989 resultados para Pierson, Barry


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This chapter explores some of the connections (causal and other) between the decline in active citizenship, the displacement of citizenship by consumer identities and interests, and the shift to a transactional mode of democratic politics and how and in what ways these are connected with “actually existing unsustainability.” It proposes an account of “green republican citizenship” as an appropriate theory and practice of establishing a link between the practices of democracy and the processes of democratization in the transition from unsustainability. The chapter begins from the (not uncontroversial) position that debt-based consumer capitalism (and especially its more recent neoliberal incarnation) is incompatible with a version of democratic politics and associated norms and practices of green citizenship required for a transition from unsustainable development. It outlines an explicitly “green republican” conception of citizenship as an appropriate way to integrate democratic citizenship and creation of a more sustainable political and socio-ecological order.

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This chapter outlines the main features of green political economy and the principal ways in which it differs from dominant mainstream or orthodox neoclassical economics. Neoclassical economics is critiqued on the grounds of denying its normative and ideological commitments in its false presentation of itself as ‘objective’ and ‘value neutral’. It is also critiqued for its ecologically irrational commitment to the imperative of orthodox economic growth as a permanent feature of the economy, compromising its ability to offer realistic or normatively compelling guides to how we might make the transition to a sustainable economy. Green political economy is presented as an alternative or heterodox form of economic thinking but one which explicitly expresses its normative/ideological value bases (hence it represents a return to ‘political economy’, the origins of modern economics). Green political economy also challenges the commitment to undifferentiated economic growth as a permanent objective of the human economy. In its place, green political economy promotes ‘economic security’ as a better objective for a sustainable, post-growth economy. The latter includes the transition to a low-carbon energy economy, and is also one which maximises quality of life (as oppose to formal employment, income and wealth), and actively seeks to lower socio-economic inequality. Green political economy views orthodox economic growth as having passed the threshold in most ‘advanced’ capitalist societies beyond which it has undermined quality of life and at best manages rather than reduces socially and ecologically damaging inequalities.

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Calls for more broad-based, integrated, useful knowledge now abound in the world of global environmental change science. They evidence many scientists' desire to help humanity confront the momentous biophysical implications of its own actions. But they also reveal a limited conception of social science and virtually ignore the humanities. They thereby endorse a stunted conception of 'human dimensions' at a time when the challenges posed by global environmental change are increasing in magnitude, scale and scope. Here, we make the case for a richer conception predicated on broader intellectual engagement and identify some preconditions for its practical fulfilment. Interdisciplinary dialogue, we suggest, should engender plural representations of Earth's present and future that are reflective of divergent human values and aspirations. In turn, this might insure publics and decision-makers against overly narrow conceptions of what is possible and desirable as they consider the profound questions raised by global environmental change.

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The purpose of this paper is to examine website adoption and its resultant effects on credit union performance in Ireland over the period 2002 to 2010. While there has been a steady increase in web adoption over the period a sizeable proportion (53%) of credit unions did not have a web-based facility in 2010. To gauge web functionality the researchers accessed all websites in 2010/2011 and it transpired that most sites were classified as informational with limited transactional options. Panel data techniques are then used to capture the dynamic nature of website diffusion and to investigate the effect of website adoption on cost and performance. The empirical analysis reveals that credit unions that have web-based functionality have a reduced spread between the loan and pay-out rate with this primarily caused by reduced loan rates. This reduced spread, although small, is found to both persist and increase over time.

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Background The aims of this study were to explore the knowledge, attitudes and beliefs that nursing home managers hold with regard to the assessment and management of pain in residents with dementia and to determine how these may be affected by the demographic characteristics of the respondents.

Methods A questionnaire comprising six sections was mailed, on two occasions during March and April 2010, to 244 nursing home managers in Northern Ireland (representing 96% of the nursing homes in Northern Ireland).

Results The response rate was 39%. Nearly all respondents (96%) provided care to residents with dementia, yet only 60% of managers claimed to use pain treatment guidelines within their nursing home. Respondents demonstrated good knowledge about pain in residents with dementia and acknowledged the difficulties surrounding accurate pain assessment. Nursing home managers were uncertain about how to manage pain in residents with dementia, demonstrating similar concerns about the use of opioid analgesics to those reported in previous studies about pain in older people. Managers who had received recent training (p = 0.044) were less likely to have concerns about the use of opioid analgesia than those who had not received training. Respondents' beliefs about painkillers were largely ambivalent and were influenced by the country in which they had received their nursing education.

Conclusions The study has revealed that accurate pain assessment, training of nursing staff and a standardised approach to pain management (the use of pain management guidelines) within nursing homes all have a significant part to play in the successful management of pain in residents with dementia. Copyright (c) 2012 John Wiley & Sons, Ltd.

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Objectives
To explore community pharmacists' experiences with and attitudes towards people with dementia, and to determine the knowledge they have about pain and its management in this patient population. 

Methods
A questionnaire comprising five sections, including the Approaches to Dementia Questionnaire, was mailed, on two occasions, during February and March 2011, to all community pharmacies in Northern Ireland (n=530). 

Results
The response rate was 34.3%. A greater proportion of pharmacists provided pharmaceutical care to people with dementia living at home (91.2%) than those living in care homes (40.1%). Respondents most frequently encountered queries relating to starting and stopping medications, compliance with medication, and availability of formulation types. The mean total score for the Approaches to Dementia Questionnaire measure was 72.8, indicating a positive attitude towards people with dementia, and respondents demonstrated a strong person-centred approach towards this patient population. The majority of respondents recognised the difficulty of assessing pain in people with dementia; however, younger pharmacists (p=0.041) and pharmacists who provided pharmaceutical care to people with dementia (p=0.012) were more likely to be aware of the pain assessment tools for use in people with dementia. Pharmacists appeared uncertain about how to appropriately manage pain in people with dementia.

Conclusions
The study has revealed that community pharmacists often encounter people with dementia, especially those living in their own homes, and they have positive attitudes towards the patient population. However, training in the assessment and management of pain in people with dementia must be developed to further improve their knowledge in this area. 

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Recent advances in hardware development coupled with the rapid adoption and broad applicability of cloud computing have introduced widespread heterogeneity in data centers, significantly complicating the management of cloud applications and data center resources. This paper presents the CACTOS approach to cloud infrastructure automation and optimization, which addresses heterogeneity through a combination of in-depth analysis of application behavior with insights from commercial cloud providers. The aim of the approach is threefold: to model applications and data center resources, to simulate applications and resources for planning and operation, and to optimize application deployment and resource use in an autonomic manner. The approach is based on case studies from the areas of business analytics, enterprise applications, and scientific computing.

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BACKGROUND: Methylation-induced silencing of promoter CpG islands in tumor suppressor genes plays an important role in human carcinogenesis. In colorectal cancer, the CpG island methylator phenotype (CIMP) is defined as widespread and elevated levels of DNA methylation and CIMP+ tumors have distinctive clinicopathological and molecular features. In contrast, the existence of a comparable CIMP subtype in gastric cancer (GC) has not been clearly established. To further investigate this issue, in the present study we performed comprehensive DNA methylation profiling of a well-characterised series of primary GC.

METHODS: The methylation status of 1,421 autosomal CpG sites located within 768 cancer-related genes was investigated using the Illumina GoldenGate Methylation Panel I assay on DNA extracted from 60 gastric tumors and matched tumor-adjacent gastric tissue pairs. Methylation data was analysed using a recursively partitioned mixture model and investigated for associations with clinicopathological and molecular features including age, Helicobacter pylori status, tumor site, patient survival, microsatellite instability and BRAF and KRAS mutations.

RESULTS: A total of 147 genes were differentially methylated between tumor and matched tumor-adjacent gastric tissue, with HOXA5 and hedgehog signalling being the top-ranked gene and signalling pathway, respectively. Unsupervised clustering of methylation data revealed the existence of 6 subgroups under two main clusters, referred to as L (low methylation; 28% of cases) and H (high methylation; 72%). Female patients were over-represented in the H tumor group compared to L group (36% vs 6%; P = 0.024), however no other significant differences in clinicopathological or molecular features were apparent. CpG sites that were hypermethylated in group H were more frequently located in CpG islands and marked for polycomb occupancy.

CONCLUSIONS: High-throughput methylation analysis implicates genes involved in embryonic development and hedgehog signaling in gastric tumorigenesis. GC is comprised of two major methylation subtypes, with the highly methylated group showing some features consistent with a CpG island methylator phenotype.

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Few pain studies have made community-dwelling people with dementia (PWD) their focus. The aim of this study was to determine the prevalence of pain among this patient population and to explore medication use. Moreover, we sought to investigate patient and caregiver variables associated with the presence of pain. Community-dwelling PWD and their caregivers were recruited between May 2009 and July 2012 from outpatient memory clinics in Northern Ireland to take part in a face-to-face structured interview with a researcher. Patients' cognitive status and presence of depression were established. A full medication history was taken. Both patients and caregivers were asked to rate patients' pain, at the time of the interview and on an average day, using a 7-point verbal descriptor scale. From the 206 patients who were eligible to take part, 75 patient-caregiver dyads participated in the study (participation rate = 36.4%). The majority of patients (92.0%) had dementia classed as mild or moderate. Pain was commonly reported among the sample, with 57.3% of patients and 70.7% of caregivers reporting patient pain on an average day. Significant differences were found between patients' and caregivers' reports of pain. Two-fifths of patients (40.0%) were prescribed analgesia. Antipsychotic, hypnotic and anxiolytic drug use was low, whereas antidepressant drugs were prescribed more commonly. Presence of pain was unaffected by dementia severity; however, the use of prescribed analgesic medication was a significant predictor of the presence of pain in these patients, whether reported by the patient or their caregiver 'right now' or 'on an average day' (P < 0.001). Patient and caregiver recruitment was challenging, and remains a barrier to research in this area in the future.

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Tin, as a constituent of bronze, was central to the technological development of early societies, but cassiterite (SnO2) deposits were scarce and located distantly from the centres of Mediterranean civilizations. As Britain had the largest workable ore deposits in the ancient Western world, this has led to much historical speculation and myth regarding the long-distance trading of tin from the Bronze Age onwards. Here we establish the first detailed chronology for tin, along with lead and copper deposition, into undisturbed ombrotrophic (rain-fed) peat bogs located at Bodmin Moor and Dartmoor in the centre of the British tin ore fields. Sustained elevated tin deposition is demonstrated clearly, with peaks occurring at 100-400 and 700-1000 calendar years AD - contemporaneous with the Roman and Anglo-Saxon periods respectively. While pre-Roman Iron Age tin exploitation undoubtedly took place, it was on a scale that did not result in convincingly enhanced deposition of the metal. The deposition of lead in the peat record provides evidence of a pre-Roman metal-based economy in southwest Britain. Emerging in the 4th century BC, this was centred on copper and lead ore processing that expanded exponentially and then collapsed upon Roman colonization during the 1st century AD. (C) 2011 Elsevier Ltd. All rights reserved.