Children, death and ageism

The position of children in the social order can be seen as an ambiguous one. On the one hand, they are highly valued, at a rhetorical level at least, as the basis of the future generation. On the other hand, however, they can be seen to be marginalized and disenfranchised, protected from more aspects of social life than is strictly necessary. This paper explores some of the important issues relating to children's disenfranchised social position, with specific reference to issues relating to death, dying and bereavement.     

Sexual Abuse by Design: an examination of the issues in learning disability services

This paper is based upon ideas developed by the authors during their past 6 years work on issues of sexuality and sexual abuse in a wide variety of learning disability settings in Britain. The paper argues that some features of service design in themselves make sexual abuse more likely to occur. It suggests ways of reducing risk, which should work alongside the more usually suggested educative approaches to individuals and groups of vulnerable people.     

Variability and Uncertainty Meet Risk Management and Risk Communication

In the past decade, the use of probabilistic risk analysis techniques to quantitatively address variability and uncertainty in risks increased in popularity as recommended by the 1994 National Research Council that wrote Science and Judgment in Risk Assessment. Under the 1996 Food Quality Protection Act, for example, the U.S. EPA supported the development of tools that produce distributions of risk demonstrating the variability and/or uncertainty in the results. This paradigm shift away from the use of point estimates creates new challenges for risk managers, who now struggle with decisions about how to use distributions in decision making. The challenges for risk communication, however, have only been minimally explored. This presentation uses the case studies of variability in the risks of dying on the ground from a crashing airplane and from the deployment of motor vehicle airbags to demonstrate how better characterization of variability and uncertainty in the risk assessment lead to better risk communication. Analogies to food safety and environmental risks are also discussed. This presentation demonstrates that probabilistic risk assessment has an impact on both risk management and risk communication, and highlights remaining research issues associated with using improved sensitivity and uncertainty analyses in risk assessment.     

Estimation of Tuberculosis Risk and Incidence under Upper Room Ultraviolet Germicidal Irradiation in a Waiting Room in a Hypothetical Scenario

Environmental control measures (ventilation, high-efficiency particulate air filtration, and upper room ultraviolet germicidal irradiation [UVGI]) are recommended to effectively control tuberculosis (TB) transmission from unsuspected TB patients in high-risk settings, but the effectiveness of their use is not often clear. This study presents a simulation model for a hypothetical hospital waiting room, in which the number of susceptible immunocompetent people in the waiting room follows a Poisson distribution (M = 5) in either low (annual number of TB patients = 5) or high TB risk settings (annual number of TB patients = 50), and used the model to evaluate the reduction of TB transmission risk by upper room UVGI. An exponential dose-response model was used for TB transmission and a two-zone model was used for evaluating the effect of upper room UVGI. Upper room UVGI reduced TB risk by 1.6-fold at 3 microW/cm2 UV irradiance in the upper room in the low TB risk setting and by 4.1-fold at 15 microW/cm2 UV irradiance in the upper room in the high TB risk setting. Use of upper room UVGI also reduced the mean annual new infection rate from 2.2 to 1.3 infections per year at 3 microW/cm2 and to 0.6 infections per year at 15 microW/cm2 in our hypothetical high-risk settings. The effect of upper room UVGI was sensitive to both vertical air velocity (air mixing) and UV irradiance level. Results from partitioning variability indicate that most variability of TB transmission risk came from waiting time in our hypothetical hospital.