Socio‐economic Considerations in Biosafety and Biotechnology Decision Making: The Cartagena Protocol and National Biosafety Frameworks

Article 26.1 of the Cartagena Protocol on Biosafety left open the possibility for member countries to include in their biosafety regulatory processes the assessment of socio‐economic considerations. Countries may also decide to include such assessments as part of their national legislation or regulations for the approval and deliberate release into the environment of genetically engineered technologies. Countries are debating if and how to implement assessment of socio‐economic considerations. This paper contributes to the ongoing policy dialogue by discussing issues related to socio‐economic assessment including scope, timing, inclusion modalities, methods, decision‐making rules and standards, and the integration of socio‐economic assessments in biosafety and/or biotechnology approval processes. This paper also discusses the implications of such inclusion for technology flows and public and private sector R&D. If inclusion is not done properly, it may negatively impact technology flows especially from the public sector and render an unworkable biosafety system.     

The devil is in the details: Managed care and the unforeseen costs of utilization review as a cost containment mechanism

This article addresses issues of liability when a single-payor in a national health care system makes a decision based on a utilization review program that injures the patient as a result. In Part I, the history of Managed Care Organizations (MCOs) is discussed to establish an understanding of the current health care landscape. Part II explains MCOs' use of utilization review to contain costs and analyzes the manner in which courts have addressed the issue of MCO liability for patient injuries sustained from denial ofcoverage. Finally, Part III concludes that current case law may limit a patient's access to a remedy for injuries sustained from a utilization review decision in a single-payor national health care system.     

An assessment of personality disorders with the Five-Factor Model among Belgian inmates

Many international studies report a high prevalence of personality disorders among inmates on the basis of (semi)-structured diagnostic interviews. The present study proposes a self-reported evaluation of personality disorders using the NEO PI-R. The sample consists of 244 male and 18 female inmates (N=262) who were psychologically assessed. The analysis of the five psychological domains shows that the French-speaking Belgian inmates are as stable, as extroverted, more closed, more agreeable and more conscientious than the normative sample. The NEO PI-R facets are also analyzed. The mean Cohen's d (.26) is small. Two personality disorders have medium effect sizes: obsessive compulsive personality disorder (high) and histrionic personality (low). Small effect sizes exist for antisocial personality (low), psychopathy (low), narcissistic personality (low), schizoid personality (high) and borderline personality (low). In our view, the context of the assessment can partially explain these results but not entirely. The results do not confirm previous studies and question the high rates of psychiatric prevalence in prison.     

Incidental findings in pediatric research

The approach to incidental research findings in children emerges by considering the child-parent relationship and balancing divergent interests and preferences. Incidental findings with clear and proximate clinical importance should be disclosed to both. We recommend that particularly sensitive or private information (e.g., pregnancy or drug use) should be disclosed to the adolescent first, while particularly serious information (e.g., cancer) should first be disclosed to the parent. These approaches allow the researcher to form an alliance with one party prior to engaging the other. However, unlike clinical settings, where there may be presumptive expectations of confidentiality about sharing information within the family, in most research settings it is reasonable to plan to disclose such information to both parties. It is important to communicate this plan during the informed consent process separately to adolescents to avoid enrolling adolescents when sensitive incidental findings such as pregnancy and drug use may be detected. The approach to incidental findings without clear and proximate benefit is challenging. Researchers should plan more limited disclosure of such incidental findings for pediatric participants than for adult participants.     

Balance of Power or the State-to-Nation Balance: Explaining Middle East War-Propensity

The Middle East is one of the most war-prone regions in the international system. What is the most powerful explanation of the war-propensity of this region? I argue that neither realism nor liberalism are able to account for variations in regional war-proneness. Instead, I advance an alternative explanation based on the concept of the state-to-nation balance in the region. This balance refers to the degree of congruence between the division of the region into territorial states and the national aspirations and political identifications of the region's peoples. The balance also refers to the prevalence of strong versus weak states in the region. Thus, I explain the Middle East's high war-proneness by focusing on its relatively low level of state-to-nation balance. This imbalance has led to a powerful combination of revisionist ideologies and state incoherence. While other regions suffer from state incoherence, powerful revisionist nationalist forces, notably pan-nationalist and irredentists (the “Greater State”), aggravate this problem in the Middle East. These revisionist forces are often transborder and are especially powerful in the Middle East because of the high degree of external/transborder incongruence in comparison with all other regions. The combination of nationalist revisionism and state incoherence has made the Middle East more prone to violence than most other regions.     

Updating Political Evaluations: Policy Attitudes, Partisanship, and Presidential Assessments

The pervasive influence of partisanship on political evaluations is well known and understood. Whether citizens rely on their policy attitudes has received less attention, especially in the context of how people update and revise their evaluations. This paper focuses on presidential assessments and uses panel data covering three presidencies to model the determinants of opinion change. The results indicate that policy preferences (like partisanship) exert a regular and substantial influence on how citizens update their presidential evaluations.     

Editor's note

This article examines the argument that the ability of a government to generate “audience costs”—to create a situation, that is, in which it would pay a domestic political price for backing down—plays a key role in determining how international crises run their course. It does this by looking at a dozen great power crises to see how well various aspects of the audience costs argument hold up in the light of the historical evidence. The audience costs mechanism, it turns out, does not play a major role in any of those crises—a conclusion which, the author claims, has certain important methodological implications.