The emergence of borders: moral questions mapped out

In this paper, we examine the extent to which the concept of emergence can be applied to questions about the nature and moral justification of territorial borders. Although the term is used with many different senses in philosophy, the concept of “weak emergence” - advocated by, for example, Sawyer (2002, 2005) and Bedau (1997 ) - is especially applicable, since it forces a distinction between prediction and explanation that connects with several issues in the discussion of territory. In particular, we argue, weak emergentism about borders allows us to distinguish between (a) using a theory of territory to say where a border should be drawn, and (b) looking at an existing border and saying whether or not it is justified (Miller, 2012; Nine, 2012; Stilz, 2011). Many authors conflate these two factors, or identify them by claiming that having one without the other is in some sense incoherent. But on our account - given the concept of emergence - one might unproblematically be able to have (b) without (a); at the very least, the distinction between these two issues is much more significant than has often been recognised, and more importantly gives us some reason to prefer “statist” as opposed to “cultural” theories of territorial borders. We conclude with some further reflections on related matters concerning, firstly, the apparent causal powers of borders, and secondly, the different ways in which borders are physically implemented (e.g., land vs. water).

Moral shielding: A grounded theory of integrity maintenance in multidisciplinary teams

Using a classic grounded theory methodology (CGT), this study explores the phenomenon of moral shielding within mental health multidisciplinary teams (MDTS). The study was located within three catchment areas engaged in acute mental health service practice. The main concern identified was the maintenance of a sense of personal integrity during situational binds. Through theoretical sampling thirty two practitioners, including; doctors, nurses, social workers, occupational therapists, counsellors and psychologists, where interviewed face to face. In addition, emergent concepts were identified through observation of MDTs in clinical and research practice. Following a classic grounded theory methodology, data collection and analysis occurred simultaneously. A constant comparative approach was adopted and resulted in the immergence of three sub- core categories; moral abdication, moral hinting and pseudo-compliance. Moral abdication seeks to re-position within an event in order to avoid or deflect the initial obligation to act, it is a strategy used to remove or reduce moral ownership. Moral gauging represents the monitoring of an event with the goal of judging the congruence of personal principles and commitments with that of other practitioners. This strategy is enacted in a bid to seek allies for the support of a given moral position. Pseudo-compliance represents behaviour that hides desired principles and commitments in order to shield them from challenge. This strategy portrays agreement with the dominant position within the MDT, whilst holding a contrary position. It seeks to preserve a reservoir of emotional energy required to maintain a sense of personal integrity. Practitioners who were successful in enacting moral shielding were found to not experience significant emotional distress associated with the phenomenon of moral distress; suggesting that these practitioners had found mechanisms to manage situational binds that threatened their sense of personal integrity.

A study of the situations, features, and coping mechanisms experienced by Irish psychiatric nurses experiencing moral distress

Purpose: The purpose of this study was toinvestigate moral distress in Irish psychiatric nurses. Design: A qualitative descriptive methodology was used. Findings: The study confirmed the presence of moral distress and the situations that gave rise to moral distress within psychiatric nurses working in acute care settings. Practice Implications: The findings indicate that while multidisciplinary teams appear to function well on the surface, situations that give rise to moral distress are not always acknowledged or dealt with effectively. Furthermore, unresolved moral conflict impacts upon the quality of clinical decision-making by not allowing open and transparent discussions that allow clinicians the opportunity to address their concerns adequately.

Nurses’ perceptions of nursing presence and the relationship between nursing presence and moral sensitivity in nurses working with people with dementia in residential care

Aim: The aim of this study was to measure nursing presence among nurses caring for people with dementia in residential care settings, and to investigate the relationship between nursing presence and moral sensitivity. Background: Nursing presence is a core relational skill in nursing and holds many benefits for nurses and their patients. Moral sensitivity is defined as how one recognises the moral elements of a situation, and how one’s moral or ethical decision making may impact on an individual. Methods: A descriptive, cross sectional quantitative methodology was used with a sample of 150 registered nurses. The Presence of Nursing Scale for Registered Nurses was used to investigate nursing presence, and the Moral Sensitivity Questionnaire for moral sensitivity. Results: Findings from the study demonstrated that participants agreed with the majority of elements of nursing presence, (mean 76.97, SD= 7.51). A mean score of 36.22 was evidence of a well developed level of moral sensitivity in participants. Nurses who perceived themselves to be highly present to their patients also scored highest on certain elements of moral sensitivity such as moral strength. Nursing presence was also found to be more developed in those participants that rated themselves as having higher levels of expertise based on Benner’s (1984) definitions. Older nurses also scored higher on nursing presence. There was a high level of agreement that factors such as lack of time (n=133), and heavy workload influenced nursing presence. Nurses, who were older and had longer clinical experience, were shown to have greater moral strength. There were differences in elements of moral sensitivity between groups of nurses who ranked themselves according to Benner’s (1984) competence framework with higher scores evident in the more expert groups. Conclusion: Overall, this study showed that participants had a well developed level of nursing presence, and certain elements of moral sensitivity are positively related to nursing presence. Nursing presence appears to be linked to the level of expertise of the nurse but factors such as time and workload do influence nursing presence.

The Kyoto School and Confucianism: a Confucian reading of the philosophy of history and political thought of Masaaki Kosaka

This dissertation examines the philosophy of Masaaki Kōsaka (1900-1969) from the East Asian perspective of Confucianism, which I believe is the most appropriate moral paradigm for comprehending his political speculations. Although largely neglected in post-war scholarship, Kōsaka was a prominent member of the Kyoto School during the 1930s and 40s. This was a group of Japanese thinkers strongly associated with the philosophies of Kitarō Nishida and Hajime Tanabe. Kōsaka is now best known for his participation in the three Chūō Kōron symposia held in 1941 and 1942. These meetings have been routinely denounced by liberal historians due to the participants’ support for the Pacific War and the Co-Prosperity Sphere. However, many of these liberal portrayals have failed to take into account the full extent of the group’s resistance to the military junta of Hideki Tōjō. Adopting the methods and techniques of the empirical disciplines of academic history and Orientalism, I develop an interpretative framework that is more receptive to the political values that mattered to Kōsaka as a Confucian inspired intellectual. This has necessitated the rejection of moral history, which typically prioritises modern liberal values brought a priori to the historical record of wartime Japan, as well as recognition of the different ontological foundations that inform the unique political theories of the East Asian intellectual tradition. Reinforced by the prior research of Michel Dalissier and Graham Parkes, as well as my own reading of the Confucian canon, I adopt David Williams’s thesis of ‘Confucian Revolution’ as my principle schema of interpretation. This, I believe, is better able to reconcile Kōsaka’s support for the war with his strong condemnation of the imperialist practices of the Japanese military. Moreover, acknowledging the importance of Confucianism allows us to fully appreciate Kōsaka’s strong affinity for Kant’s practical metaphysics, Hegel’s political philosophy and Ranke’s historiography.

Job retention and turnover: a study of child protection and welfare social workers in Ireland

Retaining social workers in child protection and welfare organisations has been identified as a problem in Ireland (McGrath, 2001; Ombudsman for Children, 2006; Houses of the Oireachtas, 2008) and internationally (Ellet et al., 2006; Mor Barak et al., 2006; Tham, 2006). While low levels of retention have been identified, there is no research that examines the factors in Ireland that influence the retention of social workers. In this thesis, data is analysed from qualitative interviews with 45 social workers in the Health Service Executive South about what influences their decisions to stay in or leave child protection and welfare social work. These social workers’ views are examined in relation to quantitative research on the levels of turnover and employment mobility of child protection and welfare social workers employed in the same organisation. Contrary to expectations, the study found that the retention rate of social workers during the period of data collection (March 2005 to December 2006) was high and that the majority of social workers remained positive about this work and their retention. The quality of social workers’ supervision, social supports from colleagues, high levels of autonomy, a commitment to child protection and welfare work, good variety in the work, and a perception that they were making a difference, emerged as important factors in social workers’ decisions to stay. Perceptions of being unsupported by the organisation, which was usually described in terms of high caseloads and demanding workloads, a lack of resources, work with involuntary clients and not being able to make a difference, were the most significant factors in social workers’ decisions to leave and/or to want to leave. Social workers felt particularly professionally unsupported when they received low quality and/or infrequent professional supervision. This thesis critiques the theories of perceived organisational support theory, social exchange theory and job characteristics theory, and uses the concept of ‘professional career’, to help analyse the retention of social workers in child protection and welfare.

The quality of diabetes care in the community: practice, policy and culture

Aim: Diabetes is an important barometer of health system performance. This chronic condition is a source of significant morbidity, premature mortality and a major contributor to health care costs. There is an increasing focus internationally, and more recently nationally, on system, practice and professional-level initiatives to promote the quality of care. The aim of this thesis was to investigate the ‘quality chasm’ around the organisation and delivery of diabetes care in general practice, to explore GPs’ attitudes to engaging in quality improvement activities and to examine efforts to improve the quality of diabetes care in Ireland from practice to policy. Methods: Quantitative and qualitative methods were used. As part of a mixed methods sequential design, a postal survey of 600 GPs was conducted to assess the organization of care. This was followed by an in-depth qualitative study using semi-structured interviews with a purposive sample of 31 GPs from urban and rural areas. The qualitative methodology was also used to examine GPs’ attitudes to engaging in quality improvement. Data were analysed using a Framework approach. A 2nd observation study was used to assess the quality of care in 63 practices with a special interest in diabetes. Data on 3010 adults with Type 2 diabetes from 3 primary care initiatives were analysed and the results were benchmarked against national guidelines and standards of care in the UK. The final study was an instrumental case study of policy formulation. Semi-structured interviews were conducted with 15 members of the Expert Advisory Group (EAG) for Diabetes. Thematic analysis was applied to the data using 3 theories of the policy process as analytical tools. Results: The survey response rate was 44% (n=262). Results suggested care delivery was largely unstructured; 45% of GPs had a diabetes register (n=157), 53% reported using guidelines (n=140), 30% had formal call recall system (n=78) and 24% had none of these organizational features (n=62). Only 10% of GPs had a formal shared protocol with the local hospital specialist diabetes team (n=26). The lack of coordination between settings was identified as a major barrier to providing optimal care leading to waiting times, overburdened hospitals and avoidable duplication. The lack of remuneration for chronic disease management had a ripple effect also creating costs for patients and apathy among GPs. There was also a sense of inertia around quality improvement activities particularly at a national level. This attitude was strongly influenced by previous experiences of change in the health system. In contrast GP’s spoke positively about change at a local level which was facilitated by a practice ethos, leadership and special interest in diabetes. The 2nd quantitative study found that practices with a special interest in diabetes achieved a standard of care comparable to the UK in terms of the recording of clinical processes of care and the achievement of clinical targets; 35% of patients reached the HbA1c target of <6.5% compared to 26% in England and Wales. With regard to diabetes policy formulation, the evolving process of action and inaction was best described by the Multiple Streams Theory. Within the EAG, the formulation of recommendations was facilitated by overarching agreement on the “obvious” priorities while the details of proposals were influenced by personal preferences and local capacity. In contrast the national decision-making process was protracted and ambiguous. The lack of impetus from senior management coupled with the lack of power conferred on the EAG impeded progress. Conclusions: The findings highlight the inconsistency of diabetes care in Ireland. The main barriers to optimal diabetes management center on the organization and coordination of care at the systems level with consequences for practice, providers and patients. Quality improvement initiatives need to stimulate a sense of ownership and interest among frontline service providers to address the local sense of inertia to national change. To date quality improvement in diabetes care has been largely dependent the “special interest” of professionals. The challenge for the Irish health system is to embed this activity as part of routine practice, professional responsibility and the underlying health care culture.

“Fiction makes a better job of the truth”: dialogism, oppositional consciousness and re-membering in the novels of Helena María Viramontes

This thesis comprises close textual analyses of Chicana author Helena María Viramontes' two published novels, Under the Feet of Jesus (1995) and Their Dogs Came With Them (2007). These analyses fall under three broad frameworks: space, time and body. Chapter One engages with the first of these frameworks, space, and explores concepts of cognitive mapping and heteroptopias. Chapter Two, which looks at time, employs theories of intertextuality and the palimpsest, while Chapter Three looks at the interrrelationship between mythology and images of the body in the texts. This study emerges five years after the publication of Viramontes' last novel, Their Dogs Came With Them, but offers fresh insight into the contribution of the author to both the Chicano literary tradition and also the U.S. canon through her critique of hegemonic power structures that suppress not only the voices of lower class ethnic citizens but also of ethnic writers. In particular, her work chastises the paucity of attention given to ethnic women writers in the U.S. This thesis reaffirms Viramontes' position as one of the most important writers living and writing in the U.S. today. It corroborates her work as a contestation against ethnic and gender suppression, and applauds the craftsmanship of her narrative style that delicately but decisively exposes the socio-political wrongs that occur in ocntemporary U.S. society.

The contribution of warlordism to the disintegration of the western Roman army (c. AD 395-480)

My thesis investigates the dynamics behind the changing nature of the leadership of the western Roman army in the fifth century through the concept of ‘warlordism’. I carried this out by analyzing those cases of insubordination and military unrest in the officer class of the western Roman army, which can be shown to be linked to the slow decline of central authority and the imperial office in the period 395-480. My thesis demonstrates that theories of ‘Warlordism’, as developed in social sciences, can be useful for both the late Imperial west as for other eras of ancient history, such as the late Roman republic. Warlordism was a way of continuing politics, if necessary by military means, when commanders found themselves outside the legitimate framework. Unlike the case of usurpation of the imperial office, when there was little hope of achieving permanent recognition and acceptance, it offered insubordinate officers a chance of returning to the ruling imperial regime depending on circumstances and the success of their resistance. I propose that warlordism functioned as an alternative to usurpation, a tool for military dissidence, fuelled by an economy of violence. Contrary to modern warlordism, the warlordism of the fifth century AD represented a transient phase which no imperial commander was willing to prolong indefinitely. At some stage, given the means, warlords in the western Roman army wanted to become part of the imperial echelon again. Yet these alternative methods of violent opposition, and the acquisition of force through private means, ensured the breakdown of the state’s monopoly on violence and the disintegration of centralized armies. What started as an accidental revolution became a new form of military rule.

The defining characteristics of alternative food initiatives in Ireland: a social movement battling for an alternative food future?

Alternative food initiatives (AFIs) have been described as an attempt to change and improve aspects of how the food system operates. They are focused around more traditional, local and sustainable food production and circulation. AFIs such as farmers’ markets, allotments and community gardens, share a desire to reduce the number of steps food goes through from production to plate. The role of these initiatives in the food system, and their potential to impact real change, has however been questioned. Working to better understand this issue is a central concern of this research. To do this a two tier analysis has been deployed. The first tier involves identifying the characteristics and general dynamics of AFIs. Bourdieu’s theory of practice, and the theories of field and capital, are the concepts applied. The research then uses these findings in the second tier of analysis concerned with relating AFI characteristics and dynamics back to their key traits, positive and negative, as well as arguments made about AFI’s role identified from previous research. Another part of this second tier of analysis is exploring if AFIs, the producers, consumers, organisations and groups that make up this phenomenon, can be considered a social movement. AFIs can be referred to collectively as a social movement, but are not often explored theoretically from this perspective. AFIs in Ireland provide the empirical context for this research. A series of qualitative interviews in four areas of Ireland, as well as evidence from primary and secondary sources are analysed. The research finds that AFIs can be understood as the potential beginnings of a lifestyle social movement. Leaders are of central importance to its development. It is also found that an important role of AFIs is revitalising, supporting and contributing to food culture.

The role of transformative thinking and practice in a property entrepreneur's response to the funding crisis since 2008

This portfolio of exploration explores the role of transformative thinking and practice in a property entrepreneur’s response to the financial crisis which swept over Ireland from 2008. The complexity of this challenge and the mental capacity to meet its demands is at the core of the exploration. This inquiry emerged from the challenges the financial crisis presented to my values, beliefs, assumptions, and theories, i.e. the interpretive lens through which I make meaning of my experiences. Given the issue identified, this inquiry is grounded in aspects of theories of constructive developmental psychology, applied developmental science, and philosophy. Integrating and linking these elements to business practice is the applied element of the Portfolio. As the 2008 crisis unfolded I realised I was at the limits of my way of knowing. I came to understand that the underlying structure of a way of knowing is the ‘subject-object relationship’ i.e. what a way of knowing can reflect upon, look at, have perspective on, in other words, make object, as against what is it embedded in, attached to, identified within, or subject to. My goal became enhancing my awareness of how I made meaning and how new insights, which would transform a way of knowing, are created. The focus was on enhancing my practice. This Portfolio is structured into three essays. Essay One reported on my self-reflection and external evaluation out of which emerged my developmental goals. In Essay Two I undertake a reading for change programme in which different meaning making systems were confronted in order to challenge me as a meaning maker. Essay Three reported on my experiment which concerned the question whether it was possible for me as a property entrepreneur, and for others alike, to retain bank finance in the face of the overwhelming objective of the bank to deleverage their balance sheet of property loans. The output of my research can be grouped into General Developmental and Specific Business Implications. Firstly I address those who are interested in a transformational-based response to the challenges of operating in the property sector in Ireland during a crisis. I outline the apparatus of thought that I used to create insight, and thus transform how I thought, these are Awareness, Subject-object separation, Exploring other’s perspectives from the position of incompleteness, Dialectical thinking and Collingwood’s Questioning activity. Secondly I set out my learnings from the crisis and their impact on entrepreneurial behaviour and the business of property development. I identify ten key insights that have emerged from leading a property company through the crisis. Many of these are grounded in common sense, however, in my experience these were, to borrow Shakespeare’s words, “More honor'd in the breach than the observance” in pre Crisis Ireland. Finally I set out a four-step approach for forging a strategy. This requires my peer practitioners to identify (i) what they are subject to, (ii) Assess the Opportunity or challenge in a Systemic Context, (iii) Explore Multiple Perspectives on the opportunity or Challenge with an Orientation to change how you know and (iv) Using the Questioning Activity to create Knowledge. Based on my experience I conclude that transformative thinking and practice is a key enabler for a property entrepreneur, in responding to a major collapse of traditional (bank debt) funding.