Proposed Policy Changes Research Articles

A trade flow analysis of the global softwood log market: implications of Russian log export tax reduction and New Zealand log production restriction

This study employs a recursive dynamic spatial partial equilibrium model to investigate the trade flow trends in the global softwood log market. A baseline forecast from 2012 to 2021 is first projected and then compared with three alternative scenarios: (1) Russia reduces its ad valorem softwood log export tax to 8 per cent to comply with its World Trade Organization accession agreements; (2) New Zealand experiences no expansion at all of its plantation forest log production due to social and environmental considerations (i.e. increased Maori ownership of forest land and the implementation of emissions trading schemes); and (3) a combination of the proposed policies in Russia and New Zealand mentioned above. The results of the baseline projection demonstrate that softwood log prices will increase in every region globally and that China will continue to be the world’s largest softwood log importer. However, softwood log exports from Russia, the US and Canada are expected to drop significantly as a result of current Russian export restrictions, the recovery of the US housing market and mountain pine beetle infestations in western Canada. A comparison of the simulated scenarios with the baseline projection reveals that reducing the Russian softwood log export tax will have a greater impact on softwood log prices and total world trade than restricting log production in New Zealand due to the comparatively large log production capacity in Russia. In any scenario, significant trade flow changes (i.e. trade-offs) in response to the proposed policy changes are observed in China and the major export regions. The results of this study offer insights for forest managers and policy makers to examine the global impacts of potential changes in trade policies and supply constraints in these two important softwood log supply regions in addition to highlighting China’s role in the world softwood log market.

The Racial Context of Convenience Voting Cutbacks

Classic models of democratic political behavior imply that eliminating opportunities to vote early in person (EIP) negatively affects the political participation of voters who prefer to use that option. Nevertheless, several U.S. state legislatures recently passed or proposed laws to scale back their EIP voting operations. Such efforts have met with opposition, as both academic researchers and federal courts have found that minority voters, especially African Americans, now utilize EIP voting at significantly higher rates than White voters. Prior to the 2012 presidential election, this argument was central to a federal court’s decision to temporarily block legislation in Ohio that sought to cut several days from the state’s EIP voting period. A post-election legal battle is reconsidering this matter, and the outcome will shape Ohio’s voting rules going forward. This article contributes empirical results to the discourse by estimating EIP voting take-up rates, by race, during the 2008 and 2012 U.S. presidential elections in Ohio’s three largest counties. Ecological inference models reveal that African Americans in all three study areas voted EIP at substantially higher rates than White voters during both elections. These results are supported by decile tables that report early voting behavior for relatively racially homogeneous geographies, and by geovisualizations that depict direct relationships between the spatial distributions of minority persons and EIP voting usage. Collectively, the findings suggest that the potential effects of Ohio’s proposed policy changes would not be equally distributed between racial groups.

APhA to CMS: Address barriers to pharmacist participation in value-based models

In a draft call letter released February 20, CMS announced proposedpolicy changes for Medicare Part D prescription drug plans for 2016.Many of the provisions build upon the agency's push for value-basedcare and payments tied to quality that it wants to see many plans transitionto in the next couple of years.

Asthma medications should be available for over-the-counter use: con.

The United States Food and Drug Administration recently considered a policy to transfer inhaled short-acting bronchodilators to over-the-counter status if conditions of safe use can be established. The American Thoracic Society filed a comment in opposition to the proposal. This article examines the negative consequences that might result from allowing nonprescription access to bronchodilators and other inhaled asthma medications. Such a proposed policy change conflicts directly with current guidelines for asthma management and would undermine efforts to achieve adequate asthma control in patients. In addition, a policy change to convert asthma medications to over-the-counter status could result in increased costs to patients as well as increased health care costs to society overall due to a worsening of asthma control in the population.

Focus on Fluorides: Update on the Use of Fluoride for the Prevention of Dental Caries

Improving the efficacy of fluoride therapies reduces dental caries and lowers fluoride exposure. BackgroundFluoride is delivered to the teeth systemically or topically to aid in the prevention of dental caries. Systemic fluoride from ingested sources is in blood serum and can be deposited only in teeth that are forming in children. Topical fluoride is from sources such as community water, processed foods, beverages, toothpastes, mouthrinses, gels, foams, and varnishes. The United States Centers for Disease Control and Prevention (CDC) and the American Dental Association (ADA) have proposed changes in their long standing recommendations for the amount of fluoride in community drinking water in response to concerns about an increasing incidence of dental fluorosis in children. Current research is focused on the development of strategies to improve fluoride efficacy. The purpose of this update is to inform the reader about new research and policies related to the use of fluoride for the prevention of dental caries. MethodsReviews of the current research and recent evidence based systematic reviews on the topics of fluoride are presented. Topics discussed include: updates on community water fluoridation research and policies; available fluoride in dentifrices; fluoride varnish compositions, use, and recommendations; and other fluoride containing dental products. This update provides insights into current research and discusses proposed policy changes for the use of fluoride for the prevention of dental caries. ConclusionsThe dental profession is adjusting their recommendations for fluoride use based on current observations of the halo effect and subsequent outcomes. The research community is focused on improving the efficacy of fluoride therapies thus reducing dental caries and lowering the amount of fluoride required for efficacy.

Clinical trials transparency and the Trial and Experimental Studies Transparency (TEST) act

Clinical trial research is the cornerstone for successful advancement of medicine that provides hope for millions of people in the future. Full transparency in clinical trials may allow independent investigators to evaluate study designs, perform additional analysis of data, and potentially eliminate duplicate studies. Current regulatory system and publishers rely on investigators and pharmaceutical industries for complete and accurate reporting of results from completed clinical trials. Legislation seems to be the only way to enforce mandatory disclosure of results. The Trial and Experimental Studies Transparency (TEST) Act of 2012 was introduced to the legislators in the United States to promote greater transparency in research industry. Public safety and advancement of science are the driving forces for the proposed policy change. The TEST Act may benefit the society and researchers; however, there are major concerns with participants' privacy and intellectual property protection.

Quantitative Analysis of Students' Reasons for Nonsuiting and Support of Policy Change at One Urban Middle School

Purpose Physical activity participation in physical education is compromised when students nonsuit. We investigated: (a) reasons for nonsuiting/support of policy change and whether they differed by gender, ethnicity, or grade; and (b) the likelihood of nonsuiting based on the same demographics. Method Participants (N = 627) were 6th and 7th graders attending 1 urban middle school located in San Diego, CA. Students completed a questionnaire composed of 4 demographic items, level of agreement with 15 reasons for nonsuiting, and level of support of 6 proposed policy changes. Exploratory and confirmatory factor analyses were used to classify reasons for nonsuiting items and policy change items. Demographic differences among resultant factor scores and individual items were analyzed using t tests. Associations between factors/items and nonsuit frequency and demographics were analyzed using multinomial logistic regression. Results Girls, Latinos, and 7th graders were more likely habitual nonsuits ( ≥ 4 nonsuits) compared with their respective counterparts. Statistically significant factor scores (reasons for nonsuiting; emotional excuses, utilitarian excuses) were higher among habitual nonsuits but were not different based on gender, grade, and ethnicity. Seventh graders and girls had statistically significantly higher policy change factor scores compared with their respective counterparts. Conclusion Acting on student input toward reformulating suiting-out policy as well as addressing emotional excuse reasons, which are primarily under teacher control, may result in lower incidence of habitual nonsuiting.

Controversy about the Role of Children's Lawyers: Advocate or Best Interests Guardian? Comparing Practices in Two Canadian Jurisdictions with Different Policies for Lawyers

There is controversy about the role that lawyers for children should play in family proceedings, but little empirical research about what they actually do. This article reports on a study (n = 166) of the experiences and perspectives of lawyers in two Canadian provinces with different policies for the role of children's counsel. Official policies seem to have only a limited impact on the practices of lawyers for children, whether the policies direct lawyers to adopt a best interests guardian or a traditional instructional advocate role. Lawyers generally seem more comfortable adopting an instructional advocacy role, especially with older children. Lawyers who represent children comment on the deep satisfaction that they feel from this work. This article compares the practice of lawyers in the two jurisdictions on a number of issues related to child clients and proposes policy changes to provide better guidance and education for children's lawyers. Keypoints for the Family Court Community This survey of lawyers in these two jurisdiction reveals: lawyers spend longer meeting with older children; that official policies have some impact on the practice of lawyers, but a significant number of lawyers decide for themselves what role they will play; lawyers generally seem more comfortable adopting an instructional advocacy role, especially with older children; lawyers in the jurisdiction where they are expected to adopt a best interests role are more likely to tell parents and the court that they were adopting this role when they were in fact advocating what the child wanted; In both jurisdictions about one fifth of the lawyers reported that they had disclosed a child's “secret” to prevent harm to the child.

Exploring culture in the world of international nutrition and nutrition sciences.

This symposium was organized to bring insights from the social sciences into the awareness of nutrition scientists committed to developing and implementing effective nutrition interventions internationally. The symposium explored three different areas in the field where a more precise analysis of culture could enhance the effectiveness of nutrition science: 1) in the implementation of nutrition science research in the field; 2) in the collaboration of multiple stakeholders working to enhance nutrition in a national setting; and 3) in the language and discussions used to frame proposed changes in large scale food and nutrition security policy transnationally. Three social scientists, Monique Centrone Stefani, Lucy Jarosz, and David Pelletier were invited to share insights from their respective disciplines and respondents from within the field of nutrition provided initial reflections to better understand such perspectives. The symposium's interdisciplinary nature was designed to illustrate the challenge of multiple perspectives and methodologies and to advance understanding that could derive from such an exchange for those in the field of international nutrition seeking to decrease global hunger and malnutrition.

The Green Deal and the Energy Company Obligation

Current UK energy efficiency policy is very fluid, with a number of new policies due to be introduced in 2012 and 2013, including the Green Deal and Energy Company Obligation. These mark a substantial change from the existing policy regime in a number of ways, notably the explicit aim of supporting higher cost energy efficiency technologies in housing and an attempt to engage new sources of private sector finance. This paper provides a critical analysis of the proposed policy changes both in terms of the institutional changes and the implications of a new finance mechanism for energy efficiency policy, as well as the overall impact on reduction of greenhouse gasses, in particular through the installation of different types of retrofitted insulation.

Women on ice: methamphetamine use among suburban women

Methamphetamine (ice, speed, crystal, shard) has been called epidemic in the United States. Yet few communities were ready for increased use of methamphetamine by suburban women. Women on Ice is the first book to study exclusively the lives of women who use the drug and its effects on their families. In-depth interviews with women in the suburban counties of one of the largest metropolitan areas in the U.S. chronicle the details of their initiation into methamphetamine, the turning points into problematic drug use, and for a few, their escape from lives veering out of control. Their life course and drug careers are analyzed in relation to the intersecting influences of social roles, relationships, social/political structures, and political trends. Examining the effects of punitive drug policy, inadequate social services, and looming public health risks, including HIV/AIDS and hepatitis C, the book gives voice to women silenced by shame. Boeri introduces new and developing concepts in the field of addiction studies and proposes policy changes to more broadly implement initiatives that address the problems these women face. She asserts that if we are concerned that the war on drugs is a war on drug users, this book will alert us that it is also a war on suburban families.

On Going (Way) Beyond One’s Data: A Proposal to Restrict Recommendations for Practice in Primary Educational Research Journals

To counteract what we see as a growing research-reporting concern, we propose the following editorial-policy change regarding the content of primary research articles in educational research journals: Contributors should restrict their discussion and conclusions to their data and not offer recommendations for educational practice nor speculate about the educational policy implications of their research. We believe that this change will be beneficial for maintaining a separation between evidence and opinion concerning the legitimate warrants of empirical research. We suggest viable accompaniments and alternatives to authors offering practical recommendations and policy speculations in primary-research journal articles. Among these is to rely on all sources of evidence, including systematic research syntheses based on the aggregated contribution of multiple research studies from different sources, with recommendations for practice tailored to specific situations so that both their validity and utility will be increased. It is hoped that our proposed policy change will initiate a conversation among researchers, editors, reviewers, and educational-policy experts with respect to the scope and purpose of primary research journal articles.

Healthy hospital food initiatives in the United States: time to ban sugar sweetened beverages to reduce childhood obesity

While childhood obesity is a global problem, the extent and severity of the problem in United States, has resulted in a number of new initiatives, including recent hospital initiatives to limit the sale of sweetened beverages and other high calorie drinks in hospital vending machines and cafeterias. These proposed policy changes are not unique to United States, but are more comprehensive in the number of proposed hospitals that they will impact. Meanwhile, however, it is advised, that these initiatives should focus on banning sugar sweetened beverages, including sodas, 100% fruit juice and sports drinks, from hospital cafeterias and vending machines instead of limiting their presence, so as to ensure the success of these programs in reducing the prevalence of childhood obesity. If US hospitals comprehensively remove sugar sweetened beverages from their cafeterias and vending machines, these programs could subsequently become a model for efforts to address childhood obesity in other areas of the world. Hospitals should be a model for health care reform in their communities and removing sugar sweetened beverages is a necessary first step.

Limitations of Food Composition Databases and Nutrition Surveys for Evaluating Food Fortification in the United States and Canada

BackgroundAs the availability of fortified foods expands, it is increasingly important to monitor risk of excessive nutrient intake. However, neither Canadian nor US nutrient composition databases systematically differentiate between naturally occurring nutrients and those added to foods at manufacturers’ discretion, and the consumption of fortified foods is not comprehensively assessed during dietary data collection. ObjectiveTo describe limitations in the estimation of nutrient intakes from voluntarily fortified foods from the Canadian Community Health Survey (CCHS 2004) and National Health and Nutrition Examination Survey (NHANES 2007-08) for the purposes of evaluating fortification policies and practices. DescriptionWorking with the US Food and Nutrient Database for Dietary Studies, we identified voluntarily fortified foods by food code descriptions containing certain key words and the presence of nutrients for which additions were tracked in the database. This strategy is likely to have resulted in an underestimation of voluntarily fortified food consumption and thus an underestimation of the probability of excessive intakes in the US population. Our efforts to model proposed policy changes to food fortification in Canada were similarly limited by our inability to differentiate added sources of niacin and retinol in the CCHS. This thwarted assessment of risks associated with fortification because the Tolerable Upper Intake Levels only apply to retinol and added niacin. ConclusionIt is important that food composition databases and 24hr dietary recall collection methods evolve to facilitate monitoring and evaluating health benefits and risks associated with growing voluntary food fortification practices.

Supporting the case for ‘progressive universalism’ in health visiting: Scottish mothers and health visitors’ perspectives on targeting and rationing health visiting services, with a focus on the Lothian Child Concern Model

To explore parents and professionals' experience of family assessment in health visiting (public health nursing), with a focus on the Lothian Child Concern Model. Health visitors currently assess families as requiring core, additional or intensive support, and offer support at a corresponding level. The majority of families are assessed as core and receive no pro-active support beyond the early days. Previous assessment tools, consisting of checklists, have been criticised as being ineffective in identifying a range of health needs and unacceptable to parents and health visitors. The Lothian Child Concern Model was developed and introduced in the study area to promote a partnership approach with parents and assess strengths as well as difficulties in parents' capacity to care for their child. Qualitative methods were used. Ten mothers and 12 health visitors took part in individual semi-structured interviews. Most mothers were aware of the assessment process but some felt that they were not involved in the decision-making process. Explaining the assessment process to parents is problematic and not all health visitors do so. The assessment process was stressful for some mothers. Health visitors find the model useful for structuring and documenting the assessment process. Many believe that most families benefit from some support, using public health approaches. Health visitors said that families are often assessed as core because there are insufficient resources to support all those who meet the criteria of the additional category and that managers assess caseloads in terms of families with child protection concerns. The study findings significant the concept of 'progressive universalism' that provides a continuum that intensity of support to families, depending on need. Mothers would like better partnership working with health visitors. The study endorses proposed policy changes to re-establish the public health role of health visitors and to lower the threshold for families to qualify for support.

Thoughts and recommendations on cancer care site of service

Within community practice, we are faced with the dual challenge of providing health care and operating a viable business entity. This problem is not unique to oncology; however, the specialty has been unfairly burdened with preferential payment incentives that favor treatment in hospital outpatient departments (HOPDs) over independent communitybased clinics. This trend toward HOPD care has caused a shift in the model of delivery of care and remains a problem for those who practice in community clinics. Furthermore, the shift is driving spending for oncology care higher at a time when payers and patients are contending with rising, unsustainable costs. Providers in individual practices who are focused on the daily responsibilities of caring for cancer patients understandably may find it difficult to keep abreast of national policy changes and understand how those changes might affect their ability to take care of patients. The US Oncology Network and the Community Oncology Alliance (COA) are collaborating to interpret this proposed policy change and to make recommendations for improvement to empower community oncologists to comprehend the impact of this policy and to work toward a better outcome. We will present this proposed policy change in 2 parts: first, an analysis of the impact of current policies on community oncology practice, and second, recommendations for proposed changes to ensure balanced payment amounts for delivery of equivalent services and strategic initiatives for valuebased cost reduction.

Innovations of the management and operation mechanism at the University of Hong Kong-Shenzhen Hospital

This article described the basics of the University of Hong Kong-Shenzhen Hospital and the practices of Shenzhen government to promote the comprehensive reform of public hospitals.The article also introduced the reform,on such aspects as hospital management structure,corporate governance,hospital operating mechanism,compensation mechanisms,service mode,staff training mechanism,and supervision mechanisms.In addition,it analyzed the benefits of these reforms and proposed policy changes. Key words: Hospital reform; Corporate governance; The University of Hong Kong-Shenzhen Hospital

Patterns of Patient Registration with Primary Health Care in the UK National Health Service

The UK National Health Service (NHS) is a long-established universal provider of health care. Most primary care is delivered by general practitioner (GP)-run health centers (surgeries) that, subject to proposed policy changes, are increasingly central to the welfare geographies of the NHS. This article develops an analysis of a unique and hitherto underexploited data set, comparing the observed pattern of patient registrations at GP surgeries with an optimum geographic pattern in the London borough of Southwark. In addition to evaluation of the level of geographic order that arises in a locally administered, centralized system of health care provision, we also use a new and innovative ethnicity classification tool to assess the ethnic dimensions to deviations from the normative arrangement. These results are considered in light of current and recent initiatives regarding patient choice in the United Kingdom.

Vaccine topics discussed at ACIP meeting

The following article covers vaccine topics discussed at the June 2012 Advisory Committee on Immunization Practices (ACIP) meeting. The article "ACIP meeting: Latest vaccine topics reviewed" on page 52 provides more information about this meeting. According to information presented at the meeting, Merck's hepatitis A vaccine Vaqta will be unavailable until mid-2012; however, production and supply of GlaxoSmithKline's adult hepatitis A vaccine (Havrix) and hepatitis A/hepatitis B combination vaccine (Twinrix) are sufficient to meet demand for routine adult usage. Sanofi Pasteur's Pentacel (tetanus, diphtheria, and pertussis [Tdap]; polio; and Haemophilus inBuenza type b [Hib]) and Daptacel (Tdap) are still on backorder; Merck's varicella virus vaccine Varivax is also backordered. In addition, it is anticipated that Merck's measles-mumpsrubella-varicella (MMRV) vaccine ProQuad will return to the market in October, and the backorder for its herpes zoster vaccine Zostavax has been resolved. Four meningococcal vaccines are now on the market: one polysaccharide (MPSV4 [Menomune—Sanofi Pasteur]), two conjugated quadrivalent (Menactra—Sanofi Pasteur and Menveo—Novartis), and a new combination of meningococcal groups C and Y and Hib-tetanus toxoid conjugate (MenHibrix—GlaxoSmithKline). This novel combination was approved by FDA in mid-June and is indicated in infants at age 2 months, 4 months, 6 months, and 12 months. ACIP has not recommended routine infant immunizations in the past due to the low incidence of disease in infants. Because the vaccine was approved shortly before the most recent ACIP meeting, the vaccine will be discussed at the group's October meeting. The 2010 Adult Vaccination Coverage schedule for patients 19 years to 64 years was recently published in CDC's Morbidity and Mortality Weekly Report. The report covers vaccines for Tdap, herpes zoster, human papillomavirus (HPV), and pneumococcal. Compared with 2009, there were only slight increases for Tdap (8.2% + 1.6%), zoster (14.4% + 4.4%), and HPV for women (20.7% + 3.6%), with the other vaccination rates remaining unchanged. The group concluded that all vaccination coverage remains low (far below 2020 targets). The improvement from 2009 was minimal, and racial and ethnic disparities remain. The inaugural National Adult Immunization Summit was held in conjunction with the National Influenza Vaccine Summit on May 15–17. The focus was increasing immunization rates in adults and reducing the burden of vaccine-preventable diseases. Major themes included improving communications and registries, decreasing policy and legal barriers for all providers, evaluating means to increase education of and incentivize providers, decreasing complexity of ACIP schedules, and engaging and encouraging immunization champions and leadership. The last time HPV was discussed by ACIP was October 2011, when the vaccine was approved for males. The National Immunization Survey for 2010 reported female coverage of the HPV vaccine to be 48.7% for one or more doses and 32% for all three doses. Data from eight Sentinel Immunization Information Systems sites funded by CDC showed only a slight increase in female coverage rates during the last 3 years. Only about 10% of males have received the HPV vaccine. Data on the impact of the HPV vaccine are currently being collected. One survey showed that the prevalence of anogenital warts in females aged 15 years to 19 years has decreased, whereas all other age groups increased. In addition, postlicensure monitoring for safety showed that the vaccine is safe but syncope remains a common problem. Currently, few trials are under way to evaluate the vaccine's efficacy with a decrease in the number of doses of vaccine needed. The last rubella pandemic was 1964–65 with 12.5 million cases in the United States. Following the development of the MMR vaccine, rubella was declared eliminated in 2004. An average of nine cases continue to occur each year, mostly in individuals older than 15 years, with onethird born in the United States. A total of 111,888 worldwide cases of congenital rubella syndrome (CRS) were reported in 2008. Six cases of CRS have been reported in the United States since 2005. Because wild measles has mostly disappeared from the American population, immunoglobulin levels of antibody against measles are also decreasing. The amount of antibody donated by people with previous MMR vaccination is lower that following natural disease. The recommended dose of intramuscular (I.M.) immunoglobulin for measles prophylaxis is 0.25 mL/kg (maximal dose is 15 mL). This dose is not adequate for measles prevention in most people. Doubling the dose would still give only minimal antibody concentrations; therefore, I.V. immunoglobulin may be needed to obtain an adequate dose. I.M. immunoglobulin is difficult to obtain because of supply issues. Discussion will continue. The ACIP working group has proposed policy changes for the MMR vaccine, including changing the definition of confirmation of disease and testing requirements, vaccination of patients with HIV, vaccination of household contacts of immunocompromised patients, and permissive use of a third dose in outbreaks. These ideas will be discussed further at future meetings. The next ACIP meeting is October 24–25 in Atlanta.

Open innovation and SMEs

PurposeThe purpose of this paper is to explore, through the use of a multidisciplinary lens, the policy context and the scope for improvements in university‐based public programmes focused on improving innovation in small and medium enterprises (SMEs).Design/methodology/approachThe authors use the street‐level bureaucracy (SLB), combined with the systems of innovation approach (SIA) and diagnostic analysis (DA) to understand the context components that impact on public programme services. The study is part of a research programme oriented to the diffusion of information systems in SMEs and which used original interview‐based programme support case studies, interviews with regional policy managers, and documentation relating to the policy system and different public programmes. Although the empirical work was UK and European Union centric the results of the research have wide applicability.FindingsThe paper establishes the importance of programme contexts for diagnosing and providing a basis for public programme improvements. It further demonstrates the robustness of the context analysis framework to provide insights into proposed policy changes. The responsibility of improving programme contexts relies on actors that operate outside programme organisations, for instance EU funding bodies, government departments in charge of SME policies, public‐private partnerships, and private evaluators. Given this complexity it is suggested that SME associations have a potentially important role in increasing participation by SMEs in the public programme for innovation and knowledge support policy. Despite possible policy changes the requirement for public programme support for innovation and hence the role of universities as programme providers is confirmed and expanded.Research limitations/implicationsThe results demonstrate the value of a multidisciplinary framework to analyse programme interventions at both macro and micro levels and provide a basis for programme policy and policy implementation improvements.Originality/valueThis research is a novel attempt to use the SLB, SIA and DA to public programme university‐based interventions in SMEs and SME policies in general. It complements extant research on open innovation and knowledge exchange by extending the concept of public programme contexts. Beneficiaries of the findings include policy makers, programme organisations, universities, SME associations, and researchers.