Health care rights and NHS rationing: turning theory into practice

How should we understand the nature of patients’ right in public health care systems? Are health care rights different to rights under a private contract for car insurance? This article distinguishes between public and private rights and the relevance of community interests and notions of social solidarity. It discusses the distinction between political and civil rights, and social and economic rights and the inherently political and redistributive nature of the latter. Nevertheless, social and economic rights certainly give rise to “rights” enforceable by the courts. In the UK (as in many other jurisdictions), the courts have favoured a “procedural” approach to the question, in which the courts closely scrutinise decisions and demand high standards of rationality from decision-makers. However, although this is the general rule, the article also discusses a number of exceptional cases where “substantive” remedies are available which guarantee patients access to the care they need.

Neural population models and cortical field theory: overview

The term neural population models (NPMs) is used here as catchall for a wide range of approaches that have been variously called neural mass models, mean field models, neural field models, bulk models, and so forth. All NPMs attempt to describe the collective action of neural assemblies directly. Some NPMs treat the densely populated tissue of cortex as an excitable medium, leading to spatially continuous cortical field theories (CFTs). An indirect approach would start by modelling individual cells and then would explain the collective action of a group of cells by coupling many individual models together. In contrast, NPMs employ collective state variables, typically defined as averages over the group of cells, in order to describe the population activity directly in a single model. The strength and the weakness of his approach are hence one and the same: simplification by bulk. Is this justified and indeed useful, or does it lead to oversimplification which fails to capture the pheno ...

Metabolic theory predicts whole-ecosystem properties

Understanding the effects of individual organisms on material cycles and energy fluxes within ecosystems is central to predicting the impacts of human-caused changes on climate, land use, and biodiversity. Here we present a theory that integrates metabolic (organism-based bottom-up) and systems (ecosystem-based top-down) approaches to characterize how the metabolism of individuals affects the flows and stores of materials and energy in ecosystems. The theory predicts how the average residence time of carbon molecules, total system throughflow (TST), and amount of recycling vary with the body size and temperature of the organisms and with trophic organization. We evaluate the theory by comparing theoretical predictions with outputs of numerical models designed to simulate diverse ecosystem types and with empirical data for real ecosystems. Although residence times within different ecosystems vary by orders of magnitude—from weeks in warm pelagic oceans with minute phytoplankton producers to centuries in cold forests with large tree producers—as predicted, all ecosystems fall along a single line: residence time increases linearly with slope = 1.0 with the ratio of whole-ecosystem biomass to primary productivity (B/P). TST was affected predominantly by primary productivity and recycling by the transfer of energy from microbial decomposers to animal consumers. The theory provides a robust basis for estimating the flux and storage of energy, carbon, and other materials in terrestrial, marine, and freshwater ecosystems and for quantifying the roles of different kinds of organisms and environments at scales from local ecosystems to the biosphere.

Rethinking disability theory and practice: challenging essentialism

This edited volume argues that even in recent Critical Disability Studies which have sought to critique essentialist assumptions in relation to Disability, nevertheless essentialisms remain which predetermine and predirect definitions and arguments in the field. This volume analyses such essentialisms in a wide range of areas such as childhood, gender, sexuality, reproduction, ADHD, autism, the animal, d/Deafness, hirsutism, the body, and vision. Particularly issues such as 'agency', 'voice' and 'body' are explored in terms of their political implications.

Articulating ‘public interest’ through complexity theory

The ‘Public interest’, even if viewed with ambiguity or scepticism, has been one of the primary means by which various professional roles of planners have been justified. Many objections to the concept have been advanced by writers in planning academia. Notwithstanding these, ‘public interest’ continues to be mobilised, to justify, defend or argue for planning interventions and reforms. This has led to arguments that planning will have to adopt and recognise some form of public interest in practice to legitimise itself.. This paper explores current debates around public interest and social justice and advances a vision of the public interest informed by complexity theory. The empirical context of the paper is the poverty alleviation programme, the Kudumbashree project in Kerala, India.

The future of strategic management research: assessing the quality of theory borrowing

In many business schools, the field of strategic management has been elevated to the same status as more traditional subject areas such as finance, marketing and organizational behaviour. However, the field is rather unclearly delineated at present, as a result of the heavy usage of borrowed theories, a phenomenon we discuss in this article. For strategic management to become a legitimate subject area, truly at par with the more conventional fields taught in business schools, we recommend much stronger selectivity when borrowing theories from other areas of scholarly inquiry than management, as the foundation of empirical work. We propose a new model consisting of seven quality tests to assess whether proper selectivity is being applied when ‘importing’ concepts from other fields than management. Our perspective has major implications both for future, evidence-based strategic management research and for the field's key stakeholders such as strategy teachers, practitioners and policy makers – who rely on research outputs from strategy scholars.

Targeting medication non-adherence behavior in selected autoimmune diseases: a systematic approach to digital health program development

Background 29 autoimmune diseases, including Rheumatoid Arthritis, gout, Crohn’s Disease, and Systematic Lupus Erythematosus affect 7.6-9.4% of the population. While effective therapy is available, many patients do not follow treatment or use medications as directed. Digital health and Web 2.0 interventions have demonstrated much promise in increasing medication and treatment adherence, but to date many Internet tools have proven disappointing. In fact, most digital interventions continue to suffer from high attrition in patient populations, are burdensome for healthcare professionals, and have relatively short life spans. Objective Digital health tools have traditionally centered on the transformation of existing interventions (such as diaries, trackers, stage-based or cognitive behavioral therapy programs, coupons, or symptom checklists) to electronic format. Advanced digital interventions have also incorporated attributes of Web 2.0 such as social networking, text messaging, and the use of video. Despite these efforts, there has not been little measurable impact in non-adherence for illnesses that require medical interventions, and research must look to other strategies or development methodologies. As a first step in investigating the feasibility of developing such a tool, the objective of the current study is to systematically rate factors of non-adherence that have been reported in past research studies. Methods Grounded Theory, recognized as a rigorous method that facilitates the emergence of new themes through systematic analysis, data collection and coding, was used to analyze quantitative, qualitative and mixed method studies addressing the following autoimmune diseases: Rheumatoid Arthritis, gout, Crohn’s Disease, Systematic Lupus Erythematosus, and inflammatory bowel disease. Studies were only included if they contained primary data addressing the relationship with non-adherence. Results Out of the 27 studies, four non-modifiable and 11 modifiable risk factors were discovered. Over one third of articles identified the following risk factors as common contributors to medication non-adherence (percent of studies reporting): patients not understanding treatment (44%), side effects (41%), age (37%), dose regimen (33%), and perceived medication ineffectiveness (33%). An unanticipated finding that emerged was the need for risk stratification tools (81%) with patient-centric approaches (67%). Conclusions This study systematically identifies and categorizes medication non-adherence risk factors in select autoimmune diseases. Findings indicate that patients understanding of their disease and the role of medication are paramount. An unexpected finding was that the majority of research articles called for the creation of tailored, patient-centric interventions that dispel personal misconceptions about disease, pharmacotherapy, and how the body responds to treatment. To our knowledge, these interventions do not yet exist in digital format. Rather than adopting a systems level approach, digital health programs should focus on cohorts with heterogeneous needs, and develop tailored interventions based on individual non-adherence patterns.

Predicting how many animals will be where: how to build, calibrate and evaluate individual-based models

Individual-based models (IBMs) can simulate the actions of individual animals as they interact with one another and the landscape in which they live. When used in spatially-explicit landscapes IBMs can show how populations change over time in response to management actions. For instance, IBMs are being used to design strategies of conservation and of the exploitation of fisheries, and for assessing the effects on populations of major construction projects and of novel agricultural chemicals. In such real world contexts, it becomes especially important to build IBMs in a principled fashion, and to approach calibration and evaluation systematically. We argue that insights from physiological and behavioural ecology offer a recipe for building realistic models, and that Approximate Bayesian Computation (ABC) is a promising technique for the calibration and evaluation of IBMs. IBMs are constructed primarily from knowledge about individuals. In ecological applications the relevant knowledge is found in physiological and behavioural ecology, and we approach these from an evolutionary perspective by taking into account how physiological and behavioural processes contribute to life histories, and how those life histories evolve. Evolutionary life history theory shows that, other things being equal, organisms should grow to sexual maturity as fast as possible, and then reproduce as fast as possible, while minimising per capita death rate. Physiological and behavioural ecology are largely built on these principles together with the laws of conservation of matter and energy. To complete construction of an IBM information is also needed on the effects of competitors, conspecifics and food scarcity; the maximum rates of ingestion, growth and reproduction, and life-history parameters. Using this knowledge about physiological and behavioural processes provides a principled way to build IBMs, but model parameters vary between species and are often difficult to measure. A common solution is to manually compare model outputs with observations from real landscapes and so to obtain parameters which produce acceptable fits of model to data. However, this procedure can be convoluted and lead to over-calibrated and thus inflexible models. Many formal statistical techniques are unsuitable for use with IBMs, but we argue that ABC offers a potential way forward. It can be used to calibrate and compare complex stochastic models and to assess the uncertainty in their predictions. We describe methods used to implement ABC in an accessible way and illustrate them with examples and discussion of recent studies. Although much progress has been made, theoretical issues remain, and some of these are outlined and discussed.

Fundamental insights into ontogenetic growth from theory and fish

The fundamental features of growth may be universal, because growth trajectories of most animals are very similar, but a unified mechanistic theory of growth remains elusive. Still needed is a synthetic explanation for how and why growth rates vary as body size changes, both within individuals over their ontogeny and between populations and species over their evolution. Here we use Bertalanffy growth equations to characterize growth of ray-finned fishes in terms of two parameters, the growth rate coefficient, K, and final body mass, m∞. We derive two alternative empirically testable hypotheses and test them by analyzing data from FishBase. Across 576 species, which vary in size at maturity by almost nine orders of magnitude, K scaled as m_∞^(-0.23). This supports our first hypothesis that growth rate scales as m_∞^(-0.25) as predicted by metabolic scaling theory; it implies that species which grow to larger mature sizes grow faster as juveniles. Within fish species, however, K scaled as m_∞^(-0.35). This supports our second hypothesis which predicts that growth rate scales as m_∞^(-0.33) when all juveniles grow at the same rate. The unexpected disparity between across- and within-species scaling challenges existing theoretical interpretations. We suggest that the similar ontogenetic programs of closely related populations constrain growth to m_∞^(-0.33) scaling, but as species diverge over evolutionary time they evolve the near-optimal m_∞^(-0.25) scaling predicted by metabolic scaling theory. Our findings have important practical implications because fish supply essential protein in human diets, and sustainable yields from wild harvests and aquaculture depend on growth rates.

Small wars and insurgencies in theory and practice, 1500-1850

In early modern times, warfare in Europe took on many diverse and overlapping forms. Our modern notions of ‘regular’ and ‘irregular’ warfare, of ‘major war’ and ‘small war’, have their roots in much greater diversity than such binary notions allow for. While insurgencies go back to time immemorial, they have become conceptually fused with ‘small wars’. This is a term first used to denote special operations, often carried out by military companies formed from special ethnic groups and then recruited into larger armies. In its Spanish form, guerrilla, the term ‘small war’ came to stand for an ideologically-motivated insurgency against the state authorities or occupying forces of another power. There is much overlap between the phenomena of irregular warfare in the sense of special operations alongside regular operations, and irregular warfare of insurgents against the regular forces of a state. This book demonstrates how long the two phenomena were in flux and fed on each other, from the raiding operations of the 16th century to the ‘small wars’ or special operations conducted by special units in the 19th century, which existed alongside and could merge with a popular insurgency. This book is based on a special issue of the journal Small Wars & Insurgencies.

Variance in male reproductive success and sexual size dimorphism in pinnipeds: testing an assumption of sexual selection theory

The theory of evolution by sexual selection for sexual size dimorphism (SSD) postulates that SSD primarily reflects the adaptation of males and females to their different reproductive roles. For example, competition among males for access to females increases male body size because larger males are better able to maintain dominant status than smaller males. Larger dominant males sire most offspring while smaller subordinate males are unsuccessful, leading to skew in reproductive success. Therefore, species with male-biased SSD are predicted to have greater variance in male reproductive success than those in which both sexes are similar in size. We tested this prediction among the Pinnipedia, a mammalian group with a great variation in SSD. From a literature review, we identified genetic estimates of male reproductive success for 10 pinniped taxa (eight unique species and two subspecies of a ninth species) that range from seals with similarly sized males and females to species in which males are more than four times as large as females. We found no support for a positive relationship between variance in reproductive success and SSD among pinnipeds after excluding the elephant seals Mirounga leonina and Mirounga angustirostris, which we discuss as distinctive cases. Several explanations for these results are presented, including the revival of one of Darwin's original ideas. Darwin proposed that natural selection may explain SSD based on differences in energetic requirements between sexes and the potential for sexual niche segregation. Males may develop larger bodies to exploit resources that remain unavailable to females due to the energetic constraints imposed on female mammals by gestation and lactation. The importance of this alternative explanation remains to be tested.

Datasets related to in-land water for limnology and remote sensing applications: distance-to-land, distance-to-water, water-body identifier and lake-centre co-ordinates

Datasets containing information to locate and identify water bodies have been generated from data locating static-water-bodies with resolution of about 300 m (1/360 deg) recently released by the Land Cover Climate Change Initiative (LC CCI) of the European Space Agency. The LC CCI water-bodies dataset has been obtained from multi-temporal metrics based on time series of the backscattered intensity recorded by ASAR on Envisat between 2005 and 2010. The new derived datasets provide coherently: distance to land, distance to water, water-body identifiers and lake-centre locations. The water-body identifier dataset locates the water bodies assigning the identifiers of the Global Lakes and Wetlands Database (GLWD), and lake centres are defined for in-land waters for which GLWD IDs were determined. The new datasets therefore link recent lake/reservoir/wetlands extent to the GLWD, together with a set of coordinates which locates unambiguously the water bodies in the database. Information on distance-to-land for each water cell and the distance-to-water for each land cell has many potential applications in remote sensing, where the applicability of geophysical retrieval algorithms may be affected by the presence of water or land within a satellite field of view (image pixel). During the generation and validation of the datasets some limitations of the GLWD database and of the LC CCI water-bodies mask have been found. Some examples of the inaccuracies/limitations are presented and discussed. Temporal change in water-body extent is common. Future versions of the LC CCI dataset are planned to represent temporal variation, and this will permit these derived datasets to be updated.

Origin of 10(15)-10(16) G magnetic fields in the central engine of gamma ray bursts

Various authors have suggested that the gamma-ray burst (GRB) central engine is a rapidly rotating, strongly magnetized, (similar to 10(15)-10(16) G) compact object. The strong magnetic field can accelerate and collimate the relativistic flow and the rotation of the compact object can be the energy source of the GRB. The major problem in this scenario is the difficulty of finding an astrophysical mechanism for obtaining such intense fields. Whereas, in principle, a neutron star could maintain such strong fields, it is difficult to justify a scenario for their creation. If the compact object is a black hole, the problem is more difficult since, according to general relativity it has ""no hair"" (i.e., no magnetic field). Schuster, Blackett, Pauli, and others have suggested that a rotating neutral body can create a magnetic field by non-minimal gravitational-electromagnetic coupling (NMGEC). The Schuster-Blackett form of NMGEC was obtained from the Mikhail and Wanas`s tetrad theory of gravitation (MW). We call the general theory NMGEC-MW. We investigate here the possible origin of the intense magnetic fields similar to 10(15)-10(16) G in GRBs by NMGEC-MW. Whereas these fields are difficult to explain astrophysically, we find that they are easily explained by NMGEC-MW. It not only explains the origin of the similar to 10(15)-10(16) G fields when the compact object is a neutron star, but also when it is a black hole.

Canonical quantum potential scattering theory

A new formulation of potential scattering in quantum mechanics is developed using a close structural analogy between partial waves and the classical dynamics of many non-interacting fields. Using a canonical formalism we find nonlinear first-order differential equations for the low-energy scattering parameters such as scattering length and effective range. They significantly simplify typical calculations, as we illustrate for atom-atom and neutron-nucleus scattering systems. A generalization to charged particle scattering is also possible.