Precautionary Regulation in Europe and the United States: A Quantitative Comparison

Much attention has been addressed to the question of whether Europe or the United States adopts a more precautionary stance to the regulation of potential environmental, health, and safety risks. Some commentators suggest that Europe is more risk-averse and precautionary, whereas the US is seen as more risk-taking and optimistic about the prospects for new technology. Others suggest that the US is more precautionary because its regulatory process is more legalistic and adversarial, while Europe is more lax and corporatist in its regulations. The flip-flop hypothesis claims that the US was more precautionary than Europe in the 1970s and early 1980s, and that Europe has become more precautionary since then. We examine the levels and trends in regulation of environmental, health, and safety risks since 1970. Unlike previous research, which has studied only a small set of prominent cases selected non-randomly, we develop a comprehensive list of almost 3,000 risks and code the relative stringency of regulation in Europe and the US for each of 100 risks randomly selected from that list for each year from 1970 through 2004. Our results suggest that: (a) averaging over risks, there is no significant difference in relative precaution over the period, (b) weakly consistent with the flip-flop hypothesis, there is some evidence of a modest shift toward greater relative precaution of European regulation since about 1990, although (c) there is a diversity of trends across risks, of which the most common is no change in relative precaution (including cases where Europe and the US are equally precautionary and where Europe or the US has been consistently more precautionary). The overall finding is of a mixed and diverse pattern of relative transatlantic precaution over the period

Characteristics of patients initiating raloxifene compared to those initiating bisphosphonates

<p>Abstract</p> <p>Background</p> <p>Both raloxifene and bisphosphonates are indicated for the prevention and treatment of postmenopausal osteoporosis, however these medications have different efficacy and safety profiles. It is plausible that physicians would prescribe these agents to optimize the benefit/risk profile for individual patients. The objective of this study was to compare demographic and clinical characteristics of patients initiating raloxifene with those of patients initiating bisphosphonates for the prevention and treatment of osteoporosis.</p> <p>Methods</p> <p>This study was conducted using a retrospective cohort design. Female beneficiaries (45 years and older) with at least one claim for raloxifene or a bisphosphonate in 2003 through 2005 and continuous enrollment in the previous 12 months and subsequent 6 months were identified using a collection of large national commercial, Medicare supplemental, and Medicaid administrative claims databases (MarketScan^®). Patients were divided into two cohorts, a combined commercial/Medicare cohort and a Medicaid cohort. Within each cohort, characteristics (demographic, clinical, and resource utilization) of patients initiating raloxifene were compared to those of patients initiating bisphosphonate therapy. Group comparisons were made using chi-square tests for proportions of categorical measures and Wilcoxon rank-sum tests for continuous variables. Logistic regression was used to simultaneously examine factors independently associated with initiation of raloxifene versus a bisphosphonate.</p> <p>Results</p> <p>Within both the commercial/Medicare and Medicaid cohorts, raloxifene patients were younger, had fewer comorbid conditions, and fewer pre-existing fractures than bisphosphonate patients. Raloxifene patients in both cohorts were less likely to have had a bone mineral density (BMD) screening in the previous year than were bisphosphonate patients, and were also more likely to have used estrogen or estrogen/progestin therapy in the previous 12 months. These differences remained statistically significant in the multivariate model.</p> <p>Conclusion</p> <p>In this sample of patients enrolled in commercial, Medicare, and Medicaid plans, patients who initiated raloxifene treatment differed from those initiating bisphosphonates. Raloxifene patients were younger, had better overall health status and appeared to be less likely to have risk factors for new osteoporotic fractures than bisphosphonate patients. Differences in the clinical profiles of these agents may impact prescribing decisions. Investigators using observational data to make comparisons of treatment outcomes associated with these medications should take these important differences in patient characteristics into consideration.</p

Counseling Native Americans

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/89558/1/j.1556-6676.1990.tb01473.x.pd

Children in care: Where do children entering care at different ages end up? An analysis of local authority administrative data

Local authorities in England are required to routinely collect administrative data on children in care and cross-sectional analyses of national data are published by central government. This paper explores the usefulness of undertaking a longitudinal analysis of these data at local authority level to determine the care pathways for children entering care, differentiating by age at entry. The sample consisted of 2208 children who entered care in one English local authority over a six-year period, and who were followed up for at least 2 years. A logistic regression model was fitted to explore factors associated with children staying long term in care. Age at entry was a key determinant of where children ended up (return to a parent, special guardianship or residence order, adoption or staying long term in care). Only a minority of entrants (mainly those entering care in their middle years) remained in longer term care. For the vast majority of children, the ‘pre-care family context’ remains important as children will either return to parents or relatives or stay in touch with them. The findings are used to urge service planners to make full use of data on care entrants, especially age at entry, when deciding on the balance between the different placement options needed, and the social work service delivery models

Physical environmental factors that invite older adults to walk for transportation

Knowledge on the physical environmental factors that invite older adults to walk for transportation is limited. The current study aimed to investigate the relationships between environmental factors and invitingness to walk for transportation and the potential moderating effects of gender, functional limitations and current walking for transportation behavior. Sixty older participants evaluated 40 panoramic photographs on their invitingness in two ways: a forced choice (first impressions) and a rating task (more deliberate evaluation). Presence of vegetation, benches, and surveillance significantly positively related to both invitingness-measures. Upkeep and presence of historic elements significantly positively related to the assigned invitingness-ratings. For the forced choice task, significant positive relationships emerged for land use and separation between sidewalk and cycling path, but only in functionally limited participants. Environments offering comfort, safety from crime, and pleasantness may attract older adults to walk for transportation. Experimental and on-site studies are needed to elaborate on current findings

A one-parameter Budyko model for water balance captures emergent behavior in darwinian hydrologic models

Hydrologic models can be categorized as being either Newtonian or Darwinian in nature. The Newtonian approach requires a thorough understanding of the individual physical processes acting in a watershed in order to build a detailed hydrologic model based on the conservation equations. The Darwinian approach seeks to explain the behavior of a hydrologic system as a whole by identifying simple and robust temporal or spatial patterns that capture the relevant processes. Darwinian-based hydrologic models include the Soil Conservation Service (SCS) curve number model, the abcd model, and the Budyko-type models. However, these models were developed based on widely differing principles and assumptions and applied to distinct time scales. Here, we derive a one-parameter Budyko-type model for mean annual water balance which is based on a generalization of the proportionality hypothesis of the SCS model and therefore is independent of temporal scale. Furthermore, we show that the new model is equivalent to the key equation of the abcd model. Theoretical lower and upper bounds of the new model are identified and validated based on previous observations. Thus, we illustrate a temporal pattern of water balance amongst Darwinian hydrologic models, which allows for synthesis with the Newtonian approach and offers opportunities for progress in hydrologic modeling

Violence in the Lives of Rural, Southern, and Poor White Women

Poor White single mothers and their children in non-urban communities in the American South experience high levels of domestic violence. We report selected findings from a life history study among White, low-income, unmarried mothers in South Carolina. Here, we examine how domestic violence in both childhood and adulthood may inhibit asset development by diminishing low-income single mothers’ accumulation of human and social capital, thus compromising their well-being as adults and parents.Yeshttps://us.sagepub.com/en-us/nam/manuscript-submission-guideline

The Hydrologic Responses of Semiarid Watersheds to the Cultivation of Switchgrass (Panicum virgatum L.)

Due in part to the very recent influx of federal and state policies promoting the development of ethanol as a gasoline additive, switchgrass (Panicum virgatum L.) has received much attention. Nevertheless, investigations of the hydrological responses to switchgrass production are few, with those existing largely interested in the Southern or Upper Midwestern regions of the United States. First, a contextualization of switchgrass as a potential biofuel crop vis-à-vis the history of land use change in the Great Plains region of the US is presented. Then, an investigation of the hydrologic responses of two Great Plains watersheds: a 1641 km2 portion of the Middle North Canadian watershed and the 1061 km2 Skeleton Creek Watershed to the cultivation of switchgrass using the semidistributed Soil and Water Assessment Tool (SWAT) hydrological model, specifically the hydrologic responses on total monthly and seasonal discharge, and evapotranspiration, are evaluated. Model results indicate that switchgrass cultivation is associated with decreased spring and summer seasonal runoff and increased spring and summer evapotranspiration relative to those under native land uses including native range grass and winter wheat. When the confounding impacts of changing precipitation and temperature patterns associated with climate change are considered, the impact of switchgrass cultivation on wintertime hydrology is a function of the particular General Circulation Model (GCM) utilized. With the addition of switchgrass, changes in surface runoff are amplified during the winter and summer and changes in evapotranspiration are amplified during all three seasons. Depending on the GCM utilized, either climate change or land use change (switchgrass cultivation) was the dominant driver of change in surface runoff while switchgrass cultivation was the major driver of changes in evapotranspiration. Therefore, any cultivation of switchgrass for biofuel production in the Great Plains region of the US must take into account hydrologic impacts and be accompanied by programs to ensure the sustainability of water supplies