The Value of Global Justice: Realism and Moralism

It is a noticeable feature of the contemporary revival of interest in realist political thought that it has very much hesitated from exploring its implications for international political theory. This is interesting both because realism is one of the dominant intellectual traditions in international relations, but also as much of the recent debates surrounding global justice have engaged with themes that are at least germane to those of realism. This article will therefore try and extend some of the themes of realist political thought into the realm of global justice. While there might be several areas worth exploring, the focus here shall be on the realist emphasis on making sense of politics as a sphere of activity that has internal sources of normativity which cannot be reduced to moral first principles, the relationship between politics and legitimacy, and how these pose fundamental questions for the political nature of global justice. It ends by arguing that, viewed through the realist lens, the question of the legitimacy of international institutions should take greater priority in global justice debates insofar as this is fundamental to enabling us to understand justice in political and not exclusively moral terms

Global inequality, human rights and power: a critique of Ulrich Beck's cosmopolitanism

This article is a critique of Ulrich Beck's advocacy of a cosmopolitan approach to global inequality and human rights. It is argued that cosmopolitanism does not bring a new and unique perspective on global inequality. In fact Beck's proposals on migration would reinforce inequality and anti-cosmopolitanism. It is argued that his `both/and' perspective on hybridization and contextual universalism is undermined by inequality, conflict and power that are glossed over in Beck's approach. I argue that human rights interventionism as advocated by Beck falls short of cosmopolitanism, in ways which are shown by qualifications about power and inequality that Beck himself makes in his arguments

The halfway house: democracy, complexity, and the limits to markets in green political economy

The argument of the Austrian school of economists that markets are indispensable in the face of social and economic complexity is of defining importance for the modern day case for markets. The dominant paradigm in green political economy accepts this view, whilst proposing that markets be combined with a thick layer of democratic, non-market institutions to ensure environmental sustainability. Closer attention to the relationship between the Austrian and green arguments reveals important implications for both. The Austrian thesis raises significant challenges for the 'halfway house' combination of market and non-market that greens propose. Also, potential responses to the Austrians emerge from green thought. New light is shed upon the problem of complexity and the how it might be addressed by non-market political institutions

Effects of immunomodulatory treatment with subcutaneous interferon beta-1a oncognitive decline in mildly disabled patients with relapsing-remitting multiple sclerosis

The objective of this study was to assess the effects of subcutaneous (sc) interferon beta-1a (IFNbeta-1a) on cognition in mildly disabled patients with relapsing-remitting multiple sclerosis (RRMS). Patients aged 18-50 years with RRMS (McDonald criteria; Expanded Disability Status Scale score <or=4.0) were assigned IFNbeta therapy at the physician's discretion and underwent standardized magnetic resonance imaging, neurological examination and neuropsychological testing at the baseline and regular intervals for up to three years. This analysis included 459 patients who received sc IFNbeta-1a (44 mcg: n = 236; 22 mcg: n = 223; three-year follow up was available for 318 patients). The hazard ratio for cognitive impairment over three years (44 mcg versus 22 mcg) was 0.68 (95% confidence interval [CI]: 0.480-0.972), suggesting a 32% lower risk with the higher dose treatment. At year 3, the proportion of patients who were cognitively impaired increased slightly from 23.5% at the baseline to 24.8% in the IFNbeta-1a 22 mcg treatment group, but remained stable at 15.2% in the IFNbeta-1a 44 mcg treatment group. The proportion of patients with cognitive impairment at year 3 was significantly higher in the 22 mcg group than in the 44 mcg group (P = 0.03), although a trend was also seen at the baseline (P = 0.058). Multivariate logistic regression (corrected for baseline cognitive deficits) indicated that treatment with the higher dose of IFNbeta-1a was predictive of lower cognitive impairment at three years (odds ratio: 0.51, 95% CI: 0.26-0.99) compared with the lower dose of IFNbeta-1a. These findings suggest that sc IFNbeta-1a may have dose-dependent cognitive benefits in mildly disabled patients with RRMS, and may support early initiation of high-dose IFNbeta-1a treatment

Quality of life, depression and fatigue in mildly disabled patients with relapsing-remitting multiple sclerosis receiving subcutaneous interferon beta-1a: 3-year results from the COGIMUS (COGnitive Impairment in MUltiple Sclerosis) study.

BACKGROUND: The precise relationships among quality of life, depression, fatigue and cognitive impairment in multiple sclerosis (MS) are complex and poorly understood. OBJECTIVE: To assess the effects of subcutaneous interferon beta-1a on quality of life, depression and fatigue over 3 years in the COGIMUS study, and to examine the relationship between these outcomes and baseline cognitive status. METHODS: COGIMUS was an observational 3-year trial assessing cognitive function in 459 patients with relapsing-remitting MS treated with subcutaneous interferon beta-1a. RESULTS: In total, 331 patients completed the study (168 received interferon beta-1a, 44 µg subcutaneously three times weekly, and 163 received interferon beta-1a, 22 µg subcutaneously three times weekly). Mean MS Quality of Life-54 (MSQoL-54) composite scores did not change over time. There were no significant differences between groups in MSQoL-54 composite scores when patients were grouped by treatment dose and baseline cognitive status. Mean (standard deviation) Hamilton Depression Rating Scale score decreased from 6.8 (4.9) at baseline to 5.8 (5.9) at year 3. Mean total Fatigue Impact Scale scores were low (<30) at all time points. CONCLUSION: Quality of life, depression and fatigue remained largely stable over 3 years; no effects of treatment dose or baseline cognitive status were found

Developing a prehospital care service in a low‐resource setting: Barriers and solutions

Abstract Prehospital care (PHC) is critical to the comprehensive and effective functioning of a healthcare system. Given the disproportionate burden of both communicable and non‐communicable diseases in low‐income nations, its significance cannot be understated. In spite of this, many of these nations lack a comprehensive PHC system. Setting up a cost‐effective PHC system in this environment can be difficult and necessitate a variety of stakeholders at various healthcare delivery system levels. Therefore, it is necessary to consider these anticipated barriers and identify feasible solutions for its execution. This will assist in creating a PHC system that is suited to the local needs and achieve sustainable and global health goals. This paper describes the challenges and solutions to establishing a prehospital care service in a low‐resource setting