On the Merits of Decentralization in Young Democracies

Three features of decentralization proposed by institutional development theory are analyzed for Mozambique's Autarquias, politically autonomous municipalities since 1997. The three issues analyzed in this article are: Consolidation of the fiscal state, democracy, and the development of service quality in the local administration. Under decentralization, each of the three features is shown empirically to allow progress toward political development. Using QCA-analysis, the politics contributing to institutional consolidation are identified. While the different socio-economic contexts of the Autarquias and power sharing play an important role, the effects of direct participation are more ambiguous. Decentralization can contribute to a "state closer to the people” and may correct the deficiencies of "top down” politics characterizing many African States. However, decentralization cannot overcome deep socio-political divides such as those existing in Mozambique within such a short time. Finally, positive development towards consolidation of democracy, of the local state and its service quality depend on different patterns of politics, more complex than general theories propos

Swiss Democracy

This open access book provides an updated and fully revised 4th edition of this authoritative analysis of Swiss democracy. It particularly explains the institutions of federalism and consensus government through political power sharing. In this new edition, the authors also address several important changes and challenges that have affected Swiss democracy, including the country's relationship with the EU, fiscal equalisation, direct democracy and the legitimacy of national referendums, territorial conflict, as well as the polarisation of party politics

Cosmological constraints from COMBO-17 using 3D weak lensing

We present the first application of the 3D cosmic shear method developed in Heavens et al. (2006) and the geometric shear-ratio analysis developed in Taylor et al. (2006), to the COMBO-17 data set. 3D cosmic shear has been used to analyse galaxies with redshift estimates from two random COMBO-17 fields covering 0.52 square degrees in total, providing a conditional constraint in the (sigma_8, Omega_m) plane as well as a conditional constraint on the equation of state of dark energy, parameterised by a constant w= p/rho c^2. The (sigma_8, Omega_m) plane analysis constrained the relation between sigma_8 and Omega_m to be sigma_8(Omega_m/0.3)^{0.57 +- 0.19}=1.06 +0.17 -0.16, in agreement with a 2D cosmic shear analysis of COMBO-17. The 3D cosmic shear conditional constraint on w using the two random fields is w=-1.27 +0.64 -0.70. The geometric shear-ratio analysis has been applied to the A901/2 field, which contains three small galaxy clusters. Combining the analysis from the A901/2 field, using the geometric shear-ratio analysis, and the two random fields, using 3D cosmic shear, w is conditionally constrained to w=-1.08 +0.63 -0.58. The errors presented in this paper are shown to agree with Fisher matrix predictions made in Heavens et al. (2006) and Taylor et al. (2006). When these methods are applied to large datasets, as expected soon from surveys such as Pan-STARRS and VST-KIDS, the dark energy equation of state could be constrained to an unprecedented degree of accuracy.Comment: 10 pages, 4 figures. Accepted to MNRA

Improving caring quality for people with dementia in nursing homes using IPOS-Dem: A stepped-wedge cluster randomized controlled trial protocol.

We aim to evaluate the effectiveness of the Integrated Palliative Care Outcome Scale for people with dementia-based case studies to improve the caring quality for people with dementia in nursing homes by frontline staff and family members. Swiss nursing homes mostly care for people with dementia. This population is at high risk of receiving little to no palliation for their complex needs. The majority of Swiss frontline healthcare staff do not systematically report on the needs of their residents. Additionally, family members do not routinely participate in assessment processes. We will conduct a stepped-wedge cluster randomized trial of repeated assessment using the Integrated Palliative Care Outcome Scale for people with dementia (IPOS-Dem) and subsequent case studies. Clusters will consist of Swiss nursing homes randomly assigned to one of three sequential intervention time points. The study population will consist of people with dementia living in nursing homes with and without specialized dementia care facilities. Over 16 months, staff working at the frontline and family members will assess the needs and concerns of people with dementia using IPOS-Dem. Depending on sequence allocation, facilitated case studies will start after 3, 6 or 9 months. The primary outcome will be caring quality measured by QUALIDEM. The secondary outcome will be symptoms and concerns, as indicated by the IPOS-Dem sum-score. The Zürich Ethics Committee approved the study in 2019 (2019-01847). The results of this study will contribute to improving the effectiveness of person-centred care for people with dementia. Collaboration between healthcare staff and family members will be systematically developed and built upon thorough assessment using the IPOS-Dem and related case studies. The use of IPOS-Dem will offer all frontline staff a systematic approach to have an independent voice within the nursing process, regardless of their qualification or grade

Lenalidomide in cancer cachexia: a randomized trial of an anticancer drug applied for anti-cachexia

Background Cancer cachexia (CC) impacts quality of life, physical function, anticancer treatment response, and survival. Inflammation is a prominent pathomechanism of CC. This small-scale study sets out to investigate the immunomodulatory drug lenalidomide in inflammatory CC in a randomized, double-blind, placebo-controlled trial. Methods Patients with advanced solid malignancies, documented weight loss, no or unchanged anticancer treatment, and C-reactive protein > 30 mg/L were included. In a 2:2:1 randomization, patients received either lenalidomide 25 mg once daily or C-reactive protein-guided dose, starting with 5 mg lenalidomide once daily or placebo once a day for 8 weeks. Dose adaption and safety were assessed twice a week. Treatment response was defined as an increase of lean body mass of more than 2% in a lower lumbar computed tomography and an increase in dynamometer-assessed handgrip strength of 4 kg. Secondary endpoints included adverse events, C-reactive protein response, nutritional intake, and symptoms. Results Of 24 eligible patients, 16 were included (25% female). At baseline, the mean age was 67 (range 51–88) years, and mean body weight was 64.7 kg (range 39.8–87.2 kg). Five were diagnosed with mesothelioma, two with non-small-cell lung cancer, two with renal cell carcinoma, two with neuroendocrine tumours, and five with other malignancies. Mean survival was 43 days. Eleven adverse events (four of which were severe) were recorded with a probable link to study participation. Nine patients completed the study. No participant showed a treatment response. C-reactive protein-guided dosing did not result in lower doses of lenalidomide. Lean body mass decreased less in the treatment groups. For the lenalidomide and placebo groups respectively, handgrip strength decreased by 2.3 vs. 5.5 kg, nutritional intake decreased by 249 vs. 32 kcal/day, and C-reactive protein increased by 35 mg/dL vs. decreased by 17 mg/dL. The study was closed prematurely due to slow accrual and the need for concurrent anticancer treatments. Conclusions No treatment response on muscle mass and muscle strength was observed with lenalidomide. Because of several limiting factors, including low recruitment caused in part by an ambitious study design and concomitant anticancer treatment, this study did not generate adequate data to draw reliable conclusions

Constraints on perfect fluid and scalar field dark energy models from future redshift surveys

We discuss the constraints that future photometric and spectroscopic redshift surveys can put on dark energy through the baryon oscillations of the power spectrum. We model the dark energy either with a perfect fluid or a scalar field and take into account the information contained in the linear growth function. We show that the growth function helps to break the degeneracy in the dark energy parameters and reduce the errors on $w_0,w_1$ roughly by 30% making more appealing multicolor surveys based on photometric redshifts. We find that a 200 square degrees spectroscopic survey reaching $z = 3$ can constrain $w_0,w_1$ to within $\Delta w_0=0.21,\Delta w_1=0.26$ and to $\Delta w_0=0.39,\Delta w_1=0.54$ using photometric redshifts with absolute uncertainty of 0.02. In the scalar field case we show that the slope $n$ of the inverse power-law potential for dark energy can be constrained to $\Delta n=0.26$ (spectroscopic redshifts) or $\Delta n=0.40$ (photometric redshifts), i.e. better than with future ground-based supernovae surveys or CMB data.Comment: 27 pages, submitted to MNRA

autonomic nervous tone in vitiligo patients a case control study

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