Systematic review of randomised controlled trials:Probiotics for functional constipation

AIM:To systematically evaluate and update evidence on the efficacy and safety of probiotic supplementation for the treatment of constipation. METHODS:The MEDLINE,EMBASE,CINAHL,and Cochrane Library databases were searched in May 2009 for randomised controlled trials(RCTs)performed in paediatric or adult populations related to the study aim. RESULTS:We included five RCTs with a total of 377 subjects(194 in the experimental group and 183 in the control group).The participants were adults (three RCTs,n=266)and ...     

Decentralization as a conflict transformation tool: The challenge in Kosovo

Perspectives are divided on whether decentralization can ease ethnic conflict. This article considers whether asymmetric decentralization reforms in Kosovo have reduced tensions between Kosovo Albanians (K‐Albanians) and Serbs (K‐Serbs). We argue that because decentralization has been linked to Kosovo's sovereignty in the years after the NATO bombings, during the final status talks, and after independence, it has not achieved intended outcomes throughout the territory of Kosovo. Instead of assuaging tensions and generating allegiance to the central government, decentralization has re‐inforced ethnic divisions and strengthened K‐Serb ties to Serbia, particularly in northern Kosovo. Concessions to majority Serb municipalities in Kosovo have been seen by K‐Serbs as a bribe to buy acceptance of independence, while K‐Albanians question their leaders' continued policy of asymmetric decentralization. Since independence, there have been some encouraging developments in southern municipalities, where K‐Serbs have participated in municipal elections organized by Pristina. Based on Kosovo's experience, we argue that policy‐makers must consider the impact of decentralization reforms at multiple levels of conflict. Further, although we find that decentralization may engage minorities in political processes if reforms are attempted after the establishment of a central government, we caution that it must be combined with policies to encourage interaction and dialogue between ethnic groups if it is to assuage conflict. Copyright © 2010 John Wiley & Sons, Ltd.     

Democracy over power? The democratic decision-making process in the case of the attempted privatization of Estonia's power production

The suspense-filled attempted partial privatization of the Narva Power Plants in the neo-liberal darling Estonia involved a rich cast, from trade unions and local scientists, via Estonian courts and ombudsmen to international consulting firms, major global banks and the US government. More important, a detailed single case study on the democratic decision-making process in this privatization case makes it possible to go beyond common generalizations regarding the consequences of neo-liberalism for democratic processes. It shows that purported proponents of economic neo-liberalism such as the US government sometimes use their arguments to advance the narrow business interests of politically well-connected firms. Established private firms can behave in a more rent-seeking manner than publicly owned, ex-communist companies. Liberal economic principles of open competition and a level playing-field are at times used by actors in the democratic process to question top-down, opaque economic decisions.     

Evaluating the Impacts of an Enhanced Family Self-Sufficiency Program

We conduct an impact analysis of the Denver, Colorado, Housing Authority’s Home Ownership Program (HOP) employing quasi experimental methodologies (i.e., nearest-neighbor matching, inverse probability weighting with regression adjustment) that permit causal inferences of program impacts with substantial confidence. HOP is an unusual, enhanced variant of the Family Self-Sufficiency program that incentivizes and assists participants’ purchase of a home. We analyze whether, compared with the control group, HOP participants exhibited significantly greater earnings growth during the program, enhanced economic security, and rates of home buying. We find that participants with a high intensity of treatment showed significant improvement in all outcomes. Results are robust to model specification and insensitive to omitted variable bias typically found in the social sciences. We conclude that a well-conceived and well-executed public housing authority program aimed at building the financial, human and social assets of low-income households receiving housing assistance can yield substantial benefits to participants.     

Responsive regulation in public‐private partnerships: Between deterrence and persuasion

Design‐Build‐Finance‐Maintain‐Operate (DBFMO) contracts are a particular type of public‐private partnership whereby governments transfer the responsibility for the design, construction, financing, maintenance, and operation of a public infrastructure or utility service building to a multi‐headed private consortium through a long‐term performance contract. These arrangements present a typical principal‐agent problem because they incorporate a “carrot and stick” approach in which the agent (consortium) has to fulfill the expectations of the principal (procurer). This article deals with a neglected aspect in the literature related to the actual use of “the sticks or sanctions” in DBFMOs and assesses to what extent and under which conditions contract managers adopt a deterrence‐based enforcement approach or switch to a persuasion‐based approach, specifically when the contract clauses require the use of (automatic) deterrence. An empirical analysis of four DBFMOs in the Netherlands shows that the continuation of service delivery, the need to build trust, and the lack of agreement on output specifications play a role in the willingness of the procurer to apply a more responsive behavior that uses persuasion, even when deterrence should be automatically applied. © 2016 John Wiley & Sons Australia, Ltd     

Collective learning and regime dynamics under uncertainty: labour reform and the way to autocracy in Russia

The article questions the structural approach to autocratic transition that sees government as knowingly and purposely building autocracy, and contributes to the tradition emphasizing the plurality of possible regime developments and the role of contingency therein, by providing a more systematic treatment of such contingency. We offer a path-dependent theory of political change and use insights from cognitive institutionalism to show how ad hoc policy reform practices become accepted as a trusted way of interaction by political actors and how they “learn” their way into autocracy. This intuition is substantiated with a case-study of the labour reform in Putin’s Russia. The early 2000s marked a surge in uncertainty in Russian politics caused by the succession crisis and the profound political turnover it triggered. This uncertainty could have resolved in a number of ways, each leading to a different political development. We trace the actual way out of this uncertainty and show that the major factor to condition further regime trajectory was the way social reforms were conducted. The course of these reforms determined the ruling coalition and the institutions that ensure credible commitment within its ranks (the dominant party), and contributed to crowding out the political market and opposition decay.     

Implementation Challenges of the National Health Insurance Scheme in Selected Districts in Ghana: Evidence from the Field

Ghana’s National Health Insurance Scheme, introduced in 2003, aims to remove financial barriers to health-care access and bridge the inequality gaps in health care. This paper reports on a study of the implementation process in four local government areas in southern and northern Ghana. The paper profiles key institutional actors and draws on qualitative interview data from 33 in-depth interviews. Findings highlight the gaps and challenges that have emerged in the implementation process. Issues of managerial capacity, inadequate and uneven distribution of medical facilities and health-care professionals, cost escalation, fraud and abuse, and reimbursement of providers threaten the sustainability of the scheme.     

The Prospective Associations between Self-Efficacy and Depressive Symptoms from Early to Middle Adolescence: A Cross-Lagged Model

Over the course of adolescence, an increasing number of adolescents experience depression. In order to effectively target depression, identifying risk factors for depressive symptoms is pivotal. Since low levels of self-efficacy were associated with higher levels of depressive symptoms in previous studies, the current study investigated the bidirectional and prospective associations between depressive symptoms and academic, social and emotional self-efficacy from early to mid adolescence in a cross-lagged path model. The sample consisted of 1,341 adolescents (47?% girls) with a mean age of 14 years, SD?=?0.56. Depressive symptoms and self-efficacy levels were assessed every 6 months over a period of 2.5 years. Depressive symptoms predicted subsequent levels of academic and emotional self-efficacy on all time points, and social self-efficacy on one time point. Self-efficacy did not predict subsequent levels of depressive symptoms. There was no evidence of sex differences in the cross-lagged associations between depressive symptoms and self-efficacy levels. Implications of the findings are discussed.