Assessing household wealth in health studies in developing countries: a comparison of participatory wealth ranking and survey techniques from rural South Africa

BACKGROUND: Accurate tools for assessing household wealth are essential for many health studies in developing countries. Household survey and participatory wealth ranking (PWR) are two approaches to generate data for this purpose. METHODS: A household survey and PWR were conducted among eight villages in rural South Africa. We developed three indicators of household wealth using the data. One indicator used PWR data only, one used principal components analysis to combine data from the survey, while the final indicator used survey data combined in a manner informed by the PWR. We assessed internal consistency of the indices and assessed their level of agreement in ranking household wealth. RESULTS: Food security, asset ownership, housing quality and employment were important indicators of household wealth. PWR, consisting of three independent rankings of 9671 households, showed a high level of internal consistency (intraclass correlation coefficient 0.81, 95% CI 0.79-0.82). Data on 1429 households were available from all three techniques. There was moderate agreement in ranking households into wealth tertiles between the two indicators based on survey data (spearman rho = 0.69, kappa = 0.43), but only limited agreement between these techniques and the PWR data (spearman rho = 0.38 and 0.31, kappa = 0.20 and 0.17). CONCLUSION: Both PWR and household survey can provide a rapid assessment of household wealth. Each technique had strengths and weaknesses. Reasons for differences might include data inaccuracies or limitations in the methods by which information was weighted. Alternatively, the techniques may measure different things. More research is needed to increase the validity of measures of socioeconomic position used in health studies in developing countries

Deep hanging out in the arts: an anthropological approach to capturing cultural value

This article presents the findings of an Arts and Humanities Research Council (AHRC) funded project carried out from September 2013 to March 2014 by five researchers at the University of Leeds (UK), who paired off with five audience-participants and engaged in a process of “deep hanging out” (Geertz 1998) at events curated as part of Leeds’ annual LoveArts festival. As part of AHRC’s Cultural Value project, the overarching aim of the research was to produce a rich, polyvocal, evocative and complex account of cultural value by co-investigating arts engagement with audience-participants. Findings suggested that both the methods and purpose of knowing about cultural value impact significantly on any exploration of cultural experience. Fieldwork culminated in the apparent paradox that we know, and yet still don’t seem to know, the value and impact of the arts. Protracted discussions with the participants suggested that this paradox stemmed from a misplaced focus on knowledge; that instead of striving to understand and rationalize the value of the arts, we should instead aim to feel and experience it. During a process of deep hanging out, our participants revealed the limitations of language in capturing the value of the arts, yet confirmed perceptions of the arts as a vehicle for developing self-identity and -expression and for living a better life. These findings suggest that the Cultural Value debate needs to be reframed from what is currently an interminable epistemological obsession (that seeks to prove and evidence the value of culture) into a more complex phenomenological question, which asks how people experience the arts and culture and why people want to understand its value. This in turn implies a re-conceptualization of the relationships between artists or arts organisations and their publics, based on a more relational form of engagement and on a more anthropological approach to capturing and co-creating cultural value

Challenges and opportunities for conducting a vaccine trial during the COVID-19 pandemic in the United Kingdom

The COVID-19 pandemic has resulted in unprecedented challenges for healthcare systems worldwide. It has also stimulated research in a wide range of areas including rapid diagnostics, novel therapeutics, use of technology to track patients and vaccine development. Here, we describe our experience of rapidly setting up and delivering a novel COVID-19 vaccine trial, using clinical and research staff and facilities in three National Health Service Trusts in Cambridgeshire, United Kingdom. We encountered and overcame a number of challenges including differences in organisational structures, research facilities available, staff experience and skills, information technology and communications infrastructure, and research training and assessment procedures. We overcame these by setting up a project team that included key members from all three organisations that met at least daily by teleconference. This group together worked to identify the best practices and procedures and to harmonise and cascade these to the wider trial team. This enabled us to set up the trial within 25 days and to recruit and vaccinate the participants within a further 23 days. The lessons learned from our experiences could be used to inform the conduct of clinical trials during a future infectious disease pandemic or public health emergency

Dimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Dimethyl fumarate (DMF) inhibits inflammasome-mediated inflammation and has been proposed as a treatment for patients hospitalised with COVID-19. This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple treatments in patients hospitalised for COVID-19 (NCT04381936, ISRCTN50189673). In this assessment of DMF performed at 27 UK hospitals, adults were randomly allocated (1:1) to either usual standard of care alone or usual standard of care plus DMF. The primary outcome was clinical status on day 5 measured on a seven-point ordinal scale. Secondary outcomes were time to sustained improvement in clinical status, time to discharge, day 5 peripheral blood oxygenation, day 5 C-reactive protein, and improvement in day 10 clinical status. Between 2 March 2021 and 18 November 2021, 713 patients were enroled in the DMF evaluation, of whom 356 were randomly allocated to receive usual care plus DMF, and 357 to usual care alone. 95% of patients received corticosteroids as part of routine care. There was no evidence of a beneficial effect of DMF on clinical status at day 5 (common odds ratio of unfavourable outcome 1.12; 95% CI 0.86-1.47; p = 0.40). There was no significant effect of DMF on any secondary outcome

Dimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Dimethyl fumarate (DMF) inhibits inflammasome-mediated inflammation and has been proposed as a treatment for patients hospitalised with COVID-19. This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple treatments in patients hospitalised for COVID-19 (NCT04381936, ISRCTN50189673). In this assessment of DMF performed at 27 UK hospitals, adults were randomly allocated (1:1) to either usual standard of care alone or usual standard of care plus DMF. The primary outcome was clinical status on day 5 measured on a seven-point ordinal scale. Secondary outcomes were time to sustained improvement in clinical status, time to discharge, day 5 peripheral blood oxygenation, day 5 C-reactive protein, and improvement in day 10 clinical status. Between 2 March 2021 and 18 November 2021, 713 patients were enroled in the DMF evaluation, of whom 356 were randomly allocated to receive usual care plus DMF, and 357 to usual care alone. 95% of patients received corticosteroids as part of routine care. There was no evidence of a beneficial effect of DMF on clinical status at day 5 (common odds ratio of unfavourable outcome 1.12; 95% CI 0.86-1.47; p = 0.40). There was no significant effect of DMF on any secondary outcome

Exploring social and cultural diversity within 'Black British Jazz' audiences

This paper presents the findings of a recent study which explores the social and cultural characteristics of audiences for performances by black British jazz musicians. It draws on Bourdieu’s theoretical concept of cultural capital, which links social class and educational qualification level to cultural consumption, as well as on Hall’s exploration of ‘new ethnicities’, demonstrating how the two theories are inter-related. The study uses a mixed method approach of observation, questionnaire survey and in-depth interviews, analysed using critical discourse analysis. The demographic data demonstrates the tendency, in line with cultural capital theory, for audiences for black British jazz musicians to be highly educated and from higher socio-economic classes. Particularly notable is that black audience members tended to be from the middle classes, suggesting that attention to the increasingly important social and demographic phenomenon of the black middle class is warranted. Qualitative data demonstrates the positioning of participants regarding the ways in cultural capital inter-relates with the dimension of ethnicity. The importance of cultural heritage to the black participants in particular suggests that Hall’s ‘new ethnicities’ is a particularly useful theory to aid understanding of the complexities of the inter-relationship between race and musical taste.Peer reviewe

Thigh-length compression stockings and DVT after stroke

Controversy exists as to whether neoadjuvant chemotherapy improves survival in patients with invasive bladder cancer, despite randomised controlled trials of more than 3000 patients. We undertook a systematic review and meta-analysis to assess the effect of such treatment on survival in patients with this disease

Processes of legitimization in contemporary art: the young British artists phenomenon

The Young British Artists (YBAs) was a generation that incorporated elements from media, advertising and cultural industry into the art world in the late 20th century. Based on a case study of the group and the distinctive phases of its meteoric trajectory, we analyze the circumstances and agents involved in the processes of legitimization in contemporary art. As an instrumental tool, we use the model presented by Alan Bowness in his 1989 publication, which outlines the process that allows artists to access certain social recognition. This outline provides us with a model of reference upon which to reconstruct the pattern of the YBAs trajectory with the intention of determining the sociocultural circumstances surrounding the media phenomenon. These results also correct and modify certain aspects of Bowness’ model to adapt it to the current socioeconomic context that sustains the processes of legitimization of art today