The bridge between social identity and community capital on the path to recovery and desistance

It has long been recognised that changes in social networks (and the underpinning changes in personal and social identity) are strong predictors of both desistance from crime and recovery from substance use. Building on existing work attempting to measure and shift social networks and transitions to prosocial groups, the current study provides pilot data from prisoners and family members about a visualisation technique widely used in specialist addiction treatment (node-link mapping) to map opportunities for linkage to prosocial groups and networks. The data presented in the paper are from a small-scale feasibility pilot. This suggests both bonding and bridging capital in prisoner populations due for release and the diversity of community capital opportunities that exists in this population. The implications of this work are significant for substance users and offenders pending return to the community, and has implications around resettlement and reintegration support for probation staff in prisons and in the community. The paper emphasises the importance of mapping connectedness as a key component of planning for reintegration back into the community for those working with offenders who are aspiring to achieve desistance and recovery

Mind the (yield) gap(s)

This paper explores the origin of the notion of “yield gap” and its use as a framing device for agricultural policy in sub-Saharan Africa. The argument is that while the yield gap of policy discourse provides a simple and powerful framing device, it is most often used without the discipline or caveats associated with the best examples of its use in crop production ecology and microeconomics. This argument is developed by examining how yield gap is used in a selection of recent and influential agricultural policy documents. The message for policy makers and others is clear: “mind the (yield) gap(s)”, for they are seldom what they appear

Neoliberalism with a community face?:A critical analysis of asset-based community development in Scotland

In this article, we trace the ideological and social policy roots of asset-based community development (ABCD) in the United States and the United Kingdom, and explore how this approach has been legitimized in Scotland. We argue that ABCD is a capitulation to neoliberal values of individualization and privatization. Drawing on findings from our empirical work, we discuss how ABCD generates dilemmas for community development. Although some practitioners are able to adapt ABCD to focus on renewing Scottish democracy, several practitioners are using ABCD to privatize public issues such as inequality and justify dramatic cuts to the Scottish welfare state

Does Genetic Diversity Predict Health in Humans?

Genetic diversity, especially at genes important for immune functioning within the Major Histocompatibility Complex (MHC), has been associated with fitness-related traits, including disease resistance, in many species. Recently, genetic diversity has been associated with mate preferences in humans. Here we asked whether these preferences are adaptive in terms of obtaining healthier mates. We investigated whether genetic diversity (heterozygosity and standardized mean d2) at MHC and nonMHC microsatellite loci, predicted health in 153 individuals. Individuals with greater allelic diversity (d2) at nonMHC loci and at one MHC locus, linked to HLA-DRB1, reported fewer symptoms over a four-month period than individuals with lower d2. In contrast, there were no associations between MHC or nonMHC heterozygosity and health. NonMHC-d2 has previously been found to predict male preferences for female faces. Thus, the current findings suggest that nonMHC diversity may play a role in both natural and sexual selection acting on human populations

Global economic burden of unmet surgical need for appendicitis

Background: There is a substantial gap in provision of adequate surgical care in many low-and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods: Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results: Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion: For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.

BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). CONCLUSION: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. TRIAL REGISTRATION: NCT02179112

You Want Me to Do What? Teach a Studio Class to Seventy Students?

Amidst widespread recognition of the need to enhance the student experience, built environment educators are facing increased pressure on their time and resources for teaching. Studio-based education, in which students apply ideas to a real site, has been seen as key to a well-rounded education in the built environment and planning professions. At the same time, traditional methods require a high degree of tutor time to be spent with students, which is increasingly impractical given resource constraints and increased class sizes. Drawing on research exploring the challenges posed by sustainable development and participatory processes in ecological planning, a core second year studio-based module at The University of Manchester was re-designed so as to meet these challenges. Key elements of the redesign include: use of the hands-on toolkit, Ketso, for creative thinking and synthesis of ideas within and across groups; mapping and layered spatial analysis; simulating aspects of community consultation, without directly contacting the community; effective use of Graduate Teaching Assistant time in giving feedback and assistance to students; and including an individual reflective learning journal as part of the assessment. The innovations trialled in this module enable an interactive studio experience with a high degree of feedback to be created for large classes. Feedback from students has been very positive. The innovations in the module re-design described in this paper jointly won the 2011 Excellence in Teaching Prize of the Association of European Schools of Planning (AESOP)

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe