Multilevel community health promotion: How can we make it work?

The need for multilevel, comprehensive health promotion programmeshas become widely accepted, as has the importance of communityapproaches. However, many health promotion programmes focuson change at the individual level, no doubt partly due to thedifficulty of implementing all-inclusive health promotion. Thispaper discusses two strategies for guiding multilevel projects:multiple methods for community assessment and charting projectactivities by level of change (a possibility framework). Thesestrategies help ensure a multilevel focus and provide valuableinformation that can assist with the implementation of multilevelhealth promotion research projects in specific community contexts.Our primary purpose, therefore, is not to focus on theory orresearch findings. Rather, our goal is to make visible two strategiesthat have been helpful in one health promotion research projectin Victoria, British Columbia, Canada.     

Urban Power Structures and Publicly Financed Stadiums

Urban elites are increasingly addressing local social problems though policies that turn their cities into tourist destinations. Often at the heart of these policies are new publicly financed sports stadiums. Ironically, this strategy is flourishing despite near-unanimous academic criticism, and increasing public skepticism, about this approach. Our research addresses this contradiction by exploring how and why powerful decisionmakers continue supporting publicly financed stadiums. We rely on local growth coalition theory to explore this topic because it offers analytical advantages, including looking beyond local sports teams as the focal point of these initiatives, addressing the variation in the outcomes of these initiatives, and acknowledging that policymakers are predisposed toward supporting these initiatives but that this predisposition does not always result in success.     

Smart money

Rick was an ambitious entrepreneur beginning the first of several businesses at age 16. He amassed a fortune by age 35. Between the ages of 42 and 50, his gambling rampage liquidated his assets, he lost his business and license to practice in his field, and he ended up in debt of over $1 million. Today at age 53 he is starting a new career in counseling and working with compulsive gamblers.     

Let Me Go: The Influences of Crawling Experience and Temperament on the Development of Anger Expression

Infants’ emerging ability to move independently by crawling is associated with changes in multiple domains, including an increase in expressions of anger in situations that block infants’ goals, but it is unknown whether increased anger is specifically because of experience with being able to move autonomously or simply related to age. To examine the influence of locomotion on developmental change in anger, infants’ (N = 20) anger expressions during an arm restraint procedure were observed longitudinally at a precrawling baseline assessment and 2 and 6 weeks after the onset of crawling. Infant age at each crawling stage was unrelated to the frequency of anger expressed in response to arm restraint. At 6 weeks postcrawling onset, infants whose mothers rated them as temperamentally higher in distress to limitations, compared with those rated lower, showed a greater increase in the frequency of anger expressed during the arm restraint relative to earlier assessments and took longer to reduce the frequency of anger expressed when no longer restrained. Findings suggest that experience with autonomous crawling has an effect on anger expression, independent of age, and that a temperamental tendency to become distressed by limitations may exacerbate the effect of crawling on anger expression.     

Horses and baseball: social work’s cultivation of one’s ‘third eye’

Active self-reflection is a sophisticated and subtle, multi-layered process that requires learning the capacity to constantly self-monitor. These fundamental interactive skills, the core of a competent social worker, are important to work in any context. Using two distinct metaphors, one relating to horses, the other to baseball, the article will explore the importance of developing competency skills and utilize a ‘third eye.’ In current social work education curricula the use of self may not be prioritized, practiced, or well understood. Evidence from human and veterinary medicine as well as social work, are discussed. An example of an undergraduate BSW course using simulated clients and standardized measures is discussed. The paper includes a brief review of the preliminary findings for a small pilot study and the relevance to future research is considered.     

Improving Weight of Evidence Approaches to Chemical Evaluations

Federal and other regulatory agencies often use or claim to use a weight of evidence (WoE) approach in chemical evaluation. Their approaches to the use of WoE, however, differ significantly, rely heavily on subjective professional judgment, and merit improvement. We review uses of WoE approaches in key articles in the peer‐reviewed scientific literature, and find significant variations. We find that a hypothesis‐based WoE approach, developed by Lorenz Rhomberg et al., can provide a stronger scientific basis for chemical assessment while improving transparency and preserving the appropriate scope of professional judgment. Their approach, while still evolving, relies on the explicit specification of the hypothesized basis for using the information at hand to infer the ability of an agent to cause human health impacts or, more broadly, affect other endpoints of concern. We describe and endorse such a hypothesis‐based WoE approach to chemical evaluation.     

Escape from the Iron Cage? Organizational Change and Isomorphic Pressures in the Public Sector

Institutional theory suggests that organizations pursue legitimacyby conforming to isomorphic pressures in their environment.We extend previous research on institutional theory by distinguishingbetween two definitions of conformity (compliance and convergence)and by taking a comprehensive view of the organizational characteristicsthat might be subject to isomorphic pressures. This frameworkis applied to change between 2001 and 2004 in the internal characteristicsof 101 public organizations in England. We find substantialevidence of compliance but more limited support for convergence.Furthermore, the impact of isomorphic pressures was strongeron organizational strategies and culture than on structuresand processes. Thus, the relevance of institutional theory tochange in the public sector depends on the definition of conformitythat is used and the organizational characteristics that areexamined.     

Estimating survival curves with left truncated and interval censored data via the ems algorithm

It is well-known that the nonparametric maximum likelihood estimator (NPMLE) of a survival function may severely underestimate the survival probabilities at very early times for left truncated data. This problem might be overcome by instead computing a smoothed nonparametric estimator (SNE) via the EMS algorithm. The close connection between the SNE and the maximum penalized likelihood estimator is also established. Extensive Monte Carlo simulations demonstrate the superior performance of the SNE over that of the NPMLE, in terms of either bias or variance, even for moderately large Samples. The methodology is illustrated with an application to the Massachusetts Health Care Panel Study dataset to estimate the probability of being functionally independent for non-poor male and female groups rcspectively.