An Architectural and Historical Survey of Public Libraries in Iowa 1870-1940, 1980

The public library movement f the early twentieth century was a national phenomenon, in which Iowa, along with its neighboring states, played a prominent role. In 1900, the Iowa Library Commission noted 48 free public libraries in the state. Today there are approximately 500, in towns ranging in size from Beaman, with a population of 222, the Des Moines, the state capitol. Iowans took enthusiastic advantage of Andre Carnegie's library philanthropy. In 1919, the Carnegie Corporation stopped funding libraries, 101 building has been erected in Iowa with Carnegie funds. Iowa place fourth among the states in terms of the number of communities obtaining Carnegie buildings, fifth in dollar appropriation per one hundred population and eighth in the total amount of money given by Carnegie to a state. These figures provide some measure by which interest in popular education among Iowans of the period can be judged. Today these early libraries, often the most distinctive public libraries in small or medium-sized towns, are physical foci in the townscapes of their communities and centers for a variety of educational and social activities. This survey was initiated by the Division of Historic Preservation in 1977. It grew out of the need to provide a framework within which libraries could be evaluated for National Register action. Several libraries (Des Moines, Grinnell, Eagle Grove, Carroll) has been recent candidates for the Register. There was every indication that enthusiasm for old library buildings was increasing and that more nominations could be expected in the future. The attrition rate among early library buildings was (and is) growing. Most libraries were built on limited budgets (Carnegie did not squander his money) and, despite the fact that future expansion was usually a conscious consideration in their design, they are rapidly becoming obsolete, due to expanding collections and changing styles of librarianship. If the protection of the threatened with demolition or alteration, action needed to be taken.

Immersion communautaire à Lausanne : une autre façon d'enseigner la santé publique [Community immersion in Lausanne: a different approach to teaching public health?].

Teaching community medicine represents a significant challenge for medical schools, which tend to struggle to promote interest in the issue among students. In 2009, the Lausanne medical school introduced a "community immersion" module specifically designed to address the issue. The new module requires students working in small groups under the supervision of a tutor to investigate a health question of their choice. The investigation involves conducting interviews with stakeholders (health professionals, patients, politicians, etc.), carrying out a survey, and presenting the results of the investigation in a "congress". An external evaluation showed that the objectives of the initiative had been largely achieved, with an increase of interest in community medicine for over 50% of students (based on a total cohort of 150 students) and a high level of satisfaction for over 90% of students and tutors. This paper presents the results of the initiative and its use for promoting community-oriented medicine.

Evolutionary dynamics of interlinked public goods traits: an experimental study of siderophore production in Pseudomonas aeruginosa.

Public goods cooperation is common in microbes, and there is much interest in understanding how such traits evolve. Research in recent years has identified several important factors that shape the evolutionary dynamics of such systems, yet few studies have investigated scenarios involving interactions between multiple public goods. Here, we offer general predictions about the evolutionary trajectories of two public goods traits having positive, negative or neutral regulatory influence on one another's expression, and we report on a test of some of our predictions in the context of Pseudomonas aeruginosa's production of two interlinked iron-scavenging siderophores. First, we confirmed that both pyoverdine and pyochelin siderophores do operate as public goods under appropriate environmental conditions. We then tracked their production in lines experimentally evolved under different iron-limitation regimes known to favour different siderophore expression profiles. Under strong iron limitation, where pyoverdine represses pyochelin, we saw a decline in pyoverdine and a concomitant increase in pyochelin - consistent with expansion of pyoverdine-defective cheats derepressed for pyochelin. Under moderate iron limitation, pyochelin declined - again consistent with an expected cheat invasion scenario - but there was no concomitant shift in pyoverdine because cross-suppression between the traits is unidirectional only. Alternating exposure to strong and moderate iron limitation caused qualitatively similar though lesser shifts compared to the constant-environment regimes. Our results confirm that the regulatory interconnections between public goods traits can significantly modulate the course of evolution, yet also suggest how we can start to predict the impacts such complexities will have on phenotypic divergence and community stability.

Three essays on the determinants of output, inflation and interest rates

Résumé: Output, inflation and interest rates are key macroeconomic variables, in particular for monetary policy. In modern macroeconomic models they are driven by random shocks which feed through the economy in various ways. Models differ in the nature of shocks and their transmission mechanisms. This is the common theme underlying the three essays of this thesis. Each essay takes a different perspective on the subject: First, the thesis shows empirically how different shocks lead to different behavior of interest rates over the business cycle. For commonly analyzed shocks (technology and monetary policy errors), the patterns square with standard models. The big unknown are sources of inflation persistence. Then the thesis presents a theory of monetary policy, when the central bank can better observe structural shocks than the public. The public will then seek to infer the bank's extra knowledge from its policy actions and expectation management becomes a key factor of optimal policy. In a simple New Keynesian model, monetary policy becomes more concerned with inflation persistence than otherwise. Finally, the thesis points to the huge uncertainties involved in estimating the responses to structural shocks with permanent effects.

Can the administration be trusted? An analysis of the concept of trust, applied to the public sector

In the first part of this paper, we present the various academic debates and, where applicable, questions that remain open in the literature, particularly regarding the nature of trust, the distinction between trust and trustworthiness, its role in specific relationships and its relationship to control. We then propose a way of demarcating and operationalizing the concepts of trust and trustworthiness. In the second part, on the basis of the conceptual clarifications we present, we put forward a number of "anchor points" regarding how trust is apprehended in the public sector with regard to the various relations hips that can be studied. Schematically, we distinguish between two types of relations hips in the conceptual approach to trust: on one hand, the trust that citizens, or third parties, place in the State or in various public sector authorities or entities, and on the other hand, trust within the State or the public sector, between its various authorities, entities, and actors. While studies have traditionally focused on citizens' trust in their institutions, the findings, limitations and problems observed in public - sector coordination following the reforms associated with New Public Management have also elicited growing interest in the study of trust in the relationships between the various actors within the public sector. Both the theoretical debates we present and our propositions have been extracted and adapted from an empirical comparative study of coordination between various Swiss public - service organizations and their politico - administrative authority. Using the analysis model developed for this specific relationship, between various actors within the public service, and in the light of theoretical elements on which development of this model was based, we propose some avenues for further study - questions that remain open - regarding the consideration and understanding of citizens' trust in the public sector.

Co-evolution of Policy Sectors: Health Care and Public Health in five Countries

Cette thèse analyse la co-évolution de deux secteurs dans la politique de la santé: santé publique (public health) et soins aux malades (health care). En d'autres termes, la relation entre les dimensions curative et préventive de la politique de la santé et leur développement dans la durée. Une telle recherche est nécessaire car les problèmes de la santé sont complexes et ont besoin de solutions coordonnées. De plus, les dépenses de la santé ont augmenté sans arrt durant les dernières décennies. Un moyen de réduire une future augmentation des dépenses pourrait consister en davantage d'investissement dans des mesures préventives. En relation avec cette idée, ma recherche analyse les politiques de la santé publique et les soins aux malades de cinq pays: Allemagne, Angleterre, Australie, Etats-Unis et Suisse. En m'appuyant sur la littérature secondaire, des statistiques descriptives et des entretiens avec des experts et des politiciens, j'analyse la relation entre les deux secteurs depuis la fin du dix-neuvième siècle. En particulier, je me focalise sur la relation des deux champs sur trois niveaux: institutions, acteurs et politiques. Mes résultats montrent les similitudes et les différences d'évolution entre les cinq pays. D'un c^oté, lorsque la profession médicale est politiquement active et que le pays consiste en une fédération centralisée ou en un gouvernement unitaire, les deux secteurs sont intégrés au niveau institutionnel, ralliant les professions et groupes d'intérêt des deux secteurs la cause commune dans une activité politique. Par contre, dans tous les pays, les deux secteurs ont co-évolué vers une complémentarité malgré de la politisation des professions et la centralisation du gouvernement. Ces résultats sont intéressants pour la science politique en général car ils soulignent l'importance des professions pour le développement institutionnel et proposent un cadre pour l'analyse de la co-évolution des politiques publiques en général. -- This Ph.D. thesis analyzes the co-evolution of the health care and the public health sectors. In other words, the relation between preventive and curative health policy and its evolution over time. Such research is necessary, because current health problems are complex and might need coordinated solutions. What is more, health expenditures have increased continuously in the last decades. One way to slow down further increase in health spending could be to invest more in preventative health policies. Therefore, I am connecting individual health care and public health into a common analysis, taking Australia, Germany, Switzerland, the UK and the U.S. as examples. Based on secondary literature, descriptive statistics and interviews with experts and policymakers, I am analyzing how the two sectors' relations co-evolved between the late nineteenth and the early twenty-first century. Specifically, I am researching how health care and public health were related on the levels of institutions, actors and policies. My results show that there are differences and similarities in the co-evolution of policy sectors between these countries. On the one hand, when the medical profession was politically active and the country a centralized federation or a unitary state, there was institutional integration and common political advocacy of the sectors' interest groups and professions. On the other hand, in all countries, both sectors co-evolved towards complementarity, irrespectively of the politicization of professions and centralization of government. These findings are interesting for the political science literature at large, because they underline the importance of professions for institutional development and propose an analytical framework for analyzing the co-evolution of policy sectors in general.

Screening and overdiagnosis : public health implications

Overdiagnosis is the diagnosis of an abnormality that bears no substantial health hazard and no benefit for patients to be aware of. Resulting mainly from the use of increasingly sensitive screening and diagnostic tests, as well as broadened definitions of conditions requiring an intervention, overdiagnosis is a growing but still largely misunderstood public health issue. Fear of missing a diagnosis or of litigation, financial incentives or patient's need of reassurance are further causes of overdiagnosis. The main consequence of overdiagnosis is overtreatment. Treating an overdiagnosed condition bears no benefit but can cause harms and generates costs. Overtreatment also diverts health professionals from caring for those most severely ill. Recognition of overdiagnosis due to screening is challenging since it is rarely identifiable at the individual level and difficult to quantify precisely at the population level. Overdiagnosis exists even for screening of proven efficacy and efficiency. Measures to reduce overdiagnosis due to screening include heightened sensitization of health professionals and patients, active surveillance and deferred treatment until early signs of disease progression and prognosis estimation through biomarkers (including molecular) profiling. Targeted screening and balanced information on its risk and benefits would also help limit overdiagnosis. Research is needed to assess the the public health burden and implications of overdiagnosis due to screening activity.

Fiscal policy and interest rates: the role of financial and economic integration

It is commonly believed that a fiscal expansion raises interest rates. However, these crowding out effects of deficits have been found to be small or non-existent. One explanation is that financial integration offsets interest rate differentials on globalised bond markets. This paper measures the degree of integration of government bond markets, using spatial modelling techniques to take this spillover on financial markets into account. Our main finding is that the crowding out effect on domestic interest rates is significant, but is reduced by spillover across borders. This spillover is important in major crises or in periods of coordinated policy actions. This result is generally robust to various measures of cross-country linkages. We find spillover to be much stronger among EU countries.

“THE PATIENT SURVIVED DESPITE THE TREATMENT”. A study of Finnish health policy and New Public Management. Case: The Government Resolution on the Health 2015 public health programme.

Internationally, Finland has been among the most respected countries during several decades in terms of public health. WHO has had the most significant influence on Finnish health policy and the relationship has traditionally been warm. However, the situation has slightly changed in the last 10-20 years. The objectives of Finnish national health policy have been to secure the best possible health for the population and to minimize disparities in health between different population groups. Nevertheless, although the state of public health and welfare has steadily improved, the socioeconomic disparities in health have increased. This qualitative case study will demonstrate why health is political and why health matters. It will also present some recommendations for research topics and administrative reforms. It will be argued that lack of political interest in health policy leads to absence of health policy visions and political commitment, which can be disastrous for public health. This study will investigate how Finnish health policy is defined and organised, and it will also shed light on Finnish health policy formation processes and actors. Health policy is understood as a broader societal construct covering the domains of different ministries, not just Ministry of Social Affairs and Health (MSAH). The influences of economic recession of the 1990s, state subsidy reform in 1993, globalisation and the European Union will be addressed, as well. There is not much earlier Finnish research done on health policy from political science viewpoint. Therefore, this study is interdisciplinary and combines political science with administrative science, contemporary history and health policy research with a hint of epidemiology. As a method, literature review, semi-structured interviews and policy analysi will be utilised. Institutionalism, policy transfer, and corporatism are understood as the theoretical framework. According to the study, there are two health policies in Finland: the official health policy and health policy generated by industry, media and various interest organisations. The complex relationships between the Government and municipalities, and on the other hand, the MSAH and National Institute for Health and Welfare (THL) seemed significant in terms of Finnish health policy coordination. The study also showed that the Investigated case, Health 2015, does not fulfil all necessary criteria for a successful public health programme. There were also several features both in Health 2015 and Finnish health policy, which can be interpreted in NPM framework and seen having NPM influences.

Public and private sector cooperative opportunities in the Finnish healthcare internationalization : views from the public sector’s perspective

Traditionally mostly publicly provided Finnish healthcare services are confronted today by the evident challenge of rising healthcare costs as the expenditure on health and social case has exceeded Finland’s national GDP growth significantly since the new millennium. While the opening of the traditional barriers through the EU’s new patient directive resulting in increasing international competition and the free flow of patients within the EU present opportunities for the Finnish healthcare services industry there are also several challenges for the existing healthcare system as proposed by the Ministry of Employment and the Economy in 2011. Due to the structure and nature of the current Finnish healthcare service system the greatest potential for internationalization is seen from a joint cooperation of the public and private sectors in an internationalization network for Finnish healthcare services. As its formation has recently also taken as a strategic initiative to be completed by the Ministry of Employment and the Economy and no earlier research exists on how this is seen in practice by the network actors, the purpose of this study is to examine the proposed solution of forming an internationalization network between the public and private sector actors in Finland in practice from the viewpoint of public sector actors. The research relied heavily on the reports by the Finnish Ministries in understanding the current situation of the Finnish healthcare services internationalization and its potential. Suitable theories were also used to build a more comprehensive view of the matter. The study applied a qualitative research approach on the explorative research problem. The data collection was achieved through expert interviews in two of the largest Finnish public healthcare service providers; the Turku and Helsinki Central University Hospitals. Expert interviews were considered as the most suitable method for data collection in order to create an in-depth understanding of the topic within the limitations of this thesis. In turn, two different public healthcare service providers were chosen to give a broader view of the field instead of focusing on a specific unit and also to allow a possible comparison between the two different organizations. The latter however was shown not to be suitable for the purposes of this study as the opinions of the respondents varied largely also within their own organizations. The conclusion is that while the actors agree on the evident internationalization of Finnish healthcare services, there are several large-scale structural challenges effectively preventing such activities while at the same time the opportunities within Finland vary, as there are several niches but no real large-scale advantages in the highly competitive industry. Interest towards cooperation between the sectors are seen especially in exploiting the advantages offered by the private sector in commercialization and marketization, yet however no clear views exist on how these activities should be governed or structured in the short-term as a larger reform of the entire Finnish healthcare service sector is needed in the long-term.

Addressing conflicts of interest in the research paper: a societal demand in contemporary science?

In the last decade, dialogue between science and society has found a forum in an increasing number of publications on topics such as public engagement with science and public trust in science. Concerning the latter, issues that include cases of research misconduct, accountability in research, and conflicts of interest (COIs) have shaped global discussions on the communication of science. In the publication setting, the perception that hiding COIs and/or not managing them well may affect public trust in the research record has grown among editors. We conducted a search for editorials addressing COIs between 1989 and 2011, using four major databases: Medline/PubMed, Embase, Scopus, and Web of Knowledge. We explored the content of these editorials and the relationship they established between COIs and the public trust in science. Our results demonstrate that the relationship between disclosure of COIs and public trust in science has become a major concern among editors. We, thus, argue that COIs should be discussed more openly and frequently in graduate courses in the sciences, around the globe, not only in biomedical but also in non-biomedical areas. This is a critical issue in contemporary science, as graduate students are the future voices and decision-makers of the research community. Therefore, COIs, especially in the broader context of science and society, merit closer attention from policymakers, researchers, and educators. At times of great expectations for public engagement with science, mishandling of COIs may have undesirable consequences for public engagement with science and confidence in the scientific endeavor.

The contagion effect of public debt on monetary policy: the Brazilian experience

This paper attempts to explain why the Brazilian inter-bank interest rate is so high compared with rates practiced by other emerging economies. The interplay between the markets for bank reserves and government securities feeds into the inter-bank rate the risk premium of the Brazilian public debt.

The role of public export promotion in Finland Industry view of public export promotion in Southwest Finland

The role of the public export promotion in Finland needed more research. The part of the public sector export promotion in the overall export is significant. In an ever more global world not only the companies but also the counties compete against each other and the governments have an interest to boost their economy as much as they are able to. Every industrialized country has export promotion services in some form or another. In the 21st century the tendency has been the bundling of the services and this has also been done in Finland with Team Finland. The role and the efficiency of the services provided deserve more research. The research question of this study is: What is the role of the public export promotion services in Finland? The question is researched primary by expert interviews conducted for this study. The situation in Southwest Finland is studied from the viewpoint of the companies of the region by conducting a survey aimed to the successfully internationalized companies of the region and asking them on their views on the impact and role of public export services in their internationalization. The theory base is formed out of various export promotion studies, studies monitoring the effects of the promotion and theories of the internationalization process of companies. The primary material for the study are the three expert interviews conducted and the answers to the survey conducted. The research method in the first part is a constructive qualitative research. The research approach in the second part, where the views of the companies in Southwest Finland are studied, is quantitative. The study findings from the expert interviews: the aligning of the public export promotion done in Finland to the previous research and the addition of the role of the public sector in classical frameworks. The study findings from the survey: the utilizing of the public export promotion services is heavily delayed and the internationalizing companies start to utilize the services very late in their internationalization process, the average being 10,3 years from the beginning of the internationalization. Another central finding from the survey is that the successfully internationalized companies see the public export promotion services generally as highly beneficial but in the light of the answers the effect on their own company is not as significant. Concluding can be stated that the public export promotion is seen as beneficial, but the monitoring of the efficiency is complicated in the case of services. Getting the companies to start utilizing the services earlier in their internationalization needs attention from the service providers. By communicating the achieved results and benefits better to the potential users of the services the internationalization process of the companies could be accelerated

Public service reform and the role of the Auditor General /

The objective of this thesis is to study the involvement of the Auditor General in the proposal, implementation and review of major public service reform initiatives during a period spanning nearly forty years, from the early 1960s to 2001 . This period began with the Glassco Commission and concludes at the end of the term in office of Auditor General Denis Desautels in 2001. It has been demonstrated throughout this work that the role of the OAG has varied, from proponent to critic, from instigator to reviewer. In the past forty years the OAG's mandate has changed to meet the requirements of critical analysis of government operations and this has been aptly demonstrated in the office's relationship to the issue of public service reform. It has been argued that many of the problems facing the public service are cultural in nature. Reform initiatives have taken on a number of various forms with each addressing a different set of priorities. However, there has been a great deal of consistency in the cultural values that these initiatives articulate. Throughout this thesis attention has been paid to values. Values define a culture and cultural change is required within the Canadian federal public service. How and when this cultural change will occur is but one question to be answered. During the period under consideration in this thesis the government undertook several significant public service reform initiatives. Those examined in this thesis include: The Royal Commission on Government Organization, The Special Committee on the Review of Personnel Management and the Merit Principle, The Royal Commission on Financial Management and Accountability, Increased Ministerial Authority and Accountability, Public Service 2000, Program Review and finally La Releve. The involvement, or interest, of the Auditor General's Office on the subject of public service reform is generally articulated through the means of its annual reports to Parliament although there have been supplementary undertakings on this issue. Such material relevant to this study include: Towards Better Governance: Public Service Reform in New Zealand (1984-94) and its Relevance to Canada and Reform in the Australian Public Service. Annual reports to Parliament include: "Values, Service and Performance," (1990), "Canada's Public Service Reform and Lessons Learned from Selected Jurisdictions," (1993), "Maintaining a Competent and Efficient Public Service," (1997), and "Expenditure and Work Force Reduction in Selected Departments,"

A Semi-Parametric Factor Model for Interest Rates.

Understanding the dynamics of interest rates and the term structure has important implications for issues as diverse as real economic activity, monetary policy, pricing of interest rate derivative securities and public debt financing. Our paper follows a longstanding tradition of using factor models of interest rates but proposes a semi-parametric procedure to model interest rates.