Technocratic attitudes: a citizens’ perspective of expert decision-making

Despite repeated appointments of technocratic governments in Europe and increasing interest in technocracy, there is little knowledge regarding citizens’ attitudes towards technocracy and the idea of governance by unelected experts. This article revisits normative debates and hypothesises that technocracy and democracy stand in a negative relationship in the eyes of European citizens. It tests this alongside a series of hypotheses on technocratic attitudes combining country-level institutional characteristics with individual survey data. While findings confirm that individual beliefs about the merits of democracy influence technocratic attitudes, two additional important factors are also identified: first, levels of trust in current representative political institutions also motivate technocratic preferences; second, historical legacies, in terms of past party-based authoritarian regime experience, can explain significant cross-national variation. The implications of the findings are discussed in the broader context of citizen orientations towards government, elitism and the mounting challenges facing representative democracy

Non-invasive bladder volume measurement for the prevention of postoperative urinary retention : validation of two ultrasound devices in a clinical setting

Ultrasound scanning of bladder volume is used for prevention of postoperative urinary retention (POUR). Accurate assessment of bladder volume is needed to allow clinical decision-making regarding the need for postoperative catheterization. Two commonly used ultrasound devices, the BladderScan® BVI 9400 and the newly released Prime® (Verathon Medical®, Bothell, WA, USA), with or without the 'pre-scan' option, have not been validated in clinical practice. The aim of this study was to assess the performance of these devices in daily clinical practice. Between June and September 2016 a prospective observational study was conducted in 318 surgical patients (18 years or older) who needed a urinary catheter perioperatively for clinical reasons. For acceptable performance, we required that the volume as estimated by the BladderScan® differs by no more than 5% from the actual urine volume after catheterization. The Schuirmann's two one-sided test was performed to assess equivalence between the BladderScan® estimate and catheterization. The BVI 9400® overestimated the actual bladder volume by + 17.5% (95% CI + 8.8 to + 26.3%). The Prime® without pre-scan underestimated by - 4.1% (95% CI - 8.8 to + 0.5%) and the Prime® with pre-scan underestimated by - 6.3% (95% CI - 11.6 to - 1.1%). This study shows that while both ultrasound devices were able to approximate current bladder volume, both BVI 9400® and Prime®-with and without pre-scan-were not able to measure the actual bladder volume within our predefined limit of ± 5%. Using the pre-scan feature of the Prime® did not further improve accuracy