A Marginalized Combined Gamma Frailty and Normal Random-effects Model for Repeated,Overdispersed, Time-to-event Outcomes

This article proposes a marginalized model for repeated or otherwise hierarchical, overdispersed time-to-event outcomes, adapting the so-called combined model for time-to-event outcomes of Molenberghs et al. (in press Molenberghs, G., Verbeke, G., Efendi, A., Braekers, R., Demétrio, C. G.B. (in press). A combined gamma frailty and normal random-effects model for repeated, overdispersed time-to-event data. In press. [Google Scholar]), who combined gamma and normal random effects. The two sets of random effects are used to accommodate simultaneously correlation between repeated measures and overdispersion. The proposed version allows for a direct marginal interpretation of all model parameters. The outcomes are allowed to be censored. Two estimation methods are proposed: full likelihood and pairwise likelihood. The proposed model is applied to data from a so-called comet assay and to data from recurrent asthma attacks in children. Both estimation methods perform very well. From simulation results, it follows that the marginalized combined model behaves similarly to the ordinary combined model in terms of point estimation and precision. It is also observed that the pairwise likelihood required more computation time on the one hand but is less sensitive to starting values and stabler in terms of bias with increasing sample size and censoring percentage than full likelihood, on the other, leaving room for both in practice.     

Exploring an HIV paradox: an ethnography of sexual minority women injectors

HIV risk and infection are markedly increased among sexual minority women injectors compared to other injecting drug users. Our ethnographic exploration of this well-documented but poorly understood phenomenon included 270 interviews and over 350 field observations with 65 sexual minority women injectors in New York City and Boston. We discuss findings in relation to four preliminary hypotheses. Neither the presence of gay or bisexual men in risk networks, nor a sense of invulnerability due to lesbian (or other sexual minority) identity seem to be plausible explanations of increased HIV among sexual minority women injectors. However, multiple marginalization was found to be pervasive and to have severe consequences that can be traced to increased HIV risk for many women in the study.     

Providing sexual education to victims of child sexual abuse:what is a clinician to do?

Despite the large body of research on childhood sexual abuse, virtually no one has examined the coverage of sexual education in treatment. Agencies from across the United States that specialize in treating child and adolescent victims of sexual abuse were surveyed. The results indicate that sexual education is covered in treatment with children of all ages, with male and female clients, and in both individual and group therapy. There was a statistically significant difference in the coverage of sexual education based on clients' age, but not based on gender or treatment modality. Parents are often included in treatment; however, the amount of parental involvement varies. Published materials, such as children's books and videos, are frequently used. Participants (i.e., clinicians) are satisfied with their coverage of sexual education in treatment even though clients often experience negative reactions. Results suggest that covering sexual education in treatment helps decrease some of the negative effects of sexual abuse. This study also serves as a test of Dillman's Total Design Method of conducting mail surveys.     

Culturally Appropriate Career Counseling With Gay and Lesbian Clients

This article details the current knowledge regarding the provision of culturally appropriate career services to gay and lesbian clients. It is divided into 5 parts: history and context for the delivery of career counseling services to gay and lesbian clients, counselor self‐preparation for working with gay and lesbian clients, client‐focused interventions useful for counseling with gay and lesbian clients, program‐focused interventions useful for addressing the special issues that this group presents, and appropriate advocacy or social action interventions. Issues of multiple cultural identities and the intersection of lesbian and gay issues with race and ethnicity are also addressed.     

The Presentation of Dead Selves in Everyday Life: Obituaries and Impression Management

This study draws on obituary content and meanings to extend Goffman's explication of the vagaries of face‐to‐face interactions to situations where people pursue goals without corporeal copresence of actor and audience. Data for the study was collected in Kumasi, the capital city of the Asante people of Ghana, West Africa. My analysis suggests that obituaries embody self‐presentation strategies that include star crafting, social risk management, and mobilization of external resources. I conclude that obituaries are cultural texts that appropriate social symbols to facilitate the presentation of the dead as part of the bereaved's identity projects. My specific observations about obituaries hint at more general reflections on self‐presentation strategies that may be extended to other aspects of social life. They also raise questions for future research.     

Examination of Interest Inventories Based on Roe's Classification

This article describes the adaptation of two interest inventories translated into English, based on Roe's (1956) classification of occupations. In an analysis based on the responses of 181 participants, the items followed the 6 rules for interest inventory items formulated by Meir and Gati (1981). The Cronbach alpha reliability of the 8 field scores in the 2 inventories ranged between .73 and .91. A Smallest Space Analysis (SSA) on 8 field scores on the Ramak, 8 field scores on the Courses and 6 personality type scores on Holland's (1973) Vocational Preference Inventory (VPI) supported the construct validity of the inventories.