The Society of States under siege? An English School perspective on the emergence of global civil society

In this article I critically examine the theoretical and empirical relationship between world society, whereby global civil society is taken to be its physical or empirical counterpart, and the society of states. This relationship is typically portrayed as contradictory or confrontational, and I contend that this mainstream perspective is reliant on a superficial analysis of the relationship. If one examines the deeper dynamics, viewed in their contemporary international normative context, then one can identify the more constructive and permissive aspects of the relationship. Rather than being wholly incompatible I argue that world society and international society are mutually constitutive and mutually dependent regimes, whose relationship is more often marked by cooperation than by conflict. English School theory provides the conceptual framework for this analysis. The relationship between international and world society presents a core ontological tension within this theory, and again they tend to occupy polarised positions. A synthesis of four international theories - pluralist international society theory, solidarist international society theory, critical international theory, and the discourse of global civil society - informs the hypothesis that the relationship can be normatively and empirically reconciled. In order to empirically support this explanation I analyse two phenomena in world politics - transnational advocacy networks and humanitarian intervention - where there is an apparent tension between international and world society.

Multisite, quality-improvement collaboration to optimise cardiac care in Queensland public hospitals

Objective: To evaluate changes in quality of in-hospital care of patients with either acute coronary syndromes (ACS) or congestive heart failure (CHF) admitted to hospitals participating in a multisite quality improvement collaboration. Design: Before-and-after study of changes in quality indicators measured on representative patient samples between June 2001 and January 2003. Setting: Nine public hospitals in Queensland. Study populations: Consecutive or randomly selected patients admitted to study hospitals during the baseline period (June 2001 to January 2002; n = 807 for ACS, n = 357 for CHF) and post-intervention period (July 2002 to January 2003; n = 717 for ACS, n = 220 for CHF). Intervention: Provision of comparative baseline feedback at a facilitative workshop combined with hospital-specific quality-improvement interventions supported by on-site quality officers and a central program management group. Main outcome measure: Changes in process-of-care indicators between baseline and post-intervention periods. Results: Compared with baseline, more patients with ACS in the post-intervention period received therapeutic heparin regimens (84% v 72%; P < 0.001), angiotensin-converting enzyme inhibitors (64% v 56%; P = 0.02), lipid-lowering agents (72% v 62%; P < 0.001), early use of coronary angiography (52% v 39%; P < 0.001), in-hospital cardiac counselling (65% v 43%; P < 0.001), and referral to cardiac rehabilitation (15% v 5%; P < 0.001). The numbers of patients with CHF receiving β-blockers also increased (52% v 34%; P < 0.001), with fewer patients receiving deleterious agents (13% v 23%; P = 0.04). Same-cause 30-day readmission rate decreased from 7.2% to 2.4% (P = 0.02) in patients with CHF. Conclusion: Quality-improvement interventions conducted as multisite collaborations may improve in-hospital care of acute cardiac conditions within relatively short time frames.

Risk reduction: Recontexualizing health as a physical education curriculum

While there is sufficient evidence to suggest that physical activity is inversely related to lifestyle diseases, researchers are far from being certain that this evidence extends to children. Nevertheless, the school physical education curriculum has been targeted as an institutional agency that could have a significant impact on health during childhood and later during adulthood if individuals could be habituated to assume a physically active lifestyle. The purpose of this article is to examine the recontextualization of biomedical knowledge into an ideology of healthism in which health is conceived as a controllable certainty and used as a pedagogical construction to transform school physical education. Using a Foucauldian perspective, we explore how the atomized biomedical model of chemical and physical relationships is constructed, reproduced, and perpetuated to service and empower the discourse and the practices of researchers and scholars. In this process the sociological or cultural aspects of public health are marginalized or ignored. As a result of this examination, alternative approaches are proposed that engage the limitations of the biomedical model and openly consider the insights that are available from the social sciences regarding what participation in physical activity means to individuals.

Politics and parties: Neglected aspects of postmaterial value change

Inglehart’s thesis of postmaterial value change is one of the most influential accounts of social and political change in advanced Western nations. This paper uses data from the World Values Survey and the Australian Election Surveys to reexamine the relationship between age and values in 19 advanced industrial nations. We find evidence of a monotonic age structuring of values in a number of countries, but in others, the relationship between age and values is not as Inglehart would predict. In addition, the impact of birth cohort on values differs between countries that are dominated by two major parties and those where there are many smaller parties. The presence of successful Green parties is also important for enhancing the uptake of postmaterialist values. These findings suggest that Inglehart’s arguments about generational value change should be modified to take into account national political institutions and political cultures that might enhance or impede generational-based values change.

Logistical aspects of large telemedicine networks. 2: Measurement of network activity

We carried out a retrospective review of the videoconference activity records in a university-run hospital telemedicine studio. Usage records describing videoconferencing activity in the telemedicine studio were compared with the billing records provided by the telecommunications company. During a seven-month period there were 211 entries in the studio log: 108 calls made from the studio and 103 calls made from a far-end location. We found that 103 calls from a total of 195 calls reported by the telecommunications company were recorded in the usage log. The remaining 92 calls were not recorded, probably for one of several reasons, including: failed calls-a large number of unrecorded calls (57%) lasted for less than 2 min (median 1.6 min); origin of videoconference calls-calls may have been recorded incorrectly in the usage diary (i.e. as being initiated from the far end, when actually initiated from the studio); and human error. Our study showed that manual recording of videoconference activity may not accurately reflect the actual activity taking place. Those responsible for recording and analysing videoconference activity, particularly in large telemedicine networks, should do so with care.