p> <p>The changes which occurred at the KHCC during its formation and leading up to its Joint Commission International (JCI) accreditation can be understood within the conceptual frame of the transformational leadership model. Interviewees and other sources for the case study suggest the use of inspirational motivation, idealized influence, individualized consideration and intellectual stimulation, four factors in the transformational leadership model, had significant impact upon the attitudes and motivation of staff within KHCC. Changes in the institution were achieved through increased motivation and positive attitudes toward the use of JCI continuous improvement processes as well as increased professional training. The case study suggests the role of culture and political sensitivity needs re-definition and expansion within the transformational leadership model to adequately explain leadership in the context of globalizing health care services, specifically when governments are involved in the change initiative.</p> <p>Conclusion</p> <p>The KHCC case underscores the utility of the transformational leadership model in an international health care context. To understand leadership in globalizing health care services, KHCC suggests culture is broader than organizational or societal culture to include an informal global network of medical professionals and Western technologies which facilitate global interaction. Additionally, political competencies among leaders may be particularly relevant in globalizing health care services where the goal is achieving international standards of care. Western communication technologies facilitate cross-border interaction, but social and political capital possessed by the leaders may be necessary for transactions across national borders to occur thus gaining access to specialized information and global thought leaders in a medical sub-specialty such as oncology.</p

Thirty years of Alma Ata pledges: is devolution in Pakistan an opportunity for rekindling primary health care?

The 1978 Alma Ata Conference presented the manifesto to attain global health for the next century by providing basic health care aimed at the urban and rural poor of the developing world. While the goals of Alma Ata were noble, they were untenable. Today, developing countries face serious issues of equity in health care delivery and fairness in health care management with even a greater need to transform the management systems and practice. Primary health care remains a cornerstone of building the capacity of health systems. Devolution in health sector in Pakistan seems like a chance to re-exert Alma Ata agenda. To achieve the millennium development goals by 2015, revitalization and effective implementation of primary health care will be a vital reform

The metaphilosophy of classic pragmatists

En este ensayo argumento que la metafilosofía de los pragmatistas es la contribución más importante de estos filósofos a la historia de la filosofía y es también lo que los distingue de otros filósofos. Los filósofos clásicos americanos (Peirce, James, y Dewey) y los filósofos pragmatistas hispanos, Ortega y Gasset y Risieri Frondizi, propusieron que la filosofía debe de partir desde la experiencia, es decir, un punto de partida práctico. Despues de explicar qué significa sostener que la experiencia es el punto de partida, examino las razones que tienen estos filósofos para sostener que la experiencia es el punto de partida apropiado si se quiere que la filosofía sea empírica y relevante. &amp;nbsp;In this paper I argue that the metaphilosophy of pragmatists is the most important contribution of&amp;nbsp; these philosophers to the history of philosophy and is also what distinguishes them from other philosophers. The classic American philosophers (Peirce, James, and Dewey) and the Hispanic philosophers, Ortega y Gasset and Risieri Frondizi, proposed that philosophy must start from experience. After explaining what it means to take experience as the starting point, I examine the reasons that pragmatists philosophers have for holding the view that experience should be the starting point if philosophy is to be empirical and relevant

Multilevel modeling of binary outcomes with three-level complex health survey data.

Complex survey designs often involve unequal selection probabilities of clus-ters or units within clusters. When estimating models for complex survey data, scaled weights are incorporated into the likelihood, producing a pseudo likeli-hood. In a 3-level weighted analysis for a binary outcome, we implemented two methods for scaling the sampling weights in the National Health Survey of Pa-kistan (NHSP). For NHSP with health care utilization as a binary outcome we found age, gender, household (HH) goods, urban/rural status, community de-velopment index, province and marital status as significant predictors of health care utilization (p-value \u3c 0.05). The variance of the random intercepts using scaling method 1 is estimated as 0.0961 (standard error 0.0339) for PSU level, and 0.2726 (standard error 0.0995) for household level respectively. Both esti-mates are significantly different from zero (p-value \u3c 0.05) and indicate consid-erable heterogeneity in health care utilization with respect to households and PSUs. The results of the NHSP data analysis showed that all three analyses, weighted (two scaling methods) and un-weighted, converged to almost identical results with few exceptions. This may have occurred because of the large num-ber of 3rd and 2nd level clusters and relatively small ICC. We performed a sim-ulation study to assess the effect of varying prevalence and intra-class correla-tion coefficients (ICCs) on bias of fixed effect parameters and variance components of a multilevel pseudo maximum likelihood (weighted) analysis. The simulation results showed that the performance of the scaled weighted estimators is satisfactory for both scaling methods. Incorporating simulation into the analysis of complex multilevel surveys allows the integrity of the results to be tested and is recommended as good practice

Tawana project-school nutrition program in Pakistan - its success, bottlenecks and lessons learned

Tawana Pakistan Project, a multifaceted pilot project (Sept. 2002 to June 2005) was funded by the Government of Pakistan to address poor nutritional status and school enrolment of primary school age girls. The core strategy was to create safe environment empowering village women to take collective decisions. Through reflective learning process women learnt to plan balanced menus, purchase food, prepare and serve a noon meal at school from locally available foods at nominal costs (USD 0.12/child). Aga Khan University partnered the government for the design, management, monitoring and evaluation of the project, 11 NGO\u27s facilitated implementation in 4035 rural government girls\u27 schools. Training was provided to 663 field workers, 4383 community organizers, 4336 school teachers and around 95 thousand rural women. Height and weight were recorded at baseline and every 6 months thereafter. Wasting, underweight and stunting decreased by 45%, 22% and 6% respectively. Enrolment increased by 40%. Women\u27s\u27 ability to plan balanced meals improved and \u3e 76% of all meals provided the basic three food groups by end of project. Government bureaucracy issues, especially at the district level proved to be the most challenging bottlenecks. Success can be attributed to synergies gained by dealing with nutrition, education and empowerment issues simultaneously