State-Level Pharmaceutical Assistance Programs for the Elderly: A national survey.

In order to put Pennsylvania's Pharmaceutical Assistance Contract for the Elderly (PACE) Program in a national context, a nationwide mail survey and telephone follow-up to each of the 58 State Unit Directors on Aging in the United States and its territories identified 10 programs. The results reported in this article are specific to the seven state-level pharmaceutical assistance programs which were in operation during the fiscal year 1984-85. In general, the programs varied on select program characteristics and on their efforts to address major policy issues. Data from the non-program states indicated support, legislative efforts, and a high interest in fiscal concerns. The findings reflect a lack of program uniformity and have implications for program development and implementation. Suggestions on how to identify the "optimum" or best combination of program and policy options are discussed.

Physicians' philosophy of care: a comparison of complementary and conventional medicine

BACKGROUND: This project is part of an evaluation of complementary and alternative medicine (CAM) aimed at providing a scientific basis for the Swiss Government to include 5 CAM methods in basic health coverage: anthroposophic medicine, homeopathy, neural therapy, phytotherapy and Traditional Chinese Medicine (TCM). OBJECTIVES: The objective was to explore the philosophy of care (convictions and values, priorities in medical activity, motivation for CAM, criteria for the practice of CAM, limits of the used methods) of conventional and CAM general practitioners (GPs) and to determine differences between both groups. MATERIALS AND METHODS: This study was a cross-sectional survey of a representative sample of 623 GPs who provide complementary or conventional primary care. A mailed questionnaire with open-ended questions focusing on the philosophy of care was used for data collection. An appropriate methodology using a combination of quantitative and qualitative approaches was developed. RESULTS: Significant differences between both groups include philosophy of care (holistic versus positivistic approaches), motivation for CAM (intrinsic versus extrinsic) and priorities in medical activity. Both groups seem to be aware of limitations of the therapeutic methods used. The study reveals that conventional physicians are also using complementary medicine. DISCUSSION: Our study provides a wealth of data documenting several aspects of physicians' philosophy of care as well as differences and similarities between conventional and complementary care. Implications of the study with regard to quality of care as well as ethical and health policy issues should be investigated further.

Mandating the HPV vaccine

Background. HPV is the underlying cause of cervical cancer, a malignant tumor of the female genital tract. Each year, cervical cancer is newly diagnosed in approximately 10,000 women, and over 3,000 women die from the malignancy. In addition, HPV is implicated as a cause of other cancers involving the genital tract, male and female, and the head and neck. ^ Gardasil, a vaccine against HPV, was licensed by the FDA in June 2006. Early study results have shown Gardasil to be safe and effective at preventing HPV infections that are commonly associated with the development of cervical cancer, as well as other HPV-related cancers and genital warts. The vaccine is most effective when administered in childhood, before initial exposure to HPV, which typically occurs shortly after the onset of sexual activity. Accordingly, the CDC's Advisory Committee on Immunization Practices (ACIP) has recommended routine vaccination of females aged 11-12 years. ^ Taking the ACIP recommendation one step further, many states have considered school-based mandates of the HPV vaccine in an attempt to reduce the burden of HPV-related illness, in particular to reduce the disparately high incidence of cervical cancer in medically underserved populations. These mandate attempts have sparked heated debate—highlighting public concerns regarding adolescent sexuality, corporate greed, and vaccines in general. ^ Methods. My research focuses on publicly available sources of information such as medical journals, government reports (federal and state), NGO reports, newspapers, and books. I begin with a background discussion of HPV, cervical cancer, and the HPV vaccine. I then discuss public health policy issues related to vaccines, vaccine mandates, and HPV-related illness. Specifically, I discuss the public health benefit of previous vaccine mandates, the legality of vaccine mandates, and the undue corporate influence on the politics of instituting HPV vaccine mandates. In addition, I examine some of the causes behind the anti-vaccine movement and the controversy surrounding adolescent sexuality as it pertains to the HPV vaccine. In the final section, I focus on the recent failed attempt by Governor Rick Perry to mandate the HPV vaccine in Texas. A retrospective analysis of Governor Perry's policy decisions is undertaken and recommendations are made regarding future attempts to mandate the HPV vaccine, or other vaccines under development for similar sexually transmitted viral diseases such as HIV and herpes simplex. ^ Results. In Texas, as in other states across the country, HPV vaccine mandates faced opposition from those who, while they may support mandates of other vaccines, oppose mandates for the HPV vaccine based largely on the idea that HPV is a sexually transmitted disease—they see responsible sexual behavior as the appropriate method for preventing HPV-related illness. A second major group of opposition comes from those who are generally opposed to all vaccine mandates, due to concerns that mandates are intended primarily for the financial benefit of the pharmaceutical industry or due to concerns—largely unfounded—that vaccines pose a greater health threat than the illnesses they are designed to prevent. ^ Conclusion. In order to reduce opposition to vaccine mandates, care must be taken to educate the public regarding the benefits of vaccination by mobilizing the public health sector, avoid the impression that the decision to institute mandates is rash or pressured by allowing time for open debate, and minimize lobbying efforts by vaccine manufacturers. ^

SOCIAL AND BIOLOGICAL DETERMINANTS OF SHORT-TERM GROWTH VELOCITY AMONG PRESCHOOLERS OF RURAL GUATEMALA: A PATH ANALYSIS APPROACH (WEIGHT-GAIN, IRON DEFICIENCY, GASTROINTESTINAL SYMPTOMS)

This dissertation develops and tests through path analysis a theoretical model to explain how socioeconomic, socioenvironmental, and biologic risk factors simultaneously influence each other to further produce short-term, depressed growth in preschoolers. Three areas of risk factors were identified: child's proximal environment, maturational stage, and biological vulnerability. The theoretical model represented both the conceptual framework and the nature and direction of the hypotheses. Original research completed in 1978-80 and in 1982 provided the background data. It was analyzed first by nested-analysis of variance, followed by path analysis. The study provided evidence of mild iron deficiency and gastrointestinal symptomatology in the etiology of depressed, short-term weight gain. Also, there was evidence suggesting that family resources for material and social survival significantly contribute to the variability of short-term, age-adjusted growth velocity. These results challenge current views of unifocal intervention, whether for prevention or control. For policy formulations, though, the mechanisms underlying any set of interlaced relationships must be decoded. Theoretical formulations here proposed should be reassessed under a more extensive research design. It is suggested that studies should be undertaken where social changes are actually in progress; otherwise, nutritional epidemiology in developing countries operates somewhere between social reality and research concepts, with little grasp of its real potential. The study stresses that there is a connection between substantive theory, empirical observation, and policy issues. ^

Essays on Inequality and Integration

Inequality and integration have been sociology’s two key paradigms since the classics, associated with the names of Marx and Durkheim and Europe’s current economic crisis has forcefully reinvigorated their joint relevance. Above all, the debt crisis has fueled the wheel of social inequality: cash-starved states are further forced to cut back on public expenditures, to minimize the margin for redistribution and to raise new challenges for the integration policies addressing the emerging disparities. At the same time, global environmental and demographic problems, intertwined with escalating migration pressure, tear at the texture of European and all Western societies, in particular, the unequal impact of climate change and the unequal distribution of population growth make migration and integration paramount public policy issues and a soaring source of social conflict. In principle, the inequalities engendered by these cascading processes are also an opportunity. They increase the diversity of society and can bring about innovation and growth. Our desire and ability for social integration depends, above all, on the ultimate balance between these advantages and disadvantages. The chapters in the volume concentrate on the opportunities as well as the risks associated with these social changes from various angles. They are a handpicked set of outstanding contributions from the Congress of the Swiss Sociological Association that took place at the University of Bern, June 26–28, 2013.

Transformation of the Rice Marketing System and Myanmar's Transition to a Market Economy

Creating a rice marketing system has been one of the central policy issues in Myanmar's move to a market economy since the end of the 1980s. Two liberalizations of rice marketing were implemented in 1987 and 2003. This paper examines the essential aspects of the liberalizations and the subsequent transformation of Myanmar's rice marketing sector. It attempts to bring into clearer focus the rationale of the government's rice marketing reforms which is to maintain a stable supply of rice at a low price to consumers. Under this rationale, however, the state rice marketing sector continued to lose efficiency while the private sector was allowed to develop on condition that it did not jeopardize the rationale of stable supply at low price. The paper concludes that the prospect for the future development of the private rice marketing sector is dim since a change in the rice market's rationale is unlikely. Private rice exporting is unlikely to be permitted, while the domestic market is approaching the saturation point. Thus, there is little momentum for the private rice sector to undertake any substantial expansion of investment.

The Transport Debate. Book Description

The lucid and accessible analysis of the key policy issues of transport is more than welcomed, now when the link between social and economic efficiency and transport is more than proved. The authors, two experts in the field, Shaw and Docherty give concise information on a timeliness topic showing that decision-making in transport (i.e. privatization of transport networks and services) has long term negative effects on the mobility of people and their accessibility to their key life activities.

ANALISANDO A RELAÇÃO DOS VOLUMES DE EXPORTAÇÃO E DE IMPORTAÇÃO, PIB, TAXAS DE CÂMBIO E INFLAÇÃO NO PERÍODO DE 2004 A 2014.

Esta dissertação visa deslumbrar uma análise macroeconômica do Brasil, especialmente no que se refere à relação dos índices mensais dos volumes das exportações e das importações com os volumes mensais do PIB, da Taxa SELIC e as Taxas de Câmbio, conforme dados coletados no período de janeiro de 2004 a dezembro de 2014, através de pesquisa literária referente aos históricos sobre cada conceito envolvido no âmbito da macroeconomia das varáveis estudadas. Foi realizado um estudo de caso embasado em dados de sites governamentais, no período delimitado, empregando-se o método de regressão linear, com base na Teoria da correlação de Pearson, demonstrando os resultados obtidos no período do estudo para as varáveis estudadas. Desta maneira, conseguiu-se estudar e analisar como as variáveis dependentes (resposta): volume das exportações e volume das importações estão relacionadas com as varáveis independentes (explicativas): PIB, Taxa Selic e taxa de Câmbio. Os resultados apurados no presente estudo permitem identificar que existe correlação moderada e negativa, quando analisadas a Taxa Selic e a Taxa de Câmbio com os volumes das exportações e das importações, enquanto o PIB apresenta correlação forte e positiva na análise com os volumes das exportações e das importações

An Introduction to Conservation Easements in the United States: A Simple Concept and a Complicated Mosaic of Law

The idea of a conservation easement – restrictions on the development and use of land designed to protect the land’s conservation or historic values – can be relatively easily understood. More significant and more challenging is the complex body of state and federal laws that shapes the creation, funding, tax treatment, enforcement, modification, and termination of conservation easements. The explosion in the number of conservation easements over the past four decades has made them one of the most popular land protection mechanisms in the United States. The National Conservation Easement Database estimates that the total number of acres encumbered by conservation easements exceeds 40 million.Because conservation easements are both novel and ubiquitous, understanding how they actual work is essential for practicing lawyers, policymakers, land trust professionals, and students of conservation. This article provides a “quick tour” through some of the most important aspects of the developing mosaic of conservation easement law. It gives the reader a sense of the complex inter-jurisdictional dynamics that shape conservation transactions and disputes about conservation easements. Professors of property law, environmental law, tax law, and environmental studies who wish to cover conservation easements in the context of a more general course can use the article to provide their students with a broad but comprehensive overview of the relevant legal and policy issues.

1 + 1 = 3? EU-US voting cohesion in the United Nations General Assembly. EU Diplomacy Paper 07/2012, September 2012

This paper investigates the factors that explain the voting cohesion of the United States (US) and the European Union (EU) on foreign policy issues in the United Nations General Assembly (UNGA). It is often argued that the EU and the US are simply too different to cooperate within international organizations and thus to vote the same way, for example, in the UNGA. However, there is still a lack of research on this point and, more importantly, previous studies have not analyzed which factors explain EU-US voting cohesion. In this paper, I try to fill this gap by studying voting cohesion from 1980 until 2011 on issues of both ‘high’ politics (security) and ‘low’ politics (human rights) not only as regards EU-US voting cohesion, but also concerning voting cohesion among EU member states. I test six hypotheses derived from International Relations theories, and I argue that EU-US voting cohesion is best explained by the topic of the issue voted upon, whether an issue is marked as ‘important’ by the US government, and by the type of resolution. On the EU level, the length of Union membership and transaction costs matter most.

Defying the Treaty: The Influence of the Polish and Lithuanian Council Presidencies on the Development of the Eastern Partnership. EU Diplomacy Paper No. 6, October 2014

Many scholars now argue that the Treaty of Lisbon has removed the role and influence of the rotating Council Presidency in the domain of the European Union’s foreign affairs. This paper will, however, go beyond a superficial, treaty-based analysis of the influence of the post-Lisbon rotating Council Presidency and instead look at two primary, residual, informal Presidential roles, namely agenda-shaping and brokering. It will examine the extent to which these informal roles allowed the Polish and Lithuanian Council Presidencies of July to December 2011 and 2013 respectively to influence the development of the bilateral, multilateral and internal tracks of the Eastern Partnership. The paper will argue that the considerable influence of these rotating Presidencies defied the logic of the Lisbon Treaty, suggesting that the ‘golden age’ of this six-month position, whereby individual Member States pursue foreign policy issues of significant domestic interest at the European level, has not yet passed.

Enhancing European Cooperation in Financial Supervision and Crisis Management. ACES Working Papers, August 2009

To overcome the regulatory pitfalls, regulatory capacity and resources in financial markets governance need to be enhanced, not only at national but also at global levels. In order to shed light on policy issues and agendas in international financial policy cooperation, this paper focuses on the case of European financial integration and regulations. The analysis of policy developments at the European level in coordinating differing national interests, supervisory systems, and practices among EU member states highlights fundamental elements of global financial regulatory cooperation.

Disentangling the Reform Gridlock: Higher Education in Germany. CES Germany & Europe Working Papers, No. 02.7, 2002

For more than a decade, bemoaning the many roadblocks to reforming important aspect of German politics has become commonplace. Explanations emphasize formal and informal veto points, such as the role of political institutions and the lack of elite and societal support for reform initiatives. Against this background, I was interested in factors that place policy issues on the political agenda and follow up with concrete courses of action; i.e., in factors that lead to a disentangling of the reform gridlock. I emphasize the importance of agenda setting in the emergence of higher education reform in Germany. Globalization, European integration and domestic pressures combined to create new pressures for change. In response, an advocacy coalition of old and new political actors has introduced a drawn-out and ongoing process of value reorientation in the direction of competition, including international competition, and greater autonomy. The result has been a burst of activities, some moderate, some more far-reaching in their potential to restructure German higher education.

The altar and the throne alliance. The Russian Orthodox Church vs. the government in Russia. OSW STUDIES 54, 2016-01-04

The Russian Orthodox Church Moscow Patriarchate (ROC), the largest religious community in Russia, plays an essential role in the process of the cultural and national self-identification of the Russian people. Being a socio-political institution with a centuries-long history, it possesses great symbolic capital and enjoys public respect, which has been used for political purposes. Since Vladimir Putin regained the presidency in 2012, in order to strengthen the political regime in Russia the Kremlin has begun to extensively draw upon conservative ideology and promote the traditional moral and social values which the Church is viewed as the guardian of. This has resulted in establishing closer relations between the secular government and the ROC, as well as in a greater engagement of ROC hierarchs and organisations in domestic and foreign policy issues. This situation exposes the ROC to criticism for being excessively involved in politics, and in the longer term, to the risks linked to potential destabilisation of the governmental system in Russia.

The Business Models and Economics of Peer-to-Peer lending. ECRI Research Report No 17, May 2016

This paper reviews peer-to-peer (P2P) lending, its development in the UK and other countries, and assesses the business and economic policy issues surrounding this new form of intermediation. P2P platform technology allows direct matching of borrowers’ and lenders’ diversification over a large number of borrowers without the loans having to be held on an intermediary balance sheet. P2P lending has developed rapidly in both the US and the UK, but it still represents a small fraction, less than 1%, of the stock of bank lending. In the UK – but not elsewhere – it is an important source of loans for smaller companies. We argue that P2P lending is fundamentally complementary to, and not competitive with, conventional banking. We therefore expect banks to adapt to the emergence of P2P lending, either by cooperating closely with third-party P2P lending platforms or offering their own proprietary platforms. We also argue that the full development of the sector requires much further work addressing the risks and business and regulatory issues in P2P lending, including risk communication, orderly resolution of platform failure, control of liquidity risks and minimisation of fraud, security and operational risks. This will depend on developing reliable business processes, the promotion to the full extent possible of transparency and standardisation and appropriate regulation that serves the needs of customers.