Beyond Individualised Approaches to Diabetes Type 2

Explanations for type 2 diabetes are broadened beyond the individual body and ‘bad lifestyles’ to include major institutions, the social and material contexts of food and eating, and employment. Precarious employment, a social determinant of health, encourages changes to food practices, lowers working conditions, worsens health, can bring poverty and increases shift work, a causal risk factor for diabetes. Scientists have played a part in revolutionising foods and technologies which minimise labour and movement. There are excess additives in processed food. Genetic explanations for the higher rates of diabetes in First Nations peoples give way to social explanations: colonial history, British/Euro‐American cuisine, food insecurity, trauma and social conditions resulting in chronic stress. Self‐management education takes a ‘nutritionist’ approach towards food and eating and tends to minimise the social context and skills of those with the condition particularly women workers in poorer social groups who have higher rates of diabetes (T2DM).     

Transitional compass: anti-capitalist pathways in the interstitial spaces of capitalism*

ABSTRACT

The focus of the special issue explores the forms of power used, engendered, and (re)produced to challenge structures of economic, social and political power that produce inequality as well as concrete empirical examples of movements, workers’ struggles, and initiatives in challenging inequality. The idea of ‘transitional compass’ looks beyond protest politics to what we call ‘generative’ politics that builds the alternatives in the interstitial spaces of capitalism. Resistance to power emerges through engendering counter-hegemonic projects that are intertwined with alternative everyday practices. To concretize the conceptual framing, we focus on the emancipatory possibilities of a universal basic income, the use of law in tackling inequality in health and education, creative initiatives to establish a people-centred food system, new forms of organizing by precarious workers, democratic possibilities in local state delivery, and reconceptualizing the good life by looking at issues of happiness and ecosocialism.     

A generalized model of logistic regression for clustered data

This paper proposes a generalized logistic regression model that can account for the correlation among responses on subunits. The subunits may arise as data on multiple observations within an individual. This method generalizes earlier work by Rosner (1984 a,b) and others. Methodological generalizations include: (1) the use of the more general Polya-Eggenberger distribution instead of the beta-binomial distribution to model the correlation structure, so that cases with negative, positive, or zero intraclass correlation can be handled; (2) a stepwise approach; (3) linear and non-linear regression; and, (4) the inclusion of the case of a truncated distribution. The model can accommodate missing data and covariates on the unit and subunit level. The derivative-free simplex algorithm is used to estimate the parameters.

The model is applied to data describing the progression of obstruction in coronary disease where multiple arterial segments are studied for each patient. The correlation in response that may exist for these multiple segments is accounted for in the analyses while attempting to examine associations with individual-specific (e.g., history of diabetes) and segment-specific (e.g., initial percent stenosis) covariates. Analyses were performed on a data set describing 382 patients with unoperated coronary artery disease and two coronary angiograms separated by at least one month and on a data set describing 284 patients undergoing percutaneous transluminal coronary angioplasty and studied by coronary angiograms.     

Making Development Assistance More Effective Through Using Political‐economy Analysis: What Has Been Done and What Have We Learned?

Politics often explains where development assistance has been effective and where it has not. Yet, until the 2000s there has been little focus by development agencies on political issues. This has recently begun to change with political‐economy analysis (PEA) now being more systematically used by development agencies to understand the real world. Nigeria and Bangladesh are two positive examples. Much remains to be done in these countries and more widely, to ensure stronger uptake of PEA. On the supply side this includes getting the ‘product’ right, and better communicating the message. On the demand side, there is a need to take more account of the incentives facing development agencies and to gather more systematic evidence on the operational impact of PEA to date.     

A Comparison of Organic and Conventional Fresh Produce Buyers in the Boston Area

Food safety concerns and the demand for organically grown produce have increased significantly in the United States over the last decade. Key differences in lifestyle characteristics, food safety attitudes and beliefs, perceived food safety risks, and valuation of health risk reductions between organic and conventional food buyers remain largely unknown, however. To better characterize how buyers of organic fresh produce differ from their conventional counterparts, over 700 food shoppers were sampled from ten major retail stores in the Boston area. Survey results show that self-reported organic buyers are more likely than conventional buyers to engage in a variety of health-promoting and environmentally friendly behaviors. Organic buyers are less trusting of federal food safety agencies than are conventional buyers, and perceive greater benefits associated with organically grown produce than do their conventional counterparts. Further, organic buyers have significantly higher risk perceptions than do conventional buyers for food safety hazards associated with conventionally grown produce. Compared to conventional buyers, organic produce buyers also perceive significant risk reductions associated with switching to organically grown produce and are willing to pay a higher price to reduce perceived food safety risks. Few sociodemographic differences between buyer types were observed, possibly due to how organic and conventional food stores were matched. Survey findings highlight the need for greater public education about a range of food safety issues and farming practices to ensure that consumers are making informed decisions in the marketplace.     

Doing Culture with Girls Like Me: Why Trying on Gender and Intersectionality Matters

Gendering is not a one‐size‐fits‐all process. Girls try on gender. In particular, girls – conditioned to value connections – search their cultural surroundings for ‘girls like me’ to answer the weighty question, Who am I? However, girls are not simply passive beneficiaries of culture, but actively construct their gendered selves by engaging in or ‘doing’ culture; girls activate certain features salient to their experiences. This paper examines how race, ethnicity, and class arbitrate girls’ gendered identities, emphasizing the concept trying on gender to capture the intersectional and experimental character of these processes. As girls try on gender –a local and culturally specific endeavor – they engage in a fluid, multifaceted, and sometimes tentative gendering process. Cross‐over literature by and for girls lends empirical support to how girls accomplish this multi‐constructed sense of self. The article concludes with implications for studies of girls, including a cautionary note about overemphasis on individualistic agency.     

Collective Action and Property Rights for Poverty Reduction: A Review of Methods and Approaches

This article provides a review of literature on the relationship between poverty and the institutions of collective action and property rights, as outlined in the conceptual framework of Di Gregorio et al. (2008). Using the elements of the framework as a guide, it offers an overview of how researchers and practitioners identify and evaluate these concepts. The article emphasises the multidimensionality of poverty and the necessity of applying various approaches and tools to conceptualising and measuring it. In addition to highlighting the crucial role that institutions play in poverty reduction, it shows power relations and the political context to be of fundamental importance in poverty‐related studies.     

The Self-Employed: Providing for the Self-Providers

A 1997 ISSA European conference produced a series of papers about providing social security to the self-employed, published in May 1998 in a separate volume. In this article, David Williams reviews these and examines points that warrant further attention. He finds that the papers confirm the difficulties of generalizing about social security and the self-employed in Europe. They identify problems in identification, funding and delivery, but also general trends towards self-employment that accentuate these difficulties. The papers offer conflicting solutions. Williams challenges the premise behind some by asking whether self-employment should be regarded as the rule rather than the exception in handling these issues.