"Las lanzas se convertirán irrevocablemente en arados": el Instituto agrario de Vicente Rocafuerte y José Indelicato (1838-1839) / “The spears shall become plows”: Vicente Rocafuerte and José Indelicato’s agrarian institute (1838-1839)

El artículo se propone analizar la fundación del primer Instituto agrario del Ecuador mediante una reconstitución del itinerario de su director, el médico siciliano José Indelicato, que permitirá esclarecer el doble contexto en que se creó el establecimiento: la difusión del socialismo utópico, que marcó el recorrido de Indelicato, y el auge de la agronomía como ciencia específica, que llevó a la creación de las primeras escuelas de agricultura en Europa y América a principios del siglo XIX.(AU)

This article aims to analyze the creation of the first Ecuadorian Agrarian Institute by reconstructing the travels of its director, the Sicilian doctor José Indelicato, between Europe and America, which will allow us to clarify the context of the Institute’s creation: the spread of utopian socialism, that influenced Indelicato’s trajectory, and the emergence of agronomy as a separate science that led to the creation of the first schools of agriculture in Europe and the Americas at the beginning of the 19th century.(AU)

Changes in medical research trends of North Korea after economic sanctions: A PRISMA-compliant systematic literature review of North Korean medical journals.

BACKGROUND: In the 1980s, North Korea established a socialist health care system. However, following the food crisis and the economic sanctions, it is estimated that North Korea's health care system has experienced continuous deterioration. Thus, in the present study, we estimated the current medical research trends of North Korea through an analysis of the medical journal Korean Medicine, published in North Korea. METHODS: We analyzed the studies in Korean Medicine, which is the only North Korean medical journal accessible to foreigners with more than 30 years of data available, based on PRISMA guidelines. We analyzed the issues of the journal published for a total of 7 years, from 1985 onwards at 5-year intervals until 2015. To evaluate changes in the North Korean medical research trends, we compared and analyzed the issues published before and after the implementation of economic sanctions against North Korea. RESULTS: In this study, we analyzed 775 articles of Korean Medicine. Following economic sanctions, the number of publications on approved services (conventional therapy and diagnosis)-related articles was decreased. In contrast, the articles related to non-conventional therapy increased sharply in number. This showed a similar pattern to North Korean medical research trends seen during the food crisis of 1995 to 1997. CONCLUSIONS: After placement of economic sanctions on North Korea, North Korean medical research trends changed significantly. These could be indirectly estimated results suggesting that recently, the North Korean health care system had deteriorated, similarly to in the food crisis of 1995 to 1997.

Narrating health and scarcity: Guyanese healthcare workers, development reformers, and sacrifice as solution from socialist to neoliberal governance.

In oral history interviews, Guyanese healthcare workers emphasize continuity in public health governance throughout the late twentieth century, despite major shifts in broader systems of governance during this period. I argue that these healthcare workers' recollections reflect long-term scarcities and the discourses through which both socialist politicians and neoliberal reformers have narrated them. I highlight the striking similarities in discourses of responsibility and efficiency advanced by socialist politicians in 1970s Guyana and by World Bank representatives designing the country's market transition in the late 1980s, and the ways these discourses have played out in Guyana's health system. Across diverging ideologies, politicians and administrators have promoted severe cost-control as the means to a more prosperous future, presenting short-term pains as necessary to creating new, better, leaner ways of life. In the health sector this has been enacted through a focus on self-help, and on nutrition as a tool available without funds dedicated for pharmaceuticals, advanced medical technologies, or a fully staffed public health system. I argue that across these periods Guyanese citizens have been offered a very similar recipe of ongoing sacrifice. I base my analysis on oral histories with forty-six healthcare workers conducted between 2013 and 2015 in Guyana in Regions 3, 4, 5, 9, and 10, as well as written records from World Bank and Guyanese national archives; I analyze official discourses as well as recollections and experiences of public health governance by those working in Guyana's health system.

[Experience and problems of implementation of family medicine in post-socialist countries].

The experience of medical-insurance organisations that provide medical services basing on family medicine principles (HMO-type organizations) shows huge potential opportunities for optimization of health care systems through family physicians operating as fundholders. The experience of training of health care specialists, in particular, family physicians at the Department of Post-Graduate Training calls for further improvement of the training in applied issues of legal, financial and economic nature that provide work of family medicine specialists under the conditions of market economy development and health insurance, in particular. In this article shows huge opportunities for optimization of financial and economic provisions of the system, as well as medical and report facility structure and network that are included in the plans of establishment of medical-insurance organizations working on the principles of family medicine and organized by family physicians. ln this regard, it is very important to provide personnel of such medical-insurance organizations with appropriate training in legal, financial and economic issues. Special attention should be paid to the training of facility administrators and managers of family medicine subunits in legal and economic issues. As this is one of the milestones of their work.

What's 'left' in the 'Garden of Sweden'?

Liberalization, restructuring, and retrenchment have been underway in Sweden for more than two decades and have rapidly accelerated under the current non-socialist coalition government. It is uncertain how much of the Swedish social policy model is "left" now, in terms of both what remains of it and its political character. A cross-temporal look at developments within Sweden reveals striking and continual rollbacks and marketization since the 1990s. However, this view must be qualified, both because Sweden's undisputed descent is from a comparatively lofty position and because there have been some noteworthy, but often ignored, gains even amidst marked decline over the past few decades. A cross-national examination indicates that, despite rapidly rising rates of income and wealth inequality, Sweden remains an egalitarian leader in several respects. This view must be qualified, too, because, while it continues to routinely out-perform Anglo nations such as Canada, the United Kingdom, and the United States, Sweden is less often, and less notably, distinct from several of its continental counterparts in Europe now. Moreover, the foundation of the model, labor strength, has been significantly undermined.

["Education" in an age of increasing equality--a path towards 'ochlocracy"?]. / "Bildung" in einem Zeitalter zunehmender Gleichheit --ein Weg zur "Ochlokratie"? (I).

A philosophical and scientific analysis of how the concept of equality has developed from biological, political, sociological, social, economic and--not least--cultural points of view. The focus here is on the German chronic shortage of educational facilities continuing for decades, a cultural revolution without any foreseeable end. These reflections encompass a period of around two and a half millennia, beginning with the Ancient Greek state philosophy, reaching into our epoch of advanced globalisation with momentous changes in Western social welfare states. In consideration of a biochemical and intrinsic individuality based on genetic and epi-genetic factors, equal opportunities are an unlikely prerequisite in evolution. With regard to free education, equality can only be a starting point since, due to individual differences, egalitarian aims of education within a "group university" can never open up equally good chances to everybody. Because of a misunderstanding of equality, the student revolt in 1968 brought forth an egalitarian remodeling of school and university careers accompanied by a leveling, among other things a "university of education for the masses". Instead of "educational knowledge" based on scientific nature, an education towards vocational knowledge and regulation of studies took place. At present, a socialistic reversal of the school system aimed at learning together in ,community schools" until the 10th grade is in progress. The unity of (pure) research and teaching no longer exists. The change in the system supported by a welfare state will have consequences in worldwide competition. The final point of the Cultural Revolution, following historical examples, could be the emergence of a degenerate form of democracy: Ochlocracy.

The "social case": Illness, psychiatry, and deinstitutionalization in postsocialist Romania.

In this article, I examine the use of an ad hoc medical category--the "social case"--by psychiatrists in contemporary Romania. "Social cases" receive intensive psychiatric care, usually through long institutional stays, remaining hospitalized because psychiatrists perceive them as too poor and, thus, "unfit" to survive without the welfare assistance provided by institutionalization. The "social case" label emerges at the intersection of (1) plans by the state to deinstitutionalize public mental health care, (2) the rise of a new class of downwardly mobile and increasingly poor formerly working-class people, and (3) the desire of psychiatrists to protect their patients in the face of neoliberal assaults on Romanian welfare state support for publicly funded mental health care. Disability status, illness categories, and everyday medical practices have become battlegrounds for struggles over medical understandings of the psychological distress and illnesses that grip what I call the "New Poor" in postsocialist Romania.

Manpower of neurologists in the post-socialist countries of Central and Eastern Europe.

BACKGROUND AND PURPOSE: Manpower of neurologists from the post-socialist countries of Central and Eastern Europe differs very much from the number of neurologists in most of the countries of Western Europe. With the enlargement of the European Union (EU), it is necessary to consider the tendencies of manpower evolution amongst the 'new' European countries to be able to consider future developments, particularly in regard to education and migration. METHODS: A survey was performed to study distribution and tendencies to migrate amongst neurologists from the post-socialist countries of Central and Eastern Europe. RESULTS: The number of neurologists per 10,000 inhabitants varies from one country to another, but is higher in the countries of Central and Eastern Europe than in most Western European countries. There are almost no available positions for neurologists in Eastern Europe, and the majority of neurologists are keen to migrate to EU countries -- for further education and for financial reasons. CONCLUSIONS: The number of neurologists in the 'reforming and transition' countries is considerably higher than in the countries of the EU. Many neurologists from these countries would like to migrate to countries of the EU or USA, but the existing barriers are difficult to overcome.

Medicalizacion del malestar. Alegato por una aproximacion compleja para un minimalismo terapeutico / Discomfort medicalization. Allegation for a complex approach to a therapeutic minimalism

Reflexiono acerca de las luces y las sombras observadas por Rendueles en mi trabajo sobre la fibromialgia. Debato alguno de sus argumentos, matizo mi postura ante la medicalización del malestar y concreto mi propuesta para una respuesta por parte del clínico de a pie (AU)

I reflect on the lights and shades noticed by Rendueles in my article about fibromyalgia. I debate some of his arguments, I make more precise my position about discomfort medicalization and I concrete my proposal for an answer of the part of the clinician (AU)

[Health and health care in Vietnam]. / Gesundheit und Gesundheitswesen in Vietnam.

The South East Asian state of Vietnam is currently undergoing a transition from a centralised socialism to a so-called socialist market economy strongly promoting the private sector. For the last 17 years economy experienced an impressive growth. If the assumption is true that economic growth is positively correlated with the health status of the population, the strengthened economy of Vietnam must go along with an improved health situation and health care system of this country. The following paper evaluates this assumption. It is demonstrated that there is indeed a strongly positive correlation between health and development in many aspects. However, it becomes obvious that economic growth is definitely accompanied by increasing regional and social disparity challenging the health care policy of Vietnam and her international partners.

The globalization of capital, the welfare state, and old age policy.

A new political economy is shaping the lives of present and future generations of older people. The key change has been the move from the mass institutions that defined growing old in the period from 1945 through the late 1970s to the more individualized structures--privatized pensions, privatized health and social care--that increasingly inform the current period. The authors examine the role of international governmental organizations in promoting this trend, with examples drawn from the work of the World Bank, World Trade Organization, and Organization for Economic Cooperation and Development, and the relationship between international governmental organizations and the state. The article concludes with an assessment of the changes to citizenship that accompany globalization and the implications for political organization among older people themselves.

The future of the welfare state: crisis myths and crisis realities.

Accounts of the future of the welfare state are often presented in crisis terms. Some commentators identify globalization as a force that has already led to a major retreat by the state and is likely to lead to further downsizing of the public sector. Others see the future burden of an aging population as creating huge public expenditure pressures that can be countered only by increased parsimony in most areas of spending. Although both crisis scenarios contain elements of truth, analysis of recent public expenditure trends shows that both are substantially exaggerated as general representations of likely developments over the next two or three decades. However, unnoticed by most commentators, a real, longer-term crisis is beginning to make itself felt. This crisis arises, in part, from the demographic impact of a cultural transformation in the labor market, in progress for several decades. Extreme scenarios of possible consequences over the next 50 to 100 years include population implosion, mass migration, increasingly dangerous eruptions of right-wing populism, and, possibly, territorial conflict between developed and underdeveloped nations. This is not a crisis of the welfare state but rather a crisis for which the welfare state may be an essential part of the answer. The only way Western societies can lessen the future impact of the ongoing cultural transformation of the labor market is through the redesign of welfare state institutions to confront these new challenges.

Risk and the welfare state.

The British welfare state developed as a state-centred response to the problem of handling the risks encountered in a typical life-course. The influential work of Giddens and others implies that the traditional welfare state is under attack from two directions: a changing international politico-economic environment limits the freedom of national governments to pursue independent policies involving relatively high taxation to finance social spending. At the same time, changes in the experience of risk and declining confidence in the expertise of welfare state planners and professionals undermine support for state-centred solutions. This approach fails to acknowledge that available non-state services are often inadequate to meet many everyday life risks and that the authority of private sector advisers, insurers and professionals is also increasingly open to question. This article discusses whether people reject welfare state solutions to problems of risk in the context of research on the perceptions and behaviour of people buying or selling their homes, considering provision for long-term care needs and defrauding social security carried out by the ESRC's Economic Beliefs and Behaviour programme. Individual responses endorse the continued provision of state welfare in order to meet unprovided risks alongside disenchantment with the record of both state and private professionals and planners and awareness that state retrenchment requires greater individual responsibility for meeting one's own needs. The theory of risk society requires development to recognize that citizens are not necessarily alienated from state welfare.

[Current surgical treatment status of gallstones in East Germany]. / Die aktuelle chirurgische Behandlungssituation des Gallensteinleidens in Ostdeutschland.

The changes of surgical treatment of gallstone disease to the laparoscopic procedure was performed just at the same time in East Germany was destroyed the socialism. That's why the new operative technique was possible in many hospitals in 1992/93 first. To describe the actually situation and the trend we started a prospective multi-institutional study included 29 East German surgical departments of all kinds. The most interesting things were perioperative antibiotic prophylaxis, laparoscopically procedures in elderly or high risc patients, the management of common bile duct stones and the minor and major complications. We discuss the results and the comparison with the results of externe quality assurance.