Expert opinion on the cough hypersensitivity syndrome in respiratory medicine

In 2011, a European Respiratory Society Task Force embarked on a process to determine the position and clinical relevance of the cough hypersensitivity syndrome, a disorder characterised by troublesome coughing often triggered by low levels of thermal, mechanical or chemical exposure, in the management of patients with chronic cough. A 21-component questionnaire was developed by an iterative process supported by a literature review. 44 key opinion leaders in respiratory medicine were selected and interviewed as to their opinions. There was a high degree of unanimity in the responses obtained, with all opinion leaders supporting the concept of cough hypersensitivity as a clinically useful paradigm. The classic stratification of cough into asthmatic, rhinitic and reflux-related phenotypes was supported. Significant disparity of opinion was seen in the response to two questions concerning the therapy of chronic cough. First, the role of acid suppression in reflux cough was questioned. Secondly, the opinion leaders were split as to whether a trial of oral steroids was indicated to establish a diagnosis of eosinophilic cough. The cough hypersensitivity syndrome was clearly endorsed by the opinion leaders as a valid and useful concept. They considered that support of patients with chronic cough was inadequate and the Task Force recommends that further work is urgently required in this neglected area.

Green Political Economy: beyond orthodox undifferentiated economic growth as a permanent feature of the economy

This chapter outlines the main features of green political economy and the principal ways in which it differs from dominant mainstream or orthodox neoclassical economics. Neoclassical economics is critiqued on the grounds of denying its normative and ideological commitments in its false presentation of itself as ‘objective’ and ‘value neutral’. It is also critiqued for its ecologically irrational commitment to the imperative of orthodox economic growth as a permanent feature of the economy, compromising its ability to offer realistic or normatively compelling guides to how we might make the transition to a sustainable economy. Green political economy is presented as an alternative or heterodox form of economic thinking but one which explicitly expresses its normative/ideological value bases (hence it represents a return to ‘political economy’, the origins of modern economics). Green political economy also challenges the commitment to undifferentiated economic growth as a permanent objective of the human economy. In its place, green political economy promotes ‘economic security’ as a better objective for a sustainable, post-growth economy. The latter includes the transition to a low-carbon energy economy, and is also one which maximises quality of life (as oppose to formal employment, income and wealth), and actively seeks to lower socio-economic inequality. Green political economy views orthodox economic growth as having passed the threshold in most ‘advanced’ capitalist societies beyond which it has undermined quality of life and at best manages rather than reduces socially and ecologically damaging inequalities.

SPSS step by step - essentials for social and political science

No abstract available

An Exploration of Political Consciousness Amongst Final Year Nursing Students in Northern Ireland

Context and background
Historically nurses perceive politics and nursing as being at odds with the caring image, synonymous with nurses (Salvage, 1985). Furthermore the concept of the ‘politics of nursing’ lacks clear conceptual clarity (Hewison, 1994). This concept ranges across a continuum from political interest to participation or engagement (Rains et al, 2001). It is often argued political interest tends to be equated with knowledge/ involvement in health policy development and nurse education can foster political consciousness, through political socialization (Brown, 1996). But despite the World Health Organization (WHO, 2002) urging this involvement, nurses globally are largely absent from the political and policy making arena. What influences nurse’s political socialization and the development of a political consciousness is not clearly identified or known, although many commentators suggest the undergraduate educational environment, plays an important role (Hanley, 1987, Winter, 1991).     

AIM
The aim of this study was to explore third year nursing student’s perceptions of politics in nursing, in the context of Northern Ireland. A number of hypotheses were tested examining the relationship between age, prior educational attainment and political interest and attitudes.  

Research methodology
A cross sectional research design was used and the data was collected using a short anonymous self-completion web survey (Bryman, 2012). The sample was a convenience sample of one cohort of final year adult nursing students (n154) in one Northern Irish university, with a 42% response rate. Data was analyzed using SPSS.

Key findings and conclusions
The results revealed 55% of students were very/fairly interested in politics, with 6% reporting no interest in politics. 85% of students were registered to vote, but only 48% voted in the 2010 N Ireland Assembly election.   
Recommend inclusion of a unit of study incorporating innovative teaching methods related to politics and health related policy, in the undergraduate nursing programme.       

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 rise of the digital citizen-stakeholder: rebalancing multistakeholder governance

The principle feature in the evolution of the internet has been its ever growing reach to include old and young, rich and poor. The internet’s ever encroaching presence has transported it from our desktop to our pocket and into our glasses. This is illustrated in the Internet Society Questionnaire on Multistakeholder Governance, which found the main factors affecting change in the Internet governance landscape were more users online from more countries and the influence of the internet over daily life. The omnipresence of the internet is self- perpetuating; its usefulness grows with every new user and every new piece of data uploaded. The advent of social media and the creation of a virtual presence for each of us, even when we are not physically present or ‘logged on’, means we are fast approaching the point where we are all connected, to everyone else, all the time. We have moved far beyond the point where governments can claim to represent our views which evolve constantly rather than being measured in electoral cycles.
The shift, which has seen citizens as creators of content rather than consumers of it, has undermined the centralist view of democracy and created an environment of wiki democracy or crowd sourced democracy. This is at the heart of what is generally known as Web 2.0, and widely considered to be a positive, democratising force. However, we argue, there are worrying elements here too. Government does not always deliver on the promise of the networked society as it involves citizens and others in the process of government. Also a number of key internet companies have emerged as powerful intermediaries harnessing the efforts of the many, and re- using and re-selling the products and data of content providers in the Web 2.0 environment. A discourse about openness and transparency has been offered as a democratising rationale but much of this masks an uneven relationship where the value of online activity flows not to the creators of content but to those who own the channels of communication and the metadata that they produce.
In this context the state is just one stakeholder in the mix of influencers and opinion formers impacting on our behaviours, and indeed our ideas of what is public. The question of what it means to create or own something, and how all these new relationships to be ordered and governed are subject to fundamental change. While government can often appear slow, unwieldy and even irrelevant in much of this context, there remains a need for some sort of political control to deal with the challenges that technology creates but cannot by itself control. In order for the internet to continue to evolve successfully both technically and socially it is critical that the multistakeholder nature of internet governance be understood and acknowledged, and perhaps to an extent, re- balanced. Stakeholders can no longer be classified in the broad headings of government, private sector and civil society, and their roles seen as some sort of benign and open co-production. Each user of the internet has a stake in its efficacy and each by their presence and participation is contributing to the experience, positive or negative of other users as well as to the commercial success or otherwise of various online service providers. However stakeholders have neither an equal role nor an equal share. The unequal relationship between the providers of content and those who simple package up and transmit that content - while harvesting the valuable data thus produced - needs to be addressed. Arguably this suggests a role for government that involves it moving beyond simply celebrating and facilitating the on- going technological revolution. This paper reviews the shifting landscape of stakeholders and their contribution to the efficacy of the internet. It will look to critically evaluate the primacy of the individual as the key stakeholder and their supposed developing empowerment within the ever growing sea of data. It also looks at the role of individuals in wider governance roles. Governments in a number of jurisdictions have sought to engage, consult or empower citizens through technology but in general these attempts have had little appeal. Citizens have been too busy engaging, consulting and empowering each other to pay much attention to what their governments are up to. George Orwell’s view of the future has not come to pass; in fact the internet has insured the opposite scenario has come to pass. There is no big brother but we are all looking over each other’s shoulder all the time, while at the same time a number of big corporations are capturing and selling all this collective endeavour back to us.

Trajectories of Adolescent Aggression and Family Cohesion: The Potential to Perpetuate or Ameliorate Political Conflict

Correlations between intergroup violence and youth aggression are often reported. Yet longitudinal research is needed to understand the developmental factors underlying this relation, including between-person differences in within-person change in aggression through the adolescent years. Multilevel modeling was used to explore developmental and contextual influences related to risk for youth aggression using 4 waves of a prospective, longitudinal study of adolescent/mother dyad reports (N = 820; 51% female; 10–20 years old) in Belfast, Northern Ireland, a setting of protracted political conflict. Experience with sectarian (i.e., intergroup) antisocial behavior predicted greater youth aggression; however, that effect declined with age, and youth were buffered by a cohesive family environment. The trajectory of aggression (i.e., intercepts and linear slopes) related to more youth engagement in sectarian antisocial behavior; however, being female and having a more cohesive family were associated with lower levels of youth participation in sectarian acts. The findings are discussed in terms of protective and risk factors for adolescent aggression, and more specifically, participation in sectarian antisocial behavior. The article concludes with clinical and intervention implications, which may decrease youth aggression and the perpetuation of intergroup violence in contexts of ongoing conflict.

Global Production, CSR and Human Rights: The Courts of Public Opinion and the Social License to Operate

This paper takes at its starting point the responsibility placed upon corporations by the United Nations’ Protect, Respect and Remedy Framework as elaborated upon by the Guiding Principles on Business and Human Rights to respect human rights. The overt pragmatism and knowledge of the complex business relationships that are embedded in global production led John Ruggie, the author of the Framework, to adopt a structure for the relationship between human rights and business that built on the existing practices of Corporate Social Responsibility (CSR). His intention was that these practices should be developed to embrace respect for human rights by exhorting corporations to move from “the era of declaratory CSR” to showing a demonstrable policy commitment to respect for human rights. The prime motivation for corporations to do this was, according to Ruggie, because the responsibility to respect was one that would be guarded and judged by the “courts of public opinion” as part of the social expectations imposed upon corporations or to put it another way as a condition of a corporation’s social license to operate.
This article sets out the background context to the Framework and examines the structures that it puts forward. In its third and final section the article looks at how the Framework requires a corporation’s social license to be assembled and how and by whom that social license will be judged. The success or failure of the Framework in persuading corporations to respect human rights is tied to whether “the courts of public opinion” can use their “naming and shaming power” effectively.

Transitional justice, demobilization, and peacebuilding amid political violence: Examining individual preferences in the Caribbean coast of Colombia

The conventional wisdom in the transitional justice literature is that there is no one-size-fits-all approach. This article suggests that this may also be true within a given state. The current paper reports on quantitative and qualitative data from 184 participants in a survey conducted in the Caribbean coast of Colombia. Results suggest widespread support for transitional justice mechanisms – such as perpetrator accountability, public acknowledgement and structural change – but dissatisfaction with national-level initiatives, specifically the 2005 Justice and Peace Law. Yet, despite a distrust of the national government and protracted conflict, individuals report social trust, community cohesion and reliance on local government institutions. These attitudes and behaviours suggest that decentralised transitional justice mechanisms may be more effective in meeting victims' needs. Moreover, analyses indicate that individual preferences are influenced by community factors, such as the presence of demobilised paramilitaries, which can be addressed through more localised approaches to promote peacebuilding. The paper concludes with best practices derived from the findings.