Diesel Engine Exhaust and Lung Cancer Mortality: Time‐Related Factors in Exposure and Risk

To develop a quantitative exposure‐response relationship between concentrations and durations of inhaled diesel engine exhaust (DEE) and increases in lung cancer risks, we examined the role of temporal factors in modifying the estimated effects of exposure to DEE on lung cancer mortality and characterized risk by mine type in the Diesel Exhaust in Miners Study (DEMS) cohort, which followed 12,315 workers through December 1997. We analyzed the data using parametric functions based on concepts of multistage carcinogenesis to directly estimate the hazard functions associated with estimated exposure to a surrogate marker of DEE, respirable elemental carbon (REC). The REC‐associated risk of lung cancer mortality in DEMS is driven by increased risk in only one of four mine types (limestone), with statistically significant heterogeneity by mine type and no significant exposure‐response relationship after removal of the limestone mine workers. Temporal factors, such as duration of exposure, play an important role in determining the risk of lung cancer mortality following exposure to REC, and the relative risk declines after exposure to REC stops. There is evidence of effect modification of risk by attained age. The modifying impact of temporal factors and effect modification by age should be addressed in any quantitative risk assessment (QRA) of DEE. Until there is a better understanding of why the risk appears to be confined to a single mine type, data from DEMS cannot reliably be used for QRA.     

Manager Characteristics and Employee Job Insecurity around a Merger Announcement: The Role of Status and Crossover

Most existing research theorizes individual factors as predictors of perceived job insecurity. Incorporating contextual and organizational factors at an information technology organization where a merger was announced during data collection, we draw on status expectations and crossover theories to investigate whether managers' characteristics and insecurity shape their employees' job insecurity. We find having an Asian as opposed to a White manager is associated with lower job insecurity, whereas managers' own insecurity positively predicts employees' insecurity. Also contingent on the organizational climate, managers' own tenure buffers, and managers' perceived job insecurity magnifies insecurity of employees interviewed after a merger announcement, further specifying status expectations theory by considering context.     

Working with legal pluralism: widowhood,property inheritance,and poverty alleviation in urban Senegal

This article explores the role of women's inheritance and ownership of property in urban Senegal. It shows how being able to inherit and own property promotes the economic and emotional security of widows and their children in urban areas, and discusses the challenges posed by legal pluralism in working on poverty alleviation and social protection in the city.     

Editorial: genetic and genomic research-changing patterns of accountability

Debates about genomic science have raised questions about the implications for ethics and accountability. Accountability has external and internal aspects. Whereas ethical review, including attention to appropriate consent procedures, has been central to 'giving an account' externally, there are also issues internal to the practice of science itself. The pursuit of truth is central to the scientific endeavour, but truths can sometimes be 'inconvenient', leading to complex questions of accountability that go beyond the issues of consent. This is illustrated by the case of the Havasupai.     

Investing in the Citizen-workers of the Future: Transformations in Citizenship and the State under New Labour

There is growing interest in the idea of the “social investment state”. This paper analyses the emergence of such a state in the UK, in the context of a brief account of the more general transformations of citizenship and the state under New Labour. It argues that, despite the iconic status of the child in the social investment state, it is the child as “citizen‐worker” of the future rather than “citizen‐child” of the present who is invoked by the future‐oriented discourse of social investment.     

The Development of the Law of Matrimonial Property—A Historical Perspective

This article outlines briefly the development of matrimonial property law from earliest times to the present day. The issue of central concern throughout is the changing status of women and the bearing that this has had on development of the law. A historical, social and economic perspective is adopted in an effort to explain why particular developments occurred when they did. Finally, attention is drawn to the inadequacies of legal solutions to what is perceived as basically an economic issue.     

Process and Results of an Immunization Requirement at the University of Rochester

Abstract

“A Double-Blind Study of Oral Acyclovir for Suppression of Recurrences of Genital Herpes Simplex Virus Infection,” JOHN M. DOUGLAS, et al. Patients with frequently recurring genital herpes were enrolled in a double-blind placebo-controlled trial comparing 200-mg acyclovir capsules, given five or two times daily, with placebo. Of 47 placebo recipients, 44 (94 per cent) had recurrences during the 120-day treatment period, compared with 13 (29 per cent) of 45 patients treated with acyclovir five times daily and 18 of 51 (35 per cent) treated with acyclovir twice daily (P < 0.001 for each regimen compared with placebo). The median time to the first clincial recurrence was 18 days in placebo recipients, compared with over 120 days in both acyclovir-treated groups (P < 0.001 for both groups compared with placebo). The mean monthly recurrence rate during the medication period was 0.86 in placebo recipients, compared with 0.13 in patients treated with acyclovir five times daily and 0.14 in patients treated with acyclovir twice daily (P < 0.001 for both groups compared with placebo). While receiving therapy, 86 of 96 acyclovir-treated patients had over a 50 per cent reduction in their pretreatment recurrence rate. Breakthrough recurrences in acyclovir recipients were of shorter duration and associated with a lower frequency of viral shedding than recurrences in placebo recipients. After medication was discontinued, the subsequent recurrence rate returned to pretreatment frequencies. Daily oral acyclovir was well tolerated. We conclude that oral acyclovir given for four months markedly reduces but does not completely prevent recurrences of genital herpes and does not influence the long-term natural history of the disease. (New England Journal of Medicine 1984 July;310:1551–6.)