Working toward effective anonymization for surveillance data: innovation at South Africa’s Agincourt Health and Socio-Demographic Surveillance Site

Linking people and places is essential for population-health-environment research. Yet, this data integration requires geographic coding such that information reflecting individuals or households can appropriately be connected with characteristics of their proximate environments. However, offering access to such geocoding greatly increases the risk of respondent identification and, therefore, holds the potential to breach confidentiality. In response, a variety of “geographic masking” techniques have been developed to introduce error into geographic coding and thereby reduce the likelihood of identification. We report findings from analyses of the error introduced by several masking techniques applied to data from the Agincourt Health and Socio-Demographic Surveillance System in rural South Africa. Using a vegetation index (Normalized Difference Vegetation Index (NDVI)) at the household scale, comparisons are made between the “true” NDVI values and those calculated after masking. We also examine the tradeoffs between accuracy and protecting respondent privacy. The exploration suggests that in this study setting and for NDVI, geomasking approaches that use buffers and account for population density produce the most accurate results. However, the exploration also clearly demonstrates the tradeoff between accuracy and privacy, with more accuracy resulting in a higher level of potential respondent identification. It is important to note that these analyses illustrate a process that should characterize spatially informed research but within which particular decisions must be shaped by the research setting and objectives. In the long run, we aim to provide insight into masking’s potential and perils to facilitate population-environment-health research.

     

Clients as Teachers: Reciprocal Influences in Therapy Relationships

The value of the continuing education industry for therapists is questioned, as is the usefulness of therapy books and journal articles, as a means of engaging therapists in life‐long learning. Instead, it is argued that our clients are our best teachers and that therapists learn most effectively from their clients. Drawing on research studies with prominent theoreticians and therapists, and on case studies from clinical work, a number of important themes are identified as ways in which therapists are influenced by their therapeutic encounters with their clients. The themes explored in this article include: (1) intimacy and high emotional arousal with clients as we witness profound change; (2) being challenged by clients; and (3) allowing for boundary ‘crossings’ in order to develop more flexible ways of working with clients. The implications for professional development are discussed.     

Working with Domestic Violence: Ethical Dilemmas in Five Theoretical Approaches

Therapists working with domestic violence are trained in many different theoretical models, each based on different values and assumptions. Each model raises different ethical dilemmas. In this paper, five theoretical approaches are evaluated in relation to the ethical principles of: respect for clients' autonomy; beneficence; non‐maleficence; and justice. The inverse relationship between respect for autonomy and beneficence and non‐maleficence is discussed. The hierarchical asymmetry involved in the therapeutic relationship is also explored.     

Beyond death: inheriting the past and giving to the future, transmitting the legacy of one's self

This study explores the phenomenon of legacy as a component of the aging experience among women. Against a backdrop of prior focus on transmission of material possessions as the primary form of legacy, the concept is critically examined in developing an expanded, theoretically and empirically grounded perspective. In-depth interviews with 38 women, ranging in age from 31 to 94 and representing diverse marital, parental, and health statuses, reveal multiple dimensions of leaving a legacy in terms of content, creation, and transmission. Through the stories of the participants in this study, legacy emerges as a means of passing on the essence of one's self, in particular one's values and beliefs. Legacy is a method of leaving something behind after death and making meaning of the end of life. The desire to leave a legacy is manifest in many different ways dependent on the individual and their culture. While the idea of legacy is often couched in terms of material possessions, it appears that passing on values and beliefs is more important to older adults.     

Examining the Association between Hazardous Waste Facilities and Rural “Brain Drain”*

Abstract Rural communities are increasingly being faced with the prospect of accepting facilities characterized as “opportunity‐threat,” such as facilities that generate, treat, store, or otherwise dispose of hazardous wastes. Such facilities may offer economic gains through jobs and tax revenue, although they may also act as environmental “disamenities.” This analysis examines the possibility that the presence of such facilities equates with lower loss of rural human capital, a question as yet unexamined on a national scale within the academic literature. Making use of secondary data from several different sources, we examine the association between age‐ and education‐specific outmigration and 1) the number of hazardous waste facilities, 2) the number of large quantity hazardous waste generators, and 3) the number of hazardous waste landfills and incinerators across rural counties within the 48 contiguous states. Our findings suggest that the presence of hazardous waste facilities does not clearly equate with reductions in rural “brain drain.”     

Care Of The Soul In Family Therapy

The writing of this article is an attempt to present the struggle of coming to terms with what moves me at my deepest levels and how this conjuncts with my work as a family therapist.