Archive for the 'Research' Category

Am I a patient?

Alan Cribb unravels the transition from an epidemiological approach to a philosophical approach to healthcare he discusses in his new book – Healthcare in transition – by examining how his identification, or not, as a patient impacts on his research.

Whilst working as an academic I tend not to identify myself as a patient. 

In the last few years one of the themes of my work has been patient-centred or person-centred healthcare, and I have just completed Healthcare in transition, a book in which I tried to tease out some of the elements of, and tensions within, this idea. But I have never self-identified as a patient in my writing and I only occasionally do so in my face to face encounters with trusted colleagues and in what feel like safe spaces to me.

In some ways this is odd. I am not simply a patient in a notional sense – like very many people, I have regular interactions with medical consultants and other health professionals, I follow a regime of treatment and I have health-related conditions that challenge my identity and frame the way I organise my life. So why not self-identify as a patient in my academic work?

“Why not self-identity as a patient in my academic work?”

Partly it is probably just about privacy or for reasons of self-protection – not to invite threatening line of enquiry from others. But it feels as if it is about something more than that. First and foremost it seems presumptuous. It feels like I have been invited to the meeting with one ticket – as a researcher – but now I am claiming to have a further ticket and am expecting to vote twice!

This sense of cheating applies however I think about what counts as a patient, and I have to confess that I am confused about this. In health services research, for example, it is now a methodological and ethical norm to worry about the inclusion of either patient perspectives or patients in some fuller sense. But there is a spectrum of attitudes and practices in response to this norm.

In some cases – and this is to exaggerate for effect – ‘patients’ is treated as a kind of self-fulfilling marginal category, such that if people happen to have any other source of relevant expertise – they are health professionals, or researchers, or activists or even heavily engaged in a peer led patient group then they will to some extent be disqualified as ‘patients’.

This attitude stems from an understandable concern that the identity of patients isn’t colonised and misrepresented by powerful voices but, at the same time – certainly in this exaggerated sense – it risks reproducing a deficit view of patients.

“I feel either disqualified or under qualified.”

At the other end of the spectrum there are strong patient voices and groups who will not only lobby for involvement in research but will themselves lead research and will challenge prevailing orthodoxies – for example, questioning not only the practices of patient involvement but also the ways in which research agendas are set and research is conducted and so on. These kinds of patient voices play an important role and can be inspirational. But there is also a danger here – again at the extreme – that the identity of patient itself becomes professionalised and owned by a few well-organised people.

The first account coincides with my worry about being presumptuous. I need to be cautious about saying I am speaking as a patient, especially with any implication that it is on behalf of other patients, when I already have a hearing as an academic.

But I am equally ruled out on the second account. I have not taken any special steps to become an expert patient; nor do I have any particular credentials to claim a quasi-professional status in this regard. For me to act as if I had would be to cheat.

In short, I feel either disqualified or under qualified. But the issue of my patient identity will not go away completely. It seems unavoidable because even not mentioning it feels like a significant choice. In some contexts there are temptations to mention it – because for certain audiences it may add a sense of authenticity and credibility. In other contexts there are temptations not to mention it – because, for example, some clinicians or others may worry about what axe I have to grind and see it as a source of ‘bias’.

How far this issue is seen to be of importance, and in what respects, is arguably a function of the kind of research we are talking about and also of disciplinary assumptions and conventions. But for anyone who thinks ‘reflexivity’ matters it does seem to be a question worth asking.

If I am being reflexive as an academic then I can treat my identity as a source of problems or limitations that need to be acknowledged, or as a source of legitimacy or authority, or sometimes as a combination of both. This seems as relevant to patient identity as to other aspects of identity. On this account there seems to be something seriously lacking in my approach to date.

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Violence against women and children in diverse contexts: FRS special issue

FRS 2013 [FC]Nicky Stanley, Ingrid Palmary and Khatidja Chantler, editors of the special issue of Families, Relationships and Societies, detail the content of the issue and explain why examining both differing and shared experience of violence and abuse is essential.

“Violence against women and children is a global phenomenon but experiences of violence and abuse and their impact are shaped by local settings and factors specific to particular societies and communities.

This special issue of Families, Relationships and Societies explores varying forms of violence and abuse in different parts of the world, including the United Kingdom, South Africa, Iran and South East Asia. Bringing these papers together highlights differences but also reveals what is common in the experience of violence and abuse, in the ways we investigate and understand those experiences and in the service response. This recognition of both differing and shared experience of violence and abuse is increasingly important as communities everywhere become more diverse. Any campaign or service aimed at preventing violence for women and children needs to take account of specific and local factors as well as those aspects of violence that are widely shared.

This special issue comes out of a research workshop held at the University of the Witwatersrand, Johannesburg, in March 2015 that was funded by the British Council.

University-of-Witwatersrand-March-2015

Nicky Stanley, Ingrid Palmary and Khatidja Chantler with special issue contributors and workshop participants, March 2015, University of Witwatersrand, Johannesburg, South Africa

Thirty-five researchers from UK and South Africa came together over four days. Their interests covered gender and violence across diverse contexts and explored the connections between gender based violence, migration and political violence. Participants came from social work, public health, psychology, sociology, social policy, health studies and anthropology with both early career researchers and experienced academics contributing. The workshop included mentoring sessions and career development opportunities as well as the papers that formed the basis of this special issue.

Two research centres led the workshop and have edited this special issue: the African Centre for Migration & Society (ACMS), University of the Witwatersrand, South Africa, and the Connect Centre for International Research on Interpersonal Violence and Harm, School of Social Work, Care and Community, University of Central Lancashire, UK. AMCS is an Africa-based centre of excellence dedicated to shaping global discourse on human mobility and social transformation. The Connect Centre works with a wide range of international partners to make connections and to challenge fragmented thinking on violence and abuse and its impact in order to develop new research and services.

The wide variety of forms of sexual and interpersonal violence, and the way in which gender and other positions of marginality, including migration, interacts with these forms are explored in this special issue. Nadia Aghtaie’s paper provides new insights on rape in Iran. Aghtaie’s study illustrates that, within an Iranian context, rape is often sanctioned implicitly and explicitly through culture, laws and policies that provide impunity for perpetrators and normalise violence against women. Similarly, Ingrid Sinclair’s paper explores the ways in which notions of women’s morality, derived from marital status, shape the responses of the South African Police Service to women who experience abuse from their partners.

Rebecca Walker’s paper in this special issue describes how structural violence is experienced by migrant mothers who sell sex in Johannesburg. Walker’s paper reveals the intersection of gender and class as predominantly shaped by the women’s marginal migration status: basic survival for themselves and their children is dependent on mothers selling sex. Women’s status as sex workers shapes public sector workers responses to them. Their often oppressive responses are legitimised by populist notions of who is and is not entitled to services. The paper by Rebecca Dudley’s also draws attention to the intersections of domestic abuse and state structures, specifically the immigration rule of No Recourse to Public Funds (NRPF) in the UK. Her UK study explores the impact of this rule and the State’s complicity in trapping women in abusive relationships. In common with other contributors, she identifies the hostility that migrant women may experience from service providers as a key factor.

Patricia Hyne’s paper explores processes of trust and mistrust in accounts of displacement and asylum drawing on analysis from different research projects over a 25 year period. She reports practitioners’ experiences working in Thai refugee transit and processing camps and Burmese refugees as well as drawing on research conducted with in the UK refugees, asylum seekers and trafficked children. Hynes provides examples of when it is ‘safe’ to trust someone and where mistrust is essential for survival. Deborah Allnock’s UK based study on childhood disclosure of sexual abuse, examines the relationship between memorable life events (MLEs) and disclosure of sexual abuse in childhood. She provides a framework that illuminates those contexts that can inhibit, alter or reverse decisions to disclose abuse.

In relation to researching ‘hard to reach’ groups, the paper by Lorraine Radford, Nancy Lombard, Franziska Meinck, Emma Katz and Stanford Mahati includes a case-study from each author’s research on children and young people’s experiences of violence and adversity across the different contexts of the UK and South Africa. Each researcher used different methodologies and concepts but shared a common understanding of the social construction of childhood and the centrality of cultural and social contexts for understanding what constitutes violence. They report considerable ethical challenges and dilemmas were experienced in gaining ethical approval and in conducting the studies. This paper highlights the importance of researching with children rather on children. Similarly, the paper by Vearey, Barter, Hynes and McGinn provides rich illustrations of the ethical dilemmas of researching gender based violence. The article draws on diverse examples including: research on the Burmese-Thai border; research in Ireland on intimate partner violence and research with school children in a number of European countries. This paper provides detailed accounts of real life problems encountered during research and the complexity of establishing an ethical response in contexts where the outcome of actions can be difficult to anticipate.

Sharma and Marsh’s Open Space piece offers an analysis of group-work at Safety4Sisters, Manchester, UK, by workers who facilitate a group for women with experiences of abuse with NRPF and insecure immigration status. Their contribution brings to life the harshness of the immigration and asylum process and the fragility of the women’s existence. In their Open Space piece, Elsa Oliveira and Jo Vearey, researchers based at the African Centre for Migration & Society, University of the Witwatersrand, discuss creative research approaches with migrant sex workers in South Africa. They are founders of the MoVE:method:visual:explore project, and their paper highlights the importance of doing research differently with marginalised groups. The emphasis is very much on working with marginalised groups through media that allow marginalised voices to be articulated. In achieving this, the boundaries between research and activism are blurred and overlap.

 

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Co-creating impact: why universities and communities should work together

Kate Pahl and Keri Facer, authors of Valuing interdisciplinary collaborative research, discuss the value of co-production and collaboration between academic researchers and community projects. 

Valuing Interdisciplinary Collaborative Research will be launched at the Co-Creating Cities & Communities Summer Event today in Bristol #ahrcconnect #citiesandcoms2017 @ahrcconnect

Kate Pahl

Keri Facer

“Increasingly, universities are being asked to work with communities in more inclusive, collaborative and ethical ways, but their processes and practices are often overlooked, particularly within the arts and humanities.

University ways of knowing and doing are only one part of research and new conceptual tools are needed to make sense of this. This makes for a new and exciting research landscape.

“Impact isn’t just about academics doing brilliant, original research… impact is co-created.”

The ‘impact’ agenda needs to shift to recognise the nature of ‘co-produced impact’. That is, impact isn’t just about academics doing brilliant, original research which is written up in articles and then re-produced in different forms to a grateful community which draws on this research.

Instead, impact is co-created. People have ideas, in communities and in universities and they work on these together, bringing different knowledges and practices to those questions and ideas. This then produces a different kind of knowledge – richer, more diverse, more carefully located in real and everyday contexts and more relevant.

Connected Communities

The Connected Communities (CC) programme, headed by the AHRC cross-research council, has funded over 300 projects, worked with over 500 collaborating organisations and over 700 academics from universities across the UK, on topics ranging from festivals to community food, from everyday creativity to care homes, from hyper-local journalism to community energy.

‘Valuing Collaborative Interdisciplinary Research’ (Policy Press 2017), the latest volume in the Connected Communities book series, brings together a number of diverse and rich research projects that range from community evaluation, to how community values play out in collaborative research, how decisions on heritage should be made, and on what artists do when they work with academics and communities together with the role of performance in highlighting community concerns.

Many different people contributed to the projects ranging from people from the Heritage Lottery Fund and The Science Museum, to people working within communities as well as within universities.

facer-blog-pic

Some themes which emerge in the book include translation, co-production, dialogic modes of research and tacit and embodied knowledge. A key theme is the nature of knowledge and its production practices . Ways of capturing everyday knowledge, through stories, maps, material objects, conversations and performances, are discussed and considered.

In the book we attempt to map this new world out. We offer a set of helpful ideas and ways forward to articulate what is needed to do this sort of work. We argue that projects like this need to include an element of productive divergence.

“Perhaps if this kind of research was funded more often, surprises like the recent election result wouldn’t have come as so much of a shock.”

The projects are often grounded in the world materially and objects play a strong part. They often involve mess, uncertainty, complexity and a focus on practice and involve translating across different fields, as well as stories as a mode of exchange. Many of the projects draw on tacit and embodied learning that were informed by arts methodologies as well as ideas from sensory and phenomenological perspectives.

Perhaps if this kind of research was funded more often, surprises like the recent election result wouldn’t have come as so much of a shock. Universities need to become more attuned to the voices of communities, to their accounts of what is important and necessary to research. The Connected Communities programme and this book make a start in redressing the balance.

 

Valuing interdisciplinary collaborative research edited by Keri Facer and Kate Pahl is available with 20% discount on the Policy Press website. Order here for £19.99.

Find out more about impact, influence and engagement at Policy Press here.

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The views and opinions expressed on this blog site are solely those of the original blog post authors and other contributors. These views and opinions do not necessarily represent those of the Policy Press and/or any/all contributors to this site.

Academic Work, Fast and Slow

Should academics strive to be ‘fast’ or ‘slow’? Helen Kara, author of Research and evaluation for busy students and practitioners, argues that there is not one, clear answer. 

Helen Kara

In recent years there has been an increasingly heated debate, in the blogosphere and elsewhere, about whether academia is – or should be – ‘fast’ or ‘slow’.

This is linked to other discourses about speed such as Slow Food and Slow Cities.

Some commentators aver that the pace of life in academia is speeding up because of managerialism, the REF and its equivalents in other countries, and the ensuing pressure to conduct and publish interesting research with significant results. All of this, in addition to the increasing casualisation of employment in academia, and the increasing speed of digital communication, has led to toxic working conditions that cause academics to have breakdowns and burn out.

This doesn’t only affect academics, but also non-academics doing academic work such as undergraduate and postgraduate degrees. Also, to some academics’ surprise, this doesn’t only apply in academia, but also in the public sector more widely, and parts of the private sector too. Perhaps this is because, as the saying goes, the speed of change is faster than it’s ever been before, yet it will never be this slow again.

Continue reading ‘Academic Work, Fast and Slow’

Why we need morality included in our public policy

In today’s guest post author of Morality and public policy, which publishes this month, Clem Henricson demands we put the discussion and inclusion of moral issues back into government decision making and law formation…

ClemWith an increasingly bitter secular religious divide we need a radical shift in our take on morality – not a breast beating on the state of morals, but an enhanced understanding of the nature of morality and a way forward to remedy what is a seriously defective relationship with public policy.

Have you ever questioned why the moral sphere is segregated from core public policy? Why in the gestation of policy is morality hived off as the provenance of private conscience and the clerisy?

We have separate development with the relegation of moral issues to some zone outside the mainstream of governmental concerns. Are governments too cowardly or ill equipped to address these matters?

Legislation and change

It emphatically should not take so long for legislation to keep up with changes in social mores – changes in attitudes to matters such as abortion, homosexuality, cohabitation and that issue that has exercised us so much recently- assisted dying – with its haunting images of campaigners such as Tony Nicklinson and Terry Pratchett.

Why does government hide behind the private member’s bill, judicial rulings, loud protracted campaigns and flouting of the law that are so often the necessary prelude to change? Why is government dilatory and evasive, instead of embracing the essence of human relations – handling fluctuations and tensions head on?

“..an illusory dividing line drawn between […] public policy and conventional ‘morality’”

Continue reading ‘Why we need morality included in our public policy’

The Illusion of China’s Economic Liberalization

China has become an economic superpower by  Author and academic Andrzej Bolesta, author of China and Post-Socialist Development 

Dr Andrzej Bolesta

Dr Andrzej Bolesta

The leading theme of the proceedings of the Chinese rubberstamp legislature – the National People’s Congress – is always reforms.

Recently, hopes have been high. The administration of president Xi Jinping and premier Li Keqiang has been promising more market forces in China’s economy. Despite this, in recent times, China’s economic liberalization has been an illusion rather than a fact and this will not change any time soon.

The assumption has been that the interventionist model, characterized by the state’s heavy involvement in the economy, which dominated the first 30 years of reforms and opening up has come to exhaustion.

Why? The implementation of the state interventionist model has led to a growth in social inequalities, significant damage to the natural environment and, perhaps most recently, an almost three percent drop in economic growth – the lowest in 24 years.

Market forces

The logic has been that if a lack of market forces has brought upon China these, to put it mildly, worrying trends, then we need to introduce more market forces to amend the situation. “We need more market forces” – has been the message of the current state administration. And what has happened since the calls for more market reforms began? In terms of economic liberalization, not much.

Since the commencement of economic transformation by Deng Xiaoping in 1978 China has undergone an extensive process of liberalization. A somewhat market-based economy was constructed. But with the administration of president Hu Jintao and premier Wen Jiabao from 2003 the liberalization process essentially halted and China has since only reluctantly been fulfilling its obligations related to its WTO membership.

“The authorities have little intention of continuing economic liberalization”

The current drive towards economic liberalization is also an illusion. Some reforms will continue but the progress towards a greater role of the market in economic affairs will be slow, painful and perhaps full of retrenchments. The authorities have little intention of continuing economic liberalization. There is an important reason for this.

Shanghai - economic capital of China Photo credit - wikipedia

Shanghai – economic capital of China Photo credit – wikipedia

The higher echelons of the Chinese communist party long ago chose the model of China’s development and since the beginning of transformation the general idea has hardly been altered, despite the plethora of analyses that claim to the contrary.

This model can essentially be summarized as an attempt to employ the systemic, institutional and policy solutions used by Japan and Korea during their high growth periods.

East Asian development model

It is true that China is very different from both countries. It is much larger and more decentralized; it has a different historical institutional background as it was a socialist country; and finally, it attempts to imitate Japan and Korea at a time when the advancements of globalization in a way impose a great deal of openness on national economies, thus making some of the Japanese and Korean historical policies incompatible with the arrangements of the contemporary world.

Nevertheless, with all its indecisiveness and reform retrenchments, China’s leadership has vigorously implemented the East Asian development model as extensively as the internal and external conditions have allowed – a model responsible for the most spectacular developmental advancements of mankind in the second half of the twentieth century.

“In this model, however, there is hardly any space left for further economic liberalization”

This implementation is clearly visible when we examine China’s trade policies to support export and to discriminate import, when we observe the deliberate policy of development of certain sectors of export-orientated production; when we see economic nationalism becoming, next to political nationalism, the leading state ideology; and when we see how the leadership wants to keep the society subordinate and obedient and at the same time supportive of the national development trajectory, and does so by keeping the social sphere weak and unorganized and by, nevertheless, creating conditions for gradual improvements in the welfare.

This model has largely been a success. China has become an economic superpower. In this model, however, there is hardly any space left for further economic liberalization. Further liberalization will only be possible once domestic companies reach the level of sophistication that enables them to control the domestic market in the free market environment, and to effectively compete on the global arena, as was the case of Japanese keiretsu and Korean chaebols.

This moment has yet to arrive. Chinese authorities continue to believe that more competition from foreign actors will negatively affect the domestic business sector. Chines authorities also believe that the social and environmental problems their country is currently facing cannot be solved by market forces. And this is the perfect excuse to continue following its long-term model of development with an intrusive and interventionist state. Chinese leadership will talk about economic liberalization as it plays the global game, for China is a part of the global economy. And the global game is to praise more market, more free trade, more economic liberalization. But it will not liberalize.

Dr. Andrzej Bolesta
@a_bolesta

China and post socialist development [FC]China and Post-Socialist Development is available for purchase from our website here (RRP £70.00). Don’t forget Policy Press newsletter subscribers get a 35% discount when ordering through our website. If you’re not a subscriber yet why not sign up here today and join our Policy Press community?

The views and opinions expressed on this blog site are solely those of the original blogpost authors and other contributors. These views and opinions do not necessarily represent those of the Policy Press and/or any/all contributors to this site.

Are you skilled in the dark art of Social Media?

In this blog post, Kim Eggleton, our Journals Executive, explains why she believes social media is the researcher’s new best friend

Kim Eggleton, Journals Executive

Kim Eggleton, Journals Executive

Whenever I talk to researchers about using social media, the most common “objection” I hear is that it’s self-promotion, and nothing more than vanity.

The second most common protest is that good research should stand on its own merits, and if it’s good enough, people will find it. I can understand where both these opinions come from, but I think the world has moved on considerably and neither of these concerns are valid any longer.

SocMediaCartoon

What’s Social Media all about

…in 2012, over 1.8 million articles were published in 28,000 journals.

With the inevitable overload of information that came with Internet for the masses, it has become harder and harder to make good work stand out. It is estimated that in 2012, over 1.8 million articles were published in 28,000 journals. In 2010 in the US alone, it is estimated that over 320,000 books were published. Continue reading ‘Are you skilled in the dark art of Social Media?’


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