Letters to the editor

Relatively little attention has been paid to the use and importance of labels used by men who have sex with men to describe insertive or receptive sexual behavior during intercourse. This study examines sexual self‐labels, sexual behavior, HIV transmission risk, and psychological functioning among 205 HIV‐seropositive men who have sex with men. The majority of participants (88%) identified as a “top, “ a “bottom, “ or “versatile. “ Tops were more likely to engage in insertive anal intercourse than bottoms, and bottoms were more likely to engage in receptive anal intercourse than tops, with versatiles reporting intermediate rates of both behaviors. Although the results suggest preliminary evidence regarding the predictive utility of self‐labels, sexual behaviors of self‐label groups were greatly overlapping. Differences were found among self‐label groups in gay self‐identification, internalized homophobia, sexual sensation seeking, and anxiety. Results suggest an added value in assessing self‐labels in addition to asking about sexual behavior.     

A personal validation of the social nature of disability: different environments,different experiences

There is neither a unified definition of disability nor a unique experience of disability across the world. The present paper aims to explore the lived experiences of disability in three different countries – Turkey, England and the USA – to evaluate the continued value of the social model of disability in those contexts. A comparison between these countries is provided through the lens of my personal experiences in each country as a disabled student and an academician. As can be seen in each example, whilst impairment does not change, the role of disabling barriers did change depending on the physical, social and psychological nature of the respective environments. We can therefore reasonably refer to the extent to which environments are disabling or non-disabling aspects of each setting. The paper provides a personal validation of the social nature of disability.     

A comparison of various methods for estimating the parameters in mixtures of von mises distributions

In this paper we compare five methods for estimating the unknown parameters in a mixture of two von Mises distributions. We propose a new method based on the characteristic function and compare it with the classical methods based on maximum likelihood and moments. Thus far these methods have been successfully applied only to linear data. Here we show that the application to circular data is reasonably straightforward and that convergence to the final estimates is fairly rapid. For various simulated known mixtures the results obtained are satisfactory. Finally, we introduce a modification of the method of moments which is considerably faster in CPU time than any of the other methods used and gives good results.     

The exact solution to the mle of a decreasing density based on arbitrarily right censored data

Nonparametric maximum likelihood estimation of decreasing and unimodal density functions, based on observations subject to arbitrary right censorship, was considered by McNichols and Padgett(1982). In order to compute their estimators, however, nonlinear equations with linear constraints had to be maximized using numerical techniques. The exact solution to this problem can now be found. An example illustrates the simplicity of the method.     

An emplrical bayes approach in estimating the parameters of the or more geometric distributions

The estimation of the parameters of two or more geometric distribuionsis considered by usinq an empirical Bayesian approach. Robbins (1983) gave empirical Bayes estimates if the number of distributions N is large, buthere we consider the cascwhore N is small. The parameters of the prior distribution areest imated by looking at maximum like lihood and momentest imation methods.     

Accounting for unsafe sex: Interviews with men who have sex with men

Semi‐structured one‐on‐one interviews with 102 gay and bisexual men were conducted to examine the reasoning processes men use to exempt themselves from practicing safe sex. Qualitative analysis of the interviews revealed the following recurring themes: (a) Many men who were in couple relationships avoided condom use for reasons involving intimacy or trust, or because both partners were HIV‐negative; (b) unsafe sex sometimes occurred inadvertently or involuntarily; (c) negative moods and self‐images were associated with unsafe sex; (d) by “intuiting” that their partner was HIV‐negative, participants exempted themselves from the need for safe sex; and (e) when the boundary between safe and unsafe was unclear, participants used a combination of unofficial and official guidelines to determine what is safe.     

On the distance paired domination of generalized Petersen graphs <Emphasis Type="Italic">P</Emphasis>(<Emphasis Type="Italic">n</Emphasis>,1) and <Emphasis Type="Italic">P</Emphasis>(<Emphasis Type="Italic">n</Emphasis>,2)

Let G=(V,E) be a graph without an isolated vertex. A set D⊆V(G) is a k -distance paired dominating set of G if D is a k-distance dominating set of G and the induced subgraph 〈D〉 has a perfect matching. The minimum cardinality of a k-distance paired dominating set for graph G is the k -distance paired domination number, denoted by γ _p ^k (G). In this paper, we determine the exact k-distance paired domination number of generalized Petersen graphs P(n,1) and P(n,2) for all k≥1.     

Continuing Competence and Relicensure

Abstract

The purpose of licensing laws is to provide assurance of high quality service and to protect the public from incompetent practitioners. Safeguarding entrance to the professions by licensing examinations is one part of this responsibility which is entrusted to the professional boards. Assuring the continuing competence of practicing professionals is another part and a major challenge to every board of nursing throughout the United States.

A 1979 mail survey identified 18 states which have specific continuing education requirements for relicensure of nurses. In addition, three states have standards of practice incorporated in the rules and regulations governing the nursing profession.

Mandatory continuing education is a first step in the implementation of a system to assure the public of the continuing competency for practice of the professional nurse. It is acknowledgement, with the force of law, that continuous renewal of knowledge is a necessary condition for assuring competence. However, it is not sufficient in itself. Knowledge must be integrated in performance, which is the final test of competency. Thus, other system components that assure continuing competency must be developed and implemented. These include the identification of standards of acceptable performance, and the development and implementation of measures to evaluate practicing professionals and assure that they meet the performance standards. These measures include peer review, self-assessment, and recertification procedures. Successful implementation of a complete effective system will require the collaborative efforts of practicing nurses, their professional organizations, and the state boards of nursing.     

Evaluation of the Service Review Model With Performance Scorecards

The current study combined a management technique termed “Service Review” with performance scorecards to enhance staff and consumer behavior in a human service setting consisting of 11 supervisors and 56 front-line staff working with 9 adult consumers with challenging behaviors. Results of our intervention showed that service review and scorecards produced significant staff behavior changes that were maintained over time. Positive consumer outcomes were also correlated with staff performance changes. The behavioral package of training, clinical consultation, service review, biweekly manager meetings, scorecards, and public posting has the potential to reduce the need for monetary staff incentives.