Differences in Pharmacokinetics Between Children and Adults—II. Children''s Variability in Drug Elimination Half-Lives and in Some Parameters Needed for Physiologically-Based Pharmacokinetic Modeling

In earlier work we assembled a database of classical pharmacokinetic parameters (e.g., elimination half-lives; volumes of distribution) in children and adults. These data were then analyzed to define mean differences between adults and children of various age groups. In this article, we first analyze the variability in half-life observations where individual data exist. The major findings are as follows. The age groups defined in the earlier analysis of arithmetic mean data (0-1 week premature; 0-1 week full term; 1 week to 2 months; 2-6 months; 6 months to 2 years; 2-12 years; and 12-18 years) are reasonable for depicting child/adult pharmacokinetic differences, but data for some of the earliest age groups are highly variable. The fraction of individual children's half-lives observed to exceed the adult mean half-life by more than the 3.2-fold uncertainty factor commonly attributed to interindividual pharmacokinetic variability is 27% (16/59) for the 0-1 week age group, and 19% (5/26) in the 1 week to 2 month age group, compared to 0/87 for all the other age groups combined between 2 months and 18 years. Children within specific age groups appear to differ from adults with respect to the amount of variability and the form of the distribution of half-lives across the population. The data indicate departure from simple unimodal distributions, particularly in the 1 week to 2 month age group, suggesting that key developmental steps affecting drug removal tend to occur in that period. Finally, in preparation for age-dependent physiologically-based pharmacokinetic modeling, nationally representative NHANES III data are analyzed for distributions of body size and fat content. The data from about age 3 to age 10 reveal important departures from simple unimodal distributional forms-in the direction suggesting a subpopulation of children that are markedly heavier than those in the major mode. For risk assessment modeling, this means that analysts will need to consider "mixed" distributions (e.g., two or more normal or log-normal modes) in which the proportions of children falling within the major versus highweight/fat modes in the mixture changes as a function of age. Biologically, the most natural interpretation of this is that these subpopulations represent children who have or have not yet received particular signals for change in growth pattern. These apparently distinct subpopulations would be expected to exhibit different disposition of xenobiotics, particularly those that are highly lipophilic and poorly metabolized.     

Client satisfaction with developmental disabilities services

Data from a representative sample of 312 developmentally disabled clients of Florida's Department of Health and Rehabilitative Services are analyzed to discover the characteristics of the clients and to determine the extent to which the clients are satisfied with various services, reasons for any dissatisfaction that exists, and the factors which are related to satisfaction with services. Clients are least likely to be satisfied with the caregiver support services and the vocational and rehabilitative services they receive. Across all categories, reasons most often given for dissatisfaction with services are inappropriateness and insufficient amount. The factors most strongly related to client satisfaction with services are age, living arrangements, and number of services received. Adolescents are less likely than persons at other ages to be satisfied with the services they receive, persons living in a family setting are less likely than persons in nonfamily settings to be satisfied with services, and the greater the number of services received the lower the likelihood of client satisfaction. Combined with information showing that most of the clients have multiple disabilities, these data suggest that the service delivery system does a better job of delivering some services than others. A slot oriented program such as that in Florida may pay insufficient attention to the existence of multiple needs among persons who are developmentally disabled and to providing services to the networks which form the client's economic and social support system.     

The Changing Governance of Welfare: Recent Trends in its Primary Functions, Scale, and Modes of Coordination

This paper discusses four dimensions of the capitalist state's role in economic and social reproduction: its economic and social policy roles, the scales on which these roles are performed, and the modes of governance with which they are associated. It describes the typical postwar welfare regime on these dimensions, analyses the crisis in the governance of welfare that began to emerge in the late 1970s and 1980s, and characterizes the new regime that is tendentially replacing the postwar welfare state.     

The politics of love in three recent U.S. and U.K. films of young gay romance: a symptomatic reading of Beautiful Thing, Get Real, and Edge of Seventeen

A symptomatic representation, from a Marxist critical vantage point, of three prototypical recent U.S. and U.K. films of young gay romance-Beautiful Thing, Get Real, and Edge of Seventeen-shows these films (as well as the larger, insurgent cinematic subgenre of which they serve as particularly exemplary instances) do significant ideological work, contrary to what might appear to be the case from a superficial (and uncritical) reading that dismisses them as pure escapism. These films confront contradictions central to contemporary U.S. and U.K. gay politics and culture-contradictions involving the unity and struggle of tendencies toward gay assimilation versus gay separation, gay normalization versus gay differentiation, and gay integration versus gay dissidence. While these films do not provide formal resolutions to these real social contradictions as much as they engage in processes of formal dissolution and irresolution (i.e., suspension) of these contradictions, they cannot fully elide the existence of these contradictions because to do so would effectively undermine the empathetic appeal of the romantic tales they tell. We can observe this ideological tension most clearly by examining (1) the fraught ways in which the films represent their protagonists' struggle to substitute individual acquisition of a seemingly secure private place for engagement in social struggle to extend collective control over public space, as well as (2) the abstractly utopian manner in which these films celebrate the power of love.     

Empowering Children Left Behind in China

In the last two decades in rural China, increasing numbers of children of economic migrants have been left behind with kin, which is of growing concern for social work and welfare policy. The genesis of this rural to urban migration has been China's rapid economic development and greater opportunities for work in better paying jobs in cities. However, there is growing evidence of the negative impact upon these children. This paper reports the views of caregivers (n = 23) and school personnel (n = 5) from a small town in Northeast China. Interviews sought adults opinions on these children's needs, with the major outcome being children's need to be empowered – to be respected, to express themselves, to have influence, and to be supported to be able to more fully participate in education and their communities. We argue that caregiver strategies to empower children left behind provide insight into culturally appropriate processes and practices that underpin social inclusion. However, some discrepancies between the views of caregivers and school personnel alert us to the potential for tension between family and broader community and institutional views. Implications for social work practice include responding to the cultural values embedded in child rearing practices and local ideas about children's entitlements.     

人造卫星捕捉污染物的全球迁移(下)

走近气体污染物 利用卫星来追踪几种气体污染物质的研究也已取得一定进展.气体污染物质中的一类为氮氧化合物(Nox),主要由车辆、发电站和工厂燃料产生,也可以由自然界如火、土壤和闪电等产生.     

Divergent Paths of Immigration Politics in the United States and Australia

The United States and Australia converged by the mid‐1980s on receptive and expan sive immigration policies reflecting “client” politics. Australia has since pursued a more restrictive and selective course while the United States has resisted pressures toward such a stance. The authors account for these differences by assessing the theoretical perspectives of interests, rights, and states. Conflicts among groups with direct interests in policy outcomes are the principal source of immigration politics, but a comparison of the roles of rights and state institutions helps explain peculiarities of the two cases. The distinctive Australian policy trajectory is shaped by greater volatility of public opinion about immigration and multiculturalism, and by political institutions that are more responsive to popular sentiment.