This paper aims to asses the transformational impact of EU integrations and e-government on the structure of government and its effectiveness and efficiency. Two examples that are used for the purpose of analysis are the Ministry of Science, Education and Sports and the government agencies that cooperate with it, and the Ministry of Finance, Tax Administration. The first is an example of the agencification model that was stimulated by European integrations in the period from 2001-2009, mainly in order to decentralize decision making and governing of the EU funds. The other example is the cash fiscalization process of Tax Administration, that was stimulated by the processes that started from 2010-2012 and are connected with the need to react to the economic crisis with the onset in 2008 that continued to the present. This process is the opposite to the first one, as it is not the process of decentralization of fund distribution, but of centralization of collection of funds, that is based on cash accounting, not accrual accounting. It can be shown that both processes were stimulated by European integrations and EU fund management, i.e. by the need to increase the collection of funds by governmnet taxing in order to meet the requirements for EU fund programmes and in order to implement European values and reduce corruption. This process is blocked by the lack of trust of citizens in government and the unequal redistribution of collected funds.
Do adolescents have the decisional capacity of adults? Or, are they in crucial ways still immature, that is, are they deficient decisionmakers? This question has been answered in quite different ways in medical versus criminal law. In medical law, an exception from the requirement of parental consent was crafted to allow adolescents to make decisions in restricted circumstances associated with quasi-medical emergencies. Over the last few decades, this exception has grown into an almost blanket acceptance of the decisional capacity of adolescents under the age of 18 and generally over the age of 14 to give valid consent to treatment. At the same time, a seemingly contrary view of the decisional capacity of minors developed in American criminal law, especially around cases such as Eddings v. Oklahoma (1982), Johnson v. Texas (1993), Roper v. Simmons (2005), Graham v. Florida (2010), Jackson v. Hobbs (2012), and Miller v. Alabama (2012). These Supreme Court decisions recognize adolescents as having a substantive lack of maturity and an underdeveloped sense of responsibility that distinguishes adolescents from adults. The Court in Graham v. Florida (2010) noted, for example, that âdevelopments in psychology and brain science continue to show fundamental differences between juvenile and adult minds . . . [in] parts of the brain involved in behavior controlâ (560 U.S., at __ [slip op., at 17]). The result is that courts have accepted the view that the decisional capacity of adolescents is not fully developed and that as a consequence adolescents cannot have the same degree of criminal culpability as adults. In evaluating the decisional capacity of minors, one thus faces the challenge of how to harmonize these two quite different trends in the assessment of adolescent decision making. This issue of The Journal of Medicine and Philosophy brings together psychological and neurophysiological data with philosophicalâbioethical reflections on what should count as decisional capacity or decisional agency. Some of the articles address as well the issue of the authority of parents over their children and how this bears on the question of whether adolescents under the age of 18 should generally make medical decisions without the involvement of their parents. The conclusions one reaches on these matters regarding adolescent decisional capacity and parental authority will determine the concrete character of medical law and public policy. In particular, it will determine whether the default position should be that of presuming that minors over the age of 14 do or do not possess decisional capacity equivalent to that of adults. Where one places the burden of proof will also turn on empirical data regarding the contribution of authoritative, even authoritarian, parenting to the successful maturation of minors into adults, for this will give a further indication of the importance of parental involvement. This issue of The Journal of Medicine and Philosophy opens with a paper from a psychologist who has been involved in developing briefs to the Supreme Court (Miller, 2012) that have influenced holdings that recognized the diminished legal culpability of adolescents (Miller v. Alabama, 2012). Laurence Steinberg in his article âDoes Recent Research on Adolescent Brain Development Inform the Mature Minor Doctrine?â argues that, because adolescents are less mature than adults, when making decisions characterized by emotional arousal and peer pressure as when committing crimes, culpability is diminished (Steinberg, 2013). However, Steinberg also argues that recent studies of the adolescent brain and of behavioral development do not undermine the mature minor doctrine. Instead, the data indicate important ways in which the doctrine should be applied. First, Steinberg stresses the difference between adolescents and children, making plausible the old rule of 7âs (i.e., infants under 7 years, children 7â14, and adolescents over 14). He holds that adolescents in the right circumstances have decisional capacity equivalent to that of adults. Second, Steinberg takes the view that healthcare practitioners can enhance the ability of adolescents to make informed and knowledgeable decisions by being involved in the decisional process and by creating a context that circumscribes impulsive decision making (i.e., decision making that does not take into account long-term as well as short-term consequences of alternative courses of action). Thus, given peer pressure and circumstances in which impulsive decision making is not counteracted, adolescents lack adult decisional capacity and, therefore, adult culpability with regard to criminal acts. However, Steinberg argues that in the context of most medical decision making, adverse influences on the decisional capacity of minors can be counteracted so that adolescents can function as mature minors. In contrast, Evan Wilhelms and Valerie Reyna advance grounds to restrict the mature minor exception to quasi-emergency situations. They come to this decision because they find a more fundamental qualitative difference between adolescent and adult decision making. In âFuzzy Trace Theory and Medical Decisions by Minors: Differences in Reasoning between Adolescents and Adults,â they report data that show that it is not merely impulsive behavior or even the failure of adolescents to take into account long-term as well as short-term consequences that makes adolescents bad decisionmakers (Wilhelms and Reyna, 2013). More importantly, it is their failure to grasp the gist of what is at stake in making a decision. Wilhelms and Reyna develop their argument through engaging âfuzzy trace theoryâ: Fuzzy trace theory (FTT) is a comprehensive theory of reasoning, judgment, and decision-making that integrates the prior standard reactive model with documented cognitive developmental differences to explain risk-taking behavior in adolescents. . . . According to FTT, deliberative, analytic reasoning and impulsive reactivity are distinct routes to risk taking, and, surprisingly, the former accounts for a great deal of risk-taking in adolescence. . . . Thus, adolescents are not just more emotional and impulsive than adults; their understanding of the gist of such decisions is not mature. (Wilhelms and Reyna, 2013, 272) The point is that it is âgist processingâ that appears to be a necessary condition for mature decision making. Even when adolescents can intellectually analyze and lay out long-term as well as short-term consequences of their decisions, they still fail crucially to apprehend what is at stake in the decisions they face. Although adolescents are capable of encoding mathematical probabilities about risks and rewards, they still do not have the mature appreciation for the meaning of those risks and rewards, and their implications for their future adult lives. Put another way, it could be said that some adolescents know âthe price of everything but the value of nothing.â (Wilhelms and Reyna, 2013, 279) Adolescents, in short, differ qualitatively from adult decisionmakers, so that Wilhelms and Reyna âconclude that circumstances in which adolescents are equivalent to consenting adults are unusualâ (Wilhelms and Reyna, 2013, 270). They, therefore, recommend that âif [mature minor] exception is necessary for an emergency situation, the physician or medical experts involved should emphasize the bottom-line gist of risks involved during the process of consent or deciding on treatment optionsâ (Wilhelms and Reyna, 2013, 279). The next essay in this issue, âThe Mature Minor: Some Critical Psychological Reflections on the Empirical Basesâ (Partridge, 2013), takes a position closer to that of Wilhelms and Reyna than to that of Steinberg. This essay concludes that there are grounds to bring into serious question the advisability of exempting minors from parental authority and guidance, save in emergency or quasi-emergency circumstances, given the qualitatively different character of adolescent decision making. These differences are not just due to differences in decisional behavior, such that adolescents tend more than adults to be impulsive decisionmakers, who often inadequately take account of the long-term consequences of their choices and who very frequently fail fully to apprehend the significance of near- and long-range consequences of decisions. In addition, the brains of adolescents are simply different from those of adults. One can through brain imaging literally see the differences. When adolescents make decisions, there is a greater engagement of limbic structures with less of an engagement of prefrontal cortical areas in comparison with adults making the same decisions. These data justify a strong but rebuttable presumption that, in general, minors lack mature decisional abilities, and that they would benefit from the guidance of those who know them well, in particular parents and guardians. A second body of data is also relevant, which shows the importance of effective parenting for the maturation of adolescents (Baumrind, 1989; Adaljarnardottir and Hafsteinsson, 2001; Huver et al., 2007). These findings indicate that one should be more concerned about false positives than false negative determinations of decisional capacity, given the benefits from parental involvement. Here matters are complex, in that the character of the family in the West is changing, with some 41% of children in the United States now being born outside of a traditional marriage (Martin et al., 2011, 2). Any actual approach to adolescents will need frankly to take into account their social context. The papers by Rachelle Barina and Jeffrey Bishop, by Mark Cherry, and by Ana Iltis locate the examination of the mature minor exceptions more explicitly within moral and bioethical concerns. In their paper, âMaturing the Minor, Marginalizing the Family: On the Social Constitution of the Mature Minor, Sexual Politics, and the Family,â Barina and Bishop address the historic and social context in which the formation of the mature minor doctrine develops, and in doing so illustrate the adversarial nature between the goals of the state and the contextual role played by families. Barina and Bishop embed their analysis of this development within a âphenomenological account of the care of the body in the familyâ and its subsequent application to reproductive health policy. They argue that, legally and medically, the concept of the mature minor does not actually depend upon the notion of maturity. Instead, the invocation of the doctrine of âmature minorâ in the context of adolescent reproductive health has become a means to assert better health outcomes for the state. A careful consideration of maturity is unnecessary because contraception is an unqualified good in the case of every teen. Socially destructive and expensive health risks, more than the adolescentâs mature ability to understand and appreciate health information, merit the provision of reproductive health services without parental consent. (Barina and Bishop, 2013, 306) They also argue that the focus on public health to the exclusion of all other factors creates a clear conflict between state interests and parental authority. In so doing, the state is interrupting the conveyance of âthe moral, social, and existential goods that belong to the particular family within which the childâs life-world is formed.â (Barina and Bishop, 2013, 309) Mark Cherry takes a stronger stand against the universal application of the mature minor doctrine in his paper âIgnoring the Data and Endangering Children: Why the Mature Minor Standard for Medical Decision Making Must Be Abandoned.â Unlike Steinberg who is able to reconcile the apparent differences in the medical and legal understanding of adolescent decision making with the neuropsychological evidence, Cherry contends clearly that the mature minor doctrine must be abandoned. In his analysis of the neuropsychological data, Cherry argues in support of the Supreme Courtâs interpretation that adolescents make decisions qualitatively differently than adults. He writes: Current trends in pediatric decision making in support of the âmature minorâ standard constitute moral and legal movement in direct opposite to what the science bearing on the matter demonstrates to be reasonable and the United States Supreme Court judges to be constitutionally appropriate. To put the matter bluntly, the âmature minorâ standard for medical decision making ignores the scientific data and endangers children. (Cherry, 2013, 326) Ana Iltis examines both the decisional capacity of adolescents as well as the authority of parents over their children and the implications this has for adolescents giving consent. In her paper, âParents, Adolescence, and Consent for Research Participation,â Iltis (2013) concludes that adolescents often do not possess a decisional capacity that will allow sufficient appreciation of information so as to be able to give valid consent for participation in research, and indeed for consent to medical treatment generally. In part, she embraces this conclusion because of data that show that, although adolescents understand the information relevant to making a treatment decision, their appreciation or evaluation of reasonable and foreseeable consequences is usually different from that of adults. Here, Wilhelms and Reynaâs reflections through fuzzy trace theory regarding the importance of getting the gist of what is at stake in a decision may be crucial. Iltis advances as well a second claim, a moral one, that minors even if they are mature are still children, and that there are, therefore, strong principled arguments for recognizing parents as being in authority to guide their children. We confront again the complexity of the issues at stake in assessing the status of the mature minor. In controversy are not merely the facts of the matter regarding how adolescents make decisions but also moral and social issues, namely, how we should regard the relationship between children and their parents. The intersection of these two areas of contention compounds the disputes in pediatric bioethics regarding the status of children. The articles in this issue are not unanimous on any point. However, all the authors appear to concur that judgments regarding the decisional capacity of an adolescent will depend on the particular adolescent and the particular context. There are clearly significant variations among persons with respect to decisional capacity. In addition, persons do not take a uniform journey from infancy to mature adulthood. Some persons become mature decisionmakers much earlier than others, while others appear never fully to achieve this status. Sorting matters out will in part require further philosophical reflection on what we want to mean by mature decisionmakers. That is, we will need to reflect on the moral issue as to what characterizes a person who has decisional capacity. Bernat, Culver, and Gert (1981) in reflecting on the definition of death developed a distinction among concepts of death, criteria for death, and tests for death. A concept of death for them is a philosophical issue, a view of what it means to be dead (e.g., loss of personhood). A criterion of death involves an intersection of philosophy and physiology (e.g., a neurological criterion such as the irreversible cessation of all functions of the brain as an indicator of death). Tests for death are the actual diagnostic determinations employed by physicians in declaring death. We will likely need to fashion similar distinctions with regard to competency, so as to be clearer as to what should be compassed by the concept of decisional capacity as well as what should serve as criteria for crucial elements of decisional capacity such as, perhaps, âgist-processing.â We will need as far as possible to determine the necessary and sufficient capacities that can serve as criteria for competent decision making. Then we need to determine what one should look for when making the judgment that a person under the age of 18 but over the age of 14 has decisional capacity. These essays point the way to further work.
Open access
Ethics and Legal Issues in Pediatric Healthcare
Child and Adolescent Health
Child and Adolescent Psychosocial and Emotional Development
We perform a comprehensive measurement analysis of Silk Road, an anonymous, international online marketplace that operates as a Tor hidden service and uses Bitcoin as its exchange currency. We gather and analyze data over eight months between the end of 2011 and 2012, including daily crawls of the marketplace for nearly six months in 2012. We obtain a detailed picture of the type of goods sold on Silk Road, and of the revenues made both by sellers and Silk Road operators. Through examining over 24,400 separate items sold on the site, we show that Silk Road is overwhelmingly used as a market for controlled substances and narcotics, and that most items sold are available for less than three weeks. The majority of sellers disappears within roughly three months of their arrival, but a core of 112 sellers has been present throughout our measurement interval. We evaluate the total revenue made by all sellers, from public listings, to slightly over USD 1.2 million per month; this corresponds to about USD 92,000 per month in commissions for the Silk Road operators. We further show that the marketplace has been operating steadily, with daily sales and number of sellers overall increasing over our measurement interval. We discuss economic and policy implications of our analysis and results, including ethical considerations for future research in this area.
Our research is concerned with the processes of collaboration that are required by organizations as they increasingly adopt more network-like organization structures (Drucker, 1988; Huber, 1984; Malone, Yates, & Benjamin, 1987). We want to understand the kinds of communication that are needed and design information technologies to support them (Boland & Tenkasi, 1995; Boland, Tenkasi, & Te&s;eni, 1994). By network-like organizations we mean those that resemble open systems as described by Hewitt (1985, 1986).Open systems are composed of decentralized, autonomous units, each with different and inconsistent knowledge bases. Open systems are characterized by distributed cognition (Hutchins, 1996; Norman, 1993) in which the task of the organization is achieved by individuals and technologies acting independently within their own domains on parts of the overall problem, but taking each other and their interdependencies into account in their actions. In a network-like, open system organization, coordination emerges within this process of distributed cognition.
In this paper, we present novel constructions of chosen-ciphertext secure (CCA secure) key encapsulation mechanism (KEM) from chosen-plaintext secure (CPA secure) KEM in the standard model. It is already known that CCA secure public key encryption (PKE) can be generically constructed from CPA secure PKE and ((simulation-sound) non-interactive zero-knowledge proof) via the Naor-Yung or Dolev-Dwork-Naor transforms. Thus, one can also immediately construct CCA secure PKE from CPA secure KEM by converting CPA secure KEM into CPA secure PKE and transforming it to be CCA secure PKE. However, such a construction seems redundant since in general PKE is less efficient than KEM and it would be more efficient if we can directly construct CCA secure KEM from CPA secure KEM without intermediating CPA secure PKE. In this work, we propose new variants of the Naor-Yung and Dolev-Dwork-Naor transforms that directly convert CPA secure KEM into CCA secure KEM, and show that our proposed schemes are more efficient than the above straightforward constructions. For example, when instantiating from the decision linear assumption, ciphertext size of our Naor-Yung variant consists of 34 group elements while that of the straightforward construction consists of 47 group elements. Furthermore, we also propose another variant of the Dolev-Dwork-Naor transform from multiple KEM and show that a KEM which is obtained from Wee's extractable hash proof system can also be considered as an efficient construction of multiple KEM.
In a recent paper at Asiacrypt'2012, Jain et al point out that Veron code-based identification scheme is not perfect zero-knowledge. In particular, this creates a gap in security arguments of proof of plaintext knowledge (PPK) and verifiable encryption for the McEliece public key encryption (PKE) proposed by Morozov and Takagi at ACISP'2012. We fix the latter result by showing that PPK for the code-based Niederreiter and McEliece PKE's can be constructed using Stern zero-knowledge identification scheme, which is unaffected by the above mentioned problem. Since code-based verifiable encryption uses PPK as a main ingredient, our proposal presents a fix for the McEliece verifiable encryption as well. In addition, we present the Niederreiter verifiable encryption.
The Bitcoin network of decentralized payment transactions has attracted a lot of attention from both Internet users and researchers in recent years. Bitcoin utilizes a peer-to-peer network to issue anonymous payment transactions between different users. In the currently used Bitcoin clients, the full transaction history is available at each node of the network to prevent double spending without the need for a central authority, forming a valuable source for empirical research on network structure, network dynamics, and the implied anonymity challenges, as well as guidance on the future evolution of complex payment systems. We found dynamical effects of which some increase anonymity while others decrease it. Most importantly, several parameters of the Bitcoin transaction graph seem to have become stationary over the last 12â18 months. We discuss the implications.
The modern homo communicans seems to prefer to be connected to, and stay in contact with, his surrounding world. Mutuality and social cohesion through sustainable finance, especially at a decentralized local level, function as security mechanisms in the current era of turbulence. Following Illouz (2009) , several theorists identify emotional capitalism as the cultural process by which new interactional-emotional scripts of economic relationships are illustrated âby the cultural frames of cooperation or team workâ. In cooperation, most major âpurchasesâ take place among kin, friends, or acquaintances who substitute impersonal markets, especially when decisions involve high levels of uncertainty. Chang (2005) analyses how social networks are the most frequent sources of saving and investment information and are most utilized by those who have the least wealth. As this research suggests, connectedness rather than expertise prevails in important matters; in other cases, risk favours reliance on friends and relatives in order to make and sustain decisions.
Following the decentralization of health services in line with Primary Health Care declaration in Alma Ata in 1978, districts have gradually become a cornerstone of health systems in sub-Saharan Africa. Though administrative systems vary, the majority of the over 4,000 districts in the region have a population between 200,000 and 400,000 people, and most have an administrative structure that relies on district health management teams.
Health information is a critical component of district health systems, and is essential for district health teams to effectively plan and manage health services. The five projects described in this special issue all centrally feature health information systems, address different aspects of district health information systems in innovative ways, and will generate important evidence on a relatively neglected area of health systems [1].
What are the essential public health information requirements of districts?
First, districts need to generate and report data for the national level on a range of indicators. District reports provide regular data on health service provision, morbidity and mortality (including immediate reporting of notifiable diseases), but are also the basis for national and subnational data on infrastructure, health workforce, financing, etc. To be consistent, comparable and reliable, reporting systems need to adhere to national and international standards.
Second, district public health information systems need to generate relevant information for the local planning, management and monitoring of services. Key parameters include population distribution; health facilities and workforce; budget and expenditures by programme and facilities; access to and quality of services; coverage of interventions; and epidemiological information. To meet these requirements, a continuous process of data generation, compilation, analysis, dissemination and use for resource allocation is essential [2,3]. For information to be useful for decision making at the district level, districts should have sufficient control over the allocation of financial and other resources, including personnel.
Districts usually do not select their own indicators for monitoring progress and performance. Most countries have selected between 20 and 40 core indicators with baselines and targets to monitor their national health sector strategic five-year plans. A full national health plan may have many additional indicators that serve to monitor the implementation of the planâs different aspects. In addition, specific health and disease programmes have their own indicators and targets. The rationalization of data collection and reporting by health facilities and districts has to be part of efforts to improve information systems [4].
The bulk of health information is generated through a small number of data sources: facility recording and reporting, registration of vital events, household surveys, facility assessments, and administrative databases. Each of those data sources can provide key information for districts.
The main vehicle for reporting health data, and for regular monitoring, is the national health management information system (HMIS) based on health facility reports. The problems of such systems are well known. Health workers often have a heavy data collection and reporting burden; much of the gathered data are not used; and incomplete and inaccurate reporting affect data quality. For a dozen or so indicators, such as immunization, institutional delivery and outpatient utilization, it is possible to estimate district coverage rates by making assumptions about denominators (e.g. the expected number of deliveries in the district). These estimates provide relevant information to district managers and allow comparisons across districts, and in some countries, such as Uganda, district league tables are produced to rank the performance of districts using an index that includes a range of coverage indicators obtained from the health facility reporting system. It is good to keep in mind, however, that there is considerable uncertainty in the denominators â the estimated target population â as these may deviate considerably from the actual population because they are based on census projections and because service utilization is pragmatic and not confined to district boundaries. As a result, district coverage estimates from facility data often have great uncertainty. Provincial or regional estimates are often more reliable, and have the advantage of being comparable to survey-based coverage estimates. A fairly recent HMIS development is the use of the internet to expedite reporting from districts (or health facilities) to the national level, such as the District Health Information System (DHIS) which is now used by more than 30 countries. Such developments increase the potential for greater investment and use of data at the district level.
Information on mortality and causes of death is often lacking even nationally, as reliable death registration systems are not in place [5]. The national census, generally conducted every ten years, can be a source of district specific child mortality estimates in some countries. Hospital data can provide a general idea of cause of death patterns, but are biased and tend to be unreliable as standardized disease classification procedures â namely the International Classification of Diseases (ICD-10) â is often not used. A notable exception is the recent work in Mozambique where an electronic reporting system, with a thorough revision of coding and certification practices, greatly improved the quality of cause of death data from hospitals [6]. Many districts, however, lack reliable information, and in this case, data on causes of death and burden of disease profiles are often generated from a small number of longitudinal community demographic surveillance sites that collect data on probable cause of death through verbal autopsy (6). In Tanzania, resulting disease profiles were incorporated in a planning and budget tool that is used by all districts to guide resource allocation.
Household surveys are a critical data source for monitoring progress and performance at the national level. Only a few national surveys have an adequate sample size to allow district level estimates for key indicators such as immunization coverage or skilled birth attendance (e.g. Malawi Demographic and Health Survey in 2010). District surveys are also conducted as part of research, but are too costly, both in terms of technical and financial resource requirements, to be conducted on a large scale. Even the relatively simple immunization coverage cluster sample surveys have never reached scale in district applications. Several innovations hold the promise of making conducting household surveys easier (including automated household sample selection, electronic data entry and compilation, as well as analysis and report production), but surveys remain a resource-intensive exercise.
Basic data on the distribution of the population, health facilities (public and private) and health workforce are critical for district health managers. These data allow computation of key management indicators (such as workload), and administrative data through medicines and logistics management systems provide continuous information for performance monitoring and management of the system. Services readiness is another critical element, which can be assessed in supervisory visits using checklists, or more systematically in a facility assessment using a standardized tool such as the Service Availability and Readiness Assessment (SARA) that includes the availability of trained staff, basic equipment, diagnostics and medicines (currently at the national level, but could be adapted for district level needs) [8].
A major weakness in many district public health information systems is the lack of capacity to analyze and synthesize data from the multiple systems to inform decision making. Most districts have a health information officer as part of the district management team, and may have additional capacity in disease programmes, but the ability to assess data quality and assemble different indicators is often limited. Information technology provides a major opportunity to facilitate this process, but in general analytical capacity strengthening requires much more attention, which is addressed by one of the studies in this volume [1]. Unfortunately, the envisioned monitoring and evaluation support function of the next administrative level â region or province â has not materialized for the health sector in many countries. National level support is often limited simply because there are too many districts in proportion to the national support capacity in the Ministry of Health or Bureau of Statistics. Innovative approaches to support district capacity have to be found.
In summary, districts need a health information system that draws from multiple data sources. Reliable mortality and cause of death information primarily relies on hospital data and mortality profiles generated by community studies. Provincial or regional estimates from household surveys can provide an indication of child mortality levels and trends and of coverage of major interventions. The main continuous sources of information for districts are, however, locally generated health facility and administrative data. Ultimately, the use of information for decision making at the district level requires that districts actually have control over allocation of financial and other resources, such as staff. Much can be done to improve the district health information systems, especially if the introduction of information technology is done in combination with a review and rationalization of data collection, to the benefit of local health services as well as national monitoring and evaluation systems.
Using a combined panel data of Chinese and Korean non-financial firms from 2000 to 2007, we study the effects of governmentsâ influence on the banking sector in their decision making, and other financial and non-financial traits of firms in the two countries on the borrowing behaviors of firms. We specifically test whether there are so-called soft budget constraint (SBC) problems in China, where banks are supposed to be under the guidance of the central government for the welfare of the people at the expenses of profits and efficiency of firms, compared with the case of Korea. For this, we estimate default risks of firms and compare the effects of default risks and other factors on bank financing of firms in two countries. We find that while firms in Korea known to have experienced SBC before the financial crisis occurred in late 1997 have been under hard budget constraints since year 2000, and that those in China are exposed to SBC problems. The results support our theoretical studies about the effects of reputation of lenders on SBC in a centralized and decentralized economy in toughening budget constraints. We also have found that factors affecting bank financing in China and Korea are quite different. Most strikingly, Chinese firms with better cash flows from operation obtain more bank loans, while such Korean firms resort less to bank financing. In addition, while Korean firms paying higher interest rates finance more loans from banks, while such Chinese banks finance less from banks. This might imply that for firms in Korea and China might have different sources of financing in the times of high interest rates or in the case of high risk premium asked.
This article examines the use of Bitcoin in money remittance markets as a specific illustration of wider emerging regulatory issues relating to the use of cryptocurrencies. While there are many conceivable benefits of using Bitcoin for remittances, there are also many risks for users of these remittance services. This article adopts a user perspective to look at what the major concerns are and what existing protections may be available to persons using cryptocurrencies under New Zealand law through the example of using Bitcoin for remittance purposes. The article then summarises approaches taken by other jurisdictions before suggesting a specific regulatory approach to cryptocurrencies that New Zealand should consider adopting.
Local government is the tier of public authority that citizens first look to solve their immediate social problems. Among all the public institutions at local level, council has a special status and authority as local elected bodies. They are uniquely placed to provide vision and leadership to their local communities. They are able to make things happen on the ground where it really matters. The government of Ethiopia in general and Addis Ababa city administration in particular establishes council at different tiers of government as parliamentary control mechanism to ensure effective policy implementation, promote local democracy and improve service delivery. However, woreda councils in Addis Ababa city administration were not seen playing such role of democracy promotion. Moreover, studies conducted in regional woredas divulged that Woredas council have not yet managed to exercise sufficient local autonomy due to several reasons such as absence of clearly established legal mandate, lack of devolution of power, poor organization of the system and tight control and intervention by higher authorities. Therefore, this study aimed to assess the challenges and prospects that woreda council at Addis Ababa city administration has faced in promoting democracy among grass-root people. It also examines the overall operations of the councils from the viewpoints of democratic government and decentralization In order to pursue the objective of the study the researcher use multi-stage sampling technique and relied on both primary and secondary data source. Primary data collected through questionnaires, interview and observations while secondary data obtained from document analysis like legislation on the issue, minutes and reports complied by counsel's office. It was found that problems prevailed in regional woreda councils are also impeded woreda councils at Addis Ababa City Administration. The internal working system of woreda councils reflected that executive domination is very soaring, and councils are not responsive to the needs of the community and most importantly democratic essence viz. accountability, transparency, participation and autonomy are not adhered principles in the councils conduct. Therefore, councils as they are impeded by the above-mentioned challenges are playing insignificant role in cultivating democratic value and improving the service delivery to the grass root people. Therefore, it is recommended that the internal working system of councils need to be very transparent, responsive, participatory and free from any unnecessary intervention. Councilors must be sensitive to public interest; legal back up from the city administration is also needed in order to make councils strong, autonomous and powerful. The field that councilors operating also should be open to all stakeholders as the democracy promotion works calls for the involvements of different actors
Christopher Zegras, Joshua Nelson, RosĂ rio MacĂĄrio, Christopher Grillo
Fiscal federalism refers to the attribution of public finance functions among different levels of government. We examine Portugal's metropolitan transportation sector through the fiscal federalist lens, in light of the country's decentralization efforts and new relevant legislation. We clarify basic principles of fiscal federalism and adapt them to the finance of metropolitan transportation systems â typically characterized by multiple jurisdictions, numerous externalities and equity concerns â showing the inadequacy of general practice. Portugal's overall public finance system partially adheres to fiscal federalist principles; the transportation sector less so. Metropolitan transportation faces particular troubles, with few direct user fees, prices inadequately reflecting costs, and heavy reliance on central government subsidies for public transportation investments and operations. A new law creating metropolitan transportation authorities is only modestly consistent with fiscal federalist principles, since it inadequately details financial responsibilities and remains under heavy central government control. Absent additional reforms, the new metropolitan authorities should aim to make the transportation finance system explicit and test incentive grants to induce inter-municipal cooperation.
FigureWASHINGTON, DCâThe ambitious continuous learning database project of the American Society of Clinical Oncology known as CancerLinQ (OT, 8/25/12) has demonstrated its feasibility for the first time, according to speakers at a news briefing at the National Press Club here. The new prototype, demonstrated for briefing attendees on a hypothetical post-surgical patient with hormone-responsive breast cancer, included anonymous data from 100,000 breast cancer patients treated at U.S. cancer care sites. CancerLinQ is not the only cancer continuous learning databaseâGeorgetown University has pioneered a similar project (see box). The prototype CancerLinQ, which makes available to oncologists via computer massive amounts of data to inform clinical decision-making and improve the quality of cancer care, has now demonstrated through a real-time testing process that it can work in actual practice, said ASCO President Sandra M. Swain, MD, Medical Director of the Washington Cancer Institute at MedStar Washington Hospital Center. Swain noted that the majority of oncologists, about 60 percent, are currently using electronic health records (EHRs), a necessity for CancerLinQ. Swain explained that when ASCO embarked on this multi-stage project about a year and a half agoâwhich she described as âvery boldâ and âscaryââit was with the continuous learning vision of the Institute of Medicine (IOM) in mind. âOur work is really grounded in the work of the IOM over the last few years,â she said.Figure: ASCO President-Elect CIFFORD HUDIS, MD, noted that one key benefit of the new prototype is that it can accept data from different electronic health records: âThe system is independent of the EHR that the physician is using. We will work with anyone; we hope all vendors will end up with transformable data.âThe vision, as set forth in a number of IOM reports, seeks to help clinicians both learn from and contribute to diagnostic and treatment data through a health information technology (HIT) computerized database containing electronic health records (EHRs). Now, she said, âthe physicians are just clamoring to give us the data,â because they realize its importance in making informed clinical decisions. She said use of the large data set should help to counter the fragmentation in cancer care that makes it very difficult to draw insights from the collective clinical experience with cancer patients. âIt means having the whole medical community available for an opinion. It confirms that every cancer patient can be an information donor.â The database makes available a vast amount of valuable patient data that cannot now be mined because it is hidden awayâsince only about three percent of adult cancer patients participate in clinical trials. âThe worst situation is not having information,â Swain continued. âEvery time I see a patient, there are one or two things that make that patient different. This helps us to get more answers.â She said it isn't just oncology that will benefit, but that the data gathered will likely be relevant to other diseases as well. âProof-of-Principle Prototypeâ âThis is a proof-of-principle prototype,â said ASCO President-Elect Clifford A. Hudis, MD, Chief of the Breast Cancer Medicine Service and Attending Physician at Memorial Sloan-Kettering Cancer Center and Professor of Medicine at Weill Medical College. âIt's a real-time, push-of-the-button load of the patient data upfront.â Hudis said much work on the prototype remains, and that over the next year âwe're going to write white papers on what we've learned.â He noted that right now ASCO's Quality Oncology Practice Initiative (QOPI), is paper-basedâan initiative that could become much more streamlined and efficient if CancerLinQ is eventually widely adopted. One key benefit of the new prototype is that it can accept data from different EHRs, he said. âThe system is independent of the EHR that the physician is using. We will work with anyone; we hope all vendors will end up with transformable data.âFigure: ASCO President SANDRA M. SWAIN, MD, said use of the large data set should help to counter the fragmentation in cancer care that makes it very difficult to draw insights from the collective clinical experience with cancer patients.In the hypothetical breast cancer case demonstrated, the patient is put on an aromatase inhibitor but develops arthralgia. The CancerLinQ database prototype tells her physician to consider using tamoxifen as an alternative, and provides supporting data for that treatment choice. âFor 25 years I've been doing one-on-one medicine,â said another speaker, W. Charles Penley, MD, a partner with Tennessee Oncology, PLLC, Board Chair of the Conquer Cancer Foundation, and a member of the Dean's Advisory Board of the College of Arts and Sciences at the University of Tennessee. âPatients have been telling me, âDoctor, I want you to learn from my case to help other patients.â This [CancerLinQ] is that taken to the modern information age.â Penley, who is one of about 25 clinicians in the network testing the ASCO database prototype and whose practice contributed breast cancer patient data to it, added, âThis tool really can be a game changer in that regard.â What it means for cancer patients, he said, is that they can have confidence that they are receiving the highest quality care no matter where they are located. The database prototype, which he called âa remarkable step forward,â offers âan opportunity to query not just a few experts known to us, but the collective experience of treating cliniciansâthus adding âsecond opinions times multiples.â Lessons from Pediatric Oncology Lynn M. Etheredge, who leads the Rapid Learning Project at George Washington University, said lessons from pediatric oncology can be valuable for CancerLinQ as it moves forward. Pediatric oncologists built a system to capture data from every patient as if he or she were on a clinical trial and then learn from that experience, noted Etheredge, who worked for the White House Office of Management and Budget in the Carter and Reagan Administrations, and who proposed the concept of the ârapid learning health systemâ in a special issue of Health Affairs in 2007 (26: w107-w118). âPediatric oncologists realized early on that there were genetic differences,â he said. âHopefully we will have the same success in treating adult patients.â Asked by OT if he could have envisioned his concept of a rapid learning health system coming to this database prototype point, Etheredge said, âI'm an optimist,â but noted that âThis is astonishing.â He said that in the past physician groups have largely been reactiveâresponding to âthings done to them,â and he praised ASCO for being proactive, innovative, and forward-thinking. âWhat we are saying now is that we have put the stake in the ground; we have demonstrated everything we wanted to demonstrate,â Joshua Mann, ASCO's Associate Director for Oncology Technology Solutions, Quality and Guidelines, said in an interview. âNow we're ready to engage the broader audience.â For the full CancerLinQ system, âwe plan to siphon off data feeds from anyone,â including small oncology practices, not just large cancer centers. The message is: âSend us whatever you have however you can.â He noted that âmachine-learning algorithmsâ convert data into a standardized format, thus allowing practices using different EHRs to participate in the continuous learning database. Lombardi's G-DOC Integrates New Knowledge with Practice At Georgetown University's Lombardi Comprehensive Cancer Center, Director Louis M. Weiner, MD, has pioneered a continuous learning system similar to CancerLinQ called Georgetown Database of Cancer, known as G-DOC. This system uses both local data and publicly available data sets to put the concept of personalized medicine into practice, Weiner explained. Commenting on ASCO's CancerLinQ prototype proof-of-principle, Weinerâa member of the Board of Scientific Advisors of the National Cancer Instituteâsaid, âCancerLinQ is very ambitious. Currently, cancer specialists have access to only limited data to help them make critical life-altering decisions for their patients. In particular, it is very difficult to knowledgeably personalize therapies based upon a person's particular circumstances that are dictated by their genetics, comorbidities, and molecular properties of the cancers that afflict them. G-DOC has been designed as a first step towards that goal.âFigureWeiner noted that while there are patient confidentiality issues that need to be overcome in drawing on large databases to make treatment decisions, the concept is sound. It is clear that âit would be logical and desirable to link multiple datasets and then to create physician- and patient-friendly user interfaces that allow for shared decision-making that is based on a nuanced understanding of who to treat, what to use, and when to use it.â
Machine Learning and Algorithms
Software Reliability and Analysis Research
Intelligent Tutoring Systems and Adaptive Learning
Ian Miers, Christina Garman, Matthew Green, Aviel D. Rubin
Bitcoin is the first e-cash system to see widespread adoption. While Bitcoin offers the potential for new types of financial interaction, it has significant limitations regarding privacy. Specifically, because the Bitcoin transaction log is completely public, users' privacy is protected only through the use of pseudonyms. In this paper we propose Zerocoin, a cryptographic extension to Bitcoin that augments the protocol to allow for fully anonymous currency transactions. Our system uses standard cryptographic assumptions and does not introduce new trusted parties or otherwise change the security model of Bitcoin. We detail Zerocoin's cryptographic construction, its integration into Bitcoin, and examine its performance both in terms of computation and impact on the Bitcoin protocol.
Programme Financing Agreement (Decentralized Programme for Rural Poverty Reduction in Ha Giang and Quang Binh Provinces) between the Socialist Republic of Viet Nam and the International Fund for Agricultural Development (with schedules and General Conditions for Agricultural Development Financing dated 2 December 1998). Rome, 15 February 2005
This paper presents a cartography of networks in (co)operation, in an urban movement: Porto Alegre Vive. We used the network topology for centralized, decentralized and distributed networks; some principles of complex thinking: dialogic, hologram and self-eco-organization, as well as the perspective of order-disorder-organization. The results point to communication forms; to centralization and mediation, as well as the distribution, emphasizing a non-bouÂndary paradigm. The cooperation is understood as cause and effect of more autonomous relations and, therefore, more democratic.
Over the last decades social and behavioural research about disability in Sweden has expanded considerably. The development over the last 40 years can be described in four phases of the development: early initiatives, getting integrated, getting established and late developments. It describes a journey from an activity separated from the traditional university system and mainly occupied by evaluating reforms sponsored by short-term grants to an established academic activity with a broad range of research topic and with a growing engagement in theoretical questions. During the past years, disability organizations have reacted critically as they found themselves having little influence on research that is done, a reaction that includes dissatisfaction with what is experienced as inability of researchers to make research politically relevant. What started in a society with a centralized structure and ambitious social engineering ideal now has to find its role in a more decentralized structure where reform ambitions and the role of social movements like disability organizations are different. To balance the need for autonomous research with the ambition of being politically relevant without falling for the temptation of being politically correct is one of the challenges social disability research in Sweden will have to deal with in the near future.
With the constant proliferation of information systems around the globe, the need for decentralized and scalable data sharing mechanisms has become a major factor of integration in a wide range of applications. Literature on information integration across autonomous entities has tacitly assumed that the data of each party can be revealed and shared to other parties. A lot of research, concerning the management of heterogeneous sources and database integration, has been proposed, for example based on centralized or distributed mediators that control access to data managed by different parties. On the other hand, real life data sharing scenarios in many application domains like healthcare, e-commerce market, e-government show that data integration and sharing are often hampered by legitimate and widespread data privacy and security concerns. Thus, protecting the individual data may be a prerequisite for organizations to share their data in open environments such as Internet. Work undertaken in this thesis aims to ensure security and privacy requirements of software systems, which take the form of web services, using query rewriting principles. The user query (SPARQL query) is rewritten in such a way that only authorized data are returned with respect to some confidentiality and privacy preferences policy. Moreover, the rewriting algorithm is instrumented by an access control model (OrBAC) for confidentiality constraints and a privacy-aware model (PrivOrBAC) for privacy constraints. A secure and privacy-preserving execution model for data services is then defined. Our model exploits the servicesÂż semantics to allow service providers to enforce locally their privacy and security policies without changing the implementation of their data services i.e., data services are considered as black boxes. We integrate our model to the architecture of Axis 2.0 and evaluate its efficiency in the healthcare application domain.
Cristian VlÄdescu, Vasile AstÄrÄstoae, Silvia Gabriela ScĂźntee
The solutions recommended by the Presidential Commission for the improvement of hospital services were: restructuring and reorganization of hospital services; hospital management decentralization and establishment of county hospital agencies to ensure the coordination of hospital services at county level; diversification and use of new hospital services financing methods based on performance and quality of services provided to the patients; development of new management models for ensuring the continuity of care under therapeutic efficacy and economic efficiency. The Commissionâs recommendations as regards the sorting out of the problems in the primary health care were: development of primary care multidisciplinary teams; improvement of resource allocation at primary care level, simultaneously with raising efficiency of their use and integration of health services; significant increase of the resources dedicated to primary health care development, in areas like human resources, physical infrastructure, information and communication systems, and medical equipment. The solutions proposed by the Commission for improving the human resources are: drafting a coherent sectorial policy for training, development and allocation of human resources in health; increasing the availability of human resources in the health sector in Romania; stimulate the professional career development in health sector. The successful implementation of the proposed measures is conditioned by the clarification of some aspects and the decision made upon some essential elements that might influence the health system performance. These are: defining the type of health system that is desired for Romania â from the public/private mix perspective, introduction of market mechanisms that determine the increase of the public sector efficiency and making accountable all those involved in decision making, including the patients.