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Background.?Saliva collection is an easy, non-invasive method to measure hormones.

Methods.?Two studies were performed. In the first, a convenience sample of 1454 males who had submitted saliva for salivary testosterone measurements were studied. In the second study, we intensively studied symptoms and measurements of total testosterone, free testosterone symptoms and measurements of total testosterone, free testosterone and bioavailable testosterone in relationship to salivary testosterone in 127 men. A secondary endpoint was to examine the relationship of salivary testosterone to hypogonadal symptoms in the ADAM and AMS questionnaires.

Results.?In the first study, we have shown that salivary testosterone, measured in 1454 males aged 20 to 89 years, declines by 47% over the lifespan. In the second study, salivary testosterone was strongly correlated with bioavailable testosterone (p < 0.000001) calculated free testosterone (p < 0.00001) and total testosterone (p < 0.002). Salivary testosterone was significantly related to hypogonadal symptoms on the St. Louis University ADAM questionnaire and the Aging Male Survey.

Conclusions.?These studies support the use of salivary testosterone as an acceptable assay for screening for hypogonadism. Salivary testosterone is not a better assay than other measures to diagnose hypogonadism.     

Where are the children? Exploring the boundaries between text and context in the study of place and space in four different countries

In this article, we demonstrate how the cultural conceptions of a team of five researchers from different cultural and national backgrounds can be used as a source of knowledge during a collective, self‐reflexive analytical process. While collectively analysing texts describing daily life produced by first‐grade children and their parents in China, Norway, South Africa and the United States, the research team engaged in a collectively negotiated analytical process, which we refer to as an ‘analytic negotiating method’. The strength of this process rests on the ability to examine critically the boundaries between the researcher's contextual conceptions and conceptions derived from the texts. Engaging in this kind of negotiated analytical process contributes to scholarship by working towards a level of self‐reflexivity that makes the link between empirical data and researcher interpretation more transparent and produces a sensitivity to context that allows insights into the conceptions of childhood that operate cross‐culturally.     

Community Mental Health Services in a Remote Rural Area

A programme was developed by the authors to provide community mental health services to an isolated rural region situated within the large catchment area of a state psychiatric hospital. The programme functioned without psychiatrist or medical officer in the team. The authors believe their programme to be effective and economical both of monetary cost and of the scarce services of psychiatrically trained professional workers. They hope it will serve as a model for other community mental health workers.     

Factors to Consider in Making Curriculum Decisions About Treatment Guidelines

As interventions based on practice guidelines spread within social work practice, educators must determine how, if at all, these guidelines may be incorporated into the curriculum of undergraduate and graduate social work education. This article provides an overview of the history and the debate surrounding practice guidelines and identifies key considerations that must be addressed in order for faculty to make a rational and deliberate decision regarding the inclusion of practice guidelines within the curriculum.     

Strategic planning—Myth or reality?—A chief executive's view

The author of this paper is Chairman, President and Chief Executive Officer of Emhart Corporation. Emhart has worldwide revenues of over $1.8bn and ranks 41st among the 150 largest U.S. multinationals. The author is a foe of interoffice memos and an advocate of face-to-face communication. The author has written and talked extensively on the role of the Chief Executive in the 1980s: thinks business's poor communication with the media may be its own fault; worries about mixing politics and sociology into foreign trade; is concerned that business should properly adjust and adapt to the better educated, more individualistic employee coming into the work force and thinks that business's credibility would improve if it applied its resources more prudently and refrained from trying to solve all of society's problems.     

Updating Uncertainty in an Integrated Risk Assessment: Conceptual Framework and Methods

Bayesian methods are presented for updating the uncertainty in the predictions of an integrated Environmental Health Risk Assessment (EHRA) model. The methods allow the estimation of posterior uncertainty distributions based on the observation of different model outputs along the chain of the linked assessment framework. Analytical equations are derived for the case of the multiplicative lognormal risk model where the sequential log outputs (log ambient concentration, log applied dose, log delivered dose, and log risk) are each normally distributed. Given observations of a log output made with a normally distributed measurement error, the posterior distributions of the log outputs remain normal, but with modified means and variances, and induced correlations between successive log outputs and log inputs. The analytical equations for forward and backward propagation of the updates are generally applicable to sums of normally distributed variables. The Bayesian Monte-Carlo (BMC) procedure is presented to provide an approximate, but more broadly applicable method for numerically updating uncertainty with concurrent backward and forward propagation. Illustrative examples, presented for the multiplicative lognormal model, demonstrate agreement between the analytical and BMC methods, and show how uncertainty updates can propagate through a linked EHRA. The Bayesian updating methods facilitate the pooling of knowledge encoded in predictive models with that transmitted by research outcomes (e.g., field measurements), and thereby support the practice of iterative risk assessment and value of information appraisals.     

Elicitation of Expert Judgments of Uncertainty in the Risk Assessment of Herbicide-Tolerant Oilseed Crops

One of the lay public's concerns about genetically modified (GM) organisms (GMO) and related emerging technologies is that not all the important risks are evaluated or even identified yet--and that ignorance of the unanticipated risks could lead to severe environmental or public health consequences. To some degree, even the scientists who participated in the analysis of the risks from GMOs (arguably the people most qualified to critique these analyses) share some of this concern. To formally explore the uncertainty in the risk assessment of a GM crop, we conducted detailed interviews of seven leading experts on GM oilseed crops to obtain qualitative and quantitative information on their understanding of the uncertainties associated with the risks to agriculture from GM oilseed crops (canola or rapeseed). The results of these elicitations revealed three issues of potential concern that are currently left outside the scope of risk assessments. These are (1) the potential loss of the agronomic and environmental benefits of glyphosate (a herbicide widely used in no-till agriculture) due to the combined problems of glyphosate-tolerant canola and wheat volunteer plants, (2) the growing problem of seed lot contamination, and (3) the potential market impacts. The elicitations also identified two areas where knowledge is insufficient. These are: the occurrence of hybridization between canola and wild relatives and the ability of the hybrids to perpetuate themselves in nature, and the fate of the herbicide-tolerance genes in soil and their interaction with soil microfauna and -flora. The methodological contribution of this work is a formal approach to analyzing the uncertainty surrounding complex problems.     

European River Floods in a Changing World

Whereas the verdict is undecided about the effects of global warming on Europe's flood risks, it is clear that Europeans are becoming more exposed and vulnerable to floods. Losses are increasing dramatically, mainly because of population and capital moving into harm's way and also because of human-driven transformations of hydrological systems, including river basins and floodplains.