The Biodemography of Variation in Human Frailty

A population is composed of individuals who are heterogeneous in their susceptibility to death and disease. This heterogeneity is reflected in the age-specific incidence or mortality (hazard) function. This variation has typically been hidden--that is, not measured directly--and has generally been modeled in a purely empirical statistical way, because there is no theory in demography for the distribution of frailty. A substantial fraction of variation in frailty, however, has an underlying genetic basis, for which there is a formal theory. This theory, based on evolutionary biology and on the nature of mendelian transmission, provides prior constraints on the distribution of variation in the population as well as providing methods for identifying genes involved in many important diseases. The accumulating effects of environmental exposures with age are another major component of variation in frailty. In some important instances, this variation and its effect on the age-specific hazard function can also be understood in terms of cause-specific biological processes. These biological considerations may enable demographers to model frailty, and thus mortality, in a better way.     

Social work students and social change: on the link between views on poverty, social work goals and policy practice

This article seeks to contribute to a better understanding of the factors that are associated with social work students' willingness to engage in policy practice. It examines a model according to which the willingness to engage in policy practice is linked to the importance that students attribute to the goals of social work and to their views on poverty. The sample consisted of 138 social work students in one of Israel's leading universities. The measures consisted of four questionnaires developed specifically for this study. The findings revealed strong relationships between students' views regarding the causes of poverty and their attitudes towards the preferred ways to deal with poverty. In addition, strong relationships were found between the importance that students attributed to the goals of social work and their willingness to engage in policy practice. However, no significant relationships were found between students' views on poverty and their willingness to engage in policy practice. Different explanations for these findings are advanced in the article.     

A Comparison of Male Sex Workers in Prague: Internet Escorts versus Men Who Work in Specialized Bars and Clubs

Prague, the Czech Republic, is a popular sex tourism destination where sex work is decriminalized and young men offer sexual services at low prices relative to countries in Western Europe. This quantitative survey aimed to identify some of the demographic characteristics of these young men and their experiences in the sex industry. Internet escorts (N = 20) and sex workers in bars and clubs (N = 20) completed the survey anonymously in spring 2011. The results showed that sex workers in clubs often had troubled pasts and were forced into sex work to survive. They also reported incidents of violence, serious alcohol and drug use, as well as frequent gambling. The larger group of sex workers in Prague is made up of Internet escorts who have backgrounds that are not atypical for the average Czech youth. They had fewer problems with drugs and alcohol but were twice as likely as sex workers in bars and clubs to be victims of violent crime. Plans for interventions to help those who would change their line of work, as well as the importance of sociocultural context in understanding sex workers, are discussed.     

Experience of Forced Sex and Subsequent Sexual,Drug, and Mental Health Outcomes: African American and Hispanic Women in the Southeastern United States

ABSTRACT. Objectives: This cross-sectional study examined African American and Hispanic women's (N = 1,509) self-reports of unwanted forced sex and its association with behavioral and mental health outcomes after the event. Methods: Twenty percent of the women had experienced forced sex (1st occurrence at age 15 years or younger for 10%, 1st occurrence at older than 15 years of age for 10%). Results: Regardless of when forced sex 1st occurred, women were more likely to have engaged in unprotected vaginal and anal sex, to have had multiple unprotected sex partners, to have sexually transmitted infections, to have reported binge drinking and illicit drug use, and to exhibit distress and have received mental health counseling. Conclusions: Forced sex may have wide-ranging behavioral and mental health consequences years later.     

The use of covariate information in the sequential analysis of dichotomous response experiments

A method is presented for the sequential analysis of experiments involving two treatments to which response is dichotomous. Composite hypotheses about the difference in success probabilities are tested, and covariate information is utilized in the analysis. The method is based upon a generalization of Bartlett’s (1946) procedure for using the maximum likelihood estimate of a nuisance parameter in a Sequential Probability Ratio Test (SPRT). Treatment assignment rules studied include pure randomization, randomized blocks, and an adaptive rule which tends to assign the superior treatment to the majority of subjects. It is shown that the use of covariate information can result in important reductions in the expected sample size for specified error probabilities, and that the use of covariate information is essential for the elimination of bias when adaptive assignment rules are employed. Designs of the type presented are easily generated, as the termination criterion is the same as for a Wald SPRT of simple hypotheses.     

Young men's perspectives on family support and disclosure of same-sex attraction

Young men who have sex with men (YMSM) face myriad challenges when deciding to disclose their sexual orientation to family members. Key to this decision is consideration of how disclosure may influence the support they receive from family. This paper explores a diverse sample of YMSM's (N = 43) perspectives on disclosure of their same-sex attractions to key family members and its impact on family support. Several stages/categories of disclosure are described and some YMSM seemed to continue to move between categories. Additionally, relationships after disclosure included negotiations between the expression of their sexual orientation and the maintenance of family support.     

The Aid Paradigm for Poverty Reduction: Does It Make Sense?

Thinking on economic policy for development has undergone many shifts in response to the perceived weak results of earlier adjustment reforms. A new donor consensus has emerged based around the central themes of economic growth, good governance and social development. This article examines the logic behind this new aid paradigm, revealing a nuanced story with country circumstances playing a critical role and particular interventions varying in impact. For example, growth does not always lead to gains for the poor that match the national average; public expenditure needs to be targeted to achieve social development, but effective targeting is difficult; governance reform may be critical but there is no simple governance blueprint, and the corruption‐growth association need not always be negative.     

Modeling Exposure to Air Pollution from the WTC Disaster Based on Reports of Perceived Air Pollution

We examined the utility of a newly developed perceived air pollution (PAP) scale and of a modeled air pollution (MAP) scale derived from it for predicting previously observed birth outcomes of pregnant women enrolled following September 11, 2001. Women reported their home and work locations in the four weeks after September 11, 2001 and the PAP at each site on a four-point scale designed for this purpose. Locations were geocoded and their distance from the World Trade Center (WTC) site determined. PAP values were used to develop a model of air pollution for a 20-mile radius from the WTC site. MAP values were assigned to each geocoded location. We examined the relationship of PAP and MAP values to maternal characteristics and to distance of home and work sites from the WTC site. Both PAP and MAP values were highly correlated with distance from the WTC. Maternal characteristics that were associated with PAP values reported for home or work sites (race, demoralization, material hardship, first trimester on September 11) were not associated with modeled MAP values. Relationships of several birth outcomes to proximity to the WTC, which we previously reported using this data set, were also seen when MAP values were used as the measure of exposure, instead of proximity. MAP developed from reports of PAP may be useful to identify high-risk areas and predict health outcomes when there are multiple sources of pollution and a "distance from source" analysis is impossible.