Prophylaxis of infectious complications with colony-stimulating factors in adult cancer patients undergoing chemotherapy-evidence-based guidelines from the Infectious Diseases Working Party AGIHO of the German Society for Haematology and Medical Oncology (DGHO).

BACKGROUND Current evidence on myelopoietic growth factors is difficult to overview for the practicing haematologist/oncologist. International guidelines are sometimes conflicting, exclude certain patient groups, or cannot directly be applied to the German health system. This guideline by the Infectious Diseases Working Party (AGIHO) of the German Society of Haematology and Medical Oncology (DGHO) gives evidence-based recommendations for the use of G-CSF, pegylated G-CSF, and biosimilars to prevent infectious complications in cancer patients undergoing chemotherapy, including those with haematological malignancies. METHODS We systematically searched and evaluated current evidence. An expert panel discussed the results and recommendations. We then compared our recommendations to current international guidelines. RESULTS We summarised the data from eligible studies in evidence tables, developed recommendations for different entities and risk groups. CONCLUSION Comprehensive literature search and expert panel consensus confirmed many key recommendations given by international guidelines. Evidence for growth factors during acute myeloid leukaemia induction chemotherapy and pegfilgrastim use in haematological malignancies was rated lower compared with other guidelines.

Electoral and Financial Bookkeeping: A Comparison of Pre-Electoral Pledges on Public Spending and the Outcome of Post-Electoral Budget Debates

In the wake of the financial crisis, budgetary discipline has taken centre stage in politics. More than ever a country's budget mirrors the true policy preferences of the legislative majority beyond all political discourse and cheap talk. The paper sheds light on mandate fulfilment in the field of public spending and fiscal policy in general. Based on previous work on pledge fulfilment in Switzerland the paper compares publicised pre-electoral statements of MPs on public spending and the development of the public finances with their post-electoral legislative behaviour during budget debates and votes. The findings of the paper confirm the results of the aforementioned earlier studies and point to the potential of budgetary statements for future mandate fulfilment research.

The structure of the debate on EU integration issues. A comparative analysis of party communication in the EP 2014 elections

The results of Eurosceptic parties in the recent European parliament election provide further evidence that the “permissive consensus” on European integration blurred. This paper focuses on the structure of the debate on EU integration issues. Which EU integration issues and positions do parties put forward? Can the debate on EU integration issues be subsumed in one or several dimensions? Do they reflect national political conflicts such as the left-right and the ‘new politics’/cultural divide? Or do they form one unique or several EU-specific dimensions, e.g. national sovereignty versus integration? In order to address these questions, this paper departs from the assumption that debate on European integration is multidimensional in its nature and therefore entails a multitude of issue areas. In other words, it does not look at how socio-economic and cultural issues are related to European integration but focuses on its components, i.e. particular EU-specific policies such as EU-wide employment, environment, immigration and monetary policy. The paper departs from the cleavage theory on political di-visions and different approaches transferring them to EU politics. Two points should be noted; first, this paper does not compare the debate on European integration issues between the national level and the EU level, but whether domestic divisions are reflected at the EU level. Second, it is not concerned with the general ideo-logical profile of political parties on EU integration issues, but on EU issues that parties communicated through press releases. By doing this, the paper is concerned with the salient EU issues that parties touch upon.

A new measure for party coherence: Applying a physics-based concept to the Swiss party system

The paper revives a theoretical definition of party coherence as being composed of two basic elements, cohesion and factionalism, to propose and apply a novel empirical measure based on spin physics. The simultaneous analysis of both components using a single measurement concept is applied to data representing the political beliefs of candidates in the Swiss general elections of 2003 and 2007, proposing a connection between the coherence of the beliefs party members hold and the assessment of parties being at risk of splitting. We also compare our measure with established polarization measures and demonstrate its advantage with respect to multi-dimensional data that lack clear structure. Furthermore, we outline how our analysis supports the distinction between bottom-up and top-down mechanisms of party splitting. In this way, we are able to turn the intuition of coherence into a defined quantitative concept that, additionally, offers a methodological basis for comparative research of party coherence. Our work serves as an example of how a complex systems approach allows to get a new perspective on a long-standing issue in political science.

Estimating Intra-Party Preferences: Comparing Speeches to Votes

Well-established methods exist for measuring party positions, but reliable means for estimating intra-party preferences remain underdeveloped. While most efforts focus on estimating the ideal points of individual legislators based on inductive scaling of roll call votes, this data suffers from two problems: selection bias due to unrecorded votes and strong party discipline, which tends to make voting a strategic rather than a sincere indication of preferences. By contrast, legislative speeches are relatively unconstrained, as party leaders are less likely to punish MPs for speaking freely as long as they vote with the party line. Yet, the differences between roll call estimations and text scalings remain essentially unexplored, despite the growing application of statistical analysis of textual data to measure policy preferences. Our paper addresses this lacuna by exploiting a rich feature of the Swiss legislature: on most bills, legislators both vote and speak many times. Using this data, we compare text-based scaling of ideal points to vote-based scaling from a crucial piece of energy legislation. Our findings confirm that text scalings reveal larger intra-party differences than roll calls. Using regression models, we further explain the differences between roll call and text scalings by attributing differences to constituency-level preferences for energy policy.

Similar outcome of upfront-unrelated and matched sibling stem cell transplantation in idiopathic paediatric aplastic anaemia. A study on behalf of the UK Paediatric BMT Working Party, Paediatric Diseases Working Party and Severe Aplastic Anaemia Working Party of EBMT

Abstract We explored the feasibility of unrelated donor haematopoietic stem cell transplant (HSCT) upfront without prior immunosuppressive therapy (IST) in paediatric idiopathic severe aplastic anaemia (SAA). This cohort was then compared to matched historical controls who had undergone first-line therapy with a matched sibling/family donor (MSD) HSCT (n = 87) or IST with horse antithymocyte globulin and ciclosporin (n = 58) or second-line therapy with unrelated donor HSCT post-failed IST (n = 24). The 2-year overall survival in the upfront cohort was 96 ± 4% compared to 91 ± 3% in the MSD controls (P = 0·30) and 94 ± 3% in the IST controls (P = 0·68) and 74 ± 9% in the unrelated donor HSCT post-IST failure controls (P = 0·02).The 2-year event-free survival in the upfront cohort was 92 ± 5% compared to 87 ± 4% in MSD controls (P = 0·37), 40 ± 7% in IST controls (P = 0·0001) and 74 ± 9% in the unrelated donor HSCT post-IST failure controls (n = 24) (P = 0·02). Outcomes for upfront-unrelated donor HSCT in paediatric idiopathic SAA were similar to MSD HSCT and superior to IST and unrelated donor HSCT post-IST failure. Front-line therapy with matched unrelated donor HSCT is a novel treatment approach and could be considered as first-line therapy in selected paediatric patients who lack a MSD. © 2015 John Wiley & Sons Ltd.

State Capture from Below? The Contradictory Effects of Decentralisation on Public Spending

This study analyses the contradictory effects of decentralisation on public spending. We distinguish three dimensions of decentralisation and analyse their joint and separate effects on public spending in the Swiss cantons over 20 years. We find that overall decentralisation has a strong, significant and negative effect on the size of the public sector, thus confirming the Leviathan hypothesis. The same holds for fiscal and institutional decentralisation. However, the extent to which political processes and actors are organised locally rather than centrally actually increases central and decreases local spending. This suggests that actors behave strategically when dealing with the centre by offloading the more costly policies. The wider implication of our study is that the balance between self-rule and shared rule has implications also for the size of the overall political system.

Intergenerational Conflict and the Political Economy of School Spending

In this paper we use survey data to examine support among voters from different age cohorts for public school spending. The survey asked potential voters in California how they intended to vote on two initiatives, one a statewide initiative that would increase spending on public schools throughout the state and the other a local initiative that would increase spending only in the respondent's local school district. We find that older voters without children generally oppose increases in state spending but are much more willing to support local spending. We examine two explanations for this voting pattern, namely the capitalization of local spending into housing values and intergenerational altruism. Our results do not strongly favor one explanation over the other. Consequently, we conclude that both factors (capitalization and intergenerational altruism) probably play important roles in sustaining support among older voters for local school spending.

The Congressional Budget Process and the Aggregate Level of Spending

This paper analyzes whether the Congressional budget process (instituted in 1974) leads to lower aggregate spending than does the piece-meal appropriations process that preceded it. Previous theoretical analysis, using spatial models of legislator preferences, is inconclusive. This paper uses a model of interest group lobbying, where a legislature determines spending on a national public good and on subsidies to subsets of the population that belong to nationwide sector-specific interest groups. In the appropriations process, the Appropriations Committee proposes a budget, maximizing the joint welfare of voters and the interest groups, that leads to overspending on subsidies. In the budget process, a Budget Committee proposes an aggregate level of spending (the budget resolution); the Appropriations Committee then proposes a budget. If the lobby groups are not subject to a binding resource constraint, the two institutional structures lead to identical outcomes. With such a constraint, however, there is a free rider problem among the groups in lobbying the Budget Committee, as each group only obtains a small fraction of the benefits from increasing the aggregate budget. If the number of groups is sufficiently large, each takes the budget resolution as given, and lobbies only the Appropriations Committee. The main results are that aggregate spending is lower, and social welfare higher, under the budget process; however, provision of the public good is suboptimal. The paper also presents two extensions: the first endogenizes the enforcement of the budget resolution by incorporating the relevant procedural rules into the model. The second analyzes statutory budget rules that limit spending levels, but can be revised by a simple majority vote. In each case,the free rider problem prevents the groups from securing the required changes to procedural and budget rules.

Das geheime Bataillon : eine Untersuchung über das kommunistische Verhalten zur Labour-Party

von Harold J. Laski

Everyone is; should healthcare? Outsourcing: Issues in strategic planning, organizational culture, and organizational ethics

Expenditures for personal health services in the United States have doubled over the last decade. They continue to outpace the growth rate of the gross national product. Costs for medical care have steadily increased at an annual rate well above the rate of inflation and have gradually outstripped payers' ability to meet their premiums. This limitation of resources justifies the ongoing healthcare reform strategies to maximize utilization and minimize costs. The majority of the cost-containment effort has focused on hospitals, as they account for about 40 percent of total health expenditures. Although good patient outcomes have long been identified as healthcare's central concern, continuing cost pressures from both regulatory reforms and the restructuring of healthcare financing have recently made improving fiscal performance an essential goal for healthcare organizations. ^ The search for financial performance, quality improvement, and fiscal accountability has led to outsourcing, which is the hiring of a third party to perform a task previously and traditionally done in-house. The incomparable nature and overwhelming dissimilarities between health and other commodities raise numerous administrative, organizational, policy and ethical issues for administrators who contemplate outsourcing. This evaluation of the outsourcing phenomenon, how it has developed and is currently practiced in healthcare, will explore the reasons that healthcare organizations gravitate toward outsourcing as a strategic management tool to cut costs in an environment of continuing escalating spending. ^ This dissertation has four major findings. First, it suggests that U.S. hospitals in FY2000 spent an estimated $61 billion in outsourcing. Second, it finds that the proportion of healthcare outsourcing highly correlates with several types of hospital controlling authorities and specialties. Third, it argues that healthcare outsourcing has implications in strategic organizational issues, professionalism, and organizational ethics that warrant further public policy discussions before expanding its limited use beyond hospital “hotel functions” and back office business processes. Finally, it devises an outsourcing suitability scale that organizations can utilize to ensure the most strategic option for outsourcing and concludes with some public policy implications and recommendations for its limited use. ^