Exposure Reconstruction for the TCDD-Exposed NIOSH Cohort Using a Concentration- and Age-Dependent Model of Elimination

Recent studies demonstrating a concentration dependence of elimination of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) suggest that previous estimates of exposure for occupationally exposed cohorts may have underestimated actual exposure, resulting in a potential overestimate of the carcinogenic potency of TCDD in humans based on the mortality data for these cohorts. Using a database on U.S. chemical manufacturing workers potentially exposed to TCDD compiled by the National Institute for Occupational Safety and Health (NIOSH), we evaluated the impact of using a concentration- and age-dependent elimination model (CADM) (Aylward et al., 2005) on estimates of serum lipid area under the curve (AUC) for the NIOSH cohort. These data were used previously by Steenland et al. (2001) in combination with a first-order elimination model with an 8.7-year half-life to estimate cumulative serum lipid concentration (equivalent to AUC) for these workers for use in cancer dose-response assessment. Serum lipid TCDD measurements taken in 1988 for a subset of the cohort were combined with the NIOSH job exposure matrix and work histories to estimate dose rates per unit of exposure score. We evaluated the effect of choices in regression model (regression on untransformed vs. ln-transformed data and inclusion of a nonzero regression intercept) as well as the impact of choices of elimination models and parameters on estimated AUCs for the cohort. Central estimates for dose rate parameters derived from the serum-sampled subcohort were applied with the elimination models to time-specific exposure scores for the entire cohort to generate AUC estimates for all cohort members. Use of the CADM resulted in improved model fits to the serum sampling data compared to the first-order models. Dose rates varied by a factor of 50 among different combinations of elimination model, parameter sets, and regression models. Use of a CADM results in increases of up to five-fold in AUC estimates for the more highly exposed members of the cohort compared to estimates obtained using the first-order model with 8.7-year half-life. This degree of variation in the AUC estimates for this cohort would affect substantially the cancer potency estimates derived from the mortality data from this cohort. Such variability and uncertainty in the reconstructed serum lipid AUC estimates for this cohort, depending on elimination model, parameter set, and regression model, have not been described previously and are critical components in evaluating the dose-response data from the occupationally exposed populations.     

International Humanitarian Law and Combat Casualties

The purpose of the article is to provide an overview of the law regulating combat in order to assist in determining whether casualties inflicted in combat should be classified as victims of war or victims of war crimes. The boundaries and the content of International Humanitarian Law are indicated. A brief statement of the law regulating combat is given. The concepts of military objective and of proportionality are analyzed. The scope of an unlawful attack is addressed as is the relationship between unlawful attack offences and other offences in International Humanitarian Law. The article concludes with a discussion of when combat casualties are war crimes victims.     

Improving on truncated linear estimates of exponential and gamma scale parameters

We consider the problem of estimating the scale parameter of an exponential or a gamma distribution under squared error loss when the scale parameter θ is known to be greater than some fixed value θ₀. Natural estimators in this setting include truncated linear functions of the sufficient statistic. Such estimators are typically inadmissible, but explicit improvements seem difficult to find. Some are presented here. A particularly interesting finding is that estimators which are admissible in the untruncated problem which take values only in the interior of the truncated parameter space are found to be inadmissible for the truncated problem.     

Immigration and the evolution of economic theory

This is a review of "the limited and scant contributions made to immigration theory in the context of the evolution of economic thought over a protracted historical time span." The economic theories considered include those of the mercantilists, Adam Smith, the classical economists, and J. M. Keynes. (SUMMARY IN FRE AND SPA)     

Selecting a family therapy model: the role of personality attributes in eclectic practice*

The expanding knowledge and skill bases within the interdisciplinary family therapy profession pose a significant challenge for evolving practitioners, at whatever stage along the professional development process they find themselves. This challenge raises a basic question regarding whether there are any constraining forces to the level of eclecticism in practice towards which one can aspire. This paper empirically explores the role played by the personality attributes of the family therapist in facilitating and/or inhibiting one's adherence to a variety of approaches to family practice.     

The prediction of learning in family therapy training programs*

Research on family therapy training has produced very little data regarding the kinds of trainees that do best in family therapy training programs. This study attempts to provide some rough and preliminary data on that issue. One hundred and seventy trainees, drawn from seven different structural!strategic training experiences, were evaluated as to how much they learned by taking the Family Therapy Assessment Exercise pre- and posttraining. Their performance was correlated using a hierarchical regression analysis with a number of trainee variables such as amount of conjugal family experience, amount of experience doing family or individual therapy, or prior knowledge of family therapy. The results indicate that, as predicted, conjugal family experience was positively related, and prior knowledge was negatively related to performance. Prior experience doing individual therapy was also positively related to performance.     

Training with o (observing) and T (treatment) teams in live supervision: reflections in the looking glass*

Working with a treatment and observing team at the same time, behind the oneway mirror, offers a variety of ways to: (a) generate multiple realities; (b) work with two different models of family therapy simultaneously; and (c) provide feedback on the teams' own roles, rules and group process. The process that 6 trainees and two supervisors used with T and O teams to examine their own coevolution as a therapeutic system using the Milan model of family therapy and Ericksonian hypnotherapy is described. The article concludes with a discussion of the advantages and pitfalls of this type of dual supervision.     

AIDS as a political issue: working with the sexually prostituted in the Philippines

An estimated 200,000-500,000 men, women, and children work in prostitution in the Philippines in a variety of venues, including brothels, nightclubs, pubs, massage parlors, and other legitimate entertainment establishments. Few, however, are voluntary prostitutes. Many people who work as prostitutes have been recruited from the provinces, kept in conditions similar to slavery, and forced to earn money from prostitution to pay for their transportation, board, and lodging. Many prostitutes work in urban centers and tourist resorts in the countryside. During the 1970s, then President Ferdinand Marcos promoted tourism as a major industry, effectively marketing attractive Filipinas to tourists. Sex tourism has flourished in the country ever since. Thousands of prostitutes are also located in Olongapo and Angeles, 2 cities north of Manila, from where they serve the sexual desires of US military personnel. The presence of US military personnel in the Philippines has always been associated with prostitution. The country's social hygiene centers, prostitutes in Manila and Davao, and AIDS education are briefly discussed.     

Research & clinical practice. Building a nursing research culture

The internalization of clinical nursing research values, norms, and attitudes via orientation and research development, along with the introduction of research tools (artifacts), constitutes the birthing phase of the acculturation process. The development of unit and individual research agendas and the implementation of research rounds illustrates a "bonding phase," in that nurses are bonding or weaving research into the fabric of their clinical practice. The final phase, stabilization, occurs when clinical nursing research is core to clinical nursing practice as illustrated by rewards or sanctions via performance evaluations, and provisions for release time for research participation.