Government stewardship and primary health care in Guatemala since 1996

This article analyzes the role of government stewardship in the expansion of primary health care in post‐conflict Guatemala. By the time the Peace Accords were signed in 1996, the country's primary health care system was scarcely functioning with virtually no services available in rural indigenous areas. To address this gaping void/deficiency, the Ministry of Public Health and Social Assistance (MSPAS) embarked on a progressive expansion of primary services aimed at covering the majority of rural poor. Through a series of legal, policy, and program reforms up to 2014, the MSPAS dramatically expanded primary coverage and greatly improved basic health indicators for the entire population. To succeed in this effort, the MSPAS and its partners needed to simultaneously grow their stewardship capacity to oversee and develop the primary health system. On the basis of recent health systems strengthening literature, we propose a stewardship framework of 6 critical functions and use it to analyze the gains in government capacity that enabled the achievement of many of the country's primary health goals. Of the 6 stewardship functions, “building relationships, coalitions, and partnerships” especially with civil society organizations stands out as one of the keys to MSPAS success.     

“The Long and Winding Road”: A Comparative Policy Analysis of Multilevel Judicial Implementation of Work‒Life Balance in Spain

ABSTRACT

This article studies how processes of policy implementation and the impact of a multilevel European legal order shape social policies. By using an interdisciplinary approach to comparative policy analysis that investigates policy implementation through the critical study of judicial litigation, the article analyses the case of García Mateos on work?life balance in its different stages before Spanish and supranational courts. It shows that the implementation of work?life balance policy through litigation in Spain is a “long and winding road” paved with discursive and material opportunities and obstacles. While multiple pressures, actors, and framings at different governmental levels contributed to a favourable judicial decision on gender equality, norms about the gendered division of labour limited its transformative potential.     

Determinants of popular financial reporting: Evidence from Swedish municipalities

This paper investigates popular financial reporting, to determine how contextual factors can favour or hinder its development. A balanced panel dataset from 289 Swedish municipalities spanning the period 2015–2021 is utilised for the empirical analysis, which is based on bivariate correlations and logistic regression models. The results are interpreted through the lens of legitimacy theory, integrated with innovation and diffusion models. The findings suggest that, while political factors play a certain role, it is primarily the local accounting networks, which enable the exchange of experiences among neighbouring municipalities within the same regional area, that are the most influential factor. These results may prove to be helpful in various contexts, contributing to the academic debate on the relevance of institutional and contextual factors in explaining the voluntary decision to prepare popular financial reports.     

Fatal intoxication with labetalol (Trandate)

The dead body of a 44-year-old woman, previously known for depression and alcoholism, has been discovered at her place of residence by her husband. A forensic autopsy has been carried out. The results indicated unspecific histological lesions (alveolar oedema, liver steatosis and interstitial nephritis) but did not reveal any apparent cause of death. Several boxes of medicines have been found near the body, justifying a toxicological analysis. This has been performed on peripheral blood and urine samples using liquid chromatography with diode array and mass spectrometric detections, in conjunction with gas chromatography coupled with mass spectrometry. Ethanol has been found (1.24 g/L in blood, 2.63 g/L in urine and 1.33 g/kg in gastric content), as well as therapeutic concentrations of meprobamate (14.1mg/L) and low concentrations of nordazepam (0.12 mg/L) in blood. On the other hand, particularly high levels of labetalol, a widely used beta-blocker, have been found both in blood (1.7 mg/L) and urine (20.2mg/L), which led us to measure labetalol levels in available viscera samples (liver, heart, kidney, and lung) and gastric content. Measured concentrations were 14.2 microg/g, 7.8 microg/g, 5.4 microg/g, 5.2 microg/g and 31.1 microg/g, respectively. We describe here the first report of a fatal intoxication attributed to labetalol that is linked to its acute toxicity, with tissue distribution of this beta-blocker.     

Sexually violent predator laws and the liberal state: an ominous threat to individual liberty

No other country has taken the idea of the liberal state - a government that relies on the rule of law to limit state power and maximize individual liberty - as seriously as the United States. But now many states are manipulating the government's civil commitment authority to indefinitely confine sex offenders who have served their criminal sentences and are entitled to their freedom in the community. This new system of preventive detention masquerading as civil commitment poses an ominous threat to individual liberty and to the continued vitality of the liberal state.     

Intentional Homicide: A Fifteen-Year Study (2000–2014) at the Department of Forensic Medicine,University of Rome “Sapienza”

This study analyzes postmortem records from 260 homicide cases autopsied by the Department of Forensic Medicine in Rome from 2000 to 2014. The victims were mainly males (74%) and young (61% aged from 21 to 50 years). Although the victims were mostly Italians, the number of foreign victims (33%) has increased since 1990, primarily due to immigration. The offenders frequently used firearms (39%), particularly in multiple murders. An increase in blunt (20%) and sharp force (32%) weapons was also seen. The primary crime scene was residential (42%), and the head was the most frequently injured body region. Male victims occurred frequently in the context of organized crime (7.6%). In family or intimate-sexual relationships, women were the majority of victims (8%). Forensic pathologists play an important role during investigation. They should consider all the information available to them, including autopsy information, crime scene information, and crime investigation data.     

Somewhere Between Love and Justice: a Roman Catholic Church in Paris Responds to the European Migration Crisis

The European migration crisis has had a transformative impact on many transit and destination localities in Europe, and in doing so it has mobilised many faith-based communities. This paper analyses the social action of Saint Bernard de La Chapelle, a Roman Catholic parish in northern Paris, which hosts a semi-formal association called Solidarités Saint Bernard (SSB) involved in support and relief activities for indigent migrants in the local area. Based on ethnographic research conducted within the parish and the association, I analyse how the topic of migration has become a point of exchange between the parish community and local civil society, how religious and secular discourses and motivations co-exist within SSB, and how these influences shape SSB’s social action. Through this micro-scale approach, and drawing on Luc Boltanski’s theoretical framework of regimes of action, my aim is to identify conceptual elements to better understand the broad convergence between religion, social action, and migration, and to better understand the relation between charity and justice within faith-based social action in the domain of migration advocacy more specifically.     

Highly efficient and automated extraction of DNA from human remains using a modified EZ1 protocol

Bones and teeth often represent the only sources of DNA available for identifying human remains. DNA in bones and teeth is generally better preserved than that in soft tissues because of the presence of hard connective tissue with a high level of calcium. Because of the extensive mineralisation, the choice of an efficient DNA extraction procedure is important to minimise the sampling of a high level of minerals and to remove polymerase chain reaction (PCR) inhibitors. Some protocols are available for DNA extraction from bones and teeth as part of the Qiagen EZ1 DNA Investigator Kit using the EZ1 Advanced XL automated purification platform. To improve the efficiency of DNA extraction from skeletal remains, the present study focuses on a modification to these already available protocols. In this study, different bones and teeth collected between 1 and 50 years after death were subjected to DNA extraction using the standard EZ1 protocol, a supplementary protocol, and a modified protocol. The modified approach included a decalcification step, whereas the Qiagen protocols worked directly on non-decalcified powder. In all three procedures, 150 mg samples were used for DNA extraction. We evaluated the quantity of DNA recovered from samples, the presence of any PCR inhibitors co-extracted, the level of DNA degradation, the quality of short tandem repeat (STR) profiles, and the reproducibility of the modified procedure. When compared with the other protocols, the modified protocol resulted in the best recovery of DNA that was free of PCR inhibitors. Additionally, the STR profiles were reliable and of high quality. In our opinion, the decalcification step increases DNA recovery by softening tissues, which allows lysis solutions to act more effectively. Furthermore, the use of two lysis solutions and the variation added to the EZ1 purification step allow for DNA recovery with quality and quantity superior to those of the previously available Qiagen-based protocols. These findings may be helpful solutions to the problems commonly encountered when dealing with difficult samples, such as bones and teeth.

Key points

• Bones and teeth often represent the only sources of DNA for identifying human remains.
• The choice of an efficient DNA extraction procedure is important for maximizing DNA recovery and removing PCR inhibitors.
• This study focuses on modifications to the previously available Qiagen-based protocols.
• The modified protocol enabled the best recovery of DNA, and both quality and quantity were superior to those of the previously available Qiagen-based protocols.
• The STR profiles obtained from samples extracted using the modified protocol were reliable and of high quality.