Understanding How Case Managers Use ‘Sabotage’ as a Frame for Clinically Difficult Situations

Case managers are among the direct service providers responsible for engaging people with severe mental illnesses. Understanding how they interpret and respond to clinically difficult situations can inform ways to intervene and reduce service disengagement. This qualitative study explored clinically difficult situations when case managers invoked the term ??sabotage??. Interviews were conducted with 21 case managers and analyzed by co-coders focusing on how case managers used the term sabotage to describe service user behavior. Themes that emerged were attributing sabotage to; fear of success, fear of attaining what you desire, avoidance of responsibility and change, and a lack of structured support. Drawing on the concepts of clinical case management and mental health recovery, we consider implications for the training and supervision of case managers and how services are structured.     

Understanding the social and cultural bases of Brexit*

We use data from a large scale and nationally representative survey to evaluate two narratives about the social bases of Brexit. The first narrative sees Brexit as a revolt of the economically left-behinds. The second narrative attributes Brexit to the resurgence of an English nationalism. There is some, albeit not always consistent, evidence that people in relative poverty or those living in areas that have seen greater Chinese import penetration are slightly more pro-Leave. People living in economically deprived neighborhoods are not more pro-Brexit. Using the Weberian class–status distinction, it is social status, not social class, which stratifies Brexit support. Individuals for whom being British is important are more pro-Leave. But those who see themselves as British rather than English, and those reporting omnivorous cultural consumption are less supportive of Brexit. Overall, there is empirical support for both narratives. But the weight of the evidence suggests a strong cultural dimension in Brexit support.     

Longitudinal patterns of anger reactivity and risk‐taking: The role of peer‐context

The current study examined the interplay between children's dispositional anger and susceptibility to peers' influence in increasing children's risk‐taking behaviors. Participants in the current study were children from a larger study of temperament and social–emotional development who were followed across 9, 24, 36, 48, and 60 months. Dispositional anger was measured using mothers' reports across 9 and 48 months. At 60 months, children played a risk‐taking computer game in presence of an unfamiliar peer who watched the child play. The child's risk‐taking was assessed during the game as the unfamiliar peers' reactions were coded based on comments that were peer directed, reflective of praising the target child's performance, or object directed, indicative of excitement toward the game. A latent profile analysis revealed three longitudinal anger profiles across infancy to early childhood: high stable, average stable, and low stable anger. Results suggested that as peers' object‐directed comments predicted risk‐taking independent of children's anger, the association between peer‐directed comments and risk‐taking was dependent on children's dispositional anger. Specifically, when peers praised the target child's performance, children in the high stable anger profile showed increased risk‐taking propensity. Findings are discussed based on the importance of considering both temperamental characteristics and aspects of the peer context in relation to children's risk‐taking.     

A Bayesian approach to Weibull survival models—Application to a cancer clinical trial

In this paper we outline a class of fully parametric proportional hazards models, in which the baseline hazard is assumed to be a power transform of the time scale, corresponding to assuming that survival times follow a Weibull distribution. Such a class of models allows for the possibility of time varying hazard rates, but assumes a constant hazard ratio. We outline how Bayesian inference proceeds for such a class of models using asymptotic approximations which require only the ability to maximize the joint log posterior density. We apply these models to a clinical trial to assess the efficacy of neutron therapy compared to conventional treatment for patients with tumors of the pelvic region. In this trial there was prior information about the log hazard ratio both in terms of elicited clinical beliefs and the results of previous studies. Finally, we consider a number of extensions to this class of models, in particular the use of alternative baseline functions, and the extension to multi-state data.     

Recommended Distributions for Exposure Factors Frequently Used in Health Risk Assessment

Although there has been nearly complete agreement in the scientific community that Monte Carlo techniques represent a significant improvement in the exposure assessment process, virtually all state and federal risk assessments still rely on the traditional point estimate approach. One of the rate-determining steps to a timely implementation of Monte Carlo techniques to regulatory decision making is the development of "standard" data distributions that are considered applicable to any setting. For many exposure variables, there is no need to wait any longer to adopt Monte Carlo techniques into regulatory policy since there is a wealth of data from which a robust distribution can be developed and ample evidence to indicate that the variable is not significantly influenced by site-specific conditions. In this paper, we propose several distributions that can be considered standard and customary for most settings. Age-specific distributions for soil ingestion rates, inhalation rates, body weights, skin surface area, tapwater and fish consumption, residential occupancy and occupational tenure, and soil-on-skin adherence were developed. For each distribution offered in this paper, we discuss the adequacy of the database, derivation of the distribution, and applicability of the distribution to various settings and conditions.     

“We Don't Call It a 'Circle'”: The Ethos of a Support Group

This paper contains the results of an eight month qualitative study of a group of young adults called a 'circle of friends', in Ontario, Canada. The 'circle of friends' concept has become increasingly popular in the field of disability in the last few years. In it, unrelated age peers are expected to befriend and support a person with a label. Utilizing participant observation and in-depth qualitative interviewing, the researcher gathered data which revealed a group ethos. The group attempted to make their activities seem as 'natural' and 'normal' as possible. It was also found that the 'circle' meant little or nothing to the supporters involved, but their friendships with the labelled person were quite important to them. The results of the study increase our understanding of how one such group operates, and the meaning participation has to those involved. As well, we can begin to build a theory about the relationship between friendship and support in such groups.     

Accounting for Exclusion: Giving a ‘Voice’ and producing a ‘subject’

SUMMARY: This article examines a series of accounts of exclusion given by pupils and a teacher in interviews and a group discussion. It is argued that it is important to hear pupils' experiences. However, it is recognised that it is never possible to access an experience directly, since the process of research alway shapes the way an account is constructed. This does not invalidate the research, since it is argued that the way pupils relate to the interviewer and the way they talk about their exclusion seemed indirectly to reflect important differences in the way exclusion is experienced. Specifically, two ways of managing exclusion were identified by pupils: some pupils protested about being excluded and welcomed the invitation to tell their story. Others distanced themselves from the event, by speaking of their exclusion in objective and concrete terms. These styles of accounting are compared to the way in which the head teacher discusses the topic of exclusion.     

Feminism and the quality of life

A measure of feminism is introduced, and a case is made for the acceptability of its levels of reliability, criterion-related, content, construct and discriminant-validity. Feminism is shown to be related to such features of the quality of life as happiness and being a good person. Survey results are reported from a sample of 431 members of the Canadian Research Institute for the Advancement of Women and 413 undergraduate women from the University of Guelph.     

Between Representations and Subjectivity: Gender Binaries and the Politics of Organizational Transformation

The distinction between male and female and masculinity and femininity continues to polarize relations between the sexes in ways that generally subordinate, marginalize, or undermine women with respect to men. The gender literature has recently challenged the singular and unitary conception of gender identity, arguing that there are a multiplicity of masculinities and femininities that are often fragile, fragmented and fluid. Despite this, the binary relationship between men and women continues to obstruct the development of sexual equality. This article is concerned with focusing critically on this binary and, in particular, its association with hierarchy, where men dominate women and masculinity assigns to femininity a marginal or ‘Other’ inferior status. It suggests that hierarchy is a condition and consequence of the reification of the binary that is difficult to challenge from within a representational epistemology that continues to dominate even studies of gender, let alone social science more generally. Deconstructing the gender binary is simply to challenge the reification of the terms wherein the divisions between male and female, masculine and feminine or men and women are treated as absolute and unchanging. The article examines conceptions of masculinity and the debate between Foucauldian and anti‐Foucauldian feminists as a basis for developing its argument. It then concludes that gender analysis can only deconstruct the hierarchical content of the gender binary by disrupting masculine hegemony at work. One way of facilitating this is temporarily to occupy a space between representations of gender and the conditions of subjectivity and language that make them possible.