Comparison of Medicine Availability Measurements at Health Facilities: Evidence from Service Provision Assessment Surveys in Five Sub-Saharan African Countries.

With growing emphasis on health systems strengthening in global health, various health facility assessment methods have been used increasingly to measure medicine and commodity availability. However, few studies have systematically compared estimates of availability based on different definitions. The objective of this study was to compare estimates of medicine availability based on different definitions. A secondary data analysis was conducted using data from the Service Provision Assessment (SPA) - a nationally representative sample survey of health facilities - conducted in five countries: Kenya SPA 2010, Namibia SPA 2009, Rwanda SPA 2007, Tanzania SPA 2006, and Uganda SPA 2007. For 32 medicines, percent of facilities having the medicine were estimated using five definitions: four for current availability and one for six-month period availability. 'Observed availability of at least one valid unit' was used as a reference definition, and ratios between the reference and each of the other four estimates were calculated. Summary statistics of the ratios among the 32 medicines were calculated by country. The ratios were compared further between public and non-public facilities within each country. Across five countries, compared to current observed availability of at least one valid unit, 'reported availability without observation' was on average 6% higher (ranging from 3% in Rwanda to 8% in Namibia), 'observed availability where all units were valid' was 11% lower (ranging from 2% in Tanzania to 19% in Uganda), and 'six-month period availability' was 14% lower (ranging from 5% in Namibia to 25% in Uganda). Medicine availability estimates vary substantially across definitions, and need to be interpreted with careful consideration of the methods used

Why do people opt-out or not opt-out of automatic enrolment? A focus group study of automatic enrolment into a workplace pension in the United Kingdom

Automatic enrolment (AE) into a workplace pension is an important recent development in pension policy. An important question for this policy is why do people opt-out or not opt-out of AE? This question is important for understanding the power of suggestion associated with AE as well as responding to concerns that women might face undue pressure to opt-out. This article addresses this question through a focus group study into the United Kingdom’s new AE policy. Women were more likely than men to cite lack of affordability as a reason for opting out. Lack of information also seemed important for the power of suggestion associated with AE. Further research should explore how to make AE less gender blind as well as the types of information or advice that should be provided alongside AE

Barriers to positive mental health in a young offenders institution: A qualitative study

Objective: To explore the barriers to positive mental health in a group of young offenders. Design A qualitative approach was used to provide insight into the ways in which mental health for young offenders is experienced and managed. Setting A Young Offenders Institute (YOI) accommodating males aged between 18 and 21 years. Method: Participants were recruited voluntarily using posters. Twelve offenders participated in focus groups and an additional three interviews were carried out with individuals who felt uncomfortable in the focus group situation. Results: Participants stressed that feelings in a YOI could not be shared due to the masculine ethos that had been created on the wings. Listener services were reported to be ineffective for support because using them would show weakness and vulnerability to other prisoners. Visiting time was the main highlight in the routine for most young offenders; however, leaving family and friends was difficult. In dealing with these emotions young offenders would use coping mechanisms, including acts of aggression to vent built-up frustrations. The issue of prison staff and their effect on mental health was raised by all offenders involved in the research. Unanimously, it was suggested that there are both excellent prison officers who engage with the prisoners, and staff who abuse their power and treat prisoners disrespectfully. Conclusion: Promoting mental health is not the principle business of a YOI. However, this research has generated some issues for consideration for governors and those working within this setting

On the side of the angels: community involvement in the governance of neighbourhood renewal.

This article draws upon the authors’ experiences of community-led regeneration developed while members of the National Evaluation Team for the NDC Programme. The article continues the focus on urban regeneration adopted in a range of outputs from two of the authors over the last decade. In assessing how the term community has been defined by policy-makers and the challenges involved in empowering communities, the output was aimed at both academic and user communities. For its direct relevance to communities involved in regeneration, the article was awarded the 2006 Sam Aaronovitch Prize, awarded annually by the journal Local Economy

On quantifying expert opinion about multinomial models that contain covariates

This paper addresses the task of forming a prior distribution to represent expert opinion about a multinomial model that contains covariates. The task has not previously been addressed. We suppose the sampling model is a multinomial logistic regression and represent expert opinion about the regression coefficients by a multivariate normal distribution. This logistic-normal model gives a flexible prior distribution that can capture a broad variety of expert opinion. The challenge is to (i) find meaningful assessment tasks that an expert can perform and which should yield appropriate information to determine the values of parameters in the prior distribution, and (ii) develop theory for determining the parameter values from the assessments. A method is proposed that meets this challenge. The method is implemented in interactive user-friendly software that is freely available. It provides a graphical interface that the expert uses to assess quartiles of sets of proportions and the method determines a mean vector and a positive-definite covariance matrix to represent the expert's opinions. The chosen assessment tasks yield parameter values that satisfy the usual laws of probability without the expert being aware of the constraints this imposes. Special attention is given to feedback that encourages the expert to consider his/her opinions from a different perspective. The method is illustrated in an example that shows its viability and usefulness

ソーシャルワークの新たなパラダイム

筆者の不勉強のためであろうか，近年，国内外で，特に国内において，数多くのソーシャルワークと銘打った著作が出版されているにもかかわらず，理論構成や実践の方向性を指し示す研究や実践報告はますます少なくなり，ソーシャルワーク研究は隘路に迷い込んでいる印象を受ける。厳密性に欠ける理論や変容力が低い実践が共有される世界に内閉的に閉じこもる限り，一定の自己充足が可能である。しかし，その場合，訴えられる問題に対しての高度に洗練された解決の実践が断念されることになる。社会生活場面で生じる問題解決，つまりソーシャルワーク実践のためには，まずは，この内閉的世界からの離脱が不可欠である。その上で，自由な立場から基礎理論および実践理論の構築に着手することが求められる。本論においては，この問題意識の下，社会構成主義的コミュニケイション理論を基礎理論とする新たな支援のパラダイムの概略を示した。総説General Articl

‘Talent-spotting’ or ‘social magic’? Inequality, cultural sorting and constructions of the ideal graduate in elite professions

Graduate outcomes – including rates of employment and earnings – are marked by persistent inequalities related to social class, as well as gender, ethnicity and institution. Despite national policy agendas related to social mobility and ‘fair access to the professions’, high-status occupations are disproportionately composed of those from socially privileged backgrounds, and evidence suggests that in recent decades many professions have become less socially representative. This article makes an original contribution to sociological studies of inequalities in graduate transitions and elite reproduction through a distinct focus on the ‘pre-hiring’ practices of graduate employers. It does this through a critical analysis of the graduate recruitment material of two popular graduate employers. It shows how, despite espousing commitments to diversity and inclusion, constructions of the ‘ideal’ graduate privilege individuals who can mobilise and embody certain valued capitals. Using Bourdieusian concepts of ‘social magic’ and ‘institutional habitus’, the article argues that more attention must be paid to how graduate employers’ practices constitute tacit processes of social exclusion and thus militate against the achievement of more equitable graduate outcomes and fair access to the ‘top jobs

Reconsidering "the love of art" : evaluating the potential of art museum outreach

Art museums have long been identified as bastions of social and cultural exclusion. This conclusion was best evidenced by the large-scale 1967 French study by Bourdieu and Darbel demonstrating the exclusionary nature of “The Love of Art.” However, in recent years there have been increasing efforts to reach out to a broader range of visitors beyond conventional audiences. The present study investigates the impacts of an outreach program at a UK art museum, which sought to engage socially excluded young mothers. This study employs ethnographic research methods on a longitudinal basis to develop qualitative insights about the program seeking to mitigate cultural exclusion. While the study’s findings uphold many longstanding critiques of art museums’ conventional approaches, the study also indicates that carefully designed outreach activities can overcome such limitations and enhance cultural engagement. Thus, art museums’ limited appeal is tied to problematic public engagement practices that can be changed