Searching for self in a world of labels

Searching for Self is a performance poetry piece that demonstrates the difficulties of identity construction in contemporary life. The author challenges the ‘self’ and ‘other’ dichotomy, and in so doing she attempts to reduce the distance between the ‘client’ and ‘expert’; the researcher and researched; the service provider and service user; and theory and practice. The poems are linked to the authors’ experiences of being labeled with a disability.     

Aging and sexual health: getting to the problem

Erectile dysfunction (ED) is one of the most common disorders in male and is often associated with other age-related comorbidities. The aging process affects the structural organization and function of penile erectile components such as smooth muscle cell and vascular architecture. These modifications affect penile hemodynamics by impairing cavernosal smooth muscle cell relaxation, reducing penile elasticity, compliance and promoting fibrosis. This review aims to identify the mechanisms of ED in the penile aging process in experimental and clinical data. It also highlights areas that are in need of more research. The search strategies yielded total records screened from PubMed. Clarification of the molecular mechanisms that accompanies corpus cavernosum aging and aging-associated ED will aid new perspectives in the development of novel mechanism-based therapeutic approaches. Age is not a limiting factor for ED medical management, and it is never too late to treat. Hypogonadism should be managed regardless of age, and synergistic effects have been found during testosterone (T) replacement therapy when used along with oral phosphodiesterase-5 (PDE-5) inhibitors. Therefore, the clinical management of ED related to aging can be done by therapeutic interventions that include PDE-5 inhibitors, and other pharmacological treatments.     

Language shift and the family: Questions from the Sri Lankan Tamil diaspora1

Fishman's Graded Intergenerational Disruption Scale (GIDS) emphasizes the family in maintaining the heritage languages of immigrant communities. This study uses interview data from Sri Lankan Tamil communities in the U.S.A., U.K., and Canada to explain how families account for the rapid loss of Tamil in the diaspora. It shows how the positive valuation of English since British colonization, the need to make up for past deprivations because of caste, religious, and gender inequality, the pressure for migrants to join the social mainstream, and the need to resolve intergenerational tensions influence the family to forego language maintenance goals. The findings encourage us to situate the family in macro‐social institutions, power, and history in order to understand the prospects for language maintenance. The article provides an inside view of the Sri Lankan Tamil migrant families to explain how they resolve the tensions of valuing cultural identity and yet disregarding heritage language proficiency.     

Two-Event Model for Carcinogenesis: Biological, Mathematical, and Statistical Considerations

A two-mutation model for carcinogenesis is reviewed. General principles in fitting the model to epidemiologic and experimental data are discussed, and some examples are given. A general solution to the model with time-dependent parameters is developed, and its use is illustrated by application to data from an experiment in which rats exposed to radon developed lung tumors.     

Investment in Shared Suppliers: Effect of Learning,Spillover, and Competition

We investigate the optimal strategies for firms to invest in their suppliers when the benefits of such investments can spillover to other firms who also source from the same suppliers. We consider two Bayesian firms that can invest in improving the quality of their shared supplier; the firms do not have complete information on the true quality of the supplier, but they update their beliefs based on the supplier's performance. We formulate the problem as an investment game and obtain Markov perfect equilibria characterized by the investment thresholds of both firms. The equilibrium investment strategies of the two firms are characterized by a region of preemption and a region of war of attrition. We also examine how the interplay between spillover, competition, and returns from the investment at shared suppliers affect the investment threshold and the time to the leader's investment, and identify the conditions under which competition delays or hastens the first investment in a shared supplier.     

Diesel Engine Exhaust and Lung Cancer Mortality: Time‐Related Factors in Exposure and Risk

To develop a quantitative exposure‐response relationship between concentrations and durations of inhaled diesel engine exhaust (DEE) and increases in lung cancer risks, we examined the role of temporal factors in modifying the estimated effects of exposure to DEE on lung cancer mortality and characterized risk by mine type in the Diesel Exhaust in Miners Study (DEMS) cohort, which followed 12,315 workers through December 1997. We analyzed the data using parametric functions based on concepts of multistage carcinogenesis to directly estimate the hazard functions associated with estimated exposure to a surrogate marker of DEE, respirable elemental carbon (REC). The REC‐associated risk of lung cancer mortality in DEMS is driven by increased risk in only one of four mine types (limestone), with statistically significant heterogeneity by mine type and no significant exposure‐response relationship after removal of the limestone mine workers. Temporal factors, such as duration of exposure, play an important role in determining the risk of lung cancer mortality following exposure to REC, and the relative risk declines after exposure to REC stops. There is evidence of effect modification of risk by attained age. The modifying impact of temporal factors and effect modification by age should be addressed in any quantitative risk assessment (QRA) of DEE. Until there is a better understanding of why the risk appears to be confined to a single mine type, data from DEMS cannot reliably be used for QRA.     

Reanalysis of the DEMS Nested Case‐Control Study of Lung Cancer and Diesel Exhaust: Suitability for Quantitative Risk Assessment

The International Agency for Research on Cancer (IARC) in 2012 upgraded its hazard characterization of diesel engine exhaust (DEE) to “carcinogenic to humans.” The Diesel Exhaust in Miners Study (DEMS) cohort and nested case‐control studies of lung cancer mortality in eight U.S. nonmetal mines were influential in IARC's determination. We conducted a reanalysis of the DEMS case‐control data to evaluate its suitability for quantitative risk assessment (QRA). Our reanalysis used conditional logistic regression and adjusted for cigarette smoking in a manner similar to the original DEMS analysis. However, we included additional estimates of DEE exposure and adjustment for radon exposure. In addition to applying three DEE exposure estimates developed by DEMS, we applied six alternative estimates. Without adjusting for radon, our results were similar to those in the original DEMS analysis: all but one of the nine DEE exposure estimates showed evidence of an association between DEE exposure and lung cancer mortality, with trend slopes differing only by about a factor of two. When exposure to radon was adjusted, the evidence for a DEE effect was greatly diminished, but was still present in some analyses that utilized the three original DEMS DEE exposure estimates. A DEE effect was not observed when the six alternative DEE exposure estimates were utilized and radon was adjusted. No consistent evidence of a DEE effect was found among miners who worked only underground. This article highlights some issues that should be addressed in any use of the DEMS data in developing a QRA for DEE.     

How Sourcing of Interdependent Components Affects Quality in Automotive Supply Chains

In the automotive industry, many firms source key components from different suppliers, even though the components may function interdependently. In this study, we investigate how component level interdependence impacts quality performance and analyze how various operational factors moderate this relation. We synthesize information from several case studies to model the quality challenges faced by an automotive firm. For several sub‐assemblies that go into its products, the firm sourced key components from two different suppliers. The sub‐assemblies would fail whenever a component fails, but due to interdependent operations, failure of one component could cause the failure of the other. The firm found it challenging to improve the suppliers' quality performance as it was difficult to trace the failures to specific components. Our analysis reveals that – (i) the impact of interdependence is governed by the supply chain structure: reducing the interdependence between components improves quality when suppliers provide the components, but reducing interdependence worsens quality when the firm manufactures the entire sub‐assembly; and (ii) the relation between interdependence and quality performance is moderated by factors such as penalties, production costs, and interdependence costs. Additionally, we find that quality performance is lower when the firm outsources the components than when the firm manufactures the entire sub‐assembly. We identify coordinating mechanisms that leverage incentives and penalties to bridge the quality performance gap.