Estimating the Prevalence of Sexual Function Problems: The Impact of Morbidity Criteria

Establishing the clinical significance of symptoms of sexual dysfunction is challenging. To address this, the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) introduced two new morbidity criteria (duration and symptom severity) to the existing criteria of distress. This study sought to establish the impact of these three criteria on the population prevalence of sexual function problems. The data come from a national probability survey (Natsal-3) and are based on 11,509 male and female participants aged 16–74, reporting at least one sexual partner in the past year. The key outcomes were: proportion of individuals reporting proxy measures of DSM-5 problems, and the proportion of those meeting morbidity criteria. We found that among sexually active men, the prevalence of reporting one or more of four specific sexual problems was 38.2%, but 4.2% after applying the three morbidity criteria; corresponding figures for women reporting one or more of three specific sexual problems, were 22.8% and 3.6%. Just over a third of men and women reporting a problem meeting all three morbidity criteria had sought help in the last year. We conclude that the DSM-5 morbidity criteria impose a focus on clinically significant symptoms.     

Equalising opportunities in health through educational policy

Despite the growing prominence of theoretical analysis of inequality of opportunity over the past twenty years, empirical work towards the normative evaluation of real-world policies has been minimal. This paper seeks to address this issue. It proposes a normative framework to model the influence of educational policy on health outcomes, grounded in Roemer’s model of equality of opportunity. We apply this model to the National Child Development Study cohort, who, since their schooling lay within the transition period of the comprehensive education reform in England and Wales, attended different types of secondary school. We use this reform in two ways: first, to evaluate the health outcomes of different educational policies under different normative principles; second, to simulate counterfactual distributions of health outcomes by neutralising the different channels through which early life circumstances influence health. Evidence on the comparative performance of the two educational systems is mixed, suggesting that the opportunity-enhancing effects of the comprehensive reform were, at best, modest in terms of adult health. For some of the health outcomes considered, this leads to a convergence between the policy recommendations made by the two ethical principles of equality of opportunity and utilitarianism, while for others, the two principles diverge in their evaluation.     

Performing Child(hood)

Taking an example of play as our point of departure, we consider what it means to be a child and to perform (Butler, Feminism/Postmodernism, 1990; Gender, 1990. Routledge: New York) childhood. By drawing on poststructuralist accounts of subjectivity, language and meaning (Foucault, Discipline and Punish: The Birth of the Prison, 1979. Penguin: Harmondsworth; Derrida, Dissemination, 1974. Athlone: London), we argue that despite powerful discourses that seek to contain childhood, children manage to exceed or interrupt sites of containment. We then go on to suggest that if children themselves are moving beyond some of the discourses in which they are enwrapped, how might we seek to further destabilise what ‘becoming’ (Deleuze,1990: http://www.generation-online.org/p/fpdeleuze3.htm ) child might mean and what might be the implications for our practice(s) with children.     

Infant Physiological and Behavioral Responses to a Jealousy Provoking Condition

Recent research has demonstrated a relationship between infants' tonic electroencephalogram (EEG) patterns and approach‐style jealousy responses (Mize & Jones, 2012 ). Although it has been found that adults exhibit approach‐style neural activity during jealousy paradigms (Harmon‐Jones, Peterson, and Harris, 2009 ), parallel research on neural activity during a jealousy paradigm in infants is lacking from the literature base. The purpose of the current research is to examine EEG patterns of 35 infants (Mean age = 8.92 months old) in a social‐rival paradigm designed to elicit jealousy responses. Consistent with past research, infants demonstrated more approach‐style, jealousy‐related behaviors when their mothers attended to a social‐rival than to a nonsocial rival. Additionally, infants demonstrated approach‐style anterior EEG activity during the social‐rival condition, a pattern that is associated with jealousy. The current findings suggest that the physiological underpinnings for the emotions that motivate the protection of important dyadic relationships are in place early in ontogeny. Therefore, jealousy‐type behaviors and physiological responses begin to be observable as early as 9‐months‐old when maternal attention is lost to a social‐rival.     

"The only dykey one": constructions of (in)authenticity in a lesbian community of practice

This article demonstrates how members of a lesbian community of practice make interactional moves that allow them to position themselves as "authentically lesbian." Through the use of discourse analysis and a sociocultural linguistics focus on indexicality, the speakers are shown to invoke broadly accessible stereotypes and ideologies and to rework them in order to create locally specific, meaningful identities. This is achieved via mutually negotiated stance taking toward group-constructed, oppositional personae. Specifically, the women in this group position styles deemed as "girly" as inauthentic and antithetical to their concept of a lesbian--the authentic "dyke."     

Fitting E(max) models to clinical trial dose-response data

We consider fitting Emax models to the primary endpoint for a parallel group dose–response clinical trial. Such models can be difficult to fit using Maximum Likelihood if the data give little information about the maximum possible response. Consequently, we consider alternative models that can be derived as limiting cases, which can usually be fitted. Furthermore we propose two model selection procedures for choosing between the different models. These model selection procedures are compared with two model selection procedures which have previously been used. In a simulation study we find that the model selection procedure that performs best depends on the underlying true situation. One of the new model selection procedures gives what may be regarded as the most robust of the procedures.     

The context of decision-making in cases of child neglect

This paper explores professional decision-making in cases of child neglect within the context of child protection practice in Britain. The literature on the nature of neglect is reviewed. Difficulties associated with decision-making are then examined within a framework that addresses the social, political and organizational context of child protection practice. It is argued that the current system, which focuses on incidents of abuse rather than the context of children's lives, provides inadequate protection for many children experiencing chronic neglect. Conclusions are drawn with regard to the development of practice that supports vulnerable parents while still remaining the child's welfare as paramount. © 1998 John Wiley & Sons, Ltd.     

Emotional Reactions of Heterosexual Men to Gay Imagery

Studies of homonegativity in the general population typically use scales to examine the attitudes of a heterosexual sample toward gay men and lesbian women. However, these scales fail to address that accepting gay and lesbian people in theory is not tantamount to accepting the sexual practices engaged in by gay and lesbian people. As a result, relying on homonegativity scales and hypothetical scenarios (i.e., asking a participant to imagine a gay man or lesbian woman from personality characteristics provided) may not offer a complete view of the complexities of homonegativity. To explore this possibility, 83 men self-identifying as either largely or exclusively heterosexual rated one of three groups of images (romantic gay, erotic gay, and control) on the basis of five questions related to their emotional responses. A psychometrically sound homonegativity scale was also completed. Results indicated that homonegativity was a significant predictor of decreased happiness, anger, disgust, task enjoyment, and reported liking of the imagery. Furthermore, homonegativity was found to moderate the association between exposure to the romantic images and four of the five emotional responses (happiness, anger, disgust, and liking). Exposure to the set of erotic gay images, however, was associated with negative emotional responses, regardless of participants’ self-reported level of homonegativity (i.e., overt homonegativity possessed less moderational power for this type of imagery). These findings suggest that standard scales of homonegative attitudes may be unable to capture the affective negativity that heterosexual men experience when viewing gay male intimacy.     

META-DESIGN CONSIDERATIONS IN DEVELOPING MODEL MANAGEMENT SYSTEMS*

This paper examines cognitive considerations in developing model management systems (MMSs). First, two approaches to MMS design are reviewed briefly: one based on database theory and one based on knowledge-representation techniques. Then three major cognitive issues—human limitations, information storage and retrieval, and problem-solving strategies—and their implications for MMS design are discussed. Evidence indicates that automatic modeling, which generates more complicated models by integrating existing models automatically, is a critical function of model management systems. In order to discuss issues pertinent to automatic modeling, a graph-based framework for integrating models is introduced. The framework captures some aspects of the processes by which human beings develop models as route selections on a network of all possible alternatives. Based on this framework, three issues are investigated: (1) What are proper criteria for evaluating a model formulated by an MMS? (2) If more than one criterion is chosen for evaluation, how can evaluations on each of the criteria be combined to get an overall evaluation of the model? (3) When should a model be evaluated? Finally, examples are presented to illustrate various modeling strategies.