Green growth or ecological commodification: debating the green economy in the Global South

This article examines recent institutional thinking on the green economy and the implications of official understandings and structuration of a green economy for the global South. Assertions about the transformative potential of a green economy by many international actors conceals a complexity of problems, including the degree to which the green economy is still based on old fossil economies and technical fixes, and the processes through which the green economy ideation remains subject to Northern economic and technical dominance. The article places the intellectual roots of the green economy within a broader historical context and suggests some ways the strategic economic and ideological interests of the global North remain key drivers of green-economy thinking. The analysis is substantiated through two illustrative Latin American examples: the Mesoamerican Biological Corridor and green economy initiatives in Brazil. These suggest that, if the green economy is to address global challenges effectively, it must be conceptualized as more than a bolt-on to existing globalizing capitalism and encompass more critical understandings of the complex socio-economic processes through which poverty is produced and reproduced and through which the global environment is being transformed, a critique which also applies to mainstream discourses of sustainable development

Standardising Costs or Standardising Care? Qualitative Evaluation of the Implementation and Impact of a Hospital Funding Reform in Ontario, Canada

Background  Since 2011, the Government of Ontario, Canada, has phased in hospital funding reforms hoping to encourage standardised, evidence-based clinical care processes to both improve patient outcomes and reduce system costs. One aspect of the reform – quality-based procedures (QBPs) – replaced some of each hospital’s global budget with a pre-set price per episode of care for patients with specific diagnoses or procedures. The QBP initiative included publication and dissemination of a handbook for each of these diagnoses or procedures, developed by an expert technical group. Each handbook was intended to guide hospitals in reducing inappropriate variation in patient care and cost by specifying an evidence-based episode of care pathway. We explored whether, how and why hospitals implemented these episode of care pathways in response to this initiative. Methods  We interviewed key informants at three levels in the healthcare system, namely individuals who conceived and designed the QBP policy, individuals and organisations supporting QBP adoption, and leaders in five case-study hospitals responsible for QBP implementation. Analysis involved an inductive approach, incorporating framework analysis to generate descriptive and explanatory themes from data. Results  The 46 key informants described variable implementation of best practice episode of care pathways across QBPs and across hospitals. Handbooks outlining evidence-based clinical pathways did not address specific barriers to change for different QBPs nor differences in hospitals’ capacity to manage change. Hospitals sometimes found it easier to focus on containing and standardising costs of care than on implementing standardised care processes that adhered to best clinical practices. Conclusion  Implementation of QBPs in Ontario’s hospitals depended on the interplay between three factors, namely complexity of changes required, internal capacity for organisational change, and availability and appropriateness of targeted external facilitators and supports to manage change. Variation in these factors across QBPs and hospitals suggests the need for more tailored and flexible implementation supports designed to fit all elements of the policy, rather than one-size-fits-all handbooks alone. Without such supports, hospitals may enact quick fixes aimed mainly at preserving budgets, rather than pursue evidence- and value-based changes in care management. Overestimating hospitals’ change management capacity increases the risk of implementation failure

Free Expression in America Post-2020 A Landmark Survey of Americans Views on Speech Rights

Free expression and the freedom of speech are cornerstones of American democracy. Yet the interpretation of the First Amendment continues to be a flashpoint in the 21st century as the nation debates how to apply these rights to our society. For the 2021 "Free Expression in America Post-2020" report, Knight Foundation commissioned Ipsos to conduct a survey with a nationally representative sample of more than 4,000 American adults, including an additional sample of 1,000 undergraduate college students. The Knight Foundation-Ipsos study provides a comprehensive look at American attitudes toward freedom of speech in a post-2020 environment, building on Knight Foundation's long-standing work studying free speech views among students since 2004. The findings described in this report cover many but not all of the rich insights possible from this complex dataset. We invite the public and researchers to explore this publicly available resource in further detail. This study finds that all Americans hold to the ideal of free speech, but putting free expression into practice reveals significant differences in experiences and attitude. It examines how Americans view free expression issues, events and the application of our First Amendment rights in an increasingly digital, diverse, and politically driven society.

Brain-responsive neurostimulation for the treatment of adults with epilepsy in tuberous sclerosis complex: A case series

OBJECTIVE: Tuberous sclerosis complex (TSC) is a genetic disorder primarily characterized by the development of multisystem benign tumors. Epilepsy is the most common neurologic manifestation, affecting 80%-90% of TSC patients. The diffuse structural brain abnormalities and the multifocal nature of epilepsy in TSC pose diagnostic challenges when evaluating patients for epilepsy surgery. METHODS: We retrospectively reviewed the safety experience and efficacy outcomes of five adult TSC patients who were treated with direct brain-responsive neurostimulation (RNS System, NeuroPace, Inc). RESULTS: The average follow-up duration was 20 months. All five patients were responders (≥50% disabling seizure reduction) at last follow-up. The median reduction in disabling seizures was 58% at 1 year and 88% at last follow-up. Three of the five patients experienced some period of seizure freedom ranging from 3 months to over 1 year. SIGNIFICANCE: In this small case series, we report the first safety experience and efficacy outcomes in patients with TSC-associated drug-resistant focal epilepsy treated with direct brain-responsive neurostimulation

Objects as Curricula: rethinking the capacities and affects of Blackfoot material artefacts

The late Frank Weasel Head, a Blackfoot Elder, observed of Blackfoot artefacts held in museum collections worldwide that these were not merely objects, but curricula. This paper will discuss the Mootookakio’ssin/Distant Awareness project, which brings together Indigenous and Non-Indigenous artists, museum professionals, archaeologists and anthropologists, led by Blackfoot ceremonial leaders, which has made digital captures of Blackfoot items in UK museum collections (Clark et. al. 2022; Minkin et. al. 2022). This paper asks what capacities were supported and permitted by the process of digital imaging, and what is the effect of considering material artefacts as curricula? Over the last twenty years or more, material culture studies have become an intellectual battleground, with competing accounts of the proper way to study material artefacts debated; from symmetrical archaeology and object oriented ontology, to new materialism. All of these accounts have been influenced by metaphysics, while some of them have also been influenced by, often unacknowledged, Indigenous accounts (see e.g., Todd 2016). Rather than merely giving Indigenous accounts lip service, this paper asks what happens when we take Indigenous philosophies seriously? How does this guide our practices and interpretations? What capacities do digital models have to teach us

Dispersal of Adult Culex Mosquitoes in an Urban West Nile Virus Hotspot: A Mark-Capture Study Incorporating Stable Isotope Enrichment of Natural Larval Habitats

Dispersal is a critical life history behavior for mosquitoes and is important for the spread of mosquito-borne disease. We implemented the first stable isotope mark-capture study to measure mosquito dispersal, focusing on Culex pipiens in southwest suburban Chicago, Illinois, a hotspot of West Nile virus (WNV) transmission. We enriched nine catch basins in 2010 and 2011 with 15N-potassium nitrate and detected dispersal of enriched adult females emerging from these catch basins using CDC light and gravid traps to distances as far as 3 km. We detected 12 isotopically enriched pools of mosquitoes out of 2,442 tested during the two years and calculated a mean dispersal distance of 1.15 km and maximum flight range of 2.48 km. According to a logistic distribution function, 90% of the female Culex mosquitoes stayed within 3 km of their larval habitat, which corresponds with the distance-limited genetic variation of WNV observed in this study region. This study provides new insights on the dispersal of the most important vector of WNV in the eastern United States and demonstrates the utility of stable isotope enrichment for studying the biology of mosquitoes in other disease systems.The open access fee for this work was funded through the Texas A&M University Open Access to Knowledge (OAK) Fund

Pharmacological evaluation of novel bioisosteres of an adamantanyl benzamide P2X7 receptor antagonist

Adamantanyl benzamide 1 was identified as a potent P2X7R antagonist but failed to progress further due to poor metabolic stability. We describe the synthesis and SAR of a series of bioisosteres of benzamide 1 to explore improvements in the pharmacological properties of this lead. Initial efforts investigated a series of heteroaromatic bioisosteres, which demonstrated improved physicochemical properties but reduced P2X7R antagonism. Installation of bioisosteric fluorine on the adamantane bridgeheads was well tolerated and led to a series of bioisosteres with improved physicochemical properties and metabolic stability. Trifluorinated benzamide 34 demonstrated optimal physicochemical parameters, superior metabolic stability (ten times longer than lead benzamide 1), and an improved physicokinetic profile and proved effective in the presence of several known P2X7R polymorphisms