A comparison study of realtime fatality rates: severe acute respiratory syndrome in Hong Kong, Singapore, Taiwan, Toronto and Beijing, China

Summary.  In an outbreak of a completely new infectious disease like severe acute respiratory syndrome (SARS), estimation of the fatality rate over the course of the epidemic is of clinical and epidemiological importance. In contrast with the constant case fatality rate, a new measure, termed the 'realtime' fatality rate, is proposed for monitoring the new emerging epidemic at a population level. A competing risk model implemented via a counting process is used to estimate the realtime fatality rate in an epidemic of SARS. It can capture and reflect the time-varying nature of the fatality rate over the course of the outbreak in a timely and accurate manner. More importantly, it can provide information on the efficacy of a certain treatment and management policy for the disease. The method has been applied to the SARS data from the regions affected, namely Hong Kong, Singapore, Toronto, Taiwan and Beijing. The magnitudes and patterns of the estimated fatalities are virtually the same except in Beijing, which has a lower rate. It is speculated that the effect is linked to the different treatment protocols that were used. The standard estimate of the case fatality rate that was used by the World Health Organization has been shown to be unable to provide useful information to monitor the time-varying fatalities that are caused by the epidemic.     

ISOLATION, INTEGRATION, AND ETHNIC BOUNDARIES IN RURAL GUATEMALA

We investigate two perspectives about the effects of reduced discrimination and greater social and economic opportunities on ethnic identity in rural areas of contemporary Guatemala. Our analysis contrasts the effects of new opportunities in Indigenous communities on language use and dress, using data from the 1995 Encuesta Guatemalteca de Salud Familiar (EGSF). While the use of both dress and language has changed substantially in recent years, language use has changed considerably more than dress. We conclude that, in this context, economic opportunities have not necessarily diminished ethnic solidarity, but may have instead reshaped it.     

When Strategic Approaches get Stuck: Maps out of the Mire

Using a biopsychosocial model, a three dimensional map provides guidelines for changing from strategic therapy when progress in this approach falters. The method is pragmatic and atheoretical, and brings together ideas from various schools which empirically have been found useful. Practical and inclusive guidelines are offered for family (and individual) therapy which address two important issues: reinforcement of change when progress is occurring, and a shift from an interactional to another dimension when stuck points are reached. The multi-dimensional approach is clear, can be used by individuals or teams, lends itself to teaching and is of particular value for entrenched and complex problems. Four case histories are presented to highlight the approach.     

Fitting In and Fighting Back: Stigma Management Strategies among Homeless Kids

Using data collected during a four‐year ethnographic study, this article examines the stigma management strategies of kids who are homeless in the San Francisco Bay area. We focus specifically on strategies of inclusion and exclusion. Strategies of inclusion are attempts by homeless kids to establish harmonious relationships with both peers and strangers. The most common are forging friendships, passing, and covering. Strategies of exclusion are aggressive and nonconciliatory attempts to gain social acceptance. They include verbal denigration and physical and sexual posturing. Some of these strategies successfully protect the kids’ sense of self, while other strategies had the unintended effect of reinforcing their spoiled identities. We argue that these stigma management strategies are both informed by and interpreted through their disadvantaged social structural location.     

The truth and lie story: developing a tool for assessing child witnesses' ability to differentiate between truth and lies

Within the court arena, the credibility and competency of child witnesses often comes under scrutiny and the decision whether a child is considered to be credible or not strongly in?uences whether their evidence will be heard by the court. A child's ability to demonstrate that they understand the difference between truth and lies and the importance of telling the truth is synonymous with competency. Research suggests that many professionals undertaking the task of establishing competency ?nd it very dif?cult, especially with younger children (Aldridge and Wood, 1997, cited in Aldridge and Wood, 1998). This paper describes the process involved in developing an innovative tool for helping professionals assess whether a child understands the difference between truth and lies. The development of the tool arose from the concerns of of?cers from Northumbria Police Force (in the UK) relating to interviews following the protocol of the government's Memorandum of Good Practice (Home Of?ce and Department of Health, 1992) on interviewing child witnesses, and the need to establish whether child witnesses can differentiate between truth and lies. As an example of good practice, The Truth and Lie Story described here has now been included in the Home Of?ce (2002) guidance Achieving Best Evidence in Criminal Proceedings, which is a revision of the 1992 Memorandum of Good Practice. Copyright © 2004 John Wiley & Sons, Ltd.     

Nationality Matters: SARS and Foreign Domestic Workers' Rights in Taiwan Province of China

Taiwan suffered the third largest national outbreak of Severe Acute Respiratory Syndrome (SARS) during the first half of 2003. A crisis often illuminates issues of power and control, and the SARS crisis highlighted important patterns in Taiwan's utilization of foreign labour in general and foreign domestic labour in particular. Firstly, inequalities between Taiwanese citizens and non‐Taiwanese migrant domestic workers were both magnified and illuminated at the level of nation and at the level of household in terms of confinement. Secondly, the generalization and intensification of existing patterns of abuse resulted in this abuse coming to light in the public arena. Notably, these issues only became known when they were brought to the attention of both the public and the state, and this occurred largely through the actions of Filipina domestic workers via the media and non‐governmental organizations (NGOs). The reason that such issues could be brought into the open for public debate was a matter of nationality. Importantly, the epidemic served to articulate the issue of the differential access of migrant domestic workers to information about their rights and the range of factors that facilitate or impede such access. This paper explores the centrality of issues of nationality to understanding the migration experiences of Indonesian and Filipina domestic workers in Taiwan by considering how SARS played out for them in terms of their occupational location, their national background, their access to support and information networks regarding rights, and their official representation. The paper seeks to expand our understanding of the experiences of migrant domestic workers in Taiwan by means of my research on Indonesian domestic workers. However, I would argue that this case study is not just an empirical curiosity but that it is instructive in a broader theoretical sense. Understanding the nationality issue stands at the core of understanding the diversity of experiences of migrant domestic workers in any given geographic and temporal location. If we combine this factor together with the key variables of the relationship to the state and the relationship to the employer, as Bridget Anderson (2000) suggests, we move closer to a more incisive and less reductionist understanding of the factors which shape the living and working conditions of migrant domestic workers.     

Threat, Group Identification, and Children's Ethnic Prejudice

This experiment tested predictions from social identity development theory (SIDT, Nesdale, 1999 ), that children's tendency to show out‐group prejudice depends on the strength of their in‐group identification and/or their perception of threat from the out‐group. Anglo‐Australian children (N= 480) aged 6, 7, or 9 years were assigned to a high‐status team and their identification with the in‐group (high vs. low) was manipulated together with threat from the out‐group (present vs. absent). The members of the out‐group were revealed to be of the same (Anglo‐Australian) or different (Pacific Islander) ethnicity to the in‐group. Results supported the SIDT predictions. In addition, consistent with socio‐cognitive theory (ST, Aboud, 1988 ), dislike for the out‐group at 6 years gave way to increasingly neutral reactions by 9 years of age. Ethnic composition of the out‐group did not impact differentially on liking but it did affect the children's desire to change groups. Strongly identified children were reluctant to leave their group regardless of the ethnicity of the out‐group, whereas children with low in‐group identification were more willing to change into a same‐ than into a different‐ethnicity out‐group. It is concluded that both social identity and social cognitive processes are implicated in the development of prejudice in middle childhood.