Re-Politicising Regulation: Politics: Regulatory Variation and Fuzzy Liberalisation in the Single European Energy Market

[From the introduction] The idea that we are living in the age of the regulatory state has dominated the study of public policy in the European Union and its member states in general, and the study of the utilities sectors in particular.1 The European Commission’s continuous drive to expand the Single Market has therefore been a free-market and rule-oriented project, driven by regulatory politics rather than policies that involve direct public expenditure. The dynamics of European integration are rooted in three central concepts: free trade, multilateral rules, and supranational cooperation. During the 1990s EU competition policy took a ‘public turn’ and set its sights on the public sector.2 EU legislation broke up national monopolies in telecommunications, electricity and gas, and set the scene for further extension of the single market into hitherto protected sectors. Both the integration theory literature (intergovernmentalist and institutionalist alike) and literature on the emergence of the EU as a ‘regulatory state’ assumed that this was primarily a matter of policy making: once agreement had been reached to liberalise the utilities markets a relatively homogeneous process would follow. The regulatory state model fit the original common market blueprint better the old industrial policy approaches. On the other hand, sector-specific studies continue to reveal a less than fully homogeneous internal market. The EU has undergone momentous changes in the last two decades, which have rendered the notion of a homogeneous single market somewhat unrealistic

An investigation of depression and fatigue post West Nile virus infection.

INTRODUCTION: The purpose of this study was to examine depression and fatigue in individuals with a seropositive confirmed history of West Nile virus (WNV) infection. METHODS: The South Dakota State Epidemiologist sent 218 letters inviting residents with a diagnosis of WNV to participate in the study. Forty-five subjects were tested. An occupational therapist and a physical therapist met with each participant to assess performance parameters, including depression and fatigue levels. Subjects (n=42) completed the Revised Center for Epidemiologic Studies Depression Scale (CES-D) during the assessment. The Modified Fatigue Impact Scale (MFIS) was sent to participants as a follow-up questionnaire, and 29 were returned. Subjects were placed within one of three diagnosis groups: West Nile Fever (WNF), West Nile Neuroinvasive Disease (WNND) and WNV without fever or neuroinvasive disease (clinical/unspecified). RESULTS: Frequency of those reporting low risk of depression was similar between diagnosis groups (each approximating 75 percent). Depression severity differences were noted, with subjects diagnosed with WNND more likely to report severe risk for depression. Low correlations between depression and overall fatigue, depression and cognitive fatigue, and depression and psychosocial fatigue indicators were found. There was little if any correlation between depression and physical fatigue indicators. Mean CES-D scores for subjects between 13 to 18 months post infection fell within the mild-moderate risk for depression category. CONCLUSIONS: Identifying depression risk is useful for patient referral purposes and may help minimize symptoms of depression correlated with fatigue, especially following hospitalization for WNV infection

Using International, Interprofessional Service Learning to Promote Transcultural Self-Efficacy and Interprofessional Attitudes in Health Science Students

Interprofessional teams of occupational therapy, physical therapy, physician assistant, and dental hygiene students from the University of South Dakota participated in a service-learning experience in Guatemala. Student perceptions were measured using the Interprofessional Attitudes Scale and the Transcultural Self-Efficacy Tool. Qualitative data were obtained through written reflections and discussions during the immersion component of the service-learning experience. Students reported statistically significant improvements in transcultural self-efficacy as defined by their confidence in interviewing individuals from different cultures; their values, attitudes, and beliefs regarding cultural awareness, acceptance, appreciation, recognition, and advocacy; and their knowledge on how cultural factors influence care. Slightly different findings emerged concerning students’ attitudes about interprofessional practice. Qualitative analysis of personal reflections showed that many students felt purposeful when working as part of an interprofessional team and appreciated the dialogue with other professionals when discussing patient care

Endocrinologic, neurologic, and visual morbidity after treatment for craniopharyngioma

Craniopharyngiomas are locally aggressive tumors which typically are focused in the sellar and suprasellar region near a number of critical neural and vascular structures mediating endocrinologic, behavioral, and visual functions. The present study aims to summarize and compare the published literature regarding morbidity resulting from treatment of craniopharyngioma. We performed a comprehensive search of the published English language literature to identify studies publishing outcome data of patients undergoing surgery for craniopharyngioma. Comparisons of the rates of endocrine, vascular, neurological, and visual complications were performed using Pearson’s chi-squared test, and covariates of interest were fitted into a multivariate logistic regression model. In our data set, 540 patients underwent surgical resection of their tumor. 138 patients received biopsy alone followed by some form of radiotherapy. Mean overall follow-up for all patients in these studies was 54 ± 1.8 months. The overall rate of new endocrinopathy for all patients undergoing surgical resection of their mass was 37% (95% CI = 33–41). Patients receiving GTR had over 2.5 times the rate of developing at least one endocrinopathy compared to patients receiving STR alone or STR + XRT (52 vs. 19 vs. 20%, χ2P < 0.00001). On multivariate analysis, GTR conferred a significant increase in the risk of endocrinopathy compared to STR + XRT (OR = 3.45, 95% CI = 2.05–5.81, P < 0.00001), after controlling for study size and the presence of significant hypothalamic involvement. There was a statistical trend towards worse visual outcomes in patients receiving XRT after STR compared to GTR or STR alone (GTR = 3.5% vs. STR 2.1% vs. STR + XRT 6.4%, P = 0.11). Given the difficulty in obtaining class 1 data regarding the treatment of this tumor, this study can serve as an estimate of expected outcomes for these patients, and guide decision making until these data are available