Assessing gamma frailty models for clustered failure time data

Proportional hazards frailty models use a random effect, so called frailty, to construct association for clustered failure time data. It is customary to assume that the random frailty follows a gamma distribution. In this paper, we propose a graphical method for assessing adequacy of the proportional hazards frailty models. In particular, we focus on the assessment of the gamma distribution assumption for the frailties. We calculate the average of the posterior expected frailties at several followup time points and compare it at these time points to 1, the known mean frailty. Large discrepancies indicate lack of fit. To aid in assessing the goodness of fit, we derive and estimate the standard error of the mean of the posterior expected frailties at each time point examined. We give an example to illustrate the proposed methodology and perform sensitivity analysis by simulations.     

Unpacking Priscilla: Subjectivity and Identity in the Organization of Gendered Appearance

This paper argues that our understandings ofourselves as gendered, as either masculine or feminine,are a power effect of the contemporary discourse ofgender difference. The main premise of the paper is that this social construction of genderallows for gender difference to be resisted — andthe form of resistance analyzed here isgender-inappropriate dress. Two forms ofgender-inappropriate dress — male transvestism and female power dressing —are discussed in the paper and argued to present aparticular kind of challenge to our discursivelyconstituted sense of the rigidity and mutual exclusivityof the gender divide. This analysis is used in theconclusion to offer some critical comments regarding thestrand of organizational analysis which argues for afeminization/reeroticization of the workplace.     

Using attachment theory to understand the treatment of adult depression

John Bowlby developed attachment theory to explain connections between infant and caregiver behavior and how these impacted children’s behavior. Extended and researched heavily in a variety of contexts, attachment theory has advanced clinical thinking over time. Its core ideas regarding infant and caregiver connections are very useful to mental health practitioners today and have particular ramifications for clinical work with adults. This paper discusses the application of Bowlby’s attachment theory to the clinical treatment of adult depression and explores a relevant case example.     

Improving community health through evaluations

There has been an increasing emphasis on sustainable communitydevelopment in recent years, which is linked to community healththrough quality of life and intergenerational considerations.Evaluations are one of the basic tools to improving communityhealth with the most effective evaluations being those thatare meaningful to the community itself, and which provide tangiblefeedback and incentives for improved performance. Drawing onwell-known methods, this paper illustrates four important componentsof community evaluations. Although each method incorporatessome or all of these components, their achievements to datehave been limited. The reasons for this, as well as how evaluationscan play a more effective role in improving community health,are discussed.     

Reciprocal relationships among alcohol use, risk perception, and sexual victimization: a prospective analysis

OBJECTIVE: The authors' purpose in this study was to assess longitudinally the relationships among alcohol use, risk perception, and sexual victimization. PARTICIPANTS: Three hundred and seventy-two women from 2 midsized universities made up the sample. METHODS: Participants filled out questionnaires regarding history of sexual victimization, alcohol use, and perceived personal risk for sexual assault in the following 2 months. The authors then reassessed participants at 2 follow-up periods. RESULTS: The pattern of results suggested that that the relationship between alcohol use and sexual victimization was complex and that alcohol use may moderate the relation between history of victimization and revictimization for women with sexual assault histories. In particular, results indicated an increase in risk for sexual revictimization with increases in alcohol use for women with a history of sexual victimization. The data did not, however, support a reciprocal relationship between sexual assault and drinking (eg, in that a sexual victimization during one time period did not predict drinking behaviors in subsequent time periods). CONCLUSIONS: These results underscore the importance of both alcohol and sexual assault programming on college campuses.     

Parenting in Females Exposed to Intimate Partner Violence and Childhood Sexual Abuse

Child sexual abuse and intimate partner violence may have a significant impact on parenting. The current study expands on existing research by examining the effects of child sexual abuse and intimate partner violence on parenting styles and parenting self-efficacy. In women from a parenting intervention program (n?=?20), child sexual abuse was related to lower parenting self-efficacy and more permissive parenting. In women at a domestic violence shelter (n?=?45), child sexual abuse was related to current sexual coercion of the partner, and authoritative parenting was related to higher parenting self-efficacy. These results indicate that having a history of child sexual abuse should be taken into consideration when dealing with mothers in violent relationships.     

Prostitution and the Politics of HIV Prevention in Cambodia: A Historical Case Study

Cambodia received international attention in the early 1990s when it emerged from civil war with the highest HIV rate in Asia, in which up to 60% of sex workers were infected. A massive influx of financial, human, and material resources ensued, and debates over “best practices” for HIV prevention were played out. Over time, the politics of AIDS shifted, mirroring changes in the politics of the largest player in global health, the United States. This sparked acrimonious polarization within international health policy, with direct implications for the lives of sex workers. This article traces those debates over sex work and HIV, highlighting the example of one brothel district in Cambodia where Medecins Sans Frontieres provided services to over 300 migrant Vietnamese sex workers. Using literature and program documentation from the time, this article highlights how countries such as Cambodia can become vulnerable to manipulation and used to serve wider political agendas.