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Real Choice (real + choice)

Distribution by Scientific Domains

Medical Sciences	50%

Selected Abstracts

Vertical Social Differentiation in Athens: Alternative or Complement to Community Segregation?

INTERNATIONAL JOURNAL OF URBAN AND REGIONAL RESEARCH, Issue 4 2001
Thomas Maloutas
Vertical social differentiation is presented in the recent literature as an important element of reduced segregation in South European cities, and the supporting evidence originates mainly from Athens. The authors of this article question the claim about the common form and function of vertical social differentiation across South Europe, as well as its opposition to community segregation, and try to reveal the specificity of the processes leading to its formation in Athens. Since the mid-1970s, the dominant process of urban growth in Athens has been middle-class suburbanization. This process has reinforced community segregation and, at the same time, has triggered a filtering-down process in wide areas around the CBD, formerly occupied by upper and mainly intermediate professional categories. Interclass vertical segregation has subsequently appeared in these areas, where intermediate professional categories and lower middle-class households are now predominant. The fact that these areas do not represent a real choice for any of their resident groups shows that this vertical cohabitation has been the unintended consequence of changing segregation patterns, and hardly the outcome or the corollary of a growing process of sociospatial homogenization. Dans les textes récents, la différenciation sociale verticale est présentée comme un facteur important dans la réduction de la ségrégation urbaine en Europe du Sud, les éléments probants provenant essentiellement d'Athènes. Cet article conteste l'idée que la différenciation sociale verticale ait une forme ou une fonction commune en Europe méridionale, et qu'elle entrave la ségrégation horizontale; de plus, il tente d'exposer la spécificité des processus qui conduisent à sa formation à Athènes. Depuis le milieu des années 1970, l'expansion urbaine de la capitale grecque se caractérise par l'implantation en banlieue des classes supérieurs et moyennes. Ce processus a renforcé la ségrégation dans les quartiers et, parallèlement, a déclenché un processus de filtrage vers le bas dans de vastes zones entourant l'hypercentre, précédemment occupées par des catégories de professionnels libéraux supérieures et surtout moyennes. Une ségrégation verticale interclasse est ensuite apparue dans ces quartiers, des catégories de libéraux moyennes et des ménages de la petite bourgeoisie y prédominant désormais. Or, quel que soit le groupe de résidents, ces zones ne représentent pas un choix réel; cette cohabitation verticale est donc bien la conséquence imprévue de la modification des schémas de ségrégation, plutôt que le résultat ou le corollaire d'une homogénéisation socio-spatiale accentuée. [source]

Factors Associated with the Choice of Delivery without Epidural Analgesia in Women at Low Risk in France

BIRTH, Issue 3 2008
Camille Le Ray MD
ABSTRACT: Background: Regional anesthesia is used for three-fourths of the deliveries in France. Epidural analgesia during labor is supposed to be available to all women at low risk. The purpose of our study was to examine how the choice of delivery without an epidural varied in this context according to women's characteristics, prenatal care, and type of maternity unit. Methods: The 2003 National Perinatal Survey in France collected data about a representative sample of births. We selected 8,233 women who were at low risk and therefore should have been able to choose whether or not to deliver without epidural analgesia. Women were interviewed in the maternity unit after delivery. The factors associated with women's choice to deliver without epidural analgesia were studied with multivariable analyses. Results: Of the 2,720 women who gave birth without epidural analgesia, 37 percent reported that they had not wanted one; other reasons were labor occurring too quickly (43.9%), medical contraindication (3.3%), and unavailability of an anesthesiologist (2.8%). The reported decision to deliver without epidural analgesia was closely associated with high parity. It was also more frequent among women in an unfavorable social situation (not cohabiting, no or low-qualified job) and among women who gave birth in nonuniversity public hospitals, in small- or medium-sized maternity units, and in maternity units without an anesthesiologist always on site. Conclusions: Unfavorable social situation and organizational factors are associated with the reported choice to give birth without epidural analgesia. This finding suggests that women are not always in a position to make a real choice. It would be useful to improve the understanding of how pregnant women define their preferences and to know how these preferences change during pregnancy and labor. (BIRTH 35:3 September 2008) [source]

Testosterone treatment comes of age: new options for hypogonadal men

CLINICAL ENDOCRINOLOGY, Issue 3 2006
Eberhard Nieschlag
Summary Male hypogonadism is one of the most frequent, but also most underdiagnosed, endocrinopathies. However, the required testosterone treatment is simple and very effective if properly administered. Although testosterone has been available for clinical use for seven decades, until quite recently the treatment modalities were far from ideal. Subdermal testosterone pellets require minor surgery for insertion and often cause local problems. The injectable testosterone enanthate, for a long period the most frequently used mode of administration, lasts for two to four weeks, but produces supraphysiological levels initially and low levels before the next injection. The oral testosterone undecanoate has to be taken three times daily, has an uncertain absorption pattern and results in peaks and valleys of serum testosterone levels throughout the day. With the advent of transdermal testosterone preparations, the desired physiological serum levels could be achieved for the first time. Scrotal testosterone patches were the first to fulfil this requirement. These were followed by nonscrotal skin patches, which, however, cause considerable skin reactions including erythema and blisters. Recently introduced, invisible transdermal testosterone gels increased the intervals of application and are now slowly replacing other modalities. A mucoadhesive buccal testosterone tablet with sustained release is also a recent competing modality. Finally, injectable testosterone undecanoate in castor oil was made into a real depot preparation requiring only four injections per year for replacement therapy. These new preparations with a desired pharmacokinetic testosterone profile give the patient a real choice and make treatment easier. Based on pharmacogenetic considerations taking the androgen receptor polymorphism into account, treatment may be individualized for each patient in the future. [source]

The Politics of a European Civil Code

EUROPEAN LAW JOURNAL, Issue 6 2004
Martijn W. Hesselink
That plan forms an important step towards a European Civil Code. In its Plan, the Commission tries to depoliticise the codification process by asking a group of academic experts to prepare what it calls a ,common frame of reference'. This paper argues that drafting a European Civil Code involves making many choices that are essentially political. It further argues that the technocratic approach which the Commission has adopted in the Action Plan effectively excludes most stakeholders from having their say during the stage when the real choices are made. Therefore, before the drafting of the CFR/ECC starts, the Commission should submit a list of policy questions regarding the main issues of European private law to the European Parliament and the other stakeholders. Such an alternative procedure would repoliticise the process. It would increase the democratic basis for a European Civil Code and thus its legitimacy. [source]