Did they ‘Read Before Burning’? The Coalition and Quangos

Attitudes to quangos are paradoxical. On the one hand they are perceived to be undemocratic, unaccountable organisations, while on the other they are seen to improve effectiveness, limit political interference and increase public confidence in government. This paradox is reflected in the behaviour of political parties, which generally adopt a harsh line towards quangos in opposition, but come to rely on these bodies in office. Ahead of the 2010 general election it was, however, noticeable that the Conservative party rejected this dynamic by promising to pursue ‘a more sophisticated approach’. This article explores the Coalition government's subsequent ‘public bodies reform programme’, assessing its progress against recommendations contained within the Institute for Government's Read before Burning report of July 2010. It concludes that while the Coalition has addressed long‐standing concerns about the day‐to‐day governance of public bodies, it has failed to resolve a set of broader and strategic (metagovernance) issues.     

Endobronchial/Tracheal Metastasis and Sudden Death

Endobronchial and endotracheal metastases are rare lesions that may cause acute occlusion of major airways. A case is reported of a 62‐year‐old man with history of renal cell carcinoma and hemoptysis who died after having suddenly become short of breath with cyanosis. At autopsy, recurrent renal cell carcinoma was identified with metastases to the lungs, pulmonary hilar lymph nodes, and brain. In addition, a solitary papillomatous metastasis arising from the mucosa of the carina was obstructing both the main bronchi and distal trachea. Death was due to acute airway obstruction by a metastatic deposit at the bifurcation of the trachea in a case of disseminated renal cell carcinoma. This case demonstrates an extremely rare cause of sudden death that may complicate disseminated malignancy.     

Fatal poisoning due to ingestion of boiled oleander leaf extract

Nerium oleander is an ornamental evergreen shrub belonging to the family Apocynaceae. The Apocynaceae family includes the attractive evergreen shrub known as oleander. The cardiotoxic glycoside, oleandrin, is present in all portions of the common oleander plant. Oleander consumption can result in deadly situations accidentally or as a suicide attempt. After consuming kettle-boiled oleander leaf extract as part of a suicide attempt, an 80-year-old man was discovered comatose in his home and taken to our emergency room. The patient's heart rate was 30 beats per minute, and he had hypotension. Arterial blood gas analysis revealed remarkable metabolic acidosis and hyperkalemia (K: 7.7 mEq/L). An electrocardiogram showed a wide QRS wave, similar to a sine curve. The patient collapsed following cardiac arrest soon after hospital arrival. Veno-arterial extracorporeal membrane oxygenation was initiated; however, the patient eventually died. The serum level of oleandrin at hospital arrival, subsequently measured by LC–MS/MS, was found to be 33.4 ng/mL, far above the levels reported in previous fatal cases.     

Public administration and the rule of law

This article deals with the enduring problem of administrative discretion in the modern American democratic-constitutional state. In the American constitutional tradition, administrative action is legitimate when and only if it adheres to the rule of law. This implies that administrators must be able to link directly their actions to grants of authority in statutes or the Constitution. But the growth of the state apparatus and the increasing intensification of the public administration's role in society have necessitated rather broad legislative grants of discretion to the bureaucracy. The result has been a seemingly perennial tension between the rule of law ideal and the modern administrative reality.

Attempts to control discretion via evolving doctrines of administrative law have proved unsatisfactory for a variety of reasons explored in this essay. The most important shortfall has been that the continuing expansion of the administrative state threatens directly the rule of law itself. After a survey of the weaknesses of these doctrines, we conclude that the rule of law is fundamentally incompatible with the necessary work of administration in the modern American state. Administrative discretion is thus seen to pose an intractable problem for the liberal democratic society, which accounts for its problematic persistence.     

The Dynamics of Local Service Delivery Arrangements and the Role of Nonprofits

This article examines the relationship between “contract failure” (the bringing “in-house” of previously contracted services) and service characteristics. The connection between contract failure and nonprofit and for-profit status is also explored. The analyses are performed using International City/County Management Association data and three service typologies constructed by previous scholars. The findings indicate that: 1) contract failure is more common than anticipated, and is actually relatively more common than privatization; 2) while service characteristics are associated with the frequency of contract failure, the nexus is tenuous; 3) nonprofit entities are less prone to contract failure than their for-profit counterparts.     

Chronic Traumatic Encephalopathy Pathology After Shotgun Injury to the Brain

Chronic traumatic encephalopathy (CTE) was initially conceptualized in boxers, but has extended to other athletes in recent years, albeit with limited clinical correlations. It is often asserted that CTE pathology represents the substrate for progressive neurodegenerative disease. We report the case of a shotgun injury to the brain with 42‐year survival and no neurological disease progression until shortly before death. The decedent had no other traumatic brain injury (TBI) exposure and did not play football or other high energy collision sport. Neuropathological examination confirmed tissue damage, but additionally demonstrated localized patterns of phosphorylated tau (p‐tau) meeting criteria for CTE pathology. P‐tau and TDP‐43 deposits within marginal tissue of damaged brain were also present focally. No amyloid‐β (Aβ) deposits were present. These findings indicate that CTE pathology may occur following a single, severe TBI.     

Death From Butane Inhalation Abuse in Teenagers: Two New Case Studies and Review of the Literature

The ready availability of butane makes butane abuse frequent. Fatalities are rare. This study presents two cases of death by butane overdose. The postmortem analyses were carried out using headspace gas chromatography–mass spectrometry. It revealed femoral blood butane concentrations of 18 and 22 mg/L, respectively, as well as specific combinations of adjuvants in each victim. In one of the victims, brain and fatty tissue also contained butane, pointing to chronic consumption. The originality of this study is to show that the identification of specific combinations of adjuvants can be helpful for identifying the brand of deodorant used. Also, sampling the skin and mucosa can help identify the method of drug delivery. The histological examination documented both the direct toxic effect of the gas on the respiratory mucosa and signs of chronic abuse. Volatile substance intoxications should be systematically considered in case of sudden death in a teenager.     

Unexpected Death in Elephantiasis Due to an Abnormal Life-Style

Abstract:  A 22-year-old man was found dead after he had continued to sit on a reclining chair for 2 years. He had consumed an unbalanced diet, kept wearing the same pair of socks and never washed himself for the term. His skin of bilateral crura developed into elephantiasis with severely festered ulcers on its surface. At autopsy, subcutaneous edema was significant in his lower limbs, and chronic circulatory disturbance of lymphoducts and veins was observed histologically. There were no crucial findings to account for chronic edema in the lower limbs. It has been reported that maintaining a seated posture obstructs both lymphoducts and veins because of bending the groin, decreases their return flow by inducing muscular atrophy, and causes subcutaneous edema in the lower limbs. Oligotrophia and dirt on his limbs might have exacerbated the chronic edema in elephantiasis. We concluded that a long-term abnormal life-style had caused fatal elephantiasis.     

State,region and order: geopolitics of the Arab Spring

State failure, sovereignty disputes, non-state territorial structures, and revolutionary and counter-revolutionary currents, among others, are intertwined within the Arab Spring process, compelling old and emerging regional actors to operate in the absence of a regional order. The emergent geopolitical picture introduces the poisonous mix of loss of state authority spiralling toward instability, defined by sectarianism, extremism, global rivalries, and ultimately irredentism within interdependent subregional formations. This assertion is substantiated by detailed and specific evidence from the shifting and multi-layered alliance formation practices of intra- and inter-state relations, and non-state and state actors. Analysis of the relations and alliances through a dichotomous flow from domestic to regional and regional to global also sheds light on prospective future order. A possible future order may take shape around a new imagination of the MENA, with porous delimitations in the form of emerging subregions.     

State disintegration and power politics in post-Suharto Indonesia

This article illustrates how discourses on ‘state fragility’ have been instrumentalised by the Indonesian military in order to consolidate its political and economic power after the fall of Suharto. In the wake of Indonesia’s transition to democracy violent conflicts escalated in East Timor, Aceh, Papua, the Moluccas and Sulawesi. Most notably East Timor’s successful secession spawned fears over the potential ‘balkanisation’ of Indonesia. In this context the Indonesian military, which had been shunned for its involvement in Suharto’s New Order, managed to re-establish itself as the ‘guardian of the nation’. Based on fieldwork in Indonesia, the article describes how post-9/11 discourses over a potential break-up of Indonesia were used by the Indonesian military to reconsolidate its power in the post-Suharto era. The research findings illustrate that, against the looming threat of state disintegration, attempts to revoke the military’s prerogatives have either failed or have been aborted during the planning stages.