The Culture Cult Revisited

Society - What is the gravest threat to “open” democratic societies today? In Karl Popper’s view it was tribalism. By contrasting closed autarkic Sparta and free-trading Athens,...     

Co-Production and Health System Reform – From Re-Imagining To Re-Making

There is growing interest in the application of citizen participation within all areas of public sector service development, where it is increasingly promoted as a significant strand of post-neoliberal policy concerned with re-imagining citizenship and more participatory forms of citizen/consumer engagement. The application of such a perspective within health services, via co-production, has both beneficial, but also problematic implications for the organisation of such services, for professional practice and education. Given the disappointing results in increasing consumer involvement in health services via 'choice' and 'voice' participation strategies, the question of how the more challenging approach of co-production will fare needs to be addressed. The article discusses the possibilities and challenges of system-wide co-production for health. It identifies the discourse and practice contours of co-production, differentiating co-production from other health consumer-led approaches. Finally, it identifies issues critically related to the successful implementation of co-production where additional theorisation and research are required.     

Built-in Safeguards and the Implementation of Civil War Peace Accords

This article contributes to analyses of peace agreement implementation by focusing on the role of built-in safeguards as procedural mechanisms within peace agreements. Recent empirical studies suggest that negotiated peace agreements are a frequent mode of armed conflict termination and implementation of those agreements to be the primary predictor of enduring peace and the quality of that peace. However, in many instances implementation takes years or even decades and is subject to breakdown before achieving the key implementation objectives. In this article, we identify and theorize three key safeguards in peace accords: transitional power-sharing, dispute resolution, and verification mechanisms. We argue that these safeguards lead to higher implementation of provisions negotiated in peace agreements by addressing mutual suspicion and by facilitating more constructive working relationships among former rivals. To test our arguments, we analyze implementation of comprehensive peace agreements negotiated between 1989 and 2012 from the Peace Accords Matrix Implementation Data (PAM_ID). We find that the built-in safeguards that we have identified significantly explain variations in levels of peace agreement implementation.     

Universities and State Policy Formation: Rationalizing a Nanotechnology Strategy in Pennsylvania

Technology‐based economic development programs have become a salient feature of the state policy landscape since the 1980s. While much research exists on the topic, little attention has been given to the processes of policy formation. State programs have moved towards high technology areas emphasized at the federal level over the past decades, and nanotechnology became one of the latest targets. This paper examines the eight‐year process through which Pennsylvania adopted a “state‐wide strategy,” culminating in the Pennsylvania Initiative for Nanotechnology. In this process, programs that responded to the interests of multiple agents came first, and a state policy was formulated after the fact. This pattern of “rationalized policy formation,” as opposed to rational policy formation, may be more common than suspected. Its strengths and weaknesses in this Pennsylvania case are discussed.     

Basal Vacuolization in Renal Tubular Epithelial Cells at Autopsy and Their Relation to Ketoacidosis

Basal vacuolization of renal tubular epithelial cells is a useful postmortem marker for ketoacidosis. To investigate its incidence and relationship to the severity of ketoacidosis, 158 autopsy cases with elevated β‐hydroxybutyrate (>1 mmol/L) over a 7‐year‐period were retrospectively reviewed. Sixty‐eight cases (43%) exhibited basal vacuolizations (vitreous β‐hydroxybutyrate: 1.16–29.35 mmol/L, mean 10.28 mmol/L), and 90 cases (57%) did not (vitreous β‐hydroxybutyrate: 1.03–13.7 mmol/L, mean 2.84 mmol/L). Quantitative analysis revealed on average a fourfold elevation in β‐hydroxybutyrate in cases with basal vacuolizations compared to those without; 10.3% of cases with β‐hydroxybutyrate concentrations between 1.01 and 2.00 mmol/L had basal vacuolizations, and this incidence increased to 33.3% with concentrations between 4.01 and 6.00 mmol/L. A marked increase in incidence to >70% was observed with concentrations >6.00 mmol/L, and basal vacuoles were invariably present (100%) with concentrations >14.01 mmol/L. This study demonstrates that basal vacuolizations are a sensitive marker for significant ketoacidosis and reaffirms its use as an indicator for likely cases of fatal ketoacidosis at autopsy.