European Recommendations for Primary Prevention of Congenital Anomalies: A Joined Effort of EUROCAT and EUROPLAN Projects to Facilitate Inclusion of This Topic in the National Rare Disease Plans

Congenital anomalies (CA) are the paradigm example of rare diseases liable to primary prevention actions due to the multifactorial etiology of many of them, involving a number of environmental factors together with genetic predispositions. Yet despite the preventive potential, lack of attention to an integrated preventive strategy has led to the prevalence of CA remaining relatively stable in recent decades. The 2 European projects, EUROCAT and EUROPLAN, have joined efforts to provide the first science-based and comprehensive set of recommendations for the primary prevention of CA in the European Union. The resulting EUROCAT-EUROPLAN 'Recommendations on Policies to Be Considered for the Primary Prevention of Congenital Anomalies in National Plans and Strategies on Rare Diseases' were issued in 2012 and endorsed by EUCERD (European Union Committee of Experts on Rare Diseases) in 2013. The recommendations exploit interdisciplinary expertise encompassing drugs, diet, lifestyles, maternal health status, and the environment. The recommendations include evidence-based actions aimed at reducing risk factors and at increasing protective factors and behaviors at both individual and population level. Moreover, consideration is given to topics specifically related to CA (e.g. folate status, teratogens) as well as of broad public health impact (e.g. obesity, smoking) which call for specific attention to their relevance in the pre- and periconceptional period. The recommendations, reported entirely in this paper, are a comprehensive tool to implement primary prevention into national policies on rare diseases in Europe.

From the Government to the Streets: Why the U.S. is a Policy Innovator in Disability Rights

Thesis (Ph.D.)--University of Washington, 2012

Strategies for economic development in the Commonwealth Caribbean: a comparative study of the foreign economic policy strategies adopted by the Manley government in Jamaica and the Williams government in Trinidad and Tobago

This thesis compares the foreign economic poUcy dimension of the development strategies adopted by the governments of two Commonwealth caribbean countries: The Hardey government In Jamaica, and the· Williams government in Trlnidad and T ooago, The foreign economic policIes adopted by these governments appeared, on the surface~ to be markedly dissimilar. The Jamakan strategv on the one hand, emphasised self-reliance and national autonomy; and featured the espousal of radical oonaHgnment together with attempts to re-deftne the terms of the Islands externaa economIc relaUoos. The Trinidadian strategy 00 the other hand, featured Uberal externaUy-oriented growth poUctes, and close relatjoos with Western governments and financial institutions. Th1s study attempts to identify the explanatory factors that account for the apparent dlssimUarUy 1n the foreign economic policies of these two govemnents. The study is based on a comparison of how the structural bases of an underdeveloped ecooomYg and the foreign penetration and vulnerabUUy to external pressures asSOCiated wUh dependence, shape and influence foreign economic poUcy strategy. The framework views fore1gn ecooom1c strategy as an adaptive response on the part of the decision makers of a state to the coostralnts and opportunities provided by a particular situation. The · situat i 00' in this case being the events, conditions, structures and processes, associated wUh dependente and underdevelopment. The results indicate that the similarities and dissimHarities in the foreign economic policies of the governments of Jamaica and Trinidad were a reflecUon of the simHarities and dissimilarities in their respective situations. The conclusion derived suggests that If the foreign pol1cy field as an arena of choice, Is indeed one of opportunities and constraints for each and every state, then poHcy makers of smaU, weak, hlghW penetrated and vulnerable states enter thlS arena with constraints outweighing opportunities. This places effective limits 00 their decisional latitude and the range of policy options avaUable. Policy makers thus have to decide critical issues with few estabUshed precedents, in the face of domestic social and political cleavages, as wen as serious foreign pressures. This is a reflection not only of the trappings of dependence, but also of the Umned capabilities arising from the sman size of the state, and the Impact of the resource-gap In an underdeveloped economy. The Trinidadian strategy 1s UlustraUve of a development strategy made viable through a combination of a fortuitous circumstance, a confluence of the interests of influential groups» and accurate perception on the part of poUcy makers. These factors enabled policy makers to minimise some of the constraints of dependence. The faUure of Manlets strategy on the other hand, 15 iHustraUve of the problems involved tn the adoption of poUcles that work against the interest of internal and external political and economic forces. It is also tUustraUve of the consequences of the faUure 00 the part of policy makers to clarify goals, and to reconcile the values of rapid economic growth with increased self-reliance and national autonomy. These values tend to be mutuany Incompatible given the existing patterns of relations in the jnternational economy.

Land Restitution and Prevention of Forced Displacement in Colombia

The armed conflict in Colombia, which has generated over three million internally displaced persons, has dramatic humanitarian consequences and raises serious issues regarding the protection of displaced peoples’ rights. The underlying reasons for the displacement often lie in the dynamics associated with territorial control and land seizures undertaken for strategic, military or purely economic purposes. Domestic and international legal provisions have established the victims’ right to the restitution of their homes and property as the “preferred remedy” in cases of displacement. However, policies dealing with displacement, both those of the Colombian government and of several international institutions, fail to take this sufficiently into account. A comprehensive reparation policy for victims must necessarily entail the reversion of lands, territories and goods seized in Colombia under the pretext of the internal armed conflict.

Preventing tobacco use and harm: what is evidence based policy?

The majority of tobacco users commence in early to mid-adolescence. Tobacco smoking can be characterised as a chronic, relapsing disorder. While risk increases with amount smoked, there is no safe level of use (i.e., all use is risky). Duration of use is the most important predictor of premature death with the majority of excess morbidity and mortality avoidable if people quit before middle age. Investment in initiatives that reduce smoking among pregnant women and those at risk of cardiovascular disease provide quickest returns -in reduced health care episodes and expenditure.  Measures that successfully reduce smoking among parents probably reduce smoking uptake by children, and high levels of smoking among both children and parents appear to be associated with higher levels of illicit drug use.
The evidence base for pharmcotherapies in the treatment of tobacco dependence is very strong. Population-level initiatives such as tax increases, mass media-led campaigns and smoke-free policies are all highly cost-effective in reducing population-smoking levels, including among children and young people.
Australian tobacco control initiatives have been based on "social ecology" conceptualisations of the problem, which acknowledge the pivotal role of the media in shaping social values, and public and political opinion.
Broad social change, as well as more focused prevention and cessation initiatives, has drawn heavily on research findings from the behavioural sciences. Considerable effort (mainly, in Australian, in the NGO sector) has gone into documenting policy inputs and monitoring impact and outcome measures.
This chapter discusses why conceptualising tobacco-related harm from legal, economic and social policy perspectives should also help build support for tobacco control policy among academic and practising economists and lawyers, and in the business, welfare and government sectors.

Snowballing obesity: Australians will get run over if they just sit there.

* Overweight and obesity are very common in Australian adults (56%) and children (27%). * Rates of overweight and obesity are snowballing and will place greater burdens on health services for the treatment and care of chronic diseases. * Prevention is urgently required from health, social and economic perspectives, but the response to date has been inadequate.
* A long-term, sustained action plan starting with a focus on young people is needed. This should particularly address the “obesogenic” environments causing the epidemic. * Although whole-of-government action is required, support from and involvement by parents, carers, community leaders, healthcare professionals, teachers, childcare workers, urban planners, recreation managers, food manufacturers, employers, advertisers, and communicators is essential. *  The health sector should take the lead, but success will only come from concerted and integrated action across the whole of society. * There are now signs of political commitment to addressing overweight and obesity. Doctors should get behind this and help mobilise community support.

Diet, nutrition and the prevention of excess weight gain and obesity

Objective: To review the evidence on the diet and nutrition causes of obesity and to recommend strategies to reduce obesity prevalence.
Design: The evidence for potential aetiological factors and strategies to reduce obesity prevalence was reviewed, and recommendations for public health action, population nutrition goals and further research were made.
Results: Protective factors against obesity were considered to be: regular physical activity (convincing); a high intake of dietary non-starch polysaccharides (NSP)/fibre (convincing); supportive home and school environments for children (probable); and breastfeeding (probable). Risk factors for obesity were considered to be sedentary lifestyles (convincing); a high intake of energy-dense, micronutrient-poor foods (convincing); heavy marketing of energy-dense foods and fast food outlets (probable); sugar-sweetened soft drinks and fruit juices (probable); adverse social and economic conditions—developed countries, especially in women (probable).
A broad range of strategies were recommended to reduce obesity prevalence including: influencing the food supply to make healthy choices easier; reducing the marketing of energy dense foods and beverages to children; influencing urban environments and transport systems to promote physical activity; developing community-wide programmes in multiple settings; increased communications about healthy eating and physical activity; and improved health services to promote breastfeeding and manage currently overweight or obese people.
Conclusions: The increasing prevalence of obesity is a major health threat in both low- and high income countries. Comprehensive programmes will be needed to turn the epidemic around.

Competition policy and prevention of abuses in the TRIPS agreement

The monopoly granted through intellectual property rights can lead to abuses ofsuch monopoly. The TRIPS Agreement recognizes such abuses along with the fact that competition policy can play a significant role in dealing with such abuses. The use of competition policy to deal with the abuse of IP monopolies reguires a discussion ofabuse of the dominant position, definition ot market and substitutability of products and whether the
patenting monopoly automatically puts the right holder in the dominant position. The issue of parallel trade and exhaustion of rights also has anti-competitive implications. The introduction of discriminatory pricing along with any ban on parallel trade would lead to absolute market control, market segregation and market exclusion by the monopolistic industries. [JEL Classiffication: K21, K33]

Policy, preparation and prevention : proactive minimisation of student plagiarism

Countless cases of plagiarism are detected across the Australian higher education sector each year. Generally speaking, policy and other responses to the issue focus on punitive, rather than on educative, measures. Recently, a subtle shift is discernable. As well as ensuring appropriate consequences for plagiarists, several universities are beginning to formalise the inclusion of learning and teaching strategies in anti-plagiarism related policy and practice, as well as paying closer attention to the communication of unambiguous definitions of plagiarism. This article outlines one example of the emerging educative approach and details the ways in which this approach has been implemented across an entire university. The necessity of evidence-based evaluation of approaches to reducing plagiarism in higher education is discussed.

Policy, preparation, prevention and punishment: one faculty's holistic approach to minimising plagiarism

Most Australian universities have made attempts of various kinds to address plagiarism. Some have responded in recent times with a primary focus on catching and punishing plagiarists, often assisted by computer software packages. Others have taken a more holistic approach incorporating foci on policy, assessment regime and student preparation and education as well as on ensuring appropriate consequences for plagiarists. This paper outlines one example of the latter approach in one Australian university faculty and details the outcomes in terms of policy recommendations and resources to support the approach. The necessity of evidence-based evaluation of attempts to reduce plagiarism in higher education is argued.

Obesity, a worldwide epidemic related to heart disease and stroke: group IV prevention/treatment

Obesity is a worldwide problem, not just an issue for industrialized nations. Therefore, we need to examine opportunities for prevention and treatment from a global perspective.

Evaluation of the implementation of a state government community design policy aimed at increasing local walking : design issues and baseline results from RESIDE, Perth Western Australia

Objectives.
To describe the design and baseline results of an evaluation of the Western Australian government's pedestrian-friendly subdivision design code (Liveable Neighborhood (LN) Guidelines).
Methods.

Baseline results (2003–2005) from a longitudinal study of people (n = 1813) moving into new housing developments: 18 Liveable, 11 Hybrid and 45 Conventional (i.e., LDs, HDs and CDs respectively) are presented including usual recreational and transport-related walking undertaken within and outside the neighborhood, and 7-day pedometer steps.
Results.

At baseline, more participants walked for recreation and transport within the neighborhood (52.6%; 36.1% respectively), than outside the neighborhood (17.7%; 13.2% respectively). Notably, only 20% of average total duration of walking (128.4 min/week (SD159.8)) was transport related and within the neighborhood. There were few differences between the groups' demographic, psychosocial and perceived neighborhood environmental characteristics, pedometer steps, or the type, amount and location of self-reported walking (p > 0.05). However, asked what factors influenced their choice of housing development, more participants moving into LDs reported aspects of their new neighborhood's walkability as important (p < 0.05).
Conclusions.

The baseline results underscore the desirability of incorporating behavior and context-specific measures and value of longitudinal designs to enable changes in behavior, attitudes, and urban form to be monitored, while adjusting for baseline residential location preferences.