Impact of maternity care policy in Catalonia: a retrospective cross-sectional study of service delivery in public and private hospitals

Background: As a result of the growing number of interventions that are now performed in the context of maternity care, health authorities have begun to examine the possible repercussions for service provision and for maternal and neonatal health. In Spain the Strategy Paper on Normal Childbirth was published in 2008, and since then the authorities in Catalonia have sought to implement its recommendations. This paper reviews the current provision of maternity care in Catalonia. Methods: This was a descriptive study. Hospitals were grouped according to their source of funding (public or private) and were stratified (across four strata) on the basis of the annual number of births recorded within their respective maternity service. Data regarding the distribution of obstetric professionals were taken from an official government survey of hospitals published in 2010. The data on obstetric interventions (caesarean, use of forceps, vacuum or non-specified instruments) performed in 2007, 2010 and 2012 were obtained by consulting discharge records of 44 public and 20 private hospitals, which together provide care in 98% of all births in Catalonia. Proportions and confidence intervals were calculated for each intervention performed in all full-term (3742 weeks) singleton births. Results: Analysis of staff profiles according to the stratification of hospitals showed that almost all the hospitals had more obstetricians than midwives among their maternity care staff. Public hospitals performed fewer caesareans [range between 19.20% (CI 18.84-19.55) and 28.14% (CI 27.73-28.54)] than did private hospitals [range between 32.21% (CI 31.78-32.63) and 39.43% (CI 38.98-39.87)]. The use of forceps has decreased in public hospitals. The use of a vacuum extractor has increased and is more common in private hospitals. Conclusions: Caesarean section is the most common obstetric intervention performed during full-term singleton births in Catalonia. The observed trend is stable in the group of public hospitals, but shows signs of a rise among private institutions. The number of caesareans performed in accredited public hospitals covers a limited range with a stable trend. Among public hospitals the highest rate of caesareans is found in non-accredited hospitals with a lower annual number of births.

The European Union and Assembling Biofuel Development – topological investigations concerning the associations between law, policy and space

Biofuels for transport are a renewable source of energy that were once heralded as a solution to multiple problems associated with poor urban air quality, the overproduction of agricultural commodities, the energy security of the European Union (EU) and climate change. It was only after the Union had implemented an incentivizing framework of legal and political instruments for the production, trade and consumption of biofuels that the problems of weakening food security, environmental degradation and increasing greenhouse gases through land-use changes began to unfold. In other words, the difference between political aims for why biofuels are promoted and their consequences has grown – which is also recognized by the EU policy-makers. Therefore, the global networks of producing, trading and consuming biofuels may face a complete restructure if the European Commission accomplishes its pursuit to sideline crop-based biofuels after 2020. My aim with this dissertation is not only to trace the manifold evolutions of the instruments used by the Union to govern biofuels but also to reveal how this evolution has influenced the dynamics of biofuel development. Therefore, I study the ways the EU’s legal and political instruments of steering biofuels are coconstitutive with the globalized spaces of biofuel development. My analytical strategy can be outlined through three concepts. I use the term ‘assemblage’ to approach the operations of the loose entity of actors and non-human elements that are the constituents of multi-scalar and -sectorial biofuel development. ‘Topology’ refers to the spatiality of this European biofuel assemblage and its parts whose evolving relations are treated as the active constituents of space, instead of simply being located in space. I apply the concept of ‘nomosphere’ to characterize the framework of policies, laws and other instruments that the EU applies and construes while attempting to govern biofuels. Even though both the materials and methods vary in the independent articles, these three concepts characterize my analytical strategy that allows me to study law, policy and space associated with each other. The results of my examinations underscore the importance of the instruments of governance of the EU constituting and stabilizing the spaces of producing and, on the other hand, how topological ruptures in biofuel development have enforced the need to reform policies. This analysis maps the vast scope of actors that are influenced by the mechanism of EU biofuel governance and, what is more, shows how they are actively engaging in the Union’s institutional policy formulation. By examining the consequences of fast biofuel development that are spatially dislocated from the established spaces of producing, trading and consuming biofuels such as indirect land use changes, I unfold the processes not tackled by the instruments of the EU. Indeed, it is these spatially dislocated processes that have pushed the Commission construing a new type of governing biofuels: transferring the instruments of climate change mitigation to land-use policies. Although efficient in mitigating these dislocated consequences, these instruments have also created peculiar ontological scaffolding for governing biofuels. According to this mode of governance, the spatiality of biofuel development appears to be already determined and the agency that could dampen the negative consequences originating from land-use practices is treated as irrelevant.

Evidence for the endophytic colonization of Phaseolus vulgaris(common bean) roots by the diazotroph Herbaspirillum seropedicae

Herbaspirillum seropedicae is an endophytic diazotrophic bacterium, which associates with important agricultural plants. In the present study, we have investigated the attachment to and internal colonization of Phaseolus vulgaris roots by the H. seropedicae wild-type strain SMR1 and by a strain of H. seropedicae expressing a red fluorescent protein (DsRed) to track the bacterium in the plant tissues. Two-day-old P. vulgaris roots were incubated at 30°C for 15 min with 6 x 10(8) CFU/mL H. seropedicae SMR1 or RAM4. Three days after inoculation, 4 x 10(4) cells of endophytic H. seropedicae SMR1 were recovered per gram of fresh root, and 9 days after inoculation the number of endophytes increased to 4 x 10(6) CFU/g. The identity of the recovered bacteria was confirmed by amplification and sequencing of the 16SrRNA gene. Furthermore, confocal microscopy of P. vulgaris roots inoculated with H. seropedicae RAM4 showed that the bacterial cells were attached to the root surface 15 min after inoculation; fluorescent bacteria were visible in the internal tissues after 24 h and were found in the central cylinder after 72 h, showing that H. seropedicae RAM4 is capable of colonizing the roots of the dicotyledon P. vulgaris. Determination of dry weight of common bean inoculated with H. seropedicae SMR1 suggested that this bacterium has a negative effect on the growth of P. vulgaris.

School funding and education policy-making models in Ontario /

The purpose of this thesis is to examine various policy implementation models, and to determine what use they are to a government. In order to insure that governmental proposals are created and exercised in an effective manner, there roust be some guidelines in place which will assist in resolving difficult situations. All governments face the challenge of responding to public demand, by delivering the type of policy responses that will attempt to answer those demands. The problem for those people in positions of policy-making responsibility is to balance the competitive forces that would influence policy. This thesis examines provincial government policy in two unique cases. The first is the revolutionary recommendations brought forth in the Hall -Dennis Report. The second is the question of extending full -funding to the end of high school in the separate school system. These two cases illustrate how divergent and problematic the policy-making duties of any government may be. In order to respond to these political challenges decision-makers must have a clear understanding of what they are attempting to do. They must also have an assortment of policy-making models that will insure a policy response effectively deals with the issue under examination. A government must make every effort to insure that all policymaking methods are considered, and that the data gathered is inserted into the most appropriate model. Currently, there is considerable debate over the benefits of the progressive individualistic education approach as proposed by the Hall -Dennis Committee. This debate is usually intensified during periods of economic uncertainty. Periodically, the province will also experience brief yet equally intense debate on the question of separate school funding. At one level, this debate centres around the efficiency of maintaining two parallel education systems, but the debate frequently has undertones of the religious animosity common in Ontario's history. As a result of the two policy cases under study we may ask ourselves these questions: a) did the policies in question improve the general quality of life in the province? and b) did the policies unite the province? In the cases of educational instruction and finance the debate is ongoing and unsettling. Currently, there is a widespread belief that provincial students at the elementary and secondary levels of education are not being educated adequately to meet the challenges of the twenty-first century. The perceived culprit is individual education which sees students progressing through the system at their own pace and not meeting adequate education standards. The question of the finance of Catholic education occasionally rears its head in a painful fashion within the province. Some public school supporters tend to take extension as a personal religious defeat, rather than an opportunity to demonstrate that educational diversity can be accommodated within Canada's most populated province. This thesis is an attempt to analyze how successful provincial policy-implementation models were in answering public demand. A majority of the public did not demand additional separate school funding, yet it was put into place. The same majority did insist on an examination of educational methods, and the government did put changes in place. It will also demonstrate how policy if wisely created may spread additional benefits to the public at large. Catholic students currently enjoy a much improved financial contribution from the province, yet these additional funds were taken from somewhere. The public system had it funds reduced with what would appear to be minimal impact. This impact indicates that government policy is still sensitive to the strongly held convictions of those people in opposition to a given policy.

A survey of attitudes of agricultural society leaders toward leadership development education

It was the purpose of this study to investigate attitudes toward leadership development education of one client group served by the ontario Ministry of Agriculture and Food. The survey, answered by 175 participants, attempted to answer the following questions: (a) What is a common definition of leadership?, (b) What leadership concepts are important to leadership development education? and, (c) What are client attitudes toward leadership development education? A descriptive research approach was used and the data were analyzed according to a model developed by Colaizzi. Concept maps were developed under the broad areas of: (a) Developing leader qualities; (b) Past experiences that developed leadership skills that worked on the jOb; (c) Leadership skills developed from present day positions; and (d) How leadership skills may be developed in future situations. A description of the dynamics of leadership development was written and the essential dynamics of leadership skill development in one volunteer organization was described. This study supports the linkages perspective of leadership within voluntary organizations developed by Vandenberg, Thullen and Fear (1987). The linkages perspective consists of three major components: perception, property and process. As a perception, leadership is the set of beliefs each group member holds regarding the behaviours and qualities characteristic of effective leaders. As a property, leadership represents the qualities attributed by group members to persons perceived as effectively (or potentially) influencing the goal achievement process. As a process, leadership involves the use of non-coercive influence to facilitate group accomplishment of valued goals. Leadership concepts important for development in a leadership development education program related to personal, organizational and societal development. The top five concepts in terms of rank order are communicating effectively, forming and working with groups, working creatively (tie), developing followers, managing meetings, directing projects or activities, understanding financial matters, managing negotiations (tie), developing resources and understanding and developing oneself (tie). Several recommendations are relevant for extension personnel as educators. Theoretical concepts on leadership need to be shared to extension practitioners involved in leadership development. currently used teaching materials for leadership development should be evaluated to see if they include concepts from preferrred theoretical leadership perceptions.

Preservation of Agricultural Lands Society (PALS) fonds, 1954-2015, n.d.

Preservation of Agricultural Lands Society [PALS] held its first meeting at Brock University on June 21, 1976. Its first executive consisted of Robert Hoover, Rick Teather, Debbie Kehler and Bill Forster. Some objectives of the organization were "to seek the preservation of valuable farm areas from non-agricultural expansion and development and to foster development and support of federal, provinicial and local policy which will provide a secure financial future for farming." Gracia Janes and John Bacher are some of the organizations' well known advocates. The organization was active in raising public awareness of the issues surrounding encroaching development onto existing agricultural lands. The organization is still active today [2016] in educating the public and attempting to influence governments at all levels to protect valuable agricultural lands.

Wage Policy of Firms: an Empirical Investigation.

This paper analyzes the dynamics of wages and workers' mobility within firms with a hierarchical structure of job levels. The theoretical model proposed by Gibbons and Waldman (1999), that combines the notions of human capital accumulation, job rank assignments based on comparative advantage and learning about workers' abilities, is implemented empirically to measure the importance of these elements in explaining the wage policy of firms. Survey data from the GSOEP (German Socio-Economic Panel) are used to draw conclusions on the common features characterizing the wage policy of firms from a large sample of firms. The GSOEP survey also provides information on the worker's rank within his firm which is usually not available in other surveys. The results are consistent with non-random selection of workers onto the rungs of a job ladder. There is no direct evidence of learning about workers' unobserved abilities but the analysis reveals that unmeasured ability is an important factor driving wage dynamics. Finally, job rank effects remain significant even after controlling for measured and unmeasured characteristics.

On Limits to the Use of Linear Markov Strategies in Common Property Natural Resource Games

We derive conditions that must be satisfied by the primitives of the problem in order for an equilibrium in linear Markov strategies to exist in some common property natural resource differential games. These conditions impose restrictions on the admissible form of the natural growth function, given a benefit function, or on the admissible form of the benefit function, given a natural growth function.

Toward a Political Theory of Environmental Policy.

This paper makes some steps toward a formal political economy of environmental policy. Economists' quasi-unanimous preferences for sophisticated incentive regulation is reconsidered. First, we recast the question of instrument choice in the general mechanism literature and provide an incomplete contract approach to political economy. Then, in various settings, we show why constitutional constraints on the instruments of environmental policy may be desirable, even though they appear inefficient from a purely standard economic viewpoint.

Private Storage of Common Property

This paper examines a characteristic of common property problems unmodeled in the published literature: Extracted common reserves are aften stored privately rather than immediately. We examine the positive and normative effects of such storage.

Involving the Public in Public Health Genomics: A Review of Guidelines and Policy Statements

Public health genomics raises exciting possibilities for preventing or reducing the occurrence of both rare and common disease. However, this area of research raises challenging ethical, legal and social issues that must be addressed. One way of addressing these issues is through public involvement in the policy-making process. This GenEdit reviews how international guidelines and policy statements related to public health genomics address the issue of public involvement. Key areas of discussion are the values and goals justifying public involvement, the proposed activities to increase public involvement, who is / who represents "the public", and the projected outcomes of public involvement.

Managing Antimicrobial Resistance In Food Production : Conflicts Of Interest And Politics In The Development Of Public Health Policy

Antimicrobial resistance is a growing public health concern and is associated with the over or inappropriate use of antimicrobials in both humans and agriculture. While there has been recognition of this problem on the part of agricultural and public health authorities, there has nonetheless been significant difficulty in translating policy recommendations into practical guidelines. In this paper, we examine the process of public health policy development in Quebec agriculture, with a focus on the case of pork production and the role of food animal veterinarians in policy making. We argue that a tendency to employ strictly techno-scientific risk analyses of antimicrobial use ignores the fundamental social, economic and political realities of key stakeholders and so limits the applicability of policy recommendations developed by government advisory groups. In particular, we suggest that veterinarians’ personal and professional interests, and their ethical norms of practice, are key factors to both the problem of and the solution to the current over-reliance on antimicrobials in food production.

Bioethics in Health Policy Development: A Primer for Decision-Makers

Article

Professors and the Management of Unavoidable Conflicts of Interest: Don’t Always Need the Heavy Artillery of Policy

Article

Innovation and Globalization Policy in Small Transition Countries ; Case study: Macedonia and Slovenia

Diese Arbeit befasst sich mit der Innovations- und Globalisierungspolitik in kleinen Transformationsländern am Beispiel Mazedoniens; diese wurde mit der Lage in Slowenien verglichen, einem Land von ungefähr gleicher Größe und mit gemeinsamer Vergangenheit als Teilrepublik der Jugoslawischen Föderation, aber mit einem wesentlich höheren ökonomischen Entwicklungsstand. Innovation wird dabei verstanden als „Herstellung, Anpassung und Ausnutzung von Neuerungen“, und sie wird durch das Umfeld, in dem sie stattfindet, beeinflusst. Anpassung und Ausnutzung sind gerade für kleine Transformationsländer von erheblicher Bedeutung, da ihre Fähigkeit zu Herstellung von Neuerungen sehr begrenzt sind. Die Rolle der Innovationspolitik besteht hierbei darin, institutionelle und organisationelle Regulierungen einzuführen, die ein günstiges Umfeld sowohl für Innovationen als auch für die Entwicklung eines nationalen Innovationssystems schaffen. Die Rolle der Politik besteht also nicht in der Innovation als solcher, sondern in der Herstellung der notwendigen Bedingungen für die Industrie und die Forschungseinrichtungen dahingehend zu schaffen, dass sie ihr Wissen, ihre Fertigkeiten und ihre praktischen Erfahrungen für innovative Tätigkeiten einsetzen können. Auf der einen Seite gibt es Institutionen und Organisationen, ohne die die Unternehmen rückständig und wenig leistungsstark wären (etwa das Patentamt oder Institutionen höherer Bildung), und auf der anderen Seite gibt es Institutionen und Organisationen, welche die Unternehmen dabei unterstützen, dass sie ihre Tätigkeit weiter unterstützen (z.B. durch Technologietransfer-Zentren und Netzwerke). Die Leistungen dieser Institutionen und Organisationen sind von großer Bedeutung für die nationalen Innovationssysteme und sollten ihrerseits durch Innovationspolitik unterstützt werden; dies bedeutet jedoch nicht, dass diese Leistungen vom Staat bereitgestellt werden, vielmehr sollte die Wirtschaftspolitik Möglichkeiten für die öffentlich/private oder sogar rein private Bereitstellung solcher Leistungen in Erwägung ziehen; dies würde nicht nur die Kosten für den Staat senken, sondern auch die Effizienz bei der Erstellung dieser Leistungen steigern. Die Arbeit kommt zu dem Schluss, dass das größte Problem der Innovationspolitik in Mazedonien darin besteht, dass es sie gar nicht gibt, und zwar nicht als Folge einer bewussten Entscheidung darüber. Tatsächlich müssen Ressourcen und Zeit für die Schaffung eines nationalen Innovationssystems eingesetzt werden mit Hilfe einer Politik, die sich auf die wesentlichen Umrisse konzentriert, wobei die Nachfrage nach Technologie im Unternehmensbereich gesteigert wird und das Wissen und das Informationsangebot restrukturiert wird. Dieses System muss offen sein, unter beständigem Verbesserungsdruck stehen und fähig sein, sich an Veränderungen anzupassen. Damit eine solche Politik erfolgreich ist, muss es einen Konsens darüber zwischen allen beteiligten Akteuren geben und darüber hinaus auch eine Kohärenz zwischen den verschiedenen politischen Institutionen. Das ist deswegen wichtig, weil der Innovationsprozess komplex ist und verschiedene Politikbereiche berührt. Ziel sollte die Schaffung eines Systems sein, das einerseits auf Autonomie und Kooperation aufbaut, andererseits aber auch Wettbewerb zwischen den beteiligten Institutionen und Organisationen fördert. Eine wichtige Bedingung für ein positives Investitionsklima im Bereich der Innovation ist die Erreichung von makroökonomischer Stabilität. Die gegenwärtige Situation ist gekennzeichnet durch Instabilität des Rechtswesens, durch Korruption und Probleme des Vertragsschutzes, die sowohl ausländische als auch inländische Akteure davon abhält, sich in wirtschaftlichen Aktivitäten in Mazedonien zu engagieren. Bei der Suche nach einem Ausweg aus diesen Problemen ist es wichtig für Mazedonien, von anderen Ländern wie Slowenien zu lernen, die ähnliche Probleme haben, aber auch schon Erfahrungen in der Problemlösung. Man muss dabei beachten, dass der Entwicklungsstand, das wirtschaftliche und das politische Umfeld in beiden Vergleichsländern sich erheblich unterscheiden, so dass die Lektionen, die Mazedonien von Slowenien lernen könnte, nicht direkt übertragen und kopiert werden können, sondern entsprechend angepasst werden müssen. Die vorliegende Arbeit liefert Einsichten in die Probleme der Innovationspolitik in Transformationsländern und liefert daher sowohl einen Anreiz als auch eine Quelle von Informationen für künftige Analysen der wirtschaftlichen Bedingungen und vor allem Innovationspolitik in Transformationsländern.