245 research outputs found
The Politics of Social Policy Reform in the United States: The Clinton and the W. Bush Presidencies Reconsidered
No full textThe purpose of this paper is to examine what key reform attempts during the Bill Clinton and George W. Bush presidencies reveal about the wider possibilities for social policy change in the United States. Most particularly, why were Presidents Clinton and Bush able to achieve their goals in some policy realms but so badly defeated in others? As argued, institutional variation from one policy area to another helps answer this question. On the one hand, strong institutional obstacles in the fields of Social Security and health insurance largely explain the defeat of the most ambitious social policy proposal put forward by each president. On the other hand, successful reforms occurred in a comparatively favourable institutional context. Yet, the analysis also suggests that paying close attention to the strategic ideas of political actors as they interact with existing institutions and policy legacies is necessary to fully understand the politics of social policy reform.social policy, Medicare, Social Security, welfare, institutions, United States
Fulminant Bacillus cereus food poisoning with fatal multi-organ failure.
No full textThis case represents a rare fulminant course of fried-rice associated food poisoning in an immunocompetent person due to pre-formed exotoxin produced by Bacillus cereus, with severe manifestations of sepsis, including multi-organ (hepatic, renal, cardiac, respiratory and neurological) failure, shock, metabolic acidosis, rhabdomyolysis and coagulopathy. Despite maximal supportive measures (continuous renal replacement therapy, plasmapheresis, N-acetylcysteine infusion and blood products, and broad-spectrum antimicrobials) and input from a multidisciplinary team (consisting of infectious diseases, intensive care, gastroenterology, surgery, toxicology, immunology and haematology), mortality resulted. This case is the first to use whole genome sequencing techniques to confirm the toxigenic potential of B. cereus It has important implications for food preparation and storage, particularly given its occurrence in home isolation during the COVID-19 pandemic
The effects of fiscal consolidation in the OECD
No full textDespite the current recession in many parts of the OECD, fiscal consolidation is likely in many OECD economies in the 1990s. The author asks: is fiscal consolidation in the OECD in a period of low growth a recipe for global stagnation? In particular, what effects are likely in developing countries? The author starts with an overview of cuts in the U.S. fiscal deficit proposed by the Clinton administration and the extent to which European governments must cut fiscal deficits between now and 1997 to satisfy deficit targets in the Maastricht Treaty. How changes in fiscal policy are transmitted within an economy and between that economy and the rest of the world depends on whether those changes lead to permanent or temporary changes in government saving; whether they are implemented through government spending or taxes; and whether the taxes fall on households or firms. The main channels of transmission are through changes in: agents'expectations about future taxes, interest rates, exchange rates, and economic activity. The author uses the MSG2 multicountry models to quantify the ramifications of those changes. He concludes, among other things, that fiscal contraction in the OECD will probably lead to slower growth over the next several years. But the current and likely paths of fiscal policy are such that deficit reduction programs may have stimulating effect in the short run, as long as future fiscal contraction is credible. And fiscal deficit reduction will probably increase long-run output in the OECD through its effects on savings and investment. Finally, growth in the developing countries (at least total growth) may not be impaired at all by fiscal consolidationin the OECD. The negative effects of fiscal contraction will occur through lower net exports of non-OECD economies. For developing countries with open capital markets, the initial reduction in demand through lower exports can be offset by the reduction in interest rates following an inflow of capital from the countries with contracting fiscal policy. A significant decline in real global interest rates is likely to increase growth in developing countries that are debt-constrained, either directly (through private capital inflows) or indirectly (by relaxing the balance of payments constraint, allowing more resources to be channeled to domestic investment needs).Economic Theory&Research,Economic Stabilization,Environmental Economics&Policies,Banks&Banking Reform,Macroeconomic Management
The Foundational Integration Model
No full text Based on the stance taken in the first article in this series (Clinton, 1990), a new methodology for doing integration of psychology and theology is proposed, called the Foundational Integration Model. Following the presentation of the model, the author discusses the need for a systematic approach, outlines the elements in a thorough model of integration, and addresses the assumptions which will have to be agreed upon or defended. The article is concluded with a call for a group of scholars to organize to meet the need. </jats:p
India's product patent protection regime: Less or more of "pills for the poor"?
No full textThe year 2005 marks the end of transition period for many developing countries with competent pharmaceutical sectors that competed in supplying generic versions of patented drugs to LDCs before, thereby inducing price competition and enhancing access to medicines. In a post-2005 scenario, the critical issue is whether LDCs without adequate manufacturing capabilities can make use of compulsory licensing expeditiously to induce price competition and secure lower prices. This paper uses empirical evidence collected during a firm-level survey of the Indian pharmaceutical sector to generate evidence on emerging strategies of firms. It shows that the vigour of compulsory licensing as a price-leveraging instrument post-2005 is incumbent mainly on its economic feasibility. It shows that Indian firms view the market potential (in terms of market size and profits involved in such supply, especially if they have to make specific technological investments to produce the drug) of the mechanism much more severely than before, and may be less inclined to engage in such production if their commercial expectations are grossly unmet. The analysis assesses implications of emerging strategies of firms in the Indian pharmaceutical sector for access to medicines both domestically and internationally, and highlights the challenges involved.product patents, Indian pharmaceuticals, generics, access
Secret agonies, hidden wolves, leper-sins: the personal pains and prostitutes of Dickens, Trollope, and Gaskell
No full textThis dissertation explores the ways in which Charles Dickens writes Nancy in Oliver Twist, Anthony Trollope writes Carry Brattle in The Vicar of Bullhampton, and Elizabeth Gaskell writes Esther in Mary Barton to represent and examine some very personal and painful anxiety. About Dickens and Trollope, I contend that they turn their experiences of shame into their prostitute's shame. For Gaskell, I assert that the experience she projects onto her prostitute is that of her own maternal grief in isolation. Further, I argue that these authors self-consciously create biographical parallels between themselves and their prostitutes with an eye to drawing conclusions about the results of their anxieties, both for their prostitutes and, by proxy, for themselves. In Chapter II, I assert that in Nancy, Dickens writes himself and his sense of shame at his degradation and exploitation in Warren's Blacking Factory. This shame resulted in a Dickens divided, split between his successful, public persona and his secret, mortifying shame. Both shame and its divisiveness he represents in a number of ways in Nancy. In Chapter III, I contend that Trollope laces Carry Brattle with some of his own biographical details from his early adult years in London. These parallels signify Carry's personal importance to her author, and reveal her silences and her subordinate role in the text as representative of Trollope's own understanding and fear of shame and its consequences: its silencing and paralyzing nature, and its inescapability. In Chapter IV, I posit that Gaskell identifies herself with Esther, and that through her, Gaskell explores three personal things: her sorrow over the loss of not one but three of her seven children, her possible guilt over these deaths, and her emotional isolation in her marriage as she grieved alone. In her creation of Esther, Gaskell creates a way both to isolate her grief and to forge a close companion to share it, thus enabling her to examine and work through grief. In Chapter V, I examine the preface of each novel and find that these, too, reflect each author's identification with and investment of anxiety in his or her particular prostitute
Pneumococcal bacteraemia in adults over a 10‐year period (2011–2020): a clinical and serotype analysis
No full textBackground: Streptococcus pneumoniae (pneumococcus) is a human nasopharyngeal tract coloniser responsible for invasive pneumococcal disease, which is largely vaccine preventable. Vaccination is recommended from birth for all, and through adulthood for those with risk conditions. Aims: To describe the clinical and serotype analysis of pneumococcus bacteraemia over a 10-year period. Methods: A 10-year (February 2011–December 2020) retrospective review was performed on all adult (age ≥18 years) pneumococcus bacteraemia presenting to the four public hospitals in Western Sydney, Australia. Comorbidities and risk factors were recorded. Results: Three hundred unique episodes of S. pneumoniae bloodstream infection (SPBI) were identified during the study period. The median age for SPBI was 63 years with 31.7% aged 70 years or older. A 94.7% had one or more risks factors for SPBI. Pneumonia was reported in 80% of all SPBI, whereas meningitis was reported in 6% and infective endocarditis in <1%. Asplenia was noted in 2.4%. Seven- and 30-day mortality was 6.6% and 11.9%, with a higher 30-day mortality in those aged ≥70 years (24.4%). The serotype distribution showed 7-valent conjugate vaccine covered 11.0% of all isolates, whereas 13-valent conjugate vaccine (13vPCV) and a 23-valent polysaccharide vaccine (23vPPV) covered 41.7% and 69.0% respectively. Immunisation details were available for 110 individuals, of whom, only 7.3% had received pneumococcal vaccination. Conclusions: Most patients with pneumococcal bacteraemia had age- or comorbidity-related risk factors but were not vaccinated. Two-thirds of cases occurred in people aged <70 years. 13vPCV and 23vPPV covered 41.7% and 69.0% of bacteraemic isolates.Full Tex
Thoreau as a free-lance journalist
No full textVita.That the author of Walden and "Civil Disobedience" also wrote for newspapers and magazines tends to be lost on Henry David Thoreau's increasing readership. Yet he referred to himself as a reporter to the gazettes and his neighbors; he free-lanced articles to periodicals for pay; and he utilized (unpaid) literary agents. He worked endlessly at perfecting his reportorial skills and the art of writing. He recorded daily in a journal for twenty-four years what he learned and thought. The usefulness to modern writers of his conclusions may equal the relevance and appeal to general readers of his genius for joyful, self-reliant living in harmony with nature. And an examination of him as a free-lance writer from the viewpoint of modern journalism may broaden our understanding of this enigmatic genius and his place in literary history. Growing up in Concord, Massachusetts, Thoreau made its surrounding woods, fields, and eaters his textbook of nature, his microcosm of the universe, and one of his two chosen reporting beats. The other beat was human nature, and he searched within himself as Representative Man for ultimate truths. In his essays, he reported the findings that he considered most newsworthy. The reports often concerned thoughts rather than events, for he considered thoughts the epochs of life, and he found the imagined more real than the actual. His education included four years at Harvard, only fifteen miles from his beloved Concord, to which he returned for good.
Perceptions of US and Australian medical students and instructors about clinical professional attire: Lapel study
No full textContext White coats have long been the professional uniform of physicians. However, when physicians opt to remove the white coat, their clothing underneath is brought to the forefront and can influence how they are perceived by their patients. Objective: To explore the perceptions of medical students and their instructors about appropriate clinical professional attire. MethodsAn anonymous, voluntary 55-question survey was electronically distributed to medical students and their instructors at 2 US and 2 Australian medical schools. The survey incorporated 30 images of sample attire, 9 demographic questions, and 16 questions regarding culture and context of clothing and accessories. ResultsIn total, 411 students and 73 instructors participated in this study. The data revealed that white coats and neckties are nearly absent in Australian clinical attire. Overall, students were significantly more supportive of full facial coverage due to religious or cultural values compared with instructors (P<.001), and US medical students were significantly more supportive than Australian students (P<.001). All cohorts preferred dress code policies that directed students to avoid but not prohibit the use of perfume or cologne. Nose rings were controversial with significantly more support for use from medical students than instructors (pooled cohorts, P=.002). Medical students in both the United States and Australia indicated that they were most influenced by observing the attire of physicians at work (155 [38%]), compared with courses in medical ethics (19 [5%]), school policy (16 [4%]), or hospital policy (9 [2%]). ConclusionAlthough regional dress code practices are different in the United States compared with Australia, medical students were overall most influenced by their instructors’ attire in clinical settings.</p
New Jersey's Rising Seas and Changing Coastal Storms: Report of the 2019 Science and Technical Advisory Panel
No full textThe first New Jersey Science and Technical Advisory Panel (STAP) on Sea-Level Rise and Coastal Storms was convened by Rutgers University on behalf of the NJ Climate Change Alliance in 2015, culminating in a 2016 report that identified planning options for practitioners to enhance the resilience of New Jersey’s people, places, and assets to sea-level rise, coastal storms, and the resulting flood risk (Kopp et al., 2016). An innovative approach used to inform the 2016 report was the complementary convening of a panel of practitioners to offer insights on the application of the STAP science to state and local planning and decision-making. Following the same process, the same team at Rutgers University was engaged by the State of New Jersey Department of Environmental Protection to update the 2016 report based on the most current scientific information. Similar to the inaugural work, the 2019 STAP was charged with identifying and evaluating the most current science on sea-level rise projections and changing coastal storms, considering the implications for the practices and policies of local and regional stakeholders, and providing practical options for stakeholders to incorporate science into risk-based decision processes.
The 2019 STAP process recommended the following key updates to the 2016 STAP report:
Making available historical sea-level rise (SLR) information for New Jersey to provide a frame of reference for future projections;
Updating information on ice sheet dynamics;
Expanding consideration of tidal flooding; and
Expanding consideration of storm tide-related flooding.
This report integrates the 2019 key STAP updates and should be considered the most recent reference in this series.Please cite this report as: Kopp, R.E., C. Andrews, A. Broccoli, A. Garner, D. Kreeger, R. Leichenko, N. Lin, C. Little, J.A. Miller, J.K. Miller, K.G. Miller, R. Moss, P. Orton, A. Parris, D. Robinson, W. Sweet, J. Walker, C.P. Weaver, K. White, M. Campo, M. Kaplan, J. Herb, and L. Auermuller. New Jersey’s Rising Seas and Changing Coastal Storms: Report of the 2019 Science and Technical Advisory Panel. Rutgers, The State University of New Jersey. Prepared for the New Jersey Department of Environmental Protection. Trenton, New Jersey.
This work was made possible with financial assistance from the Coastal Zone Management Act of 1972, as amended, as administered by the Office of Coastal Management, National Oceanic and Atmospheric Administration (NOAA) Program through the New Jersey Department of Environmental Protection, Coastal Management Program, Bureau of Climate Resilience Planning. The LocalizeSL sea-level rise projection framework used in this report was developed with grants to REK from the National Science Foundation (Grant ICER-1663807) and the National Aeronautics and Space Administration (Grant 80NSSC17K0698), as well as from the Rhodium Group (for whom REK has previously worked as a consultant) as part of the Climate Impact Lab collaboration."November 2019
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