Critical realism in empirical research: employing techniques from grounded theory methodology

Whilst critical realism (CR) is becoming recognised as a significant meta-theory for the social sciences, there is little guidance on how to produce research which is consistent with its ontological and epistemological assumptions. This article contributes to an emerging discussion about how CR can be applied, drawing on an example of a qualitative study that has sought to understand and explain the causes of unmet need amongst a group of rural labourers in Tunisia . Using this study as an illustration, I show how techniques from grounded theory methodology can be usefully harnessed in the data collection, coding and analysis stages of a research project that adopts a CR philosophical and methodological framework. I illustrate how an ‘abductive’ variant of grounded theory allowed drawing on pre-existing theoretical knowledge throughout the research stages; whilst open and axial coding techniques could be harnessed for identifying and postulating CR causal mechanisms. This article should be of interest to students and researchers involved with grounded theory and applied critical realism.     

Gendered uncertainty and variation in physicians' decisions for coronary heart disease: the double-edged sword of "atypical symptoms"

Nonmedical factors and diagnostic certainty contribute to variation in clinical decision making, but the process by which this occurs remains unclear. We examine how physicians' interpretations of patient sex-gender affect diagnostic certainty and, in turn, decision making for coronary heart disease. Data are from a factorial experiment of 256 physicians who viewed 1 of 16 video vignettes with different patient-actors presenting the same symptoms of coronary heart disease. Physician participants completed a structured interview and provided a narrative about their decision-making processes. Quantitative analysis showed that diagnostic uncertainty reduces the likelihood that physicians will order tests and medications appropriate for an urgent cardiac condition in particular. Qualitative analysis revealed that a subset of physicians applied knowledge that women have "atypical symptoms" as a generalization, which engendered uncertainty for some. Findings are discussed in relation to social-psychological processes that underlie clinical decision making and the social framing of medical knowledge.     

Physical abuse in early childhood and transition to first sexual intercourse among youth in Cape Town, South Africa

This study examined the relationship of physical abuse in early childhood and timing of first sexual intercourse among young South Africans aged 14 to 22 in Cape Town. Using the Cape area panel survey and applying log-normal models, time ratios were estimated to show how rapidly or slowly youth experience first sexual intercourse. Results indicated that boys who experienced physical abuse in early childhood had faster timing to first sex. Boys and girls with violent school environments had faster timing to first sex. Race moderated the effects of physical abuse. Compared to Blacks, Coloreds who experienced higher levels of physical abuse in early childhood had faster timing to first sex. Youth with greater knowledge about HIV/AIDS and those with greater risk perception of contracting HIV/AIDS delayed first sex. On the basis of these findings, policy makers are encouraged to consider the early childhood experiences of youth when designing policies toward HIV/AIDS prevention in South Africa.     

Reactions to resistance: the role of contextual factors in sex offending

Upon encountering victim resistance during the commission of a sexual assault, an offender makes a decision as to how to react to the resistance via the use of varying degrees of coercive or noncoercive tactics. Exhaustive chi-squared automatic interaction detection (CHAID) analyses were performed on a sample of 369 criminal events to detect the significant situational and crime-specific factors, the pertinent interactions between these factors, and how these affect an offender's reaction to victim resistance depending on whether the victim is a child or an adult. Findings show that multiple interactions do occur and, moreover, factors affecting the offender's reaction to victim resistance are very different depending on whether the victim is a child or an adult. Planning and preparation variables, such as the offender's attack strategy, were found to be significant in the child victim model, whereas reactive variables, such as the type of victim resistance, were found to be significant in the adult victim model. The findings lend support to the social interac-tionist perspective and the importance of victim-offender dynamics.     

The importance of job training to job satisfaction of older workers

If job training has positive impacts on worker satisfaction, then job training can have desirable consequences for an organization that result both directly through its effects on productivity and indirectly through its effects on job satisfaction. Furthermore, the aging of the workforce implies that older workers will become increasingly important to firms and to the economy. This study, therefore, seeks to examine the relationship between job training and job satisfaction, focusing in particular on U.S. workers born in 1964 or earlier. The results of ordered logit regression analysis indicate that availability and quality of training received directly affect job satisfaction.     

Innovation and design approaches within prospective ergonomics

In this conceptual article the topic of "Prospective Ergonomics" will be discussed within the context of innovation, design thinking and design processes & methods. Design thinking is essentially a human-centred innovation process that emphasises observation, collaboration, interpretation, visualisation of ideas, rapid concept prototyping and concurrent business analysis, which ultimately influences innovation and business strategy. The objective of this project is to develop a roadmap for innovation, involving consumers, designers and business people in an integrative process, which can be applied to product, service and business design. A theoretical structure comprising of Innovation perspectives (1), Worldviews supported by rationalist-historicist and empirical-idealistic dimensions (2) and Models of "design" reasoning (3) precedes the development and classification of existing methods as well as the introduction of new ones.     

Space-time generation of high intensity patterns using growth-interaction processes

We describe a novel spatial-temporal algorithm for generating packing structures of disks and spheres, which not only incorporates all the attractive features of existing algorithms but is also more flexible in defining spatial interactions and other control parameters. The advantage of this approach lies in the ability of marks to exploit to best advantage the space available to them by changing their size in response to the interaction pressure of their neighbours. Allowing particles to move in response to such pressure results in high-intensity packing. Indeed, since particles may temporarily overlap, even under hard-packing scenarios, they possess a greater potential for rearranging themselves, and thereby creating even higher packing intensities than exist under other strategies. Non-overlapping pattern structures are achieved simply by allowing the process to ‘burn-out’ at the end of its development period. A variety of different growth-interaction regimes are explored, both symmetric and asymmetric, and the convergence issues that they raise are examined. We conjecture that not only may this algorithm be easily generalised to cover a large variety of situations across a wide range of disciplines, but that appropriately targeted generalisations may well include established packing algorithms as special cases.     

Trends in long-acting reversible contraceptive (LARC) use,LARC use predictors,and dual-method use among a national sample of college women

Objective: Assess long-acting reversible contraceptive (LARC) and other contraceptive use trends, identify LARC use predictors, and examine dual method use. Participants: Women in the American College Health Association-National College Health Assessment (ACHA-NCHA) II, aged 18–24 years, who reported having vaginal sex (N = 37,899). Methods: Secondary analyses of Fall 2011–2014 ACHA-NCHA II data. Results: Statistically significant increases in LARC usage and, specifically, implant usage, were found. Characteristics associated with LARC use included age, race/ethnicity, relationship status, and school type. Students reporting LARC use had lower odds of condom usage compared with non-LARC hormonal method users. Conclusion: This analysis of LARC predictors and dual LARC/condom use has implications for research and health promotion efforts. Findings suggest that college health services are well positioned to meet the sexual and reproductive health needs of diverse populations of students. College health professionals should elicit students' individual and/or relationship priorities to tailor messaging/services offered for pregnancy/STI prevention.     

Fingerprint-based background checks for personal care workers: Stakeholder views of policy criteria

Decision makers face difficult choices when tasked with identifying and implementing appropriate mechanisms for protecting the elderly and other vulnerable adults from abuse. A pilot project involving fingerprint-based criminal history background checks for personal care workers in Michigan has supplied an opportunity to examine one such mechanism. In conjunction with the pilot project, we have conducted a stakeholder analysis with the aim of informing decision makers about stakeholder perceptions of standard policy criteria like effectiveness, efficiency, and equity. We employed focus groups and a Web-based survey to collect data from stakeholders. While stakeholders generally see fingerprint-based background checks for personal care workers as potentially effective and as a net benefit, they also point to a variety of contingencies. They also recognize difficulties and constraints for government involvement. This preliminary analysis provides solid foundational information for decision makers and for more extensive benefit–cost analysis.