Assessing Potential Human Health Hazards and Benefits from Subtherapeutic Antibiotics in the United States: Tetracyclines as a Case Study

Many scientists, activists, regulators, and politicians have expressed urgent concern that using antibiotics in food animals selects for resistant strains of bacteria that harm human health and bring nearer a “postantibiotic era” of multidrug resistant “super‐bugs.” Proposed political solutions, such as the Preservation of Antibiotics for Medical Treatment Act (PAMTA), would ban entire classes of subtherapeutic antibiotics (STAs) now used for disease prevention and growth promotion in food animals. The proposed bans are not driven by formal quantitative risk assessment (QRA), but by a perceived need for immediate action to prevent potential catastrophe. Similar fears led to STA phase‐outs in Europe a decade ago. However, QRA and empirical data indicate that continued use of STAs in the United States has not harmed human health, and bans in Europe have not helped human health. The fears motivating PAMTA contrast with QRA estimates of vanishingly small risks. As a case study, examining specific tetracycline uses and resistance patterns suggests that there is no significant human health hazard from continued use of tetracycline in food animals. Simple hypothetical calculations suggest an unobservably small risk (between 0 and 1.75E‐11 excess lifetime risk of a tetracycline‐resistant infection), based on the long history of tetracycline use in the United States without resistance‐related treatment failures. QRAs for other STA uses in food animals also find that human health risks are vanishingly small. Whether such QRA calculations will guide risk management policy for animal antibiotics in the United States remains to be seen.     

COMMON FACTORS ACROSS THEORIES OF MARRIAGE AND FAMILY THERAPY: A MODIFIED DELPHI STUDY

The Delphi methodology was used to explore common factors across theories of marriage and family therapy (MFT). Leading clinicians and researchers from the American Family Therapy Academy and select faculty members from MFT training programs accredited by the Commission on Accreditation for Marriage and Family Therapy Education were asked to achieve consensus regarding common factors. Respondents were asked to report on commonalities across the various MFT theories, as well as what they personally considered to be the core ingredients of change. A final profile of items was created from the responses. Qualitative interviews were conducted with selected panelists to clarify discrepancies as well as to add meaning to the data. Implications for the training and practice of MFTs as well as direction for future research are discussed.     

TOWARD A THEORY OF CONSTRAINTS

Grounded in the cybernetic concept of negative explanation, the theory of constraints examines how human systems are kept from solving problems. To identify constraints, therapists must know where to look for them and what to look for. The theory proposes that constraints exist among the levels of a biopsychosocial system, which include biology, person, relationship, family, community, and society. The six metaframeworks of organization, sequences, mind, development, gender, and culture assist constraint identification. Combining the levels and metaframeworks creates a web of constraints, the complexity of which determines how difficult it will be to solve a given problem. The theory of constraint offers an integrative and pragmatic approach to therapy while simultaneously honoring the complexity of human systems.     

Processes of Internal and International Migration from Chitwan, Nepal

In this study we examine which factors predict internal and international migration from Chitwan, a flat valley located in the South-Central region of Nepal, seeking to measure the effect of theoretically specified variables such as human capital, social capital, physical capital, and neighborhood socioeconomic conditions while controlling for demographic variables. We use data from the Chitwan Valley Family Study (CVFS) to estimate a series of discrete time event history models of first and repeat migration to three competing destinations: other locations within Chitwan, other districts within Nepal, and places outside of Nepal. Results support hypotheses derived from neoclassical economics, the theory of new economics of migration, social capital theory, and cumulative causation theory. Our results underscore the need for a synthetic theoretical model that incorporates factors operating at the individual, household, and community levels. The use of multiple explanatory models yields a clearer picture of the forces driving internal and international migration from rural districts in developing nations such as Nepal.     

The Research-Informed Clinician: A Guide to Training the Next-Generation MFT

The gap between clinical research and practice is a major challenge facing marriage and family therapy (MFT) training programs. Until now, the answer to bridge this gap has primarily been the Boulder Scientist-Practitioner Model. Although realistic for doctoral students, it may not be a good fit for MFT master’s students who have primarily clinical career ambitions—which we believe is a legitimate and positive career choice. The following article articulates a “research informed” perspective as opposed to the scientist-practitioner framework as a research-training model for clinically oriented MFT master’s programs. After articulating the similarities and differences between these two approaches, the authors outline 10 practical ideas to integrate research into programs that desire to remain clinical in focus, but also research informed.     

Reviews

ANOTHER RUSSIA Through the Eyes of the New Soviet Photographers: A Lesson in Looking and Not Seeing Facts on File, 1986

Camera Culture, by Halla Beloff

Poletown Lives! Film/Videotape: 52 mins.

Exploding Into Life, by Dorthea Lynch and Eugene Richards

Documentary Filmmaking: A Closer Look A Seminar

Videology and Utopia: Explorations in a New Medium A. Willener, G. Milliard, and A. Ganty     

The new labor market: Immigrants and wages after IRCA

We examine the effect of the Immigration Reform and Control Act (IRCA) on migrants' wages using data gathered in 39 Mexican communities and their U.S. destination areas. We examine changes in the determinants of wages before and after the passage of IRCA, as well as the effects of its massive legalization program. Migrants' wages deteriorated steadily between 1970 and 1995, but IRCA did not foment discrimination against Mexican workers per se. Rather, it appears to have encouraged greater discrimination against undocumented migrants, with employers passing the costs and risks of unauthorized hiring on to the workers. Although available data do not permit us to eliminate competing explanations entirely, limited controls suggest that the post-IRCA wage penalty against undocumented migrants did not stem from an expansion of the immigrant labor supply, an increase in the use of labor subcontracting, or a deterioration of the U.S. labor market.