Global risk management

Industries that deal with hazardous systems are faced with the task of managing a spectrum of risks within resource contraints. They have essentially two options that can be combined in a global risk-management strategy: insurance (loss sharing) and risk mitigation through technical and organizational measures. In this article, global risk-management strategies based on probabilistic risk analysis and its extension to include management factors are described. Some issues and solutions are illustrated through practical examples, drawn mostly from the recent research of the Industrial Engineering Risk Research Group at Stanford (the tiles of the U.S. Space Shuttle, offshore platforms, marine pipelines, and anesthesia in modern hospitals).     

Ill health and social conditions amongst migrants and refugees—the case of Sweden

The present article delineates the state of health and socioeconomic situation of migrants and refugees in Sweden. Special attention is given to refugees. Migrants appear to have more extensive health problems and a shorter longevity span than native Swedes. The refugees constitute an especially exposed group of migrants. Experiences in the home country that relate to organised violence is a specific problem for this group. It has been estimated that 20 to 25 per cent of all adult refugees who have arrived to Sweden during the recent years have experienced torture in their native countries. Swedish migrant and refugee policy operates according to a model of decentralisation, aiming to avoid ethnic segregation in the big city areas. However, the integration policy seems, in many instances, to have had a negative affect on the situation of the refugees. During the period of time, in which the refugees wait for a residence permit, they are not permitted to work. The long period of forced inactivity—in some instances up to a couple of years—seems frequently to have aggravated the health of the refugees. In addition it appears to contribute to the ever increasing animosity towards them.     

‘Coming of Age’: An Individual Perspective*

An outsider's view of family therapy in Australia which raises the question of professional responsibility within the profession and towards the larger system.     

Problem Behavior and Heart Rate Reactivity in Adopted Adolescents: Longitudinal and Concurrent Relations

The present longitudinal study examined resting heart rate and heart rate variability and reactivity to a stressful gambling task in adopted adolescents with aggressive, delinquent, or internalizing behavior problems and adopted adolescents without behavior problems (total N=151). Early‐onset delinquent adolescents showed heart rate hyporeactivity to the stress‐eliciting gambling task compared to late‐onset delinquent adolescents and adolescents without behavior problems. Heart rate, heart rate variability, and reactivity to stress were not related to environmental factors such as early‐childhood parental sensitivity, parental socioeconomic status, or adoptee's health status at arrival. We conclude that the distinction between delinquency and aggression and between childhood‐onset and adolescence‐onset delinquency is important for the study of stress reactivity in adolescents.     

Writing Experience: Does Ethnography Convey a Crisis of Representation,or an Ontological Break with the Everyday World?

L'auteur pose comme prémisse la «brisure ontologique», telle qu'imaginée par Alfred Schutz, qui sépare deux champs: le «monde des coassociés», dans lequel la réalité sociale est directement expérimentée en face à face avec le présent intense, et l'«univers des contemporanéités», dans lequel l'autre est représenté selon des «types». Il soutient que cette coupure constitue un véhicule incitant à présenter une méta‐exposition de revendications majeures problématisant l'autorité traditionnelle en ethnographie. À la lumière de cette brisure, les tentatives postmodernistes d'acquérir ou de conserver la compréhension ici et maintenant de la signification subjective, ou de la «voix» des ethnographies, ne forment que des impossibilités épistémologiques. L'auteur conclut que le privilège postmoderniste accordéà une «ethnographie naïve» insistant sur les processus «expérimentaux», «interprétatifs», «dialogiques» et «polyphoniques» ne peut remplir sa promesse sur le plan méthodologique, pas plus qu'il n'est adaptable à la brisure ontologique de Schutz sur le plan théorique. This paper is premised on the “ontological break” as coined by Alfred Schutz that disconnects two realms: the “world of consociates” where social reality is directly experienced face‐to‐face in the vivid present, and the “world of contemporaries” where the other is interpreted in terms of “types.” It is argued that this break is a suggestive vehicle for conducting a meta‐exposition of major claims which problematize the traditional authority of ethnography. In the light of the break, the postmodernist attempts to attain or retain the here‐and‐now understanding of subjective meaning, or “voice” in ethnographies are but epistemological impossibilities. It is concluded that the postmodernist privileging of a “naive ethnography” which emphasizes “experiential,”“interpretive,”“dialogical,” and “polyphonic” processes is neither able to deliver on its promise at the methodic level, nor amendable to Schutz's ontological break at the theoretical level.     

Bringing Two Worlds Together: A Collaborative Interview With JoEllen Patterson

JoEllen Patterson is Professor in the Marital and Family Therapy Program at the University of San Diego. She is also an Associate Clinical Professor of Family Medicine and Psychiatry at the University of California, San Diego, directing a medical family therapy clinic embedded in a Family Medicine residency (equivalent to General Practice in New Zealand). She also works in Pediatrics and Reproductive Medicine at UCSD. At present her work involves training family therapy students and family medicine residents to do interdisciplinary work using a biopsychosocial model. Research suggests that our bodies are influenced by our mental health; our immune systems and cardiovascular systems seem especially susceptible to mind‐body interplay. JoEllen is particularly interested in how family functioning influences the mind‐body system. In 2003, JoEllen Patterson received a Fulbright Senior Scholars award to visit the Wellington School of Medicine and Health Sciences, and the Child, Adolescent and Family Service in Lower Hutt, New Zealand. She spent two weeks between the clinical service and the academic department, teaching, consulting and advising. I was lucky enough to arrange this posting and to spend time with her during it.     

Unmet service needs of families of young children with chronic illnesses and disabilities

Data about health and educational services were collected from 187 families with young children (under two years) who have chronic illnesses and disabilities. The purpose was to assess parents' satisfaction with services their families received and to identify families' unmet service needs as well as the reasons for these unmet needs. Although families' ratings of the adequacy of services are relatively high, 28% of the families report unmet service needs. The unmet needs most often reported are occupational, physical, or speech therapy; respite care/child care; and special education. Lack of funding is the most commonly given reason for unmet needs. Children with multiple impairments are at highest risk for unmet needs. Only 22% of unmet needs reported at the initial interview have been met by the time of the six-month follow-up. Increased coordination and monitoring of services across service sectors are indicated. Her research interests include the effects of disability on family identity and families' responses to minority stress. She received her Ph.D. from the University of Minnesota. She gratefully acknowledges Shelley Blazis and Nadav Casuto for statistical consulting. Her research interests focus on the impact of chronic illness and disability on families. She received her Ph.D. from the University of Minnesota. Her research interests include families and health and chronic illness and disability in children. She received her Ph.D. in Family Social Science at the University of Minnesota. His areas of interest include neurodevelopmental outcomes of low birth weight infants and training in developmental pediatrics. He was graduated from the University of Minnesota Medical School. His areas of interest include adolescents with chronic illness and disabilities, adolescent sexual decision making, and international adolescent health care issues. He was graduated from Howard University College of Medicine was awarded his earned doctorate in Health Policy from the University of Minnesota. Preparation of this article was supported by the National Institute on Disability and Rehabilitation Research Grant #H133890012.