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Subjectivity and ideology in international intervention: the meaning-making of EU staff in the Sahel
No full textWhy do European intervention staff persistently invest in the promise of capacity building programmes despite witnessing their overwhelming failure to produce their desired effects around the world? Combining a Lacanian psychoanalytic theoretical framework with an ethnographic focus on everyday meaning-making practices, this thesis draws on 65 long-form interviews, participant observation in Mali and Brussels and extensive online archival material. This thesis critiques existing Foucauldian and institutionalist accounts to argue that the continuity of failed interventions is made possible on the ground level by staff who are actively invested in them but also confront the myriad contradictions of these policies in their daily work. This thesis uncovers the everyday affective and ideological investments staff make in intervening, through an examination of the EU’s decade-long engagement in Mali and Niger. First, I demonstrate that staff are attached to an identity as expert ‘Europeans supposed to know’ – based on a disavowed but enduring colonial hierarchy – while also grappling with the limits of European expertise in West Africa. Second, I analyse the collective lesson learning exercises that take place after each failed intervention and how the desired object of the successful intervention keeps staff invested but is always just out of reach. Third, I examine EU staff’s fantasised relationship with the African recipients of assistance, who play a dual role both as objects of blame for the poor results of the intervention and whose fantasised gaze and recognition European interveners desire and enjoy. EU staff disavow accusations of neocolonialism, blaming French involvement for spoiling their otherwise meaningful relations with recipients. These findings have important implications for understanding intervention continuity and repetition despite failure, but also contribute to theory on questions of identity, desire, epistemic authority and postcolonial anxiety in the everyday practice of European foreign policy, particularly in Africa
Comparing the cost of cirrhosis to other common chronic diseases: A longitudinal study in a large national insurance database
No full textData Availability - Comparing the cost of cirrhosis to other common chronic diseases: A longitudinal study in a large national insurance database
Data Availability
The claims data used for this publication is stored in a secure portal, the UnitedHealth Group (UHG) Enclave, and is accessible only by those with prior authorization to view the data (Table D1). This data is only available to those who have signed Data Use Agreements (DUA) and have undergone training on accessing the data. All statistical analyses were performed using Stata 14.1.
Table D1: Access to Enclave Person Title Organization Access to Enclave Federico Crippa Research Analyst Northwestern University Yes Aditya Jain Research Analyst Northwestern University Yes Filip Obradović Research Analyst Northwestern University Yes Eleena Koep Director of Research UnitedHealth Group Yes
Study Methods
A retrospective, longitudinal cohort study was conducted between January 1, 2011, and December 31, 2020, by using claims data from UHG, a large national insurer in the United States. The study follows the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guideline for cohort studies. The Northwestern University Institutional Review Board deemed this study exempt from review and waived the need for patient-informed consent. The database included deidentified medical and pharmacy claims data for enrollees. Available data included claims for all medical services and prescription medications that were submitted to the insurer for payment, patient diagnoses, and, when available, linked laboratory results. For this study, all enrollees were defined and reported as patients.
Patients enrolled in non-health maintenance organization (HMO), Medicare Advantage (MA) plans between January 1, 2011, and December 31, 2020, were included in the analysis. Because provider fees under HMO plans/capitated contracts are not available in large insurer data sets, this study focused on patients covered under non-HMO plans (ie, non-capitated claims). Previously validated and published codes were used. Patients diagnosed with cirrhosis were defined as those with at least 1 claim specifying a validated cirrhosis code from the International Classification of Diseases, 9th Revision (ICD-9) or 10th Revision (ICD-10) (571.2, 571.5, 571.6, K70.30, K70.31, K74.0, K74.60, K74.69, K74.3, K74.4, and K74.5), in any position on the claim (Supplemental Figure S1).
Cirrhosis etiologies were defined by at least 1 claim specifying an ICD-9 or -10 code for: alcohol-associated (ETOH), metabolic dysfunction–associated steatohepatitis (MASH, previously NASH), HBV, HCV, biliary cirrhosis (eg, primary sclerosing cholangitis and primary biliary cirrhosis), cardiac cirrhosis, genetic cirrhosis (eg, hereditary hemochromatosis), and autoimmune hepatitis. Patients were included in the HCV cohort even if they had multiple etiologies, any one of which was HCV.
Other etiologies were analyzed separately unless otherwise specified. Of note, MASH/NASH did not have a dedicated ICD code before October 1, 2015. For data before October 1, 2015, MASH/NASH was identified using a previously published algorithm (patients without specific cirrhosis etiology plus obesity, dyslipidemia, diabetes, and/or hypertension). Patients were categorized into 5 mutually exclusive groups by etiology: MASH, ETOH (which includes alcohol-associated liver disease and metabolic dysfunction–associated steatotic liver disease with increased alcohol intake), HCV, biliary (primary biliary cirrhosis and primary sclerosing cholangitis), and “Other” (eg, hemochromatosis). Validated ICD-9/-10 codes were used to define comorbidities and quantify the Charlson Comorbidity Index.
To provide a tangible comparison, costs associated with cirrhosis were compared with costs associated with HF and COPD. Patients with HF and COPD were identified by ICD-9/-10 codes as previously published. A sample of these patients was included in the cohort as detailed in Supplemental Figure S1, and the Supplemental Appendix.
Analyses were performed at the patient-month level. Costs are reported per patient-month unless otherwise specified. For patients with cirrhosis, the index date was the earliest listed date of service on a claim with a diagnosis of cirrhosis or cirrhosis decompensation. For patients with HF and COPD, the index date was the earliest listed date of service on a claim for the appropriate corresponding diagnosis. Diagnoses on claims were defined and identified by validated inclusion ICD codes. If the index code for a patient with cirrhosis indicated decompensation, the patient was considered to be decompensated at the time of inclusion. To most closely represent the epidemiological reality, cirrhosis, HF, and COPD were not considered mutually exclusive. All months of coverage for all included patients under non-HMO MA plans, including and following the index month until the end of observation, were analyzed. The end of observation was defined as disenrollment, transplant, or the end of the cohort study period (December 31, 2020). In the case of a patient receiving a transplant, the entire month of transplantation was censored.
Months of coverage were subcategorized into compensated and decompensated cirrhosis patient-months. The date of decompensation was defined as the date of service on the first claim under any plan that listed an ICD or CPT code for a decompensation event (ie, ascites, spontaneous bacterial peritonitis, HE, variceal bleeding, hepatorenal syndrome, or hepatopulmonary syndrome) (see the Supplemental Appendix). Patients were considered to have decompensated cirrhosis starting from and including the month of the decompensation date until the end of observation. The total number of patient-months with compensated cirrhosis was calculated from the index month until the decompensation month. Inpatient costs were calculated by identifying claims between admission and discharge. The same method of categorizing months of coverage was applied to decompensated HF and exacerbated COPD. Decompensated HF and exacerbated COPD were defined as inpatient admissions with the corresponding condition as the primary diagnosis.
Cost was defined as the total amount paid by the insurer and patient, taking the health care sector cost perspective. These data were analyzed and reported over time using mean costs in a specific calendar month during the study period. Data reported per patient-year were estimated by multiplying patient-month data by 12. Following common practice, denied service lines were excluded from cost calculation. Average costs were adjusted for inflation to 2021 US dollars using the Bureau of Labor Statistics consumer price index to adjust for inflation between 2011 and 2020. Mean costs were reported with corresponding standard deviations (±SD). Comparisons between relevant subgroups were performed using unequal variance, 2-sided Student t tests. Contained in the Supplemental Appendix is a discussion of the process of generating the patient data and the assumptions underlying the standard inference methods. To identify predictors of increased cost, a multivariable linear regression model of costs for patients with cirrhosis was performed. The outcome of interest was the cost per patient per month, which was modeled continuously. The reference group was non-female patients with ETOH. All statistical analyses were performed using Stata 14.1
Replication Data for: Subordinate monopolization and the origins of major power conflict
No full textData and do file for replication
The embodied state: emotions, state power and social marginalisation
No full textThis edited collection advances a reconceptualisation of state power through emotions. Methodologically, it rethinks the study of the state from the bottom up, by seeking contributions that engage with performances and enactments of state power at the ground level, by frontline staff in direct contact with marginalised populations, and those that reflect on encounters with symbols and practices of state power. Conceptually, it advances a new theory of state power which places values and affects at the heart of its analysis. In doing so, it seeks to make a crucial intellectual intervention in the study of the people, images and processes involved in the governance of social marginality in various institutional settings – criminal justice, immigration and asylum bureaucracies, the welfare system, the care sector, etc. – to explore how emotions are mobilised, how their expression in contemporary institutional settings of state power connects to broader moral and affective economies, the contradictions, and dilemmas they embody and reproduce, and the implications of these emotionalised forms of governance for state praxis and theory. The Embodied State will therefore appeal to students and scholars of critical criminology, political sociology, anthropology, migration and border studies, and penology. It will also be of interest to policymakers and professionals involved in these fields
The café economy: structural transformation in Greece in the wake of austerity and “reforms”
No full textThis paper investigates the structural transformation of the Greek economy over the past fifteen years, focusing on the increasing dominance of the Accommodation and Food Service Activities (AFSA) sector in the aftermath of austerity and structural reforms. Despite promises of productivity gains through labor market and product market reforms, the Greek economy has experienced a sharp decline in labor productivity and a significant reallocation of employment towards low-productivity sectors, especially AFSA, reminiscent of a Lewis-type dual sector economy. Using a simple Panel-VAR model we find that declining aggregate demand and real wages were key drivers of this productivity collapse. Our findings support theories of technological change that emphasize output growth and the cost of labor as fundamental determinants of productivity growth
A research-backed training method that improves hiring outcomes
No full textIn the current climate, generic and expensive programs to promote diversity, equity, and inclusion—for example, trainings—are increasingly falling out of favor. In fact, most of the existing research suggests that trainings have not been effective at changing people’s behaviors or measurable organizational outcomes, such as who gets hired. Yet, what hasn’t changed is companies’ need to tap into the broadest possible talent pool to hire the best person for the right role at the right time. The question on many leaders’ minds, then, is how they can continue to improve the quality and fairness of their hiring in an effective and palatable way
Enhancing transparency and accountability in climate finance mobilization from developed to developing countries
Get PDFThis chapter, developed as part of the Planetary Governance Program at The New Institute, chaired by the Climate Governance Commission, identifies and discusses key climate finance reform proposals to enhance transparency and ability within climate finance governance. It first highlights the need for high-quality climate finance to be transferred from developed to developing countries and the lack of transparency in identifying the majority of climate finance contributions from developed countries. This lack of transparency has exacerbated the gap between exiting climate finance needs and the actual level of finance that is provided by the developed world. As a first step toward addressing these issues, the chapter proposes key governance innovations that build off the Climate Governance Commission’s 2023landmark report, “Governing Our Planetary Emergency”. These proposals include the establishment of common definitions of “climate finance”, stricter accounting rules to tighten standards regarding what qualifies as “climate finance”, the establishment of new climate finance accounting and reporting systems, and the full operationalization of Article 2.1(c) of the Paris Agreement
Outcome-based reinforcement learning to predict the future
Get PDFReinforcement Learning with Verifiable Rewards (RLVR) has been an effective approach for improving Large Language Models’ reasoning in domains such as coding and mathematics. Here, we apply RLVR methods towards forecasting future real-world events – a challenging task for RL due to the very noisy (and delayed) outcomes involved. Using a novel dataset of recent questions from a prediction market, and accompanying relevant news headlines, we show that a compact (14B) reasoning model can be trained to match or surpass the predictive accuracy of frontier models like o1, while greatly improving probabilistic calibration. The model’s performance is also practically meaningful: in a Polymarket trading simulation, we estimate that its bets would have yielded a return on investment of over 10% across all questions in the test set. We detail and compare approaches used in training our model, including augmenting our training-data with synthetic prediction questions, guardrails for learning stability, and median prediction sampling at inference-time.1
robertospacey / A3F_SP500
No full textThis repository contains the data assembled and produced as part of the Spacey Martín et al. 2024 study.
The file "Manuscript_model_results_SP500.xlsx" is the output of the LLM using the Adaptation Alignment Assessment Framework on the sustainability reports of the S&P500 companies. The 'data_sources' tab in the file provides an overview of the companies assessed and the exact reports accessed.
The Releases section in this repository includes the raw data used for the data (i.e. the sustainability reports of the S&P500 companies). These have been packaged into batches for ease of file management