Political theory

Political theory, sometimes also called “normative political theory”, is a subfield of the disciplines of philosophy and political science that addresses conceptual, normative, and evaluative questions concerning politics and society, broadly construed. Examples are: When is a society just? What does it mean for its members to be free? When is one distribution of goods socially preferable to another? What makes a political authority legitimate? How should we trade off different values, such as liberty, prosperity, and security, against one another? What do we owe, not just to our fellow citizens, but to people in the world at large? In this article, we review the methodology of a core branch of contemporary political theory: the one commonly described as “analytic” political theory. In Section 1, we briefly demarcate the scope of political theory. In Section 2, we comment on the analysis of political concepts. In Section 3, we introduce the notions of principles and theories, as distinct from concepts. In Section 4, we discuss the methods of assessing such principles and theories, for the purpose of justifying or criticizing them. In Section 5, we review a recent debate on how abstract and idealized political theory should be. In Section 6, finally, we discuss the significance of disagreement in political theory. Although we cover established ground, we do so from an angle that will be somewhat unfamiliar to at least some political theorists – namely an angle inspired by the philosophy of science. We have chosen this angle with a view to systematizing the activity of analytic political theorizing so as to make its connections with other fields of philosophy and positive science more transparent

Respiratory support in patients with severe COVID-19 in the International Severe Acute Respiratory and Emerging Infection (ISARIC) COVID-19 study: a prospective, multinational, observational study

Background: Up to 30% of hospitalised patients with COVID-19 require advanced respiratory support, including high-flow nasal cannulas (HFNC), non-invasive mechanical ventilation (NIV), or invasive mechanical ventilation (IMV). We aimed to describe the clinical characteristics, outcomes and risk factors for failing non-invasive respiratory support in patients treated with severe COVID-19 during the first two years of the pandemic in high-income countries (HICs) and low middle-income countries (LMICs). Methods: This is a multinational, multicentre, prospective cohort study embedded in the ISARIC-WHO COVID-19 Clinical Characterisation Protocol. Patients with laboratory-confirmed SARS-CoV-2 infection who required hospital admission were recruited prospectively. Patients treated with HFNC, NIV, or IMV within the first 24 h of hospital admission were included in this study. Descriptive statistics, random forest, and logistic regression analyses were used to describe clinical characteristics and compare clinical outcomes among patients treated with the different types of advanced respiratory support. Results: A total of 66,565 patients were included in this study. Overall, 82.6% of patients were treated in HIC, and 40.6% were admitted to the hospital during the first pandemic wave. During the first 24 h after hospital admission, patients in HICs were more frequently treated with HFNC (48.0%), followed by NIV (38.6%) and IMV (13.4%). In contrast, patients admitted in lower- and middle-income countries (LMICs) were less frequently treated with HFNC (16.1%) and the majority received IMV (59.1%). The failure rate of non-invasive respiratory support (i.e. HFNC or NIV) was 15.5%, of which 71.2% were from HIC and 28.8% from LMIC. The variables most strongly associated with non-invasive ventilation failure, defined as progression to IMV, were high leukocyte counts at hospital admission (OR [95%CI]; 5.86 [4.83–7.10]), treatment in an LMIC (OR [95%CI]; 2.04 [1.97–2.11]), and tachypnoea at hospital admission (OR [95%CI]; 1.16 [1.14–1.18]). Patients who failed HFNC/NIV had a higher 28-day fatality ratio (OR [95%CI]; 1.27 [1.25–1.30]). Conclusions: In the present international cohort, the most frequently used advanced respiratory support was the HFNC. However, IMV was used more often in LMIC. Higher leucocyte count, tachypnoea, and treatment in LMIC were risk factors for HFNC/NIV failure. HFNC/NIV failure was related to worse clinical outcomes, such as 28-day mortality. Trial registration This is a prospective observational study; therefore, no health care interventions were applied to participants, and trial registration is not applicable

The value of open-source clinical science in pandemic response: lessons from ISARIC

International audienc