On Baseline Conditions for Zero-Inflated Longitudinal Count Data

We describe a mixed-effect hurdle model for zero-inflated longitudinal count data, where a baseline variable is included in the model specification. Association between the count data process and the endogenous baseline variable is modeled through a latent structure, assumed to be dependent across equations. We show how model parameters can be estimated in a finite mixture context, allowing for overdispersion, multivariate association and endogeneity of the baseline variable. The model behavior is investigated through a large-scale simulation experiment. An empirical example on health care utilization data is provided.     

Women's working conditions in hospital cleaning: a case study

Hospital cleaning work, as health care work, is mainly performed by women all over Europe. Hospital cleaning activities represent a poorly studied sector although very important also for patient's health. We applied the Method of Organizational Congruencies to study cleaning work in three typical hospital units (Emergency Room, Haematology, General Medicine) of a roman University hospital where 198 women cleaners work. We analyzed the 731 technical actions performed in the three shifts and the related Organizational Constraints (OC). Working outsourcing, no occupational risks training, washing personal equipment at home, standing, long walking, early morning and night shift in emergency room, high monotony (>10 actions per hour) contact with biological and chemicals materials, risk conditions of accidents, artificial lights, hot microclimate and working in a cure setting represent the main Organizational Constraints. Differences among the three Units are discussed together with the importance of considering cleaning hospital as a preventive action towards hospital clinical risk.     

Sociological Conceptualisations of ‘Career’: A Review and Reorientation

In the last decades, the use and meaning of the concept of career has profoundly changed, shaped by a ‘new career’ literature rhetoric and a move away from mainstream sociological debate. Our aim in this article is to provide a critical assessment of the concept, and to make a productive contribution to the current debate on careers, and work more generally. Specifically, we seek to: (i) critique the lack of elaboration of the concept within the discipline of sociology in recent years; (ii) reposition the concept of careers as a key sociological category; and (iii) assess and reorient the current meanings of career. After tracing the history of career from linear to boundaryless, we situate the concept in a broader sociological understanding of gender and habitus and structure and agency, and through a methodological discussion of narrative approaches for studying careers. These concepts and approaches are especially effective for understanding careers. Having showed the added value of the concept of career for sociology, we conclude with a research agenda which attempts to overcome the voluntaristic pitfall of its use in recent years and opens up a more thoughtful and articulated understanding of careers for both teaching and research.     

Menopause and sexual desire: the role of testosterone

The present short review underlines the role of testosterone (T) in the motivational and satisfaction components of women's sexuality and critically discusses the strategies to treat hypoactive sexual desire disorder (HSDD), a condition of low desire associated with personal and/or interpersonal difficulties, which is more common in surgical menopausal women. There are multiple ways androgens target the brain regions (hypothalamic, limbic and cortical) involved in sexual function and behaviour. Even though circulating available androgens have been implicated in several domains of sexual response, they seem to be related weakly to symptoms, such as low sexual desire, poor sexual arousal, orgasm and diminished well-being in postmenopausal women. The possibilities of treating low sexual desire/HSDD are multifaceted and should include the combination of pharmacological treatments able to maximize biological signals driving the sexual response, and individualized psychosocial therapies in order to overcome personal and relational difficulties. Transdermal T has been shown to be effective at a dose of 300 μg/day both in surgically and naturally menopausal women replaced with estrogen or not, without any relevant side-effects. However, the decision to treat postmenopausal women with HSDD with T is mainly based on clinical judgement, after informed consent regarding the unknown long-term risks.