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Competition, effects and predictability: Rule of law and the economic approach to competition, by Bruce Wardhaugh, Oxford: Hart, 2020, 272 pp, hb 70.00. pounds

Marking the fifteenth anniversary of the entry into force of Regulation 1/2003, 2019 offers a vantage point from which to analyse the rise of commitment decisions as the primary enforcement mechanism for non-cartel competition law investigations at EU level. Commitment decisions, the closure of competition cases with a package of remedial obligations in response to Commission concerns, have an undeniable administrative appeal. They afford the Commission the absolute discretion to counteract any form of market conduct, whether beyond the pre-existing scope of the law deduced by the EU Courts from Articles 101 and 102 TFEU, or below exacting thresholds for prohibition of legally controversial business practices. Furthermore, the Commission can secure any remedial outcome, even if disproportionate or seemingly disconnected from its competitive concerns, to thereby redraw markets according to its idealized vision. In this regard, commitment decisions allow the Commission to achieve its policy goals with utmost effectiveness. Nevertheless, this article argues that such a method of market intervention represents a significant divergence from realizing the ideal of the formal rule of law in EU competition enforcement: normative certainty for businesses, facilitated by the equal application of generalized legal norms, which are subject to close oversight by courts. This offers an aspirational legal form of considerable political and economic value. Using commitment decisions to enforce EU competition policy via ad hoc, subject-specific decision making, conditional upon unforeseeable remedial obligations, is of systemic detriment to the legal comprehensibility of not just future Commission decision making, but the entire edifice of norms deduced from the Treaties by the EU Courts in this field. A rather relaxed approach to judicially reviewing the remedial proportionality of commitment decisions has partly contributed to this issue. However it is suggested that the EU Courts are largely unable to remedy the problems of novel theories of harm or subject-specific determinations, delivering upon their important residual role envisaged by the rule of law ideal, because of a factor mostly beyond their control: the lack of commitment decisions brought before them for review. To that end, the article concludes by recommending the automatic review of commitment decisions by the Courts. This would hopefully foster a more balanced reconciliation of effective policy achievement by the Commission and realization of the formal rule of law ideal in contemporary EU competition enforcement.

This paper will take its cue from recent work in international migration, particularly the writings of Ewa Morawska and Karen O’Reilly, that has explicitly placed structuration theory at its heart in analysing issues of causality. While firmly endorsing this work, I argue that it is possible to further strengthen the use of structuration in international migration studies by paying more attention to certain tenets of strong structuration theory (SST), synthesised with aspects of critical realism. This entails closer engagement with issues of epistemology and methodology, and also a more fine-grained approach to ontological concepts, the relationships between them, and their use in empirical analysis. The device of a 'theorised contextual frame’ is introduced as a reference point that can be used to systematically evaluate the status and adequacy of individual migration studies. The device combines attention to the structural context or field relevant to a particular migration issue with the systematic focus demanded by a specific research question or objective. In sketching out the structural context, I draw out the relationship between critical realism’s emphasis on plural causal mechanisms or 'planes of analysis’, and strong structuration theory’s emphasis on clusters of position-practice relations. The device is also designed to highlight the phenomenological and interpretative dimensions within particular causal processes, while insisting that such dimensions need to be grounded within the relevant structural aspects of the contextual frame. Two ideal types of 'hermeneutic-structural’ text – contextualising and floating – are presented to help sharpen a sense of how to employ the theoretical model to heighten critical awareness of the status and quality of particular research accounts of international migration. Finally, I conduct a close analysis of Ewa Morawska’s recent structuration-inspired account of large-scale migration across the Atlantic from Polish villages in the longue durée from the 1870s to the 1930s. This is undertaken in order to illustrate, clarify and exemplify the strengths of the approach.

The Chicago School advanced a particular conceptualisation of the relationship between law and economics in antitrust that has been misunderstood for decades. A well-known consequence for US antitrust of their scholarship was for greater determinations of legality through the ad hoc, conduct-specific analysis of the rule of reason standard, inspiring advocacy for a similarly “more economic” approach to EU competition law. But although supporting the substantive economic outcomes of overturning rules of per se illegality, Bork, Posner, Easterbrook, and other Chicagoans routinely and consistently rejected this form of market intervention for determining legality. Rather than ex post effects-based analysis, the Chicagoan approach was to incorporate economics ex ante into the design of generalised norms (rules, presumptions, structured tests) to thereby foster legal certainty and administrability, virtues associated with the formal rule of law. The overlooked importance of the formal rule of law ideal can be discerned from Bork and Easterbrook’s antitrust writing, Posner’s economic analysis of law, and even traced back to the foundational scholarship of the Chicago School of economics. Reemphasising the importance of legal form in Chicagoan writing challenges their common contemporary portrayal, supporters of a particular version of “more economic” European enforcement, and the supposedly “neo”-Chicago approach.

This report was prepared for the 29th biennial Congress of the International Federation of European Law (FIDE) to be held in The Hague in May 2020. It is the national report for the United Kingdom in response to Topic 3 of the 2020 FIDE Congress, titled ‘EU Competition Law and the Digital Economy’. This report offers an overview of UK competition enforcement in digital economy markets by answering twelve questions organised into four sections. Part A summarises key UK antitrust and merger decisions, agency publications, priorities and goals of enforcement in digital economy markets. Part B focuses upon the definition of markets and conceptualisation of market power by UK authorities in digital economy cases in light of their challenges and particularities. Part C offers a detailed overview of the issues underpinning UK antitrust and merger scrutiny in this field: the types of conduct investigated, relevant factors and concepts, theories of harm, efficiency justifications and remedies in digital economy cases. Finally, Part D identifies the potential for incoherent enforcement in this field from two different sources: the overlap between UK competition law and ex ante regulatory regimes (e.g. consumer protection, data protection); and the overlap between the powers of various UK competition decision-makers (e.g. sectoral regulators, the Competition Appeal Tribunal, and the courts).

A simple and operationally practical method to sequester and remove fluoride generated through the SNAr reaction between amines and aryl fluorides is reported. Calcium propionate acts as an inexpensive and environmentally benign in situ scrubber of the hydrofluoric acid byproduct, which is simply precipitated and filtered from the reaction mixture during standard aqueous work-up. The method has been tested from 10 → 100 g scale of operation, showing > 99.5% decrease in fluoride content in each case. Full mass recovery of calcium fluoride is demonstrated at both scales, proving this to be a general, efficient and robust method of fluoride abstraction to help prevent corrosion of glass-lined reactors.

Background Star defined infrastructure as something other things “run on”; it consists mainly of “boring things.” Building on her classic 1999 paper, and acknowledging contemporary developments in technologies, services, and systems, we developed a new theorization of health information infrastructure with five defining characteristics: (1) a material scaffolding, backgrounded when working and foregrounded upon breakdown; (2) embedded, relational, and emergent; (3) collectively learned, known, and practiced (through technologically-supported cooperative work and organizational routines); (4) patchworked (incrementally built and fixed) and path-dependent (influenced by technical and socio-cultural legacies); and (5) institutionally supported and sustained (eg, embodying standards negotiated and overseen by regulatory and professional bodies). Objective Our theoretical objective was, in a health care context, to explore what information infrastructure is and how it shapes, supports, and constrains technological innovation. Our empirical objective was to examine the challenges of implementing and scaling up video consultation services. Methods In this naturalistic case study, we collected a total of 450 hours of ethnographic observations, over 100 interviews, and about 100 local and national documents over 54 months. Sensitized by the characteristics of infrastructure, we sought examples of infrastructural challenges that had slowed implementation and scale-up. We arranged data thematically to gain familiarity before undertaking an analysis informed by strong structuration, neo-institutional, and social practice theories, together with elements taken from the actor-network theory. Results We documented scale-up challenges at three different sites in our original case study, all of which relate to “boring things”: the selection of a platform to support video-mediated consultations, the replacement of desktop computers with virtual desktop infrastructure profiles, and problems with call quality. In a fourth subcase, configuration issues with licensed video-conferencing software limited the spread of the innovation to another UK site. In all four subcases, several features of infrastructure were evident, including: (1) intricacy and lack of dependability of the installed base; (2) interdependencies of technologies, processes, and routines, such that a fix for one problem generated problems elsewhere in the system; (3) the inertia of established routines; (4) the constraining (and, occasionally, enabling) effect of legacy systems; and (5) delays and conflicts relating to clinical quality and safety standards. Conclusions Innovators and change agents who wish to introduce new technologies in health services and systems should: (1) attend to materiality (eg, expect bugs and breakdowns, and prioritize basic dependability over advanced functionality); (2) take a systemic and relational view of technologies (versus as an isolated tool or function); (3) remember that technology-supported work is cooperative and embedded in organizational routines, which are further embedded in other routines; (4) innovate incrementally, taking account of technological and socio-cultural legacies; (5) consider standards but also where these standards come from and what priorities and interests they represent; and (6) seek to create leeway for these standards to be adapted to different local conditions.

Right heart failure is the major cause of death in Pulmonary Artery Hypertension (PAH) patients but is not a current, specific therapeutic target. Pre-clinical studies have shown that adrenoceptor blockade can improve cardiac function but the mechanisms of action within right ventricular (RV) myocytes are unknown. We tested whether the β₁–adrenoceptor blocker metoprolol could improve RV myocyte function in an animal model of PAH, by attenuating adverse excitation-contraction coupling remodeling. PAH with RV failure was induced in rats by monocrotaline injection. When PAH was established, animals were given 10 mg/kg/day metoprolol (MCT + BB) or vehicle (MCT). The median time to the onset of heart failure signs was delayed from 23 days (MCT), to 31 days (MCT + BB). At 23 ± 1 days post-injection, MCT + BB showed improved in vivo cardiac function, measured by echocardiography. RV hypertrophy was reduced despite persistent elevated afterload. RV myocyte contractility during field stimulation was improved at higher pacing frequencies in MCT + BB. Preserved t-tubule structure, more uniform evoked Ca²⁺ release, increased SERCA2a expression and faster ventricular repolarization (measured in vivo by telemetry) may account for the improved contractile function. Sarcoplasmic reticulum Ca²⁺ overload was prevented in MCT + BB myocytes resulting in fewer spontaneous Ca²⁺ waves, with a lower pro-arrhythmic potential. Our novel finding of attenuation of defects in excitation contraction coupling by β₁–adrenoceptor blockade with delays in the onset of HF, identifies the RV as a promising therapeutic target in PAH. Moreover, our data suggest existing therapies for left ventricular failure may also be beneficial in PAH induced RV failure.

Summary Passive properties of the myocardium influence diastolic filling and cardiac output. In heart failure, changes in contributors to the passive properties of the ventricle, such as titin and collagen, and loss of the metabolic enzyme creatine kinase, increase resistance to filling resulting in diastolic dysfunction. Pulmonary artery hypertension (PAH) arises from interactions between the pulmonary vasculature and the right ventricle (RV) which ultimately leads to RV failure. Beta1‐adrenergic receptor blockers (BB) act on the myocardium and are beneficial in left heart failure but are not used in PAH. We investigated whether BB improved survival and RV function in a rat model of PAH. Rats were injected with monocrotaline (60 mg/kg) to induce PAH and RV failure, or saline as controls (CON). When PAH was established, rats were treated with metoprolol (10 mg/kg per day) (MCT+BB) or vehicle (sucrose) (MCT); CON were treated with vehicle. In vivo measurement of RV compliance using pressure–volume catheter, indicated diastolic dysfunction in the RV of MCT rats was improved with BB treatment. Expression of creatine kinase protein and mRNA was lower in MCT rats compared to CON, with a trend for reversion by BB treatment. Isolated CON RV myocytes had a positive contraction response to faster pacing, whereas it was negative in MCT. MCT+BB cells had an intermediate response, indicating improved ability to respond to increased demand. BB improved diastolic function, partially restored metabolic enzymes and augmented contractility in PAH. These data support the hypothesis that BB may be beneficial in PAH by supporting RV function.

This paper introduces a framework for assessing the quality of care of institutional maternity services developed by researchers at the University of Southampton. The framework divides quality into two parts: the quality of the provision of care and the quality of users’ experience of care. Preliminary findings from the application of this framework within a slum area of Mumbai are presented. Data from municipal and private hospitals were collected using a community survey of 650 women, observation, exit interviews, provider interviews, review of hospital records, and the mystery client approach. Findings provide evidence that quality is far from optimal in both municipal and private facilities. Quality issues identified include a lack of essential drugs, the use of inappropriate procedures that are not evidence-based, users being left unsupported, evidence of physical and verbal abuse and institutional delivery which does not guarantee attendance by a health professional. There is also evidence that the quality of experience of care varies significantly by background characteristics of the woman and her family.

The interval between births is associated with child survival in the developing world. We investigate associations between use of depot medroxyprogesterone acetate and other reversible contraception and short birth intervals in sub-Saharan Africa. Data from successive Demographic and Health Surveys undertaken in nine African countries were analysed. Logistic regression was used to explain changes in the proportion of short birth intervals in four countries with relatively high use of reversible contraception. The overall odds ratio for the trend was 0.90 (95%CI 0.84 to 0.95) and this was unaffected by adjusting for the other variables. The odds of a short birth interval were reduced by exclusive breast feeding (OR 0.67, 95% CI 0.58 to 0.78) and increased by use of injectable contraception (OR 1.23, 95% CI 1.11 to 1.38). The proportion of short birth intervals has changed little over the last decade in a context of very low use of the intrauterine device. Widespread adoption of injectable contraception is associated with greater odds of a short birth interval, thus not contributing favourable conditions for improved child health.