The struggle for safe staffing levels in the USA: A political economy of evidence-based practice

This paper examines the debate over nursing staff to patient ratios through the lens of Marxist political economy, arguing that the owners and controllers of healthcare in the USA have a vested interest in opposing mandated minimum ratios, while those involved in carrying out nursing care have a vested interest in their implementation, which coincides with the interests of patients. We examine how evidence-based practice articulates with social power, and proceed to interrogate the research methods used to generate evidence for practice, noting that randomised controlled trials are not suitable for evaluating nurse/patient ratios, which means that observational studies are the primary source of evidence. Representatives of nursing managers have used the fact that observational studies, while demonstrating an association between high ratios and poor outcomes, have not established a causal relationship, to support their argument that there is not sufficient evidence for the imposition of mandatory ratios. We argue that the precautionary principle provides firm justification for mandatory ratios, unless and until a causal relationship has been disproved. We conclude that those involved in the generation of evidence have to choose between technical arguments about the inferiority of observational studies, or emphasising their sufficiency in triggering the precautionary principle.

The Political Economy of Swift's Satires and other Prose Works

Jonathan Swift wrote perceptively about the emerging commercial society
in Britain in the early eighteenth century. His particular focus was on the
financial revolution and its implications for economic and political stability
as well as for shifts of power between the landed and commercial
classes. Following his return to Ireland Swift’s focus shifted to the developmental
problems of his native country. In several pamphlets he advocated
consumption of domestic products, challenged existing political
structures and made trenchant criticisms of absenteeism and other dysfunctional
aspects of the land tenure system. Swift’s politico-economic
concerns are fully reflected in his best known work, Gulliver’s Travels but
his most pointed criticism of the emerging commercial system is contained
in A Modest Proposal. Written in the form of an economic pamphlet, A
Modest Proposal is ostensibly designed to address the problem of poverty
in Ireland. In addition to its implicit criticism of economic policy in Ireland,
the pamphlet challenges the separation of economics and morality as
evidenced in the writings of William Petty and Bernard Mandeville. Swift
parodies Petty’s political arithmetic but it is suggested here that he also
had in his sights the consequentialist reasoning present in the work of
both authors but explicitly so in Mandeville.
Keywords: financial revolution, public debt, paper credit, rationality, political
arithmetic, consequentialism, Petty (William), Mandeville (Bernard)

The impact of interventions to promote physical activity in urban green space: A systematic review and recommendations for future research

Evidence is mounting on the association between the built environment and physical activity (PA) with a call for intervention research. A broader approach which recognizes the role of supportive environments that can make healthy choices easier is required. A systematic review was undertaken to assess the effectiveness of interventions to encourage PA in urban green space. Five databases were searched independently by two reviewers using search terms relating to 'physical activity', 'urban green space' and 'intervention' in July 2014. Eligibility criteria included: (i) intervention to encourage PA in urban green space which involved either a physical change to the urban green space or a PA intervention to promote use of urban green space or a combination of both; and (ii) primary outcome of PA. Of the 2405 studies identified, 12 were included. There was some evidence (4/9 studies showed positive effect) to support built environment only interventions for encouraging use and increasing PA in urban green space. There was more promising evidence (3/3 studies showed positive effect) to support PAprograms or PA programs combined with a physical change to the built environment, for increasing urban green space use and PAof users. Recommendations for future research include the need for longer term follow-up post-intervention, adequate control groups, sufficiently powered studies, and consideration of the social environment, which was identified as a significantly under-utilized resource in this area. Interventions that involve the use of PA programs combined with a physical change to the built environment are likely to have a positive effect on PA. Robust evaluations of such interventions are urgently required. The findings provide a platform to inform the design, implementation and evaluation of future urban green space and PAintervention research.

Green prospects in Greece

The radical left-wing Syriza and the Green party Ecologists Greens/Oikologoi Prasinoi (EG) have been seen as representatives of the left-libertarian/new politics party families in Greece. These type of parties are marked by a commitment to new politics issues such as gender and racial equality, peace and ecology. In countries where two party formations of this kind are in competition to attract a very similar clientele and one of them is electorally significant, it is unlikely for the other to achieve autonomous electoral success. This is a well-known fact that has penetrated discussions on the strategic orientation of both parties since their first electoral participation in 2004 (only European parliament elections for EG).

Azepanium-based ionic liquids as green electrolytes for high voltage supercapacitors

This work provides a first-time-study of Azepanium-based ionic liquids (ILs) as electrolyte components for electrochemical double layer capacitors (EDLCs). Herein, two Azepanium-based ILs, namely N-methyl, N-butyl-azepanium bis(trifluoromethanesulfonyl)imide (Azp(14)TFSI) and N-methyl, N-hexyl-azepanium bis(trifluoromethanesulfonyl)imide (Azp(16)TFSI) were compared with the established IL N-butyl, N-methylpyrrolidinium bis(trifluoromethanesulfonyl)imide (Pyr(14)TFSI) in terms of viscosity, conductivity, thermal stability and electrochemical behavior in EDLC systems. The ILs' operative potentials were found to be comparable, leading to operative voltages up to 3.5 V without significant electrolyte degradation. 

Recombinant Subgroup B Human Respiratory Syncytial Virus Expressing Enhanced Green Fluorescent Protein Efficiently Replicates in Primary Human Cells and Is Virulent in Cotton Rats

Human respiratory syncytial virus (HRSV) is the most important viral cause of severe respiratory tract disease in infants. Two subgroups (A and B) have been identified, which cocirculate during, or alternate between, yearly epidemics and cause indistinguishable disease. Existing in vitro and in vivo models of HRSV focus almost exclusively on subgroup A viruses. Here, a recombinant (r) subgroup B virus (rHRSV(B05)) was generated based on a consensus genome sequence obtained directly from an unpassaged clinical specimen from a hospitalized infant. An additional transcription unit containing the gene encoding enhanced green fluorescent protein (EGFP) was introduced between the phosphoprotein and matrix genes (position 5) of the genome to generate rHRSV(B05)EGFP(5). The recombinant viruses replicated efficiently in both HEp-2 cells and in well-differentiated normal human bronchial cells grown at air-liquid interface. Intranasal infection of cotton rats (Sigmodon hispidus) resulted in high numbers of EGFP(+) cells in epithelia of the nasal septum and conchae. When administered in a relatively large inoculum volume, the virus also replicated efficiently in bronchiolar epithelial cells and spread extensively in both the upper and lower respiratory tracts. Virus replication was not observed in ciliated epithelial cells of the trachea. This is the first virulent rHRSV strain with the genetic composition of a currently circulating wild-type virus. In vivo tracking of infected cells by means of EGFP fluorescence in the absence of cytopathic changes increases the sensitivity of virus detection in HRSV pathogenesis studies.

IMPORTANCE

Virology as a discipline has depended on monitoring cytopathic effects following virus culture in vitro. However, wild-type viruses isolated from patients often do not cause significant changes to infected cells, necessitating blind passage. This can lead to genetic and phenotypic changes and the generation of high-titer, laboratory-adapted viruses with diminished virulence in animal models of disease. To address this, we determined the genome sequence of an unpassaged human respiratory syncytial virus from a sample obtained directly from an infected infant, assembled a molecular clone, and recovered a wild-type recombinant virus. Addition of a gene encoding enhanced green fluorescent protein allowed this wild-type virus to be tracked in primary human cells and living animals in the absence of significant cytopathic effects. Imaging of fluorescent cells proved to be a highly valuable tool for monitoring the spread of virus and may help improve assays for evaluating novel intervention strategies.

Improving fuel economy application of the organic Rankine Cycle on a hybrid bus

Globally vehicle operators are experiencing rising fuel costs and increased
running expenses as governments around the world attempt to decrease carbon dioxide emissions and fossil fuel consumption, due to global warming and the drive to reduce dependency on fossil fuels. Recent advances in hybrid vehicle design have made great strides towards more efficient operation, with regenerative braking being widely used to capture otherwise lost energy. In this paper a hybrid series bus is developed a step further, by installing another method of energy capture on the vehicle. In this case, it is in the form of the Organic Rankine Cycle (ORC). The waste heat expelled to the exhaust and coolant streams is recovered and converted to electrical energy which is then stored in the hybrid vehicles batteries. The electrical energy can then be used for the auxiliary power circuit or to assist in vehicle propulsion, thus reducing the load on the engine, thereby improving the overall fuel economy of the vehicle and reducing carbon dioxide emissions.

The Day After Tomorrow: Transition Management, Spatial Planning & the Low Carbon Economy

Many of the societal challenges that current spatial planning practice claims to be addressing (climate change, peak oil, obesity, aging society etc) encompass issues and timescales that lie beyond the traditional scope planning policy (Campbell 2006). The example of achieving a low carbon economy typifies this in that it demands a process of society-wide transition, involving steering a wide range of factors (markets, infrastructure, governance, individual behaviour etc). Such a process offers a challenge to traditional approaches to planning as they cannot be guided by a fixed blueprint, given the timescales involved (up to 50 years) and an enhanced level of uncertainty, social resistance, lack of control over implementation and a danger of ‘policy lock in’ (Kemp et al 2007). One approach to responding to these challenges is the concept of transition management which has emerged from studies of science, technology and innovation (Geels 2002, Markard et al 2012). Although not without criticism, this perspective attempts to uncertainty and complexity encompassing long term visions that integrates multi-level, multi-actor and multi-domain perspectives (Rotmans et al 2001).
 
Given its origins, research on transition management has tended to neglect spatial contexts (Coenen et al 2012) and, related to this, it’s relationship with spatial planning is poorly understood. Using the example of the low carbon transition, this paper will review the relationships between the concepts, methodologies and goals of transition management and spatial planning to explore whether a closer integration of the two fields offers benefits to achieving the long term challenges facing society.
 

Stability in a Network Economy: The Role of Institutions

We consider an economy in which agents are embedded in a network of potential value-generating relationships. Agents are assumed to be able to participate in three types of economic interactions: Autarkic self-provision; bilateral interaction; and multilateral collaboration through endogenously provided platforms.
We introduce two stability concepts and provide sufficient and necessary conditions on the network structure that guarantee existence, in cases of the absence of externalities, link-based externalities and crowding externalities. We show that institutional arrangements based on socioeconomic roles and leadership guarantee stability. In particular, the stability of more complex economic outcomes requires more strict and complex institutional rules to govern economic interactions. We investigate strict social hierarchies, tiered leadership structures and global market places.

Capital Markets Union and ending short-termism: lessons from the European Commission's public consultation

The European Commission’s initiative to establish a Capital Markets Union is in sharp conflict with the more radical goals of downsizing significantly certain financial activities and firms that have become too-big-to-fail and too-big-to-govern and of ending or at least drastically limiting extreme speculation and short-termism in finance and the real economy in order to increase financial stability. The recent public consultation on the Commission’s Green Paper Building a Capital Markets Union gives evidence of how weak such demands are compared to calls for deeper capital markets with more ‘shadow banking’ and rebuilding (sound) securitisation. The consultation is an example of how framing the problem and the refined better regulation agenda influence post-crisis financial reregulation and help to marginalize more radical ideas demanding a return to a more traditional banking model and transforming finance back to serving the real economy.