Development and Consideration of Global Policies for Managing the Future Risks of Poliovirus Outbreaks: Insights and Lessons Learned Through Modeling

The success of the Global Polio Eradication Initiative promises to bring large benefits, including sustained improvements in quality of life (i.e., cases of paralytic disease and deaths avoided) and costs saved from cessation of vaccination. Obtaining and maintaining these benefits requires that policymakers manage the transition from the current massive use of oral poliovirus vaccine (OPV) to a world without OPV and free of the risks of potential future reintroductions of live polioviruses. This article describes the analytical journey that began in 2001 with a retrospective case study on polio risk management and led to development of dynamic integrated risk, economic, and decision analysis tools to inform global policies for managing the risks of polio. This analytical journey has provided several key insights and lessons learned that will be useful to future analysts involved in similar complex decision-making processes.     

A comparison of objective and subjective measures of clinical competence

The purpose of this study was to determine if objective performance measures from a simulated patient practical examination were related to faculty subjective assessments of surgery students' performance. Another purpose was to determine if those students performing well on a simulated patient practical examination were the same students awarded honor ratings by faculty. Faculty ratings of students (n = 72) on history taking ability, physical exam skills, problem identification, use of investigations, problem integration, patient management, and patient relations skills were correlated with objective measures on these same criteria achieved on a practical exam employing three simulated patient cases. Correlations were also calculated to study the relationship between practical exam scores and honor rating recipients. Results indicated significant relationships between faculty subjective ratings and practical exam outcomes on all practical examination skills except physical exam skills and patient management skills. Findings also indicated the performance of honor students on the practical examination was significantly better than non-honor students on two skills: history-taking and patient relations. The implications of these research findings are discussed.     

Using Automated Emergency Notification Systems to Inform the Public: A Field Experiment

Research and experience have shown that it can be difficult to get citizens to pay attention to risk messages and preparedness information in the absence of an actual emergency. As the use computerized systems that alert the public to hazards by automatically ringing their home phones increases, we thought it important to ask if tests of these "call down" systems can also be used to convey preemergency information. We worked with a local government to add instructions on how to shelter-in-place to the message on a routine test of a call down system. We then surveyed a test group and a control group before and after the test call and a second control group on after the call. The results indicate that the test call raised awareness of the emergency notification system without generating undue concern about the possibility of a chemical accident. Those who received the test call demonstrated significant improvements in their knowledge of how to shelter-in-place while no such improvement was observed in those who did not get the call. While the nature of the sample used in this study limits generalizability, we feel this outcome is positive enough to warrant further exploration of this method of disseminating risk information and preparedness instructions.     

Anger Management Taught to Adolescents with an Experiential Object Relations Approach

The authors propose a method of teaching anger management utilizing an objects relations theory conceptualization. The inner structure of the angry adolescent is described, and methods of addressing anger tailored to the individual differences of each adolescent's internal world are presented Role playing is utilized in the anger management group to illustrate the concepts presented. The authors conclude that when the clinical intervention resonates with the internal world of the client, the intervention will be experienced as meaningful.     

‘Wallbanking’, innovativeness and computer attitudes: 25–40-year-old ATM-users on the spot

Attitudes towards ‘wallbanking’ (making use of banking services through an Automated Teller Machine (ATM)) and self-reported frequency of wallbanking have been related to attitudes towards innovations and towards computers. The investigation also included the perception of advantages as well as disadvantages of wallbanking, factors that determine one's choice of a bank, man-machine problems related to the use of an ATM, and demographic factors. Using a sample of 201 respondents in the age range of 25 to 40 years, structural equation modeling revealed that wallbanking attitudes have a major influence on the frequency of using ATMs. The innovativeness attitude ‘New is wasteful’ also showed a clear negative link with the frequency of wallbanking. On the other hand, the relationship between computer attitudes and the frequency of using ATMs had to be rejected. Income and education proved to have an indirect link with the frequency of wallbanking, which refines other research findings. These results may reflect specific financial management characteristics of the age group under investigation.     

An Introduction to the Multidimensional Students' Life Satisfaction Scale

QOL researchers have primarily focusedtheir attention on adults. The purpose of thispresentation is to describe the rationale,development, and psychometric properties of amultidimensional life satisfaction scaleappropriate for children and youth, theMultidimensional Students' Life SatisfactionScale (MSLSS: Huebner, 1994; Huebner et al.,1998). This multidimensional self-report scalewas designed for use with students from thirdthrough the twelfth grades. The currentversion of the MSLSS includes 40 items intendedto assess satisfaction with five specificdomains (School, Self, Family, Friends, andLiving Environment). The presentation willsummarize a series of recent studies assessingits reliability, factor structure, andconvergent and discriminant validity. Additionally, the potential usefulness ofchildren's life satisfaction scales forresearch and clinical applications werediscussed.     

"Homo Sociologicus" and Personality Theory

L'image que la sociologie peint de l'homme en théorie contemporaine a été l'objet de critiques qui se groupent autour des deux thèmes suivants: 1 les modéles actuels de l'univers social Agent l'homme dans un moule, en en faisant le prisonnier de ses rôles afin d'expliquer ses comportements; 2 une théorie explicite de la personnalité est un indispensable élément de toute théorie sociologique valable, puisque l'action individuelle est un passage obligatoire pour que se manifeste toute disposition commune au niveau de la collectivité. L'auteur est d'opinion que si, afin d'expliquer l'harmonie sociale, on appuie trop sur l'intériorisation des valeurs collectives, on appauvrit la notion de personnalité en plus de rabaisser, parmi les mécanismes qui produisent l'accord, ceux qui sont de caractère social plutôt que psychologique.     

Social representations of diversity: multi/intercultural education in a South African urban school 1

The story of School X started in South Africa in 1875. At that time, the school was built for white children only. More than hundred years later, the 1994 elections demarcated the end of the apartheid era and the school enrolled black Xhosa‐speaking children for the first time. As a result, in 2004, 90% of the students were black Xhosa‐speaking. The theoretical perspectives of our study are based on notions of multicultural and intercultural education, and of diversity. Our study is embedded in a socio‐constructivist inquiry paradigm. Using questionnaires and interviews, we aimed to understand the social representations regarding diversity of a principal, a teacher, seven students and four parents in a K‐7 open school. We examined diversity of values, cultures, religions, languages, attitudes, beliefs, behaviors, etc. regarding a multi/intercultural perspective in education. We attempted to discern what the participants’ understandings of diversity were, how they identified diversity, and why they justified their practices and actions with respect to diversity.

The song can only be beautiful if we all play the same tune. (Esmé Goosen, Multimedia, 2004)

This is the title of a painting that is part of an exhibition in Nelson Mandela Metropolitan Museum of Art, Port Elizabeth, South Africa     

Seroadaptive Strategies of Vancouver Gay and Bisexual Men in a Treatment as Prevention Environment

British Columbia’s treatment as prevention policy has provided free access to highly active antiretroviral therapy (HAART) to all HIV-positive provincial residents since 1996. One outcome is an increase in HIV-positive gay and bisexual men (GBM) with suppressed viral loads. Previous cross-sectional analyses indicated that some Vancouver GBM now recognize condomless anal sex with men on HAART who report a suppressed viral load as a seroadaptive strategy. To test the hypothesis that this new strategy, termed viral load sorting (VLS), is recognized and used among by GBM in the Momentum Health Study, we analyzed longitudinal data for HIV-negative/unknown (n = 556) and HIV-positive (n = 218) serostatus participants. Analyses indicated that both groups reported VLS, and that serostatus and Treatment Optimism Scale scores were significant determinants in frequency and use. Results exemplify the medicalization of sex and Rogers’ Diffusion Of Preventative Innovations Model, and they have important implications for HIV research and GBM sexual decision-making.