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The changing hospital landscape: An exploration of international experiences

August 20, 2014 Comments off

The changing hospital landscape: An exploration of international experiences
Source: RAND Corporation

The nature of hospital activity is changing in many countries, with some experiencing a broad trend towards the creation of hospitals groups or chains and multi-hospital networks. This report seeks to contribute to the understanding of experiences in other countries about the extent to which different hospital ‘models’ may provide lessons for hospital provision in England by means of a review of four countries: France, Germany, Ireland and the United States, with England included for comparison. We find that here has been a trend towards privatisation and the formation of hospital groups in France, Germany and the United States although it is important to understand the underlying market structure in these countries explaining the drivers for hospital consolidation. Thus, and in contrast to the NHS, in France, Germany and the United States, private hospitals contribute to the delivery of publicly funded healthcare services. There is limited evidence suggesting that different forms of hospital cooperation, such as hospital groups, networks or systems, may have different impacts on hospital performance. Available evidence suggests that hospital consolidation may lead to quality improvements as increased size allows for more costly investments and the spreading of investment risk. There is also evidence that a higher volume of certain services such as surgical procedures is associated with better quality of care. However, the association between size and efficiency is not clear-cut and there is a need to balance ‘quality risk’ associated with low volumes and ‘access risk’ associated with the closure of services at the local level.

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The Role of the Informal Economy in Addressing Urban Food Insecurity in Sub-Saharan Africa

August 20, 2014 Comments off

The Role of the Informal Economy in Addressing Urban Food Insecurity in Sub-Saharan Africa
Source: Centre for International Governance Innovation

Sub-Saharan Africa (SSA) is facing high rates of urbanization and increasing food insecurity. The informal food economy addresses food insecurity by providing access to affordable food and significant employment opportunities to the urban poor in the SSA. The authors of the latest installment of the Junior Fellows Policy Brief Series state that different policy approaches need to be taken into account to address the diverse needs of the informal food economy, including the needs of “survivalist” traders, larger constrained enterprises and female vendors. They recommend that there should be a targeted social protection scheme for survivalists in the informal economy; informal-sector policies should consider the structural barriers women face in the informal sector; budgets for municipal governments should be increased; and government officials should consider policies to create an enabling environment for informal-sector enterprises facing constraints to growth.

Consumer Cash Usage: A Cross-Country Comparison with Payment Diary Survey Data

August 20, 2014 Comments off

Consumer Cash Usage: A Cross-Country Comparison with Payment Diary Survey Data
Source: Federal Reserve Bank of Boston

We measure consumers’ use of cash by harmonizing payment diary surveys from seven countries. The seven diary surveys were conducted in 2009 (Canada), 2010 (Australia), 2011 (Austria, France, Germany, and the Netherlands), and 2012 (the United States). Our paper finds cross-country differences — for example, the level of cash use differs across countries. Cash has not disappeared as a payment instrument, especially for low-value transactions. We also find that the use of cash is strongly correlated with transaction size, demographics, and point-of-sale characteristics such as merchant card acceptance and venue.

Networks of Military Alliances, Wars, and International Trade

August 20, 2014 Comments off

Networks of Military Alliances, Wars, and International Trade
Source: Social Science Research Network

We investigate the role of networks of military alliances in preventing or encouraging wars between groups of countries. A country is vulnerable to attack if some allied group of countries can defeat the defending country and its (remaining) allies based on their collective military strengths. We show that there do not exist any networks which contain no vulnerable countries and that are stable against the pairwise addition of a new alliance as well as against the unilateral deletion of any existing alliance. We then show that economic benefits from international trade provide incentives to form alliances in ways that restore stability and prevent wars, both by increasing the density of alliances so that countries are less vulnerable and by removing the incentives of countries to attack their allies. In closing, we examine historical data on interstate wars and trade, noting that a dramatic (more than ten-fold) drop in the rate of interstate wars since 1950 is paralleled by the advent of nuclear weapons and an unprecedented growth in trade over the same period, matched with a similar densification and stabilization of alliances, consistent with the model.

Ebola: 2014 Outbreak in West Africa – CRS In Focus (August 8, 2014)

August 20, 2014 Comments off

Ebola: 2014 Outbreak in West Africa – CRS In Focus (PDF)
Source: Congressional Research Service (via U.S. State Department Foreign Press Center)

An ongoing outbreak of Ebola Virus Disease (EVD), the largest, most persistent ever documented, and the first in West Africa, began in March 2014 in Guinea, Sierra Leone, and Liberia (the “affected countries”) and has spread to Nigeria. More people have contracted and died from EVD in this outbreak than in any single prior outbreak. In the current outbreak, the case fatality rate (the estimated percentage of infected persons dying) is about 55%; past outbreak rates have ranged between 41% and 88%.

Prior human EVD outbreaks had occurred in the Democratic Republic of Congo, Gabon, Sudan, and Uganda, primarily in rural and forested areas (Figure 2). The current outbreak is more geographically extensive and cases are emerging in both urban and rural settings. Health experts are accelerating efforts to contain the outbreak, as transmission in densely populated urban areas may be far more difficult to control and lead to higher death tolls. According to the World Health Organization (WHO), from March through August 6, Ebola was known or suspected to have infected 1,779 persons and caused 961 deaths; of these, 1,134 cases had been confirmed in laboratories.

The Shifting Economics of Global Manufacturing: How Cost Competitiveness Is Changing Worldwide

August 20, 2014 Comments off

The Shifting Economics of Global Manufacturing: How Cost Competitiveness Is Changing Worldwide
Source: Boston Consulting Group

For the better part of three decades, a rough, bifurcated conception of the world has driven corporate manufacturing investment and sourcing decisions. Latin America, Eastern Europe, and most of Asia have been viewed as low-cost regions. The U.S., Western Europe, and Japan have been viewed as having high costs.

But this worldview now appears to be out of date. Years of steady change in wages, productivity, energy costs, currency values, and other factors are quietly but dramatically redrawing the map of global manufacturing cost competitiveness. The new map increasingly resembles a quilt-work pattern of low-cost economies, high-cost economies, and many that fall in between, spanning all regions.

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Parental child abduction within the EU

August 20, 2014 Comments off

Parental child abduction within the EU
Source: European Parliamentary Research Service

The separation of parents is always a complicated and sensitive issue for the ex-partners and the child(ren). Citizens recurrently turn to the European Parliament asking for help in cases of alleged discrimination on grounds of nationality regarding parental authority or in cases of possible parental child abduction.

The number of bi-national marriages in the EU is constantly growing. When such a marriage breaks down the ex-partners often decide to return to their respective country of origin. If a couple has a child the situation can become very complicated. Frequently, once parents have separated, the parent who does not have custody of the child(ren) abducts them or refuses to send them back following an access visit. Another scenario is even more common: children are removed or retained by their primary carer, but without the permission of the other parent. This is in breach of the legal rights of the other parent and often leads to court proceedings.

UK — Ofcom publishes research on mobile phone call service quality

August 20, 2014 Comments off

Ofcom publishes research on mobile phone call service quality
Source: Ofcom

Ofcom has today published research on mobile phone call quality provided by network operators.

Improving mobile quality of service for consumers is a priority area for Ofcom. Today’s research is part of a plan to help support initiatives to improve mobile coverage in the UK, and provide consumers with quality information on mobile reception.

This information is important in helping consumers choose a mobile service that suits their needs. It also helps promote competition between mobile operators on service quality, to benefit consumers. Ofcom will continue to monitor and report on how service quality develops over time.

The report includes research on mobile phone call quality from the consumers’ perspective on mobile handsets; data supplied by EE, O2, Three and Vodafone on the performance of their networks; and consumer research on satisfaction with mobile networks.

Ofcom’s research found that while overall levels of consumer satisfaction with mobile networks are high (76%), this varies by location. Some 78% of people in urban areas were satisfied with their mobile network, compared to 67% in rural parts of the UK and 70% in remote areas.

AU — Crime and law enforcement: a quick guide to key Internet links

August 19, 2014 Comments off

Crime and law enforcement: a quick guide to key Internet links
Source: Parliamentary Library of Australia

This Quick Guide provides key Internet links to websites with information on crime and law enforcement arrangements and issues. Australian Government Attorney-General’s Department —the lead Commonwealth agency for criminal law, law enforcement policy, crime prevention and anti-corruption. Key pages include:
– crime and corruption—overview and links to more specific information including legislation and policy on organised crime, money laundering, people smuggling, human trafficking, cybercrime, foreign bribery, anti-corruption, illicit drugs and federal offenders
– crime prevention—information on the government’s crime prevention initiatives, including grants programs and
– international crime cooperation arrangements—information on extradition, mutual assistance and international transfer of prisoners processes and arrangements with other countries.

CA — The burden of premature opioid-related mortality

August 19, 2014 Comments off

The burden of premature opioid-related mortality
Source: Addiction

Background and Aims
The burden of premature mortality due to opioid-related death has not been fully characterized. We calculated temporal trends in the proportion of deaths attributable to opioids and estimated years of potential life lost (YLL) due to opioid-related mortality in Ontario, Canada.

Design
Cross-sectional study.

Setting
Ontario, Canada.

Participants
Individuals who died of opioid-related causes between January 1991 and December 2010.

Measurements
We used the Registered Persons Database and data abstracted from the Office of the Chief Coroner to measure annual rates of opioid-related mortality. The proportion of all deaths related to opioids was determined by age group in each of 1992, 2001 and 2010. The YLL due to opioid-related mortality were estimated, applying the life expectancy estimates for the Ontario population.

Findings
We reviewed 5935 opioid-related deaths in Ontario between 1991 and 2010. The overall rate of opioid-related mortality increased by 242% between 1991 (12.2 per 1 000 000 Ontarians) and 2010 (41.6 per 1 000 000 Ontarians; P < 0.0001). Similarly, the annual YLL due to premature opioid-related death increased threefold, from 7006 years (1.3 years per 1000 population) in 1992 to 21 927 years (3.3 years per 1000 population) in 2010. The proportion of deaths attributable to opioids increased significantly over time within each age group (P < 0.05). By 2010, nearly one of every eight deaths (12.1%) among individuals aged 25–34 years was opioid-related.

Conclusions
Rates of opioid-related deaths are increasing rapidly in Ontario, Canada, and are concentrated among the young, leading to a substantial burden of disease.

In-work poverty in the EU

August 19, 2014 Comments off

In-work poverty in the EU
Source: European Parliamentary Research Service

Having a job yet still being unable to make a living: In-work poverty is a phenomenon that affected 9,1 percent of the working age EU population in 2012. The rate of those in work and at risk of poverty has been on the rise since 2005. It applies to those with an income below 60% of the national median. In the aftermath of the crisis, wage polarisation and an increase of part-time work have led to higher rates of in-work poverty in Europe. At the same time, nearly a quarter of the overall EU population is facing the risk of poverty or exclusion.

Employment does not always protect from poverty. Whether a person is becoming “working poor” is decided by working status and household income. Analysts often see a combination of low pay, high needs and weak ties to the labour market as root causes. In general the risk is higher for single households (sole earners, especially women with dependent children), young workers and temporarily employed people as well as those with low levels of education. Paradoxically, men face a higher risk than women, even though women are more often in part-time employment with a lower salary. Yet women are more often secondary earners, meaning that the household income does not depend only on them.

Baby Names in England and Wales, 2013

August 19, 2014 Comments off

Baby Names in England and Wales, 2013
Source: Office for National Statistics

Key Findings

  • Oliver and Amelia were the most popular first names given to babies born in England and Wales in 2013. Amelia has been in the top spot since 2011 while Oliver replaced Harry, the top name in 2011 and 2012.
  • In England, Amelia was the most popular name in all regions and Oliver was the most popular name in five out of the nine regions.
  • In Wales, Oliver was the most popular name, replacing Jacob, while Amelia has been the most popular name since 2012.
  • Oscar and George replaced Alfie and Riley in the top 10 most popular names, climbing from number 17 to 7 and number 12 to 10 respectively.
  • Poppy replaced Lily in the top 10 most popular names, climbing from number 13 to 7.

Left in the Dark: International Military Operations in Afghanistan

August 18, 2014 Comments off

Left in the Dark: International Military Operations in Afghanistan
Source: Amnesty International

Thousands of Afghan civilians have been killed since 2001 by international forces, and thousands more have been injured. This report examines the record of accountability for civilian deaths caused by international military operations in the five-year period from 2009 to 2013. In particular, it focuses on the performance of the US government in investigating possible war crimes and in prosecuting those suspected of criminal responsibility for such crimes. Its overall finding is that the record is poor.

Notes from the Field: Hospitalizations for Respiratory Disease Among Unaccompanied Children from Central America — Multiple States, June–July 2014

August 18, 2014 Comments off

Notes from the Field: Hospitalizations for Respiratory Disease Among Unaccompanied Children from Central America — Multiple States, June–July 2014
Source: Morbidity and Mortality Weekly Report (CDC)

During October 2013–June 2014, approximately 54,000 unaccompanied children, mostly from the Central American countries of El Salvador, Guatemala, and Honduras, were identified attempting entry into the United States from Mexico, exceeding numbers reported in previous years (1). Once identified in the United States, U.S. Customs and Border Protection, an agency of the U.S. Department of Homeland Security, processes the unaccompanied children and transfers them to the Office of Refugee Resettlement (ORR), an office of the Administration for Children and Families, U.S. Department of Health and Human Services. ORR cares for the children in shelters until they can be released to a sponsor, typically a parent or relative, who can care for the child while their immigration case is processed. In June 2014, in response to the increased number of unaccompanied children, U.S. Customs and Border Protection expanded operations to accommodate children at a processing center in Nogales, Arizona. ORR, together with the U.S. Department of Defense, opened additional large temporary shelters for the children at Lackland Air Force Base, Texas; U.S. Army Garrison Ft. Sill, Oklahoma; and Naval Base Ventura County, California.

On July 10, 2014, CDC was informed by the California Department of Public Health and ORR about four unaccompanied male children aged 14–16 years with respiratory illnesses at Naval Base Ventura County, three of whom were hospitalized with pneumonia. Among the three patients with pneumonia, two were bacteremic with Streptococcus pneumoniae, ultimately determined to be serotype 5, one of whom also had laboratory-confirmed influenza B virus by polymerase chain reaction (PCR). The fourth patient, without pneumonia, had PCR-confirmed influenza A(H1N1)pdm09. Pneumococcal bacteremia is uncommon among U.S. adolescents, particularly serotype 5, with only three such cases identified in the past 10 years by CDC (2). In addition, influenza activity in the United States is typically lowest in the middle of summer, and Ventura County had no reports of an unusual increase in influenza activity in the community at the time. ORR asked CDC to investigate the scope of this apparent outbreak and implement measures to interrupt transmission.

During July 6–19, 2014, CDC was informed of other clusters of hospitalized children with respiratory disease, increasing the total to 16 cases. The cases were from Naval Base Ventura County (eight cases), Ft. Sill (three), Lackland Air Force Base (two), a standard ORR shelter near Houston, Texas (two), and the Nogales processing center (one). Cases were in persons aged 14–17 years. Diagnoses included laboratory-confirmed pneumococcal pneumonia with laboratory-confirmed influenza (three cases) and without laboratory-confirmed influenza (four cases), influenza pneumonia (one case), and pneumonia with no identified etiology (eight cases). Five patients experienced septic shock requiring intensive care. No case was fatal. All six cases for which pneumococcal isolates were available were identified as serotype 5, a serotype included in 13-valent pneumococcal conjugate vaccine (PCV13) (Prevnar-13, Pfizer). Of the 16 patients identified in this cluster, 11 were tested for influenza viruses; four (36%) were positive (two for influenza A[H1N1]pdm09, one for influenza B, and one for influenza A by rapid test).

Because of the concern that unaccompanied children were at increased risk for influenza and pneumococcal pneumonia in this outbreak setting and the clinically important interaction between influenza and pneumococcal infections (3), CDC recommended that all children residing in temporary or standard ORR shelters receive influenza vaccine and PCV13 in addition to routinely recommended vaccines. Approximately 2,000 children in four affected shelters were vaccinated during July 18–30 with PCV13 and with Food and Drug Administration–approved extended expiration date–specific lots of 2013–14 seasonal influenza vaccine, which includes influenza A(H1N1)pdm09 and influenza B viruses. The shelters reported no serious adverse events.

Coordinating Immigrant Integration in Germany: Mainstreaming at the federal and local levels

August 18, 2014 Comments off

Coordinating Immigrant Integration in Germany: Mainstreaming at the federal and local levels
Source: Migration Policy Institute

In contrast to other European countries, the idea of “mainstreaming” immigrant integration policy—the practice of reaching people with a migration background through social programming and policies that address the needs of the general population—has not caught on among policymakers in Germany. Although characterized by fragmented policies scattered across many levels of government with little vertical coordination, integration policy in Germany has made many strides over the past decade. Still, civil-society organizations and employees in public services continue to call for a shift away from policymaking that targets specific groups, and toward measures directed at society, or young people, as a whole.

This report explores the history and recent trends of integration policy in Germany, focusing on the past 15 years, when immigrant integration became an important issue. Aside from matters of nationality, freedom of movement, and passports, which are the exclusive domain of the federal government, and matters of education, which are up to the Länder (state-level governments) to decide, integration has consisted of a tangled web of overlapping and unclear legislative jurisdiction. Integration policy, which cuts across areas such as education, labor, and urban development, also suffers from a lack of horizontal coordination across various governmental departments and across states.

The report also examines various integration measures taken by the federal, Länder, and local governments as well as civil-society actors, including those that have attempted to reach the general population and those targeted at specific groups. Young people have been a particular focus of many projects, in a country where one-fourth of the estimated 15.6 million people with an immigrant background are under the age of 25.

CRS — Trade Adjustment Assistance for Firms: Economic, Program, and Policy Issues (August 4, 2014)

August 15, 2014 Comments off

Trade Adjustment Assistance for Firms: Economic, Program, and Policy Issues (PDF)
Source: Congressional Research Service (via Federation of American Scientists)

The Trade Adjustment Assistance (TAA) programs were authorized by Congress in the Trade Expansion Act of 1962 to help workers and firms adjust to import competition and dislocation caused by trade liberalization. Trade liberalization, which is widely held to increase the economic welfare of all trade partners, can also cause adjustment problems for import-competing firms and workers. TAA has long been justified on grounds that TAA may be the least disruptive option for offsetting policy-driven trade liberalization. The TAA programs for workers, firms, and farmers represent an alternative to policies that would restrict imports, and so provides assistance while bolstering freer trade and diminishing prospects for potentially costly tension (retaliation) among trade partners.

CRS — Iraq Crisis and U.S. Policy (August 8, 2014)

August 15, 2014 Comments off

Iraq Crisis and U.S. Policy (PDF)
Source: Congressional Research Service (via Federation of American Scientists)

The offensive in northern and central Iraq led by the Sunni Islamist insurgent and terrorist group the Islamic State (IS, formerly ISIL/ISIS) has raised significant concerns for the United States and precipitated new U.S. military action in Iraq. U.S. concerns include a possible breakup of Iraq’s political and territorial order; the establishment of a potential base for terrorist attacks in the region or even against the U.S. homeland; the potential for a humanitarian catastrophe; and direct threats to the approximately 5,000 U.S. personnel in Iraq.

The crisis has raised several questions for U.S. policy because it represents the apparent unraveling of a seemingly stable and secure Iraq that was in place when U.S. combat troops departed Iraq at the end of 2011. The Islamic State offensive into Kurdish-controlled territory in early August has caused the United States to become reengaged militarily in Iraq. The Administration has said its intervention will remain limited and will not result in a deployment of U.S. ground troops back into Iraq. The Administration also has engaged in humanitarian air drops to members of minority communities in northern Iraq that fled the IS onslaught.

AU — National security: a quick guide to key Internet links

August 15, 2014 Comments off

National security: a quick guide to key Internet links
Source: Parliamentary Library of Australia

This Quick Guide provides key Internet links to websites with information on national security arrangements and issues. Australian Government agencies and websites provides information on what governments are doing to protect Australia’s national security, outlines relevant legislation and the roles of federal and state and territory agencies in countering terrorism, and provides links to key Australian Government publications relating to national security. It also has a list of organisations identified as terrorist organisations under the Criminal Code Act 1995 (Cth) and associated regulations, with links to statements of reasons and the Australian Government’s listing protocol.

The Islamic Caliphate and Australia

August 15, 2014 Comments off

The Islamic Caliphate and Australia
Source: Parliamentary Library of Australia

In June 2014, the Islamic State (IS) declared an Islamic Caliphate spanning the area from Syria’s Aleppo governorate in the west, to Iraq’s province of Diyala in the east. The area under IS control now covers up to one third of Iraq, including the city of Mosul, which previously had a strong Christian community, but who have now mostly been forced to flee. The IS was formerly known as the Islamic State of Iraq and the Levant (ISIL or ISIS), and previously operated as a front organisation for Al-Qaeda in Iraq (AQI) until Al-Qaeda broke ties with the group early this year. Although the group has been proscribed by Australia since 2005, it was only listed under the name Islamic State on 12 July 2014. Iraq’s national army and police force put up little resistance to the insurgents, and are reported to have abandoned their weapons and fled. However, Iraqi-Kurdistan in the far north-east tip of the country remains intact, and its military, the peshmerger, have secured Kirkuk, an oil rich city that the Kurds have previously laid claim to, but which is not recognised as part of Iraqi-Kurdistan.

The Human-Capital Needs of Tech City, London

August 15, 2014 Comments off

The Human-Capital Needs of Tech City, London
Source: Migration Policy Institute

Cities are important sites of entrepreneurship and innovation, especially for the tech industry, and skilled migrants can play critical roles in economic development in high-tech clusters such as London’s Tech City (also known as Silicon Roundabout). In the United Kingdom, an undersupply of skilled native-born developers encourages recruiters to look afield, but visa restrictions make hiring the right workers difficult. Evidence that firms are having trouble making the most of immigration point to a number of areas for policy action, as this report outlines.

A raft of policies were introduced to grow the Tech City cluster, but while the United Kingdom is reforming policies to attract and retain skilled migrant workers and migrant entrepreneurs, getting the design of these programs right has proved especially difficult. Policymakers’ control over cluster development is limited: policies that seek to map clusters and maximize their growth rarely deliver expected benefits. However, policies that are not cluster specific—such as human-capital interventions aimed at improving the international supply of workers through migration or the local supply of workers through skills training—are likely to have indirect effects that help clusters grow.

This report analyzes the importance of human capital to the development of Tech City and sets this discussion in a broader framework linking cities, digital sectors, and highly skilled immigration.

The report is part of a series from MPI’s Transatlantic Council on Migration focused on how policymakers at all levels can work together to help cities and regions get more out of immigration. The reports were commissioned for the Council’s eleventh plenary meeting, “Cities and Regions: Reaping Migration’s Local Dividends.”

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