No abstract

No abstract

AimTo develop and test a new adverse drug reaction (ADR) causality assessment tool (CAT).MethodsA comparison between seven assessors of a new CAT, formulated by an expert focus group, compared with the Naranjo CAT in 80 cases from a prospective observational study and 37 published ADR case reports (819 causality assessments in total).Main Outcome Measures Utilisation of causality categories, measure of disagreements, inter-rater reliability (IRR).ResultsThe Liverpool ADR CAT, using 40 cases from an observational study, showed causality categories of 1 unlikely, 62 possible, 92 probable and 125 definite (1, 62, 92, 125) and ‘moderate’ IRR (kappa 0.48), compared to Naranjo (0, 100, 172, 8) with ‘moderate’ IRR (kappa 0.45). In a further 40 cases, the Liverpool tool (0, 66, 81, 133) showed ‘good’ IRR (kappa 0.6) while Naranjo (1, 90, 185, 4) remained ‘moderate’.ConclusionThe Liverpool tool assigns the full range of causality categories and shows good IRR. Further assessment by different investigators in different settings is needed to fully assess the utility of this tool.

This article is set in the context of debates about how far social identity and agency should be seen as individualised or relational concepts. It examines how people in a qualitative study in the North of England constructed personal narratives about their residential histories. These were fundamentally about identity and agency, because they centred upon 'what mattered' more widely to the narrator, and upon what had constrained or enabled action and change in their life. The narratives were characterised by contextuality, contingency and in particular by relationality. Four styles of relational narrative are explored: relational inclusion and co-presence, relational participation, relational constraint and conflict, and relational individualism. Overall, it is argued that both agency and identity need to be understood relationally, and that through their narratives people in the study were constructing relational selves. It is suggested that a misreading of personal narrative as an individualistic discursive form has fuelled the hold of the concept of individualism on popular and sociological imagination, in the face of increasingly compelling empirical evidence about the extent and nature of people's connectivity with others.

This article uses the examples of the `kinship consequences'of assisted conception, the contemporary enthusiasm for tracing family histories, and a more general interest in family resemblances to argue that there is a contemporary fascination with kinship which existing sociological and anthropological theory do not entirely explain. It proposes a conceptual framework for understanding what is both distinctive and fascinating about kinship, based on four dimensions of affinity: fixed affinities, negotiated and creative affinities, ethereal affinities and sensory affinities. These are dimensions where kinship is engaged with, defined, known and expressed. Collectively, these are referred to as`tangible'affinities, not because they are all literally tangible but because of their resonance in lived experience and their vivid and palpable (or almost palpable) character.