Report on Policy Delivery Systems and their relations with types of governance models

This report has focused on many aspects linked to objectives of the WP3. We have tried to identify the main relations amongst the different levels of governance; we have also explored and described the delivery systems in different contexts, including those with a LEADER-like approach. The analysis of the delivery systems in different contexts is a crucial issue in understanding the impact of Rural Development Programmes. But RDP delivery is an issue not very widely studied in policy analysis and, when studied, is essentially based on the traditional State-Region dichotomy and on the operational side, on the opposition between National Programme and Regional Programmes. We need to explore delivery at the micro-level and to take into account of more complex variables. The typology that was identified in this report proved to some extent to explain the main differences between countries and regions. Based on two main dimensions, the typology classified delivery in four types: a) Centralised and driven by sectoral administration; b) Decentralised and driven by sectoral administration; c) Centralised and driven by multiple actors; d) Decentralised and driven by multiple actors. This typology of delivery is strictly based on typical variables of governance. Most countries have been managing their RDP(s) through a delivery system which is defined within the boundaries of sectoral administrations. Therefore, even the analysis of delivery confirms the dominance of agricultural interests in driving the implementation of RDP. This feature has to be associated with the concentration of the decisional power in the hands of central structures, being either Ministries or Regional Departments of Agriculture. These types show clear differences in terms of difficulties met by delivery and times of implementation. However, other differences emerge from the analysis between: · Groups of measures (mainly between measures of investment and measures of income support); · Groups of countries. We have to take into account relevant differences between old and new Member States, being much more diversified than was foreseen in their delivery systems and in the performances of the different systems. The analysis of crucial phases of the delivery reveals interesting differences according to type of macro-delivery, type of measure and group of countries in terms of times of implementation and intensity of problems met in delivery. However, implementation times are influenced by many institutional and structural variables, and the comparative analysis above needs some note of caution

Review of Rural Development Instruments: DG Agri project 2006-G4-10. Final Report

The aim of the study was to review the policy instruments under the framework of the European Agricultural Fund for Rural Development (EAFRD), 2007-13, by: • reviewing intervention rationales and instruments and their use against the objectives, priorities and key actions in the EU Strategic Guidelines; • assessing whether and how RD rationales and instruments should be adapted to deliver these more effectively. The study involved 8 tasks, grouped into 3 themes of analysis: 1) the targeting of EU-27 rural development expenditure, 2000-13, including the development of databases of EU-27 rural area characteristics and ‘indicators of need’ for RD; 2) consideration of the adequacy of the current EAFRD framework, based upon an evaluation of instruments’ cost-effectiveness; the a priori development of a typology of RD interventions and catalogue of instruments; an analysis of delivery mechanisms; and assessment of instruments in ‘fiches’; 3) conclusions and recommendations. In the event, progress in finalising national and/or regional RDPs 2007-13 was delayed,over the study period. Thus, the approach was modified to incorporate more qualitative analysis and the expenditure analysis was made using incomplete figures (July 2007), so 4% of total EAFRD planned expenditure was missing

Causal effect of plasminogen activator inhibitor type 1 on coronary heart disease

Background--Plasminogen activator inhibitor type 1 (PAI-1) plays an essential role in the fibrinolysis system and thrombosis. Population studies have reported that blood PAI-1 levels are associated with increased risk of coronary heart disease (CHD). However, it is unclear whether the association reflects a causal influence of PAI-1 on CHD risk. Methods and Results--To evaluate the association between PAI-1 and CHD, we applied a 3-step strategy. First, we investigated the observational association between PAI-1 and CHD incidence using a systematic review based on a literature search for PAI-1 and CHD studies. Second, we explored the causal association between PAI-1 and CHD using a Mendelian randomization approach using summary statistics from large genome-wide association studies. Finally, we explored the causal effect of PAI-1 on cardiovascular risk factors including metabolic and subclinical atherosclerosis measures. In the systematic meta-analysis, the highest quantile of blood PAI-1 level was associated with higher CHD risk comparing with the lowest quantile (odds ratio=2.17; 95% CI: 1.53, 3.07) in an age- and sex-adjusted model. The effect size was reduced in studies using a multivariable-adjusted model (odds ratio=1.46; 95% CI: 1.13, 1.88). The Mendelian randomization analyses suggested a causal effect of increased PAI-1 level on CHD risk (odds ratio=1.22 per unit increase of log-transformed PAI-1; 95% CI: 1.01, 1.47). In addition, we also detected a causal effect of PAI-1 on elevating blood glucose and high-density lipoprotein cholesterol. Conclusions--Our study indicates a causal effect of elevated PAI-1 level on CHD risk, which may be mediated by glucose dysfunction

Application of Next-Generation Sequencing for the Genomic Characterization of Patients with Smoldering Myeloma

Genomic analysis could contribute to a better understanding of the biological determinants of the evolution of multiple myeloma (MM) precursor disease and an improved definition of high-risk patients. To assess the feasibility and value of next-generation sequencing approaches in an asymptomatic setting, we performed a targeted gene mutation analysis and a genome-wide assessment of copy number alterations (CNAs) by ultra-low-pass whole genome sequencing (ULP-WGS) in six patients with monoclonal gammopathy of undetermined significance and 25 patients with smoldering MM (SMM). Our comprehensive genomic characterization highlighted heterogeneous but substantial values of the tumor fraction, especially in SMM; a rather high degree of genomic complexity, in terms of both mutations and CNAs, and inter-patient variability; a higher incidence of gene mutations and CNAs in SMM, confirming ongoing evolution; intraclonal heterogeneity; and instances of convergent evolution. ULP-WGS of these patients proved effective in revealing the marked genome-wide level of their CNAs, most of which are not routinely investigated. Finally, the analysis of our small SMM cohort suggested that chr(8p) deletions, the DNA tumor fraction, and the number of alterations may have clinical relevance in the progression to overt MM. Although validation in larger series is mandatory, these findings highlight the promising impact of genomic approaches in the clinical management of SMM