Practical reasoning in political discourse: The UK government's response to the economic crisis in the 2008 Pre-Budget Report

This article focuses on practical reasoning in political discourse and argues for a better integration of argumentation theory with critical discourse analysis (CDA). Political discourse and its specific genres (for example, deliberation) primarily involve forms of practical reasoning, typically oriented towards finding solutions to problems and deciding on future courses of action. Practical reasoning is a form of inference from cognitive and motivational premises: from what we believe (about the situation or about means—end relations) and what we want or desire (our goals and values), leading to a normative judgement (and often a decision) concerning action. We offer an analysis of the main argument in the UK government’s 2008 Pre-Budget Report (HM Treasury, 2008) and suggest how a critical evaluation of the argument from the perspective of a normative theory of argumentation (particularly the informal logic developed by Douglas Walton) can provide the basis for an evaluation in terms of characteristic CDA concerns. We are advancing this analysis as a contribution to CDA, aimed at increasing the rigour and systematicity of its analyses of political discourse, and as a contribution to the normative concerns of critical social science

A Comparison of the International Classification of Functioning, Disability, and Health to the Disability Tax Credit

Background. The Disability Tax Credit (DTC) Certification is an assessment tool used to provide Canadians with disability tax relief. The International Classification of Functioning, Disability and Health (ICF) provides a universal framework for defining disability. Purpose. The purpose of this study was to evaluate the DTC and familiarize occupational therapists with the process of mapping measures to the ICF classification system. Method. Concepts within the DTC were identified and mapped to appropriate ICF codes (Cieza et al., 2005). Results. The DTC was linked to 45 unique ICF codes (16 Body Functions, 19 Activities and Participation, and 8 Environmental Factors). Implications: The DTC encompasses various domains of the ICF; however, there is no consideration of Personal Factors, Body Structures, and key aspects of Activities and Participation. Refining the DTC to address these aspects will provide an opportunity for fair and just determinations for those who experience disability.</p

Effect of early tracheostomy on resource utilization and clinical outcomes in critically ill patients: meta-analysis of randomized controlled trials

Background Early tracheostomy may decrease the duration of mechanical ventilation, sedation exposure, and intensive care stay, possibly resulting in improved clinical outcomes, but the evidence is conflicting. Methods Systematic review and meta-analysis of randomized trials in patients allocated to tracheostomy within 10 days of start of mechanical ventilation was compared with placement of tracheostomy after 10 days if still required. Medline, EMBASE, the Cochrane Controlled Clinical Trials Register, and Google Scholar were searched for eligible trials. The co-primary outcomes were mortality within 60 days, and duration of mechanical ventilation, sedation, and intensive care unit stay. Secondary outcomes were the number of tracheostomy procedures performed, and incidence of ventilator-associated pneumonia (VAP). Outcomes are described as relative risk or weighted mean difference with 95% confidence intervals. Results Of note, 4482 publications were identified and 14 trials enrolling 2406 patients were included. Tracheostomy within 10 days was not associated with any difference in mortality [risk ratio (RR): 0.93 (0.83–1.05)]. There were no differences in duration of mechanical ventilation [−0.19 days (−1.13–0.75)], intensive care stay [−0.83 days (−2.05–0.40)], or incidence of VAP. However, duration of sedation was reduced in the early tracheostomy groups [−2.78 days (−3.68 to −1.88)]. More tracheostomies were performed in patients randomly assigned to receive early tracheostomy [RR: 2.53 (1.18–5.40)]. Conclusion We found no evidence that early (within 10 days) tracheostomy reduced mortality, duration of mechanical ventilation, intensive care stay, or VAP. Early tracheostomy leads to more procedures and a shorter duration of sedation