SOCIAL ATOMISM, HOLISM, AND TRUST

The metatheoretical difference between social atomism and social holism is clarified by analysis of the generic necessity of trust. A theoretical approach to trust can be traced from Durkheim, Simmel, Parsons, and the recent work of Luhmann and Barber. Trust functions as a deep assumption underwriting social order and is not reducible to individual characteristics. Changes in trust alter social relationships. The study of power, exchange, family, and politics illustrates how trust constitutes social reality as emergent and holistic. This helps us understand the formation of interpersonal relationships, the difference between economic and social exchange, and the discrepancy between attitudes toward society and toward particular institutional actors.     

The Practical Significance of Measurement Error in Pulmonary Function Testing Conducted in Research Settings

Conventional spirometry produces measurement error by using repeatability criteria (RC) to discard acceptable data and terminating tests early when RC are met. These practices also implicitly assume that there is no variation across maneuvers within each test. This has implications for air pollution regulations that rely on pulmonary function tests to determine adverse effects or set standards. We perform a Monte Carlo simulation of 20,902 tests of forced expiratory volume in 1 second (FEV₁), each with eight maneuvers, for an individual with empirically obtained, plausibly normal pulmonary function. Default coefficients of variation for inter‐ and intratest variability (3% and 6%, respectively) are employed. Measurement error is defined as the difference between results from the conventional protocol and an unconstrained, eight‐maneuver alternative. In the default model, average measurement error is shown to be ～5%. The minimum difference necessary for statistical significance at p < 0.05 for a before/after comparison is shown to be 16%. Meanwhile, the U.S. Environmental Protection Agency has deemed single‐digit percentage decrements in FEV₁ sufficient to justify more stringent national ambient air quality standards. Sensitivity analysis reveals that results are insensitive to intertest variability but highly sensitive to intratest variability. Halving the latter to 3% reduces measurement error by 55%. Increasing it to 9% or 12% increases measurement error by 65% or 125%, respectively. Within‐day FEV₁ differences ≤5% among normal subjects are believed to be clinically insignificant. Therefore, many differences reported as statistically significant are likely to be artifactual. Reliable data are needed to estimate intratest variability for the general population, subpopulations of interest, and research samples. Sensitive subpopulations (e.g., chronic obstructive pulmonary disease or COPD patients, asthmatics, children) are likely to have higher intratest variability, making it more difficult to derive valid statistical inferences about differences observed after treatment or exposure.     

Does the Organization of Emotional Expression Change Over Time? Facial Expressivity From 4 to 12 Months

Differentiation models contend that the organization of facial expressivity increases during infancy. Accordingly, infants are believed to exhibit increasingly specific facial expressions in response to stimuli as a function of development. This study tested this hypothesis in a sample of 151 infants (83 boys and 68 girls) observed in 4 situations (tickle, sour taste, arm restraint, and masked stranger) at 4 and 12 months of age. Three of the 4 situations showed evidence of increasing specificity over time. In response to tickle, the number of infants exhibiting joy expressions increased and the number exhibiting interest, surprise, and surprise blends decreased from 4 to 12 months. In tasting a sour substance, more infants exhibited disgust and fewer exhibited joy and interest expressions, and fear and surprise blends over time. For arm restraint, more infants exhibited anger expressions and anger blends and fewer exhibited interest and surprise expressions and surprise blends over time. In response to a masked stranger, however, no evidence of increased specificity was found. Overall, these findings suggest that infants increasingly exhibit particular expressions in response to specific stimuli during the 1st year of life. These data provide partial support for the hypothesis that facial expressivity becomes increasingly organized over time.     

OBLIGATED CLINICAN SELF-DISCLOSURE: JONE THERAPITS'S INTERVENTIONS FOLLOWING A FAMILY MEMBERS'S PUBLICIZED MURDER*

This article describes a family therapist's management of the sudden collision between profesional and personal boundaries following the publicized murder of her spouse. Reasons are offered to explain why it is becoming difficult for all clinicians to control the process of self-disclosure in therapy. Strategies used to meet the demands of affirming professional distance while maintaining therapeutic effectiveness are described. Brief recommendations are proposed for therapists in group, medical, rural, inpatient, and underserved settings. It is hoped that this case study will generate further discussion and assist health care providers who may face this challenge in the future.     

“I Did Not Get that Job Because of a Black Man...”: The Story Lines and Testimonies of Color-Blind Racism

In this paper we discuss the dominant racial stories that accompany color-blind racism, the dominant post–civil rights racial ideology, and asses their ideological role. Using interview data from the 1997 Survey of College Students Social Attitudes and the 1998 Detroit Area Study, we document the prevalence of four story lines and two types of testimonies among whites. We also provide data on ideological dissidence among some whites (we label them racial progressives) and blacks. We show that although these stories, and the racial ideology they reinforce, have become dominant, neither goes uncontested.     

Children and young people requiring home assisted ventilation in the South of England: incidence,receipt of care support and components of the care package

The study found an increasing number of ventilator dependent children and young people living at home. Almost three quarters of the sample had a physical disability as a result of or in addition to their primary diagnosis. There was wide variation in the amount of paid care supporting these families which appeared unrelated to the level of ventilatory dependence. Nurses working in community children's teams or hospital outreach teams were the most frequent care organisers and care managers. The majority of the care packages were funded by Health Authorities.