Inventory and perspectives of chronic disease management programs in Switzerland: an exploratory survey.

OBJECTIVE: To describe chronic disease management programs active in Switzerland in 2007, using an exploratory survey. METHODS: We searched the internet (Swiss official websites and Swiss web-pages, using Google), a medical electronic database (Medline), reference lists of pertinent articles, and contacted key informants. Programs met our operational definition of chronic disease management if their interventions targeted a chronic disease, included a multidisciplinary team (>/=2 healthcare professionals), lasted at least six months, and had already been implemented and were active in December 2007. We developed an extraction grid and collected data pertaining to eight domains (patient population, intervention recipient, intervention content, delivery personnel, method of communication, intensity and complexity, environment, clinical outcomes). RESULTS: We identified seven programs fulfilling our operational definition of chronic disease management. Programs targeted patients with diabetes, hypertension, heart failure, obesity, psychosis and breast cancer. Interventions were multifaceted; all included education and half considered planned follow-ups. The recipients of the interventions were patients, and healthcare professionals involved were physicians, nurses, social workers, psychologists and case managers of various backgrounds. CONCLUSIONS: In Switzerland, a country with universal healthcare insurance coverage and little incentive to develop new healthcare strategies, chronic disease management programs are scarce. For future developments, appropriate evaluations of existing programs, involvement of all healthcare stakeholders, strong leadership and political will are, at least, desirable.

Beyond the Transatlantic Divide: The Multiple Authorities of Standards in the Global Political Economy of Services

This paper explores the plurality of institutional environments in which standards for the service sector are expected to support the rise of a global knowledge-based economy. Despite the careful wording of the World Trade Organization (WTO), a whole range of international bodies still have the capacity to define technical specifications affecting how services are expected to be traded on worldwide basis. The analysis relies on global political economy approaches to extend to the area of service standards the assumption that the process of globalization is not opposing states and markets, but a joint expression of both of them including new patterns and agents of structural change through formal and informal power and regulatory practices. It analyses on a cross-institutional basis patterns of authority in the institutional setting of service standards in the context of the International Organisation for Standardisation (ISO), the European Union, and the United States. In contrast to conventional views opposing the American system to the ISO/European framework, the paper questions the robustness of this opposition by showing that institutional developments of service standards are likely to face trade-offs and compromises across those systems and between two opposing models of standardisation.

Hybrids and Regulation in the Global Political Economy

While regulation theory literature has made important contributions to the much-debated domain of globalisation by focusing on various aspects of post-Fordism, it has not yet fully engaged with the implications that can be drawn from critical approaches in international political economy. Recent studies have explored the transnational bases of new patterns and agents of change beyond states, firms and institutions traditionally involved in regulatory practices. Hybrid is often used as a default attribute reflecting lack of clear understanding of the breadth of this new type of influence and the opacity of the means involved. Drawing on the insights of philology and mythology, the paper argues that the notion of hybrid is relevant in elucidating the ontological ambiguity between imaginary and real aspects of globalisation. Furthermore, it specifies the categories involved in the analysis of emerging forms of hybrid regulation. Recent scholarship on globalisation tends to focus on the private-public nexus of the subjects involved in new forms of institutional arrangements and authority. Here, subjects, objects and space are analysed as joint issues. By focusing particularly on transformations affecting the role of the state, forms of competition, and their rescaling on a transnational basis, the concept of global hybrid is seen as complementary to the emancipation of regulation approaches from early emphasis on national levels of compromises.

Presidents and parties in regional politics: Italy and Spain compared

This article examines the relationship between political parties and regional presidents in Italy and Spain, adopting a comparative case study approach based on extensive archival analysis and in-depth interviews with regional politicians. The findings confirm a strong pattern of growing presidentialism at regional level, regardless of whether there are formal mechanisms for direct election, and regardless of the partisan composition of regional government. Regional presidents tend to exert their growing power through a personalised control of regional party organisations, rather than governing past parties in a direct appeal to the electorate. Nevertheless, parties can still present a significant constraint on regional presidents, so successful regional presidents tend to maintain a mediating form of leadership and fully exploit the opportunities for party patronage to build up their support and smooth governing tensions. An autonomist drive helps presidents hold together disparate coalitions or loose parties at regional level, but their lack of internal coherence presents major problems when it comes to political succession.

From Leadership to Citizenship Behavior in Public Organizations: When Values Matter

After decades of management reforms in the public sector, questions on the impact of leader-ship behavior in public organizations have been attracting increasing attention. This paper investigates the relationship between transformational leadership behavior and organizational citizenship behavior as one major extra-role outcome of transformational leadership. Refer-ring to a growing body of research that shows the importance of public service values and employee identification in public administration research, we include public service motiva-tion and organizational goal clarification as mediating variables in our analysis. Structural equation modeling is applied as the method of analysis for a sample of 569 public managers at the local level of Switzerland. The findings of our study support the assumed indirect relation-ship between leadership and employee behavior and emphasize the relevance of public ser-vice values when analyzing leadership behavior in public sector organizations.

Do Fiscal and Political Decentralization Raise Students’ Performance? A Cross-Country Analysis

The low quality of education is a persistent problem in many developed countries. Parallel to in the last decades exists a tendency towards decentralization in many developed and developing countries. Using micro data from the Programme for International Student Assessment (PISA) referred to 22 countries, we test whether there exists an impact of fiscal and political decentralization on student performance in the areas of mathematics, reading skills and science. We observe that fiscal decentralization exerts an unequivocal positive effect on students’ outcomes in all areas, while the effect of political decentralization is more ambiguous. On the one hand, the capacity of the subnational governments to rule on its region has a positive effect on students’ performance in mathematics. On the other hand, the capacity to influence the country as a whole has a negative impact on mathematics achievement. As a general result, we observe that students’ performance in Mathematics is more sensible to these exogenous variations than in Sciences and reading skills. Keywords: School outcomes, PISA, fiscal decentralization, political decentralization JEL codes: H11, H77, I21

The Impact of the Electoral System on Political Campaigning : Are Candidates for the Council of States More Moderate than their Fellow Candidates for the National Council ?

It is commonly believed that majority voting enhances parties to cluster around the centre of the political space, whereas proportional systems (PR) foster great ideological divergence. The theoretical arguments for these expectations go back to the work of Downs (1957) and Duverger (1954). More recent studies, however, produced quite contradictory empirical findings. In this paper I will test whether similar arguments hold true for the positioning of candidates campaigning in different electoral systems. The elections for the two chambers of the Swiss Parliament and the data from the Swiss Electoral Studies (SELECTS) and the Swiss Voting Advice Application (VAA) smartvote offer an excellent - almost laboratory like - opportunity to do so empirically. The analyses show clearly, the theoretical claims that majority voting necessarily fosters more moderate positions find no support. The candidates for the Council of States, elected in a majority system, are not more moderate than their fellow party candidates for the National Council which are elected in a PR system.

An Inquiry into the use of illegal electoral practices and effects of political violence

This article investigates whether vote-buying and the instigation of violence in the disputed 2007 Kenyan elections were strategically motivated, and whether those affected by electoral violence changed their views towards ethno-politics and the use of violence. To answer these questions, a panel survey conducted before and after the elections is combined with external indicators of electoral violence. We find that political parties targeted vote-buying towards specific groups to weaken the support of their political rivals and to mobilize their own supporters. Furthermore, parties instigated violence strategically in areas where they were less likely to win. Although the victims of violence would prefer that parties are no longer allowed to organize in ethnic or religious lines, they are more likely to identify in ethnic terms, support the use of violence and avoid relying on the police to resolve disputes. The overall findings suggest an increased risk of electoral-violence reoccurring.

Uncertainty, electoral Incentives and political myopia

In this paper, we study the determinants of political myopia in a rational model of electoral accountability where the key elements are informational frictions and uncertainty. We build a framework where political ability is ex-ante unknown and policy choices are not perfectly observable. On the one hand, elections improve accountability and allow to keep well-performing incumbents. On the other, politicians invest too little in costly policies with future returns in an attempt to signal high ability and increase their reelection probability. Contrary to the conventional wisdom, uncertainty reduces political myopia and may, under some conditions, increase social welfare. We use the model to study how political rewards can be set so as to maximise social welfare and the desirability of imposing a one-term limit to governments. The predictions of our theory are consistent with a number of stylised facts and with a new empirical observation documented in this paper: aggregate uncertainty, measured by economic volatility, is associated to better ...scal discipline in a panel of 20 OECD countries.