Leukemia Risk Associated with Benzene Exposure in the Pliofilm Cohort: I. Mortality Update and Exposure Distribution

The National Institute of Occupational Safety and Health (NIOSH) recently completed a vital status update adding 6 years of observation on the rubber workers known as the Pliofilm cohort. Using traditional standardized mortality ratio (SMR) analysis, we investigate the impact of the additional information gathered in the NIOSH update. We also compare the effect of using three sets of job-, plant-, and year-specific exposure estimates on the evaluation of benzene's leukemogenicity. The lack of any additional cases of multiple myeloma does not support trends toward elevated risks for this endpoint (as had been observed earlier), and there is no indication of increased incidences of solid tumors (as predicted by animal studies). Qualitatively, which exposure estimates are used does not alter the conclusions. The data added in the update did not greatly modify the estimated relative risk of leukemia associated with benzene exposure, but did confirm previous findings that occupational exposure to high concentrations had leukemogenic potential. The fact that leukemia has not been observed in any individual who started employment in Pliofilm production after 1950 suggests that the observed leukemia cases could be a response to very high levels of benzene exposure that occurred during the early years of this manufacturing process.     

Binge drinking in female college students: the association of physical activity, weight concern, and depressive symptoms

As an initial step in building gender-specific binge drinking intervention programs, the authors investigated the relation of potentially modifiable factors (physical activity level, weight concern, and depressive symptoms) to binge drinking while controlling for the effects of previously established correlates of binge drinking (tobacco and marijuana use, GPA, and perception of peer alcohol use). Four-hundred-twelve college women completed an in-class survey. Multivariate analyses revealed that tobacco and marijuana use, GPA, and physical activity were significantly associated with binge drinking, whereas tobacco use and perception of peers' alcohol use were associated with more frequent binge drinking. The findings suggested that the variables associated with any binge drinking and frequency of binge drinking may differ and that binge drinking can be associated with positive health behaviors (ie, greater physical activity) as well as risky health behaviors (eg, tobacco use).     

Caregiver role strain of older workers

The purpose of this study was to measure role strain in older adult workers who were also caregivers of frail elders according to Komarovsky's role strain theory, and to determine whether different patterns of role strain exist for male worker-caregivers than females. METHOD: Researchers developed the Job-Caregiver Role Strain Scale Survey, which was adapted from a survey that measured role strain in working parents and spouses. Surveys were distributed to 11 male and 34 female older workers who were also caregivers. RESULTS: A factor analysis was completed, which isolated four factors of role strain. Researchers named the factors time management and arrangements, health and competing role demands, low rewards, and reactions to perceptions. Role strain in older adult worker-caregivers is complex and involves multiple variables. A discriminant function analysis predicted differences in the way older male and female worker-caregivers perceived role strain. Use of role strain theory can assist employers and occupational therapists in developing and maintaining work environments that support not only the older employee's work performance, but participation in the role of elder caregiver as well.     

An investigation of successfully treated adolescent sex offenders

Little is known about the characteristics of adolescent sex offenders who do not reoffend. Most studies emphasize reoffense rates, recidivism and those who reoffend. Moreover, these studies provide quantitative summaries without describing the individual, his behavior, and challenges after treatment. The present study seeks to provide novel information about the life experiences of adolescent sex offenders who have not reoffended after reentering society. Through a structured questionnaire and an in-depth qualitative interview, the adolescents (N = 7) provided information regarding their life experiences after treatment with an emphasis on the challenges they face in society.     

Gay priests and other bogeymen

The sexual abuse of boys by priests was at the center of the 2002 scandal in the Roman Catholic Church. This scandal has resurrected the misconception that a link exists between having a homosexual orientation and being at increased risk for being a pedophile or child molester. This paper reviews and debunks the arguments in support of this misconception. Central to these arguments is what might be called the "proportionality argument": that the ratio of homosexuals to heterosexuals among child molesters is higher than the ratio of homosexuals to heterosexuals in the general population. The flaws in the proportionality argument and several other misconceptions are discussed.     

Statistical methods for handling missing data to align with treatment policy strategy

The International Council for Harmonization (ICH) E9(R1) addendum recommends choosing an appropriate estimand based on the study objectives in advance of trial design. One defining attribute of an estimand is the intercurrent event, specifically what is considered an intercurrent event and how it should be handled. The primary objective of a clinical study is usually to assess a product's effectiveness and safety based on the planned treatment regimen instead of the actual treatment received. The estimand using the treatment policy strategy, which collects and analyzes data regardless of the occurrence of intercurrent events, is usually utilized. In this article, we explain how missing data can be handled using the treatment policy strategy from the authors' viewpoint in connection with antihyperglycemic product development programs. The article discusses five statistical methods to impute missing data occurring after intercurrent events. All five methods are applied within the framework of the treatment policy strategy. The article compares the five methods via Markov Chain Monte Carlo simulations and showcases how three of these five methods have been applied to estimate the treatment effects published in the labels for three antihyperglycemic agents currently on the market.     

A Cross-National Analysis of Lifespan Inequality, 1950–2015: Examining the Distribution of Mortality Within Countries

Cross-national health research devotes considerable attention to lifespan and survival rate disparities that are found between countries. However, the distribution of mortality across the world is shaped mostly by what happens within countries. We address this striking gap in the literature by modeling length-of-life inequality for individual nation-states. We use life tables from the United Nation’s (2015) World Population Prospects to estimate inequality levels for 200 countries across 13 waves between 1950 and 2015. We find that lifespan inequality is steadily declining across the world, but that each country’s level of inequality, and the rate at which it declines, vary considerably. Our models account for more than 90% of the longitudinal and cross-sectional variation in country-level lifespan inequality during the 1990–2015 period. Maternal mortality is the strongest predictor in our model, while disease prevalence, access to safe water, and health interventions figure prominently, as well. Gross domestic product per capita shows the expected curvilinear association with lifespan inequality, while primary education (both overall enrollment and gender equity in enrollment), external debt, and migration also play critical roles in shaping health outcomes. By contrast, the distribution of political and economic resources (i.e., democracy and income inequality) is less important.