Whose problem? Disability narratives and available identities

Special Issue on the Arts and Community Development, Volume42, Number 4. Unfortunately, the article contained an incorrect quotationthat     

Polymorphism-screening: genetic testing for predisposition—guidance for technology assessment

Health policy is increasingly confronted with the demand for financing genetic testing on inherited susceptibility to disease. Tests on polymorphism/SNP associated with multicausal and chronic conditions are already offered in private commercial institutions or in academic hospitals. The increasing pressure on public health services to offer SNP testing leads to first methodological approaches for a generally valid regulatory framework applicable for inclusion or refusal of genetic tests into the public health services. Systematic search in Medline, Embase and the Web for methodological papers or guidelines for the assessment of polymorphism-screening. Since genetic testing has not only clinical and economic effects on health care, but also primarily ethical consequences by profiling our understanding of “health” and “disease”, this paper gives an overview of relevant aspects and background information to consider in the assessment of genetic tests. Although 2–3 million SNPs are identified and the journals are full of reported “significant” associations between disease and mutation, only a few can be replicated unequivocally. The ACCE (Analytic and Clinical Validity, Clinical utility; Ethical, legal and social implications)-framework was developed by the Center of Disease Control for the assessment of genetic testing. This standardised appraisal approach proposes collecting and evaluating: (a) Prevalence, genotype-/phenotype-relation. (b) Clinical presentation: natural history; the different expressions of disease. (c) Performance of the genetic test. (d) Implications for therapy and prevention. (e) Conclusion for clinical applications of risk-profiling of health on their susceptibility to disease and/or for clarification of disease for therapy planning. Since genetic testing is urging its way into the health care system, the actual danger is, that population screening starts before valid evidence from big prospective studies have been carried out and delivered proofs of direct causal associations. Before diffusing into the health care system we are suggesting to take a cautious and standardised approach.     

Interval estimates for variance components

The fiducial approach to the two components of variance random effects model developed by Venables and James (1978) is related to the Bayesian approach of Box and Tiao (1973). The operating characteristics, under repeated sampling, of the resulting interval estimators for the “within classes” variance component are investigated, and the behaviour of the two sets of intervals is found to be very similar, the coverage frequency of 95% probability intervals being approximately 91% when the “between classes” variance component is zero but rising rapidly to 95% as the between component increases. The probability intervals are shown to be shorter on average than a comparable confidence interval based upon the within classes sum of squares, and to be robust against nonnormality in the class means.     

Computer simulation of adult sentencing proposals

Several legislative proposals have been introduced in the State of Washington which would alter sentencing procedures for adults convicted of felonies. A major policy concern is the degree to which such new legislation would impact population levels in an already overcrowded prison system. The Sentencing Alternatives Impact Simulation Project developed a series of computer simulation programs to model the sentencing proposals. Results of the simulations were made available to the Legislature and to planners for Adult Corrections. This article describes the major model developed, the data required to run it, and the results obtained from it under a variety of hypothetical conditions. It includes a discussion of the level of utilization made of the results, and some comments on the requirements for maximizing utilization in future simulation projects.     

Intention or Attention Before Pointing: Do Infants’ Early Holdout Gestures Reflect Evidence of a Declarative Motive?

Gestures are the first signs of intentional communication within prelinguistic infants and can reflect various motives, including a declarative motive to share attention and interest. The ability to use gestures declaratively has been linked to later language development; therefore, it is important to understand the origins of this motive. Previous research has focused on the use of declarative pointing at around 12 months; however, other potential forms of declarative communication, such as holdout gestures, are yet to be studied in detail. The purpose of this study was to examine whether from 10 months, infants use holdouts declaratively. We elicited holdouts from 36 infants and then reacted to these gestures in four different conditions: (1) joint attention: shared interest; (2) infant attention: attended to infant; (3) toy attention: attended to toy; (4) ignore: gesture was not attended to. Infants’ behavioral responses were recorded. When the experimenter engaged in joint attention, infants were significantly more likely to display a positive attitude and produced fewer re‐engagement attempts. In contrast, the three non‐joint attention conditions displayed significantly higher negative attitudes and attempts to re‐engage the experimenter. We conclude that infants display declarative communication prior to 12 months, resetting the age at which these more complex skills emerge.     

Lessons from stochastic small-area population projections: the case of Waikato subregions in New Zealand

Subnational population projections in New Zealand by means of the conventional deterministic cohort-component method have had a tendency to be conservative: underprojecting fast-growing populations and overprojecting slow-growing ones. In this paper we use a stochastic population projection method as an alternative. We generate population projections for five demographically distinct administrative areas within the Waikato region of New Zealand: Hamilton City, Franklin District, Thames-Coromandel District, Otorohanga District and South Waikato District. The results are compared to official subnational deterministic projections. The accuracy of subnational population projections in New Zealand is strongly affected by the instability of migration as a component of population change. Differently from the standard cohort-component method, in which net migration levels are projected, the key parameters of our method are age-gender-area specific probabilistic net migration rates. Generally, the identified and modelled uncertainty makes the traditional ‘mid-range’ scenario of subnational deterministic projections of limited use for policy analysis or planning beyond a relatively short projection horizon. We find that the projected range of rates of population growth is wider for smaller regions and/or regions more strongly affected by net migration. Directions for further development of the methodology are suggested.     

Summarizing Risk Using Risk Measures and Risk Indices

Our society is fascinated with risk in many different areas and disciplines. One of the main ways to describe and communicate the level of risk is through risk indices, which summarize risk using numbers or categories such as words, letters, or colors. These indices are used to communicate risks to the public, understand how risk is changing over time, compare among different risks, and support decision making. Given the different methods to construct risk indices, including flawed methods such as risk matrices, this article develops specific steps that analysts can follow to create a risk index. This article emphasizes the importance of describing risk with a probability distribution, developing a numerical risk measure that summarizes the probability distribution, and finally translating the risk measure to an index. Measuring the risk is the most difficult part and requires the analyst to summarize a probability distribution into one or possibly a few numbers. The risk measure can then be transformed to a numerical or categorical index. I apply the method outlined in this article to construct a risk index that compares the risk of fatalities in aviation and highway transportation.     

Semiparametric methods for response-selective and missing data problems in regression

Suppose that data are generated according to the model f ( y | x ; θ ) g ( x ), where y is a response and x are covariates. We derive and compare semiparametric likelihood and pseudolikelihood methods for estimating θ for situations in which units generated are not fully observed and in which it is impossible or undesirable to model the covariate distribution. The probability that a unit is fully observed may depend on y , and there may be a subset of covariates which is observed only for a subsample of individuals. Our key assumptions are that the probability that a unit has missing data depends only on which of a finite number of strata that ( y , x ) belongs to and that the stratum membership is observed for every unit. Applications include case–control studies in epidemiology, field reliability studies and broad classes of missing data and measurement error problems. Our results make fully efficient estimation of θ feasible, and they generalize and provide insight into a variety of methods that have been proposed for specific problems.