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This paper reports on key findings of a critical qualitative inquiry undertaken with an Indigenous early child development (ECD) program in Canada, known as the Aboriginal Infant Development Program (AIDP). In depth, semi-structured interviews were used to obtain the perspectives of: Indigenous caregivers and Elders, AIDP workers, and administrative leaders. The findings centre on: (1) a relational perspective of family wellbeing that emphasises the inseparability between child health inequities and the impact of structural social factors on families’ lives, and (2) how AIDP workers’ enact relational accountability to families by: (a) fostering cultural connections; (b) creating networks of belonging and support; (c) responding to caregivers’ self-identified priorities; (d) mitigating racism in healthcare encounters, and (e) deferring an ‘ECD agenda’. Rather than a one-size-fits-all model, these findings illustrate relational approaches to early intervention, characterised by a broader and socially responsive scope of practice and the deferral of a normative ‘ECD agenda’. This study has relevance in a variety of international contexts and to a broad range of disciplines and programs that serve families and children impacted by structural inequities. [ABSTRACT FROM AUTHOR]

Racial discrimination is primarily conceptualised and dealt with at the individual level in health research and practice. Most conceptualisations, and the measures which follow, are grounded in stress-coping theories thus reinforcing individual level understandings. This draws attention away from how structures and systems reproduce racial discrimination, and further supports the very racial categorisations upon which racism depends. The purpose of this paper is to discuss the relevance of critical theoretical perspectives in conceptualising racial discrimination and how it is taken-up and measured in health research. Drawing on Indigenous, Black and material feminist, intersectional, critical race, postcolonial and political economy perspectives, we propose that racial discrimination can most usefully be understood as a relational socio-historical concept. Racial discrimination understood at the systemic level in research and measurement will support more effective policies and practices to mitigate intersecting forms of discrimination in healthcare. Critical theoretical approaches to studying racial discrimination in health research could inform future analyses needed to address and limit the harms perpetuated through individual and structural forms of discrimination. [ABSTRACT FROM AUTHOR]

In Australia, fluoridation was first endorsed as an effective, safe and equitable means of improving population oral health over fifty years ago. However, recent opposition to attempts to introduce the measure in several regional Victorian towns has demonstrated that it remains a highly controversial health policy. This paper investigates the history of the Victorian fluoridation debate within a national and international context. It finds that although the evidence concerning fluoridation has advanced considerably, the essential arguments put forward by proponents and opponents have remained largely unchanged over that time. Protagonists incorporate the same scientific evidence yet come to polarised and unshakeable conclusions. I argue that the concept of deep structure ideation is a useful means to understand how this occurs. Furthermore, analysis of the ideas and social processes that determine a partisan position in the fluoridation debate makes this an important case study for approaching other durable scientific controversies. [ABSTRACT FROM AUTHOR]

Against a backdrop of economic globalisation, where welfare practitioners fi nd themselves caught between modernising policy reform and demanding practice realities, there is an urgent need to rethink the relationship between research, evaluation and professional practice. In this article three perspectives concerned with accountability, critical knowledge production and development will be examined as a basis for understanding the different methodological discourses on evaluation. The debate between evidence-based practice (EBP) and critical practice (CP) is deployed to highlight a choice facing both the practitioner and researcher between producing two competing kinds of knowledge for practice. The former is based upon technical know how and skills that may be equated with a 'search for certainty' and found increasingly in technocratic systems of accountability; whilst the latter is concerned with critical exploration and development in promoting more emancipatory forms of practice that may be equated with the 'creative use of uncertainty'. Drawing on practice examples and research from the fi eld of mental health, it is argued that balancing accountability, critical knowledge production and development offers a valid paradigm for achieving effective practice evaluation alongside a broader commitment to social justice. [ABSTRACT FROM AUTHOR]