The level of congruence between parties and their voters can vary greatly from one policy issue to another, which raises questions regarding the effectiveness of political representation. We seek... Show moreThe level of congruence between parties and their voters can vary greatly from one policy issue to another, which raises questions regarding the effectiveness of political representation. We seek to explain variation in party-voter congruence across issues and parties. We focus on the hypotheses that (1) average proximity between the positions of voters and the party they vote for will be highest on the issues that the party emphasises in the election campaign and that (2) this relationship will be stronger for niche parties. We test these hypotheses using data on the policy preferences of voters, party positions, party attention profiles and salience on concrete policy issues in four countries: The Netherlands, Ireland, Germany and Sweden. Overall, we find that voter-party proximity tends to be higher on issues that the party emphasises. As these are the issues where parties typically have the greatest policy impact, this implies that the quality of representation is highest where it matters most. There is some limited evidence that the positive relationship between issue salience and proximity is stronger for niche parties. In sum, the quality of policy representation varies strongly with party-level issue salience and to a lesser extent with the type of political party. Show less
Little is known about the characteristics and treatments of patients with severe asthma across Europe, but both are likely to vary. This is the first study in the European Respiratory Society... Show moreLittle is known about the characteristics and treatments of patients with severe asthma across Europe, but both are likely to vary. This is the first study in the European Respiratory Society Severe Heterogeneous Asthma Research collaboration, Patient-centred (SHARP) Clinical Research Collaboration and it is designed to explore these variations. Therefore, we aimed to compare characteristics of patients in European severe asthma registries and treatments before starting biologicals.This was a cross-sectional retrospective analysis of aggregated data from 11 national severe asthma registries that joined SHARP with established patient databases.Analysis of data from 3236 patients showed many differences in characteristics and lifestyle factors. Current smokers ranged from 0% (Poland and Sweden) to 9.5% (Belgium), mean body mass index ranged from 26.2 (Italy) to 30.6 kg.m(-2) (the UK) and the largest difference in mean pre-bronchodilator forced expiratory volume in 1 s % predicted was 20.9% (the Netherlands versus Hungary). Before starting biologicals patients were treated differently between countries: mean inhaled corticosteroid dose ranged from 700 to 1335 mu g.day(-1) between those from Slovenia versus Poland when starting anti-interleukin (IL)5 antibody and from 772 to 1344 mu g.day(-1) in those starting anti-IgE (Slovenia versus Spain). Maintenance oral corticosteroid use ranged from 21.0% (Belgium) to 63.0% (Sweden) and from 9.1% (Denmark) to 56.1% (the UK) in patients starting anti-IL-5 and anti-IgE, respectively.The severe asthmatic population in Europe is heterogeneous and differs in both clinical characteristics and treatment, often appearing not to comply with the current European Respiratory Society/American Thoracic Society guidelines definition of severe asthma. Treatment regimens before starting biologicals were different from inclusion criteria in clinical trials and varied between countries. Show less
