Relearning liberation: critical methodologies for the general crisis

How can critical theory help us to articulate the nature of social suffering in twenty-first century capitalism, and to expand our horizons of possibility for liberation and alternative futures at a moment of apparent impasse? In this essay, we explore how critical theorists across three generations in the European Frankfurt School tradition articulated the ‘struggles and wishes’ of their age and place, and reflect on the contextual limits and enduring relevance of their negative, utopian, democratic and ethical methods. We then turn to developments of this work in the Latin American tradition, particularly as elaborated by feminists, which articulate critical theorizing as a transformative praxis within the material construction of dignified communitarian life. In the final part of the paper, we consider what we might learn about how to theorize our own dominations and liberations through this critical methodology

Examining the impact of comorbid serious mental illness on rehospitalization among medical and surgical inpatients

Multiple barriers to quality health care may affect the outcomes of postacute treatment for individuals with serious mental illness (SMI). This study examined rehospitalization for medical and surgical inpatients with and without a comorbid diagnosis of SMI which included psychotic disorders, bipolar disorder and major depressio

Examining the impact of comorbid serious mental illness on rehospitalization among medical and surgical inpatients

Multiple barriers to quality health care may affect the outcomes of postacute treatment for individuals with serious mental illness (SMI). This study examined rehospitalization for medical and surgical inpatients with and without a comorbid diagnosis of SMI which included psychotic disorders, bipolar disorder and major depressio

A Systems Approach to Healthcare: Agent-based Modeling, Community Mental Health, and Population Well-being

Purpose Explore whether agent-based modeling and simulation can help healthcare administrators discover interventions that increase population wellness and quality of care while, simultaneously, decreasing costs. Since important dynamics often lie in the social determinants outside the health facilities that provide services, this study thus models the problem at three levels (individuals, organizations, and society). Methods The study explores the utility of translating an existing (prize winning) software for modeling complex societal systems and agent\u27s daily life activities (like a Sim City style of software), into a desired decision support system. A case study tests if the 3 levels of system modeling approach is feasible, valid, and useful. The case study involves an urban population with serious mental health and Philadelphia\u27s Medicaid population (n = 527,056), in particular. Results Section 3 explains the models using data from the case study and thereby establishes feasibility of the approach for modeling a real system. The models were trained and tuned using national epidemiologic datasets and various domain expert inputs. To avoid co-mingling of training and testing data, the simulations were then run and compared (Section 4.1) to an analysis of 250,000 Philadelphia patient hospital admissions for the year 2010 in terms of re-hospitalization rate, number of doctor visits, and days in hospital. Based on the Student t-test, deviations between simulated vs. real world outcomes are not statistically significant. Validity is thus established for the 2008–2010 timeframe. We computed models of various types of interventions that were ineffective as well as 4 categories of interventions (e.g., reduced per-nurse caseload, increased check-ins and stays, etc.) that result in improvement in well-being and cost. Conclusions The 3 level approach appears to be useful to help health administrators sort through system complexities to find effective interventions at lower costs

Randomized Clinical Trial of the Effectiveness of a Home-Based Advanced Practice Psychiatric Nurse Intervention: Outcomes for Individuals with Serious Mental Illness and HIV

Individuals with serious mental illness have greater risk for contracting HIV, multiple morbidities, and die 25 years younger than the general population. This high need and high cost subgroup face unique barriers to accessing required health care in the current health care system. The effectiveness of an advanced practice nurse model of care management was assessed in a four-year random controlled trial. Results are reported in this paper. In a four-year random controlled trial, a total of 238 community-dwelling individuals with HIV and serious mental illness (SMI) were randomly assigned to an intervention group (n=128) or to a control group (n=110). Over 12 months, the intervention group received care management from advanced practice psychiatric nurse, and the control group received usual care. The intervention group showed significant improvement in depression (P=.012) and the physical component of health-related quality of life (P=.03) from baseline to 12 months. The advanced practice psychiatric nurse intervention is a model of care that holds promise for a higher quality of care and outcomes for this vulnerable population

Psychiatric Comorbidity and Greater Hospitalization Risk, Longer Length of Stay, and Higher Hospitalization Costs in Older Adults with Heart Failure

OBJECTIVES: To explore associations between psychiatric comorbidity and rehospitalization risk, length of hospitalization, and costs. DESIGN: Cross‐sectional study of 1‐year hospital administrative data. SETTING: Claims‐based study of older adults hospitalized in the United States. PARTICIPANTS: Twenty‐one thousand four hundred twenty‐nine patients from a 5% national random sample of U.S. Medicare beneficiaries aged 65 and older, with at least one acute care hospitalization in 1999 with a Diagnostic‐Related Group of congestive heart failure. MEASUREMENTS: The number of hospitalizations, mean length of hospital stay, and total hospitalization costs in calendar year 1999. RESULTS: Overall, 15.8% of patients hospitalized for heart failure (HF) had a coded psychiatric comorbidity; the most commonly coded comorbid psychiatric disorder was depression (8.5% of the sample). Most forms of psychiatric comorbidity were associated with greater inpatient utilization, including risk of additional hospitalizations, days of stay, and hospitalization charges. Additional hospitalization costs associated with psychiatric comorbidity ranged up to $7,763, and additional days length of stay ranged up to 1.4 days. CONCLUSION: Psychiatric comorbidity appears in a significant minority of patients hospitalized for HF and may affect their clinical and economic outcomes. The associations between psychiatric comorbidity and use of inpatient care are likely to be an underestimate, because psychiatric illness is known to be underdetected in older adults and in hospitalized medical patients

A Longitudinal Study of Industrial and Clerical Workers: Predictors of Upper Extremity Tendonitis

Upper extremity tendonitis (UET) associated with work activity is common but the true incidence and risk factors can best be determined by a prospective cohort study. This study followed a cohort of 501 active workers for an average of 5.4 years. Incident cases were defined as workers who were asymptomatic at baseline testing and had no prior history of UET and went on to be diagnosed with an UET during the follow-up period or at the follow-up evaluation. The incident cases were compared to the subset of the cohort who also had no history of an UET and did not develop tendonitis during the study. The cumulative incidence in this cohort was 24.3% or 4.5% annually. The factors found to have the highest predictive value for identifying a person who is likely to develop an UET in the near future included age over 40, a BMI over 30, a complaint at baseline of a shoulder or neck discomfort, a history of CTS and a job with a higher shoulder posture rating. The risk profile identifies both ergonomic and personal health factors as risks and both categories of factors may be amenable to prevention strategies.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/45013/1/10926_2005_Article_872.pd

Re-imagining critique in cultural sociology

In this chapter, we argue that normative practices of critique, judgment and imagination are integral aspects of cultural practice – including the production of theory about culture – and that critical theory, particularly that of the broadly defined Frankfurt School tradition, is therefore an important element of a fully articulated sociology of culture

“Who else is gonna do it if we don’t?” Gender, education and the crisis of care in the 2018 West Virginia teachers’ strike

In 2018, a sequence of powerful education strikes and work stoppages across the United States sent shock waves through the country’s public education system. This eruption of collective workers’ organization was strongly led by women teachers responding to the current crisis of care, demanding resources, dignity and justice for themselves, the children they teach, and their communities. While mainstream reports often represent these actions as traditional labor and/or feminist struggles, our research demonstrates that they were sites of more nuanced response to “care extraction” in education, and for understanding how constructions of gender and gender injustice both gave rise to the strikes and shaped their unfolding. Drawing on in-depth interviews with ten teacher-activists who participated in the West Virginia strikes, we examine how teachers’ labor is being transformed in a context of post-industrial austerity, illustrate the complex political identity of the strike actions, and explore the relationship between specific constructions of gendered labor and collective organizing in US public education today