Controversial Strategies Research Articles

(Mis)adventures in Rumsfeld space

Ewald’s recent genealogy of constructions of risk in Western societies argues that the 1980s saw an important paradigm shift to the “precautionary principle”. Critical scholars have taken up this idea as a lens through which to interpret the Bush administration’s ‘war on terror’. I argue that 11 September 2001 actually brought about qualitative changes to this paradigm. Bush’s pre-emptive doctrine is driven, and perhaps even more importantly, continually justified to the US population, by what might be called the “trans-precautionary principle”, a move from “decisionism” to “actionism”, and a new radicalization of the way fear is produced and managed. Donald Rumsfeld’s famous typology of different articulations of knowledge and ignorance offers an excellent analytical window onto the connections between ignorance, fear and geopolitical action in this new regime. In the latter part of the essay, his four modes of knowledge/ignorance are arrayed, for heuristic purposes, in an abstract spatial grid organized along dimensions of the specificity and possession of knowledge. This allows a ‘mapping’ of some of the Bush administration’s more controversial strategies in the ‘war on terror’, as a set of different pathways through Rumsfeld Space.

Seclusion practice: a critical examination of the nurses' decision-making process

Background Seclusion continues to be a widespread measure used in psychiatric settings. Furthermore, the humanitarian, ethical and legal issues associated with the use of seclusion make it one of the most controversial management strategies available. Despite these important issues, little nursing research has sought to gain an understanding of the nurses' decision-making process regarding the use of seclusion in psychiatric settings. Objective: The objective of this presentation is to outline the research results of a grounded theory study conducted in two major Canadian university affiliated psychiatric hospitals.

Use of 40-Detector Row Computed Tomography Before Catheter Coronary Angiography to Select Early Conservative Versus Early Invasive Treatment for Patients with Low-risk Acute Coronary Syndrome

Using catheter coronary angiography (CAG) as reference standard, we examined the agreement of 40-detector row computed tomography (MDCT) in triaging patients into the 2 controversial strategies of managing low-risk acute coronary syndrome (ACS). Seventy-eight patients with low-risk ACS received both MDCT and CAG. Early invasive strategy was assigned for the patient if there was significant stenosis (> or =50% diameter stenosis) in any of the coronary artery segments with diameter larger than 1.5 mm. The results of MDCT were compared with the CAG for agreement. The overall agreement of the early conservative/early invasive strategy assignment was 92.3%, with kappa value of 0.82 between MDCT and CAG. Only 1 patient needing early invasive strategy was missed by MDCT. Forty-detector row computed tomography is reliable in triaging patients into the 2 strategies of managing low-risk ACS.

Management of Gastroschisis

After completing this article, readers should be able to: 1. Describe various aspects of prenatal management for pregnancies complicated by gastroschisis, including diagnosis and counseling. 2. Know the increased risk of third trimester complications in pregnancies with gastroschisis and the need for close monitoring and vigilance during the perinatal period. 3. Discuss the controversial management strategies regarding timing and mode of delivery in gastroschisis and the resolution of some of the ongoing debates. 4. Delineate the important aspects of neonatal management of gastroschisis, including enumeration of modalities of surgical repair and postoperative complications. 5. Discuss the need for multicenter prospective controlled trials to standardize care of infants who have gastroschisis and improve outcomes. Gastroschisis is a common neonatal congenital anomaly whose global prevalence is increasing. Although survival of affected infants has improved over the past several decades, the relationship among prenatal diagnosis, the resulting perinatal management (including timing and mode of delivery), and timing and type of neonatal surgery remain uncertain. Over the past several years, a number of clinical and animal studies have clarified some aspects of the confusion. ### Diagnosis Gastroschisis is diagnosed prenatally via ultrasonography that documents the ventral abdominal wall defect through which loops of bowel protrude and float freely in the amniotic fluid. The umbilical cord insertion site usually appears normal, but it can be difficult to discern because herniated bowel loops may be pressed against it. Maternal serum alpha-fetoprotein concentrations usually are elevated and may be a marker for fetal gastroschisis, but specific diagnostic biochemical testing (eg, amniotic fluid acetylcholine esterase) is not recommended as a screening tool. Furthermore, genetic amniocentesis generally is not recommended because of the low risk of chromosomal abnormalities. Researchers have tried to identify sonographic predictors of bowel damage, such as fixed dilation of the herniated bowel and thickening of the bowel wall, but none has been …

Initial and residual effects of fertilizer phosphorus on soil phosphorus and maize yields on phosphorus fixing soilsA case study in south-west Kenya

Abstract The objective of this article is to provide experimental data and new insights about the best P fertilization strategy for phosphorus (P) fixing soils in the tropics. Two controversial strategies to manage soils with high phosphorus (P) fixation capacity were compared with regard to effects on maize ( Zea mays L.) yields and the fate of fertilizer P in soil. One strategy was broadcasting and incorporation of fertilizer P to quench P-fixation of the whole topsoil; the other strategy was subseed placement of fertilizer P to each crop to quench P-fixation in small volumes just below the plant. Field trials with maize as test crop were carried out on granite, rhyolite, basalt, felsite–andesite, and volcanic ash soils in south-west Kenya during three growing seasons. Incorporation rates ranged from 66 to 2096 kg ha −1 P, and placement rates from 11 to 131 kg ha −1 . Fertilized soils were analyzed regularly over a period of about 600 days. Grain yields responded strongly to P, except on the P-rich volcanic ash soil. Among the other soils, felsite–andesite had the least response to incorporated P as well as to placed P. In fertilized soil layers, Δtotal P was higher for placed than for incorporated P. The ratio of ΔP-Olsen/Δtotal P did not change over time. It was lower in P-fixing felsite–andesite than in non-fixing volcanic ash, and higher for placed P than for incorporated P. The crop's response was related to calculated volumes of P-enriched soil. Placement gave higher yields than incorporation at P rates −1 , especially on soils with low yields. The residual effect was high because P-Olsen in the fertilized soil remained far above the values required for optimum growth. It was somewhat lower for placed than for incorporated P. Placement of P at low rates repeated in each season was better than a single placement at higher rates in the first season only, because placed fertilizer was in subsequent seasons not as close to the roots as in the first season. In conclusion, high P retention of soils did not adversely affect the response to fertilizer P. Low-input is preferred above high-input because of higher P use efficiency, less weed growth, and easier adoption by farmers.

Electronic Curfew Orders and Juvenile Offenders

In the last two decades government sentencing policy has increasingly looked at ways of dealing with offenders within the community. As with many criminal justice strategies the government turned to America for inspiration in penal policy. One of the more controversial strategies to be adopted was the use of electronic tagging for young offenders at a time when Home Office statistics show this group has increased its reoffending rate. This article discusses the findings of research, undertaken in the Southampton area of the UK, which considered its effectiveness as an overall deterrent to crime and anti-social behaviour. Its conclusion questions the viability of tagging as a deterrence.

Fuzzy cognitive maps for issue identification in a water resources conflict resolution system

In water management, conflicts of interests are inevitable due to the variety in quality demands and the number of stakeholders, which are affected in different ways by decisions concerning the use of the resources. Ignoring the differences among interests involved in water resources management and not resolving the emerging conflicts could lead to controversial strategies. In such cases, proposed solutions could generate strong opposition, making these solutions unfeasible. In our contribution, a Community Decision Support System is proposed. Such a system is able to support discussion and collaboration. The system helps participants to structure their problem, to help them learn about possible alternatives, their constraints and implications and to support the participants in the specification of their own preferences. More in detail, the proposed system helps each user in representing and communicating problem perspectives. To reach this aim, cognitive maps are used to capture parts of the stakeholders’ point of view and to enhance negotiation among individuals and organizations. The aim of the negotiation process is to define a shared cognitive map with regard to water management problems. Such a map can be called a water community cognitive map. The system performance has been tested by simulating a real conflict on water resources management that occurred some years ago in a river basin in the south of Italy.

Everyday experiences of implicit rationing: comparing the voices of nurses in California and British Columbia

Managed Care in the U.S. is one of the more controversial strategies to implicitly ration health care. It has also been creeping into Canada where care is similarly being managed albeit in a different socio‐political environment. Based on nine group interviews with 35 RNs in California and 10 group interviews with 39 RNs in British Columbia, we find that the price to be paid for the promise of cheaper, more efficient health care through managerial strategies is borne largely by nurses and other health care providers. The data reveal that nurses in British Columbia and California share similar experiences with how the amount of care is rationed at the bedside – through care pathways, early discharge policies and reduced staffing – while the rationing of access to care differs because of the socio‐political contexts of their respective health care systems. In both cases, the implicit rationing of care through managerial strategies fails to deliver on its promises.

Advertising complainants: who and where are they?

A trend in images and messages that eventually cause offence was noted among significant international advertisers, accompanied by a steady increase in formal complaints over a 6-year period in the UK. Though the numbers are at present small, reanalysis of large-scale industry research reports suggested they are the tip of an iceberg consisting of many million potential complainants. If this latent activism reaches a critical mass, it will become a phenomenon that planners can no longer afford to ignore. Meanwhile, the literature on complaining behaviour has concentrated on the causes and responses rather than on the sources. Therefore, this study applied geographic and psychographic analysis techniques to postcodes accompanying over 50 000 complaints to the two main regulatory bodies in the UK, which were hitherto unavailable to independent researchers. A resulting index of complaints by location confirmed the intuitively logical assumption that it is characteristic of London and the south of England. A profile of the complainants showed that they typically belong to a distinctive and relatively homogeneous social group of potential opinion leaders. Together, these outputs provide an original and unique template for minimizing the risk of longterm negative effects due to accidental provocation of an unintended audience. This is a media-strategy solution; the alternative would of course be to abandon potentially controversial creative strategies.

Redefinição de espaços e papéis na gestão de serviços públicos: fronteiras e funções da regulação social

Ao assistirmos às transformações nos mercados de serviços urbanos, com fenômenos como privatização, liberalização e globalização que questionam os serviços públicos e as própriasfunções do Estado, uma questão nos parece fundamental: como assegurar direitos dos cidadãos e eficiência produtiva da iniciativa privada, garantindo a eqüidade territorial? O Estado precisa de políticas capazes de manter os princípios de continuidade, regularidade, igualdade de acesso, não discriminação, não exclusão e interesse coletivo dos serviços públicos, e desenvolver mecanismos que lhe permita privatizar sem perder o domínio sobre o espaço público e o controle do papel social dos serviços. Nesse sentido, o papel da regulação social na manutenção do equilíbrio entre atores que têm objetivos diferenciados e estratégias específicas é fundamental. Busca-se, neste artigo, renovar a reflexão acerca dos rumos que pode tomar esta fase atual de revisão por que passam os serviços públicos e de suas conseqüências possíveis, procurando, também, abrir perspectivas para a compreensão das novas configurações dos modelos de gestão dos serviços públicos que se delineiam.

Risk Behaviours for Blood-borne Viruses in a Victorian Prison

Hepatitis B and C viruses continue to spread in Victorians at risk of incarceration. We have therefore studied risk behaviours for these infections among 51 prisoners with a history of injecting drug use (IDU) in the central Victorian prison; 33 were also interviewed about their tattooing experience. Half had injected inside prison in the preceding month, an average of 5.5 times, suggesting up to 9,000 injections p.a. in this prison. Almost all shared inadequately disinfected equipment, with no way of knowing how many had used it before. First sharing of injecting equipment had been in prison for a fifth. Almost 90% were HCV infected. Almost all had been tattooed, with 60% having had at least one while in prison, while five reported more than 50 tattoos in prison. Urgent consideration of methods to decrease these risks is necessary, including assessment of the feasibility of controversial strategies such as needle and syringe exchange programs and the provision of sterile tattooing equipment.

Needle Access as an AIDS Prevention Strategy for IV Drug Users: A Research Perspective

The AIDS crisis has forced the consideration of controversial prevention strategies, including the public distribution of sterile syringes and needles as a public heath measure. Because this strategy appears to some to condone IV drug use, it has met with considerable opposition. Arguing for the importance of a research approach to evaluating the health costs and benefits of needle exchange, this paper reviews existing studies and reports on needle exchange programs, IV drug user attitudes and behavior relative to needle sharing, and public attitudes on needle access. to draw public health policy recommendations.

Controversial strategies for the regional advancement of developing countries

The following article outlines the theories of development strategy which approach the subject from the theory of growth and discusses their practical applicability to planning activities in developing countries.