Multiparameter evidence synthesis in epidemiology and medical decision-making: current approaches

Summary.  Alongside the development of meta-analysis as a tool for summarizing research literature, there is renewed interest in broader forms of quantitative synthesis that are aimed at combining evidence from different study designs or evidence on multiple parameters. These have been proposed under various headings: the confidence profile method, cross-design synthesis, hierarchical models and generalized evidence synthesis. Models that are used in health technology assessment are also referred to as representing a synthesis of evidence in a mathematical structure. Here we review alternative approaches to statistical evidence synthesis, and their implications for epidemiology and medical decision-making. The methods include hierarchical models, models informed by evidence on different functions of several parameters and models incorporating both of these features. The need to check for consistency of evidence when using these powerful methods is emphasized. We develop a rationale for evidence synthesis that is based on Bayesian decision modelling and expected value of information theory, which stresses not only the need for a lack of bias in estimates of treatment effects but also a lack of bias in assessments of uncertainty. The increasing reliance of governmental bodies like the UK National Institute for Clinical Excellence on complex evidence synthesis in decision modelling is discussed.     

Population Policy in Early Victorian England

This paper argues that the generally-held belief that there was no population policy in Great Britain during its fertility transition is incorrect. There were, in fact, clear and implicit and explicit policies in place by the early 19th Century which aimed at reducing population growth. These were negative, involving elimination of family allowances (the famous Poor Laws), and also positive, through subsidised emigration and ``transportation' of felons to the colonies. Moreover, a changed ``ideation' on the part of the nation's political, intellectual and spiritual leaders, changed norms about marriage and child-bearing, raising sharply the perceived economic and psychic cost of children. Lacking acceptable means to control pregnancies, many working class women resorted to abortion, infanticide and child abandonment to reduce their family size. The policy's actual impact on overall fertility is uncertain but it did constitute a deliberate attempt by society to affect demographic behaviour and outcomes.     

The Fatherbook: A Document for Therapeutic Work with Father-Absent Early Adolescent Boys

There is convincing evidence that children who grow up without fathers are vulnerable for psychosocial dysfunction. A document called the Fatherbook is presented for therapeutic work with the father-absent early adolescent boy. Modeled on the life story book used with children in foster care, the Fatherbook records information, thoughts, and feelings about absent fathers. It provides a tangible object with which the youngster can begin to work through the experience of being fatherless. The boy's mother must have the opportunity to voice her feelings about the Fatherbook because the Fatherbook brings the father back into her life as well as her son's.     

Meeting myself: race-gender oppression and a genre study of Black men teachers’ interactions with Black boys

ABSTRACT

Increasing the number of Black men teachers and single-sex schooling options have been heralded as necessary to reverse trends in the failure of US education institutions to adequately educate Black boys. Too little research interrogates Black men teachers’ interactions with Black boys for how they might reinforce anti-oppressive conceptions of race, gender and sexuality. A genre study – the multidimensional, intersectional examination of social identity to explain one’s persistent dehumanization – was utilized to investigate how Black men teachers’ interactions with Black boys shape the boys’ understanding of Black manhood and masculinities. Regardless of schooling arrangement, findings suggest Black men teachers must recognize and disavow hegemonic gender logics in interaction efforts aimed at improving Black boys’ lives. Additionally, I argue the potential of Black men teachers’ interactions with Black boys to function as sites for reimagining Black boys’ humanity in ways that counter persistent messages of their inferiority and disposability (i.e. aniblackness).     

Spatio-temporal patterns of pre-eclampsia and eclampsia in relation to drinking water salinity at the district level in Bangladesh from 2016 to 2018

Population and Environment - This analysis examines whether salinity in drinking water is associated with pre-eclampsia and eclampsia (PE/E), a leading cause of maternal morbidity and mortality....     

Communication in assisted living

This study of communication in an Assisted Living Facility (ALF) focuses on staff's interpretive frameworks and situational tactics for managing elderly residents. It is based on interviews with staff and residents in an ALF together with ethnographic fieldwork. As in other quasi-total institutions, staff members engage in control as well as care, monitoring residents for compliance with rules and directives. Residents, aware of the threat of being moved to a nursing home, also monitor their own behavior and cognition in comparison to other residents. Other communication issues include the infantilization of the elderly by staff, and the race, class, and ethnic prejudices of residents.