Behavioral consequences of consumer dissatisfaction with medical care

The effects of consumer dissatisfaction with doctors and medical care services on intentions to seek care and subsequent behavior were estimated using data from four general population studies. Satisfaction was linked to reported intentions regarding care-seeking behavior (choices between self-care and seeking care from a regular doctor or emergency room) in response to both minor and serious medical problems. These results were replicated in two populations with diverse sociodemographic characteristics. Satisfaction scales also predicted subsequent changes in medical care providers and disenrollments from prepaid health plans independent field tests. These results suggest that the behavioral consequences of individual differences in satisfaction with doctors and health care services are noteworthy from both clinical and social perspectives.     

Citizenship in hard times: intra-EU naturalisation and the Euro crisis

Demarcated by growing austerity, economic uncertainty, and EU-exits, the past decade witnessed monumental shifts across the political and economic landscapes of Europe. Citizenship is a stabilising force in this era of crisis, particularly for intra-EU migrants. In this contribution, I examine how the Euro crisis impacted citizenship acquisition among these migrants. Building upon the model proposed by John Graeber’s article [2016. ‘Citizenship in the shadow of the Euro crisis: explaining changing patterns in naturalisation among intra-EU migrants.’ Journal of Ethnic and Migration Studies 42 (10): 1670–1692], I discuss the relative importance of citizenship in times of crisis from global and regional perspectives. I argue Graeber’s theory presents a strong model for citizenship acquisitions during the crisis, yet leaves the core dyadic structure and several inconsistent findings unexamined. I replicate these models and introduce a dyadic model using bilateral data from 21 receiving and 23 sending states in Europe between 2007 and 2013. Contrary to Graeber’s theory, I find citizenship acquisitions among intra-EU migrants primarily coincide with increased in-migration, rather than influences of the Euro crisis. I conclude that while economic sending and receiving contexts matter, the Euro crisis did not appear to restructure intra-EU migrant citizenship incentives.     

Poverty,exclusion and child protection practice: the contribution of ‘the politics of recognition&respect’

The affective dimensions of poverty, including the impact of wider policy discourses and services that ‘other’ and shame people in poverty, are increasingly recognized. In response, Lister [(2013). Power, not Pity: Poverty and Human Rights. Ethics and Social Welfare, 7(2), 109–123] advocates for ‘a politics of recognition&respect’ that centralizes the voices, participation and lived experiences of those who live in poverty. This paper considers how applying Lister’s theory could improve child protection (CP) social work in England, from a human rights and social justice perspective. The paper draws on findings from an ATD Fourth World participatory research project aimed at updating the course content for a pre-existing social worker training module on poverty awareness. The project brings together families with experience of poverty and CP interventions, social work practitioners and academics.     

Hoofbeats and heartbeats: equine-assisted therapy and learning with young people with psychosocial issues – theory and practice

The practice of equine-assisted therapy and learning (EAT/L) to deliver psychosocial interventions to young people is a rapidly growing field. However, recent reviews have cited a need for further documentation of a theoretical foundation and evidence of outcomes of these programmes. This paper is a theoretical discussion of psychotherapeutic theories and models that the authors understood as being relevant and giving substance to the application of EAT/L at a Therapeutic Horsemanship centre in the UK. It also describes and defines the practice of EAT/L at the centre. Philosophical and psychological theories/models of Non-Violent Communication, Object Relations, Play and Dramatherapy, Mindfulness practice, and Attachment Theory, all set within a person-centred and relationship-based approach employed at the centre were examined and illustrated in the form of client case material. The authors report the central role relationship plays between client-horse-therapist and horse-handler in the building of trust and resolution of the impact of trauma. The paper highlights a need to carry out well-designed empirical studies with different client groups in the field of EAT/L in order to gain more insight into this growing field.     

Perceptual dialectology in northern England: Accent recognition,geographical proximity and cultural prominence

Work in perceptual dialectology has argued that listeners’ successful identification of accent areas is facilitated by their geographical proximity to a particular region. Montgomery ( 2007 , 2012 ) argues that this proximity effect is mediated by a ‘cultural prominence’ effect, where localities of high cultural salience seem less distant. We explore these claims using an online survey in which listeners were asked to identify the regional origin of speakers of five accents from England's ‘linguistic north’ (Liverpool, Manchester, Crewe, Stoke‐on‐Trent and Macclesfield) from audio clips of four different sentences. We show that the proximity and cultural prominence effects are partially supported, and that the proximity effect is driven by listeners’ likely contact with/experience of the dialect in question. We also show that listeners react differently to different sentences in the same accent. While some sentences are identified correctly very often, others, even for culturally prominent locations with distinctive accents (i.e. Liverpool), are hardly ever correctly identified. We connect this to the geographical distribution of the linguistic features in the clips, and we argue that the presence, absence and range of individual linguistic features should be systematically considered in all perceptual dialectology work which uses audio stimuli.     

Family group conferences: evidence,outcomes and future research

This is the second article of a two‐part review of the literature relating to family group conferences (FGCs); it explores outcomes and challenges in implementing FGCs. The complex data relating to outcomes, drawing on a range of national contexts, is presented. The challenges of researching outcomes and the role of longitudinal and randomized, controlled trials are considered. The article concludes with a discussion of the implementation of FGC policy and practice in the contemporary context.     

Exploring user experience and technology acceptance for a fall prevention system: results from a randomized clinical trial and a living lab

Background

Falls are common in older adults and can result in serious injuries. Due to demographic changes, falls and related healthcare costs are likely to increase over the next years. Participation and motivation of older adults in fall prevention measures remain a challenge. The iStoppFalls project developed an information and communication technology (ICT)-based system for older adults to use at home in order to reduce common fall risk factors such as impaired balance and muscle weakness. The system aims at increasing older adults’ motivation to participate in ICT-based fall prevention measures. This article reports on usability, user-experience and user-acceptance aspects affecting the use of the iStoppFalls system by older adults.

Methods

In the course of a 16-week international multicenter study, 153 community-dwelling older adults aged 65+ participated in the iStoppFalls randomized controlled trial, of which half used the system in their home to exercise and assess their risk of falling. During the study, 60 participants completed questionnaires regarding the usability, user experience and user acceptance of the iStoppFalls system. Usability was measured with the System Usability Scale (SUS). For user experience the Physical Activity Enjoyment Scale (PACES) was applied. User acceptance was assessed with the Dynamic Acceptance Model for the Re-evaluation of Technologies (DART). To collect more detailed data on usability, user experience and user acceptance, additional qualitative interviews and observations were conducted with participants.

Results

Participants evaluated the usability of the system with an overall score of 62 (Standard Deviation, SD 15.58) out of 100, which suggests good usability. Most users enjoyed the iStoppFalls games and assessments, as shown by the overall PACES score of 31 (SD 8.03). With a score of 0.87 (SD 0.26), user acceptance results showed that participants accepted the iStoppFalls system for use in their own home. Interview data suggested that certain factors such as motivation, complexity or graphical design were different for gender and age.

Conclusions

The results suggest that the iStoppFalls system has good usability, user experience and user acceptance. It will be important to take these along with factors such as motivation, gender and age into consideration when designing and further developing ICT-based fall prevention systems.