Problematisations of Complexity: On the Notion and Production of Diverse Complexities in Healthcare Interventions and Evaluations

Within the literature on the evaluation of health (policy) interventions, complexity is a much-debated issue. In particular, many claim that so-called ‘complex interventions’ pose different challenges to evaluation studies than apparently ‘simple interventions’ do. Distinct ways of doing evaluation entail particular ontologies and epistemologies of complexity. They differ in terms of whether they define complexity as a quantitative trait of interventions, whether they see evaluation as part of or outside the intervention, and whether complexity can be regarded as an emergent property of the intervention and its evaluation. In practice, evaluators and commissioners of large health care improvement programmes rely on different, sometimes contradictory, repertoires about what it means to conduct a ‘good’ evaluation. This is an ongoing matter negotiated between and among commissioners, researchers, and—sometimes—programme managers. In particular, notions of evaluability, usefulness and distance/independence are problematised in different ways and with diverse consequences, which, in turn, produce other notions and layers of complexity such as temporal, institutional and affective complexities. When (social science) researchers claim that one method or another is better able to grasp complexity, they elide the issue that any methodological choice emphasises some complexities and lets others fade into the background. Analysing the practicalities and emotions involved in evaluation studies opens up the notion of complexity to analytical scrutiny, and suggests a basis for co-theorising between biomedical, public health and social scientists (including Science and Technology Studies scholars).     

Uncovering personality structure with the Inventory of Personality Organization: An exploration of factor structure with a Portuguese sample

IntroductionThe Inventory of Personality Organization (IPO) is a self-report measure intended to assess the severity of personality disturbance according to Otto F. Kernberg's model.ObjectiveTo study factor structure and psychometric properties of the Portuguese version of IPO (IPO-Pt).MethodTwo independent samples of 586 individuals each were used for exploratory and confirmatory factor analyses. Different models were compared in terms of reliability and validity.ResultsA three-factor solution resulted, comprising dimensions labeled as Instability of Self, Instability of Others, and Psychosis. Internal consistency and temporal stability yielded acceptable to excellent results. Correlations with measures of self-concept coherence, emotion dysregulation, psychoticism, symptom severity, and personality disturbance were as expected, and sensitivity to clinical status was confirmed.ConclusionIPO-Pt shows encouraging psychometric qualities and its latent structure resonates with important aspects of Kernberg's model, previous findings, and the DSM-5 level of personality functioning scale.     

Association between obesity and suicide in woman,but not in man: a population-based study of young adults

The relationship between obesity and suicide risk is still unclear with controversial research results. The aim of this study is to investigate the relationship between obesity and suicide risk for men and women in a population-based study of young adults. This is a cross-sectional population-based study that identified young adults between 18 and 35 years of age. Suicide risk was investigated through the structured clinical interview Mini. Weight and height were assessed, and participants were classified as normal-weight body mass index (BMI < 30) or obese (BMI > 30). The prevalence of obesity was of 19.9% of the total sample (n = 1953). Obesity was more prevalent among women and participants between 27 and 35 years of age. Suicide risk was present in 13.0% of the sample and more prevalent among women. In our study we found an association between obesity and suicide risk for women, but not for men. Obesity was associated with a higher prevalence of suicide risk in women. Given the strength of the relationship between BMI and suicide, identifying the mechanisms associated with obesity, especially for women, can lead to new insights into the prevention of suicide risk     

离退休与在职人员生命质量的比较研究

为了寻找离退休人员生命质量 (QOL)影响因素 ,指导有限资源投入 ,本研究以问卷形式对该单位 1 4 2名离退休人员、66名在职人员随遇抽样调查。从物质生活状态、躯体功能、心理功能和社会功能四个方面对其QOL进行了多维评估研究。结果显示 :①该单位离退休人员QOL与在职人员有明显差异 ,其中离退休人员QOL总评、躯体、心理、社会功能评分等均低于在职人员 ;②躯体功能与离退休人员年龄呈负相关性趋势 ,其他维度与年龄相关性不显著。因此 ,离退休人员QOL总体上低于在职人员 ,因子、维度及QOL总评之间的相关性也有其特点 ,且年龄不是差异的决定因素 ,应通过改善主导需要的相关因子等手段提高离退休人员QOL ,为全社会的可持续发展服务。     

The Younger Generation of Culture Scholars and Culture-studies in Russia Today

I consider the main problem areas within theacademic project ``The 1990s: The Semantics ofRussian Culture,' undertaken by researchers,recent graduates, and the first post-graduatesof the Moscow Institute for European Cultures.The areas include new figures on the publicscene; new forms of communication; newinstitutions; current processes in culture andsociety. I examine the social and historicalframework of the formation of culture studiesas an academic discipline in contemporaryRussia, the alternative perspectives and tasksof the sociology of culture in Russian today.     

Midlife Educational,Career, and Family Outcomes of Women Educated at Two Single-Sex Colleges

We examined midlife educational, career, and family outcomes of women who attended prestigious women's colleges in the 1960s. One college had a coeducational learning environment (CLE), the other was a single-sex environment (SLE). We hypothesized that in CLEs, exposure to men's standards of achievement might have resulted in greater educational and career status outcomes but more discrimination; in SLEs, there might have been fewer opportunities to engage with men intellectually, which could lead to lesser educational and career status outcomes, but the environment might have felt more supportive. Graduates of both colleges were very accomplished 30 years after graduation; however, those who had experienced a CLE reported more sexism and more active involvement in the women's movement than SLE graduates.     

Educational Theory as a Writerly Practice

Educational theory does not oppose educational practice, as manyseem to think; instead it is a form of practice and the action oftheory exists at two levels. At a cultural level theory ischaracterized by linguistic forms of action and at a social level it is characterized by the day to day practices thatorganize and reward the work of producing educational philosophy.While the social practices that govern the production ofphilosophy certainly beg for ethnographic attention,any consideration anthropologists or philosophers giveit will eventually find its way to the page and hence tothe cultural forms of linguistic action that are thesubject of this paper. Focusing on how educationalphilosophers see the things that they do, as opposedto what they see, I will suggest that the wayeducational philosophy is fashioned is an importantpart of what is fashioned. Ironically, as I will show,the ``way' of educational philosophy can flow with oragainst the ``what' of it – an author, that is, can saythat they are for or against this or that, but their stylized way of saying it can contradict the literalmeaning of their words.     

Research in person‐centred,experiential and humanistic counselling and psychotherapy: Meeting new challenges

As a result of the programme of research into client‐centred therapy led by Carl Rogers, the humanistic therapies could claim, in the 1950s, to possess a comprehensive evidence base. Over the following decades, however, there was a marked decline in the productivity and influence of research into person‐centred and humanistic therapies. The present paper celebrates the publication of three books that mark a resurgence in research into these approaches, and comments on emerging themes and trends.     

The Role of Culture in the Relationship Between Religiosity and Psychological Well-being

Several measures of religious practice and religious orientation (intrinsic/extrinsic/quest) and two measures of psychological well-being (positive affect and negative affect) have been employed in a cross-cultural survey of undergraduate university students from five different cultural/religious environments: Slovenia, Bosnia and Herzegovina, Serbia, the United States of America, and Japan. Results suggest that measures of exstrinsic, intrinsic, and quest religiosity are not entirely applicable in most of the cultures observed. Nevertheless, it was possible to discern abbreviated cross-culturally valid scales for each dimension. The strength and direction of the correlation between psychological well-being and a particular type of religious orientation proved to depend substantially upon culture. More importantly, the cultural environment plays a crucial role in shaping the relationship between general measures of religiosity and psychological well-being. According to the data, higher general levels of religiosity at the societal level are linked to more positive correlations between religiosity and psychological well-being. The overall picture leads to the conclusion that there is no culturally universal pattern in the relationship between measures of religiosity and psychological well-being and that the particular cultural and religious context should always be considered in studies dealing with this issue.

The ‘Fractionable Autism Triad’: A Review of Evidence from Behavioural,Genetic, Cognitive and Neural Research

Autism is diagnosed on the basis of a triad of impairments in social interaction, communication, and flexible imaginative functions (with restricted and repetitive behaviors and interests; RRBIs). There has been a strong presumption that these different features of the syndrome are strongly intertwined and proceed from a common cause at the genetic, cognitive and neural levels. In this review we examine evidence for an alternative approach, considering the triad as largely ‘fractionable’. We present evidence from our own twin studies, and review relevant literature on autism and autistic-like traits in other groups. We suggest that largely independent genes may operate on social skills/impairments, communication abilities, and RRBIs, requiring a change in molecular-genetic research approaches. At the cognitive level, we suggest that satisfactory accounts exist for each of the triad domains, but no single unitary account can explain both social and nonsocial features of autism. We discuss the implications of the fractionable-triad approach for both diagnosis and future research directions.