On scale work: evidential practices and global health interventions

Abstract

Scalability can be understood as the ability to expand without changing. Yet, expanding an intervention to a global scale, we suggest, is a significant and difficult accomplishment. In this paper we propose to explore the kind of evidential exigencies that this accomplishment involves. To do so, we focus on the field of global health and examine how child immunization against the pneumococcus bacterium has been scaled up in low-income countries. The paper first attends to initial epidemiological scrutiny that revealed the existence of a large-scale public health problem and the possibility of an expandable solution (vaccination). It then describes the set-up of a funding arrangement using overseas aid to purchase vaccine doses manufactured by pharmaceutical companies, before paying attention to various frictions that affect the widespread use of pneumococcal vaccines. In these different moments through which scalability is accomplished, always partially and temporarily, we show that a dual activity can be witnessed, a pivoting between referential work and forward projection. To conclude, we suggest that scalability is more usefully approached as a form of expansion that is always attentive to the possibilities of change.     

The uses of history by the Polish democratic opposition in the late 1970s

During the late 1970s, members of the Polish democratic opposition revised and reinterpreted key elements in the Polish past in support of their contemporary ideas about Polish society and opposition. The birth of the independent press in Poland in 1976 provided these debates with a medium for wide dissemination and discussion. Analysis of democratic opposition debates in the independent press on the Polish–Lithuanian Commonwealth, historic Polish–Russian relations, and the struggle for and achievement of independence in the early twentieth century shed light on the ways in which the democratic opposition perceived Polish society and the legacy of tolerance, diversity, nationalism, and socialism within it. It also reveals the major divisions within the democratic opposition and its primary tactical proposals prior to the birth of the Solidarity trade union in 1980. Forty years later, these debates continue to reverberate.     

‘Alien family’: The impact of the Aliens Act 1935 and subsequent Orders on the family in Ireland, 1933–1945

This article examines the consequences of Irish ‘aliens’ policy on families fleeing Nazi Germany using case studies of Irish German-speaking families and German-speaking families to ascertain the difficulties they faced. Analysis of the applications process undergone by families in order to secure a safe-haven from the reaches of the Third Reich reveals the main concerns of the Irish establishment and how these matters affected the potential safety of some individuals above others because of how they were officially categorised. Juxtaposing those who were considered an asset to Irish society against those who were not granted refuge this study traces the process both endured. While this article outlines the Irish government policy on refugees it focuses more particularly on how civil servants and government agencies implemented such policies and the subsequent impact on refugee family units affected by the Nazi regime.1 1?My doctoral research forms part of the German-speaking exiles in Ireland Project an initiative led by Dr Gisela Holfter in the Centre for Irish-German Studies at the University of Limerick. The overall project is attempting to fill a previous void in international exile studies, from an Irish perspective see Holfter, Gisela (Ed.). (2006 Holfter, Gisela, ed. 2006. German-speaking Exiles in Ireland 1933-1945, Amsterdam: Rodopi. New York [Google Scholar]). German-speaking Exiles in Ireland 1933-1945 Amsterdam/New York: Rodopi. This article attempts to reconcile internal policy, international relations and the effect these had on the lives of ordinary people both German-speaking and Irish. It will conclude by recognising the importance to the Irish authorities of the former two elements while acknowledging that despite them there were some successes for refugees although they were of least consequence in the priorities of the day.     

Trade-offs implicit in child-support guidelines

Recent U.S. federal legislation required states to establish mandatory judicial guidelines for the setting of child-support awards. An equivalence-based approach is used to compare three formulae (two in use, one proposed) to three theoretical benchmarks, to clarify unavoidable trade-offs in the choice of a guideline.

1 Generally, the formulae in use leave children worse off economically than would the benchmark formulae.

Since the economic well-being of children cannot be separated from that of their custodial parent, that which most privileges children's welfare will usually privilege the custodial parent over the absent parent, and what appears more fair between the two adults may be less favorable to the children. Another possible trade-off is between children's welfare and work incentives: The guidelines that prescribe larger awards are those with higher implied marginal tax rates. Despite their work disincentive effects, the formulae with higher marginal tax rates are more favorable to children's economic interests.     

The Legal Characterization of the Armed Conflicts in Afghanistan and Iraq: Implications for Protection

This article explores the implications for the protection of civilians and other vulnerable persons, of the requalification of a conflict downwards from international to non-international, focusing in particular on the changes in the characterization of the conflicts in Afghanistan and Iraq from 2001 and 2003 respectively.

Determining the legal character of an armed conflict is rooted in an inherently political interpretation of black letter treaty law. It is generally agreed that when the United States and its coalition allies entered the wars in Afghanistan in 2001, and Iraq in 2003, their operations in those countries were initially subject to the laws of international armed conflict. However the International Committee of the Red Cross (ICRC) has determined that the conflict in Afghanistan became noninternational with the establishment of the United States’ backed government of Hamid Karzai on 19 June 2002 and that the conflict in Iraq became non-international with the establishment of the Iraqi Interim Government on 28 June 2004. The basis for this requalification is Article 2 of the Geneva Conventions read in conjunction with an interpretation of the meaning of ‘state’ (and of its power to authorize a foreign intervention in its own territory) that is inherently, and possibly inevitably, political.

Changes in the legal characterization of a war have profound implications for the protection of both non-combatants and combatants under international humanitarian law, in particular for humanitarian access; for the protection of non-nationals from deportation; for the protection of detainees; for the conduct of hostilities; and for the protection of persons transferred into the hands of local authorities. The practical consequence of a requalification of an armed conflict downwards to non-international is a marked loss of protection for persons that were protected by the Geneva Conventions in the earlier stages of the conflict.

     

Methamphetamine and alcohol detection in vehicle-driver fatalities in South Australia: A 10-year survey (2008–2018)

Motor vehicle driver fatalities (≥18 years) from the files at Forensic Science South Australia were reviewed from January 2008 to December 2018 for cases in which either positive blood sample for methamphetamine (MA) or an illegal blood alcohol concentration (BAC) >0.05g/100 ml were found. Three hundred driver deaths were found with MA detected in 28 cases (age range 21–62 years; ave. 37.8 years; M:F 23:5). Hundred and fifteen cases with a BAC > 0.05 g/100 ml were identified (age range 18–67 years; ave 35.7 years; M:F 95:20). No change was found in numbers of MA cases, although alcohol cases showed a significant decline (p < 0.001). Drunk driving-related fatal crashes tended to occur in the evening (5 p.m. to 11 p.m.), while MA-related fatal crashes had a longer peak extending from late evening until late morning (11 p.m. to 8 a.m.). This study has demonstrated that while roadside breath testing, legislative changes, and increased monitoring have resulted in reduced levels of drunk driving, similar safety countermeasures have had negligible effects on MA use in drivers. Continued monitoring of MA use by drivers will, therefore, be necessary to assess the possible effects, or not, of new countermeasures.