Globalisation, markets and healthcare policy:redrawing the patient as consumer

Although the last two decades have seen the healthcare systems of most developed countries face pressure for major reform, the impact of this reform on the relationship between empowerment, consumerism and citizen’s rights has received limited research attention. Globalisation, Markets and Healthcare Policy sets out to redress this imbalance. This book explores the extent to which globalisation and commercialisation relate to current and emerging health policies. It also looks at the implications for citizens, patients and social rights, as well as how policy making interacts with the interests of global and European trade and economic policies. Topics discussed include: •How the impact of globalisation on health systems is apparent in the influence of international actors and European policies. •How the impact of globalisation is mediated by national priorities and policies and is therefore reflected in diverse influences. •How commercialisation of health is presented as benefiting citizens and patients but has the potential to undermine the aims and values inherent in health systems. •How the role of citizens' interests, social rights, patient’s rights and priorities of patient and public involvement need to be separated from commercialisation, choice and consumerism in health care. Essential reading for policy makers and students of public policy, politics, law and health services, Globalisation, Markets and Healthcare Policy will also appeal to those interested in patient involvement international healthcare, international relations, trans-national organisations and the EU.

Reflecting on time, timing and timeliness in public sector supply networks

Despite recent research on time (e.g. Hedaa & Törnroos, 2001), consideration of the time dimension in data collection, analysis and interpretation in research in supply networks is, to date, still limited. Drawing on a body of literature from organization studies, and empirical findings from a six-year action research programme and a related study of network learning, we reflect on time, timing and timeliness in interorganizational networks. The empirical setting is supply networks in the English health sector wherein we identify and elaborate various issues of time, within the case and in terms of research process. Our analysis is wide-ranging and multi-level, from the global (e.g. identifying the notion of life cycles) to the particular (e.g. different cycle times in supply, such as daily for deliveries and yearly for contracts). We discuss the ‘speeding up’ of inter-organizational ‘e’ time and tensions with other time demands. In closing the paper, we relate our conclusions to the future conduct of the research programme and supply research more generally, and to the practice of managing supply (in) networks.

Institutions, policies, and arguments:context and strategy in EU policy framing

Studies of framing in the EU political system are still a rarity and they suffer from a lack of systematic empirical analysis. Addressing this gap, we ask if institutional and policy contexts intertwined with the strategic side of framing can explain the number and types of frames employed by different stakeholders. We use a computer-assisted manual content analysis and develop a fourfold typology of frames to study the frames that were prevalent in the debates on four EU policy proposals within financial market regulation and environmental policy at the EU level and in Germany, Sweden, the Netherlands and the United Kingdom. The main empirical finding is that both contexts and strategies exert a significant impact on the number and types of frames in EU policy debates. In conceptual terms, the article contributes to developing more fine-grained tools for studying frames and their underlying dimensions.

Public policy and electrical-grid sector innovation

Purpose – This paper aims to investigate the manner in which technological innovation in the European electrical-grid sector has developed by focusing, in particular, on the effect of public policy on innovation. To achieve this aim, this paper highlights how technological innovation and development progressed from the 1960s to the 1980s, and contrasts this period with the deregulated/privatization environment. Design/methodology/approach – The paper is based on a series of in-depth multiple company case studies of grid companies, some of their suppliers and other actors in their broader business network. Empirical data were collected through 55 interviews. Findings – The authors find that a phase of mutual collaboration was encouraged in the first period, which led to strong technological innovation with a focus on product quality and the development of functionality. Buyers played a pivotal role in the development of products and posed technical requirements. In contrast, the current role of the buyer has transformed principally into one of evaluating competing bids for specific projects. Today, buyers face increasing pressure to substantially lower CO2 emissions and transform the energy grid system. These goals are difficult to achieve without a new way of thinking about innovation. Research limitations/implications – Models to achieve innovation must not only focus on individual research projects; instead, the innovation should be factored into normal business dealings in the supply chain. Practical implications – We propose that policymakers and regulators need to: accommodate for innovation and address the collaborative elements of innovation when developing policies and regulations. Furthermore, regulators have the option of either developing a strategic vision for the electrical-grid network or incorporating sustainability into the evaluation of electrical grids and, thus, consumers’ willingness to pay. Originality/value – This paper makes a distinctive contribution in the area of innovation for electrical grids. Our paper shows how innovation and the development of new technology for electrical grids changed over time. Furthermore, this paper describes the energy sector in terms of a business network comprising the different actors involved in innovation and development and, thus, their role in the energy supply chain.

Exploring how social workers experience and cope with public perception of their profession

The public’s perception of the social work profession is a rarely considered perspective, and yet a topic that is a concern to front Thepublic’sperceptionofthesocialworkprofessionisararelyconsideredperspective and yet a topic that is a concern to front line professionals. This paper explores how social workers experience and attempt to cope with public perception of their profession. It highlights the impact of these concerns on social workers’ personal experiences and professional practice. Using semi-structured interviews with sixteen UK social workers, from local authorities and private organisations,we explore the experiences of this group.Thematic analysis of the data identified four concerns: the experience of public perception, drivers of public perception, coping with public perception, and mechanisms to raise the professions profile. Examining public perception through the eyes of social workers provides valuable insights into the lived experiences of these professionals, and offers practical implications at both the micro and macro levels. It reveals two key ways in which the profession can begin to address the prevailing negative perception considered to be emanating from the public: through developing a more co-operative relationship with external sources of public perception (e.g. government and the media) and by engaging in more pro-active self-promotion of the service.

Linking herbivory and pollination: Costs and selection implications in Centrosema virginianum Bentham (Fabaceae: Papilionoideae)

This research first evaluated levels and type of herbivory experienced by Centrosema virginianum plants in their native habitat and how florivory affected the pollinator activity. I found that populations of C. virginianum in two pine rockland habitat fragments experienced higher herbivory levels (15% and 22%) compared with plants in the protected study site (8.6%). I found that bees (Hymenoptera) pollinated butterfly pea. Furthermore, I found that florivores had a negative effect in the pollinators visitation rates and therefore in the seed set of the population. ^ I then conducted a study using a greenhouse population of C. virginianum. I applied artificial herbivory treatments: control, mild herbivory and severe herbivory. Flower size, pollen produced, ovules produced and seeds produced were negatively affected by herbivory. I did not find difference in nectar volume and quality by flowers among treatments. Surprisingly, severely damaged plants produced flowers with larger pollen than those from mildly damaged and undamaged plants. Results showed that plants tolerated mild and severe herbivory with 6% and 17% reduction of total fitness components, respectively. However, the investment of resources was not equisexual. ^ A comparison in the ability of siring seeds between large and small pollen was necessary to establish the biological consequence of size in pollen performance. I found that fruits produced an average of 18.7 ± 1.52 and 17.7 ± 1.50 from large and small pollen fertilization respectively. These findings supported a pollen number-size trade-off in plants under severe herbivory treatments. As far as I know, this result has not previously been reported. ^ Lastly, I tested how herbivory influenced seed abortion patterns in plants, examining how resources are allocated on different regions within fruits under artificial herbivory treatments. I found that self-fertilized fruits had greater seed abortion rates than cross-fertilized fruits. The proportion of seeds aborted was lower in the middle regions of the fruits in cross-fertilized fruits, producing more vigorous progeny. Self-fertilized fruits did not show patterns of seedling vigor. I also found that early abortion was higher closer to the peduncular end of the fruits. Position of seeds within fruits could be important in the seed dispersion mechanism characteristic of this species. ^

Politics at the water's edge: The presidency, Congress, and the North Korea policy of the United States

For all their efforts to avoid a nuclear North Korea, the Clinton and Bush administrations failed to achieve this goal, the most important policy objective of the United States in its relations with North Korea for decades, mainly because of inconsistencies in U.S. policy. This dissertation seeks to explain why both administrations ultimately failed to prevent North Korea from going nuclear. It finds the origins of this failure in the implementation of different U.S. policy options toward North Korea during the Clinton and Bush administrations. To explain the lack of policy consistency, the dissertation investigates how the relations between the executive and the legislative branches and, more specifically, different government types—unified government and divided government—have affected U.S. policy toward North Korea. It particularly emphasizes the role of Congress and partisan politics in the making of U.S. policy toward North Korea. This study finds that divided government played a pivotal role. Partisan politics are also central to the explanation: politics did not stop at the water’s edge. A divided U.S. government produced more status quo policies toward North Korea than a unified U.S. government, while a unified government produced more active policies than a divided government. Moreover, a unified government with a Republican President produced more aggressive policies toward North Korea, whereas a unified government with a Democratic President produced more conciliatory policies. This study concludes that the different government types and intensified partisan politics were the main causes of the inconsistencies in the United States’ North Korea policy that led to a nuclear North Korea.

Framing infectious diseases and U.S. public opinion

The United States has been increasingly concerned with the transnational threat posed by infectious diseases. Effective policy implementation to contain the spread of these diseases requires active engagement and support of the American public. To influence American public opinion and enlist support for related domestic and foreign policies, both domestic agencies and international organizations have framed infectious diseases as security threats, human rights disasters, economic risks, and as medical dangers. This study investigates whether American attitudes and opinions about infectious diseases are influenced by how the issue is framed. It also asks which issue frame has been most influential in shaping public opinion about global infectious diseases when people are exposed to multiple frames. The impact of media frames on public perception of infectious diseases is examined through content analysis of newspaper reports. Stories on SARS, avian flu, and HIV/AIDS were sampled from coverage in The New York Times and The Washington Post between 1999 and 2007. Surveys of public opinion on infectious diseases in the same time period were also drawn from databases like Health Poll Search and iPoll. Statistical analysis tests the relationship between media framing of diseases and changes in public opinion. Results indicate that no one frame was persuasive across all diseases. The economic frame had a significant effect on public opinion about SARS, as did the biomedical frame in the case of avian flu. Both the security and human rights frames affected opinion and increased public support for policies intended to prevent or treat HIV/AIDS. The findings also address the debate on the role and importance of domestic public opinion as a factor in domestic and foreign policy decisions of governments in an increasingly interconnected world. The public is able to make reasonable evaluations of the frames and the domestic and foreign policy issues emphasized in the frames.

``This is your brain on drugs'': The public policy of anti -drug programming. An exploratory analysis of media and other sources of drug information for adolescents

In the 1980s, government agencies sought to utilize research on drug use prevention to design media campaigns. Enlisting the assistance of the national media, several campaigns were designed and initiated to bring anti-drug use messages to adolescents in the form of public service advertising. This research explores the sources of information selected by adolescents in grades 7 through 12 and how the selection of media and other sources of information relate to drug use behavior and attitudes and perceptions related to risk/harm and disapproval of friends' drug-using activities.^ Data collected from 1989 to 1992 in the Miami Coalition School Survey provided a random selection of secondary school studies. The responses of these students were analyzed using multivariate statistical techniques.^ Although many of the students selected media as the source for most of their information on the effects of drugs on the people who use them, the selection of media was found to be positively related to alcohol use and negatively related to marijuana use. The selection of friends, brothers, or sisters was a statistically significant source for adolescents who smoke cigarettes, use alcohol or marijuana.^ The results indicate that the anti-drug use messages received by students may be canceled out by media messages perceived to advocate substance use and that a more persuasive source of information for adolescents may be friends and siblings. As federal reports suggest that the economic costs of drug abuse will reach an estimated $150 billion by 1997 if current trends continue, prevention policy that addresses the glamorization of substance use remains a national priority. Additionally, programs that advocate prevention within the peer cluster must be supported, as peers are an influential source for both inspiring and possibly preventing drug use behavior. ^

Examining the validity of the GRE General Test scores and undergraduate GPA for predicting success in graduate school at a large racially and ethnically diverse public university in Southeast Florida

The purpose of the study was to determine the degree of relationships among GRE scores, undergraduate GPA (UGPA), and success in graduate school, as measured by first year graduate GPA (FGPA), cumulative graduate GPA, and degree attainment status. A second aim of the study was to determine whether the relationships between the composite predictor (GRE scores and UGPA) and the three success measures differed by race/ethnicity and sex. A total of 7,367 graduate student records (masters, 5,990; doctoral: 1,377) from 2000 to 2010 were used to evaluate the relationships among GRE scores, UGPA and the three success measures. Pearson's correlation, multiple linear and logistic regression, and hierarchical multiple linear and logistic regression analyses were performed to answer the research questions. The results of the correlational analyses differed by degree level. For master's students, the ETS proposed prediction that GRE scores are valid predictors of first year graduate GPA was supported by the findings from the present study; however, for doctoral students, the proposed prediction was only partially supported. Regression and correlational analyses indicated that UGPA was the variable that consistently predicted all three success measures for both degree levels. The hierarchical multiple linear and logistic regression analyses indicated that at master's degree level, White students with higher GRE Quantitative Reasoning Test scores were more likely to attain a degree than Asian Americans, while International students with higher UGPA were more likely to attain a degree than White students. The relationships between the three predictors and the three success measures were not significantly different between men and women for either degree level. Findings have implications both for practice and research. They will provide graduate school administrators with institution-specific validity data for UGPA and the GRE scores, which can be referenced in making admission decisions, while they will provide empirical and professionally defensible evidence to support the current practice of using UGPA and GRE scores for admission considerations. In addition, new evidence relating to differential predictions will be useful as a resource reference for future GRE validation researchers.

Fear and U.S. foreign policy during the Truman administration, 1945-1952

The purpose of this study was to investigate how the Truman administration used fear to generate popular support for its Cold War foreign policies. Three issues were examined through the use of published government documents, personal memoirs, and weekly periodicals to assess the responses of the American public: the enactment of universal military training (UMT), the Soviet detonation of an atomic device, and the Truman administration's decision to build the hydrogen bomb. This study shows that the changing attitudes in the Truman administration toward the Soviet Union occurred in a climate of fear. Through press releases and by exerting influence on the media, the administration attempted to control the information the public received. Through the use of propaganda, the Truman administration pursued the implementation of UMT, generated fear of the Soviet Union after its detonation of the atomic bomb, and gained relative public support for the decision to build the hydrogen bomb.