Census adjustment and the distribution of federal spending

In 1989, programs that use population counts to determine the distribution of their funds transferred $236 per capita to state and local governments. If the 1990 census were adjusted to reflect undercounting, about 40% of state and local governments would receive increased grants averaging $56 per miscounted person; other jurisdictions would lose an almost equal amount of grant money. The surprisingly small reallocations arise because 1) total funds allocated by population are essentially fixed; 2) allocations depend on other factors in addition to population; and 3) programs vary as to whether they allocate funds in direct or inverse proportion to population.     

Logistic retainment interval dose exploration design for Phase I clinical trials of cytotoxic agents

Phase I studies of a cytotoxic agent often aim to identify the dose that provides an investigator specified target dose-limiting toxicity (DLT) probability. In practice, an initial cohort receives a dose with a putative low DLT probability, and subsequent dosing follows by consecutively deciding whether to retain the current dose, escalate to the adjacent higher dose, or de-escalate to the adjacent lower dose. This article proposes a Phase I design derived using a Bayesian decision-theoretic approach to this sequential decision-making process. The design consecutively chooses the action that minimizes posterior expected loss where the loss reflects the distance on the log-odds scale between the target and the DLT probability of the dose that would be given to the next cohort under the corresponding action. A logistic model is assumed for the log odds of a DLT at the current dose with a weakly informative t-distribution prior centered at the target. The key design parameters are the pre-specified odds ratios for the DLT probabilities at the adjacent higher and lower doses. Dosing rules may be pre-tabulated, as these only depend on the outcomes at the current dose, which greatly facilitates implementation. The recommended default version of the proposed design improves dose selection relative to many established designs across a variety of scenarios.     

Piketty comes to South Africa

One of the most valuable features of Capital and Ideology is its concern to take history seriously and consider how the emergence of different political and economic regimes relate to discourses about fairness and justice across time. This paper pushes this agenda further by acknowledging that the experience of a few developed nations should not be taken as the template for the generalized study of inequality dynamics across time and space. In this paper, we interrogate Piketty's analysis and policy proposals against specificities that are central to understanding the production and reproduction of inequalities within South Africa. We reflect on the South African case, the structure of inequality and its changes since 1994. We review a battery of policy interventions that have been implemented to address inequality in the last 25 years. We emphasize that the long shadow cast by centuries of colonialism and various forms of apartheid strongly affirm Piketty's emphasis on understanding history. But this is both affirmation and critique given the foundational, imbedded impact that this specific legacy has had on post‐apartheid society and its policies. Piketty is aware that the levels of inequality in South Africa are so high that this is “unknown territory.” We map out some of this territory to reveal how these extreme initial wealth and racial inequities inform the reproduction of inequalities in all dimensions and undermine well intentioned policies. We claim that understanding extractive histories, imbedded wealth inequalities, and complex social and political institutions allows us to understand and confront some of the reasons why even in light of progressive policies, many of which are in line with the proposals from Piketty, government interventions have thus far failed to reduce inequality.     

'Anti-Oppressiveness': Critical Comments on a Discourse and its Context

This paper identifies and aims to explain an apparent dissonancebetween the dominance in Britain of ‘anti-oppressive’social work discourse and the socio-political context surroundingits use; a context often claimed to feature excessive regulationand control. Pursuing this, some politically radical aims associatedwith ‘anti-oppressiveness’ are spelt out, and thedifficulty of achieving these in an unconducive climate is discussed.Then, a distinction made by Robert Merton between ‘latent’and ‘manifest’ functions is used to suggest thatthe manifest radicalism of ‘anti-oppressive’ discoursecan helpfully be distinguished from some latent largely unrecognisedconsequences of its use – not consequences with politicallyradical impact, but with a social meaning congruent with a climateof control. It is concluded that the ‘success’ ofanti-oppressive discourse might well be viewed as requiringmore of the kind of critical analysis that the discourse itselfwas supposed to espouse.     

“The only equality is the pain”: An exploration of the Irish policy sphere's approach to “access” and “entitlement” in health care

This paper critically analyses how overarching policy goals and practices surrounding access and entitlement to health care (HC) have been dominated by a conflicting system of libertarian and equity-based principles. We examine how this mixed-motives system originated and the importance of policy legacies inherited from the Poor Laws era in shaping modern conceptions of access and entitlement to HC. We also considered how these determined the scope of state intervention in this policy domain. Drawing on empirical evidence and interviews with key stakeholders in Irish health policy, we explored the appetite to engage in meaningful HC reforms that address the growing gaps of inequity between higher and lower socio-economic groups in society. Rather than emulating European counterpartsapos; emphasis on universal coverage within an egalitarian paradigm, Irish policy actors have sought to instill a spirit of fairness in HC delivery. Under the guise of equality of opportunity and equity, the policy focus has centred on directing publicly funded HC towards lower-income groups and the most vulnerable in Irish society. However, we argue that the operation of the mixed-motives structure has also created conflict and policy ambiguity surrounding overarching goals which frame the governance and consumption of HC in Ireland. This is evidenced by the dysfunction and complexity of the two-tier system of public-versus-private access to HC services. Ultimately, we argue that the policy aspirations of equality that underpin the HC structures surrounding access and entitlement should be revisited to achieve greater health outcomes and create a more equal society.     

Illuminating urban street (u)topias

ABSTRACT

A utopian vision of the city is often bright, well-lit, and conversely darkness and night are more often associated with dystopia. This paper uses an ethnographic study of night-time in a busy street space in the middle of a south coast UK city in order to demonstrate the application of ‘utopia as method’, or rather utopia as a mobile method in understanding justice and injustice in urban space. In doing so, we suggest the possibilities of urban mobile space, arguing that ‘utopia as method’ originates in Lefebvre’s (1991) work on the possibilities that arise from the seemingly impossible imaginings of urban transformation. We use what are considered to be distinct approaches to photography: ‘ethnographic’ and ‘expressive’ in demonstrating this. Photography tells a story of the lighting of the space in illuminating the street in particular ways and making visible aspects that otherwise may go unnoticed. We draw from the boundaries, of photography (and therefore light), of method, and of urban space, looking to the ‘territorial edges’ for Lefebvre’s possibilities.     

Working with parents of spinal cord injured adolescents: A family systems perspective

Concepts from family systems theory are used to facilitate understanding of the needs of families coping with the spinal cord injury of an adolescent. Five assumptions derived from systemic principles are discussed as related to assessment and family functioning. Related suggestions are given for assisting parents in dealing with this non-normative stressor and its long-range effects on the adolescent and family.