Ethics in Health Policy for Allergy : A Practical Approach for Decision-Makers

Comme à l’approche d’un tsunami, l’incidence grandissante des allergies affecte maintenant plus de 30% de la population des pays développés. Étant la cause de nombreuses morbidités et un risque significatif de mortalité, les allergies nécessitent des dépenses exorbitantes au système de santé et constituent une des plus importantes sources d’invalidité. Cette thèse a pour but de contribuer à faciliter la prise de décision éclairée dans le développement de politiques en santé en lien avec cette maladie immunitaire chronique en utilisant des principes d’éthique comme outils pour guider le développement de politiques en santé. Le premier chapitre démontre le présent déficit d’analyses des enjeux éthiques en allergologie et démontre de quelle façon les réflexions en éthique peuvent guider le développement de politiques et l’élaboration de stratégies appliquées aux allergies. Les chapitres qui suivront présentent des applications spécifiques des principes d’éthiques ciblant des contextes précis comme des méthodes qui fournissent des outils de réflexion et des cadres théoriques qui peuvent être appliqués par les décideurs pour guider des interventions en santé concernant les allergies et les conditions de co-morbidité reliées. Le second chapitre présente un cadre théorique pour l’évaluation et la priorisation d’interventions en santé publique par la diminution des allergènes présents dans l’environnement basées sur des théories de justice sociale. Les critères entourant les politiques d’évaluation se concentrent sur les enjeux éthiques référant aux populations vulnérables, sur une distribution plus égale des bénéfices pour la santé, et sur le devoir d’éviter la stigmatisation. Le troisième chapitre offre aux administrateurs et au personnel infirmier du réseau scolaire un cadre décisionnel pour guider le développement de politiques efficaces et éthiquement justifiables concernant les allergies alimentaires pour les écoles. Dans ce contexte, les principes de base d’éthique en santé publique et en bioéthique - par exemple, l’empowerment des populations vulnérables dans la prise en charge de leur santé et la protection de la confidentialité du dossier médical - servent d’outils pour évaluer les politiques. Le dernier chapitre emploie les principes de base de recherche en éthique comme méthode pour développer un argumentaire en faveur de la réforme des réglementations entourant la production de médicaments immunothérapeutiques. La nécessité éthique d’éviter les risques de méfait à l’endroit du sujet humain dans la recherche permettra de servir de guide pour structurer de futures politiques en santé publique en égard à la production d’immunothérapeutiques à l’échelle mondiale.

Pattern of Executive Remuneration in the Manufacturing Public Enterprises in Kerala

The study is undertaken by the researcher with the object of examining the remuneration pattern of executive personnel in the manufacturing public enterprises in Kerala so as to find out whether there is any rationale or criteria involved in remunerating executives. It is also envisaged to find out the pattern of executive remuneration in the various categories of industries and inter—industry disparities among the public sector enterprises. This is considered to be a very fruitful area for investigation, particularly in view of the generally prevailing notion that public sector executives in Kerala are not remunerated properly and glaring inequalities and disparities are existing among the various categories of industries and within the same industry. Therefore the study is to explore the criteria used for the determination of executive remuneration and the relative weightage of various factors such as size of the firm, rate of return sales volume etc of the organisation and various other factors such as qualification, experience, level of job and functions of executives. Further the study is extended to find out the role of 'pay' towards motivation and efficiency of the executive personnel

Educational Loans And The Higher Education Sector In India

In 2001 the Indian Banks Association have come up with a model frame work for educational loans in the country. With the approval of the Central Government the public sector banks in India started to give education loans. The private and cooperative banks also joined the fray. Due to growing NPAs and the intervention of the Government these norms were modified in 2011. The budget allocation for the primary and higher secondary education is on the increase in India. However, higher education has been of late relegated or left to the mercy of the private players. There has been a steady growth of educational loans disbursed, private colleges and deemed universities started and enrolments of students in higher education during the years 2001 to 2011. This paper is a humble attempt to 1) analyse the growth of the educational loans vis-à-vis other forms of personal loans at the national level, 2) showcase the disbursements of educational loans in Kerala State, 3) to assess the growth of educational institutions and enrolment of students in higher education in India from secondary data and 4) to make suggestions based on the findings

Las prácticas de recursos humanos y su incidencia en el bienestar laboral de los empleados

El objetivo del presente trabajo es formular, mediante una profunda revisión documental, bibliográfica y empírica, una fundamentación teórica sobre si existe o no incidencia de las prácticas de recursos humanos sobre el bienestar laboral de los empleados, y el que grado en que esta se presenta sobre aspecto como el engagement y la satisfacción laboral. Se realizó la revisión de múltiples estudios empíricos que aportaran evidencia sobre la relación que se presenta entre las principales prácticas de recursos humanos – provisión de personal, formación y desarrollo, promoción de personal, evaluación de desempeño, compensación y pago, y balance trabajo-familia – y el bienestar laboral, representado en el engagement y satisfacción en el trabajo de los empleados. Los resultados de este trabajo indican la existencia de una relación e incidencia de las prácticas de recursos humanos, el bienestar laboral, el engagement y la satisfacción laboral. De igual forma se encontró que estas relaciones son principalmente de carácter positivo, lo cual indica que las organizaciones que desarrollan este tipo de prácticas en su interior, fomentan tanto el desarrollo y la presencia de bienestar laboral en sus empleados, como su perdurabilidad.

Public leisure provision under Compulsory Competitive Tendering: the maintenance of ideological dominance?

Although much has been written about the effect on services of public sector restructuring, little is yet available on public leisure provision. This omission is addressed by considering how the delivery of public leisure services in Britain has been affected by the imposition of Compulsory Competitive Tendering (CCT). In particular, it focuses on the changing relationship between the central and local levels of government recognising, on the part of local government, a continuum of structural responses to central initiatives which have, in some cases, conspired to reduce the impact of CCT on public leisure provision. The paper concludes that although attempts have been made to protect local services, the outcome of the CCT process has been the regeneration of public leisure provision away from its service roots, but within an enduring ideological paradigm of conservative professionalism.

Fair trade and European public procurement: legal principles and governance dynamics

Purpose The article examines principles of Fair Trade in public procurement in Europe, focusing on legal dimensions related to the European Public Procurement Directives. Design/methodology/approach The article situates public procurement of Fair Trade products in relation to the rise of non-state regulatory initiatives, highlighting how they have entered into new governance dynamics in the public sector and play a part in changing practices in sustainable procurement. A review of legal position on Fair Trade in procurement law is informed by academic research and campaigning experience from the Fair Trade Advocacy Office. Findings Key findings are that the introduction of Fair Trade products into European public procurement has been marked by legal ambiguity, having developed outside comprehensive policy or legal guidelines. Following a 2012 ruling by the Court of Justice of the European Union, it is suggested that the legal position for Fair Trade in procurement has become clearer, and that forthcoming change to the Public Procurement Directives may facilitate the uptake of fair trade products by public authorities. However potential for future expansion of the public sector ‘market’ for Fair Trade is approached with caution: purchasing Fair Trade products as a marker of sustainability, which started to be embedded within procurement practice in the 2000s, is challenged by current European public austerity measures. Research limitations/implications Suggestions for future research include the need for systematic cross-institutional and multi-country comparison of the legal and governance dimensions of procurement practice with regard to Fair Trade. Practical implications A clarification of current state-of-play with regard to legal aspects of fair trade in public procurement of utility for policy and advocacy discussion. Originality/value The article provides needed elaboration on an under researched topic area of value to academia and policy makers.

Performance-based contracting in the construction sector

Construction procurement is complex and there is a very wide range of options available to procurers. Inappropriate choices about how to procure may limit practical opportunities for innovation. In particular, traditional approaches to construction procurement set up many obstacles for technology suppliers to provide innovative solutions. This is because they are often employed as sub-contractors simply to provide and install equipment to specifications developed before the point at which they become involved in a project. A research team at the University of Reading has developed a procurement framework that comprehensively defines the various options open to procurers in a more fine-grained way than has been known in the past. This enables informed decisions that can establish tailor-made procurement approaches that take into account the needs of specific clients. It enables risk and reward structures to be aligned so that contracts and payment mechanisms are aligned precisely with what a client seeks to achieve. This is not a “one-size-fits-all” approach. Rather, it is an approach that enables informed decisions about how to organize individual procurements that are appropriate to particular circumstances, acknowledging that they differ for each client and for each procurement exercise. Within this context, performance-based contracting (PBC) is explored in terms of the different ways in which technology suppliers within constructed facilities might be encouraged and rewarded for the kinds of innovation sought by the ultimate clients. Examples from various industry sectors are presented, from public sector and from private sector, with a commentary about what they sought to achieve and the extent to which they were successful. The lessons from these examples are presented in terms of feasibility in relation to financial issues, governance, economics, strategic issues, contractual issues and cash flow issues for clients and for contractors. Further background documents and more detailed readings are provided in an appendix for those who wish to find out more.

For the public without the public

How is the notion of public interest operationalised in the regulatory practices of the International Public Sector Accounting Standards Board (IPSASB)? A fundamental objective in setting international accounting standards for both the private and public sector is to serve the ‘public interest’. Who or what constitutes ‘public interest’ however remains a highly complex and controversial issue. Private sector financial reporting research posits that users (of financial information) are used as a proxy for the ‘public’ and users are further refined to current and potential investors - a small proportion of the public. The debates surrounding public interest are even more contentious in public sector financial reporting which deals with ‘public’ (tax payers’) money. In our study we use Bourdieu’s notion of semi-homogenous fields to show how autonomous and heteronomous pressures from the epistemic community of the accounting profession and political/government interests compete for the right to define the public interest and determine how (by what accounting solutions) this interest is best served. This is a theoretical study grounded in the analysis of empirical data from interviews with the board members of the IPSASB. The main contribution of the paper is to further our understanding of the perceptions of the main decision makers from the ‘inner regulatory circle’ with regards to the problematic construct of public interest. The main findings suggest a paternal and un-reflexive attitude of the board members leading to the conclusion that the public have no real voice in these matters.

Legal and regulatory barriers to effective public-private partnership governance in Kazakhstan

Purpose – The purpose of this paper is to provide a critical assessment of legal and regulatory impediments to effective governance of public-private partnerships (PPPs) in Kazakhstan. Design/methodology/approach – The qualitative study develops propositions from the PPP literature and then tests them against findings from in-depth interviews. Interviewees have been selected by a purposeful sampling from PPP projects in Kazakhstan as well as from national and regional PPP centres. Findings – The identified barriers to effective PPP management include irregularities in the PPP legal framework, such as lack of legal definition of a PPP and controversy with the government guarantee’s legal status for its long-term payments to partnerships; bureaucratic tariff setting for partnership services; non-existent opportunity for private asset ownership; and excessive government regulation of PPP workers’ wage rates. Practical implications – The partners’ opposing perspectives on a number of PPP issues show that management needs to identify and carefully reconcile stakeholder values in a partnership in order to achieve more effective PPP governance. Practitioners, particularly those in the public agencies, have to be concerned with ways to reduce the government overregulation of the private operators, which is likely to result in greater PPP flexibility in management and, ultimately, higher efficiency in delivering the public services. Originality/value – By elucidating multiple examples of overregulation and PPPs’ inefficiency, the paper demonstrates that the government dominance in PPP management is conceptually inappropriate. Instead, the government should adopt the concept of co-production and manage its relations with the private sector partner in a collaborative fashion.

The impact of public capital and public investment on economic growth: an empirical investigation

in this anicle we measure the impact of public sector capital and investment on economic growth. Initially, traditional growth accounting regressions are run for a cross-country data set. A simple endogenous growth model is then constructed in order to take into account the determinants of labor, private capital and public capital. In both cases, public capital is a separate argument of the production function. An additional data-set constructed with quarterly American data was used in the estimations of the growth mode!. The results indicate lhat public capital and public investment play a significant role in determining growth rates and have a significant impact on capital and labor returns. Furthermore, the impact of public investment on productivity growth was found to be positive and always significant for bolh samples. Hence. in a fully optimizing modelo we confmn previous results in the literature that lhe failure of public investment to keep pace with output growlh during the Seventies and Eighties may have played a major role in the slowdown of lhe productivity growth in the period. Anolher main outcome concems the output elasticity wilh respect to public capital. The coefficiem estimates are always positive and significant but magnitudes depend on each of lhe two data set used.

Avaliação do estágio de desenvolvimento da responsabilidade social no Banco Central do Brasil

This study examines the corporate social responsibility (CSR) theme in Central Bank of Brazil (Bacen). The CSR movement is growing worldwide and it is related to values such as sustainability, ethics and transparency to the stakeholders. The study was performed in two parts. The first part consists of a bibliography research on the origins, the concept and the practice relating to CSR in the contemporary organizational environment. In the second part - field research - the Central Bank's Board of Directors and representatives of Ibase and Ethos Institute were interviewed and the content analysis method - a qualitative research method - was used in the interpretation of information obtained. The analysis of the interviews shows that the Board is receptive to the CSR development and that they consider the accomplishment of Central Bank's institutional mission fundamental in this process. The participation of the Bank's personnel and the incorporation of the CSR principles into the day-to-day practice are also considered necessary. Finally, one hundred indicators - based on the Ethos CSR Indicators - are proposed to evaluate the stage of development of social responsibility in Bacen on the following subjects: Values, Transparency and Governance; Internal Public; Natural Environment, Suppliers and Society. In summary, this study aims to contribute to the improvement of the knowledge of corporate social responsibility and the best practices in the public sector, particularly in Central Bank of Brazil.

From public to private : the performance of former public workers in the Brazilian labor market

This paper analyzes the placement in the private sector of a subset of Brazilian public-sector employees. This group left public employment in the mid-1990’s through a voluntary severance program. This paper contrasts their earnings before and after quitting the public sector, and compares both sets of wages to public and private sector earnings for similar workers. We find that participants in this voluntary severance program suffered a significant reduction in average earnings wage and an increase in earnings dispersion. We test whether the reduction in average earnings and the increase in earnings dispersion is the expected outcome once one controls for observed characteristics, by means of counterfactual simulations. Several methods of controlling for observed characteristics (parametric and non-parametrically) are used for robustness. The results indicate that this group of workers was paid at levels below what would be expected given their embodied observable characteristics.

Prevalence of enamel white spots and risk factors in children up to 36 months old

The aim of this study was to determine the prevalence of enamel white spots and the quality of oral hygiene in children up to 36 months old, in municipalities with different fluoride levels in the water supply, analyzing the contribution of several variables. After approval of the Ethics Committee, the parents signed an informed consent form and were interviewed about their educational level, economic classification of the family, nursing habits, use of toothpaste, access to dental service and other information. The children were clinically examined using the same codes and criteria established by the WHO (World Health Organization) and ADA (American Dental Association). The data were processed and analyzed with the Epi-info software program, version 3.2, and Microsoft Excel. Fisher's exact test (p<0.05) was applied to assess the association among the variables. The enamel white spot prevalence was 30.8% and the age group, duration of the bedtime milk feeding habit, age of initial practice of oral hygiene and presence of caries lesions with cavitation were considered statistically significant with regard to enamel white spot prevalence (p < 0.05). No association was found between oral hygiene quality and the study variables. © 2009 Sociedade Brasileira de Pesquisa Odontológica.

Public policy for pensions, health and sickness insurance

Includes bibliography