Institutional Settings Research Articles

The War in Ukraine and Russia’s Quest to Reshape the World Order

Moscow is actively using the conflict in Ukraine to advance its vision of a different international order. This vision emphasises a world fragmented into spheres of influence centred on a handful of ‘civilisational states’ embodying distinct political cultures not necessarily compatible with liberalism and democracy. Russia uses its own sphere of influence in Eurasia as the incubator of an alternative set of norms and institutions that it seeks to socialise globally. This Russian vision appeals to other revisionist powers, notably China and Iran, which support Russia’s war in Ukraine largely out of a desire to diminish US influence and consolidate their own regional spheres. Elements of it also appeal across the Global South, now a key arena for competition over the future global order. The outcome of Russia’s war in Ukraine is perhaps the most important determinant of what the coming world order will look like.

Chemicals regulation and non-animal methods: displacing the gold standard.

Regulating industrial chemicals in foodstuffs and consumer products is a major aspect of protecting populations against health risks. Non-animal testing methods are an essential part of the radical change to the framework for toxicity testing that is long overdue in global economies. This paper discusses reasons why the drive to reduce animal testing for chemical safety testing is so difficult to achieve, as perceived by those who are closely involved in chemicals regulations in different capacities. Progress is slow, despite the fact that the ethico-legal conditions for a move away from animal testing are largely in place, and despite scientific arguments for a radical change in the paradigm of toxicity testing, away from reliance on animal studies. I present empirical data drawn from two studies in a European Commission context promoting non-animal methods. The aim of the paper is modest. It is to foreground the voices of those who deal with the science and regulation of chemicals on a day-to-day basis, rather than to offer a theoretical framework for what I heard from them. I offer a synthesis of the main challenges faced by non-animal alternatives, as these are perceived by people in different stakeholder groups dealing with chemicals regulation. I show where there are pockets of agreement between different stakeholders, and where the main disagreements lie. In particular there is dispute and disagreement over what counts as validation of these alternative tests, and by implication of the traditional 'gold standard' of animal testing. Finally, I suggest that the shift to non-animal methods in chemicals regulation demonstrates the need for the concept of validation to be broadened from a purely techno-scientific definition, and be more explictly understood as a demand for trust and acceptance, with more attention given to the complex social, institutional and economic settings in which it operates.

A matter of balance. Positioning of parents' selves through negotiations of symptoms' meaning at a pain clinic for children/young people.

This paper traces how the meaning of symptoms and the positioning of selves are entangled and discursively constructed in therapeutic conversations between parents and therapists at a pain clinic for children and young people (age 8 to 18) with recurrent or chronic pain or other somatic symptoms with no established biophysical pathology. Based on data material from an ethnographic fieldwork it is examined how the selves of respectively children/young people and their parents are discursively positioned in conversational encounters and the role positioning of selves play in the context of establishing and negotiating the symptoms' meaning. The bearer of medically unexplained symptoms is oftentimes subjected to moral assessments. In this paper it will be shown that parents, in the institutional setting of the pain clinic, enter the negotiation of moral assessments assigned to their children, and that these moral assessments not only concern the sufferers' selves but also the selves of the parents. The overall argument is that dialogues between parents and therapists concerning the meaning and source of their children's symptoms are simultaneously negotiations in which not only the sufferers' but also their parents' moral positions are at stake.

The Carceral Logic of Female Eligibility Policies: Gender as a Civilizing Narrative, the Science of Sex Testing, and Anti-Trans Legislation1

Female eligibility policies punish people for gender nonconformity and normalize patriarchal rule. These policies were used first to exclude women deemed “too masculine” from competing against women who more closely conform to gender stereotypes. In recent years, this form of discipline has dovetailed with efforts to determine the circumstances, if any, under which transgender women may compete against cisgender women. Modern sport, as a set of institutions, does not stand apart from capitalism, colonialism, white supremacy, and heteropatriarchy. In this article, I use a prison abolitionist lens to connect anti-trans campaigns and female eligibility policies that police sporting identity to the carceral logics of racial capitalism to make the argument that sex surveillance is related to race, social control, and capital accumulation.

Carving to excise, carving to create: Conversations on creating and sustaining safe spaces in higher education

AbstractIn this piece, we grapple with the conditions of creating and sustaining liberatory, healing spaces connected to higher education, delivering our analysis through a fictive podcast format. We present three different scenes authored by undergraduates, tied together by common, intersecting threads of both struggle and resistance, community in/as healing amidst layered crises and traumas, and deep desires for universities to fulfill their potential as learning spaces of safety, structural critique and connection. We consider our individual and collective roles as faculty and program directors in these institutional settings, and the conditions that help and hinder opportunities for students to co‐construct or live into liberatory spaces. We also consider the threats to the sustainability and viability of these initiatives, as well as the disproportionate impact on minoritized students, staff, and faculty. These learnings are in line with research that highlights the importance of students' sense of safety and belonging, the role of student agency, and perspectives that position educators through the lens of accompaniment.

Neurodiversity and disability: what is at stake?

Neurodiversity has come hugely to the fore in recent years in a variety of contexts, and is now subject to academic debate, activist discussion, and increasingly embedded in a range...

Assessing the Validity of Front-of-Pack Nutrition Labels for Evaluating the Healthiness of Mediterranean Food Choices: A Global Comparison.

In response to growing public health concerns, governments worldwide have implemented various nutrition labelling schemes to promote healthier eating habits. This study aimed to assess the consistency and effectiveness of these labels in an out-of-home context, specifically focusing on restaurant, hospitality, and institutional food service settings. In total, 178 different dishes from Spain were analysed using labels from the Mazocco method, the UK's traffic light system, the Health Star Rating (Australia), Nutri-Score (France), multiple traffic lights (Ecuador), and warning labels (Chile and Uruguay). The results demonstrated a generally low level of agreement among these labels (K < 0.40), indicating notable variability and a lack of consensus, which could hinder consumers' ability to make informed food choices in out-of-home settings. Nutri-Score classified the highest number of dishes as unhealthy (38%). This study underscores the need for an easy-to-understand labelling system tailored to each country's culinary and socio-cultural contexts to improve consumer decision-making in various dining environments. Future research should focus on developing and testing qualitative methods to more accurately gauge the nutritional quality of cooked dishes in diverse out-of-home settings, thereby enhancing public health outcomes. By addressing the specific needs of the home, restaurants, hospitality, and institutional food services, tailored labelling schemes could significantly improve consumers' ability to make healthier food choices.

Psychometric properties of instruments for measuring abuse of older people in community and institutional settings: A systematic review.

Psychometric properties of instruments for measuring abuse of older people in community and institutional settings: A systematic review.

Does capital flight set Africa as the seat of darkness? Linking capital flight and energy poverty

Despite the fact that capital flight is a scourge for African economies, no study, to the best of our knowledge, has analyzed its effects on energy poverty. This study aims to fill this gap in the literature by providing one of the first empirical studies of the effects of capital flight on energy poverty. The present study focuses on a panel of 30 countries in Africa over the period 2000–2018. We use Principal Component Analysis (PCA) to construct an energy poverty indicator. Results suggest that capital flight increases energy poverty in Africa. This result is robust when controlling for endogeneity. Additionally, good institutional quality helps mitigate the negative effects of capital flight on energy poverty. Further analysis allows us to identify income inequality, government spending and unemployment as the channels through which capital flight influences energy poverty. Policy wise, better control of capital flows based on appropriate institutional settings should reduce energy poverty in Africa.

Elevated care at home: An alternative to traditional levels of care.

Elevated care at home (ECH) is a novel in-home care model supporting early hospital discharge and providing an alternative to institutional postacute care. This study compares patient characteristics, mortality, and readmission outcomes of hospitalized patients who transitioned to ECH to patients who transitioned to skilled nursing facilities (SNF) and skilled home health services (SHH). A retrospective study of patients between May 2020 and January 2022 transitioned from the hospital to ECH, SNF, or SHH. The analysis compared patient characteristics, 30-day mortality, and readmission stratified by COVID-19 infection status. Outcomes were assessed using logistic regression after propensity score matching. Of 32,132 eligible patients, 6.3% were transitioned to ECH, 39.7% to SNF, and 54.0% to SHH. After matching, all baseline characteristics except for age were balanced between groups. Postmatch and adjusting for age differences, ECH patients experienced lower risk of death compared to SNF (adjusted odds ratio [AOR] 0.61, 95% confidence interval [CI] 0.40, 0.92) and similar risk of hospital readmission compared to SNF patients (AOR 1.08, 95% CI 0.89, 1.31) and SHH patients (AOR 0.96, 95% CI 0.80, 1.16). COVID-19-negative ECH patients compared to matched SNF patients were more likely to readmit (AOR 1.30, 95% CI 1.02, 1.65) with no significant difference in risk of mortality (AOR 0.72, 95% CI 0.44, 1.18). ECH had similar or improved outcomes relative to SNF and SHH. COVID-19-negative ECH patients experienced higher readmissions relative to SNF. ECH supported patients to return home from the hospital and provided an alternative to an institutional postacute setting.

Touches across time: queer as provenance

Carolyn Dinshaw describes her queer historical practice as being about looking for “an affective connection, for community, for even a touch across time” (1999, p 21). Queer engagements with records—these touches across time—are not easily or adequately accounted for in current conceptualisations of provenance. The dissonance between how we currently understand record co-creation, and the historical perspectives and recordkeeping needs of queer users, substantially and negatively impacts the visibility and accessibility of queer histories in institutional archival settings. In this paper, I articulate the proposed concept of queer as provenance. I argue that we must extend our current conceptualisation of multiple provenance beyond mere co-creatorship. With a focus on queer records and record users, I argue that we must expand our understanding to encapsulate not only the relationship between record, creator, and subject, but also the relationship between record, creator, subject, and user. Through a continuum lens, I consider how queer/ing engagements and interactions with, and responses to, queer records could and should inform our descriptive practices, and explore the potential of considering queer users as co-creators within such a dynamic. I conclude by articulating queer as provenance and consider its potential as a foundation on which transformative, reparative, and liberatory archival practices might be built.

Color Fundus Photography and Deep Learning Applications in Alzheimer Disease

ObjectiveTo report the development and performance of 2 distinct deep learning models trained exclusively on retinal color fundus photographs to classify Alzheimer disease (AD). Patients and MethodsTwo independent datasets (UK Biobank and our tertiary academic institution) of good-quality retinal photographs derived from patients with AD and controls were used to build 2 deep learning models, between April 1, 2021, and January 30, 2024. ADVAS is a U-Net–based architecture that uses retinal vessel segmentation. ADRET is a bidirectional encoder representations from transformers style self-supervised learning convolutional neural network pretrained on a large data set of retinal color photographs from UK Biobank. The models’ performance to distinguish AD from non-AD was determined using mean accuracy, sensitivity, specificity, and receiving operating curves. The generated attention heatmaps were analyzed for distinctive features. ResultsThe self-supervised ADRET model had superior accuracy when compared with ADVAS, in both UK Biobank (98.27% vs 77.20%; P<.001) and our institutional testing data sets (98.90% vs 94.17%; P=.04). No major differences were noted between the original and binary vessel segmentation and between both eyes vs single-eye models. Attention heatmaps obtained from patients with AD highlighted regions surrounding small vascular branches as areas of highest relevance to the model decision making. ConclusionA bidirectional encoder representations from transformers style self-supervised convolutional neural network pretrained on a large data set of retinal color photographs alone can screen symptomatic AD with high accuracy, better than U-Net–pretrained models. To be translated in clinical practice, this methodology requires further validation in larger and diverse populations and integrated techniques to harmonize fundus photographs and attenuate the imaging-associated noise.

Seizing a venue linking opportunity: China’s strategy to advance its sea cucumber interests in global environmental governance

This study explores how China strategically advances its position and interacts with institutional contexts to shape environmental negotiations. By employing process-tracing methods and conducting expert interviews on the case of sea cucumber negotiations, we find that China intends to garner international support in a policy venue (CITES) while actively engaging in another policy venue that better aligns with China's interests (FAO). Building upon existing studies on institutional change and negotiation strategy, we highlight two aspects of a venue-linking framework, including the institutional settings enabling countries to deploy such a strategy in environmental negotiations and the actors’ capacity to seize the opportunity. In doing so, we show how China has strategically engaged in multiple policy venues to advance its preferences through a particular, more amenable venue. Our findings offer new empirical insights into how China navigates the complex political dynamics in global environmental governance when multiple policy venues with overlapping jurisdictions are involved.

The personalization of government: concept and comparative analysis

ABSTRACT The personalization of politics is one of the most important political phenomena of our time. Following the decline of traditional party government, various political systems have seen a radical shift of power from collective to individual actors. In this context, one of the main forms of the personalization of politics is the personalization of government. Heads of government have become more central to democratic executives due to their direct relationship with citizens, their greater control over government action, and structural changes in the institutional setting in which they operate. Although a large body of comparative evidence seems to support this trend, the existing literature has not yet offered a precise conceptual lens through which to do a detailed analysis of this transformation over time. This article introduces the concept of “monocratic government” as a way to study the personalization of government in terms of the ability of leaders to create consensus and use their powers effectively, and to analyse other contextual factors such as the party-system and executive-legislative relations. The last section analyses the Italian Republic over different time periods, paving the way for further comparative analysis.

Distal Triceps Tendon Repair in Strength Athletes Leads to Satisfactory Return to Sports: A Retrospective Analysis of 22 Cases.

Background: Distal triceps brachii tendon rupture (DTTR) is a relatively rare injury that is common in bodybuilding and high-intensity contact sports and can lead to significant functional impairment of the elbow joint. This study was conducted to evaluate clinical outcomes and the rate of return to sports among competitive bodybuilders and high-demand strength athletes after surgical repair of DTTR. Methods: This retrospective case series was performed in an institutional setting in tertiary health care. Return to sports of 22 competing or high-demand strength athletes (meaning three or more exercises per week) were analyzed pre- and postoperatively after surgical repair of DTTR using a hybrid technique of transosseous sutures and anchor fixation. Descriptive statistics were used to analyze demographic variables, and independent and paired t-tests were used to assess clinical outcomes. Results: The follow-up showed that from pre- to postoperatively, there was no deterioration in the number of sports disciplines (2.4 and 2.5 sporting activities per person, respectively; p = 0.540) or in the frequency of weekly training (4.1 and 4.1 times per person, respectively; p = 0.329). The postoperative visual analog scale for pain (from 6.0 to 1.6, p < 0.001), level of fitness (from 5.1 to 2.6, p = 0.002), and ability to train (from 5.2 to 1.3, p < 0.001) improved significantly. The time of return to sports was 1.5-3 months and 4-6 months after the surgery for ten patients each. The overall rate of return to sports was 95%, whereas 86% returned to the preinjury level of sporting activity. Conclusions: Repair of DTTR leads to high rates of return to sports in competitive athletes.

Efekty spillover chińskich inwestycji zagranicznych w Angoli i Zambii

SPILLOVER EFFECT OF THE CHINESE FDI IN ANGOLA AND ZAMBIAIn recent years, Chinese foreign direct investment (FDI) in Africa has attracted interest from both academia and the wider political world. Some postulate that Chinese companies – unlike Western corporations – have greater potential to initiate and carry out the structural transformation of the continent. Some researchers even indicate that thanks to the inflow of Chinese FDI, Africa may become “the next factory of the world”. The aim of this article is to analyse external effects (also called spillover effects) related to Chinese FDI in Africa using the examples of Angola and Zambia. According to the current state of knowledge, spillover effects are the most desirable effects of FDI in the host country, because the related increase in the productivity of local enterprises is key to the occurrence of structural transformation in local economies. The subject of the analysis presented in this article are three aspects (determinants) of spillover effects: (i) the potential of Chinese FDI to generate spillover effects, (ii) the absorptive capacity of local companies and (iii) local institutional settings favouring the occurrence of spillover effects. The findings indicate that due to the existence of weak and few linkages between foreign investors and local firms, spillover effects occur rarely and are relatively small. They are also not sufficient to initiate the transfer of valuable knowledge and technology. The presented research results were based on over 150 in-depth interviews and two rounds of surveys conducted among Chinese investors, Angolan and Zambian companies and representatives of local authorities.

The scientific councils of natural protected areas as a window on the epistemic landscape of the conservation knowing-doing space

In environmental management, like in other applied operational domains, concrete actions are often at odds with state-of-the-art theoretical knowledge. Institutional settings organizing the way scientific knowledge is applied in environmental management practice play an active role in structuring such knowledge-action discrepancies. Scientific councils of protected areas are key institutions playing this role. Their two main missions are (1) to design, monitor, and evaluate the production of knowledge inside protected areas, and (2) to advise managers as to designing and implementing conservation actions. This article explores a database gathering information on scientific councils in France. The case of this country is exemplary because the existence of scientific councils is systematic in its protected areas, and their structure is streamlined by regulatory requirements. We use this database to investigate the publication records of the members of these scientific councils. This enables us to shed a quantitative light on the “epistemic landscape” (i.e., the kinds of knowledge and knowledge-holders that play a key role in interactions between science and practice) that scientific councils materialize. Our findings suggest that this epistemic landscape is poorly connected to the concerned protected areas. Moreover, some prominent topics in academic research (functional ecology, invasion biology and conservation planning) appear to be neglected in the recollected publication records. Such results prompt the question of whether the composition of SCs should be adjusted to reinforce the role of scientists tackling research questions applied to the PA at issue, and to better reflect scientific priorities in the conservation literature. Though results solely based on bibliometric analysis should be interpreted with due caution, they are useful to open debates on how to improve the design of institutions structuring knowing-doing spaces, beyond the specific case of French scientific councils.

Collective co-production of health and care services – a systematic review of research from the United Kingdom, Germany and Norway

This article reviews all published English-language articles concerning collective co-production of welfare services in the United Kingdom, Germany and Norway, which are countries representing different welfare regimes. The review identifies facilitators for collective co-production and inductively identifies four themes that are important for successful collective co-production: (1) the motivation individuals have for engaging in collective co-production, (2) the institutional contextual conditions for co-production, (3) the relational conditions for co-production, and (4) the facilitation of different effects of co-production. No studies have investigated why public sector entities or voluntary sector organisations choose to engage in co-production, and we lack studies that compare sectors with different institutional settings.

Exploring institutional dynamics in a multi-level analysis in Southeast Europe

ABSTRACT The European Union (EU) integration process of transition economies from Southeast Europe has faced significant political and economic challenges. Two decades in, these challenges persist, leading to slower-than-expected economic development and fostering local frustration, nationalism, populism, and migration flows. This article aims to disentangle the institutional complexities in these regions. Using an exploratory, inductive approach based on 30 qualitative interviews across three Southeast European countries, the research conducts a multi-level analysis. The findings reveal that complex institutional settings are characterised by institutional voids and asymmetries stemming from the transition process and EU integration. The perception of the overall institutional setup is central, negatively influenced by institutional voids and asymmetries but positively impacted by participatory law-making approaches. Additionally, competing institutional logics on the micro-level influence companies’ perspective. This article provides insights into the institutional challenges faced by companies in transition economies, crucial for policy formulation and development projects in the context of EU integration. The key takeaway emphasises the importance of well-designed participatory policymaking, highlighting the need for careful preparation and a foundation of trust.

Independent Supported Housing vs institutional housing rehabilitation settings for non-homeless individuals with severe mental illness – longitudinal results from an observational study

BackgroundMost individuals with severe mental illness (SMI) strongly prefer independent living over living in an institution. Independent Supported Housing (ISH) provides housing rehabilitation for persons with SMI in their accommodations. However, most individuals who need housing rehabilitation live in institutional housing settings (housing rehabilitation as usual: HAU). We investigated which housing rehabilitation setting is effective on which variable in the long term to support service users to form an informed preference for either housing rehabilitation setting.MethodsWe conducted a two-year longitudinal observational non-inferiority study to test the effectiveness of ISH in improving participants’ social inclusion, quality of life, emotional social support, capabilities, symptom severity, functioning, service utilisation and costs. Participants were assessed at baseline and after six, twelve, and 24 months. Mixed effects models were computed to test between-group and within-group effects.ResultsThe study included 83 participants in ISH (n = 31) and HAU (n = 52) housing rehabilitation settings with a mean age of 36.2 years. Most participants were male (64%) and had a primary psychotic or schizophrenic (35%) or an affective diagnosis (24%). During the study, ISH participants significantly improved their quality of life (β = 0.54; 95% CI: 0.26 to 0.82), symptoms (β = -0.32; 95% CI: -0.60 to -0.03), and capabilities (β = 4.46; 95% CI: 0.14 to 8.77) and decreased psychiatric hospitalisations (p = 0.04). HAU participants improved their quality of life (β = 0.40; 95% CI: 0.12 to 0.69). Housing and rehabilitation support costs were almost half with ISH than with HAU.ConclusionISH has been shown to be much less expensive than HAU and was associated with several improvements like reduced psychiatric hospitalisations and improved quality of life. Therefore, our findings strongly argue for a preference-driven provision of housing rehabilitation services and to end the institutionalisation of persons with SMI.Trial registrationThe study was registered on December 04, 2018, at ClinicalTrials.gov (NCT03815604).