| 1. |
- Cinque, Serena, 1975, et al.
(författare)
-
Frontline bureaucrats in wildlife management: Caught in the dilemma between effectiveness and responsiveness
- 2022
-
Ingår i: Environmental Policy and Governance. - : Wiley. - 1756-932X .- 1756-9338. ; 32:1, s. 17-28
-
Tidskriftsartikel (refereegranskat)abstract
- Frontline bureaucrats are positioned at the interface between citizens and the state. They convert political resolution into action and in effect form the core of many public decisions through interaction and communication with both the recipients of those decisions and upper management levels that initiate them. However, dilemmas often arise when frontline bureaucrats attempt to translate political goals and strategies into local administrative praxis. The case of large carnivore management in Sweden will be used to demonstrate the insuperable difficulties that can arise when managers simultaneously need to balance the bureaucratic tasks of planning, executing, and evaluating performed decisions with attending to calls for increased responsiveness to public values in order to improve the delivery of service. This responsiveness is typically reflected through the new principles of public participation and collaboration, which are added to the bureaucracy to support the integration of broader sets of interests, experiences, and knowledge. In such an environment, the work of frontline managers becomes even more crucial in order to balance and align policy goals with the need to enhance public involvement. Our study reveals that in striving to meet the formal policy requirement to implement and lead collaboration (which in turn creates the central dilemma that concerns us here) managers develop strategies to secure effectiveness rather than responsiveness. Actually, they have few possibilities to do, otherwise when the latest policy edict clearly instructs the authorities to oversee the effective implementation and achievement of goals, leaving little opportunity to pursue genuine collaboration.
|
|
| 2. |
- Ulfhammer, Gustaf, et al.
(författare)
-
Cerebrospinal Fluid viral load across the spectrum of untreated HIV-1 infection: a cross-sectional multi-center study.
- 2022
-
Ingår i: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. - : Oxford University Press (OUP). - 1537-6591. ; 75:3, s. 493-502
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of this large multicenter study was to determine variations in cerebrospinal fluid (CSF) HIV-RNA in different phases of untreated HIV-1 infection and its associations with plasma HIV-RNA and other biomarkers.Treatment naïve adults with available CSF HIV-RNA quantification were included and divided into groups representing significant disease phases. Plasma HIV-RNA, CSF white blood cell count (CSF WBC), neopterin, and albumin ratio were included when available.1.018 patients were included. CSF HIV-RNA was in median (IQR) 1.03 log10 (0.37-1.86) copies/mL lower than in plasma, and correlated with plasma HIV-RNA (r=0.44, p< 0.01), neopterin concentration in CSF (r=0.49, p< 0.01) and in serum (r=0.29, p< 0.01), CSF WBC (r=0.34, p< 0.01) and albumin ratio (r=0.25, p< 0.01). CSF HIV-RNA paralleled plasma HIV-RNA in all groups except neuroasymptomatic patients with advanced immunodeficiency (CD4 < 200) and patients with HIV-associated dementia (HAD) or opportunistic CNS infections.Patients with HAD had the highest CSF HIV-RNA (in median [IQR] 4.73 (3.84-5.35) log10 copies/mL). CSF > plasma discordance was found in 126 of 972 individuals (13%) and varied between groups, from 1% in primary HIV, 11% in neuroasymptomatic groups, up to 30% of patients with HAD.Our study confirms previous smaller observations of variations in CSF HIV-RNA in different stages of HIV disease. Overall, CSF HIV-RNA was approximately 1 log10 copies/mL lower in CSF than in plasma, but CSF discordance was found in a substantial minority of subjects, most commonly in patients with HAD, indicating increasing CNS compartmentalization paralleling disease progression.
|
|
