755 research outputs found
Seeking the Real Adam Smith and Milton Friedman
In this paper we will analyze the relationship between free market principles and ethics through an exploration of how too many business managers often approach the ideas of Adam Smith and Milton Friedman. In doing so, we aim to provide a thoughtful foundation for future discussions of how we ought to navigate this intersection. We briefly examine questions such as: What is the relationship between the “best” economy in terms of efficiency and the common good for society? Is pursuing one’s individual economic advantage the same as promoting the general interest? As we analyze and discuss these questions, specifically in the context of Smith and Friedman, we also make some alternative normative assertions, grounded in social welfare, about adopting a broader societal perspective for the purpose of business
Patients with ischaemic, mixed and nephrotoxic acute tubular necrosis in the intensive care unit – a homogeneous population?
INTRODUCTION: Acute tubular necrosis (ATN) is usually studied as a single entity, without distinguishing between ischaemic, nephrotoxic and mixed aetiologies. In the present study we evaluated the characteristics and outcomes of patients with ATN by aetiological group. METHOD: We conducted a retrospective comparison of clinical features, mortality rates and risk factors for mortality for the three types of ATN in patients admitted to the general intensive care unit of a university hospital between 1997 and 2000. RESULTS: Of 593 patients with acute renal failure, 524 (88%) were classified as having ATN. Their mean age was 58 years, 68% were male and 52% were surgical patients. The overall mortality rate was 62%. A total of 265 patients (51%) had ischaemic ATN, 201 (38%) had mixed ATN, and 58 (11%) had nephrotoxic ATN. There were no differences among groups in terms of age, sex, APACHE II score and reason for ICU admission. Multiple organ failure was more frequent among patients with ischaemic (46%) and mixed ATN (55%) than in those with nephrotoxic ATN (7%; P < 0.0001). The complications of acute renal failure (such as, gastrointestinal bleeding, acidosis, oliguria and hypervolaemia) were more prevalent in ischaemic and mixed ATN patients. Mortality was higher for ischaemic (66%; P = 0.001) and mixed ATN (63%; P = 0.0001) than for nephrotoxic ATN (38%). When ischaemic ATN patients, mixed ATN patients and all patients combined were analyzed by multivariate logistic regression, the independent factors for mortality identified were different except for oliguria, which was the only variable universally associated with death (odds ratio [OR] 3.0, 95% confidence interval [CI] 1.64–5.49 [P = 0.0003] for ischaemic ATN; OR 1.96, 95% CI 1.04–3.68 [P = 0.036] for mixed ATN; and OR 2.53, 95% CI 1.60–3.76 [P < 0.001] for all patients combined]). CONCLUSION: The frequency of isolated nephrotoxic ATN was low, with ischaemic and mixed ATN accounting for almost 90% of cases. The three forms of ATN exhibited different clinical characteristics. Mortality was strikingly higher in ischaemic and mixed ATN than in nephrotoxic ATN. Although the type of ATN was not an independent predictor of death, the independent factors related to mortality were different for ischaemic, mixed and all patients combined. These data indicate that the three types of ATN represent different patient populations, which should be taken into consideration in future studies
Introducing EMMIE: An evidence rating scale to encourage mixed-method crime prevention synthesis reviews
Objectives This short report describes the need for, and the development of, a coding system to distil the quality and coverage of systematic reviews of the evidence relating to crime prevention interventions. The starting point for the coding system concerns the evidence needs of policymakers and practitioners. Methods The coding scheme (EMMIE) proposed builds on previous scales that have been developed to assess the probity, coverage and utility of evidence both in health and criminal justice. It also draws on the principles of realist synthesis and review. Results The proposed EMMIE scale identifies five dimensions to which systematic reviews intended to inform crime prevention should speak. These are the Effect of intervention, the identification of the causal Mechanism(s) through which interventions are intended to work, the factors that Moderate their impact, the articulation of practical Implementation issues, and the Economic costs of intervention
'Reaching the hard to reach' - lessons learned from the VCS (voluntary and community Sector). A qualitative study.
Background The notion 'hard to reach' is a contested and ambiguous term that is commonly used within the spheres of social care and health, especially in discourse around health and social inequalities. There is a need to address health inequalities and to engage in services the marginalized and socially excluded sectors of society. Methods This paper describes a pilot study involving interviews with representatives from eight Voluntary and Community Sector (VCS) organisations . The purpose of the study was to explore the notion of 'hard to reach' and perceptions of the barriers and facilitators to accessing services for 'hard to reach' groups from a voluntary and community sector perspective. Results The 'hard to reach' may include drug users, people living with HIV, people from sexual minority communities, asylum seekers, refugees, people from black and ethnic minority communities, and homeless people although defining the notion of the 'hard to reach' is not straight forward. It may be that certain groups resist engaging in treatment services and are deemed hard to reach by a particular service or from a societal stance. There are a number of potential barriers for people who may try and access services, including people having bad experiences in the past; location and opening times of services and how services are funded and managed. A number of areas of commonality are found in terms of how access to services for 'hard to reach' individuals and groups could be improved including: respectful treatment of service users, establishing trust with service users, offering service flexibility, partnership working with other organisations and harnessing service user involvement.
Conclusions: If health services are to engage with groups that are deemed 'hard to reach' and marginalised from mainstream health services, the experiences and practices for engagement from within the VCS may serve as useful lessons for service improvement for statutory health services
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An integrated view of data quality in Earth observation
Data quality is a difficult notion to define precisely, and different communities have different views and understandings of the subject. This causes confusion, a lack of harmonization of data across communities and omission of vital quality information. For some existing data infrastructures, data quality standards cannot address the problem adequately and cannot fulfil all user needs or cover all concepts of data quality. In this study, we discuss some philosophical issues on data quality. We identify actual user needs on data quality, review existing standards and specifications on data quality, and propose an integrated model for data quality in the field of Earth observation (EO). We also propose a practical mechanism for applying the integrated quality information model to a large number of datasets through metadata inheritance. While our data quality management approach is in the domain of EO, we believe that the ideas and methodologies for data quality management can be applied to wider domains and disciplines to facilitate quality-enabled scientific research
What is regulation? An interdisciplinary concept analysis
The concept of regulation is believed to suffer from a lack of shared understanding. Yet, the maturation of the field raises the question whether this conclusion is still valid. By taking a new methodological approach towards this question of conceptual consolidation, this study assesses how regulation is conceived in the most-cited articles in six social science disciplines. Four main conclusions are drawn. First, there is a remarkable absence of explicit definitions. Second, the scope of the concept is vast, which requires us to talk about regulation in rather abstract terms. Third, scholars largely agree that ‘prototype regulation’ is characterised by interventions which are intentional and direct – involving binding standard-setting, monitoring and sanctioning – and exercised by public-sector actors on the economic activities of private-sector actors. Fourth, while there is considerable variation in research concerns, this variation cannot be attributed to disciplinary differences. Instead, our findings support the portrayal of the field as interdisciplinary, including a shared conception of regulation
De-studentification: emptying housing and neighbourhoods of student populations
This is the accepted version of a paper subsequently published in the journal, Environment and Planning A. The definitive version is available at: http://dx.doi.org/10.1177/0308518X16642446International scholarship on student geographies and urban change continues to advance knowledge of the intense commodification of student lifestyles and student housing. The main aim of this paper is to consider some of the hitherto under-researched wider knock-on effects of more commodified student housing markets. Here we present findings from the first-ever empirical study of de-studentification. Using the case study of Loughborough, we demonstrate how de-studentification is a process of change that has been stimulated by the increased supply of purpose-built student accommodation. We show that de-studentification leads to the depopulation and decline of some classical studentified neighbourhoods. Moreover, these urban transformations have several significant implications for pre-existing conceptualisations of urban change and student geographies. Notably, the impacts of de-studentification pose important questions for the conceptual boundaries of studentification – a prerequisite of de-studentification – and although, to date, dominant conceptualisations of studentification are wedded to upgrading-led representations of urban gentrification, it is shown that de-studentification, conversely, leads to physical downgrading and emptying of neighbourhoods in distinct phases. We therefore argue for a process-led definition of de-studentification, to illustrate how studentified neighbourhoods are gradually ‘emptied’ of student populations and student housing. More broadly, it is asserted that new student geographies are being created by the deepening neoliberalisation and commodification of higher education, which, in turn, will have unintentional consequences for wider social, cultural and economic relations in university towns and cities, such as emergent community cohesion and changing senses of place
Therapeutic DNA vaccine induces broad T cell responses in the gut and sustained protection from viral rebound and AIDS in SIV-infected rhesus macaques.
Immunotherapies that induce durable immune control of chronic HIV infection may eliminate the need for life-long dependence on drugs. We investigated a DNA vaccine formulated with a novel genetic adjuvant that stimulates immune responses in the blood and gut for the ability to improve therapy in rhesus macaques chronically infected with SIV. Using the SIV-macaque model for AIDS, we show that epidermal co-delivery of plasmids expressing SIV Gag, RT, Nef and Env, and the mucosal adjuvant, heat-labile E. coli enterotoxin (LT), during antiretroviral therapy (ART) induced a substantial 2-4-log fold reduction in mean virus burden in both the gut and blood when compared to unvaccinated controls and provided durable protection from viral rebound and disease progression after the drug was discontinued. This effect was associated with significant increases in IFN-γ T cell responses in both the blood and gut and SIV-specific CD8+ T cells with dual TNF-α and cytolytic effector functions in the blood. Importantly, a broader specificity in the T cell response seen in the gut, but not the blood, significantly correlated with a reduction in virus production in mucosal tissues and a lower virus burden in plasma. We conclude that immunizing with vaccines that induce immune responses in mucosal gut tissue could reduce residual viral reservoirs during drug therapy and improve long-term treatment of HIV infection in humans
What explains ethnic organizational violence? Evidence from Eastern Europe and Russia
Why do some ethnopolitical organizations use violence? Research on substate violence often uses the state level of analysis, or only analyzes groups that are already violent. Using a resource mobilization framework drawn from a broad literature, we test hypotheses with new data on hundreds of violent and non-violent ethnopolitical organizations in Eastern Europe and Russia. Our study finds interorganizational competition, state repression and strong group leadership associated with organizational violence. Lack of popularity and holding territory are also associated with violence. We do not find social service provision positively related to violence, which contrasts with research on the Middle East
An exploratory randomised controlled trial of a premises-level intervention to reduce alcohol-related harm including violence in the United Kingdom
<b>Background</b><p></p>
To assess the feasibility of a randomised controlled trial of a licensed premises intervention to reduce severe intoxication and disorder; to establish effect sizes and identify appropriate approaches to the development and maintenance of a rigorous research design and intervention implementation.<p></p>
<b>Methods</b><p></p>
An exploratory two-armed parallel randomised controlled trial with a nested process evaluation. An audit of risk factors and a tailored action plan for high risk premises, with three month follow up audit and feedback. Thirty-two premises that had experienced at least one assault in the year prior to the intervention were recruited, match paired and randomly allocated to control or intervention group. Police violence data and data from a street survey of study premises’ customers, including measures of breath alcohol concentration and surveyor rated customer intoxication, were used to assess effect sizes for a future definitive trial. A nested process evaluation explored implementation barriers and the fidelity of the intervention with key stakeholders and senior staff in intervention premises using semi-structured interviews.<p></p>
<b>Results</b><p></p>
The process evaluation indicated implementation barriers and low fidelity, with a reluctance to implement the intervention and to submit to a formal risk audit. Power calculations suggest the intervention effect on violence and subjective intoxication would be raised to significance with a study size of 517 premises.<p></p>
<b>Conclusions</b><p></p>
It is methodologically feasible to conduct randomised controlled trials where licensed premises are the unit of allocation. However, lack of enthusiasm in senior premises staff indicates the need for intervention enforcement, rather than voluntary agreements, and on-going strategies to promote sustainability
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