Work stressors and cardiovascular disease

Over the past 20 years, an extensive body of research evidence has documented that psychosocial work stressors are risk factors for hypertension and cardiovascular disease. These stressors, which appear to be increasing in prevalence, include job strain (the combination of psychological job demands and low job control), imbalance between job efforts and rewards, threat-avoidant vigilant work, and long work hours. This article reviews the evidence linking these stressors with hypertension and CVD, and the physiological and social psychological mechanisms underlying the associations. Also described are methods for measuring work stressors and new, more accurate techniques for measuring blood pressure. Finally, strategies for reducing work stressors and preventing hypertension and CVD are reviewed. These include clinical assessment, worksite health promotion, work organization interventions, legal approaches and work site surveillance.     

Pathway Analysis for Population-Total Health Impacts of Toxic Metal Emissions

This article describes a simple model for quantifying the health impacts of toxic metal emissions. In contrast to most traditional models it calculates the expectation value of the total damage (summed over the total population and over all time) for typical emission sites, rather than "worst-case" estimates for specific sites or episodes. Such a model is needed for the evaluation of many environmental policy measures, e.g., the optimal level of pollution taxes or emission limits. Based on the methodology that has been developed by USEPA for the assessment of multimedia pathways, the equations and parameters are assembled for the assessment of As, Cd, Cr, Hg, Ni, and Pb, and some typical results are presented (the dose from seafood is not included and for Hg the results are extremely uncertain); the model is freely available on the web. The structure of the model is very simple because, as we show, if the parameters can be approximated by time-independent constants (the case for the USEPA methodology), the total impacts can be calculated with steady-state models even though the environment is never in steady state. The collective ingestion dose is found to be roughly 2 orders of magnitude larger than the collective dose via inhalation. The uncertainties are large, easily an order of magnitude, the main uncertainties arising from the parameter values of the model, in particular the transfer factors. Using linearized dose-response functions, estimates are provided for cancers due to As, Cd, Cr, and Ni as well as IQ loss due to Pb emissions in Europe.     

Systemic Uptake and Clearance of Chloroform by Hairless Rats Following Dermal Exposure. I. Brief Exposure to Aqueous Solutions

The systemic uptake of chloroform from dilute aqueous solutions into live hairless rats under conditions simulating dermal environmental exposure was studied. Whole blood was sampled during a 30-min immersion of an animal within water containing a known concentration of chloroform and then for 5.5 h following its removal from the bath. The amount of chloroform systemically absorbed was determined by comparing the AUCs of the blood concentration vs. time plots from dermal exposure to that obtained after IV infusion (for a period of 30 min) of an aqueous solution containing a known amount of chloroform (positive control). Although dermal data implied two-compartment disposition characteristics, IV infusion data fit best to a three-compartment disposition. Linear pharmacokinetics was observed both by IV administration and percutaneous absorption at the dose levels studied. Chloroform was detected in the rat blood as early as 4 min following exposure. Our findings suggest that about 10.2 mg of chloroform was systemically absorbed after dermal exposure of a rat to an aqueous solution of 0.44 mg/ml. This amount is substantially higher than the predictions of mathematical risk-models put forth by some investigators. However, when expressed as the "effective" permeability coefficient ( K _p^eff), close agreement was noticed between our value and those estimated by others using physiologically based pharmacokinetic (PBPK) models. Also, in terms of K _p^eff, reasonable agreement existed between our and another investigator's past estimates of uptake based on depletion of bath level of chloroform and the actual uptake measured in our current experiments. The estimated onset of systemic entry seen here is entirely consistent with our estimate of how long it takes to establish the diffusion gradient across the stratum comeum based on tape stripping.     

Type Methodology and Type Myth: Some Antecedents of Max Weber's Approach*

The methodological proposals of Windelband, Knies, Schmoller, Menger, Simmel, Dilthey and Rickert are surveyed and compared. Two difficulties in the writings are identified: the strict division which is urged (or accepted) between science and history, and the tendency to treat societies as “social wholes,” which have an autonomous existence and are self-developing.     

Critical review of the concept of the borderline child

The concept of the borderline child is reviewed in this paper. Questions are raised about the generally held assumption that a similarity exists between the dynamics of borderline children and those of borderline adults. It is suggested that no data is currently available to substantiate such a view. Further questions are raised about the assumption that the etiology of the disorder in childhood is based on poor or improper nurturance. A working definition of the concept of the borderline child is proposed that is free of preconceptions as to the etiology of the dysfunction. A hypothesis is presented for further investigation that at least some borderline children's etiology may be found in the presence of a minimal brain dysfunction or a severe learning disability.     

The effects of relationship aversive female partner behavior on attributions and physiological reactivity of verbally aggressive and non-aggressive males

The present study assessed the effects of aversive female partner behavior on cognitive attributions and physiological reactivity in verbally aggressive and non-aggressive college males (N = 39). Participants were presented four audiotaped vignettes which depicted hypothetical dating situations in which the female's behavior was relationship aversive or non-relationship aversive. Participants' physiological reactivity (i.e., systolic blood pressure, diastolic blood pressure, and heart rate) was obtained before and after hearing each vignette. Attributional responses were obtained following the presentation of all vignettes. Relationship aversive partner behavior was expected to produce greater increases in attributional and physiological reactivity than non-relationship aversive partner behavior. Additionally, verbally aggressive males were expected to demonstrate greater negative intent and responsibility attributions and evidence greater physiological reactivity for situations involving relationship aversive partner behavior than were non-aggressive males.As hypothesized, results showed that relationship aversive partner behavior produced greater increases in systolic and diastolic blood pressure than did non-relationship aversive partner behavior. Results also showed that verbally aggressive males evidenced significantly greater negative attributions to relationship aversive partner behavior than did non-aggressive males. The potential interaction between physiological reactivity and attributions in explaining males' verbally aggressive behavior toward their female partners is discussed.     

Recalling sexual behavior: a methodological analysis of memory recall bias via interview using the diary as the gold standard

This study examined the effect of time lag on the validity of retrospective self-reports of sexual behavior. Seventy-five heterosexual students (44 women, 31 men) made daily recordings of sexual behavior, condom use, and alcohol or substance use for 1 month. Ability of respondents to recall sexual behavior recorded during this period was assessed at 1, 2, and 3 months after diary completion using recall interviews (25 interviewed at each interval). For vaginal intercourse, total recall error was significantly greater at 3 months than at 1 month post-diary. For all other variables assessed, the 2- and 3-month time intervals did not produce significant increase in total recall error. Higher frequency of vaginal intercourse, orgasm, and alcohol use prior to sexual activity were associated with total recall error for some but not all behaviors and outcomes. The results provide a partial validation of the diary-interview recall model as a method for studying recall error.     

Participation and Change: Using Large Group Intervention Methods to Inform Reflective Practice in a Community of Public Organizations

Public leaders face increasing pressure to build effective organizational communities. However, the purposive-rational foundation of knowledge in existing theory fails to inform the reflective practice necessary for this level of change. This article contrasts the prevailing viewpoint with the notion of changing organizations, an approach rooted in critical theory in which large group intervention methods are employed to foster participation and emancipatory change across organizational communities. The article features a case study involving a local government grant-making agency to show how participants engaged in reflective practice as a way of patterning community-wide change.     

Ethnics and minorities: A review of the literature

Summary Numerous studies have suggested that ethnicity has at least as powerful an influence on mental health and mental illness as socio-economic status. The influence of ethnicity becomes particularly significant in those studies where social class is held constant. Yet, while professionals have readily accepted socio-economic differentials, ethnic variation is still often ignored or, worse, denied outright.The studies reviewed here underscore the need for new models of treatment, as well as serious research on the values and attitudes of ethnic groups and their implications for health and illness. Studies such asBlack Rage (Cobb and Grier, 1968) andThe Mental Health of the Poor (Reissman and Pearl, 1964), for example, have already influenced the development of new models and treatment programs. It is becoming increasingly clear that it takes different methods and programs to reach the varied groups within our society, and that we will have to reshape our current mental health policies and programs to make access to services easy for all of them.