As democracy has spread over the past three decades to a majority of the world's states, analytic attention has turned increasingly from explaining regime transitions to evaluating and explaining the character of democratic regimes. Much of the democracy literature of the 1990s was concerned with the consolidation of democratic regimes. In recent years, social scientists as well as democracy practitioners and aid agencies have sought to develop means of framing and assessing the quality of democracy.

LICOS Center for Transition Economics
K.U.Leuven
Deberiotstraat
34 3000 Leuven, Belgium

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Professor at the University of Leuven (KUL) in Belgium. Research Affiliate, Rural Education Action Project, FSE Visiting Scholar
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Johan Swinnen is Professor of Development Economics and Director of LICOS Center for Institutions and Economic Performance at the University of Leuven (KUL) in Belgium. He is also Senior Research Fellow at the Centre for European Policy Studies (CEPS), Brussels, where he directs the programme on EU agricultural and rural policy. From 2003 to 2004 he was Lead Economist at the World Bank and from 1998 to 2001 Economic Advisor at the European Commission.

He is a regular consultant for these organizations and for the OECD, FAO, the EBRD, and several governments and was coordinator of several international research networks on food policy, institutional reforms, and economic development. He is President—Elect of the International Association of Agricultural Economists and a Fellow of the European Association of Agricultural Economists. He holds a Ph.D from Cornell University.  

His research focuses on institutional reform and development, globalization and international integration, media economics, and agriculture and food policy. His latest books are “Political Power and Economic Policy” (Cambridge Univ Press),  “The Perfect Storm: The Political Economy of the Reform of the Common Agricultural Policy” (CEPS),  “Global Supply Chains, Standards, and the Poor” (CABI), “Distortions to Agricultural Incentives in the Transition Economies of Europe and Central Asia” (World Bank Publications), and “From Marx and Mao to the Market” (Oxford University Press -- and Chinese translation by Beijing University Press). He is the president of The Beeronomics Society and editor of the book “The Economics of Beer” (Oxford Univ Press).

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Background Optimal treatment for patients with both type 2 diabetes mellitus and stable ischemic heart disease has not been established.

Methods We randomly assigned 2368 patients with both type 2 diabetes and heart disease to undergo either prompt revascularization with intensive medical therapy or intensive medical therapy alone and to undergo either insulin-sensitization or insulin-provision therapy. Primary end points were the rate of death and a composite of death, myocardial infarction, or stroke (major cardiovascular events). Randomization was stratified according to the choice of percutaneous coronary intervention (PCI) or coronary-artery bypass grafting (CABG) as the more appropriate intervention.

Results At 5 years, rates of survival did not differ significantly between the revascularization group (88.3%) and the medical-therapy group (87.8%, P=0.97) or between the insulin-sensitization group (88.2%) and the insulin-provision group (87.9%, P=0.89). The rates of freedom from major cardiovascular events also did not differ significantly among the groups: 77.2% in the revascularization group and 75.9% in the medical-treatment group (P=0.70) and 77.7% in the insulin-sensitization group and 75.4% in the insulin-provision group (P=0.13). In the PCI stratum, there was no significant difference in primary end points between the revascularization group and the medical-therapy group. In the CABG stratum, the rate of major cardiovascular events was significantly lower in the revascularization group (22.4%) than in the medical-therapy group (30.5%, P=0.01; P=0.002 for interaction between stratum and study group). Adverse events and serious adverse events were generally similar among the groups, although severe hypoglycemia was more frequent in the insulin-provision group (9.2%) than in the insulin-sensitization group (5.9%, P=0.003).

Conclusions Overall, there was no significant difference in the rates of death and major cardiovascular events between patients undergoing prompt revascularization and those undergoing medical therapy or between strategies of insulin sensitization and insulin provision. (ClinicalTrials.gov number, NCT00006305.)

The members of the writing group (Robert L. Frye, M.D., Mayo Clinic, Rochester, MN; Phyllis August, M.D., M.P.H., New York Hospital Queens, Queens, NY; Maria Mori Brooks, Ph.D., Regina M. Hardison, M.S., Sheryl F. Kelsey, Ph.D., Joan M. MacGregor, M.S., and Trevor J. Orchard, M.B., B.Ch., University of Pittsburgh, Pittsburgh; Bernard R. Chaitman, M.D., Saint Louis University, St. Louis; Saul M. Genuth, M.D., Case Western Reserve University, Cleveland; Suzanne H. Goldberg, R.N., M.S.N., National Heart, Lung, and Blood Institute, Bethesda, MD; Mark A. Hlatky, M.D., Stanford University, Palo Alto, CA; Teresa L.Z. Jones, M.D., National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD; Mark E. Molitch, M.D., Feinberg School of Medicine, Northwestern University, Chicago; Richard W. Nesto, M.D., Lahey Clinic Medical Center, Burlington, MA; Edward Y. Sako, M.D., Ph.D., University of Texas Health Science Center, San Antonio; and Burton E. Sobel, M.D., University of Vermont, Burlington) assume responsibility for the overall content and integrity of the article.

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New England Journal of Medicine
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Mark A. Hlatky
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According to Professor Muiznieks, since the early 1990s, the Baltic states have been seen as unfriendly in the eyes of Russians due to their "return to the West" attitude. Professor Muiznieks explains the key features of Baltic-Russian relations while looking at how these problems may be resolved in the future.

Synopsis

Professor Muiznieks begins by discussing the less than warm relations between the Baltic states and Russia. He explains how this is particularly due to the Baltic states’ desire to “return to the West” since the early 1990s and escape Russian influence after so many years of occupation. This is particularly evident in the EU and the UN where Poland and Baltic States form a sort of anti-Russian “axis.” However, the Baltic states’ membership of such organizations means a share of their secrets, which, as Professor Muiznieks explains, the Russians subsequently exploit for intelligence purposes.

At the same time, Professor Muiznieks cites another crucial security issue for the Baltic states, energy security. Currently, there is less oil transit through the Baltic states then there was before; Professor Muiznieks believes this has helped issues of corruption. However, he notes energy companies still play a significant role both locally and in relations with Russia. Looking the future, Professor Muiznieks believes that while there are options for the Baltic states to lessen their electrical dependence on Russia by looking to Scandinavia, the shutting of Lithuania’s nuclear plant will most likely mean Latvia and Lithuania will turn to Russia for further supply. To Professor Muiznieks, the current situation holds opportunities but also many risks.

Unfortunately, the strategic power-plays continue on another platform, memory wars. Professor Muiznieks feels World War II is the key point of debate between the Baltic states and Russia. While Russia sees the war as a great triumph, the Baltic states view the conflict as a catastrophe which led to further occupation. Professor Muiznieks discusses the fact that this battle plays out locally through monuments or textbooks but also internationally through border disputes and UN resolutions. He cites the European Court of Human Rights as a new strategic arena for this war because of its utmost authority on the continent and the fact that its rulings can cement one group as victims and force others to pay compensation.  However, Professor Muiznieks believes any truce is unlikely. For him, this conflict is too linked to many personal family histories and not government based enough to be put to a real end.

Professor Muiznieks also looks to “compatriots” as a focal point of Baltic-Russian relations. “Compatriots,” in this case, are Russian citizens living abroad, particularly in the Baltic states. This issue is serious because Russian speakers comprise over a quarter of both Latvia and Estonia’s populations. Professor Muiznieks explains that tension was caused in the Baltic states after Russia’s war with Georgia as to how Russian policy would change towards its diasporas. In addition, Professor Muiznieks reveals that there is further concern over the possibility that Russia is encouraging speakers abroad to take up citizenship to create legal basis for any action against other states in the future. Professor Muiznieks also argues that funding for these “compatriots” is perhaps to counteract increasing EU influence in the region.

Overall, Professor Muiznieks believes that the Baltic states are seriously suffering from the global economic crisis which in turn is making it difficult for them to counteract Russian policy and be effective. Professor Muiznieks argues this makes the Baltic states quite vulnerable.

In a lengthy question-and-answer session, a multitude of points were raised. One of the key issues addressed was where the Baltic States, and in particular Latvia, fit in the European framework. This led to discussion of several other issues such as Scandanivia's changing role in the Baltic States, the role of the Baltic States in NATO, and language integration. Finally, another possibility much emphasized was the potential creation of nuclear power plants as a way to offset surging prices for Russian energy.

Encina Ground Floor Conference Room

Nils Muiznieks Director, Advanced Social and Political Research Institute, Faculty of Social Sciences, University of Latvia Speaker
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As pressure builds on the White House and Congress to deliver on their promise of health care reform, the idea of a government health insurance company to compete with for-profit and not-for-profit private companies is gaining political momentum. Advocates claim that this new company would be more efficient, honest, and successful in forcing lower reimbursement rates on physicians and hospitals. However, a close look at how the present health care system functions, what its major problems are, and what reforms are needed to solve them suggests that this new idea is not the answer. The three major problems of the current U.S. system are that 45 million to 50 million people have no health insurance, the cost of care is high and rapidly increasing, and there are gross lapses in the quality of care. There is no reason to think that a government insurance company would make a significant dent in any one of these problems, let alone all three. To do that would require real reform in the financing, organization, and delivery of care.

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Swedish Minister of Employment, Sven Otto Littorin, will present the strategies of the Swedish Government for handling the financial crisis and the challenges on the labor market. He will talk about the previous Swedish financial crisis in the 1990's, when he had a central role in handling the crisis. Salvaging the Swedish Banking System at that time is today much discussed as the model for the present US banking crisis. Sweden starts its Presidency of the European Union on July 1, 2009, a role which will encompass the addressing of these issues. Minister Littorin will be the president of the European Council of Ministers for Employment, Social Policy, Health and Consumer Affairs.

The presentation is co-hosted by the recently launched VINNOVA-Stanford Research Center of Innovation Journalism and the Forum on Contemporary Europe.

Peter Wallenberg Learning Theater (Rm 124), Wallenberg Hall

Sven Otto Littorin Swedish Minister of Employment Speaker
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Background

Although the Accreditation Council for Graduate Medical Education (ACGME) limits the work hours of residents, concerns about fatigue persist. A new Institute of Medicine (IOM) report recommends, among other changes, improved adherence to the 2003 ACGME limits, naps during extended shifts, a 16-hour limit for shifts without naps, and reduced workloads.

Methods

We used published data to estimate labor costs associated with transferring excess work from residents to substitute providers, and we examined the effects of our assumptions in sensitivity analyses. Next, using a probability model to represent labor costs as well as mortality and costs associated with preventable adverse events, we determined the net costs to major teaching hospitals and cost-effectiveness across a range of hypothetical changes in the rate of preventable adverse events.

Results

Annual labor costs from implementing the IOM recommendations were estimated to be $1.6 billion (in 2006 U.S. dollars) across all ACGME-accredited programs ($1.1 billion to $2.5 billion in sensitivity analyses). From a 10% decrease to a 10% increase in preventable adverse events, net costs per admission ranged from $99 to $183 for major teaching hospitals and from $17 to $266 for society. With 2.5% to 11.3% decreases in preventable adverse events, costs to society per averted death ranged from $3.4 million to $0.

Conclusions

Implementing the four IOM recommendations would be costly, and their effectiveness is unknown. If highly effective, they could prevent patient harm at reduced or no cost from the societal perspective. However, net costs to teaching hospitals would remain high.

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Shadi Hamid
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President Bush's vision of a democratic Middle East was premised in part on the region's popular Islamist groups reconciling themselves to the give-and-take nature of democracy.

It might make sense then, that the Bush administration would do what it could to support a party that has made such a transformation in Turkey. But it's not.

Turkey's Justice and Development Party (AKP), which fashioned itself as the Muslim equivalent of Europe's Christian Democrats, has stood out by passing a series of unprecedented political reforms as the country's ruling party.

Yet the Turkish Constitutional Court - bastion of the hard-line secularist old guard - is now threatening to close down the AKP and ban its leading figures, including Prime Minister Recep Tayyip Erdogan and President Abdullah Gul, from party politics for five years. And the Bush administration, in the face of this impending judicial coup, has chosen to remain indifferent. The consequences could reach beyond a setback to democracy in Turkey and affect the Middle East.

The Constitutional Court will rule as soon as next week on an indictment accusing the AKP of being a "focal point of antisecular activities."

Turkey's Constitution establishes secularism as an unalterable principle and allows the court to ban parties it deems antisecular. But disbanding a democratically-elected party on such dubious grounds as attempting to lift a controversial ban on wearing head scarves in universities - the crux of the case against the AKP - is not how mature democracies handle divisive issues. Judges should not decide parties' fates; voters should.

Indeed, voters have flocked to the AKP since its founding by break away reformists within the Islamic movement. The party was elected in 2002 on pledges to preserve secularism and vigorously pursue Turkey's efforts to join the European Union. It also explicitly disavowed the Islamist label.

The AKP-led government then passed a series of democratic reforms that led Brussels to begin formal accession negotiations with Turkey. Those reforms, together with a booming economy, spurred 47 percent of Turks to vote for the AKP in its landslide 2007 reelection.

To be sure, the AKP's democratic credentials are hardly perfect. It has been overly cautious in repealing certain restrictions on freedom of speech, and it abruptly lifted the head scarf ban without first initiating a national dialogue.

Yet despite its flaws, the AKP is the most democratically inclined - and somewhat ironically, the most pro-Western - political party on the Turkish scene today. Closing it down would be a mistake.

A ban on a party that nearly half of the country supports could spark violence - which Turkey's secularist generals might then use as a pretext for a direct military intervention. Regardless, senior EU figures have criticized the closure case and warned that banning the AKP could gravely damage Turkey's candidacy.

Even more troubling is the message it would send to the rest of the Muslim world - no matter how much Islamists moderate, they won't be accepted as legitimate participants in the democratic process.

In recent years, mainstream Islamist groups throughout the region - including in Egypt, Jordan, and Morocco - have embraced many of the foundational components of democratic life. Yet their moderation has been met with harsh government repression, or more subtle designs to restrict their political participation.

More is at stake than may initially appear. If the AKP - the most moderate, pro-democratic "Islamist" party in the region today - is disbanded, it will strengthen those Islamists who see violence and confrontation as a surer means to influence political power.

During the past year, a number of Islamist leaders we've spoken to in Egypt and Jordan have warned that rank-and-file activists are losing faith in the democratic process, and may soon become attracted to more radical approaches. A ban on the AKP would only make it that much harder for moderates to continue making the case that participating in elections is worthwhile.

Though US Secretary of State Condoleezza Rice praises the AKP's democratization agenda, last month she said, "Obviously, we are not going to get involved in ... the current controversy in Turkey about the court case." Yet moments later she opined, "Sometimes when I'm asked what might democracy look like in the Middle East, I think it might look like Turkey." It's difficult to tell if she's referring to the new, democratizing Turkey of the past five years - or the reactionary Turkey where judges and generals flagrantly overrule the people's will.

President Bush has one last opportunity to reinvigorate the cause of Middle East democracy. By publicly denouncing the closure case, the administration would signal that the US not only supports Turkish democracy against a dangerous internal assault, but that it is also committed to defending all actors willing to abide by democratic principles in a region that desperately needs more of them.

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David Holloway is the Raymond A. Spruance Professor of International History, a professor of political science, and an FSI senior fellow. He was co-director of CISAC from 1991 to 1997, and director of FSI from 1998 to 2003. His research focuses on the international history of nuclear weapons, on science and technology in the Soviet Union, and on the relationship between international history and international relations theory. His book Stalin and the Bomb: The Soviet Union and Atomic Energy, 1939-1956 (Yale University Press, 1994) was chosen by the New York Times Book Review as one of the 11 best books of 1994, and it won the Vucinich and Shulman prizes of the American Association for the Advancement of Slavic Studies. It has been translated into six languages, most recently into Czech in 2008. Holloway also wrote The Soviet Union and the Arms Race (1983) and co-authored The Reagan Strategic Defense Initiative: Technical, Political and Arms Control Assessment (1984). He has contributed to the Bulletin of the Atomic Scientists, Foreign Affairs, and other scholarly journals.

Since joining the Stanford faculty in 1986 -- first as a professor of political science and later (in 1996) as a professor of history as well -- Holloway has served as chair and co-chair of the International Relations Program (1989-1991), and as associate dean in the School of Humanities and Sciences (1997-1998). Before coming to Stanford, he taught at the University of Lancaster (1967-1970) and the University of Edinburgh (1970-1986). Born in Dublin, Ireland, he received his undergraduate degree in modern languages and literature, and his PhD in social and political sciences, both from Cambridge University.

Theodore Postol is Professor of Science, Technology and National Security Policy in the Program in Science, Technology, and Society at MIT. He did his undergraduate work in physics and his graduate work in nuclear engineering at the Massachusetts Institute of Technology. After receiving his Ph.D., Dr. Postol joined the staff of Argonne National Laboratory, where he studied the microscopic dynamics and structure of liquids and disordered solids using neutron, x-ray and light scattering, along with computer molecular dynamics techniques. Subsequently he went to the Congressional Office of Technology Assessment to study methods of basing the MX Missile, and later worked as a scientific adviser to the Chief of Naval Operations. After leaving the Pentagon, Dr. Postol helped to build a program at Stanford University to train mid-career scientists to study developments in weapons technology of relevance to defense and arms control policy. In 1990 Dr. Postol was awarded the Leo Szilard Prize from the American Physical Society. In 1995 he received the Hilliard Roderick Prize from the American Association for the Advancement of Science and in 2001 he received the Norbert Wiener Award from Computer Professionals for Social Responsibility for uncovering numerous and important false claims about missile defenses.

Philip Taubman is a consulting professor at CISAC, where is working on a book project about nuclear threats and the joint effort of Sid Drell, Henry Kissinger, Sam Nunn, Bill Perry and George Shultz to reduce nuclear dangers. Before joining CISAC this fall, Mr. Taubman worked at the New York Times as a reporter and editor for nearly 30 years, specializing in national security issues, including intelligence and defense policies and operations. At the Times, Taubman served as a Washington correspondent, Moscow bureau chief, deputy editorial page editor, Washington bureau chief and associate editor. Taubman also serves as Stanford associate vice president for university affairs, working on special projects for Stanford's president, John Hennessy.

Taubman was a history major at Stanford, Class of 1970, and served as editor-in-chief of the Stanford Daily in 1969. Before joining the New York Times, he worked as a correspondent for Time magazine and was sports editor of Esquire. He was a member of the Stanford Board of Trustees, 1978-1982. He is author of Secret Empire: Eisenhower, the CIA, and the Hidden Story of America's Space Espionage. (Simon & Schuster, 2003.) Taubman is married to Felicity Barringer, the national environmental correspondent of the New York Times and a fellow Stanford graduate, Class of 1971.

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Senior Fellow Emeritus at the Freeman Spogli Institute of International Studies
Raymond A. Spruance Professor of International History
0820stanford-davidholloway-238-edit.jpg PhD

David Holloway is the Raymond A. Spruance Professor of International History, a professor of political science, and an FSI senior fellow. He was co-director of CISAC from 1991 to 1997, and director of FSI from 1998 to 2003. His research focuses on the international history of nuclear weapons, on science and technology in the Soviet Union, and on the relationship between international history and international relations theory. His book Stalin and the Bomb: The Soviet Union and Atomic Energy, 1939-1956 (Yale University Press, 1994) was chosen by the New York Times Book Review as one of the 11 best books of 1994, and it won the Vucinich and Shulman prizes of the American Association for the Advancement of Slavic Studies. It has been translated into seven languages, most recently into Chinese. The Chinese translation is due to be published later in 2018. Holloway also wrote The Soviet Union and the Arms Race (1983) and co-authored The Reagan Strategic Defense Initiative: Technical, Political and Arms Control Assessment (1984). He has contributed to the Bulletin of the Atomic Scientists, Foreign Affairs, and other scholarly journals.

Since joining the Stanford faculty in 1986 -- first as a professor of political science and later (in 1996) as a professor of history as well -- Holloway has served as chair and co-chair of the International Relations Program (1989-1991), and as associate dean in the School of Humanities and Sciences (1997-1998). Before coming to Stanford, he taught at the University of Lancaster (1967-1970) and the University of Edinburgh (1970-1986). Born in Dublin, Ireland, he received his undergraduate degree in modern languages and literature, and his PhD in social and political sciences, both from Cambridge University.

Faculty member at the Center for International Security and Cooperation
Affiliated faculty at the Center on Democracy, Development, and the Rule of Law
Affiliated faculty at The Europe Center
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David Holloway Raymond A. Spruance Professor of International History Speaker Stanford University
Theodore Postol Professor of Science, Technology, and International Security Speaker MIT
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Philip Taubman is affiliated with the Center for International Security and Cooperation at Stanford University. Before joining CISAC in 2008, Mr. Taubman worked at the New York Times as a reporter and editor for nearly 30 years, specializing in national security issues, including United States diplomacy, and intelligence and defense policy and operations. He served as Moscow bureau chief and Washington bureau chief, among other posts. He is author of Secret Empire: Eisenhower, the CIA, and the Hidden Story of America's Space Espionage (2003), The Partnership: Five Cold Warriors and Their Quest to Ban the Bomb (2012),  In the Nation's Service: The Life and Times of George P. Shultz (2023), as well as co-author (with his brother, William Taubman) of McNamara at War: A New History (2025).

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