187 research outputs found
Traps of multi-level governance. Lessons from the implementation of the Water Framework Directive in Italy
During recent decades, different patterns of multi-level governance (MLG) have spread across Europe as a consequence of Europeanisation of public policies, which have increasingly adopted decentralized and participatory procedures conceived as a tool of more effective and accountable policy-making. It appears, however, that the implementation of operational designs based on MLG may be rather problematic and it does not necessarily bring to the expected performance improvements. Referring to the case of the EU Water Framework Directive (2000/60/EC), which conceives the creation of new multi-level institutional settings as a key tool for enacting a new holistic approach to water management and protection, this article explores the difficulties that the implementation of such settings has brought in Italy, despite some favorable pre-conditions existing in the country. Evidence is provided that along with institutional and agency variables, the implementation effectiveness of MLG arrangements promoted by the EU can be challenged by their inherent characteristics
Dynamic Reconstruction of Facial Paralysis in Craniofacial Microsomia
BACKGROUND: Craniofacial microsomia is associated with maxillomandibular hypoplasia, microtia, soft-tissue deficiency, and variable severity of cranial nerve dysfunction, most often of the facial nerve. This study evaluated the incidence of facial paralysis in patients with craniofacial microsomia and outcomes after free functioning muscle transfer for dynamic smile reconstruction.
METHODS: A single-center, retrospective, cross-sectional study was performed from 1985 to 2018 to identify pediatric patients with craniofacial microsomia and severe facial nerve dysfunction who underwent dynamic smile reconstruction with free functioning muscle transfer. Preoperative and postoperative facial symmetry and oral commissure excursion during maximal smile were measured using photogrammetric facial analysis software.
RESULTS: This study included 186 patients with craniofacial microsomia; 41 patients (21 male patients, 20 female patients) had documented facial nerve dysfunction (22 percent) affecting all branches (51 percent) or the mandibular branch only (24 percent). Patients with severe facial paralysis (n = 8) underwent smile reconstruction with a free functioning muscle transfer neurotized either with a cross-face nerve graft (n = 7) or with the ipsilateral motor nerve to masseter (n =1). All patients achieved volitional muscle contraction with improvement in lip symmetry and oral commissure excursion (median, 8 mm; interquartile range, 3 to 10 mm). The timing of orthognathic surgery and facial paralysis reconstruction was an important consideration in optimizing patient outcomes.
CONCLUSIONS: The authors' institution's incidence of facial nerve dysfunction in children with craniofacial microsomia is 22 percent. Free functioning muscle transfer is a reliable option for smile reconstruction in children with craniofacial microsomia. To optimize outcomes, a novel treatment algorithm is proposed for craniofacial microsomia patients likely to require both orthognathic surgery and facial paralysis reconstruction
Policy Entrepreneurship and Multilevel Governance: A Comparative Study of European Cross-Border Regions
This article was publsihed in the journal, Environment and Planning C [© Pion]. The definitive version is available at: http://www.envplan.com/C.htmlThis article addresses the recent proliferation of Cross-Border Regions, or Euroregions,
in Europe. It argues that EU multi-level governance patterns generate opportunities for
entrepreneurial policy organisations to attract policy tasks and resources. This is
conceptualised as policy entrepreneurship and applied to a comparative case study
analysis of three Euroregions: EUREGIO (Germany â Netherlands), Viadrina (Poland â
Germany) and Tyrol (Austria â Italy). The analysis focuses on the ability of these
initiatives to establish themselves as autonomous organisations. It finds considerable
variation across the cases in this respect. Following on from this, the paper shows how
different administrative and institutional environments in different EU member states
affect the ability of Euroregions to engage in policy entrepreneurship. It concludes that
is it premature to perceive Euroregions as new types of regional territorial entities;
rather, they are part of the policy innovation scenario enabled by EU multi-level
governance
Co-ordination of local policies for urban development and public transportation in four Swiss cities
The present article aims at assessing the possibility for urban areas to coordinate local policies of urban development and public transportation and at explaining the differences in this achievement between urban regions. In order to do so, the study draws support from two empirical sources: a historical analysis of the "mass-production" generated by the public service sectors in the field of transport and urban development in the cities of Basel, Bern, Geneva, and Lausanne since 1950, and a series of six case studies in these four cities. The study identifies factors located both at context level regarding morphological and geographical conditions as well as institutional settings and case-specific idiosyncrasies regarding organizational structure, past policy decisions, as well as vocational cultures that determine the possibility for urban areas to meet the need for policy coordination
Mechanisms of international influence on domestic elite sport policy
In the analysis of sport policy the permeability of domestic policy processes and the significance of non-domestic policy influences is increasingly acknowledged. There is also a growing awareness of the role of domestic institutional arrangements in mediating influences external to the domestic policy system. Taking the interaction between non-domestic influences and domestic policy processes as its starting point the article evaluates, in relation to elite sport, the variety of mechanisms that have been identified as linking the domestic and non-domestic policy spheres. It is argued that the mechanisms vary in relation to the locus of initiative, the basis of engagement, the key relationships and the nature of power relationships. It is also argued that in many countries in relation to elite sport policy there is a dual process in operation of domestically initiated policy learning and non-domestically initiated policy harmonisation through policy regimes
Between Governance-Driven Democratisation and Democracy-Driven Governance: explaining changes in Participatory Governance in the Case of Barcelona
Scholars of participatory democracy have long noted dynamic interactions and transformations within and between political spaces that can foster (de)democratisation. At the heart of this dynamism lie (a) the processes through which topâdown âclosedâ spaces can create opportunities for rupture and democratic challenges and (b) viceâversa, the mechanisms through which bottomâup, open spaces can be coâopted through institutionalisation. This paper seeks to unpick dynamic interactions between different spaces of participation by looking specifically at two forms of participatory governance, or participatory forms of political decision making used to improve the quality of democracy. First, Mark Warren's concept of âgovernanceâdriven democratizationâ describes topâdown and technocratic participatory governance aiming to produce better policies in response to bureaucratic rationales. Second, we introduce a new concept, democracyâdriven governance, to refer to efforts by social movements to invent new, and reclaim and transform existing, spaces of participatory governance and shape them to respond to citizensâ demands. The paper defines these concepts and argues that they coâexist and interact in dynamic fashion; it draws on an analysis of case study literature on participatory governance in Barcelona to illuminate this relationship. Finally, the paper relates the theoretical framework to the case study by making propositions as to the structural and agential drivers of shifts in participatory governance
Wettbewerb und Regulierung
Wettbewerb und Regulierung werfen sowohl aus einer wirtschafts- als auch aus einer politikwissenschaftlichen Perspektive interessante Fragestellungen auf und haben daher in beiden Disziplinen umfangreiche Beachtung gefunden. Der vorliegende Beitrag gibt eine Ăbersicht ĂŒber beide Herangehensweisen. Dabei wer-den zunĂ€chst die grundlegenden Unterschiede und Gemeinsamkeiten offengelegt (Abschnitt 2), bevor die disziplinĂ€ren Schwerpunkte in der Analyse vorgestellt, und aus Sicht der jeweils anderen Disziplin kommentiert werden (Abschnitte 3 und 4). Wir kommen zu dem Ergebnis, dass beide Sichtweisen in erster Linie komplementĂ€r sind und sich gegenseitig befruchten können
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