The Difficulties and Dilemmas of International Intelligence Cooperation
Stéphane Lefebvre is a former Strategic Analyst at the Canadian Department of National Defence and a former Marcel Cadieux Policy Planning Fellow at the Canadian Department of Foreign Affairs and International Trade. The views expressed here are the author's and do not necessarily reflect the views of any governmental or nongovernmental organizations with which he is or has been affiliated. An earlier version of this article was presented at the Colloque Renseignement et Sécurité internationale, Laval University, Quebec City, Canada, on 20 March 2003.
Intelligence Analysis Under Pressure of Rapid Change: The Canadian Challenge
The Canadian intelligence analysis arrangements are currently in trouble. The number of analysts in the Canadian Intelligence Community (CIC) is too small to meet the new and varied policy needs of the government. The chronic inability of the CIC to coordinate analysis activities to ensure optimum production of information and use of personnel has reached critical levels. Perhaps, above all, there is an inability not unique to Canada to decide on the proper role of intelligence in a world where priorities, relationships, threats and power structures keep changing at an accelerating pace. The present arrangements are likely to be temporary, and some correctives to be only evolutionary. But, the fact remains that the system as it stands is unworkable and hence unstable. Whether or not those concerned agree with this diagnosis, let alone the counsel offered, the CIC is necessarily in a state of transition that offers both tests and temptations to exploit new opportunities.
Study on essential drug use status and its influencing factors among cerebral infarction inpatients in county level hospitals of Anhui Province, China
Background and purpose Drug costs is one of the main components of hospitalization expenditure for cerebral infarction inpatients. In China, the National Essential Medicine System (NEMS) was created to relieve the heavy drug-cost burden for patients. The objective of this study was to investigate essential drug-use status and its influencing factors among cerebral infarction inpatients in county-level hospitals of Anhui province, China. Methods Three county-level hospitals were selected through a multi-stage cluster random sampling method. The hospitalization cost data of cerebral infarction inpatients in the three hospitals were extracted from the Anhui provincial information platform of the New Rural Cooperative Insurance System (NCMS), and whether the proportion of essential drug cost in the total drug cost reached the median value of 33.05% which was set as the evaluation index for essential drug-use status. Questionnaires for hospitals and physicians were designed and given to them to assess influencing factors. Results We retrieved the cost data of 2,189 inpatients from the NCMS platform and investigated 51 corresponding physicians in total. The drug costs accounted for 52.6% of the total hospitalization cost, and essential drug costs alone accounted for 37.0% of the total drug costs. The essential drug-cost proportion was high among physicians with a higher recognition degree on NEMS, older age, lower final academic degree, longer work experience and lower professional title. Married physicians and those with tight organizational affiliation also prescribed more essential drugs. Conclusions Increasing the proportion of essential drugs was an effective way to reduce the disease burden for cerebral infarction patients. Perfecting the NEMS, increasing government investment, reinforcing education and propaganda, and formulating relevant incentive and restrictive mechanisms were all effective ways to promote and increase the number of essential drug prescriptions written by physicians.