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Given the dramatic growth in the financial burden of cancer care over the past decades, individuals with cancer are increasingly susceptible to developing social needs (e.g., housing instability and food insecurity) and experiencing an adverse impact of these needs on care management and health outcomes. However, resources required to connect individuals with needed social and community services typically exceed the available staffing within clinical teams. Using input from focus groups, key informant interviews, user experience/user interface testing, and a multidisciplinary community advisory board, we developed a new technology solution, ConnectedNest, which connects individuals in need to community based organizations (CBOs) that provide services through direct and/or oncology team referrals, with interfaces to support all three groups (patients, CBOs, and oncology care teams). After prototype development, we conducted usability testing, with participants noting the importance of the technology for filling a current gap in screening and connecting individuals with cancer with needed social and community services. We employ a patient-empowered approach that engages the support of an individual’s healthcare team and community organizations. Future work will examine the integration and implementation of ConnectedNest for oncology patients, oncology care teams, and cancer-focused CBOs to build capacity for effectively addressing distress in this population.
This paper outlines the development, deployment and use, and testing of a tool for measuring and improving healthcare researcher embeddedness – i.e., being connected to and engaged with key leverage points and stakeholders in a health system. Despite the widely acknowledged importance of embeddedness for learning health systems and late-stage translational research, we were not aware of useful tools for addressing and improving embeddedness in scholar training programs. We developed the MN-LHS Embeddedness Tool covering connections to committees, working groups, leadership, and other points of contact across four domains: patients and caregivers; local practice (e.g., operations and workflows); local institutional research (e.g., research committees and agenda- or initiative-setting groups); and national (strategic connections within professional groups, conferences, etc.). We used qualitative patterns and narrative findings from 11 learning health system training program scholars to explore variation in scholar trajectories and the embeddedness tool’s usefulness in scholar professional development. Tool characteristics showed moderate evidence of construct validity; secondarily, we found significant differences in embeddedness, as a score, from baseline through program completion. The tool has demonstrated simple, practical utility in making embeddedness an explicit (rather than hidden) part of applied and learning health system researcher training, alongside emerging evidence for validity.
One significant difficulty in reliable quantification of the rates of mass-loss from hot, massive stars lies in uncertainties associated with quantifying temporal and spatial variability within stellar winds. The consequences of low-metallicity conditions for wind structure also merit continued investigation. We present initial results from ULLYSES data with the aim of identifying structure within the stellar winds of early B type supergiants with sub-solar metallicities in the Large and Small Magellanic Clouds. We demonstrate how single-epoch ULLYSES data can be used to investigate significant wind structure for these stars.
The investigation of Islamic archaeology in Ethiopia has until recently been neglected. Excavations at Harlaa, a large urban centre in eastern Ethiopia, are now beginning to redress this lack of research attention. By establishing occupation and material sequences, and by assessing the chronology and material markers of Islamisation, recent work provides important new insight on the presence and role of Muslims and Islamic practice at Harlaa, and in the Horn of Africa more generally. The results challenge previous assumptions of cultural homogeneity, instead indicating the development of cosmopolitanism. They also suggest a possible historical identity for Harlaa: as Hubät/Hobat, the capital of the Hārlā sultanate.
In recent years, a variety of efforts have been made in political science to enable, encourage, or require scholars to be more open and explicit about the bases of their empirical claims and, in turn, make those claims more readily evaluable by others. While qualitative scholars have long taken an interest in making their research open, reflexive, and systematic, the recent push for overarching transparency norms and requirements has provoked serious concern within qualitative research communities and raised fundamental questions about the meaning, value, costs, and intellectual relevance of transparency for qualitative inquiry. In this Perspectives Reflection, we crystallize the central findings of a three-year deliberative process—the Qualitative Transparency Deliberations (QTD)—involving hundreds of political scientists in a broad discussion of these issues. Following an overview of the process and the key insights that emerged, we present summaries of the QTD Working Groups’ final reports. Drawing on a series of public, online conversations that unfolded at www.qualtd.net, the reports unpack transparency’s promise, practicalities, risks, and limitations in relation to different qualitative methodologies, forms of evidence, and research contexts. Taken as a whole, these reports—the full versions of which can be found in the Supplementary Materials—offer practical guidance to scholars designing and implementing qualitative research, and to editors, reviewers, and funders seeking to develop criteria of evaluation that are appropriate—as understood by relevant research communities—to the forms of inquiry being assessed. We dedicate this Reflection to the memory of our coauthor and QTD working group leader Kendra Koivu.1
Scholarly and popular histories of Kenya largely agree that African Second World War veterans played a central role in the Kenya Land Freedom Army. Former African members of the colonial security forces have reinforced these assumptions by claiming to have been covert Mau Mau supporters, either after their discharge, or as serving soldiers. In reality, few Mau Mau generals had actual combat experience. Those who served in the colonial military usually did so in labor units or support arms. It therefore warrants asking why so many Kenyans accept that combat veterans played such a central role in the KLFA and in Kenyan history. Understanding how veterans of the colonial army have become national heroes, both for their wartime service and their supposed leadership of Mau Mau, reveals the capacity of popular history to create more useful and inclusive forms of African nationalism.
We use contingent behavior analysis to study the effects of pfiesteria-related fish kills on the demand for seafood in the Mid-Atlantic region. We estimate a set of demand difference models based on individual responses to questions about seafood consumption in the presence of fish kills and with different amounts of information provided about health risks. We use a random-effects Tobit model to control for correlation across each observation and to account for censoring. We find that (i) pfiesteria-related fish kills have a significant negative effect on the demand for seafood even though the fish kills pose no known threat to consumers through seafood consumption, (ii) seafood consumers are not responsive to expert risk information designed to reassure them that seafood is safe in the presence of a fish kill, and (iii) a mandatory seafood inspection program largely eliminates the welfare loss incurred due to misinformation.
How did empires rule different peoples across vast expanses of space and time? And how did small numbers of imperial bureaucrats govern large numbers of subordinated peoples? Empires and Bureaucracy in World History seeks answers to these fundamental problems in imperial studies by exploring the power and limits of bureaucracy. The book is pioneering in bringing together historians of antiquity and the Middle Ages with scholars of post-medieval European empires, while a genuinely world-historical perspective is provided by chapters on China, the Incas and the Ottomans. The editors identify a paradox in how bureaucracy operated on the scale of empires and so help explain why some empires endured for centuries while, in the contemporary world, empires fail almost before they begin. By adopting a cross-chronological and world-historical approach, the book challenges the abiding association of bureaucratic rationality with 'modernity' and the so-called 'Rise of the West'.
Discernable across the flux of history is a persistent trend: the proclivity of human groups to establish large-scale and durable political formations that rule over subject populations of different ethnicities, religions and cultures – in short, to build empires. On this narrow point, scholars appear to have achieved consensus. But having gained power, usually through violent conquest, how did empires rule over different peoples across vast expanses of space and time? Or to recalibrate the question with the particular concerns of the present volume in mind: how did relatively small numbers of imperial bureaucrats govern large numbers of subordinated peoples? Dane Kennedy has aptly described this as ‘one of the most persistent conundrums to arise from the study of Western Imperialism’. Indeed, we can amplify his observation: this administrative sleight of hand is a conundrum of world history. It is also a matter with an urgent contemporary resonance. The past decade has witnessed a surge of work on the subject of empire inspired by what might be termed the ‘imperial turn’ in contemporary world affairs. Much of this literature swirls around a deceptively simple question: ‘what is an empire?’ Any satisfactory answer must take account of political structures and forms of governance – of how real empires actually ran. This book represents a collaborative effort to advance our understanding of these issues by exploring the power and limits of bureaucracy in historical empires across a broad canvas, from ancient Rome to the dismantling of European empires after World War II.
Such chronological and geographical scope, not to mention the range of disciplinary backgrounds and theoretical dispositions represented among our authors, is unusual in a book of this sort. It is quite deliberate. We explicitly reject the notion that an unbridgeable chasm separates historicist and generalist positions, ‘splitters’ and ‘lumpers’. Our methodological point of departure is that a diachronic approach to the history of empires is mutually enriching for all the sub-disciplines involved, and that it is possible to engage in long-range comparison while attending closely to geographical specificity, human agency and change over time.
On 30 June 1922, an explosion and fire destroyed the records treasury of the Public Record Office of Ireland (PROI), situated at the western end of the Four Courts complex that lies on the north quays of the River Liffey in Dublin. Established by an act of the Westminster parliament in 1867, the PROI was a state-of-the-art archival facility for the preservation of the public records and state papers of English government in Ireland. Its holdings stretched back some seven hundred years to the early decades of the thirteenth century, when Ireland first became a dominion of the English crown. Following the signing and ratification of the Anglo-Irish Treaty of 1921, control of the PROI was transferred to the provisional government of the southern twenty-six counties of Ireland on 1 April 1922. A fortnight later, on 14 April 1922, ‘irregular’ forces opposed to the treaty occupied the Four Courts, including the PROI buildings. After temporizing for more than two months, the Irish National Army began to bombard the Four Courts in the early morning of 28 June, employing eighteen-pounder guns borrowed from British forces. Ireland had slipped into a bitter civil war. The exact sequence of events that led to the catastrophic explosion remains contested. What is clear is that – despite the pleas of a few learned scholars with impeccable Irish nationalist credentials – neither pro- nor anti-treaty forces demonstrated much concern in practice for the safeguard of the accumulated records of English (later British) colonial rule in Ireland. The anti-treaty forces had heavily mined the records treasury. A double blast on 30 June 1922 caused a near-total archival cataclysm. The intense blaze that raged afterwards destroyed even those records stored in protective metal casings. As a report of the deputy keeper of the public records in Ireland later lamented: ‘The fire left little but tangled iron work, blocks of masonry, mason rubbish and the charred fragments and ashes of what had once been Public Records.’
Empires and Bureaucracy in World History finds its oblique beginnings in this post-colonial Irish bonfire.
Look, young man, if you're going to understand colonial administration, there are two words you will instantly excise from your vocabulary. The first word is ‘bureaucracy’ and the second word is ‘theory’. Without them you'll get on much better.
—J. J. Tawney (Director, Oxford Colonial Records Project) to Bruce Berman
J. J. Tawney's seemingly dismissive statement about administration in British Africa, which he made to a young academic in 1975, was actually quite telling. In offering this blunt advice, Tawney – a former member of the colonial civil service – acknowledged that imperial systems of rule were fundamentally different from the bureaucratic institutions of Western nation states, and he made it clear that the men who ran British Africa did not see themselves as bureaucrats. Max Weber's ideal-type bureaucracy was depersonalized, rational and ordered precisely by regulation. Social scientists often list this kind of efficient bureaucracy as a central characteristic of ‘modernity’, but the administrative systems that the architects of the ‘new’ empires of the 1880s used to govern their African territories met few of Weber's criteria. Until World War II, the primary inspiration for British systems of imperial rule in Africa were the chartered companies of the early modern era, not the Western nation state. Most significantly, the post-war Labour government's attempt to revitalize Britain's African empire by making it more rational and efficient actually accelerated its unexpectedly rapid demise a decade later.
Empire, by strict definition, was the formal, permanent and authoritarian rule of one group of people over another. In hindsight, the great empires of the past appeared omnipotent and stable because they were long lived, but they actually lacked the capacity to govern directly at the local level. This meant that conquerors needed allies from subject populations to assert authority and extract revenue. They had to share power to exert power. Contrary to Weber, bureaucratic inefficiency was thus a virtue in that it made imperial rule more stable by forcing foreign rulers to temper their demands for tribute and labour.
The system of indirect rule, which British administrators developed in India, was an inexpensive pragmatic innovation that allowed a small handful of field officers to govern colonial majorities by enlisting some of them in their own subjugation.