Constructing ‘disability’ in Myanmar: teachers,community stakeholders,and the complexity of disability models

This article explores Myanmar teachers’ and community stakeholders’ constructions of disability. We examine how various religious perspectives – particularly Buddhism – inform and shape understandings of impairment and how these beliefs intersect with a strongly medicalised construction of disability. However, in our discussion and exploration of the responses, we also found that the notion of two primary disability ‘models’ – namely the medical model and the social model – lack nuance, complexity, and socio-cultural consideration. Through examining teachers’ and community members’ perspectives of disability in Myanmar, we highlight the importance of socio-cultural variance in understanding local constructions of disability.     

Managing the Care Home Closure Process: Care Managers' Experiences and Views

This paper reports case study research that set out to identifywhat care managers do during independent care home closures.Little research has focused on the way in which care homes forolder people are closed in England, or what those involved thinkabout the process. This paper reports the activities and viewsof care managers directly involved in helping older people relocatefrom care homes that were closed by their owners. During suchclosures, residents and their families have no choice but tomove, usually to a deadline, and with little control over theprocess. Care managers have a responsibility to help arrangealternative care for those current residents who are publiclyfunded, and to offer information and support to those fundingtheir own care (the ‘self-funded’). Closure relatedactivities could involve considerable staff time. Care managementarrangements, including the organization of teams and provisionof needs assessments, varied across authorities. The care managersdescribed drawing on emotional counselling and inter-personalskills, as well as practitioner knowledge and experience, particularlywhen offering support and advice about finding appropriate newhomes. Tensions between aims, constraints on their actions andviews of good practice are identified.     

A Bayesian approach for generalized linear models with explanatory biomarker measurement variables subject to detection limit: an application to acute lung injury

Biomarkers have the potential to improve our understanding of disease diagnosis and prognosis. Biomarker levels that fall below the assay detection limits (DLs), however, compromise the application of biomarkers in research and practice. Most existing methods to handle non-detects focus on a scenario in which the response variable is subject to the DL; only a few methods consider explanatory variables when dealing with DLs. We propose a Bayesian approach for generalized linear models with explanatory variables subject to lower, upper, or interval DLs. In simulation studies, we compared the proposed Bayesian approach to four commonly used methods in a logistic regression model with explanatory variable measurements subject to the DL. We also applied the Bayesian approach and other four methods in a real study, in which a panel of cytokine biomarkers was studied for their association with acute lung injury (ALI). We found that IL8 was associated with a moderate increase in risk for ALI in the model based on the proposed Bayesian approach.     

The evolution of family planning in an African city: Ibadan, Nigeria

Summary Data drawn from a 1973 probability sample of 6,606 Yoruba females, 15-59 years of age in Ibadan City, Nigeria, are employed to analyse changing family planning practice over time. Usage and method rates are calculated for broad age groups from 1930 to 1973. Contraceptive practice is shown to have increased rapidly during the 1960s and early 1970s, from a very low initial base with a doubling period for the proportion of contraceptors of about four years, so that by 1973 one-sixth of the women had practised contraception and one-ninth were currently doing so. The major determinant of contraceptive practice is education. Oral contraceptives and IUDs account for an ever larger proportion of all contraception over time and together made up over 50 per cent by 1973. The Ibadan data give strong support to a suggestion emanating from scattered findings elsewhere that there is a special pattern of sub-Saharan contraceptive use: it begins with use in pre-marital and extra-marital relationships; then is increasingly employed as a substitute for post-marital sexual abstinence, and only later becomes the means for limiting the size of the family. Hence, the success of a family planning programme is indicated by rising average parity among the acceptors. Most couples in Ibadan will probably be practising contraception at some time in the 1980s, but even then such rates will probably still be low in rural areas.     

On scale and scope and the history of the non-profit sector in the United Kingdom

This article argues that Alfred Chandler's analysis of the British firm cannot be transposed to the very different context of non-profit organisations in Britain. Both in relation to charitable non-profit organisations and mutual benefit organisations, Chandler's theory of the development of firms does not help explain organisational development. The main thrust of the argument is that the explanation for the smaller size of charitable non-profits in Britain than in America is largely institutional and partly socio-cultural; the explanation does not lie in any failure in Britain to adopt new techniques of management and organisation. With mutual benefit non-profits, a rather different account is presented. ‘Mutuals’ which had a strong fraternal element were relatively more successful in Britain than in America, although there is less difference between the two countries with regard to ‘non-fraternal’ mutuals. Once again, it is argued that institutional and socio-cultural factors—rather than the factors identified by Chandler—account for this. I wish to thank Desmond King for his helpful comments on an earlier version of this essay.     

Defining and measuring patient satisfaction with medical care

This paper describes the development of Form II of the Patient Satisfaction Questionnaire (PSQ), a self-administered survey instrument designed for use in general population studies. The PSQ contains 55 Likert-type items that measure attitudes toward the more salient characteristics of doctors and medical care services (technical and interpersonal skills of providers, waiting time for appointments, office waits, emergency care, costs of care, insurance coverage, availability of hospitals, and other resources) and satisfaction with care in general. Scales are balanced to control for acquiescent response set. Scoring rules for 18 multi-item subscales and eight global scales were standardized following replication of item analyses in four field tests. Internal-consistency and test-retest estimates indicate satisfactory reliability for studies involving group comparisons. The PSQ well represents the content of characteristics of providers and services described most often in the literature and in response to open-ended questions. Empirical tests of validity have also produced generally favorable results.     

Fertility and work-force participation: The experience of Melbourne Wives

Summary Current and retrospective data on the fertility control, work-force participation intentions and practice of Melbourne wives are combined in an examination of the causal link between work-force participation and reduced family size. Stress is laid on the analysis of the interaction between work-force participation and fertility over time, taking into account the proportion of married life spent in the work-force, rather than relying exclusively on a measure of current participation, the only option available in the analysis of census-type data. The wide range of information available makes it possible to study the effects of work-force participation on wives of unimpaired fertility, as well as the different consequences of planned and unplanned participation, and of working in a variety of occupations and for a number of distinct reasons. Examination of the future fertility intentions and current contraceptive practice of the younger wives shows that working wives are not, in these respects, markedly different from their house-wife peers. Overall, the balance of the evidence indicates that in the majority of cases fertility influences work-force participation rather than the converse.     

All the rage: decolonizing the history of the British women's suffrage movement

ABSTRACT

The intervention of British feminists in the South African War is a chapter of feminist history that is rarely included either in the memorialization of the suffrage movement or the genealogies of global counterinsurgency. The careers of pacifist Emily Hobhouse and suffragist Millicent Fawcett provide rich opportunities to examine the gendered and racialised politics of British imperial militarism. By exploring the confrontation between these two white women within the wider context of aggressive colonial expansion, this essay will draw out the implications of their differing stances towards the conduct and practice of war, particularly as it impacted on female civilians in the war zone. In doing so, it will contribute to our analysis of the interconnected histories of racism, imperialism, feminism and militarism that have undeniably shaped the politics of global security today.     

Comparison of Six Dose-Response Models for Use with Food-Borne Pathogens

Food-related illness in the United States is estimated to affect over six million people per year and cost the economy several billion dollars. These illnesses and costs could be reduced if minimum infectious doses were established and used as the basis of regulations and monitoring. However, standard methodologies for dose-response assessment are not yet formulated for microbial risk assessment. The objective of this study was to compare dose-response models for food-borne pathogens and determine which models were most appropriate for a range of pathogens. The statistical models proposed in the literature and chosen for comparison purposes were log-normal, log-logistic, exponential, -Poisson and Weibull-Gamma. These were fit to four data sets also taken from published literature, Shigella flexneri, Shigella dysenteriae,Campylobacter jejuni, and Salmonella typhosa, using the method of maximum likelihood. The Weibull-gamma, the only model with three parameters, was also the only model capable of fitting all the data sets examined using the maximum likelihood estimation for comparisons. Infectious doses were also calculated using each model. Within any given data set, the infectious dose estimated to affect one percent of the population ranged from one order of magnitude to as much as nine orders of magnitude, illustrating the differences in extrapolation of the dose response models. More data are needed to compare models and examine extrapolation from high to low doses for food-borne pathogens.     

Mesothelioma: Risk Apportionment Among Asbestos Exposure Sources

The mesothelioma epidemic in the United States, which peaked during the 2000–2004 period, can be traced to high‐level asbestos exposures experienced by males in occupational settings prior to the full recognition of the disease‐causing potential of asbestos and the establishment of enforceable asbestos exposure limits by the Occupational Safety and Health Administration (OSHA) in 1971. Many individuals diagnosed with mesothelioma where asbestos has been identified as a contributing cause of the disease have filed claims seeking compensation from asbestos settlement trusts or through the court system. An individual with mesothelioma typically has been exposed to asbestos in more than one setting and from more than one asbestos product. Apportioning risk for mesothelioma among contributing factors is an ongoing problem faced by occupational disease compensation boards, juries, parties responsible for paying damages, and currently by the U.S. Senate in its efforts to formulate a bill establishing an asbestos settlement trust. In this article we address the following question: If an individual with mesothelioma where asbestos has been identified as a contributing cause were to be compensated for his or her disease, how should that compensation be apportioned among those responsible for the asbestos exposures? For the purposes of apportionment, we assume that asbestos is the only cause of mesothelioma and that every asbestos exposure contributes, albeit differentially, to the risk. We use an extension of the mesothelioma risk model initially proposed in the early 1980s to quantify the contribution to risk of each exposure as a percentage of the total risk. The percentage for each specific discrete asbestos exposure depends on the start and end dates, the intensity, and the asbestos fiber type for the exposure. We provide justification for the use of the mesothelioma risk model for apportioning risk and discuss how to assess uncertainty associated with its application.