Non-attendance for health care: When rational beliefs collide

Some patients choose not to attend for health care despite health concerns or an opportunity for improved health. Social norms that privilege professional expertise, and good health, deem this choice irrational. However, this paper explores how a particular version of rational choice theory suggests ‘positive choices’ for such non‐attendance. These are cognitive and subjectively rational decisions, which are made freely with potentially positive consequences and are not social problems if respect for personal autonomy trumps obligations to others. Specifically, Boudon's ‘cognitivist theory of action’ is used to conceptualise non‐attendance as both a rational and irrational choice, from different perspectives. Because the perspective of non‐attendees has been marginalised, the paper also suggests a typology of instrumental and non‐instrumental ‘strong reasons’ for rational non‐attendance. This may help groups such as professionals to understand and accept that non‐attendance can be subjectively rational, without relinquishing their own perspective that it is irrational. Acceptance of the defensibility, if not the rightness, of the perspective of non‐attendees is needed to show respect for non‐attendees' moral agency and to begin to repair relationships with these individuals, who may seek help from health professionals in the future.     

The truth and lie story: developing a tool for assessing child witnesses' ability to differentiate between truth and lies

Within the court arena, the credibility and competency of child witnesses often comes under scrutiny and the decision whether a child is considered to be credible or not strongly in?uences whether their evidence will be heard by the court. A child's ability to demonstrate that they understand the difference between truth and lies and the importance of telling the truth is synonymous with competency. Research suggests that many professionals undertaking the task of establishing competency ?nd it very dif?cult, especially with younger children (Aldridge and Wood, 1997, cited in Aldridge and Wood, 1998). This paper describes the process involved in developing an innovative tool for helping professionals assess whether a child understands the difference between truth and lies. The development of the tool arose from the concerns of of?cers from Northumbria Police Force (in the UK) relating to interviews following the protocol of the government's Memorandum of Good Practice (Home Of?ce and Department of Health, 1992) on interviewing child witnesses, and the need to establish whether child witnesses can differentiate between truth and lies. As an example of good practice, The Truth and Lie Story described here has now been included in the Home Of?ce (2002) guidance Achieving Best Evidence in Criminal Proceedings, which is a revision of the 1992 Memorandum of Good Practice. Copyright © 2004 John Wiley & Sons, Ltd.     

As Good as it Gets? A Life Course Perspective on Marital Quality

Marital relationships, like individuals, follow a developmental trajectory over time with ups and downs and gains and losses. We work from a life course perspective and use growth curve analysis to look at trajectories of change in marital quality over time. Although the tendency is for marital quality to decline over time, some groups begin with much higher levels of marital quality than others. Moreover, a number of life course and contextual factors can accelerate or slow this path of change. Our findings point to the importance of considering the multi-dimensionality of time (e.g., age, marital duration, the passage of years) as well as family transitions (e.g., having children, emptying or refilling the nest) in creating the meanings and experiences of marriage over time.     

Mental health support needs of people with a learning difficulty: a medical or a social model?

People with learning difficulties, like all disabled people, face social oppression. Much recent policy and practice are underpinned by at least some understanding of this oppression, and the social model of disability has been influential in discussions of services and supports for people with learning difficulties. However, in the area of mental health, the picture is somewhat different. This paper argues that the medical model has predominated in discussions of mental health support for people with learning difficulties, and that a social model approach could have much to offer. The paper draws on an ongoing action research study in which service providers, families and young people with learning difficulties are working together to articulate what is needed, in order to find routes to improve the support offered to young people with learning difficulties and mental health support needs.     

Inequality and Educational Investment in Thai Children*

Abstract In this paper we examine differences in upper secondary school attendance among subgroups of the population in Thailand. We ascertain where inequalities continue to exist and where they have been mediated. We analyze data from samples of the 1990 and 2000 Thai censuses. We find that the gender gap favoring boys has closed at the national level and that girls now transition to upper secondary school more often than do boys. Inequalities still exist according to socioeconomic background of families. Rural‐urban differences have narrowed considerably since 1990, but they continue to be observed, particularly in certain parts of the country. Similarly, differences between Muslims and others appear to have lessened over the last decade, but Muslims continue to be disadvantaged compared to others, particularly in the South.     

Different worlds of motoring: choice, constraint and risk in household consumption

The article shows how the old economic variable of income can be related to spatial location and used to reinforce recent revisionism in sociology which questions the automatic link between consumption and identity. The diversity of motoring experience is demonstrated through a case study of motoring in inner and outer London which draws on a variety of resources, including interviews from two London boroughs, survey evidence on household expenditure and other official statistics. The analysis shows how income and space variably define household motoring experience as one of choice or constraint and risk. The end result is a cultural economy analysis that shows how motoring sustains multiple, overlapping identities in different worlds of enabling and enforced consumption which connect with production.     

Multiple Public Service Performance Indicators: Toward an Integrated Statistical Approach

Public service organizations usually produce multiple outputs,measured on different scales, giving rise to a suite of performanceindicators. The traditional approach to statistical analysisof organizational performance has been to develop a separateregression model for each performance indicator. This piecemealapproach, the article argues, may discard valuable information,as it ignores potentially important relationships between individualperformance measures. We therefore propose modeling an organization'sperformance measures simultaneously, using the methods of seeminglyunrelated regressions. The approach implicitly introduces alatent organizational variable into the regressions and maytherefore economize on the need to assemble explicit measuresof organizational characteristics. The method is illustratedusing an example from English public hospitals.     

When and How Does Ethnicity Matter? A Cross-National Study of Social Work Responses to Ethnicity in Child Protection Cases

It is an established part of the conventional wisdom of socialwork theory and practice that attention to ethnic differenceis at the core of best practice. This principle is endorsedin welfare legislation or in the training and education of socialworkers in most European countries. Little empirical evidenceexists, however, to demonstrate that this principle guides practitionerdecision making, or to verify the claim that it benefits ethnicminority clients. At a cross-national level, no robust evidenceexists to illustrate similarities or differences in social workresponse to ethnicity. This article reports on aspects of astudy that examines these concerns within the context of childprotection. It demonstrates, perhaps surprisingly given nationalvariations in legislation and professional practice, that overall,country by country, the child’s ethnic affiliation evokeslittle significant response by social workers, confirming alargely universalist approach. However, through a detailed focuson the qualitative data, this paper considers the nature ofthe references to ethnicity that are made by social workersin terms of how they confirm or refute the dominant approachto multiculturalism within social work.     

ROW AND COLUMAN DESIGNS WITH CONTIGUOUS REPLICATES

A method is given for constructing row and column designs for situations where replicates are contiguous. Designs of this type are needed in cotton variety trials. A table of generating arrays is given from which a series of resolvable designs can be constructed; these designs are called latinized α-designs. Some results from cotton variety trials are presented.