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Research-based Theater (RbT) is shaped by both the form of theater, as an embodied, gestural, spatial, imaginative multi-dimensional art form, and traditions of research surrounding knowledge production, specifically qualitative research. When ethical tensions and questions arise in RbT they are often framed as a dichotomy, such as the ways aesthetic or artistic interests of creating a compelling piece of theater for audiences contrast with responsibilities to research. By drawing on the frame of an aesthetic of relationality, and an example from my work as an RbT playwright from the project Cracked: new light on dementia, I consider the ways both theater and research might be more clearly aligned. This includes how relational and aesthetic accountabilities can offer an important foundation for considering how RbT might be rooted in caring practices and might influence theater-making and the traditions of scientific research more broadly.

Background and Objectives Relational caring has the capacity to reduce stigma associated with dementia by shifting the focus from dysfunction and behavior management, to attending to the interdependencies and reciprocities that underpin caring relationships, and making explicit the centrality of relationships to quality care, growth, and quality of life. Education, particularly arts-based approaches, has been identified as a key strategy to decrease stigma. Yet rarely are the arts utilized in educational initiatives, and particularly so in community care settings. With an interest in redressing this, our team evaluated the impact of a Canadian filmed research-based drama—Cracked: new light on dementia—about stigma associated with people living with dementia and their families. Research Design and Methods We conducted interviews with family carers of people living with dementia and formal care providers affiliated with community-based dementia care, and also the general public at 3 and 8 months postscreening. Results Our analysis of participants’ perceptions/experiences illustrates the effectiveness of Cracked in reducing stigma by demonstrating changes in the understanding of dementia and changes in practice. Our analysis also includes attention to how the film, as a form of cultural production, deepened engagement and facilitated transformation. Discussion and Implications Our evaluation of Cracked demonstrates that it is an effective strategy for decreasing the stigma associated with dementia by promoting relational caring. It also importantly contributes to the theoretical literature that supports film-based approaches to stigma reduction.

Charcot Marie Tooth disease (CMT) is the most common inherited neuropathy and is also called Hereditary Motor Sensory Neuropathy (HMSN). Whilst both motor and sensory deficits are present, motor deficits tend to predominate over sensory deficits. Charcot neuroarthropathic joints occur in conditions, most commonly diabetes nowadays, where joints are destroyed in association with reduced protective sensation, pain in particular. Three cases of development of Charcot joint disorders in patients with CMT are discussed and the literature is reviewed. Orthopaedic surgeons should be aware that Charcot joints can occur in CMT and surgery can be complicated by Charcot joints.

Background Major prevention trials for Alzheimer’s disease (AD) are now focusing on multidomain lifestyle interventions. However, the exact combination of behavioral factors related to AD pathology remains unclear. In 2 cohorts of cognitively unimpaired individuals at risk of AD, we examined which combinations of personality traits, neuropsychiatric symptoms, and cognitive lifestyle (years of education or lifetime cognitive activity) related to the pathological hallmarks of AD, amyloid-β, and tau deposits. Methods A total of 115 older adults with a parental or multiple-sibling family history of sporadic AD (PREVENT-AD [PRe-symptomatic EValuation of Experimental or Novel Treatments for AD] cohort) underwent amyloid and tau positron emission tomography and answered several questionnaires related to behavioral attributes. Separately, we studied 117 mutation carriers from the DIAN (Dominant Inherited Alzheimer Network) study group cohort with amyloid positron emission tomography and behavioral data. Using partial least squares analysis, we identified latent variables relating amyloid or tau pathology with combinations of personality traits, neuropsychiatric symptoms, and cognitive lifestyle. Results In PREVENT-AD, lower neuroticism, neuropsychiatric burden, and higher education were associated with less amyloid deposition (p = .014). Lower neuroticism and neuropsychiatric features, along with higher measures of openness and extraversion, were related to less tau deposition (p = .006). In DIAN, lower neuropsychiatric burden and higher education were also associated with less amyloid (p = .005). The combination of these factors accounted for up to 14% of AD pathology. Conclusions In the preclinical phase of both sporadic and autosomal dominant AD, multiple behavioral features were associated with AD pathology. These results may suggest potential pathways by which multidomain interventions might help delay AD onset or progression.

When political principals send agents to international organizations, those agents are often assumed to speak in a single voice. Yet, various types of country representatives appear on the international stage, including permanent representatives as well as more overtly “political” government officials. We argue that permanent delegates at the United Nations face career incentives that align them with the bureaucracy, setting them apart from political delegates. To that end, they tend to speak more homogeneously than do other types of speakers, while also using relatively more technical, diplomatic rhetoric. In addition, career incentives will make them more reluctant to criticize the United Nations. In other words, permanent representatives speak more like bureaucratic agents than like political principals. We apply text analytics to study differences across agents’ rhetoric at the United Nations General Assembly. We demonstrate marked distinctions between the speech of different types of agents, contradictory to conventional assumptions, with implications for our understandings of the interplay between public administration and agency at international organizations.Points for practitionersDelegations to international organizations do not “speak with one voice.” This article illustrates that permanent representatives to the United Nations display more characteristics of bureaucratic culture than do other delegates from the same country. For practitioners, it is important to realize that the manner in which certain classes of international actors “conduct business” can differ markedly. These differences in tone—even among delegates from the same principal—can impact the process of negotiation and debate.

Fusion of biologic therapeutics to hyaluronic acid binding proteins, such as the link domain (LD) of Tumor necrosis factor (TNF)-Stimulated Gene-6 (TSG-6), is expected to increase vitreous residence time following intravitreal injection and provide for long-acting delivery. The toxicity of a single intravitreal dose of free TSG-6-LD and fusion proteins of TSG-6-LD and a nonbinding rabbit antibody fragment (RabFab) were assessed in New Zealand White rabbits. Animals administered free TSG-6-LD exhibited extensive lens opacities and variable retinal vascular attenuation, correlated with microscopic findings of lens and retinal degeneration. Similar but less severe findings were present in animals dosed with the RabFab-TSG-6-LD fusion proteins. In-life ocular inflammation was noted in all animals from 7-days postdose and was associated with high anti-RabFab antibody titers in animals administered fusion proteins. Inflammation and retinal degeneration were multifocally associated with evidence of retinal detachment, and hypertrophy and migration of vimentin, glial fibrillary acidic protein, and glutamine synthetase positive Müller cells to the outer nuclear layer. Further assessment of alternative hyaluronic acid binding protein fusions should consider the potential for retinal degeneration and enhanced immune responses early in development.

Important insights into the early pathogenesis of Alzheimer's disease can be provided by studies of autosomal dominant Alzheimer's disease and Down syndrome. However, it is unclear whether the timing and spatial distribution of amyloid accumulation differs between people with autosomal dominant Alzheimer's disease and those with Down syndrome. We aimed to directly compare amyloid changes between these two groups of people.In this cross-sectional study, we included participants (aged ≥25 years) with Down syndrome and sibling controls who had MRI and amyloid PET scans in the first data release (January, 2020) of the Alzheimer's Biomarker Consortium-Down Syndrome (ABC-DS) study. We also included carriers of autosomal dominant Alzheimer's disease genetic mutations and non-carrier familial controls who were within a similar age range to ABC-DS participants (25-73 years) and had MRI and amyloid PET scans at the time of a data freeze (December, 2020) of the Dominantly Inherited Alzheimer Network (DIAN) study. Controls from the two studies were combined into a single group. All DIAN study participants had genetic testing to determine PSEN1, PSEN2, or APP mutation status. APOE genotype was determined from blood samples. CSF samples were collected in a subset of ABC-DS and DIAN participants and the ratio of amyloid β42 (Aβ42) to Aβ40 (Aβ42/40) was measured to evaluate its Spearman's correlation with amyloid PET. Global PET amyloid burden was compared with regards to cognitive status, APOE ɛ4 status, sex, age, and estimated years to symptom onset. We further analysed amyloid PET deposition by autosomal dominant mutation type. We also assessed regional patterns of amyloid accumulation by estimated number of years to symptom onset. Within a subset of participants the relationship between amyloid PET and CSF Aβ42/40 was evaluated.192 individuals with Down syndrome and 33 sibling controls from the ABC-DS study and 265 carriers of autosomal dominant Alzheimer's disease mutations and 169 non-carrier familial controls from the DIAN study were included in our analyses. PET amyloid centiloid and CSF Aβ42/40 were negatively correlated in carriers of autosomal dominant Alzheimer's disease mutations (n=216; r=-0·565; p0·0001) and in people with Down syndrome (n=32; r=-0·801; p0·0001). There was no difference in global PET amyloid burden between asymptomatic people with Down syndrome (mean 18·80 centiloids [SD 28·33]) versus asymptomatic mutation carriers (24·61 centiloids [30·27]; p=0·11) and between symptomatic people with Down syndrome (77·25 centiloids [41·76]) versus symptomatic mutation carriers (69·15 centiloids [51·10]; p=0·34). APOE ɛ4 status and sex had no effect on global amyloid PET deposition. Amyloid deposition was elevated significantly earlier in mutation carriers than in participants with Down syndrome (estimated years to symptom onset -23·0 vs -17·5; p=0·0002). PSEN1 mutations primarily drove this difference. Early amyloid accumulation occurred in striatal and cortical regions for both mutation carriers (n=265) and people with Down syndrome (n=128). Although mutation carriers had widespread amyloid accumulation in all cortical regions, the medial occipital regions were spared in people with Down syndrome.Despite minor differences, amyloid PET changes were similar between people with autosomal dominant Alzheimer's disease versus Down syndrome and strongly supported early amyloid dysregulation in individuals with Down syndrome. Individuals with Down syndrome aged at least 35 years might benefit from early intervention and warrant future inclusion in clinical trials, particularly given the relatively high incidence of Down syndrome.The National Institute on Aging, Riney and Brennan Funds, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the German Center for Neurodegenerative Diseases, and the Japan Agency for Medical Research and Development.

Economists have long argued that central banks ran by technocrats have greater independence from the government. But in many countries, politically experienced central bankers are at the helm, including even highly independent central banks. To explain the level of central bank independence awarded, we develop a formal model where nominating politicians screen central bankers for their political ambitions. We show how screening and reelection efforts by the nominating politician changes the level of autonomy associated with different types of candidates. We predict that technocrats are associated with higher levels of independence than nominees with political experience, but as the appointing politician faces tougher reelection, candidates with political experience are associated with higher independence as well. We test our theory using new data from 29 post-communist countries between 1990 and 2012. We find evidence that the reelection strategy of the nominating politician is an important predictor of the level of central bank independence.

Background: This article describes two dehumanising patterns associated with modern culture and their consequences of stigma and suffering for persons living with dementia: the increasing division, judgment and exclusion of persons based on difference, disability, and undesirability; and the increasing attention to management and control, and their links with ageism, healthism and consumerism. These patterns have been established in media, policies, discourses and care practices, and have profound and harmful consequences for persons living with dementia. Aim: Inspired by philosophers Foster and Foucault, we examine societal patterns that intensify stigma and suffering for persons living with dementia through a critical lens. We then turn to a relational model of citizenship in order to advance an alternative care ethic. Subsequently, we provide examples for relational practices and legacies that model a relational care ethic and thereby disrupt the harmful patterns of modern culture. Conclusion: This article argues that relational practices that foster relational citizenship and relational caring create a more humane world for persons living with memory loss. Implications for practice development: Longstanding concerns about stigmatising attitudes and inhumane care practices have prompted urgent calls for culture change in dementia and long-term care. Most recently, researchers and professionals have emphasised the relational nature of caring and advocate for the adoption of relational caring practices. This article critiques the harmful patterns of modern culture that threaten the quality of care and quality of life, and offers relational practice possibilities for enhancing care and life quality, and honouring the full citizenship of persons living with dementia.

How do countries settle disputes in the shadow of the law? Even in the presence of legalized dispute settlement, countries still rely on diplomatic channels to resolve conflicts. But it can be difficult to assess diplomacy’s impact on dispute resolution because those channels tend to be opaque. We present both an original theory of the impact of diplomacy on dispute resolution and a novel measure of diplomacy. If countries with close or, conversely, distant relationships use legal channels for dispute resolution, diplomacy will have little impact on dispute settlement; resorting to legal recourse among friends or adversaries likely means that the dispute is intractable. However, diplomacy can increase the chances of settlement between countries with moderate levels of affinity. We test this argument using a protocol-based proxy for diplomatic interactions—gifts given at the occasion of meetings between diplomatic counterparts—that would otherwise be difficult to observe. Using the case of the United States and its disputes in the World Trade Organization, we find support for our argument. This suggests that even when countries resort to legalized methods of dispute settlement, bilateral dealmaking still plays an important role.

The life spans of international organizations (IOs) can take unexpected turns. But when we reduce IO life spans simply to their existence or lack thereof, or to formal change involving the addition of new members or the revision of charters, we miss the subtler dynamics within IOs. A broader continuum of IO life spans acknowledges life, death, inertia, and change as responses to crises, and affords a more nuanced perspective on international cooperation. Through this lens, the setbacks that many IOs are currently experiencing look less extraordinary.

Despite the recognized benefits of sexual expression and its importance in the lives of people living with dementia, research demonstrates that there are multiple barriers to its positive expression (e.g., expression that is pleasurable and free of coercion, discrimination, and violence) in RLTC homes. These barriers constitute a form of discrimination based on age and ability, and violate the rights of persons living with dementia to dignity, autonomy, and participation in everyday life and society. Drawing on a human rights approach to dementia and sexual expression, we explored the experiences of diverse professionals, family members, and persons living with dementia with explicit attention to the ways in which macro-level dynamics are influencing the support, or lack thereof, for sexual expression at the micro level. Focus groups and in-depth interviews were conducted with 27 participants, and the collected data were analyzed thematically. While all participants acknowledged that intimacy and sexual expression of persons living with dementia should be supported, rarely is such expression supported in practice. Micro-level factors included negative attitudes of professionals toward sexual expression by persons living with dementia, their discomfort with facilitating intimacy and sexual expression in the context of their professional roles, their anxieties regarding potential negative reactions from family members, and concerns about sanctions for failing to prevent abuse. In our analysis, we importantly trace these micro-level factors to macro-level factors. The latter include the cultural stigma associated with dementia, ageism, ableism, and erotophobia, all of which are reproduced in, and reinforced by, professionals’ education, as well as legal and professional standards that exclusively focus on managing and safeguarding residents from abuse. Our analysis demonstrates a complexity that has enormous potential to inform future research that is critically needed for the development of educational initiatives and to promote policy changes in this area.

Aims To assess the characteristic clinical features, management, and outcome of patients who present to orthopaedic surgeons with functional dystonia affecting the foot and ankle. Methods We carried out a retrospective search of our records from 2000 to 2019 of patients seen in our adult tertiary referral foot and ankle unit with a diagnosis of functional dystonia. Results A total of 29 patients were seen. A majority were female (n = 25) and the mean age of onset of symptoms was 35.3 years (13 to 71). The mean delay between onset and diagnosis was 7.1 years (0.5 to 25.0). Onset was acute in 25 patients and insidious in four. Of the 29 patients, 26 had a fixed dystonia and three had a spasmodic dystonia. Pain was a major symptom in all patients, with a coexisting diagnosis of chronic regional pain syndrome (CRPS) made in nine patients. Of 20 patients treated with Botox, only one had a good response. None of the 12 patients who underwent a surgical intervention at our unit or elsewhere reported a subjective overall improvement. After a mean follow-up of 3.2 years (1 to 12), four patients had improved, 17 had remained the same, and eight reported a deterioration in their condition. Conclusion Patients with functional dystonia typically presented with a rapid onset of fixed deformity after a minor injury/event and pain out of proportion to the deformity. Referral to a neurologist to rule out neurological pathology is advocated, and further management should be carried out in a movement disorder clinic. Response to treatment (including Botulinum toxin (Botox) injections) is generally poor. Surgery in this group of patients is not recommended and may worsen the condition. The overall prognosis remains poor. Cite this article: Bone Joint J 2021;103-B(6):1127–1132.

This paper interrogates and reclaims clown practices in children's rehabilitation as 'foolish.' Attempts to legitimize and 'take seriously' clown practices in the health sciences frame the work of clowns as secondary to the 'real' work of medical professionals and diminish the ways clowns support emotional vulnerability and bravery with a willingness to fail and be ridiculous as fundamental to their work. Narrow conceptualizations of clown practices in hospitals as only happy and funny overlook the ways clowns also routinely engage with sadness, despair, discomfort and many other ways of being and doing. Our exploration of clown practices as foolish exposes the ways children's rehabilitation upholds particular neoliberal models of success and invites a re-centring of rehabilitation and health care research and practice towards relationship building, supporting meaningful projects and a continued nurturing of aesthetic and pleasurable ways of being-in-the-world in the present moment as valuable unto themselves.

As artist and social researchers working in health research, we work ‘against the grain’ in marginalised spaces to resist the marketisation of knowledge and related neoliberal practices. Our cross-...

For every successful international organisation, many others died out or never got off the ground.

Through this paper, I consider how we might be aesthetically and relationally accountable in creating research-informed theatre through the conceptual frame of an aesthetic of relationality, and in...

Background and aims Foot deformities are frequently observed in patients with Charcot Marie Tooth disease (CMT) and orthopaedic surgery is often required. Currently there is no evidence based guideline on surgical management and only a few studies which have evaluated long-term outcomes of surgical procedures. The aim of the study was to evaluate longitudinally the effect of foot surgery in a cohort of CMT patients. Methods 25 CMT adult patients were assessed using a comprehensive group of validated scales and questionnaires before and after surgery. A wide range of surgical procedures were performed by one team of dedicated foot ankle orthopaedic surgeons. Results Foot alignment as measured by the Foot Posture Index, pain, quality of life and callosities significantly improved after one year and the improvement was maintained up to 4 years after surgery. There was a trend towards a reduction in the number of falls post-operatively. Surgery had no effect on fatigue, balance and CMT Examination Score (CMTES). Interpretation Our findings showed significant improvement of pain, foot alignment, callosities and quality of life after surgery and suggested that foot deformity correction in adults with CMT performed in a specialised foot and ankle unit is beneficial. This article is protected by copyright. All rights reserved.

Persons living with dementia and their carers experience stigma. Stigma intensifies social exclusion and threatens health and well-being. Decreasing stigma associated with dementia is a public heal...

While the percentage of female heads of state in the world has increased to around 10 percent in the 2010s, a female president or prime minister still remains an exception. Recent scholarship has proposed a number of explanations behind this phenomenon, but there exist important gaps. The contribution of this paper is threefold. First, we use new and comprehensive data to undertake a systematic examination of the differences in the personal, education, and career backgrounds between female and male effective political leaders from 1960 to 2010. We find that female leaders are as qualified as men. Second, because the phenomenon of female leadership is still a rare occurrence, we argue that this fact must be accounted for in empirical modeling. Third, we show that many female leaders tend to acquire the necessary resources, support, and name recognition through political dynasties. To that end, women leaders need to rely on family ties more than men do. However, the importance of such connections attenuates when female suffrage has been in place for longer, and citizens are more open to women in politics.

Ischemia after correction of lesser toe deformities is usually due to temporary vasospasm and can rarely cause gangrene. The published literature on dealing with the issue and been reviewed and used to suggest an algorithm for a logical step by step approach to a pale or white toe when encountered in the postoperative period.

Research-informed theater is often informed by an assumed linear trajectory between research findings and performance, overlooking the multiple embodied perspectives that are implicated in the development of research-informed theater. To challenge this assumption, we explore how artist-researchers draw on their own embodiment and imagination as ways to understand the research findings, how they conceptualize the intended audience, and how those understandings shape the creative process of the research-informed play. Using the case study of the research-informed play Cracked: New Light on Dementia, we focus on three interrelated modes of practice: playful extending, foolish disrupting, and inventive disrupting. We argue that these modes of practice create an aesthetic of relationality, what we define as an aesthetic space within which the embodied interpretive work of artist-researchers is extended into spatial, relational contexts. We discuss implications of this theoretical framework for a new critical inquiry.

Under what conditions do states uphold their formal trade commitments? While recent work focuses on the formation and design of trade agreements, we know comparatively little about the durability of agreements over time. We argue that government turnover undermines states’ commitments to liberalization, even if they have already signed an international agreement meant to constrain their behavior. We test this argument using data on realized trade in the presence of around 300 preferential trade agreements (PTAs) since 1970. Even in the presence of an international agreement, ideological turnover is associated with increased political barriers to trade, especially when the shift is toward left-wing leaders. These findings have important implications for our understanding of international cooperation: If new leaders do not adhere to their predecessors’ commitments, international agreements may not have lasting economic consequences.

Most international organizations (IOs) expand their membership over the course of their lifespan. Although these enlargements tend to be heralded as normatively positive | for the IOs themselves, for the new members, and for cooperative outcomes more generally | expansions can also lead to con icts in the organization. What conditions lead to enlargement rounds that reshape an organization in unexpected ways? We ar- gue that, depending upon the diversity of the initial group of countries, members may vote to admit new entrants that can tilt organizational decision-making in unexpected directions. We anticipate fewer enlargements with lesser impact on the character of the organization among organizations that have either a smaller range of founding members or a relatively even initial dispersion. We develop an agent-based model that accounts for the complex decision-making environment and social dynamics that typify IO ac- cession processes. The model helps us explain how the nature of decision-making in organizations can shift following enlargement, likely changing the organization's output and goals.

Healthcare literature, public discourse, and policy documents continue to represent persons with dementia as “doomed” and “socially dead.” This tragedy meta-narrative produces and reproduces misunderstandings about dementia and causes stigma, oppression, and discrimination for persons living with dementia. With few opportunities to challenge the dominant discourse, persons with dementia continue to be denied their citizenship rights. Drawing on the concept of narrative citizenship, we describe a community-based, critical arts-based project where persons with dementia, family members, visual and performance artists, and researchers came together to interrogate the tragedy discourse and construct an alternative narrative of dementia using the arts. Our research demonstrates the power of the arts to create transformative spaces in which to challenge dominant assumptions, foster critical reflection, and envision new possibilities for mutual support, caring, and relating. This alternative narrative supports the reclamation of citizenship for persons living with dementia and fosters the relational citizenship of all.

Working as a Veterinary Nurse has many high points; however, there are sad cases too. If we are always caring for our clients and patients without giving ourselves time to rest and recuperate we will inevitably suffer with compassion fatigue. With structured and supportive frameworks we can continue to support our clients and protect ourselves as well.

Background Despite the chronic, progressive, and life-threatening nature of cystic fibrosis (CF), there are no guidelines for when and how to communicate prognosis to children with CF. Methods Semi-structured interviews with young adults with CF, parents of young adults with CF, and multidisciplinary CF health care providers assessed recall of and practices for communicating about prognosis. Recommendations for improvements were also solicited. Results Young adults with CF recalled learning that life expectancy is limited by CF between the ages of 8 and 16 years, and that CF is a progressive disease between the ages of 7 and 19 years. They reported that the information often came from CF physicians or from online resources. Patients and parents reported earlier knowledge of prognosis than providers assumed. While learning about prognosis caused sadness and stress for some patients and families, others denied negative feelings. Interestingly, most patients reported that disclosure of prognosis had minimal impact on their adherence and treatment goals. Patients and parents reported wanting physicians to be involved in conversations about prognosis. However, providers noted several barriers to discussing prognosis, including their own reluctance, time limitations, and uncertainty about appropriate timing and content of communication. Conclusions Communication about prognosis is important but also difficult for providers, patients, and families. Appropriately timed conversations, using tools to facilitate communication, could ensure patients receive timely, accurate information.

Background. Theatre-based interventions use artistic media to facilitate social and emotional awareness and have therapeutic benefits for persons with developmental disabilities and mental health problems. The role of these interventions with Indigenous youth who have emotional, behavioural, and cognitive sequelae related to fetal alcohol spectrum disorder (FASD) has not been explored. Purpose. The purpose of this study was to explore the experiences and acceptability of a theatre-based approach for facilitating social communication and engagement in youth with FASD. Method. Participants were three Indigenous youth with FASD. A qualitative exploration of the experiences and acceptability of the intervention was conducted via focus groups held 2 weeks post–program participation with the participants, their caregivers, and program facilitators. The transcripts were analyzed using an inductive thematic approach. Findings. Our results identified perceived postintervention improvements in participants’ development of self-esteem, social skills, and emotional awareness. Implications. A theatre-based arts intervention has the potential to support improvements in social skills for youth with FASD.

Countries around the world have signed a multitude of bilateral investment treaties (BITs), many of which leaves the parties vulnerable to legal action through Investor-State Dispute Settlement (ISDS). But unbeknownst to many of these countries at the time of signing, these BITs are also subject to abuse through a practice known as "treaty shopping," through which firms can sue other states via subsidiaries in a third country. This chapter examines several prominent cases of treaty shopping and strategies used by developing countries to insulate themselves.

International legal frameworks exist to formalize interactions between countries, supposedly muting the need for behind-the-scenes bargaining in the event of disagreements. Yet diplomacy persists, and sometimes escalates, even after countries invoke dispute settlement mechanisms. What is the purpose and impact of diplomatic engagement in the presence of international law? To date, the answer to this question has been elusive due to a shortage of both granular, systematic data on diplomatic interaction and precise theories about its effects. This paper redresses these deficits by exploring the relationship between diplomacy and the settlement of international trade disputes prior to a final legal judgment. We argue that even when states resort to international legal mechanisms, they still engage in a considerable amount of diplomacy outside of those processes. But the effects of diplomatic engagement vary depending on pre-existing state affinity. Specifically, we argue that diplomatic interactions help states that have dissimilar policy preferences resolve their disputes before they reach a formal ruling. By contrast, diplomacy has minimal impact on dispute settlement in relationships between countries with higher affinity. To establish this argument, we focus on the diplomatic interactions behind litigation involving the United States (US) at the World Trade Organization (WTO).

How do countries’ actions on the international stage affect their reputations? We propose that, particularly when evaluating countries about whom individuals may have few prior beliefs, internation...

Many have argued that international agreements face a trade-off between width and depth: that is, that having more members (and greater diversity among those members) tends to lead to lower levels of co-operation within an organization. Recent theoretical literature has called into question the nature of this trade-off, and has even questioned its existence. In this contribution, we seek to uncover the empirical relationship between width and depth using a cross-sectional dataset on regional economic organizations (REOs). We use expert survey data to capture information on key dimensions that taps into the depth of co-operation. We demonstrate that there is no empirical relationship between the number of members in an organization and the depth of co-operation. However, organizations with more members tend to have more ambitious goals and broader scope. This may contribute to the perception of a depth and breadth tradeoff.