Fructose toxicity: is the science ready for public health actions?

PURPOSE OF REVIEW: The assumption that fructose may be toxic and involved in the pathogenesis of noncommunicable diseases such as obesity, diabetes mellitus, dyslipidemia, and even cancer has resulted in the call for public health action, such as introducing taxes on sweetened beverages. This review evaluates the scientific basis for such action. RECENT FINDINGS: Although some studies hint towards some potential adverse effects of excessive fructose consumption especially when combined with excess energy intake, the results from clinical trials do not support a significant detrimental effect of fructose on metabolic health when consumed as part of a weight-maintaining diet in amounts consistent with the average-estimated fructose consumption in Western countries. However, definitive studies are missing. SUMMARY: Public health policies to eliminate or limit fructose in the diet should be considered premature. Instead, efforts should be made to promote a healthy lifestyle that includes physical activity and nutritious foods while avoiding intake of excess calories until solid evidence to support action against fructose is available. Public health is almost certainly to benefit more from policies that are aimed at promoting what is known to be good than from policies that are prohibiting what is not (yet) known to be bad.

The neo-liberal state and the crisis of public service broadcasting in the Anglo-American democracies /

The NeO'liberal State and the Crisis ofPublic Service Broadcasting in the Anglo-American Democracies The purpose ofthis analysis ofthe present condition ofpublic service broadcasting in the Anglo- American democracies was to investigate whether such media can still be regarded as the primarypublic spherefor a dialogue between each nation 's civil society and the State. The motivationfor this thesis was based on a presumption that such fora for public discussion on the central issues of each society have become viewed as less relevant bypoliticians andpolicy-makers and thepublics they were intended to serve in the Anglo-American democracies over thepast two decades. It is speculated that this is the case because ofa beliefthat the post-war consensus between the respective States andpublics that led to the construction of the Keynesian Welfare State and the notion ofpublic service broadcasting has been displaced by an individualistic, neo-liberal, laissez-faire ideology. In other words, broadcasting as a consumer-oriented, commercial commodity has superseded concerns pertaining to the importance ofthe public interest. The methodology employed in this thesis is a comparative analysisfrom a criticalpolitical economy perspective. It was considered appropriate to focus on the United Kingdom, Australia, Canada and the\ United States because they comprise the four largest Anglo-American nations with democratic political systems andprimarily market economies. Justificationfor this particular sample is reinforced by thefact that case study countries also share a common socio-political and economic tradition. The evidence assembledfor this thesis consisted almost exclusively ofexisting literature on the subjects ofpublic service broadcasting, global economic andpolitical integration, and the ascendance ofthe 'free-market ' ethos in Western democracies since the late mid- to late-1970s. In essence, this thesis could be considered as a reinterpretation ofthe existing literature relevant to these issues. Several important common features werefound among the political, economic and broadcasting systems of the four case study nations. It is proposed that the prevalence of the neo-liberal world view throughout the political and policy environments of the four countries has undermined the stability and credibility of each nation 's national public service broadcasting organization, although with varying intensity and effect,. Deregulation ofeach nation 's broadcasting system and the supremacy ofthe notion of 'consumer sovereignty' have marginalized the view of broadcasting on any basis other than strictly economic criteria in thefour case study countries. This thesis concludes that,for a reconstruction ofa trulyparticipatory anddemocraticpublicsphere to be realized in the present as well as thefuture, a reassessment ofthe conventional concept ofthe 'public sphere ' is necessary. Therefore, it is recommended that thefocus ofpolicy-makers in each Anglo-American democracy be redirectedfrom that which conceived ofan all-encompassing, large, state-ownedand operated public broadcasting service toward a view which considers alternativeforms ofpublic communication, such as local community and ethnic broadcasting operations, that are likely to be more responsive to the needs of the increasingly diverse and heterogeneous populations that comprise the modem Anglo-American democracies. The traditional conception of public broadcasters must change in accordance with its contemporary environment if the fundamental principles of the public sphere and public service broadcasting are to be realized.

Partnership, politics and public administration: a case study of the Ontario Ministry of Natural Resources

Efforts to reform the public sector reflect the social, political and economic environment within which government must function. The recent demands by the public for more consensual decision-making, as well as more efficient, effective and responsive public service, have resulted in a number of reform initiatives, including an emphasis on partnership development. The purpose of this thesis is to examine partnership arrangements within the public sector. Specifically, the thesis will assess the value of partnerships and their impact on government by examining six partnership arrangements involving the Ontario Ministry of Natural Resources (OMNR). The OMNR, having recently been awarded the 1992 Institute of Public Administration of Canada Award for Innovative Management, on the theme of partnership development, is being lauded as an example for other government agencies considering similar alliances. The thesis begins by introducing the concept and practice of partnership within the public sector in general and the OMNR specifically. Descriptive analysis of six OMNR partnerships is provided and a number of criteria are used to determine the success of each of these arrangements. Special attention is paid to the political implications of partnerships and to those attributes which appear to contribute to the successful establishment and iii maintenance of partnership arrangements. The conclusion is drawn that partnerships provide the government with an opportunity to address public demands for greater involvement in decision-making while accommodating government's limited financial resources. However, few truly collaborative partnerships exist within the public sector. There are also significant political implications associated with partnerships which must be dealt with both at the political and bureaucratic levels of government. Lastly, it is argued that while partnerships within the OMNR are experiencing some difficulties, they constitute a genuine attempt to broaden the base of decision-making and to incorporate the concerns of stakeholders into resource management.

The development of self directedness in public health nurses

This qualitative study examined the perceived thoughts, feelings and experiences of seven public health nurses employed in a southern ontario health department, regarding the initial phase of the introduction of a self-directed orientation program in their place of employment. A desire to understand what factors facilitate public health nurses in the process of becoming self-directed learners was the purpose of this study. Data were gathered by three methods: 1) a standard open-ended interview was conducted by the researcher with each nurse for approximately one hour; 2) personal notes were kept by the researcher throughout the study; and 3) a review of all pertinent health department documents such as typed minutes of meetings and memos which referred to the introduction of the self-directed learning model was conducted. The meaning of the experience for the nurses provided some insights into what does and does not facilitate public health nurses in the process of becoming self-directed learners. Implications and recommendations for program planners, nurse administrators, facilitators of learning and researchers evolved from the findings of this study.

Equitable and Inclusive Education for All? Public Funding for Denominational Schools in Ontario

Roman Catholic separate schools’ denominational right to receive public funding is a contentious issue in Ontario’s educational system. Ontario’s publicly funded denominational schools historically served a purpose at Confederation; however, in light of Ontario’s evolving demographics, publicly funding denominational schools today may no longer serve the needs of Ontario. The research problem in this study is expressed through growing problems reconciling Roman Catholic schools with diversity and current public views. Additionally, recent tensions, public views, and political consensus suggest it is time to revisit the existing policy. In order to understand both the history of denominational schools and the present context, this study conducted II policy analyses as its research design by completing 2 policy cycles. The first policy cycle determined that based upon Upper and Lower Canada’s pre-Confederation diversity, extending public funding to denominational schools at Confederation was an effective way of protecting minority rights; however, the analysis in the second policy cycle; which examined how equitable and inclusive denominational schools are today, concluded that the denominational school system no longer serves the diversity and equity needs of contemporary Ontario. Building on these findings, this study then explored two viable alternative educational arrangements for Ontario’s future educational system: publicly funding all faith-based schools, or publicly financing a one-school-system. To address the diversity issue in Ontario, transitioning toward publicly funding a one-school-system is found to be the most viable option.

Well-Being Freedom and The Possibility of Public-Provision Unit in Global Context

The purpose of this paper is, first, to investigate the interconnections of substantive freedoms, which are indispensable for every individual to “lead the kind of lives they have reason to value” (Sen, 1999b, p.10,18), and which have legitimate and ethical reasons to be publicly secured, second, to investigate a conception of public-provision unit that embodies “the right to well-being freedom”, and a conception of decision-making unit that corresponds to it, based on the perspective of Sen’s capability theory and its extension, comparing with that of Rawls’ Theory of Justice and A Law of People. If we intend to construct such a public-provision unit, which conducts redistribution as a whole, and which receives every individual who cannot belong to any fixed local group, what kind of a body should we assume as a public-provision unit? And further, what kind of a body should we assume as a decision-making unit, which is responsible for deciding or revising the basic conceptions of public provision unit?

Potential of built environment interventions involving deployment of public bicycles to increase utilitarian cycling : the case of BIXI in Montreal, Quebec

Contexte : Les interventions sur l'environnement bâti reliées au transport peuvent contribuer à l'augmentation de la pratique de l'activité physique. En tant qu’intervention, les programmes de vélos en libre-service (PVLS) peuvent contribuer à l’utilisation du vélo. BIXI© (nom qui fusionne les mots BIcyclette et taXI) est un programme de vélos en libre-service implanté à Montréal, au Canada, en mai 2009. Le programme BIXI© met à la disposition des gens 5050 vélos à 405 bornes d’ancrage. Objectif : L'objectif général de cette thèse est d'étudier l'impact d'un programme de vélos en libre-service sur l’utilisation du vélo. Les objectifs spécifiques de la thèse sont de : 1) Estimer la prévalence populationnelle et identifier des variables environnementales, sociodémographiques et comportementales associées à l’utilisation des vélos en libre-service. 2) Estimer l’impact populationnel de l’implantation des vélos en libre-service sur l’utilisation du vélo et les contributions respectives de l’utilisation du vélo pour des fins utilitaires et récréatives à l’utilisation totale du vélo. 3) Estimer l’impact local de l’implantation des vélos en libre-service sur l’utilisation du vélo. Méthodes : Un devis populationnel transversal avec mesures répétées. Des enquêtes ont été réalisées au moment du lancement du programme de vélos en libre-service (4 mai au 10 juin, 2009), à la fin de la première année d’implantation (8 octobre au 12 décembre, 2009), et à la fin de la deuxième année d’implantation (8 novembre au 12 décembre, 2010). Les échantillons se composaient de 2001 (âge moyen = 49,4 années, 56,7 % de femmes), 2502 (âge moyen = 47,8 ans, 61,8 % de femmes) et 2509 (âge moyen = 48,9 années, 59,0 % de femmes) adultes à chaque période de mesure respectivement. Résultats : Globalement, les résultats démontrent le potentiel des PVLS pour augmenter l’utilisation du vélo. Les résultats suggèrent que près de 128 744 habitants ou 8,1 % de la population adulte ont utilisé les vélos BIXI© au moins une fois dans la première saison. Après deux ans d’implantation, ceux qui sont exposés à BIXI© dans leur milieu résidentiel avaient une probabilité significativement plus élevée d’utiliser le vélo par rapport à ceux non exposés. Par contre, il n'y avait aucun impact local de l’implantation du programme BIXI© sur l’utilisation du vélo. Conclusions : L’implantation d'un PVLS à Montréal a augmenté la probabilité d’utiliser le vélo chez les individus habitant près d'une borne d'ancrage. Mots clés : programme de vélos en libre-service, expérience naturelle, santé des populations.

Bootstrap for panel data models with an application to the evaluation of public policies

Le but de cette thèse est d étendre la théorie du bootstrap aux modèles de données de panel. Les données de panel s obtiennent en observant plusieurs unités statistiques sur plusieurs périodes de temps. Leur double dimension individuelle et temporelle permet de contrôler l 'hétérogénéité non observable entre individus et entre les périodes de temps et donc de faire des études plus riches que les séries chronologiques ou les données en coupe instantanée. L 'avantage du bootstrap est de permettre d obtenir une inférence plus précise que celle avec la théorie asymptotique classique ou une inférence impossible en cas de paramètre de nuisance. La méthode consiste à tirer des échantillons aléatoires qui ressemblent le plus possible à l échantillon d analyse. L 'objet statitstique d intérêt est estimé sur chacun de ses échantillons aléatoires et on utilise l ensemble des valeurs estimées pour faire de l inférence. Il existe dans la littérature certaines application du bootstrap aux données de panels sans justi cation théorique rigoureuse ou sous de fortes hypothèses. Cette thèse propose une méthode de bootstrap plus appropriée aux données de panels. Les trois chapitres analysent sa validité et son application. Le premier chapitre postule un modèle simple avec un seul paramètre et s 'attaque aux propriétés théoriques de l estimateur de la moyenne. Nous montrons que le double rééchantillonnage que nous proposons et qui tient compte à la fois de la dimension individuelle et la dimension temporelle est valide avec ces modèles. Le rééchantillonnage seulement dans la dimension individuelle n est pas valide en présence d hétérogénéité temporelle. Le ré-échantillonnage dans la dimension temporelle n est pas valide en présence d'hétérogénéité individuelle. Le deuxième chapitre étend le précédent au modèle panel de régression. linéaire. Trois types de régresseurs sont considérés : les caractéristiques individuelles, les caractéristiques temporelles et les régresseurs qui évoluent dans le temps et par individu. En utilisant un modèle à erreurs composées doubles, l'estimateur des moindres carrés ordinaires et la méthode de bootstrap des résidus, on montre que le rééchantillonnage dans la seule dimension individuelle est valide pour l'inférence sur les coe¢ cients associés aux régresseurs qui changent uniquement par individu. Le rééchantillonnage dans la dimen- sion temporelle est valide seulement pour le sous vecteur des paramètres associés aux régresseurs qui évoluent uniquement dans le temps. Le double rééchantillonnage est quand à lui est valide pour faire de l inférence pour tout le vecteur des paramètres. Le troisième chapitre re-examine l exercice de l estimateur de différence en di¤érence de Bertrand, Duflo et Mullainathan (2004). Cet estimateur est couramment utilisé dans la littérature pour évaluer l impact de certaines poli- tiques publiques. L exercice empirique utilise des données de panel provenant du Current Population Survey sur le salaire des femmes dans les 50 états des Etats-Unis d Amérique de 1979 à 1999. Des variables de pseudo-interventions publiques au niveau des états sont générées et on s attend à ce que les tests arrivent à la conclusion qu il n y a pas d e¤et de ces politiques placebos sur le salaire des femmes. Bertrand, Du o et Mullainathan (2004) montre que la non-prise en compte de l hétérogénéité et de la dépendance temporelle entraîne d importantes distorsions de niveau de test lorsqu'on évalue l'impact de politiques publiques en utilisant des données de panel. Une des solutions préconisées est d utiliser la méthode de bootstrap. La méthode de double ré-échantillonnage développée dans cette thèse permet de corriger le problème de niveau de test et donc d'évaluer correctement l'impact des politiques publiques.

Principe de finalité, protection des renseignements personnels et secteur public : étude sur la gouvernance des structures en réseau

Thèse réalisée en cotutelle avec l'Université de Montréal et l'Université Panthéon-Assas Paris II

Quand la politique et la génétique se rencontrent : comment le public interprète-t-il la recherche?

L’objectif général de cette thèse de doctorat est de mieux comprendre comment le public interprète les nouvelles scientifiques portant sur la génétique humaine, plus précisément les nouvelles portant sur la génétique des comportements et celles portant sur la génétique des groupes raciaux. L’ouvrage prend la forme d’une thèse par article. Le Chapitre 1 introduit le lecteur aux buts et aux pratiques de la vulgarisation scientifique, présente un sommaire de la recherche sur les effets des médias, résume les principaux travaux produits par le champ de la génopolitique, et définit la structure des croyances du public à l’égard de l’influence de la génétique sur les traits humains. Le Chapitre 2 présente les fondements de la méthode expérimentale, il en explique les atouts et il offre des exemples de différents types de devis expérimentaux utilisés en science politique. Toutes les recherches produites dans cette thèse reposent au moins en partie sur cette méthode. Le Chapitre 3 présente les résultats d’une expérience de sondage qui vise à mesurer l’effet de la lecture d’une nouvelle à propos de la recherche en génétique des comportements sur des participants. L’étude démontre que le public interprète la nouvelle avec maladresse et tend à généraliser l’influence de la génétique à d’autres traits humains qui n’y sont pas mentionnés. J’avance l’hypothèse qu’un raccourci psychologique amplement documenté puisse expliquer cette réaction : l’heuristique de l’ancrage et de l’ajustement. Le Chapitre 4 présente lui aussi les résultats d’une expérience de sondage. L’étude consiste à manipuler certaines informations du contenu d’une nouvelle sur la génopolitique de manière à vérifier si certains éléments sont particulièrement susceptibles de mener à la généralisation hâtive mise en évidence dans le Chapitre 3. Les analyses suggèrent que cette généralisation est amplifiée lorsque la nouvelle présente de hauts niveaux d’héritabilité tirés d’études de jumeaux, ainsi que lorsqu’elle présente des travaux de génétique des populations visant à étudier l’origine des différences géographiques. Ce chapitre présente des recommandations à l’égard des journalistes scientifiques. Le Chapitre 5 s’intéresse à un aspect différent de la génétique humaine : celui de la génétique des races. L’objectif de cette recherche est de comprendre comment le public réagit aux travaux qui invalident l’idée selon laquelle les humains sont divisés en différentes races génétiquement distinctes. Les analyses de données transversales ainsi que les résultats d’une expérience de sondage convergent et indiquent que les conservateurs et les libéraux réagissent de manière diamétralement opposée à cette information. D’un côté, les libéraux acceptent le constat scientifique et réduisent leur impression que la génétique explique en partie les inégalités sociales; de l’autre, les conservateurs rejettent l’argument avec une intensité si forte que le rôle qu’ils attribuent aux différences génétiques s’en voit bonifié. Ces résultats sont interprétés à partir de la théorie du raisonnement motivé. Enfin, le Chapitre 6 résume les principaux constats, met en évidence les contributions que ma thèse apporte à la science politique et à la communication scientifique, et présente quelques pistes pour la recherche future.

Decision‐Making in Public Good Dilemmas: Theory and Agent‐Based Simulation

In many real world contexts individuals find themselves in situations where they have to decide between options of behaviour that serve a collective purpose or behaviours which satisfy one’s private interests, ignoring the collective. In some cases the underlying social dilemma (Dawes, 1980) is solved and we observe collective action (Olson, 1965). In others social mobilisation is unsuccessful. The central topic of social dilemma research is the identification and understanding of mechanisms which yield to the observed cooperation and therefore resolve the social dilemma. It is the purpose of this thesis to contribute this research field for the case of public good dilemmas. To do so, existing work that is relevant to this problem domain is reviewed and a set of mandatory requirements is derived which guide theory and method development of the thesis. In particular, the thesis focusses on dynamic processes of social mobilisation which can foster or inhibit collective action. The basic understanding is that success or failure of the required process of social mobilisation is determined by heterogeneous individual preferences of the members of a providing group, the social structure in which the acting individuals are contained, and the embedding of the individuals in economic, political, biophysical, or other external contexts. To account for these aspects and for the involved dynamics the methodical approach of the thesis is computer simulation, in particular agent-based modelling and simulation of social systems. Particularly conductive are agent models which ground the simulation of human behaviour in suitable psychological theories of action. The thesis develops the action theory HAPPenInGS (Heterogeneous Agents Providing Public Goods) and demonstrates its embedding into different agent-based simulations. The thesis substantiates the particular added value of the methodical approach: Starting out from a theory of individual behaviour, in simulations the emergence of collective patterns of behaviour becomes observable. In addition, the underlying collective dynamics may be scrutinised and assessed by scenario analysis. The results of such experiments reveal insights on processes of social mobilisation which go beyond classical empirical approaches and yield policy recommendations on promising intervention measures in particular.

The Assault on Human Rigths and the Resilience of the Andean Dream: Health Inequities in Ecuador. IV Annual Distinguished Lecture sponsored by the Center for Research on Ethnicity, Culture and Health; School of Public Health; University of Michigan

The point of departure for these reflections is life, since its protection is the central purpose encouraging the defense of human rights and of public health. Life in the Andes has an exceptional diversity. Particularly in Ecuador, my country, this diversity constitutes a characteristic sign that is expressed in two main forms: natural megadiversity and multiculturalism. Indeed, Ecuador’s small territory synthesizes practically all types of lifezones that exist on Earth, having received the gift of high average rates of solar energy and abundant nutritional sources, which have facilitated the natural reproduction of countless species that show their beautiful vitality in the variety of ecosystems that compose the Andean mountain range, the tropical plains, the Amazon humid forests, and the Galapagos Islands. But besides being a highly biodiverse country, it is also a plurinational and multi-cultural society, in which the activity of human beings, organized into social conglomerates of different historical and cultural backgrounds, have formed more than a dozen nations and peoples. Regrettably this natural and human wealth has not been able to bear its best fruits due to the violent operation of a deep social inequity – unfortunately also one of the highest in the Americas—which conspires against life and is reproduced in national and international inequitable relations. This structural inequity has changed its form throughout the centuries and currently has reached its highest and most perverse level of development.

Does watershed development implemented through public private partnership empower women? A case review from Rajasthan, Western India

This paper critically examines the impact of the ‘Guidelines for Hariyali’ – a rural watershed development policy launched in Rajasthan, Western India which has been implemented through a Public Private Partnership (PPP) – for local communities. In 2003, the Government of India launched the ‘Guidelines’ (a comprehensive Integrated Wastelands Development Programme and Drought Prone Areas Programme and Desert Development Programme), the purpose of which is to restore ecological balance by harnessing, conserving and developing natural resources in drought-prone and arid rural areas for the benefit of villages. In the particular case-study area, the policy has been implemented through institutional linkages between a corporation and the government with the aim of sharing responsibilities for finances, planning, implementation and monitoring, the end goal being to enhance the livelihoods of rural households. The analysis focuses specifically on how the ‘Guidelines’ have affected the livelihoods of Rajasthani women, drawing upon findings from focus groups with men and women in the project catchment area, as well as interviews with key actors at public and private sector institutions. Findings reveal that there are significant gaps between policy objectives and the realities on the ground, particularly in the context of women's accessibilities and entitlements. The paper also broadens understanding of how PPPs, if implemented properly, could empower women in the area of watershed management across rural South Asia.

Fair trade and European public procurement: legal principles and governance dynamics

Purpose The article examines principles of Fair Trade in public procurement in Europe, focusing on legal dimensions related to the European Public Procurement Directives. Design/methodology/approach The article situates public procurement of Fair Trade products in relation to the rise of non-state regulatory initiatives, highlighting how they have entered into new governance dynamics in the public sector and play a part in changing practices in sustainable procurement. A review of legal position on Fair Trade in procurement law is informed by academic research and campaigning experience from the Fair Trade Advocacy Office. Findings Key findings are that the introduction of Fair Trade products into European public procurement has been marked by legal ambiguity, having developed outside comprehensive policy or legal guidelines. Following a 2012 ruling by the Court of Justice of the European Union, it is suggested that the legal position for Fair Trade in procurement has become clearer, and that forthcoming change to the Public Procurement Directives may facilitate the uptake of fair trade products by public authorities. However potential for future expansion of the public sector ‘market’ for Fair Trade is approached with caution: purchasing Fair Trade products as a marker of sustainability, which started to be embedded within procurement practice in the 2000s, is challenged by current European public austerity measures. Research limitations/implications Suggestions for future research include the need for systematic cross-institutional and multi-country comparison of the legal and governance dimensions of procurement practice with regard to Fair Trade. Practical implications A clarification of current state-of-play with regard to legal aspects of fair trade in public procurement of utility for policy and advocacy discussion. Originality/value The article provides needed elaboration on an under researched topic area of value to academia and policy makers.