Drivers for Policy Agreement in Nascent Subsystems: An Application of the Advocacy Coalition Framework to Fracking Policy in Switzerland and the UK

The study of public policy deals with subsystems in which actors cooperate or compete to turn their beliefs into policy solutions. Yet, most studies concern mature subsystems in which the main actors and their allies and enemies can easily be identified. This paper tackles the challenge of studying nascent subsystems, in which actors have begun to engage in politics but are uncertain about other actors’ beliefs. Actors therefore find it relatively difficult to identify their allies and opponents. Focusing on the Advocacy Coalition Framework, we examine three main ways in which actors might agree to support the same policy design before they decide whether or not to form long-term relationships within advocacy coalitions: they see the issue through the same lenses, they follow leaders, or they know each other from earlier cooperation. We use the case of fracking policy in Switzerland and the UK as a key example, in which actors have begun to agree with each other, but where final policy outputs were not yet defined, and long-term relationships not yet observable. We find that, when dealing with new issues, actors strongly rely on former contacts rather than shared ideologies or leadership

Familial hypercholesterolaemia in children and adolescents from 48 countries: a cross-sectional study

Background: Approximately 450 000 children are born with familial hypercholesterolaemia worldwide every year, yet only 2·1% of adults with familial hypercholesterolaemia were diagnosed before age 18 years via current diagnostic approaches, which are derived from observations in adults. We aimed to characterise children and adolescents with heterozygous familial hypercholesterolaemia (HeFH) and understand current approaches to the identification and management of familial hypercholesterolaemia to inform future public health strategies. Methods: For this cross-sectional study, we assessed children and adolescents younger than 18 years with a clinical or genetic diagnosis of HeFH at the time of entry into the Familial Hypercholesterolaemia Studies Collaboration (FHSC) registry between Oct 1, 2015, and Jan 31, 2021. Data in the registry were collected from 55 regional or national registries in 48 countries. Diagnoses relying on self-reported history of familial hypercholesterolaemia and suspected secondary hypercholesterolaemia were excluded from the registry; people with untreated LDL cholesterol (LDL-C) of at least 13·0 mmol/L were excluded from this study. Data were assessed overall and by WHO region, World Bank country income status, age, diagnostic criteria, and index-case status. The main outcome of this study was to assess current identification and management of children and adolescents with familial hypercholesterolaemia. Findings: Of 63 093 individuals in the FHSC registry, 11 848 (18·8%) were children or adolescents younger than 18 years with HeFH and were included in this study; 5756 (50·2%) of 11 476 included individuals were female and 5720 (49·8%) were male. Sex data were missing for 372 (3·1%) of 11 848 individuals. Median age at registry entry was 9·6 years (IQR 5·8-13·2). 10 099 (89·9%) of 11 235 included individuals had a final genetically confirmed diagnosis of familial hypercholesterolaemia and 1136 (10·1%) had a clinical diagnosis. Genetically confirmed diagnosis data or clinical diagnosis data were missing for 613 (5·2%) of 11 848 individuals. Genetic diagnosis was more common in children and adolescents from high-income countries (9427 [92·4%] of 10 202) than in children and adolescents from non-high-income countries (199 [48·0%] of 415). 3414 (31·6%) of 10 804 children or adolescents were index cases. Familial-hypercholesterolaemia-related physical signs, cardiovascular risk factors, and cardiovascular disease were uncommon, but were more common in non-high-income countries. 7557 (72·4%) of 10 428 included children or adolescents were not taking lipid-lowering medication (LLM) and had a median LDL-C of 5·00 mmol/L (IQR 4·05-6·08). Compared with genetic diagnosis, the use of unadapted clinical criteria intended for use in adults and reliant on more extreme phenotypes could result in 50-75% of children and adolescents with familial hypercholesterolaemia not being identified. Interpretation: Clinical characteristics observed in adults with familial hypercholesterolaemia are uncommon in children and adolescents with familial hypercholesterolaemia, hence detection in this age group relies on measurement of LDL-C and genetic confirmation. Where genetic testing is unavailable, increased availability and use of LDL-C measurements in the first few years of life could help reduce the current gap between prevalence and detection, enabling increased use of combination LLM to reach recommended LDL-C targets early in life

Legislative Productivity in Comparative Perspective: An Introduction to the Comparative Agenda Project

Working pape

Partisanship and political attention in France: Agenda dynamics and electoral incentives

23 pages, August 28-31, 2008http://www.personal.psu.edu/frb1/papers/apsa_08_French_agendas.pd

Agenda-setting dynamics in France: Revisiting the 'partisan hypothesis'

This paper presents an original way of testing the `partisan hypothesis'. Building on the substantial literature on the party-policy link, we test this link with respect to issue attention, rather than spending or macroeconomic outcomes. We examine the evolution of issue attention through the systematic analysis of agenda setting of three major French political institutions: the President, the government and the National Assembly. Although our results point to partisan differentiation on some issues, the overall conclusion is that partisan differentiation is at best one factor of variation among others