Science and Decisions: Advancing Risk Assessment

At the request of the U.S. Environmental Protection Agency (EPA), the National Research Council (NRC) recently completed a major report, Science and Decisions: Advancing Risk Assessment, that is intended to strengthen the scientific basis, credibility, and effectiveness of risk assessment practices and subsequent risk management decisions. The report describes the challenges faced by risk assessment and the need to consider improvements in both the technical analyses of risk assessments (i.e., the development and use of scientific information to improve risk characterization) and the utility of risk assessments (i.e., making assessments more relevant and useful for risk management decisions). The report tackles a number of topics relating to improvements in the process, including the design and framing of risk assessments, uncertainty and variability characterization, selection and use of defaults, unification of cancer and noncancer dose‐response assessment, cumulative risk assessment, and the need to increase EPA's capacity to address these improvements. This article describes and summarizes the NRC report, with an eye toward its implications for risk assessment practices at EPA.     

I Frameworks for analysis of course content and practice learning

The authors note that the recent changes to the C.C.E.T.S.W. Guidelines contain no stipulation that the teaching of economics should constitute an integral part of social work education. They argue that it is impossible for social workers and their clients to achieve control of their lives without a knowledge of the economic influences that help to determine them. The authors' conflict with the priorities implied by the C.C.E.T.S.W. Guidelines led them to survey British courses which lead to a professional social work qualification. They found that only 28% teach economics formally, while some evidence suggests that this proportion is declining despite a widespread expression of regret at the absence of economics. The authors attempt to outline the objectives of a relevant economics syllabus for social work students. They conclude that powerful positive and negative arguments exist to support a substantial economics component in social work education and that the present crisis of both welfare and the economy intensifies, but does not create, this need.     

Selection and Preparation of Faculty for Schools of Social Work

The need to prepare social work administrators for the field is now recognized. As schools belatedly mobilize to address this need, there is uncertainty concerning our knowledge base and ability to perform in this area. While these concerns are genuine, there is a wealth of experience in curriculum development that should guide the profession. This paper focuses on the field instruction component of the administration concentration. Problems pertaining to the development of administration placements are identified and special arrangements are suggested to engage them that require a departure from traditional field instruction models and school-agency relationships.     

Avoidance of Heights on the Visual Cliff in Newly Walking Infants

Work with infants on the “visual cliff” links avoidance of drop‐offs to experience with self‐produced locomotion. Adolph's (2002) research on infants' perception of slope and gap traversability suggests that learning to avoid falling down is highly specific to the postural context in which it occurs. Infants, for example, who have learned to avoid crossing risky slopes while crawling must learn anew such avoidance when they start walking. Do newly walking infants avoid crossing the drop‐off of the visual cliff? Twenty prewalking but experienced crawling infants were compared with 20 similarly aged newly walking infants on their reactions to the visual cliff. Newly walking infants avoided moving onto the cliff's deep side even more consistently than did the prewalking crawlers. Thus, in the context of drop‐offs in visual texture, our results show that once avoidance of drop‐offs is established under conditions of crawling, it is developmentally maintained once infants begin walking.     

Effects of uncertainty and risk on the allocation of time of married women

This article develops a model in which the existence of uncertainty in the rate of return to household production is shown to reduce the number of hours allocated to work at home. Empirically, the implications of the theoretical model are tested for married women with data from the Panel Study of Income Dynamics. The findings indicate that uncertainty variables are significant determinants both of participation in the market and of hours allocated to work, home work, and leisure. Specifically, permanent income and measures of uncertainty exert a stronger influence on the allocation of time of married women than do transitory changes in income. In addition, women for whom the probability of divorce is high are both more likely to work in the market and to work more hours in this sector than are women for whom the probability of divorce is low.She is currently engaged in research on a comparative crossnational analysis of family policy.     

Hospital social work in Sweden and the UK: Access to chances of physical health and well-being

In Swedish and UK practice, interest is developing in social work's contribution to tackling service users' unequal chances and experience of physical health. This is through alleviating disadvantaged social conditions such as relative poverty which service users face and which are associated with health inequalities. Ready access to social work services is an essential preliminary if service users are to gain the material and social resources services can provide, to alleviate their adverse social circumstances and thereby improve their health prospects. However, despite hospital social work's well-established position, its significance as an access point for services has tended to be marginalized. Drawing on a comparative account of Swedish and UK practice featuring two action research projects, we explore how hospital social work is a key point of access to services for service users experiencing profound disadvantage. We analyse major barriers to such access, notably the underfunded nature of hospital social work, discriminatory procedures, and unequal professional service user power relations. Nevertheless, the action research projects show how these barriers may be breached to some degree, enabling service users as patients and carers to access resources which contribute to more equal chances of health and well-being in ill-health.     

HEALTH RISK ANALYSIS AND SOCIOMEDICAL TECHNOLOGIES OF THE SELF: PRIVATE HEALTH INSURANCE GETS INTO HEALTH PROMOTION

In October 1994 the then Australian Federal Minister for Health, Dr. Carmen Lawrence, announced that Medicare, the Australian universal national healthcare fund was considering introducing Healthtrac a computerised health promotion program. The change of government in 1995 put paid to this plan, however, lifestyle based health promotion programs, including computerised programs, are an increasing trend in contemporary health care. Research from the United States indicates a growing interest by private insurers and Health Maintenance Organisations (HMOs) in funding and encouraging members, particularly older members and retirees, to engage in healthy lifestyle programs, some of which provide written reports, periodic up-dates and checks to members as well as summary advice to employers and insurers. In this article we argue that while many of these programs are well researched programs that take cognisance of the contradictions surrounding scientific research related to lifestyle behaviours, disease and disability, they take a narrow approach to health promotion. Further, in the hands of private insurers and HMOs these programs have the potential to become sociomedical techniques (Stone 1989) of dominance, arising out of risk analysis that informs and refines techniques of governance of the self (Burchell 1993; Rose 1993). Consistent with Stevensen and Burke (1991) we see health promotion not as a new social movement, but as a political strategy of the state and capitalism to deal with among other things, escalating health care budgets. Given this, health promotion strategies that overly focus on risk analysis for the individual citizen reinforce techniques of self-governance by linking lifestyle behaviour to immorality as well as potentially creating a culture of anxiety - surely a public health problem in itself.     

Embodied Women at Work in Neoliberal Times and Places

In this article five women explore (female) embodiment in academic work in current workplaces. In a week‐long collective biography workshop they produced written memories of themselves in their various workplaces and memories of themselves as children and as students. These memories then became the texts out of which the analysis was generated. The authors examine the constitutive and seductive effects of neoliberal discourses and practices, and in particular, the assembling of academic bodies as particular kinds of working bodies. They use the concept of chiasma, or crossing over, to trouble some aspects of binary thinking about bodies and about the relations between bodies and discourses. They examine the way that we simultaneously resist and appropriate, and are seduced by and appropriated within, neoliberal discourses and practices.     

A Comparison of Statistical Methods for Age-related Reference Intervals

Age-specific reference intervals are commonly used in the routine monitoring of individuals, where interest lies in the detection of extreme values, possibly indicating abnormality. Here, a review is given of the wide range of statistical techniques which have been proposed for the construction of these intervals and issues such as the estimation of confidence bands and goodness of fit are discussed. Three methods, thought to be the most widely applied approaches, are considered in more detail. Comparisons are made on the basis of reference interval estimation for three real data sets.