Extubation failure is a common problem, occurring in nearly 40% of ELBW infants who require mechanical ventilation. IF CPAP was as effective but no more effective than conventional CPAP in preventing extubation failure among ELBW infants. New strategies are needed to identify predictors of extubation success and to treat apnea/bradycardia, the most common cause of extubation failure, thereby reducing the likelihood of prolonged intubation in this high-risk cohort of premature infants.

Opening ParagraphInequality based on privileged knowledge is an old topic in social analysis. It figures prominently, for example, in early works such as Condorcet's study of human progress. Condorcet argues that obstacles to progress arise when society is divided into two categories: ‘the one jealously hiding what it boasts of knowing, the other receiving with respect whatever is condescendingly revealed to it’ [1955 (1795): 17].

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Any relatively stable polity must possess means for converting many, if not most, demands made on political authorities into satisfying outputs, whether material or symbolic. Failure to cope with pressing demands might lead to a severely dysfunctional loss of public support for particular officials as well as for the regime itself. On the other hand, efforts to meet demands through blatant violations of accepted rules can also cause great loss in public support.

Anthropologists have made important contributions to the understanding of formal institutional factors that determine (1) the need for a broker role; (2) the kind of people who assume the role; and (3) the benefits, conflicts, and changes associated with the role in different societies ( e g , Wolf 1956; Geertz 1959-60; Silverman 1965). Silverman's succinct definition of the broker who links a local community and an encapsulating colonial administration or nation-state exemplifies this approach. She defines a mediator, a synonymous term for broker, as one who performs functions that meet two criteria: the functions must be critical, viz., "of direct importance t o the basic structures of either or both systems," and exclusive, viz., "if the link is t o be made at all between the two systems with respect t o a particular function, it must be made through the mediator" (Silverman 1965:173). This structural perspective, however, needs to be broadened by recognizing brokerage as a process in which individuals seek to convince others that their activities are indeed mediating, critical, and exclusive. Such a cultural approach is not intended to minimize the importance of sociopolitical structure in determining broker behavior, but to stress that this structure is itself shaped and mediated by individuals' management of meaning.This essay delineates a key premise underlying the Kpelle view of brokerage and analyzes the ways in which this cognitive resource is politically managed by those seeking broker identities. The analytical framework derives from a position outlined recently by This paper argues that Kpelle brokers draw upon the key cultural idea of danger inherent in privileged knowledge to contrive a broker role and to construe its indispensability and threatening power in local politics. Both traditional religious brokers, who mediate between the village and the mystical world, as well as modern brokers, who mediate between the local community and the wider national institutions, use this idiom to persuade the local community that their knowledge of unfamiliar domains is exclusive, critically important, and dangerously powerful. The Kpelle case supports the notion that the broker role is not simply the result of a structural need to link patrons and clients of two different sociocultural domains. I t shows that the role emerges as well from individuals'purposive use of cultural meanings to shape and manage those needs and their political significance. [West Africa, political management of meaning, brokerage, knowledge/secrecy, center-periphery relations]