How the East Was Won: Transnational Social Forces and the Neoliberalisation of Poland's Post-Communist Transition*

The article proposes a Gramscian account of Poland's transition to a market economy. It considers what has generated, sustained, and legitimated neoliberal hegemony and illustrates how neoliberal ideas attained a hegemonic position through the development of a particular class and national state project. It uncovers where the agents of this process are visible by contrasting two waves of post-communist reform that have contributed to the reconfiguration of the Polish political economy in the current conjuncture of global restructuring. Firstly, it focuses on the centrepiece of neoliberal efforts to constitute hegemony in the shape of the “shock therapy” reform programme and then on the later application of a highly selective form of Europeanisation. Finally the article considers which social forces have offered the most effective resistance to neoliberalism in an appraisal of the recent populist turn in Polish politics.     

Assessing policy capacity in Canada's public services: Perspectives of deputy and assistant deputy ministers

Abstract: The state of policy capacity within Canada's various levels of government has for some time been the subject of discussion both within the public services themselves and among the academic research community. Drawing on the results of a 2006 survey of deputy and assistant deputy ministers working in Canada's federal, ten provincial and three territorial governments, this article presents assessments made by the most senior leadership. The survey results show that ninety per cent of deputy ministers and assistant deputy ministers agree that policy capacity has changed but that the change is not uni‐directional. Both improvements and decline in policy capacity were observed, although assessments of decline were somewhat more pronounced. Moreover, improvements in policy capacity were found to be associated with a reduced focus on direct service delivery, a greater concern with long‐term planning, and the presence of a political leadership interested in innovation. Conversely, declining policy capacity was found to be linked to centralization of power, the loss of institutional memory, and “churning” within the ranks of the executive leadership. Additionally, level of government was also observed to be linked with change in policy capacity, with provincial deputies reflecting more negatively on policy capacity decline in their government than deputies at other levels.     

Sudden Death Due To Acute Cocaine Toxicity—Excited Delirium in a Body Packer

Excited delirium denotes a life-threatening medical condition characterized by the acute onset of agitated and violent behavior that often results in a sudden and unexplained death. Cocaine-induced excited delirium refers to fatal cocaine intoxication with the following symptoms occurring sequentially: hyperthermia, delirium with agitation, respiratory arrest, and death. We present a case of cocaine-induced excited delirium in a cocaine “body packer” or a “mule”, specifically an individual who attempts to smuggle cocaine within the body. Investigators at the scene initially suspected homicide due to the victim's sharp and blunt force injuries. Three rubber packets containing cocaine were removed from the victim's rectum. Blood toxicological analysis revealed an alcohol concentration of 0.016 g/100 and cocaine >1 mg/L. The forensic pathologist should consider cocaine-induced excited delirium when an individual exhibits aggressive behavior, unexpected strength, and resistance to pain who dies suddenly. Further analysis should be performed during the scene investigation and autopsy for evidence of body packing.     

Sudden and unexpected death from pituitary tumor apoplexy

Pituitary tumor apoplexy refers to a clinical syndrome precipitated by the expansion of a pituitary adenoma by hemorrhage or infarction. Individuals may present with myriad signs, including sudden onset of severe headache, visual changes, altered mental status, cranial nerve palsies, and hormonal dysfunction. This disorder constitutes a medical emergency and warrants an expedited evaluation, diagnosis, and treatment to prevent the potential sequelae of permanent visual loss, endocrine abnormalities, or death. We report a case of sudden death from undiagnosed pituitary tumor apoplexy. The decedent was evaluated by medical personnel on three occasions in the week prior to her death for severe headache, nausea, vomiting, and photophobia. Postmortem examination demonstrated a hemorrhagic infarction of a pituitary adenoma with necrosis and expansion out of the sella turcica. The recognition of and treatment for a patient with pituitary tumor apoplexy requires a rapid multidisciplinary effort. Failure of prompt diagnosis may be fatal and require a medico-legal death investigation for sudden and unexpected death.