Regulatory approaches to genetic testing in insurance

Rapid advancements in the field of genetic science have engendered considerable debate, speculation, misinformation and legislative action worldwide. While programs such as the Human Genome Project bring the prospect of seemingly miraculous medical advancements within imminent reach, they also create the potential for significant invasions of traditional areas of privacy and human dignity through laying the potential foundation for new forms of discrimination in insurance, employment and immigration regulation. The insurance industry, which has of course, traditionally been premised on discrimination as part of its underwriting process, is proving to be the frontline of this regulatory battle with extensive legislation, guidelines and debate marking its progress.

Estimating the burden of disease attributable to smoking in South Africa in 2000

Objectives To quantify the burden of disease attributable to smoking in South Africa for 2000. Design The absolute difference between observed lung cancer death rate and the level in non-smokers, adjusted for occupational and indoor exposure to lung carcinogens, was used to estimate the proportion of lung cancer deaths attributable to smoking and the smoking impact ratio (SIR). The SIR was substituted for smoking prevalence in the attributable fraction formula for chronic obstructive pulmonary disease (COPD) and cancers to allow for the long lag between exposure and outcome. Assuming a shorter lag between exposure and disease, the current prevalence of smoking was used to estimate the population-attributable fractions (PAF) for the other outcomes. Relative risks (RR) from the American Cancer Society cancer prevention study (CPS-II) were used to calculate PAF. Setting South Africa. Outcome measures Deaths and disability-adjusted life years (DALYs) due to lung and other cancers, COPD, cardiovascular conditions, respiratory tuberculosis, and other respiratory and medical conditions. Results Smoking caused between 41 632 and 46 656 deaths in South Africa, accounting for 8.0 - 9.0% of deaths and 3.7 - 4.3% of DALYs in 2000. Smoking ranked third (after unsafe sex/sexually transmitted disease and high blood pressure) in terms of mortality among 17 risk factors evaluated. Three times as many males as females died from smoking. Lung cancer had the largest attributable fraction due to smoking. However, cardiovascular diseases accounted for the largest proportion of deaths attributed to smoking. Conclusion Cigarette smoking accounts for a large burden of preventable disease in South Africa. While the government has taken bold legislative action to discourage tobacco use since 1994, it still remains a major public health priority.

Saviour Siblings and the Regulation of Assisted Reproductive Technology: Harm, Ethics and Law

Advances in the field of Assisted Reproductive Technology (ART) have been revolutionary. This book focuses on the use of ARTs in the context of families who seek to conceive a matching sibling donor as a source of tissue to treat an existing sick child. Such children have been referred to as ‘saviour siblings’. Considering the legal and regulatory frameworks that impact on the accessibility of this technology in Australia and the UK, the work analyses the ethical and moral issues that arise from the use of the technology for this specific purpose. The author claims the only justification for limiting a family’s reproductive liberty in this context is where the exercise of reproductive decision-making results in harm to others. It is argued that the harm principle is the underlying feature of legislative action in Western democratic society, and as such, this principle provides the grounds upon which a strong and persuasive argument is made for a less-restrictive regulatory approach in the context of ‘saviour siblings’.

An analysis of the effectiveness of parliamentary questions in the Uttar Pradesh State Legislative Assembly (India)

Parliamentary questions are the most popular and visible tool for making the executive accountable to the legislature. However, their use, purpose and effectiveness vary in different countries. In this study, 4023 parliamentary questions asked in the Uttar Pradesh State Legislative Assembly were analysed. The results show that half of the total members of the Assembly used this device. Contrary to findings in the Australian parliamentary system, there was no evidence of ‘Dorothy Dix’ and party influence on parliamentary questions. Furthermore, 30% of the questions were aimed at seeking information and 70% pressed for action. The government provided the required information in 95% of the questions in the former category but only took action in 37% in the latter category. The study concludes that parliamentary questions serve as an effective legislative tool in the Uttar Pradesh Legislature

An analysis of parliamentary questions raised by Opposition in the Uttar Pradesh (India) State Legislative Assembly

The use of parliamentary questions is the most popular and visible tool in the hands of the Opposition as a means to make government accountable. Their main purpose is to seek information or press for action. Contemporary parliamentary literature from the UK, Canada, and Australia, however, suggests that parliamentary questions have lost their effectiveness. The literature points out that Question Time in parliaments has become a battle ground between Ruling and Opposition parties in their fight to gain maximum political advantage. In this context, the effectiveness of parliamentary questions in the Indian state legislatures has not been investigated. The aim of this study, therefore, is to analyse the use, purpose and effectiveness of parliamentary questions in the State Legislative Assembly of Uttar Pradesh (India) to explore differences, if any, between Ruling and Opposition parties. In this study, 4023 parliamentary questions asked in the Uttar Pradesh State Legislative Assembly were analysed. The effectiveness of answers was also analysed qualitatively. The results show that half of the total members of the Assembly used this device, out of which 60% of the questions were asked by the Opposition party members. 31% of the questions from the Opposition were seeking information and 69% were pressing for action. The government provided the required information in 96% of the questions in the former category and took action in only 35% of the latter category. Furthermore, 60% of the questions raised by the Opposition were related to constituency matters and the remaining 40% were related to policy issues or public welfare. Comparing the data with the ruling party, the results indicate that the use,purpose and effectiveness of parliamentary questions were similar to that of the Opposition except some minor differences. Surprisingly, there was no evidence of any ‘Dorothy Dix’ questions. The study concludes parliamentary question is an effective device in the Indian state of Uttar Pradesh.

Trends in the Australian gender wage differential over the 1980s : some evidence on the effectiveness of legislative reform

The article examines the legislative reforms incorporating the Sex Discrimination Act and the Affirmative Action Act introduced during the 1980s. We utilise the Australian Bureau of Statistics Income Distribution Surveys 1981–82 and 1989–90 to reflect pre- and post-legislative reform. The article adopts the Brown, Moon and Zoloth (1980) methodology which treats both the wage and occupational status of the individual as endogenously determined. In the current context this is a particularly flexible framework allowing one to capture both the direct and indirect effects of the legislative reforms. The indirect effect refers to the narrowing of the gender wage gap associated with legislative manipulation of the male-female occupational distributions. The results contrast the slow convergence in the gender wage gap during the 1980s with the much faster pace of the 1970s. The article concludes that despite the focus of the 1980s legislation on employment equity, changes in the male-female occupational distribution over the period are small and the associated impact on gender wage convergence is also small.

Learning, evaluation, action and reflection for new technologies, empowerment and rural sustainability (The LEARNERS project)

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Developing a participatory impact assessment approach and action research culture within a communication for social change organisation in Nepal

Developing an effective impact evaluation framework, managing and conducting rigorous impact evaluations, and developing a strong research and evaluation culture within development communication organisations presents many challenges. This is especially so when both the community and organisational context is continually changing and the outcomes of programs are complex and difficult to clearly identify.----- This paper presents a case study from a research project being conducted from 2007-2010 that aims to address these challenges and issues, entitled Assessing Communication for Social Change: A New Agenda in Impact Assessment. Building on previous development communication projects which used ethnographic action research, this project is developing, trailing and rigorously evaluating a participatory impact assessment methodology for assessing the social change impacts of community radio programs in Nepal. This project is a collaboration between Equal Access – Nepal (EAN), Equal Access – International, local stakeholders and listeners, a network of trained community researchers, and a research team from two Australian universities. A key element of the project is the establishment of an organisational culture within EAN that values and supports the impact assessment process being developed, which is based on continuous action learning and improvement. The paper describes the situation related to monitoring and evaluation (M&E) and impact assessment before the project began, in which EAN was often reliant on time-bound studies and ‘success stories’ derived from listener letters and feedback. We then outline the various strategies used in an effort to develop stronger and more effective impact assessment and M&E systems, and the gradual changes that have occurred to date. These changes include a greater understanding of the value of adopting a participatory, holistic, evidence-based approach to impact assessment. We also critically review the many challenges experienced in this process, including:----- • Tension between the pressure from donors to ‘prove’ impacts and the adoption of a bottom-up, participatory approach based on ‘improving’ programs in ways that meet community needs and aspirations.----- • Resistance from the content teams to changing their existing M&E practices and to the perceived complexity of the approach.----- • Lack of meaningful connection between the M&E and content teams.----- • Human resource problems and lack of capacity in analysing qualitative data and reporting results.----- • The contextual challenges, including extreme poverty, wide cultural and linguistic diversity, poor transport and communications infrastructure, and political instability.----- • A general lack of acceptance of the importance of evaluation within Nepal due to accepting everything as fate or ‘natural’ rather than requiring investigation into a problem.

Review article : ecological approach in studying the relation of perception-action : review of the theoretical and empirical data

In daily activities people are using a number of available means for the achievement of balance, such as the use of hands and the co-ordination of balance. One of the approaches that explains this relationship between perception and action is the ecological theory that is based on the work of a) Bernstein (1967), who imposed the problem of ‘the degrees of freedom’, b) Gibson (1979), who referred to the theory of perception and the way which the information is received from the environment in order for a certain movement to be achieved, c) Newell (1986), who proposed that movement can derive from the interaction of the constraints that imposed from the environment and the organism and d) Kugler, Kelso and Turvey (1982), who showed the way which “the degrees of freedom” are connected and interact. According to the above mentioned theories, the development of movement co-ordination can result from the different constraints that imposed into the organism-environment system. The close relation between the environmental and organismic constraints, as well as their interaction is responsible for the movement system that will be activated. These constraints apart from shaping the co-ordination of specific movements can be a rate limiting factor, to a certain degree, in the acquisition and mastering of a new skill. This frame of work can be an essential tool for the study of catching an object (e.g., a ball). The importance of this study becomes obvious due to the fact that movements that involved in catching an object are representative of every day actions and characteristic of the interaction between perception and action.

Consumers' emotional appraisals and action tendencies arising from mobile viral marketing

This study examines consumers' emotional responses to receiving viral mobile marketing communications in comparison to receiving mobile marketing communications where permission has not been given. The study also examines the relationship between these experienced emotions and what action tendencies consumers might consider as a result of these emotions, as well as how they attribute causality for their emotions. Using scenarios in an experimental design, the findings show that there are differences in consumer emotions as a result of the two marketing approaches. The findings also identify relationships between consumers' causal attributions and action tendencies in relation to themselves, the friend sending the viral m-marketing communication and the company involved.

Kids, counsellors and troubles-telling : morality-in-action in talk on an Australian children’s helpline

This chapter investigates one instance of ‘morality-in-action’, which transpires when children describe their troubles to the adult counsellors at Kids Help Line, an Australian national helpline that deals specifically with callers aged approximately 5-18 years. We focus, in particular, on how a young female caller who has forged a medical certificate in relation to a problem with school attendance, determines both what to report, and how this should be disclosed. Throughout the call, the moral implications of the troubles talk are delicately managed by both caller and counsellor. The call takes the form of an extended story (Labov & Waletzky, 1997) that includes a preface (‘I have some problems at school’), an orientation (“I was sick, went to the doctor, stayed home”), a complicating action (“I went back to school and photocopied my certificate from last time”), result (“I got caught”) and evaluation (“I don’t know why it happened”). As the account unfolds, we observe how both the student and counsellor seek to make sense of these actions. While this account is partly about deception, both the caller and counsellor delicately sidestep naming this action, precluding this implication. For example, the counsellor lets stand the caller’s main assessment of the trouble. He simply asks, “so what happened then,” when the caller reports that her forgery was discovered. The caller, from the very beginning of the call, seeks to find out why she could have done this, “you see I don’t know why it happened”. As the call unfolds, the counsellor follows the opening provided by the caller and they put forward motives for consideration. By agreeing that the motives are to be explored, the act takes on a character other than deception.