Background: Non-medical use of prescription drugs (NMUPD) refers to the use of prescription drugs which are traditionally utilized to manage pain or treat psychiatric problems but without a doctor’s prescription. In 2010, an investigation by the Substance Use and Mental Health Services Administration (SAMHSA) revealed that 5.3% of young adults (18 to 25-year-olds) in the United States reported past-month NMUPD. NMUPD has become a growing concern owing to associations with consequences such as college dropout, poor academic achievement, and health jeopardizing behaviors. College students' NMUPD has been well documented in the United States. Limited studies, however, have been conducted among college students in China. The purposes of this study are to examine the prevalence and motives of NMUPD among college students in China, and to assess its relationship with stress (i.e., perceived stress and traumatic events), mental health problems (depression, anxiety, and post-traumatic stress disorder (PTSD)), utilization of healthcare, cultural orientation, and protective factors (i.e., resilience and future orientation). Methods: In Jan-April 2017, online data were collected using SONA system from a total of 720 undergraduates at Beijing Normal University (BNU) and University of Macau (UM) with an average age of 19.65. All participants reported their nonmedical use of prescription drugs (i.e., opioids, sedatives, stimulants, and anxiolytics) in their lifetime and the past three months, stress, mental health, utilization of healthcare, cultural orientation, and protective factors. Spearman’s rank-order corrections and logistic regression were employed for statistical analyses. Results: Findings indicate that 41.2% of Chinese students reported taking prescription drugs without a doctor’s prescription. The most commonly misused prescription drugs were opioids (40.5% lifetime use, 31.8% past-three-months use), followed by sedatives (1.8% lifetime, 0.8% past 3 months), anxiolytics (0.9% lifetime,0 .3% past three months), and stimulants (0.2% lifetime, 0% past three months). Bivariate analyses suggest significantly positive correlations of lifetime NMUPD with mental health problems (anxiety and PTSD), cultural orientation (individualism and collectivism), and utilization of healthcare (frequency of healthcare use, time spent for healthcare, and money spent for healthcare). Similar results were found in terms of past-three-month NMUPD. The results of logistic regressions indicate the significant association of lifetime NMUPD with individualism of cultural orientation, and frequency of healthcare use. Specially, individualism, frequency of healthcare use, and time spent for healthcare were found to be associated with lifetime opioid misuse, and depression was significantly associated with sedative misuse. Resilience was negatively associated with lifetime sedative misuse. Frequency of healthcare use was also found to be positively associated with past-three-month opioid misuse. Conclusion: Utilization of healthcare, cultural orientation, and mental health problems appear to be the factors associated with NMUPD among college students at BNU and UM. More discussion is needed in Chinese society about regulation of prescription drug use. Future culturally-tailored prevention intervention programs may be beneficial to reduce the risk of NMUPD among Chinese college students.

This dissertation examines the effectiveness of interventions related to family planning and the uptake of HIV-related preventive services among women in low-income settings. Women in low-income settings and living with HIV face many barriers to care, including limited access to services for family planning and HIV-related preventive care. At the same time, national, regional, and global efforts are looking for interventions to help control rapid population growth, create an HIV-free generation, and provide adequate preventive care for those living with HIV. This dissertation cuts across these issues and can help to inform debate and policies to address these issues. This dissertation comprises three discrete papers. Paper 1 (chapter 1) examines the effectiveness of a national scale-up of community-based distribution of family planning services on contraceptive use in Malawi’s rural areas during the period 2005-2016. The national-scale up of the intervention followed the success of a pilot of a similar intervention implemented in the period 1999-2004. As in the pilot, the scaled-up program distributed condoms and oral contraceptives and provided family planning education. Further, because education and income are important determinants of individual contraceptive use, the paper also examines whether the effectiveness of the national scale CBDs varies over these dimensions. The paper uses the Malawi Demographic and Health Surveys. The study finds that the intervention increased contraceptive use by 6.8 percentage points and the effects were greater among uneducated and low-income women. Paper 2 (chapter 2) conducts a cost-effectiveness analysis of a trial of cash incentives aimed at increasing the uptake of services for the prevention of mother-to-child transmission (PMTCT) of HIV. The trial was conducted in the Democratic of the Congo (DRC) as part of an effort to find ways of increasing uptake of PMTCT services in sub-Saharan Africa where uptake of these services remains low. The study is conducted from the societal perspective, relies on multiple sources within and outside of the DRC for cost data, and reports economic costs in 2016 International Dollars (I$). At a threshold of 3*GDP per capita for the DRC (I$2409), the study finds that the intervention is cost-effective. Paper 3 (chapter 3) examines the guideline concordance of the time to follow-up anal cancer screening in women living with HIV at high risk for anal cancer. In the US, the incidence of anal cancer in women living with HIV has increased significantly in the past 2-3 decades. However, early detection of anal cancer, through regular screening, can lead to effective secondary prevention of the disease. While guidelines for anal cancer screening exist, very little is known about the guideline concordance of the time to follow-up anal cancer screening in women at high risk of acquiring anal cancer. Hence this study. The study uses Medicaid Analytic eXtract files which compile claims of individuals enrolled in Medicaid—a public health insurance program largely for eligible low-income adults and the largest single payer for HIV/AIDS in the US. The study finds that time to follow-up screening is not guideline-concordant for most women living with HIV, particularly those with one of the two risk factors for anal cancer: a history of abnormal cervical test results or a history of genital warts.

La prolifération des armes légères et de petit calibre est un phénomène nouvellement saisi par le droit international. En tant que menace pour la paix et la sécurité internationale, elle fait, depuis la fin de la guerre froide, l’objet d’attentions grandissantes. Tout d’abord abordée par des organisations internationales régionales, elle constitue désormais le domaine d’action privilégié de l’Organisation des Nations Unies en matière de désarmement. Néanmoins, la construction d’une lutte contre la prolifération ambitieuse et cohérente est difficile et doit faire face à des oppositions nombreuses justifiées par des intérêts étatiques profondément divergents. Le corpus normatif adopté est donc sujet à d’importantes limites et insuffisances. Par ailleurs, les instruments classiques de l’ordre juridique international apparaissent inaptes à garantir l’effectivité de ces nouvelles règles qui étendent le champ du droit international. La lutte contre la prolifération nécessite, pour être effective, de reposer sur des mécanismes plus approfondis que ceux régissant le droit international de la coopération duquel les règles classiques de désarmement étaient jusqu’alors issues. / The proliferation of small arms and light weapons has only recently been inquired into by international law. As for threatening the global peace and security, it has increasingly been scrutinized since the end of the Cold War. First handled by regional international organizations, it henceforth constitutes, regarding disarmament, the elected field of action for the United Nations. Structuring, nevertheless, an ambitious and coherent action against this proliferation appears quite challenging and has thus to overcome numerous oppositions grounded in profoundly diverging static interests. The current body of norms appears rather limited and inadequate. Furthermore, the classical instruments of the international legal order do not seem suitable to secure the effectiveness of those recent norms that expand the reach of international law. Successfully acting against this proliferation requires to relying on mechanisms that are deeper than the current international law of cooperation, and out of which the classical rules of disarmament have been hitherto extracted.

一般而言，國際間無償移轉有兩大分析方向。為公共財理論（考慮外部性效果）；一為國際貿易理論（考慮貿易條件變動效果）。此兩種截然不同的分析方式卻有類似的結論（國際間移轉支付發生時，關係的國家之福利水準，可能會有各種矛盾的情形）。此點引起吾人之好奇，若將兩模型合併，是否使會此不同兩領域之分析結果改變。也就是說，若同時考慮外部性及貿易條件時，所有結論是否仍能成立。 　　本文中以一較符合真實狀況（有公共財之存在且考慮國際貿易）之模型成功的推翻了僅由公共財或國際貿易觀點分析時，所得之結論及矛盾條件。也得知在較複雜較接近真實之情形的模型下，移轉支出發生時，很難確定福利水準之變動。

Reconnu à l'article 51 de la Charte des Nations unies, la légitime défense est élevée au rang de règle primaire de l'ordre juridique international. C'est un droit accordé au profit d'un Etat victime d'une agression armée. Il découle de l'interdiction générale du recours à la force posée par l'article 2§4. L'analyse montre que les dérives qui affectent le droit de légitime défense résultent d'un double déficit. Un manque d'effectivité tout d'abord ; le droit de légitime défense est détourné dans son application et dénaturé dans son interprétation. Il est souvent abusivement invoqué par les Etats afin de fonder juridiquement un emploi de la force contraire à la Charte. Les événements récents liés à la lutte contre le terrorisme conduisent certains à une relecture élargissant le champ d'application de l'article 51. Un manque d'efficacité ensuite ; si le droit de légitime défense est conditionné dans sa mise en oeuvre, il n'est encore que peu contrôlé. La CIJ a ainsi identifié les conditions conventionnelles et coutumières de son exercice. Le droit international dispose, en outre, de divers instruments afin de contrôler les actes de légitime défense que ce soit dans le cadre du droit commun de la responsabilité internationale ou dans celui du droit de la sécurité collective via le Conseil de sécurité ou les opérations de maintien de la paix. Ces mécanismes permettent d'engager la responsabilité étatique, mais aussi individuelle. La pratique témoigne néanmoins de carences importantes et pose la nécessaire question de la réforme de la Charte.

Les opérations de consolidation de la paix (OCP) sont l'ensemble des actions menées en vue de définir et d'étayer les structures propres à raffermir la paix afin d'éviter une reprise des hostilités. Bien que des actions de consolidation se rencontrent avant 1992, l'existence des opérations de consolidation de la paix fut consta-tée et dénommée par l'ancien Secrétaire général des Nations unies Boutros Boutros-Ghali dans l'Agenda pour la paix. Par la suite, les diffé-rentes études réalisées et la pratique ont permis de cerner les acteurs, les objectifs et les besoins d'une OCP. Ainsi la consolidation de la paix inclut non seulement des questions de sécurité – qui peuvent relever d'une mission de police – mais également des questions de restauration de la démocratie, de développement socio-économique et de la justice. Même si le Conseil de sécurité occupe une place importante dans la consolidation de la paix, il n'en est ni le seul acteur, ni le principal responsable. Ce sont, au contraire, de nombreux organes de l'ONU et organismes internationaux qui interviennent au cours des différentes étapes de la consolidation de la paix. Afin d'apporter une réponse adéquate au besoin de coordination et de coopération entre ces différents acteurs, la Commission de consolidation de la paix a été créée en 2005. Elle est le premier organe cosubsidiaire des Nations unies : elle dépend à la fois de l'Assemblée générale et du Conseil de sécurité, ce qui n'est pas sans susciter des difficultés. Elle n'est cependant pas le principal acteur de la consolida-tion de la paix puisque la responsabilité principale de chaque opération incombe à l'Etat en question. Malgré le nombre important de conflits dans le monde, la Commission n'a actuellement que quatre pays inscrits à son ordre du jour : le Burundi, la Sierra Leone, la Guinée-Bissau et la République Centrafricaine. On peut, toutefois, souhaiter qu'un nombre croissant d'Etats s'inscrive prochainement auprès de cette nouvelle Commission pour éviter le retour des conflits.

In the first chapter, I quantify the welfare effect of eliminating the U.S. capital income tax under international financial integration. I employ a two-country, heterogeneous-agent incomplete markets model calibrated to represent the U.S. and the rest of the world. Short-run and long-run factor price dynamics are key: after the tax reform, post-tax interest rate increases less under financial openness relative to autarky. Therefore the wealth-rich households gain less. Post-tax wages also fall less, so the wealth-poor are hurt less. Hence, the fraction in favor of the reform increases, although the majority still prefers the status quo. Aggregate welfare effect to the U.S. is a permanent 0.2 % consumption equivalent loss under financial openness which is 85.5 % smaller than the welfare loss under autarky. The second chapter aims to answer two questions: What helps forecast U.S. inflation? What causes the observed changes in the predictive ability of variables commonly used in forecasting US inflation? In macroeconomic analysis and inflation forecasting, the traditional Phillips curve has been widely used to exploit the empirical relationship between inflation and domestic economic activity. Atkeson and Ohanian (2001), among others, cast doubt on the performance of Phillips curve-based forecasts of U.S. inflation relative to naive forecasts. This indicates a difficulty for policy-making and private sectorâs long term nominal commitments which depend on inflation expectations. The literature suggests globalization may be one reason for this phenomenon. To test this, we evaluate the forecasting ability of global slack measures under an open economy Phillips curve. The results are very sensitive to measures of inflation, forecast horizons and estimation samples. We find however, terms of trade gap, measured as HP-filtered terms of trade, is a good and robust variable to forecast U.S. inflation. Moreover, our forecasts based on the simulated data from a workhorse new open economy macro (NOEM) model indicate that better monetary policy and good luck (i.e. a remarkably benign sample of economic shocks) can account for the empirical observations on forecasting accuracy, while globalization plays a secondary role. / text

Understanding the barriers to treatment for individuals with HIV/AIDS in developing countries could have a major impact on their ability to seek healthcare services. The purpose of this study is to quantitatively analyze the effect of daily activities and structural factors, which act as barriers to seeking health services for individuals living with HIV/AIDS in Tanzania. The study is based on the hypothesis that (1) Individuals living with HIV/AIDS who face both personal and structural barriers have poor health compared to those not facing the barriers. (2) Individuals living with HIV/AIDS demonstrate different decisions and abilities to seek health services depending on their socioeconomic and clinical factors. A retrospective study design has been chosen for the current project. The source data-set comprises demographic and health surveys (DHS) in 2011-12 with N=839, male=661, female=178 the independent variables identified have been sub classified into, structural, personal, and socioeconomic groups. The data is analyzed using SPSS Statistical Package for Social Science, version 20. The data analysis shows the significant relationship between various variables included in the study such as owning livestock and frequency of eating meat in a week, distance from the health facility and the mode of transportation. We subdivided the data into these categories: urban, rural, male and female for further analysis. Based upon the results from the study, resources can be managed optimally so as to minimize costs and treatment delays / failures for individuals suffering with HIV/AIDS, especially in the context of developing world. These results could be applied to other developing countries as well. The global picture relates to maximizing the benefits and minimizing healthcare costs as a way to reducing morbidity and mortality in HIV/AIDS populations in developing countries.

Parmi les critiques visant l'Organisation mondiale du commerce (OMC), il est souvent reproché à celle-ci d’accorder trop peu d’importance aux préoccupations non commerciales des consommateurs et des États, reflet de leurs valeurs sociétales ou culturelles, sous prétexte de lutter contre les entraves au commerce international. Pourtant, dans le domaine du commerce des marchandises, l’article XX du GATT prévoit certaines exceptions générales, permettant éventuellement aux États de justifier une mesure restrictive pour le commerce, notamment pour des raisons de protection de la moralité publique. Or, cette « exception de moralité publique », rarement invoquée à ce jour, est au cœur du différend commercial opposant actuellement le Canada à l’Union européenne, après l’embargo adopté en 2009 par celle-ci sur les produits issus de la chasse au phoque, considérée comme cruelle par de nombreux Européens. Dans ce mémoire, nous avons tenté d’envisager l’issue possible de ce litige. À cette fin, nous avons réalisé une étude préliminaire du concept de moralité publique en droit international public et présenté en détails le contexte, notamment politique, de ce différend; puis nous avons procédé à son analyse par étapes, selon la méthode retenue à ce jour par l’Organe de règlement des différends (ORD). À l’issue de nos réflexions, nous avons conclu que l’ORD devrait constater que la mesure européenne contestée vise à répondre à un réel souci de protection de la moralité publique en Europe; toutefois, il est probable, selon nous, que l’embargo européen ne soit pas considéré comme « nécessaire » à cette fin, au sens de l’article XX du GATT : en effet, l’ORD estimera sans doute que l’Union européenne aurait pu mettre en œuvre des solutions moins incompatibles avec ses obligations au titre du GATT. Nous pensons donc, hélas, que l’issue de ce litige ne satisfera pas ceux qui réclament une plus grande ouverture de l’OMC vis-à-vis de considérations non commerciales légitimes. / Among other criticisms, the World Trade Organization (WTO) is often blamed for not taking sufficient account of non-trade concerns, which express consumers and States’ societal or cultural values, under the pretext of international trade liberalization. Concerning trade in goods, though, GATT article XX provides certain general exceptions, allowing States to justify trade-restrictive measures intended to protect public morals. Now, this rarely-invoked "public morals clause" is at the very heart of a pending trade dispute between Canada and the European Union (EU), after the EU decided in 2009 to ban products derived from seal hunt, which is seen as cruel by many Europeans. In this report, the author tries to predict what the outcome of this dispute could be. To this end, the report first examines the public morals concept in public international law. Then, it describes in details the context of this conflict, in particular at the political level. Finally, the author makes an assessment of an article XX defense, following the method adopted to date by the Dispute Settlement Body (DSB). This report concludes that the DSB is likely to consider that the challenged measure aims at addressing a real concern about the protection of public morals in Europe; however, in the author’s view, the European ban will not be deemed "necessary" to achieve this end under GATT article XX. Indeed, the DSB will most likely consider that the European Union had less trade-restrictive available options that are more compatible with its obligations under the GATT. Regrettably, the author believes that the ORD decision in this dispute will not satisfy those who call for a better recognition of legitimate non-trade concerns by the WTO.

本文採文獻歸納方式，針對全球暖化問題，以國際公共財理論作為議題緣起，分析京都彈性機制—清潔發展機制之運作。全球暖化為一純粹國際公共財問題。而京都議定書要求各國履行排放減量之標的，可作為提供公共財依據。並以排放減量份額作為供給數量之評估。而CDM即為促進各國均能參與溫室氣體減量活動之機制，達成經濟永續發展之目標。 當就不對稱關係以賽局討論國際公共財之供給，邊際成本較低國家，應從事較多公共財貢獻行動；邊際成本較高的國家則發生搭便車行為。但卻與CDM文獻結論有所不同。CDM計畫中的開發中國家因不受約束，反而有搭便車行為。多數的減量行動仍由已開發國家在境內進行。故國際公共財賽局可否用於研究CDM之運作，仍有待評估。 有關CDM在模型理論上可利用動態規劃之最適模型，研究投資國與被投資國之行為。當排放權證交易為不完全競爭市場時，可以Stackelberg模型進行。若不僅以經濟分析，尚可加入生態研究作成整合模型。在CDM執行成效方面，必須審慎評估CDM計畫型式，並考量是否合乎額外性準則。而CERs之境內分配政策，則可能會因利益交換，導致勾結行為相繼發生。此外，排放基線與CERs具有密切關聯，基線設定遂成為CDM之核心議題。有效建立CDM法則，強化合作的透明度，對於減少交易成本將佔有關鍵性地位。又CERs以選擇權出售；CDM與IIA的衝突及CDM資訊不對稱問題，都可再作研究。 儘管台灣非京都議定書締約國，無法作為CDM之地主國。僅能間接參與投資。不過國內學者多已提出產業因應措施作為諮詢。並以TAIGEM-E模型推算排放基線，建立從事溫室氣體減量行動之數據。受限於台灣國際地位，CDM計畫成效可能難以進行實證分析。不過中國和日本有許多CDM計畫，可針對較具爭議性之議題作延伸討論，並研讀相關文獻作為參考。本文即為發掘核心議題，提供文獻彙整，協助擬研究清潔發展機制者作為參議。