Extreme value modelling of laboratory safety data from clinical studies

Most clinical studies collect several safety‐related laboratory variables. Generally, it is the extreme values of these variables that indicate potential safety issues. We illustrate the novel application of extreme value modelling to such data, with the aim of predicting the incidence of severe adverse drug reactions. By applying the methods to a clinical trial data set, we identify a dose–response relationship and use Bayesian techniques to identify a potential safety concern by making predictions from the fitted model, despite the small sample size. Copyright © 2012 John Wiley & Sons, Ltd.     

Financial exploitation of older persons: challenges and opportunities to identify, prevent, and address it in the United States

Financial exploitation is a recognized social problem of unknown, though likely increasing, magnitude. It can occur through numerous methods, including the misuse of powers of attorney and guardianship, illegal transfers of property, and outright fraud and theft. Financial crimes against older persons are difficult to address because they often go unreported. This paper provides a summary of findings from a study of financial exploitation of older persons. We review what is known about the nature and scope of financial exploitation of older persons and describe barriers to addressing the problem. We also identify gaps in knowledge, discuss current methods for addressing financial exploitation, and provide recommendations and suggested policy approaches for prevention and remediation.     

What's up? What young teens and parents want from youth programs

Young teens and their parents clearly state that the "if you build it, they will come" approach, even if it is well built, is only part of the solution for engaging young people in learning opportunities. Interviews with youth and parents explore what they are doing and what they say they want in their nonschool hours. Opportunities that are flexible, less structured, and more leisure-based emerge as priorities. Although relatively content with the options currently available to them, when pressed, youth and families want more connections between people and age groups as well as more of the free-spirited, organic activities likely to emerge in neighborhoods and communities.     

A Student Looks at Junior Town Meetings

This article provides some strategies to alleviate the current tensions between personal responsibility and freedom of speech rights in the public school classroom. The article advocates the necessity of making sure students understand the points and implications of the first amendment by providing a mock trial unit concerning free speech rights. This unit not only teaches the rules of civility in a courtroom, it also presents a free speech case based upon one that actually happened in a public school classroom. Direct involvement in this case provides a safe environment for students to grapple openly with free speech limits.     

The Process of Problem Pregnancy Counseling

Abstract

Effective counseling for women experiencing an unwanted pregnancy can facilitate quality decision making and personal growth. Supportive counseling minimizes the trauma and the potential for emotional deterioration. Timely counseling augments a woman's coping ability with this current life crisis and provides her with a positive, growth-producing experience. A counseling process to accomplish these objectives is described. The concepts of crisis theory and active decision making are applied to the pertinent social, emotional, and medical ramifications of pregnancy, parenthood, and abortion. Subjective reporting and clinical experience indicate that women receiving such counseling are better able to deal with and resolve the crisis of unwanted pregnancy.     

Texts in action: how nurses are doing the fiscal work of health care reform

Canada's publicly insured system of socialized health care is coming under intense scrutiny by governments firmly focused on the politics of national indebtedness and public spending. Contemporary health care reforms aimed at cutting costs and increasing productivity place new emphasis on “official knowledge” constituted through particular textual practices. Since 1994 the Canadian Institute of Health Information (CIHI) has become a powerful regulator of patient care. It has entered business-like accountability and rationing practices based on competitive, market-like comparisons into Canadian hospitals in order to “assist leaders in the health sector make informed decisions” (CIHI 2000). Using Canadian sociologist Dorothy E. Smith's (1987) Institutional Ethnography, with a specific focus explicating a Smithian textual analysis (1990a, 1990b, 1999), this paper explores, in depth, one feature of how a business genre is being inserted into the everyday practices of nurses and doctors who work with the frail elderly in a small community hospital in British Columbia.     

RE-MAPPING THE PUBLIC

This paper traces the changing political/cultural formations of publicness in Britain, and how these intersect with emerging strategies for governing the social. It draws on three sets of discursive oppositions or elisions – those of public/community; community/bureaucracy; and public/social – to trace successive struggles over the fortunes of a public institution that, I argue, stands as an icon of the public sphere – the public library service. The account illuminates how notions of publics and publicness have been made and remade, expanded and residualized, by state professionals in Britain over the last 50 years as they struggled with the incursions of ‘new’ publics as well as seeking to mediate the impact of the Thatcher years and Blair governments. But rather than reading the decline of the public library service in Britain as just another example of neo-liberal governance, the paper argues for an approach that pays attention to the specificity of institutional histories and to the organizational and occupational forces that produce and mediate cultural change.     

Gender and ethnic equity in Aotearoa New Zealand's public service before and since Covid-19: Toward intersectional inclusion?

Since its bi-cultural foundation with Te Tiriti o Waitangi (the Treaty of Waitangi, signed in 1840 by Māori, the indigenous Polynesian people of Aotearoa New Zealand (NZ), chiefs and representatives of the British Crown), cultural identities have expanded through immigration. While Aotearoa NZ's government seeks to encourage workplace diversity in public service agencies, developments are being disrupted by Covid-19. Using a typology of equality approaches, this study appraises the “ambition” of equity progress in Aotearoa NZ public service agencies based on content analysis of interviews with sector experts, agency staff and managers. In terms of equity discourses, workplace inequities emerge as more pronounced for Māori and Pasifika (the indigenous peoples of the Pacific), indicating that more “ambitious” equality initiatives, including those which aim for intersectional inclusion, are needed. The study thereby contributes a more nuanced understanding of equity approaches that could meaningfully inform workplace initiatives designed to recognize, value and empower gender diversity. Its relevance for Aotearoa NZ, which has one of the most diverse working-age populations in the world, is likely to resonate in other countries where workforce diversity is yet to translate into equitable engagement in and experiences of work organizations by all.     

The evolution and impacts of Graeme Hugo’s environmental migration research

Drawing on Graeme’s published and unpublished work, as well as his long-term collaborations with two of us, we identify strands of thought that Graeme kept returning to and refining over the course of his career. We trace the evolution of four key points that he often reiterated: (1) The migration-environment relationship is complex and oversimplified; (2) Migration is both a consequence and a cause of environmental change; (3) Migration is just one possible response to environmental change; and (4) Displacement is just one type of migration response. We briefly map his impact on environmental migration scholarship and policy by revealing how key publications have been used in different contexts to shape theory and practice.