Examining Reports and Policies on Cognitive Enhancement: Approaches,Rationale, and Recommendations

The phenomenon of cognitive enhancement is attracting attention in bioethics literature and beyond, in public policy. In response, three bodies—the British Medical Association (BMA); the Commission de l'éthique de la Science et de la technologie (CEST) du Québec; the American Academy of Neurology (AAN)—have produced reports and guidance on this topic. To gain insights into different public policy approaches, rationales, and recommendations on the topic, we analyzed these reports in depth. We found convergence on the definition (with the exception of the CEST) of cognitive enhancement. However, we noted a lack of critical reflection with respect to the underlying rationale for developing these reports, i.e., that cognitive enhancement practices are rampant and represent major social changes. As it currently stands, cognitive enhancement is constituted in a way that challenges the creation of coherent and effective policy recommendations. However, policy makers should not simply wait for definitional consensus and hope that on balance the benefits turn out to be greater than the risks. Some components of cognitive enhancement could be reduced down to clearly identified policy targets to be further examined. Then, if appropriate, policy should be created that is, amongst other criteria, beneficial to the majority of the population.     

Enhanced rate of resting energy expenditure in women using hormone-replacement therapy: preliminary results

Hormone-replacement therapy (HRT) attenuates the menopause-associated alterations in body composition. It is not known, however, whether this effect is a result of a concomitant increase in energy expenditure. The authors examined whether women submitted to a long-term HRT treatment presented greater energy expenditure than women who had never used HRT. We compared 13 postmenopausal women using HRT (>1 yr) with 13 age- (+/-2 yr) and body-mass-index-matched (BMI; +/-1.5 kg/m2) postmenopausal women not using HRT. Resting energy expenditure (REE; indirect calorimetry), body composition, and daily (DEE) and physical activity (PAEE) energy expenditure (accelerometry) were obtained. Although BMI, fat mass, fat-free mass, DEE, and PAEE were similar between groups, the HRT group displayed a significantly greater REE than the no-HRT group (Delta +222 kcal/day). In conclusion, the authors observed that a long-term treatment with HRT is associated with a greater REE in postmenopausal women. These results need to be confirmed.     

Quality Risk Ratings in Global Supply Chains

Extended enterprises face many challenges in managing the product quality of their suppliers. Consequently characterizing the quality risk posed by value‐chain partners has become increasingly important. There have been several recent efforts to develop frameworks for rating the quality risk posed by suppliers. We develop an analytical model to examine the impact of such quality ratings on suppliers, manufacturers, and social welfare. While it might seem that quality ratings would benefit high‐quality suppliers and hurt low‐quality suppliers, we show that this is not always the case. We find that such quality ratings can hurt both types of suppliers or benefit both, depending on the market conditions. We also find that quality ratings do not always benefit the most demanding manufacturers who desire high‐quality suppliers. Finally, we find that social welfare is not always improved by risk ratings. These results suggest that public policy initiatives addressing risk ratings must be carefully considered.     

Examining the Impact of Demographic Factors on Air Pollution

This study adds to the emerging literature examining empirically the link between population size, other demographic factors and pollution. We contribute by using more reliable estimation techniques and examine two air pollutants. By considering sulfur dioxide, we become the first study to explicitly examine the impact of demographic factors on a pollutant other than carbon dioxide at the cross-national level. We also take into account the urbanization rate and the average household size neglected by many prior cross-national econometric studies. For carbon dioxide emissions we find evidence that population increases are matched by proportional increases in emissions while a higher urbanization rate and lower average household size increase emissions. For sulfur dioxide emissions, we find a U-shaped relationship, with the population-emissions elasticity rising at higher population levels. Urbanization and average household size are not found to be significant determinants of sulfur dioxide emissions. For both pollutants, our results suggest that an increasing share of global emissions will be accounted for by developing countries. Implications for the environmental Kuznets curve literature are described and directions for further work identified.     

Is Maternal and Child Health Service use a Causal Gateway to Subsequent Contraceptive use?: A Multi-Country Study

The purpose of this study is to examine the relationship between MCH service utilization and contraceptive use in five countries: Bolivia, Guatemala, Indonesia, Morocco, and Tanzania. The analysis is carried out at the level of the individual woman, with contraceptive-use status modeled as a function of: (1) the availability, quality, and packaging of MCH and family planning services; (2) community- and individual-level determinants of health service and contraceptive use; and (3) intensity of prior MCH service use. Data for the analysis comes from DHS data on women of reproductive age linked with data from service-availability surveys. We use full-information, maximum-likelihood regression techniques to control for the effects of unobserved heterogeneity that might otherwise bias our estimates. In three of the five countries (Morocco, Guatemala, and Indonesia) the results of the analysis suggest that the intensity of MCH service use is positively associated with subsequent contraceptive use among women, even after controlling for observed and unobserved individual- and community-level factors. This result lends support to the proposition that, at least in the context of these three countries, the intensity of MCH service per se use does have a “causal” impact on subsequent contraceptive use, even after controlling for factors that “predispose” sample women to use health care services.     

Changes in the age dependence of mortality and disability: Cohort and other determinants

Though the general trend in the United States has been toward increasing life expectancy both at birth and at age 65, the temporal rate of change in life expectancy since 1900 has been variable and often restricted to specific population groups. There have been periods during which the age- and gender-specific risks of particular causes of death have either increased or decreased. These periods partly reflect the persistent effects of population health factors on specific birth cohorts. It is important to understand the ebbs and flows of cause-specific mortality rates because general life expectancy trends are the product of interactions of multiple dynamic period and cohort factors. Consequently, we first review factors potentially affecting cohort health back to 1880 and explore how that history might affect the current and future cohort mortality risks of major chronic diseases. We then examine how those factors affect the age-specific linkage of disability and mortality in three sets of birth cohorts assessed using the 1982, 1984, and 1989 National Long Term Care Surveys and Medicare mortality data collected from 1982 to 1991. We find large changes in both mortality and disability in those cohorts. providing insights into what changes might have occurred and into what future changes might be expected.     

Work ethic and orientations to work of the young generations: The impact of educational level

The present study challenges the view that a new work ethic is widespread among the new generations of young people. A survey among 663 Flemish army recruits covering their attitudes to more traditional work motives and facets of the new work ethic, indicated that a “split” of the orientations to work according to educational level could be discerned. These results were interpreted as a social-psychological correlate of unemployment and discussed in the light of the ongoing social transformations of the so-called Third Industrial Revolution.     

Stakeholder value disclosures: anchoring on primacy and importance of financial and nonfinancial performance measures

In the growing debate about stakeholder values, there has been little discussion about information overload or whether the requested disclosures can be effectively used. Stakeholder advocates call for complicated and massive environmental and related social disclosures while not considering how information overload might affect the discourse about corporate performance. Stakeholders, including shareholders, plead for more transparency in financial statements, management discussion and analysis (MDA), and other corporate disclosures. As we know, shareholders and boards of directors are most concerned with the ‘Holy Trinity’ of earnings per share, dividends and market value changes. We believe that managers and stakeholders involved in performance evaluations have multiple interests that extend beyond traditional shareholder value measures. We note that the Balanced Scorecard (BSC) was developed as one tool to reflect and communicate these multiple measures. We test how managers use (or ignore) multiple performance measures and we posit that stakeholders will face many of the same constraints when using and processing multiple disclosures including Corporate Social Reports (CSR), environmental, or similar disclosures. While we do not directly test a wide variety of stakeholder disclosures, we examine eight (four for a single subject) shareholder values (financial measures) and four stakeholder values (nonfinancial measures). The eight measures included in our research instruments serve as proxies for the multiple concerns that might be of interest to many stakeholders. Note that stakeholders are likely to be extremely interested in nonfinancial performance measures, while many shareholders will likely concentrate on financial performance measures. Field research has reported managers tend to favor financial measures while discounting or ignoring nonfinancial measures when evaluating subordinates, making it difficult to align performance evaluations and incentives with corporate strategies (Ittner et al. Account Rev 78:725–758, 2003). In this study, we find the relative weights managers place on financial and nonfinancial performance measures are influenced by both (1) presentation order and (2) the relative importance of specific measures. When financial measures are presented first, the manager who performs better on financial measures is rated higher than the manager who performs better on nonfinancial measures. However, when nonfinancial measures are presented first, managers who excel on nonfinancial measures are rated higher. Reports that include financial measures that are relatively more (less) important also produce higher (lower) ratings for the manager who excels on financial measures. Thus, the relative weights that superiors place on financial and nonfinancial measures in evaluating corporate managers’ performance are substantially anchored both by the order in which measures are presented as well as by the importance of the specific performance measures employed. Other stakeholder disclosures are likely to be similarly anchored, perhaps biased, by primacy and a priori importance rankings.     

Men's sexual health and the metabolic syndrome

The aim of this article is to provide an overview of the current literature on the impact of the metabolic syndrome on male sexual health and current developments in the management of sexually dysfunctional men with a metabolic syndrome. The increasing prevalence across the world of the metabolic syndrome-a cluster of cardiovascular disease risk factors-causes the metabolic syndrome to be considered the most important threat to male sexual health of the 21st century. It has been shown to have a negative impact on male sexual function through its relationship with cardiovascular disease risk, its association with hypogonadism, and associated psychosocial factors. Besides established pharmacological and hormonal interventions, lifestyle modification programs are considered important therapeutic tools.     

Non-governmental organizations, democracy, and HIV prevalence: a cross-national analysis

Despite the scale, reach, and global impact of the human immunodeficiency virus (HIV), its study has remained largely at the purview of various micro-level analyses (e.g., Gutmann 2007; Levi and Vitória 2002). However, differences in prevalence rates at the national level suggest that other forces might be at work. Following the work of McIntosh and Thomas (2004), the only cross-national study of HIV/AIDS published to our knowledge, we conduct a cross-national analysis that examines world polity ideas that higher levels of health and women’s non-governmental organizations (NGOs) should be associated with lower levels of HIV prevalence. Initially, we find no support for these hypotheses. However, we respecify our models to test a political opportunity structure hypothesis that democracy enhances the ability of health and women’s NGOs to deal with HIV. We test this line of reasoning by including an interaction term between democracy and the health and women’s NGO variables. In doing so, we find that health and women’s NGOs are associated with lower levels of HIV prevalence in democratic rather than repressive nations.