EVALUATION AS SOCIAL POLICY

Policy research has become an integral part of the policymaking process but is changing as the goals and emphases o f policies change. The paper explores the shift in emphasis in evaluation research away from predominantly programmatic concerns and toward accountability issues in personnel and job evaluation. It depicts an inward turning in domestic policies from the provision of services to evaluation of government itself, and an acceleration in conflict over how the work of government should be structured and performed, and by whom. Using examples from three levels o f government, it describes what makes policies controversial, their evaluations political, and how the search for legitimacy and legitimizing technologies raises the stakes for all actors in the policy process–elected officials, administrators, consumers, and evaluators. Conclusions are drawn regarding the effect on research o f these changes in policy.     

Variations in Organizational Participation in Government: The Case of Denmark*

The main purpose of this article is to refine, modify, and elaborate some central propositions and assumptions in the scholarly debate on corporatism or corporate pluralism. The empirical base is a data archive containing information on practically all interest groups in Denmark. Hypotheses are formulated and tested concerning variations in direct representation and participation of interest groups in public policy-making across (a) types of interest groups, (b) organizational resources, (c) organizational structures, and{d) political issue areas. Contrary to prevailing propositions in the literature on corporatism, the Danish case shows that corporate structures and practices go hand in hand with a system of interest groups characterized by myriads of interest groups, and an overall, rather decentralized structure.     

Postmortem Blood Concentrations of R‐ and S‐Enantiomers of Methadone and EDDP in Drug Users: Influence of Co‐Medication and P‐glycoprotein Genotype

Abstract: We investigated toxicological and pharmacogenetic factors that could influence methadone toxicity using postmortem samples. R‐ and S‐methadone were measured in femoral blood from 90 postmortem cases, mainly drug users. The R‐enantiomer concentrations significantly exceeded that of the S‐enantiomers (Wilcoxon’s test, p < 0.001). The samples were divided into four groups according to other drugs detected (methadone only, methadone and strong analgesics, methadone and benzodiazepines, or methadone and other drugs). There was no significant difference in any of the R‐methadone/total methadone ratios among the four groups. The median R/S ratio was 1.38, which tends to be higher than that reported for the plasma of living subjects. In addition, we investigated whether small nucleotide polymorphisms in the MDR1 gene that encode the drug transporter P‐glycoprotein were associated with the concentrations of R‐ and S‐methadone and its metabolite 2‐ethylidene‐1,5‐dimethyl‐3,3‐diphenylpyrrolidine. No significant association was detected.     

A fatal overdose of the ergot derivative cabergoline

A 79-year-old woman, with Parkinson's disease treated with cabergoline, was admitted to a hospital due to jaundice and weakness. She was found confused, absent minded, and died after 2 weeks. Autopsy showed an extrahepatic bile duct adenocarcinoma with spread to the gall bladder, the liver, and regional lymphnodes. While cleaning the hospital bed after her death, the nurses found several tablets hidden in the bed. Biological samples obtained at the autopsy were screened for common drugs and narcotics. Several drugs such as buprenorphine, codeine, paracetamol, and propranolol were detected in the blood at therapeutic levels. A method to determine cabergoline in whole blood and other forensic matrices was developed, and further investigations determined cabergoline concentrations in whole blood and liver tissue of 94 and 3100 microg/kg, respectively. The blood concentration was 100 times above the therapeutic level reported on cabergoline in plasma and in combination with her symptoms, suggest she took a fatal overdose of cabergoline.     

Dominance of pre-analytical over analytical variation for measurement of methadone and its main metabolite in postmortem femoral blood

On the basis of simultaneously sampled postmortem blood specimens from the left and right femoral veins the pre-analytical variation of methadone measurements was evaluated and compared to the analytical variation. The material consisted of a series of 27 duplicate samples from routine autopsy cases comprising mainly drug addicts. A chiral LC-MS/MS method was used for measurement of the R- and S-enantiomers of methadone and its main metabolite 2-ethyl-1,5-dimethyl-3,3-diphenylpyrrolinium (EDDP). The analytical CV% was determined to be in the range 3-4% for methadone enantiomers and 4-6% for EDDP enantiomers. The total measurement uncertainty (CV(T)) was estimated from the pre-analytical variation (CV(PA)), analytical variation proper (CV(A)), and variation related to calibration (traceability) (CV(Cal)) according to the relationship CV(T) = [CV(2)(PA) + CV(2)(A) + CV(2)(cal)](0.5). Uncertainty related to calibration concerned a component related to the purity of drug reference compound and a contribution from the production of calibrator solutions (CV(Cal)<1%). Pre-analytical sampling variation was estimated from the duplicate measurements of blood samples after subtraction of the analytical component. The pre-analytical variation amounted to a CV% of 19-21% for R- and S-methadone and 30-38% for R- and S-EDDP, i.e. considerably larger than the other components. Due to the squared addition principle, the resulting total uncertainty (CV(T)) became largely identical to the CV(PA), i.e. 19-21% for R- and S-methadone and 31-38% for R- and S-EDDP enantiomers. Accordingly, CV(T) exceeded CV(A) by a factor 5 or more. Dominance of the pre-analytical component of variation may also be likely for other compounds measured in postmortem blood samples. Thus, the width of the 95%-uncertainty interval (+/-2CV(T)) for a postmortem measurement is largely determined by the pre-analytical component of variation. This should be kept in mind when judging on the uncertainty of postmortem measurement results.     

FROM SOCIAL DOCTRINE TO IMPLEMENTATION: AGENDA SETTING IN COMPARABLE WORTH

Comparable worth is a policy issue with twofaces. It is both a social doctrine proposing equal pay for work of comparable value and a methodology in personnel administration, called "objective job evaluation," that introduces new evaluative criteria to assess job worth. It has achieved policy status on the subnational level through the use of multiple agenda setting and implementation strategies by coalitions of women's advocacy groups and unions. The shifting use of comparable worth as a social doctrine or as a methodology to assess jobs has varied with the distribution of power resources of the sponsors and the receptiveness of the policy setting. The paper explores how comparable worth developed as a general policy issue on the subnational level. It offers a policy framework to interpret i t s transformation into policies and programs and assesses i t s probable impact on personnel administration.