Is the Pro-Poor Premium Exemption Policy of Ghana’s NHIS Reducing Disparities Among the Elderly?

Under the act that established the National Health Insurance Scheme (NHIS), persons 70 years of age or above are automatically enrolled in the scheme and therefore can access health services free at the point of use. This suggests that the elderly who are unable to afford the premiums of private health insurance can enrol in the NHIS thereby eliminating the possibility of disparities in health insurance coverage. Notwithstanding, few studies have examined health insurance coverage among the elderly in Ghana. The lack of studies on the elderly in Ghana may be due to limited data on this important demographic group. Using data from the Study on Global Ageing and Health and applying logit models, this paper investigates whether the pro-poor exemption policy is eliminating disparities among the elderly aged 70 years and older. The results show that disparities in insurance coverage among the elderly are based on respondents’ socio-economic circumstances, mainly their wealth status. The study underscores the need for eliminating health access disparities among the elderly and suggests that the current premium exemptions alone may not be the solution to eliminating disparities in health insurance coverage among the elderly.     

Strategic interaction sequences: the institutionalization of participatory budgeting in New York City

ABSTRACT

An interactive approach to social movements highlights time dynamics in ways more correlational approaches do not, in that interaction and outcomes unfold in sequences as players react to one another. Some aspects of these engagements are shaped by institutional schedules, while others leave discretion to the players. Some institutional schedules, meanwhile, may be reshaped by strategic interactions. By examining the implicit trade-offs and explicit dilemmas that pervade strategic interaction, we see how some are tightly linked to time whereas others more closely reflect ongoing structural situations. Analyzing the case of participatory budgeting in New York City, we focus on two trade-offs, ‘being there’ and ‘powerful allies’, that appear when social movements attempt to institutionalize new policies and processes. These time-based strategic trade-offs complicate activists’ efforts to secure lasting gains.     

Actor-Network Theory, Gabriel Tarde and the Study of an Urban Social Movement: The Case of Can Ricart, Barcelona

This article explores the possibilities that a deeper engagement with the work of Gabriel Tarde opens for Actor-Network Theory (ANT). It argues that the combination of ANT’s methodological and analytical orientation and Tarde’s neo-monadology offers a useful framework for the study of new forms of political activism. Findings from an ethnographic project on the conflict surrounding the eviction and demolition of the Can Ricart factory in Barcelona are used to discuss: a) how ANT transforms the objects of inquiry into performative, relational entanglements (or monads); and b) how Tarde’s neo-monadology helps to re-imagine the political in ANT, moving away from the design of new parliamentary forms and towards a politics of invention. Three key moments of invention in the conflict of Can Ricart are examined: the assemblage of a new activist collective, the fabrication of the very factory the movement was trying to save, and the generation of a bifurcation in the conditions of possibility in which the conflict was taking place.     

The Overlooked Side of the Experience: Personal Growth and Quality of Life Among Grandparents of Children Who Survived Cancer

This study adopted the theoretical framework of Schaefer and Moos (1992) to identify the resources that contributed to the personal growth and quality of life of 56 grandparents of childhood cancer survivors and compare them with 60 grandparents of healthy children. Participants filled out questionnaires addressing sense of coherence, social support, personal growth, and quality of life. A significant difference was found only with regards to personal growth. Hierarchical regressions revealed that health, economic status, higher levels of sense of coherence, and support contributed to quality of life, whereas being a grandparent of a child who survived cancer, lower sense of coherence, support, and past experience of the Holocaust contributed to personal growth. It seems that though they are both positive dimensions, quality of life and personal growth represent different entities in grandparents’ lives. This study sheds light on the experiences and perspectives of grandparents, indicating that alongside the physical and emotional toll taken by their grandchild’s illness, there are also positive implications that can lead to personal growth. Strengthening grandparents could enable families to take advantage of the potential contribution of one of the most committed support providers in the family.     

“Sensory Ordering” in Nurses' Clinical Decision‐Making: Making Visible Senses,Sensing, and “Sensory Work” in the Hospital

The objective of this article is to present a study on the constitutive role of senses in clinical decision‐making. The methodology is based on a series of focus groups with nurses in various hospital departments. Based on a narrative approach, our study examines “sensory work” in clinical decision‐making in order to reveal its specificity in the clinical work of nurses. Nurses shared stories—in focus groups—about the influence of senses in clinical decision‐making. The analysis of clinical narratives helped to identify various situations revealing the “sensory work” that underlines clinical decision‐making. We put the emphasis on the spectrum of sensory activities and the interactions occurring during a clinical decision‐making. One specific contribution of our study is to make visible the “sensory ordering” at work as constituted by interactions between nurses during a clinical assessment.     

Adaptive power priors with empirical Bayes for clinical trials

Incorporating historical information into the design and analysis of a new clinical trial has been the subject of much discussion as a way to increase the feasibility of trials in situations where patients are difficult to recruit. The best method to include this data is not yet clear, especially in the case when few historical studies are available. This paper looks at the power prior technique afresh in a binomial setting and examines some previously unexamined properties, such as Box P values, bias, and coverage. Additionally, it proposes an empirical Bayes‐type approach to estimating the prior weight parameter by marginal likelihood. This estimate has advantages over previously criticised methods in that it varies commensurably with differences in the historical and current data and can choose weights near 1 when the data are similar enough. Fully Bayesian approaches are also considered. An analysis of the operating characteristics shows that the adaptive methods work well and that the various approaches have different strengths and weaknesses.     

清教文化的性别形而上学： 对萨勒姆审巫案的诠释性解释

本文参照行动的文化结构化理论来解释北美历史上最大规模的猎巫事件--萨勒姆审巫案。对该案如何以及何以发生的理解与解释,需要考虑当时活跃在清教徒生活中复杂且被深刻感知的意义。本文揭示了清教文化中的危机。这场造成19个英国男女被绞死的审巫案是在原告、牧师及法官的主导下进行的,他们深植于一个充满意义的世界观中,操纵这一世界观,并最终借助合法暴力捍卫这一世界观。这个世界观是根据如下的紧张与矛盾节点而得以重建的：妇女在社会中的地位、殖民地与上帝之间的关系、世界如何运转的形而上信仰（如巫术与驱魂）。研究萨勒姆审巫案牵涉文化、诠释以及社会学解释的问题。为了回答这些问题,本文指出:（1）文化社会学的解释包含且不限于叙事性意向、意识、言说的意义及行动者的策略;（2）文化社会学的解释应把符号结构与政治经济学的互相嵌入纳入考虑范畴,但又注意不将前者化约为后者;（3）一个危机或事件的走势与参与其中的人们对危机的诠释之间相互纠缠。这意味着,文化社会学能够给出对社会生活的一种因果性诠释,从而超越在理解与解释之间长久存在的区分。     

Infant mortality by cause: A comparison of underlying and multiple cause designations

Through the use of unique data for the 1980–1982 birth cohorts in the State of Florida, USA, the present analysis examines the extent of variability in the social, economic, and demographic characteristics of decedents when grouped by detailed cause of infant death, across four models for identifying cause of death. The analysis first compares cause-of-death-specific infant, neonatal, and postneonatal mortality between each of the four cause-of-death models. Next, interest shifts to an examination of the variability among decedents, specific to cause of death, in a range of background, proximate, and immediate determinants of infant health and survival. Variability is evident in cause-specific mortality rates as well as in decedent characteristics across the cause-of-death models. These findings suggest that more attention be given to the mode of identifying cause of death in studies of infant mortality.