Infants and children born with CHD are at significant risk for neurodevelopmental delays and abnormalities. Individualised developmental care is widely recognised as best practice to support early neurodevelopment for medically fragile infants born premature or requiring surgical intervention after birth. However, wide variability in clinical practice is consistently demonstrated in units caring for infants with CHD. The Cardiac Newborn Neuroprotective Network, a Special Interest Group of the Cardiac Neurodevelopmental Outcome Collaborative, formed a working group of experts to create an evidence-based developmental care pathway to guide clinical practice in hospital settings caring for infants with CHD. The clinical pathway, “Developmental Care Pathway for Hospitalized Infants with Congenital Heart Disease,” includes recommendations for standardised developmental assessment, parent mental health screening, and the implementation of a daily developmental care bundle, which incorporates individualised assessments and interventions tailored to meet the needs of this unique infant population and their families. Hospitals caring for infants with CHD are encouraged to adopt this developmental care pathway and track metrics and outcomes using a quality improvement framework.

Pragmatic trials aim to generate timely evidence while ensuring feasibility, minimizing practice burden, and maintaining real-world conditions. We conducted rapid-cycle qualitative research in the preimplementation period of a trial evaluating a community paramedic program to shorten and prevent hospitalizations. Between December 2021 and March 2022, interviews (n = 30) and presentations/discussions (n = 17) were conducted with clinical and administrative stakeholders. Two investigators analyzed interview and presentation data to identify potential trial challenges, and team reflections were used to develop responsive strategies. Solutions were implemented prior to the commencement of trial enrollment and were aimed at bolstering feasibility and building ongoing practice feedback loops.

Political parties in Venezuela have historically played a mediating role between the state and the working class and also between labor and the private sector. Indeed, the political party system has been widely credited in the literature with sustaining the rather remarkable electoral democracy in Venezuela since 1958. Yet structural change in the world oil market and the Venezuelan economy in the early 1970s combined with the dynamics of past state-labor-party relations have produced an expanded role for the state in the economy as well as in the system of industrial relations. New patterns of interest mediation have emerged that have facilitated the adjustment of the democratic regime to changing political and economic conditions, thus helping to ensure its survival.

Democracy in Latin America: Political Change in Comparative Perspective. By Peter H. Smith. New York: Oxford University Press, 2005. 380p. $74.00 cloth, $28.95 paper.

Peter Smith set out to write a textbook and ended up compiling an original database of Latin American democracy from 1900 to 2000. Analyzing a century of democratic change, Smith has written an impressive book that is accessible to undergraduates, a great literature review for graduate students, instructive for policymakers, and a significant contribution to scholarly understanding of a complex phenomenon. All of this is done with a lively and jargon-free writing style.

Venezuela's contemporary politics poses a problematic different from those predominating in the literature on democratization. Scholarly research in the last decade focused first on the crisis of authoritarian rule and the ensuing transition to civilian governments, with the reestablishment of electoral procedures, and, more recently, on the problems of the consolidation of a democratic regime, including alternation in power, universal acceptance of the rules of the game, and generation of a democratic political culture.

The challenges confronting Venezuela are not those of transition or consolidation but, rather, the decomposition — or deconsolidation — of an established democratic regime. In other Latin American countries in recent decades, longstanding models of statist development developed crises that led, in turn, to complex transformations in the economy and in society. One consequence of these changes was that authoritarian regimes began a transition to more democratic forms of governance.

This study examines the case of the Brazilian debt rescheduling agreement of 1988 as a two-level game in which each of the two main negotiators—the Brazilian state and the international bank advisory committee—must satisfy its own constituents while trying to negotiate an international agreement. It is argued that the interaction between the domestic and international levels must be understood in order to explain the outcomes of international debt negotiations. This article draws on Robert Putnam's concept of the two-level game in international politics and on a wider literature concerning the influence of domestic political considerations in international negotiations to demonstrate that such an analysis can explain the process and outcome of the 1988 agreement, where a unitary negotiating level fails to predict the final result. The two-level model explains how domestic constraints and opportunities affect international outcomes, and it highlights the importance of the ratification process.

In mid-1985, the US Embassy in Caracas stated that “Venezuela appears to have successfully coped with its financial crisis” (US Embassy, 1985). In January 1986, the Wall Street Journal announced that