Vertical Grants and Local Public Efficiency

This paper analyses the impact of vertical grants on local public sector efficiency. First, we develop a theoretical model in which the bureaucrat sets the tax price while voters choose the quantity of public services. In this model, grants reduce efficiency if voters do not misinterpret the amount of vertical grants the local bureaucrats receive. If voters suffer from fiscal illusion, i.e. overestimate the amount of grants, our model yields an ambiguous effect of grants on efficiency. Second, we use the model to launch a note of caution concerning the inference that can be drawn from the existing cross-sectional studies in this field: Taking into account vertical financial equalization systems that reduce differences in fiscal capacity, empirical studies based on cross-sectional data may yield a positive relationship between grants and efficiency even when the underlying causal effect is negative. Third, we perform an empirical analysis for the German state of Saxony-Anhalt, which has implemented such a fiscal equalization system. We find a positive relationship between grants and efficiency. Our analysis shows that a careful reassessment of existing empirical evidence with regard to this issue seems necessary.Dieser Beitrag untersucht den Einfluss vertikaler Zuweisungen (d.h. Zuweisungen einer übergeordneten Gebietskörperschaft an eine nachgeordnete Gebietskörperschaft) auf die Effizienz des kommunalen Sektors. Erstens wird ein theoretisches Modell entwickelt, in dem die Bürokraten den Steuerpreis festsetzen, während die Wähler über die gewünschte Menge der öffentlichen Leistungen entscheiden. In diesem Modellrahmen bewirken Zuweisungen eine Effizienzverringerung, solange die Wähler die Höhe der vertikalen Zuweisungen, die die Bürokraten erhalten haben, nicht falsch einschätzen. Falls die Wähler unter Fiskalillusion leiden sollten, d.h. die Höhe der erhaltenen Zuweisungen überschätzen, liefert das Modell keine eindeutigen Ergebnisse bezüglich der Effizienzwirkungen von Zuweisungen mehr. Zweitens werden die Modellergebnisse herangezogen, um zur Vorsicht bei Rückschlüssen aus den vorliegenden Querschnittsanalysen zu diesem Bereich zu mahnen: Bei vertikalen Finanzausgleichssystemen zum Ausgleich von Finanzkraftunterschieden können empirische Untersuchungen auf der Basis von Querschnittsdaten einen positiven Zusammenhang zwischen Effizienz und Zuweisungen nahelegen, selbst wenn der zugrundeliegende Kausalzusammenhang negativ ist. Drittens wird eine empirische Analyse für das Bundesland Sachsen-Anhalt durchgeführt, das ein entsprechendes System des kommunalen Finanzausgleichs praktiziert. Die Ergebnisse deuten auf einen positiven Zusammenhang zwischen Zuweisungen und kommunaler Effizienz hin. Die Analyse zeigt daher, dass eine vorsichtige Neubewertung der vorliegenden empirischen Ergebnisse zu diesem Thema notwendig scheint

Vertical Grants and Local Public Efficiency

This paper analyses the impact of vertical grants on local public sector efficiency. First, we develop a theoretical model in which the bureaucrat sets the tax price while voters choose the quantity of public services. We use a very simple theoretical model to show that grants reduce efficiency even if voters do not suffer from fiscal illusion. Second, we use the model and the fact that vertical financial equalization systems often reduce differences in fiscal capacity to argue that empirical studies based on cross-sectional data may yield a positive relationship between grants and efficiency even when the underlying causal effect is negative. Third, we perform an empirical analysis for the German state of Saxony-Anhalt, which has implemented such a fiscal equalization system. The empirical patterns we observe support the argument that the fiscal equalization system may have this inference-disturbing effect.Dieser Beitrag untersucht den Einfluss vertikaler Zuweisungen (d.h. Zuweisungen einer übergeordneten Gebietskörperschaft an eine nachgeordnete Gebietskörperschaft) auf die Effizienz des kommunalen Sektors. Erstens wird ein theoretisches Modell entwickelt, in dem die Bürokraten den Steuerpreis festsetzen, während die Wähler über die gewünschte Menge der öffentlichen Leistungen entscheiden. In diesem Modellrahmen bewirken Zuweisungen eine Effizienzverringerung, solange die Wähler die Höhe der vertikalen Zuweisungen, die die Bürokraten erhalten haben, nicht falsch einschätzen. Falls die Wähler unter Fiskalillusion leiden sollten, d.h. die Höhe der erhaltenen Zuweisungen überschätzen, liefert das Modell keine eindeutigen Ergebnisse bezüglich der Effizienzwirkungen von Zuweisungen mehr. Zweitens werden die Modellergebnisse herangezogen, um zur Vorsicht bei Rückschlüssen aus den vorliegenden Querschnittsanalysen zu diesem Bereich zu mahnen: Bei vertikalen Finanzausgleichssystemen zum Ausgleich von Finanzkraftunterschieden können empirische Untersuchungen auf der Basis von Querschnittsdaten einen positiven Zusammenhang zwischen Effizienz und Zuweisungen nahelegen, selbst wenn der zugrundeliegende Kausalzusammenhang negativ ist. Drittens wird eine empirische Analyse für das Bundesland Sachsen-Anhalt durchgeführt, das ein entsprechendes System des kommunalen Finanzausgleichs praktiziert. Die Ergebnisse deuten auf einen positiven Zusammenhang zwischen Zuweisungen und kommunaler Effizienz hin. Die Analyse zeigt daher, dass eine vorsichtige Neubewertung der vorliegenden empirischen Ergebnisse zu diesem Thema notwendig scheint.This is a revised version of the original paper of March 2014

The landscape of childhood. A study of young adults’ memories in the face of childhood nature

I denne studien undersøker vi hvilke minner som kommer til syne når unge voksne møter barndommens nærnatur igjen, og hvordan kan vi forstå disse minnene. Arbeidet tar utgangspunkt i en kulturell fenomenologisk forståelse. Åtte unge voksne har gått tilbake til sine barndomssteder i skolens nærnatur sammen med en av forskerne. De har gått, klatret og snakket om friluftsliv, lek og lekesteder ute i barndommen. Metoden åpner for å studere komplekse, kroppsliggjorte og stedsspesifikke minner og erfaringer knyttet til konkrete steder, aktiviteter og sosiale relasjoner. Teoretisk bygger studien på fenomenologen Merleau-Pontys beskrivelser av hvordan mennesker bebor verden, Rosas teori om resonans og Caseys tekster om minner og steder. Resultatene viser at de unge voksnes kroppslige utforskning gjennom lek og friluftsliv i barndommen har vært avgjørende for dannelsen av det vi betegner som barndommens landskap. Deres minner fra stedene har hatt betydning for hvem de er i dag, og har lagt et grunnlag for hvordan de forholder seg til natur og medmennesker. Stedsidentitet, formet gjennom friluftsliv og lek i barndommens landskap, kan gi tilhørighet, forankring og resonans i en omskiftelig verden. Dette arbeidet viser at skolens nærnatur kan være viktig for barn og unges dannelse i vid forstand.publishedVersio

Safety and feasibility of a Dalcroze eurhythmics and a simple home exercise program among older adults with mild cognitive impairment (MCI) or mild dementia: the MOVE for your MIND pilot trial

Background Falls represent a major health problem for older adults with cognitive impairment, and the effects of exercise for fall reduction are understudied in this population. This pilot randomized controlled trial evaluated the feasibility, safety, and exploratory effectiveness of a Dalcroze eurhythmics program and a home exercise program designed for fall prevention in older adults with mild cognitive impairment (MCI) or early dementia. Methods For this three-arm, single-blind, 12-month randomized controlled pilot trial, we recruited community-dwelling women and men age 65 years and older with MCI or early dementia through participating memory clinics in Zurich, Switzerland. Participants were randomly assigned to a Dalcroze eurhythmics group program, a simple home exercise program (SHEP), or a non-exercise control group. All participants received 800 IU of vitamin D3 per day. The main objective of the study was to test the feasibility of recruitment and safety of the interventions. Additional outcomes included fall rate, gait performance, and cognitive function. Results Over 12 months, 221 older adults were contacted and 159 (72%) were screened via telephone. Following screening, 12% (19/159) met the inclusion criteria and were willing to participate. One participant withdrew at the end of the baseline visit and 18 were randomized to Dalcroze eurhythmics (n = 7), SHEP (n = 5), or control (n = 6). Adherence was similarly low in the Dalcroze eurhythmics group (56%) and in the SHEP group (62%; p = 0.82). Regarding safety and pilot clinical endpoints, there were no differences between groups. Conclusion The MOVE for your MIND pilot study showed that recruitment of older adults with MCI or early dementia for long-term exercise interventions is challenging. While there were no safety concerns, adherence to both exercise programs was low

Effects of Vitamin D, Omega-3 Fatty Acids and a Home Exercise Program on Prevention of Pre-Frailty in Older Adults: The DO-HEALTH Randomized Clinical Trial

Background: The benefits of supplemental vitamin D3, marine omega-3 fatty acids, and a simple home exercise program (SHEP) on frailty prevention in generally healthy community-dwelling older adults are unclear. Objective: To test the effect of vitamin D3, omega-3s, and a SHEP, alone or in combination on incident pre-frailty and frailty in robust older adults over a follow-up of 36 months. Methods: DO-HEALTH is a multi-center, double-blind, placebo-controlled, 2x2x2 factorial randomized clinical trial among generally healthy European adults aged 70 years or older, who had no major health events in the 5 years prior to enrollment, sufficient mobility and intact cognitive function. As a secondary outcome of the DO-HEALTH trial, among the subset of participants who were robust at baseline, we tested the individual and combined benefits of supplemental 2,000 IU/day of vitamin D3, 1 g/day of marine omega-3s, and a SHEP on the odds of being pre-frail and frail over 3 years of follow-up. Results: At baseline, 1,137 out of 2,157 participants were robust (mean age 74.3 years, 56.5% women, mean gait speed 1.18 m/s). Over a median follow-up time of 2.9 years, 696 (61.2%) became pre-frail and 29 (2.6%) frail. Odds ratios for becoming pre-frail were not significantly lower for vitamin D3, or omega 3-s, or SHEP, individually, compared to control (placebo for the supplements and control exercise). However, the three treatments combined showed significantly decreased odds (OR 0.61 [95% CI 0.38-0.98; p=0.04) of becoming pre-frail compared to control. None of the individual treatments or their combination significantly reduced the odds of becoming frail. Conclusion: Robust, generally healthy and active older adults without major comorbidities, may benefit from a combination of high-dose, supplemental vitamin D3, marine omega-3s, and SHEP with regard to the risk of becoming pre-frail over 3 years. Keywords: Frailty prevention; clinical trial; older adults

Graphene growth on h-BN by Molecular Beam Epitaxy

The growth of single layer graphene nanometer size domains by solid carbon source molecular beam epitaxy on hexagonal boron nitride (h-BN) flakes is demonstrated. Formation of single-layer graphene is clearly apparent in Raman spectra which display sharp optical phonon bands. Atomic-force microscope images and Raman maps reveal that the graphene grown depends on the surface morphology of the h-BN substrates. The growth is governed by the high mobility of the carbon atoms on the h-BN surface, in a manner that is consistent with van der Waals epitaxy. The successful growth of graphene layers depends on the substrate temperature, but is independent of the incident flux of carbon atoms.Comment: Solid State Communications, 201

Effects of diet on the outcomes of rheumatic and musculoskeletal diseases (RMDs): systematic review and meta-analyses informing the 2021 EULAR recommendations for lifestyle improvements in people with RMDs

BackgroundA EULAR taskforce was convened to develop recommendations for lifestyle behaviours in rheumatic and musculoskeletal diseases (RMDs). In this paper, the literature on the effect of diet on the progression of RMDs is reviewed.MethodsSystematic reviews and meta-analyses were performed of studies related to diet and disease outcomes in seven RMDs: osteoarthritis (OA), rheumatoid arthritis (RA), systemic lupus erythematosus, axial spondyloarthritis, psoriatic arthritis, systemic sclerosis and gout. In the first phase, existing relevant systematic reviews and meta-analyses, published from 2013 to 2018, were identified. In the second phase, the review was expanded to include published original studies on diet in RMDs, with no restriction on publication date. Systematic reviews or original studies were included if they assessed a dietary exposure in one of the above RMDs, and reported results regarding progression of disease (eg, pain, function, joint damage).ResultsIn total, 24 systematic reviews and 150 original articles were included. Many dietary exposures have been studied (n=83), although the majority of studies addressed people with OA and RA. Most dietary exposures were assessed by relatively few studies. Exposures that have been assessed by multiple, well conducted studies (eg, OA: vitamin D, chondroitin, glucosamine; RA: omega-3) were classified as moderate evidence of small effects on disease progression.ConclusionThe current literature suggests that there is moderate evidence for a small benefit for certain dietary components. High-level evidence of clinically meaningful effect sizes from individual dietary exposures on outcomes in RMDs is missing

Validity of hand hygiene compliance measurement by observation: A systematic review

BACKGROUND: Hand hygiene is monitored by direct observation to improve practice, but this approach can potentially cause information, selection, and confounding bias, threatening the validity of findings. The aim of this study was to identify and describe the potential biases in hand hygiene compliance monitoring by direct observation; develop a typology of biases and propose improvements to reduce bias; and increase the validity of compliance measurements. METHODS: This systematic review of hospital-based intervention studies used direct observation to monitor health care workers' hand hygiene compliance. RESULTS: Seventy-one publications were eligible for review. None was free of bias. Selection bias was present in all studies through lack of data collection on the weekends (n = 61, 86%) and at night (n = 46, 65%) and observations undertaken in single-specialty settings (n = 35, 49%). We observed inconsistency of terminology, definitions of hand hygiene opportunity, criteria, tools, and descriptions of the data collection. Frequency of observation, duration, or both were not described or were unclear in 58 (82%) publications. Observers were trained in 56 (79%) studies. Inter-rater reliability was measured in 26 (37%) studies. CONCLUSIONS: Published research of hand hygiene compliance measured by direct observation lacks validity. Hand hygiene should be measured using methods that produce a valid indication of performance and quality. Standardization of methodology would expedite comparison of hand hygiene compliance between clinical settings and organizations

Cotranslational folding of spectrin domains via partially structured states.

How do the key features of protein folding, elucidated from studies on native, isolated proteins, manifest in cotranslational folding on the ribosome? Using a well-characterized family of homologous α-helical proteins with a range of biophysical properties, we show that spectrin domains can fold vectorially on the ribosome and may do so via a pathway different from that of the isolated domain. We use cryo-EM to reveal a folded or partially folded structure, formed in the vestibule of the ribosome. Our results reveal that it is not possible to predict which domains will fold within the ribosome on the basis of the folding behavior of isolated domains; instead, we propose that a complex balance of the rate of folding, the rate of translation and the lifetime of folded or partly folded states will determine whether folding occurs cotranslationally on actively translating ribosomes.Supported by grants from the Swedish Cancer Foundation, the Swedish Research Council and the Knut and Alice Wallenberg Foundation (to G.v.H.); the Wellcome Trust (WT095195 to J.C.) and the European Research Council (ERC-2008-AdG 232648, to R.B.). J.C. is a Wellcome Trust Senior Research Fellow

31st Annual Meeting and Associated Programs of the Society for Immunotherapy of Cancer (SITC 2016) : part two

Background The immunological escape of tumors represents one of the main ob- stacles to the treatment of malignancies. The blockade of PD-1 or CTLA-4 receptors represented a milestone in the history of immunotherapy. However, immune checkpoint inhibitors seem to be effective in specific cohorts of patients. It has been proposed that their efficacy relies on the presence of an immunological response. Thus, we hypothesized that disruption of the PD-L1/PD-1 axis would synergize with our oncolytic vaccine platform PeptiCRAd. Methods We used murine B16OVA in vivo tumor models and flow cytometry analysis to investigate the immunological background. Results First, we found that high-burden B16OVA tumors were refractory to combination immunotherapy. However, with a more aggressive schedule, tumors with a lower burden were more susceptible to the combination of PeptiCRAd and PD-L1 blockade. The therapy signifi- cantly increased the median survival of mice (Fig. 7). Interestingly, the reduced growth of contralaterally injected B16F10 cells sug- gested the presence of a long lasting immunological memory also against non-targeted antigens. Concerning the functional state of tumor infiltrating lymphocytes (TILs), we found that all the immune therapies would enhance the percentage of activated (PD-1pos TIM- 3neg) T lymphocytes and reduce the amount of exhausted (PD-1pos TIM-3pos) cells compared to placebo. As expected, we found that PeptiCRAd monotherapy could increase the number of antigen spe- cific CD8+ T cells compared to other treatments. However, only the combination with PD-L1 blockade could significantly increase the ra- tio between activated and exhausted pentamer positive cells (p= 0.0058), suggesting that by disrupting the PD-1/PD-L1 axis we could decrease the amount of dysfunctional antigen specific T cells. We ob- served that the anatomical location deeply influenced the state of CD4+ and CD8+ T lymphocytes. In fact, TIM-3 expression was in- creased by 2 fold on TILs compared to splenic and lymphoid T cells. In the CD8+ compartment, the expression of PD-1 on the surface seemed to be restricted to the tumor micro-environment, while CD4 + T cells had a high expression of PD-1 also in lymphoid organs. Interestingly, we found that the levels of PD-1 were significantly higher on CD8+ T cells than on CD4+ T cells into the tumor micro- environment (p < 0.0001). Conclusions In conclusion, we demonstrated that the efficacy of immune check- point inhibitors might be strongly enhanced by their combination with cancer vaccines. PeptiCRAd was able to increase the number of antigen-specific T cells and PD-L1 blockade prevented their exhaus- tion, resulting in long-lasting immunological memory and increased median survival