Risk adjustment for hospital use using social security data: cross sectional small area analysis

Objectives: To identify demographic and socioeconomic determinants of need for acute hospital treatment at small area level. To establish whether there is a relation between poverty and use of inpatient services. To devise a risk adjustment formula for distributing public funds for hospital services using, as far as possible, variables that can be updated between censuses. Design: Cross sectional analysis. Spatial interactive modelling was used to quantify the proximity of the population to health service facilities. Two stage weighted least squares regression was used to model use against supply of hospital and community services and a wide range of potential needs drivers including health, socioeconomic census variables, uptake of income support and family credit, and religious denomination. Setting: Northern Ireland. Main outcome measure: Intensity of use of inpatient services. Results: After endogeneity of supply and use was taken into account, a statistical model was produced that predicted use based on five variables: income support, family credit, elderly people living alone, all ages standardised mortality ratio, and low birth weight. The main effect of the formula produced is to move resources from urban to rural areas. Conclusions: This work has produced a population risk adjustment formula for acute hospital treatment in which four of the five variables can be updated annually rather than relying on census derived data. Inclusion of the social security data makes a substantial difference to the model and to the results produced by the formula.

Instrumental and interpretive methods in evaluating urban programmes

The turn within urban policy to address increasingly complex social, economic and environmental problems has exposed some of the fragility of traditional measurement models and their reliance on the rational paradigm. This article looks at the experiences of the European Union (EU) Programme for Peace and Reconciliation in Northern Ireland and its particular attempt to construct new District Partnerships to deliver area-based regeneration programmes. It highlights the need to combine instrumental and interpretative evaluation methods in an attempt to explain the wider contribution of governance to conflict resolution and participatory practice in local development. It concludes by highlighting the value of conceptual approaches that deal with the politics of evaluation and the distributional effects of policy interventions designed to create new relationships within and between multiple stakeholders.

Key issues in the study of new and alternative social movements in Spain: The Left, Identity and Globalizing Processes

This article highlights the importance of dedicating a whole special issue on New and Alternative Social movements in Spain. It sets the basis for this endeavour by emphasizing the importance of the 2004, unexpected, electoral victory of the Spanish socialists, and the subsequent satisfaction of the important demands promoted by certain social movements actors and Spanish society in general (the withdrawal of Spanish troops from Iraq, the cancellation of the National Hydrological Plan and the Legalization of same sex marriages. The view supported is that these developments signify the end of a protest cycle, which could have the same effect with the early 1980s socialist victory. After a discussion around the low associationalism that characterizes Spanish society and recent experience of authoritarianism, it is suggested that it is time for the study of new and alternative social movements in Spain and other south European societies to move beyond the emphasis on exceptionality but appreciate differences by focusing on the available political opportunities and the identity of social movement actors. The remainder of the article is dedicated to introducing the contributing articles.

Morphological and molecular characters reveal differentiation in a Neotropical social bee, Melipona beecheii (Apidae : Meliponini)

Morphometrics and DNA microsatellites were used to analyse the genetic structure of populations of the stingless bee M. beecheii from two extremes of its geographic range. The results showed that populations from Costa Rica and Yucatan exhibit substantial phenotypic and molecular differentiation. Bees from Yucatan were smaller and paler than those from Costa Rica. The value of multilocus F-ST = 0.280 (P <0.001) confirmed that there were significant molecular genetic differences between the two populations. Populations showed significant deviation from Hardy Weinberg equilibrium and the values of FIS (the inbreeding coefficient) were positive for Costa Rica = 0.416 and the Yucatan Peninsula = 0.193, indicating a lack of heterozygotes in both populations possibly due to inbreeding. The DNA sequence of 678 bp of the mitochondrial gene COI differed between populations by 1.2%. The results of this study should be considered in conservation programmes, particularly with regard to the movement of colonies between regions.

Movement-related potentials in high-functioning autism and Asperger's disorder

Autism and Asperger's disorder (AD) are neurodevelopmental conditions that affect cognitive and social-communicative function. Using a movement-related potential (MRP) paradigm, we investigated the clinical and neurobiological issue of 'disorder separateness' versus 'disorder variance' in autism and AD. This paradigm has been used to assess basal ganglia/supplementary motor functioning in Parkinson's disease. Three groups (high functioning autism [HFA]: 16 males, 1 female; mean age 12y 5mo [SD 4y 4mo]; AD: 11 males, 2 females; mean age 13y 5mo [SD 3y 8mo]; comparison group: 13 males, 8 females; mean age 13y 10mo, [SD 3y 11 mo]) completed a cued motor task during electroencephalogram recording of MRPs. The HFA group showed reduced peak amplitude at Cz, indicating less activity over the supplementary motor area during movement preparation. Although an overall significant between-group effect was found for early slope and peak amplitude, subanalysis revealed that the group with AD did not differ significantly from either group. However, it is suggested that autism and AD may be dissociated on the basis of brain-behaviour correlations of IQ with specific neurobiological measures. The overlap between MRP traces for autism and Parkinson's disease suggests that the neurobiological wiring of motor functioning in autism may bypass the supplementary motor area/primary motor cortex pathway.

'Research Training and Professional Social Work Education: Developing Research-Minded Practice' Social Work Education, .

The movement towards developing practice more firmly grounded on empirical research has, arguably, been one of the most significant international trends in social work during the past decade. However, in the UK the implications of this trend for pedagogical practices and the design of educational programmes have still to be fully explored. This paper reports on the findings of a repeated cross-sectional survey of MSW students in Queen's University Belfast which focused on their perceptions of the value of research training to professional practice. The study, conducted over a four year period, explored students' awareness of the relationship between research and practice and their readiness to engage with research training. The findings suggested that the majority of students perceived research training as a valuable component of professional development. However, the study also found a level of scepticism among students about its practical utility along with some resistance towards actively embracing a research agenda. The paper evaluates the significance of these findings for developing research and evidence-based practice as integral components of the new degrees in social work in the UK and for social work education programmes in other countries aiming to develop research-minded practice.