Gastrostomy and children: a review of the literature in learning disabilities

Children with developmental delays often suffer feeding difficulties. It has become common for those with a severe likelihood of malnutrition to be considered for alternative methods of nutritional intake, often a gastrostomy. As part of a pilot study investigating the effects of gastrostomy on the child and their family, we conducted a literature review in order to establish the current areas of research, progress and concern. This paper describes the method and findings of the literature review and concludes with a discussion of the topics raised. The main conclusion is that although the need for gastrostomy in this group of children has been shown to be effective in maintaining adequate weight gain and nutritional intake, the support given to the family prior to, and after the operation is inadequate. Greater emphasis needs to be placed on detailed family assessment as part of the early intervention package. Copyright © 2001 John Wiley & Sons, Ltd.     

Promising research and methodological approaches for health behavior research with homeless persons

High-risk health behaviors have high prevalence among homeless persons prompting substantial research on health behavior and behavior change strategies within the population. Previously, much of this research focused solely on the target behavior without consideration of contextual factors that may contribute to the behavior or that may inhibit behavior change. We describe three overlapping trends in homeless health behavior research – longitudinal, qualitative, and participatory – which consider the link between the context of homelessness and health behavior. These approaches contribute to the understanding of the social determinants of health behavior and health and demonstrate opportunities for intervention beyond the individual level.     

Acts of Last Resort: Asylum,Whistleblowing and the Anthropology of Secrecy

Anthropologists face fresh challenges as they endeavour to conduct research in an increasingly securitised and secretive world. Those who wield asymmetrical power in society often seek to guard information and knowledge. Therefore, it is imperative that anthropologists seek new ways of navigating the politics of secrecy if they are to reveal anything of its inner workings. In pursuit of this imperative, this paper examines practices of whistleblowing and posits secrecy as a dialectic that is characterised by processes and practices that work towards concealment, as well as revelation. In shifting the analytical focus from that which is concealed to what is revealed in acts such as whistleblowing, we contend that anthropologists may elucidate something about secrecy that is revealing of context-specific forms of agency and power. In doing so, analysis draws upon Australia’s secretive immigration and border protection regime and in particular a recent government inquiry that enabled whistleblowers to reveal details of secrets that had previously been closely held.     

The Role of Social Networks in Getting a Job

This article reviews recent research on the effect s of social networks on access to job information and getting a job in the United States. Drawing on network ties from friends, family members, acquaintances, employers, or coworkers can improve the job search because individuals gain access to and make use of their network’s social capital. While this job searching strategy can result in a successful job search for some, not all job seekers benefit from reliance on social networks. We spotlight research that documents how reliance on social networks as a means to find work can actually maintain sex and racial/ethnic inequality at work. We discuss research documenting the important role social networks play in the job acquisition process. The last half of this review focuses on several new developments in the literature that promise to further our understanding of social networks’ lasting effects on employment outcomes.     

Productive Activities And Subjective Well-Being Among Older Adults: The Influence Of Number Of Activities And Time Commitment

This study examines relationships among three measures of subjective well-being (life satisfaction, happiness and depressive symptoms), and two global measures of productive activity (number of activities and time commitment). We argue that participation in multiple productive activities should increase subjective well-being because these behaviors increase social integration and provide meaningful social roles. Using the first two waves of the Americans’ Changing Lives survey, we estimate a series of OLS and ordered logistic regression models to examine this issue among a sample of respondents 60 years old and older. Our multivariate regression results show that as time committed to productive activities increases, life satisfaction increases. Both increasing numbers of productive activities and increasing time commitment predict higher levels of happiness. Also, we find only modest support for a relationship between productive activities and the number of and changes in depressive symptoms. Our results provide support for the idea that engaging in productive activities is beneficial to older persons’ well-being, implying confirmation of the role enhancement hypothesis and demonstrating the importance of social integration.This research was partially supported by a grant from the National Institute on Aging (R03 AG018910). We thank Jan Mutchler for helpful comments on an earlier version of this paper.     

Role of bisphosphonates in the management of postmenopausal osteoporosis: an update on recent safety anxieties

Following their introduction in the 1990s, bisphosphonates have become the mainstay of treatment in the management of postmenopausal osteoporosis, and their use continues to rise. Commonly noted adverse effects in clinical practice include gastrointestinal side-effects, acute phase reactions (predominately seen with intravenous preparations) cutaneous reactions and more rarely, ocular side-effects. However, recent reports of potentially serious adverse effects of bisphosphonate therapy, including atypical subtrochanteric and femoral shaft fractures, atrial fibrillation, oesophageal carcinoma and osteonecrosis of the jaw, have prompted concerns regarding the long-term safety of this class of drugs. This review summarizes the benefits and potential adverse effects of bisphosphonates used in the treatment of postmenopausal osteoporosis. Although evidence of a definitive casual relationship between bisphosphonate therapy and serious adverse effects is lacking, concern remains particularly in relation to atypical subtrochanteric and femoral shaft fractures. This has important consequences in terms of determining optimum duration of therapy and how best to target therapy at those most at risk. Recently, attention has focused on individual fracture risk assessment in order to optimize the risk-benefit ratio of treatment for individual patients. A review of the role of hormone replacement therapy in younger women with significant risk of osteoporotic fractures may be timely in these circumstances.     

Perceived Stigma and Depression among Black Adolescents in Outpatient Treatment

Despite the high prevalence of depression among children and adolescents, most that need mental health treatment do not seek care. This is especially true for ethnic minority adolescents. Prior research has shown that perceived stigma may act as a barrier to the initiation of and adherence to depression treatment, yet few studies have examined the relationship between stigma and depression among Black adolescents. This exploratory study examined the relationship between Black adolescents' depression severity and their current level of perceived stigma in an outpatient sample. Face-to-face interviews were conducted with a clinical sample of adolescents referred for mental health services at a community-based outpatient clinic (n =108), participating in a prospective pilot study on adolescents' patterns of mental health service use. The analyses revealed that greater depression severity was significantly associated with higher perceived stigma (p < .05), particularly among females. The results also suggest that Black adolescents appear to exhibit an appropriate level of self-assessment regarding their need for mental health services. These results are interpreted in relation to previous literature, and limitations and directions for future research are discussed.     

Envisioning emerging nanotechnologies: a three-year panel study of South Carolina citizens

This article reports results from a three-year panel study of a nonrandom sample of 76 South Carolina citizens, recruited from a variety of walks of life, and their impressions of emerging nanotechnology. This discussion focuses on material from depth interviews conducted alongside a baseline opinion and awareness inventory at the beginning of the study, the most intensive data-gathering phase. These results are placed in the context of data from three additional surveys conducted at about equal intervals over the three years, plus exit interviews from 21 of the 34 individuals who completed the entire study. The results give insight into popular thinking about technology but little indication of strong emerging concerns, a trajectory of amplification of those concerns, or opinion polarization over time, despite some awareness of risks and potential ethical dimensions. Nanotechnology may stand out more as an example of risk attenuation than of risk amplification, consistent with most results from national surveys.     

Immigrant Settlement Patterns: The Role of Metropolitan Characteristics*

Immigration continues to change the social, economic, and political landscapes of urban America. Consequently, scholars, as well as the general public, are interested in the internal migration patterns of immigrants. In this research, we identify and explain the characteristics of metropolitan areas that have the strongest effects on the percentage change in the foreign‐born population between 1990 and 2000. Using lagged independent variables and a sample of 150 metropolitan areas, we find that settlement patterns among immigrants are diverging from traditional patterns. That is, those metropolitan areas that had moderately high levels of globalization and lower costs of living as well as lower disadvantage indicators (e.g., percentage poverty) in 1990, had larger increases in percentage foreign‐born between 1990 and 2000 compared to areas with lower levels of globalization and higher costs of living and disadvantage. These trends suggest the increasing importance of second‐tier metropolises such as Atlanta, Phoenix, and Las Vegas in understanding where immigrants settle.     

Some alternatives to Edgeworth

The Edgeworth expansion is well known as a means for obtaining approximate tail probabilities from information concerning the moments of the distribution. Recent saddlepoint and asymptotic methods lead to several alternative approximations. These alternatives are developed and compared by means of average relative error.