Black/White Differences in Health Status and Mortality Among the Elderly

Grade of membership (GOM) representations are used to characterize and compare the health status of a very heterogeneous sample of blacks and whites in an elderly cohort of 2,806 noninstitutionalized men and women living in New Haven, Connecticut. They were interviewed in 1982 as part of the Established Populations for the Epidemiologic Study of the Elderly (EPESE). Ideal profiles based on functional disabilities, chronic diseases, and selected biomedical and behavioral risk factors are constructed empirically. Each individual in the sample is represented by a set of GOM scores, interpreted as degrees of similarity of his or her health record to each of the profiles. Four profiles emerge from GOM analyses: healthy elderly, elderly with cognitive impairment, elderly with impairment in mobility function and physical performance and with selected chronic conditions, and elderly with major limitations in activities of daily living and multiple chronic conditions. Although elderly blacks and whites generally have similar configurations of profiles, there are important differences, especially when chronic conditions are related to specific types of functional impairments. Questions about and claims for black/white mortality crossovers at older ages, usually addressed with aggregate data, are examined conditional on GOM scores that correspond to diverse combinations of disabilities (or lack thereof) together with housing characteristics of cohort members (e.g., whether they live in public housing for the elderly or in owned or rented housing in the community).     

The efficacy of early intervention programs for children with organic impairment: A quantitative review

The results of studies examining the effectiveness of early intervention for infants and children with organic impairment and developmental delay were reviewed using recently developed quantitative methods that treat the literature review process as a unique type of scientific inquiry. Thirty-eight studies meeting certain predetermined criteria were included in the review. The 38 studies contained a total of 118 statistical hypothesis tests that evaluated the effectiveness of early intervention. An analysis of these tests based on the calculation of effect sizes revealed that subjects receiving early intervention performed better on a wide range of dependent measures than subjects not receiving intervention. The outcomes were found to be related to several design and study characteristics. Larger effect sizes were associated with preexperimental designs, and also with studies in which the internal validity was rated as poor. Several other design variables such as how subjects were assigned to conditions and how the dependent measure was recorded were related to study outcome as measured by effect size. The conclusion was made that an accurate interpretation of the early intervention research literature cannot be made without consideration of specific design variables and study characteristics.     

Deviance,Rule-Breaking and Male Dominance in Conversation

Previous research on dyadic interaction indicates that cross-sex conversations (male-female) are characterized by more frequent interruptions than same-sex conversations. More specifically, males consistently tend to interrupt their female co-conversationalists. Survey data from three student samples suggest that normative definitions reflected in perceptions of interruption are inconsistent with the empirical distribution of rule-breaking observed by conversational researchers. These results provide some strategic insights into the problematic distinction between deviance and rule-breaking that has been central to labeling theory.     

Religion as a Meaning System: Policy Implications for the New Millennium

The development of social policy related to religion has received increasing focus in recent years, yet psychology continues to play a relatively minor role in this important domain. In the current article, religion's positive and negative influences as a meaning system on individual, community, and societal well-being are delineated. The challenges facing psychology in contributing to public policy development in the religious arena are examined, challenges that stem from profound differences in the meaning systems of religion, government, and psychology. These challenges notwithstanding, a number of different pathways in the domains of applied research, community practice, and policy development are delineated through which psychology can help to maximize positive, and minimize negative, outcomes in the religion and social policy arena.     

A comparison study of realtime fatality rates: severe acute respiratory syndrome in Hong Kong, Singapore, Taiwan, Toronto and Beijing, China

Summary.  In an outbreak of a completely new infectious disease like severe acute respiratory syndrome (SARS), estimation of the fatality rate over the course of the epidemic is of clinical and epidemiological importance. In contrast with the constant case fatality rate, a new measure, termed the 'realtime' fatality rate, is proposed for monitoring the new emerging epidemic at a population level. A competing risk model implemented via a counting process is used to estimate the realtime fatality rate in an epidemic of SARS. It can capture and reflect the time-varying nature of the fatality rate over the course of the outbreak in a timely and accurate manner. More importantly, it can provide information on the efficacy of a certain treatment and management policy for the disease. The method has been applied to the SARS data from the regions affected, namely Hong Kong, Singapore, Toronto, Taiwan and Beijing. The magnitudes and patterns of the estimated fatalities are virtually the same except in Beijing, which has a lower rate. It is speculated that the effect is linked to the different treatment protocols that were used. The standard estimate of the case fatality rate that was used by the World Health Organization has been shown to be unable to provide useful information to monitor the time-varying fatalities that are caused by the epidemic.     

INDICES OF ROBUSTNESS FOR SAMPLE REPRESENTATION

Social scientists are rarely able to gather data from the full range of contexts to which they hope to generalize ( Shadish, Cook, and Campbell 2002 ). Here we suggest that debates about the generality of causal inferences in the social sciences can be informed by quantifying the conditions necessary to invalidate an inference. We begin by differentiating the target population into two subpopulations: a potentially observed subpopulation from which all of a sample is drawn and a potentially unobserved subpopulation from which no members of the sample are drawn but which is part of the population to which policymakers seek to generalize. We then quantify the robustness of an inference in terms of the conditions necessary to invalidate an inference if cases from the potentially unobserved subpopulation were included in the sample. We apply the indices to inferences regarding the positive effect of small classes on achievement from the Tennessee class size study and then consider the breadth of external validity. We use the statistical test for whether there is a difference in effects between two subpopulations as a baseline to evaluate robustness, and we consider a Bayesian motivation for the indices and compare the use of the indices with other procedures. In the discussion we emphasize the value of quantifying robustness, consider the value of different quantitative thresholds, and conclude by extending a metaphor linking statistical and causal inferences.     

The use of confrontation in group treatment: Attack or challenge?

This paper considers the use of confrontation as a part of group treatment. When done carefully, confrontation leads to expanded awareness by the members and strengthens group cohesion. When done awkwardly, it leads to increased resistance and defensiveness. The author explores ways in which confrontation can be used to challenge discrepancies, distortions, games and smoke screens, and resistance. There is also a discussion of therapeutic guidelines for the practitioner.     

Planning for better channel management

Manufacturers must modify with their channels of distribution to keep their products available in broadening and maturing markets. The authors of this article provide four broad guidelines to develop more effective relationships with channel partners.