Negotiating regional futures:the successes and failures of the West Midlands Regional Development Agency Network

The introduction of Regional Development Agencies (RDAs) in the English regions in 1999 presented a new set of collaborative challenges to existing local institutions. The key objectives of the new policy impetus emphasise increased joined-up thinking and holistic regional governance. Partners were enjoined to promote cross-sector collaboration and present a coherent regional voice. This study aims to evaluate the impact of an RDA on the partnership infrastructure of the West Midlands. The RDA network incorporates a wide spectrum of interest and organisations with diverse collaborative histories, competencies and capacities. The study has followed partners through the process over an eighteen-month period and has sought to explore the complexities and tensions of partnership working 'on the ground'. A strong qualitative methodology has been employed in generating 'thick descriptions' of the policy domain. The research has probed beyond the 'rhetoric' of partnerships and explores the sensitivities of the collaboration process. A number of theoretical frameworks have been employed, including policy network theory; partnership and collaboration theory; organisational learning; and trust and social capital. The structural components of the West Midlands RDA network are explored, including the structural configuration of the network and stocks of human and social capital assets. These combine to form the asset base of the network. Three sets of network behaviours are then explored, namely, strategy, the management of perceptions, and learning. The thesis explores how the combination of assets and behaviours affect, and in turn are affected by, each other. The findings contribute to the growing body of knowledge and understanding surrounding policy networks and collaborative governance.

From ‘poor parenting’ to micro-management:coalition governance and the sponsorship of arm’s-length bodies in the United Kingdom, 2010–13

The delegation of public tasks to arm’s-length bodies remains a central feature of contemporary reform agendas within both developed and developing countries. The role and capacity of political and administrative principals (i.e. ministers and departments of state) to control the vast network of arm’s-length bodies for which they are formally responsible is therefore a critical issue within and beyond academe. In the run-up to the 2010 General Election in the United Kingdom, the ‘quango conundrum’ emerged as an important theme and all three major parties committed themselves to shift the balance of power back towards ministers and sponsor departments. This article presents the results of the first major research project to track and examine the subsequent reform process. It reveals a stark shift in internal control relationships from the pre-election ‘poor parenting’ model to a far tighter internal situation that is now the focus of complaints by arm’s-length bodies of micro-management. This shift in the balance of power and how it was achieved offers new insights into the interplay between different forms of governance and has significant theoretical and comparative relevance. Points for practitioners: For professionals working in the field of arm’s-length governance, the article offers three key insights. First, that a well-resourced core executive is critical to directing reform given the challenges of implementing reform in a context of austerity. Second, that those implementing reform will also need to take into account the diverse consequences of centrally imposed reform likely to result in different departments with different approaches to arm’s-length governance. Third, that reforming arm’s-length governance can affect the quality of relationships, and those working in the field will need to mitigate these less tangible challenges to ensure success.

Measuring the Diversity and the Integration of Film Production in Mercosur: A Social Network Analysis

Based on an original and comprehensive database of all feature fiction films produced in Mercosur between 2004 and 2012, the paper analyses whether the Mercosur film industry has evolved towards an integrated and culturally more diverse market. It provides a summary of policy opportunities in terms of integration and diversity, emphasizing the limiter role played by regional policies. It then shows that although the Mercosur film industry remains rather disintegrated, it tends to become more integrated and culturally more diverse. From a methodological point of view, the combination of Social Network Analysis and the Stirling Model opens up interesting research tracks to analyse creative industries in terms of their market integration and their cultural diversity.

Letting the managers manage: analyzing capacity to conserve biodiversity in a cross-border protected area network

Biodiversity loss is one of the most significant drivers of ecosystem change and is projected to continue at a rapid rate. While protected areas, such as national parks, are seen as important refuges for biodiversity, their effectiveness in stemming biodiversity decline has been questioned. Public agencies have a critical role in the governance of many such areas, but there are tensions between the need for these agencies to be more “adaptive” and their current operating environment. Our aim is to analyze how institutions enable or constrain capacity to conserve biodiversity in a globally significant cross-border network of protected areas, the Australian Alps. Using a novel conceptual framework for diagnosing biodiversity institutions, our research examined institutional adaptive capacity and more general capacity for conserving biodiversity. Several intertwined issues limit public agencies’ capacity to fulfill their conservation responsibilities. Narrowly defined accountability measures constrain adaptive capacity and divert attention away from addressing key biodiversity outcomes. Implications for learning were also evident, with protected area agencies demonstrating successful learning for on-ground issues but less success in applying this learning to deeper policy change. Poor capacity to buffer political and community influences in managing significant cross-border drivers of biodiversity decline signals poor fit with the institutional context and has implications for functional fit. While cooperative federalism provides potential benefits for buffering through diversity, it also means protected area agencies have restricted authority to address cross-border threats. Restrictions on staff authority and discretion, as public servants, have further implications for deploying capacity. This analysis, particularly the possibility of fostering “ambidexterity”—creatively responding to political pressures in a way that also achieves a desirable outcome for biodiversity conservation—is one promising way of building capacity to buffer both political influences and ecological pressures. The findings and the supporting analysis provide insight into how institutional capacity to conserve biodiversity can be enhanced in protected areas in Australia and elsewhere, especially those governed by public agencies and/or multiple organizations and across jurisdictions.

A life cycle framework for governance of Intermodal terminals; planning, operations and strategic management.

This chapter establishes a framework for the governance of intermodal terminals throughout their life cycle, based on the product life cycle. The framework covers the initial planning by the public sector, the public/private split in funding and ownership, the selection of an operator, ensuring fair access to all users, and finally reconcessioning the terminal to a new operator, managing the handover and maintaining the terminal throughout its life cycle. This last point is especially important as industry conditions change and the terminal's role in the transport network comes under threat, either by a lack of demand or by increased demand requiring expansion, redesign and reinvestment. Each stage of the life cycle framework is operationalised based on empirical examples drawn from research by the authors on intermodal terminal planning and funding, the tender process and concession and operation contracts. In future the framework can be applied in additional international contexts to form a basis for transport cost analysis, logistics planning and government policy.

Rising China and Internet governance: Multistakeholderism, fragmentation and the Liberal Order in the age of digital sovereignty

In its open and private-based dimension, the Internet is the epitome of the Liberal International Order in its global spatial dimension. Therefore, normative questions arise from the emergence of powerful non-liberal actors such as China in Internet governance. In particular, China has supported a UN-based multilateral Internet governance model based on state sovereignty aimed at replacing the existing ICANN-based multistakeholder model. While persistent, this debate has become less dualistic through time. However, fear of Internet fragmentation has increased as the US-China technological competition grew harsher. This thesis inquires “(To what extent) are Chinese stakeholders reshaping the rules of Global Internet Governance?”. This is further unpacked in three smaller questions: (i) (To what extent) are Chinese stakeholders contributing to increased state influence in multistakeholder fora?; (ii) (how) is China contributing to Internet fragmentation?; and (iii) what are the main drivers of Chinese stakeholders’ stances? To answer these questions, Chinese stakeholders’ actions are observed in the making and management of critical Internet resources at the IETF and ICANN respectively, and in mobile connectivity standard-making at 3GPP. Through the lens of norm entrepreneurship in regime complexes, this thesis interprets changes and persistence in the Internet governance normative order and Chinese attitudes towards it. Three research methods are employed: network analysis, semi-structured expert interviews, and thematic document analysis. While China has enhanced state intervention in several technological fields, fostering debates on digital sovereignty, this research finds that the Chinese government does not exert full control on its domestic private actors and concludes that Chinese stakeholders have increasingly adapted to multistakeholder Internet governance as they grew influential within it. To enhance control over Internet-based activities, the Chinese government resorted to regulatory and technical control domestically rather than establishing a splinternet. This is due to Chinese stakeholders’ interest in retaining the network benefits of global interconnectivity.

Structural Connectivity Of The Default Mode Network And Cognition In Alzheimer׳s Disease.

Disconnectivity between the Default Mode Network (DMN) nodes can cause clinical symptoms and cognitive deficits in Alzheimer׳s disease (AD). We aimed to examine the structural connectivity between DMN nodes, to verify the extent in which white matter disconnection affects cognitive performance. MRI data of 76 subjects (25 mild AD, 21 amnestic Mild Cognitive Impairment subjects and 30 controls) were acquired on a 3.0T scanner. ExploreDTI software (fractional Anisotropy threshold=0.25 and the angular threshold=60°) calculated axial, radial, and mean diffusivities, fractional anisotropy and streamline count. AD patients showed lower fractional anisotropy (P=0.01) and streamline count (P=0.029), and higher radial diffusivity (P=0.014) than controls in the cingulum. After correction for white matter atrophy, only fractional anisotropy and radial diffusivity remained significantly lower in AD compared to controls (P=0.003 and P=0.05). In the parahippocampal bundle, AD patients had lower mean and radial diffusivities (P=0.048 and P=0.013) compared to controls, from which only radial diffusivity survived for white matter adjustment (P=0.05). Regression models revealed that cognitive performance is also accounted for by white matter microstructural values. Structural connectivity within the DMN is important to the execution of high-complexity tasks, probably due to its relevant role in the integration of the network.

Can We Predict The Clinical Outcomes Of Genitourinary Trauma Patients And Offer Them An Evidence-based Support? The Case For Telemedicine Network.

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[gait Speed, Grip Strength And Self-rated Health Among The Elderly: Data From The Fibra Campinas Network, São Paulo, Brazil].

The article seeks to investigate patterns of performance and relationships between grip strength, gait speed and self-rated health, and investigate the relationships between them, considering the variables of gender, age and family income. This was conducted in a probabilistic sample of community-dwelling elderly aged 65 and over, members of a population study on frailty. A total of 689 elderly people without cognitive deficit suggestive of dementia underwent tests of gait speed and grip strength. Comparisons between groups were based on low, medium and high speed and strength. Self-related health was assessed using a 5-point scale. The males and the younger elderly individuals scored significantly higher on grip strength and gait speed than the female and oldest did; the richest scored higher than the poorest on grip strength and gait speed; females and men aged over 80 had weaker grip strength and lower gait speed; slow gait speed and low income arose as risk factors for a worse health evaluation. Lower muscular strength affects the self-rated assessment of health because it results in a reduction in functional capacity, especially in the presence of poverty and a lack of compensatory factors.

Going Beyond Seizure Control: Can Pharmacotherapy Help To Restore Cognitive Network Function?

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Whole Cortical And Default Mode Network Mean Functional Connectivity As Potential Biomarkers For Mild Alzheimer's Disease.

The search for an Alzheimer's disease (AD) biomarker is one of the most relevant contemporary research topics due to the high prevalence and social costs of the disease. Functional connectivity (FC) of the default mode network (DMN) is a plausible candidate for such a biomarker. We evaluated 22 patients with mild AD and 26 age- and gender-matched healthy controls. All subjects underwent resting functional magnetic resonance imaging (fMRI) in a 3.0 T scanner. To identify the DMN, seed-based FC of the posterior cingulate was calculated. We also measured the sensitivity/specificity of the method, and verified a correlation with cognitive performance. We found a significant difference between patients with mild AD and controls in average z-scores: DMN, whole cortical positive (WCP) and absolute values. DMN individual values showed a sensitivity of 77.3% and specificity of 70%. DMN and WCP values were correlated to global cognition and episodic memory performance. We showed that individual measures of DMN connectivity could be considered a promising method to differentiate AD, even at an early phase, from normal aging. Further studies with larger numbers of participants, as well as validation of normal values, are needed for more definitive conclusions.

[strategies For Integration Of Health Care Practices And Sanitary Surveillance In The Context Of The Implementation Of Rede Cegonha - A Brazilian Mother And Infant Health Care Network].

Mother and infant mortality has been the scope of analysis throughout the history of public health in Brazil and various strategies to tackle the issue have been proposed to date. The Ministry of Health has been working on this and the Rede Cegonha strategy is the most recent policy in this context. Given the principle of comprehensive health care and the structure of the Unified Health System in care networks, it is necessary to ensure the integration of health care practices, among which are the sanitary surveillance actions (SSA). Considering that the integration of health care practices and SSA can contribute to reduce mother and infant mortality rates, this article is a result of qualitative research that analyzed the integration of these actions in four cities in the State of São Paulo/Brazil: Campinas, Indaiatuba, Jaguariúna and Santa Bárbara D'Oeste. The research was conducted through interviews with SSA and maternal health managers, and the data were evaluated using thematic analysis. The results converge with other studies, identifying the isolation of health care practices and SSA. The insertion of SSA in collectively-managed areas appears to be a potential strategy for health planning and implementation of actions in the context under scrutiny.

[child Protection Network And The Intersector Implementation Of The Circle Of Security As Alternatives To Medication].

To describe the clinical history of a child with aggressive behavior and recurring death-theme speech, and report the experience of the team of authors, who proposed an alternative to medication through the establishment of a protection network and the inter-sector implementation of the circle of security concept. A 5-year-old child has a violent and aggressive behavior at the day-care. The child was diagnosed by the healthcare center with depressive disorder and behavioral disorder, and was medicated with sertraline and risperidone. Side effects were observed, and the medications were discontinued. Despite several actions, such as talks, teamwork, psychological and psychiatric follow-up, the child's behavior remained unchanged. A unique therapeutic project was developed by Universidade Estadual de Campinas' Medical School students in order to establish a connection between the entities responsible for the child's care (daycare center, healthcare center, and family). Thus, the team was able to develop a basic care protection network. The implementation of the inter-sector circle of security, as well as the communication and cooperation among the teams, produced very favorable results in this case. This initiative was shown to be a feasible and effective alternative to the use of medication for this child.

[access To Information About How To Prevent Oral Problems Among School Children In The Public School Network].

The scope of this study is to identify the prevalence of access to information about how to prevent oral problems among schoolchildren in the public school network, as well as the factors associated with such access. This is a cross-sectional and analytical study conducted among 12-year-old schoolchildren in a Brazilian municipality with a large population. The examinations were performed by 24 trained dentists and calibrated with the aid of 24 recorders. Data collection occurred in 36 public schools selected from the 89 public schools of the city. Descriptive, univariate and multiple analyses were conducted. Of the 2510 schoolchildren included in the study, 2211 reported having received information about how to prevent oral problems. Access to such information was greater among those who used private dental services; and lower among those who used the service for treatment, who evaluated the service as regular or bad/awful. The latter use toothbrush only or toothbrush and tongue scrubbing as a means of oral hygiene and who reported not being satisfied with the appearance of their teeth. The conclusion drawn is that the majority of schoolchildren had access to information about how to prevent oral problems, though access was associated with the characteristics of health services, health behavior and outcomes.

The Psychedelic State Induced By Ayahuasca Modulates The Activity And Connectivity Of The Default Mode Network.

The experiences induced by psychedelics share a wide variety of subjective features, related to the complex changes in perception and cognition induced by this class of drugs. A remarkable increase in introspection is at the core of these altered states of consciousness. Self-oriented mental activity has been consistently linked to the Default Mode Network (DMN), a set of brain regions more active during rest than during the execution of a goal-directed task. Here we used fMRI technique to inspect the DMN during the psychedelic state induced by Ayahuasca in ten experienced subjects. Ayahuasca is a potion traditionally used by Amazonian Amerindians composed by a mixture of compounds that increase monoaminergic transmission. In particular, we examined whether Ayahuasca changes the activity and connectivity of the DMN and the connection between the DMN and the task-positive network (TPN). Ayahuasca caused a significant decrease in activity through most parts of the DMN, including its most consistent hubs: the Posterior Cingulate Cortex (PCC)/Precuneus and the medial Prefrontal Cortex (mPFC). Functional connectivity within the PCC/Precuneus decreased after Ayahuasca intake. No significant change was observed in the DMN-TPN orthogonality. Altogether, our results support the notion that the altered state of consciousness induced by Ayahuasca, like those induced by psilocybin (another serotonergic psychedelic), meditation and sleep, is linked to the modulation of the activity and the connectivity of the DMN.