Quantifying public preferences for agri-environmental policy in Scotland: A comparison of methods

This paper compares two methods for determining policy priorities for reform of Scottish agricultural support. Multifunctional agriculture attempts to establish a new balance between traditional commodity support and payment for the production of non-market goods and services that are increasingly demanded by the public. Supplying non-market goods presents particular problems for optimal policy design, not least the elicitation of consumer demand for those goods. From public focus groups, a range of attributes was derived as central to the Scottish public’s preferences for future agri-environmental reform. This information was then combined in two separate survey methods using the Analytical Hierarchy Process (AHP) and choice experiments (CE). Both applications suggest that the public has defined preferences and a willingness to pay (using general income taxation) to affect changes beyond the status quo, and that policy payments should be targeted towards both environmental and social benefits. The divergent preference orderings derived from the alternative methods can be considered in the light of previous methodological debates on question framing, bounded rationality and respondent uncertainty. We speculate about the validity of alternative methodologies for informing particular policy questions.     

Transparency and trust in the European pharmaceutical sector: outcomes from an experimental study

Many European pharmaceutical regulators have committed to a more open, inclusive, and transparent model of regulatory decision-making in recent years. Yet, based on little empirical evidence, they have overwhelmingly adopted ‘fishbowl’ transparency measures, ‘the full disclosure of information without explanatory information or contextualization’ (e.g. heightening access to raw data). This paper conveys recent findings from an open-ended questionnaire with 200 face-to-face interviews carried out in the UK and the Netherlands. The study provides evidence on how members of the public are likely to react to ‘fishbowl’ transparency policies and receiving decontextualized data. After showing respondents raw data from a periodic safety update report that regulators are proposing to proactively release, the survey found they were shocked, concerned, and more worried, while many said they would reconsider taking their medicines and seek further advice. Based on these findings, the authors argue that enhancing ‘transparency’ needs to be integrated with effective, evidence- and science-based benefit/risk communication.     

Adherence,persistence, and inpatient utilization among adult schizophrenia patients using once-monthly versus twice-monthly long-acting atypical antipsychotics

Aims: This study compared healthcare resource utilization (HRU), healthcare costs, adherence, and persistence among adult patients with schizophrenia using once-monthly (OM) vs twice-monthly (TM) atypical long-acting injectable (LAI) antipsychotic (AP) therapy.

Materials and methods: A longitudinal retrospective cohort study was conducted using Medicaid claims data from six states. Patients initiated on aripiprazole or paliperidone palmitate were assigned to the OM cohort; risperidone-treated patients were assigned to the TM cohort. HRU and healthcare costs were assessed during the first 12 months following stabilization on the medication. Adherence was measured using the proportion of days covered (PDC) during the first year of follow-up. Persistence to the index medication was measured during the first 2 years following the index date. Comparison between the cohorts was achieved using multivariable generalized linear models, adjusting for demographic and clinical characteristics.

Results: Patients in the OM LAI cohort had lower inpatient HRU and medical costs when compared with patients in the TM cohort. Higher medical costs in the TM LAI cohort offset the higher pharmacy costs in the OM LAI cohort. Mean PDC during the first 12 months of follow-up was higher in the OM cohort than in the TM cohort (0.56 vs 0.50, p?<?.01). Median persistence was longer in the OM cohort than in the TM cohort (7.5 months vs 5.5 months), as was the hazard of discontinuing the index medication (hazard ratio?=?0.83, p?=?.01). Kaplan-Meier rates of persistence at 1 year were higher for OM patients than for TM patients (37.6% vs 29.6%, p?<?.01).

Limitations: This was a Medicaid sample with few aripiprazole LAI patients (5.4% of OM cohort). Medication use was inferred from pharmacy claims.

Conclusions: Among Medicaid patients in these six states, OM AP treatment was associated with lower HRU, better adherence and persistence, and similar total costs compared to patients on TM treatment.     

The economic burden of psoriasis with high comorbidity among privately insured patients in the United States

Objective: To evaluate the impact of comorbidities on healthcare resource use (HRU), and direct and indirect work-loss-related costs in psoriasis patients.

Methods: Adults with psoriasis (≥2 diagnoses, the first designated as the index date) and non-psoriasis controls (no psoriasis diagnoses, randomly generated index date) were identified in a US healthcare claims database of privately-insured patients (data between January 2010 and March 2017 were used). Psoriasis patients were stratified based on the number of psoriasis-related comorbidities (0, 1–2, or ≥3) developed during the 12?months post-index. All outcomes were evaluated during the follow-up period, spanning the index date until the end of continuous health plan eligibility or data cut-off. HRU and costs per-patient-per-year (PPPY) were compared in psoriasis and non-psoriasis patients with ≥12?months of follow-up.

Results: A total of 9,078 psoriasis (mean age?=?44?years, 51% female) and 48,704 non-psoriasis (mean age?=?41?years, 50% female) patients were selected. During the 12?months post-index, among psoriasis vs non-psoriasis patients, 71.0% vs 83.0% developed no psoriasis-related comorbidities, 26.3% vs 16.0% developed 1–2, and 2.6% vs 1.0% developed ≥3 psoriasis-related comorbidities. Compared to non-psoriasis patients, psoriasis patients had more HRU including outpatient visits (incidence rate ratios [IRRs]?=?1.52, 2.03, and 2.66 for 0, 1–2, and ≥3 comorbidities, respectively [all p?p?p?p?Conclusions: HRU and cost burden of psoriasis are substantial, and increase with the development of psoriasis-related comorbidities.     

The regional and global competitiveness of multinational firms

International competitiveness ultimately depends upon the linkages between a firm’s unique, idiosyncratic capabilities (firm-specific advantages, FSAs) and its home country assets (country-specific advantages, CSAs). In this paper, we present a modified FSA/CSA matrix building upon the FSA/CSA matrix (Rugman 1981). We relate this to the diamond framework for national competitiveness (Porter 1990), and the double diamond model (Rugman and D’Cruz 1993). We provide empirical evidence to demonstrate the merits and usefulness of the modified FSA/CSA matrix using the Fortune Global 500 firms. We examine the FSAs based on the geographic scope of sales and CSAs that can lead to national, home region, and global competitiveness. Our empirical analysis suggests that the world’s largest 500 firms have increased their firm-level international competitiveness. However, much of this is still being achieved within their home region. In other words, international competitiveness is a regional not a global phenomenon. Our findings have significant implications for research and practice. Future research in international marketing should take into account the multi-faceted nature of FSAs and CSAs across different levels. For MNE managers, our study provides useful insights for strategic marketing planning and implementation.     

Seeds of distrust: conflict in Uganda

We study the effect of civil conflict on social capital, focusing on Uganda’s experience during the last decade. Using individual and county-level data, we document large causal effects on trust and ethnic identity of an exogenous outburst of ethnic conflicts in 2002–2005. We exploit two waves of survey data from Afrobarometer (Round 4 Afrobarometer Survey in Uganda, 2000, 2008), including information on socioeconomic characteristics at the individual level, and geo-referenced measures of fighting events from ACLED. Our identification strategy exploits variations in the both the spatial and ethnic intensity of fighting. We find that more intense fighting decreases generalized trust and increases ethnic identity. The effects are quantitatively large and robust to a number of control variables, alternative measures of violence, and different statistical techniques involving ethnic and spatial fixed effects and instrumental variables. Controlling for the intensity of violence during the conflict, we also document that post-conflict economic recovery is slower in ethnically fractionalized counties. Our findings are consistent with the existence of a self-reinforcing process between conflicts and ethnic cleavages.     

Key research themes on governance and sustainable urban mobility

ABSTRACT

This article discusses the governance of sustainable urban development and in particular assesses the role of policy instruments to promote soft forms of governance associated with persuasion and coordination. These instruments are critically examined in terms of how they might help to promote greater policy integration and more sustainable development. Five types of strategies for promoting more sustainable transport policies are discussed: (1) policy indicators and targets, (2) benchmarking, (3) policy transfer and best practices, (4) policy experimentation/innovation, and (5) visioning/envisioning. The article is divided into four main parts. First, it presents an overview of recent trends in the governance of urban transport. Second, it examines the notion of policy integration, a central theme in discussions about sustainable transport and governance. Third, it considers how selected types of policy instruments might contribute to policy integration and sustainable urban development. Fourth, alongside the conclusions, suggestions are made for new research related to policy instruments and soft forms of governance in relation to urban transport.     

The Single Tax Movement and Progressivism, 1880-1920*

Abstract . Henry George's Single Tax movement and the Progressive movement in the United States were inter-related. After the publication of Progress and Poverty a political movement developed around George. It failed, partly because George was a poor politician although he had proved a master-publicist, partly because he aroused a formidable opposition. Nevertheless the single taxers did contribute to progressive reform a specific plan for manipulating the environment in a Social Darwinistic way. George's philosophy also rejected socialism in favor of a reformed and purified capitalism—perhaps the most important theme in 20th century reform thought in America. Moreover, the Single Tax movement contributed to the democratic reform movement such leaders as Tom L. Johnson, Brand Whitlock, Louis F. Post, Frederic C. Howe, George L. Record, Newton D. Baker and Franklin K. Lane.