Shaping the Future of Mental Health Policy and Legislation in Northern Ireland: The Impact of Service User and Professional Social Work Discourses

This paper explores the complex interrelationship between service user and professional social work discourses and provides a critical commentary on their respective contributions to the recent review of mental health policy and legislation in Northern Ireland. The analysis indicates that dominant trends in mental health care, as mediated through service structures and institutional identities, have tended to prioritize the more coercive aspects of the social work role and reinforce existing power inequalities with service users. It is argued that such developments underline the need for a ‘refocusing’ debate in mental health social work to consider how a more appropriate balance can be achieved between its participatory/empowering and regulatory/coercive functions. Whilst highlighting both congruence and dissonance between respective discourses, the paper concludes that opportunities exist within the current change process for service users and social workers to build closer alliances in working together to reconstruct practice, safeguard human rights and develop innovative alternatives to a traditional bio-medical model of treatment.

'Surfacing' Micropolitics as a Potential Management Change Frame

This paper considers the findings of a small-scale survey undertaken in a university department. Against a background of massification and commodification, the the increased level of responsibility and accountability has intensified political activity in general but at the micro level in particular. The conclusions of this research demonstrate that staff perceived power in the form of workload, appointment's and promotions were all contingent on the micro politics within the department and the affiliation to senior staff.

Implementing a resuscitation policy for patients at the end of life in an acute hospital setting: qualitative study

Objective : To explore attitudes and experiences of doctors and nurses regarding cardiopulmonary resuscitation for patients with end stage illness in an acute hospital. Design : Qualitative study; thematic analysis of two audio-taped focus groups and four semi-structured interviews. Setting : Acute district hospital, Northern Ireland. Participants : Seven nurses and nine doctors; varying nationality, gender and years of professional experience; involved in cardiopulmonary resuscitation decision-making. Results : Participants reported different interpretations of resuscitation policy and of what do not attempt to resuscitate (DNAR) decisions meant in relation to practical care for patients. This confusion in translating policy into practice contributed to communication difficulties in initiating, documenting and implementing cardiopulmonary resuscitation decisions. Participants were aware of how clinical conditions could change and reported uncertainty in determining end stage illness; they expressed fears of potential consequences of DNAR decisions for patients' care. The more disease-centred approach of doctors to patients' management, compared to nurses' more patient-centred approach, contributed to inter-professional conflict within teams. Doctors identified training needs in applying resuscitation policy and ethical principles in `real life' and nurses identified a need for ongoing professional support, which was perceived as being less available to junior doctors. Personal relationships between staff and patients, cultural reluctance to address sensitive issues and local community expectations of relatives being involved in decisions added to policy implementation difficulties. Conclusions : The findings indicate a need for ongoing staff support and training in applying resuscitation policy to decisions for patients with end stage illness in an acute hospital. They support suggestions that reviews of local resuscitation policy and of national guidelines should be undertaken with openness and honesty regarding the goals, opportunities and difficulties involved in trying to deliver good end of life care in local settings. Palliative Medicine 2007; 21 : 305—312 Key Words: do not attempt resuscitation (DNAR) • end stage illness • inter-professional • policy • resuscitation decisions

Inscribir el declive en el tiempo. Detroit: Auge y crisis de la ciudad industrial

A comienzos del siglo XX, Detroit era una ciudad dinámica en pleno desarrollo. Pronto se convirtió en la cuarta ciudad de Estados Unidos, la capital de la naciente industria automovilística. El crecimiento se prolongó hasta finales de los años 50, cuando, a pesar del auge económico de Estados Unidos y de su área metropolitana, Detroit comenzó a mostrar los primeros signos de estancamiento. La crisis se ha prolongado hasta hoy, cuando Detroit constituye el paradigma de la ciudad industrial en declive. Estas dos imágenes contrapuestas, el auge y la crisis, no parecen explicar por sí mismas las causas de la intensidad y persistencia del declive de Detroit. Analizar las interacciones entre crecimiento económico, políticas públicas locales y desarrollo urbano a lo largo del tiempo permitirá subrayar las continuidades y comprender en qué medida el declive de Detroit ancla sus raíces en el modelo planteado durante la etapa de auge.

Where there is smoke, there is (the potential for) fire: soft indicators of research and policy impact

There is a growing literature examining the impact of research on informing policy, and of research and policy on practice. Research and policy do not have the same types of impact on practice but can be evaluated using similar approaches. Sometimes the literature provides a platform for methodological debate but mostly it is concerned with how research can link to improvements in the process and outcomes of education, how it can promote innovative policies and practice, and how it may be successfully disseminated. Whether research-informed or research-based, policy and its implementation is often assessed on such 'hard' indicators of impact as changes in the number of students gaining five or more A to C grades in national examinations or a percentage fall in the number of exclusions in inner city schools. Such measures are necessarily crude, with large samples smoothing out errors and disguising instances of significant success or failure. Even when 'measurable' in such a fashion, however, the impact of any educational change or intervention may require a period of years to become observable. This paper considers circumstances in which short-term change may be implausible or difficult to observe. It explores how impact is currently theorized and researched and promotes the concept of 'soft' indicators of impact in circumstances in which the pursuit of conventional quantitative and qualitative evidence is rendered impractical within a reasonable cost and timeframe. Such indicators are characterized by their avowedly subjective, anecdotal and impressionistic provenance and have particular importance in the context of complex community education issues where the assessment of any impact often faces considerable problems of access. These indicators include the testimonies of those on whom the research intervention or policy focuses (for example, students, adult learners), the formative effects that are often reported (for example, by head teachers, community leaders) and media coverage. The collation and convergence of a wide variety of soft indicators (Where there is smoke …) is argued to offer a credible means of identifying subtle processes that are often neglected as evidence of potential and actual impact (… there is fire).

Textualising British Politics: Deconstructing the subject of British foreign policy

British politics has been described as a sub-discipline crying out for methodological and ideational cross-fertilisation. Where other areas of political science have benefited from new ideas, British politics has remained largely atheoretical and underdeveloped. This has changed recently with the rise of interpretivism but the study of British politics would also benefit from more serious engagement with poststructuralism. With this in mind, I examine how the thought of Jacques Derrida and deconstruction could be useful for thinking through the foundations of British politics, re-examining what appears natural or given and revealing the problematic and contradictory status of these foundations. After suggesting the need to 'textualise' British politics', I illustrate how deconstruction operates in a specific context, that of British foreign policy since 1997. This exploration reveals how certain decisions (such as the invasion of Iraq in 2003) became possible in the first place, and how their basis in an idea of an 'us' and a 'them', a coherent, autonomous subject separate from its object, is deeply problematic. Such a critical reading of British politics is impossible within the dominant interpretivist framework, and opens up new possibilities for thought which form an important supplement to existing ways of studying the field.

Growth Coalitions and Rural Development Police in the EU and the US

A recent issue of EuroChoices (7:1) was devoted to a discussion of comparative US-EU rural development policies. This article discusses the concept of growth coalitions, well developed in urban literature but less so in rural literature. Some light is shed on the different positions of rural and environmental issues in EU and US policies. The agricultural lobby is the dominant actor in agricultural growth coalitions because it perceives land in terms of its exchange value. Environmental and rural development actors perceive land in terms of its use value and its contributions to quality of life: they form a rural development coalition, seeing the need to balance growth with quality of life, but they have less political power than the agricultural growth coalition. In the European context, rural and environmental agendas are linked to a multi-functional agricultural agenda allowing common ground between these two coalitions and greater visibility in the policy arena. In the US, rural interests and environmental groups are more often in opposition to agriculture. This reduces their political visibility and clout. The challenge is how to link the power of the agricultural growth coalitions with rural development coalitions to achieve a broader balance of concerns and a more effective rural development policy.

The diversification and financial performance of US credit unions

For US credit unions, revenue from non-interest sources has increased significantly in recent years. We investigate the impact of revenue diversification on financial performance for the period 1993–2004. The impact of a change in strategy that alters the share of non-interest income is decomposed into a direct exposure effect, reflecting the difference between interest and non-interest bearing activities, and an indirect exposure effect which reflects the effect of the institution’s own degree of diversification. On both risk-adjusted and unadjusted returns measures, a positive direct exposure effect is outweighed by a negative indirect exposure effect for all but the largest credit unions. This may imply that similar diversification strategies are not appropriate for large and small credit unions. Small credit unions should eschew diversification and continue to operate as simple savings and loan institutions, while large credit unions should be encouraged to exploit new product opportunities around their core expertise.

UN 2006 Climate Change Conference: a confidence building step?

An analysis of the UN 2006 COP.

Restraing Regulatory Capture? Anglo America, Crisis Politics and Trajectories of Change in Global Financial Governance

A growing number of respected commentators now argue that regulatory capture of public agencies and public policy by leading banks was one of the main causal factors behind the financial crisis of 2007–2009, resulting in a permissive regulatory environment. This regulatory environment placed a faith in banks own internal risk models, contributed to pro-cyclical behaviour and turned a blind eye to excessive risk taking. The article argues that a form of ‘multi-level regulatory capture’ characterized the global financial architecture prior to the crisis. Simultaneously, regulatory capture fed off, but also nourished the financial boom, in a fashion that mirrored the life cycle of the boom itself. Minimizing future financial booms and crises will require continuous, conscious and explicit efforts to restrain financial regulatory capture now and into the future. The article assesses the extent to which this has been achieved in current global financial governance reform efforts and highlights some of the persistent difficulties that will continue to hamper efforts to restrain regulatory capture. The evidence concerning the extent to which regulatory capture is being effectively restrained is somewhat mixed, and where it is happening it is largely unintentional and accidental. Recent reforms have overlooked the political causes of the crisis and have failed to focus explicitly or systematically on regulatory capture.

Who We Are and Who Can Join Us: National Identity Content and Entry Criteria for New Immigrants

We argue that attitudes about immigration can be better understood by paying closer attention to the various ways in which national group boundaries are demarcated. We describe two related lines of work that address this. The first deals with national group definitions and, based on evidence from studies carried out in England and analyses of international survey data, argues that the relationship between national identification and prejudice toward immigrants is contingent on the extent to which ethnic or civic definitions of nationality are endorsed. The second, which uses European survey data, examines support for ascribed and acquired criteria that can be applied when determining who is permitted to migrate to one's country, and the various forms of national and individual threat that affect support for these criteria. We explain how the research benefits from a multilevel approach and also suggest how these findings relate to some current policy debates.