Knowledge, beliefs, risk behaviors, and social skills for HIV/STD prevention in junior college students (grades 11--12) in Bombay, India

1230 year 11 and 12 college students, modal age 16 and 17, in three colleges in Bombay, India, were studied on sexual behaviors or risk of sexual behaviors, beliefs about sex, HIV/STD knowledge, perceived norms regarding sexual behaviors, and the relationships between social skills/anxieties in HIV/STD prevention and actual and anticipated sexual behaviors. A quantitative questionnaire examining HIV/STD risk behaviors, knowledge, attitudes and beliefs, and the AIDS Social Assertiveness Scale (ASAS) were administered to these 1230 college students. Data indicated that 8% of males and 1% of females had had sexual experience, but over one third were not sure at all of being able to abstain from sexual activity with either steady or casual partners. Perceived norms were slanted toward sexual abstinence for the majority of the sample. Knowledge of protective effects of condoms was high, although half of those who had had sex did not use condoms. Logistic regression showed knowledge was higher among males, those who believed it was OK to have sex with a steady partner and that they should not wait until they were older, those who believed that condoms should be used even if the partner is known, and those who believed it was acceptable to have multiple partners. Gender differences in sexual activity and beliefs about sexual activity showed males were less likely to believe in abstaining from sexual activity. The 5 scales of the ASAS were scored and compared on ANOVA on: those who had had sexual experience (HS), those who anticipated being unable to refuse sex (AS), and those who did not anticipate problems in refusing sex (DS). Those in the AS group had greater anxieties about refusing sexual or other risk behaviors than HS and DS groups. There were greater anxieties about dealing with condoms in the AS and DS groups compared with the HS group. Confiding sexual or HIV/STD-related problems to significant others was more anxiety-provoking for the AS group compared with the HS group, and the AS group were more anxious about interactions with people with HIV. Factor analysis produced the same 5 factors as those found in previous studies. Of these, condom interactions and confiding in significant others were most anxiety provoking, and condom interactions most variable based on demographic and attitudinal factors.^ This age group is appropriate for HIV/STD reduction education given the low rate of sexual activity but despite knowledge of the importance of condom use, social skills to apply this knowledge are lacking. Social skills training in sexual negotiations, condom negotiations, and confiding HIV/STD-related concerns to significant others should reduce the risks of Indian college students having unwanted or unprotected sex. ^

International Regulation of Postal Communications

The article provides a concise overview of the rules applicable to postal communications at the international level. Particular attention is paid to the regulations of the Universal Postal Union (UPU), the General Agreement on Trade in Services (GATS) of the World Trade Organization (WTO), as well as the relationship between the two. Outlook on possible future developments accounting for the rapid technological advances and the liberalisation of markets wraps the analysis up. This is a 2010 update that takes into consideration the changes made in the UPU acts in 2008, as well as the latest developments in the WTO's Doha Round negotiations.

Postal Communications, International Regulation

The article provides a concise overview of the rules applicable to postal communications at the international level. Particular attention is paid to the regulations of the Universal Postal Union (UPU), the General Agreement on Trade in Services (GATS) of the World Trade Organization (WTO), as well as the relationship between the two. Outlook on possible future developments accounting for the rapid technological advances, in particular the Internet, and the liberalisation of markets wraps up the analysis. This is a 2013 update that takes into consideration the changes made in the UPU acts in 2012, as well as the latest developments in the WTO's Doha Round negotiations.

Swiss national guideline for reimbursement of enzyme replacement therapy in late-onset Pompe disease.

Glycogen storage disease type II is a rare multi-systemic disorder characterised by an intracellular accumulation of glycogen due a mutation in the acid alpha glucosidase (GAA) gene. The level of residual enzyme activity, the genotype and other yet unknown factors account for the broad variation of the clinical phenotype. The classical infantile form is characterised by severe muscle hypotonia and cardiomyopathy leading to early death. The late-onset form presents as a limb girdle myopathy with or without pulmonary dysfunction. Enzyme replacement therapy (ERT) with recombinant human GAA (rhGAA) in infants is life saving. In contrast, therapeutic efficacy of rhGAA in the late-onset form is modest. High expenses of rhGAA, on-going infusions and poor pharmacokinetic efficacy raised a discussion of the cost effectiveness of ERT in late-onset Pompe disease in Switzerland. This discussion was triggered by a Swiss federal court ruling which confirmed the reluctance of a health care insurer not to reimburse treatment costs in a 67-year-old female suffering from Pompe disease. As a consequence of this judgement ERT was stopped by all insurance companies in late-onset Pompe patients in Switzerland regardless of their clinical condition. Subsequent negotiations lead to the release of a national guideline of the management of late-onset Pompe disease. Initiation and limitation of ERT is outlined in a national Pompe registry. Reimbursement criteria are defined and individual efficacy of ERT with rhGAA is continuously monitored.

Three “Bali Deliverables” for more Food Security

As the clock is ticking for a positive outcome at the Ninth WTO Ministerial Conference to be held in Bali in December 2013, agricultural negotiators are scrambling to find solutions to issues such as tariff-rate quota (TRQ) administration and export competition in order to improve trade flows. The main issue seems to be whether WTO rules applying to public stockpiles in developing countries need to be changed or temporarily suspended as a means to enhance national food security. This paper is based on a note submitted to the ICTSD-IPC Expert Group “Meeting on Agriculture and Food Security – Policy Options for MC9 and beyond” (Geneva, June 2013). It lists the policy instruments impacting on global, national and (urban and rural) household food security – “The Food Security Tool Box” – and asks which immediate decisions the WTO Ministers might take in this field despite the political difficulties such as continued agro-dumping practices or the “land grab” issue. Three such “deliverables” are outlined: (i) regional and “virtual” food security schemes could be allowed to provide reserves to other countries without violating the obligation to “form an integral part of a food security programme identified in national legislation” (Agreement on Agriculture, Annex II, para 3); (ii) TRQ under-fills could be improved by mandatory enquiries into low fill rate situations; and (iii) World Food Program (WFP) and other non-commercial food purchases could be exempted from export restrictions and prohibitions. High ambitions for Bali seem to be misplaced. A more realistic yet real progress could restore the dwindling credibility of the WTO as a forum for trade negotiations.

The WTO and Food Security: What’s Wrong with the Rules?

The WTO Agreement on Agriculture (AoA) is the predominant multilateral legal framework governing agricultural trade. The objective of the AoA is to liberalise trade in agriculture through reductions in tariffs, domestic support and export subsidies. The AoA has not, however, ‘levelled the playing field’ and has not resulted in the equitable distribution of food, particularly for the poorer developing countries. On the other hand, support for small farmers does not ensure food security for the poor. While food security has no simple solutions such as “free trade is good for you”, reform proposals for trade rules which only address agricultural policy instruments fail to account for consumer and other interests: neither tariff reductions and subsidy disciplines, nor safeguards and other measures of producer protection can automatically increase food security. Rather, what is needed is the full and proper implementation of a number of commitments which the international community has already entered into in various human rights treaties, but which even the envisaged results of the now failed Doha Round negotiations could not ensure without revisiting relevant multilateral trade and investment rules.

Caring for ageing migrants in nursing homes: 'doing diversity' while 'doing death'

The proposed paper will present first results of a research project investigating how nursing homes in Switzerland deal with migrant elders who are in intensive need of care. Focusing on the end-of-life in institutional care settings, the intention is to explore the dimensions of ‘doing death’ in Swiss nursing homes when the elderly involved are of migrant background. The focus is laid on the co-construction of end of life in interactions between residents of migrant background and professional carers involved (often of migrant background themselves), and will thereby focus on processes of ‘doing diversity’ while ‘doing death’. To do so, we chose an ethnographic approach focusing on the participant observation of everyday practices of ‘doing death’ and ‘death work’ and on interviewing staff, residents and their relatives. Caring for ageing migrants at the end of their lives is studied in different types of assisted living at the end of life: The field of research was entered by studying a group specific department for residents of so-called ‘Mediterranean’ background. It was contrasted by a department stressing the individuality of each resident but including a considerable number of residents with migrant background. We are interested in how (and if at all) specific forms of ‘doing community’ within different types of departments may also lead to specific ways of ‘doing death’, which aim at a stronger embeddedness of dying trajectories in social relations of reciprocity and exchange. Furthermore, migrant ‘doing death’ is expected to be particularly negotiable since the potential diversities of symbolic reference systems and daily practices are widened. If the respective resident is limited in his/her capacities to play an active part in negotiating about ‘good care’ and ‘good dying’ – either due to language competences, which would be migrant specific, or due to degenerative diseases, which is not migrant specific – the field of negotiations will be left up to the professionals within the organization (and to the relatives, which are, however, not constantly present). Strategies of stereotyping the ‘other’ as well as driving nurses, caring aides and other professionals of migrant background into roles of ‘cultural experts’ or ‘transcultural translators’ are expected to be common in such situations. However, the task of negotiating what would be a ‘good dying’ and what measures are appropriate is always at stake in contemporary heterogeneous societies. Therefore we would argue that studying dying processes involving migrant residents is looking at paradigmatic manifestations of doing death in recent contexts of reflexive modernity.

Scales of justice in water governance: hydropower controversies in Switzerland

One significant challenge for the operationalization of water justice arises from the many dynamic scales involved. In this paper we explore the scalar dimension of justice in water governance through the insights derived from empirical research on hydropower production in the Swiss Alps and the application of the geographical concept of politics of scale. More specifically, we investigate how different actors frame the justice problem, the scales that they invoke and which actors consequently get included or excluded in their justice assessments. This study shows that there is no ideal scale for justice evaluations; whichever scale is used, some actors and justice claims are included whereas others are excluded. This is particularly true when using Fraser’s trivalent concept of justice, taking into account issues of distribution, recognition and participation where each calls for its own set of scales. Moreover, focusing on the politics of scale framing, our study reveals that the justice claim itself can become a power element. Consequently, to achieve more just water governance, there is not only a need for debate and negotiations about the conceptions and meanings of justice in a specific context, there is also a need for debate about the relevance and implications of divergent scales involved in justice claims.

Promoting Local Innovations: A tool for adaptation to climate change and sustainable development in Mountains

Throughout their history mountain communities have had to adapt to changing environmental and socio-economic conditions. They have developed strategies and specialized knowledge to sustain their livelihoods in a context of adverse climatic events and constant change. As negotiations and discussions on climate change emphasize the critical need for locally relevant and community owned adaptation strategies, there is a need for new tools to capitalize on this local knowledge and endogenous potential for innovation. The toolkit Promoting Local Innovation (PLI) was designed by the Centre for Development and Environment (CDE) of the University of Bern, Switzerland, to facilitate a participatory social learning process which identifies locally available innovations that can be implemented for community development. It is based on interactive pedagogy and joint learning among different stakeholders in the local context. The tried-and-tested tool was developed in the Andean region in 2004, and then used in International Union for Conservation of Nature (IUCN) climate change adaptation projects in Thailand, Burkina Faso, Senegal, and Chile. These experiences showed that PLI can be used to involve all relevant stakeholders in establishing strategies and actions needed for rural communities to adapt to climate change impacts, while building on local innovation potential and promoting local ownership

El Capítulo de Inversiones en el Acuerdo de Asociación Transpacífico:¿Una Posibilidad de Cambio y Convergencia?

Spanish Abstract: El presente trabajo analiza los posibles efectos que generaría en la regulación internacional de la inversión extranjera, el acuerdo de un capítulo de inversiones en el Acuerdo de Asociación Transpacífico (TPP), actualmente en negociaciones, sobre la base de la información disponible a la fecha. El artículo aborda cuatro aspectos que presentan especial importancia dada la divergencia de intereses entre algunos de los Estados negociadores: el ámbito de protección de la inversión extranjera; las normas sobre transparencia de los regímenes de inversión y sus disputas; la irrupción de entidades estatales como inversionistas extranjeros; y la solución de controversias a través del arbitraje inversionista-Estado. El autor concluye que en comparación a la actual fragmentación regulatoria de la que dan cuenta los acuerdos internacionales de inversión suscritos por los países negociadores del TPP, la incorporación de un capítulo de inversiones en ese Acuerdo es una oportunidad para avanzar en la convergencia de la regulación sobre inversión extranjera, tanto en materia de estándares sustantivos de protección de la inversión como en la mejora del arbitraje inversionista-Estado como mecanismo de solución de controversias.

The Chilean Experience in South-South Trade and Investment Agreements

This paper analyzes the main features of Chilean trade and investment treaties, examining if there is a Chilean pattern in the regulation of trade and investment flows or if it is influenced by agreements signed by Chile with developed countries. The article also examines if there are differences between the treaties signed by Chile and other “Southern” developing countries and those negotiated with “Northern” developed economies, and if sustainable development concerns are part of the negotiations of trade and investment agreements by Chile.

Coalition Structures and Policy Change in a Consensus Democracy

This paper studies the relation between coalition structures in policy processes and policy change. While different factors such as policy images, learning processes, external events, or venue shopping are important to explain policy change, coalition structures within policy processes are often neglected. However, policy change happens as a result of negotiations and coordination among coalitions within policy processes. The paper analyzes how conflict, collaboration, and power relations among coalitions of actors influence policy change in an institutional context of a consensus democracy. Empirically, I rely on a Qualitative Comparative Analysis to conduct a cross-sector comparison of the 11 most important policy processes in Switzerland between 2001 and 2006. Coalition structures with low conflict and strong collaboration among coalitions as well as structures with dominant coalitions and weak collaboration both facilitate major policy change. Competing coalitions that are separated by strong conflict but still collaborate strongly produce policy outputs that are close to the status quo.

Europeanization in parliament and in the press

Europeanization challenges national democratic systems. As part and parcel of the broader internationalization of politics, Europeanization is associated with a shift from policymaking within majoritarian, elected representative bodies towards technocratic decisions among non-majoritarian and non-elected bodies (Kohler-Koch and Rittberger 2008, Lavenex 2013). It is thus said to weaken the influence of citizens and parliaments on the making of policies and to undermine democratic collective identity (Lavenex 2013, Schimmelfennig 2010). The weakening of national parliaments has been referred to as “de-parliamentarisation” (Goetz and Meyer-Sahling 2008) and has nurtured a broader debate regarding the democratic deficit in the EU. While not being a member of the EU, Switzerland has not remained unaffected by these changes. As discussed in the contribution by Fischer and Sciarini, state executive actors take the lead in Switzerland's European policy. They are responsible for the conduct of international negotiations, they own the treaty making power, and it is up to them to decide whether they wish to launch a negotiation with the EU. In addition, the strong take-it or leave-it character of Europeanized acts limits the room for manoeuver of the parliamentary body also in the ratification phase. Among the public, the rejection of the treaty on the European constitution has definitely closed the era of “permissive consensus” (Hooghe and Marks 2009). However, the process of European unification remains far remote from the European public. In Switzerland, the strongly administrative character of international legislation hinders public discussion (Vögeli 2007). In such a context, the media may serve as cue for the public: By delivering information about the extent and nature of Europeanized policymaking, the media enable citizens to form their own opinions and to hold their representatives accountable. In this sense media coverage may not only be considered an indicator of the information delivered to the public, but it may also enhance the democratic legitimacy of Europeanized policymaking (for a similar argument, see Tresch and Jochum 2005). While the previous contributions to this debate have examined the Europeanization of Swiss (primary and secondary) legislation, we take a closer look at two additional domestic arenas that are both supposed to be under pressure due to Europeanization: The parliament and the media. To that end, we rely on data gathered in a research project that two of us carried out in the context of the NCCR Democracy.1 While this project was primarily interested in the mediatization of decision-making processes in Switzerland, it also investigated the conditional role played by internationalization/Europeanization. For our present purposes, we shall exploit the two data-sets that were developed as part of a study of the political agenda-setting power of the media (Sciarini and Tresch 2012, 2013, Tresch et al. 2013): A data-set on issue attention in parliamentary interventions (initiatives, motions, postulates,2 interpellations and questions) and a data-set on issue attention in articles from the Neue Zürcher Zeitung (NZZ). The data covers the years 1995 to 2003 and the coding of issues followed the classification system developed in the “Policy Agendas Project” (Baumgartner and Jones 1993).