Rini Sasanti Handayani, Max Joseph Herman, Selma Siahaan
Background: Since decentralization era the health budgets including drug budget has been allocated into the development regional budget through formula-based DAU, based on regional revenues and fiscal needs. Health budget is included in DAU, though not explicitly stated. Therefore the health sector practically has to strive for their own budget in every province or every district. This is a new kind of phenomenon for regional governments especially related to the health sector. They should have strategic plan in financing while competing with other sectors to obtain it. Drug consumption in Indonesia is lower than in other ASEAN countries. To ensure access to drugs in primary heath care, the government (Ditjen Bina Farmasi dan Alkes) in the mid-year of 2003 in collaboration with WHO has facilitated a meeting among districts. This meeting leads to an agreement that the regional government should allocate Rp5.000,00 per capita annually for drug budget. Methods: A cross sectional descriptive study was done in ten districts in Indonesia in the year of 2006 on how far the realization of the district agreement of drug budget allocation, particularly in relation with improving drug access issues. District Health Office and Drug Management Unit were taken as samples and data were collected by structured interviews. Results: 1) Drug budget for most districts/cities is still less than Rp5.000,00 per capita per annum so that it can be assumed a shortage in terms of kind of, as well as, quantity of drugs. 2) Some districts showed an increase in drug budget, while the other ones showed just the opposite. 3) Not all districts had all essential and/or generic drug procurement. Conclusion: We suggest more intensive socializations for drug financing to districts in order to improve the commitment to the agreement on the allocation of drug budget and, secondly, a better technical training with topics: planning, advocacy and negotiation with relevant stakeholders. Key words: drug financing, drug budget, districts/cities
Pharmaceutical Economics and Policy
Healthcare Systems and Reforms
Health Systems, Economic Evaluations, Quality of Life
The main idea is to protect the signer of a document against the document being digitally distributed without the cooperation of signer. This paper proposes a new scheme of undeniable signature, which is so effective and improved D. Chaum's scheme. And our scheme which is zero-knowledge proved by using one-way function and partition - selection method, shows that its communication(challenge-response) only needs much fewer times during the confirmation protocol and disavowal protocol respectively, being very useful for wireless network environment. In the meantime our scheme allows the verifier to verify that the signature is valid, while the signer doesn't know the original message and the signature, to preserve the privacy of the verifier.
This chapter critiques environmental agencies' use of cost-benefit analysis (CBA) in the context of a concrete case study: the U.S. Environmental Protection Agency's (EPA's) recent regulation of mercury emissions from coal-fired utilities under the Air Mercury Rule (CAMR). It identifies seven issues for regulatory impact analysis (RIA) that the CAMR brings to the fore. Rather than informing the decisionmaking process, the CAMR RIA served to obscure the range and contours of the regulatory options on the table. Rather than providing a neutral tally of are obviously and of the rule, the CAMR RIA enlisted value judgments to assign the impacts of mercury contamination to one side of the ledger or the other. Rather than permitting a complete accounting of these impacts, the CAMR RIA provided an accounting that was partial - in both senses of the term. Rather than laying bare the answer to the question what is at stake, for whom?, the CAMR RIA assessed only those impacts that had been monetized. Its bottom line, moreover, told us nothing about how the costs and benefits would be distributed. Rather than affording enhanced oversight by elected officials and the public, the CAMR RIA dazzled with detail but often obfuscated the considerations relevant to EPA's decision. Finally, rather than helping EPA satisfy its legal mandates, the CAMR RIA provided information that was unconnected to the relevant Clean Air Act provisions, treaties with the fishing tribes, and other legal obligations that constrained EPA's decision. Having identified these shortcomings, the chapter closes with recommendations for reforming regulatory impact analysis - suggestions that echo other recent efforts to envision a more pragmatic orientation for analysis of health, safety, and environmental regulations.
François Guerquin, A. Hammad Tarek, Mi Hua, Tetsuya Ikeda ¡ 6 authors
Competition for freshwater resources is increasing because of increased demand, a greater variety of uses and users, and depletion of some resources and loss of others because of pollution. However, the view expressed in World Water Vision: Making Water Everybody&s;s Business (Cosgrove and Rijsberman 2000) is that all uses could be served in the future, without depleting the Earth&s;s natural capital, if everybody committed to improving water management. Politicians and decision-makers must be the ones to initiate change. This should start with a management environment that enables the emergence of new tools, institutions, and capacities. Many countries have already started to adjust their approaches to water, introducing decentralization and participation and empowering communities and user groups. Water management requires clear definitions of water ownership and use and of responsibilities regarding water pollution. It requires transparent and participatory decision-making on investments, cost recovery, and service delivery. Above all it requires effective accountability and enforcement mechanisms that give voice and choice to users and societies. More and more countries are reforming their water management. However, financial issues often remain unresolved, approaches remain sectoral, and investment is often inadequate. The challenge of improving water management is especially daunting in countries with weak institutions and endemic corruption. Countries that lack a good educational system are also severely disadvantaged. In all countries reform will take time and so needs to begin now. Dialogue, debate, and exchange of experience at all levels will help to steer the process in the right direction and to keep it going.
[ILLUSTRATION OMITTED] Introduction From the simplest to the most sophisticated human activities, the power of computing has changed the way we interact individually, socially, governmentally, culturally, and globally. Yet have these influences been for the good or have they been less than positive? This year, we celebrate the 50th anniversary of the implementation of COBOL, a.k.a. Common Business Oriented Language, one of the most well-known of computer fundamentals. COBOL arose from the profound scholarship and industry of Admiral Grace Murray Hopper. Amazing Grace, as she was known, was one of the greatest American pioneers in the history of computer science. COBOL, one of the oldest programming languages, is an acronym for Common Business-Oriented Language, which defines its primary domain in business, finance, and administrative systems for companies and governments. Obtaining her doctorate in mathematics at a time when such academic achievements were not the usual experience for American women, Admiral Hopper was eventually elevated to her Navy rank by a specific honor from the Congress of the United States because of her genius, dedication, forward thinking, and unprecedented discoveries. She was an inventor par excellence whose personal life sustained the price of dedicated scholarship. The reflections and contributions of Admiral Hopper can be found today throughout our information industry. Just as we now develop new software or design new data chips, Admiral Hopper discovered the path to wide-spread usability from debugging software to developing the software engineering disciplines necessary to carry out today's demand for information. Her belief in decentralization opened new thought-provoking collaborative models that have both leap-frogged the advancement of technologies and, ironically, added to the many challenges we face today in managing the application of such new technologies. Reflections and Impact: From Mathematician to Professor, to Programmer, to Icon The many contributions of Admiral Hopper are well discussed in Kurt Beyer's 2009 work published by the Massachusetts Institute of Technology, Grace Hopper and the Invention of the Information Age. Among these contributions is debugging, a methodical process of finding and reducing the number of bugs, or defects, in a computer program or a piece of electronic hardware, to make it behave as expected. The terms bug and debugging were popularly attributed to Admiral Hopper in the 1940s. While she was working on a Mark II Computer at Harvard University, her associates discovered a moth stuck in a relay, thereby impeding operation; thereupon she remarked that they were debugging the system. Sub-routines, as the name subprogram suggests, behave in much the same way as a computer program used as one step in a larger program or another subprogram. A subroutine is often coded so that it can be started (called) several times and/or from several places during a single execution of the program, including from other subroutines, and then branch back (return) to the next instruction after the call once its task is done. Sub-routines today can be found in many object-oriented programming development models known as classes which represent real world activities and objects. More famously, Admiral Hopper had a strong belief in decentralized management--a process of dispersing decision-making governance closer to the users of software applications. It includes the dispersal of administration or governance in sectors like engineering, management science, political science, political economy, sociology and economics. Decentralization has enormous significance beyond software usage or computer governance. It is fundamental to contemporary organizational systems development and the structures and substructures of institutional life, including universities and research institutions. âŚ
As it is provided in the 1999 Constitution, federalism in Venezuela is a contradictory form of government. Typically, a federation is a politically decentralized state organization based on the existence and functioning of autonomous states. The power of that decentralized state is distributed among the national state and the member states. In contrast, the federation in Venezuela is a centralized federation, which is a contradiction in itself. Unfortunately, Venezuela is not a good example of the importance of federalism in Latin America because it is a federation based on a very centralized national government, with twenty-three formal autonomous states and one capital district. Each of these twenty-three formal autonomous states is without its own effective public policies and its own substantive subnational constitutions; and if it is true that they have elected authorities, those have been weakened by the central government. Regarding the capital district, against the provisions of the 1999 Constitution, it has been regulated in 2009 by a national law with the same trends as the former federal district; that is, without self-government, dependent of the national executive. But the federation in the country's history has not always been like it is now. The centralization of the federation occurred progressively during the twentieth century and has been particularly accentuated during the past decade. Centralization began with the installment of the authoritarian government of the dictator Juan Vicente GĂłmez, who ruled for approximately three decades in the first half of the twentieth century. During those years, no democratic institutions were developed.
This paper examines the role of national feminist periodicals in the West German womenâs movement during the late 1970s. It focuses on how feminist ideas of autonomy were applied to magazine administration. As womenâs centres began to decline, national publications worked as co-ordinating forces for the largely decentralized network of groups and institutions that made up the German womenâs movement. Sources such as internal papers and letters are used in addition to the magazines themselves in order to examine the political goals and ideologies communicated by these periodicals and their editors. Each magazineâs organizational principles are assessed in terms of their influence on editorial development and relationship to political ideologies of the womenâs movement. This paper shows that the autonomous organizational principles of national feminist periodicals were characterized by an anti-hierarchal impulse expressed through emphases on editorial fluidity and individual thought.
This paper studies the relationship between R&D decentralization and financial performance. It examines also the impact of this decentralization on earnings management. To specify what does matter in the decentralization of the R&D we try to examine the relationship between centralization or decentralization of the R&D and the firmâs performance on one hand and the earnings management as measured by discretionary accruals on the other hand. We use two internal finance indexes (internal cash flows, internal market capital) and two mechanism of governance (stock-options, institutional investors) to explain the determinants of the R&Dâs strategy.Using a sample of 160 U.S. Multinational companies (MNCs) between 2001 and 2006 our results show that MNCs decentralize their R&D for dual goal to improve firmâs profitability or performance and to help manager to manage earnings in their own interest. Moreover, despite the fact that R&D decentralization has a positive impact on performance, institutional shareholders and performance-based compensation encourage managers to decentralize their R&D in order to spur their opportunistic behavior.
This paper presents the significance of the issues related to the activity of territorial self-government for the social and economic development of Ukraine. The efficient operation of self-government in any country is unfeasible without financial resources. Polish experience in the development of territorial self-government is particularly valuable in relation to the reform of Ukraineâs self-government. The paper outlines the differences in the structure and operation of territorial self-government in both countries. The paper is concluded with numerous observations on the direction of selected reforms of Ukrainian self-government. It shows the weaknesses of local self-government in Ukraine, which result from the lack of decentralization of finance and the small amount of state-collected taxes. The conclusions end with the observation that a consistent development of the Ukrainian state is required for Poland to develop well.
The first chapter reviews the theoretical and empirical literature about political budget cycles at national and local level, starting from earlier traditional political business cycles models to political agency models. This last strand of literature is discussed, starting from earlier signalling models to the more recent advancements in theoretical predictions about the selection and disciplining effect of elections on politicians. A particular emphasis is given to the full review of empirical tests based on political agency models predictions about the links between accountability and decentralization, especially at the local level. The second chapter focuses on the issues of electoral cycles in taxes and expenditures for a sample of Italian municipalities. Econometric estimates show a strong electoral cycle on municipal property tax, and extending political
agency models' implications about the differences in tax-setting behavior between first- and second-term mayors, evidence is shown of a stronger electoral manipulation of property rates applied to main residence tax base when mayors run for re-election. Estimation of property tax rates' sensitivity to term-limited mayors' fiscal behaviors also uncovers a party discipline effect
on tax rates applied to business and non homeowner property tax base. Furthermore, this chapter goes beyond previous econometric estimates of expenditure cycles focusing solely on the dynamics of current and capital expenditures without taking into account the basis on which outlays are recorded in local budgets. Some preliminary evidence points to the existence of an electoral cycle in cash-recorded budgetary investment outlays. An econometric test on the effect of formal expenditures restraints on municipal spending behaviors concludes the chapter.
In the last chapter, results from the second chapter relative to business and main residence property tax ratesâ choices are further investigated, exploring the link between opportunistic rational cycles and accountability of tax instruments. A formal political agency model predicts that the political incentives for using the two different property taxes may be different, according to their level of transparency. Three empirically testable implications derives from theoretical predictions: 1) first-term mayors should use a local income tax surcharge, introduced in 1999 in Italy, more than second-term mayors; 2) political turnover should be lower following the reform, and in particular for mayors using more the local income tax surcharge and 3) the reform might also affect the decision to run again by mayors, as it should be easier to get re-elected after the reform. Empirical estimates using a sample of Italian municipalities are presented, confirming theoretical predictions of the model.
Epidemic theory has wide range of applications in computer networks, from spreading of malware to the information dissemination algorithms. Our society depends more strongly than ever on such computer networks. Many of these networks rely to a large extent on decentralization and self-organization. While decentralization removes obvious vulnerabilities related to single points of failure, it leads to a higher complexity of the system. A more complex type of vulnerability appears in such systems. For instance, computer viruses are imminent threats to all computer networks. We intend to study the interaction between malware spreading and strategies that are designed to cope with them. The main goals of this thesis are: 1. to analyze influence of network topology on infection spread 2. to determine how topology can be used for network protection 3. to formulate and study optimization of malware protection problem with respect to topology 4. to investigate non-cooperative game of security We used analytical tools from various fields to answer these questions. First of all, we have developed homogeneous and heterogeneous N-intertwined, susceptible - infected - susceptible (SIS) model for virus spread. This model is used to determine the influence of topology on the spreading process. For the N-intertwined model, we show that the largest eigenvalue of the adjacency matrix of the graph rigorously defines the epidemic threshold. The results of the model also predict the upper and lower bounds on epidemics as a function of nodal degree. The epidemic threshold is found to be a consequence of the mean field approximation. However, slow convergence to the steady-state justifies the application of the threshold concept. We used the exact 2N-state Markov chain model to explore the phase transition phenomenon for two contrasting cases, namely the line graph and the complete graph. The N-intertwined model assumes that the infection spreading over a link is a Poisson process. By introducing infection delay, we studied the influence of deviation from Poisson process assumption on epidemic threshold for the special case of a complete bi-partite graph. Due to the special structure of bi-partite graphs we were also able to derive approximate formula for the extinction probability in the first phase of the infection. In the case of SIS epidemic models, the effects of infection depend on the protection of individual nodes. We studied optimization of protection scheme for different networks. We use the results from heterogeneous N-intertwined model to determine the global optimum at the threshold. Above the threshold, the problem is a sum of ratios fractional programming problem, which is NP-complete. Therefore, we only determine the upper bound on the optimum. Contrary to the common sense, reducing the probability of infection for higher degree nodes pushes the network out of the global optimum. For the case of complete bi-partite graphs, we derive optimal threshold if only 2 fixed protection rates are available. Computer networks are generally distributed systems and protection cannot be globally optimized. The Internet is an extreme example: there is no global control center, and obtaining complete information on its global state is an illusion. To approach the issue of security over decentralized network, we derived a novel framework for network security under the presence of autonomous decision makers. The problem under the consideration is the N players non-cooperative game. We have established the existence of a Nash equilibrium point (NEP). The willingness of nodes to invest in protection depends on the price of protection. We showed that, when the price of protection is relatively high for all the nodes, the only equilibrium point is that of a completely unprotected network; while if this price is sufficiently low for a single node, it will always invest in protecting itself. We determine bounds on the Price of Anarchy (PoA), that describes how far the NEP is from the global optimum. We have also proposed two methods for steering the network equilibrium, namely by influencing the relative prices and by imposing an upper bound on infection probabilities. A quarantine is another possible measure against the epidemic. A quarantine on a set of network nodes separates them from the rest of the network by removing links. The concept of threshold and the N-intertwined model provides a tool to analyze how quarantine improves the network protection. We studied several different networks from artificially generated to real-world examples using the modularity algorithm. The real-world networks tend to show a better epidemic threshold after clustering than artificially generated graphs. The real-world networks have typically two or three big clusters and several smaller ones, while Barabasi-Albert (BA) and Erdos-Renyi (ER) graphs have several smaller clusters comparable in size. However, the number of removed links in a graph using modularity algorithm is unjustifiably high, suggesting that complete quarantine is not a viable solution for real-world networks.
Kathryn Church, Korrie de Koning, Adriane Martin Hilber, Hermen Ormel ¡ 5 authors
Current attempts to address the high burden of sexual health morbidity and mortality in developing countries remain limited in scale due to a range of health system constraints. We conducted a literature review of the policy and programmatic issues that influence the integration of sexual health into primary care services in developing countries. Forty-seven reports were identified from a search of both peer-reviewed and gray literature. Key issues identified were intersectoral and intergovernmental coordination; management and organizational issues including decentralization, health sector reform, logistics, and referral systems; human resources, including training and support required to increase service scope; relationships between the public and private sectors; and scaling-up and financing issues.
Abstract A vast territory, deep regional and linguistic differences, and a diverse population pose a challenge to the administration of elections and the determination of voting behavior. Election management in Canada has changed in recent years. Campaign financing is more strictly controlled that ever, advance voting and same-day registration have been introduced to facilitate easier voting, and fixed-term elections have been introduced. This article discusses the changes and challenges faced by the Canadian elections and voting system. Among the challenges faced are the efforts to enhance the equity and fairness of the electoral process. These efforts are seen as conflicting with the right of freedom of expression guaranteed by the Canadian Charter. Among the changes Canadian electoral processes have undergone are the emergence of campaigns, the pervasiveness of media coverage, decentralized federalism, and the introduction of a single-member plurality electoral system. Some of the topics discussed in this article include: managing elections, voter registration, distribution of seats, and anomalies in the Canadian electoral system.
With the economic recovery gaining momentum, travel experts predict that tourism in all regions will increase in 2010 by an estimated 3% to 4%. 1 This increase in travel is forecasted to exceed 5% in Africa, Asia, and the Middle East, where the risk of acquiring meningococcal disease or becoming a carrier is higher. 2 When evaluating the need for vaccination in travelers, particularly for those traveling to developing world countries, it is important to consider not only the incidence rate but also the impact of the respective infection (Figure 1). 3 As an example, meningococcal disease is rarely reported in travelers, but the impact of this infection can be as devastating for travelers as for any other individual. With its rapid clinical course and narrow window for diagnosis, the potential for negative outcomes from meningococcal disease may be increased particularly in travelers to remote locations where access to adequate health care facilities and antibiotics is limited. There is an additional public health concern with meningococcal infection, as travelers who are carriers may spread the infection in the society back home. Impact and incidence of vaccineâpreventable diseases in travelers to developing countries. 3 PPD = purified protein derivative, a tuberculin test. Outbreaks of meningococcal disease frequently occurred among Hajj pilgrims, their contacts, and thereafter even in persons without known contacts prior to 2002, when authorities of the Kingdom of Saudi Arabia issued a quadrivalent meningococcal vaccination requirement to obtain a Hajj visa. 4,5 Otherwise meningococcal disease usually has been considered to be rare among travelers (Figure 2). 6 A single retrospective survey has attempted to quantify the risk of meningococcal disease among international travelers originating in industrialized countries. 7 Health authorities in 56 of 108 contacted countries (51.9%) completed questionnaires concerning reported cases of meningococcal disease, and tourism data were derived from statistics provided by the World Tourism Organization and national tourism authorities for the study period (1986â1989). On the basis of 13 cases imported to 56 countries, a monthly incidence rate of 0.4 per million was extrapolated, which corresponds to approximately 0.4 per 100,000 population per year. 7 When this rate is compared with the commonly quoted annual incidence rate of 0.5 to 10 cases per 100,000 population in industrialized countries, 8,9 it appears that ordinary travel does not result in an increased risk for meningococcal disease. Incidence rate per month of vaccineâpreventable diseases in developing countriesâ2010. 4 CFR = case fatality rate. As in the general population, infections in travelers can occur in healthy persons without any apparent risk factors and regardless of the type of traveling or the travel destination. In the past few years, a number of anecdotal reports of meningococcal disease among travelers have been published (Table 1). 10â15 An additional six cases, which so far are unpublished, have been detected in the GeoSentinel, a worldwide communication and data collection network for the surveillance of travelârelated morbidity. 16 Among them, two occurred after a visit to Disney World (Pat Schlagenhauf, personal communication). This demonstrates that, among travelers, meningococcal disease may occur in all parts of the world and in various types of travelersâtrekkers, leisure and business travelers, students, and pilgrimsâand in all age groups. As in the population affected at home, children and young travelers were most frequently affected. Some of the cases of meningococcal disease in travelers reported in recent years confirm what we know from data in other populations: environmental risk is increased by staying in dormitories, 11,15 educational or military institutions, 17,18 and refugee camps 19 and by attending sporting events 20,21 and discotheques. 22 Clusters of meningococcal disease caused by the same strain have occurred in children whose connection was riding the same school bus, 23 which indicates there could be potential for transmission aboard tour buses. Almost 30 years ago during an outbreak situation, six trekkers fell ill in Nepal. 24 The sum of these examples illustrates that the risk of meningococcal disease in travelers can vary based on destination, mode of transport, type of accommodation, and reason for travel/destination activities. While highârisk groups can be determined primarily on theoretical and general epidemiological considerations, there is no zero risk in any traveler. Anecdotal cases of meningococcal disease in travelers, 1996 to 2008 10â15 Anecdotal cases of meningococcal disease in travelers, 1996 to 2008 10â15 International travelers can also facilitate the global spread of meningococcal disease. Until 2002, this occurred almost annually after the Hajj. However, potentially risks may still occur, as illustrated by a 2009 case of an individual aged 43 years who contracted a fluoroquinoloneâresistant strain of Neisseria meningitidis serogroup A. 12 The patient developed symptoms within 24 hours of returning to Italy after traveling to Delhi and Chennai in India, with a stopover of a few hours in Frankfurt, Germany. Although the patient had no known contact with anyone in India with previous or current meningococcal disease, testing revealed the strain was the same that had caused epidemics in the area in 2005 to 2006. Fortunately, no known secondary cases have been reported in Italy. 12 During epidemics of meningococcal disease in subâSaharan Africa, the soâcalled African meningitis belt that stretches from Senegal to Ethiopia, as many as 1,000 per 100,000 population may be affected. 25 Recently, the epidemicâsusceptible area has been expanded to GuineaâBissau, Guinea, the Ivory Coast, Togo, the Central African Republic, and Eritrea. 8 Countries around the Rift Valley and Great Lakes regions are also now considered to be at risk (Figure 3).26,27 Predicted probability of epidemic experience of meningococcal meningitis. 26 The risk of meningococcal disease in the population in this area is particularly elevated during the dry season between December and June because of dust winds and background upper respiratory tract infections. However, due to the dynamics of climate variability, risk exists somewhat all year. Population displacements, such as when nomads and farmers congregate in traditional market areas, and overcrowded living conditions can increase the risk of transmission and contribute to epidemics of disease. 28 According to the World Health Organization (WHO), in the 2009 epidemic season, 78,416 suspected cases of meningococcal disease, including 4,053 deaths, were reported in 14 African countries implementing enhanced surveillance techniques. 28 This represents the largest number of cases and deaths since the previous large meningococcal disease epidemic in this region in 1996 to 1997, during which >25,000 people died. 25 However, to our knowledge, there has not been a single case published about a traveler having been affected in the African meningitis belt. At the least, to some extent, this may be due to the fact that, following essentially congruent vaccination recommendations, a fair proportion of highârisk travelers may have been protected appropriately. This may also be, in part, because active surveillance is limited in Africa, Latin America, and Asia, 25 which may result in an underestimation of burden. Finally, an important proportion of travelers has a different behavior and far more social distancing as compared to the local population. During the annual Hajj pilgrimage, >2 million Muslims from across the globe travel to Mecca and Medina. 29 The congregation of such a large population of individuals from such a wide variety of regions, as well as the crowded conditions at the destination, creates a good environment for meningococcal disease transmission, and the international spread of meningococcal disease resulting in outbreaks and epidemics in several countries has been linked to pilgrims returning from the Hajj prior to the institution of current vaccination protocols. 30â33 In 1987, outbreaks in the United States and a large epidemic in Africa of meningococcal serogroup A disease were associated with returning pilgrims. 33,34 More recently, in 2001 to 2002, outbreaks of serogroup Wâ135 disease in Europe, the United States, the Middle East, and Asia, as well as a large epidemic in Burkina Faso in Africa, were linked to returning pilgrims. 30â32 One study assessing the risk for meningococcal disease spread as a result of the Hajjâevaluated N meningitidis carriage in US pilgrims traveling through John F. Kennedy Airport in New York, NY, in February 2001. 31 The prevalence of N meningitidis carriage was higher in those returning from the Hajj (2.6% of 844) than in departing pilgrims (0.9% of 425). Although none of the outbound study participants tested were carriers of serogroup Wâ135, nine of those tested inbound were positive for the serogroup (1.3%; p = 0.01). 31 After the 2001 Hajj, a 15% serogroup Wâ135 carriage rate also was observed in 171 pilgrims returning to Singapore, with evidence of spread to household contacts. 35 In comparison, data from 2001 indicate that the risk of the international spread of meningococcal disease is much lower for Umrah pilgrimage, which is shorter, occurs all year, and involves much smaller groups of travelers. 29 Fortunately, as a consequence of enforced implementation of the meningococcal vaccine requirements issued by the Kingdom of Saudi Arabia health authorities, no exportation of meningococcal disease by Hajj pilgrims has been reported since 2004. There is, however, some concern about serogroup B meningococcal disease for the future. 36 Approximately every 6 weeks, the CDC investigates an incident of possible transmission of meningococcal disease on an aircraft. 37,38 Many other national institutions have similar queries, and passengers have been diagnosed with meningococcal disease after arrival, such as a journalist with serogroup Wâ135 in Singapore and an Israeli student in the United States. 9,29 On the other hand, to our knowledge, only two reports of inâflight transmission have been published. The first occurred on a 14.5âhour flight from Los Angeles to Sydney. Two individuals who had been sitting 12 rows apart were diagnosed with serogroup B meningococcal disease of the same allelic profile. Both patients were women aged >65 years, and both recovered after treatment with antibiotics. One patient reported walking around the plane with some frequency, whereas the other, seated in an aisle seat, only got up a few times to use the rest room. It remains unknown whether transmission occurred from one passenger to the other or whether a third carrier infected them both. 39 In the second report, one passenger and one crew member were infected on an 11âhour military charter flight from the Southwestern United States to Frankfurt. One of the individuals had serogroup B disease; the serogroup in the other individual was undetermined. 40 Vaccination against meningococcal disease is not required for individuals traveling into any country except for Hajj and Umrah pilgrims to Saudi Arabia. 5,41 This visa requirement for Saudi Arabia has been extended to all nationals of many countries in tropical Africa arriving by air. 42 Proof of immunization is needed for all Hajj and Umrah visa applicants of all ages; depending on the age group and origin, other vaccinations may also be required (yellow fever, poliomyelitis, and influenza). 5 Applicants must have been immunized more than 10 days and less than 3 years before entering Saudi Arabia. 5 Because of this requirement for periodic vaccination, waning immunity due to immunologic hyporesponsiveness after repeat administration of meningococcal polysaccharide vaccines can be a concern. 6 A study on residents of Mecca and Jeddah, Saudi Arabia, aged 10 to 29 years found that repeated administration of the AC polysaccharide vaccine resulted in immunologic hyporesponsiveness to serogroup C. 6 Hyporesponsiveness is not a factor with conjugate quadrivalent meningococcal vaccines, 43 and they should therefore be preferred for use for instance in Hajj pilgrims. Several national health authorities as well as the WHO have issued guidance on vaccinating travelers against meningococcal disease based on environmental factors, such as travel destination, time of year, and type of contact with the local population (Table 2). Although not all the recommendations are consistentâespecially in terms of the strength of the recommendationâmany overlap to some degree, and all recommend vaccination for all travelers visiting destinations with current outbreaks or epidemic situations. Synopsis of meningococcal vaccine recommendations in travelers WHO = World Health Organization; CDC = Centers for Disease Control and Prevention; CATMAT = Canadian Committee to Advise on Tropical Medicine and Travel; NaTHNac = National Travel Health Network and Centre; ECTM = Expert Committee for Travel Medicine. Synopsis of meningococcal vaccine recommendations in travelers WHO = World Health Organization; CDC = Centers for Disease Control and Prevention; CATMAT = Canadian Committee to Advise on Tropical Medicine and Travel; NaTHNac = National Travel Health Network and Centre; ECTM = Expert Committee for Travel Medicine. In its 2010 edition of International Travel and Health, the WHO lists meningococcal disease vaccination as being of selective use in travelers, along with hepatitis A vaccine, for example. 44 For travelers to industrialized nations, where they may be exposed to sporadic cases of meningococcal disease, WHO cautions that risk is increased in locations where large groups of adolescents and young adults congregate, such as in schools and college dormitories, and recommends considering vaccination for college students. Vaccination should also be considered in âall travelers to countries in the subâSaharan meningitis belt.â The risk of infection may be greater in those traveling during the dry season or those staying in the area for longer periods and living with or being in close contact with the local population. 44 Vaccination is also to be considered in âall travelers ⌠to areas with current epidemics.â 44 The WHO, US, UK, and German/Swiss recommendations are very similar (Table 2). Essentially, vaccination is considered or recommended in similar atârisk groups as those mentioned in the WHO guidance, including travelers to the African meningitis belt and those with prolonged contact with indigenous populations. The UK recommendations also specify meningococcal vaccination for health care workers and travelers visiting friends and relatives due to the close contact these activities involve. The US Centers for Disease Control and Prevention (CDC) and the German/Swiss guidelines explicitly recommend vaccination with a quadrivalent meningococcal vaccine. The preferred vaccine in the United States for individuals aged 2 to 55 years is a glycoconjugate vaccine, with the polysaccharide quadrivalent meningococcal vaccine currently still recommended for those aged >55 years. Children who received either vaccine at age 2 to 6 years who remain at risk should be revaccinated 3 years later with the indicated glycoconjugate quadrivalent meningococcal vaccine, and then every 5 years thereafter. Recommendations are similar for those aged 7 to 55 years who remain at increased risk, except that the period from the initial vaccination to the first revaccination is 5 instead of 3 years. 8 Travelers to or residents of countries where meningococcal disease is hyperendemic or epidemic are one of the groups considered to have prolonged increased risk for meningococcal disease (along with those with increased susceptibility to infection and those with anatomic or functional asplenia). 45 Although the CDC travelers' guidelines do not include a recommendation for college students studying abroad in endemic areas (eg, Europe), general guidelines from the Advisory Committee on Immunization Practices recommend all college freshman living in dormitories in the United States who were vaccinated with the quadrivalent polysaccharide vaccine more than 5 years ago be revaccinated with a glycoconjugate quadrivalent meningococcal vaccine. 45 According to the American College Health Association adolescents and young adults account for nearly 30% of all cases of meningitis in the United States. Some 100 to 125 cases of meningococcal disease occur on college campuses each year, and 5 to 15 students will die as a result. Evidence shows 70% to 80% of cases in the college age group are caused by serogroup C, Wâ135, or Y, which are potentially vaccine preventable. 46 One could extrapolate that this recommendation would hold whether the student was entering college in the United States or abroad. However, national recommendations differ according to the indicated age groups and of the vaccine. as vaccines are country recommendations should be Recently, the Canadian Committee to Advise on Tropical Medicine and Travel issued guidance on the and recommendations for meningococcal disease vaccination in travelers. In the guidelines recommend a to the to Vaccination should be considered for any individuals traveling to a region of meningococcal disease caused by one of the in the include not only the African meningitis belt countries guidelines that the dry season from country to country and the time to to but also those countries in subâSaharan Africa the traditional meningitis belt where recent epidemics have including the and The guidelines also recommend vaccination for the groups of travelers who may have prolonged close contact with the local population in these areas, but specify this may include and those public In to areas with active vaccination may also be for travelers to areas with disease including industrialized where sporadic cases of disease have been reported in the previous 6 In developed countries, travelers should the recommendations of the Although vaccination against serogroup with a vaccine is required for all Canadian CATMAT that this vaccination does not to individuals traveling to destinations where disease due to other is serogroup is due to this risk, and the preferred vaccine is a glycoconjugate quadrivalent meningococcal vaccine due to its polysaccharide vaccines including longer of of hyporesponsiveness with and possible of carriage For the of travelers, those not to Saudi Arabia or those not entering college where vaccination is required in the United the to is based essentially on an of the risk to the individual of developing disease of becoming a carrier of This must account for destination, and of potential and background health of the traveler (Figure Because meningococcal vaccines are associated with few events and these need to be vaccination for travelers. = = Kingdom of Saudi UK = United US = United = visiting friends and vaccination should be recommended for all travelers visiting destinations with outbreaks or epidemic that be, except those who have been vaccinated within the past 3 years. There are that can on active areas, such as developed by a As most groups recommend vaccination against meningococcal disease for at some travelers with destinations in the African meningitis belt. There is whether this recommendation should be limited to the dry season, by various as from to June or only December to 8 or in of the no to be in the WHO and 44 experts also consider parts of the Rift Valley in Africa, including parts of and to as many risks as the traditional meningitis but not the destinations in Recommendations may also differ based on risk of to meningococcal disease in the highârisk countries as in the A meningococcal vaccine that all is for travelers to the African meningitis belt due to the need to against that disease in the the general factors, we must also consider that personal living and and social behavior a or for (eg, in refugee may be at higher In the African meningitis any health should consider not only the of but also whether there will be close contact to the local population in the the and type of public in dormitories or similar may an increased risk of transmission, and meningococcal vaccination at to be Finally, factors need to be into There is that, for persons with and some with or should meningococcal vaccination regardless of This factor is and a is an for vaccination in such however, infection is not an for meningococcal vaccination, such patients these patients may only have received a vaccine against serogroup and may quadrivalent Some health care will also consider that children are at higher risk of that travelers may be and at higher risk of As with many other immunization in the general population, the of vaccinating travelers is to both the individual from meningococcal disease and society from its In of the large variety of against all vaccineâpreventable is and therefore meningococcal vaccines are to be preferred vaccines for travelers. meningococcal glycoconjugate vaccines should be preferred polysaccharide vaccines due to their in terms of in of immunologic longer of apparent of hyporesponsiveness with repeat and in carriage of N 43 vaccines are particularly considering that the of immunization in travelers is to the risk of disease in the individual as well as the of transmission to and the international spread of At there are two glycoconjugate meningococcal vaccines that against disease caused by C, Wâ135, and for use in individuals aged to 55 one also to Although these vaccines are and well remain in our against meningococcal disease. There currently is no vaccine that against of N meningitidis serogroup which is a of meningococcal disease outbreaks and epidemics in many regions in the the of the serogroup in recent years, in must be as there is no vaccine for Finally, there is no vaccine currently indicated for against meningococcal disease in 2 years of However, there is for the future. A glycoconjugate meningococcal vaccine is now in various countries that can be from the age of 2 against serogroup B are in national travel recommendations may travel with an to meningococcal vaccination as a to and spread of disease by International is has for and on for attending for from and
Commitment schemes, secret sharing schemes, interactive zero-knowledge proofs which underlie the offered interactive secrete sharing schemes are considered. Such schemes are one of the main computing primitives in the theory of secure computations. Base elements of the theory of secure computations and schemes of construction of synchronous verifiable secrete sharing as schemes of secure function evaluation are resulted.
Pervasive computing is an exciting and blooming research field, in which innovative techniques and applications are continuously emerging and aim to provide ambient and personalized services to users with high quality. Ad hoc networks are wireless, self-organizing systems formed by co-operating nodes within communication range of each other that form temporary networks. Their topology is dynamic, decentralized, ever changing and the nodes may move around arbitrarily. The last few years have witnessed a wealth of research ideas on ad hoc networking that are moving rapidly into implemented standards. Technology under development for ad hoc networks and pervasive computing is making important steps toward this end goal possible. However, the security concerns remain a serious impediment to widespread adoption. The underlying radio communication medium for wireless network provides serious exposure to attacks against wireless networks. Wireless ad hoc networks usually cannot depend on traditional infrastructure found in enterprise environments such as dependable power sources, high bandwidth, continuous connectivity, common network services, well-known membership, static configuration, system administration, and physical security. Finally, throw in malicious adversaries with Byzantine collusion threats and you have a very interesting and challenging problem. Without adequate security, enterprises will not be able to profit from the use of wireless ad hoc networks and pervasive computing environment, defense organizations might be unable to guarantee the safety of their personnel in battlefield scenarios, and wireless ad hoc networks and pervasive computing will remain on the drawing board even if the other problems associated with them are solved. This special issue is focused on various aspects of security in ad hoc networks and pervasive computing research and development to report both in-depth research and applications-oriented works. The special issue is intended to foster state-of-the-art research in the area of security in ad hoc networks and pervasive computing. The aim of this special issue is to present a collection of high quality research papers that report the latest research advances in security of ad hoc. In this special issue, we selected seven papers, which can demonstrate advanced works in this field. A detailed overview of the selected works is given below. The first paper, An RC4-Based Lightweight Protocol for Secure Data Transmission on Resource-Constrained Devices, presents a simple, lightweight, but robust security protocol based on the backward property of RC4 stream cipher. The proposed protocol provides data confidentiality, data authentication, data integrity, and data freshness with low overhead and simple operation, allows packets be received in an arbitrary order, achieves semantic security, and does not require frequent key renew. The second paper, PAPA-UIC: A Design Approach and a Framework for Secure Mobile Ad-hoc Networks, proposes a new design approach and a framework for securing a practical type of MANETs. The framework is named PAPA-UIC. The paper proposes a secure routing protocol and solutions to general problems of identity-based cryptography. The routing protocol has several improvements over existing ones. The third paper, RFIDGuard: A Lightweight Privacy and Authentication Protocol for Passive RFID Tags, introduces a protocol which requires little computation and achieves both privacy and authentication simultaneously. The lightweight and secure nature of the RFIDGuard protocol make it particularly suitable for supply chain management. The fourth paper, Using Hidden Markov Model to Detect Rogue Access Points, proposes a statistical based approach to detect rogue access points using a Hidden Markov Model, which is applied to passively measure packet-header data collected at a gateway router. The main idea is to process the sequence of packet traces in order to distinguish the normal packets from the abnormal ones. The approach is scalable and non-intrusive, requiring little deployment cost and effort, and is easy to manage and maintain. The fifth paper, Defending Sybil Attacks Based on Neighboring Relations in Wireless Sensor Networks, develops a mechanism to protect a WSN from Sybil attacks without using any authentication-based method. Furthermore, the detection approach requires no specialized hardware or support devices. The feature that a malicious node creates many fake identities is exploited to distinguish legitimate nodes from Sybil/malicious nodes. Since all of the fake identities forged by the same malicious node are associated with the same physical device, they will have the same legitimate neighbors. Therefore, by collecting the neighboring information of the suspected victim of the Sybil attacks, the legitimate nodes which are the neighbors of the malicious nodes can be determined. In contrast to existing protection schemes, this approach has no requirement for shared keys, secret information, or special hardware support. The sixth paper, An Autonomous Attestation Token to Secure Mobile Agents in Disaster Response, introduces the Autonomous Attestation Token (AAT), a hardware token for mobile computing devices that is capable of guaranteeing the trusted state of a limited set of devices without relying on a networked service. The paper proposes a Local Attestation protocol with user interaction that in conjunction with the AAT prevents unauthorized access to an emergency mobile agent platform. In addition, the paper sketches a possible solution which integrates trusted computing to leverage ad hoc networks and peer-to-peer systems to provide a robust communication platform. The seventh paper, Building Advanced Applications with the Belgian eID, introduces the Belgian Electronic Identity Card. The card enables Belgian citizens to digitally prove their identity and to sign electronic documents. This paper presents two reusable extensions to the Belgian eID technology that opens up new opportunities for application developers. First, a secure and ubiquitously accessible remote storage service is presented. Second, it is shown how the eID card can be used to issue new certificates. The feasibility and reusability of both extensions are validated through the development of several applications in different domains. In conclusion, this issue of Security in Ad hoc offers a groundbreaking view into the recent advances in secure ad hoc networks. This issue offers both academic and industry appeal the former as a basis toward future research directions, and the latter toward viable commercial applications. Finally, we would like to express our gratitude to the Editor-in-Chief, Professor HsiaoHwa Chen for his advice, patience, and encouragements since the beginning until the final stage. Special thanks go to Michelle in Wiley during the production. We thank all anonymous reviewers who spent much of their precious time reviewing all the papers. Their timely reviews and comments greatly helped us select the best papers in this special issue. We also thank all authors who have submitted their papers for consideration for this issue. We hope you will enjoy reading the great selection of papers in this issue.
China has been carrying out a significant fiscal decentralization policy for over three decades. However, reforms have largely concentrated on the revenue side of budgets, and generally they have not been coordinated with an explicit strategy for the decentralization of expenditure assignments. Although significant strides have been made in the areas of tax assignments and tax administration, other areasâin particular, the assignment of government functionsâhave advanced much less. Yet a stable, efficient, and fair decentralized system of public finance in China will require an unambiguous and well-defined institutional framework in the assignment of expenditure responsibilities among the different levels of government. The assignment of responsibilities is by no means the only condition, but it is the most important, and it should also be the first in a well-sequenced decentralization reform effort. This chapter reviews the most important current issues surrounding the assignment of expenditure responsibilities in China. In order to put those issues in the proper perspective, an overview is provided of the general principles of expenditure assignments and the common problems encountered in the international experience. The chapter also provides a road map and practical recommendations for the reform of expenditure assignments in China.
First, Veblen's distinction between industrial and pecuniary employments with special regard to speculation is introduced. Second, investment banking as a prime example for pecuniary activities is presented. Third, a dominant fundamentalist, market efficiency and a heterodox speculation paradigm of financial markets are distinguished. Fourth, ten proposals for financial market reform (e.g., decentralization) are proposed. Finally, it is asked why these reforms, which should support a productive-serviceable function of finance, will not be realized. This is due to a capturing of the public sector and the prevailing scientific and ideological habits of thought.