A Pragmatic Approach to Designing Changes Using Convergent Interviews: Occupational Violence Against Paramedics as an Illustration

Developing a change program to address complex problems can appear overwhelming. This study presents how an inductive diagnostic technique known as convergent interviewing can provide a summary of the critical issues that could be addressed by a change program. A systems perspective is used to show how the issues raised by the diagnostic process can be targeted in order to have the most effect and be pragmatically implementable. The use of the tool is illustrated by analysing an employee problem that needs to be addressed in public services, the high rates of occupational violence against paramedics. The resulting inductive systems model can be used for diagnosis or for informing a variety of change interventions. Convergent interviews are relatively easy to use, powerful, and applicable to many situations. This tool is particularly useful for developing innovations regarding a specific problem, changes that could be a source of substantial public value.     

Reexamining Adolescent Suicidal Ideation: A Developmental Perspective Applied to a Diverse Population

The purpose of this study was to test the hypothesis that suicidal ideation is a common experience in a general population of African American, Hispanic, and White urban high school students residing in low-income neighborhoods. Based upon a developmental framework, it was hypothesized that once attitudes toward suicide were controlled, ideation would not vary significantly by ethnicity, gender, or psychosocial variables usually associated with ideation. The multivariate analysis revealed that ideation did not vary by ethnicity however, females, substance users, and those with greater tolerance toward suicide, higher family coping, and lower self-esteem were more likely to report ideation. A series of ideator profiles, calculated from the probability estimates, showed that an increase in tolerance substantially raises the likelihood of ideation. The results taken together raise the question of whether it is time to reconceptualize the relationship between ideation and normal adolescent development.     

Use of "therapeutic complication" as a manner of death

Analyses of deaths due to therapeutic complications (TCs) provide important quality of care information for medical providers. In New York City, 463 deaths were investigated by the Office of Chief Medical Examiner and certified with TC as the manner of death in 2003. The TC manner of death is used for fatalities due to predictable complications of appropriate medical therapy. All death certificates and select autopsy, hospital, and investigation reports were reviewed. Data concerning cause of death, contributing conditions, age, race, and sex were extracted. The types of complications and the causes of death were classified into various types of surgical and nonsurgical categories of complications. These included: postoperative infections, pulmonary emboli, and technical and medication complications. The use of TC as a manner of death has benefits and limitations. Without the TC option, one is forced to certify certain deaths (e.g., penicillin anaphylaxis) either as natural or accident. The TC option allows easy identification and tracking of medical complications for public health purposes and also allows more consistent reporting of natural and medical-accidental deaths. In general, complications that occur during emergency surgeries/procedures for natural disease, tend to be certified with a natural manner. The "but for" test may be used to distinguish natural from TC deaths. There are criteria for distinguishing TC from accidents and homicides. TCs that occur during treatment of a potentially life-threatening injury, are superseded by the manner dictated by the circumstances of the initiating injury. The certification of TC usually does not address errors of omission, clinical judgement/management, or missed diagnoses.     

Antecedents of collegiate drinking

A model designed to explain variations in the use of alcohol among undergraduates draws together three categories of variables: (1) sociocultural—race, sex, and population of student's hometown; (2) familial characteristics—father's occupation, parents' marital status, and closeness to a problem drinker; and (3) the onset of student drinking—age at first drinking and extent of drinking at its onset. A 10% random sample was drawn from the undergraduate students enrolled in two state-supported universities in the southeastern U.S. The present analysis focuses on 856 nonmarried, full-time undergraduate students. Overall, the findings show that race, degree of closeness to a problem-drinker, age at the onset of drinking, and its extent markedly influence the level of alcohol consumption among undergraduates. The strongest overall predictor of undergraduate drinking is the extent of adolescent consumption.Received M.A. from the University of North Carolina at Greensboro. Research interests include alcohol and drug use and individual forms of deviance.Received Ph.D. from the University of New Hampshire. Current interests include alcohol and drug use, suicidal behavior, and interpersonal violence.     

The ‘science’ of superiority: Africa and scholarly colonial assumptions

ABSTRACT

The use of ‘neopatrimonialism’ as a category in mainstream scholarship on African polities and economies is ubiquitous. A critique by Thandika Mkandawire has shown that the ‘neopatrimonial school’ is devoid of conceptual coherence and analytical power – it is an expression of a prejudice, not a useful tool for research and analysis. The article endorses Mkandawire's view but points out that this is by no means the only example of its kind. On the contrary, the use of categories which assume the superiority of societies in the global North over those in Africa is widespread. The article illustrates this by discussing and criticising two others, the ‘democratic consolidation’ paradigm and the ‘failed state’ framework. It argues that all three shape assumptions by scholars in Africa as well as outside it which obstruct concrete analysis. A critique of these paradigms is thus essential to the development of scholarship on and about Africa.