C Wright Mills and the Theorists of Power

This chapter reviews C. Wright Mills?s analysis of power and the elites of his era in his three major texts of the 1940s and 1950s. It considers elements of his project that often attract less comment: Mills?s search for possible ways of redistributing power and enhancing democracy: his attempt to forge an ethico-political stance in rapidly changing conditions. We reveal Mills?s various intellectual debts, suggesting that he refused a relation of mere imitation to those from whom he borrowed. Considering a variety of criticism of Mills, we reflect on what we might take from Mills today in our own time

Bureaucracy, citizenship, governmentality: Towards a re-evaluation of New Labour

Drawing inspiration from the genre of studies of governmentality, this note explores developments in the organisation of the British Civil Service during the years of New Labour. Arguments and debates over the limits of bureaucratic knowledge and communitarian arguments borrowed from the American context served to encourage modes of citizen participation in respect of the work of the central bureaucracy. Bureaucrats during these years were encouraged to assume the role of agents of what we term here ?participatory citizenship?, seeking to bring citizens into a new relationship with bureaucracy. Bureaucrats were enjoined to attend to the voice of the citizen in new ways. Arguments and prescriptions for change ultimately led to innovations in the technologies of rule to be effected by bureaucrats, designed to ?activate? citizens and to bring them into a new and more participatory relationship to the central State. Exploring these developments, we highlight their costs, risks as well as certain suppressed political possibilities. Conceived as a preliminary investigation and certainly making no claim to historical completeness, the aim here is to begin to re-evaluate the experience of New Labour

Codifying ethics: New Labour and the government of civil servants

In July 2007, Gordon Brown spoke of the need to restore trust in government and to strengthen citizenship. Amongst the issues at stake were the powers of the executive over the Civil Service. A subsequent Act of Parliament included proposals to formalize the role of the Civil Service and required the publication of a code defining its core values. A particular way of governing civil servants was to serve wider governmental objectives, helping to renew politics and society. This chapter addresses the historical conditions of possibility of Brown?s scheme. We reflect critically on these developments, emphasizing tensions with the concern for business like and politically responsive administration in recent years and reviewing the fate of Brown?s scheme

Rare quantum metastable states in the strongly dispersive Jaynes-Cummings oscillator

We present evidence of metastable rare quantum-fluctuation switching for the driven dissipative Jaynes-Cummings oscillator coupled to a zero-temperature bath in the strongly dispersive regime. We show that single-atom complex amplitude bistability is accompanied by the appearance of a low-amplitude long-lived transient state, hereinafter called `dark state', having a distribution with quasi-Poissonian statistics both for the coupled qubit and cavity mode. We find that the dark state is linked to a spontaneous flipping of the qubit state, detuning the cavity to a low-photon response. The appearance of the dark state is correlated with the participation of the two metastable states in the dispersive bistability, as evidenced by the solution of the Master Equation and single quantum trajectories.Comment: Extensively revised text, 18 revised figures (16 in main and 2 in appendix), 38(+1) references, appendi

Designing image segmentation studies: Statistical power, sample size and reference standard quality.

Segmentation algorithms are typically evaluated by comparison to an accepted reference standard. The cost of generating accurate reference standards for medical image segmentation can be substantial. Since the study cost and the likelihood of detecting a clinically meaningful difference in accuracy both depend on the size and on the quality of the study reference standard, balancing these trade-offs supports the efficient use of research resources. In this work, we derive a statistical power calculation that enables researchers to estimate the appropriate sample size to detect clinically meaningful differences in segmentation accuracy (i.e. the proportion of voxels matching the reference standard) between two algorithms. Furthermore, we derive a formula to relate reference standard errors to their effect on the sample sizes of studies using lower-quality (but potentially more affordable and practically available) reference standards. The accuracy of the derived sample size formula was estimated through Monte Carlo simulation, demonstrating, with 95% confidence, a predicted statistical power within 4% of simulated values across a range of model parameters. This corresponds to sample size errors of less than 4 subjects and errors in the detectable accuracy difference less than 0.6%. The applicability of the formula to real-world data was assessed using bootstrap resampling simulations for pairs of algorithms from the PROMISE12 prostate MR segmentation challenge data set. The model predicted the simulated power for the majority of algorithm pairs within 4% for simulated experiments using a high-quality reference standard and within 6% for simulated experiments using a low-quality reference standard. A case study, also based on the PROMISE12 data, illustrates using the formulae to evaluate whether to use a lower-quality reference standard in a prostate segmentation study

C Wright Mills, power and the power elites ? a reappraisal

This paper revisits and presents a critical appraisal of Mills's analysis of power and the power elite. There are signs of a revival of interest in Mills, but recent commentators have shown little interest in the intellectual, social or political context of his analysis. Setting Mills's thesis in its historical context, we consider an element of his project that has been particularly neglected in recent discussion: Mills's search for possible ways of redistributing power and his attempt to forge an ethico-political stance. Reflecting on recent discussion of contemporary elite formations, we comment on what critics might take from Mills in our own time in relation to the analysis of elites and the politics of critical management studies

Collaborative medication management services: improving patient care

The document attached has been archived with permission from the editor of the Medical Journal of Australia (10 January 2008). An external link to the publisher’s copy is included.Objective: To implement and evaluate a collaborative medication management service model. Design: Participatory action research. Setting and participants: The study was conducted from March 1999 to March 2000; 1000 patients, 63 pharmacists and 129 general practitioners from six Divisions of General Practice in South Australia participated. Interventions: A collaborative service delivery model, involving a preliminary case conference, a home visit and a second case conference, was agreed through discussions with medical and pharmacy organisations and then implemented. Outcome measures: Medication-related problems; actions recommended; actions implemented; and outcomes after actions taken. Results: Overall, 2764 problems were identified. The most common medication-related problem (17.5% of all problems) was the need for additional tests. Thirty-seven per cent of problems related to medicine selection, 20% to patient knowledge, and 17% to the medication regimen. Of 2764 actions recommended to resolve medication-related problems, 42% were implemented. Of the 978 problems for which action was taken and follow-up data were available, 81% were reported to be "resolved", "well managed" or "improving". Conclusion: This implementation model was successful in engaging GPs and pharmacists and in assisting in the resolution of medication-related problems.Andrew L Gilbert, Elizabeth E Roughead, Justin Beilby, Kathy Mott and John D Barrat

Online prostate cancer screening decision aid for at-risk men: A randomized trial

Objective: This study examines the efficacy of an online decision aid (DA) for men with a family history of prostate cancer. Methods: Unaffected Australian men (40 - 79 years) with at least one affected relative completed the first online questionnaire, were randomized to read either the tailored DA (intervention) or nontailored information about prostate cancer screening (control), then completed a questionnaire postreading and 12 months later. The primary outcome was decisional conflict regarding prostate specific antigen (PSA) testing. The impact of the DA on longitudinal outcomes was analyzed by using random intercept mixed effects models. Logistic and linear regressions were used to analyze the impact of the DA on screening behavior and decision regret. Stage of decision-making was tested as a moderator for decisional conflict and decision regret. The frequency of online material access was recorded. Results: the DA had no effect on decisional conflict, knowledge, inclination toward PSA testing, accuracy of perceived risk, or screening behavior. However, among men considering PSA testing, those who read the DA had lower decision regret compared with men who read the control materials, β=.34 , p \u3c.001, 95% confidence interval (CI) = [.22, .53]. Conclusions: This is the first study to our knowledge to evaluate the uptake and efficacy of an online screening DA among men with a family history of prostate cancer. Men who were undecided about screening at baseline benefitted from the DA, experiencing less regret 12 months later. In relation to decisional conflict, the control materials may have operated as a less complex and equally informative DA