From Research Evidence to “Evidence by Proxy”? Organizational Enactment of Evidence‐Based Health Care in Four High‐Income Countries

Drawing on multiple qualitative case studies of evidence‐based health care conducted in Sweden, Canada, Australia, and the United Kingdom, the authors systematically explore the composition, circulation, and role of codified knowledge deployed in the organizational enactment of evidence‐based practice. The article describes the “chain of codified knowledge,” which reflects the institutionalization of evidence‐based practice as organizational business as usual, and shows that it is dominated by performance standards, policies and procedures, and locally collected (improvement and audit) data. These interconnected forms of “evidence by proxy,” which are informed by research partly or indirectly, enable simplification, selective reinforcement, and contextualization of scientific knowledge. The analysis reveals the dual effects of this codification dynamic on evidence‐based practice and highlights the influence of macro‐level ideological, historical, and technological factors on the composition and circulation of codified knowledge in the organizational enactment of evidence‐based health care in different countries.     

Memory Frictions: Localizing the Truth and Reconciliation Commission in Sierra Leone

This paper concerns the frictions of engagement when transitionaljustice mechanisms are implemented in local contexts. My focusis the practice of truth-telling as part of a global paradigmof redemptive memory. I first trace the genealogy of this paradigm,examining how it came to appear ‘natural’ and ‘universal.’Second, I explore struggles over memory that ensued when SierraLeone's Truth and Reconciliation Commission (TRC) assertivelypromoted this paradigm in a region in which alternative memorytechniques reflected popular priorities in an unstable contextof ‘no peace, no war.’ These struggles were rootednot only in the contested content of memories, but also in aperceived incommensurability between contrasting memory projectsbelieved to have divergent implications for processes of reconstruction.Finally, I examine the significance of reparations both forlocal practices of post-war memory and for the local effectivenessof the TRC.     

Fatalities temporally associated with the ingestion of ibogaine

Ibogaine is a naturally occurring psychoactive plant alkaloid that is used globally in medical and nonmedical settings for opioid detoxification and other substance use indications. All available autopsy, toxicological, and investigative reports were systematically reviewed for the consecutive series of all known fatalities outside of West Central Africa temporally related to the use of ibogaine from 1990 through 2008. Nineteen individuals (15 men, four women between 24 and 54 years old) are known to have died within 1.5-76 h of taking ibogaine. The clinical and postmortem evidence did not suggest a characteristic syndrome of neurotoxicity. Advanced preexisting medical comorbidities, which were mainly cardiovascular, and/or one or more commonly abused substances explained or contributed to the death in 12 of the 14 cases for which adequate postmortem data were available. Other apparent risk factors include seizures associated with withdrawal from alcohol and benzodiazepines and the uninformed use of ethnopharmacological forms of ibogaine.     

Participatory action research into donor–recipient relations: a case study

This article describes the exploratory and preparatory phase of a research project designed to use co-operative enquiry as a method for transformative and participatory action research into relations between donors and recipients in two developing countries, Bolivia and Bangladesh. It describes the origins of the idea, the conceptual challenges that the authors faced in seeking funding, and what they learned from this first phase. The authors analyse why the researchers, as well as the potential subjects of the research, were uncomfortable with the proposed methodology, including the challenges arising from their own positions and the highly sensitive nature of the topic. They explain why they decided to abandon the project, and they reach some tentative conclusions concerning the options for participatory action learning and research in development practice.     

Citizen support for European Union membership: the role of socialisation experiences

The article explores whether European Union membership has a socialisation effect on citizens’ attitudes towards their country’s membership of the EU. Using a sample of 15 Western European countries, it is shown that this is the case. First, evidence is provided of a positive lifelong socialisation effect: citizen support for their country’s membership of the EU increases with years spent living in an EU member state. Second, it is shown that those who joined the EU during their formative years are less supportive of the EU, whilst those who spent their formative years in a non-democracy are more positive about EU membership. The size of these effects is very small in comparison to that found for the lifelong socialisation effect, suggesting that the lifelong socialisation process of continued EU membership is much more important for EU attitudes. This study offers new insights into the formation of EU attitudes.