On Extraterritoriality and the Gazprom case

In September 2012 the European Commission opened a formal investigation of Gazprom’s business practices in the EU. The Gazprom investigation raises a number of questions. One of them is the issue of jurisdiction—whether EU competition law applies to Gazprom, a foreign company. A day after the opening of the proceeding, in a press note and alongside other issues, Gazprom raised the question of jurisdiction, noting that it complies with laws of the countries in which it operates and that is it ‘registered outside the jurisdiction of the EU’. This statement, possibly, prompted some commentators to consider the applicability of EU law in this case.
In a piece in the ECLR, entitled ‘Iron Curtain at the border: Gazprom and the Russian blocking order to prevent the extraterritoriality of EU competition law’, Sean Morris offered his views on some of the aspects of the Gazprom case, including the issue of jurisdiction. Morris discussed also the blocking Order issued by the Russian President in response to the European Commission’s investigation, and its possible effects in the Gazprom case.
This article seeks to add a few important and relevant issues of law relating to extraterritoriality and the reach of EU law generally and in particular— in the context of the Gazprom investigation and in the light of the Morris article. This piece also sheds some light on the considerations which might have informed Russia’s hastily enactment of the Blocking Order.

How should teaching on whole person medicine, including spiritual issues, be delivered in the undergraduate medical curriculum in the United Kingdom?

Background

Although the General Medical Council recommends that United Kingdom medical students are taught ‘whole person medicine’, spiritual care is variably recognised within the curriculum. Data on teaching delivery and attainment of learning outcomes is lacking. This study ascertained views of Faculty and students about spiritual care and how to teach and assess competence in delivering such care.

A questionnaire comprising 28 questions exploring attitudes to whole person medicine, spirituality and illness, and training of healthcare staff in providing spiritual care was designed using a five-point Likert scale. Free text comments were studied by thematic analysis. The questionnaire was distributed to 1300 students and 106 Faculty at Queen’s University Belfast Medical School.

351 responses (54 staff, 287 students; 25 %) were obtained. >90 % agreed that whole person medicine included physical, psychological and social components; 60 % supported inclusion of a spiritual component within the definition. Most supported availability of spiritual interventions for patients, including access to chaplains (71 %), counsellors (62 %), or members of the patient’s faith community (59 %). 90 % felt that personal faith/spirituality was important to some patients and 60 % agreed that this influenced health. However 80 % felt that doctors should never/rarely share their own spiritual beliefs with patients and 67 % felt they should only do so when specifically invited. Most supported including training on provision of spiritual care within the curriculum; 40-50 % felt this should be optional and 40 % mandatory. Small group teaching was the favoured delivery method. 64 % felt that teaching should not be assessed, but among assessment methods, reflective portfolios were most favoured (30 %). Students tended to hold more polarised viewpoints but generally were more favourably disposed towards spiritual care than Faculty. Respecting patients’ values and beliefs and the need for guidance in provision of spiritual care were identified in the free-text comments.

Students and Faculty generally recognise a spiritual dimension to health and support provision of spiritual care to appropriate patients. There is lack of consensus whether this should be delivered by doctors or left to others. Spiritual issues impacting patient management should be included in the curriculum; agreement is lacking about how to deliver and assess.

'Something That Unites Us All': Understandings of St. Patrick's Day Parades as Representing the Irish National Group

The present study investigates how attendees at national celebratory crowd events-specifically St. Patrick's Day parades-understand the role of such events in representing and uniting the national community. We conducted semi-structured interviews with people who attended St. Patrick's Day parades in either Dublin or Belfast. In year 1, full-length interviews were conducted before and after the events (N=17), and in years 1 and 2, shorter interviews were conducted during the events (year 1 N=170; year 2 N=142). Interview data were analysed using thematic analysis, allowing the identification of three broad themes. Participants reported that (i) the events extend the boundary of the national group, using participation to define who counts as Irish; (ii) the events strategically represent the nature of the national group, maximising positive images and managing stereotypical representations; and (iii) symbolism serves to unify the group but can also disrupt already fragile unity and so must be managed. Overall, this points to a strategic identity dimension to these crowd events. We discuss the implications of these findings for future research in terms of the role of large-scale celebratory events in the strategic representation of everyday social identities.

The Impact of the Recent Economic Recession on the NEC Contract in Northern Ireland: A Preliminary Study

In comparison to the rest of the United Kingdom (UK) the Northern Irish Construction Industry was disproportionately affected by the recent economic recession. During this period, use of the New Engineering Contract (NEC) has proliferated in the public sector, however no study has been undertaken to examine the impact of the recession on this contract in Northern Ireland. The aim of this paper is to explore NEC contract implementation in Northern Ireland and the impact of the recession on its operation. A qualitative methodology is adopted using a literature review and semi structured interviews with six construction professionals. A qualitative analysis identifies themes and issues arising exploring connections and links between them using thematic coding. The initial findings are that the introduction of the NEC contract in Northern Ireland makes demands of contractors and consultants in terms of additional resources and training. Some consultants show a clear lack of understanding of the contract and its provisions. Whilst there is general agreement that the contract does help to stimulate good project management, the interviewees find the contract time consuming and complicated to administer, describing it as “unforgiving for the architect and unforgiving to the contractor.” Due to the impact of the recession, both contractors and consultants are still reporting a drop in income from pre-recession levels. Project resourcing levels have dropped significantly since the onset of the recession. Adversarial and opportunistic behaviour has increased. Many consultants and contractors are struggling to adequately administer the NEC contract at current income levels. The introduction of the NEC contract and the economic recession have exerted opposing forces on the implementation of the contract, hindering its execution. As the pressures exerted by the economic recession abate and a greater understanding of the contract develops, these opposing forces will ease leading to a more consistent implementation of the contract.

Parents' perceptions of microneedle-mediated monitoring as an alternative to blood sampling in the monitoring of their infants

OBJECTIVES: Microneedle (MN) arrays could offer a pain-free, minimally invasive approach to monitoring. This is envisaged to be particularly beneficial for younger patients, but parents' views to date are unknown. The aim of this study was to explore parental perceptions of MN-mediated ISF monitoring, as an alternative to the use of conventional blood sampling, and to understand the important factors for technique approval.

METHODS: Semi-structured interviews were conducted with parents with recent experience of a premature birth. Recruitment was through the Northern Ireland premature infant charity, Tinylife. Interviews progressed until data saturation was reached and thematic analysis employed.

KEY FINDINGS: The study included 16 parents. Parental support for MN-mediated monitoring was evident, alongside the unpopularity of traditional blood sampling in neonates. Factors facilitating MN approval included the opportunity for pain reduction, the simplicity of the procedure, the potential for increased parental involvement and the more favourable appearance, owing to the minute size of MNs and similarities with a sticking plaster. Confirmation of correct application, a pain-free patch removal and endorsement from trusted healthcare professionals were important.

CONCLUSION: These findings will inform researchers in the field of MN development and enlighten practitioners regarding parental distress resulting from conventional blood sampling. Further work is necessary to understand MN acceptability among practitioners. This work should assist in the development of an acceptable MN device and facilitate the reduction of parental distress.

The design and psychometric assessment of a TPB-based questionnaire suitable for use with primary school children

Despite the popularity of the Theory of Planned Behaviour (TPB) a lack of research assessing the efficacy of the model in understanding the health behaviour of children exists, with those studies that have been conducted reporting problems with questionnaire formulation and low to moderate internal consistencies for TPB constructs. The aim of this study was to develop and test a TPB-based measure suitable for use with primary school children aged 9 to 10 years. A mixed method sequential design was employed. In Stage 1, 7 semi-structured focus group discussions (N=56) were conducted to elicit the underlying beliefs specific to tooth brushing. Using content thematic analysis the beliefs were identified and a TPB measure was developed. A repeated measures design was employed in Stage 2 using test re-test reliability analysis in order to assess its psychometric properties. In all, 184 children completed the questionnaire. Test-retest reliabilities support the validity and reliability of the TPB measure for assessing the tooth brushing beliefs of children. Pearson’s product moment correlations were calculated for all of the TPB beliefs, achieving substantial to almost perfect agreement levels. Specifically, a significant relationship between all 10 of the direct and indirect TPB constructs at the 0.01 level was achieved. This paper will discuss the design and development of the measure so could serve as a guide to fellow researchers and health psychologists interested in using theoretical models to investigate the health and well-being of children.

An investigation into the factors influencing tooth brushing behaviour amongst school children living in Northern Ireland: An application of the Theory of Planned Behaviour.

Background: Northern Ireland has the worst oral health in the UK and its children have among the highest levels of tooth decay in Europe (DHSSPS, 2007).
Aim: The aim of this study is to investigate the factors influencing tooth brushing behaviour among Year 6 primary schoolchildren using the Theory of Planned Behaviour (TPB).
Method: Seven semi-structured focus groups involving 56 children were conducted during which children were asked questions about the factors that influence whether or not they brush their teeth. Thematic analysis was used with the purpose of eliciting the belief-based measures for all the TPB constructs.
Results: The findings suggest that children are knowledgeable about their teeth and are aware of the importance of maintaining good oral health; although a number of barriers to consistent tooth brushing exist.
Discussion: The findings will be used to inform stage 2 of the research project; questionnaire development to identify the factors influencing young people’s motivations to improve their tooth brushing behaviour and to assess their relative importance.

Patience, Persistence and Pragmatism: Experiences and Lessons Learnt from the Implementation of Clinically Integrated Teaching and Learning of Evidence-Based Health Care - A Qualitative Study

Background

Clinically integrated teaching and learning are regarded as the best options for improving evidence-based healthcare (EBHC) knowledge, skills and attitudes. To inform implementation of such strategies, we assessed experiences and opinions on lessons learnt of those involved in such programmes.

Methods and Findings

We conducted semi-structured interviews with 24 EBHC programme coordinators from around the world, selected through purposive sampling. Following data transcription, a multidisciplinary group of investigators carried out analysis and data interpretation, using thematic content analysis. Successful implementation of clinically integrated teaching and learning of EBHC takes much time. Student learning needs to start in pre-clinical years with consolidation, application and assessment following in clinical years. Learning is supported through partnerships between various types of staff including the core EBHC team, clinical lecturers and clinicians working in the clinical setting. While full integration of EBHC learning into all clinical rotations is considered necessary, this was not always achieved. Critical success factors were pragmatism and readiness to use opportunities for engagement and including EBHC learning in the curriculum; patience; and a critical mass of the right teachers who have EBHC knowledge and skills and are confident in facilitating learning. Role modelling of EBHC within the clinical setting emerged as an important facilitator. The institutional context exerts an important influence; with faculty buy-in, endorsement by institutional leaders, and an EBHC-friendly culture, together with a supportive community of practice, all acting as key enablers. The most common challenges identified were lack of teaching time within the clinical curriculum, misconceptions about EBHC, resistance of staff, lack of confidence of tutors, lack of time, and negative role modelling.

Conclusions

Implementing clinically integrated EBHC curricula requires institutional support, a critical mass of the right teachers and role models in the clinical setting combined with patience, persistence and pragmatism on the part of teachers.

Islamic fundamentalism since 1945:2nd revised and expanded edition

Featuring a brand new examination of Islamic fundamentalism in the wake of the Arab Spring, this fully revised and updated second edition of Islamic Fundamentalism since 1945 analyzes the roots and emergence of Islamic movements in the modern world and the main thinkers that inspired them.

Providing a much-needed historical overview of a fast-changing socio-political landscape, the main facets of Islamic fundamentalism are put in a global context, with a thematic debate of issues such as:

- the effects of colonialism on Islam

- secularism and the Islamic reaction

- Islam and violence in the 9/11 era

- globalization and transnational Islamist movements

- Islam in the wake of the Arab Awakening

Islamic Fundamentalism since 1945 provides an authoritative account of the causes and diversity of Islamic fundamentalism, a modern phenomenon which has grabbed the headlines as a grave threat to the West and a potentially revolutionary trend in the Middle East. It is a valuable resource for students and those interested in the history, effects and consequences of these Islamic movements

Contemporary Politics in the Middle East (Cambridge: Polity, 2011 – third edition)

The third edition of this dynamic book has been fully revised and updated to provide a comprehensive introduction to contemporary politics in the Middle East. Purposefully employing a clear thematic structure and including a wide range of case studies, data, visuals and further reading guidance the book explores and analyses the major issues which define the politics of this region of the globe.
Milton-Edwards begins by introducing and explaining key concepts and debates and goes on to outline the impact of colonialism and its legacy, the rise of Arab nationalism and anti-colonial politics. She then examines major political issues affecting the region, such as American foreign policy, political Islam, war and conflict, political economy, democratization, ethnicity and the role of women. The book concludes by highlighting the politics of the region in the twenty-first century and the future challenges it faces. This is a perfect introduction for undergraduates, covering key political, economic and social debates and providing updates and guidance for further reading.

"The genius of this book is that it integrates together the different themes which run through Middle Eastern politics. The coherence of the approach which the author has adopted is indicated by the manner in which she has updated the work in this second edition. Despite the substantial changes which the East has undergone since 9/11 and the 2003 Gulf War, the original line of analysis retains all its force. It remains a key reference for all those who are seeking to understand the region's politics, whether undergraduates, postgraduates or lay readers."
Tim Niblock, Exeter University
"I welcome the new edition of this comprehensive guide to the politics of such an important region of the world. It combines sensible generalizations with useful case studies of particularly important subjects. It is a must for all those who want to understand the complex politics of the modern Middle East."
Roger Owen, Harvard University
"Beverley Milton-Edwards has produced an excellent book, which is both wide-ranging in its coverage and punchy in its arguments. As such, its functions are dual. It works well as a text book, introducing the general reader to key themes in the contemporary region, from oil politics to ethnicity, to women and nationalism. But it also works as a running commentary on key debates, such as the rile of colonialism and the relationship between Islam and democracy. In short, this is a book with attitude."
Philip Robins, St Antony's College, Oxford

Conflicts in the Middle East since 1945, (London: Routledge, 2007, Third Edition).

This third edition of Conflicts in the Middle East since 1945 analyzes the nature of conflict in the Middle East, with its racial, ethnic, political, cultural, religious and economic factors. Throughout the book Peter Hinchcliffe and Beverley Milton-Edwards put the main conflicts into their wider context, with thematic debates on issues such as the emergence of radical Islam, the resolution of conflicts, diplomacy and peace-making, and the role of the superpowers.

The book is brought fully up to date with events in the Middle East, covering, for instance, developments in Iraq in 2006 where a democratically elected government is in place but the insurgency show no sign of coming under control. The analysis of the Palestinian/Israeli conflict is also brought up to the present day, to include the election of the Hamas government and the 2006 conflict between Israel and Lebanon’s Hizballah.

Including a newly updated bibliography and maps of the area, this is the perfect introduction for all students wishing to understand the complex situation in the Middle East, in its historical context.

Finding Merit in Judicial Appointments: NIJAC and the Search for a New Judiciary in Northern Ireland

The post-Agreement constitutional architecture has produced a new legal space in Northern Ireland. While the court structure has largely endured in a recognisable format there are perhaps now new expectations of how it will function in the next stage of Northern Ireland’s transition from a society in conflict. These expectations come into focus around the nature and role of the judiciary that is to oversee this new legal space. At the same time there are other, wider forces pressing upon the judiciary across the United Kingdom and these are being acted out in the various appointment commissions and regimes that have been created to modernise the judiciary. This all contributes to establishing a dynamic context for considering whether and/or how the judiciary in Northern Ireland is changing, and the forces that may be conditioning any change. This chapter looks at some of the expectations that might arise for the judiciary. It focuses both on some ideas about what might be the role of a judge in a transitional context, and the debate about how judges generally should be appointed across the United Kingdom where the idea of “merit” emerges as governing concept. Next consideration is given to how this idea of merit plays out in the Northern Ireland context and, in particular, how it impacts on the appointment of women to senior judicial roles which has emerged as the central concern in the new dispensation. Here the chapter draws on two pieces of research: the first looking at the issues surrounding judicial appointments and attitudes towards seeking such posts in the Northern Ireland context, and a second project where the idea of “merit” as a governing factor in judicial appointment was further explored in focus groups and interviews. Finally the chapter looks ahead at the challenges around judicial appointment that remain and suggests that notion of ‘merit’ has not provided the robust foundation which its proponents imagined it would.

Capital Markets Union and ending short-termism: lessons from the European Commission's public consultation

The European Commission’s initiative to establish a Capital Markets Union is in sharp conflict with the more radical goals of downsizing significantly certain financial activities and firms that have become too-big-to-fail and too-big-to-govern and of ending or at least drastically limiting extreme speculation and short-termism in finance and the real economy in order to increase financial stability. The recent public consultation on the Commission’s Green Paper Building a Capital Markets Union gives evidence of how weak such demands are compared to calls for deeper capital markets with more ‘shadow banking’ and rebuilding (sound) securitisation. The consultation is an example of how framing the problem and the refined better regulation agenda influence post-crisis financial reregulation and help to marginalize more radical ideas demanding a return to a more traditional banking model and transforming finance back to serving the real economy.

Symposium - Organisational transformation in policing: Leadership and change in extreme contexts

Nearly 4000 people died in Northern Ireland’s long running conflict, 314 of them police officers (Brewer and Magee 1991, Brewer 1996, Hennessey 1999, Guelke and Milton-Edwards 2000). The republican and loyalist ceasefires of 1994 were the first significant signal that NI society was moving beyond the ‘troubles’ and towards a normalised political environment. The Belfast (Good Friday) Agreement of 1998 cemented that movement (Hennessey 1999). Policing was a key and seemingly unresolvable element of the conflict, seen as unrepresentative and partisan. Its reform or ‘recasting’ in a new dispensation was an integral part of the conflict transformation endeavour(Ellison 2010). As one of the most controversial elements of the conflicted past, it had remained outside the Agreement and was subject to a specific commission of interest (1999), generally known as the Patten Commission. The Commission’s far reaching proposals included a change of name, badge and uniform, the introduction of 50/50 recruitment (50% Roman Catholic and 50% other), a new focus on human rights, a new district command and headquarter structure, a review of ‘Special Branch’ and covert techniques, a concern for ‘policing with the community’ and a significant voluntary severance process to make room for new recruits, unconnected with the past history of the organisation(Murphy 2013).

This paper reflects upon the first data collection phase of a long term processual study of organisational change within the Royal Ulster Constabulary / Police Service of Northern Ireland. This phase (1996-2002) covers early organisational change initiation (including the pre-change period) and implementation including the instigation of symbolic changes (name, badge, and crest) and structural changes (new HQ structure and District Command structure). It utilises internal documentation including messages from the organisations leaders, interviews with forty key informants (identified through a combination of snow-balling from referrals by initial contacts, and key interviews with significant individuals), as well as external documentation and commentary on public perceptions of the change. Using a processual lens (Langley, Smallman et al. 2013) it seeks to understand this initial change phase and its relative success in a highly politicised environment.

By engaging key individuals internally and externally, setting up a dedicated change team, adopting a non normative, non urgent, calming approach to dissent, communicating in orthodox and unorthodox ways with members, acknowledging the huge emotional strain of letting go of the organisation’s name and all it embodied, and re-emphasising the role of officers as ‘police first’, rather than ‘RUC first’, the organisations leadership remained in control of a volatile and unhappy organisational body and succeeded in moving it on through this initial phase, even while much of the political establishment lambasted them externally. Three years into this change process the organisation had a new name, a new crest, new structures, procedures and was deeply engaged in embedding the joint principles of human rights and community policing within its re-woven fabric. While significant problems remained, the new Police Service of Northern Ireland had successfully begun a long journey to full community acceptance in a post conflict context.

This case illustrates the significant challenges of leading change under political pressure, with external oversight and no space for failure(Hannah, Uhl-Bien et al. 2009). It empirically reflects the reality of change implementation as messy, disruptive and unpredictable and highlights the significance of political skill and contextual understanding to success in the early stages(Buchanan and Boddy 1992). The implications of this for change theory and the practice of change implementation are explored (Eisenhardt and Graebner 2007) and some conclusions drawn about what such an extreme case tells us about change generally and change implementation under pressure.

Oral rehabilitation for partially dentate elders: a qualitative analysis

Aims: This study aimed to gain insight into patient’s perceptions of natural tooth loss and explored their experiences of oral rehabilitation according to a functionally orientated approach (SDA) and Removable Partial Dentures (RPD).
Study Design: For this qualitative study, a purposive sample of 15 partially dentate older patients
were recruited from Cork Dental School and Hospital. These patients had previously participated in a randomised controlled clinical trial (RCT) where they were provided with either SDA treatment using adhesive bridgework or provided with Cobalt Chromium framework RPDs. In- depth interviews were undertaken and thematic analysis was utilised to interpret the data.
Results: The findings of this study indicated strong satisfaction with SDA treatment. Patients referred to the ease in which they adapted to the adhesive prostheses as they were “lightweight”, “neat” and “fixed”. Irrespective of treatment option, patients indicated that they felt
their new prostheses were durable and an improvement on previous treatments. Most patients indicated that, previous to the RCT, they had not attended a general dentist for a number of years and only then for acute issues. They had concerns that treatment which was provided to them as part of the RCT would not be available to them in primary care. Interestingly, although they do not want their condition to dis-improve, if their prostheses failed they stated that they would not seek alternative treatment but would revert back
to adopting previous coping mechanisms.
Conclusion: This study illustrates that partially dentate older patients were very satisfied with oral rehabilitation according to a functionally orientated approach. Unfortunately they did not believe that this treatment would currently be made available to them in a primary care setting.