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THE CONCEPTS IN THE LITERATURE ON POLICY NETWORKS AND COMMUNITIES ARE IMPORTANT BECAUSE THEY SUGGEST A RENEWED ATTEMPT TO BE BOTH ENCOMPASSING AND DISCRIMINATING IN DESCRIBING THE POLICY PROCESS. HOWEVER, IF THE CONCEPTS ARE GOING TO CONTINUE TO MAKE A CONTRIBUTION, SOME PROBLEMS MUST BE RESOLVED. THIS ARTICLE SUGGESTS THREE THAT ARE PARTICULARLY IMPORTANT: 1) NETWORK AND COMMUNITY CONCEPTS ENCOUNTER OBSTACLES IN INCORPORATING THE INFLUENCE OF MACROPOLITICAL INSITITUIONS AND THE POWER OF POLITICAL DISCOURSE; 2) THEY HAVE HAD SOME DIFFICULTY IN ACCOMODATING THE INTERNATIONALIZATION OF MANY POLICY DOMAINS; AND, 3) THEY HAVE NOT ADDRESSED WELL THE ISSUES OF POLICY INNOVATION AND POLICY CHANGE.

IT HAS BEEN ARGUED THAT RAPID MEMBERSHIP TURNOVER IN THE CANADIAN HOUSE OF COMMONS ROBS THE INSTITUTION OF A DEDICATED AND EXPERIENCED GROUP OF MPS AND PRODUCES A PARLIAMENT STOCKED WITH POLITICAL AMATEURS. BOTH ELECTORAL DEFEAT AND VOLUNTARY RETIREMENT HAVE BEEN SEEN TO PLAY A ROLE IN THE AMATEURISM PHENOMENON. THE AUTHORS EXPLORE THE ROOTS OF AMATEURISM AND CRITICALLY EXAMINE THE ARGUMENT THAT A FRUSTRATING CAREER STRUCTURE IN THE HOUSE OF COMMONS ENCOURAGES VOLUNTARY VACANCIES. USING A RANDOM SAMPLE OF FORMER MPS, THE AUTHORS FIND SUPPORT FOR BOTH A "FRUSTRATION" AND AN "EXHAUSTION" MODEL OF CAREER CHOICE. THE ARTICLE CONCLUDES THAT WHILE AMATEURISM MAY BE PROBLEMATIC, NOT ALL MPS ARE AMATEURS AND THE PROBLEM OF AMATEURISM CANNOT BE ADDRESSED SIMPLY BY SATISFYING FRUSTRATED AMBITION.

ABSTRACT. THE RATIONAL CHOICE MODEL OF POLITICS, WHICH CONSTRUES IMPORTANT POLITICAL PROCESSES AS A SERIES OF CHOICES TAKEN BY SELF-INTERESTED POLITICAL ACTORS, HAS DOMINATED THEORIZING ON THE SUBJECT OF POLICY INSTRUMENTS IN CANADA. WHILE USEFUL, THIS APPROACH IS NONETHELESS LIMITED BY ITS NARROW CONCEPTION OF RATIONALITY AND ITS INATTENTION TO THE CONTEXT OF INSTRUMENT CHOICE. AS AN ALTERNATIVE, THE NEO-INSTITUTIONAL APPROACH OFFERS A PERSPECTIVE ON POLITICAL CHOICE THAT TAKES BETTER ACCOUNT OF CONTEXTUAL AND ORGANIZATIONAL FACTORS. IN THIS ARTICLE, THE LOGIC OF BOTH APPROACHES IS USED TO EXPLAIN THE POLICY PROCESS IN THE CASE OF AUTOMOBILE INSURANCE IN ONTARIO. THE STUDY CONCLUDES THAT IT IS ESSENTIAL THAT RESEARCH STRATEGIES IN THE REALM OF INSTRUMENT CHOICE INCORPORATE INSIGHTS FROM THE NEO-INSTITUTIONAL APPROACH.

Medication persistence (MP) is important in HIV management as lifelong HIV therapy is needed and discontinuation of HIV therapy could represent a permanent loss of therapeutic options. Many factors have been shown to decrease HIV treatment persistence; however, the evidence for comorbidities has been conflicting [1,2]. This study was conducted to further explore the impact of comorbidities on HIV MP. Data from the IMS PharMetrics claims database was used. To be included, patients had to 1) be 18 years of age or older; 2) have a diagnosis code for HIV during the study period (Jan 2006–Sep 2011); 3) have a claim for at least one HIV medication during the index period (Jan 2007–Sep 2010); and 4) have continuous enrollment 12 months before and after the index date. Patients could not have a diagnosis code for pregnancy during the study period or a claim for an HIV medication during the 12 months prior to the index date. The index date was the date of the first claim of an HIV medication during the index period and all HIV medications recorded on the index date were included as the HIV index regimen. MP was defined as time to discontinuation of the HIV index therapy using a 90‐day grace period. Variables statistically significant (p<0.05) in bivariate testing were included in a Cox proportional hazard model to adjust for confounding. Gender, index year, insurance provider type, number of HIV pills/day, and number of comorbidities were included in the final Cox model. A total of 3,057 patients were included in the analysis. The mean age was 43.9 yrs and 76.3% were male. The average MP was 315 days (min 92–max 365). In the Cox model, patients with 1, 2 and≥3 comorbidities had a 6% (p=0.528), 28% (p=0.014) and 31% (p=0.002), respectively, higher risk of discontinuing HIV index regimens than patients with no comorbidities. Additionally, females had a 29% (p<0.001) higher risk of discontinuing HIV index regimens than males. The analysis supports prior evidence that comorbidities decrease HIV MP. This observation may be the result of patients switching HIV medications due to drug‐drug interactions from polypharmacy for managing HIV and comorbidities or due to HIV medication adverse effects. Further research should address the impact of specific HIV regimens on HIV MP among patients with comorbidities and potential differences between genders.

AbstractIndividual retirees face a daunting task when they consider how best to invest their accumulated superannuation account and non‐superannuation savings. This article highlights the fact that there is rarely an obvious decision in this choice and that the optimal decision depends on a number of factors. These factors include the valuation criterion adopted, the level of benefits, the individual's income level, the means‐tests, the tax rates on income and superannuation benefits and the person's life expectancy. The optimal behaviour at retirement is significantly affected by the individual characteristics of relative lifetime earnings and post‐retirement rates of mortality.