971 resultados para Policy makers


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Background and context Since the economic reforms of 1978, China has been acclaimed as a remarkable economy, achieving 9% annual growth per head for more than 25 years. However, China's health sector has not fared well. The population health gains slowed down and health disparities increased. In the field of health and health care, significant progress in maternal care has been achieved. However, there still remain important disparities between the urban and rural areas and among the rural areas in terms of economic development. The excess female infant deaths and the rapidly increasing sex ratio at birth in the last decade aroused serious concerns among policy makers and scholars. Decentralization of the government administration and health sector reform impacts maternal care. Many studies using census data have been conducted to explore the determinants of a high sex ratio at birth, but no agreement has been so far reached on the possible contributing factors. No study using family planning system data has been conducted to explore perinatal mortality and sex ratio at birth and only few studies have examined the impact of the decentralization of government and health sector reforms on the provision and organization of maternal care in rural China. Objectives The general objective of this study was to investigate the state of perinatal health and maternal care and their determinants in rural China under the historic context of major socioeconomic reforms and the one child family planning policy. The specific objectives of the study included: 1) to study pregnancy outcomes and perinatal health and their correlates in a rural Chinese county; 2) to examine the issue of sex ratio at birth and its determinants in a rural Chinese county; 3) to explore the patterns of provision, utilization, and content of maternal care in a rural Chinese county; 4) to investigate the changes in the use of maternal care in China from 1991 to 2003. Materials and Methods This study is based on a project for evaluating the prenatal care programme in Dingyuan county in 1999-2003, Anhui province, China and a nationwide household health survey to describe the changes in maternal care utilization. The approaches used included a retrospective cohort study, cross sectional interview surveys, informant interviews, observations and the use of statistical data. The data sources included the following: 1) A cohort of pregnant women followed from pregnancy up to 7 days after birth in 20 townships in the study county, collecting information on pregnancy outcomes using family planning records; 2) A questionnaire interview survey given to women who gave birth between 2001 and 2003; 3) Various statistical and informant surveys data collected from the study county; 4) Three national household health interview survey data sets (1993-2003) were utilized, and reanalyzed to described the changes in maternity care utilization. Relative risks (RR) and their confidence intervals (CI) were calculated for comparison between parity, approval status, infant sex and township groups. The chi-square test was used to analyse the disparity of use of maternal care between and within urban and rural areas and its trend across the years in China. Logistic regression was used to analyse the factors associated with hospital delivery in rural areas. Results There were 3697 pregnancies in the study cohort, resulting in 3092 live births in a total population of 299463 in the 20 study townships during 1999-2000. The average age at pregnancy in the cohort was 25.9 years. Of the women, 61% were childless, 38% already had one child and 0.3% had two children before the current pregnancy. About 90% of approved pregnancies ended in a live birth while 73% of the unapproved ones were aborted. The perinatal mortality rate was 69 per thousand births. If the 30 induced abortions in which the gestational age was more than 28 weeks had been counted as perinatal deaths, the perinatal mortality rate would have been as high as 78 per thousand. The perinatal mortality rate was negatively associated with the wealth of the township. Approximately two thirds of the perinatal deaths occurred in the early neonatal period. Both the still birth rate and the early neonatal death rate increased with parity. The risk of a stillbirth in a second pregnancy was almost four times that for a first pregnancy, while the risk of early neonatal deaths doubled. The early neonatal mortality rate was twice as high for female as for male infants. The sex difference in the early neonatal mortality rate was mainly attributable to mortality in second births. The male early neonatal mortality rate was not affected by parity, while the female early neonatal mortality rate increased dramatically with parity: it was about six times higher for second births than for first births. About 82% early neonatal deaths happened within 24 hours after birth, and during that time, girls were almost three times more likely to die than boys. The death rate of females on the day of birth increased much more sharply with parity than that of males. The total sex ratio at birth of 3697 registered pregnancies was 152 males to 100 females, with 118 and 287 in first and second pregnancies, respectively. Among unapproved pregnancies, there were almost 5 live-born boys for each girl. Most prenatal and delivery care was to be taken care of in township hospitals. At the village level, there were small private clinics. There was no limitation period for the provision of prenatal and postnatal care by private practitioners. They were not permitted to provide delivery care by the county health bureau, but as some 12% of all births occurred either at home or at private clinics; some village health workers might have been involved. The county level hospitals served as the referral centers for the township hospitals in the county. However, there was no formal regulation or guideline on how the referral system should work. Whether or not a woman was referred to a higher level hospital depended on the individual midwife's professional judgment and on the clients' compliance. The county health bureau had little power over township hospitals, because township hospitals had in the decentralization process become directly accountable to the township government. In the township and county hospitals only 10-20% of the recurrent costs were funded by local government (the township hospital was funded by the township government and the county hospital was funded by the county government) and the hospitals collected user fees to balance their budgets. Also the staff salaries depended on fee incomes by the hospital. The hospitals could define the user charges themselves. Prenatal care consultations were however free in most township hospitals. None of the midwives made postnatal home visits, because of low profit of these services. The three national household health survey data showed that the proportion of women receiving their first prenatal visit within 12 weeks increased greatly from the early to middle 1990s in all areas except for large cities. The increase was much larger in the rural areas, reducing the urban-rural difference from more than 4 times to about 1.4 times. The proportion of women that received antenatal care visits meeting the Ministry of Health s standard (at least 5 times) in the rural areas increased sharply from 12% in 1991-1993 to 36% in 2001-2003. In rural areas, the proportion increase was much faster in less developed areas than in developed areas. The hospital delivery rate increased slightly from 90% to 94% in urban areas while the proportion increased from 27% to 69% in rural areas. The fastest change was found to be in type 4 rural areas, where the utilization even quadrupled. The overall difference between rural and urban areas was substantially narrowed over the period. Multiple logistic regression analysis shows that time periods, residency in rural or urban areas, income levels, age group, education levels, delivery history, occupation, health insurance and distance from the nearest health care facilities were significantly associated with hospital delivery rates. Conclusions 1. Perinatal mortality in this study was much higher than that for urban areas as well as any reported rate from specific studies in rural areas of China. Previous studies in which calculations of infant mortality were not based on epidemiological surveys have been shown to underestimate the rates by more than 50%. 2. Routine statistics collected by the Chinese family planning system proved to be a reliable data source for studying perinatal health, including still births, neonatal deaths, sex ratio at birth and among newborns. National Household Health Survey data proved to be a useful and reliable data source for studying population health and health services. Prior to this research there were few studies in these areas available to international audiences. 3.Though perinatal mortality rate was negatively associated with the level of township economic development, the excess female early neonatal mortality rate contributed much more to high perinatal mortality rate than economic factors. This was likely a result of the role of the family planning policy and the traditional preferences for sons, which leads to lethal neglect of female newborns and high perinatal mortality. 4. The selective abortions of female foetuses were likely to contribute most to the high sex ratio at birth. The underreporting of female births seemed to have played a secondary role. The higher early neonatal mortality rate in second-born as compared to first-born children, particularly in females, may indicate that neglect or poorer care of female newborn infants also contributes to the high sex ratio at birth or among newborns. Existing family planning policy proved not to effectively control the steadily increased birth sex ratio. 5. The rural-urban gap in service utilization was on average significantly narrowed in terms of maternal healthcare in China from 1991 to 2003. This demonstrates that significant achievements in reducing inequities can be made through a combination of socio-economic development and targeted investments in improving health services, including infrastructure, staff capacities, and subsidies to reduce the costs of service utilization for the poorest. However, the huge gap which persisted among cities of different size and within different types of rural areas indicated the need for further efforts to support the poorest areas. 6. Hospital delivery care in the study county was better accepted by women because most of women think delivery care was very important while prenatal and postnatal care were not. Hospital delivery care was more systematically provided and promoted than prenatal and postnatal care by township hospital in the study area. The reliance of hospital staff income on user fees gave the hospitals an incentive to put more emphasis on revenue generating activities such as delivery care instead of prenatal and postnatal care, since delivery care generated much profits than prenatal and postnatal care . Recommendations 1. It is essential for the central government to re-assess and modify existing family planning policies. In order to keep national sex balance, the existing practice of one couple one child in urban areas and at-least-one-son a couple in rural areas should be gradually changed to a two-children-a-couple policy throughout the country. The government should establish a favourable social security policy for couples, especially for rural couples who have only daughters, with particular emphasis on their pension and medical care insurance, combined with an educational campaign for equal rights for boys and girls in society. 2. There is currently no routine vital-statistics registration system in rural China. Using the findings of this study, the central government could set up a routine vital-statistics registration system using family planning routine work records, which could be used by policy makers and researchers. 3. It is possible for the central and provincial government to invest more in the less developed and poor rural areas to increase the access of pregnant women in these areas to maternal care services. Central government together with local government should gradually provide free maternal care including prenatal and postnatal as well as delivery care to the women in poor and less developed rural areas. 4. Future research could be done to explore if county and the township level health care sector and the family planning system could be merged to increase the effectiveness and efficiency of maternal and child care. 5. Future research could be done to explore the relative contribution of maternal care, economic development and family planning policy on perinatal and child health using prospective cohort studies and community based randomized trials. Key words: perinatal health, perinatal mortality, stillbirth, neonatal death, sex selective abortion, sex ratio at birth, family planning, son preference, maternal care, prenatal care, postnatal care, equity, China

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In the present research Finnish education policy-makers describe the transformation in upper secondary education in the 1990s. They answered questions related to equality and all-round education. The timeline of the research extends from the early development of the welfare state and equality policy to the 2000s. Its focus is on upper secondary education, which, in this paper, denotes general upper secondary education and vocational upper secondary education. The chronological analysis proceeds from the education committee of 1971 up to the youth education experiment of the 1990s. The voices of the then policy-makers are heard in this research. They were the ones who planned the reforms and/or made the decisions. This being the case, the interviewees include cabinet ministers, permanent secretaries, representatives of organisations and the research community as well as civil servants. The research material can be construed as contextual interpretations of the past, influenced by both the times and places where the narrations were given. The persons interviewed described their experiences and views on education policy. In their narratives they illustrated the transformation that occurred in relation to equality and all-round education. The narrative interviews painted a picture of the upper secondary education transformation and the matriculation examination as having a slowing effect on education policy reforms. It was not until the 1990s when the said examination began to make a difference to students in vocational upper secondary education Those interviewed named the persons who, in their opinion, had the most say in Finnish education policy. This list comprised a small circle of people who more or less agreed on the grand values of education policy, i.e. all-round education and equality. Only a small minority represented a radical view of equality, being true believers in universal upper secondary education implemented in accordance with comprehensive school reform. Finnish education policy was led from the perspective of traditional conception of equality from the 1970s to the 1980s. The transformation finally occurred in the 1990s when equality was understood to mean individual needs and the right to choose. As was the case with matriculation education, the insistence on all-round education also hampered the development of universal upper secondary education. The interviews revealed that any attempts to increase the academic syllabus of vocational education caused organisations as well as other policy-makers to oppose such development well into the 1980s. It was not until the youth education experiment of the 1990s that vocational education finally carved a path to higher education, when the polytechnic schools were made permanent. Three principal groups of key players emerged in the research: ministers of education, civil servants and organisations. The research showed that the ministers and civil servant education policy-makers of the 1990s also included only handful women. The circle of policy-makers was small and represented similar schools of thought. In the 1970s era of government committees, representatives of organisations actively participated in education policy. When the committee establishment was discontinued, this eliminated lobbying venues for the organisations. Nonetheless, the organisations regained their policymaking status in the 1990s. New lobbying organisations included the Finnish Entrepreneurs and the Union of Finnish Upper Secondary School Students. However, in contrast to the 1970s, only rarely would individuals rise from the ranks of organisations to the cadre of policy-makers. The interviewees had a twofold view of neo-liberalism Contrary to other policy-makers, representatives of the research community and organisations concur that neo-liberalism did exist in education policy decision-making in the 1990s.

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Despite a significant growth in food production over the past half-century, one of the most important challenges facing society today is how to feed an expected population of some nine billion by the middle of the 20th century. To meet the expected demand for food without significant increases in prices, it has been estimated that we need to produce 70-100 per cent more food, in light of the growing impacts of climate change, concerns over energy security, regional dietary shifts and the Millennium Development target of halving world poverty and hunger by 2015. The goal for the agricultural sector is no longer simply to maximize productivity, but to optimize across a far more complex landscape of production, rural development, environmental, social justice and food consumption outcomes. However, there remain significant challenges to developing national and international policies that support the wide emergence of more sustainable forms of land use and efficient agricultural production. The lack of information flow between scientists, practitioners and policy makers is known to exacerbate the difficulties, despite increased emphasis upon evidence-based policy. In this paper, we seek to improve dialogue and understanding between agricultural research and policy by identifying the 100 most important questions for global agriculture. These have been compiled using a horizon-scanning approach with leading experts and representatives of major agricultural organizations worldwide. The aim is to use sound scientific evidence to inform decision making and guide policy makers in the future direction of agricultural research priorities and policy support. If addressed, we anticipate that these questions will have a significant impact on global agricultural practices worldwide, while improving the synergy between agricultural policy, practice and research. This research forms part of the UK Government's Foresight Global Food and Farming Futures project.

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Urbanisation has evinced interest from a wide section of the society including experts, amateurs, and novices. The multidisciplinary scope of the subject invokes the interest from ecologists, to urban planners and civil engineers, to sociologists, to administrators and policy makers, students and finally the common man. With the development and infrastructure initiatives mostly around the urban centres, the impacts of urbanisation and sprawl would be on the environment and the natural resources. The wisdom lies in how effectively we plan the urban growth without - hampering the environment, excessively harnessing the natural resources and eventually disturbing the natural set-up. The research on these help urban residents and policymakers make informed decisions and take action to restore these resources before they are lost. Ultimately the power to balance the urban ecosystems rests with regional awareness, policies, administration practices, management issues and operational problems. This publication on urban systems is aimed at helping scientists, policy makers, engineers, urban planners and ultimately the common man to visualise how towns and cities grow over a period of time based on investigations in the regions around the highway and cities. Two important highways in Karnataka, South India, viz., Bangalore - Mysore highway and the Mangalore - Udupi highway, in Karnataka and the Tiruchirapalli - Tanjavore - Kumbakonam triangular road network in Tamil Nadu, South India, were considered in this investigation. Geographic Information System and Remote Sensing data were used to analyse the pattern of urbanisation. This was coupled with the spatial and temporal data from the Survey of India toposheets (for 1972), satellite imageries procured from National Remote Sensing Agency (NRSA) (LANDSAT TM for 1987 and IRS LISS III for 1999), demographic details from the Census of India (1971, 1981, 1991 and 2001) and the village maps from the Directorate of Survey Settlements and Land Records, Government of Karnataka. All this enabled in quantifying the increase in the built-up area for nearly three decades. With intent of identifying the potential sprawl zones, this could be modelled and projected for the future decades. Apart from these the study could quantify some of the metrics that could be used in the study of urban sprawl.

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This paper shows how multidisciplinary research can help policy makers develop policies for sustainable agricultural water management interventions by supporting a dialogue between government departments that are in charge of different aspects of agricultural development. In the Jaldhaka Basin in West Bengal, India, a stakeholder dialogue helped identify potential water resource impacts and livelihood implications of an agricultural water management rural electrification scenario. Hydrologic modelling demonstrated that the expansion of irrigation is possible with only a localized effect on groundwater levels, but cascading effects such as declining soil fertility and negative impacts from agrochemicals will need to be addressed.

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Certain parts of the State of Nagaland situated in the northeastern region of India have been experiencing rainfall deficit over the past few years leading to severe drought-like conditions, which is likely to be aggravated under a climate change scenario. The state has already incurred considerable losses in the agricultural sector. Regional vulnerability assessments need to be carried out in order to help policy makers and planners formulate and implement effective drought management strategies. The present study uses an 'index-based approach' to quantify the climate variability-induced vulnerability of farmers in five villages of Dimapur district, Nagaland. Indicators, which are reflective of the exposure, sensitivity and adaptive capacity of the farmers to drought, were quantified on the basis of primary data generated through household surveys and participatory rural appraisal supplemented by secondary data in order to calculate a composite vulnerability index. The composite vulnerability index of village New Showba was found to be the least, while Zutovi, the highest. The overall results reveal that biophysical characteristics contribute the most to overall vulnerability. Some potential adaptation strategies were also identified based on observations and discussions with the villagers.

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Models of river flow time series are essential in efficient management of a river basin. It helps policy makers in developing efficient water utilization strategies to maximize the utility of scarce water resource. Time series analysis has been used extensively for modeling river flow data. The use of machine learning techniques such as support-vector regression and neural network models is gaining increasing popularity. In this paper we compare the performance of these techniques by applying it to a long-term time-series data of the inflows into the Krishnaraja Sagar reservoir (KRS) from three tributaries of the river Cauvery. In this study flow data over a period of 30 years from three different observation points established in upper Cauvery river sub-basin is analyzed to estimate their contribution to KRS. Specifically, ANN model uses a multi-layer feed forward network trained with a back-propagation algorithm and support vector regression with epsilon intensive-loss function is used. Auto-regressive moving average models are also applied to the same data. The performance of different techniques is compared using performance metrics such as root mean squared error (RMSE), correlation, normalized root mean squared error (NRMSE) and Nash-Sutcliffe Efficiency (NSE).

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These last twenty years have seen the development of an abundant literature on the influence of soil macrofauna on soil structure. Amongst these organisms, earthworms, termites and ants are considered to play a key role in regulating the physical, chemical and microbiological properties of soils. Due to these influential impacts, soil ecologists consider these soil macro-invertebrates as `soil engineers' and their diversity and abundance are nowadays considered as relevant bioindicators of soil quality by many scientists and policy makers. Despite this abundant literature, the soil engineering concept remains a `preach to the choir' and bioturbation only perceived as important for soil ecologists. We discussed in this article the main mechanisms by which soil engineers impact soil structure and proposed to classify soil engineers with respect to their capacity to produce biostructures and modify them. We underlined the lack of studies considering biostructure dynamics and presented recent techniques in this purpose. We discussed why soil engineering concept is mainly considered by soil ecologists and call for a better collaboration between soil ecologists and soil physicists. Finally, we summarized main challenges and questions that need to be answered to integrate soil engineers activities in soil structure studies. (C) 2014 Elsevier B.V. All rights reserved.

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We report on the results of a country-wide survey of people's perceptions of issues relating to the conservation of biodiversity and ecosystems in India. Our survey, mainly conducted online, yielded 572 respondents, mostly among educated, urban and sub-urban citizens interested in ecological and environmental issues. 3160 ``raw'' questions generated by the survey were iteratively processed by a group of ecologists, environmental and conservation scientists to produce the primary result of this study: a summarized list of 152 priority questions for the conservation of India's biodiversity and ecosystems, which range across 17 broad thematic classes. Of these, three thematic classes-''Policy and Governance'', ``Biodiversity and Endangered Species'' and ``Protection and Conservation''-accounted for the largest number of questions. A comparative analysis of the results of this study with those from similar studies in other regions brought out interesting regional differences in the thematic classes of questions that were emphasized and suggest that local context plays a large role in determining emergent themes. We believe that the ready list of priority issues generated by this study can be a useful guiding framework for conservation practitioners, researchers, citizens, policy makers and funders to focus their resources and efforts in India's conservation research, action and funding landscape. (C) 2015 Elsevier Ltd. All rights reserved.

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Using remotely sensed Tropical Rainfall Measuring Mission (TRMM) 3B42 rainfall and topographic data from the Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) Digital Elevation Model (DEM), the impact of oroghraphical aspects such as topography, spatial variability of elevation and altitude of apexes are examined to investigate capacious summer monsoon rainfall over the Western Ghats (WG) of India. TRMM 3B42 v7 rainfall data is validated with Indian Meteorological Department (IMD) gridded rainfall data at 0.5 degrees resolution over the WG. The analysis of spatial pattern of monsoon rainfall with orography of the WG ascertains that the grade of orographic precipitation depends mainly on topography of the mountain barrier followed by steepness of windward side slope and altitude of the mountain. Longer and broader, i.e. cascaded topography, elevated summits and gradually increasing slopes impel the enhancement in precipitation. Comparing topography of various states of the WG, it has been observed that windward side of Karnataka receives intense rainfall in the WG during summer monsoon. It has been observed that the rainfall is enhanced before the peak of the mountain and confined up to the height about 800m over the WG. In addition to this, the spatial distribution of heavy and very heavy rainfall events in the last 14 years has also been explored. Heavy and very heavy rain events on this hilly terrain are categorized with a threshold of precipitation (R) in the range 150>R>120mmday(-1) and exceeding 150mmday(-1) using probability distribution of TRMM 3B42 v7 rainfall. The areas which are prone to heavy precipitation are identified. The study would help policy makers to manage the hazard scenario and, to improve weather predictions on mountainous terrain of the WG.

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This research aims to develop a conceptual framework in order to enquire into the dynamic growth process of University Spin-outs (hereafter referred to as USOs) in China, attempting to understand the capabilities configuration that are necessary for the dynamic growth. Based on the extant literature and empirical cases, this study attempts to address the question how do USOs in China build and configure the innovative capabilities to cope with the dynamic growth. This paper aims to contribute to the existing literature by providing a theoretical discussion of the USOs' dynamic entrepreneurial process, by investigating the interconnections between innovation problem-solving and the required configuration of innovative capabilities in four growth phases. Further, it presents a particular interest on the impact to the USOs' entrepreneurial innovation process by the integrative capabilities, in terms of knowledge integration, alliance, venture finance and venture governance. To date, studies that have investigated the dynamic development process of USOs in China and have recognized the heterogeneity of USOs in terms of capabilities that are required for rapid growth still remain sparse. Addressing this research gap will be of great interest to entrepreneurs, policy makers, and venture investors. ©2009 IEEE.

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The main aim of this paper is to measure the extent to which part-time work enhances fertility for married or cohabiting women of fertile age. The study covers eleven European countries. The data used are a pool sample of five waves of the European Community Household Panel. Given that we believe that the decisions concerning fertility and labor market status are taken jointly, we carry out a simultaneous estimation approach. Results suggest that policy makers wishing to implement adequate part-time schedules so as to enhance fertility should look at the part-time schedules available in Belgium, Ireland and The Netherlands, which enhance fertility for women who take advantage of this flexibility measure so as to reconcile family and work.

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This report is a compilation of five regional reviews that document the global status of tropical rivers and inland fisheries in three continents: Latin America, Africa and Asia. It explores the role of ‘valuation’ methods and their contribution to policy-making and river fishery management. From the compilation, the best estimate of the global value of inland fisheries for those three continents is US$ 5.58 billion (gross market value), which is equivalent to 19 percent of the current value of annual fish exports from developing countries (US$ 29 billion) for 2004. The compilation shows that there is a general shortage of information on inland fisheries, especially derived from conventional economic valuation methods, though information from economic impact assessment methods and socio-economic and livelihood analysis methods is more widely available. The status of knowledge about the impact of changes in river management on the value of tropical river fisheries is weak and patchy. Although the impacts of large dams on the hydrology, ecology and livelihood support attributes of tropical rivers are well-recognized, there have been only few valuation studies of these issues. The document highlights the need for further valuation studies of tropical river and inland fisheries in developing countries. It underlines how vital it is for policy-makers and other stakeholders to understand the importance of these natural resources in order to make appropriate decisions concerning their role in development policy and illustrates why capacity building in valuation should become a major priority for agencies concerned with fisheries management and policy-making.

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CONTENTS: Learning from each other about conflict, by Ronet Santos. E-learning to support knowledge sharing in aquatic resources, by Robert T. Raab and Jonathan Woods. Livelihood strategies, gender and participation in aquaculture: findings from participatory research in northwestern Sri Lanka, by Lindsay J. Pollock and David C. Little. Farming of giant tiger shrimp in northern central Vietnam, by Jesper Clausen. Interacting with stakeholders and policy-makers, by To Phuc Tuong. The role of nutrition communications in meeting the nutritional challenges of the Asia-Pacific region, by Georgina Cairns. (PDF has 16 pages.)

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Setting total allowable catches (TACs) is an endogenous process in which different agents and institutions, often with conflicting interests and opportunistic behaviour, try to influence policy-makers. Such policy-makers, far from being the benevolent social planners many would wish them to be, may also pursue self-interest when making final decisions. Although restricted knowledge of stock abundance and population dynamics, and weakness in enforcement, have effects, these other factors may explain the reason why TAC management has failed to guarantee sustainable exploitation of fish resources. Rejecting the exogeneity of the TAC and taking advantage of fruitful debate on economic policy (i.e. the rules vs. discretion debate, and that surrounding the independence of central banks), two institutional developments are analysed as potential mechanisms to face up to misconceptions about TACs: long-term harvest control rules, and a central bank of fish.