Addressing teenage pregnancy in rural areas: A case study from Liberty County, Texas

This study explores the issue of teenage pregnancy in a case study of Liberty County, a rural area in Texas with no public health department. It also describes the decision-making process and barriers faced in the beginning phases of adopting a sexual education program, and sets forth an implementation plan for two school districts on disseminating an evidence-based, comprehensive curriculum. Methods include a review of epidemiological data surrounding teenage pregnancy on the national, state, and county level; a literature review of factors related to teenage pregnancy and past interventions implemented in a rural community; a policy review of past and current bills in Legislature; and an analysis of barriers and decision making in implementing an evidence based program through qualitative observations, discussions with community members during meetings, presentations, and discussions. Results of this study indicate that there is a lack of research conducted in rural areas in the field of teenage pregnancy prevention and sexual education programs. Barriers experienced in Liberty County are shown to be consistent in scientific literature such as funding, logistical issues, and problems approaching the School Board in adopting a comprehensive sexual education program. This study fills a large gap in the literature on rural adolescents and attempts to analyze the process of decision-making in a rural area related to adoption of sexual education programming. In order to relieve this health disparity, further research should focus on rural areas to gain insight on the attitudes and behaviors of rural adolescents and beliefs among community stakeholders.^

Chinese Intellectuals and China`s Policy toward Japan

This dissertation aims at integrating two scholarships: state-society relation studies and Chinese foreign policy analysis. I created Two-level Perception Gap Model to analyze different intellectual groups' relations with party-state by confirming Chinese intellectuals play a role in CFP making in general, China's Japan policy in particular. This model is an alternative approach, instead of conventional wisdom patron-client approach, to explain and analyze the pluralized intellectual-state relations in China. This model first analyzed the role of two intellectual groups, namely think tank scholars and popular nationalist, in China's Japan policy making, and then based on these analyses it explains the interactional patterns between these two intellectual groups and party-state. I used three case studies, which represented different types of issue, Chinese attitude toward the U.S.-Japan alliance and the Japanese defense policy, the controversy over the Yasukuni Shrine Visit, and the territorial dispute over the Diaoyu/Senkaku Islands, to examine this model. First, I examined think tank scholar groups and the extent they influenced "core interest issue and sensitive issue (Issue 1)," Chinese attitude toward the U.S.-Japan alliance and the Japanese defense policy, and their international patterns with party-state. Chapter 3 compares the responses of Chinese officials to the changes in the defense policy of Japan to the analyses from the think tank scholars. As the model assumes, results show that think tank scholars' analyses are consistent with China's policy position; nevertheless, it is difficult to confirm their analyses have influence on Chinese attitude toward the U.S.-Japan alliance and the Japanese defense policy. Based on the analysis of journal articles, most articles do not provide policy suggestions or simply provide suggestions that do not deviate from the policy. As Gu's theory of pluralist institutionalism and my hypothesis points out, most think tank scholars are establishment intellectuals so they tend to be self-disciplined. Second, this model provide a new concept "patriotic dilemma" for analyzing the challenge and constraints brought by popular nationalist discourses and public mobilization to Chinese foreign policy decision makers. Chapter 4 investigated the cases study of the controversy over the Yasukuni Shrine Visit, defined as "major/minor interest issue/ sensitive issue (Issue 3)," and the discourses from the popular nationalist, mainly focusing on anti-Japanese activists. The chapter also observes their influence on nationalist public opinions and analyzes how the nationalist public opinions constrain the policy choices among decision makers. Results strongly supported the hypothesis of patriotic dilemma that, although the popular nationalist group and public opinions constrained the policy choices of Chinese decision makers in the short term, they were unable to change the fundamental policy direction. Third, chapter 5 also focuses on anti-Japanese activists and examines the model with the case of the territorial dispute over the Diaoyu/Senkaku Islands. The result supported that hypothesis that China's policy change was not because of the influence from popular nationalist's discourses or public opinions but because of the change of priority of this issue, from major/minor interest issue to core interest issue. These two chapters also indicate that the patron-client model is unable to describe the popular nationalist. An alternative approach, such as the concept "patriotic dilemma" is needed to describe the relations between the popular nationalist and the government.

An evolutionary approach to the delineation of functional areas based on travel-to-work flows

This paper presents a new approach to the delineation of local labor markets based on evolutionary computation. The aim of the exercise is the division of a given territory into functional regions based on travel-to-work flows. Such regions are defined so that a high degree of inter-regional separation and of intra-regional integration in both cases in terms of commuting flows is guaranteed. Additional requirements include the absence of overlap between delineated regions and the exhaustive coverage of the whole territory. The procedure is based on the maximization of a fitness function that measures aggregate intra-region interaction under constraints of inter-region separation and minimum size. In the experimentation stage, two variations of the fitness function are used, and the process is also applied as a final stage for the optimization of the results from one of the most successful existing methods, which are used by the British authorities for the delineation of travel-to-work areas (TTWAs). The empirical exercise is conducted using real data for a sufficiently large territory that is considered to be representative given the density and variety of travel-to-work patterns that it embraces. The paper includes the quantitative comparison with alternative traditional methods, the assessment of the performance of the set of operators which has been specifically designed to handle the regionalization problem and the evaluation of the convergence process. The robustness of the solutions, something crucial in a research and policy-making context, is also discussed in the paper.

Grouping genetic operators for the delineation of functional areas based on spatial interaction

The delineation of functional economic areas, or market areas, is a problem of high practical relevance, since the delineation of functional sets such as economic areas in the US, Travel-to-Work Areas in the United Kingdom, and their counterparts in other OECD countries are the basis of many statistical operations and policy making decisions at local level. This is a combinatorial optimisation problem defined as the partition of a given set of indivisible spatial units (covering a territory) into regions characterised by being (a) self-contained and (b) cohesive, in terms of spatial interaction data (flows, relationships). Usually, each region must reach a minimum size and self-containment level, and must be continuous. Although these optimisation problems have been typically solved through greedy methods, a recent strand of the literature in this field has been concerned with the use of evolutionary algorithms with ad hoc operators. Although these algorithms have proved to be successful in improving the results of some of the more widely applied official procedures, they are so time consuming that cannot be applied directly to solve real-world problems. In this paper we propose a new set of group-based mutation operators, featuring general operations over disjoint groups, tailored to ensure that all the constraints are respected during the operation to improve efficiency. A comparative analysis of our results with those from previous approaches shows that the proposed algorithm systematically improves them in terms of both quality and processing time, something of crucial relevance since it allows dealing with most large, real-world problems in reasonable time.

Evaluation of an integrated system for classification, assessment and comparison of services for long-term care in Europe: the eDESDE-LTC study

Background: The harmonization of European health systems brings with it a need for tools to allow the standardized collection of information about medical care. A common coding system and standards for the description of services are needed to allow local data to be incorporated into evidence-informed policy, and to permit equity and mobility to be assessed. The aim of this project has been to design such a classification and a related tool for the coding of services for Long Term Care (DESDE-LTC), based on the European Service Mapping Schedule (ESMS). Methods: The development of DESDE-LTC followed an iterative process using nominal groups in 6 European countries. 54 researchers and stakeholders in health and social services contributed to this process. In order to classify services, we use the minimal organization unit or “Basic Stable Input of Care” (BSIC), coded by its principal function or “Main Type of Care” (MTC). The evaluation of the tool included an analysis of feasibility, consistency, ontology, inter-rater reliability, Boolean Factor Analysis, and a preliminary impact analysis (screening, scoping and appraisal). Results: DESDE-LTC includes an alpha-numerical coding system, a glossary and an assessment instrument for mapping and counting LTC. It shows high feasibility, consistency, inter-rater reliability and face, content and construct validity. DESDE-LTC is ontologically consistent. It is regarded by experts as useful and relevant for evidence-informed decision making. Conclusion: DESDE-LTC contributes to establishing a common terminology, taxonomy and coding of LTC services in a European context, and a standard procedure for data collection and international comparison.

Bridging qualified majority and unanimity decision-making in the EU. IHS Political Science Series No. 132, February 2013

The EU has tried to bridge decision making by qualified majority and unanimity over the years by expanding qualified majorities (consensus) or by making unanimities easier to achieve. I call this decision-making procedure q-“unanimity” and trace its history from the Luxembourg compromise to the Lisbon Treaty, and to more recent agreements. I analyze the most recent and explicit mechanism of this bridging (article 31 (2) of the Lisbon Treaty) and identify one specific means by which the transformation of qualified majorities to unanimities is achieved: the reduction of precision or scope of the decision, so that different behaviors can be covered by it. I provide empirical evidence of such a mechanism by analyzing legislative decisions. Finally, I argue that this bridging is a ubiquitous feature of EU institutions, used in Treaties as well as in legislative decision-making.

Iceland’s contested European Policy: The Footprint of the Past - A Small and Insular Society. Jean Monnet Occasional Paper 01/2013

Introduction. Iceland’s domestic politics and foreign affairs are undergoing drastic changes. After an economic crash, violent protests on the streets of Reykjavik for the first time in Iceland’s history contributed to the defeat of the government. The party system has been altered. A turn has been taken towards Europe after the United States left the island, first by closing its military base in 2006 and then by its clear stance not to assist the country in its economic difficulties. The former close relations with the superpower are unlikely ever to be restored. The EU membership application is placing severe constraints on political parties which are split on the issue and has put in jeopardy the unity of the first left majority in the Icelandic parliament, the Althingi. Society is in a state of flux after an unprecedented economic downscaling and the collapse of almost its entire financial sector – which had boomed rapidly beginning in the mid-1990s. The credibility of politicians, the parliament and the media is in ruins. Iceland’s smallness and its location on the geographical map – one could also say the geopolitical map – has had a profound influence on its domestic and foreign affairs. Iceland is closely associated with the other Nordic states and has adopted many of their domestic characteristics, with important exceptions. On the other hand, the country has come under American influence – geographically, it straddles the Mid-Atlantic rift – and has limited its participation in the European project. Its geographical location in the middle of the North Atlantic has led to a notion that the country’s culture is unique and should be protected by all available means. Politicians continue to play the ‘nationalistic uniqueness’ card with considerable success even though the country has been swept by globalization. Rapid modernization (which only really began in the Second World War with British and American occupations) and sudden engagement with the outside world (which only extended to the general public in the last quarter of the twentieth century) are still slowly but steadily making their mark on the country’s foreign policy. The country’s political discourse and foreign policy still bear the hallmark of the past, i.e. of a small and insular society This paper will address the political developments in Iceland since the 2008 economic crash and place it in a historical context. The aim is to understand Iceland’s present foreign policy and, in particular, the highly contested decision by its government in 2009 to apply for membership of the European Union. The paper is divided into five sections in addition to this introduction and the concluding remarks. First, it starts by explaining the importance in Iceland of a political discourse based on the concept of independence which dates back to the historical narrative of the settlement period. This section will also examine Iceland’s close relations with the other Nordic states – despite important differences between it and the others. Second, the paper will analyse the importance of the party system, i.e. the dominance of the centre-right in Icelandic politics, and the changed nature of the system. Third, it examines how Iceland further distinguishes itself from the other Nordic states in many important features. Fourthly, the paper analyses the country’s three main foreign policy priorities in the post-war period, i.e. extensions of the Exclusive Economic Zone, firm defence arrangements with the US and membership of NATO, and the drive for better market access for marine products – including a partial engagement in the European project. Fifthly, the paper examines how the country’s smallness, in terms of its central administrative capacity, has affected its domestic and foreign policy-making. The concluding section summarizes the main findings concerning the political and historical obstacles that the Social Democratic Alliance faces in its hard-fought battle to change the country’s European Policy.

Economics of Policy Errors and Learning in the European Union. Bruges European Economic Policy (BEEP) Briefing 31/2013

Policy errors occur regularly in EU Member States. Learning from these errors can be beneficial. This paper explains how the European Union can facilitate this learning. At present, much attention is given to “best practices”. But learning from mistakes is also valuable. The paper develops the concept of “avoidable error” and examines evidence from infringement proceedings and special reports of the European Court of Auditors which indicate that Member States do indeed commit avoidable errors. The paper considers how Member States may take measures not to repeat avoidable or predictable errors and makes appropriate proposals.

Rethinking Migration Distribution in the EU: Shall we start with the facts? CEPS Essay 23/22 January 2016

Sound policy-making about migration –how to distribute responsibility for asylum seekers, how to deal with the issue of secondary movement (when asylum seekers move from one state to another within the EU) and whether migrants are welcome or not – needs to be based on solid evidence. On 16 November 2015, EUROSTAT published comprehensive statistics on the issue of first-residence permits by member states. This CEPS Essay closely examines these data and reports some surprising findings, some of which vary considerably from the impression promoted by the European media.

The EU’s Decision-Making Process Changes in the Constitutive Treaties

Since the beginning of its existence in the form of communities, the European Union’s decision-making process underwent constant evolution. There were continuous adjustments that transformed a pure intergovernmental process into one having rather federal features. Based on the hypothesis that changes have occurred at the decision level in regards to the actors, procedures, influence and ways of taking decisions in order for the new realities, needs and will at the European level to be properly addressed, this paper aims to present the reforms performed through the adoption of new treaties and the modification of the existing ones. The reality is that in order for the European dream and integration to go on and also for further development of the European Union, finally becoming an entity far beyond the founders expectations, decision makers had to constantly and carefully adapt the decision-making process. The purpose of this paper will be achieved by conducting a research based on the qualitative method, analyzing the related researches on this topic and the consolidated versions of the treaties. Thus, we will finally validate our research hypothesis that there was an evolution in what the EU’s decision-making process and decision procedures are concerned.

A Knowledge-based System for Intelligent Support in Pharmacogenomics Evidence Assessment: Ontology-driven Evidence Representation, Retrieval, Classification and Interpretation

Thesis (Ph.D.)--University of Washington, 2016-06

Attitudes, Perceptions, and Support of Student Leaders for a Tobacco-Free Campus Policy at the University of Washington: A Pilot Qualitative Study

Thesis (Master's)--University of Washington, 2016-06

Promoting better use of the PSA test in general practice: Randomized controlled trial of educational strategies based on outreach visits and mailout

Background. Prostate-specific antigen (PSA) testing for prostate cancer is controversial. Demand for PSA testing is likely to rise in the UK, Australia and other western countries. Primary care needs to develop appropriate strategies to respond to this demand. Objectives. Our aim was to compare the effectiveness of educational outreach visits (EOVs) and mailout strategies targeting PSA testing in Australian primary care. Methods. A randomized controlled trial was conducted in general practices in southern Adelaide. The main outcome measures at baseline, 6 months and 12 months post-intervention were PSA testing rates and GP knowledge in key areas relating to prostate cancer and PSA testing. Results. The interventions were able to demonstrate a change in clinical practice. In the 6 months post-intervention, median PSA testing rate in the EOV group was significantly lower than in the postal group, which in turn was significantly lower than the control group (P < 0.001). Statistically significant differences were not, however, maintained in the 6-12 month post-intervention period. The EOV group, at 6 months follow-up, had a significantly greater proportion of 'correct' responses than the control group to questions about prostate cancer treatment effectiveness (P = 0.004) and endorsement of PSA screening by professional bodies (P = 0.041). Conclusions. Primary care has a central role in PSA testing for prostate cancer. Clinical practice in this area is receptive to evidence-based interventions.

Academic medicine: The evidence base

The International Campaign to Revitalise Academic Medicine recognises that an evidence based approach is important in discussing the problems of academic medicine. A preliminary exploration of the evidence on academic medicine has led to a research agenda for examining and proposing realistic solutions. Copyright © 2004, BMJ Publishing Group Ltd.

International symposium on career development and public policy: Synthesis of country papers

During the conference, country teams were asked to select and address selection of six themes: human capital, labour supply, employability skills, carer development services for workforce development, older workers or evidence based research. This synthesis of country papers covers the conceptual links between these themes. It then goes on to cover three reframed themes focusing on career development policies and services, but distinguishing three levels of such policies and services: workforce preparation, workforce adaptability and workforce re-integration.