The macroeconomic imbalance procedure as European integration: a legalisation perspective

The Macroeconomic Imbalance Procedure seeks to prevent and correct destabilising economic imbalances in the European Union. Scholars are divided as to whether this instrument of economic policy coordination relies on the same intergovernmental modes of decision-making as the Broad Economic Policy Guidelines or reflects supranational institutions more significant role in EU economic policy following the euro crisis. Such diametrically opposed interpretations are symptomatic of longstanding concerns over the lack of a clear-cut definition of European integration. To address these definitional difficulties, this paper turns to the concept of legalisation. Taking account of the design and early implementation of the Macroeconomic Imbalance Procedure and using the Broad Economic Policy Guidelines as a point of comparison, it shows that the former can be understood as a modest but clear-cut increase in legalisation compared to the latter. On this basis, it considers whether legalisation, in spite of its own conceptual limitations, can contribute to a more rigorous definition of European integration

The European Union in disequilibrium: new intergovernmentalism, postfunctionalism and integration theory in the post-Maastricht period

The crises that weigh heavily on the European Union (EU) in the 2010s have underlined the continued importance of integration theory, albeit in ways that go beyond classic debates. Postfunctionalism, in particular, has shown how European integration and its problems stand on shifting political cleavages. And yet, postfunctionalist claims that such changes would create a constraining dissensus in the EU rests uneasily with the intensification of European integration since the Maastricht Treaty was signed. This article offers a new intergovernmentalist explanation of this puzzle, which shows how mainstream governing parties have circumvented rather than being constrained by Eurosceptic challenger parties and challenger governments. The result, it contends, is not a constraining but a destructive dissensus that adds to the EU’s political disequilibrium. Understanding the persistence of this disequilibrium and its potential to unwind disruptively is a key challenge for contemporary integration theory

The use of antibiotic-loaded bone cement and systemic antibiotic prophylactic use in 2,971,357 primary total knee arthroplasties from 2010 to 2020: an international register-based observational study among countries in Africa, Europe, North America, and Oceania

Background and purpose - Antibiotic-loaded bone cement (ALBC) and systemic antibiotic prophylaxis (SAP) have been used to reduce periprosthetic joint infection (PJI) rates. We investigated the use of ALBC and SAP in primary total knee arthroplasty (TKA).Patients and methods - This observational study is based on 2,971,357 primary TKAs reported in 2010-2020 to national/regional joint arthroplasty registries in Australia, Den-mark, Finland, Germany, Italy, the Netherlands, New Zealand, Norway, Romania, South Africa, Sweden, Switzerland, the UK, and the USA. Aggregate-level data on trends and types of bone cement, antibiotic agents, and doses and duration of SAP used was extracted from participating registries.Results - ALBC was used in 77% of the TKAs with variation ranging from 100% in Norway to 31% in the USA. Palacos R+G was the most common (62%) ALBC type used. The primary antibiotic used in ALBC was gentamicin (94%). Use of ALBC in combination with SAP was common prac-tice (77%). Cefazolin was the most common (32%) SAP agent. The doses and duration of SAP used varied from one single preoperative dosage as standard practice in Bolzano, Italy (98%) to 1-day 4 doses in Norway (83% of the 40,709 TKAs reported to the Norwegian arthroplasty register). Conclusion - The proportion of ALBC usage in pri-mary TKA varies internationally, with gentamicin being the most common antibiotic. ALBC in combination with SAP was common practice, with cefazolin the most common SAP agent. The type of ALBC and type, dose, and duration of SAP varied among participating countries.Orthopaedics, Trauma Surgery and Rehabilitatio