Tax morale and (de-)centralization: An experimental study

We consider an economy composed of two regions. Each of them provides a public good whose benefits reach beyond local boundaries. In case of decentralization, taxes collected by members of a region are spent only on that region's public good. In case of centralization, tax receipts from the two regions are pooled and used to finance both public goods according to the population size of each region. The experiment shows that centralization induces lower tax morale and less efficient outcomes. The reasons are that centralization gives rise to an interregional incentive problem and creates inequalities in income between regions.     

Criminal poisoning of commuters in Bangladesh: prospective and retrospective study

Travel-related poisoning is an emerging social and public health emergency in Bangladesh but its cause and significance have not been determined. To investigate this syndrome we performed a prospective clinical study and retrospective analysis of hospital records in a general medicine unit of a public tertiary care teaching hospital in Dhaka, Bangladesh, using toxicological analysis by fluorescence polarization immunoassay (FPIA) and liquid chromatography coupled to time-of-flight mass spectrometry (LC-TOF MS). The participants of the prospective study were 130 consecutive patients aged 16-80 years who were admitted with central nervous system depression (Glasgow Coma Score 3-14) after using public transportation, in the absence of other abnormalities, from January through June 2004, and a convenience sample of 15 such patients admitted during 3 days in May 2006. In 2004-2006, travel-related poisoning increased from 6.1 to 9.5% of all admissions (210-309 of 3266-3843 per year), representing 46.6-55.7% of all admitted poisoning cases. Incidents were associated with bus (76%), taxi, train, and air travel, or local markets; 98% of patients remembered buying or accepting food or drinks before losing consciousness. Direct financial damage (missing property) was diverse and frequently existential. Among 94 urine samples analyzed by FPIA, 74% tested positive for benzodiazepines. Among 15 urine samples analyzed by LC-TOF MS, lorazepam was detected in all; five also contained diazepam or metabolites; nitrazepam was present in three. FPIA results obtained for these 15 samples were below the recommended cut-off in eight (53%; lorazepam only). Our findings show that the massive medicosocial emergency of travel-related poisoning in Bangladesh is the result of drug-facilitated organized crime and that benzodiazepine drugs are used to commit these crimes, suggesting modifications to the local emergency management of the victims of this type of poisoning. They also highlight the need for more research in the neglected field of acute poisoning in Bangladesh, and for criminal investigations of the use of benzodiazepine drugs in this country.     

The concept of forensic emergency medicine as illustrated by an unusual complication of pulmonary artery catheterization

Forensic pathologists are regularly confronted with emergency and invasive medical procedures performed on critically ill or traumatized patients. Basic knowledge of such procedures and their possible complications is therefore mandatory in medico-legal practice. In this article, we describe a very unusual complication of pulmonary artery catheterization: through-and-through perforation of the carotid artery, initially without hemodynamic consequence. Death resulted from an aggravation of the preexisting cerebral edema (secondary to a craniocerebral trauma). The misplacement of the pulmonary artery catheter was clinically missed because the guidewire was initially deflected on the cervical spine towards the subclavian vein where the catheter--by chance--entered the circulatory system and followed its normal route further. The forensic importance of leaving all invasive medical devices in situ on a deceased person when a medico-legal autopsy is to be expected and the mutual interaction between emergency and forensic medicine (forensic emergency medicine) are discussed.     

Effect of Lower Third Molar Segmentations on Automated Tooth Development Staging using a Convolutional Neural Network

Staging third molar development is commonly used for age estimation in subadults. Automated developmental stage allocation to the mandibular left third molar in panoramic radiographs has been examined in a pilot study. This method used an AlexNet Deep Convolutional Neural Network (CNN) approach to stage lower left third molars, which had been selected by manually drawn bounding boxes around them. This method (bounding box AlexNet = BA) still contained parts of surrounding structures which may have affected the automated stage allocation performance. We hypothesize that segmenting only the third molar could further improve the automated stage allocation performance. Therefore, the current study aimed to determine and validate the effect of lower third molar segmentations on automated tooth development staging. Retrospectively, 400 panoramic radiographs were collected, processed and segmented in three ways: bounding box (BB), rough (RS), and full (FS) tooth segmentation. A DenseNet201 CNN was used for automated stage allocation. Automated staging results were compared with reference stages – allocated by human observers – overall and per stage. FS rendered the best results with a stage allocation accuracy of 0.61, a mean absolute difference of 0.53 stages and a Cohen's linear κ of 0.84. Misallocated stages were mostly neighboring stages, and DenseNet201 rendered better results than AlexNet by increasing the percentage of correctly allocated stages by 3% (BA compared to BB). FS increased the percentage of correctly allocated stages by 7% compared to BB. In conclusion, full tooth segmentation and a DenseNet CNN optimize automated dental stage allocation for age estimation.     

Authority in statebuilding as communicative practice. The Joint Working Group on the Constitutional Framework in Kosovo

Post-war constitution-making touches the future identity of the concerned society. In externally led democratization, it can turn into a challenging negotiation process between international and so-called local actors. But who can claim the authority to define and interpret identity and fundamental norms of society, and on what grounds? Based on an analysis of the “Joint Working Group on the Constitutional Framework” held in spring 2001 in Kosovo, the article argues that external actors have a structural disadvantage in the authoritative communication with local actors, even if equipped with a strong international mandate. While external actors can set the opportunity structures to negotiate constitutional politics, local actors will use every chance to publically claim authority on their behalf in the process. Guided by the theoretical framework of interpretative authority (Deutungsmacht), the article concludes that we have to understand authority in statebuilding primarily, not as an attribute of actors, but as an outcome of communicative practices.     

Women’s Participation in Peace Negotiations and the Durability of Peace

There is an emerging consensus that women’s participation in peace negotiations contributes to the quality and durability of peace after civil war. However, to date, this proposition has remained empirically untested. Moreover, how women’s participation may contribute to durable peace has not been systematically explored. This article uses a mixed method design to examine this proposition. Our statistical analysis demonstrates a robust correlation between peace agreements signed by female delegates and durable peace. We further find that agreements signed by women show a significantly higher number of peace agreement provisions aimed at political reform, and higher implementation rates for provisions. We argue that linkages between women signatories and women civil society groups explain the observed positive impact of women’s direct participation in peace negotiations. Collaboration and knowledge building among diverse women groups contributes to better content of peace agreements and higher implementation rates of agreement provisions. We substantiate this argument with qualitative case study evidence and demonstrate how collaboration between female delegates and women civil society groups positively impacts peace processes. Our findings support the assumption that women’s participation in peace negotiations increases the durability and the quality of peace.     

Von der Organisation Krankenhaus zum Behandlungsnetzwerk?

The following paper is based on ethnographic studies in German hospitals and focuses on medical actions and decision-making. As the investigation was conducted as a panel, it is possible to perceive of how the organizational changes have affected the medical work in hospitals. In the first part of the study, from 2000 to 2002, field research took place in four different types of departments in several hospitals. In the second part of the study, in the year 2004, the general ward and the department of abdominal surgery were revisited. In the time period between the two field-research phases the hospitals in Germany were experiencing an extensive process of organizational change. On the one hand, the introduction of the new “Diagnose Related Groups” (DRG) brought a new cost accounting structure. The base for calculating the cost is now no longer length of hospital stays, but a billing system related to diagnosis. On the other hand, connected to the ongoing privatization of hospitals, concepts of modern management (computer based “controlling”, “outsourcing” and centralization of important functions) are beginning to enter into hospital life. These processes are significantly changing the context of medical work and also the way in which medical decisions are processed.     

德国的国家范式和行政改革

国家范式可以通过许多不同的方式加以理解。本文主要通过考察行政改革或行政政策来界定二战后现代德国不同的国家范式。通过聚焦行政理论的内在基础和外在表现,本文将二战后的德国划分为五个阶段,分析范式转变的因果关系和各阶段不同的特点。在结论部分,本文分析了德国行政改革中所表现出的一些动态特征。