What now for the contact hypothesis? Towards a new research agenda

This article begins with a review of recent research on the Contact Hypothesis. It will be shown that the literature in this area has become essentially closed and self-referential where the core political and theoretical premises that underpin the Hypothesis have been taken for granted and the debates have therefore become restricted simply to how best to measure the influence of inter-group contact. One of the key reasons for this is the lack of critical engagement with the Contact Hypothesis from those of a more structuralist and/or ‘radical’ perspective. This may be because the individualistic focus of the Hypothesis is seen from such a perspective as largely irrelevant to addressing racial and ethnic divisions and/or because it may be felt that to engage with the concept is to give it undue legitimacy. It will be argued in this article, however, that the wholesale dismissal of the Contact Hypothesis is a little premature. Just as recent research on racial and ethnic divisions has drawn attention to the way in which such divisions exist at a number of layers within the social formation – from the structural, political and ideological through to the sub-cultural, interactional and biographical – so must any initiatives aimed at addressing these divisions be similarly ‘multi-layered’ in their approach. However, it will be argued that for research to help inform specific strategies at the interactional level, there needs to be a significant change in the way that inter-group contact, and the Contact Hypothesis more generally, is studied. The article will ‘model out’ one potentially fruitful way in which such research can develop through the use of an ethnographic case study involving a cross-community scheme arranged for Protestant and Catholic children in Northern Ireland.

Seen but never heard: rethinking approaches to researching racism and young children

This paper is concerned with the methodology underlying attempts to understand the nature and impact of racism among young children. In drawing upon data gathered from a year-long ethnographic study of five- and six-year-old children in an English multi-ethnic, inner-city primary school, the paper provides a critique of traditional approaches to the study of racial attitudes among young children. It is argued that such research has been conceived through the articulation of two, inter-related discourses on children and on 'race'; the former couched in traditional socialisation and developmental models of childhood with their tendency to neglect the agency and social competency of young children and the latter being embedded within essentialist notions of 'race' and ethnicity that tend to deny the contingent and context-specific nature of racialised identities. The paper argues that the result of this has been that while children have often been the objects of research they have rarely been the subjects; in other words they are often seen but never heard. The paper argues for the need to move beyond the methodological confines set by these discourses and rethink alternative approaches that begin with the assumption that young children are socially competent. One such approach, drawing upon ethnographic methods and fore-grounding the importance of largely unstructured small group interviews with young children, is illustrated. Through the use of a number of examples, it is shown how this approach can help to emphasise the ability of children as young as five and six to respond to and negotiate their social worlds and more specifically within this the competency with which they are able to appropriate, rework and reproduce a number of discourses on 'race' to make sense of their own social experiences. In doing this the paper also illustrates the way in which it provides a methodology able to draw out and highlight the contradictions, contingency and complexity of racialised identities among young children. Ultimately, it is an approach concerned with placing the children themselves central within the research processes and foregrounding their voices and experiences.

A need to belong?: The prevalence of experiences of belonging and exclusion in school among minority ethnic children living in the 'White hinterlands'

Based on a survey of 711 children in Northern Ireland, this paper explores a range of aspects of experiences of belonging and exclusion in relation to school among three main minority ethnic groups: Irish Traveller, Chinese/Asian and European Migrant children. The study examines variations between each group and how they compare to the White settled population. The findings indicate that all three groups experience lower levels of belonging and higher levels of exclusion compared to their White, settled Northern Irish peers. The experiences of Irish Traveller children were the most negative. The article adds to the dearth of data on minority ethnic children living in mainly white regions in the UK and Ireland. It argues for the need to move beyond achievement gaps in assessing minority ethnic children’s differential experiences in education and highlights the potential of belongingness as a concept for the further study of differential patterns of need and processes of inclusion.

Hypermobility and musculoskeletal pain in children:a systematic review

Objective: To examine the evidence of an association between hypermobility and musculoskeletal pain in children. Methods: A systematic review of the literature was performed using the databases PubMed, EMBASE, NHS Evidence, and Medline. Inclusion criteria were observational studies investigating hypermobility and musculoskeletal pain in children. Exclusion criteria were studies conducted on specialist groups (i.e. dancers) or hospital referrals. Pooled odds ratios (ORs) were calculated using random effects models and heterogeneity was tested using ?(2)-tests. Study quality was assessed using the Newcastle-Ottawa Scale for case-control studies. Results: Of the 80 studies identified, 15 met the inclusion criteria and were included in the review. Of these, 13 were included in the statistical analyses. Analysing the data showed that the heterogeneity was too high to allow for interpretation of the meta-analysis (I(2) = 72%). Heterogeneity was much lower when the studies were divided into European (I(2) = 8%) and Afro-Asian subgroups (I(2) = 65%). Sensitivity analysis based on data from studies reporting from European and Afro-Asian regions showed no association in the European studies [OR 1.00, 95% confidence interval (CI) 0.79-1.26] but a marked relationship between hypermobility and joint pain in the Afro-Asian group (OR 2.01, 95% CI 1.45-2.77). Meta-regression showed a highly significant difference between subgroups in both meta-analyses (p <0.001). Conclusion: There seems to be no association between hypermobility and joint pain in Europeans. There does seem to be an association in Afro-Asians; however, there was a high heterogeneity. It is unclear whether this is due to differences in ethnicity, nourishment, climate or study design.

Premorbid IQ in patients with functional psychosis and their first-degree relatives

Numerous studies have found deficits in premorbid IQ in schizophrenic patients, but it is not clear whether this deficit is shared by (a) patients with other functional psychoses, and (b) relatives of these patients. Ninety-one schizophrenic patients, 66 affective psychotic patients (29 schizoaffective and 37 manic or depressed), and 50 normal control subjects were administered the National Adult Reading Test (NART) which provides an estimate of premorbid IQ. The NART was also completed by 85 first-degree relatives of schizophrenic patients and by 65 first-degree relatives of affective psychotic patients. After adjustments were made for sex, social class, ethnicity and years of education, schizophrenic patients had significantly lower premorbid IQ than their relatives, the affective psychotic patients and controls. Manic and depressed patients had significantly lower NART scores than their first-degree relatives, but schizoaffective patients did not, and neither group differed significantly from controls. There was no significant difference in premorbid IQ between patients who had experienced obstetric complications (OC +) and those who had not (OC -). Both OC + and OC - schizophrenic patients differed significantly from their relatives, but the disparity was greatest between OC + patients and their relatives. Relatives of OC + schizophrenic patients had significantly higher IQ than relatives of OC - schizophrenic patients. (C) 2000 Elsevier Science B.V. All rights reserved.

The clinical effectiveness and cost-effectiveness of screening for open angle glaucoma:A systematic review and economic evaluation

Objectives: To assess whether open angle glaucoma (OAG) screening meets the UK National Screening Committee criteria, to compare screening strategies with case finding, to estimate test parameters, to model estimates of cost and cost-effectiveness, and to identify areas for future research. Data sources: Major electronic databases were searched up to December 2005. Review methods: Screening strategies were developed by wide consultation. Markov submodels were developed to represent screening strategies. Parameter estimates were determined by systematic reviews of epidemiology, economic evaluations of screening, and effectiveness (test accuracy, screening and treatment). Tailored highly sensitive electronic searches were undertaken. Results: Most potential screening tests reviewed had an estimated specificity of 85% or higher. No test was clearly most accurate, with only a few, heterogeneous studies for each test. No randomised controlled trials (RCTs) of screening were identified. Based on two treatment RCTs, early treatment reduces the risk of progression. Extrapolating from this, and assuming accelerated progression with advancing disease severity, without treatment the mean time to blindness in at least one eye was approximately 23 years, compared to 35 years with treatment. Prevalence would have to be about 3-4% in 40 year olds with a screening interval of 10 years to approach cost-effectiveness. It is predicted that screening might be cost-effective in a 50-year-old cohort at a prevalence of 4% with a 10-year screening interval. General population screening at any age, thus, appears not to be cost-effective. Selective screening of groups with higher prevalence (family history, black ethnicity) might be worthwhile, although this would only cover 6% of the population. Extension to include other at-risk cohorts (e.g. myopia and diabetes) would include 37% of the general population, but the prevalence is then too low for screening to be considered cost-effective. Screening using a test with initial automated classification followed by assessment by a specialised optometrist, for test positives, was more cost-effective than initial specialised optometric assessment. The cost-effectiveness of the screening programme was highly sensitive to the perspective on costs (NHS or societal). In the base-case model, the NHS costs of visual impairment were estimated as £669. If annual societal costs were £8800, then screening might be considered cost-effective for a 40-year-old cohort with 1% OAG prevalence assuming a willingness to pay of £30,000 per quality-adjusted life-year. Of lesser importance were changes to estimates of attendance for sight tests, incidence of OAG, rate of progression and utility values for each stage of OAG severity. Cost-effectiveness was not particularly sensitive to the accuracy of screening tests within the ranges observed. However, a highly specific test is required to reduce large numbers of false-positive referrals. The findings that population screening is unlikely to be cost-effective are based on an economic model whose parameter estimates have considerable uncertainty, in particular, if rate of progression and/or costs of visual impairment are higher than estimated then screening could be cost-effective. Conclusions: While population screening is not cost-effective, the targeted screening of high-risk groups may be. Procedures for identifying those at risk, for quality assuring the programme, as well as adequate service provision for those screened positive would all be needed. Glaucoma detection can be improved by increasing attendance for eye examination, and improving the performance of current testing by either refining practice or adding in a technology-based first assessment, the latter being the more cost-effective option. This has implications for any future organisational changes in community eye-care services. Further research should aim to develop and provide quality data to populate the economic model, by conducting a feasibility study of interventions to improve detection, by obtaining further data on costs of blindness, risk of progression and health outcomes, and by conducting an RCT of interventions to improve the uptake of glaucoma testing. © Queen's Printer and Controller of HMSO 2007. All rights reserved.

Attitudes towards ideal family size of different ethnic/nationality groups in Great Britain, France and Germany.

This article reports upon results from a European Union funded project on the integration of children of international migrants in Britain, France and Germany. It provides both a descriptive and a multivariate analysis of the factors that determine attitudes towards ideal family size. The results reveal that there are large differences between ethnic groups in Britain: Indian and Pakistani respondents in Britain expressed a preference for significantly larger families. However, many children of international migrants expressed a desire for smaller families than the autochthonous population in both countries. This was particularly the case for Portuguese respondents in France and Turks in Germany. Religious affiliation also had a significant effect, above and beyond ethnicity per se. Both Moslems and Christians preferred larger families than those with no religious affiliation. The article concludes that ethnic differences in attitudes towards fertility behaviour will remain important in the foreseeable future in western Europe, particularly in Britain.

Interventions to reduce prejudice and enhance inclusion and respect for ethnic differences in early childhood: A systematic review

A systematic review was conducted of studies evaluating the effects of interventions aimed at reducing ethnic prejudice and discrimination in young children. Articles published between 1980 and 2010 and including children of 8 years and under were identified, harvested, and assessed for quality, both for the exposure/program as well as for the evaluation. In total, 32 studies (14 contact and 18 media or instruction) yielded 62 effects on attitudes and 59 effects on peer relations. An overall count of the positive (40%), non-significant (50%), and negative effects (10%) indicate a mixed picture. Overall, more attitude effects (55%) than peer relations effects (25%) were positive, and media/instruction (47%) was more successful than contact (36%). Most of the effects were observed with children from a majority ethnicity: 67% of the attitude effects were positive, and media/instruction and contact were equally effective at delivering these. Few differences were found as a function of the quality of the exposure and evaluation, but differences were found depending on the context of exposure (naturally occurring or experimental manipulation) and research design (random assignment or self-selection). In conclusion, the findings were more mixed than expected, though sufficiently strong studies exist to provide lessons for future research.


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"From Indomania to Indophobia":Thomas De Quincey's Providential Orientalism

Thomas De Quincey’s terrifying oriental nightmares, reported to sensational acclaim in his Confessions of an English Opium-Eater (1821), have become a touchstone of romantic imperialism in recent studies of the literature of the period (Leask 1991; Barrell 1992 et al). De Quincey’s collocation of “all creatures, birds, beasts, reptiles, all trees and plants, usages and appearances, that are found in all tropical regions” in the hypnagogic hallucinations that characterized what he called “the pains of opium” seems to anticipate neatly Said’s theory of orientalism, whereby the orient was supplied by the west with “a mentality, a genealogy, an atmosphere,” the attitudinal basis as he argues for the continuing march of imperialism from the late eighteenth century. Yet, as Thomas Trautmann (1997) has pointed out, orientalist scholarship based in India and led by the influential Asiatic Society of Bengal in the late eighteenth century was extremely enthusiastic about Indian classical antiquity. The early orientalist scholarship posited ethnic, linguistic, cultural and religious links between Europe and India, while recognizing the greater antiquity of Indian civilization. This favourable attitude (which Trautmann calls “Indomania”) was overtaken in the nineteenth century by disavowal of that scholarship and repugnance (which he calls “Indophobia”), influenced by utilitarian and evangelical attitudes to colonialism. De Quincey’s lifespan covers this crucial period of change. My paper examines his evangelical upbringing and interest in biblical and orientalist scholarship to suggest his anxious investment in these modes of thinking. I will suggest that the bizarre orientalist fusions of his dreams can be better understood in the context of changing attitudes to the imperialism during the period. An examination of his work provides a far more dynamic understanding of the processes of orientalism than the binary model suggested by Said. The transformation implied from imperial scholarship to governance, I will suggest, is not irrelevant to a world which continues to pull apart on various grounds of race and ethnicity, and reflects on our own role in the academy today.

An international review of the patterns and determinants of health service utilisation by adult cancer survivors

Background: There is a need to review factors related to health service utilisation by the increasing number of cancer survivors in order to inform care planning and the organisation and delivery of services.

Methods: Studies were identified via systematic searches of Medline, PsycINFO, CINAHL, Social Science Citation Index and the SEER-MEDICARE library. Methodological quality was assessed using STROBE; and the Andersen Behavioural Model was used as a framework to structure, organise and analyse the results of the review.

Results: Younger, white cancer survivors were most likely to receive follow-up screening, preventive care, visit their physician, utilise professional mental health services and least likely to be hospitalised. Utilisation rates of other health professionals such as physiotherapists were low. Only studies of health service use conducted in the USA investigated the role of type of health insurance and ethnicity. There appeared to be disparate service use among US samples in terms of ethnicity and socio-demographic status, regardless of type of health insurance provisions- this may be explained by underlying differences in health-seeking behaviours. Overall, use of follow-up care appeared to be lower than expected and barriers existed for particular groups of cancer survivors.

Conclusions: Studies focussed on the use of a specific type of service rather than adopting a whole-system approach and future health services research should address this shortcoming. Overall, there is a need to improve access to care for all cancer survivors. Studies were predominantly US-based focussing mainly on breast or colorectal cancer. Thus, the generalisability of findings to other health-care systems and cancer sites is unclear. The Andersen Behavioural Model provided an appropriate framework for studying and understanding health service use among cancer survivors. The active involvement of physicians and use of personalised care plans are required in order to ensure that post-treatment needs and recommendations for care are met.

Migration to Northern Ireland

For a long time the society in Northern Ireland has been considered in binary terms of Protestantism or Catholicism, reflecting the two majority communities. Tradition and culture have long played an important role for these communities and the latest arrival of migrants has complicated this already complex picture. Problems have arisen with respect to social attitudes with incidences of discrimination being experienced by particular groups. Clearly cohesion and positive integration is not necessarily something that flows from an appropriate legislative framework. But equally, and perhaps more optimistically, early indications are that civil society and locality are important for building positive inter-group relations. This article presents a brief overview of recent patterns and processes of migration to Northern Ireland. It is based on ongoing research into this subject that has been conducted by the author since 2005. It presents the key features of recent migration before identifying some challenges arising for our society.

“Do You Want to See My Hornpipe?”: The Traditional Irish Dancing Body at Play in the Work of Jean Butler and Colin Dunne.

This chapter considers the radical re-imaginings of traditional Irish step dance in the recent works of Jean Butler and Colin Dunne. In Butler's Does She Take Sugar (2007) and Dunne's Out of Time (2008), the Irish step dancing body is separated from its historical roots in nationalism, from the exhibitionism required by the competitive form, and from the spectacularization of the commercialized theatrical format. In these works, which are both solo pieces performed by the choreographers themselves, the traditional form undergoes a critical interrogation in which the dancers attempt to depart from the determinacy of the traditional technique, while acknowledging its formation of their corporealities; the Irish step dance technique becomes a springboard for creative experimentation. In order to consider the importance of the creative potential revealed by these works, this chapter will contextualize them within the dance background from which they emerged, outlining the history of competitive step dancing in Ireland, the "modernization" of traditional Irish dance with the emergence of Riverdance (1994), and the experiments of Ireland's national folk theatre, Siamsa Tíre.

Obesity and kidney disease in type 1 and 2 diabetes: an analysis of the National Diabetes Audit

Background: Obesity is increasingly prevalent in many countries. Obesity is a major risk factor for the development of type 2 diabetes but its relationship with diabetic kidney disease (DKD) remains unclear. Some studies have suggested that the metabolic syndrome (including obesity) may be associated with DKD in type 1 diabetes. Aim: To investigate the association between obesity and DKD. Design: Retrospective cross-sectional study. Methods: National Diabetes Audit data were available for the 2007–08 cycle. Type 1 and 2 diabetes patients with both a valid serum creatinine and urinary albumin:creatinine ratio were included. DKD was defined as an estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m2, albuminuria or both. Logistic regression was used to analyse associations of obesity (body mass index ≥30 kg/m2) and other variables including year of birth, year of diagnosis, ethnicity and stage of kidney disease. Results: A total of 58 791 type 1 and 733 769 type 2 diabetes patients were included in the analysis. After adjustment, when compared with type 1 diabetes patients with normal renal function those with DKD were up to twice as likely to be obese. Type 2 DKD patients were also more likely to be obese. For example, type 2 diabetes patients with an eGFR <15 ml/min/1.73 m2 and normoalbuminuria, microalbuminuria or macroalbuminuria were all more likely to be obese; odds ratios (95% CI) 1.65 (1.3–2.1), 1.56 (1.28–1.92) and 1.27 (1.05–1.54), respectively. Conclusions: This study has highlighted a strong association between obesity and kidney disease in type 1 diabetes and confirmed their association in type 2 diabetes.

Promoting multicultural education in the primary classroom:Broadband videoconferencing facilities and digital video

The aim of this study was to explore the impact of interaction (through gathering local field data and engaging in remote reciprocal presentations) on aspects of multicultural awareness. Sixty-six 11-12-year-old Scottish primary school pupils collected data in the field from their local community through questionnaires, interviews, direct observation, digital images and video. From this they distilled a multimedia presentation, delivered by videoconference to a partner school in the USA, who reciprocated. There was some evidence of pre-post project gains in the complexity of the children's perceptions of their community environment, the ethnicity of their community, their own ethnicity, and news images. The children's use of language to define ethnicity also became more complex and their attitudes toward ethnic minorities became more inclusive. The implications for practice, policy and future research were explored. © 2004 Elsevier Ltd. All rights reserved.

Drivers of inequality in disability-free expectancy at birth and age 85 across space and time in Great Britain

Background: Although mortality and health inequalities at birth have increased both geographically and in socioeconomic terms, little is known about inequalities at age 85, the fastest growing sector of the population in Great Britain (GB).

Aim: To determine whether trends and drivers of inequalities in life expectancy (LE) and disability-free life expectancy (DFLE) at age 85 between 1991 and 2001 are the same as those at birth.

Methods: DFLE at birth and age 85 for 1991 and 2001 by gender were calculated for each local authority in GB using the Sullivan method. Regression modelling was used to identify area characteristics (rurality, deprivation, social class composition, ethnicity, unemployment, retirement migration) that could explain inequalities in LE and DFLE.

Results: Similar to values at birth, LE and DFLE at age 85 both increased between 1991 and 2001 (though DFLE increased less than LE) and gaps across local areas widened (and more for DFLE than LE). The significantly greater increases in LE and DFLE at birth for less-deprived compared with more-deprived areas were still partly present at age 85. Considering all factors, inequalities in DFLE at birth were largely driven by social class composition and unemployment rate, but these associations appear to be less influential at age 85.

Conclusions: Inequalities between areas in LE and DFLE at birth and age 85 have increased over time though factors explaining inequalities at birth (mainly social class and unemployment rates) appear less important for inequalities at age 85.