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Mobile instant messaging is widely used in governing circles today. This article considers the implications for political legitimacy, examining how far the technology encourages those in authority to act consistently with the obligations that come with their roles. It looks at several recent political scandals in which officeholders are alleged to have transgressed public norms with their use of instant messaging. It goes on to argue that the concerns raised are well grounded, as the affordances of the technology point to personalized, informal, and untransparent modes of rule. As the final section argues, that figures in public authority embrace the technology despite the scandals it can yield tells us something important about their political priorities, in particular their willingness to prize output over procedural legitimacy. [ABSTRACT FROM AUTHOR]

Clinical trials have demonstrated efficacy of vedolizumab in ulcerative colitis (UC) and Crohn's disease (CD). Further real-world data is needed to inform clinical practice. The primary outcome was to assess corticosteroid-free and clinical remission after vedolizumab initiation. Secondary outcomes included effect on disease activity scores, biochemical markers, concomitant drug use, endoscopic remission, surgical intervention, hospital admissions and adverse events. A multi-centre retrospective observational study was conducted with patients initiated on vedolizumab across seven UK hospitals 1/11/14-30/11/16. Clinical disease activity was assessed using the partial Mayo Scores (pMS) and Harvey Bradshaw Index (HBI). Clinical remission was defined as HBI ≤4 or pMS <2 with a combined stool frequency and rectal bleeding sub score of ≤1. Clinical response was defined as ≥2-point decrease from baseline in pMS and ≥3-point decrease from baseline in HBI. One hundred ninety-two patients were included in the final analysis. 45% of UC and 10% of CD patients were anti-TNF naive. Over the observation period corticosteroid-free remission rates for UC and CD were 46% and 45%, while clinical remission rates were 52% and 44%, respectively. Time to corticosteroid free remission for UC and CD was 17.6 [IQR: 8.7–29.6] and 14.1 [QR: 6.0–21.7] weeks, respectively. Time to clinical response for UC was 9.4 [IQR: 5.7–15.4] and CD was 9.5 [IQR: 6.1–18.2] weeks. There was a substantial decrease in the concomitant use of immunomodulators and a similar decrease in concomitant corticosteroid use over the study period. Results in this predominately anti-TNF experienced population mirror other published real-world data, demonstrating good clinical effectiveness and a comparable safety profile. [ABSTRACT FROM AUTHOR]

Often, and increasingly, social and political life is narrated using the concept of generation. This article looks at contemporary expressions of 'generationalism' in British public life. It identifies the salient themes which emerge, links these to the social and political contexts in which these ideas are produced, and examines the points where they are vulnerable to critique. Bridging science and normativity, the generational view offers a convenient master-narrative for a variety of political orientations - yet one whose democratic credentials are doubtful. [ABSTRACT FROM AUTHOR]

In all kinds of political action, citizens are confronted with the performances of other citizens. An important guide to political behaviour is therefore likely to be the assumptions people make concerning how others can be expected to behave. This article explores common sense ideas about other citizens as potential political participants, drawing on a series of group interviews conducted with taxi-drivers in Britain, Germany and the Czech Republic. I argue the expectations voiced of other citizens tend to be pessimistic in nature, casting them as ill-informed, apathetic, passive and unduly self-interested, notwithstanding the appearance of a more optimistic view which holds they can be expected to follow the lead of those who 'take a stand'. These empirical observations lead to a discussion of the theoretical issues they raise, notably where to locate the origins of such views, and how to appraise their implications for democracy. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Since 1999 important widely publicized issues have affected morale in UK cardiothoracic (CT) surgery. Because more surgeons are needed, we sought to investigate whether these events have affected recruitment and demographic change in the specialty between 1999 and 2014. METHODS: We collected information on UK consultant CT surgeons using the SCTS public portal, the GMC Specialist Register and the NHS Annual Workforce Census via the Health & Social Care Information Centre. We analysed the demographics of UK CT surgeons with regard to country of primary medical qualification and ethnicity between 1999 and 2014. We compared the changes with other surgical specialties, cardiology and respiratory medicine. RESULTS: There has been a worrying decline in UK medical graduates entering the specialty and a 4-fold increase (282%) in consultant appointments from Europe. Whilst consultant numbers expanded by 83% overall, 59% of congenital heart surgeons, 46% of thoracic surgeons and 36% of adult cardiac surgeons are overseas graduates. It is found that 5% are female. Currently, only 32% of trainee surgeons are UK graduates. Of those receiving UK Certificate of Completion of Training in 2013, only 18% were UK graduates compared with 68% in 2000. Comparison with other specialties shows fewer UK graduates in CT surgery with the exception of Obstetrics and Gynaecology (52%). In cardiology, 77% are UK graduates with only 8% from Europe. CONCLUSIONS: Repeated negative messages have had a detrimental influence on recruitment. Because 55% of UK medical graduates, but less than 5% of CT surgeons are female, recruitment problems may worsen. Action is needed to restore interest in the specialty. [ABSTRACT FROM AUTHOR]