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Mandate
Selected AbstractsBericht über die 68.DIBT MITTEILUNGEN (FORMERLY-MITTEILUNGEN DEUT INST FUER BAUTECHNIK), Issue 1 2009Sitzung des Ständigen Ausschusses für das Bauwesen Am 10. und 11. November 2008 fand die 68. Sitzung des Ständigen Ausschusses für das Bauwesen (StAB) in Brüssel statt. Den Vorsitz hatte der Leiter des Referats "Baugewerbe" bei den Kommissionsdiensten. Im Folgenden werden die wesentlichen Beratungsinhalte kurz wiedergegeben. 1. Berichte über die Ergebnisse verschiedener europäischer Arbeitsgruppen 2. Harmonisierte Normen 3. Änderung zweier Mandate an EOTA 4. Kommissionsentscheidungen 5. Mandate 6. Entwurf einer Verordnung über Bauprodukte 7. Verordnung über gegenseitige Anerkennung 8. Sonstiges [source] The Palestinian peasant economy under the Mandate: a story of colonial bungling , By Amos NadanECONOMIC HISTORY REVIEW, Issue 2 2007Jacob Metzer No abstract is available for this article. [source] Why a Dual Mandate is Right for Monetary Policy,INTERNATIONAL FINANCE, Issue 2 2008Benjamin M. FriedmanArticle first published online: 18 NOV 200 First page of article [source] Mission Following the Missionary Mandate of the Risen ChristINTERNATIONAL REVIEW OF MISSION, Issue 378-379 2006Francuco Pérez Herrero First page of article [source] A Strategy for Dealing with Financial Reporting Fraud: Fewer Mandates, More Auditing,ACCOUNTING PERSPECTIVES, Issue 2 2008Steven E. Salterio First page of article [source] A reconstructed digit by transplantation of a second toe for control of an electromechanical prosthetic handMICROSURGERY, Issue 1 2002Zhong Wei Chen M.D. The treatment options for the loss of an entire human hand and part of the forearm are currently limited to the transplantation of toe(s) to the amputation stump or a Krukenberg's bifurcation hand, and using a cosmetic or functional prosthesis. The functional prosthetic hand, such as the prevailing myoelectrically controlled prosthetic hand, has an action accuracy that is affected by many factors. The acceptance rate of the three planes freedom myoelectronic hand by the patients was 46,90% because of poor function caused by the weakness of signal and strong external interference. In this report, the left second toe was transplanted to the patient's forearm amputation stump. Mandates from the brain are relayed by the action of this reconstructed digit, to control a special designed multidimension freedom electronic prosthetic hand. After rehabilitation and adaptation training, the correct recognition rate of the electronic prosthetic hand controlled by this reconstructed digit is a remarkable 100%. © 2002 Wiley-Liss, Inc. MICROSURGERY 22:5,10, 2002 DOI 10.1002/micr.22002 [source] Comparing Competing Theories on the Causes of Mandate PerceptionsAMERICAN JOURNAL OF POLITICAL SCIENCE, Issue 2 2005Lawrence J. Grossback The discussion of presidential mandates is as certain as a presidential election itself. Journalists inevitably discuss whether the president-elect has a popular mandate. Because they see elections as too complex to allow the public to send a unitary signal, political scientists are more skeptical of mandates. Mandates, however, have received new attention by scholars asking whether perceptions of mandate arise and lead representatives to act as if voters sent a policy directive. Two explanations have emerged to account for why elected officials might react to such perceptions. One focuses on the president's strategic decision to declare a mandate, the second on how members of Congress read signals of changing preferences in the electorate from their own election results. We test these competing views to see which more accurately explains how members of Congress act in support of a perceived mandate. The results indicate that members respond more to messages about changing preferences than to the president's mandate declaration. [source] Dog Whistles and Democratic MandatesTHE POLITICAL QUARTERLY, Issue 4 2005ROBERT E. GOODIN Manipulative mixed messages from candidates to voters affect what governments are entitled to do in office. A party that wins an election gains a 'mandate to rule'. But there is a second type of mandate: a 'policy mandate' to enact specific policy proposals central to the winning party's campaign. Mixed-message politics in general can undermine policy mandates, and the use of 'dog whistle politics' - telling one group of voters one thing, while allowing or encouraging another group to believe another - makes the inferring of policy mandates especially problematic. Referendums provide only a partial remedy to dog whistle politics. Winning a clear policy mandate means forgoing dog whistle politics, despite the short term electoral advantage they may deliver. [source] The Efficacy of Third-Party Consultation in Preventing Managerial Escalation of Commitment: The Role of Mental Representations,CONTEMPORARY ACCOUNTING RESEARCH, Issue 1 2004KATHRYN KADOUS Abstract Avoiding continued investment in poorly performing projects is an important function of management control systems. However, prior research suggests that managers fail to use accounting information indicating that a project is performing poorly to discontinue it; that is, they escalate commitment to the project. We perform two experiments to investigate the efficacy of a potential control mechanism, third-party consultation, in preventing managerial escalation of commitment. We hypothesize that the information-processing objective (that is, purpose) assigned to consultants influences the mental representations they construct to process and store information, which ultimately influences their recommendations regarding the continuation of a poorly performing project. Results suggest that consultants will not construct mental representations amenable to making high-quality project-continuation recommendations unless they are assigned that specific purpose. Results further suggest that applying additional effort likely will not overcome the adverse effects of having inappropriate mental representations when making project-continuation recommendations. An implication of our study is that third-party consultants likely will not prevent managerial escalation of commitment unless consultants have a specific mandate of making a project-continuation recommendation in mind when they encounter relevant accounting information. [source] Homicide, psychopathology, prosecutorial and jury discretion and the death penaltyCRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 4 2000Chief, Division of Forensic Psychiatry, Richard M. Yarvis MD MPH Professor of Clinical Psychiatry Introduction The American preoccupation with the death penalty persists and, in fact, shows no sign of abatement. This is demonstrated not only by attitudinal measures but also by the quickening pace of executions. In California, homicide convictions can result in either 25-year-to-life, life-with-no-possibility-of-parole, or death sentences. The ultimate outcome in any given case is determined by a complex interaction of prosecutorial and jury decisions. Three vignettes illustrate how heinous crimes have been handled quite variably. Method A data set comprising 115 homicide cases was examined. To determine how murderers who qualify for the death penalty differed, if at all, from those who did not so qualify, 52 defendants who met the criteria for a death sentence were compared with 63 who did not. Criteria utilized and ignored by prosecutors in seeking the death penalty were analysed by comparing 39 cases in which death sentences could have been and were sought with 13 cases in which prosecutors chose to seek a lesser penalty instead. Finally, criteria utilized and ignored by juries to reach sentencing decisions were analysed by comparing 25 cases in which juries chose not to hand down death sentences with 14 cases in which they did render death verdicts. Results Special circumstance murderers did not differ significantly on personal variables from ordinary murderers. (1) Special circumstances were invariably charged when more than one criterion for this was present. Robbery and sexual assault usually provoked a special circumstances charge. Mitigating factors did not deter prosecutors from charging a special circumstance. (2) There was no excess of aggravating factors in individuals sentenced to death by juries, indeed there was a trend for the opposite to be the case, but there was a trend for mitigating factors to be commoner in those excused the death penalty. Conclusion It is not clear that the death penalty process in California carries out the legislature's intent but the US Supreme Court's 1976 mandate that mitigating and aggravating factors should provide discretion may be having a modest impact. Copyright © 2000 Whurr Publishers Ltd. [source] The Animated Muse: An Interpretive Program for Creative ViewingCURATOR THE MUSEUM JOURNAL, Issue 3 2005Austin Clarkson ABSTRACT Explore a Painting in Depth, an experiment presented in the Canadian Collection of the Art Gallery of Ontario, consisted of a booth that offered seating for two visitors and, opposite them, The Beaver Dam, a 1919 landscape painting by the Canadian artist J. E. H. MacDonald. In a 12-minute audio-guided Exercise for Exploring, visitors were invited to engage in a creative process with the imagery of the painting. This paper sketches how the experiment evolved, presents the background of the Exercise for Exploring, and surveys the effects of the exhibit on a wide range of visitors. The question is raised: How can facilitating visitors' creative responses to artworks be part of the museum's educational mandate and its arsenal of interpretive resources? More broadly: Do strategies that foster and privilege visitor creativity, as well as honor the creativity of artists, affect the accessibility and relevance of the museum for the general public? [source] Sustainable Responsible Design: Insights from Wales (UK)DESIGN MANAGEMENT REVIEW, Issue 3 2005Frank O'Connor As Frank O'Connor and Iain Cox share two cases to illustrate what Design Wales is doing to promote responsible design among SMEs, it is evident that several elements are needed to implement what turns out to be a complex mandate. Governments must support the agenda with appropriate policy. Companies must make the commitment to value-based brands. Designers have to contribute relevant expertise, and consumers must to be willing to buy. [source] Patriotism for Citizens of the Penultimate SuperpowerDIALOG, Issue 4 2003Walter Brueggemann Abstract: The United States of America confesses its penultimate status as "One nation under God." Yet this relationship,of the ultimacy of God and the penultimacy of nations,is frequently forgotten when foreign policy is crafted. The arrogant autonomy of such superpowers operates on the mistaken conviction that they will not be called into account. But the preacher says otherwise. The Old Testament witness teaches us that there is a grave danger to nations making such unrestricted claims of temporal ultimacy. Any state that imagines that it can use its power in unrestrained ways against any other state or vulnerable population,no matter how weak,misunderstands its place in a world under divine rule. It is thus essential that the preacher, along with the congregation, must dare to recover the rhetoric of prophetic imagination concerning God's governance in the public sphere. Empowered and humbled by the mandate of scripture, the preacher must counter the rhetoric of popular patriotism and witness to God's sovereignty over nations. We may then move beyond analysis to alternative, and finally set our hearts and minds on the evangelical task of empowering the faithful to alternative forms of citizenship. [source] Transformative Teaching: Restoring the teacher, under erasureEDUCATIONAL PHILOSOPHY AND THEORY, Issue 2 2009Jenny Steinnes Abstract In the large and complex landscape of pedagogy, the focus seems to have turned away from the concept of teaching and towards a stronger emphasis on learning, probably supported by neo-liberal ideology. The teacher is presented more as part of the force of production than as an autonomous performer of a mandate given to him/her by society. He/she is supposed to supply knowledge that is considered useful to a society geared to production and consumption. During the past few decades, enlightenment as a legitimising concept for education has been challenged from different angles, both by a self-critique from within and from external forces. One angle of approach is the questioning of the relationship between the state and education, by way of a critique of modernity. Another approach comes from a critique of knowledge, which has lost most of its universal implications and is left with more pragmatic and utilitarian considerations. Into this landscape of lost legitimisation, I will make an attempt to visualise an impossible/possible position for teaching, featuring ancient, contemporary and phantom-like figures. I am suggesting the concept of transformation as an alternative to development or improvement, which I find to be concepts with a close link to modernity and its linearity. By a careful and conscious use of the word transformation, taking Derrida's intensified focus of language into account, a possible active position might be intimated in spite of the fundamental critique, which has been directed at pedagogy and its imperialistic implications from different angles. [source] The effect of nightshift on emergency registrars' clinical skillsEMERGENCY MEDICINE AUSTRALASIA, Issue 3 2010Leonie Marcus Abstract Objective: The effect of nightshift on ED staff performance is of clinical and risk-management significance. Previous studies have demonstrated deterioration in psychomotor skills but the present study specifically assessed the impact of nightshift on clinical performance. Methods: The ED registrars in a tertiary hospital were enrolled in a prospective observational study and served as their own controls. During nightshift, subjects were presented simulated scenarios and tested with eight clinical questions developed to Fellowship examination standard. Matched scenarios and questions for the same subjects during dayshift served as controls. Two investigators, blinded to subject identity and the setting in which questions were attempted, independently collated answers. Results: Of 22 eligible subjects, all were recruited; four were excluded owing to incomplete data. A correlation of 0.99 was observed between the independent scoring investigators. Of a possible score of 17, the median result for nightshift was 9.5 (interquartile range: 8,11); corresponding value for dayshift was 12 (interquartile range: 10,13); P= 0.047. Conclusion: Nightshift effect on clinical performance is anecdotally well known. The present study quantifies such effects, specifically for the ED setting, and paves the way for focused research. The implications for clinical governance strategies are significant, as the fraternity embraces the mandate to maintain quality emergency care 24 h per day. [source] Evolution of hazardous waste combustors MACT standardsENVIRONMENTAL PROGRESS & SUSTAINABLE ENERGY, Issue 4 2001Charles W. Lamb Ph.D. This year, on July 24, the DC Circuit Court ruled that the EPA had not correctly derived emission standards, and vacated the MACT (Maximum Achievable Control Technology) rule for Hazardous Waste Combustors (HWC) [1, 2]. A major complaint, voiced by the Sierra Club, was that the MACT methodology was misapplied in a manner that produced overly lenient standards. Industry and trade associations argued just the opposite. The Sierra Club won the first round when the court agreed that the emission standards should be based on the average of the best-performing 12% of units in each category. The next question was, "What will be the regulations until the final standards can be developed?" This caused considerable angst because, if no standards were in place by May 15, 2002, control would revert to case-by-case permits by Federal and State regulatory agencies as set forth in Section 112 of the Clean Air Act. Obviously, that would be the antithesis of the Congressional mandate and the objectives of environmental groups. The Sierra Club and most litigants did not want the uncertainties and inconsistencies this would introduce. [source] A continuing education programme for general practitionersEUROPEAN JOURNAL OF DENTAL EDUCATION, Issue 2 2000Status report after 5 years of function In 1992, following newly issued university regulations, the board of the School of Dental Medicine of the University of Geneva decided to establish a structured continuing education course programme for practising dentists in an effort to better meet the school's continuing education mandate. The programme started in January 1994 and was structured so that regular courses would be offered in each discipline of dentistry. The course contents were aimed at satisfying the demands of practising dentists, but it was also established that basic science issues and theoretical concepts should be included. Possible course formats were ,conference', ,hands-on', ,clinical' and ,seminar'. The courses were meant as a form of knowledge transfer from the school to the practising community, but also as a means to generate revenue for research and teaching programmes. Operative aspects were supervised by a small staff which was assisted by computer software designed to handle all procedural steps of course administration, participant registration, accounting, communication. The dentists' responses were rewarding in that attendance was very satisfactory. Closer scrutiny of our data, however, indicates that our impact is still low since at best only 20% of the course-hours required by the Swiss dental association are actually taken. Both course and programme evaluations were satisfactory and are discussed using the Harden and Laidlaw CRISIS criteria. [source] Acute cardiorespiratory collapse from heparin: a consequence of heparin-induced thrombocytopeniaEUROPEAN JOURNAL OF HAEMATOLOGY, Issue 5 2004Martha P. Mims Abstract: Background:, Heparin has rarely been reported to cause acute cardiorespiratory reactions or collapse. Some reports relate this to underlying heparin-induced thrombocytopenia. Objective:, To confirm and increase awareness of acute life-threatening cardiopulmonary events when patients with heparin-induced thrombocytopenia are re-exposed to heparin. Design:, Retrospective observational case series. Patients/setting:, Four cardiovascular surgery patients were identified in two adjacent large urban hospitals over a 2-yr-period who experienced eight episodes of cardiorespiratory collapse immediately following heparin administration. All had underlying heparin-induced thrombocytopenia. Results:, Intravenous boluses of unfractionated heparin were given to four patients with known or previously unrecognized heparin-induced thrombocytopenia. Two patients experienced severe respiratory distress within 15 min for which they required endotracheal intubation. Two other patients experienced cardiac arrest or a lethal arrhythmia within minutes of receiving intravenous heparin. Serologic tests for heparin-induced antibodies were positive in all patients. In three cases, the platelet count was normal or near normal but fell dramatically (71%) immediately following the heparin bolus. Three cases had prior diagnoses of heparin-induced thrombocytopenia, but health care workers administered heparin either unaware of the diagnosis or ignorant of its significance. No patients died, but all required some form of cardiopulmonary resuscitation and subsequent intensive care. Conclusions:, Heparin administration to patients with heparin-induced antibodies can result in life-threatening pulmonary or cardiac events. Appreciation of this phenomenon can unmask cases of heparin-induced thrombocytopenia and strengthens the mandate to avoid any heparin exposure in affected patients. Recognition is crucial to avoiding disastrous outcomes. [source] The Current Status and Prospects of the ,Strategic Partnership' between the EU and China: Towards the Conclusion of a Partnership and Cooperation AgreementEUROPEAN LAW JOURNAL, Issue 6 2007Antoine Sautenet In the absence of a category of ,emerging countries' in international economic law, the Union must adapt its foreign policy with regard to this major economic and commercial power. Relations between the European Community and China are currently governed by a second-generation agreement from 1985. However, a new dynamic has been set in motion since 2003, by the drawing up of preparatory documents by both parties and joint declarations at annual summits bearing on the ,strategic partnership'. Seen in a long-term perspective, this partnership helps provide a measure of predictability in relations between the two partners, through combining elements of ,soft law' and ,hard law'. If the insertion of political dialogue into the strategic partnership seems to alter the coherence of the Union, notably with regard to the difficulties of implementing the dialogue on human rights, the added value of the partnership lies essentially in its economic and commercial aspects, through not only the putting into place of non-binding ,economic dialogues' which cover a large spectrum of the relationship, but also by the multiplication of sector-based accords in numerous areas (maritime transport, customs cooperation, etc.). This constant development has thus allowed parties, at the last annual summit, to envisage the conclusion of a new framework agreement: this is the origin of the mandate given to the Commission in December 2005 to conclude a partnership and cooperation agreement. This article will sketch out a forecast of the legal framework, measured against the yardsticks of Asiatic regional reconfigurations and the law of the World Trade Organisation (WTO). The commercial risks of the relationship could imply the integration of the domains known as ,WTO plus' into the future agreement, notably in the field of investments and intellectual property rights, which would introduce a greater variety into the agreement. That being the case, the negotiations risk being equally fragile at the political level, in particular concerning the insertion of a clause of democratic conditionality in the future agreement. Also, any clash between the values and the interests of the EU would be uncomfortably highlighted during negotiations. [source] RECENT STUDIES ON THE HPV VACCINE GARDASIL: ADDENDUM TO OCTOBER 2008 NOTEFAMILY COURT REVIEW, Issue 1 2009Giuseppe Aguanno This Note advocates that states require all females entering the sixth grade to be vaccinated with the HPV vaccine Gardasil, as a means of preventing cervical cancer deaths in the United States. States that do pass such a mandate would receive federal funding to help disperse the cost of the expensive three-dose vaccine, especially to those females most in need. Subject to each individual state's mandate, parents would be allowed to opt their children out of such a mandate for either, religious, medical, and/or philosophical reasons. [source] Subnational Foreign Policy Actors: How and Why Governors Participate in U.S. Foreign PolicyFOREIGN POLICY ANALYSIS, Issue 3 2008Samuel Lucas McMillan U.S. governors lead overseas missions seeking investment and promoting trade, establish international offices, meet with heads of government, receive ambassadors, and take positions on foreign policy. This paper describes how governors are involved in participating in U.S. foreign policy, explains why governors seek to voice their views and play an active role in working with leaders and issues beyond their state's borders, and argues that U.S. states and governors need to be better conceptualized and considered in both international relations theory and foreign policy analysis. This study reveals that governors with greater institutional powers,such as appointment and budgetary control,as well as personal powers,derived from their electoral mandate, ambition, and public approval,are more likely to have higher degrees of foreign policy activity. These actions are more likely to take place during wartime and also from governors representing U.S. states bordering Canada or Mexico. [source] Endemic species and ecosystem sensitivity to climate change in NamibiaGLOBAL CHANGE BIOLOGY, Issue 5 2006WILFRIED THUILLER Abstract We present a first assessment of the potential impacts of anthropogenic climate change on the endemic flora of Namibia, and on its vegetation structure and function, for a projected climate in ,2050 and ,2080. We used both niche-based models (NBM) to evaluate the sensitivity of 159 endemic species to climate change (of an original 1020 plant species modeled) and a dynamic global vegetation model (DGVM) to assess the impacts of climate change on vegetation structure and ecosystem functioning. Endemic species modeled by NBM are moderately sensitive to projected climate change. Fewer than 5% are predicted to experience complete range loss by 2080, although more than 47% of the species are expected to be vulnerable (range reduction >30%) by 2080 if they are assumed unable to migrate. Disaggregation of results by life-form showed distinct patterns. Endemic species of perennial herb, geophyte and tree life-formsare predicted to be negatively impacted in Namibia, whereas annual herb and succulent endemic species remain relatively stable by 2050 and 2080. Endemic annual herb species are even predicted to extend their range north-eastward into the tree and shrub savanna with migration, and tolerance of novel substrates. The current protected area network is predicted to meet its mandate by protecting most of the current endemicity in Namibia into the future. Vegetation simulated by DGVM is projected to experience a reduction in cover, net primary productivity and leaf area index throughout much of the country by 2050, with important implications for the faunal component of Namibia's ecosystems, and the agricultural sector. The plant functional type (PFT) composition of the major biomes may be substantially affected by climate change and rising atmospheric CO2, currently widespread deciduous broad leaved trees and C4 PFTs decline, with the C4 PFT particularly negatively affected by rising atmospheric CO2 impacts by ,2080 and deciduous broad leaved trees more likely directly impacted by drying and warming. The C3 PFT may increase in prominence in the northwestern quadrant of the country by ,2080 as CO2 concentrations increase. These results suggest that substantial changes in species diversity, vegetation structure and ecosystem functioning can be expected in Namibia with anticipated climate change, although endemic plant richness may persist in the topographically diverse central escarpment region. [source] Vulnerability of African mammals to anthropogenic climate change under conservative land transformation assumptionsGLOBAL CHANGE BIOLOGY, Issue 3 2006WILFRIED THUILLER Abstract Recent observations show that human-induced climate change (CC) and land transformation (LT) are threatening wildlife globally. Thus, there is a need to assess the sensitivity of wildlife on large spatial scales and evaluate whether national parks (NPs), a key conservation tools used to protect species, will meet their mandate under future CC and LT conditions. Here, we assess the sensitivity of 277 mammals at African scale to CC at 10, resolution, using static LT assumptions in a ,first-cut' estimate, in the absence of credible future LT trends. We examine the relationship between species' current distribution and macroclimatic variables using generalized additive models, and include LT indirectly as a filter. Future projections are derived using two CC scenarios (for 2050 and 2080) to estimate the spatial patterns of loss and gain in species richness that might ultimately result. We then apply the IUCN Red List criteria A3(c) of potential range loss to evaluate species sensitivity. We finally estimate the sensitivity of 141 NPs in terms of both species richness and turnover. Assuming no spread of species, 10,15% of the species are projected to fall within the critically endangered or extinct categories by 2050 and between 25% and 40% by 2080. Assuming unlimited species spread, less extreme results show proportions dropping to approximately 10,20% by 2080. Spatial patterns of richness loss and gain show contrasting latitudinal patterns with a westward range shift of species around the species-rich equatorial zone in central Africa, and an eastward shift in southern Africa, mainly because of latitudinal aridity gradients across these ecological transition zones. Xeric shrubland NPs may face significant richness losses not compensated by species influxes. Other NPs might expect substantial losses and influxes of species. On balance, the NPs might ultimately realize a substantial shift in the mammalian species composition of a magnitude unprecedented in recent geological time. To conclude, the effects of global CC and LT on wildlife communities may be most noticeable not as a loss of species from their current ranges, but instead as a fundamental change in community composition. [source] Banishing Bureaucracy or Hatching a Hybrid?GOVERNANCE, Issue 2 2000The CanadianFood Inspection Agency, the Politics of Reinventing Government The Canadian Food Inspection Agency (CFIA) is a means to overcoming long-standing bureaucratic politics while attaining some major policy ends.Contrary to some of the new public management bravado of transforming the public sector, the CFIA is not a bureaucratic revolution in reshaping the Canadian State. Changes in scientific staffing, funding, and inspection have been more incremental than fundamental. Moreover, the CFIA is something less than the special and separate operating agency models discussed in the alternative service delivery literature in terms of autonomy and market orientation, but something more autonomous and entrepreneurial than traditional government departments. These organizational and managerial reforms are modest extensions providing a means for achieving economies and enhanced effectiveness in carrying out the mandate of safety, consumer protection, and market access for Canadian food, animal, plant, and forestry products. [source] The efficiency frontier approach to economic evaluation of health-care interventionsHEALTH ECONOMICS, Issue 10 2010J. Jaime Caro Abstract Background: IQWiG commissioned an international panel of experts to develop methods for the assessment of the relation of benefits to costs in the German statutory health-care system. Proposed methods: The panel recommended that IQWiG inform German decision makers of the net costs and value of additional benefits of an intervention in the context of relevant other interventions in that indication. To facilitate guidance regarding maximum reimbursement, this information is presented in an efficiency plot with costs on the horizontal axis and value of benefits on the vertical. The efficiency frontier links the interventions that are not dominated and provides guidance. A technology that places on the frontier or to the left is reasonably efficient, while one falling to the right requires further justification for reimbursement at that price. This information does not automatically give the maximum reimbursement, as other considerations may be relevant. Given that the estimates are for a specific indication, they do not address priority setting across the health-care system. Conclusion: This approach informs decision makers about efficiency of interventions, conforms to the mandate and is consistent with basic economic principles. Empirical testing of its feasibility and usefulness is required. Copyright © 2010 John Wiley & Sons, Ltd. [source] Prison health care: is contracting out healthy?HEALTH ECONOMICS, Issue 11 2009Kelly Bedard Abstract US prison health care has recently been in the news and in the courts. A particular issue is whether prisons should contract out for health care. Contracting out has been growing over the past few decades. The stated motivation for this change ranges from a desire to improve the prison healthcare system, sometimes in response to a court mandate, to a desire to reduce costs. This study is a first attempt to quantify the impact of this change on inmate health. As morbidity measures are not readily obtainable, we focus on mortality. More specifically, we use a panel of state prisons from 1979 to 1990 and a fixed effects Poisson model to estimate the change in mortality associated with increase in the percentage of medical personnel employed under contract. In contrast to the first stated aim of contracting, we find that a 13% increase in percentage of medical personnel employed under contract increases mortality by 1.3%. Copyright © 2009 John Wiley & Sons, Ltd. [source] Evaluating Medical Effectiveness for the California Health Benefits Review ProgramHEALTH SERVICES RESEARCH, Issue 3p2 2006Harold S. Luft An important aspect of the mandate assessments requested by the California legislature is a review of the scientific and medical literature on the medical effectiveness of the proposed health insurance benefit mandate. Although such a review bears many similarities to effectiveness reviews that might be undertaken for publication as research studies, several important differences arise from the requirements of the California legislation. Our reviews are intended to assist the legislators in deciding whether to support a specific mandate to modify health insurance benefits in a particular way. Thus, our assessments focus on how the scientific literature bears on the proposed mandate, which may involve a complicated chain of potential effects leading from altered coverage to ultimate impact on health. Evidence may be available for only some of the links in the chain. Furthermore, not all the evidence may be directly applicable to the diverse population of California or the subpopulation affected by the mandate. The mandate reviews, including the medical effectiveness analyses, may be used in a potentially contentious decision making setting. The legislative calendar requires that they need to be timely, yet they must be as valid, credible, and based on the best information available as possible. The focus on applicability also implies the need for informed, technical decisions concerning the relevance of the articles for the report, and these decisions need to be made as transparent as possible. These goals and constraints yield an approach that differs somewhat from an investigator-initiated review of the literature. [source] Intelligence bound: the South African constitution and intelligence servicesINTERNATIONAL AFFAIRS, Issue 1 2010LAURIE NATHAN This article explores the functions and impact of the South African constitution in relation to the country's intelligence services. The constitution has proved to be a powerful instrument for transforming, controlling and constraining the services, safeguarding human rights and contributing to the management of political conflicts and crises. Yet the constitution's relevance for the intelligence community is also contested and contradictory. Paradoxically, the executive, parliament and the intelligence services believe that it is legitimate for the services to deviate from constitutional provisions because their mandate to identify and counter threats to national security is intended to protect the constitution. The article contributes to filling a gap in the literature on security sector reform, which is concerned with democratic governance but ignores the role of a constitution in regulating the security organizations and determining the nature of their governance arrangements. Intelligence agencies around the world have special powers that permit them to operate with a high level of secrecy and acquire confidential information through the use of intrusive measures. Politicians and intelligence officers can abuse these powers to manipulate the political process, infringe the rights of citizens and subvert democracy. While a constitution cannot eliminate these risks, it can establish an overarching vision, a set of principles and rules and a range of mechanisms for promoting intelligence transformation and adherence to democratic norms. [source] Structural Traps, Politics and Monetary PolicyINTERNATIONAL FINANCE, Issue 1 2004Robert H. Dugger Structural conditions pose a challenge to monetary policy, as the example of Japan shows. In this paper we develop the concept of structural trap, where the interplay of long-term economic development incentives, politics, and demographics results in economies being unable to efficiently reallocate capital from low- to high-return uses. The resulting macroeconomic picture looks like a liquidity trap , low GDP growth and deflation despite extreme monetary easing. But the optimal policy responses are very different and mistaking them could lead to perverse results. The key difference between a liquidity trap and a structural one is the role of politics. We show how, in the Japanese case, longstanding economic incentives and protections and demographic trends have resulted in a political leadership that resists capital reallocation from older protected low-return sectors to higher-return newer ones. If the Japanese case is instructive, in a structural trap, extremely loose monetary policy perpetuates deflation and low GDP growth, because unproductive but politically important firms are allowed to survive and capital reallocation is prevented. By preventing the needed reduction in excess capacity, a structural trap condemns reflationary policies to failure by making the creation of credible inflation expectations impossible. Faced with a structural trap, an independent central bank with a price stability mandate should adopt a monetary policy stance consistent with restructuring. If political resistance is high, monetary policy decision makers will need to keep nominal rates high enough to ensure that capital reallocation takes place at an acceptable pace. [source] Global health partnerships in practice: taking stock of the GAVI Alliance's new investment in health systems strengtheningINTERNATIONAL JOURNAL OF HEALTH PLANNING AND MANAGEMENT, Issue 1 2009Joseph F. Naimoli Despite a burgeoning literature on global health partnerships (GHPs), there have been few studies of how GHPs, particularly those trying to build a bridge between horizontal and vertical modes of delivering essential health services, operate at global and country levels. This paper will help address this knowledge gap by describing and analyzing the GAVI Alliance's early experience with health systems strengthening (HSS) to improve immunization coverage and other maternal-child health outcomes. To date, the strengths of HSS reside in its potential to optimize GAVI's overall investment in immunization, efforts to harmonize with other initiatives, willingness to acknowledge risk and identify mitigation strategies, engagement of diverse stakeholders, responsiveness to country needs, and effective management of an ambitious grant-making enterprise. The challenges have been forging a common vision and approach, governance, balancing pressure to move money with incremental learning, managing partner roles and relationships, managing the "value for money" risk, and capacity building. This mid-point stock-taking makes recommendations for moving GAVI forward in a thoughtful manner. The findings should be of interest to other GHPs because of their larger significance. This is a story about how a successful alliance that decided to broaden its mandate has responded to the technical, organizational, and political complexities that challenge its traditional business model. Copyright © 2009 John Wiley & Sons, Ltd. [source] | |||||||||||||||||||||||||||||||||||||