The Frontier of Telecommunications Deregulation: Small Countries Leading the Pack

Interconnection, equal access, unbundling, and industry structure are four key determinants of facilities-based competition in telecommunications. Using these building blocks, this paper analyzes the differences in telecommunications regulatory regimes in Australia, Chile, Guatemala, and New Zealand, assessing the effect on competition and consumer welfare. Some regulation is necessary as incumbents can prolong their market power after demonopolization by exploiting positive externalities inherent to telecommunications networks. The authors emphasize the superiority of market mechanisms over traditional regulatory processes to achieve efficient transactions among operators. Such market mechanisms need clear rules and credible enforcement.

Unsocial capital. Patronage and cronysm in postmodern power

Not always the relational capita is also a "social" capital. Often, this type of capital tough composed of bonds and interactions, appears nonetheless as a capital which is profoundly unsocial. This happens in two cases: either when the laces do not bind to each other, or when they bind well between them but do not bind to the wider society in which they are also inserted. It presents itself then, as a capital that binds but not as one that unites, which connects but not that which integrates. It is the capital of linkages and of small groups, which however do not amalgamate into larger forms of cohesion. The illustrative image may be that of many small aggregations that do not however make a single large network. It is the capital of narrow ties rather than relations which are broader and inclusive. Or it is the case of strong ties and closure forms of pseudo-community. In this case that we speak of capital which bonds rather than which bridges, to use an expression which is dear to the dominant literature on the subject . For these reasons, it ends up making more for the convenience "of" the society, than “for" the society and therefore social cohesion and amalgamation are clumped into many small social circles and just for very exclusively selected affinities. The hypothesis that in these pages we intend to support is that the unsocial capital is the product of "certain forms" of relational particularism, which produce a patronage degeneration of power. At question therefore is not relational particularism "in itself", but rather relational particularism "under certain conditions" or "with certain characteristics" which are able to mark a continuum between unsocial capital and forms of patronage (but also nepotistic or familistic) of power. The story of the power of Rome can help us to grasp some of these unexpected relational consequences

Lung recruitment before surfactant administration in extremely preterm neonates with respiratory distress syndrome (IN-REC-SUR-E): a randomised, unblinded, controlled trial

Background: The importance of lung recruitment before surfactant administration has been shown in animal studies. Well designed trials in preterm infants are absent. We aimed to examine whether the application of a recruitment manoeuvre just before surfactant administration, followed by rapid extubation (intubate-recruit-surfactant-extubate [IN-REC-SUR-E]), decreased the need for mechanical ventilation during the first 72 h of life compared with no recruitment manoeuvre (ie, intubate-surfactant-extubate [IN-SUR-E]). Methods: We did a randomised, unblinded, controlled trial in 35 tertiary neonatal intensive care units in Italy. Spontaneously breathing extremely preterm neonates (24 + 0 to 27 + 6 weeks' gestation) reaching failure criteria for continuous positive airway pressure within the first 24 h of life were randomly assigned (1:1) with a minimisation algorithm to IN-REC-SUR-E or IN-SUR-E using an interactive web-based electronic system, stratified by clinical site and gestational age. The primary outcome was the need for mechanical ventilation in the first 72 h of life. Analyses were done in intention-to-treat and per-protocol populations, with a log-binomial regression model correcting for stratification factors to estimate adjusted relative risk (RR). This study is registered with ClinicalTrials.gov, NCT02482766. Findings: Of 556 infants assessed for eligibility, 218 infants were recruited from Nov 12, 2015, to Sept 23, 2018, and included in the intention-to-treat analysis. The requirement for mechanical ventilation during the first 72 h of life was reduced in the IN-REC-SUR-E group (43 [40%] of 107) compared with the IN-SUR-E group (60 [54%] of 111; adjusted RR 0·75, 95% CI 0·57–0·98; p=0·037), with a number needed to treat of 7·2 (95% CI 3·7–135·0). The addition of the recruitment manoeuvre did not adversely affect the safety outcomes of in-hospital mortality (19 [19%] of 101 in the IN-REC-SUR-E group vs 37 [33%] of 111 in the IN-SUR-E group), pneumothorax (four [4%] of 101 vs seven [6%] of 111), or grade 3 or worse intraventricular haemorrhage (12 [12%] of 101 vs 17 [15%] of 111). Interpretation: A lung recruitment manoeuvre just before surfactant administration improved the efficacy of surfactant treatment in extremely preterm neonates compared with the standard IN-SUR-E technique, without increasing the risk of adverse neonatal outcomes. The reduced need for mechanical ventilation during the first 72 h of life might facilitate implementation of a non-invasive respiratory support strategy. Funding: None