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PubMed2000

The 'considerate' smoker in public space: the micro-politics and political economy of 'doing the right thing'.

This paper examines the discourse of 'interactions' as applied to the interpersonal management of smoking in public places (and to accounts thereof). Empirical data from a qualitative study of smokers and non-smokers in metropolitan Toronto, Ontario (Canada) are used to illustrate how smokers and non-smokers define and claim to operationalize 'consideration' in their daily lives. Drawing on the work of Foucault, Rose, Castel, and Bourdieu, the paper explores the possible significance of 'consideration' as a discourse of risk management masked as 'common sense', as a marker of social competence. In particular, parallels with emergent forms of governmentality embedded in community participation and individual self-monitoring and self-restraint are noted. Further, the social control implications of 'consideration' as moral discourse are examined with respect to Bourdieu's analysis of class struggles for (social) distinction. In this light, it is suggested that legitimate health concerns raised by tobacco control advocates cannot be divorced from other implicit social agendas which also fuel the drive for the 'purification of public space'.

Humans↗
PubMedDate not supplied

The politics of health sector reform in developing countries: three cases of pharmaceutical policy.

This paper examines the political dynamics of health sector reform in poor countries, through a comparative study of pharmaceutical policy reform in Sri Lanka, Bangladesh, and the Philippines. The paper first reviews five reasons why policy reform is political. It then presents three political economic models of the policy reform process: the political will, political factions, and political survival models. Next, the paper describes the three cases of national pharmaceutical policy reform, and identifies common conditions that made these reforms politically feasible. The paper's analysis suggests that health sector reform is feasible at certain definable, and perhaps predictable, political moments, especially in the early periods of new regimes. The most important and manipulable political factors are: political timing, which provides opportunities for policy entrepreneurs to introduce their ideas into public debate, and political management of group competition, which allows leaders to control the political effects of distributional consequences and protect the regime's stability. A strong and narrow political coalition improves the capacity of political leaders to resist the pressures of concentrated economic costs (both inside and outside national boundaries). The paper argues that for reform to succeed, policy-makers need effective methods to analyze relevant political conditions and shape key political factors in favor of policy reform. The method of Political Mapping is briefly introduced as a technique that can help policy-makers in analyzing and managing the political dimensions of policy reform and in improving the political feasibility of reform.

Bangladesh↗
PubMed2003

Mental health and health-related quality of life among adult Latino primary care patients living in the United States with previous exposure to political violence.

CONTEXT: Although political violence continues in parts of Central America, South America, and Mexico, little is known about its relationship to the health of Latino immigrants living in the United States. OBJECTIVE: To determine (1) rates of exposure to political violence among Latino adult primary care patients who have immigrated to the United States from Central America, South America, and Mexico and its impact on mental health and health-related quality of life and (2) frequency of disclosure of political violence to primary care clinicians. DESIGN, SETTING, AND PARTICIPANTS: Two-stage cluster design survey of a systematic sample of Latino immigrant adults in 3 community-based primary care clinics in Los Angeles, conducted from July 2001 to February 2002. MAIN OUTCOME MEASURES: Reports of exposure to political violence in home country before immigrating to the United States and communication with clinicians about political violence; self-reported measures of health-related quality of life using the Medical Outcomes Study Short Form 36 (MOS SF-36); symptoms of depression, anxiety, and alcohol disorders using the Primary Care Evaluation of Mental Disorders (PRIME-MD); and symptoms of posttraumatic stress disorder (PTSD) using the PTSD Checklist-Civilian Version (PCL-C). RESULTS: A total of 638 (69%) of 919 eligible patients participated. The nonresponse rates did not differ by age, sex, recruitment sites, or clinic sessions. In weighted analyses, 54% of participants reported political violence experiences in their home countries, including 8% who reported torture. Of those exposed to political violence, 36% had symptoms of depression and 18% had symptoms of PTSD vs 20% and 8%, respectively, among those not exposed to political violence. Controlling for age, sex, country, years lived in the United States, acculturation, income, health insurance status, and recruitment site in a subsample of 512 participants (56%), those who reported political violence exposure were more likely to meet symptom criteria for PTSD (adjusted odds ratio [AOR], 3.4; 95% confidence interval [CI], 1.4-8.4) and to have symptoms of depression (AOR, 2.8; 95% CI, 1.4-5.4) and symptoms of panic disorder (AOR, 4.8; 95% CI, 1.6-14.4) than participants not reporting political violence. Those exposed to political violence reported more chronic pain and role limitations due to physical problems, as well as worse physical functioning and lower perceptions of general health than those who were not exposed to political violence. Only 3% of the 267 patients who had experienced political violence reported ever telling a clinician about it after immigrating; none reported their current physician asking about political violence. CONCLUSION: Latino immigrants in primary care in Los Angeles have a high prevalence of exposure to political violence before immigrating to the United States and associated impairments in mental health and health-related quality of life.

Adult↗
PubMed1998

Politics, moral reasoning and the Defining Issues Test: a reply to Barnett et al. (1995).

Previous research has consistently shown that those on the political Right tend to prefer or use conventional or Stage 4 moral reasoning, while those on the political Left prefer principled or Stage 5 reasoning (cf. Kohlberg, 1976). One interpretation of this finding is that developmental level of moral reasoning influences a person's political views, another that the moral 'stages' associated with contrasting political positions are in fact contrasting politico-moral ideologies and that people choose the form of moral reasoning which best expresses their own political identity. We report four studies to test aspects of these alternatives. Participants (N = 50) in Study 1 rated moral arguments representing different stages as differentially relevant to people of varying political persuasions. In Study 2, participants (N = 106), assigned to play the role of constituency political parties (either Labour or Conservative) selecting candidates to represent their party, evaluated imaginary candidates differentially as a function of the kinds of moral arguments the candidates expressed. In Study 3 (N = 61), principled and particularly conventional moral arguments were again found to express contrasting political identities. In Study 4 (N = 51) a manipulation of the salience of participants' political identity produced as predicted high correlations between moral reasoning scores and measures of political attitudes when political identity was salient but not when personal identity was salient. The findings overall, however, only partially support the view that political identity influences moral reasoning. We conclude that, although degree of preference for conventional or Stage 4 reasoning is a function of political identity, principled reasoning may be unrelated to political orientation. We also propose that these two forms of reasoning do not reflect successive development stages and that preference for one may be independent of preference for the other.

Adult↗
PubMed2001

Political strategy, business strategy, and the academic medical center: linking theory and practice.

The purpose of this paper is to link external political strategy theory to a specific health care setting-that of the academic medical center (AMC). Political strategy encompasses those activities undertaken by AMCs to acquire, develop, and use power (clout, influence, and credibility) to gain an advantage in situations of conflict. It should be differentiated from internal politics, a topic that will not be dealt with in this review. Political strategy should also be distinguished from but not divorced from competitive strategy. As political and social action can change the competitive landscape and the rules of competition, AMCs must become adept in issues management and stakeholder management. The focus on political strategy is a reflection of the enormous changes in the external environment that have impacted AMCs in recent years. These changes have often emerged out of political and social action and they impact significantly on the organization's more traditional business strategies. We suggest that a tighter alignment between political and business strategies in the future will help ensure organizational survival and success. This article reviews the literature and theory in corporate political strategy and illustrates the application of political strategy with examples of issues and problems faced by AMCs. Models of political strategy are well crafted, and this article concludes with succinct observations on the use of political strategies to enhance the business-based strategies of AMCs. Although the focus is on AMCs, the use of political strategies is applicable to any health care institution.

Academic Medical Centers↗
PubMedDate not supplied

Incorporating political socialization theory into baccalaureate nursing education.

Political socialization theory explains how an individual develops a political belief system. As the health care system undergoes dramatic changes, nursing faculty should use political socialization theory to enhance the education of student nurses. A political thread can be woven through the nursing curricula, and students can be socialized to the political role. The new generation of nurses must incorporate a political component into their professional role identity. Political socialization theory can guide nursing faculty as knowledge of the political system and political skills are incorporated into nursing curricula.

Curriculum↗
PubMed2006

Cosmopolitan political science.

Until recently, the term cosmopolitism could rarely be found in modern political science literature. It was only in the 1990s that the term was rediscovered by political scientists in the critical discourse on globalization. In this article, I will explore the full potential of cosmopolitism as an analytical concept for empirical political science. I will argue that the concept of cosmopolitism should not be restricted to the analysis of global politics. Indeed, cosmopolitism has much more to offer for political scientists. Properly understood, it enables--and necessitates--a re-invention of political science in the age of globalization, comparable to the behavioural revolution in political science in the 1950s. Such a paradigmatic shift should be based on a twofold transformation of existing disciplinary boundaries: A removal of the boundary between national (and comparative) and international politics on the one hand; and a re-definition of the boundaries between empirical and normative approaches on the other. As a result, cosmopolitism may serve as a new, critical theory of politics based on the integration of hitherto separated fields and sub-fields.

European Union↗
PubMed1997

Medicaid and the politics of groups: recipients, providers, and policy making.

There is a substantial heterogeneity of interests within the Medicaid program. Its major beneficiary groups include the elderly, people with disabilities, children in low-income families, and adults receiving Aid to Families with Dependent Children. Providers who deliver medical services to these recipients represent another set of potential claimants. These groups are likely to be treated differently by the politics that affect the design and management of the Medicaid program. The Medicaid recipient groups vary in several important dimensions: First, the groups differ politically, a dimension that includes their political participation, their relationships to parties and electoral coalitions, the images they present to other political actors, and the legacy of public policies that affect them. Second, the groups have different medical and social needs. Third, the groups differ with respect to economic constraints, including the political economy of labor markets and of government spending programs, and they have differing relationships to the various types of medical providers. The medical providers are themselves political actors with a variety of characteristics that create political advantages relative to recipients, although there is also diversity among providers. The politics of the Medicaid program involves more than simply technical decisions about eligibility, coverage of medical services, reimbursement, and the implementation of managed care initiatives. Instead the differences between the program's multiple claimants are an important element of current Medicaid politics and the likely path of future reforms.

Adult↗
PubMedDate not supplied

Understanding and using organizational politics, Part Two.

Politics is a fact of life in industry, academia, the military, religion, and even health care. Remember these five major ideas: 1. Politics exists in organizations. 2. Politics can be understood. 3. Politics can be managed. 4. Denial won't make politics go away. 5. You can become a better and more ethical organizational politician. Try these web sites for more information: http://www.bredemeyer.com/pdf_files/PoliticsCompetency.PDF. The political competency model presented here is for architects; however, it provides some interesting insights that you may find helpful. http://www.andersonconsulting.com/doopinto.htm. This web site has "The Dysfunctional Office and Organizational Politics Scale" that you can take online. http://www.politicalsavvy.com/. In addition to a newsletter, this web site lets you test your political savvy IQ and allows you to read further about politics in organizations.

Leadership↗
PubMed1997

The covariation of religion and politics during the transition to young adulthood: challenging global identity assumptions.

This study was undertaken to examine the relation between religion and politics in terms of identity and beliefs, as well as the relations among identity and beliefs, during the transition to young adulthood. Data were obtained from 209 college students using self-administered questionnaires. Constructs included religious and political identity diffusion, foreclosure, moratorium and achievement, as well as intrinsic religiosity, church/temple importance, Christian orthodoxy, political involvement, and faith in government. Correlational analyses revealed that the only significant relations between religion and politics was for identity foreclosure and moratorium, and that none of the religious beliefs were significantly correlated with political beliefs. Hierarchical regression analyses, controlling for gender and year in college, indicated that religious diffusion proved to be the most powerful (negative) predictor of religious beliefs; similarly, political diffusion was the most powerful (negative) predictor of political involvement. Religious achievement was associated with higher levels of intrinsic religiosity. The findings provide additional validity for the construct of identity diffusion. At the same time, the inconsistent and low covariation between religious and political identity suggests that focus on global identity has limited utility.

Adolescent↗