Inadequate Vaccine Responses in Children With Multiple Sclerosis

Objective: Immunizations against Hepatitis B virus (HBV) and Varicella Zoster virus (VZV), are recommended for patients with pediatric onset multiple sclerosis (POMS) and may be required prior to initiation of some disease modifying therapies. However, the efficacy of routine vaccine administration in POMS has never been studied. We sought to assess the humoral mediated vaccine response to HBV and VZV in children with POMS.Methods: A multi-center retrospective chart-based review of 62 patients with POMS was performed. Clinical data and antibody titers against HBV and VZV were collected prior to initiation of disease modifying therapy or steroids and compared to institutional control data, using t-test and chi squared analysis.Results: There were low rates of immunity against both HBV and VZV (33 and 25% respectively) among individuals with POMS. Fifteen individuals (24%) were non-immune to both. Compared to institutional control data, individuals with POMS were significantly less likely to be immune to and HBV (p = 0.003, 95% CI: 0.22–0.75) and VZV (p < 0.001, 95% CI: 0.09–0.39).Interpretation: Individuals with POMS have low rates of antibody-mediated immunity against HBV and VZV, despite receiving the appropriate vaccinations. This suggests an association between POMS and systemic immune dysregulation although further study is needed.

The Wheel Comes Full Circle? An Integrated View of Organizational Responses to Institutional Pressures

In the face of increasing pressure to comply with institutional norms, firm managers may retreat from previous commitments to comply once they realize the challenges involved. This study examines how firms respond to institutional pressures in a particular way called reversion, in which an organization's managers temporarily comply when there are no consequences but resist when it is in their interest to resist. By integrating institutional and agency theories, we model the reversion decision as a tension between institutional constituents and organizational managers. An empirical analysis of a sample of Japanese firms that scheduled annual shareholder meetings during the 2001 through 2014 period was performed. Our findings show that although organizations’ susceptibility to certain institutional pressures determines initial organizational compliance, managers whose interests diverge from those of the institutional constituents can revert their decisions, especially when they have discretion in decision making to protect their own interests. These findings highlight the temporary nature of organizational responses to institutional pressures and help us understand how organizational agency can limit institutional control over an organization's actions.

Institutional control of the financial and business operations of state institutions: practical data in the area of public healthcare and trends in its development

Subject. The organisational and methodological aspects of the institutional control of financial and business operations and other types of institutional control carried out by executive authorities in relation to their subordinate institutions. Purpose. The study aims to determine the position of the institutional control of financial and business operations within the system of financial control of the Russian Federation, to study the existing organisational models of certain types of institutional control using the example of the public healthcare system of the Voronezh Region, to identify issues of concern, and to offer possible solutions. Method. The study used data from the consolidated budget of the Russian Federation and the budgets of state extra-budgetary funds of the Russian Federation for 2020, the consolidated budget of state medical organisations of the Voronezh Region, and other financial indicators of the healthcare system in the Voronezh Region for the same period. The methods of the investigation included analysis, observation, generalisation, comparison, grouping, classification, etc. Results. The organisational structure of control (supervision) in the field of healthcare and the financial control of the public healthcare sector was developed and the powers and functions of the executive authorities were investigated. The analysis of the main types of control revealed a relationship between external and internal control as elements of a unified system. The paper provides examples of typical violations identified as a result of the institutional control of state medical organisations in the Voronezh Region. Conclusions. The hypothesis was confirmed that it is necessary to implement institutional control of the financial and business operations as part of the system of state (municipal) management by using financial control tools with due consideration for industry specifics.

Socio-Institutional Drivers of Groundwater Contamination Hazards: The Case of On-Site Sanitation in the Bwaise Informal Settlement, Kampala, Uganda

Socio-institutional factors are poorly addressed in the risk assessment of groundwater contamination. This paper contributes to the development of a socio-institutional assessment framework based on a case study of contamination by on-site sanitation (OSS) in an informal settlement of Bwaise (Kampala, Uganda). We conducted a snapshot survey of the recent extent of groundwater contamination by OSS using microbial and hydro-chemical indicators. Through transition arenas and key informant interviews, we investigated the socio-institutional drivers of the contamination. Overall, 14 out of the 17 sampled groundwater sources tested positive for Escherichia coli during the wet season. Nitrate concentrations at four sources exceeded the World Health Organization guideline value (50 mg/L), attributed to OSS. Despite the high contamination, the community highly valued groundwater as an alternative to the intermittent municipal water supply. We deduced six drivers of groundwater contamination, including land-use management, user attributes, governance, infrastructure management, groundwater valuation, and the operating environment (“LUGIVE”). Qualitative indicators for each of the drivers were also construed, and their interlinkages presented in a causal loop diagram, representing a socio-institutional assessment framework. The framework can help policymakers and the community to analyze various socio-institutional control levers to reduce the risk of groundwater contamination by OSS in informal settlements.

Percutaneous ultrasound gastrostomy (PUG): first prospective clinical trial

Graphical abstarct Purpose To report the results of the first-in-human trial evaluating the safety and efficacy of the percutaneous ultrasound gastrostomy (PUG) technique. Methods A prospective, industry-sponsored single-arm clinical trial of PUG insertion was performed in 25 adult patients under investigational device exemption (mean age 64 ± 15 years, 92% men, 80% inpatients, mean BMI 24.5 ± 2.7 kg/m2). A propensity score-matched retrospective cohort of 25 patients who received percutaneous radiologic gastrostomy (PRG) was generated as an institutional control (mean age 66 ± 14 years, 92% men, 80% inpatients, mean BMI 24.0 ± 2.7 kg/m2). Primary outcomes included successful insertion and 30-day procedure-related adverse events (AE’s). Secondary outcomes included procedural duration, sedation requirements, and hospital length of stay. Results All PUG procedures were successful, including 3/25 [12%] performed bedside within the ICU. There was no significant difference between PUG and PRG in rates of mild AE’s (3/25 [12%] for PUG and 7/25 [28%] for PRG, p = 0.16) or moderate AE’s (1/25 [4%] for PUG and 0/25 for PRG, p = 0.31). There were no severe AE’s or 30-day procedure-related mortality in either group. Procedural room time was longer for PUG (56.5 ± 14.1 min) than PRG (39.3 ± 15.0 min, p < 0.001). PUG procedure time was significantly shorter after a procedural enhancement, the incorporation of a Gauss meter to facilitate successful magnetic gastropexy. Length of stay for outpatients did not significantly differ (2.4 ± 0.5 days for PUG and 2.6 ± 1.0 days for PRG, p = 0.70). Conclusion PUG appears effective with a safety profile similar to PRG. Bedside point-of-care gastrostomy tube insertion using the PUG technique shows promise. Trial Registration Number: ClinicalTrials.gov ID NCT03575754. Graphical abstract

The Crisis of Social Institutions and Police Homicides: The Adverse Effects of Low Institutional Control

Using U.S. census data and a multi-source database on officer-involved killings, the current study extends previous research by exploring the influence of measures of weak social control in economic, educational, and familial institutions on state rates of police homicide. States with lower levels of institutional control are found to have higher overall rates of police homicides and police killings involving Black, Hispanic, and White decedents. The significant effects of institutional control on these police homicide rates are generally found to exhibit contextual invariance across different levels of various control variables (e.g., comparisons of states with low or high violent crime rates, low vs high economic inequality, low vs high levels of urbanization). These results and the limitations of this study are discussed in terms of implications for future research and public policy on police homicides and the role of social institutions in minimizing the occurrence of these incidents.

Public Policy Analysis on Watershed Governance in Indonesia

This paper, which is focused on evaluating the policies and institutional control of the Brantas River Basin, East Java, Indonesia, aims to review government regulations on watershed governance in Indonesia. A qualitative approach to content analysis is used to explain and layout government regulations regarding planning, implementation, coordination, monitoring, evaluation, and accountability of the central and local governments in managing the Brantas watershed, East Java, Indonesia. Nvivo 12 Plus software is used to map, analyze, and create data visualization to answer research questions. This study reveals that the management regulations of the Brantas watershed, East Java, Indonesia, are based on a centralized system, which places the central government as an actor who plays an essential role in the formulation, implementation, and accountability of the Brantas watershed management. In contrast, East Java Province’s regional government only plays a role in implementing and evaluating policies. The central government previously formulated the Brantas watershed. This research contributes to strengthening the management and institutional arrangement of the central government and local governments that support the realization of good governance of the Brantas watershed. Future research needs to apply a survey research approach that focuses on evaluating the capacity of the central government and local governments in supporting good management of the Brantas watershed.

Political Performances of Control During COVID-19: Controlling and Contesting Democracy in Germany

Drawing from interpretive, namely discursive-performative approaches to both institutional and grassroots (populist) politics, this article explores political performances and counter-performances of control in Germany during the so-called first wave of the COVID-19 pandemic. Methodologically, the article constructs a comparative analytical framework including three cases from both within and outside of the federal institutional structure of Germany: at the institutional level, the cases comprise Angela Merkel, long-term federal Chancellor of Germany, and Michael Kretschmer, the regional Governor of the state of Saxony; at the grassroots level, the selected case is the populist protest movement “Patriotic Europeans Against the Islamization of the Occident” (Patriotische Europäer gegen die Islamisierung des Abendlandes, PEGIDA). Based on original empirical data generated using the toolkit of qualitative-interpretive methodology, notably online ethnography, the comparative analysis focuses on a few key counter-performances of control, among them a TV address (Merkel), a visit to an “anti-lockdown” demonstration (Kretschmer), and virtual protest events (PEGIDA). Emphasizing the performed, dynamic, and contested character of political control in Germany in spring 2020, the empirical analysis yields the following results: first, it sheds light on the different political styles of performing and contesting institutional control, including the habitus, modes, and (emotional) tones of the communication of the performers, and the scripts, stages, intended audiences as (imagined) constituencies, and modalities of transmission of their performances. Second, the discourse-theoretical perspective of the analysis reveals that political performances of control were closely linked to articulations of democracy as an empty signifier, and to claims for safeguarding democratic principles as such. Third, the article demonstrates the value of interpretive approaches to politics to generate more nuanced understandings of the relationships between the pandemic, democracy, and populism in a situation of an ultimate lack of control.

Led by the Spirit and the Church: Finland's Licensed Lutheran Lay Preachers, c.1870–1923

This article examines the interplay between religious agency and institutional control. The Church Law of 1869 gave members of the Lutheran Church of Finland the right to apply to chapters for permission to preach. Men who passed the examinations became licensed lay preachers, who could take part in teaching Christianity and give sermons in church buildings. Applicants had varying backgrounds, skills and motivations. In order to avoid any disruption in church life, they had to be screened carefully and kept under clerical supervision. However, licensed lay preachers could also be of great help to the church. In a rapidly changing modern society with a growing population and a recurring lack of pastors, the church could not afford to disregard lay aid. The article shows how the Lutheran Church both encouraged and constrained the agency of the licensed lay preachers.