The production of understanding

While there is little doubt that sociological theory and research has had an important impact on the way people think about health and health care, mental health and medical sociologists are often confronted with challenges concerning the utility of the work that they do. Among the doubters are deans, funding agencies and family members. We are challenged by the ascendency of biological interpretations of human behaviors, by the incompatibility between the contextual view we prefer and the very strong individualistic orientation of our culture, and by the fact that we do not have an applied arm that trains the professionals who treat health and mental-health conditions. How do we respond to this challenge? The title of this paper gives a short answer: "The Production of Understanding." I propose that a powerful but under-recognized value of our work is the generation of explanations about health and mental health matters that help people understand the other side of an "us"/"them" divide. We produce understanding in a context in which misunderstanding is regularly constructed by powerful people who offer victim-blaming explanations for the circumstances experienced by people with less power. The production of understanding serves as an important counterbalance to this tendency. Our work shapes the way people think about problems related to health and mental health, limits the power of inaccurate victim-blaming accounts and provides understanding about why health and mental health are mal-distributed among people from different social circumstances.     

Resolution of depression among victims of intimate partner violence: is cessation of violence enough?

The objective of this article is to assess the effect of abuse cessation on depressive symptoms among women abused by a male intimate partner. This prospective cohort study of Seattle women with a history of intimate partner violence (IPV) who were classified by history of abuse and abuse status at 3 month, 9 month, and 2 year follow-up interviews. Relative risks (RR) were calculated using generalized estimating equations. Among subjects with a history of psychological abuse only, cessation of abuse was associated with a nonsignificant reduction in the likelihood of depression compared to subjects whose abuse continued (aRR = 0.88; 95%CI: 0.75,1.03). Among subjects with a history of physical/sexual abuse and psychological abuse, cessation of physical/sexual abuse only was associated with a 27% decline, and cessation of both types of abuse was associated with a 35% decline in the likelihood of depression (aRR = 0.73, 95%CI: 0.63,0.86; and aRR = 0.65; 95%CI: 0.55,0.76; respectively). Cessation of abuse among victims of IPV is associated with a decreased prevalence of depression.     

Use of Markov Chain Monte Carlo Analysis with a Physiologically-Based Pharmacokinetic Model of Methylmercury to Estimate Exposures in U.S. Women of Childbearing Age

A Bayesian approach, implemented using Markov Chain Monte Carlo (MCMC) analysis, was applied with a physiologically‐based pharmacokinetic (PBPK) model of methylmercury (MeHg) to evaluate the variability of MeHg exposure in women of childbearing age in the U.S. population. The analysis made use of the newly available National Health and Nutrition Survey (NHANES) blood and hair mercury concentration data for women of age 16–49 years (sample size, 1,582). Bayesian analysis was performed to estimate the population variability in MeHg exposure (daily ingestion rate) implied by the variation in blood and hair concentrations of mercury in the NHANES database. The measured variability in the NHANES blood and hair data represents the result of a process that includes interindividual variation in exposure to MeHg and interindividual variation in the pharmacokinetics (distribution, clearance) of MeHg. The PBPK model includes a number of pharmacokinetic parameters (e.g., tissue volumes, partition coefficients, rate constants for metabolism and elimination) that can vary from individual to individual within the subpopulation of interest. Using MCMC analysis, it was possible to combine prior distributions of the PBPK model parameters with the NHANES blood and hair data, as well as with kinetic data from controlled human exposures to MeHg, to derive posterior distributions that refine the estimates of both the population exposure distribution and the pharmacokinetic parameters. In general, based on the populations surveyed by NHANES, the results of the MCMC analysis indicate that a small fraction, less than 1%, of the U.S. population of women of childbearing age may have mercury exposures greater than the EPA RfD for MeHg of 0.1 μg/kgg/day, and that there are few, if any, exposures greater than the ATSDR MRL of 0.3 μgg/kgg/day. The analysis also indicates that typical exposures may be greater than previously estimated from food consumption surveys, but that the variability in exposure within the population of U.S. women of childbearing age may be less than previously assumed.     

Absorptive and transformative capacities in nanotechnology innovation systems

We identify managerial challenges offered by an emergent nanotechnology innovation system in which knowledge is dispersed, asymmetric and contested. We argue the proposed models of knowledge absorption and transformation enhance existing theories of knowledge and emergent technology by recognizing how and why knowledge flows among the actors in emergent technology innovation system. We base our argument on combined research evidence from a Delphi study concerning the future of European manufacturing, from which a selected statement has been analyzed, and from analysis of the NanoManufacturing Institute at Leeds University, UK; specifically its work in building ties between different actors associated with nanotechnology. We conclude our paper with suggestions for future research.     

Industrial engineering: a dynamic response to change?

A study of industrial engineering in seven European countries was carried out for the purpose of comparing European organization and practice in that field with the American situation as revealed by an earlier survey. The data obtained relate to organizational variables such as distinctiveness, location, degree of centralization and contact with headquarters; staffing factors such as number of personnel and their education, and the use made of specified techniques. Changes and trends in these terms are then explained. The data suggest that Europe and the U.S. are essentially similar. Finally, the future of industrial engineering is explained in terms of the demands which will be made on industry and the contribution which industrial engineering can make to meeting these.     

Conflicting evidence and decisions by agency professionals: an experimental test in the context of merger regulation

Many important regulatory decisions are taken by professionals employing limited and conflicting evidence. We conduct an experiment in a merger regulation setting, identifying the role of different standards of proof, volumes of evidence, cost of error and professional or lay decision making. The experiment was conducted on current practitioners from 11 different jurisdictions, in addition to student subjects. Legal standards of proof significantly affect decisions. There are specific differences because of professional judgment, including in how error costs and volume of evidence are taken into account. We narrow the range of explanations for why professional decision making matters.     

Estimating conditional tail expectation with actuarial applications in view

We develop statistical inferential tools for estimating and comparing conditional tail expectation (CTE) functions, which are of considerable interest in actuarial science. In particular, we construct estimators for the CTE functions, develop the necessary asymptotic theory for the estimators, and then use the theory for constructing confidence intervals and bands for the functions. Both parametric and non-parametric approaches are explored. Simulation studies illustrate the performance of estimators in various situations. Results are obtained under minimal assumptions, and the general Vervaat process plays a crucial role in achieving these goals.     

Reading Skills in Children with Multichannel Cochlear-lmplant Experience

Forty children with prelingual, profound deafness who received the Nucleus multichannel cochlear implant between the ages of 2 and 13 years participated in this study. The children had an average of 63.3 months (SD=24 months) of experience with their cochlear implants. A majority of the children used simultaneous communication and attended public-school programs at the time of testing. Reading achievement was assessed using the Paragraph Comprehension subtest of the Woodcock Reading Mastery Test-Revised, Form G (1987). This study compared the reading-achievement levels of this group of cochlear-implant users with the results of previous studies of children with profound hearing losses who did not have the benefit of cochlear implants. Results indicated that nearly one half of the children in this study were reading at or within 8 months of their grade level. The reading-grade quotient of .74 was calculated based upon the slope of the regression line for the plot of years in school and reading grade-level achieved. This finding indicates that using a cochlear implant has a positive effect on reading achievement level.