Clinicians’ Perspectives on the Diagnosis of Antisocial Disorders in Adolescence

The intent of the study was to explore how professionals view the assessment and diagnosis of antisocial disorders such as oppositional defiant disorder (ODD) and conduct disorder (CD). Six professionals from varying theoretical orientations were interviewed in order to gain insight into how theoretical and clinical perspectives influence the diagnostic process of antisocial disorders. Data was analyzed using a qualitative, constructivist grounded theory research methodology. The findings from the research interviews suggest that clinicians perceive a multifaceted approach to diagnosis. Participants emphasized the importance of individualized assessment, differential diagnosis, the role of context and impairment, and the functional and stigmatizing effects of diagnostic labels. The results illustrate relative consistency among practitioners in the assessment and diagnostic process. Further, it appears that clinicians incorporate a biopsychosocial approach to conceptualizing ODD and CD. This type of qualitative research serves to develop a conceptual understanding of the diagnostic process related to antisocial disorders.     

Assessment of Health Risk from Historical Use of Cosmetic Talcum Powder

This study's objective is to assess the risk of asbestos‐related disease being contracted by past users of cosmetic talcum powder.  To our knowledge, no risk assessment studies using exposure data from historical exposures or chamber simulations have been published. We conducted activity‐based sampling with cosmetic talcum powder samples from five opened and previously used containers that are believed to have been first manufactured and sold in the 1960s and 1970s.  These samples had been subject to conflicting claims of asbestos content; samples with the highest claimed asbestos content were tested.  The tests were conducted in simulated‐bathroom controlled chambers with volunteers who were talc users.  Air sampling filters were prepared by direct preparation techniques and analyzed by phase contrast microscopy (PCM), transmission electron microscopy (TEM) with energy‐dispersive x‐ray (EDX) spectra, and selective area diffraction (SAED).  TEM analysis for asbestos resulted in no confirmed asbestos fibers and only a single fiber classified as “ambiguous.”  Hypothetical treatment of this fiber as if it were asbestos yields a risk of 9.6 × 10^?7 (under one in one million) for a lifetime user of this cosmetic talcum powder.  The exposure levels associated with these results range from zero to levels far below those identified in the epidemiology literature as posing a risk for asbestos‐related disease, and substantially below published historical environmental background levels.  The approaches used for this study have potential application to exposure evaluations of other talc or asbestos‐containing materials and consumer products.     

Kernel density estimation for hierarchical data

Abstract

Multistage sampling is a common sampling technique employed in many studies. In this setting, observations are identically distributed but not independent, thus many traditional kernel smoothing techniques, which assume that the data are independent and identically distributed (i.i.d.), may not produce reasonable density estimates. In this paper, we sample repeatedly with replacement from each cluster, create multiple i.i.d. samples containing one observation from each cluster, and then create a kernel density estimate from each i.i.d. sample. These estimates will then be combined to form an estimate of the marginal probability density function of the population.     

Co‐production in the epidemiological clinic: A decentred analysis of the tensions in community‐based,client‐facing risk work

Public health policies to prevent disease within populations are giving rise to shifting patterns of healthcare delivery in the late modern era. There is an inherent tension in modern medicine between evidence‐based standardisation, on the one hand, and patient‐centred specificity on the other. This tension manifests in recent policy narratives regarding public health risk (which we have characterised in terms of the epidemiological clinic) and co‐production. Drawing on co‐produced data with health trainers (lay health workers tasked with supporting behavioural change in patients at high risk of cardiovascular disease) in a deprived post‐industrial region of England, our decentred analysis focuses on three extended narratives from this data set. Our analysis builds on and develops emerging theories of risk work, informed by Habermas, and we explore the extent to which elite narratives of public health risk are resisted, absorbed, or bracketed off by client‐facing health workers—emphasising the heterogeneity of responses—and locate these responses within the context of the workers' employment conditions, their embodied experiences, and their wider beliefs and traditions. We argue that co‐production—albeit in a highly constrained form—is possible while delivering public health interventions. However, in the context of a community where health is so adversely affected by wider social problems and where task shifting has drawn lower status healthcare workers into these client‐facing roles, workers must find their own ways to negotiate and attempt to reconcile this context with the risk‐framed practices they are required to carry out.     

What Became of Bruce the Shark? From Man‐Eating Monster to Savable Subject in Forty Years of Conservation

Forty years after Jaws, sharks have become savable subjects. Through public advocacy and personal adventures, shark conservationists claim these animals are not monstrous, but misunderstood. On rare occasions, the success of their advocacy is tempered by a fatal encounter, or “attack.” When this happens, multiple intentionalities emerge around the aesthetic category of the monstrous. Drawing on ethnographic and archival research in Western Australia, New England, and South Florida, this article examines these ways of being‐toward‐sharks in ongoing colonial contexts, and asks what is at stake when humans enter the sea alongside these large predatory animals.     

Concepts of Time and Temporality in the Storytelling and Sensemaking Literatures: A Review and Critique

A considerable body of literature exists on narratives and stories in explaining how individuals and groups make and give sense to their experiences in organizations. Classic Aristotelian narratives with a linear time structure (stories with a beginning, middle and end) are prominent in the storytelling literature, whereas retrospection, in drawing on the past in making sense of the present, is a temporal modality central to foundational concepts of sensemaking. In examining time and temporality in these related fields, the authors show how the conventional temporal sequence of a past, present and future dominates, with little consideration being given to time as a multiple rather than singular concept. The authors compare and contrast differences in the temporal aspects of mainstream theories and identify a growing interest in philosophical concepts of time. This review highlights how conventional explanations in these related fields of study are underpinned by linear conceptions of temporality (with an associated causality) and how there is growing recognition of fluidity in the way pasts and futures come together in temporal sensemaking of an emergent present. Although this movement towards explanations that engage with non‐linear modalities deepen insight, they do not explicitly address concepts of time. Time continues to receive scant attention, with temporal but ‘timeless’ theories taking precedence, ultimately constraining theoretical development. In building on this analysis, the authors characterize a range of temporal modalities from which they identify six pathways for charting out an agenda for future research in which multiple concepts of time and temporality are brought to the fore.     

Intervention time series analysis of voluntary,counselling and testing on HIV infections in West African sub-region: the case of Ghana

In this paper, intervention time series models were developed to examine the effectiveness of the voluntary counselling and testing (VCT) programme in the northern and southern sectors of Ghana. Pre-intervention data of HIV reported cases in the northern and southern sectors were first modelled as Box–Jenkins univariate time series. Second, the adopted models from the pre-intervention data were extended to include the intervention variable. The intervention variable was coded as zero for the pre-intervention period (1 January 1996–31 December 2002) and one for the post-intervention period (1 January 2003–31 December 2007). The models developed were applied to the entire data for the two sectors to estimate the effect of the VCT programme. Our findings indicate that the VCT programme was found to be associated with detection of 20 and 40 new HIV infections per 100,000 persons per month in the northern and southern sectors (p?相似文献   

Temporary Integration, Resilient Inequality: Race and Neighborhood Change in the Transition to Adulthood

This article focuses on neighborhood and geographic change arising with the first "selection" of an independent residential setting: the transition out of the family home. Data from two sources-the Project on Human Development in Chicago Neighborhoods, and the Panel Study of Income Dynamics-are used to provide complementary analyses of trajectories of change in geographic location and neighborhood racial and economic composition during young adulthood. Findings indicate that for young adults who originate in segregated urban areas and remain in such areas, the period of young adulthood is characterized by continuity in neighborhood conditions and persistent racial inequality from childhood to adulthood. For young adults who exit highly segregated urban areas, this period is characterized by a substantial leveling of racial inequality, with African Americans moving into less-poor, less-segregated neighborhoods. However, the trend toward racial equality in young adulthood is temporary, as the gaps between whites and blacks grow as the young adults move further into adulthood. Crucial to the reemergence of racial inequality in neighborhood environments is the process of "unselected" change, or change in neighborhood conditions that occurs around young adults after they move to a new neighborhood environment.