Compelling Evidence: Research Methods,HIV/AIDS,and Politics in Papua,Indonesia

Increasing calls for an evidence-based public health (EBPH) rely on forms of quantitative evidence to decide HIV/AIDS interventions. A major criticism of this method is it downplays the significance of experiential, cultural or political facets of HIV/AIDS. We apply the concept of ‘rendering technical’ to explore the relationship between methods used in HIV/AIDS research in Papua, Indonesia and current socioeconomic conditions. We analysed research methods used in sixty-two HIV/AIDS studies, assessed presentations at an international AIDS conference, and conducted ethnographic research in Papua. Nation-wide EBPH initiatives are implemented in Papua, yet there remains a critical mass of qualitative ethnographic studies carried out by indigenous scholars emphasising experiences of persons and culture, often within a colonial or post-colonial framework. We argue these studies partially counter approaches which render technical complex realities. In political conditions where indigenous minorities suffer inequities, qualitative ethnographic research may yield critical kinds of evidence, potentially contributing to more nuanced decision-making around HIV.     

The Remains of the Say: Zero,Double‐crossing and the Landscaping of Language

This essay argues for a “landscaping” understanding of language, contrasting this with the more contemporary tradition of deconstruction, through Saussure, on difference. The paper opens with an evocation of the method of “double crossing” in Heidegger's () deconstruction of Western ontology, before drawing extensively on Heidegger's later discussion of the “bridge” to illustrate his landscaping argument over language. By crossing and criss‐crossing this reading of Heidegger with a critique of the same essay by Hillis Miller, a strong similarity in deconstructive technique is elicited despite an apparent clash in their views about language.     

Bayesian estimation of the mean of an autoregressive process

The marginal posterior probability density function (pdf) for the mean of a stationary pth order Gaussian autoregressive process is derived using the conditional likelihood function. While the posterior pdf provides a small sample analysis, the pdf is not well known and must be analyzed numerically. This is relatively easy since it is a function of only one variable. Two sets of examples are presented. The first set involves synthetic data generated by computer, and the second set deals with energy expenditure data on a bum patient.     

Adolescents' Expenditure On Alcohol: A Pilot Study

Minimal research has examined the extent to which underage youth access and purchase alcohol. This pilot study investigated adolescents' expenditure on alcohol, and the circumstances in which underage youth access alcohol. A street intercept survey was used to interview 187 young people aged 13 to 17 years in shopping centres in metropolitan and rural Victoria, Australia. Seventy percent of the sample self‐reported that they drink alcohol. Young people were more likely to report that they were drinkers as their income increased. More than one‐third of the sample and over half of drinkers purchased alcohol with their own money, spending on average $22 when they last purchased alcohol. Drinkers obtained their alcohol from a variety of other sources including friends over 18 years old and their parents. This study shows that underage youth have access to and pay for alcohol even if they do not purchase it personally. Further research in this area with a larger sample is clearly warranted to inform both prevention strategies and effective practice.     

Detection and Localization in Test Accuracy: A Bayesian Perspective

In assessing the area under the ROC curve for the accuracy of a diagnostic test, it is imperative to detect and locate multiple abnormalities per image. This approach takes that into account by adopting a statistical model that allows for correlation between the reader scores of several regions of interest (ROI).

The ROI method of partitioning the image is taken. The readers give a score to each ROI in the image and the statistical model takes into account the correlation between the scores of the ROI's of an image in estimating test accuracy. The test accuracy is given by Pr[Y > Z] + (1/2)Pr[Y = Z], where Y is an ordinal diagnostic measurement of an affected ROI, and Z is the diagnostic measurement of an unaffected ROI. This way of measuring test accuracy is equivalent to the area under the ROC curve. The parameters are the parameters of a multinomial distribution, then based on the multinomial distribution, a Bayesian method of inference is adopted for estimating the test accuracy.

Using a multinomial model for the test results, a Bayesian method based on the predictive distribution of future diagnostic scores is employed to find the test accuracy. By resampling from the posterior distribution of the model parameters, samples from the posterior distribution of test accuracy are also generated. Using these samples, the posterior mean, standard deviation, and credible intervals are calculated in order to estimate the area under the ROC curve. This approach is illustrated by estimating the area under the ROC curve for a study of the diagnostic accuracy of magnetic resonance angiography for diagnosis of arterial atherosclerotic stenosis. A generalization to multiple readers and/or modalities is proposed.

A Bayesian way to estimate test accuracy is easy to perform with standard software packages and has the advantage of employing the efficient inclusion of information from prior related imaging studies.     

COMBINING INDIVIDUAL PARTICIPANT DATA AND SUMMARY STATISTICS FROM BOTH CONTINUOUSLY VALUED AND BINARY VARIABLES TO ESTIMATE REGRESSION PARAMETERS

Recent research has extended standard methods for meta‐analysis to more general forms of evidence synthesis, where the aim is to combine different data types or data summaries that contain information about functions of multiple parameters to make inferences about the parameters of interest. We consider one such scenario in which the goal is to make inferences about the association between a primary binary exposure and continuously valued outcome in the context of several confounding exposures, and where the data are available in various different forms: individual participant data (IPD) with repeated measures, sample means that have been aggregated over strata, and binary data generated by thresholding the underlying continuously valued outcome measure. We show that an estimator of the population mean of a continuously valued outcome can be constructed using binary threshold data provided that a separate estimate of the outcome standard deviation is available. The results of a simulation study show that this estimator has negligible bias but is less efficient than the sample mean – the minimum variance ratio is based on a Taylor series expansion. Combining this estimator with sample means and IPD from different sources (such as a series of published studies) using both linear and probit regression does, however, improve the precision of estimation considerably by incorporating data that would otherwise have been excluded for being in the wrong format. We apply these methods to investigate the association between the G277S mutation in the transferrin gene and serum ferritin (iron) levels separately in pre‐ and post‐menopausal women based on data from three published studies.     

Potential Health Effects of Light-Duty Diesel Exhaust

The purpose of this paper is to review briefly the evidence for potential human health effects that may result from increased dieselization of the nation's light-duty vehicle fleet. An effort is made to put the potential effects into perspective, both with regard to projected excess cancer deaths, should diesel exhaust be carcinogenic to humans, and in relation to past use of vehicles using leaded gasoline. Certain related research needs are highlighted. Available data concerning the relationship between diesel emissions, ambient air quality, and human health are summarized. On the basis of exposure estimates and relative potency factors, the authors conclude that the best estimate of the number of excess annual U.S. lung cancer deaths as a result of lifetime exposure to light-duty diesel particulate under 1990 conditions is between 80 and 1500. Available data suggest that the carcinogenic hazard of exhaust from vehicles burning leaded gasoline may be an order of magnitude greater, on a per mile basis, than that of diesel engines. The hazard of emissions from diesel are, in turn, probably an order of magnitude greater than that of gasoline engines with catalytic converters burning unleaded gasoline. Important research needs identified by the authors include determining whether diesel exhaust is in fact a human carcinogen, studying the effect of atmospheric chemical transformation of organics in diesel exhaust on the toxicity of the exhaust, making a better determination of the relative carcinogenicity of diesel and gasoline exhausts, and determining whether exposure to diesel exhaust contributes to the development or exacerbation of chronic lung disease or of respiratory illness, especially in the very young and the aged.     

Risk and the welfare state

The British welfare state developed as a state-centred response to the problem of handling the risks encountered in a typical life-course. The influential work of Giddens and others implies that the traditional welfare state is under attack from two directions: a changing international politico-economic environment limits the freedom of national governments to pursue independent policies involving relatively high taxation to finance social spending. At the same time, changes in the experience of risk and declining confidence in the expertise of welfare state planners and professionals undermine support for state-centred solutions. This approach fails to acknowledge that available non-state services are often inadequate to meet many everyday life risks and that the authority of private sector advisers, insurers and professionals is also increasingly open to question. This article discusses whether people reject welfare state solutions to problems of risk in the context of research on the perceptions and behaviour of people buying or selling their homes, considering provision for long-term care needs and defrauding social security carried out by the ESRC's Economic Beliefs and Behaviour programme. Individual responses endorse the continued provision of state welfare in order to meet unprovided risks alongside disenchantment with the record of both state and private professionals and planners and awareness that state retrenchment requires greater individual responsibility for meeting one's own needs. The theory of risk society requires development to recognize that citizens are not necessarily alienated from state welfare.     

Some Effects of the Community on Cultural Integration*

Attitudinal and behavioral data indicative of cultural integration support the hypothesis of decreasing race/ethnic differences. The study data were collected from inmigrant Mexican-Americans and Negroes and a control group of Anglo residents at two points in time separated by eleven years. Tau is used to describe similarity or dissimilarity in race ethnic distributions within each year's data and as a measure of changing race/ethnic response across the eleven-year span.     

Overlooked and Invisible: Everyday Experiences of Microaggressions for LGBTQ Adolescents

ABSTRACT

Lesbian, gay, bisexual, transgender, and queer (LGBTQ) adolescents face a number of challenges in their lives related to heterosexism and cissexism. Drawing on the microaggressions framework, we conducted two focus groups with LGBTQ adolescents (n = 11; ages 14–18, six trans/genderfluid, one person of color) to (1) explore the type and nature of microaggressions experienced by LGBTQ adolescents; (2) assess the relevance of existing LGBTQ microaggression taxonomies for this group; and (3) understand the impact of microaggressions on LGBTQ adolescents. Participants’ experiences of microaggressions reflected complex forms of discrimination emerging from the intersections of sexual and gender identity.