Evidence Use and the Institutions of the State: The Role of Parliament and the Judiciary

This chapter explores the role of parliaments and the judiciary in shaping evidence use in health policy making. Most analyses of the role of scientific evidence focus on the executive, i.e. national governments and ministries of health, as the key state actors in health policy and health system governance. This chapter shifts attention to the other two powers within the state, the legislative and the judiciary. Using the examples analysed in this book the chapter examines how parliaments can use evidence to inform legislative processes and to hold governments to account, although there are substantial differences between countries and political systems. However, there was little suggestion that such approaches were undertaken systematically. In cases in which policies are brought to court, judges may have to deal with scientific evidence within a country’s legal and constitutional framework, again with significant differences between national legal practices

Protocol for Birmingham Atrial Fibrillation Treatment of the Aged study (BAFTA): a randomised controlled trial of warfarin versus aspirin for stroke prevention in the management of atrial fibrillation in an elderly primary care population.

Background Atrial fibrillation (AF) is an important independent risk factor for stroke. Randomised controlled trials have shown that this risk can be reduced substantially by treatment with warfarin or more modestly by treatment with aspirin. Existing trial data for the effectiveness of warfarin are drawn largely from studies in selected secondary care populations that under-represent the elderly. The Birmingham Atrial Fibrillation Treatment of the Aged (BAFTA) study will provide evidence of the risks and benefits of warfarin versus aspirin for the prevention of stroke for older people with AF in a primary care setting. Study design A randomised controlled trial where older patients with AF are randomised to receive adjusted dose warfarin or aspirin. Patients will be followed up at three months post-randomisation, then at six monthly intervals there after for an average of three years by their general practitioner. Patients will also receive an annual health questionnaire. 1240 patients will be recruited from over 200 practices in England. Patients must be aged 75 years or over and have AF. Patients will be excluded if they have a history of any of the following conditions: rheumatic heart disease; major non-traumatic haemorrhage; intra-cranial haemorrhage; oesophageal varices; active endoscopically proven peptic ulcer disease; allergic hypersensitivity to warfarin or aspirin; or terminal illness. Patients will also be excluded if the GP considers that there are clinical reasons to treat a patient with warfarin in preference to aspirin (or vice versa). The primary end-point is fatal or non-fatal disabling stroke (ischaemic or haemorrhagic) or significant arterial embolism. Secondary outcomes include major extra-cranial haemorrhage, death (all cause, vascular), hospital admissions (all cause, vascular), cognition, quality of life, disability and compliance with study medication

The Hijab controversy and French republicanism: Critical analysis and normative propositions

info:eu-repo/semantics/publishe

Migration and Access to Welfare Benefits in the EU: The Interplay between Residence and Nationality

peer reviewedIncreasing mobility to and from European Union (EU) countries has started to challenge the principles of territoriality and national citizenship through which European democracies traditionally conditioned access to social benefits. Existing typologies of immigrant social protection regimes do not seem to adequately capture (nor explain) the diverse repertoire of policy configurations through which European welfare regimes adapt to migration-driven societal dynamics. This introductory chapter provides a critical reflection on the link between migration and access to welfare in the EU. In doing so, it aims to propose a comprehensive analytical framework that allows for a systematic comparison of the inclusiveness of social protection systems towards mobile individuals. We argue that states’ responsiveness towards the social protection needs of their immigrant and emigrant populations has to be examined through a combination of factors, including the characteristics of these populations, the migration history of these countries, as well as the main features of their welfare state.Migration and transnational social protection in (post)crisis Europe (MiTSoPro