Early modern ideas about artistic geography related to the Baltic Region

The paper analyses the gradual changes in assistance offered to widows and widowers between 1900 and 1964. It highlights the conflicts between the principle of the family as provider of welfare and the principle of self-help embodied in poor relief, in varying municipal pensions during the inter-war period and in the right to economic assistance legitimised through the Mothers' and Widows' Pension Act in 1964. The development is seen as part of the construction of a welfare society, built on the perception of men as wage-earners and providers, women as wives and mothers. These perceptions of masculinity and femininity resulted in gender-differentiated needs in the case of widowhood, and in gender-differentiated means of covering such needs. Civil status had no importance for men's role as wage-earners, while it was decisive for the economic situation of women. Focusing on the problem of economic support, the paper discusses solutions at the individual private level, at the municipal level and at the national level. The different weighting of widows as mothers or as providers is taken into consideration, and so are consequences of demographic changes in the widowed population.     

Iran–US Public Health Cooperative Organization (PHCO): Education,Healthcare, and Health Services in the Southwest of Iran (Fars), 1950–60

Fars is among the largest provinces of Iran that received the most technical assistance from the American economic delegation in the 1950s. After settling in the province and during ten years of activity, the American delegation provided technical assistance in the fields of health engineering, health education, preventive medicine, nursing, medical services, and medical education. This paper explains how the technical assistance of US personnel contributed to the general health of the Fars province. The findings of this research show that after the formation of the Public Health Cooperative Organization (PHCO) in 1950, not only did most of the cities and villages of this province began to enjoy safe drinking water, but also public health improved. Additionally, the birth of children with disabilities and the spread of infectious diseases such as malaria and trachoma declined by means of preventive medicine centers and health education.     

The political economy of maize production and poverty reduction in Zambia: analysis of the last 50 years

Poverty and food security are endemic issues in much of sub-Saharan Africa. To eradicate extreme poverty and hunger in the region remains a key Millennium Development Goal. Many African governments have pursued economic reforms and agricultural policy interventions in order to accelerate economic growth that reduces poverty faster. Agricultural policy regimes in Zambia in the last 50 years (1964–2008) are examined here to better understand their likely impact on food security and poverty, with an emphasis on the political economy of maize subsidy policies. The empirical work draws on secondary sources and an evaluation of farm household data from three villages in the Kasama District of Zambia from 1986/87 and 1992/93 to estimate a two-period econometric model to examine the impact on household welfare in a pre- and post-reform period. The analysis shows that past interventions had mixed effects on enhancing the production of food crops such as maize. While such reforms were politically popular, it did not necessarily translate into household-level productivity or welfare gains in the short term. The political economy of reforms needs to respond to the inherent diversity among the poor rural and urban households. The potential of agriculture to generate a more pro-poor growth process depends on the creation of new market opportunities that most benefit the rural poor. The state should encourage private sector investments for addressing infrastructure constraints to improve market access and accelerate more pro-poor growth through renewed investments in agriculture, rural infrastructure, gender inclusion, smarter subsidies and regional food trade. However, the financing of such investments poses significant challenges. There is a need to address impediments to the effective participation of public private investors to generate more effective poverty reduction and hunger eradication programmes. This article also explores the opportunities for new public–private investments through South–South cooperation and Asia-driven growth for reducing poverty in Zambia.     

Privatisation: An attempt that failed

Throughout the twentieth century doctors in most western countries strongly resisted government attempts to intervene in private medical markets. The support for privatisation that has developed during the current economic recession is welcomed therefore by the medical profession. In several countries campaigns have been staged for a full or partial return to market forces in the health care field. This article traces the course of one such push in Canada where doctors and other advocates of privatisation demanded a larger role for the private sector in the funding and management of Medicare, the national health insurance system. The policy outcome is contrary to the general privatising tendency in many countries: after a period of intense controversy the federal government passed legislation to preserve and strengthen the public aspects of the scheme. The normally powerful medical profession lost its campaign for an infusion of private funds into the health system and for the retention of the right of doctors to set their own fees. Consumer and other non‐producer groups, which have not traditionally played a central role in health policy, mobilised in defense of Medicare and were able to achieve most of their aims.     

Strangers and estrangement: young people’s renegotiations of birth and foster family relationships as they transition out of care and the implications for the state as parent*

ABSTRACT

Many young people ageing out of state care continue to experience very poor life outcomes. Based on research following 21 care leavers aged 15–18 over three years, this article charts how children’s experiences in troubled birth families are often compounded in care by multiple placement moves, the gradual disintegration of sibling units over time and troubling relationships with the adults charged with their care. It considers the effects of living with strangers and of transient relationships with carers and professionals, and explores young people’s feelings of rejection by, and responsibility for, their birth families. The capacity of the ‘corporate parent’ model to ensure adequate attention is paid to relationships in young people’s lives is questioned. Hollingsworth’s theory of foundational rights, incorporating considerations of relational autonomy, is utilised to reconsider the state’s obligations towards children for whom it has taken on the parental role, both during and beyond their legal minority.     

Personal Assistance Services: The Hub of the Policy Wheel for Community Integration of People with Severe Physical Disabilities

The success of persons with severe physical disabilities in living independently in the community, engaging in self-directed productive activities, and staying healthy depends, in part, on getting and maintaining adequate personal assistance with basic tasks such as getting out of bed and tending to personal hygiene. Although few policymakers would disagree with the contention that many people with disabilities need assistance with daily tasks, there is considerable debate about who should provide assistance, what services should be included, who should pay, who should be entitled to publicly provided and paid services, how much assistance should be provided, and who should control its administration. The prevailing model for delivery of personal assistance services has been primarily medical, with control of services by health care professionals, rather than independent living, with control by consumers receiving services. Traditionally there has been an institutional bias of funding for disability-related service, despite its much higher expense than community-based personal assistance services and its violation of basic human rights. Proponents of various solutions to health care reform have given little consideration to the provision of support services for people with disabilities. The advantages of implementing a uniform national system for the delivery of personal assistance services based on consumer control are discussed.     

Decomposing the Rural-Urban Differentials in Childhood Malnutrition in India, 1992–2006

Using data from multi-waves of the National Family Health Survey conducted in India between 1992 and 2006, this study examines the pattern of rural–urban differentials in childhood malnutrition in India over time. Furthermore, it identifies the factors responsible for the rural–urban gap in childhood malnutrition and quantifies their contribution. The result shows a considerable and widening gap in childhood malnutrition across rural–urban residence in the country over the study period. The rural–urban gap in childhood malnutrition has narrowed in a few states whereas it widened in most states over time. The economic status of the household and parental education was the most significant contributors to the rural–urban gap in childhood malnutrition in India. Based on the findings, this study suggests that to reduce the rural–urban gap in childhood malnutrition, focus should be given to the rural poor.     

Access anxiety: HIPAA and historical research

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) establishes new standards for the protection of private health information in the United States. The Privacy Rule, one of the specific regulatory provisions of the act, went into effect 14 April 2003 for covered health care providers, institutions, and businesses. The Privacy Rule directly affected medical archivists and their collections. It has significant implications for historians of health care, as well. The Privacy Rule is the first major regulation that protects the privacy of the deceased in perpetuity. It establishes requirements that researchers must satisfy in order to gain access to "individually identifiable health information" held by HIPAA-protected institutions. While these requirements will burden historians in some cases, the Privacy Rule could open up opportunities for well-prepared historians to work with a more extensive range of twentieth-century documents.     

AIDS. Grim news for Asia

While Asia was the last region to be exposed to the global spread of HIV and AIDS, the incidence of HIV infection there is increasing fastest. The Asian Development Bank predicts mortality from AIDS will cause some town and village populations to begin declining by the year 2000. With an estimated 1 million people infected in India, and 400,000 in Thailand, these 2 countries are particularly exposed to the risk of epidemic HIV spread. In 5 years, more people may be affected by AIDS in India than anywhere else in the world. Concern over a growing presence of HIV is also merited for the Philippines, Indonesia, China, and the drug trade's Golden Triangle. The Second International Conference on AIDS in Asia and the Pacific in November 1992 stressed that AIDS no longer affects only homosexual and IV drug using populations. 50% of new infections worldwide in the first half of 1992 were among women, 65% of Thailand's AIDS cases are among heterosexuals, and 3-5% of Thailand's long-haul truck drivers have tested positive for HIV infection. HIV and AIDS robs economies and societies of their best workers. The immediate costs of caring for AIDS patients will pale next to the far greater losses to be realized in private sector economic productivity. Asia's more developed economies will probably be able to survive the epidemic, but small, poor countries like Laos will wilt. Prompt action must be taken to overcome public and religious ignorance and objections to promoting and using condoms throughout the region. For the first time, Beijing has organized an AIDS awareness conference for male homosexuals. Further, Singapore has implemented compulsory testing for lower-income foreign workers. Pakistan has even solicited educational assistance and support from Islamic religious leaders; similar action is being considered in Bangladesh.     

Job polarization in the new economy in Danish cities: location,size, and the role of the public sector

ABSTRACT

In this paper we examine the geographic patterns of employment growth and employment polarization in small and medium-sized cities (SMCs) in Denmark during the rise of the new economy. The geography of employment polarization in Danish cities is examined using register-based employment data on occupations and wages divided into the public and private sectors in the period 1993–2006; it therefore covers a long period of transformation and growth in the Danish economy. We conclude that employment growth is characterized by employment polarization combined with growth in low- and high-wage employment and a decline in medium-wage employment. However, these patterns of polarization differ across the public and private sectors, as well as by geography. While local labour market (LLM) size, city position and city specialization influence the geography of private-sector employment growth and polarization, municipal population and composition influence the geography of public-sector growth patterns across wage levels. Finally, public and private employment are positively associated within SMCs, predominantly driven by the positive association between public employment and private-sector low-wage employment. However, public employment is not associated with an increase in private low-wage employment in more remote areas.     

QUANTIFYING KNOWLEDGE SPILLOVERS USING SPATIAL ECONOMETRIC MODELS

ABSTRACT This paper seeks to develop our understanding of the somewhat diffuse nature of technological externalities and space by associating a geographical dimension with the sectoral dimension. Using a panel data set containing French patents as well as private and public research expenditures by industry and region over the period from 1992 to 2000, this paper estimates a knowledge production function. The region‐ and industry‐specific nature of the sample data allows us to empirically examine spatial spillovers associated with public and private research expenditures in own‐ and other‐industry sectors for our sample of 94 French regions. We find that the largest direct and indirect effects are associated with private R&D activity that spills across industry boundaries. However, since Jacobs externalities decrease more drastically with distance than MAR externalities, our results also point to different optimal strategies for regional versus national officials.     

Contesting Keweenaw: competing visions of landscape aesthetics at Keweenaw National Historical Park

Keweenaw National Historical Park (hereafter KNHP) is one of a periodically growing list of partnership parks developed in response to changing ideals of what the National Park Service ought to preserve and interpret. Established in 1992, KNHP and some other newer parks are intended by Congress to be public–private partnerships. This paper illuminates how KNHP stakeholders used information vacuums to intensify competing narratives regarding landscapes in a partnership park. Ethnographic fieldwork illustrates that stakeholders’ competing narratives complicate KNHP's management. Furthermore, this case study highlights the need for historic preservation professionals to build trust and to communicate effectively with all stakeholders in communities with historic preservation programs. Within a social group, insiders’ knowledge construction guides ideas of landscape aesthetics.     

Forging Creative Partnerships

While much public attention focuses on the impact of immigration policy at the national level or in major metropolitan areas, the realities of political policy regarding refugees and immigrant populations are also felt in smaller, more rural communities as well. Local decisionmakers increasingly face new community needs at a time when mandated programs are being shifted as federal responsibility changes. This article recounts the work of a unique, ongoing collaborative effort that began in 1996 establishing a partnership between health care and public safety services in support of low-income and immigrant populations in the city of Portland, Maine. The project seeks to address two of the most pressing problems associated with immigrant populations: preventive medical care and the reduction of neighborhood violence. The project is predicated on the belief that community building works best when all residents are stakeholders in a vision that includes strong schools, safe neighborhoods, and healthy families. The elements of the Portland experience in service provision are recounted for other state and local policymakers in forging new and collaborative working relationships among service providers and government agencies     

Single-Child Families in India: Levels,Trends and Determinants

This paper discusses a relatively new but an emerging demographic phenomenon of single-child families in India. This paper examines the levels, trends and determinants of single-child families using the data from three rounds of National Family Health Surveys (NFHS) conducted in 1992–1993, 1998–1999 and 2005–2006. The paper analyses women who have completed their reproductive life to understand the characteristics of single-child families. The results show that the proportion of single-child families is higher among the urban, educated and professionally employed women. Among the determinants, age at marriage and first birth, place of residence, economic and education status were significantly associated with single-child families.     

Supporting women's empowerment in Djibouti

This article reports on the work carried out by the UN Population Fund (UNFPA) in the small island of Djibouti, Africa. The republic's population has been plagued with problems of high levels of unemployment, poverty, malnutrition, an almost non-existent family reproductive health care service, 100% prevalence rate of female genital mutilation and low literacy rate, especially for women. In addition, refugees from Ethiopia and Eritrea have settled in the country increasing the risks of sexually transmitted diseases (STDs), HIV/AIDS, prostitution, and other social ills. In 1983, UNFPA started funding family planning and later reproductive health projects aimed at assuring access to services for a majority of Djiboutan women. The first country population program of assistance was started in 1992. This would help the government with health care for its population and to conduct a population census. In addition, the Fund has paid for training of doctors, midwives, and traditional birth assistants in the country and for rehabilitating maternity clinics and information centers. Moreover, it has supported agencies concerned with educating people on STDs, HIV/AIDS, safe motherhood and reproductive health for men and women, and other important issues.     

Temporal and Spatial Dynamics of the New Residential Areas around Tallinn

New housing construction is the most visible manifestation of the rapid suburbanization process taking place in the former centrally planned countries of Central Eastern Europe. This paper analyses residential housing construction around Tallinn, the capital city of Estonia, in the period 1991–2005. Our data comes from the New Residential Area Survey that was carried out in 2006. The main results of the study reveal that housing construction was modest in the 1990s, but grew rapidly in the 2000s. In comparison with the Soviet period, private interest led new housing construction to take place in areas closer to Tallinn that were earlier reserved for other functions; that is former agricultural and coastal (often military) areas. Instead of the sprawl of detached housing further away from the capital city seen over time, we find increasing in-fills and multifamily housing construction in the 2000s around Tallinn. This leads to changes both in the internal structure (small but merging settlements close to Tallinn are different from the Soviet time compact settlements located all over the rural areas) and functioning (increase in daily commuting) of the metropolitan area. We argue that the transition period ends in the housing market when a new and better balance between public and private interests emerges in Estonia like in Western Europe.     

Medical versus social work-places: constructing and compensating the personal support worker across health care settings in Ontario,Canada

This article explores the role of place in explaining variation in caregiver compensation. Using the labour category of Personal Support Worker (PSW) in Ontario, Canada, it contrasts wage rates across three health care settings: hospitals, long-term care facilities and private homes. An evaluation of current literature from disciplines spanning geography, gender studies, political science and sociology is combined with a critical analysis of policy documents and wage data to reveal that, despite holding similar qualifications and performing comparable job duties, hospital-based workers receive higher wages than home-based workers. I theorize that this wage disparity is partially attributable to the historical privileging of hospital settings in Canada, based on a medical-social continuum of health care valuation. Given that the hospital is constructed as a highly medical place, whereas the home is considered to be a social place, caregiving work enjoys greater financing protection in the former. I argue that these constructions stem from deeply gendered historical roots which view the marketplace as a male-dominated setting for productive waged labour, and the home as a female-dominated setting for unpaid social pursuits. Thus, when personal support services shift from public institutions into private homes, these activities become invisible to the state, and their provision beyond its purview. I conclude that the medical versus social nature of the duties performed by PSWs has become secondary to the medical versus social nature of the setting in which these activities take place. This has translated into lower wages for home-based PSWs, effectively resulting in wage discrimination.     

Benefits,safety, and risks of immunisation programmes

Abstract

Immunisation is potentially the most effective and efficient of all preventive medical activities. It is also unique among interventions in that it protects both the individual and the community. The UK's immunisation programme has been highly successful in controlling a number of life threatening infectious diseases, and consequently public concern has shifted from the diseases to vaccine safety. In recent years a series of vaccine myths and vaccine safety scares have affected the UK and other industrialised countries. Although an effective vaccine without any risk is probably unachievable, the vaccines in use in the UK are very safe. Serious adverse outcomes truly attributable to vaccination are extremely rare, always far rarer than adverse outcomes among individuals acquiring the vaccines' target infections. Vaccine safety may be called into question, however, on the basis of spurious coincidental associations between vaccination and adverse events. An inadequate public health response in the 1970s to a scare over whooping cough vaccine allowed substantial losses of professional and public confidence to take place. Vaccine coverage halved and much preventable morbidity and mortality resulted. Plausible vaccine associations must be investigated thoroughly, and the UK has become a world leader in developing techniques for rapid investigations. The public health response to scares over MMR (measles, mumps, and rubella) vaccine safety has been faster and firmer than for whooping cough and no link has been found between MMR vaccine and inflammatory bowel disease or autism. Consequently the impact on immunisation coverage has been small, though the cumulative threat of measles, mumps, and rubella epidemics is growing. Recently an international investigation excluded a possible association of intussusception with oral polio vaccine before it could become a vaccine scare. A clearer chain of communication in responding to vaccine myths and scares is needed. This must provide rapid information and, if appropriate, reassurance to professionals and the public. Considerably more training is needed for professionals in providing information to the public and supporting parents in making difficult decisions over vaccination. Though there is no place for complacency, and improvements are needed, the UK's ability to monitor vaccine effectiveness, safety, and risks is strong. As a consequence it has a vaccination programme that is very safe and very effective.     

山西省稷山县农村公共卫生事业述评(1949～1984年)——以太阳村(公社)为重点考察对象

山西省稷山县太阳村(公社)是集体化时代闻名全国的卫生红旗单位,其公共卫生工作及合作医疗制度建设成绩斐然,具有明显的典型意义和时代特征。不过,这种农村公共卫生事业是建立在计划经济体制和高度集中的政治体制以及较低医疗保障水平基础上的,并与历次政治运动关系密切。改革开放后,经济体制逐渐向市场经济过渡,稷山县公共卫生事业因难以适应新的社会经济体制而最终走向了衰落,但其经验和教训可为今后创新农村公共卫生事业、建立新型合作医疗体系提供有益的借鉴。