Policy In France Research Articles

Diffusion of antipsychotics in the US And French markets, 1998-2008.

Second-generation antipsychotics captured most of the U.S. antipsychotic market shortly after their introduction. Little is known about how second-generation antipsychotics have diffused in other countries with different health systems. The study objective was to describe trends in antipsychotic use in the United States and France from 1998 to 2008. Pharmaceutical policies in France and the United States are briefly described, followed by descriptive data on quarterly prescriptions for oral antipsychotics dispensed between January 1998 and September 2008. Data are from Xponent for the United States and the GERS database for France. Trends in the use of first- versus second-generation antipsychotics and in ingredient formulations of second-generation antipsychotics used are reported. Between 1998 and 2008, total antipsychotic use in the United States increased by 78%. Total use in France was consistently higher despite a 9% decrease during the period. By 2008, second-generation antipsychotics represented 86% of the antipsychotics sold in the U.S. market, versus only 40% of the French market. However, average annual growth rates in use of second-generation antipsychotics were similar in the two countries. In France, use of all but one second-generation antipsychotic steadily increased, whereas in the United States trends in the use of newer drugs varied substantially by drug. For example, use of olanzapine decreased after 2003, but use of quetiapine increased. These results highlight markedly divergent trends in the diffusion of new antipsychotics in France and the United States. Some differences may be explained by differences in health systems; others may reflect physicians' preferences and norms of practice.

Keeping up Appearances: National Narratives and Nuclear Policy in France and Russia

In the latter part of the 20th century, much academic attention has been devoted to the patterns of change in international power relations. From the legacy of imperialism to the end of the Cold Wa...

Changing patterns of first injection across key periods of the French Harm Reduction Policy: PrimInject, a cross sectional analysis

BackgroundMonitoring of emerging modes of drug consumption in France has identified new patterns of injection among youths with diverse social backgrounds, which may explain the persistence of high rates of hepatitis C virus infection. The circumstances surrounding the first injection have been poorly documented in the group of heavy drug users and in the context of the French opioid substitution treatment (OST) policy that provides expanded access to high-dosage buprenorphine (BHD) MethodsAn Internet survey (Priminject) was conducted from October 2010 to March 2011 with French drug users. Four time periods were compared based on critical dates throughout the implementation of the Harm Reduction Policy in France. ResultsCompared with drug users who injected for the first time prior to 1995, the aspects of drug use for users who recently injected for the first time were as follows: (1) experimentation with miscellaneous drugs before the first injection; (2) an older age at the time of first injection; (3) heroin as the drug of choice for an individual's first injection, notwithstanding the increased usage of stimulant drugs; (4) BHD did not appear to be a pathway to injection; and (5) an increased number of users who injected their first time alone, without the help or presence of another individual. ConclusionThe PrimInject study showed that there is a group of injection drug users that is larger than the group of injection drug users observed in previous studies; therefore, it is necessary to diversify programs to reach the entire spectrum of high-risk users.

Méningites à Haemophilus chez des enfants vaccinés : à propos de 3 cas

The 1993 introduction in France of the vaccine against the serotype b of Haemophilus influenzae (Hib) resulted in a fast reduction of invasive infections caused by this species. However, despite the introduction of a booster dose, cases of Hib meningitis can still be observed, even if they are exceptional. We report here on 3 cases of Hib meningitis observed at Rennes University Hospital, which occurred during the winter seasons between 2007 and 2010, in properly vaccinated infants and children aged 9, 14, and 29 months. Progression after treatment was satisfactory in all 3 cases, and no immune deficiency was detected. After 18 years of the vaccination policy in France, these observations demonstrate that a risk, although much lower, of Hib meningitis persists in infants and children, including in vaccinated patients, and that strains still are circulating within the general population.

Forgotten Virtues

Forgotten Virtues

The National security of France in White Papers on Defense. Continuity or change?

France after World War II was in a difficult situation. This involved a loss of position, not only as a superpower in the world but in Europe. Superpower, the global position of France, decided to rebuild, after the new president was elected in June 1959, Gen. Ch. de Gaulle. According to his conception of a foreign policy for France it should have a global dimension, supported by the independent French defense not only as a conventional but also nuclear power. Gen. Ch. De Gaulle took the position that France having regard to its independence in the political, military, economic and cultural center should not submit to any of the blocks. Independence in the foreign policy of France was understood as the freedom to determine their own place in the world, freely determine their fate, the defense of vital national interests and full freedom in the choice of ends, means and methods of foreign policy.

Forced Assimilation is an unhealthy policy intervention: the case of the hijab ban in France and Quebec, Canada

Women of many cultures and religions find a means of coping with stress and ill health in faith-based practices, such as meditation and prayer. It is customary for Muslim women to participate in such activities, usually with a special dress code, which often includes a hijab. The headscarf ban in French and formerly in Quebec public schools not only forces Muslim female students to shed their essential religious dress code, but also fails to address the resulting health consequences and to acknowledge the cultural aspects of head-covering. This paper argues that the ban on head coverings in public schools is not only an infringement on religious and cultural freedoms, and violation of human rights, but that it is also an unhealthy policy intervention, as it undermines health by restricting prayers, mindfulness and spirituality. Furthermore, the ban has taken away Muslim women's choice to wear a hijab, thus restricting a sense of self-autonomy and in turn causing additional negative health implications. By synthesising these ideas, this paper holds a novel and critical perspective that the headscarf ban policy in France should be re-examined not only because of its infringement of human rights, but also to assess the negative health impacts on affected groups. For these reasons the paper advocates a reversal of the ban, as has happened in Quebec, Canada.

Serving the State and the private sector: The paradoxical effects of the reconstruction of public action on the career paths of Sports Ministry agents in France

Faced with the problems of governing high-level sports policy in France caused by the mobilisation of various categories of private actors, and with the downgrading of France in the ranking of leading sports nations, the Sports Ministry instigated a reform of this policy based on the principles of New Public Management. While some studies have shown that neo-managerial reforms provoke opposition among public agents, or even a decline in certain professions, the results of the survey conducted on Technical Sports Advisors ( Conseillers Techniques Sportifs – CTS), Sports Ministry agents who ‘report to’ the sports federations, instead reveal that they heighten the uncertainty of these agents’ careers and exacerbate the segmentation of this professional group. These observations can also be explained by the now recurrent tensions between the State and the French sports movement, tensions which confirm that the conduct of public action is above all a matter of power and institutional legitimacy.

The Recent Changes of the Penal Policy in France

The Recent Changes of the Penal Policy in France

Fortress Europe or Europe of Rights? The Europeanisation of Family Migration Policies in France, Germany and the Netherlands

Abstract Are the restrictive reforms of family migration policy recently implemented in France, Germany and the Netherlands a result of the introduction of the Family Reunification Directive in 2003? Most existing literature on the Europeanisation of migration policies suggests that restriction-minded national governments shift decision-making to the EU level to escape domestic political and judicial constraints. However, as the Treaties of Amsterdam and Lisbon have empowered the Commission and Court to constrain restrictive reform, this perspective is losing analytical validity. Also, this perspective fails to capture the intensifying processes of policy transfer among Member States, which have inadequately been labelled ‘horizontal’ Europeanisation. We therefore propose a new, actor-centred analytical framework of Europeanisation. We show that contrasting yet parallel dynamics of Europeanisation may emanate from a single legislative instrument and may constrain and empower national governments at the same time.

France’s great energy debate

Many countries rethought their domestic nuclear power programs after the meltdowns at the Fukushima Daiichi Nuclear Power Station. In fact, even France—which generates half of the European Union’s nuclear electricity—has a new approach to nuclear power and to energy policy. President François Hollande vowed to reduce use of nuclear power, and his administration is moving to close the country’s two oldest reactors at Fessenheim. The government also plans to sponsor a large public debate on the future of energy policy in France, and that discussion is supposed to include all major stakeholders. It remains unclear, however, whether the debate will be a democratic exercise that influences the policy-making process, or if policy will continue to be determined by the technocratic elites who have guided France’s energy and nuclear programs from their outset.

Recent Tax Changes

Following the recent presidential election, the tax policy in France radically changed. This note provides an overview of the key elements of the Second Amending Financial Law for 2012 and provides insight into the new underlying tax policy.

다문화사회의 주거를 위한 공공주택의 법정책적 연구

The foreign population in South Korea marked about 1 million as of 2011. This study was proposed for improving the supportive housing problems of foreigners and multicultural families with multicultural society in Korea. I was examined to the public rental housing policies of France, Japan and Singapore. This implies that housing policies should be improved in the direction of achieving the of social integration. The HLM Built massively since 1950s in France. and it was conceived by the principle of social mix. The Singaporean housing policies shows the housing provision system that includes housing market, housing supply and distribution, housing financing. Japanese housing policies are coincident with an international tendency toward privatization. The housing polices are necessity to which the nation must imperatively answer for foreigners and multicultural families. The right housing policies is needed at a right time to spearhead a society in a desirable direction. Its ultimate goals of the long-range public housing development are clearly addressed including funding sources to execute the relevant law polices for multicultural society. And multicultural hosing policies should be collaborated with the related government departments. So we should specifically divide roles between government departments and local governments for multicultural housing policy.

From Silent Marginality to Spotlight Scapegoating? A Brief Case Study of France's Policy Towards the Roma

This article addresses the way in which the Roma were framed as an important ‘security issue’ on the French public policy agenda during the Sarkozy presidency. By pointing out continuities and discontinuities in the association between ‘immigation’ and ‘insecurity’ in official discourse, it analyses the somehow unexpected and sudden scapegoating of the Roma as responding to immediate political imperatives, but also as an expression of a mounting trend of nationalism. The fact that, in France, public space is officially ethnicity-blind contributed, paradoxically, to the rapid stigmatisation of the Roma as a group.

CAMIF, an SME Repositioning Its Line as Sustainable Development Products

The purpose of this article is to review the application of Sustainable Development (SD) in the marketing strategies of French firms, and to show how one SME, CAMIF, has repositioned its product line around SD. Although SD policies in France are now driven by rising demands from lawmakers and consumers alike, their application has not yet become a central feature of the strategies of major companies and SMEs. In this regard, the innovative repositioning of CAMIF around fair and responsible value is found to be consistent with the firm’s values, and permeates its marketing mix.

Teaching the history of colonization and decolonization in France: A shared history or to each their own?

Strongly influenced by the paradigm of republican universalism, education policy in France favours an approach that largely relativizes, or even denies, the dimension of cultural diversity. The content of the secondary school history curriculum reveals this phenomenon. In the 2007–2008 school year, 185 students in the final 2 years of secondary school in Amiens completed questionnaires about the importance their schools place on the history of colonization and decolonization. The analysis showed how the respondents’ relationship to this historical topic was linked to the degree of their own experience of migration. Although today’s classes are pluralistic, schools’ failure to take into account the diversity of the population—a legacy of history—diminishes students’ ability to think in terms of “otherness” and, as a result, to imagine a common history shared by the various populations living in France.

Endoscopist-directed propofol administration versus anesthesiologist assistance for colorectal cancer screening: a cost-effectiveness analysis

Propofol for colonoscopy is largely administered by anesthesiologists or anesthesiology nurses in the United States (US) and Europe. Endoscopist-directed administration of propofol (EDP) by nonanesthesiologists has recently been proposed, with potential savings of anesthetist reimbursement costs. We aimed to assess potential EDP-related benefit in a screening setting. In a Markov model the total number of screening and follow-up colonoscopies in a cohort of 100 000 US subjects were estimated. Anesthetist-assisted colonoscopy was compared with an EDP strategy. Model outputs were projected onto the 50 - 80-year-old US population, assuming 27 % as the current uptake for colonoscopy screening. Anesthetist costs were estimated using the mean reimbursement for the corresponding Medicare code (≥ 65-year-olds) and from commercial insurance information (50 - 64-year-olds). The proportion of colonoscopies with anesthesiologist assistance was estimated from the Medicare database. Mean nurse salary was used to estimate the cost of a 2-week EDP training. The absolute number of US endoscopists was estimated by inflating by 33 % the number of board-certified gastroenterologists. No EDP mortality was assumed in the reference scenario, and 0.0008 % mortality in the sensitivity analysis. US census data were adopted. Analogous inputs were used for France to assess EDP-related benefit in a European country. EDP training for 17 166 nurses (one for each US endoscopist) showed a cost of $ 47 million. Cost estimates for anesthesiologist assistance for colonoscopy were $ 95 (Medicare) and $ 450 (non-Medicare commercial insurance), with 34.8 % of colonoscopies requiring anesthesiologist assistance. US implementation of an EDP policy showed a 10-year saving of $ 3.2 billion (Monte Carlo analysis 5 - 95 % percentiles $ 2.7 - $ 11.9 billion). In the sensitivity analysis, assuming 50 % of colonoscopies were anesthetist-assisted showed an EDP benefit of $ 4.6 billion. Assuming a 0.0008 % mortality rate, the incremental cost - effectiveness of anesthetist-assisted colonoscopy versus an EDP policy was $ 1.5 million per life-year gained, supporting EDP as the optimal choice. A 31-fold increase of EDP-related mortality or a 17-fold cost reduction for anesthetist-assisted colonoscopy was required for EDP to become not cost-effective in this scenario. Implementation of an EDP policy in France, within a guaiac-fecal occult blood test (g-FOBT) screening program, was estimated to save € 0.8 billion in 10 years. The absolute economic benefit of EDP implementation in a screening setting is probably substantial with 10-year savings of $3.2 billion in the US and €0.8 billion in France. The impact of an eventual EDP-related mortality on EDP cost - effectiveness seems marginal. The huge economic and medical resources entailed by anesthetist-assisted colonoscopy could be more efficiently invested in other clinical fields.

Evaluation of the impact of environmental public policy measures on energy consumption and greenhouse gas emissions in the French residential sector

A cut in energy consumption by 2050 to reach 50 kWhpe/m2/year and reduce GHG emissions by 75% are important objectives of environmental policy in France. The residential sector represents a significant potential source of energy savings. In this paper, our main objective is to construct a simulation model and to evaluate the impact of environmental public policy measures. We model energy consumption and GHG emissions, the decision to invest in energy saving renovations and the dynamics of the housing stock. Particular attention is paid to household investment decisions regarding home renovation. To generate the dynamics and the structure of the housing stock through 2050, we introduce socioeconomic variables that alter the number of renovations and new constructions. This study has three major outputs. First, we estimate the energy consumption and GHG emissions of the residential sector in France through 2050. Second, we study the impact of environmental public policy measures. Lastly, we propose different means to reach the objectives. The results show that while current policies are effective, they are not sufficient to reach the objectives.

WHY ARE THERE SO FEW COOPERATIVE AGREEMENTS BETWEEN FARMERS AND WATER SERVICES IN FRANCE? WATER POLICIES AND THE PROBLEM OF LAND USE RIGHTS

ABSTRACTOne of the recurrent shortcomings of water policy in France is the control of diffuse agricultural pollution. Numerous lacunae and incoherencies in the French Rural, Public Health, and Environmental Codes have hindered the effective implementation of efficient protection measures. In this paper, we underline the extent to which these incoherencies have hampered the emergence of cooperative agreements (CAs) between farmers and drinking water service providers. The theoretical framework of institutional resource regimes (IRRs) provides a key to understanding the failure of public policy to impose restrictions on agricultural land use rights and to encourage voluntary arrangements concerning agricultural practices. The IRR framework was applied before 2005 to 12 cases of public attempts to negotiate a reduction in polluting practices. Our study enabled us to characterise the lack of extent and coherence of the water sector's IRR in France. Since 2005, regulatory changes have extended the scope of this IRR with a view to making water, agriculture and health policies more coherent. We discuss the complexity of the new approach, and question its capacity to mobilise the actors concerned around the territorial reorganisation of agriculture aimed at reducing diffuse pollution. Copyright © 2012 John Wiley & Sons, Ltd.

French nuclear idiosyncrasy: how it affects French nuclear policies towards the United Arab Emirates and Iran

This article elaborates the notion of ‘nuclear idiosyncrasy’ as a specific understanding of what nuclear weapons and energy are, what they stand for and what they can do. It then assesses the persistence of nuclear idiosyncrasy over time and its effects on French nuclear policies in the United Arab Emirates (UAE) and Iran. Based on interviews in France, Geneva and the UAE, this article contributes to three debates within foreign policy analysis and nuclear history. Is a regional approach necessary to understand the framing of foreign policies in the twenty-first century? Does a change in leadership fundamentally affect the orientations of nuclear policies? Are the risks of nuclear proliferation in the Middle East and the measures to prevent it similarly understood by all the players in the international community? First, it shows that French nuclear policies in the Middle East are not shaped by dynamics specific to the region as the often invoked notion of an ‘Arab policy of France’ would suggest. Secondly, in-depth analysis leads one to reject the idea of a major change between the nuclear policies of Presidents Chirac and Sarkozy. Thirdly, persistent French nuclear idiosyncrasy leads also to rejection of the idea of convergence towards a shared understanding of the proliferation threat in the Middle East.