Comparison of Two Smoothing Methods for Exploring Waning Vaccine Effects

We consider the statistical evaluation and estimation of vaccine efficacy when the protective effect wanes with time. We reanalyse data from a 5-year trial of two oral cholera vaccines in Matlab, Bangladesh. In this field trial, one vaccine appears to confer better initial protection than the other, but neither appears to offer protection for a period longer than about 3 years. Time-dependent vaccine effects are estimated by obtaining smooth estimates of a time-varying relative risk RR( t ) using survival analysis. We compare two approaches based on the Cox model in terms of their strategies for detecting time-varying vaccine effects, and their estimation techniques for obtaining a time-dependent RR( t ) estimate. These methods allow an exploration of time-varying vaccine effects while making minimal parametric assumptions about the functional form of RR( t ) for vaccinated compared wit unvaccinated subjects.     

Estimating the transmission probability of human immunodeficiency virus in injecting drug users in Thailand

We estimate the transmission probability for the human immunodeficiency virus from seroconversion data of a cohort of injecting drug users (IDUs) in Thailand. The transmission probability model developed accounts for interval censoring and incorporates each IDU's reported frequency of needle sharing and injecting acts. Using maximum likelihood methods, the per needle sharing act transmission probability estimate between infectious and susceptible IDUs is 0.008. The effects of covariates, disease dynamics, mismeasured exposure information and the uncertainty of the disease prevalence on the transmission probability estimate are considered.     

Between universalism and particularism: the historical bases of Muslim communal,national, and global identities

In recent decades there has been an extraordinary flourishing of transnational and global Islamic movements. Most of these are religious reform and missionary movements; some are political networks working to form Islamic states. Yet on closer examination we find that universalistic Islamic movements are almost always embedded in national state and parochial settings. Muslim, and national, ethnic, tribal and local identities blend together. This blending of universalistic and particularistic affiliations has deep‐rooted precedents in Islamic history. The original Muslim community of Medina represented a monotheistic vision encadred in a community of clans. The universal empire of the Caliphate gave rise to schools, brotherhoods, and sectarian communities. Sufi reform teachings of the late seventeenth to the twentieth century defined Islamo‐tribal movements. In the twentieth century universalistic Islamic reformism inspired nationalism and anti‐colonialism. The paper concludes with some comments on the mechanisms by which historical and cultural precedents are carried into modern times.     

Psychotherapeutic approaches to the cancer patient

Three basic therapeutic approaches applicable to the majority of cancer patients are outlined and illustrated with case vignettes. They are: (1) Initial catharsis and validation of feelings, (2) Restoring communication impaired by denial, and (3) Understanding the psychological meaning of the illness. Using this framework, the therapist's professional skills may be organized toward specific interventions, thereby stabilizing the associated ego functions against the regression often induced by the anxieties mobilized by working with seriously ill patients.     

Role Transitions,Objects, and Identity

Most research on role transitions, following a tradition pioneered by van Gennep, regards these major turning points in the life course primarily as times when people move between different sets of social networks. While these studies acknowledge that rites of passage occur within particular physical spaces in which material objects are present, the importance of such objects has received little attention. I explore one particular role transition—moving away to college—and illustrate that objects play a central role in how students construct their identities. Students at “Midwestern” University make strategic choices about which objects to leave at home as anchors of prior identities and which ones to bring to school as markers of new identities. Moreover, I suggest that the meanings of these two categories of objects differ by gender. I argue that this case opens up the possibility that objects play a much more central part in role transitions than social scientists have acknowledged. This study also challenges existing assumptions about different processes of identity formation. Therefore, it engenders the need for additional research about how people reinterpret objects during role transitions, and about the different meanings that objects may have for the constructions of masculinity and femininity.     

Challenging Social Work Education’s Urban Legends

Urban legends circulate throughout society, including higher education and social work education. Some academic mythologies take on the status of a tradition—no matter the evidence or lack thereof—and continue to thrive, to influence thinking, and to shape norms, which, in turn, direct behaviors. As with urban legends, academic myths are able to overpower and dismiss the conclusions drawn from critical thinking processes. Accreditation standards, common program structures, and faculty behaviors and expectations have evolved over time grounded in and shaped by various legends. Social work educators applying critical thinking processes to their educational enterprise will be able to challenge with intellectual rigor the profession’s urban legends, which will then result in national standards and program models that are creative, proactive, and forward-thinking.     

Evaluating strategies to avoid AIDS: Number of partners vs. use of condoms

A probability model based on the best estimates we have today for prevalence and infectivity of Human Immunodeficiency Virus (HIV) has been developed. The model is used to compare the two most widely publicized risk reduction strategies: (1) Reducing the number of partners and (2) Using condoms. The results indicate that under almost all conditions of prevalence and infectivity, consistent and careful condom use is a far more effective method of reducing the risk of HIV infection. The analysis is applied to both high and low prevalence groups. In order to test more rigorously the conclusions, infectivity rates ten times higher than now estimated are examined, and infectivity is estimated on a per partner, as well as a per sexual act basis. Epidemic growth of prevalence is estimated to further check our findings. None of these conditions alters our basic conclusion. It is suggested that there is reluctance to publicize such findings about AIDS because they may be used to support having multiple sexual partners. Nevertheless, it is assumed to be more important to protect ourselves from infection than to sustain norms opposed to multiple sexual partners. Thus, our results may prove extremely useful to those who give advice to people concerning risk reduction strategies.