Still-births among the offspring of male radiation workers at the Sellafield nuclear reprocessing plant: detailed results and statistical aspects

Summary. This study investigates whether there was evidence of increasing risk of still-birth with increasing paternal exposure to ionizing radiation received during employment at the Sellafield nuclear installation before the child was conceived. A significant positive association is found between the total paternal preconceptional exposure to external ionizing radiation and the risk of still-birth (after adjustment for year of birth, social class, birth order and paternal age, odds ratio at 100 mSv 1.24 (95% confidence interval 1.04–1.45)). A summary of the principal scientific findings of this study has been published in the Lancet . This paper describes in detail the statistical methods that were used in the investigation and presents the results in full.     

Stjepan Metrović and Michel Maffesoli's 'implosive' defence of the Durkheimian tradition: theoretical convergences around Baudrillard's thesis on the 'end' of the social

This paper critically examines Metrovi? and Maffesoli's attempt to understand postmodernity through Émile Durkheim's nonrational link between society, religion and morality. Metrovi? (1991, 1997) and Maffesoli's (1996) work draws upon this emotional element when attempting to refute Baudrillard's (1983) cognitively focused, if implicit, critique of the Durkheimian tradition. Despite their best intentions, Metrovi? and Maffesoli still fail to exploit the partialities of Baudrillard's critique to the full. While both have some appreciation of the link between emotion and religion as found in Durkheim's The Elementary Forms of Religious Life (1912) they, nevertheless, fall short of grasping its full conceptual importance. This leads them to an implicit acceptance of Baudrillard's thesis on the ‘end’ of the social. This pitfall could have been avoided if Metrovi? and Maffesoli had built their respective analyses of the postmodern condition on a closer reading of The Elementary Forms. Reading this text alongside those other insights on emotion and social life as contained within Durkheim and Mauss's Primitive Classification (1903) and Talcott Parsons's subsequent writings on the sociological problem of religion, would have helped to distance the work of Metrovi? and Maffesoli from that of Baudrillard, and allowed them to offer a stronger and more comprehensive defence of the said tradition.     

Estimation of Hazard, Density and Survivor Functions for Randomly Censored Data

Maximum likelihood estimation and goodness-of-fit techniques are used within a competing risks framework to obtain maximum likelihood estimates of hazard, density, and survivor functions for randomly right-censored variables. Goodness-of- fit techniques are used to fit distributions to the crude lifetimes, which are used to obtain an estimate of the hazard function, which, in turn, is used to construct the survivor and density functions of the net lifetime of the variable of interest. If only one of the crude lifetimes can be adequately characterized by a parametric model, then semi-parametric estimates may be obtained using a maximum likelihood estimate of one crude lifetime and the empirical distribution function of the other. Simulation studies show that the survivor function estimates from crude lifetimes compare favourably with those given by the product-limit estimator when crude lifetimes are chosen correctly. Other advantages are discussed.     

BUILDING THE EVIDENCE BASE FROM LONGITUDINAL DATA

Survey data from cross-sectional snapshots give an incomplete picture of the social fabric. Without longitudinal information, planners, practitioners, social scientists and policy makers would be in the dark about dynamics, durations and pathways of human development. Longitudinal data collected in birth cohort studies give a better guide to long-term processes and outcomes and are more informative about the causal relations that are the drivers of disadvantage or success. The content and structure of Britain's Birth Cohort Studies are described to illustrate the challenges of creating and studying longitudinal evidence. Examples of findings and policies based on these prospective longitudinal studies are given, along with a discussion of the practical decisions that have to be confronted in undertaking them.     

Risk management: a general framework for rural development

This paper proposes a new concept of rural development in an uncertain world. The nature of risk and uncertainty is discussed and risk management is defined as a positive model of economic and social behaviour. Some relevant paradigms for rural development are reviewed and evaluated within the general approach of risk management. It is demonstrated that the proposed view of risk management can effectively combine and reconcile different approaches by highlighting their advantages and shortcomings. Departing from a subjective definition of risk management, we progressively include its social dimensions which introduce both complexity and structure into the process of rural development.     

Health technology assessment between our health care system and our health

In this contribution, I wish to explore the potential of health technology assessment and ethics for increasing our capacity to pre-empt the shortcomings and undesired consequences of modern health care while maintaining its benefits. Central is the presumption that in case of some health problems this cannot be done unless we explicitly reconsider some features of the modern health care system, especially those related to its strong reliance on scientific rationality and the strong role played by medical professionals. So as to both maintain the benefits of advanced health care and ensure that it produces less reason for concern, we need to reconsider our approach to rationality—and maybe even the way in which we build our health care system around that rationality. That is, we need to introduce an element of reflexivity. Two types of circumstances are being explored in which such reflexivity may prove worthwhile: controversies on side effects, and persistent problems encountered in optimising health care. Drawing on brief discussions of typical cases, we explore the potential of reflexive HTA and its methodical prerequisites. We conclude that ethicists may contribute to reflexive HTA, if they combine a hermeneutic—and often also participative—methodology with a solid understanding of the relation between the health problem under scrutiny and more general critique of the health care system. Insights from the areas of science and technology studies, as well as from social philosophy may be critical items in their tool kit.