The postmodernist war on evidence-based practice

In this paper, we examine the war of words between those who contend that health care practice, including nursing, should primarily be informed by research (the evidence-based practice movement), and those who argue that there should be no restrictions on the sources of knowledge used by practitioners (the postmodernists). We review the postmodernist interventions of Dave Holmes and his colleagues, observing that the postmodernist style to which they adhere, which includes the use of continental philosophy, metaphors, and acerbic delivery, tends to obscure their substantive arguments. The heated nature of some responses to them has tended to have the same effect. However, the substantive arguments are important. Five main postmodernist charges are identified and discussed. The first argument, that the notion of ‘best evidence’ implies a hierarchical and exclusivist approach to knowledge, is persuasive. However, the contention that this hierarchy is maintained by the combined pressures of capitalism and vested interests within academia and the health services, is less well founded. Nevertheless, postmodernist contentions that the hierarchy embraced by the evidence-based practice movement damages health care because it excludes other forms of evidence that are needed to understand the complexity of care, it marginalizes important aspects of clinical knowledge, and it fails to take account of individuals or their experience, are all seen to be of some merit. However, we do not share the postmodernist conclusion that this adds up to a fascist order. Instead, we characterize evidence-based practice as a necessary but not sufficient component of health care knowledge.

Placing political economy: organising opposition to free trade before the abolition of the Corn Laws

The unfurling of global capitalism – and its attendant effects – has long been fertile intellectual terrain for geographers. But whilst studies of the processes and mechanisms of globalisation undoubtedly assume a talismanic importance in the discipline, geographers, with few exceptions, have left examinations of early economic liberalism to historians. One such critically important episode in the evolution of the liberal economic project was the repeal of the so-called 'Corn Laws' in 1846. Whilst the precise impact of the Manchester-based Anti-Corn Law League (ACLL) continues to be a matter of conjecture, Eric Sheppard has asserted that their particular take on political economy managed to assume a 'truth-like status' and worldwide universality. But the ACLL's campaign represents only one, albeit decisive, stage in the long intellectual and practical struggle between 'protectionists' and the disciples of free trade. Studies of the non-'Manchester' components have tended to focus squarely upon national politics. This paper examines a pivotal attempt in 1838 by Lord Melbourne's Government to experiment with the effective elimination of import duties on fresh fruit. Unlike most agricultural commodities, table fruit was produced in a tightly defined area, thus allowing the Government's experiment to play out, in theory, without national political fallout. Whilst the Government's clandestine actions left little time for a concerted opposition to develop, Kentish fruit growers soon organised. A formidable lobby was forged that drew wide local support yet also evolved beyond the original 'epistemic community'. Whilst the coalition failed in their efforts to reintroduce protective duties, their actions allow us to see how protectionist ideologies and policies were vivified through practices at many different spatial scales and to better understand the complex spatiality of protectionist takes on political economy. Their campaign also changed – at least in the short term – the course of British mercantile policy.

Sufrimiento y pesimismo en Schopenhauer

El presente artículo investiga de qué forma la centralidad del sufrimiento en la filosofía de Schopenhauer sirve para fundamentar su pesimismo. Tres son los argumentos analizados: el lugar del sufrimiento en el mundo, su lugar en la conciencia humana y su lugar frente a la felicidad. A la luz de estos tres argumentos, se destaca que el vínculo indisoluble entre el sufrimiento y la esencia del mundo, la determinación del sufrimiento en la conciencia, tanto en su génesis como en su intensidad, y su anterioridad ontológica frente a la felicidad hacen del pesimismo una categoría necesaria. Finalmente, se señala una posible contribución del pesimismo schopenhaueriano a la crítica social contemporánea, considerando la idea de mundo que el capitalismo tardío promueve.

Language and Power: A Resource Book for Students

Language and Power offers a comprehensive survey of the ways in which language intersects and connects with the social, cultural and political aspects of power; provides a comprehensive introduction to the history of the field, and covers all the major approaches, theoretical concepts and methods of analysis in this important and developing area of academic study; covers all the 'traditional' topics, such as race, gender and institutional power, but also incorporates newer material from forensic discourse analysis, the discourse of new capitalism and the study of humour as power; includes readings from works by seminal figures in the field, such as Roger Fowler, Deborah Cameron and Teun van Dijk; uses real texts and examples throughout, including advertisements from cosmetics companies; newspaper articles and headlines; websites and internet media; and spoken dialogues such as a transcription from the Obama and McCain presidential debate; and is accompanied by a supporting website that aims to challenge students at a more advanced level and features a complete four-unit chapter which includes activities, a reading and suggestions for further work.

Contemporary Radio Art and Spatial Politics: The Critical Radio Utopias of Anna Friz

The article explores the work of the Canadian sound artist Anna Friz over the last decade. Her work deals explicitly with issues of technology and the relative absence of women's voices on radio. Exploring her work as a composer, installation artist, instrumentalist, performance artist and storyteller, and contextualising these practices within feminist critiques and radio conventions, the article explores Friz's ‘self-reflexive radio’. Ideas of ‘supermodernity’, ‘displacement’ and ‘critical utopia’ are deployed to discuss specific pieces of Friz's work in relation to identity and space. The article argues that Friz reconfigures the radio as a site of resistance to dominant constructions of contemporary globalised space and cultures, the politics of informational capitalism and the uneven flows that these cultures and politics engender.

Large-scale association analysis identifies 13 new susceptibility loci for coronary artery disease

We performed a meta-analysis of 14 genome-wide association studies of coronary artery disease (CAD) comprising 22,233 individuals with CAD (cases) and 64,762 controls of European descent followed by genotyping of top association signals in 56,682 additional individuals. This analysis identified 13 loci newly associated with CAD at P < 5 x 10(-8) and confirmed the association of 10 of 12 previously reported CAD loci. The 13 new loci showed risk allele frequencies ranging from 0.13 to 0.91 and were associated with a 6% to 17% increase in the risk of CAD per allele. Notably, only three of the new loci showed significant association with traditional CAD risk factors and the majority lie in gene regions not previously implicated in the pathogenesis of CAD. Finally, five of the new CAD risk loci appear to have pleiotropic effects, showing strong association with various other human diseases or traits.

‘Marxism and Ecology: From Political Economy to Political Ecology’

One of the reasons for the 'fin de seicle' angst within western liberal capitalist societies is the rise in prominance of ecological concerns within these societies. Long before the New Right declared the post-war welfare state to be untenable, early green critics had claimed it to be ecologically unsustainable. The addiction of the welfare state on ever increasing levels of economic growth was pronounced to be simply impossible within the context of a finite planet. Although it was not expressed in this manner, what these early ecological concerns with Limits to Growth were in effect saying was that the accumulation of capital rendered capitalism unsustainable. Yet the ecological critique of capitalism has not found much favour within the Marxist critique untile recently. Early Marxist analyses of the ecology movement dismissed them as ‘petty bourgeios radicals’ while many greens still view Marxism as ‘fair shares in extinction’. The lack of positive engagement and dialogue between Marxism and ecology has in recent years been put right with a discernable overlap between the two critiques of capitalism. This article seeks to present the areas of disagreement and agreement between the two and seeks to provide an ‘environmental audit’ on both the Marxist method and political project.

Veblen's Placebo: A historical perspective on administrative evil

Thorstein Veblen was a turn of the 20th century American economist concerned with the implications of financial capitalists directing the means of production. Veblen proposed that the rationality of "material science" as practiced by the "production engineers" is fundamentally different from the rationality of market capitalism. If this claim is valid, our previous contentions regarding accounting, as a facilitating technology, for administrative evil warrant reconsideration. Veblen's position provides a historical perspective on one dimension of administrative evil that is generally unquestionably accepted, especially within accounting. That is, technology, such as accounting and the related information systems, is amoral, and it is only through ideologically instigated applications that any moral value accrues. We discuss administrative evil and the role of instrumental rationality generally, and accounting specifically, in creating it. Veblen's characterization of financial capitalism and production engineers and his arguments for the primacy of economic efficiency versus "pecuniary gain" provide a basis for evaluating the legitimating action. We consider how Veblen's work relates to notions of instrumental rationality and then undertake a critical assessment of the ideas. Some of Veblen's ideas, while utopian, might be seen as an elixir for the detrimental influences of financial capital; however, at best, they provide a placebo for the ills of administrative evil and, as such, do not provide an amoral basis for legitimating the associated accounting systems.

Animal maiming, intimacy and the politics of shared life: the bestial and the beastly in eighteenth- and early nineteenth-century England

The everyday lives of many farm workers in eighteenth- and early nineteenth-century England were intricately and often intimately bound with the lives of animals, the ebb and flow of human life being inseparable from that of animal life. Farmyards, fields, folds as well as barns and stables were all spaces where animals transcended being the mere instruments of capital to instead being obvious co-constituents of the rhythms of existence. Living and working in such close proximity meant that the ‘species barrier’ was crossed and intimacies developed in everyday agricultural practices. Still, the relationship was based upon, if not reducible to, the workings of capital: the animal enrolled as a form of embodied capital, the labourer engaged by the farmer to act upon the animal. And in such relationships intimacies are mirrored by violences: the keeping captive, slaughter, and – occasionally – abuse. In this formative period in which the discourses and policies that continue to inform animal welfare were first formulated, the declining economic and material fortunes of farm workers when juxtaposed to farm animals’ fortune as increasingly ‘cosseted capital’ gave a particular charge to these abuses. Farm animals, and especially horses and cattle, so it is shown, were subjected to a series of violences. Many cases of animal maiming parodied tenderness in their brutality, whilst other attacks on the sexual organs of animals represented complex statements about the ways in which agrarian capitalism regulated all culture. Analysing the changing relationship between humans and animals therefore also helps us to better understand how capitalism mediates – and is mediated by – the non-human as well as the human, and how it defines cultural relations.

Care of the Self, Care of the Earth: A new conversation for Rio+20

What if capitalism, understood as an economic, social and cultural complex, was on the agenda of a world summit on sustainable development? How has the culture of capitalism - its psychic investment in colonizing our attention - compromised our ability to respond meaningfully to the challenges of sustainable development? These are two of the questions behind this exploration of the constraints that appear to limit the scope of economic debate at conferences such as the Rio+20 conference

Plasma HDL cholesterol and risk of myocardial infarction: A mendelian randomisation study

Background: High plasma HDL cholesterol is associated with reduced risk of myocardial infarction, but whether this association is causal is unclear. Exploiting the fact that genotypes are randomly assigned at meiosis, are independent of non-genetic confounding, and are unmodified by disease processes, mendelian random isation can be used to test the hypothesis that the association of a plasma biomarker with disease is causal.
Methods: We performed two mendelian randomisation analyses. First, we used as an instrument a single nucleotide polymorphism (SNP) in the endothelial lipase gene (LIPG Asn396Ser) and tested this SNP in 20 studies (20 913 myocardial infarction cases, 95 407 controls). Second, we used as an instrument a genetic score consisting of 14 common SNPs that exclusively associate with HDL cholesterol and tested this score in up to 12 482 cases of myocardial infarction and 41 331 controls. As a positive control, we also tested a genetic score of 13 common SNPs exclusively associated with LDL cholesterol.
Findings: Carriers of the LIPG 396Ser allele (2·6% frequency) had higher HDL cholesterol (0·14 mmol/L higher p=8×10-13) but similar levels of other lipid and non-lipid risk factors for myocardial infarction compared with noncarriers. This difference in HDL cholesterol is expected to decrease risk of myocardial infarction by 13% (odds ratio [OR] 0·87, 95% CI 0·84-0·91). However, we noted that the 396Ser allele was not associated with risk of myocardial infarction (OR 0·99, 95% CI 0·88-1·11, p=0·85). From observational epidemiology, an increase of 1 SD in HDL cholesterol was associated with reduced risk of myocardial infarction (OR 0·62, 95% CI 0·58-0·66). However, a 1 SD increase in HDL cholesterol due to genetic score was not associated with risk of myocardial infarction (OR 0·93 95% CI 0·68-1·26, p=0·63). For LDL cholesterol, the estimate from observational epidemiology (a 1 SD increase in LDL cholesterol associated with OR 1·54, 95% CI 1·45-1·63) was concordant with that from genetic score (OR 2·13 95% CI 1·69-2·69, p=2×10 -10).
Interpretation: Some genetic mechanisms that raise plasma HDL cholesterol do not seem to lower risk of myocardial infarction. These data challenge the concept that raising of plasma HDL cholesterol will uniformly translate into reductions in risk of myocardial infarction.

Trades Unions and the Transition away from 'actually existing unsustainability':From economic crisis to a new political economy beyond growth

Traditionally trades unions have accepted and promoted orthodox economic growth as a policy imperative. In recent years there has been a noticeable ‘greening’ of trade unions in relation to initiatives such as the ‘Green new deal’ and the creation of ‘green collar’ employment and the focus on a ‘just transition’ to a low carbon economy. Yet given the growing evidence of the negative impacts of economic growth in terms of environmental, resource and pollution impacts as well as the inability of economic growth to tackle (as opposed to managed) socio-economic inequality, it is timely to review the case for trades unions to fundamentally rethink the commitment to orthodox economic growth. That is, for trades unions to consider going beyond their current ‘green/sustainability’ strategies to consider more radical ‘post-growth’ policy positions. This chapter will explore some of the dimensions of a ‘post-growth’ trade union agenda by considering the evidence for going beyond growth from within the trade union movement (specifically looking at the International Labor Organization’s 2004 report on Economic Security, to internal union discussions around trades unionism and climate change) and external evidence ranging from Wilkinson and Pickett’s The Spirit Level (which suggests amongst other things that in the developed world what is needed is not economic growth but greater redistribution and lowering inequality – issues also of traditional interest to the Trades Union movement) to Tim Jackson’s Prosperity without Growth (which suggests that economic growth is ecologically unsustainable as well having passed a threshold beyond which it is contributing to human well-being in the developed world). As well as discussing the relationship between trades unionism and what may be called ‘green political economy’ (such as the ‘degrowth’ and ‘limits to growth’ perspectives) this chapter will also discuss the practical/policy implications of this ‘post-growth’ perspective in relation to trades unionism’s analysis of capitalism and its transformation in the context of a climate changed, carbon constrained world, including implications for ideas such as basic income, a shorter working week and what a trades unionism focused on how to achieve high quality of life within a low carbon context might look like.

The rebirth of dependence– offering an alternative understanding of the financial crisis

Purpose – This article aims to contribute to the re-evaluation of the global market system using a Marxist inspired theory of development, dependency.

Design/methodology/approach – This article draws on dependency theory as an alternative means of understanding global relationships. Building on existing literature, it modifies dependency to encapsulate technological developments and trends in the global market.

Findings – Re-evaluating the global market and the relationships that underpin it, through an alternative theory, highlights the fragility of markets and associated relationships. Increasingly, nation states are becoming irrelevant. This presents a problem as the main actors in the global market today are “above” inter-state relations, yet the organs that regulate their behaviour still are grounded in inter-state rhetoric. The relationship between development and underdevelopment remains.

Research limitations/implications – The financial crisis has propagated a wealth of interest in the relationships between states, between multi-national corporations (MNCs) and between MNCs and state. Using this broad theory of modified dependency, it can be applied to a range of different relationships. In the wake of financial crisis, there is the opportunity to raise awareness of these ingrained issues and initiate discussions at national, regional and international levels to alleviate some of the conditions of dependence.

Practical implications – Regardless of the work of national governments and NGOs to instigate development in lesser-developed regions through policy and regulations, unless there is a conscientious commitment from MNCs operating in that region to contribute to development, the result will be the development of underdevelopment and the underdevelopment of development. CSR can help alleviate the conditions of the dependence on capital generated by MNCs, but this is not a solution to an ingrained problem, capitalism.

Originality/value – This article introduces a modified theory of dependency for the first time. It applies the theory to the financial crisis and to the continent of Africa. It considers the role that CSR can play in alleviating the conditions of dependence.

Government Laws, Regulations and Policies: Small Fish in a Big Pond

Global development has, in recent years, been shaped by the rise of transnational capital. This has implications for the quality and effectiveness of those national laws, regulations and policies in place to monitor transnational capital, ensure that multi national organisations assume responsibility and hold them accountable should they fail to do so. In balancing these objectives, contrasting issues come to the fore, such as the fear of capital flight; an issue especially profound in small open economies where the balance may tip in the favour of retaining, as opposed to regulating, foreign capital.
This paper can be considered in three parts. First, the paper addresses the shift in global leadership from national governments to multinational corporations (with particular reference to the rise of the Transnational Capitalist Class). This shift will incorporate the connotations of the Third Way. In considering this ideology, it will propose the Third Way as a transition phase to a stage when government is more the “third wheel” than an equal partner in governance structures. Second, the implications of the changing nature of governance on the capacity of nation states to develop effective laws, regulations and policies is discussed which leads on to the third aspect of the paper which identifies the challenges for governments, business and society in reimagining the governance structure pertaining to law, regulation and policy and the need to reconsider existing structures in light of global shifts in power structures.
A new leadership structure, both within the national and international governance system has far reaching implications. Boundary constraints no longer an issue, the potential for equality and global democracy is huge. Instead, a post recessionary world faces new governance challenges in the shape of; legitimacy; accountability and responsibility. Capitalism has invaded government and the primary challenge will be in avoiding the same issues that have dogged our financial markets for the last number of years. The challenge then to laws, regulations and public policy is huge, especially considering that the governments regulating are smaller than those dictating agenda on a global level