A Desultory Defense of Democracy: OAS Resolution 1080 and the Inter-American Democratic Charter

This article evaluates the effectiveness of OAS mechanisms for safeguarding democracy through multilateral diplomacy, what some scholars have dubbed the interamerican defense of democracy regime. Drawing on a range of international relations theories, this study derives competing hypotheses about member states' responses to democratic crises in the Americas. It then analyzes all instances in which a collective response—that is, an application of Resolution 1080 or the Inter-American Democratic Charter—was debated in the OAS between 1991 and 2002. Patterns of state behavior suggest that domestic politics, rather than the structural or systemic traits of the interamerican system, best explain foreign policy responses to crises of democracy in the region. The OAS record in confronting such crises is uneven.     

Quantitative analysis of chlorpromazine by electron spin resonance (ESR) spectroscopy

A simple and sensitive method is described for quantitative analysis of chlorpromazine in blood, serum, urine and tissue homogenate. The chlorpromazine cation radical produced by adding perchloric acid and 2,3-dichloro-5,6-dicyano-p-benzoquinone to the sample can be detected by the ESR method at room temperature. The sensitivity limit is 10 ng, that is, 20 μl of the solution containing 0.5 μg chlorpromazine/ml. The time needed for the measurement is within 10 min. The chlorpromazine radical thus produced is very stable; for example, 95% of the radical was observed after 24 h. The advantage of this method is discussed by comparing with the ordinary spectrophotometry which requires the purification of the sample.     

The judicial role in life-sustaining medical treatment decisions.

Although there has been speculation regarding the pervasiveness and nature of judicial decisions regarding life-sustaining medical treatment (LSMT), no attempt has been made to empirically assess their prevalence or the issues they address. An exploratory study utilizing a mail survey of a nationwide random sample (N = 905) of state trial court judges was conducted to provide initial information regarding this decision-making process. Twenty-two percent of the responding judges had heard at least one LSMT case, and judicial review did not appear endemic to particular states. The number of judges hearing LSMT cases dropped from 1975 to 1981 but has increased since then. Three major issues predominate: patient competency, appointment of a surrogate decisionmaker, and resolution of the ultimate issue of forgoing LSMT. Relatively few cases either contested a prior directive's validity or involved imposing sanctions for instituting or forgoing LSMT. Although subject to different interpretations, the results suggest the courts are having a significant impact on certain aspects of the LSMT decision-making process. However, the infrequency with which any one judge is called upon to make an LSMT decision causes concern about the judiciary's ability to respond in a timely and appropriate manner. With their potential for a profound effect on the actions of health care providers, greater attention to this decision-making process is warranted.     

A unique case of congenital bilateral absence of parietal bones in a neonate

The remains of an unidentified female neonate were discovered in a field in central Missouri. Examination revealed bilateral absence of the parietal bones. A search of the literature describing similar defects suggests that the present case represents a unique condition, described here for the first time.     

SUPRANATIONAL GOVERNANCE OR NATIONAL BUSINESS‐AS‐USUAL? THE NATIONAL ADMINISTRATION OF EU STRUCTURAL FUNDS IN THE NETHERLANDS AND DENMARK

The partnership principle in EU cohesion policy was introduced in order to involve subnational authorities and interest organizations in policy formulation and implementation. In this article we examine how the member states have reacted to this call for a new way of making public policy. We argue that the multi‐level governance literature and the critics of the multi‐level governance framework have not examined implementation structures properly, but have focused on regional influence. We conduct a comparative analysis of the Dutch and Danish implementations of the European Social Fund and the European Regional Development Fund. Our findings show that when examining implementation structures it becomes clear that member states are in full control of the re‐allocation of EU funds. They show that Denmark and The Netherlands have been able to absorb EU cohesion policy within already existing national implementation structures of labour market policies and regional development. One central theoretical implication of our study is that the focus of studies of any fundamental re‐allocation of power resources in cohesion studies should comprise the entire network of implementation rather than the strategies of its individual component actors.     

Has PPS increased Medicare expenditures on physicians?

We use data from 1983 and 1985 on the volume of Medicare physician services to analyze whether Medicare's Prospective Payment System (PPS), which resulted in a significant decline in hospital spending, led to a partially offsetting increase in real expenditures for physician services. We also analyze the effect of increases in assignment rates, increasing incomes of the elderly, and other factors on real expenditures during this period. Our main conclusion is that PPS has at most a small positive effect on real physician expenditures. Because people spent less time in the hospital, Medicare physician spending declined; but because of incentives to shift radiology and other services out of the hospital, some of this decline was offset. We also conclude that the sharp increase in Medicare assignment rates over this period, along with the rising incomes of the elderly during this period, contributed to the observed growth.     

R before D: the case of post conflict reintegration in Tajikistan1

Reintegration was prioritised over demobilisation and disarmament in Tajikistan's peace process. Inadequate disarmament rates were disregarded, but integration of opposition fighters into military and law enforcement units was relatively swift. This created high levels of trust among the former fighters and commanders. The quick provision of incentives, such as comprehensive amnesties and the offer of government positions and economic assets created stakes in the peace process for a number of actors. Transitional justice was largely overlooked. In this way, the case of Tajikistan runs counter to key elements of what has been termed the ‘post-conflict reconstruction orthodoxy’. At the same time, Tajikistan is a rare example of the emergence of post-war stability. This article provides a detailed account of the DDR process and outlines the incentives that it created for the warring parties. It also assesses the emergence of spoilers and the government's counter strategies. The article concludes by highlighting the consolidation of President Rakhmonov's power since 2001, but also raises some questions regarding the viability of Tajikistan's long-term political and economic development.     

Acidic and neutral drugs screen in blood with quantitation using microbore high-performance liquid chromatography–diode array detection and capillary gas chromatography–flame ionization detection

Blood previously acidified with aqueous saturated ammonium chloride solution was extracted with ethyl acetate. The dried extract was subjected to acetonitrile–hexane partition. The acetonitrile portion was analysed for the presence of acidic and neutral drugs by HPLC–DAD (200 mm×2.1 mm I.D. microbore ODS-Hypersil column) and GC–FID (25 m narrow-bore×0.25 mm I.D. HP-5 column with 0.33 μm film thickness). The protocol was found to be suitable for both clinical toxicology (including emergency toxicology) and postmortem toxicology. At least 66 drugs of interest were unequivocally identified by RRTs (HPLC) and UV spectra (DAD) match while another 12 were unequivocally identified by double RRTs match (HPLC and GC). Quantitation was facilitated by incorporating calibration blood standards in each assay batch. The five drugs most commonly encountered in clinical blood specimens (1150 cases) were: paracetamol (47.4% of the cases); chlormezanone (6.6%), theophylline (1.74%), naproxen (1.65%) and mefenamic acid (1.56%). The following drugs were detected in toxicologically significant quantities in postmortem blood specimens (245 cases): phenobarbitone (1.22% of the cases), naproxen (0.82%), chlormezanone (0.82%), theophylline (0.82%), carbamazepine (0.41%) and paracetamol (0.41%).