The phytolith archaeological record: strengths and weaknesses evaluated based on a quantitative modern reference collection from Greece

The phytolith record from archaeological strata is a powerful tool for reconstructing aspects of past human behaviour and ecology. Considerable insights into the problems and potentials of this record can be obtained by studying phytoliths in modern plants. We prepared a phytolith reference collection of modern plants mostly from northern Greece that includes quantitative information on phytolith concentrations (number of phytoliths per gram dry organic material) and morphological assemblages. Here we analyse this reference collection with the aim of evaluating the strengths and weaknesses of the archaeological phytolith record. The reference collection comprises 62 different plant taxa. Of them, 28 are trees, 1 conifer, 10 shrubs and 1 herb, 3 domesticated annual legumes and 19 monocotyledons. We demonstrate quantitatively the extent to which woody species, legumes and fruits of dicots contribute only small amounts of phytoliths to the sediments per unit tissue dry weight, while leaves of trees and shrubs produce significant amounts of phytoliths and grasses are prolific phytolith producers. We compare the data of this reference collection with a similar reference collection from another Mediterranean ecosystem (Israel). The comparison indicates that some aspects of phytolith production are probably genetically controlled, whereas others are environmentally controlled. We note that despite the fact that woody species produce few phytoliths per gram of tissue, their record can be most informative when taking into account other properties of the sediments. We also note that jigsaw puzzle-shaped phytoliths normally form in plants that grow in humid conditions, but may form in arid environments when the plants are irrigated. This study clearly shows the extent to which some plants can be under-represented and others over-represented in the phytolith record. Knowing the extent of this bias can greatly improve our interpretation of the phytolith record.     

劳动力市场竞争与分割的再认识

马克思在《资本论》中所论述的劳动力买卖、平均利润与生产价格,都是以完全竞争或自由竞争为前提条件的。但是,马克思指出,这是一种"理论上的假定"。这就存在着如何把马克思抽象化的理论运用于活生生的现实的问题。在现实生活中,劳动力市场既有竞争的一面,又有分割的一面,而且二者往往是交错在一起的。     

The geographies of crisis: exploring accessibility to health care in Canada

There is increasing concern in Canada that the health care system is in a state of crisis. It is argued that reductions in federal government transfers to the provinces have resulted in a health care system characterized by under‐funding in key areas and policy decisions based more on provincial fiscal concerns than the health needs of their constituents. Provincial governments have responded to reduced levels in federal funding by undertaking aggressive restructuring tactics such as the closure of hospitals and the deinsuring of medical services from provincial health plans. The end result of this restructuring, as argued by the media, consumer groups and indeed some health researchers, is a state of crisis' (i.e., lower levels of accessibility, long waiting lists, overcrowding in hospitals and increasing costs of medication). One crisis theme often mentioned is that fiscal decisions of various kinds are reducing economic and geographic accessibility, one of the five principles of the Canada Health Act (CHA) that defines the very essence of the Canadian health care system. Using data from the 1998‐99 National Population Health Survey (NPHS), this paper explores the extent to which an accessibility crisis exists within the Canadian health care system by examining access to health care services and the barriers encountered in trying to access services in each of the ten provinces. The results show that approximately 6.0 percent of Canadians report access problems, with values ranging from 4.5 percent in Newfoundland to 8.3 percent in Manitoba. Regional variations in barriers to accessing care were also observed. In particular, geographic accessibility appears to be a main barrier to care in Atlantic Canada while economic accessibility emerges as a main barrier to care in Western Canada. We discuss these findings in the context of the current debates on the Canadian health care system ‘crisis’. De plus en plus de Canadiens s'inquiétent que leur systéme de soins de santé soit en état de crise. On défend l'idée selon laquelle la réduction des paiements de transfert aux provinces par le gouvernement fédéral serait responsable de l'état d'un systeme de santé caractérisé par un sous‐financement dans les domaines‐clés et des décisions politiques de santé basées, non pas sur les besoins des membres de la société canadienne, mais sur la fiscalité provinciale. Les gouvernements provinciaux ont réagi à la réduction du financement fédéral par une tactique de restructuration agressive (fermeture d'hôpitaux et retrait de services médicaux des programmes d'assurance de santé provinciaux). Selon les médias, les groupes de consommateurs et même les chercheurs en soins de santé, cette restructuration a eu pour effet un système en état de ‘crise’ (diminution de l'aecès aux services, longues fetes d'attente, hôpitaux surchargés, augmentation des coûts des médicaments etc). Un des thèmes récurrent est celui des décisions flscales de toutes sortes qui entraînent une baisse de l'accessibilité financière et géographique. Cette accessibilité est pourtant un des cinq principes de la Loi canadienne sur la santé définissant l'essence même du système de santé au Canada. Utilisant les données tirèes de l'Enquête nationale sur la santé de la population, 1998‐99 et examinant l'accès aux services de santé et les obstacles rencontrés dans les 10 provinces canadiennes, cet article évalue dans quelle mesure une crise d'accessibilité existe au sein du système de santé canadien. Les résultats démontrent qu'environ 6.0 pour cent des Canadiens ont rencontré des problèmes d'accessibilité, avec des variantes allant de 4.5 pour cent à Terre‐Neuve jusqu'à 8.3 pour cent au Manitoba. On observe aussi des variantes régionales dans les obstacles rencontrés. L'accessibilité géographique en particulier semble un obstacle mqjeur dans les régions de l'Atlantique, alors que l'accessibilite financière semble être un obstacle majeur dans l'Ouest du Canada. Ces résultats sont présentés dans le contexte des débats actuels sur l'existence dune, ‘crise’ dans le système de santé au Canada.     

Strengths and weaknesses of accessibility instruments in planning practice: technological rules based on experiential workshops

Accessibility instruments can play a valuable role in urban planning practice by providing a practical framework for exploring and testing relationships between land use and transport infrastructure. Despite many available accessibility instruments, they are still not widely used in planning practice. This paper explores the background of this problem by examining the findings of a EU-funded study on the usability and usefulness of existing accessibility instruments. The study applied 16 instruments in local planning contexts according to a standardized process protocol. The outcomes of these so-called experiential workshops were analysed through a standardized measurement protocol, which included participant observation along with pre- and post-workshop practitioner questionnaires. This broad investigation presents a rich analytical tool for understanding how different types of accessibility measures, spatial resolutions of output and levels of comprehensiveness affect usability and usefulness. Based on this we propose 10 technological rules that (a) can be used directly in practice to improve usability of accessibility instruments and (b) can provide hypotheses to be examined in further academic studies. Our results suggest that instead of striving for the ultimate accessibility measure, it would be more effective to identify which measures could successfully serve different user needs in accessibility planning.     

The social organization of health care in China

Hillier, S.M., and J.A. Jewell. Health Care and Traditional Medicine in China 1800–1982. London: Routledge and Kegan Paul, 1983. xix + 453 pp. including plates, chapter references, appendix, and indices. $50.00 cloth.

Henderson, Gail E., and Myron S. Cohen. The Chinese Hospital: A Socialist Work Unit. New Haven: Yale University Press, 1984. xvi + 183 pp. including photographs, appendices, references, and index. $22.50 cloth.     

On the Road and on their Own: Autonomy and giving in home health care in Quebec

The reorganization of health care in Quebec, as in the rest of Canada, has helped reinforce inequities based on gender, race, ethnic status, etc. in employment in this field. Home health care workers in Quebec, called auxiliaires, are mostly women, frequently immigrants, and often immigrant women of colour. Their jobs are low status and badly paid, yet auxiliaires express a high degree of attachment to the work and find it highly rewarding. We suggest this is largely due to the worker's mobility and physical distance from the institutions that employ them; this allows them considerable autonomy and gives them the freedom to provide service beyond the requirements of the job. Drawing on recent analyses of Mauss' notion of the gift, as well as Tronto and others, we look at ‘giving’ in home health care, and its implications for the workers.

En el camino y estar solo: Autonomía y Regalando en el cuidado de salud en casa en Quebec

La reorganización del sistema de salud en Québec, como en el resto de Canadá, ha ayudado reiterar las inigualdades de género, raíz, etnicidad, etcétera, en el empleo de salud. La mayoría de los trabajadores de salud en Québec—que se llaman ‘auxiliaires’—son mujeres y muchas veces inmigrantes y además, mujeres inmigrantes de color. Su trabajo se considera como estatus inferior y tiene salario bajo, sin embargo ‘auxiliaires’ declaran un apego significativo al trabajo y lo encuentran gratificante. Sugerimos que el apego y gratificación se resultan de la movilidad de las trabajadoras y sus distantes físicos de la institución; ésta situación las permite una autonomía considerable y como consecuencia tienen ellas la libertad para proveer asistencia por encima de los requisitos del trabajo. Usando unos análisis recientes de la noción del regalo de Gauss, además de Tronto y otros, examinamos ‘regalar’ en el cuidado de salud en casa y las implicaciones para las trabajadoras.     

Fig Springs: The mid-seventeenth century in North-Central Florida

Historical Archaeology -     

From equalisation to rationalisation: public health care provision in New South Wales

This article examines the changing nature of the resource allocation formula for health care provision in New South Wales. It looks at the technical changes to the formula reviewing its problems and limitations and subsequent modifications. The impact of the formula on actual resource provision is established and this provision is placed in the context of health policy and public expenditure debates in Australia. Finally, the formula and its use as a rationalisation device are examined in relation to economic crisis and state practice with the suggestion being made that certain features of the Australian state may lead to a review of aspects of the theory of the state.     

Toward a care ethical approach to access to health care in neoliberal times

In December 2017, the Republican-controlled US Congress closed its session by pushing through a comprehensive tax overhaul bill, HR 1. Additional provisions of the ‘must pass’ bill included a last-ditch effort to quash the Affordable Care Act (ACA), otherwise known as Obamacare. In this article, I unpack some of the immediate and long-term net-positive impacts that the ACA has had on access to health care for women, infants, and children in the US while also acknowledging the continued unevenness of health outcomes along race, gender, and income differences. I argue that if we take seriously the potential of a care ethical analysis to respond to neoliberal ethics, then there is a need for a more robust engagement with intersectional analysis in order to address interlocking oppressions that exacerbate ongoing inequalities. By extension, I show how HR 1 clearly highlights the racist, classist, and gendered neoliberal logics that permeate contemporary US political and legislative debates related to health care access, underscoring the uncaring nature of US democracy and making plain a need to ‘care with’ others. I end by posing a set of speculative possibilities, asking what might be possible if we take seriously care and caring relations as fundamental to imagining worlds-otherwise.     

Florida in the 2000 presidential election: historical precedents and contemporary landscapes

Given the social and spatial dynamics of the electoral college, small groups of voters can profoundly shape national outcomes. This paper examines the 2000 election in Florida in three ways. First, it offers historical depth by comparing and contrasting the 2000 and 1876 presidential elections. Second, it portrays the spatial distribution of votes across the state. Third, it applies a combinatorial analysis of the power of small groups of Florida voters to influence the 2000 presidential election to demonstrate the discrepancy between their influence compared to those of voters nationwide.     

Gender disparities in child health care seeking in northern Vietnam

Vietnam recently demonstrated a skewed sex ratio at birth. Little research has examined postnatal impacts of son preference in Vietnam, such as in child health care seeking. Past research in other Asian countries with son preference has found that parents are more likely to take sons to a health facility when they are sick, to do so more promptly, and invest more resources in care, than daughters. Using data from a paediatric hospital emergency department, we analyse gender differences in illnesses, referral patterns, and outcomes among children to understand how gender disparities in paediatric hospital admissions arise. Almost twice as many boys were brought into the facility as girls. Compared to girls, boys were significantly more likely to have bypassed lower-level facilities and entered care at the tertiary facility, controlling for severity of illness and socio-demographic characteristics. This suggests parents provide preferential treatment to boys, potentially leading to excess morbidity among girls who become ill. However, we find no significant differences in delay of care seeking or evidence of provider bias. Ensuring that girls are able to access appropriate, quality care when needed, will improve equity of access to care for all children.     

A geographic assessment of 'total' health care supply in Ontario: complementary and alternative medicine and conventional medicine

Shortages of family physicians, specialists and other personnel working within the realm of conventional medicine (CM) concern citizens in many regions and municipalities in Canada. Complementary and alternative medicine (CAM) approaches (such as chiropractic, holistic, homeopathic, naturopathic, massage and acupuncture) are increasingly used in conjunction with, or in some cases as replacements for, conventional medicine. Thus, to get an idea of 'total' health care supply in a jurisdiction and to draw comparisons between locations, it is useful to understand the spatial tendencies of both CM and CAM offices. With the use of a sample that contains the location, employment and sales of 4,955 CAM and 8,709 CM offices, this study details the spatial patterns of health care supply in the Canadian province of Ontario. The analysis comprises three main parts. First, the geographic tendencies of CAM and CM office activity are revealed in per capita terms and while regional differences are detectable, the main contrast is that CAM displays a much more even distribution across the urban-rural continuum in comparison to CM. Second, through the use of location quotients and a local spatial autocorrelation analysis, it is shown that certain municipalities (especially in Ontario's southwest and south-central regions) specialize in CAM and the most outstanding spatial feature is an '81 municipality CAM cluster' that represents arguably the pinnacle of CAM activity in the province. CM specialization is rarer and is biased towards the more populated municipalities. Third, a Spearman's correlation analysis suggests that CAM and CM health care supply are associated with community well-being indictors and urban density measures.