"Racism in a Melting Pot...?" Trinidadian mid-life transnational migrants' views on race and colour-class on return to their homes of descent

This paper deals with second-generation, one-and-a-half generation and ‘‘prolonged sojourner” Trinidadian transnational migrants, who have decided to ‘return’ to the birthplace of their parents. Based on 40 in-depth interviews, the paper considers both the positive and critical things that these youthful transnational migrants report about returning to, and living in, this multi-ethnic plural society and the salience of racial and colour-class stratification as part of their return migration experiences. Our qualitative analysis is based on the narratives provided by these youthful returnees, as relayed ‘‘in their own words”, presenting critical reflections on racism, racial identities and experiences as transnational Trinidadians. It is clear that it is contexts such as contemporary working environments, family and community that act as the reference points for the adaptation ‘‘back home” of this strongly middle-class cohort. We accordingly encounter a diverse, sometimes contesting set of racial issues that emerge as salient concerns for these returnees. The consensus is that matters racial remain as formidable legacies in the hierarchical stratification of Trinidadian society for a sizeable number. Many of our respondents reported the positive aspects of racial affirmation on return. But for another sub-set, the fact that multi-ethnic and multi-cultural mixing are proudly embraced in Trinidad meant that it was felt that return experiences were not overly hindered, or blighted by obstacles of race and colour-class. For these returnees, Trinidad and Tobago is seen as representing a 21st century ‘‘Melting Pot”. But for others the continued existence of racial divisions within society – between ethnic groups and among those of different skin shades – was lamented. In the views of these respondents, too much racial power is still ascribed to ‘near-whiteness’. But for the most part, the returnees felt that where race played a part in their new lives, this generally served to advantage them. However, although the situation in Trinidad appears to have been moderated by assumptions that it remains a racial ‘Melting Pot’, the analysis strongly suggests that the colour-class system of stratification is still playing an essential role, along with racial stereotyping in society at large.

Educational and psychosocial programmes for adolescents with diabetes: approaches, outcomes and cost-effectiveness

Diabetes incurs heavy personal and health system costs. Self-management is required if complications are to be avoided. Adolescents face particular challenges as they learn to take responsibility for their diabetes. A systematic review of educational and psychosocial programmes for adolescents with diabetes was undertaken. This aimed to: identify and categorise the types of programmes that have been evaluated; assess the cost-effectiveness of interventions; identify areas where further research is required. Sixty-two papers were identified and Subjected to a narrative review. Generic programmes focus on knowledge/skills, psychosocial issues, and behaviour/self-management. They result in modest improvements across a range of outcomes but improvements are often not sustained, suggesting a need for continuous support, possibly integrated into normal care. In-hospital education at diagnosis confers few advantages over home treatment. The greatest returns may be obtained by targeting poorly controlled individuals. Few studies addressed resourcing issues and robust cost-effectiveness appraisals are required to identify interventions that generate the greatest returns on expenditure. (C) 2004 Elsevier Ireland Ltd. All rights reserved.

Language support for immigrant children: a study of state schools in the UK and US

In recent decades, immigrants, refugees and asylum seekers have sought a new way of life in large numbers, often leaving their countries of origin behind in search of places that offer a better way of life. The purpose of this study was to investigate how elementary and middle school students in state schools in Reading, England (primarily speakers of Asian languages), and Richmond, Virginia (primarily speakers of Spanish), were supported academically, when most children's first language was not English. The authors were interested in exploring whether or not there were cultural or structural differences in the way each country helped or hindered these students as they progressed through the school systems. Three UK schools in a district of approximately 100,000 and three US schools in a district of approximately 250,000 were the focus of this exploration from 2000 to 2003. Findings indicated that there were cultural and legislative differences and similarities. Teachers and administrators in both countries attempted to provide services with limited and sometimes diminishing resources. Community support varied based on resources, attitudes toward various ethnic groups, and the coping strategies adopted by these groups in their new environments. Marked differences appeared with regard to the manner in which assessments took place and how the results were made available to the public.

Language, education and ethnicity: whose rights will prevail in an age of globalisation?

Education and ethnicity cannot be discussed without taking language into account. This paper will argue that any discussion of ethnic minorities cannot ignore the question of language, nor can any discussion of human rights ignore the question of language rights. Unfortunately, in today's globalised world, governments and minorities are faced with conflicting pressures: on the one hand, for the development and use of education in a global/international language; on the other for the use and development of mother tongue, local or indigenous languages in education. Language complexity and ethnic plurality were largely brought about as a result of the creation of nation-states, which were spread around the world as a result of European colonialism. European languages and formal education systems were used as a means of political and economic control. The legacy that was left by the colonial powers has complicated ethnic relations and has frequently led to conflict. While there is now greater recognition of the importance of language both for economic and educational development, as well as for human rights, the forces of globalisation are leading towards uniformity in the languages used, in culture and even in education. They are working against the development of language rights for smaller groups. We are witnessing a sharp decline in the number of languages spoken. Only those languages which are numerically, economically and politically strong are likely to survive. As a result many linguistic and ethnic groups are in danger of being further marginalised. This paper will illustrate this thesis both historically and from several contemporary societies, showing how certain policies have exacerbated ethnic conflict while others are seeking to promote harmony and reconciliation. Why this should be so will be explored. (c) 2006 Elsevier Ltd. All rights reserved.

Expressing medicine side effects: assessing the effectiveness of absolute risk, relative risk, and number needed to harm, and the provision of baseline risk information

Objective: To assess the effectiveness of absolute risk, relative risk, and number needed to harm formats for medicine side effects, with and without the provision of baseline risk information. Methods: A two factor, risk increase format (relative, absolute and NNH) x baseline (present/absent) between participants design was used. A sample of 268 women was given a scenario about increase in side effect risk with third generation oral contraceptives, and were required to answer written questions to assess their understanding, satisfaction, and likelihood of continuing to take the drug. Results: Provision of baseline information significantly improved risk estimates and increased satisfaction, although the estimates were still considerably higher than the actual risk. No differences between presentation formats were observed when baseline information was presented. Without baseline information, absolute risk led to the most accurate performance. Conclusion: The findings support the importance of informing people about baseline level of risk when describing risk increases. In contrast, they offer no support for using number needed to harm. Practice implications: Health professionals should provide baseline risk information when presenting information about risk increases or decreases. More research is needed before numbers needed to harm (or treat) should be given to members of the general populations. (c) 2005 Elsevier Ireland Ltd. All rights reserved.

Over the counter medicines and the need for immediate action: a further evaluation of European Commission recommended wordings for communicating risk

A study examined people's interpretation of European Commission (EC) recommended verbal descriptors for risk of medicine side effects, and actions to take if they do occur. Members of the general public were presented with a fictitious (but realistic) scenario about suffering from a stiff neck, visiting the local pharmacy and purchasing an over the counter (OTC) medicine (Ibruprofen). The medicine came with an information leaflet which included information about the medicine's side effects, their risk of occurrence, and recommended actions to take if adverse effects are experienced. Probability of occurrence was presented numerically (6%) or verbally, using the recommended EC descriptor (common). Results showed that, in line with findings of our earlier work with prescribed medicines, participants significantly overestimated side effect risk. Furthermore, the differences in interpretation were reflected in their judgements of satisfaction, side effect severity, risk to health, and intention to take the medicine. Finally, we observed no significant difference between people's interpretation of the recommended action descriptors ('immediately' and 'as soon as possible'). (C) 2003 Elsevier Science Ireland Ltd. All rights reserved.

Small wars and insurgencies in theory and practice, 1500-1850

In early modern times, warfare in Europe took on many diverse and overlapping forms. Our modern notions of ‘regular’ and ‘irregular’ warfare, of ‘major war’ and ‘small war’, have their roots in much greater diversity than such binary notions allow for. While insurgencies go back to time immemorial, they have become conceptually fused with ‘small wars’. This is a term first used to denote special operations, often carried out by military companies formed from special ethnic groups and then recruited into larger armies. In its Spanish form, guerrilla, the term ‘small war’ came to stand for an ideologically-motivated insurgency against the state authorities or occupying forces of another power. There is much overlap between the phenomena of irregular warfare in the sense of special operations alongside regular operations, and irregular warfare of insurgents against the regular forces of a state. This book demonstrates how long the two phenomena were in flux and fed on each other, from the raiding operations of the 16th century to the ‘small wars’ or special operations conducted by special units in the 19th century, which existed alongside and could merge with a popular insurgency. This book is based on a special issue of the journal Small Wars & Insurgencies.

Gender, childhood and children’s literature: the CIRCL approach

This paper explores the unique approach to childhood and children’s literature of the research and teaching of the ‘Graduate Centre for International Research in Childhood: Literature, Culture, Media (CIRCL)’. CIRCL follows in its work the arguments of UK critical theorist Jacqueline Rose in her seminal 1984 book The case of Peter Pan or the impossibility of children’s fiction. Rose’s work has been widely and routinely referenced in Children’s Literature studies particularly, but CIRCL interprets her arguments as having quite different implications than those usually assumed. Rose is generally attributed with having pointed out that ‘childhood’ is not one, homogenous category, but that childhood is divided by gender, race, and ethnic, political and religious (and so on) identities. But for CIRCL this is only a first step in Rose’s arguments and certainly one not unique to her work anyway: the perception of various cultural and historical childhoods is widely held. Instead, my paper explores how Rose’s arguments are centrally about how ‘childhood’ itself cannot be maintained in the face of division, a division, moreover, which operates inevitably at every level, and which derives from Rose’s interpretation of psychoanalysis as formulated by Sigmund Freud, which Rose derives in turn from her readings of the interpretations of Freud by French analyst Jacques Lacan and French critical theorist Jacques Derrida. Finally, my paper argues how Rose’s position is about any ‘identity’, including gender and that this allies her work closely to that of the famous gender theorist Judith Butler, whose arguments are often (mis) understood in the same ways as those of Rose.

How was patient empowerment portrayed in information leaflets describing the community pharmacy Medicines Use Review service in the UK?

Objective The Medicines Use Review (MUR) community pharmacy service was introduced in 2005 to enhance patient empowerment but the service has not been taken up as widely as expected. We investigated the depiction of the patient–pharmacist power relationship within MUR patient information leaflets. Methods We identified 11 MUR leaflets including the official Department of Health MUR booklet and through discourse analysis examined the way language and imagery had been used to symbolise and give meaning to the MUR service, especially the portrayal of the patient–pharmacist interactions and the implied power relations. Results A variety of terminology was used to describe the MUR, a service that aimed ultimately to produce more informed patients through the information imparted by knowledgeable, skilled pharmacists. Conclusion The educational role of the MUR overshadowed the intended patient empowerment that would take place with a true concordance-centred approach. Although patient empowerment was implied, this was within the boundaries of the biomedical model with the pharmacist as the expert provider of medicines information. Practice implications If patient empowerment is to be conveyed this needs to be communicated to patients through consistent use of language and imagery that portrays the inclusivity intended.

Judah Benjamin: marginalized outsider or admitted insider?

Judah Benjamin (1811-1884) was one of the greatest of nineteenth century lawyers. This article analyses how a young man who might have been marginalized in society because of the circumstances of his birth, ethnic origin and religious identity rose to prominence in law, politics and business in the United Kingdom and the United States.

Teaching English as an additional language: a MESHGuide

This guide has been co-authored by Naomi Flynn, an Associate Professor at The University of Reading, working with Chris Pim and Sarah Coles who are specialist advisory teachers with Hampshire’s Ethnic Minority and Traveller Achievement Service (EMTAS). It was constructed with the support of teachers in primary and secondary schools in Hampshire, selected for their existing expertise in teaching EAL learners, who used the guidance for action research during the spring and summer of 2015. The guide is written principally to support teachers and learning support assistants working with EAL learners in any educational setting and who are at any stage of fluency in the learning of English. It will also support senior leaders in their strategic response to the EAL learners in their schools. As with all MESH guides it seeks to share knowledge with professionals in order to support the growth of evidence informed practice that works in promoting the best in pupil outcomes

Cost-effectiveness of a preventive counseling and support package for postnatal depression

Objectives: This study reports the cost-effectiveness of a preventive intervention, consisting of counseling and specific support for the mother-infant relationship, targeted at women at high risk of developing postnatal depression. Methods: A prospective economic evaluation was conducted alongside a pragmatic randomized controlled trial in which women considered at high risk of developing postnatal depression were allocated randomly to the preventive intervention (n = 74) or to routine primary care (n = 77). The primary outcome measure was the duration of postnatal depression experienced during the first 18 months postpartum. Data on health and social care use by women and their infants up to 18 months postpartum were collected, using a combination of prospective diaries and face-to-face interviews, and then were combined with unit costs ( pound, year 2000 prices) to obtain a net cost per mother-infant dyad. The nonparametric bootstrap method was used to present cost-effectiveness acceptability curves and net benefit statistics at alternative willingness to pay thresholds held by decision makers for preventing 1 month of postnatal depression. Results: Women in the preventive intervention group were depressed for an average of 2.21 months (9.57 weeks) during the study period, whereas women in the routine primary care group were depressed for an average of 2.70 months (11.71 weeks). The mean health and social care costs were estimated at 2,396.9 pound per mother-infant dyad in the preventive intervention group and 2,277.5 pound per mother-infant dyad in the routine primary care group, providing a mean cost difference of 119.5 pound (bootstrap 95 percent confidence interval [Cl], -535.4, 784.9). At a willingness to pay threshold of 1,000 pound per month of postnatal depression avoided, the probability that the preventive intervention is cost-effective is .71 and the mean net benefit is 383.4 pound (bootstrap 95 percent Cl, -863.3- pound 1,581.5) pound. Conclusions: The preventive intervention is likely to be cost-effective even at relatively low willingness to pay thresholds for preventing 1 month of postnatal depression during the first 18 months postpartum. Given the negative impact of postnatal depression on later child development, further research is required that investigates the longer-term cost-effectiveness of the preventive intervention in high risk women.