New directions for the teaching computer: Citizen participation in community planning

In 1970 an experiment was conducted to demonstrate the feasibility of using the teaching computer as a medium for involving people in community planning. A program on an environmental issue was presented on the PLATO system to a nonrandom sample of the population of Champaign-Urbana, Illinois. The participants included government leaders, civic leaders, and interested citizens. The data from this experiment suggests the following:

1. 1. People from the community were willing to come to work through the program.

2. 2. Participants found the medium useful for presenting concise and relevant information.

3. 3. Presentation of information in this way may be particularly useful for those who have not yet formed an opinion on the issue.

4. 4. Participants found particular advantage in being able to make comments and respond to questions.

5. 5. Participants indicated that they would like to see more issues presented in this way.

Useful suggestions were also made for including more information on costs, sources of information, political considerations, and views of the various interest groups. The criticisms dealt primarily with the inconvenient location of the terminals and the presence of some bias in the program.     

An introduction to the Millennium Project

The pace, complexity, and globalization of change requires attention to the future. The change of millennia — the coming of the year 2001 — provides an opportunity, a psychological focus, for a global review of past achievements and problems and a unique chance to assess and reflect on future issues and opportunities.Unfortunately, there is as yet no mechanism or information utility to support a worldwide effort to study past achievements and problems or future issues and opportunities. Although there are many individual, isolated, special purpose, and one-time study efforts underway, there is no international system that can provide coherence or continuity to these studies, including feedback and sharing of information, and, in particular, the systematic exploration of future possibilities and policy alternatives. With growing interest in the future, the spread of instantaneous and global communications, the advent of powerful new nondeterministic modeling techniques, the ability to evoke, capture, and share information and perceptions with systematic questioning techniques and software, the proliferation of data bases, and knowledge visualization, it is now possible for futurists, scholars and others around the world to interact globally and take a fresh look at the future possibilities and policies in ways not previously possible.As the World Bank provides an ongoing system for research and feedback to improve economic policy, so too the United Nations University could provide an ongoing system for the improvement of futures research and its application to the policy process. According to a series of interviews, questionnaires, and meetings with leading futurists and scholars around the world, the proposed “Millenium Project” has the potential to become such a system.This study had as its principal objective determining the design of an information system that could effectively tap contributors, worldwide, to focus on lessons of the past that bear on world issues and the potential of future developments for intensifying or mitigating these and future issues. The first phase of the feasibility study was both methodological and substantive. Worldwide panels of experts contributed their judgments about the method or process of organizing the project; and the system that emerged from this interaction was applied in a prototype study to the issues of growing world population and the environment.During the first phase of the feasibility study, we found that:

1. 1. The Millennium Project is feasible and likely to be helpful to many institutions in examining and resolving policy issues at several levels. An overview of the project design and objectives appears in Section 2 of this article.

2. 2. Organizations that have an issues scanning function, or have a mandate to keep abreast of a broad range of futures thinking, have a need for access to a non-political, scholarly, and international system of future studies. Such organizations have requested continued participation in the second and third phase of this feasibility study, as well as establishing formal relations with the full Millennium Project.

3. 3. While several questions remain, the design features of a system to collect judgments using the Delphi process that were suggested by the international panel (outlined elsewhere in this report) form a straight forward operational system. Among the remaining questions are the design and use of international information systems and data bases, integration with quantitative techniques such as system modeling, the requirements for special study teams, and institutionalization and financial support. The design of the operational system is described in detail in Section 3 of this report.

4. 4. Cost estimates have been made for establishing international panels and collecting and analyzing information they provide using the Delphi process. Several assumptions are required. If a maximum of four topics are addressed in a particular year, each of the four panels consists of 150–200 people, the staff is kept to a base of three people with an additional 1.5 per panel, and advisors are paid an honorarium of $1.500, then the cost of this element of the full scale Project is likely to be approximately $900,000 per year. While communications modes are important in terms of timing and information access, the costs of communications are the smallest of the Project's cost elements. Detail of our cost estimates appear in Section 7 of this report.

This is not the final feasibility study report, but only a report on part of Phase I. As such, it contains our initial findings about how the Project might be organized. We welcome comments from the reader. Please consider this as work in progress.     

Regulation of a Risk Averse Firm

We extend the Laffont–Tirole regulation model to the case of risk-averse firms. Our main results are:

• The impact of risk aversion is to shift the optimal contract toward a cost-plus contract.

• As compared with the risk-neutral case, distortions are greater and informational rents are smaller.

• For high levels of risk aversion, the optimal contract involves cost ceilings and the less efficient firms are bunched together.

Journal of Economic LiteratureClassification Numbers: D8, L5.     

Term limits and pork barrel politics

We develop a dynamic model of democratic politics in which both potential office holders and the electorate have heterogeneous ideologies. Voters have incomplete information about candidate ideologies, so they must use information from previous positions taken in office to make informed re-election decisions. We characterize the effects of term limits on the evolution over time of the ideological positions taken by office holders and derive the implications for voter choice and welfare. Contributions of our paper include:

•

We detail how pork provision by more senior incumbents interacts with term limits to affect electoral outcomes. Pork provision—transfers of resources from districts with junior legislators to districts with more senior legislators—induces voters to be more forgiving of extreme location by incumbents, especially incumbents in small or poor districts. Pork provision can explain why re-election probabilities in Congress exceed those for governors.

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Term limits reduce voter welfare when all that matters are the ideological positions taken by the office holder.

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Term limits may be advantageous when senior incumbents can extract benefits for their constituencies at the expense of districts with more junior representatives. Large or rich districts especially value term limits when there is substantial pork provision.

•

We characterize the welfare of all voters, not just the median voter.

     

Evaluating the accessibility of essential medicines in China

Objective: To evaluate the accessibility of essential medicines in China through a new system which integrated the structure, process, and effect of the National Essential Medicine Policy (NEMP).

Methods: A structural equation model was built to verify the reliability of the evaluation system. This study utilized the Delphi method to obtain the structure and process index data, and used the WHO/HAI standard method for the effect index data to evaluate the NEMP. Six regions were selected for empirical analysis so that suggestions for optimization could be put forward.

Results: The structural equation model consisted of three parts: organization structure, executive process, and effect. The factor loading of the three indicators exceeded 0.5, indicating that this model complied with the preliminary fit criteria. In the organizational structure, rules and regulations and resource investment accounted for a large proportion, indicating that they had a great impact on the effect. As for the executive process, the weight of the seven indicators were similar, and they accounted for a large proportion, indicating that each indicator had a non-negligible impact on the effect. The “p” of all the three hypothesizes was less than .01, especially the “p” of hypothesis 3 was less than .001, indicating that the structure and process of NEMP affected the accessibility of the essential medicines, and three components of the model were positively correlated.

Limitations: Some errors may exist in achieving appropriate expert selection because of potential researcher bias in the Delphi approach. The results from only six provinces in China may not be generalized nationwide.

Conclusion: The structural indicators and process indicators have a significant impact on outcome indicators, and they also have correlations. That is, the formulation and implementation of the national drug policy and related supporting measures play an important role in improving the accessibility of essential medicines.     

The research strategy in management of technological innovation

The increasing importance of technology in the application world has imposed high demand on the research community for insightful and useful principles about “management of technological innovation” (MTI). This paper examines the academic legacy in terms of conceptual categories, causal relationships and taxonomy of relevant systems, and asserts from a system perspective that MTI as an applied science is still in its infancy.Based on methodological argument, this paper warns of the danger of hasty compromise of strategically important topics to “popular” definition of “researchability,” and suggests several research guidelines and approaches for this young interdisciplinary discipline:

1. (1)To explore new frontiers, use “proximate variables,” consider contextual factors and causation in broad terms, conceptualize “independently,” and pay more attention to case study method.

2. (2)To understand driving forces, be aware of practice, and focus on internal dynamics.

3. (3)To transcend complexity, adopt a hierarchical structure perspective and state-and-flow concept, and condense findings into configurations.

Finally, this paper urges the formation of an overall research strategy to accelerate the accumulation of MTI grounded knowledge.     

Individual monotonicity and the leximin solution

Summary. Most axiomatic treatments of bargaining do not give a substantive role to individually irrational points. We show in this paper that it can matter greatly whether axioms and solutions are formulated with respect to the entire feasible set or with respect to only the individually rational portion. In particular, a principle of individual monotonicity becomes much more powerful when all feasible points are considered. We characterize the n-person Leximin solution as the only solution that satisfies Pareto efficiency, symmetry, individual monotonicity, and independence of individually irrational points.     

When does economic model type become a decisive factor in health technology appraisals? Learning from the expanding treatment options for relapsing–remitting multiple sclerosis

Objectives: Specific economic model types often become de facto standard for health technology appraisal over time. Markov and discrete event simulation (DES) models were compared to investigate the impact of innovative modeling on the cost-effectiveness of disease-modifying therapies (DMTs) in relapsing–remitting multiple sclerosis (RRMS). Fingolimod was compared to dimethyl fumarate (DMF; in highly active [HA] RRMS), alemtuzumab (in HA RRMS) and natalizumab (in rapidly evolving severe RRMS). Comparator DMTs were chosen to reflect different dosing regimens.

Materials and methods: Markov and DES models used have been published previously. Inputs were aligned in all relevant respects, with differences in the modeling of event-triggered attributes, such as relapse-related retreatment, which is inherently difficult with a memoryless Markov approach. Outcomes were compared, with and without different attributes.

Results: All results used list prices. For fingolimod and DMF, incremental cost-effectiveness ratios (ICERs) were comparable (Markov: £4206/quality-adjusted life year [QALY] gained versus DES: £3910/QALY gained). Deviations were observed when long-term adverse events (AEs) were incorporated in the DES (Markov: £25,412 saved/QALY lost, versus DES: £34,209 saved/QALY lost, fingolimod versus natalizumab; higher ICERs indicate greater cost-effectiveness). For fingolimod versus alemtuzumab, when relapse-triggered retreatment was included in the DES, large cost differences were observed (difference between incremental cost is £35,410 and QALY is 0.10).

Limitations: UK payer perspective, therefore societal approach was not considered. Resource utilization and utilities for both models were not derived from the subpopulations; as the focus is on model type, input limitations that apply to both models are less relevant.

Conclusions: Whilst no model can fully represent a disease, a DES allows an opportunity to include features excluded in a Markov structure. A DES may be more suitable for modeling in RRMS for health technology assessment purposes given the complexity of some DMTs. This analysis highlights the capabilities of different model structures to model event-triggered attributes.     

A systematic review of cost-effectiveness modeling of pharmaceutical therapies in neuropathic pain: variation in practice,key challenges,and recommendations for the future

Objectives: Complexities in the neuropathic-pain care pathway make the condition difficult to manage and difficult to capture in cost-effectiveness models. The aim of this study is to understand, through a systematic review of previous cost-effectiveness studies, some of the key strengths and limitations in data and modeling practices in neuropathic pain. Thus, the aim is to guide future research and practice to improve resource allocation decisions and encourage continued investment to find novel and effective treatments for patients with neuropathic pain.

Methods: The search strategy was designed to identify peer-reviewed cost-effectiveness evaluations of non-surgical, pharmaceutical therapies for neuropathic pain published since January 2000, accessing five key databases. All identified publications were reviewed and screened according to pre-defined eligibility criteria. Data extraction was designed to reflect key data challenges and approaches to modeling in neuropathic pain and based on published guidelines.

Results: The search strategy identified 20 cost-effectiveness analyses meeting the inclusion criteria, of which 14 had original model structures. Cost-effectiveness modeling in neuropathic pain is established and increasing across multiple jurisdictions; however, amongst these studies, there is substantial variation in modeling approach, and there are common limitations. Capturing the effect of treatments upon health outcomes, particularly health-related quality-of-life, is challenging, and the health effects of multiple lines of ineffective treatment, common for patients with neuropathic pain, have not been consistently or robustly modeled.

Conclusions: To improve future economic modeling in neuropathic pain, further research is suggested into the effect of multiple lines of treatment and treatment failure upon patient outcomes and subsequent treatment effectiveness; the impact of treatment-emergent adverse events upon patient outcomes; and consistent and appropriate pain measures to inform models. The authors further encourage transparent reporting of inputs used to inform cost-effectiveness models, with robust, comprehensive and clear uncertainty analysis and, where feasible, open-source modeling is encouraged.     

Structural models, information and inherited restrictions

The derived structural estimates of the system βY = γZ + δU impose identifying restrictions on the reduced form estimates ex post. Some or all of the derived structural estimates are presented as evidence of the model's efficacy. In fact, the reduced form inherits a great deal of information from the structure's restrictions and hypothesized sign patterns, limiting the allowable signs for the reduced form. A method for measuring a structural model's statistical information content is proposed. Further, the paper develops a method for enumerating the allowable reduced form outcomes which can be used to falsify the proposed model independently of significant coefficients found for the structural relations.     

Belief-free equilibria in games with incomplete information: Characterization and existence

We generalize the results of Hörner and Lovo (2009) [15] to N-player games with arbitrary information structure. First, we characterize the set of belief-free equilibrium payoffs under low discounting as the set of feasible payoffs that are individually rational, jointly rational, and incentive compatible. Second, we provide necessary and sufficient conditions on the information structure for this set to be non-empty.     

Capital–labor substitution and balanced growth

This paper explores how different values of the elasticity of substitution between capital and labor (σ) impact on the balanced growth paths and growth potential of a country in exogenous growth models. The behavior of the system depends on the value of σ and the passage of σ through two critical values causes a qualitative change in the nature of the singular points and of its trajectories. The balanced growth path defined by a singular point in the form of a saddle-path exists and is locally stable if σ lies between two critical values.     

A new methodology for anticipating STEEP surprises

In technological forecasting and futures research on social change, the term wild card (a.k.a. disruptor or STEEP surprise), traditionally refers to a plausible future event that is estimated to have low probability but high impact should it occur.This article introduces:

1.

A Type II Wild Card, defined as having high probability and high impact as seen by experts if present trends continue, but low credibility for non-expert stakeholders of importance.

2.

A four-level typology of wild cards, leading to a systematic methodology for monitoring the emerging awareness and credibility of high probability disruptors and for assessment of stakeholder-specific views about them.

An informal pilot test of the methodology both indicated that the approach has practical value, and highlighted the importance of highly plausible tipping points which could rapidly lead to massive disruption, either toward collapse or reformation in the complex adaptive systems (CAS) making up human civilization.For reasons of historical continuity, wild card-related nomenclature is used throughout the majority of this article although the term STEEP Surprise is advocated for further work. (STEEP being a frequently used acronym denoting five conceptual sectors of importance.)Suggestions for further work include:

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Research on how to diminish the discounting of Type II phenomena by institutional leaders

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Monitoring of transitions in the perceived credibility of critical Type II STEEP Surprises by thought leaders

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A Snowball Survey of wisdom leaders having multidisciplinary expertise from all walks of life to identify specific Type II possibilities (especially positive ones), they see as having greatest importance

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A Cooperative Clearinghouse on STEEP Surprises for sharing of intelligence on highly probable/highly disruptive events, together with plausible impacts and proactive policies.

     

企业协同创新风险与创新绩效关系实证研究

在科技信息化和经济全球化的今天,协同创新成为企业生存和发展的必然选择。在已有研究基础上,总结出企业协同创新的5类风险,即合作主体风险、信息风险、利益风险、结构风险、环境风险,探究企业协同创新风险与创新绩效之间的关系,并基于京津冀地区206家高技术企业的问卷调研数据,运用结构方程模型对企业协同创新风险与创新绩效之间的关系进行实证分析。结果表明：①合作主体风险、信息风险、利益风险、结构风险、环境风险均与企业创新绩效呈负相关关系;②不同风险对创新绩效的影响程度有所差别,其中信息风险和利益风险对企业协同创新绩效的影响更为显著。     

PRICE STATISTICS REQUIRED BY DEVELOPING COUNTRIES FOR NATIONAL ACCOUNTING PURPOSES

In both developed and developing countries, the national accounting statistician who wishes to establish a composite set of values in current and base year prices is faced with a series of difficulties arising from a lack of indicators which are adequate for relating quantities and values within the national accounting framework. Consequently, ad hoc solutions are extensively adopted and use is made of price data which in the majority of cases have been collected for completely different purposes. The inter-relationship of prices, quantities and values fundamental to the compatibility of the national accounts can therefore be, and often is, a rather tenuous one. In the case of many developing countries, the situation is accentuated by a very volatile behaviour of prices, a greater impact of price change and a much greater scarcity of useable statistical material. In addition, since structural change is frequently implicit in a development process, the pattern of values and of prices is often variable and irregular—this in turn creates problems in determining relative importance, in assigning weights and in imputing for prices of items not directly entering into the calculation of the indicators.
This paper analyses the series which are most commonly available, it points out the major deficiencies or limitations and it attempts to formulate a few guide-lines for determining priorities called for in an integrated network of price statistics.     

The cost-effectiveness of dulaglutide versus insulin glargine for the treatment of type 2 diabetes mellitus in Japan

Aims: Dulaglutide is a new once weekly glucagon-like peptide-1 (GLP-1) receptor agonist administered via a disposable auto-injection pen for the management of type 2 diabetes mellitus (T2DM). The objective of this study was to estimate the cost-effectiveness of dulaglutide vs insulin glargine for the management of T2DM from a Japanese healthcare perspective, in accordance with recently approved Japanese Cost-Effectiveness Guidelines.

Methods: The IQVIA CORE Diabetes Model (version 9) was used to estimate the long-term costs and effects of treatment with dulaglutide and insulin glargine. Direct comparative data from the Araki 2015 trial (NCT01584232) was used to inform the analysis. Costs associated with treatment and complications were derived from Japanese sources wherever possible and inflated to 2015 Japanese Yen (JPY). Utilities were based upon a European systematic review of diabetes utilities and adjusted for use in a Japanese population. One-way and probabilistic sensitivity analyses (OWSA and PSA) were conducted on all inputs and key modeling assumptions.

Results: Dulaglutide 0.75?mg was associated with higher quality-adjusted life years (QALYs), life years (LYs), and total costs, compared to insulin glargine, resulting in an incremental cost-effectiveness ratio (ICER) of 416,280 JPY/QALY gained. Treatment with dulaglutide increased the time alive and free from diabetes-related complications by 4 months. OWSA and PSA indicated that results were robust to plausible variations in input parameters and modeling assumptions.

Limitations: Key limitations of this study are similar to other cost-utility analyses of diabetes, including the extrapolation of short-term clinical trial data into lifelong durations. In addition, due to the lack of robust published Japanese data, some values were derived from non-Japanese sources.

Conclusions: This analysis suggests that dulaglutide 0.75?mg may be a cost-effective treatment alternative to insulin glargine for patients with T2DM in Japan.     

Exact equivalence of instrumental variable estimators in an error component structural system

The paper establishes an equivalence result in the context of anm-equation error component structural system, whose disturbances have the usual three-component structure, and whose equations feature explanatory variables of the formz _i, z_t andz _it; the latter vary (respectively) only over individuals, only over time, and over both. Under the stochastic specification assumed, it is shown that the alternative instrumental variables (IV) estimators commonly used in the special cases of this system are all equivalent (numerically identical); the result is a generalization of the equivalences established previously for the special cases. In the single equation (m=1) context, the equivalence requires that the IV set contain variables of the formz _i and/orz _t, and further, in numbers determined by the ranks of (respectively) the individuals-mean and time-mean matrices of the instruments. If such an IV set is common to all equations, the equivalence also holds for the system under joint estimation. The result is used to recommend a couple of estimators for use in panel data, on grounds of computational simplicity.This is a revision of the December 1990 draft with the same title, and is a substantial revision of the April 1990 version entitled: Analysis of an error component structural system. This revision has benefited from comments received from a referee and a editor of this journal. I came to know from an anonymous reader that the equivalence criterion developed in my 1990 a article, used here and the two earlier versions, was infact obtained previously in an unpublished paper by Balestra (1988). Balestra's paper, which was made available to me by Badi Baltagi at the time of this revision, and subsequently by Balestra, considers the equivalence of ^b, ^c and one other estimator which differs from our ^a. Errors, if any, are my responsibility.     

Network structure and industrial dynamics. The long-term evolution of the aircraft-engine industry

This paper proposes a new approach to explain the long-term evolution of a supplier industry. The network of vertical relations between suppliers and buyers is identified as a determinant of the concentration of the supplier industry and of the dynamics of market shares. The vertical structure of the industry is captured by collecting information on all vertical relations between dyads of firms and by building matrices of interaction for the aircraft-engine industry from 1953 to 1997. An econometric exercise is used to test some hypotheses about the relation between selected network measures and industrial dynamics.     

Budget impact of managing cow milk allergy in the Netherlands

Objective: To assess the resource implications and budget impact of managing cow milk allergy (CMA) in the Netherlands from the perspective of the healthcare insurers.

Methods: A model was constructed depicting the management of CMA in the Netherlands using information obtained from interviews with youth healthcare doctors (n = 14), general practitioners (n = 6) and paediatricians (n = 11) with relevant clinical experience of managing CMA. The model was used to estimate the expected level of healthcare resource use and corresponding cost (at 2007/08 prices) attributable to managing 4,382 new CMA sufferers.

Results: The expected cost of healthcare resource use attributable to managing 4,382 new CMA sufferers up to 1 year of age following initial consultation with a community-based physician at a mean 3 months of age was estimated to be €11.28 (95% CI: €7.82; €14.33) million. Clinical nutrition preparations emerged as the primary cost driver accounting for 91% of the total cost and clinician visits collectively accounted for a further 5%. The time taken for CMA sufferers to be put on an appropriate diet and achieve symptom resolution was estimated to be 30 (95% CI: 27; 32) days. Sensitivity analysis showed that the costs would increase by ～16% if all new CMA sufferers were to undergo a double-blind placebo-controlled cow milk challenge in a hospital setting, as is currently being proposed. It is not clear how this proposal would affect time to symptom resolution since this would depend on the efficiency of hospitals being able to deal with the increased workload.

Limitations: The intolerance rates were derived from a 1-year follow-up study among 1,000 infants with CMA in the UK, healthcare resource use was not collected prospectively and the study period was censured at 1 year of age and does not consider the impact of CMA in subsequent years. However, most children outgrow this form of allergy during their second year.

Conclusion: Within the model's limitations, CMA imposes a substantial burden on the Dutch healthcare system. Moreover, initiating a double-blind placebo-controlled cow milk challenge for all CMA sufferers will potentially increase clinicians’ workload and use of limited resources within paediatric hospital departments in the Netherlands.