Ethics across borders

This article takes what has always been a methodological and ethical question for anthropologists (how should we relate to others?) and turns it into an ethnographic one (how do those we study think ethically across borders?). We show that, paradoxically, anthropologists’ commitment to their own forms of ethics across borders have frequently effaced alternative conceptions among the people we study, whilst the burgeoning field of the anthropology of ethics has reintroduced ideas of cultural boundedness and incommensurability into the anthropological canon. Moreover, within anthropology, a focus on either universal motivation or cultural relativism has obscured ethics across borders, which as a practice is premised on both the existence of ethical difference and the possibility of transcending it. In relation to an example taken from Evans’ work on Ahmadi Muslims in India, we develop the idea that ethics across borders depends as much on the creative production and elaboration of incommensurable differencem - a process we call “incommensuration” - as on the identification of affinities. As suggested by the collection this essay introduces, ethics across borders in this sense must be widespread, and deserves greater ethnographic attention, particularly with regard to the diverse ways in which difference and affinity are imagined.This article and the collection it introduces grew out of an interdisciplinary seminar organized by Jonathan Mair from 2012 to 2013 at the Centre for Research in the Arts, Social Sciences and Humanities (CRASSH), Cambridge, as part of a Melon Newton Research Fellowship. Articles collected here were presented at a conference convened by Mair and Evans under the title “Ethical Conversations Across Borders” in January 2014 held in Cambridge with the support of CRASSH, King’s College, Cambridge and St. John’s College, Cambridge. We would like to thank participants and contributors to the seminar and conference for their contribution to the development of the project, including Michael Banner, Naor Ben-Yehoyada, Matei Candea, Joanna Cook, Jane Heal, Caroline Humphrey, Paolo Heywood, Tim Jenkins, James Laidlaw, Michael Lempert, Hallvard Lillehammer, Patrick McKearney, and Alice Wilson. We would also like to thank Marie Lemaire and Ruth Rushworth for invaluable organizational support. Nicholas Evans’ contribution to this project is due, in part, to a generous research grant from the Economic and Social Research Council (UK) to which we also extend our thanks. Finally, we are extremely grateful to Giovanni da Col and two anonymous reviewers of this introduction for their insightful comments, and to Sean Dowdy, Andra Le-Roux Kemp, and Justin Dyer for their very significant help with its production.This is the final version of the article. It first appeared from HAU via http://dx.doi.org/10.14318/hau5.2.01

Permeability evolution during progressive development of deformation bands in porous sandstones

[1] Triaxial deformation experiments were carried out on large (0.1 m) diameter cores of a porous sandstone in order to investigate the evolution of bulk sample permeability as a function of axial strain and effective confining pressure. The log permeability of each sample evolved via three stages: (1) a linear decrease prior to sample failure associated with poroelastic compaction, (2) a transient increase associated with dynamic stress drop, and (3) a systematic quasi-static decrease associated with progressive formation of new deformation bands with increasing inelastic axial strain. A quantitative model for permeability evolution with increasing inelastic axial strain is used to analyze the permeability data in the postfailure stage. The model explicitly accounts for the observed fault zone geometry, allowing the permeability of individual deformation bands to be estimated from measured bulk parameters. In a test of the model for Clashach sandstone, the parameters vary systematically with confining pressure and define a simple constitutive rule for bulk permeability of the sample as a function of inelastic axial strain and effective confining pressure. The parameters may thus be useful in predicting fault permeability and sealing potential as a function of burial depth and faul

The Women’s Equality Party: Emergence, Organisation and Challenges

Women's political parties are designed to increase women's representation in politics. More than thirty have been established in Europe since 1987, yet there has been little systematic analysis of why and when they emerge, how they organize, and what challenges they face. We argue that the study of women's parties can offer insights into questions concerning inter and intra-party power relations and the relationship between social movements and political parties, whilst also contributing to broader debates around the 'big questions' of representation, gender (in)equality, and the dynamics of political inclusion and exclusion. This article explores these issues through a case study analysis of the UK's Women's Equality Party. Drawing upon original empirical research undertaken with party activists and officials, we argue that the party's impact has been constrained by wider organizational logics and an unequal party system, whilst it has so far adhered to traditional (male-dominated) patterns of party organisation

Counseling with guided use of a mobile well-being app for students experiencing anxiety or depression: Clinical outcomes of a feasibility trial embedded in a student counseling service

Background: Anxiety and depression continue to be prominent experiences of students approaching their university counseling service. These services face unique challenges to ensure that they continue to offer quality support with fewer resources to a growing student population. The convenience and availability of mobile phone apps offer innovative solutions to address therapeutic challenges and expand the reach of traditional support. Objective: The primary aim of this study was to establish the feasibility of a trial in which guided use of a mobile phone well-being app was introduced into a student counseling service and offered as an adjunct to face-to-face counseling. Methods: The feasibility trial used a two-arm, parallel nonrandomized design comparing counseling alone (treatment as usual) versus counseling supplemented with guided use of a mobile phone well-being app (intervention) for 38 university students experiencing moderate anxiety or depression. Students in both conditions received up to 6 sessions of face-to-face counseling within a 3-month period. Students who approached the counseling service and were accepted for counseling were invited to join the trial. Feasibility factors evaluated include recruitment duration, treatment preference, randomization acceptability, and intervention fidelity. Clinical outcomes and clinical change were assessed with routine clinical outcome measures administered every counseling session and follow-up phases at 3 and 6 months after recruitment. Results: Both groups demonstrated reduced clinical severity by the end of counseling. This was particularly noticeable for depression, social anxiety, and hostility, whereby clients moved from elevated clinical to low clinical or from low clinical to nonclinical by the end of the intervention. By the 6-month follow-up, TAU clients' (n=18) anxiety had increased whereas intervention clients' (n=20) anxiety continued to decrease, and this group difference was significant (Generalized Anxiety Disorder-7: t22=3.46, P=.002). This group difference was not replicated for levels of depression: students in both groups continued to decrease their levels of depression by a similar amount at the 6-month follow-up (Physical Health Questionnaire-9: t22=1.30, P=.21). Conclusion: Supplementing face-to-face counseling with guided use of a well-being app is a feasible and acceptable treatment option for university students experiencing moderate anxiety or depression. The feasibility trial was successfully embedded into a university counseling service without denying access to treatment and with minimal disruption to the service. This study provides preliminary evidence for using a well-being app to maintain clinical improvements for anxiety following the completion of counseling. The design of the feasibility trial provides the groundwork for the development of future pilot trials and definitive trials embedded in a student counseling service

Crisis responses for children and young people: an evidence synthesis of effectiveness, experiences and service organisation (CAMH-Crisis)

Background Mental health care for children and young people is a rising concern, with one in six children aged 5–19 years in England having a probable diagnosable mental disorder. Care for children and young people in crisis is known to be delivered by multiple agencies using a range of approaches. Objectives The review objectives of this study were to critically appraise, synthesise and present the best-available international evidence related to crisis services for children and young people aged 5–25 years, specifically looking at the organisation of crisis services across education, health, social care and the third sector, and the experiences and perceptions of young people, families and staff, to determine the effectiveness of current models and the goals of crisis intervention. Methods All relevant English-language international evidence specifically relating to the provision and receipt of crisis support for children and young people aged 5–25 years, from January 1995 to January 2021, was sought. Comprehensive searches were conducted across 17 databases and supplementary searching was undertaken to identify grey literature. Two team members appraised all the retrieved research reports (except grey literature) using critical appraisal checklists. A separate analysis was conducted for each objective. Confidence in research findings was assessed using the Grading of Recommendations Assessment, Development and Evaluation and the Confidence in the Evidence from Reviews of Qualitative research approaches. Findings One hundred and thirty-eight reports were used to inform this evidence synthesis, including 39 descriptive accounts of the organisation of crisis services (across 36 reports), 42 research studies (across 48 reports) and 54 grey literature documents. The organisation of crisis services has been categorised as follows: triage/assessment only, digitally mediated support approaches, and intervention approaches and models. When looking at experiences of crisis care, the following four themes were identified: (1) barriers to and facilitators of seeking and accessing appropriate support; (2) what children and young people want from crisis services; (3) children’s, young people’s and families’ experiences of crisis services; and (4) service provision. In determining effectiveness, the findings are summarised by type of service and were generated from single heterogenous studies. The goals of a crisis service should be to (1) keep children and young people in their home environment as an alternative to admission; (2) assess need and plan; (3) improve children’s and young people’s and/or their families’ engagement with community treatment; (4) link children and young people and/or their families to additional mental health services, as necessary; (5) provide peer support; (6) stabilise and manage the present crisis over the immediate period; and (7) train and/or supervise staff. The key limitation of this review was that much of the literature was drawn from the USA. Owing to the differences between USA and UK in terms of commissioning and delivering services, approaches to crisis care operating in the USA may not be directly applicable to the UK

Crisis responses for children and young people: A mixed methods systematic review of effectiveness, experiences and service organisation (CAMH-Crisis)

Background: In England, one in six children aged 5-19 have a probable diagnosable mental health disorder. Increasing numbers of children and young people (CYP) are seeking help at a point of crisis with care known to be delivered by multiple agencies using a range of approaches. Crisis care for CYP has become a national and international policy priority, with substantial funding allocated to the development of crisis services. During periods of crisis, it is vital that care is timely, effective, and based on evidence. Methods: A mixed methods systematic review (PROSPERO-CRD42019160134) was conducted. The aim was to examine the organisation of crisis services across education, health, social care and voluntary sectors; the experiences and perceptions of young people, families, and staff; the effectiveness of current approaches to care, and the goals of crisis intervention. All relevant English language international evidence was sought specifically relating to the provision and receipt of crisis support for CYP aged 5-25. Comprehensive searches were conducted across 17 databases from 1995 to 2021. Supplementary searching was undertaken to identify relevant UK only non-research literature. Screening, critical appraisal and data extraction was conducted by two team members following standard systematic review processes. A narrative approach to synthesis was conducted separately for each objective. Confidence in research findings was assessed using the GRADE and GRADE CERQual approaches. Results: One hundred and thirty-eight reports (48 reports covering 42 primary research studies; 36 reports covering 39 descriptive accounts of the organisation services and 54 UK only grey literature reports) were included. We found that the organisation of crisis services has been categorised as follows: triage/assessment-only; digitally mediated support approaches; intervention approaches and models. A wide variety of different interventions have been described ranging from approaches that started in the emergency department then moved to outpatient services, inpatient care through hospitals or residential treatment centres, home-based programmes, child and adolescent mental health based services, using telepsychiatry or via a community resource such as mobile outreach through to school hospital partnerships and generic walk-in crisis services provided by voluntary organisations. When looking at experiences of crisis care, four themes were identified: 1) barriers and facilitators to seeking and accessing appropriate support; 2) what CYP want from crisis services; 3) children’s, young people’s, and families’ experiences of crisis services; 4) service provision. Twenty-seven synthesis summary statements were generated, of which two were judged as having a high degree of confidence while the rest were moderate (n=15), low (n=3), and very low (n=7) using the CERQual approach. The statements of high confidence related to what CYP want from crisis services which centred around the need for different forms of support and pathways to services. This included support via telephone (through a direct line, with out of hours availability and staffed by trained counsellors) as well as text and email. In determining effectiveness, the findings are summarised by type of service and were generated from single heterogenous studies so a meta-analysis could not be performed. Using the GRADE approach, outcomes across the studies were graded as moderate for randomised controlled trials, and very low for observational studies. One of the approaches that worked was crisis care in emergency departments but it is noted that this is not policy provision across all countries. We also showed that school, community, and home-based crisis programmes may also lead to positive outcomes. The goals of a crisis service were identified. Implications: Findings suggest that support prior to reaching crisis point is important. From this work various aspects of crisis care have been identified that can be incorporated into existing services across education, health, social care and the voluntary sector

Crisis responses for children and young people: a systematic review of effectiveness, experiences and service organisation (CAMH-Crisis)

Background: In England, one in six children aged 5–19 has a probable diagnosable mental health disorder. This is a major public health problem, with multiple agencies adopting varying approaches to care delivery for children and young people (CYP) in crisis. Objectives: To examine the organisation of crisis services across education, health, social care and voluntary sectors; the experiences and perceptions of CYP, families and staff; the effectiveness of current approaches to care and the goals of crisis intervention. Methods: A systematic review of all relevant English language evidence regarding the provision and receipt of crisis support for CYP aged 5–25 (PROSPERO-CRD42019160134). Seventeen databases were searched from 1995 to 2002 and relevant UK-only grey literature was identified. Critical appraisal was conducted using appropriate design specific appraisal tools. A narrative approach to synthesis was conducted. Results: In total, 138 reports (48 reports covering 42 primary research studies; 36 reports covering 39 descriptive accounts of the organisation services and 54 UK-only grey literature reports) were included. The evidence suggests that crisis services were organised as follows: triage/assessment-only, digitally mediated support approaches, and intervention approaches and models. When looking at experiences of crisis care, four themes were identified: (a) barriers and facilitators to seeking and accessing appropriate support; (b) what children and young people want from crisis services; (c) children's, young people's and families' experiences of crisis services; and (d) service provision. In determining effectiveness, the findings are summarised by type of service and were generated from single heterogenous studies. The goals of crisis services were identified. Discussion: Despite a lack of high-quality international studies, findings suggest that support prior to reaching crisis point is important. From this work, various aspects of crisis care have been identified that can be incorporated into existing services across education, health, social care and the voluntary sector

Effectiveness of work skills programmes for offenders with mental disorders: a systematic review

Background: Academic literature and government initiatives have emphasised the importance of work as a means of improving health and reducing reoffending among offenders with mental disorders. Whilst a number of work skills programmes have shown promise for offenders more generally, evaluation of evidence for their effectiveness for those with a mental disorder is lacking, particularly in relation to improving employment outcomes. Aims: To assess the evidence on the effectiveness of work skills programmes for mentally disordered offenders. Method: A systematic review of the literature was conducted by searching the following databases: PsycINFO, CINAHL, Cochrane Library (Trials Register), Embase and Medline, using search terms which included Work Skills Programme*, Offend* and Mental*. Any empirical comparison study of work skills programmes was included in this review. The primary outcome was employment. Secondary outcomes included employment outcomes, reoffending, education, mental state, substance misuse, global functioning, quality of life, acceptability, leaving the study early and cost effectiveness or other economic outcomes. Results: Six articles met the inclusion criteria. Collectively they provided limited evidence that work skills programmes increase the likelihood of people with mental disorder who are offenders obtaining employment in the short term, but there are insufficient studies to determine the long-term impact of work skills programmes. Conclusions: There is modest evidence to support inclusion of specific work skills programmes in the treatment of offenders with mental disorder. Future studies should be of theoretically driven programmes, such as Individual Placement Support (IPS), use a standard set of relevant outcome measures and long enough follow-up for testing the effectiveness of any programme on engagement in competitive, paid employment as, even if skilled, offenders with mental disorder must constitute a hard to place group