Setting health priorities: a review of concepts and approaches

The setting of health priorities is primarily concerned with the equitable distribution of resources and is now more than ever an important part of strategic planning within the National Health Service (NHS). The basic information which can be used to assist in such decision-making and the process by which different agencies become involved are important aspects of priority-setting; this article is based on a major review of the research literature on these aspects and provides a discussion and an analysis of experience within health and other fields. From this material a number of possible approaches to priority-setting are identified and discussed. The article concludes that, before it can be decided how priorities should be set in the future, outstanding questions about how far rational approaches are feasible, about who is to be involved and what role they should play, and about how far such decisions are to be taken nationally or locally will need further consideration.     

Sexuality in Older Adults (65+)—An Overview of the Literature,Part 1: Sexual Function and its Difficulties

Objectives: The aim of the current article was to provide an overview of literature on sexual function and sexual difficulties in older adults. Method: The authors conducted a narrative review of papers published in English between January 2005 and July 2015 based on an extensive search in PsycINFO. Results: The review showed that although common biological changes may adversely affect sexual function in old age, sexual experience seems to also be affected by psychological and interpersonal factors. Conclusions: Greater life expectancy and better medical care will result in older individuals with chronic diseases living longer. The need for help to cope with changes in sexual health is likely to increase in older adults, as sexuality may be negatively affected through several pathways.     

Substance‐dependent women becoming mothers: breaking the cycle of adverse childhood experiences

Parenting may be particularly challenging for substance‐dependent mothers who have grown up with parents who themselves had substance use disorders (SUDs). The aim of this study was to explore how substance‐dependent mothers describe their childhood experiences with substance‐abusing parents and the association between these earlier experiences and their own role as caregivers. Using purposeful sampling, mothers admitted for 1 year to a family ward at a substance abuse clinic were approached. Through in‐depth, qualitative interviews, nine substance‐dependent mothers described their lives in the form of present, past and future tense. The findings indicate that substance‐dependent women, who have experienced SUDs in their families of origin, face several major challenges when they become mothers. Some describe having lived their whole lives ‘on the edge of society'. This makes their rehabilitation process more complex. All mothers work to abstain from substances, process traumatic experiences and integrate their family into society. They need help to build supportive social networks and to establish a safe and predictable family environment for themselves and their children. The therapeutic implications of these findings will be discussed.     

Social support available for substance‐dependent mothers from families with parental substance abuse

Substance‐dependent mothers, who have grown up with parental substance abuse, struggle during and after treatment to abstain from substances while trying to process traumatic experiences and integrate their family into society. The aim of this study was to explore the social support available for these mothers to help them stay abstinent and create safe family environments for themselves and their children. Using purposeful sampling, we approached nine mothers admitted for 1 year to a family ward at a substance abuse clinic and their significant others. Through in‐depth, qualitative interviews, first with the mothers, later with their significant others, we investigated characteristics of the available social support. The findings indicated that the significant others had limited resources and were themselves exposed to adverse and cumulative psychosocial and socioeconomic risk factors. Their relationships with the mothers were, nevertheless, close, consistent and reliable. Supporting the existing social network should be an integrated part of the work of family welfare services aiming to help substance‐dependent mothers from families with parental substance abuse to rehabilitate and to integrate successfully into local communities.     

Abuse of disabled children in Ghana

Even though disabled children are targets of various forms of abuse, such issues remain mostly undocumented open secrets in many countries including Ghana. The article is based on a qualitative data provided by three key informants. Six stories emerged from the data and are discussed in terms of four main forms of abuse. Labelling theories are employed to strengthen the discussions. The article is aimed at increasing awareness on the various forms of abuse experienced by disabled children in Ghana. The study is also meant to capture the attentions of stakeholders that have the responsibility to end abusive practices against disabled children in Ghana.     

A Scoping Review of Challenges in Adult Intimate Relationships After Childhood Sexual Abuse

Childhood sexual abuse is a severe problem worldwide. Childhood sexual abuse can be detrimental to children and their abilities to cope with and communicate in their subsequent adult intimate relationships. The aim of this review was to generate and summarize knowledge about how childhood sexual abuse manifests in adult intimate relationships so healthcare professionals can incorporate this knowledge into treatment and care. A scoping review methodology was selected because it supports examination of the extent, range, and nature of research activity. A content analysis of the studies included in this review led to three thematic categories of challenges in adult intimate relationships after childhood sexual abuse: (a) relationship satisfaction, (b) sexual satisfaction, and (c) communication and trust.     

The dynamics of citizen sociolinguistics

The objective of this paper is to explore the dynamics of citizen science (CS) in sociolinguistics or citizen sociolinguistics, i.e. the engagement of non‐professionals in doing sociolinguistic research. Based on a CS‐study undertaken in Norway where we engaged young people as citizen scientists to explore linguistic diversity, this paper aims to clarify the definition of citizen sociolinguistics; it seeks to advance the discussion of the advantages of CS and of how CS can contribute to sociolinguistics; it also addresses the opposite: how sociolinguistics can contribute to the general field of citizen science; and it discusses the challenges of a CS‐methodology for sociolinguistic research, epistemologically and ethically, as well as in terms of recruitment, quality control and possible types of sociolinguistic tasks and topics. To meet the needs of society and societal challenges of today there is a need to develop methods and establish scientific acceptance for the relevance of public engagement in research. This paper argues that citizen sociolinguistics has the potential to advance the societal impact of sociolinguistics by constructing a dialogue between ‘the academy’ and ‘the citizens’; citizen sociolinguistics relies on and encourages participatory citizen agency, provides research experience, stimulates curiosity, further research, public understanding of science and (socio)linguistic awareness, and encourages linguistic stewardship.     

Cost-effectiveness analysis of the New South Wales adult drug court program

In New South Wales, Australia, a cost-effectiveness evaluation was conducted of an adult drug court (ADC) program as an alternative to jail for criminal offenders addicted to illicit drugs. This article describes the program, the cost-effectiveness analysis, and the results. The results of this study reveal that, for the 23-month period of the evaluation, the ADC was as cost-effective as were conventional sanctions in delaying the time to the first offense and more cost-effective in reducing the frequency of offending for those outcome measures selected. Although the evaluation was conducted using the traditional steps of a cost-effectiveness analysis, because of the complexity of the program and data limitations it was not always possible to adhere to textbook procedures. As such, each step involved in undertaking the cost-effectiveness analysis is discussed, highlighting the key issues faced in the evaluation.     

Begging as work: a study of people with mobility difficulties in Accra, Ghana

Even though begging is illegal in Ghana, an increasing number of disabled people engage in it. Begging is not only abhorred by the law, but also regarded by many Ghanaians as stigmatizing and devaluing. Successive governments of the country and some non-governmental organizations (NGOs) have made efforts either to reduce or eliminate begging. The attempts made have, however, been unsuccessful and the disabled beggars involved have returned to the streets of Accra. The question is why is it difficult to reduce begging in the research area. While poverty, mobility needs, lack of education and employable skills and employment avenues are factors that explain the decision to start begging, it also seems that the ways in which beggars justify their activities contribute to its perseverance. The study aims at sensitizing policy-makers and other stakeholders in attempts to find empowering alternatives to begging.     

There's more to the picture than meets the eye: Measuring tangible and intangible capital in two marginal communities in rural Denmark

A missing link in economics has been what Veblen in 1908 termed intangible capital. This includes common norms, trust and high levels of cooperative performance. Intangibles are invisible to the eye and not easily measured in quantitative terms. They nevertheless involve visible, socioeconomic outcomes and should therefore rightly be seen as productive, like tangibles. Thus, uneven levels of intangible capital would explain Differential Economic Performance (DEP) between, say, two firms containing exactly the same stock of physical, economic and human capital. Despite this common sense observation, most economists have failed to see that ‘there's more to the picture than meets the eye’, as Neil Young once sang. We use statistical, historical and fieldwork data from two Danish, marginal rural communities both rich on intangible capital. This to show how intangible capital in the form of social, organisational and cultural capital is accumulated and utilised in situ, at the microlevel. We suggest that the difference between these two, very similar communities should be explained in their varying ability to utilise local stocks of tangible and intangible capital. Drawing on seminal ideas from Bourdieu [The forms of capital. In: Richardson, J.G. (Ed.) Handbook of Theory and Research for the Sociology of Education. Greenwood Press, New York, Westport, CT and London, 1986, pp. 241–58] and the DORA project [Bryden, Differential economic performance in rural areas. In: International Conference on Rural Communities and Identities in the Global Millennium. Malpasino University College, Nainamo, BC, Canada, 2000], we want to develop a ‘total capital’ assessment tool for mapping and measuring socioeconomic development in marginal rural communities. In this way, we hope to count in ‘all’ capital as Schultz [Investment in human capital. In: Kiker, B.F. (Ed.) Investment in Human Capital. Columbia, 1971, pp. 3–21] prophesised. This in order to explain what we term Differential Local Development (DLD), where ‘good’, sustainable development is associated with high economic performance and increase in population.