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Three Challenges for UK Peacebuilding Policy in the South Caucasus After Brexit

21 January 2020

Laurence Broers

Associate Fellow, Russia and Eurasia Programme
Building on the legacies of a long-term British investment in a peace strategy for the South Caucasus is a realistic and attainable goal.

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A building in Nagorny Karabakh flies the flag of the self-proclaimed republic. 'Abkhazia, South Ossetia and Nagorny Karabakh have evolved into examples of what scholars call "de facto states" that, to differing degrees, control territory, provide governance and exercise internal sovereignty,' writes Laurence Broers. Photo: Getty Images.

What does Britain’s departure from the EU mean for the country’s policy towards the South Caucasus, a small region on the periphery of Europe, fractured by conflict? Although Britain is not directly involved in any of the region’s peace processes (except in the case of the Geneva International Discussions on conflicts involving Georgia, as an EU member state), it has been a significant stakeholder in South Caucasian stability since the mid-1990s.

Most obviously, Britain has been the single largest foreign investor in Caspian oil and gas. Yet beyond pipelines, Britain also has been a significant investor in long-term civil society-led strategies to build peace in the South Caucasus.

Through what was then the Global Conflict Prevention Pool, in the early 2000s the Department for International Development (DfID) pioneered large-scale peacebuilding interventions, such as the Consortium Initiative, addressing Armenian-Azerbaijani conflict, in 2003-09. These built civic networks in the South Caucasus and partnerships with British-based NGOs.

This experience left a strong intellectual legacy. British expertise on the South Caucasus, including specific expertise on its conflicts, is highly regarded in the region and across the world.

There is also a strong tradition of British scholarship on the Caucasus, and several British universities offer Caucasus-related courses. Through schemes such as the John Smith Fellowship Trust, the Robert Bosch Stiftung Academy Fellowship at Chatham House and Chevening Scholarships, significant numbers of young leaders from the South Caucasus have spent time in British institutions and built effective relationships within them.

Three challenges

This niche as a champion of long-term, strategic peacebuilding and repository of area-specific knowledge should not be lost as Britain’s relationship with the EU and regional actors evolves. This can be ensured through awareness of three challenges confronting a post-Brexit Caucasus policy.

The first challenge for London is to avoid framing a regional policy in the South Caucasus as an extension of a wider ‘Russia policy’. Deteriorating Russian-British relations in recent years strengthen a tendency to view policies in the European neighbourhood through the traditional prisms of Cold War and Russian-Western rivalries.

Yet an overwhelming focus on Russia fails to capture other important aspects of political developments in South Caucasus conflicts. Although often referred to as ‘breakaway’ or ‘occupied’ territories, Abkhazia, South Ossetia and Nagorny Karabakh are not ungoverned spaces. They have evolved into examples of what scholars call ‘de facto states’ that, to differing degrees, control territory, provide governance and exercise internal sovereignty.

Few disagree that these entities would not survive without external patronage. But neither does that patronage explain their sustainability on its own. Russia-centricity diminishes Britain’s latitude to engage on the full range of local drivers sustaining these entities, contributing instead to less effective policies predicated on competition and containment.

A second and related challenge is to maintain and develop Britain’s position on the issue of engaging populations in these entities. De facto states appear to stand outside of the international rules-based system. Yet in many cases, their civil societies are peopled by skilled and motivated activists who want their leaders to be held accountable according to international rules.

Strategies of isolation ignore these voices and contribute instead to fearful and demoralized communities less likely to engage in a transformation of adversarial relationships. Making this case with the wider international community, and facilitating the funding of local civil societies in contested territories, would be important steps in sustaining an effective British policy on the resolution of conflicts.    

The third challenge for Britain is to maintain a long-term approach to the conflicts of the South Caucasus alongside potential short-term imperatives in other policy fields, as relationships shift post-Brexit.

In this fluid international environment, the Foreign and Commonwealth Office has a role to play both as an internal champion of a long-term peacebuilding strategy and a coordinator of British efforts with those of multilateral actors engaged in the South Caucasus. These include the United Nations, the EU’s Special Representative for the South Caucasus and the Crisis in Georgia and OSCE’s Special Representative for the OSCE Chairperson-in-Office for the South Caucasus, all of which have built relationships with relevant actors on the ground.

Recommendations

Britain’s niche as a champion and advocate of a strategic approach to peaceful change can be secured post-Brexit in the following ways.  

First, in-house expertise is crucial to effective peacebuilding programming. The Foreign Office’s research analysts play a vital role in generating independent internal advice and liaising with academic and NGO communities. Their role could be supplemented by the reinstatement of a regional conflict adviser post, based in Tbilisi, tasked with strengthening Britain’s regional presence on conflict issues and coordinating policy at a regional level.

This post, with a remit to cover conflicts and build up area knowledge and relationships can contribute significantly to working closely with local civil societies, where so much expertise and knowledge resides, as well as other stakeholders.

Second, programming should build in conflict sensitivity by dissociating eligibility from contested political status. This can encourage local populations to take advantage of opportunities for funding, study, comparative learning and professional development irrespective of the status of the entity where they reside.

The Chevening Scholarships are an excellent example, whereby applicants can select ‘South Caucasus’ as their affiliated identity from a drop-down menu. This enables citizens from across the region to apply irrespective of the status of the territory in which they live.   

Finally, a holistic understanding of peace is crucial. Programming in unrecognized or partially-recognized entities should acknowledge that effective peacebuilding needs to embrace political dynamics and processes beyond cross-conflict contact and confidence building. Local actors in such entities may find peacebuilding funding streams defined exclusively in terms of cross-conflict contact more politically risky and ineffective in addressing domestic blockages to peace.

While cross-conflict dynamics remain critical, ‘single-community’ programming framed in terms of civic participation, inclusion, civil society capacity-building, minority and human rights in contested territories, and building the confidence from within to engage in constructive dialogue, are no less important.

The ’global Britain’ promised by Brexit remains a fanciful idea. Quiet, painstaking work to build on the legacies of a long-term British investment in a peace strategy for the South Caucasus, on the other hand, is a realistic and attainable goal.




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UK Unplugged? The Impacts of Brexit on Energy and Climate Policy

26 May 2016

In the field of energy and climate change policy, remaining in the EU offers the best balance of policy options for Britain’s national interests.

Antony Froggatt

Senior Research Fellow, Energy, Environment and Resources Programme

Thomas Raines

Director, Europe Programme

Shane Tomlinson

Senior Associate, E3G; Former Senior Research Fellow, Chatham House

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A line of electricity pylons stretches beyond fields of rapeseed near Hutton Rudby, North Yorkshire, on 27 April 2015. Photo: Getty Images.

Summary

  • Over the last 30 years the EU has played a central role in addressing the competitiveness, security and climate dimensions of energy policy among its member states. The UK has been critical in driving forward integration of the European energy market, and has been a strong advocate of liberalized energy markets and some climate change mitigation policies.
  • If, at the June 2016 referendum, the UK does vote to leave the EU, energy and climate policy will be part of the overall package of issues to be negotiated, as it is unlikely that each sector will be treated separately. The model of relations for energy and climate may well be determined by political and public sentiment on higher-profile issues such as freedom of movement, rather than by what is best for the UK in these policy areas.
  • The UK is increasingly reliant on imports, including from and through continental Europe, and its energy market is deeply integrated with that of its European neighbours. As a growing share of the UK’s electricity is exchanged with EU partners, it would be neither possible nor desirable to ‘unplug’ the UK from Europe’s energy networks. A degree of continued adherence to EU market, environmental and governance rules would be inevitable.
  • This paper reviews the risks and trade-offs associated with five possible options for a post-exit relationship. Of these, the Norway or the Energy Community models would be the least disruptive, enabling continuity in energy market access, regulatory frameworks and investment; however, both would come at the cost of accepting the vast majority of legislation while relinquishing any say in its creation. The UK would thus have less, rather than more, sovereignty over energy policy.
  • The Switzerland, the Canada and the WTO models offer the possibility of greater sovereignty in a number of areas, such as buildings and infrastructure standards as well as state aid. None the less, each would entail higher risks, with greater uncertainty over market access, investment and electricity prices. These models would reduce or even eliminate the UK’s contribution to the EU budget, but would also limit or cut off access to EU funding mechanisms.
  • All five Brexit models would undermine the UK’s influence in international energy and climate diplomacy. The UK would no longer play any direct role in shaping the climate and energy policies of its EU neighbours, at a time when the EU’s proposed Energy Union initiatives offer the prospect of a more integrated and effective European energy sector. A decision to leave the EU would make it easier for a future UK government to change direction on climate policy, since only a change in domestic legislation would be required.
  • ‘Brexit’ could affect the balance of energy policy among the remaining member states. In its absence, the centre of gravity for EU energy policy might shift away from market mechanisms and result in weaker collective action on greenhouse gas reduction targets.
  • In the field of energy and climate change policy, remaining in the EU offers the best balance of policy options for Britain’s national interests: the UK would continue to benefit from the integrated energy market, while maintaining influence over its direction and minimizing uncertainty for crucial investment.




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The government is lacking detail over Brexit planning

Brexit. Who knows what’s going to happen in the next few weeks, months, years - the uncertainty is high. In the face of that, you’d hope that the government was doing all it could to plan for any eventuality - let alone for a massive, country altering one like suddenly crashing out without a deal - but Martin McKee, professor of public health at...




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Brexit - Planning for medicine shortages

This week we saw the release of the much awaited Yellowhammer documents from the government, documents which outline some of the risks involved with Britain’s sudden departure from the EU. The documents themselves outline that there are risks to the supply of medicines - but do not set out the detail of how those risks have been mitigated, and...




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Reflections on the Brexit Election

Invitation Only Research Event

6 December 2019 - 8:30am to 9:30am

Chatham House | 10 St James's Square | London | SW1Y 4LE

Event participants

Alistair Burt, Conservative Member of Parliament (1983-97 and 2001-19); Minister of State for the Middle East, UK Foreign & Commonwealth Office and Minister of State at the Department for UK International Development (2017-19)

On 12 December 2019, the United Kingdom will hold one of its most crucial elections in the 21st century. The result will have a direct impact on the Brexit process and will most likely determine the country’s future direction for years to come.  

Yet the final outcome is far from predictable. It seems quite certain that the 2019 election is unlikely to produce a clear two-party share of the vote as happened back in 2017. Public trust in politicians is low and party loyalty is looser than ever. Polls show that Brexit it overwhelmingly considered as the main issue among the electorate alongside a deep concern about the future of public services. This raises multiple questions: can the 2019 election represent a chance to unite the country and move on? Will cross-party identities of ‘Leavers’ and ‘Remainers’ translate to how people vote in the election? And what will the outcome mean for Brexit and the future of party politics in Britain? 

Attendance at this event is by invitation only. 

Event attributes

Chatham House Rule

Alina Lyadova

Europe Programme Coordinator




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Virtual Breakfast: Is a Brexit Delay Possible?

Research Event

7 April 2020 - 8:30am to 9:30am

Event participants

Gavin Barwell, Downing Street Chief of Staff to Prime Minister Theresa May (2017-19)
Chair: Thomas Raines, Director, Europe Programme, Chatham House

Please note this an online-only event.

According to a previously agreed timetable for phase two of Brexit talks, negotiations on the future EU-UK trade relations were scheduled to begin in March. Then a global pandemic hit. Despite the ongoing COVID-19 outbreak, the UK government insists that the Brexit negotiations are on track and there are currently no plans to extend the transition period beyond 2020.

However, the original timetable for trade talks was already widely seen as extremely constrained. Can negotiations still be done in time? With the decision on any possible extension to be made by July at the latest, can the two sides make sufficient progress by that point? Or would the ongoing public health crisis make requesting an extension to the transition period more politically viable for the UK government? Finally, if there is no extension, could Britain still leave the EU with no deal?

In this webinar, the speaker will discuss how the need to manage other challenges, such as the current COVID-19 outbreak, might affect the government’s approach to the negotiations with the EU. He will also share his insights on what to expect from the second phase of negotiations and on the most important lessons from phase one. 

Alina Lyadova

Europe Programme Coordinator




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Nuclear Energy in a Post-Brexit Europe

Invitation Only Research Event

11 October 2019 - 8:30am to 10:00am

Chatham House | 10 St James's Square | London | SW1Y 4LE

Event participants

Tim Yeo, Chairman, The New Nuclear Watch Institute
Chair: Antony Froggatt, Senior Research Fellow, Energy, Environment and Resources, Chatham House 

Brexit will significantly change the balance within the EU in relation to nuclear energy. Apart from France and Finland, both of whose nuclear development programmes are behind schedule, the UK is the only member state in northern or western Europe currently investing in new nuclear capacity. Brexit will therefore leave the supporters of nuclear energy within the EU27 and the European Commission in a weaker position.

The speaker will argue that at a time when the energy industry needs to accelerate its shift away from fossil fuels, and when the electricity generation industry must cut its carbon emissions faster than it has ever managed to do in the past, this change is unhelpful.

The workshop will also address the need for additional interconnector capacity and the future of carbon-trading outside the EU emission trading system and how this relates to potential nuclear energy capacity.

Attendance at this event is by invitation only. 

Event attributes

Chatham House Rule

Chloé Prendleloup




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Safe or Sorry? Prospects for Britons in the European Union after Brexit

Amid ongoing Brexit negotiations, much remains uncertain for the roughly 1 million UK citizens living elsewhere in the European Union. This report offers a demographic profile of these Brexpats, considering what form an EU-UK deal on citizens’ rights might take and identifying key challenges many Britons are likely to face—including difficulty securing legal status and accessing labor markets, social security, and health-care systems.




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Brexit Day—Is This the Dawning of the Age of Immobility?

Brexit Day, on January 31, 2020, marks a dramatic turn for the United Kingdom as it leaves the European Union, in significant measure because it wants to control its immigration destiny. But it remains unclear whether Brexit will allow the United Kingdom to cast a net wider for the global workers it seeks or will deepen the moat around the island. Either way, Brexit is likely to spark new forms of mobility—and immobility.




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When the Dust Settles: Migration Policy after Brexit

While the political and economic ramifications of the UK vote to quit the European Union hit with full force within hours, it will take far more time to sort out what Brexit means for migration policy. In the short term, the rights of EU nationals living in Britain are the most pressing, with border-control negotiations and future immigration levels also high on the agenda. Against a backdrop of deep public skepticism, this commentary suggests the next government should underpromise and overdeliver.




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The Science of Presidential Complexity

Mitt Romney wants to round up 12 million illegal immigrants and deport them. John Edwards wants to put an end to lobbyists. All the Democratic and Republican presidential candidates rail against the ways of Washington.




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On the Brink: Prospects for UK Nationals in the EU-27 after a No-Deal Brexit

Six months on from the original March 2019 Brexit date and staring a new deadline in the face, many EU countries still had only skeletal plans for how to adjust the status of their resident UK nationals should a no-deal Brexit come to pass. This policy brief highlights critical gaps in these plans, the groups most likely to be affected by them, and strategies Member States and the United Kingdom could adopt to soften the impact.




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A Low Complexity Algorithm with O(√T) Regret and O(1) Constraint Violations for Online Convex Optimization with Long Term Constraints

This paper considers online convex optimization over a complicated constraint set, which typically consists of multiple functional constraints and a set constraint. The conventional online projection algorithm (Zinkevich, 2003) can be difficult to implement due to the potentially high computation complexity of the projection operation. In this paper, we relax the functional constraints by allowing them to be violated at each round but still requiring them to be satisfied in the long term. This type of relaxed online convex optimization (with long term constraints) was first considered in Mahdavi et al. (2012). That prior work proposes an algorithm to achieve $O(sqrt{T})$ regret and $O(T^{3/4})$ constraint violations for general problems and another algorithm to achieve an $O(T^{2/3})$ bound for both regret and constraint violations when the constraint set can be described by a finite number of linear constraints. A recent extension in Jenatton et al. (2016) can achieve $O(T^{max{ heta,1- heta}})$ regret and $O(T^{1- heta/2})$ constraint violations where $ hetain (0,1)$. The current paper proposes a new simple algorithm that yields improved performance in comparison to prior works. The new algorithm achieves an $O(sqrt{T})$ regret bound with $O(1)$ constraint violations.




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On the Complexity Analysis of the Primal Solutions for the Accelerated Randomized Dual Coordinate Ascent

Dual first-order methods are essential techniques for large-scale constrained convex optimization. However, when recovering the primal solutions, we need $T(epsilon^{-2})$ iterations to achieve an $epsilon$-optimal primal solution when we apply an algorithm to the non-strongly convex dual problem with $T(epsilon^{-1})$ iterations to achieve an $epsilon$-optimal dual solution, where $T(x)$ can be $x$ or $sqrt{x}$. In this paper, we prove that the iteration complexity of the primal solutions and dual solutions have the same $Oleft(frac{1}{sqrt{epsilon}} ight)$ order of magnitude for the accelerated randomized dual coordinate ascent. When the dual function further satisfies the quadratic functional growth condition, by restarting the algorithm at any period, we establish the linear iteration complexity for both the primal solutions and dual solutions even if the condition number is unknown. When applied to the regularized empirical risk minimization problem, we prove the iteration complexity of $Oleft(nlog n+sqrt{frac{n}{epsilon}} ight)$ in both primal space and dual space, where $n$ is the number of samples. Our result takes out the $left(log frac{1}{epsilon} ight)$ factor compared with the methods based on smoothing/regularization or Catalyst reduction. As far as we know, this is the first time that the optimal $Oleft(sqrt{frac{n}{epsilon}} ight)$ iteration complexity in the primal space is established for the dual coordinate ascent based stochastic algorithms. We also establish the accelerated linear complexity for some problems with nonsmooth loss, e.g., the least absolute deviation and SVM.




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The complexity of bird behaviour : a facet theory approach

Hackett, Paul, 1960- author
9783030121921 (electronic bk.)




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Complexity and approximation : in memory of Ker-I Ko

9783030416720 (electronic bk.)




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Almost sure uniqueness of a global minimum without convexity

Gregory Cox.

Source: The Annals of Statistics, Volume 48, Number 1, 584--606.

Abstract:
This paper establishes the argmin of a random objective function to be unique almost surely. This paper first formulates a general result that proves almost sure uniqueness without convexity of the objective function. The general result is then applied to a variety of applications in statistics. Four applications are discussed, including uniqueness of M-estimators, both classical likelihood and penalized likelihood estimators, and two applications of the argmin theorem, threshold regression and weak identification.




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Convergence complexity analysis of Albert and Chib’s algorithm for Bayesian probit regression

Qian Qin, James P. Hobert.

Source: The Annals of Statistics, Volume 47, Number 4, 2320--2347.

Abstract:
The use of MCMC algorithms in high dimensional Bayesian problems has become routine. This has spurred so-called convergence complexity analysis, the goal of which is to ascertain how the convergence rate of a Monte Carlo Markov chain scales with sample size, $n$, and/or number of covariates, $p$. This article provides a thorough convergence complexity analysis of Albert and Chib’s [ J. Amer. Statist. Assoc. 88 (1993) 669–679] data augmentation algorithm for the Bayesian probit regression model. The main tools used in this analysis are drift and minorization conditions. The usual pitfalls associated with this type of analysis are avoided by utilizing centered drift functions, which are minimized in high posterior probability regions, and by using a new technique to suppress high-dimensionality in the construction of minorization conditions. The main result is that the geometric convergence rate of the underlying Markov chain is bounded below 1 both as $n ightarrowinfty$ (with $p$ fixed), and as $p ightarrowinfty$ (with $n$ fixed). Furthermore, the first computable bounds on the total variation distance to stationarity are byproducts of the asymptotic analysis.




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Exponential integrability and exit times of diffusions on sub-Riemannian and metric measure spaces

Anton Thalmaier, James Thompson.

Source: Bernoulli, Volume 26, Number 3, 2202--2225.

Abstract:
In this article, we derive moment estimates, exponential integrability, concentration inequalities and exit times estimates for canonical diffusions firstly on sub-Riemannian limits of Riemannian foliations and secondly in the nonsmooth setting of $operatorname{RCD}^{*}(K,N)$ spaces. In each case, the necessary ingredients are Itô’s formula and a comparison theorem for the Laplacian, for which we refer to the recent literature. As an application, we derive pointwise Carmona-type estimates on eigenfunctions of Schrödinger operators.




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Exiting low inflation traps by "consensus": nominal wages and price stability

Exiting low inflation traps by "consensus": nominal wages and price stability - Speech by Luiz A Pereira da Silva and Benoît Mojon, based on the keynote speech at the Eighth High-level Policy Dialogue between the Eurosystem and Latin American Central Banks, Cartagena de Indias, Colombia, 28-29 November 2019.




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The Janus face of bank geographic complexity

This paper studies the relationship between bank geographic complexity and risk. We use a unique dataset of 96 bank holding companies around the world to measure the geographic dispersion of their affiliates. We study how this dispersion interacts with economic and regulatory conditions to affect the riskiness of the bank.




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Growing Evidence for Successful Care Management in Children With Medical Complexity




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Coronavirus in Scotland: Scottish Government advisor backs lockdown exit that lifts restrictions for majority but shields most vulnerable

RESEARCHERS have called for a two-track approach to easing lockdown which would strengthen protection for the most vulnerable but relax restrictions for the majority of the population.




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Scotland at risk of missing affordable homes target as Brexit bites

SCOTLAND is struggling to meet its targets for new affordable homes despite government funding.




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Supply of homes for sale at three-year low amid Brexit wrangling

The flow of homes coming on to the UK market is at its weakest level in three years as "endless wrangling about Brexit" continues, according to surveyors.




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David Torrance: The SNP's independence proposition resembles another Brexit-like leap into the unknown

In “Painting Nationalism Red?”, an engaging new pamphlet published by Democratic Left Scotland, the journalist Neal Ascherson pays tribute to Tom Nairn as Scotland’s “pre-eminent political intellectual”.




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David Torrance: How Gibraltar learned to stop fearing Brexit

A few days after a majority of Britons backed Brexit in June 2016, this newspaper reported that Nicola Sturgeon had been in talks with London Mayor Sadiq Khan and the Chief Minister of Gibraltar, Fabian Picardo.




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David Torrance: How Brexit vote has left the SNP making the same historical error

“Scotland”, declared a young Alex Salmond in May 1975, “knows from bitter experience what treatment is in store for a powerless region of a common market.”




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Iain Macwhirter: We're heading for a hard Brexit on Friday, but it needn't have been this way

The European Union (Withdrawal Agreement) Bill got the Royal Assent this week. It was then solemnly signed, sealed and ratified by Ursula von der Leyen, the new President of the European Commission. We’re finally out.




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Patterns and Costs of Health Care Use of Children With Medical Complexity

Children with medical complexity are high users of acute health care, but little is known about their service use across the continuum of care services and in the context of overall health care expenditures.

Although accounting for <1% of the child population, children with medical complexity use almost one-third of all pediatric health care expenditures and make multiple transitions across providers and health care settings. (Read the full article)




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Capture of Complexity of Specialty Care in Pediatric Cardiology by Work RVU Measures

Few reports have explored the measurement validity of the relative value unit (RVU) system, particularly in pediatrics. The RVU system, although broadly applied in health care settings, was developed for the adult population and thus may possess unique inadequacies in pediatrics.

We found deficiencies in the ability of the RVU system to capture features of case mix complexity and differences related to age. Additional investigation may be warranted to determine the validity of RVU as a measurement tool in pediatrics. (Read the full article)




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Pediatric Medical Complexity Algorithm: A New Method to Stratify Children by Medical Complexity

Quality measures developed by the Pediatric Quality Measures Program are required to assess disparities in performance according to special health care need status. Methods are needed to identify children according to level of medical complexity in administrative data.

The Pediatric Medical Complexity Algorithm is a new, publicly available algorithm that identifies the small proportion of children with complex chronic disease in Medicaid claims and hospital discharge data with good sensitivity and good to excellent specificity. (Read the full article)




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Hospital Variation in Health Care Utilization by Children With Medical Complexity

Children with medical complexity require a disproportionate amount of health services due to a multitude of chronic severe illness, and their impact on the health care system appears to be increasing.

This study provides one of the first comparisons of health care utilization patterns for children with medical complexity between medical centers in a population-based cohort. (Read the full article)




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Fin24.com | EU allegedly mulling no-deal Brexit summit as pressure mounts

United Kingdom and European Union negotiators were working through Sunday as the outcome of Brexit talks hung in the balance.




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Fin24.com | Brexit talks put on hold as stalemate deepens

The UK and the European Union are on course to miss a key milestone on the road to a Brexit deal after talks hit a roadblock. Negotiations are now paused, putting pressure on leaders to step into the breach later this week.




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No Exit?




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Costs and Use for Children With Medical Complexity in a Care Management Program

BACKGROUND AND OBJECTIVES:

Children with medical complexity (CMC) comprise only 6% of the pediatric population, account for ~40% of pediatric health care spending, and provide an important opportunity for cost saving. Savings in this group can have an important impact on pediatric health care costs. The objective of this study was to assess the impact of a multicenter care management program on spending and use in CMC.

DESIGN AND METHODS:

We conducted a prospective cohort analysis of a population of 4530 CMC enrolled in a learning collaborative designed to improve care for CMC ages 0 to 21 years identified using 3M Clinical Risk Group categories 5b through 9. The primary outcome was total per-member per-year standardized spending; secondary outcomes included inpatient and emergency department (ED) spending and use. We used a 1:1 propensity score match to compare enrolled patients to eligible nonenrolled patients and statistical process control methods to analyze spending and usage rates.

RESULTS:

Comparison with the matched group showed a 4.6% (95% confidence interval [CI]: 1.9%–7.3%) decrease in total per-member per-year spending (P < .001), a 7.7% (95% CI: 1.2%–13.5%) decrease in inpatient spending (P = .04), and an 11.6% (95% CI: 3.9%–18.4%) decrease in ED spending (P = .04). Statistical process control analysis showed a decrease in hospitalization rate and ED visits.

CONCLUSIONS:

CMC enrolled in a learning collaborative showed significant decreases in total spending and a significant decrease in the number of hospitalizations and ED visits. Additional research is needed to determine more specific causal factors for the results and if these results are sustainable over time and replicable in other settings.




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Europe Committee to question Secretary of State for Scotland over Brexit

The Culture, Tourism, Europe and External Affairs Committee will on Thursday (5 March) question the Secretary of State for Scotland regarding the Withdrawal Agreement and the future relationship between the European Union and the UK.




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Fin24.com | WATCH: How Gordhan's exit threatens SA

Head of Goldman Sachs Colin Coleman tells Bloomberg TV the stand-off between Finance Minister Pravin Gordhan and the Hawks can devastate the country.




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Fin24.com | Anglo American set to exit coal mining in SA

Mining giant Anglo American plans to exit coal mining in South Africa, in a major shift away from carbon-intense operations.




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Report: Qualcomm to Exit Server Chip Market

Intel's domination will continue as Qualcomm is set to quit after just seven months of trying.




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DHSS Releases Delaware’s Plan for Managing the Health Care Needs of Children with Medical Complexity

NEW CASTLE (May 30, 2018) – As a way to better support the needs of children with medical complexity and their families, the Division of Medicaid and Medical Assistance this week released Delaware’s Plan for Managing the Health Care Needs of Children with Medical Complexity and announced that stakeholders will continue work to develop longer-term […]




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TRAFFIC ALERT - Daytime Closure of Exit 119 on Route 1 NB for Paving

Smyrna --

Location: Exit 119/US 13/SR 6/SR 300 closed between Route 1 northbound and US 13, Smyrna.

Times and Dates: 10:00 a.m. until Noon on Thursday, April 23, 2020

Traffic Information: DelDOT's contractor will be paving Exit 119.

Detour Route: Motorists will take Exit 114/US 13, south of Smyrna. [More]




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TRAFFIC ALERT - Closure of Exit 2 and Airport Road for Construction of Ramps

Newport --

As part of the Route 141 Improvements, I-95 Interchange to Jay Drive project, the Delaware Department of Transportation (DelDOT) announces to motorists that Exit 2 and Airport Road will be closed to traffic stating on March 1, 2020.

Exit 2/Route 141 southbound to I-295 northbound will be closed starting at 4:00 p.m. on March 1, 2020 until late-May 2020 to construct the ramps and roadway.

Detour Routes for Exit 2:

For traffic on Route 141 southbound, north of I-95 interchange, motorists will take the ramp to I-95 southbound to Route 58/Churchmans Road, turn left onto Route 7, take ramp to I-95 northbound and take ramp to I-295 northbound. [More]




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TRAFFIC ALERT - Daytime Intermittent Lane Closures Route 1 NB at Exit 114-Smyrna for Bridge Repairs

Smyrna --

Traffic Information: DelDOT announces to motorists that intermittent lane closures will occur on Route 1 northbound near Exit 114 (US 13/SR 6/SR 300) for bridge repairs.

Location: Route 1 Northbound at Exit 114, south of Smyrna.

Times and Dates: 6:00 a.m. until 3:00 p.m. [More]




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TRAFFIC ALERT - Closure of Route 141 NB and Exits for the Installation of Waterline and Repairs to the Ramps

Newport --

DelDOT announces to motorists that their contractor will be closing Route 141 Northbound at Exit 3A and Ramps on Friday, May 15, 2020 and Saturday, May 16, 2020 for the installation of the waterline and repairs to the ramps. In the event of inclement weather on Friday, the closures will start on Saturday, May 16, 2020 at 8:00 p.m. until 9:00 p.m. on Sunday, May 17, 2020.

The following closures will occur at 8:00 p.m. on Friday, May 15, 2020 until 9:00 p.m. on Saturday, May 16, 2020

Route 141 Northbound at Exit 3A/I-95 Northbound

Exit 5B/I-95 Northbound to Route 141 Northbound

Exit 3B/Route 141 Northbound to I-95 Southbound

Exit 5B/I-95 Southbound to Route 141 Northbound

Exit 5/I-295 Southbound to Route 141 Northbound

Detour Routes:

Detour Route for Route 141 Northbound to Exit 3A/I-95 Northbound

Motorists will take the ramp from Route 141 northbound to I-95 northbound and take the ramp to Route 4 and continue straight onto Adams Street. [More]




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Australia Launches A Tourism Campaign for the UK After its EU Exit

Australia has involved the tourism chiefs to launch a huge UK advertising campaign on Christmas Day with the aim of reversing the decline of visitors from Britain which is linked to uncertainty over its exit from the EU.  The Campaign and the…




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UK Home Secretary Says Post-Brexit Minimum Salary Threshold will be 36k Pounds

The UK Home Secretary will be asked to raise the recommended £30,000 minimum salary threshold for all latest international workers to defend lower-paid British workers.At the moment, the limitation only appeals to non-EU migrants, but it's assumed…




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Mutual funds: Exiting equity now may lead to missing out on any recovery subsequently

As of February 29, 2020; equities outperformed gold over the trailing 10-, 15- and 20-years, delivering annualised 10.39%, 13.89% and 12.0% respectively compared with 8.16%, 12.59% and 11.49% respectively delivered by gold.




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Barcelona’s beaches partially open as Spanish govt decides on next steps to exit lockdown


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