Liberal conservatism, ‘boardization’ and the government of civil servants

Drawing inspiration from the loosely coupled genre of studies of governmentality, this article explores the emergence in Britain during the early years of the millennium of a distinctive liberal conservative scheme for the government of civil servants. The term ‘boardization’ has been used to characterize the trend to reproduce the technology of the board of directors in central government. Conservatives currently assign a distinctive role to the work of departmental ‘boards’ in the effective management of the Civil Service. Intimating the costs and risks of the Conservatives’ programme, we explore the role of diverse governmental forces in the emergence of the boards of the Civil Service as an object for action and intervention during the early years of the new millennium. We explore a mutation in the application of practices and techniques drawn from the domain of the business enterprise to the organization of the Civil Service. </jats:p

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Looking at the soft-bottom around a coastal coral reef: the impact of terrigenous input on Polychaeta (Annelida) community

Abstract Erosion on coral reefs produces fragments of the constructor organisms that are scattered all around, thus enlarging the reef boundaries. Statistical modelling approach was used to investigate whether the Polychaeta community around Sebastião Gomes reef (Abrolhos Bank, Brazil) is influenced equally by sediment characteristics and/or by position related to the reef, that are variables related to the terrigenous input influence. In July 2007, a period dominated by winds that resuspend fine sediment from the land to coastal reefs, sediment samples were taken on four transects perpendicular to the reef (S, W, N and E) and a total of 121 species of polychaetes were recorded. The most abundant species was the carnivorous Goniadides carolinae and the model selected for it approximates to the best models fitted for both total macrofauna and polychaete abundance. These models represented higher abundance in coarse carbonate sediments on windward reef faces, where there is almost no terrigenous sediment. On the other hand, the Polychaeta richness did not depend on the transects. Sebastião Gomes reef is one of the many coastal reefs from Abrolhos Bank, whose healthy is probably in danger because of the increase of mud related to human activities, as deforestation and, recently, mining waste

Initial measurements of Z-boson resonance parameters in e+e- annihilation

We have measured the mass of the Z boson to be 91.11±0.23 GeV/c^2, and its width to be 1.61-0.43+0.60 GeV. If we constrain the visible width to its standard-model value, we find the partial width to invisible decay modes to be 0.62±0.23 GeV, corresponding to 3.8±1.4 neutrino species

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

Construct design for efficient, effective and high-throughput gene silencing in plants

Post-transcriptional silencing of plant genes using anti-sense or co-suppression constructs usually results in only a modest proportion of silenced individuals. Recent work has demonstrated the potential for constructs encoding self-complementary 'hairpin' RNA (hpRNA) to efficiently silence genes. In this study we examine design rules for efficient gene silencing, in terms of both the proportion of independent transgenic plants showing silencing, and the degree of silencing. Using hpRNA constructs containing sense/anti-sense arms ranging from 98 to 853 nt gave efficient silencing in a wide range of plant species, and inclusion of an intron in these constructs had a consistently enhancing effect. Intron-containing constructs (ihpRNA) generally gave 90-100% of independent transgenic plants showing silencing. The degree of silencing with these constructs was much greater than that obtained using either co-suppression or anti-sense constructs. We have made a generic vector, pHANNIBAL, that allows a simple, single PCR product from a gene of interest to be easily converted into a highly effective ihpRNA silencing construct. We have also created a high-throughput vector, pHELLSGATE, that should facilitate the cloning of gene libraries or large numbers of defined genes, such as those in EST collections, using an in vitro recombinase system. This system may facilitate the large-scale determination and discovery of plant gene functions in the same way as RNAi is being used to examine gene function in Caenorhabditis elegans