14 results
How has the idea of prevention been conceptualised and progressed in adult social care in England?
- Jerry Tew, Sandhya Duggal, Sarah Carr
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- Journal of Social Policy , First View
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- 05 June 2023, pp. 1-19
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Over recent years, a preventative approach has been promoted within adult social care policy and practice in England. However, progress has been somewhat inconsistent, in part due to issues around conceptualising what exactly prevention means within this context. Particularly since the financial crisis, there have emerged tensions between seeing prevention as a positive strategy to build assets and capability; as part of a neo-liberal project to roll back expectations for state support; or simply as a technocratic strategy to increase efficiency by deploying resources ‘upstream’ where they might have greater impact. This paper provides a critical perspective on how policy has unfolded over the last 15 years, which provides the context for an analysis of findings from a national survey of English local authorities and interviews with key stakeholders. These findings demonstrate a substantial commitment to preventative activity, but also some serious confusions and contradictions in how this agenda may be taken forward in the current policy environment.
How do you Shape a Market? Explaining Local State Practices in Adult Social Care
- CATHERINE NEEDHAM, KERRY ALLEN, EMILY BURN, KELLY HALL, CATHERINE MANGAN, HARETH AL-JANABI, WARDA TAHIR, SARAH CARR, JON GLASBY, MELANIE HENWOOD, STEVE MCKAY
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- Journal:
- Journal of Social Policy / Volume 52 / Issue 3 / July 2023
- Published online by Cambridge University Press:
- 02 March 2022, pp. 640-660
- Print publication:
- July 2023
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The Care Act 2014 gave English local authorities a duty to ‘shape’ social care markets and encouraged them to work co-productively with stakeholders. Grid-group cultural theory is used here to explain how local authorities have undertaken market shaping, based on a four-part typology of rules and relationships. The four types are: procurement (strong rules, weak relationships); managed market (strong rules, strong relationships); open market (weak rules, weak relationships); and partnership (weak rules, strong relationships). Qualitative data from English local authorities show that they are using different types of market shaping in different parts of the care market (e.g. residential vs home care), and shifting types over time. Challenges to the sustainability of the care system (rising demand, funding cuts, workforce shortages) are pulling local authorities towards the two ‘strong rules’ approaches which run against the co-productive thrust of the Care Act. Some local authorities are experimenting with hybrids of the two ‘weak rules’ approaches but the rival cultural biases of different types mean that hybrid approaches risk antagonising providers and further unsettling an unstable market.
Multimorbidity and fit note receipt in working-age adults with long-term health conditions
- Sarah Dorrington, Ewan Carr, Sharon A.M. Stevelink, Alex Dregan, Charlotte Woodhead, Jayati Das-Munshi, Mark Ashworth, Matthew Broadbent, Ira Madan, Stephani L Hatch, Matthew Hotopf
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- Journal:
- Psychological Medicine / Volume 52 / Issue 6 / April 2022
- Published online by Cambridge University Press:
- 08 September 2020, pp. 1156-1165
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Background
Research on sickness absence has typically focussed on single diagnoses, despite increasing recognition that long-term health conditions are highly multimorbid and clusters comprising coexisting mental and physical conditions are associated with poorer clinical and functional outcomes. The digitisation of sickness certification in the UK offers an opportunity to address sickness absence in a large primary care population.
MethodsLambeth Datanet is a primary care database which collects individual-level data on general practitioner consultations, prescriptions, Quality and Outcomes Framework diagnostic data, sickness certification (fit note receipt) and demographic information (including age, gender, self-identified ethnicity, and truncated postcode). We analysed 326 415 people's records covering a 40-month period from January 2014 to April 2017.
ResultsWe found significant variation in multimorbidity by demographic variables, most notably by self-defined ethnicity. Multimorbid health conditions were associated with increased fit note receipt. Comorbid depression had the largest impact on first fit note receipt, more than any other comorbid diagnoses. Highest rates of first fit note receipt after adjustment for demographics were for comorbid epilepsy and rheumatoid arthritis (HR 4.69; 95% CI 1.73–12.68), followed by epilepsy and depression (HR 4.19; 95% CI 3.60–4.87), chronic pain and depression (HR 4.14; 95% CI 3.69–4.65), cardiac condition and depression (HR 4.08; 95% CI 3.36–4.95).
ConclusionsOur results show striking variation in multimorbid conditions by gender, deprivation and ethnicity, and highlight the importance of multimorbidity, in particular comorbid depression, as a leading cause of disability among working-age adults.
EXCAVATION OF AN OBSIDIAN CRAFT WORKSHOP AT TEOTIHUACAN, MEXICO
- Kenneth G. Hirth, David M. Carballo, Mark Dennison, Sean Carr, Sarah Imfeld, Eric Dyrdahl
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- Journal:
- Ancient Mesoamerica / Volume 30 / Issue 1 / Spring 2019
- Published online by Cambridge University Press:
- 11 April 2019, pp. 163-179
- Print publication:
- Spring 2019
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The original research by the Teotihuacan Mapping Project (TMP) identified a large number of obsidian workshops within Teotihuacan based on surface concentrations of production debris. Clark (1986b) questioned the validity of these identifications and called for subsurface excavation to confirm the presence of in situ workshop locales. This article summarizes the results from the excavation of one of the obsidian workshops identified in the Tlajinga district of Teotihuacan at Compound 17:S3E1 (Compound 17). We describe the excavations, discuss the lithic technology, and examine the subsurface contexts in terms of what they tell us about in situ obsidian craft activity. Excavations confirm that Compound 17 was a locus of large-scale obsidian craft production during the Classic period. While only a single test case, these results suggest that surface remains at Teotihuacan can be a useful guide in identifying craft production areas when they are confirmed through subsurface testing.
Association between childhood trauma exposure and pro-inflammatory cytokines in schizophrenia and bipolar-I disorder
- Yann Quidé, Chiara C. Bortolasci, Briana Spolding, Srisaiyini Kidnapillai, Oliver J. Watkeys, Sarah Cohen-Woods, Michael Berk, Vaughan J. Carr, Ken Walder, Melissa J. Green
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- Journal:
- Psychological Medicine / Volume 49 / Issue 16 / December 2019
- Published online by Cambridge University Press:
- 18 December 2018, pp. 2736-2744
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Background
Elevated levels of pro-inflammatory cytokines are consistently reported in schizophrenia (SZ) and bipolar-I disorder (BD), as well as among individuals who have been exposed to childhood trauma. However, higher levels of inflammatory markers in these disorders are yet to be investigated with respect to levels of exposure to different types of childhood trauma.
MethodsParticipants were 68 cases with a diagnosis of schizophrenia/schizoaffective disorder (SZ), 69 cases with a diagnosis of psychotic BD and 72 healthy controls (HC). Serum levels of interleukin 6 (IL-6), tumour necrosis factor-α (TNF-α) and C-reactive protein (CRP) were quantified, and childhood trauma exposure was assessed with the Childhood Trauma Questionnaire.
ResultsThe SZ group had significantly higher levels of IL-6, TNF-α and CRP when compared with the HC group (all p < 0.05, d = 0.41–0.63), as well as higher levels of TNF-α when compared with the BD group (p = 0.014, d = 0.50); there were no differences between the BD and HC groups for any markers. Exposure to sexual abuse was positively associated (standardised β = 0.326, t = 2.459, p = 0.018) with levels of CRP in the SZ group, but there were no significant associations between any form of trauma exposure and cytokine levels in the HC or BD groups.
ConclusionsThese results contribute to the evidence for a chronic state of inflammation in SZ but not BD cases. Differential associations between trauma exposure and levels of pro-inflammatory cytokines across the diagnostic categories suggest that trauma may impact biological (stress and immune) systems differently in these patient groups.
Mental health service user experiences of targeted violence and hostility and help-seeking in the UK: a scoping review
- Sarah Carr, Jessica Holley, Trish Hafford-Letchfield, Alison Faulkner, Dorothy Gould, Christine Khisa, Claudia Megele
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- Journal:
- Global Mental Health / Volume 4 / 2017
- Published online by Cambridge University Press:
- 11 December 2017, e25
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Background.
The aim of this research scoping review was to assemble an evidence base for the UK on mental health service user experiences and perspectives on mental health-related targeted violence and hostility (‘disability hate crime’). It also aims to address some of the gaps in the knowledge on risk management, help-seeking and prevention from the perspectives of those who experienced targeted violence and hostility because of their mental health problems or psychiatric status.
Methods.Seven key mental health and social care bibliographic databases were searched for relevant UK research studies from 1990 until 2016. Grey literature was identified through online searches. A scoping review charting approach and thematic analysis methodology were used to analyse the studies.
Results.In total 13 studies were finally included, over half of which used survey methods. All studies included people with experiences of mental health problems. The studies provide information on: the types of potential hate crime; indicate where incidents take place; give some insight into the victims’ relationship with the perpetrators; the location of incidents as well as the psychological, social, financial and physical impacts on the victim; the types of help-seeking behaviours adopted by the victims; a range coping strategies that people with mental health problems adopted in response to experiences of targeted violence or abuse.
Conclusion.This scoping review provides a UK-based overview of mental health service user concepts and experiences of mental health-related targeted violence and hostility (‘disability hate crime’). It reveals some specific issues relating to mental health and disability hate crime. Further investigation into disability hate crime with a specific focus on mental health is required. This is a UK-based overview, which offers a useful comparator for researchers, practitioners and policy-makers internationally.
Contributors
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- By Mitchell Aboulafia, Frederick Adams, Marilyn McCord Adams, Robert M. Adams, Laird Addis, James W. Allard, David Allison, William P. Alston, Karl Ameriks, C. Anthony Anderson, David Leech Anderson, Lanier Anderson, Roger Ariew, David Armstrong, Denis G. Arnold, E. J. Ashworth, Margaret Atherton, Robin Attfield, Bruce Aune, Edward Wilson Averill, Jody Azzouni, Kent Bach, Andrew Bailey, Lynne Rudder Baker, Thomas R. Baldwin, Jon Barwise, George Bealer, William Bechtel, Lawrence C. Becker, Mark A. Bedau, Ernst Behler, José A. Benardete, Ermanno Bencivenga, Jan Berg, Michael Bergmann, Robert L. Bernasconi, Sven Bernecker, Bernard Berofsky, Rod Bertolet, Charles J. Beyer, Christian Beyer, Joseph Bien, Joseph Bien, Peg Birmingham, Ivan Boh, James Bohman, Daniel Bonevac, Laurence BonJour, William J. Bouwsma, Raymond D. Bradley, Myles Brand, Richard B. Brandt, Michael E. Bratman, Stephen E. Braude, Daniel Breazeale, Angela Breitenbach, Jason Bridges, David O. Brink, Gordon G. Brittan, Justin Broackes, Dan W. Brock, Aaron Bronfman, Jeffrey E. Brower, Bartosz Brozek, Anthony Brueckner, Jeffrey Bub, Lara Buchak, Otavio Bueno, Ann E. Bumpus, Robert W. Burch, John Burgess, Arthur W. Burks, Panayot Butchvarov, Robert E. Butts, Marina Bykova, Patrick Byrne, David Carr, Noël Carroll, Edward S. Casey, Victor Caston, Victor Caston, Albert Casullo, Robert L. Causey, Alan K. L. Chan, Ruth Chang, Deen K. Chatterjee, Andrew Chignell, Roderick M. Chisholm, Kelly J. Clark, E. J. Coffman, Robin Collins, Brian P. Copenhaver, John Corcoran, John Cottingham, Roger Crisp, Frederick J. Crosson, Antonio S. Cua, Phillip D. Cummins, Martin Curd, Adam Cureton, Andrew Cutrofello, Stephen Darwall, Paul Sheldon Davies, Wayne A. Davis, Timothy Joseph Day, Claudio de Almeida, Mario De Caro, Mario De Caro, John Deigh, C. F. Delaney, Daniel C. Dennett, Michael R. DePaul, Michael Detlefsen, Daniel Trent Devereux, Philip E. Devine, John M. Dillon, Martin C. Dillon, Robert DiSalle, Mary Domski, Alan Donagan, Paul Draper, Fred Dretske, Mircea Dumitru, Wilhelm Dupré, Gerald Dworkin, John Earman, Ellery Eells, Catherine Z. Elgin, Berent Enç, Ronald P. Endicott, Edward Erwin, John Etchemendy, C. Stephen Evans, Susan L. Feagin, Solomon Feferman, Richard Feldman, Arthur Fine, Maurice A. Finocchiaro, William FitzPatrick, Richard E. Flathman, Gvozden Flego, Richard Foley, Graeme Forbes, Rainer Forst, Malcolm R. Forster, Daniel Fouke, Patrick Francken, Samuel Freeman, Elizabeth Fricker, Miranda Fricker, Michael Friedman, Michael Fuerstein, Richard A. Fumerton, Alan Gabbey, Pieranna Garavaso, Daniel Garber, Jorge L. A. Garcia, Robert K. Garcia, Don Garrett, Philip Gasper, Gerald Gaus, Berys Gaut, Bernard Gert, Roger F. Gibson, Cody Gilmore, Carl Ginet, Alan H. Goldman, Alvin I. Goldman, Alfonso Gömez-Lobo, Lenn E. Goodman, Robert M. Gordon, Stefan Gosepath, Jorge J. E. Gracia, Daniel W. Graham, George A. Graham, Peter J. Graham, Richard E. Grandy, I. Grattan-Guinness, John Greco, Philip T. Grier, Nicholas Griffin, Nicholas Griffin, David A. Griffiths, Paul J. Griffiths, Stephen R. Grimm, Charles L. Griswold, Charles B. Guignon, Pete A. Y. Gunter, Dimitri Gutas, Gary Gutting, Paul Guyer, Kwame Gyekye, Oscar A. Haac, Raul Hakli, Raul Hakli, Michael Hallett, Edward C. Halper, Jean Hampton, R. James Hankinson, K. R. Hanley, Russell Hardin, Robert M. Harnish, William Harper, David Harrah, Kevin Hart, Ali Hasan, William Hasker, John Haugeland, Roger Hausheer, William Heald, Peter Heath, Richard Heck, John F. Heil, Vincent F. Hendricks, Stephen Hetherington, Francis Heylighen, Kathleen Marie Higgins, Risto Hilpinen, Harold T. Hodes, Joshua Hoffman, Alan Holland, Robert L. Holmes, Richard Holton, Brad W. Hooker, Terence E. Horgan, Tamara Horowitz, Paul Horwich, Vittorio Hösle, Paul Hoβfeld, Daniel Howard-Snyder, Frances Howard-Snyder, Anne Hudson, Deal W. Hudson, Carl A. Huffman, David L. Hull, Patricia Huntington, Thomas Hurka, Paul Hurley, Rosalind Hursthouse, Guillermo Hurtado, Ronald E. Hustwit, Sarah Hutton, Jonathan Jenkins Ichikawa, Harry A. Ide, David Ingram, Philip J. Ivanhoe, Alfred L. Ivry, Frank Jackson, Dale Jacquette, Joseph Jedwab, Richard Jeffrey, David Alan Johnson, Edward Johnson, Mark D. Jordan, Richard Joyce, Hwa Yol Jung, Robert Hillary Kane, Tomis Kapitan, Jacquelyn Ann K. Kegley, James A. Keller, Ralph Kennedy, Sergei Khoruzhii, Jaegwon Kim, Yersu Kim, Nathan L. King, Patricia Kitcher, Peter D. Klein, E. D. Klemke, Virginia Klenk, George L. Kline, Christian Klotz, Simo Knuuttila, Joseph J. Kockelmans, Konstantin Kolenda, Sebastian Tomasz Kołodziejczyk, Isaac Kramnick, Richard Kraut, Fred Kroon, Manfred Kuehn, Steven T. Kuhn, Henry E. Kyburg, John Lachs, Jennifer Lackey, Stephen E. Lahey, Andrea Lavazza, Thomas H. Leahey, Joo Heung Lee, Keith Lehrer, Dorothy Leland, Noah M. Lemos, Ernest LePore, Sarah-Jane Leslie, Isaac Levi, Andrew Levine, Alan E. Lewis, Daniel E. Little, Shu-hsien Liu, Shu-hsien Liu, Alan K. L. Chan, Brian Loar, Lawrence B. Lombard, John Longeway, Dominic McIver Lopes, Michael J. Loux, E. J. Lowe, Steven Luper, Eugene C. Luschei, William G. Lycan, David Lyons, David Macarthur, Danielle Macbeth, Scott MacDonald, Jacob L. Mackey, Louis H. Mackey, Penelope Mackie, Edward H. Madden, Penelope Maddy, G. B. Madison, Bernd Magnus, Pekka Mäkelä, Rudolf A. Makkreel, David Manley, William E. Mann (W.E.M.), Vladimir Marchenkov, Peter Markie, Jean-Pierre Marquis, Ausonio Marras, Mike W. Martin, A. P. Martinich, William L. McBride, David McCabe, Storrs McCall, Hugh J. McCann, Robert N. McCauley, John J. McDermott, Sarah McGrath, Ralph McInerny, Daniel J. McKaughan, Thomas McKay, Michael McKinsey, Brian P. McLaughlin, Ernan McMullin, Anthonie Meijers, Jack W. Meiland, William Jason Melanson, Alfred R. Mele, Joseph R. Mendola, Christopher Menzel, Michael J. Meyer, Christian B. Miller, David W. Miller, Peter Millican, Robert N. Minor, Phillip Mitsis, James A. Montmarquet, Michael S. Moore, Tim Moore, Benjamin Morison, Donald R. Morrison, Stephen J. Morse, Paul K. Moser, Alexander P. D. Mourelatos, Ian Mueller, James Bernard Murphy, Mark C. Murphy, Steven Nadler, Jan Narveson, Alan Nelson, Jerome Neu, Samuel Newlands, Kai Nielsen, Ilkka Niiniluoto, Carlos G. Noreña, Calvin G. Normore, David Fate Norton, Nikolaj Nottelmann, Donald Nute, David S. Oderberg, Steve Odin, Michael O’Rourke, Willard G. Oxtoby, Heinz Paetzold, George S. Pappas, Anthony J. Parel, Lydia Patton, R. P. Peerenboom, Francis Jeffry Pelletier, Adriaan T. Peperzak, Derk Pereboom, Jaroslav Peregrin, Glen Pettigrove, Philip Pettit, Edmund L. Pincoffs, Andrew Pinsent, Robert B. Pippin, Alvin Plantinga, Louis P. Pojman, Richard H. Popkin, John F. Post, Carl J. Posy, William J. Prior, Richard Purtill, Michael Quante, Philip L. Quinn, Philip L. Quinn, Elizabeth S. Radcliffe, Diana Raffman, Gerard Raulet, Stephen L. Read, Andrews Reath, Andrew Reisner, Nicholas Rescher, Henry S. Richardson, Robert C. Richardson, Thomas Ricketts, Wayne D. Riggs, Mark Roberts, Robert C. Roberts, Luke Robinson, Alexander Rosenberg, Gary Rosenkranz, Bernice Glatzer Rosenthal, Adina L. Roskies, William L. Rowe, T. M. Rudavsky, Michael Ruse, Bruce Russell, Lilly-Marlene Russow, Dan Ryder, R. M. Sainsbury, Joseph Salerno, Nathan Salmon, Wesley C. Salmon, Constantine Sandis, David H. Sanford, Marco Santambrogio, David Sapire, Ruth A. Saunders, Geoffrey Sayre-McCord, Charles Sayward, James P. Scanlan, Richard Schacht, Tamar Schapiro, Frederick F. Schmitt, Jerome B. Schneewind, Calvin O. Schrag, Alan D. Schrift, George F. Schumm, Jean-Loup Seban, David N. Sedley, Kenneth Seeskin, Krister Segerberg, Charlene Haddock Seigfried, Dennis M. Senchuk, James F. Sennett, William Lad Sessions, Stewart Shapiro, Tommie Shelby, Donald W. Sherburne, Christopher Shields, Roger A. Shiner, Sydney Shoemaker, Robert K. Shope, Kwong-loi Shun, Wilfried Sieg, A. John Simmons, Robert L. Simon, Marcus G. Singer, Georgette Sinkler, Walter Sinnott-Armstrong, Matti T. Sintonen, Lawrence Sklar, Brian Skyrms, Robert C. Sleigh, Michael Anthony Slote, Hans Sluga, Barry Smith, Michael Smith, Robin Smith, Robert Sokolowski, Robert C. Solomon, Marta Soniewicka, Philip Soper, Ernest Sosa, Nicholas Southwood, Paul Vincent Spade, T. L. S. Sprigge, Eric O. Springsted, George J. Stack, Rebecca Stangl, Jason Stanley, Florian Steinberger, Sören Stenlund, Christopher Stephens, James P. Sterba, Josef Stern, Matthias Steup, M. A. Stewart, Leopold Stubenberg, Edith Dudley Sulla, Frederick Suppe, Jere Paul Surber, David George Sussman, Sigrún Svavarsdóttir, Zeno G. Swijtink, Richard Swinburne, Charles C. Taliaferro, Robert B. Talisse, John Tasioulas, Paul Teller, Larry S. Temkin, Mark Textor, H. S. Thayer, Peter Thielke, Alan Thomas, Amie L. Thomasson, Katherine Thomson-Jones, Joshua C. Thurow, Vzalerie Tiberius, Terrence N. Tice, Paul Tidman, Mark C. Timmons, William Tolhurst, James E. Tomberlin, Rosemarie Tong, Lawrence Torcello, Kelly Trogdon, J. D. Trout, Robert E. Tully, Raimo Tuomela, John Turri, Martin M. Tweedale, Thomas Uebel, Jennifer Uleman, James Van Cleve, Harry van der Linden, Peter van Inwagen, Bryan W. Van Norden, René van Woudenberg, Donald Phillip Verene, Samantha Vice, Thomas Vinci, Donald Wayne Viney, Barbara Von Eckardt, Peter B. M. Vranas, Steven J. Wagner, William J. Wainwright, Paul E. Walker, Robert E. Wall, Craig Walton, Douglas Walton, Eric Watkins, Richard A. Watson, Michael V. Wedin, Rudolph H. Weingartner, Paul Weirich, Paul J. Weithman, Carl Wellman, Howard Wettstein, Samuel C. Wheeler, Stephen A. White, Jennifer Whiting, Edward R. Wierenga, Michael Williams, Fred Wilson, W. Kent Wilson, Kenneth P. Winkler, John F. Wippel, Jan Woleński, Allan B. Wolter, Nicholas P. Wolterstorff, Rega Wood, W. Jay Wood, Paul Woodruff, Alison Wylie, Gideon Yaffe, Takashi Yagisawa, Yutaka Yamamoto, Keith E. Yandell, Xiaomei Yang, Dean Zimmerman, Günter Zoller, Catherine Zuckert, Michael Zuckert, Jack A. Zupko (J.A.Z.)
- Edited by Robert Audi, University of Notre Dame, Indiana
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- The Cambridge Dictionary of Philosophy
- Published online:
- 05 August 2015
- Print publication:
- 27 April 2015, pp ix-xxx
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three - Making it real: from Putting People First to Think Local, Act Personal
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- By Sarah Carr
- Edited by Catherine Needham, University of Birmingham, Jon Glasby, University of Birmingham
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- Book:
- Debates in Personalisation
- Published by:
- Bristol University Press
- Published online:
- 04 March 2022
- Print publication:
- 15 October 2014, pp 25-34
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Summary
This chapter is a critical examination of the core government personalisation policy documents – Putting People First (DH, 2007) and Think Local, Act Personal (TLAP, 2011b) – and how the proposals were influenced by broader strategies for welfare reform. It analyses the policy documents across changing ideological standpoints following the 2010 change of government from New Labour to a Conservative-dominated coalition with the Liberal Democrats. The intention is not to assess the implementation of all the personalisation policy reforms set out in the key government documents, but rather to examine the documents as artefacts of the broader welfare and public policy reform ideologies of the different administrations. In this way it is possible to explore how some of the wider government public sector reform strategies have shaped personalisation implementation proposals. The methodology is informed by a documentary analysis approach. This exploration of key personalisation policy documents highlights how they bear the hallmarks of wider welfare reform approaches in both administrations and draws on critical perspectives offered by selected academics. The analysis draws on research-based explorations of the ‘modernisation’ and ‘transformation’ reform agendas in adult social care (Newman et al, 2008), refers to a critique of joined-up government (Pollitt, 2003) and traces adult social care policy evolution (Means, 2012). Evidence is drawn from findings from the individual budgets (IB) pilot evaluation (Glendinning et al, 2011; Moran et al, 2011).
Policy evolution
Means (2012) offers a helpful historical perspective for contexualising personalisation reforms in adult social care. He sees the agenda as belonging within a historical continuum of policy development, where major themes about funding, quality, provision, access and defining social care continually re-emerge as challenges. Means argues that ‘it needs to be remembered that the Griffiths Report is now over 20 years old and in many ways it set out the personalisation agenda which the coalition government now intends to implement’ (2012, p 317). The 2007 Putting People First policy concordat refers back to the Community Care reforms instigated by Griffiths and the initial coalition adult social care reform document refers to the 1968 Seebohm Report, again highlighting the evolutionary nature of the policy.
Vocational rehabilitation in early psychosis: cluster randomised trial
- Tom Craig, Geoff Shepherd, Miles Rinaldi, Jo Smith, Sarah Carr, Fay Preston, Swaran Singh
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- Journal:
- The British Journal of Psychiatry / Volume 205 / Issue 2 / August 2014
- Published online by Cambridge University Press:
- 02 January 2018, pp. 145-150
- Print publication:
- August 2014
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Background
Individual placement and support (IPS) is effective in helping patients return to work but is poorly implemented because of clinical ambivalence and fears of relapse.
AimsTo assess whether a motivational intervention (motivational interviewing) directed at clinical staff to address ambivalence about employment improved patients' occupational outcomes.
MethodTwo of four early intervention teams that already provided IPS were randomised to receive motivational interviewing training for clinicians, focused on attitudinal barriers to employment. The trial was registered with the International Standard Randomised Controlled Trial Register (ISRCTN71943786).
ResultsOf 300 eligible participants, 159 consented to the research. Occupational outcomes were obtained for 134 patients (85%) at 12-month follow-up. More patients in the intervention teams than in the IPS-only teams achieved employment by 12 months (29/68 v. 12/66). A random effects logistic regression accounting for clustering by care coordinator, and adjusted for participants' gender, ethnicity, educational and employment history and clinical status scores, confirmed superiority of the intervention (odds ratio = 4.3, 95% CI 1.5–16.6).
ConclusionsEmployment outcomes were enhanced by addressing clinicians' ambivalence about their patients returning to work.
Personalisation, participation and policy construction: a critique of influences and understandings
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- By Sarah Carr
- Edited by Iain Ferguson, University of New South Wales, Michael Lavalette
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- Book:
- Critical and Radical Debates in Social Work
- Published by:
- Bristol University Press
- Published online:
- 04 February 2022
- Print publication:
- 12 March 2014, pp 100-105
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Summary
When it first appeared, the adult social care personalisation policy seemed to assume that there was a universal understanding of the policy terminology, meaning and aims, which included a rhetorical commitment to ‘empowerment’, ‘co-production’ and ‘choice and control’ (HM Government, 2007). However, Beresford's analysis provides insight into some of the confusions of meaning and contradictions inherent in this policy for adult social care. Other critics and observers also agree that as a public policy discourse, personalisation is imprecise, ambiguous and contains certain internal inconsistencies and tensions (Cutler et al, 2007; Pykett, 2009; Roulstone and Morgan, 2009; Needham, 2011a; 2011b), particularly as regards the conceptualisation, design and operation of the personal budget scheme in England (Boxall et al, 2009; Audit Commission, 2010; Carr, 2011a). This response is an attempt to deepen Beresford's criticisms about personalisation not being ‘a user-led development’ and offers an expansion of his exploration of its origins by further critiquing the influential ideas of Charles Leadbeater.
Before it was introduced for adult social care, the personalisation agenda had already formed part of the policy for education reform and was being championed by the social policy think tank Demos (for an extensive critique, see Pykett, 2009), particularly through the work of Charles Leadbeater, a former Financial Times editor, management consultant and policy advisor to Tony Blair, with no experience in adult social care. Despite this, Leadbeater and Demos had a profound influence on the personalisation agenda for adult social care, with Demos publishing Making it personal (Leadbeater et al, 2008), a largely theoretical outline for reform, two months after the 2008 local authority circular outlining the adult social care transformation plans (Department of Health, 2008). Leadbeater et al's report focused on self-directed support and personal budgets. Demos positioned the ‘new operating system’ of the In Control programme (led by Simon Duffy) as the model for adult social care reform, using evidence from the small-scale evaluation of the first pilot phase focusing on people with learning disabilities in seven local authorities and highlighting particular individual stories to illustrate the positive impact of the ‘radical’ new approach.
ten - Individual narratives and collective knowledge: capturing lesbian, gay and bisexual service user experiences
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- By Sarah Carr
- Edited by Patsy Staddon, University of Plymouth
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- Book:
- Mental Health Service Users in Research
- Published by:
- Bristol University Press
- Published online:
- 03 February 2022
- Print publication:
- 12 June 2013, pp 135-152
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Summary
Behind the story I tell is the one I don’t. Behind the story you hear is the one I wish I could make you hear. (Allison, 1996, p 39)
Even in my earliest storytelling I saw myself as overcoming adverse situations. (Hammer, 2010, p 9)
Introduction
This chapter explores the idea of capturing individual testimony to contribute to collective knowledge on lesbian, gay and bisexual (LGB) experiences of mental distress and mental health service use. The exploration draws upon some of my own reflections about the methodologies I have used in some of my own research, where I use personal experience both as a starting point and as a form of inquiry and then locate individual accounts as part of collective user and survivor knowledge. I attempt to situate this within the wider tradition of the use of experiential knowledge, narrative and testimony in user and survivor research. I also link the use of personal narrative to the development of individual and collective identity for LGB people. Finally, I examine the potential of autoethnography to provide a viable methodology for capturing personal testimony, experience and narrative for research on mental health and LGB people.
Marginalised memoirs and collective knowledge
Beginning with some brief contextualisation, personal narrative and first-hand experiential accounts of mental distress have not historically been valued as knowledge equal to that of professionally trained clinicians and practitioners (Beresford, 2000, 2003; Turner and Beresford, 2005; Tew et al, 2006; Sweeney et al, 2009). However, it is useful to note that one of the only encounters Sigmund Freud had with a person who experienced what would now be termed ‘psychotic symptoms’ was through the detailed memoirs of a man who had been diagnosed with ‘dementia praecox’ – now known as schizophrenia. Published in 1903, Daniel Schreber's Memoirs of my nervous illness (Schreber, 2000) gave a unique insight into his thoughts, beliefs and experiences and could arguably count as one of the first pieces of user research into mental distress. Schreber himself was the subject of his own investigation and the result was a personal account of his experience of ‘psychosis’. Freud then went on to psychoanalyse Schreber's memoirs in an attempt to establish a psychoanalytic understanding of psychosis (Freud, 2002).
11 - NETWORKS – The assessment of marine reserve networks: guidelines for ecological evaluation
- from Part IV - Scale-up of marine protected area systems
- Edited by Joachim Claudet, Centre National de la Recherche Scientifique (CNRS), Paris
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- Marine Protected Areas
- Published online:
- 05 August 2012
- Print publication:
- 29 September 2011, pp 293-321
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Summary
Introduction
As marine ecosystems are plagued by an ever-increasing suite of threats including climate change, pollution, habitat degradation, and fisheries impacts (Roessig et al., 2004; Lotze et al., 2006; Jackson, 2008), there are now no ocean areas that are exempt from anthropogenic impacts (Halpern et al., 2008). In order to preserve marine biodiversity, ecosystem function, and the goods and services provided by resistant and/or resilient systems, marine reserves have been increasingly recommended as part of an ecosystem-based approach to management (Browman and Stergiou, 2004; Levin et al., 2009). Marine reserves are defined as “areas of the ocean completely protected from all extractive and destructive activities” (Lubchenco et al., 2003) and can be experimental controls for evaluating the impact of these activities on marine ecosystems. Growing scientific information has shown consistent increases in species density, biomass, size, and diversity in response to full protection inside reserves of varying sizes and ages located in diverse regions (Claudet et al., 2008; Lester et al., 2009; Molloy et al., 2009). However, most of these data are from individual marine reserves and therefore have inherently limited transferability to networks of marine reserves, which when properly designed can outperform single marine reserves for a variety of ecological, economic, and social management goals (Roberts et al., 2003; Almany et al., 2009; Gaines et al., 2010).
The concept of marine reserve networks grew out of a desire to achieve both conservation and fishery management goals by minimizing the potential negative economic, social, and cultural impacts of a single large reserve while still producing similar or even greater ecological and economic returns (Murray et al., 1999; Gaines et al., 2010). In addition, reserves networks can provide insurance by protecting areas across a region and spreading the risk that these sites may be impacted by localized catastrophes such as hurricanes or oil spills (Allison et al., 2003). The World Conservation Union's Marine Programme defines a network as “a collection of individual marine protected areas (MPAs) or reserves operating co-operatively and synergistically, at various spatial scales and with a range of protection levels that are designed to meet objectives that a single reserve cannot achieve” (IUCN–WCPA, 2008). However, general terms such as “co-operatively” and “synergistically” can have myriad meanings. Without a clear definition of a network, it becomes difficult to identify attainable management goals and design a process for evaluating whether the network achieves those goals. Besides, different management goals may in turn result in the need for different types of networks. The use of MPAs with varying protection levels together with no-take zones in multiple-zoning schemes adds another layer of complexity to network design and evaluation; however, partially protected areas are generally used to manage coastal uses and avoid conflicts (rather than for strict ecological purposes) and are therefore a function of the local social, economic, and cultural context. As we are here interested in the ecological effects of networks, for the purposes of this chapter, we focus on marine reserves because these areas are no-take and therefore offer greater ecological benefits than other types of MPAs that allow some forms of extraction (Lester and Halpern, 2008).
Contributors
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- By Phillip L. Ackerman, Soon Ang, Susan M. Barnett, G. David Batty, Anna S. Beninger, Jillian Brass, Meghan M. Burke, Nancy Cantor, Priyanka B. Carr, David R. Caruso, Stephen J. Ceci, Lillia Cherkasskiy, Joanna Christodoulou, Andrew R. A. Conway, Christine E. Daley, Janet E. Davidson, Jim Davies, Katie Davis, Ian J. Deary, Colin G. DeYoung, Ron Dumont, Carol S. Dweck, Linn Van Dyne, Pascale M. J. Engel de Abreu, Joseph F. Fagan, David Henry Feldman, Kurt W. Fischer, Marisa H. Fisher, James R. Flynn, Liane Gabora, Howard Gardner, Glenn Geher, Sarah J. Getz, Judith Glück, Ashok K. Goel, Megan M. Griffin, Elena L. Grigorenko, Richard J. Haier, Diane F. Halpern, Christopher Hertzog, Robert M. Hodapp, Earl Hunt, Alan S. Kaufman, James C. Kaufman, Scott Barry Kaufman, Iris A. Kemp, John F. Kihlstrom, Joni M. Lakin, Christina S. Lee, David F. Lohman, N. J. Mackintosh, Brooke Macnamara, Samuel D. Mandelman, John D. Mayer, Richard E. Mayer, Martha J. Morelock, Ted Nettelbeck, Raymond S. Nickerson, Weihua Niu, Anthony J. Onwuegbuzie, Jonathan A. Plucker, Sally M. Reis, Joseph S. Renzulli, Heiner Rindermann, L. Todd Rose, Anne Russon, Peter Salovey, Scott Seider, Ellen L. Short, Keith E. Stanovich, Ursula M. Staudinger, Robert J. Sternberg, Carli A. Straight, Lisa A. Suzuki, Mei Ling Tan, Maggie E. Toplak, Susana Urbina, Richard K. Wagner, Richard F. West, Wendy M. Williams, John O. Willis, Thomas R. Zentall
- Edited by Robert J. Sternberg, Oklahoma State University, Scott Barry Kaufman, New York University
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- Book:
- The Cambridge Handbook of Intelligence
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- 05 June 2012
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- 30 May 2011, pp xi-xiv
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The algebra of cell-zeta values
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- Francis Brown, Sarah Carr, Leila Schneps
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- Compositio Mathematica / Volume 146 / Issue 3 / May 2010
- Published online by Cambridge University Press:
- 10 March 2010, pp. 731-771
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- May 2010
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In this paper, we introduce cell-forms on 𝔐0,n, which are top-dimensional differential forms diverging along the boundary of exactly one cell (connected component) of the real moduli space 𝔐0,n(ℝ). We show that the cell-forms generate the top-dimensional cohomology group of 𝔐0,n, so that there is a natural duality between cells and cell-forms. In the heart of the paper, we determine an explicit basis for the subspace of differential forms which converge along a given cell X. The elements of this basis are called insertion forms; their integrals over X are real numbers, called cell-zeta values, which generate a ℚ-algebra called the cell-zeta algebra. By a result of F. Brown, the cell-zeta algebra is equal to the algebra of multizeta values. The cell-zeta values satisfy a family of simple quadratic relations coming from the geometry of moduli spaces, which leads to a natural definition of a formal version of the cell-zeta algebra, conjecturally isomorphic to the formal multizeta algebra defined by the much-studied double shuffle relations.