Low dose risk estimation via simultaneous statistical inferences

Summary.  The paper develops and studies simultaneous confidence bounds that are useful for making low dose inferences in quantitative risk analysis. Application is intended for risk assessment studies where human, animal or ecological data are used to set safe low dose levels of a toxic agent, but where study information is limited to high dose levels of the agent. Methods are derived for estimating simultaneous, one-sided, upper confidence limits on risk for end points measured on a continuous scale. From the simultaneous confidence bounds, lower confidence limits on the dose that is associated with a particular risk (often referred to as a bench-mark dose ) are calculated. An important feature of the simultaneous construction is that any inferences that are based on inverting the simultaneous confidence bounds apply automatically to inverse bounds on the bench-mark dose.     

Benchmark Analysis: Shopping with Proper Confidence

We discuss the issue of using benchmark doses for quantifying (excess) risk associated with exposure to environmental hazards. The paradigm of low-dose risk estimation in dose-response modeling is used as the primary application scenario. Emphasis is placed on making simultaneous inferences on benchmark doses when data are in the form of proportions, although the concepts translate easily to other forms of outcome data.     

Attention and Executive Functions as Mediators of Attachment and Behavior Problems

The purpose of this study was to provide a more comprehensive understanding of the relation between early parent‐child interactions and subsequent behavior problems and how certain cognitive processes mediate this relation. Specifically, this study investigated whether attention, inhibition, and planning skills mediate the relation between attachment security and behavior problems. Data were collected as part of the National Institute of Child Health and Development‐Study of Early Child Care and Youth Development when children (N = 1004) were between 36 months and the third grade. Results from structural equation models indicated that sustained attention mediated the relation between disorganized attachment and social problems. Planning mediated the relation between disorganized attachment and subsequent thought problems, attention problems, and delinquent behavior. Avoidant, ambivalent, and disorganized attachment directly predicted several behavior problems. Implications for theory and future research are discussed.     

Curved versus straight scissors to avoid 3rd and 4th degree perineal tears: A randomised feasibility study

BackgroundSevere perineal tears sustained during childbirth cause significant distress and morbidity amongst women. The objective of this study was to compare the use of straight scissors for cutting an episiotomy with the use of curved scissors, which are designed to curve away from the anal sphincter.MethodsWe used a single-centre, randomised feasibility trial. The intervention was the use of curved scissors. Women were recruited during a prenatal visit and randomised in the delivery suite, when it became clear that an episiotomy was required. The feasibility outcomes were the proportion of women able to be recruited, randomised and followed up. We also calculated the incidence of obstetric anal sphincter injury when either straight or curved scissors were used to cut an episiotomy. Other outcomes assessed were pain, length of hospital stay, perineal infection and perineal dehiscence.ResultsOf the 155 patients recruited in the prenatal period, only 20 (12.9%) were eventually randomised at birth. The main reasons for the high loss were that women either did not have a vaginal delivery (38, 24.5%), or they did not need an episiotomy (72, 46.5%). Rates of obstetric anal sphincter injury and other outcomes were similar between groups.DiscussionAnal sphincter injury during childbirth remains an important problem. Although the use of curved scissors provides a theoretical solution, we found that the high attrition rate made feasibility of conducting a suitably powered, randomised trial using the current design untenable. Alternative strategies have been suggested to make any future study more viable.     

Characteristics of a central change programme within a governmental bureaucracy: a grounded theory study

Purpose The purpose of the paper is to present a theory of organisational change within the setting of a governmental bureaucracy. Design/methodology/approach Orthodox grounded theory is employed in the setting of a change programme in 12 Audit departments of the Dutch Ministries (public-sector). Findings The examined organisational change has specific characteristics. The Dutch ‘ministerial autonomy’ and the clearly recognizable role types of the key figures involved have a strong impact on the change programme and the realisation of its goals. Research limitations/implications Findings are derived on the basis of a substantive case study of the change programme of the Dutch Departmental Audit function. The research sheds new light on characteristics related to the occupational group of Chartered Accountants and characteristics of a governmental bureaucracy and it helps to understand change programmes within this bureaucracy. Practical implications The grounded theoretical model draws attention to the impact of key figures and circumstances on a change programme within the central government. Originality/value The paper builds on theories of organisational change but applies them in the typical context of the Dutch civil service where ministerial autonomy, on the one hand, and a move in the direction of more centrally organised activities (concern idea), on the other, require a difficult balancing act of all players in the change arena.     

Cast in a racial mould

Women of Phokeng: Consciousness, Life Strategy, and Migrancy in South Africa 1900 ‐1983 by Belinda Bozzoli, with the assistance of Mmantho Nkotsoe, Johannesburg, Ravan Press, 1991.

Our Precious Metal: African Labour in South Africa's Gold Industry, 1970–1990 by Wilmot G. James, David Philip, James Currey &; Indiana University Press, Cape Town, London &; Bloomington,1992.

Bounds of Possibility ‐ The Legacy of Steve Biko &; Black Consciousness by N.B. Pityana, M. Ramphele, M. Mpumlwana, &; L. Wilson, (eds), Cape Town, David Philip, 1991.

Faces in the revolution: the psychological effects of violence on township youth in South Africa by Gill Straker, with Fathima Moosa, Rise Becker and Madiyoyo Nkwale. Cape Town, David Philip, 1992 and Athens, Ohio, Ohio University Press, 1992.

Lives of Courage: Women for a New South Africa by Diana E.H.Russell. New York, Basic Books, 1989.

Towards Justice? Crime and State Control in South Africa by Desiree Hansson and Dirk van Zyl Smit (eds), Cape Town, Oxford University Press, 1990.

South Africa in the Nineties by DJ van Vuuren, NE Wiehahn, NJ Rhoodie en M Wiechers (eds), HSRC Publishers, 1991.

To Live in Fear: Witchburning and Medicine Murder in Venda by A de V. Minnar, D Offringa and C Payze, HSRC, Pretoria, 1992.

The Anti‐Politics Machine: ‘Development’, Depoliticization and Bureaucratic Power by James Ferguson, Cambridge, Cambridge University Press, 1990.

Zimbabwe's Guerrilla War: Peasant Voices by Norma J. Kriger. Cambridge University Press, African Studies Series, number 70,1992.

A Passage to England ‐ Barbadian Londoners speak of home by John Western. U.C.L. Press, London, 1992.

Breaking the formal frame: Readings in South African education in the eighties by Clive Millar, Sarah‐Anne Raynham and Angela Schaffer (eds). Cape Town: Oxford University Press, 1991.

Negotiation : Theories, Strategies and Skills by Wynand Pienaar and Manie Spoelstra, Kenwyn, Juta, 1991

SUM: Selected Works by Martin Versveld. Cape Town: Carrefour Press 1991.

Projections in the Past Tense, by Kelwyn Sole. Ravan Press, 1992.     

The Three-Item Thinking about Your Partner’s Drinking Scale (TPD-3): Item Response Theory,Reliability, and Validity

Interdependence is a defining feature of close relationships, and alcohol use is one domain where one person’s motivations and behaviors can affect a partner’s well-being. Concern about partner drinking is a gauge that determines whether a partner’s alcohol use has the potential to be problematic to the relationship, and brief and efficient measurement of this construct can be used to serve clinicians, scientists, and practitioners. Across four studies (N = 1,807), we use item response theory analysis to present a 3-item brief screening tool assessing concern about partner drinking: Thinking about your Partner’s Drinking-3 (TPD-3). The TPD-3 revealed strong test–retest reliability and expected patterns of convergent, concurrent, and incremental validity with perceived partner drinking and alcohol-related consequences, behavioral responses to partner drinking, and relationship well-being. We present the TPD-3 as a useful screening tool and for measurement of concern about partner drinking when efficient assessment is desired.     

The Role of Media Exposure on Coordination in the Humanitarian Setting

Despite high demand and resource limitations, humanitarian organizations (HOs) typically do not share resources and/or coordinate in the field. While coordination enhances operational performance and saves costs, the general perception is that it dilutes the media attention that individual organizations might receive, and negatively influences their future donation income. In this study, we empirically unveil the impact of media exposure and operational performance on the donations obtained by HOs. Then, based on the empirical results, we develop a stylized model to characterize the structure of preferred coordination policies with respect to an organization's funding source and main mandate. Our findings shed light on the incentives and dynamics that drive behaviors in humanitarian operations and provide insights for policy makers on designing and implementing mechanisms that encourage humanitarian coordination.