Comparing Rawlsian Justice and the Capabilities Approach to Justice from a Spiritually Sensitive Social Work Perspective

‘This is an electronic version of an article published in the March, 2012 special issue of the Journal of Religion and Spirituality and Social Work entitled Spirituality and Social Justice volume 31, (1-2), pp. 9-31. It is available online at http://dx.doi.org/10.1080/15426432.2012.647874This article examines two social justice theories, Rawlsian Justice and the Capabilities Approach of Sen and Nussbaum, in relation to congruence with four principles of spiritually sensitive social work. We find that although Rawlsian justice has valuable insights, it has some gaps for promoting spiritually sensitive practice. In contrast, the Capabilities Approach bears more promise for promoting spiritually sensitive social work as it meets all these ethical principles. Scholars could build on its insights to articulate a vision for spiritually sensitive social justice that can guide our profession’s approaches to macro practice and social polic

“Ghosts from the past”: The re-emergence of internalised religious stigma following diagnosis of HIV among Northern Irish gay men

This paper explores how previous exposure to religious homo-negativity features in the sense making process following HIV diagnosis in a homogenous sample of six gay men living in Northern Ireland. Interpretive Phenomenological Analysis was used to identify two key overarching themes: ‘Negotiating authenticity in unsafe space’ which relates to the experience of negotiating same sex attraction within religious environments and ‘Re-emergence of religious shame in diagnosis’ which relates to the way in which the men made sense of diagnosis from the position of having been exposed to religious homo-negativity earlier in their lives. Findings demonstrate how the men negotiated their sexual orientation within religious contexts and how a reconstruction of God was necessary to preserve an authentic sense of self. Despite reaching reconciliation, HIV was initially appraised within a retributive religious framework that served to temporarily reinforce previously learned shame-based models of understanding this aspect of the self

The “untouchable” who touched millions: Dr. B. R. Ambedkar, Navayana Buddhism, and complexity in social work scholarship on religion

Dr. B. R. Ambedkar was a twentieth century socio-political and religious reformer whose activities impacted millions of lives, especially among India’s Dalit community. This article illustrates his lifework and its lessons for social work scholarship on religion. Using the examples of Ambedkar and Navayana Buddhism, I discuss three sources of complexity for social work scholarship on religion: 1) religion may function as both oppressive and emancipatory; 2) religion is malleable, not monolithic; and 3) religion is situated in and interactive with contexts. I conclude with suggestions for how social work scholarship on religion may account for complexity

Integrating religion and belief in social work practice: an exploratory study

This exploratory study examines how social work practitioners in England integrate service users’ religion, belief and spiritual identities. The study involved 34 semi-structured interviews with Qualified Social Workers and took a qualitative investigational perspective. By means of thematic analysis, the study suggests that practitioners employ either avoidant or utilitarian approaches, which may indeed be a coping strategy before the vast religious plurality in practice. The study also highlights when professionals perceive religion, belief and spirituality important. Those times are a) initial assessments, b) conditional intervention, c) referrals and d) response to this subject when safeguarding and child protection issues arise

The Global Burden of Alveolar Echinococcosis

Human alveolar echinococcosis (AE), caused by the larval stage of the fox tapeworm Echinococcus multilocularis, is amongst the world's most dangerous zoonoses. Transmission to humans is by consumption of parasite eggs which are excreted in the faeces of the definitive hosts: foxes and, increasingly, dogs. Transmission can be through contact with the definitive host or indirectly through contamination of food or possibly water with parasite eggs. We made an intensive search of English, Russian, Chinese and other language databases. We targeted data which could give country specific incidence or prevalence of disease and searched for data from every country we believed to be endemic for AE. We also used data from other sources (often unpublished). From this information we were able to make an estimate of the annual global incidence of disease and disease burden using standard techniques for calculation of DALYs. Our studies suggest that AE results in a median of 18,235 cases globally with a burden of 666,433 DALYs per annum. This is the first estimate of the global burden of AE both in terms of global incidence and DALYs and demonstrates the burden of AE is comparable to several diseases in the neglected tropical disease cluster

Evaluation of the Growth Assessment Protocol (GAP) for antenatal detection of small for gestational age: The DESiGN cluster randomised trial

BACKGROUND: Antenatal detection and management of small for gestational age (SGA) is a strategy to reduce stillbirth. Large observational studies provide conflicting results on the effect of the Growth Assessment Protocol (GAP) in relation to detection of SGA and reduction of stillbirth; to the best of our knowledge, there are no reported randomised control trials. Our aim was to determine if GAP improves antenatal detection of SGA compared to standard care. METHODS AND FINDINGS: This was a pragmatic, superiority, 2-arm, parallel group, open, cluster randomised control trial. Maternity units in England were eligible to participate in the study, except if they had already implemented GAP. All women who gave birth in participating clusters (maternity units) during the year prior to randomisation and during the trial (November 2016 to February 2019) were included. Multiple pregnancies, fetal abnormalities or births before 24+1 weeks were excluded. Clusters were randomised to immediate implementation of GAP, an antenatal care package aimed at improving detection of SGA as a means to reduce the rate of stillbirth, or to standard care. Randomisation by random permutation was stratified by time of study inclusion and cluster size. Data were obtained from hospital electronic records for 12 months prerandomisation, the washout period (interval between randomisation and data collection of outcomes), and the outcome period (last 6 months of the study). The primary outcome was ultrasound detection of SGA (estimated fetal weight <10th centile using customised centiles (intervention) or Hadlock centiles (standard care)) confirmed at birth (birthweight <10th centile by both customised and population centiles). Secondary outcomes were maternal and neonatal outcomes, including induction of labour, gestational age at delivery, mode of birth, neonatal morbidity, and stillbirth/perinatal mortality. A 2-stage cluster-summary statistical approach calculated the absolute difference (intervention minus standard care arm) adjusted using the prerandomisation estimate, maternal age, ethnicity, parity, and randomisation strata. Intervention arm clusters that made no attempt to implement GAP were excluded in modified intention to treat (mITT) analysis; full ITT was also reported. Process evaluation assessed implementation fidelity, reach, dose, acceptability, and feasibility. Seven clusters were randomised to GAP and 6 to standard care. Following exclusions, there were 11,096 births exposed to the intervention (5 clusters) and 13,810 exposed to standard care (6 clusters) during the outcome period (mITT analysis). Age, height, and weight were broadly similar between arms, but there were fewer women: of white ethnicity (56.2% versus 62.7%), and in the least deprived quintile of the Index of Multiple Deprivation (7.5% versus 16.5%) in the intervention arm during the outcome period. Antenatal detection of SGA was 25.9% in the intervention and 27.7% in the standard care arm (adjusted difference 2.2%, 95% confidence interval (CI) -6.4% to 10.7%; p = 0.62). Findings were consistent in full ITT analysis. Fidelity and dose of GAP implementation were variable, while a high proportion (88.7%) of women were reached. Use of routinely collected data is both a strength (cost-efficient) and a limitation (occurrence of missing data); the modest number of clusters limits our ability to study small effect sizes. CONCLUSIONS: In this study, we observed no effect of GAP on antenatal detection of SGA compared to standard care. Given variable implementation observed, future studies should incorporate standardised implementation outcomes such as those reported here to determine generalisability of our findings. TRIAL REGISTRATION: This trial is registered with the ISRCTN registry, ISRCTN67698474