Exploring relational engagement practices in stroke rehabilitation using the Voice Centred Relational Approach

While discussions on patient engagement commonly focus on patient behaviors, a small body of research highlights the patient-practitioner relationship as critical in engagement. Understanding this relationship might be facilitated through a relationally-oriented methodology. The Voice Centred Relational Approach is one such qualitative methodology. Within this paper, we present one turn in a long conversation about this methodology. Drawing on our longitudinal observational study of engagement practices in stroke rehabilitation in New Zealand, we explicate how a theoretical framework can inform how the Voice Centred Relational Approach is enacted in the research process, from entering the field to dissemination. We detail how we adapted the associated analytic techniques (the Listening Guide and i-poems) for use with multiple forms and sources of data. We propose that the underlying relational ontology and relational orientation of this methodology makes it a useful approach in researching relational practice in healthcare.     

When class is colorblind: A race‐conscious model for cultural capital research in education

Sociologists of education frequently draw on the cultural capital framework to explore the ways in which educational institutions perpetuate inequality in schools and the larger society. However, these studies adhere to a white centered “class‐based master‐narrative,” to legitimize and perpetuate the assumption that racial differences are secondary manifestations of class‐based structures. The class‐based master‐narrative elevates a one‐dimensional view of inequality as rooted primarily in class‐based stratification and downplays the fact that the economic elites who inhabit these dominant social positions are predominantly white. In this essay, I propose a race‐conscious framework to challenge the colorblind assumptions and deficit perspectives inherent to the cultural capital framework. The race‐conscious model (a) focuses on how racial stratification impacts the cultivation, transmission, and activation of cultural capital on the individual and institutional levels and (b) highlights the harmful impact of the lack of racial literacy that is inherent to the white habitus.     

Differentiating among penal states

This review article assesses Loïc Wacquant's contribution to debates on penality, focusing on his most recent book, Punishing the Poor: The Neoliberal Government of Social Insecurity ( Wacquant 2009 ), while setting its argument in the context of his earlier Prisons of Poverty (1999). In particular, it draws on both historical and comparative methods to question whether Wacquant's conception of ‘the penal state’ is adequately differentiated for the purposes of building the explanatory account he proposes; about whether ‘neo‐liberalism’ has, materially, the global influence which he ascribes to it; and about whether, therefore, the process of penal Americanization which he asserts in his recent writings is credible.     

Seeing the Invisible Children and Young People Affected by Disability

This paper presents a brief review of literature relating to children in families with a disabled member, including the 'young carers' and disability studies literature, and relevant works from the social psychology and sociology of childhood. Key themes identified in the literature are then illustrated by findings from two exploratory research studies that sought to explore the experiences and service needs of children in families with a disabled member, within two Scottish areas. The authors suggest that, although young people affected by disability in the family, including young carers, face significant problems, particularly in socially disadvantaged areas, there are other issues that need to be addressed. Alternative conceptual frameworks are proposed, which challenge the dominance of the young carers research paradigm.     

A shared component model for detecting joint and selective clustering of two diseases

The study of spatial variations in disease rates is a common epidemiological approach used to describe the geographical clustering of diseases and to generate hypotheses about the possible 'causes' which could explain apparent differences in risk. Recent statistical and computational developments have led to the use of realistically complex models to account for overdispersion and spatial correlation. However, these developments have focused almost exclusively on spatial modelling of a single disease. Many diseases share common risk factors (smoking being an obvious example) and, if similar patterns of geographical variation of related diseases can be identified, this may provide more convincing evidence of real clustering in the underlying risk surface. We propose a shared component model for the joint spatial analysis of two diseases. The key idea is to separate the underlying risk surface for each disease into a shared and a disease-specific component. The various components of this formulation are modelled simultaneously by using spatial cluster models implemented via reversible jump Markov chain Monte Carlo methods. We illustrate the methodology through an analysis of oral and oesophageal cancer mortality in the 544 districts of Germany, 1986–1990.     

Permutation Approaches for Stochastic Ordering

In many application problems, when dealing with comparisons between two or more groups, the classical parametric inferential statistical methods are used, although in real problems the quite stringent assumptions required by such methods are rarely satisfied. In particular a parametric approach to the test on ordering of C > 2 populations is very difficult. In order to tackle this problem two alternative methods are proposed in the present paper. Both the methods consist in permutation combination based tests: the first is supposed to be more powerful and it is suitable when the main goal of the study is related to the global ordering of the populations; the second is useful when the interest is in the pairwise comparisons between the populations.     

Dynamic consistency in extensive form decision problems

In a stimulating paper, Piccione and Rubinstein (1997) argued how a decision maker could undertake dynamically inconsistent choices when, in an extensive form decision problem, she has a particular type of imperfect recall named absentmindedness. Such memory limitation obtains whenever information sets include decision histories along the same decision path. Starting from work focusing on the absentminded driver example, and independently developed by Segal (2000) and Dimitri (1999), the main theorem of this article provides a general result of dynamically consistent choices, valid for a large class of finite extensive form decision problems without nature.      

Co‐production in the epidemiological clinic: A decentred analysis of the tensions in community‐based,client‐facing risk work

Public health policies to prevent disease within populations are giving rise to shifting patterns of healthcare delivery in the late modern era. There is an inherent tension in modern medicine between evidence‐based standardisation, on the one hand, and patient‐centred specificity on the other. This tension manifests in recent policy narratives regarding public health risk (which we have characterised in terms of the epidemiological clinic) and co‐production. Drawing on co‐produced data with health trainers (lay health workers tasked with supporting behavioural change in patients at high risk of cardiovascular disease) in a deprived post‐industrial region of England, our decentred analysis focuses on three extended narratives from this data set. Our analysis builds on and develops emerging theories of risk work, informed by Habermas, and we explore the extent to which elite narratives of public health risk are resisted, absorbed, or bracketed off by client‐facing health workers—emphasising the heterogeneity of responses—and locate these responses within the context of the workers' employment conditions, their embodied experiences, and their wider beliefs and traditions. We argue that co‐production—albeit in a highly constrained form—is possible while delivering public health interventions. However, in the context of a community where health is so adversely affected by wider social problems and where task shifting has drawn lower status healthcare workers into these client‐facing roles, workers must find their own ways to negotiate and attempt to reconcile this context with the risk‐framed practices they are required to carry out.     

Hidden dangers among circuit parties—A systematic review of HIV prevalence,sexual behaviors and drug abuse during the biggest gay events

ABSTRACT

Circuit parties (CP) are extended celebrations, lasting from a day to a week, primarily attended by gay and bisexual men in their thirties and forties. The increasing popularity of circuit parties may play a significant role in the epidemiology of HIV and other sexually transmitted diseases. We performed a systematic literature search in MEDLINE, without any temporal limit, using the term “circuit party”. Only articles reporting cross-sectional studies were analyzed. Ten articles, published in the period from 2001 to 2015 were included in our systematic review and reported data on samples ranging from 173 to 13,883 gay/bisexual men. The HIV prevalence among men who attended the CPs was very high, ranging from 6% to 40.8%. Sexual risk behaviors (e.g. unsafe sex or multiple partners) and drug use were particularly frequent. It wo'uld be useful to promote efficient strategies with the cooperation of party planners, catching the participants before nightlife activities in order to prevent HIV transmission and the use of recreational drugs.     

The effect of classification errors in survival data analysis

Survival data analysis aims at collecting data on durations spent in a state by a sample of units, in order to analyse the process of transition to a different state. Survival analysis applied to social and economic phenomena typically relies upon data on transitions collected, for a sample of units, in one or more follow-up surveys. We explore the effect of misclassification of the transition indicator on parameter estimates in an appropriate statistical model for the duration spent in an origin state. Some empirical investigations about the bias induced when ignoring misclassification are reported, extending the model to include the possibility that the rate of misclassification can vary across units according to the value of some covariates. Finally it is shown how a Bayesian approach can lead to parameter estimates.