Psychopathic Cultures: Sexual and Lateral Violence in Contemporary Chicana and Métis Women's Writing

The chapter examines the memoir Mean (2017) by Chicana author Myriam Gurba and the novel The Break (2016) by Métis writer Katherena Vermette. Through textual analysis, the chapter shows how these two writers resist dominant ideas concerning “psychopathy” that perpetuate gendered, raced, and classed stereotypes. The chapter argues that these authors unsettle psychopathy as something situated in the individual to depict the United States and Canada as psychopathic structures that create the conditions for certain forms of violence to flourish. Vermette and Gurba’s work contributes to the body of Indigenous and Chicana writing that rejects, rewrites, and resists misleading images of violence

A Randomised Controlled Trial of a psychotherapeutic intervention to improve quality of life and other outcomes in people who repeatedly self-harm: FReSH START study protocol

Background Self-harm is a major public health challenge and repeated self-harm is common in those attending hospital following an episode. Evidence suggests psychological interventions could help people who self-harm, but few definitive studies have assessed their clinical and cost-effectiveness. Repeated self-harm is associated with poor quality of life, depression, suicide and increased health service costs which justify the development of psychotherapeutic interventions tailored for people with repeated self-harm. Methods FReSH START is a multicentre individually 1:1 randomised controlled trial evaluating the clinical and cost-effectiveness of standard care plus psychological therapy or standard care alone for adults (>=18 years) presenting at an emergency department (ED) with repeated self-harm. Recruiting 630 participants, it includes an internal pilot, economic evaluation and process evaluation. The intervention will be delivered by mental health staff working in acute settings, with experience of assessing and managing risk in people presenting to emergency services with self-harm. Staff will be trained and supervised to deliver one of three specially adapted therapies: psychodynamic interpersonal therapy, cognitive behavioural therapy, or acceptance and commitment therapy. Participants allocated to the intervention will receive one of the adapted therapies according to therapist allocation for up to 6 months via 12 weekly, one to one, 45-50 minute sessions. The primary outcome is quality of life measured by the Clinical Outcomes in Routine Evaluation Outcome Measure at 12 months post-randomisation. Secondary outcomes include suicidal intent, depression, and cost-effectiveness. Data are collected using hospital attendance records and online/postal/telephone questionnaires at 6 and 12 months post-randomisation, with resource use additionally collected at 3 and 9 months). Discussion This protocol outlines a randomised controlled trial to investigate whether modified therapies are cost-effective and improve quality of life for people who repeatedly self-harm. Few interventions are proven to be deliverable in the NHS for this population. This study is strengthened by the involvement of qualified mental health workers experienced in managing risk as therapists

Ontology, complex adaptive systems and economics

In this article we first set out what complexity theory is and its place in economics. We then discuss whether complexity economics has observably transformed the mainstream before asking, even if complexity economics did in fact succeed in changing the mainstream, would this make the mainstream significantly different? The purpose of the article is to establish that complexity economics is different than the previously existing mainstream but, drawing on critical realism and social ontology, not as different as one might think. We conclude by suggesting there is scope for a more ontologically nuanced understanding of complexity

Perspectives on community-based system change for people living with persistent pain: insights from developing the “Rethinking Pain service”

In this perspective article we advocate community-based system change for people living with persistent pain. Our view is that greater use of the voluntary and community sector, in partnership with the clinical sector, creates the conditions for a “whole person” approach to pain management, leading to greater personalised care for adults living with long-term pain whilst having the potential to ease some of the pressures on General Practitioners and other clinical services. We advocate pain care that is socially connected, meaningful within socio-cultural contexts and aligned with the principles of salutogenesis. We provide an example of a UK National Health Service (NHS) commissioned pain service called “Rethinking Pain” that operationalises this perspective. Led by the voluntary and community sector, Rethinking Pain works in partnership with the clinical sector to provide a central holistic pathway of care for people experiencing persistent pain. This is the first time that this model of care has been commissioned for persistent pain in this area of England. The Rethinking Pain service is underpinned by core values to work with people to manage their pain holistically. The Rethinking Pain team proactively engage with people in the community, actively approaching and engaging those who experience the biggest health inequalities. In this article we provide an overview of the context of pain services in the UK, the rationale and supporting evidence for community-based system change, and the context, pathway, values, goals, and aspirations of the Rethinking Pain service

Editorial: Passionate about improving diversity in the profession

This article describes the establishment of a mentorship programme which aims to support students feeling under-represented in occupational therapy, higher education and healthcare

"[K]neeling only goes to highlight your ignorance. England is NOT! a #racist country": Aversive racism, colour-blindness, and racist temporalities in discussions of football online

Drawing on theories of aversive racism and colour-blindness, which stress the invisibility of contemporary racism, this article analyses online discussions on taking the knee (TTK) during EURO2020 men’s football tournament. While highly visible racist abuse directed at Black English players after losing the final to Italy (dominative racism) received most public attention and repudiation, based on 6,850 English language tweets published on Twitter/X, this article shows how subtle racism and colour-blindness were reinforced in discussions around TTK over the duration of the tournament (aversive racism). The article also shows how individuals online developed a variety of strategies (evidence, othering, critique, and activism) to challenge the main arguments against anti-racist activism in football (identified in four themes: BLM, Marxism, virtue signalling, and woke). The article makes an original contribution by examining the changing intensity of online conversations on TTK over the duration of the tournament. Our analysis identifies key moments in the tournament, political elites’ rhetoric, and trends of success and failure as relevant factors that shaped vernacular conversations online. The discussion ultimately argues that investigating the temporal patterns of public discussions on (anti)racism provides valuable insights to understand the contemporary complexity of racism in football and society more broadly

Keystrokes: A practical exploration of semantic drift in timed word association tasks

This study investigates the phenomena of semantic drift through the lenses of language and situated simulation (LASS) and the word frequency effect (WFE) within a timed word association task. Our primary objectives were to determine whether semantic drift can be identified over the short time (25 seconds) of a free word association task (a predicted corollary of LASS), and whether more frequent terms are generated earlier in the process (as expected due to the WFE). Respondents were provided with five cue words (tree, dog, quality, plastic and love), and asked to write as many associations as they could. We hypothesized that terms generated later in the task (fourth time quartile, the last 19–25 seconds) would be semantically more distant (cosine similarity) from the cue word than those generated earlier (first quartile, the first 1–7 seconds), indicating semantic drift. Additionally, we explored the WFE by hypothesizing that earlier generated words would be more frequent and less diverse. Utilizing a dataset matched with GloVe 300B word embeddings, BERT and WordNet synsets, we analysed semantic distances among 1569 unique term pairs for all cue words across time. Our results supported the presence of semantic drift, with significant evidence of within-participant, semantic drift from the first to fourth time (LASS) and frequency (WFE) quartiles. In terms of the WFE, we observed a notable decrease in the diversity of terms generated earlier in the task, while more unique terms (greater diversity and relative uniqueness) were generated in the 4th time quartile, aligning with our hypothesis that more frequently used words dominate early stages of a word association task. We also found that the size of effects varied substantially across cues, suggesting that some cues might invoke stronger and more idiosyncratic situated simulations. Theoretically, our study contributes to the understanding of LASS and the WFE. It suggests that semantic drift might serve as a scalable indicator of the invocation of language versus simulation systems in LASS and might also be used to explore cognition within word association tasks more generally. The findings also add a temporal and relational dimension to the WFE. Practically, our research highlights the utility of word association tasks in understanding semantic drift and the diffusion of word usage over a sub-minute task, arguably the shortest practically feasible timeframe, offering a scalable method to explore group and individual changes in semantic relationships, whether via the targeted diffusion of influence in a marketing campaign, or seeking to understand differences in cognition more generally. Possible practical uses and opportunities for future research are discussed

Depicting deterministic variables within directed acyclic graphs (DAGs): An aid for identifying and interpreting causal effects involving derived variables and compositional data

Deterministic variables are variables that are functionally determined by one or more parent variables. They commonly arise when a variable has been functionally created from one or more parent variables, as with derived variables, and in compositional data, where the 'whole' variable is determined from its 'parts'. This article introduces how deterministic variables may be depicted within directed acyclic graphs (DAGs) to help with identifying and interpreting causal effects involving derived variables and/or compositional data. We propose a two-step approach in which all variables are initially considered, and a choice is made whether to focus on the deterministic variable or its determining parents. Depicting deterministic variables within DAGs brings several benefits. It is easier to identify and avoid misinterpreting tautological associations, i.e., self-fulfilling associations between deterministic variables and their parents, or between sibling variables with shared parents. In compositional data, it is easier to understand the consequences of conditioning on the ‘whole’ variable, and correctly identify total and relative causal effects. For derived variables, it encourages greater consideration of the target estimand and greater scrutiny of the consistency and exchangeability assumptions. DAGs with deterministic variables are a useful aid for planning and interpreting analyses involving derived variables and/or compositional data

Normalisation and equity of referral to the NHS Low Calorie Diet programme pilot; a qualitative evaluation of the experiences of health care staff.

BACKGROUND: Health and wellbeing can be profoundly impacted by both obesity and type 2 diabetes, while the normalisation and equity of care for people living with these non-communicable diseases remain as challenges for local health systems. The National Health Service Low Calorie Diet programme in England, aims to support people to achieve type 2 diabetes remission, while also reducing health inequalities. We have explored the experiences of health care staff who have made a referral to the LCD programme, while identifying effective and equitable delivery of programme referrals, and their normalisation into routine care. METHODS: Nineteen individual semi-structured interviews were completed health care staff in the first year of the Low Calorie Diet programme. Interviewees were purposively sampled from the ten localities who undertook the Low Calorie Diet programme pilot. Each interview explored a number of topics of interest including communication and training, referrals, equity, and demands on primary care, before being subjected to a thematic analysis. RESULTS: From the data, five core themes were identified: Covid-19 and the demands on primary care, the expertise and knowledge of referrers, patient identification and the referral process, barriers to referrals and who gets referred to the NHS LCD programme. Our findings demonstrate the variation in the real world settings of a national diabetes programme. It highlights the challenge of COVID-19 for health care staff, whereby the increased workload of referrals occurred at a time when capacity was curtailed. We have also identified several barriers to referral and have shown that referrals had not yet been normalised into routine care at the point of data collection. We also raise issues of equity in the referral process, as not all eligible people are informed about the programme. CONCLUSIONS: Referral generation had not yet been consistently normalised into routine care, yet our findings suggest that the LCD programme runs the risk of normalising an inequitable referral process. Inequalities remain a significant challenge, and the adoption of an equitable referral process, normalised at a service delivery level, has the capacity to contribute to the improvement of health inequalities

SCMC: Smart city measurement and control process for data security with data mining algorithms

In this paper the importance of monitoring smart city with integration of sensors and Internet of Things (IoT) is discussed with establishment of node control process. To describe the feature of smart cities time measurements are considered with one hop distance between various nodes. Hence the system model is established for various parameters that are integrated with K-means algorithm for clustering and C4.5 for classification. As a result of combining the dual algorithms with system model it is possible to establish a secured state for each data with proper response factor. The major significance of proposed method is to introduce node point where all increasing queues in smart cities are controlled due to the information that is achieved from every data points. Moreover the improvement in projected model can be observed with four scenarios where security at every data point plays an important role at an increased level of 84%. In addition to security the amount of stable points is increased with reduction in disparities for about 2% thereby every applications in smart cities are monitored in a precise way