Exchange, Conflict and Coercion: The Ritual Dynamics of the Notting Hill Carnival Past and Present

This study investigates patterns of social relationships involving the Notting Hill Carnival. Two theoretical approaches are employed elementary relations theory and structural ritualization theory - to explain how the carnival has been strategically used in very different ways by various groups to accomplish their objectives. We suggest the Notting Hill Carnival is a special collective ritual event that has played a crucial role in three quite different structured arrangements involving coercion, conflict, and exchange since its beginning in Trinidad and subsequently in London. Four time periods where distinct changes in the nature of these relationships have occurred are examined: (1) 1800s Trinidad; (2) the Notting Hill Carnival from 1965-1970; (3) the Notting Hill Carnival from 1971-1989; and (4) the Notting Hill Carnival from 1990-present. This study contributes to the existing literature by focusing on how ritual and these types of relationships are intertwined in the production of the carnival. Implications of this research and possible directions for future research are also discussed

Comparative Effectiveness Research: Challenges for Medical Journals

Editors from a number of medical journals lay out principles for journals considering publication of Comparative Effectiveness Research (CER). In order to encourage dissemination of this editorial, this article is freely available in PLoS Medicine and will be also published in Medical Decision Making, Croatian Medical Journal, The Cochrane Library, Trials, The American Journal of Managed Care, and Journal of Clinical Epidemiology

Area-level deprivation and overall and cause-specific mortality: 12 years' observation on British women and systematic review of prospective studies.

BACKGROUND: Prospective studies have suggested a negative impact of area deprivation on overall mortality, but its effect on cause-specific mortality and the mechanisms that account for this association remain unclear. We investigate the association of area deprivation, using Index of Multiple deprivation (IMD), with overall and cause-specific mortality, contextualising findings within a systematic review. METHODS AND FINDINGS: We used data from 4,286 women from the British Women's Heart Health Study (BWHHS) recruited at 1999-2001 to examine the association of IMD with overall and cause-specific mortality using Cox regression models. One standard deviation (SD) increase in the IMD score had a hazard ratio (HR) of 1.21 (95% CI: 1.13-1.30) for overall mortality after adjustment for age and lifecourse individual deprivation, which was attenuated to 1.15 (95% CI: 1.04-1.26) after further inclusion of mediators (health behaviours, biological factors and use of statins and blood pressure-lowering medications). A more pronounced association was observed for respiratory disease and vascular deaths. The meta-analysis, based on 20 published studies plus the BWHHS (n=21), yielded a summary relative risk (RR) of 1.15 (95% CI: 1.11-1.19) for area deprivation (top [least deprived; reference] vs. bottom tertile) with overall mortality in an age and sex adjusted model, which reduced to 1.06 (95% CI: 1.04-1.08) in a fully adjusted model. CONCLUSIONS: Health behaviours mediate the association between area deprivation and cause-specific mortality. Efforts to modify health behaviours may be more successful if they are combined with measures that tackle area deprivation

Does clinical examination aid in the diagnosis of urinary tract infections in women? A systematic review and meta-analysis

<p>Abstract</p> <p>Background</p> <p>Clinicians should be aware of the diagnostic values of various symptoms, signs and antecedents. This information is particularly important in primary care settings, where sophisticated diagnostic approaches are not always feasible. The aim of the study is to determine the probability that various symptoms, signs, antecedents and tests predict urinary tract infection (UTI) in women.</p> <p>Methods</p> <p>We conducted a systematic search of the MEDLINE and EMBASE databases to identify articles published in all languages through until December 2008. We particularly focused on studies that examined the diagnostic accuracy of at least one symptom, sign or patient antecedent related to the urinary tract. We included studies where urine culture, a gold standard, was preformed by primary care providers on female subjects aged at least 14 years. A meta-analysis of the likelihood ratio was performed to assess variables related to the urinary tract symptoms.</p> <p>Results</p> <p>Of the 1, 212 articles identified, 11 met the selection criteria. Dysuria, urgency, nocturia, sexual activity and urgency with dysuria were weak predictors of urinary tract infection, whereas increases in vaginal discharge and suprapubic pain were weak predictors of the absence of infection. Nitrites or leukocytes in the dipstick test are the only findings that clearly favored a diagnosis of UTI.</p> <p>Conclusions</p> <p>Clinical findings do not aid in the diagnosis of UTI among women who present with urinary symptoms. Vaginal discharge is a weak indicator of the absence of infection. The urine dipstick test was the most reliable tool for detecting UTI.</p

Post-mortem assessment in vascular dementia: advances and aspirations.

BACKGROUND: Cerebrovascular lesions are a frequent finding in the elderly population. However, the impact of these lesions on cognitive performance, the prevalence of vascular dementia, and the pathophysiology behind characteristic in vivo imaging findings are subject to controversy. Moreover, there are no standardised criteria for the neuropathological assessment of cerebrovascular disease or its related lesions in human post-mortem brains, and conventional histological techniques may indeed be insufficient to fully reflect the consequences of cerebrovascular disease. DISCUSSION: Here, we review and discuss both the neuropathological and in vivo imaging characteristics of cerebrovascular disease, prevalence rates of vascular dementia, and clinico-pathological correlations. We also discuss the frequent comorbidity of cerebrovascular pathology and Alzheimer's disease pathology, as well as the difficult and controversial issue of clinically differentiating between Alzheimer's disease, vascular dementia and mixed Alzheimer's disease/vascular dementia. Finally, we consider additional novel approaches to complement and enhance current post-mortem assessment of cerebral human tissue. CONCLUSION: Elucidation of the pathophysiology of cerebrovascular disease, clarification of characteristic findings of in vivo imaging and knowledge about the impact of combined pathologies are needed to improve the diagnostic accuracy of clinical diagnoses

Long-term care workers and bureaucracy: The occupational ritualization of maltreatment in nursing homes and recommended policies

This article proposes that occupational rituals are an important part of social life for long-term care workers. Using 40 biographies, autobiographies, and research monographs to examine nursing homes, it reviews various symbolic themes expressed through daily work rituals in nursing homes. The themes involve concepts related to the culture of bureaucracy. This includes staff separation, rules, documentation, efficiency, and meetings. Using structural ritualization theory, we suggest that certain ritualized symbolic practices that express these themes influence the behaviors of nursing home employees shaping the thoughts and social interaction of nursing home staff members, creating occupational ritualization. Ritualized symbolic practices also contribute to the unintended maltreatment of residents. However, we believe alternative policies can generate work rituals with the potential to replace or offset the negative impacts of bureaucracy on maltreatment

The social dynamics of elder care: Rituals of bureaucracy and physical neglect in nursing homes

This research concerns nursing home rituals involving bureaucracy and physical neglect. It uses 40 ethnographies, biographies, and autobiographies to explore various symbolic themes expressed through everyday interaction in nursing homes. The themes involve bureaucratic concepts such as staff separation, rules, documentation, and efficiency. They also involve ideas of physical neglect, such as medical dereliction, personal negligence, environmental negligence, and bodily harm. Relying on structural ritualization theory, this work argues ritualized symbolic practices of bureaucracy unintentionally manufacture attitudes and acts of mercilessness for workers in both for-profit and nonprofit nursing homes. This aids in the development of rituals facilitating the physical maltreatment of residents. Copyright © Taylor & Francis Group, LLC

©2009 Academic Journals Full Length Research Paper Ecological stress and deritualization in East Asia: Ritual practices during dark age phases

Despite highlighting the implications of resource over utilization and scarcity on social systems, recent studies under explore the impact of environmental stress on culture. Specifically, further research is needed to understand the importance of natural resources for ritual practices. This study utilizes structural ritualization theory to analyze historical periods characterized by ecological degradation and deritualization. The period examined corresponds to the former and latter Han Dynasties, a moment in time that saw the first universal history of China written and where discussion of ritual appears prominently in historical documents. In addition to primary texts, secondary sources are used to examine deritualization and the continuity, abandonment, and emergence of new ritual practices. The results demonstrate that despite periods of resource unavailability social rituals survive. By tracing the introduction of Chinese ceramics and burial practices into the Korean peninsula and Japan, we see the strategies human communities employ when they can no longer obtain needed materials to practice specific rituals

Elder Crimes of the Law Abiding: Backwards Dresses, Covered Up Messes, and Nursing Homes

This article uses data from 75 biographies, autobiographies, and research monographs on nursing homes to explore physical neglect and abuse. Linked to crimes of the law abiding concepts, it implies employees see maltreatment as “normal.” It extends lines of research examining bureaucratic forces and their influence on nursing homes. It also provides a history of elder care in the UK and US and a review of structural ritualization theory. Findings concentrate on how rituals involving hierarchical structure, work efficiency, documentation, and rules adversely influence care homes. This includes physical maltreatment involving employee neglect of personal needs of residents, failing to provide medical help, bodily harm, and not maintaining quality living spaces

Exposing Enron: Media representations of ritualized deviance in corporate culture

This article argues that rituals are an important part of corporate culture. However, they can involve deviance. Employing multiple media sources, this study identifies symbolic themes expressed through daily work rituals at Enron\u27s corporate headquarters. The themes involve risk, gratification, pride, and fantasy imagery. Utilizing structural ritualization theory, this article suggests that ritualized symbolic practices expressing these themes extensively influenced Enron employees. They shaped their cognitions, patterns of behavior, and social interaction. They also led to the normalization and reproduction of deviance. The findings of this study contribute to research on organizational deviance and structural ritualization. © 2006 SAGE Publications