The Last Best Hope for Progressivity in Tax

We argue that a spending tax, as opposed to an income or wage tax, is the “last best hope” for a return to significantly more progressive marginal tax rates than obtain today. The simple explanation for this central claim looks to incentive effects, especially for “rich people,” as both economists and commentators are inclined to focus. High marginal tax rates under an income tax fall on and hence deter the socially productive activities of work and savings. High marginal rates under a wage tax fall on and hence deter the socially productive activity of work alone. But high marginal rates under a spending tax fall on and hence deter high-end spending, which is arguably a social “bad,” and do not necessarily deter the social goods of work and savings. This is a possible empirical result. In this Article, we present the analytic arguments for it and sketch out a research agenda that might verify it. The idea is that because one can escape or defer paying taxes under a progressive spending tax by saving, an activity with positive social externalities, the efficiency costs of high marginal rates under a spending tax can be mitigated. Unless people work only in order to be able to spend on themselves, and even then only if they fully internalize in their present labor supply decisions the ultimate tax they will pay - and we argue that each of these assumptions is unlikely to hold in the extreme - a spending tax can bear more steeply progressive rates with less cost in efficiency or social wealth than can an income or wage tax. A progressive spending tax also holds out the possibility of sorting the rich or high ability into two groups, elastic savers and inelastic spenders, which could yield welfare gains unavailable under income or wage taxes, which under current technologies can only sort the high ability into workers and non-workers. Progressive spending taxes also fall on consumption financed by windfall gains, as to which unexpected good fortune exante incentive effects are likely to be weak

Hybrid Software Development Approaches in Practice: A European Perspective

Agile and traditional development approaches are used in combination in todays software development. To improve the understanding and to provide better guidance for selecting appropriate development approaches, it is important to analyze such combinations in practice. Results obtained from an online survey strongly confirm that hybrid development approaches are widely used in industry. Our results show that hybrid development approaches: (i) have become reality for nearly all companies; (ii) are applied to specific projects even in the presence of company-wide policies for process usage; (iii) are neither planned nor designed but emerge from the evolution of different work practices; and, (iv) are consistently used regardless of company size or industry secto

Residency Times and Patterns of Movement of Postbreeding Dunlin on a Subarctic Staging Area in Alaska

Understanding how individuals use key resources is critical for effective conservation of a population. The Yukon-Kuskokwim Delta (YKD) in western Alaska is the most important postbreeding staging area for shorebirds in the subarctic North Pacific, yet little is known about movements of shorebirds there during the postbreeding period. To address this information gap, we studied residency times and patterns of movement of 17 adult and 17 juvenile radio-marked Dunlin (Calidris alpina) on the YKD between early August and early October 2005. Throughout this postbreeding period, during which Dunlin were molting, most birds were relocated within a 130 km radius of their capture site on the YKD, but three birds were relocated more than 600 km to the south at estuaries along the Alaska Peninsula. On average, juvenile Dunlin were relocated farther away from the banding site (median relocation distance = 36.3 km) than adult Dunlin (median relocation distance = 8.8 km). Post-capture, minimum lengths of stay by Dunlin on the YKD were not significantly different between juveniles (median = 19 days) and adults (median = 23 days), with some birds staging for more than 50 days. Body mass at time of capture was the best single variable explaining length of stay on the YKD, with average length of stay decreasing by 2.5 days per additional gram of body mass at time of capture. Conservation efforts for postbreeding shorebirds should consider patterns of resource use that may differ not only by age cohort but also by individual condition.Pour donner lieu à la conservation efficace d’une population, il est essentiel de comprendre comment les individus se servent des ressources importantes. Le delta Yukon-Kuskokwim, dans l’ouest de l’Alaska, est l’escale de post-reproduction la plus importante des oiseaux de rivage du Pacifique Nord subarctique. Pourtant, on en sait peu sur les déplacements des oiseaux de rivage à cet endroit pendant la période de post-reproduction. Afin de combler ce manque d’information, nous avons étudié les durées de résidence et les habitudes de déplacement de 17 bécasseaux variables (Calidris alpina) adultes et de 17 bécasseaux variables juvéniles radio-marqués dans le delta Yukon-Kuskokwim du début août au début octobre 2005. Pendant la période de post-reproduction pendant laquelle les bécasseaux variables muaient, la plupart des oiseaux ont été déplacés dans un rayon de 130 km de leur lieu de capture dans le delta Yukon-Kuskokwim, mais trois oiseaux ont été relocalisés à plus de 600 km vers le sud, aux estuaires le long de la péninsule de l’Alaska. En moyenne, les bécasseaux variables juvéniles ont été déplacés plus loin du lieu de baguage (distance de déplacement médiane = 36,3 km) que les bécasseaux variables adultes (distance de déplacement médiane = 8,8 km). Par bécasseau variable, les durées de séjour minimales après la capture au delta Yukon-Kuskokwim ne différaient pas considérablement entre les juvéniles (médiane = 19 jours) et les adultes (médiane = 23 jours), certains oiseaux faisant escale pendant plus de 50 jours. La masse corporelle au moment de la capture était la meilleure et la seule variable expliquant la durée du séjour au delta Yukon-Kuskokwim, la durée moyenne du séjour diminuant de 2,5 jours par gramme supplémentaire de masse corporelle au moment de la capture. Les efforts de conservation des oiseaux de rivage en période de post-reproduction devraient tenir compte des modèles d’utilisation des ressources qui risquent de différer non seulement en fonction de la cohorte d’âge, mais également en fonction de l’état de l’individu

Development and pilot-testing of a colorectal cancer screening decision aid for individuals with varying health literacy levels

Objective: Making an informed decision about colorectal cancer screening requires health literacy. Our aim was to develop and pilot-test a computer-based decision aid to support informed decision making about whether or not to participate in colorectal cancer screening for individuals with varying health literacy levels in the Netherlands. Methods: First, we designed and adapted the decision aid prototype among 25 individuals with low (n = 10) and adequate (n = 15) health literacy. Second, we used a before/after study to assess changes in knowledge, attitude, intention, decisional conflict, deliberation, anxiety and risk perception in an online survey among 81 individuals eligible for colorectal cancer screening with low (n = 35) and adequate (n = 46) health literacy. Results: The decision aid was acceptable, comprehensible, reduced decisional conflict, increased deliberation and improved knowledge about colorectal cancer screening, but not about colorectal cancer, among individuals with adequate and low health literacy. Usability was slightly higher for participants with adequate health literacy compared to those with low health literacy. Conclusion: The decision aid is promising in supporting informed decision making about colorectal cancer screening, also among individuals with lower health literacy. Practice implications: Further refinement of interactive features, such as videos, animations and the values clarification exercise, is needed to increase the usability of the decision aid

Public awareness of cancer in Britain: a population-based survey of adults

*_Objective:_* To assess public awareness of cancer warning signs, anticipated delay, and perceived barriers to seeking medical advice in the British population. 
Methods: We carried out a population-based survey using face-to-face, computer-assisted interviews to administer the Cancer Awareness Measure (CAM), a newly-developed, validated measure of cancer awareness. The sample included 2216 adults (970 male and 1246 female) recruited as part of the Office for National Statistics Opinions Survey using stratified probability sampling.

*_Results:_* Awareness of cancer warning signs was low when open-ended (recall) questions were used and higher with closed (recognition) questions; but on either measure, awareness was lower in those who were male, younger, and from lower socioeconomic status (SES) groups or ethnic minorities. The most commonly endorsed barriers to help-seeking were difficulty making an appointment, worry about wasting the doctor’s time and worry about what would be found. Emotional barriers were more prominent in lower SES groups and practical barriers (e.g. too busy) more prominent in higher SES groups. Anticipated delay was lower in ethnic minority and lower SES groups. In multivariate analysis, higher symptom awareness was associated with lower anticipated delay, and more barriers with greater anticipated delay.

*_Conclusions:_* A combination of public education about symptoms and empowerment to seek medical advice, as well as support at primary care level, could enhance early presentation and improve cancer outcomes

Mitochondrial Fusion Is Required for mtDNA Stability in Skeletal Muscle and Tolerance of mtDNA Mutations

Mitochondria are highly mobile and dynamic organelles that continually fuse and divide. These processes allow mitochondria to exchange contents, including mitochondrial DNA (mtDNA). Here we examine the functions of mitochondrial fusion in differentiated skeletal muscle through conditional deletion of the mitofusins Mfn1 and Mfn2, mitochondrial GTPases essential for fusion. Loss of the mitofusins causes severe mitochondrial dysfunction, compensatory mitochondrial proliferation, and muscle atrophy. Mutant mice have severe mtDNA depletion in muscle that precedes physiological abnormalities. Moreover, the mitochondrial genomes of the mutant muscle rapidly accumulate point mutations and deletions. In a related experiment, we find that disruption of mitochondrial fusion strongly increases mitochondrial dysfunction and lethality in a mouse model with high levels of mtDNA mutations. With its dual function in safeguarding mtDNA integrity and preserving mtDNA function in the face of mutations, mitochondrial fusion is likely to be a protective factor in human disorders associated with mtDNA mutations

Making sense of information about HPV in cervical screening: a qualitative study

Introducing human papillomavirus (HPV) testing into cervical cancer screening has the potential to change the way that women understand cervical cancer, the psychological impact of abnormal screening results and the likelihood of future participation in screening. The study used in-depth interviews to examine how women make sense of information about HPV in the context of cervical cancer screening. A total of 74 women were recruited following participation in HPV testing. Women varied widely in their beliefs about the aetiology of cervical cancer and its relationship with sexual activity, as well as in their understanding of the sexually transmitted nature of HPV. While some women who understood that HPV is sexually transmitted were able to integrate this into their existing model of cervical cancer, others were shocked by the link between cervical cancer and sex, of which they had been previously unaware. Women were generally reassured to know that HPV is common, has no symptoms, can lie dormant for many years, can clear up on its own and need not raise concerns about transmission to sexual partners. Women's understanding of HPV varied considerably, even after participation in testing. The way in which information is presented to women will be crucial in minimising the negative psychological impact of testing positive and ensuring that participation in screening remains high