New roles for farming in a differentiated countryside: the Portuguese example

Throughout Europe, the role of farming as the private provider of public goods and services increasingly valuated by society is today generally acknowledged. Furthermore, in the turn towards rural development concerns, multifunctionality as an attribute of rural space has emerged, justifying the territorial approach of farming. The situation facing the multifunctionality demand is nevertheless not the same in all European regions, which by all means is getting strengthened in the transition towards post-productivism. In some regions, there is a productivist orientation and production has a dominant economic role, while others will need to be supported on other functions to survive economically and socially, or may be best suited to environmental functions alone. The vocation of the rural territories is different, and thus also the functions they are able to support. This paper discusses the concept of multifunctionality of the rural areas, and defines a possible methodological approach towards the identification of the different types of rural areas in Europe, based on the identification of ideal types, through the analysis of selected indicators. The empirical application has been developed for the Portuguese Ministry of Agriculture, aiming at assessing the differentiated characteristics and dynamics of the Portuguese rural territory. Analyzing data from 1990 and 2000, at municipal level, three dimensions have been considered: the land cover, the agricultural sector and the rural community. Combining the three analyses, it was possible to identify different vocations of the rural space, and the role that farming could have in the future for the multifunctionality of the territory. Accordingly, the municipalities have been grouped in types, pre-defined as ideal types. This was a first attempt to understand the differentiation of the rural territory in Portugal. For decision-making it should be further developed. It nevertheless shows that there is clear differentiation concerning the possible landscape functions to be developed between regions and a possible way to assess. It also shows that a territorial approach to agriculture may be the key for the maintenance of the sector in many areas where production by itself, as it has been know until now, may be severely threatened

Nash Equilibria in the Response Strategy of Correlated Games

In nature and society problems arise when different interests are difficult to reconcile, which are modeled in game theory. While most applications assume uncorrelated games, a more detailed modeling is necessary to consider the correlations that influence the decisions of the players. The current theory for correlated games, however, enforces the players to obey the instructions from a third party or "correlation device" to reach equilibrium, but this cannot be achieved for all initial correlations. We extend here the existing framework of correlated games and find that there are other interesting and previously unknown Nash equilibria that make use of correlations to obtain the best payoff. This is achieved by allowing the players the freedom to follow or not to follow the suggestions of the correlation device. By assigning independent probabilities to follow every possible suggestion, the players engage in a response game that turns out to have a rich structure of Nash equilibria that goes beyond the correlated equilibrium and mixed-strategy solutions. We determine the Nash equilibria for all possible correlated Snowdrift games, which we find to be describable by Ising Models in thermal equilibrium. We believe that our approach paves the way to a study of correlations in games that uncovers the existence of interesting underlying interaction mechanisms, without compromising the independence of the players

Survie à long terme de l'octogénaire traité par angioplastie primaire pour un infarctus transmural aigu du myocarde

Introduction Selon les recommandations internationales, l'angioplastie primaire est le traitement de choix de l'infarctus transmural aigu du myocarde (STEMI). L'évidence de ce constat reste peu claire en ce qui concerne certaines sous-­‐populations. C'est le cas, par exemple, des personnes d'âge avancé. La problématique du traitement de l'infarctus du myocarde chez le sujet âgé semble essentielle à une époque de vieillissement démographique mondial, et ce car le patient type présentant un STEMI évolue parallèlement à ce phénomène. L'objectif de la présente étude était d'observer la survie à long terme des octogénaires résidant en Suisse après traitement d'un infarctus de type STEMI selon les recommandations internationales. Méthodologie Inclusion rétrospective de tous les patients âgés de ≥ 80 ans victimes d'un STEMI entre janvier 2008 et novembre 2011. Informations démographiques et pathologiques récoltées à partir des archives et dossiers informatisés du Centre hospitalier universitaire vaudois (CHUV). Critère d'évaluation principal : mortalité à 3 ans, toutes causes confondues. Données de mortalité obtenues par le dossier informatisé (si décès intra-­‐hospitalier) ou par contact avec les autorités administratives de la Suisse romande. Critères d'évaluation secondaire : réussite de l'intervention et événements intra-­‐hospitaliers (informations obtenues grâce au dossier informatisé). Ce\e recherche clinique a reçu l'aval de la Commission d'éthique cantonale vaudoise. Résultats 108 patients correspondaient à nos critères dans la période sélectionnée ; 5 ont été exclus car non domiciliés en Suisse. Collectif final (103 patients) âgé en moyenne de 84.3 ans. Une majorité de femmes (51.4%) et une plus faible proportion de tabagiques étaient les divergences par rapport à la population STEMI générale. À 3 ans, une mortalité supérieure à 32% fut enregistrée dont plus du tiers des décès survenant dans le premier mois suivant l'infarctus. Discussion et conclusion La mortalité objectivée chez l'octogénaire traité par angioplastie pour un STEMI est particulièrement élevée, inattendue et semble plus importante que celle d'un octogénaire non coronarien. Ce constat devra être confirmé par d'autres auteurs car les études concernant cette problématique sont encore rares

The divisionalized professional bureaucracy model in hospital organizations: Challenging the role of professionalism and managerialism

Following up on previous reflections (Correia, 2012), this presentation seeks now to provide the debate with a more systematized reading of the adaptation of hospital organizations in the context of globalized managerialism, notably the implication for its design and functioning while a professional bureaucracy and for the interplay between managerialism and professionalism. The presentation reports to a qualitative research whose fieldwork was conducted in a general public hospital during the process it adopted a corporatized model now dominant in Portugal. Direct observations were systematically made over a year and half from 2008 to 2010, followed by 26 in-depth, semi-structured interviews with all managers on the hospital’s board of directors, doctors from internal medicine and from surgery. Evidence shows a new, unpredicted organizational structure in Mintzberg’s theory – the divisionalized professional bureaucracy – that combines professionalism and balkanization as prime coordinating mechanisms. Divisionalized professional structures are created within hospitals standing medicine and management closely together. Implications are discussed in the light of two fields of debate. One is health professions, as professionalism seems to be reinforced through the control of both managerial and self-regulated clinical tools. The other is management studies, as it is significant to find professionalism and balkanization coupled though they are conceived as barely articulable in theory. Therefore, the reflection allows to illustrate empirically how these organizations successful adapt by following processes assumed not only as impossible but also as responsible for disintegrating large bureaucracies.info:eu-repo/semantics/publishedVersio

Orbits and masses in the young triple system TWA 5

We aim to improve the orbital elements and determine the individual masses of the components in the triple system TWA 5. Five new relative astrometric positions in the H band were recorded with the adaptive optics system at the Very Large Telescope (VLT). We combine them with data from the literature and a measurement in the Ks band. We derive an improved fit for the orbit of TWA 5Aa-b around each other. Furthermore, we use the third component, TWA 5B, as an astrometric reference to determine the motion of Aa and Ab around their center of mass and compute their mass ratio. We find an orbital period of 6.03+/-0.01 years and a semi-major axis of 63.7+/-0.2 mas (3.2+/-0.1 AU). With the trigonometric distance of 50.1+/-1.8 pc, this yields a system mass of 0.9+/-0.1 Msun, where the error is dominated by the error of the distance. The dynamical mass agrees with the system mass predicted by a number of theoretical models if we assume that TWA5 is at the young end of the age range of the TW Hydrae association. We find a mass ratio of M_Ab / M_Aa = 1.3 +0.6/-0.4, where the less luminous component Ab is more massive. This result is likely to be a consequence of the large uncertainties due to the limited orbital coverage of the observations.Comment: 9 pages, 8 figures, accepted by Astronomy and Astrophysic

New Public Management in the Portuguese health sector: a comprehensive reading

We present an analysis of the main orientations that have guided the introduction of the New Public Management principles in the Portuguese health sector. Despite of being a result of international dynamics we also equate some national institutional characteristics such as a delayed and unfinished Welfare State and a centralized structure in political decision making that configures in a particular way the Portuguese health sector reform. Five main dynamics are here identified: dece ntralization of competences, financing and accountability, rationalization of expenses, deregulation of the labour market and internal competition and differentiation in the NHS. One of the most important arguments that we stress is that the health reform pursued in Portugal over the last decades has followed an ideological convergence despite today’s growing uncertainties about the f uture of the Portuguese NHS, moving between Beveridge and Bismarck principles and dealing with an emergent for-profit sector that is allowed to act in competition with public sector

Tensions and paradoxes in health involving rights, knowledge and trust: mapping the debate and pointing to directions of research

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The medical profession between new limits and values: Lessons from the Portuguese case

The challenges of the growing exposure to the market and the neo-liberal policies generally adopted in the European countries to the governance of public services and the professions has been widely debated. One of the conclusions often referred to is the variety of outcomes across countries, particularly in the health sector, which therefore calls for comprehensive analyses focusing on such processes in different contexts. This presentation seeks to address the situation of Portugal specifically referring the healthcare system. One the one hand, the place of health professions and their relationship with the State is still poorly understood in comparison with countries sharing the Beveridge model (e.g. UK, Sweden, Norway, Finland). On the other hand, Portugal was one of the European countries subjected to the conditions imposed by financial assistance programs with the institutions also known as the Troika, which resulted in tighter mechanisms to control both clinical and managerial procedures while public investment retracted considerably. These are usually considered as factors responsible for changing professional values and autonomy in healthcare organizations. Based on a national scale survey to doctors (n=3442) collected in 2014, the aim of the analysis is to describe how doctors think their work has been affected by the policies applied during the bailout and to discuss possible implications to their autonomy. The doctors’ response is consistent regarding greater administrative controls to their practice of medicine. However, we argue that this is not enough evidence to conclude as to new limits to medical autonomy and that medical professionalism actually can be reinforced in this context. In sum, theoretical conclusions are drawn in order to help framing this evidence as indicative of the interdependence between the State and medicine rather than simply assuming new limits to medical autonomy and deep changes in professionalism.info:eu-repo/semantics/publishedVersio

Refinements to the study of the day-to-day life in organizations: Exploring a neo-institutionalist approach to doctors’ behaviour in hospital organizations

The evidence gathered has not yet produced a clear picture of how the institutional (i.e. macro) and behavioural (i.e. micro) relationship/link works for doctors in hospital organizations, in particular with regard to their reasons for being for or against organizational change driven by managerial values. This article seeks to address this issue by looking at what structures the actions of doctors, in order to see possible reasons for the conflict and alliances among them and between them and? managers. Drawing on qualitative, in-depth research conducted in a hospital organization, with the focus on doctors from two wards (one surgery and one internal medicine), differences in their actions and discourses challenge the coherence associated, as a rule, with professional values and organizational culture. Rather than denying these influences/differences, we relate them to the way the medical professionals reflexively make use of their roles in situated circumstances. In sum, this presentation discusses not only the fact that the doctors’ medical rationale is crisscrossed by a diversity of influences – ethics, management itself and the organizational culture and subcultures – but also that they make reflexive deliberations about themselves and that their personal interest(s) are defined in relation to specific contexts. Theoretically, the analysis is aligned with other work on critical realism, which is expected to refine the study of organizations as inhabited spaces by adding empirical accuracy to theoretical arguments in social theory on reflexivity.info:eu-repo/semantics/publishedVersio