Middleman Minority Nation : Globalization and Social Democracy in Singapore

The Singaporean state is a social democracy with middleman minority characteristics. This thesis argues that it is the fusion of these two – the culture of the middleman minority, and the statist corporatism of social democracy – that has allowed the Singaporean state to set up a form of social democracy that is capable of not just surviving but flourishing under conditions of globalized capitalism. The outcome of this fusion, I dub a “middleman minority state” (MM state), extending on the arguments made by Bonacich and Sowell, by which I mean a state that scales up the logic of the classic middleman minority to the level of a nation-state. The key difference between the MM state and traditional social democracy, I argue, is that the MM state does not depend on the ability of the state to exert political control over the market. Instead, as a small state operating within the global market, the MM state operates the same way as any middleman minority operates in a host society: by inserting itself into an economy over which it has no political control, and making money by entering into mutually beneficial and voluntary business deals with whoever is willing to trade. Theoretically, my goal in making this argument is to debunk two dominant perspectives in the research areas of globalization, capitalism and the state. On the one hand, this is the Marxist perspective, which commonly states that globalization necessarily leads to the destruction of the social democratic state. On the other hand, this is the idea that Singapore is best understood as a neoliberal state, and more generally that “neoliberalism” should be understood in broad term as a movement which seeks to make the market into the dominant force in human society. Both of these perspectives, I argue, fail to offer a comprehensive and coherent account of the Singaporean state, as both fail to conceptualize Singapore as a social democracy adapted to the conditions of globalized capitalism. The Marxist perspective, I will show, does so by precluding this possibility a priori, by defining social democracy too narrowly, and incorrectly. The neoliberal perspective, conversely, does so by always-already including Singapore’s form of a globally viable social democracy under a too broad definition of the term “neoliberalism”. Ultimately, my aim is to describe the MM state as a new form of social democracy that is set up to tackle the novel challenges of globalization. As such, my aim is to look at the relation between social democracy and globalization as an open question, rather than as a foregone conclusion, in our increasingly globalized world.Doktorgradsavhandlin

Treatment Patterns, Treatment Satisfaction, Severity of Disease Problems, and Quality of Life in Patients with Psoriasis in Three Nordic Countries

Peer reviewe

OIL CORROSION AND CONDUCTING CU 2 S DEPOSITION IN POWER TRANSFORMER WINDINGS

SUMMARY Copper corrosion and Cu 2 S deposition, has recently led to failures of transformers & shunt reactors during service. Units from several different operators and several OEMs have been affected. Analysis of actual failure cases showed that these transformers were well within established industry standard practice regarding design as well as operation, and used oil that fulfilled international material standards. Sealed units with rubber sack appear primarily to have been affected. Final failure has occurred as a turn-to-turn breakdown in the HV windings, and inspection of the failed windings showed deposits in the winding consisting of Cuprous Sulphide, Cu 2 S, an electrically conducting compound. The deposits varied within the winding, usually with more deposits in the upper part of the windings, but the complex deposition pattern could not be explained simply by the temperature distribution. We have carried out comprehensive corrosion research aiming at a thorough understanding of the phenomenon, and have reproduced the corrosion as well as the deposition of Cu 2 S in our laboratories. The influence of the gas content of the oil, and other parameters have been studied under very well controlled circumstances, and a number of different oils have been evaluated at temperatures ranging from 80 to 150 °C. The main finding is that Cu 2 S deposition occurs only for certain oils, which can cause corrosion and deposition under the typical environment of a sealed power transformer. With such oils deposition has been demonstrated over a wide temperatures range, from as low as 80 °C, and on a variety of solid materials. These oils further show a very strong oxygen dependence of the deposition, which explains much of the observed complex deposition patterns in the failed units. Real failures have all occurred with transformer oils that passed the corrosion tests in the international standards, DIN 51353 and ASTM D1275 respectively. Improved test methods are clearly needed that can take into account the observed oxygen dependence, an important factor present in real transformers. A Covered Conductor Deposition (CCD) test has demonstrated a superior selectivity for identifying the corrosive oils that have caused actual failures in transformers, and is thus a very promising type of test

Are Treatment Satisfaction, Quality of Life, and Self-assessed Disease Severity Relevant Parameters for Patient Registries? Experiences from Finnish and Swedish Patients with Psoriasis

Peer reviewe

'Rumours' and clinical trials: a retrospective examination of a paediatric malnutrition study in Zambia, southern Africa

BACKGROUND: Many public health researchers conducting studies in resource-constrained settings have experienced negative 'rumours' about their work; in some cases they have been reported to create serious challenges and derail studies. However, what may appear superficially as 'gossip' or 'rumours' can also be regarded and understood as metaphors which represent local concerns. For researchers unaccustomed to having concerns expressed from participants in this manner, possible reactions can be to be unduly perturbed or conversely dismissive.This paper represents a retrospective examination of a malnutrition study conducted by an international team of researchers in Zambia, Southern Africa. The fears of mothers whose children were involved in the study and some of the concerns which were expressed as rumours are also presented. This paper argues that there is an underlying logic to these anxieties and to dismiss them simply as 'rumours' or 'gossip' would be to overlook the historic and socio-economic factors which have contributed to their production. METHODS: Qualitative interviews were conducted with the mothers whose children were involved in the study and with the research nurses. Twenty five face-to-face interviews and 2 focus group discussions (FGDs) were conducted with mothers. In addition, face-to-face interviews were conducted with research nurses participating in the trial. RESULTS: A prominent anxiety expressed as rumours by the mothers whose children were involved in the study was that recruitment into the trial was an indicator that the child was HIV-infected. Other anxieties included that the trial was a disguise for witchcraft or Satanism and that the children's body parts would be removed and sold. In addition, the liquid, milk-based food given to the children to improve their nutrition was suspected of being insufficiently nutritious, thus worsening their condition.The form which these anxieties took, such as rumours related to the stealing of body parts and other anxieties about a stigmatised condition, provide an insight into the historical, socio-economic and cultural influences in such settings. CONCLUSIONS: Employing strategies to understand local concerns should accompany research aims to achieve optimal success. The concerns raised by the participants we interviewed are not unique to this study. They are produced in countries where the historic, socio-economic and cultural settings communicate anxieties in this format. By examining this study we have shown that by contextualizing these 'rumours', the concerns they express can be constructively addressed and in turn result in the successful conduct of research aims

Environmental and genetic risk factors and gene-environment interactions in the pathogenesis of chronic obstructive lung disease.

Current understanding of the pathogenesis of chronic obstructive pulmonary disease (COPD), a source of substantial morbidity and mortality in the United States, suggests that chronic inflammation leads to the airways obstruction and parenchymal destruction that characterize this condition. Environmental factors, especially tobacco smoke exposure, are known to accelerate longitudinal decline of lung function, and there is substantial evidence that upregulation of inflammatory pathways plays a vital role in this process. Genetic regulation of both inflammatory responses and anti-inflammatory protective mechanisms likely underlies the heritability of COPD observed in family studies. In alpha-1 protease inhibitor deficiency, the only genetic disorder known to cause COPD, lack of inhibition of elastase activity, results in the parenchymal destruction of emphysema. Other genetic polymorphisms have been hypothesized to alter the risk of COPD but have not been established as causes of this condition. It is likely that multiple genetic factors interacting with each other and with a number of environmental agents will be found to result in the development of COPD

The Financial Burden of Non-Communicable Chronic Diseases in Rural Nigeria: Wealth and Gender Heterogeneity in Health Care Utilization and Health Expenditures

Objectives Better insights into health care utilization and out-of-pocket expenditures for non-communicable chronic diseases (NCCD) are needed to develop accessible health care and limit the increasing financial burden of NCCDs in Sub-Saharan Africa. Methods A household survey was conducted in rural Kwara State, Nigeria, among 5,761 individuals. Data were obtained using biomedical and socio-economic questionnaires. Health care utilization, NCCD-related health expenditures and distances to health care providers were compared by sex and by wealth quintile, and a Heckman regression model was used to estimate health expenditures taking selection bias in health care utilization into account. Results The prevalence of NCCDs in our sample was 6.2%. NCCD-affected individuals from the wealthiest quintile utilized formal health care nearly twice as often as those from the lowest quintile (87.8% vs 46.2%, p = 0.002). Women reported foregone formal care more often than men (43.5% vs. 27.0%, p = 0.058). Health expenditures relative to annual consumption of the poorest quintile exceeded those of the highest quintile 2.2-fold, and the poorest quintile exhibited a higher rate of catastrophic health spending (10.8% among NCCD-affected households) than the three upper quintiles (4.2% to 6.7%). Long travel distances to the nearest provider, highest for the poorest quintile, were a significant deterrent to seeking care. Using distance to the nearest facility as instrument to account for selection into health care utilization, we estimated out-of-pocket health care expenditures for NCCDs to be significantly higher in the lowest wealth quintile compared to the three upper quintiles. Conclusions Facing potentially high health care costs and poor accessibility of health care facilities, many individuals suffering from NCCDs—particularly women and the poor—forego formal care, thereby increasing the risk of more severe illness in the future. When seeking care, the poor spend less on treatment than the rich, suggestive of lower quality care, while their expenditures represent a higher share of their annual household consumption. This calls for targeted interventions that enhance health care accessibility and provide financial protection from the consequences of NCCDs, especially for vulnerable populations