Ethnicity, Governance and the Provision of Public Goods

Ethnicity is an important institution and one that impacts on the quality of governance. This paper focuses on the behavior of ethnic groups and specifically on their impact on the provision of public goods. The paper shows that ethnic heterogeneity results in under-provision of non-excludable public goods. On the other hand, such societies associate with provision of patronage goods. The paper proposes some areas of research such the economics of ethnic institutions, empirical evidence of the role ethnic groups on public goods provision, tax compliance and institutional reforms to improve governance.

Assessment of markers of medication literacy in a US-Mexico border community

Each year an estimated 180,000 people in the United States (U.S.) die as a result of medication errors, now considered a major public health problem. If a patient cannot correctly act on information related to medication use or "Medication Literacy" there is an increased potential for error. Medication use issues are unique on the US-Mexico border because they include high rates of herbal products and medication products from Mexico as well as issues related to the preferred language (English or Spanish) of the patient. To evaluate the medication literacy in a US-Mexico border community, this retrospective study evaluates 180 subjects representing four diverse economic segments of a metropolitan US-Mexico Border community who have taken a Medication Literacy Assessment. The assessment tool has been created to understand how patients interpret medication information for prescription, over-the-counter, herbal, and Mexican medication product use, and how they problem-solve medication questions. The Medication Literacy Assessment tool specifically assesses document literacy (e.g., prescription labels), prose literacy (e.g., patient leaflets), numeracy (e.g., calculations and measurements) as well as qualitative data related to medication use practices. The main hypothesis of this study is that the ability to interpret and use medications will vary based on education, language (Spanish or English), and recruitment sites (economically diverse communities). The results will provide information to better characterize medication use in a primarily Hispanic population on the US-Mexico border and may be used to influence policy decisions regarding prescription and over-the-counter product information.^

Persistently elevated troponin I in heart failure patients - a suitable prognosticator and a possible boon to public health?

Baseline elevation of troponin I (TnI) has been associated with worse outcomes in heart failure (HF). However, the prevalence of persistent TnI elevation and its association with clinical outcomes has not been well described. HF is a major public health issue due to its wide prevalence and prognosticators of this condition will have a significant impact on public health. Methods: A retrospective study was performed in 510 patients with an initial HF admission between 2002 to 2004, and all subsequent hospital admissions up to May 2009 were recorded in a de-identified database. Persistent TnI elevation was defined as a level ≥0.05 ng/ml on ≥3 HF admissions. Baseline characteristics, hospital readmissions and all cause mortality were compared between patients with persistent TnI elevation (Persistent), patients with no persistence of TnI (Nonpersistent) and patients who had less than three hospital admissions (admission <3) groups. Also the same data was analyzed using the mean method in which the mean value of all recorded troponin values of each patient was used to define persistence i.e. patients who had a mean troponin level ≥0.05 ng/ml were classified as persistent. Results: Mean age of our cohort was 68.4 years out of which 99.6% subjects were male, 62.4% had ischemic HF. 78.2% had NYHA class III to IV HF, mean LVEF was 25.9%. Persistent elevation of TnI was seen in 26% of the cohort and in 66% of patients with more than 3 hospital admissions. Mean TnI level was 0.67 ± 0.15 ng/ml in the 'Persistent' group. Mean TnI using the mean method was 1.11 ± 7.25 ng/ml. LVEF was significantly lower in persistent group. Hypertension, diabetes, chronic renal insufficiency and mean age did not differ between the two groups. 'Persistent' patients had higher mortality (HR = 1.26, 95% CI = 0.89–1.78, p = 0.199 when unadjusted and HR = 1.29, 95% CI = 0.89–1.86, p = 0.176 when adjusted for race, LVEF and ischemic etiology) HR for mortality in persistent patients was 1.99 (95% CI = 1.06–3.73, p = 0.03) using the mean method. The following results were found in those with ischemic cardiomyopathy (HR = 1.44034, 95% CI = 0.92–2.26, p = 0.113) and (HR = 1.89, 95% CI = 1.01–3.55, p = 0.046) by using the mean method. 2 out of three patients with HF who were readmitted three or more times had persistent elevation of troponin I levels. Patients with chronic persistence of troponin I elevation showed a trend towards lesser survival as compared to patients who did not have chronic persistence, however this did not reach statistical significance. This trend was seen more among ischemic patients than non ischemic patients, but did not reach statistical significance. With the mean method, patients with chronic persistence of troponin I elevation had significantly lesser survival than those without it. Also ischemic patients had significantly lesser survival than non ischemic patients. ^

The response of Texas public health agencies and workers to the emergency preparedness initiatives after 9/11

The purpose of this research was to better understand the impact of the terrorist attacks in 2001 on public health, particularly for Texas public health. This study employed mixed methods to examine changes to public health culture within Texas local public health agencies, important attitudes of public health workers toward responding to a disaster, and the funding policies that might ensure our investment in public health emergency preparedness is protected. ^ A qualitative analysis of interviews conducted with a large sample of public health officials in Texas found that all the constituent parts of a peculiar culture for public health preparedness existed that spanned the state's local health departments regardless of size, or funding level. The new preparedness culture in Texas had the hallmarks necessary for a robust public health preparedness and emergency response system. ^ The willingness of public health workers, necessary to make these kinds of changes and mount a disaster response was examined in one of Texas' most experienced disaster response teams—the public health workers for the City of Houston. A hypothesized latent variable model showed that willingness mediated all other factors in the model (self-efficacy, knowledge, barriers, and risk perception) for self-reported likelihood of reporting to work for a disaster. The RMSEA for the final model was 0.042 with a confidence interval of 0.036—0.049 and the chi-squared difference test was P=0.08, indicating a well-fitted model that suggests willingness is an important factor for consideration by preparedness planners and researchers alike. ^ Finally, with disasters on the rise and federal funding for preparedness dwindling, a review of states' policies for the distribution of these funds and their advantages and disadvantages were examined through a review of current literature and public documents, and a survey of state-level public health officials, emergency management professionals and researchers. Although the base plus per-capita method is the most common, it is not necessarily perceived to be the most effective. No clear "optimal" method emerged from the study, but recommendations for a strategic combination of three methods were made that has the potential to maximize the benefits of each method, while minimizing the weaknesses.^

Patenting genes and gene sequences: Analysis of public health implications and the law

At issue is whether or not isolated DNA is patent eligible under the U.S. Patent Law and the implications of that determination on public health. The U.S. Patent and Trademark Office has issued patents on DNA since the 1980s, and scientists and researchers have proceeded under that milieu since that time. Today, genetic research and testing related to the human breast cancer genes BRCA1 and BRCA2 is conducted within the framework of seven patents that were issued to Myriad Genetics and the University of Utah Research Foundation between 1997 and 2000. In 2009, suit was filed on behalf of multiple researchers, professional associations and others to invalidate fifteen of the claims underlying those patents. The Court of Appeals for the Federal Circuit, which hears patent cases, has invalidated claims for analyzing and comparing isolated DNA but has upheld claims to isolated DNA. The specific issue of whether isolated DNA is patent eligible is now before the Supreme Court, which is expected to decide the case by year's end. In this work, a systematic review was performed to determine the effects of DNA patents on various stakeholders and, ultimately, on public health; and to provide a legal analysis of the patent eligibility of isolated DNA and the likely outcome of the Supreme Court's decision. ^ A literature review was conducted to: first, identify principle stakeholders with an interest in patent eligibility of the isolated DNA sequences BRCA1 and BRCA2; and second, determine the effect of the case on those stakeholders. Published reports that addressed gene patents, the Myriad litigation, and implications of gene patents on stakeholders were included. Next, an in-depth legal analysis of the patent eligibility of isolated DNA and methods for analyzing it was performed pursuant to accepted methods of legal research and analysis based on legal briefs, federal law and jurisprudence, scholarly works and standard practice legal analysis. ^ Biotechnology, biomedical and clinical research, access to health care, and personalized medicine were identified as the principle stakeholders and interests herein. Many experts believe that the patent eligibility of isolated DNA will not greatly affect the biotechnology industry insofar as genetic testing is concerned; unlike for therapeutics, genetic testing does not require tremendous resources or lead time. The actual impact on biomedical researchers is uncertain, with greater impact expected for researchers whose work is intended for commercial purposes (versus basic science). The impact on access to health care has been surprisingly difficult to assess; while invalidating gene patents might be expected to decrease the cost of genetic testing and improve access to more laboratories and physicians' offices that provide the test, a 2010 study on the actual impact was inconclusive. As for personalized medicine, many experts believe that the availability of personalized medicine is ultimately a public policy issue for Congress, not the courts. ^ Based on the legal analysis performed in this work, this writer believes the Supreme Court is likely to invalidate patents on isolated DNA whose sequences are found in nature, because these gene sequences are a basic tool of scientific and technologic work and patents on isolated DNA would unduly inhibit their future use. Patents on complementary DNA (cDNA) are expected to stand, however, based on the human intervention required to craft cDNA and the product's distinction from the DNA found in nature. ^ In the end, the solution as to how to address gene patents may lie not in jurisprudence but in a fundamental change in business practices to provide expanded licenses to better address the interests of the several stakeholders. ^

Public management and regional development

Este trabajo tiene por objetivo analizar los elementos de la gestión pública del desarrollo regional a partir de las condiciones del desarrollo regional y las nociones de desarrollo local y desarrollo sustentable. Bajo estas premisas se avanzan planteamientos esquemáticos en torno a la gestión pública del desarrollo local

Public management and regional development

Este trabajo tiene por objetivo analizar los elementos de la gestión pública del desarrollo regional a partir de las condiciones del desarrollo regional y las nociones de desarrollo local y desarrollo sustentable. Bajo estas premisas se avanzan planteamientos esquemáticos en torno a la gestión pública del desarrollo local

Public management and regional development

Este trabajo tiene por objetivo analizar los elementos de la gestión pública del desarrollo regional a partir de las condiciones del desarrollo regional y las nociones de desarrollo local y desarrollo sustentable. Bajo estas premisas se avanzan planteamientos esquemáticos en torno a la gestión pública del desarrollo local

Essays on Inequality and Integration

Inequality and integration have been sociology’s two key paradigms since the classics, associated with the names of Marx and Durkheim and Europe’s current economic crisis has forcefully reinvigorated their joint relevance. Above all, the debt crisis has fueled the wheel of social inequality: cash-starved states are further forced to cut back on public expenditures, to minimize the margin for redistribution and to raise new challenges for the integration policies addressing the emerging disparities. At the same time, global environmental and demographic problems, intertwined with escalating migration pressure, tear at the texture of European and all Western societies, in particular, the unequal impact of climate change and the unequal distribution of population growth make migration and integration paramount public policy issues and a soaring source of social conflict. In principle, the inequalities engendered by these cascading processes are also an opportunity. They increase the diversity of society and can bring about innovation and growth. Our desire and ability for social integration depends, above all, on the ultimate balance between these advantages and disadvantages. The chapters in the volume concentrate on the opportunities as well as the risks associated with these social changes from various angles. They are a handpicked set of outstanding contributions from the Congress of the Swiss Sociological Association that took place at the University of Bern, June 26–28, 2013.

Patent policy and public health in developing countries: lessons from Japan

The introduction of pharmaceutical product patents in India and other developing countries is expected to have a significant effect on public health and local pharmaceutical industries. This paper draws implications from the historical experience of Japan when it introduced product patents in 1976. In Japan, narrow patents and promotion of cross-licensing were effective tools to keep drug prices in check while ensuring the introduction of new drugs. While the global pharmaceutical market surrounding India today differs considerably from that of the 1970's, the Japanese experience offers a policy option that may profitably be considered by India today. The Indian patent system emphasizes the patentability requirement in contrast to the Japanese patent policy which relied on narrow patents and extensive licensing. R&D by local firms and the development of local products may be promoted more effectively under the Japanese model.

Public Support for Enlargement: Economic, Cultural, or Normative?

The current research questioned whether public opinion on enlargement can be adequately explained only by economic calculation and cultural/community identity. When the analytical viewpoint was expanded from the conventional individual level to state level, it was revealed that constructivist considerations-such as the democratization and reunification of Europe-play a critical role in pushing forward enlargement. Drawing on the perspective of international relations, this study introduced a synthetic model to analyze public opinion on enlargement in the EU's 15 old member states. The analysis using a Eurobarometer dataset showed that on public support for enlargement, constructivist attitudes held as much sway as cultural/community attitudes. In fact, expectations of democratization were the most important determinant of support for enlargement in the case of Turkey.

Firm-level impacts of natural disasters on production networks : evidence from a flood in Thailand

In this paper, we explore the firm-level impacts of flooding in Thailand in 2011, specifically those on the procurement patterns at Japanese affiliates in Thailand. Our findings are as follow. First, the damaged small firms are more likely to lower their local procurement share, particularly the share of procurement from other Japanese-owned firms in Thailand. Second, damaged young firms and damaged old firms are more likely to raise the shares of imports from Japan and China, respectively. Third, there are no impacts on imports from ASEAN and other countries. These findings are useful for uncovering how multinational firms adjust their production networks before and after natural disasters.

Solución para la delegación de identidad en Sistemas de Gestión de Identidad paneuropeos basada en infraestructuras de certificación y lenguajes formales de asertos de seguridad

La estrategia i2010 de la UE tiene como objetivo garantizar el liderazgo europeo en materia de TIC y poner los beneficios de la Sociedad de la Información al servicio de la economía, la sociedad y la calidad de vida personal, teniendo presente que los éxitos de Europa hasta la fecha se han basado en favorecer la competencia leal en los mercados de las telecomunicaciones y crear un mercado sin fronteras para contenidos y medios de comunicación digitales. En esta línea, la Comisión Europea ha establecido que los distintos estados miembros deben contribuir activamente al desarrollo y uso seguro de los servicios telemáticos entre sus ciudadanos. Más concretamente, atribuye a las Administraciones Públicas, tanto a nivel nacional, regional como local, un papel dinamizador de la Sociedad de la Información que les obliga a ofrecer paulatinamente todos los actos administrativos a los ciudadanos a través de Internet. Como primer paso para el uso seguro de los servicios telemáticos que ofrecen las instituciones públicas se hace preciso dotar a los ciudadanos de una identidad digital que les permita identificarse ante un Proveedor de Servicio o ante otros ciudadanos de manera inequívoca. Por esta razón, la mayoría de países europeos – y otros en el resto del mundo – están promoviendo, sistemas fiables de gestión de identidad electrónica (eIDM), de tal manera que los ciudadanos, las empresas y departamentos gubernamentales (incluso en Estados miembros diferentes) pueden identificar y certificar sus operaciones con precisión, rapidez y sencillez. Sin embargo, la gestión de esta identidad por las Administraciones Públicas supone un importante desafío, acentuado cuando se hace necesaria la interoperabilidad entre Administraciones de diferentes países, puesto que personas y entidades tienen credenciales de identificación diferentes en función de su propio marco jurídico nacional. Consciente del problema, en la Unión Europea se han puesto en marcha una serie de proyectos con el objetivo de conseguir la interoperabilidad de los eIDMs entre las instituciones públicas de diferentes Estados miembros. A pesar de ello, las soluciones adoptadas hasta la fecha son insuficientes porque no prevén todos los posibles casos de interacción del usuario con las instituciones. En concreto, no tienen en cuenta un aspecto muy importante que se ofrece en los distintos sistemas jurídicos nacionales, a saber, la delegación de la identidad, mediante la cual un ciudadano puede autorizar a otro para que actúe en su nombre para acceder a determinados servicios prestados por las instituciones públicas. En esta tesis se realizan un conjunto de aportaciones que dan solución a distintos aspectos de los problemas planteados y que, de forma conjunta, permiten la interoperabilidad y la delegación de identidad en determinados Sistemas de Gestión de Identidad aplicados al entorno de las Administraciones Públicas. En el caso de la delegación, se ha definido un sistema de delegación dinámica de identidad entre dos entidades genéricas que permite solucionar el problema del acceso delegado a los servicios telemáticos ofrecidos por las Administraciones Públicas. La solución propuesta se basa en la generación de un token de delegación, constituido a partir de un Certificado Proxy, que permite a la entidad que delega establecer la delegación de identidad en otra entidad en base a un subconjunto de sus atributos como delegador, estableciendo además, en el propio token de delegación, restricciones en el conjunto de servicios accesibles a la entidad delegada y el tiempo de validez de la delegación. Adicionalmente, se presentan los mecanismos necesarios tanto para poder revocar un token de delegación como para comprobar sin un token de delegación ha sido o no revocado. Para ello se propone una solución para la identificación unívoca de tokens de delegación y la creación de una nueva entidad denominada Autoridad de Revocación de Tokens de Delegación. Entre las características del sistema de delegación propuesto destaca el que es lo suficientemente seguro como para ser utilizado en el entorno de la Administración Pública, que no requiere el uso de mecanismos off‐line para la generación de la delegación y que se puede realizar la delegación de forma instantánea y sin la necesidad de trámites complejos o la participación de un elevado número de entidades. Adicionalmente, el token de delegación propuesto es perfectamente integrable en las infraestructura de clave pública actual lo que hace que, dado que gran parte de las Administraciones Públicas europeas basan sus sistemas de identidad digital en el uso de la PKI y certificados de identidad X.509, la solución pueda ser puesta en marcha en un entorno real sin necesidad de grandes cambios o modificaciones de comportamiento. En lo referente a la interoperabilidad, se realiza un análisis exhaustivo y la correspondiente evaluación de las principales propuestas de Sistemas de Gestión de Identidad orientados a conseguir la interoperabilidad realizadas hasta la fecha en el marco de la Unión Europea y se propone, a alto nivel, una arquitectura de interoperabilidad para la gestión de identidad en las Administraciones Públicas. Dicha arquitectura es lo suficientemente genérica como para poder ser aplicada tanto en el entorno pan‐Europeo como en los entornos nacionales, autonómicos y locales, de tal forma que la interoperabilidad en la gestión de la identidad esté garantizada en todos los niveles de la Administración Pública. Por último, mediante la integración de la solución de delegación dinámica de identidad y la arquitectura de interoperabilidad propuestas se presenta una solución al problema de la delegación en un escenario pan‐Europeo de gestión de identidad, dando lugar a una arquitectura global de interoperabilidad pan‐Europea con soporte a la delegación de identidad. SUMMARY The i2010 European Union Plan aims to ensure European leadership in ICT and to promote the positive contribution that information and communication technologies can make to the economic, social and personal quality of life, bearing in mind that, to date, success in Europe has been based on promoting fair competition in telecommunications markets and on creating a borderless market for contents and digital media. In this line, the European Commission has established that the different member states should contribute actively to the development and secure use of telematic services among their citizens. More specifically, it is attributed to national, regional and local Public Administrations to have a supportive role of the Information Society, requiring them to gradually provide the citizens with Internet‐based access to all administrative procedures acts. As a first step for the secure use of telematic services offered by public institutions, it is necessary to provide the citizens with a digital identity to enable them to identify themselves unequivocally to a Service Provider or to other citizens. For this reason, most European countries ‐ and others in the rest of the world ‐ are promoting reliable systems for managing electronic identity (eIDM), so that citizens, businesses and government departments (even in different Member States) can identify and certify their operations with precision, speed and simplicity. However, the identity management by Public Administrations is a major challenge that becomes more difficult when interoperability between administrations of different countries is needed, due to the fact that individuals and entities have different identification credentials according to their own national legal framework. Aware of the problem, the European Union has launched a series of projects with the aim of achieving interoperability of eIDMs between public institutions of different Member States. However, the solutions adopted to date are insufficient because they do not foresee all possible cases of user interaction with the institutions. In particular, solutions do not take into account a very important aspect that is offered in different national legal systems, namely, the delegation of identity, by which a citizen can authorize another to act on his/her behalf to access certain services provided by public institutions. In this thesis a collection of contributions that provide solution to different aspects of the aforementioned problems are carried out. The solutions, in global, enable interoperability and identity delegation in some of the Identity Management Systems applied to Public Administration environment. In the case of delegation, a dynamic identity delegation system between generic entities is defined. This system makes it possible to solve the problem of delegated access to telematic services offered by Public Administrations. The proposed solution is based on the generation of a piece of information called delegation token. This delegation token, derived from a Proxy Certificate, allows the establishment of identity delegation by an entity that delegates (delegator) in other entity (delegatee) making use of a subset of delegator attributes. It also establishes restrictions on services that can be used by the delegated entity and the expiry date of delegation. In addition to this, the mechanisms necessary to revoke and check the revocation status of a delegation token are presented. To do this, a solution to univocally identify delegation tokens and the creation of a completely new entity, called Token Delegation Revocation Authority, are proposed. The most remarkable characteristics of the proposed delegation system are its security, enough for it to be used in the Public Administration environment, the fact that it does not require off‐line processes in order to generate the delegation, and the possibility of performing the delegation instantaneously and without neither complex processes nor the intervention of a large number of entities. The proposed delegation token can be completely incorporated into current Public Key Infrastructure (PKI). Thus, since most of the European Public Administrations base their digital identity systems on PKI and X.509 identity certificates, the solution can be adopted in a real environment without great changes or performance modifications. Regarding interoperability, an exhaustive analysis and evaluation of most significant proposals on Identity Management Systems that aim to achieve interoperability carried out in the European Union framework until now are performed. A high level identity management interoperability architecture for Public Administrations is also proposed. This architecture is sufficiently generic to be applied to both pan‐European environment and national, regional or local environments, thus interoperability in identity management at all Public Administration levels is guaranteed. Finally, through the integration of the proposed dynamic identity delegation solution and the high level interoperability architecture, a solution to the problem of identity delegation in a pan‐European identity management environment is suggested, leading to a pan‐European global interoperability architecture with identity delegation support.

Prototype of EN 301 549 Decision tree

The new European Standard EN 301 549 “Accessibility requirements suitable for public procurement of ICT products and services in Europe” is the response by CEN, CENELEC and ETSI to the European Commission’s Mandate 376. Today, ICT products and services are converging, and the boundaries between product categories are being constantly blurred. For that reason EN 301 549 has been drafted using a feature-based approach, instead of being based on product categories. The result is a standard that can be applied to any ICT product and service, by identifying applicable requirements depending on the features of the ICT. This demonstration presents ongoing work at the research group CETTICO of the Technical University of Madrid. CETTICO is developing a workgroup-based support tool where teams of people can annotate the result of performing a conformity assessment of a given ICT product or service according to the requirements of the EN. One of the functions of the tool is creating evaluation projects. During that task the user defines the features of the corresponding ICT product or service by answering questions presented by the tool. As a result of this process, the tool will create a list of applicable requirements and recommendations.

Intracellular localization of P1 ParB protein depends on ParA and parS

The P1 partition system promotes faithful plasmid segregation during the Escherichia coli cell cycle. This system consists of two proteins, ParA and ParB, that act on a plasmid site called parS. By immunofluorescence microscopy, we observed that ParB localizes to discrete foci that are most often located close to the one-quarter and three-quarters positions of cell length. The visualization of ParB foci depended completely on the presence of parS, although their visualization was independent of the chromosomal context of parS (in P1 or the bacterial chromosome). In integration host factor-defective mutants, in which ParB binding to parS is weakened, only a fraction of the total pool of ParB had converged into foci. Taken together, these results indicate that parS recruits a pool of ParB into foci and that the resulting ParB–parS complexes serve as substrates for the segregation reaction. In the absence of ParA, the position of ParB foci in cells is perturbed, indicating that at least one of the roles of ParA is to direct ParB–parS complexes to the proper one-quarter positions from a cell pole. Finally, inhibition of cell division did not inhibit localization of ParB foci in cells, indicating that the positioning signals in the E. coli host that are needed for P1 partition do not depend on early division events.