Advocacy coalitions:influencing the policy process in the EU

The aim of this contribution is to critically evaluate one of the theoretical approaches used to study the European Union (EU) political system and interest groups activity: the advocacy coalition framework (ACF). ACF considers that the outcome of legislative procedures is influenced by the alignment and role played by advocacy coalitions. This contribution assesses the impact of ACF on our understanding of the influences on the EU policy processes, highlighting the strengths and weaknesses of the approach. The main argument is that the ACF, although very useful in studying the EU political system, shows shortcomings when applied to the study of EU interest groups' performance. The contribution ends with a consideration of future directions for theoretical and empirical ACF research, alone and as part of wider integrated theoretical approaches to understanding the dynamics of influence in the EU. © 2013 Copyright Taylor and Francis Group, LLC.

Women and peace in a divided society:peace-building potentials of feminist advocacy and reform in Bosnia and Herzegovina

Despite an improving international rhetoric highlighting the necessity of women’s participation in postwar settings, women still tend to be disadvantaged in peace-building processes (Chinkin and Charlesworth, 2006; United Nations, 2002). This chapter argues that women’s struggles for rights entail important potentials for peace-building in divided postwar societies. Women frequently are among the first who cooperate across ethnic divisions established and hardened during ethno-political wars. Feminist policy reforms often strengthen common state structures and their legitimacy, contributing to the overcoming of ethnic divisions. Women’s participation and contributions should, therefore, be much more recognized and promoted in peace-building processes. However, it is feminist advocacy that is key, not women’s participation per se. Women have often promoted nationalistic and violent agendas; yet, only if they champion the rights of women independent of their ethnic and political differences can peace-building potentials come into effect.

The role of expertise in governance processes

In present day knowledge societies political decisions are often justified on the basis of scientific expertise. Traditionally, a linear relation between knowledge production and application was postulated which would lead, with more and better science, to better policies. Empirical studies in Science and Technology studies have essentially demolished this idea. However, it is still powerful, not least among practitioners working in fields where decision making is based on large doses of expert knowledge. Based on conceptual work in the field of Science and Technology Studies (STS) I shall examine two cases of global environmental governance, ozone layer protection and global climate change. I will argue that hybridization and purification are important for two major forms of scientific expertise. One is delivered though scientific advocacy (by individual scientists or groups of scientists), the other through expert committees, i.e. institutionalized forms of collecting and communicating expertise to decision makers. Based on this analysis lessons will be drawn, also with regard to the stalling efforts at establishing an international forestry regime.

How do older people with sight loss manage their general health? A qualitative study

Purpose: Older people with sight loss experience a number of barriers to managing their health. The purpose of this qualitative study was to explore how older people with sight loss manage their general health and explore the techniques used and strategies employed for health management. Methods: Semi-structured face-to-face interviews were conducted with 30 participants. Interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis. Results: Health management challenges experienced included: managing multiple health conditions; accessing information; engaging in health behaviours and maintaining wellbeing. Positive strategies included: joining support groups, clubs and societies; using low vision aids; seeking support from family and friends and accessing support through health and social care services. Conclusion: Healthcare professionals need to be more aware of the challenges faced by older people with sight loss. Improved promotion of group support and charity services which are best placed to share information, provide fora to learn about coping techniques and strategies, and give older people social support to prevent isolation is needed. Rehabilitation and support services and equipment can only be beneficial if patients know what is available and how to access them. Over-reliance on self-advocacy in current healthcare systems is not conducive to patient-centred care. Implications for Rehabilitation Sight loss in older people can impact on many factors including health management. This study identifies challenges to health management and highlights strategies used by older people with sight loss to manage their health. Access to support often relies on patients seeking information for themselves. However, self-advocacy is challenging due to information accessibility barriers. Informal groups and charities play an important role in educating patients about their condition and advising on available support to facilitate health management.

The political shaping of energy technology:combined heat and power in Britain

There has been negligible adoption of combined heat and power (CHP) for district heating (DH) in Britain, despite continued advocacy. This thesis constructs an account of the treatment of the option, and devises a framework for explanation. Analysis of technological development and adoption, it is argued, should be similar to that of other social processes, and be subject to the same requirements and criticisms. They will, however, show features peculiar to the institutions developing and selecting technologies, their relation to different social groups, and the forms of knowledge in and about technology. Conventional approaches - organisation and interorganisation theories, and analyses of policy-making - give useful insights but have common limitations. Elements of an analytical framework situating detailed issues and outcomes in a structured historical context are derived from convergent radical critiques. Thus activity on CHP/DH is essentially shaped by the development and relations of energy sector institutions: central and local government, nationalised industries and particularly the electricity industry. Analysis of them is related to the specific character of the British state. A few CHP and DH installations were tried before 1940. During postwar reconstruction, extensive plans for several cities were abandoned or curtailed. In the 1960s and 70s, many small non-CHP DH schemes were installed on housing estates. From the mid-70s, the national potential of CHP/DH has been reappraised, with widespread support and favourable evaluations, but little practical progress. Significant CHP/DH adoption is shown to have been systematically excluded ultimately by the structure of energy provision; centralised production interests dominate and co-ordination is weak. Marginal economics and political commitment have allowed limited development in exceptional circumstances. Periods of upheaval provided greater opportunity and incentive for CHP/DH but restructuring eventually obstructed it. Explanation of these outcomes is shown to require analysis at several levels, from broad context to detailed action.

The association between presenteeism and engagement of National Health Service staff

Objective: Although several studies have demonstrated a relationship between staff engagement and health and wellbeing, none has analysed the association with presenteeism in the National Health Service (NHS) context. Our aim is to determine whether there is a relationship between presenteeism and staff engagement. Methods: A hierarchical logistic multilevel modelling of cross-sectional data from the NHS staff survey (2009) was conducted. We controlled for a range of demographic and socioeconomic background variables, including ethnic group, gender, age and occupational group. The sample was 156,951 respondents across all 390 English NHS trusts, each providing a random sample of employees. Engagement was measured using three facets: motivation, advocacy and involvement, which were also used in a composite score. Results: Therewas a low-to-moderate negative correlation between presenteeismand staff engagement: odds ratio 0.42 (95% confidence interval [CI] 0.42-0.43) for overall staff engagement and 0.53 (95% CI 0.52-0.54) for staff advocacy of the trust; 0.53 (95% CI 0.52-0.54) for motivation and 0.50 (95% CI 0.49-0.51) for involvement. Conclusions: Putting pressure on health-care staff to come to work when unwell is associated with poorer staff engagement with their jobs. © The Royal Society of Medicine Press Ltd 2011.

Consumer engagement with self-expressive brands:brand love and WOM outcomes

Purpose: The purpose of this paper is to explore attitudes of consumers who engage with brands through Facebook "likes". It explores the extent to which these brands are self-expressive and examines the relationship between brand "liking" and brand outcomes. Brand outcomes include brand love and advocacy, where advocacy incorporates WOM and brand acceptance. Design/methodology/approach: Findings are presented from a survey of Facebook users who engage with a brand by "liking" it. Findings: Brands "liked" are expressive of the inner or social self. The study identifies a positive relationship between the self-expressive nature of brands "liked" and brand love. Consumers who engage with inner self-expressive brands are more likely to offer WOM for that brand. By contrast, consumers who engage with socially self-expressive brands are more likely to accept wrongdoing from a brand. Research limitations/implications: The research is exploratory and is limited to consumers who are engaged with a brand through "liking" it on the Facebook social network. Practical implications: The study offers suggestions for managers seeking to enhance brand engagement through Facebook "liking", and to encourage positive brand outcomes (such as WOM) among consumers already engaged with a brand on Facebook. Originality/value: This paper provides new insights into consumer brand engagement evidenced through Facebook "liking". It charts the relationship between "liked" self-expressive brands and brand love. Distinctions are drawn between brand outcomes among consumers who "like" for socially self-expressive reasons, and consumers who are brand engaged by "liking" to express their inner selves. © Emerald Group Publishing Limited.

Managing crisis:the role of primary care for people with serious mental illness

Background and Objectives: More than 30% of patients with serious mental illness in the United Kingdom now receive all their health care solely from primary care. This study explored the process of managing acute mental health crises from the dual perspective of patients and primary care health professionals. Methods: Eighteen focus groups involving 45 patients, 39 general practitioners, and eight practice nurses were held between May and November 2002 in six Primary Care Trusts across the British West Midlands. The topic guide explored perceptions of gold standard care, current issues and critical incidents in receiving/providing care, and ideas on improving services. Results: Themes relevant to the management of acute crisis included issues of process, such as access, advocacy, communication, continuity, and coordination of care; the development of more structured care that might reduce the need for crisis responses; and issues raised by the development of a more structured approach to care. Conclusions: Access to services is a complicated yet crucial feature of managing care in a crisis, with patients identifying barriers at the level of primary care and health professionals at the interface with secondary care. The development of more structured systems as a solution may generate its own ethical and pragmatic challenges.

Growing better brains? Pregnancy and neuroscience discourses in English social and welfare policies

In recent years, English welfare and health policy has started to include pregnancy within the foundation stage of child development. The foetus is also increasingly designated as ‘at risk’ from pregnant women. In this article, we draw on an analysis of a purposive sample of English social and welfare policies and closely related advocacy documents to trace the emergence of neuroscientific claims-making in relation to the family. In this article, we show that a specific deterministic understanding of the developing brain that only has a loose relationship with current scientific evidence is an important component in these changes. We examine the ways in which pregnancy is situated in these debates. In these debates, maternal stress is identified as a risk to the foetus; however, the selective concern with women living in disadvantage undermines biological claims. The policy claim of neurological ‘critical windows’ also seems to be influenced by social concerns. Hence, these emerging concerns over the foetus’ developing brain seem to be situated within the gendered history of policing women’s pregnant bodies rather than acting on new insights from scientific discoveries. By situating these developments within the broader framework of risk consciousness, we can link these changes to wider understandings of the ‘at risk’ child and intensified surveillance over family life.

Biologising parenting:neuroscience discourse, English social and public health policy and understandings of the child

In recent years, claims about children's developing brains have become central to the formation of child health and welfare policies in England. While these policies assert that they are based on neuro-scientific discoveries, their relationship to neuroscience itself has been debated. However, what is clear is that they portray a particular understanding of children and childhood, one that is marked by a lack of acknowledgment of child personhood. Using an analysis of key government-commissioned reports and additional advocacy documents, this article illustrates the ways that the mind of the child is reduced to the brain, and this brain comes to represent the child. It is argued that a highly reductionist and limiting construction of the child is produced, alongside the idea that parenting is the main factor in child development. It is concluded that this focus on children's brains, with its accompanying deterministic perspective on parenting, overlooks children's embodied lives and this has implications for the design of children's health and welfare services.

Neuroscience and family policy:what becomes of the parent?

This article discusses the findings of a study tracing the incorporation of claims about infant brain development into English family policy as part of the longer term development of a ‘parent training’, early intervention agenda. The main focus is on the ways in which the deployment of neuroscientific discourse in family policy creates the basis for a new governmental oversight of parents. We argue that advocacy of ‘early intervention’, in particular that which deploys the authority of ‘the neuroscience’, places parents at the centre of the policy stage but simultaneously demotes and marginalises them. So we ask, what becomes of the parent when politically and culturally, the child is spoken of as infinitely and permanently neurologically vulnerable to parental influence? In particular, the policy focus on parental emotions and their impact on infant brain development indicates that this represents a biologisation of ‘therapeutic’ governance.

Developing an intervention to equip nurses for acute life threatening events (ALTEs) in hospital:a phenomenological approach to healthcare research

Objectives: To understand staff's experiences of acute life threatening events (ALTEs) in a pediatric hospital setting. These data will inform an intervention to equip nurses with clinical and emotional skills for dealing with ALTEs. Method: A mixed design was used in the broader research program; this paper focuses on phenomenon-focused interviews analyzed using interpretative phenomenological analysis (IPA). Results: Emerging themes included staff's relationships with patients and the impact of personhood on their ability to perform competently in an emergency. More experienced nurses described "automatic" competence generated through increased exposure to ALTEs and were able to recognize "fumbling and shaking" as a normal stress response. Designating a role was significant to staff experience of effectiveness. Key to nurses' learning experience was reflection and identifying experiences as "teachable moments." Findings were considered alongside existing theories of self-efficacy, reflective thought, and advocacy inquiry to create an experiential learning intervention involving a series of clinical and role-related scenarios. Conclusion: The phenomenological work facilitated an in-depth reading of experience. It accentuated the importance of exposure to ALTEs giving nurses experiential knowledge to prepare them for the impact of these events. Challenges included bracketing the personhood of child patients, shifting focus to clinical tasks during the pressured demands of managing an ALTE, normalizing the physiological stress response, and the need for a forum and structure for reflection and learning. An intervention will be designed to provide experiential learning and encourage nurses to realize and benefit from their embodied knowledge.

Determinants of civil society influence:the case of international development and humanitarian NGOs in the Czech Republic and Hungary

Accession to the EU has had ambiguous effects on civil society organizations (CSOs) in the East Central European countries. A general observation is that accession has not led to the systematic empowerment of CSOs in terms of growing influence on national policy making. This article investigates the determinants of successful CSO advocacy by looking at international development and humanitarian NGOs (NGDOs) in the Czech Republic and Hungary. Reforms in the past decade in the Czech Republic have created an international development policy largely in line with NGDO interests, while Hungary’s ministry of foreign affairs seems to have been unresponsive to reform demands from civil society. The article argues that there is clear evidence of NGDO influence in the Czech Republic on international development policy, which is because of the fact that Czech NGDOs have been able solve problems of collective actions, while the Hungarian NGDO sector remains fragmented. They also have relatively stronger capacities, can rely on greater public support and can thus present more legitimate demands towards their government.

Corporate coalitions and policy making in the European Union:how and why British American tobacco promoted "better regulation"

Over the past fifteen years, an interconnected set of regulatory reforms, knownas Better Regulation, has been adopted across Europe, marking a significant shift in theway that European Union policies are developed. There has been little exploration of the origins of these reforms, which include mandatory ex ante impact assessment. Drawing on documentary and interview data, this article discusses how and why large corporations, notably British American Tobacco (BAT), worked to influence and promote these reforms. Our analysis highlights (1) howpolicy entrepreneurs with sufficient resources (such as large corporations) can shape the membership and direction of advocacy coalitions; (2) the extent to which "think tanks" may be prepared to lobby on behalf of commercial clients; and (3) why regulated industries (including tobacco) may favor the use of "evidence tools," such as impact assessments, in policy making. We argue that a key aspect of BAT's ability to shape regulatory reform involved the deliberate construction of a vaguely defined idea that could be strategically adapted to appeal to diverse constituencies.We discuss the theoretical implications of this finding for the Advocacy Coalition Framework, as well as the practical implications of the findings for efforts to promote transparency and public health in the European Union.