Vulnerability and multiple deprivation perspectives on economic exclusion in Europe: A latent class analysis

In this paper we address issues relating to vulnerability to economic exclusion and levels of economic exclusion in Europe. We do so by applying latent class models to data from the European Community Household Panel for thirteen countries. This approach allows us to distinguish between vulnerability to economic exclusion and exposure to multiple deprivation at a particular point in time. The results of our analysis confirm that in every country it is possible to distinguish between a vulnerable and a non-vulnerable class. Association between income poverty, life-style deprivation and subjective economic strain is accounted for by allocating individuals to the categories of this latent variable. The size of the vulnerable class varies across countries in line with expectations derived from welfare regime theory. Between class differentiation is weakest in social democratic regimes but otherwise the pattern of differentiation is remarkably similar. The key discriminatory factor is life-style deprivation, followed by income and economic strain. Social class and employment status are powerful predictors of latent class membership in all countries but the strength of these relationships varies across welfare regimes. Individual biography and life events are also related to vulnerability to economic exclusion. However, there is no evidence that they account for any significant part of the socio-economic structuring of vulnerability and no support is found for the hypothesis that social exclusion has come to transcend class boundaries and become a matter of individual biography. However, the extent of socio-economic structuring does vary substantially across welfare regimes. Levels of economic exclusion, in the sense of current exposure to multiple deprivation, also vary systematically by welfare regime and social class. Taking both vulnerability to economic exclusion and levels of exclusion into account suggests that care should be exercised in moving from evidence on the dynamic nature of poverty and economic exclusion to arguments relating to the superiority of selective over universal social policies.

The validity of a latent class typology of adolescent drinking patterns

Objectives: This study examined the validity of a latent class typology of adolescent drinking based on four alcohol dimensions; frequency of drinking, quantity consumed, frequency of binge drinking and the number of alcohol related problems encountered. Method: Data used were from the 1970 British Cohort Study sixteen-year-old follow-up. Partial or complete responses to the selected alcohol measures were provided by 6,516 cohort members. The data were collected via a series of postal questionnaires. Results: A five class LCA typology was constructed. Around 12% of the sample were classified as �hazardous drinkers� reporting frequent drinking, high levels of alcohol consumed, frequent binge drinking and multiple alcohol related problems. Multinomial logistic regression, with multiple imputation for missing data, was used to assess the covariates of adolescent drinking patterns. Hazardous drinking was associated with being white, being male, having heavy drinking parents (in particular fathers), smoking, illicit drug use, and minor and violent offending behaviour. Non-significant associations were found between drinking patterns and general mental health and attention deficient disorder. Conclusion: The latent class typology exhibited concurrent validity in terms of its ability to distinguish respondents across a number of alcohol and non-alcohol indicators. Notwithstanding a number of limitations, latent class analysis offers an alternative data reduction method for the construction of drinking typologies that addresses known weaknesses inherent in more tradition classification methods.

Marginalization, deprivation, and fatalism in the Republic of Ireland. Class and underclass perspectives

The emergence of large-scale long-term unemployment in the Republic of Ireland suggests that it might provide an interesting case to which to apply the concept of an 'underclass'. In this paper we explore the relationship between labour-market marginality, deprivation, and fatalism. The available evidence in relation to both social isolation and milieu effects suggests that the term 'underclass' can have only a very limited applicability in the Irish case. Instead, what we ate confronted with is different types of working-class marginalization arising from the rapid and uneven nature of class transformation in Ireland and changing patterns of emigration. In relation to what we have termed 'pervasive marginalization' the costs of economic change have been borne disproportionately by those members of the younger cohorts originating in the lower working class rather than by those in particular locations. The evidence relating to the social and psychological consequences of labour-market detachment, rather than providing support for the value of an 'underclass' perspective, confirms the continued relevance of class analysis.

GENDER AND CLASS MOBILITY - EVIDENCE FROM THE REPUBLIC-OF-IRELAND

Gender has frequently been identified as the most controversial issue confronting class analysis. In this paper we make use of data from the Republic of Ireland to assess the extent to which the incorporation of women in class mobility analysis alters our understanding of the central processes of social mobility. We find that for married women their husband's class is a more powerful predictor of household poverty and life-style than their own 'class' as indicated by current or previous occupation. With regard to employment mobility we find that the sole source of gender variation in mobility chances relates to differences in the objective opportunity structures faced by men and women. Applying a measured variable model to 'men only' and 'complete' mobility tables reveals only modest differences in the patterns of social fluidity. The inclusion of women in class mobility tables requires little in the way of substantial modification of our understanding of the pattern of class relationships underlying the observed pattern of mobility.

Applying Health Locus of Control and Latent Class Modelling to food and physical activity choices affecting CVD risk

Health Locus of Control (HLC) classifies our beliefs about the connection between our actions and health outcomes (Skinner, 1996) into three categories: “internal control”, corresponding to health being the result of an individual's effort and habits; “control by powerful others”, whereby health depends on others, such as doctors; and “chance control”, according to which health depends on fate and chance. Using Choice Experiments we investigate the relationship between HLC and willingness to change lifestyle, in terms of eating habits, physical activity and associated cardiovascular disease risk, in a 384 person sample representative of the 40–65 aged population of Northern Ireland administered between February and July 2011. Using latent class analysis we identify three discrete classes of people based on their HLC: the first class is sceptical about their capacity to control their health and certain unhealthy habits. Despite being unsatisfied with their situation, they are reluctant to accept behaviour changes. The second is a group of individuals unhappy with their current situation but willing to change through exercise and diet. Finally, a group of healthy optimists is identified, who are satisfied with their current situation but happy to take more physical activity and improve their diet. Our findings show that any policy designed to modify people's health related behaviour should consider the needs of this sceptical class which represents a considerable proportion of the population in the region.

Understanding the socio-economic distribution of multiple deprivation: An application of self-organising maps

In this paper we seek to contribute to recent efforts to develop and implement multi-dimensional approaches to social exclusion by applying self-organising maps (SOMs) to a set of material deprivation indicators from the Irish component of EU-SILC. The first stage of our analysis involves the identification of sixteen clusters that confirm the multi-dimensional nature of deprivation in contemporary Ireland and the limitations of focusing solely on income. In going beyond this mapping stage, we consider both patterns of socio-economic differentiation in relation to cluster membership and the extent to which such membership contributes to our understanding of economic stress. Our analysis makes clear the continuing importance of traditional forms of stratification relating to factors such as income, social class and housing tenure in accounting for patterns of multiple deprivation. However, it also confirms the role of acute life events and life cycle and location influences. Most importantly, it demonstrates that conclusions relating to the relative impact of different kinds of socio-economic influences are highly dependent on the form of deprivation being considered. Our analysis suggests that debates relating to the extent to which poverty and social exclusion have become individualized should take particular care to distinguish between different kinds of outcomes. Further analysis demonstrates that the SOM approach is considerably more successful than a comparable latent class analysis in identifying those exposed to subjective economic stress. (C) 2010 International Sociological Association Research Committee 28 on Social Stratification and Mobility. Published by Elsevier Ltd. All rights reserved.

Economic vulnerability, multidimensional deprivation and social cohesion in an enlarged European community

In this article we have sought to combine regional and social exclusion perspectives on economic exclusion in the enlarged European Community. Our analysis, based on the European Quality of Life Survey, confirms that while the economically vulnerable, identified through latent class analysis, constitute substantially larger groups in the poorer economic clusters, they are much more sharply differentiated from others in the richer clusters. While the economically vulnerable are also disadvantaged in relation to measures of multidimensional deprivation and social cohesion, between economic clusters differences on these dimensions cannot be accounted for by corresponding variations in levels and intensity of economic vulnerability. In fact, the impact of such vulnerability on social cohesion is greater in the more affluent clusters. Copyright © 2005 SAGE Publications.

Beyond the standard work model? Varieties of flexible working time in European economies

Working time has been among the first aspect of the employment relation to be the object of intense regulation at the national and supra-national level. This standard regulation of working time comprised a number of elements: full-time hours, rigid working schedules, strong employers’ control and clear boundaries around working time In spite of general claims about the erosion of this model, few studies have investigated this process in a comparative and empirical perspective. The aim of this paper is to investigate the diversity of working time arrangements in European economies by applying latent class analysis to data
from the European Working Conditions Survey (EWCS). This analysis shows the existence of six different types of working time organization highlighting five cross-national patterns: multiple flexibilities, extended flexibility, standard, rigid and fragmented time.

Rapid detection of health-care-associated bloodstream infection in critical care using multipathogen real-time polymerase chain reaction technology: a diagnostic accuracy study and systematic review

Background: There is growing interest in the potential utility of real-time polymerase chain reaction (PCR) in diagnosing bloodstream infection by detecting pathogen deoxyribonucleic acid (DNA) in blood samples within a few hours. SeptiFast (Roche Diagnostics GmBH, Mannheim, Germany) is a multipathogen probe-based system targeting ribosomal DNA sequences of bacteria and fungi. It detects and identifies the commonest pathogens causing bloodstream infection. As background to this study, we report a systematic review of Phase III diagnostic accuracy studies of SeptiFast, which reveals uncertainty about its likely clinical utility based on widespread evidence of deficiencies in study design and reporting with a high risk of bias. 

Objective: Determine the accuracy of SeptiFast real-time PCR for the detection of health-care-associated bloodstream infection, against standard microbiological culture. 

Design: Prospective multicentre Phase III clinical diagnostic accuracy study using the standards for the reporting of diagnostic accuracy studies criteria. 

Setting: Critical care departments within NHS hospitals in the north-west of England. 

Participants: Adult patients requiring blood culture (BC) when developing new signs of systemic inflammation. 

Main outcome measures: SeptiFast real-time PCR results at species/genus level compared with microbiological culture in association with independent adjudication of infection. Metrics of diagnostic accuracy were derived including sensitivity, specificity, likelihood ratios and predictive values, with their 95% confidence intervals (CIs). Latent class analysis was used to explore the diagnostic performance of culture as a reference standard. 

Results: Of 1006 new patient episodes of systemic inflammation in 853 patients, 922 (92%) met the inclusion criteria and provided sufficient information for analysis. Index test assay failure occurred on 69 (7%) occasions. Adult patients had been exposed to a median of 8 days (interquartile range 4–16 days) of hospital care, had high levels of organ support activities and recent antibiotic exposure. SeptiFast real-time PCR, when compared with culture-proven bloodstream infection at species/genus level, had better specificity (85.8%, 95% CI 83.3% to 88.1%) than sensitivity (50%, 95% CI 39.1% to 60.8%). When compared with pooled diagnostic metrics derived from our systematic review, our clinical study revealed lower test accuracy of SeptiFast real-time PCR, mainly as a result of low diagnostic sensitivity. There was a low prevalence of BC-proven pathogens in these patients (9.2%, 95% CI 7.4% to 11.2%) such that the post-test probabilities of both a positive (26.3%, 95% CI 19.8% to 33.7%) and a negative SeptiFast test (5.6%, 95% CI 4.1% to 7.4%) indicate the potential limitations of this technology in the diagnosis of bloodstream infection. However, latent class analysis indicates that BC has a low sensitivity, questioning its relevance as a reference test in this setting. Using this analysis approach, the sensitivity of the SeptiFast test was low but also appeared significantly better than BC. Blood samples identified as positive by either culture or SeptiFast real-time PCR were associated with a high probability (> 95%) of infection, indicating higher diagnostic rule-in utility than was apparent using conventional analyses of diagnostic accuracy. 

Conclusion: SeptiFast real-time PCR on blood samples may have rapid rule-in utility for the diagnosis of health-care-associated bloodstream infection but the lack of sensitivity is a significant limiting factor. Innovations aimed at improved diagnostic sensitivity of real-time PCR in this setting are urgently required. Future work recommendations include technology developments to improve the efficiency of pathogen DNA extraction and the capacity to detect a much broader range of pathogens and drug resistance genes and the application of new statistical approaches able to more reliably assess test performance in situation where the reference standard (e.g. blood culture in the setting of high antimicrobial use) is prone to error.

The Effects of Social Class and Ethnicity on Gender Differences in GCSE Attainment: A Secondary Analysis of the Youth Cohort Study of England and Wales 1997-2001

This article is based upon a secondary analysis of the Youth Cohort Study of England and Wales 1998 and examines the effects of social class and ethnicity on gender differences in GCSE attainment for those who left school in 1997 (n = 14,662). The article shows that both social class and ethnicity exert a far greater influence on the GCSE performance of boys and girls than gender. Moreover, the article also shows that an interaction effect is present between social class and gender and also between ethnicity and gender in relation to their impact upon GCSE attainment. More specifically, the findings suggest that a strong correlation exists such that the lower the overall levels of educational attainment for any group (whether that group is defined in terms of social class or ethnicity), the higher the gender differences that exist between those within that group.

Analysis and Synthesis of pHEMT Class-E Amplifiers with Shunt Inductor including ON-State Active-Device Resistance Effects

In this theoretical paper, the analysis of the effect that ON-state active-device resistance has on the performance of a Class-E tuned power amplifier using a shunt inductor topology is presented. The work is focused on the relatively unexplored area of design facilitation of Class-E tuned amplifiers where intrinsically low-output-capacitance monolithic microwave integrated circuit switching devices such as pseudomorphic high electron mobility transistors are used. In the paper, the switching voltage and current waveforms in the presence of ON-resistance are analyzed in order to provide insight into circuit properties such as RF output power, drain efficiency, and power-output capability. For a given amplifier specification, a design procedure is illustrated whereby it is possible to compute optimal circuit component values which account for prescribed switch resistance loss. Furthermore, insight into how ON-resistance affects transistor selection in terms of peak switch voltage and current requirements is described. Finally, a design example is given in order to validate the theoretical analysis against numerical simulation.

Analysis of the effect of finite d.c. blocking capacitance and finite d.c. feed inductance on the performance of inverse class-E amplifiers

The first analysis and synthesis equations for the newly introduced inverse Class-E amplifier when operated with a finite d.c. blocking capacitance and a finite d.c.-feed inductance are presented in the paper. Closed-form design equations are derived in order to establish the circuit component values required for optimum synthesis. Excellent agreement between numerical simulation results and theoretical prediction is obtained. It is shown that drain efficiency approaching 100 at a pre-specified output power level can be achieved as zero-current switching and zero-current derivative conditions are simultaneously satisfied. The proposed analysis offers the prospect for realistic MMIC implementation.

Analysis and Design of Class-E3F and Transmission-Line Class-E3F2 Power Amplifiers

In this paper, analysis and synthesis approach for two new variants within the Class-EF power amplifier (PA) family is elaborated. These amplifiers are classified here as Class-E3 F2 and transmission-line (TL) Class-E3 F 2. The proposed circuits offer means to alleviate some of the major issues faced by existing topologies such as substantial power losses due to the parasitic resistance of the large inductor in the Class-EF load network and deviation from ideal Class-EF operation due to the effect of device output inductance at high frequencies. Both lumped-element and transmission-line load networks for the Class-E 3 F PA are described. The load networks of the Class-E3 F and TL Class-E 3 F2amplifier topologies developed in this paper simultaneously satisfy the Class-EF optimum impedance requirements at fundamental frequency, second, and third harmonics as well as simultaneously providing matching to the circuit optimum load resistance for any prescribed system load resistance. Optimum circuit component values are analytically derived and validated by harmonic balance simulations. Trade-offs between circuit figures of merit and component values with some practical limitations being considered are discussed. © 2010 IEEE.