Research project on advocacy and autism

This article presents the findings of a qualitative research project about the difficulties in accessing advocacy faced by adults labelled as having autism and Asperger's Syndrome in the Northwest of England. It is also an example of partnership working between three organisations. The article examines both the process of team-led (emancipatory) research and the project findings. Seven main themes emerged throughout the research: late diagnosis and lack of service support; bad experiences with systems of care; feelings of 'not belonging' (identity issues); barriers around communication and sensitivity towards individuals; lack of awareness and access to advocacy and rights; difficulties of 'fitting into' what is already available; and interest in developing knowledge around advocacy. Examination of the main themes pointed to a disturbing link between poor service response, episodes of crisis and mental ill health. The Carlisle People First Research Team is made up of 6 researchers who are labelled as having 'learning difficulties' who work in partnership with one other researcher.     

Two phase parametric and probabilistic NPV calculations, with possible deferral of disposal of UK nuclear waste as an example

This paper illustrates the value of several particular features of a first phase parametric approach to discounted cash flow (DCF) decision analysis when significant uncertainty is involved. It also illustrates the value of second phase probabilistic approaches to selected parameters for five quite different example reasons. The most controversial example reason concerns the discount rate. The particular example used to illustrate both phases may stimulate general interest because of the important issues involved, but it is argued that the two phase approach as a whole has a wide range of applications for decisions large and small.     

Danish and Norwegian hospital social workers’ cross-institutional work amidst inter-sectoral restructuring of health and social welfare

Starting in the 2000s, Denmark and Norway have undergone extensive restructuring of their health-related social benefit programmes, including how they are governed. Several reforms have sought to enhance inter-sectoral collaboration. Aiming at ensuring patients’ faster return to work, policy-makers have instituted economic incentives to both individuals and the health and welfare organisations who handle them. Through an institutional logics approach, this paper explores how hospital social workers in these countries are experiencing these changes. The ‘social’ part of post-treatment care and rehabilitation receives more attention in the Norwegian institutional set-up than in the Danish, and whilst challenges are experienced in both countries, in group interviews Danish social workers in particular express concerns about the implications of the accelerated return-to-work focus. In both countries, they report increasing difficulties in ‘making their way through’ the state-municipal bureaucracy. However, by drawing on the formal health knowledge derived from medical settings and the symbolic capital it bestows on them, they often manage to negotiate the work-and-welfare services, thereby transforming the social context for the patients.     

Multiple-class classification: Ordinal and categorical labels

We study multiple-class classification problems. Both ordinal and categorical labeled cases are discussed. The common approaches for multiple-class classification are built on binary classifiers, in which one-versus-one and one-versus-rest are typical approaches. When the number of classes is large, then these binary-classifier-based methods may suffer from either computational costs or the highly imbalanced sample sizes in their training stage. In order to alleviate the computational burden and the imbalanced training data issue in multiple-class classification problems, we propose a method that has competitive performance and retains the ease of model interpretation, which is essential for a prognostic/predictive model.     

Use of thermobalancing therapy in ageing male with benign prostatic hyperplasia with a focus on etiology and pathophysiology

Introduction: We investigated if “thermobalancing” therapy (TT), using Dr Allen’s therapeutic device (DATD) in men with benign prostatic hyperplasia (BPH), can aid in understanding the etiology and pathophysiology of BPH.

Methods: We compared urinary and other parameters of BPH patients who received TT over 6 months (treatment group) with those of healthy volunteers who had not received the treatment (control group). Dynamics of symptoms and indicators in each group were evaluated in comparison with their data at the beginning and end of the study. Parameters were the International Prostate Symptom Score (IPSS) for urinary symptoms and quality of life (QoL), ultrasound measurement of prostate volume (PV) and uroflowmetry (maximum flow rate, Q_max). TT effectiveness was examined in 124 men with BPH and PV?<60?mL. We also investigated the data of five patients with BPH and PV?>60?mL.

Results: TT decreased urinary symptoms and PV, increased Q_max and improved QoL in men with BPH, PV?<60?mL, and in men with BPH, PV?>60?mL.

Conclusions: The present study demonstrated that TT is effective for BPH, suggesting that blood circulation plays a crucial role in its cause. The continuous heat exposure that does not exceed the normal body temperature terminates the trigger of BPH development, “micro-focus” of hypothermia, and the following spontaneous expansion of capillaries. TT could be considered to be a useful tool in BPH treatment.     

Household Assets,the Role of Government Assistance,and Depression Among Low-Income Families in Shanghai

As China’s economy is rapidly changing from a planned to a capitalist economy, many families find themselves financially struggling. In some cases, conflicting values and attitudes may contribute to mental health challenges such as depression that would lead to further feelings of helplessness and immobilization. Using a random sample of 1006 low-income households from Pudong District of Shanghai, China, this study aims to examine the relationships between household assets, beliefs about government as the primary way to improve economic circumstances and self-reported depressive symptoms. In addition, this study investigates the mediation effects of beliefs that government is the best change agent for improved life circumstances on the relationship between household assets and depression. We found those who indicated that government was the main means for attaining a better life had significantly higher depression levels whereas higher numbers of household assets were associated with lower depression levels. We also found that viewing government as the most important change agent only partially mediated the relationship between household assets and depression (p?<?.001). Findings from this study support anti-poverty policies and social work related practice initiatives aimed at assisting low income families in China, in particular the need to address psychological as well as economic needs.

     

Exploring Heideggerian hermeneutic phenomenology: A perfect fit for midwifery research

BackgroundHeideggerian hermeneutic phenomenology has been used widely to understand the meaning of lived experiences in health research. For midwifery scholars this approach enables deep understanding of women's and midwives’ lived experiences of specific phenomena. However, for beginning researchers this is not a methodology for the faint hearted. It requires a period of deep immersion to come to terms with at times impenetrable language and perplexing concepts.ObjectivesThis paper aims to assist midwives to untangle and examine some of the choices they face when they first come to terms with an understanding of this methodology and highlights the methodology's capacity to reveal midwifery authenticity and holistic practice.DiscussionThe illumination of a selection of various concepts underpinning hermeneutic phenomenology will inform midwives considering this methodology as suitable framework for exploring contemporary midwifery phenomena.