Is Somaliland a Country? An Essay on Institutional Objects in the Social Sciences

Searle claims that his theory of institutional reality is particularly suitable as a theoretical scheme of individuation for work in the social sciences. We argue that this is not the case. The first problem with regulatory individuation is due to the familiar fact that institutional judgments have constrained revisability criteria. The second problem with regulatory individuation is due to the fact that institutions amend their declarative judgments based on the inferential (syntactic) properties of the judgments and in response to regulatory pressure, and not based on descriptive (semantic) properties and in response to matters of descriptive adequacy. These two problems imply that ‘regulatory kinds' (countries, borders, kings) will almost inevitably be disjunctive kinds that are ill-suited for scientific theorizing. This also explains why the law often makes odd pronouncements, e.g. calling ketchup a vegetable, considering an arm bent fifteen degrees to be straight, and not admitting that Somaliland is a country

High birthweights among infants of north African immigrants in Belgium.

OBJECTIVES: This study examined birthweights of North African immigrants in Belgium. METHODS: Analyses focused on Belgian single live birth certificates from 1981 to 1988. RESULTS: Low-birthweight (< 2500 g) rates were 3.1% among 34,686 newborns of North African origin and 4.8% among 804,286 newborns of Belgian origin. The entire North African birthweight distribution was shifted toward higher birthweights than the Belgian distribution. Low frequencies of low birthweights among North Africans were still observed after marital status, occupation of the father, and parity had been taken into account. CONCLUSIONS: Despite their low socioeconomic status, North African immigrants have high birthweights

Cigarettes, dollars and bitcoins – an essay on the ontology of money

What does being money consist in? We argue that something is money if, and only if, it is typically acquired in order to realise the reduction in transaction costs that accrues in virtue of agents coordinating on acquiring the same thing when deciding what thing to acquire in order to exchange. What kinds of things can be money? We argue against the common view that a variety of things (notes, coins, gold, cigarettes, etc.) can be money. All monetary systems are best interpreted as implementing the same basic protocol. Money, i.e. the thing that we coordinate on acquiring in order to lower our transaction costs, is, in all cases, a set of positions on an abstract mathematical object, namely a relative ratio scale. The things that we ordinarily call ‘money’ are merely records of positions on such a scale

What is money? An alternative to Searle's institutional facts

In The Construction of Social Reality, John Searle develops a theory of institutional facts and objects, of which money, borders and property are presented as prime examples. These objects are the result of us collectively intending certain natural objects to have a certain status, i.e. to ‘count as’ being certain social objects. This view renders such objects irreducible to natural objects. In this paper we propose a radically different approach that is more compatible with standard economic theory. We claim that such institutional objects can be fully understood in terms of actions and incentives, and hence the Searlean apparatus solves a non-existent problem

The unmet need for Emergency Obstetric Care in Tanga Region, Tanzania

<p>Abstract</p> <p>Background</p> <p>Improving maternal health by reducing maternal mortality constitutes the fifth Millennium Development Goal and represents a key public health challenge in the United Republic of Tanzania. In response to the need to evaluate and monitor safe motherhood interventions, this study aims at assessing the coverage of obstetric care according to the Unmet Obstetric Need (UON) concept by obtaining information on indications for, and outcomes of, major obstetric interventions. Furthermore, we explore whether this concept can be operationalised at district level.</p> <p>Methods</p> <p>A two year study using the Unmet Obstetric Need concept was carried out in three districts in Tanga Region, Tanzania. Data was collected prospectively at all four hospitals in the region for every woman undergoing a major obstetric intervention, including indication and outcome. The concept was adapted to address differentials in access to emergency obstetric care between districts and between rural and urban areas. Based upon literature and expert consensus, a threshold of 2% of all deliveries was used to define the expected minimum requirement of major obstetric interventions performed for absolute maternal indications.</p> <p>Results</p> <p>Protocols covering 1,260 complicated deliveries were analysed. The percentage of major obstetric interventions carried out in response to an absolute maternal indication was only 71%; most major obstetric interventions (97%) were caesarean sections. The most frequent indication was cephalo-pelvic-disproportion (51%). The proportion of major obstetric interventions for absolute maternal indications performed amongst women living in urban areas was 1.8% of all deliveries, while in rural areas it was only 0.7%. The high proportion (8.3%) of negative maternal outcomes in terms of morbidity and mortality, as well as the high perinatal mortality of 9.1% (still birth 6.9%, dying within 24 hours 1.7%, dying after 24 hours 0.5%) raise concern about the quality of care being provided.</p> <p>Conclusion</p> <p>Based on the 2% threshold, Tanga Region – with an overall level of major obstetric interventions for absolute maternal indications of 1% and a caesarean section rate of 1.4% – has significant unmet obstetric need with a considerable rural-urban disparity. The UON concept was found to be a suitable tool for evaluating and monitoring the coverage of obstetric care at district level.</p

Using antenatal care as a platform for malaria surveillance data collection: study protocol

BACKGROUND: While many malaria-endemic countries have health management information systems that can measure and report malaria trends in a timely manner, these routine systems have limitations. Periodic community cross-sectional household surveys are used to estimate malaria prevalence and intervention coverage but lack geographic granularity and are resource intensive. Incorporating malaria testing for all women at their first antenatal care (ANC) visit (i.e., ANC1) could provide a more timely and granular source of data for monitoring trends in malaria burden and intervention coverage. This article describes a protocol designed to assess if ANC-based surveillance could be a pragmatic tool to monitor malaria. METHODS: This is an observational, cross-sectional study conducted in Benin, Burkina Faso, Mozambique, Nigeria, Tanzania, and Zambia. Pregnant women attending ANC1 in selected health facilities will be tested for malaria infection by rapid diagnostic test and administered a brief questionnaire to capture key indicators of malaria control intervention coverage and care-seeking behaviour. In each location, contemporaneous cross-sectional household surveys will be leveraged to assess correlations between estimates obtained using each method, and the use of ANC data as a tool to track trends in malaria burden and intervention coverage will be validated. RESULTS: This study will assess malaria prevalence at ANC1 aggregated at health facility and district levels, and by gravidity relative to current pregnancy (i.e., gravida 1, gravida 2, and gravida 3 +). ANC1 malaria prevalence will be presented as monthly trends. Additionally, correlation between ANC1 and household survey-derived estimates of malaria prevalence, bed net ownership and use, and care-seeking will be assessed. CONCLUSION: ANC1-based surveillance has the potential to provide a cost-effective, localized measure of malaria prevalence that is representative of the general population and useful for tracking monthly changes in parasite prevalence, as well as providing population-representative estimates of intervention coverage and care-seeking behavior. This study will evaluate the representativeness of these measures and collect information on operational feasibility, usefulness for programmatic decision-making, and potential for scale-up of malaria ANC1 surveillance