Speaking in Pictures and Play: The Unique Approach to Using Art and Play as Data in Hermeneutic Research

Art and play are the language of children. The act of creating art and playing help children to make sense of their world. Pediatric clinicians have used art and play as therapy to elicit conversation, to allow children to express themselves, and to overcome communication barriers when children may not have the vocabulary to articulate what they would like to say. Art and play therapy have demonstrated their utility in practice, and this way of communicating should be equally effective as part of data collection and analysis in hermeneutic research. By approaching hermeneutic interviews with children in a novel way, using art and play to augment what is said in an interview, new opportunities for understanding the worlds of children may arise.             Keywords: art, play, children, hermeneutic research, data collection, data analysi

Raising Children: Philosophical Hermeneutics and Children with Life-Limiting Illness

Children are authentically hermeneutic beings; they are not only open to the possibility that the other may be right, but often expect that the perspective of the other is correct. The hermeneutic tenets of history, tradition, and authority shape how children and childrearing are perceived in society. Children are often regarded as in-progress, and this has implications for children diagnosed with life-limiting illness and the pediatric palliative healthcare providers that care for them. Children who experience unique phenomena, such as dying in childhood, may possess an authority gained through superior insight that adults often overlook. Art is a common language that can be used in hermeneutic research to better understand children’s experiences of life-limiting illness. Researchers who work with children must raise the value of children’s perspectives, find a shared language to foster understanding, and enter the circle with the same genuine hermeneutic spirit that children exemplify.   Keywords: hermeneutics, children, authority, art, pediatric palliative car

High risk alcohol use after sleeve gastrectomy

Obesity is a major health problem associated with a plethora of health risks and a high economic cost in the United States. While non-surgical treatment options exist, surgical treatments have been shown to provide better success with weight-loss long term. Despite its success, an early type of weight loss surgery (WLS) called Roux-en-Y Gastric Bypass (RYGB) has been linked to a higher risk of alcohol consumption post-operatively; however, the potential risk between the newer, more commonly performed surgery, sleeve gastrectomy, has yet to be explored. This pilot study conducted at the Bariatric Center at Beth Israel Deaconess Medical Center in Boston, Massachusetts, will provide preliminary data on high-risk alcohol use before and after sleeve gastrectomy (SG). Patients were interviewed regarding eating and drinking behaviors before and after SG using modified versions of the Three Factor Eating Questionnaire Revised-18 and the Alcohol Use Disorder Identification Test-C respectively. In this interim analysis, 37 of 70 eligible subjects underwent the baseline questionnaire (52.9% participation) and out of the 9 participants who had 3-month follow-ups, 8 participants completed their interview (88.9% retention). The overall prevalence of high-risk drinkers at baseline was 27%. Among the 8 participants who completed the 3-month follow-up, 1 reported high-risk drinking baseline and none reported high risk alcohol use at follow-up. In conclusion, although 27% of patients were high-risk drinkers at baseline, none of the patients were high-risk drinkers at the 3-month follow-up. Future studies investigating the change of alcohol use after longer-time periods after weight loss surgery are necessary in order to better assess if there is an increased alcohol use after sleeve gastrectomy

Harnessing Hollywood Hype: Film Marketing Meets the Challenges and Opportunities of the 21st Century

Marketing is a vital commercial activity and source of competitive advantage within the Hollywood film industry, serving to create, circulate and translate symbolic meaning around a film and its ancillary products, construct and target key audience segments, guide audience expectations and viewing choices, and mitigate financial risk. Marketers thus play an increasingly central role in all stages of the filmmaking process. To examine the often overlooked structures and practices of Hollywood’s marketing arm, this study adopts a media industry studies approach, employing interviews, fieldwork, and textual analysis to explore the social, technological, organizational, economic, and spatial forces that shape the contemporary context of Hollywood marketing materials’ creation. In the early 21st century, Hollywood studios face profound challenges and opportunities wrought by the dual forces of globalization and digitization. In response, marketers have developed a novel view of their audience: as increasingly global and empowered. Globalization and digitization are thus treated as centrifugal forces, diffusing production and meaning-making capabilities across geographic space and media platforms, and threatening the centralized control traditionally held by Hollywood studios. Marketers are incentivized to embrace these decentralizing forces and the cultural labor now provided by third party marketing agencies, international distributors, and audiences. However, Hollywood studios’ institutional inertia, risk aversion, and inclination to maintain firm control of their marketing messages and intellectual property preclude a whole-hearted embrace of these changes. Studio marketers thus act with deep ambivalence toward these outside players, attempting to capitalize on their cultural labor while simultaneously acting to circumscribe their power

Increasing the voluntary and community sector’s involvement in Integrated Offender Management(IOM)

As part of an undertaking to increase voluntary and community sector (VCS) involvement in service delivery, the Home Office set up an initiative to provide small grants to VCS organisations to work with IOM partnerships. The Home Office commissioned an evaluation of the initiative which aimed to: explore the strengths and weaknesses of the funding model; identify perceived barriers and facilitators to voluntary and community sector involvement in IOM; explore how the Home Office might best work with the VCS to encourage and support their capacity to work in partnership with statutory agencies; and identify any implications for the delivery of future similar projects

Process evaluation of Derbyshire Intensive Alternatives to Custody Pilot

The aim of this study was to critically assess the implementation and development of the Intensive Alternatives to Custody (IAC) pilot in Derbyshire. The Ministry of Justice (MoJ) Penal Policy paper (May 2007) outlined the government’s intention to develop higher intensity community orders as an alternative to short-term custody. The IAC Order was subsequently developed and piloted, first in Derbyshire and then in six other areas.* The pilots were centrally funded until March 2011

Developing an understanding of networks with a focus on LMIC health systems: how and why clinical and programmatic networks form and function to be able to change practices: a realist review

Networks are an increasingly employed approach to improve quality of care, service delivery, and health systems performance, particularly in low-and-middle income country (LMIC) health systems. The literature shows that networks can improve the provision and quality of services and health system functioning but there is limited evidence explaining how and why networks are established and work to achieve their reported results. We undertook a realist review to explore this. The objective of this realist review was to develop a programme theory outlining the underlying mechanisms and interactions of contexts that explain how and why a network’s set-up and function enable high-quality care and services and improved clinical outcomes in LMIC health systems. We followed Pawson’s five steps for realist reviews. The search strategy was based on a previously published scoping review with additional searches. Literature was selected based on its relevance to the programme theory and rigour. Context-mechanism-outcome configurations were developed from the extracted data to refine the initial programme theory with causal explanations. Theories on social movements and organisations supported the identification of mechanism and brought additional explanatory power to the programme theory. The programme theory explains how networks are initiated, formed, and function in a way that sets them up for network leadership and committed, engaged, and motivated network members to emerge and to change practices, which may lead to improved quality of care, service delivery, and clinical outcomes through the following phases: identify a problem, developing a collective vision, taking action to solve the problem, forming purposeful relationships, linkages, and partnerships, building a network identity and culture, and the creation of a psychological safe space. This deeper understanding of networks formation and functioning can lead to a more considered planning and implementation of networks, thereby improving health system functioning and performance