The Power of Perception: Health Risk Attributed to Air Pollution in an Urban Industrial Neighbourhood

This paper describes a multi-stakeholder process designed to assess the potential health risks associated with adverse air quality in an urban industrial neighborhood. The paper briefly describes the quantitative health risk assessment conducted by scientific experts, with input by a grassroots community group concerned about the impacts of adverse air quality on their health and quality of life. In this case, rather than accept the views of the scientific experts, the community used their powers of perception to advantage by successfully advocating for a professionally conducted community health survey. This survey was designed to document, systematically and rigorously, the health risk perceptions community members associated with exposure to adverse air quality in their neighborhood. This paper describes the institutional and community contexts within which the research is situated as well as the design, administration, analysis, and results of the community health survey administered to 402 households living in an urban industrial neighborhood in Hamilton, Ontario, Canada. These survey results served to legitimate the community's concerns about air quality and to help broaden operational definitions of health. In addition, the results of both health risk assessment exercises served to keep issues of air quality on the local political agenda. Implications of these findings for our understanding of the environmental justice process as well as the ability of communities to influence environmental health policy are discussed.     

Situational and relational factors associated with coitus during vaginal bleeding among adolescent women

Menstruation is a normal, developmental event anchored in contradictory value systems. Although it demarcates a transition to womanhood, it is often associated with negative sentiments such as shame, camouflage and discomfort. Certain behavioral expectations, including avoiding sexual intercourse, also accompany menstruation. Research has generally suggested that sex does decrease during menstruation. However, not all sexual activity is suppressed during menses; both individual and relationship factors provide influence. Accordingly, this study investigated situational and relational factors associated with the day-to-day likelihood of sex and vaginal bleeding among 387 (aged 14-17 at enrollment) adolescent women. Generalized estimating equation logistic regression, in SUDAAN 9.0, was used; predictors of coitus and bleeding included recent sexual activity, past coitus/bleeding, marijuana use before intercourse and higher partner support, higher sexual interest and lower feelings of being in love. The findings highlight appropriate areas of focus for information, education and STI prevention counseling.     

Treating emotion dysregulation in a couples context: a pilot study of a couples skills group intervention

This article reports the development of a couple-based intervention in which at least one partner had experienced chronic difficulties in emotion regulation, operationalized as having participated in a yearlong dialectical behavior therapy (DBT) skills training group. Integrating dialectical behavior therapy and cognitive-behavioral couple therapy, this group intervention taught couples emotion regulation, communication, and problem-solving skills, and led them through an exploration of how strong feelings affect and are affected by their relationship. The effects of treatment were evaluated in terms of relationship satisfaction and individual well-being. Sizeable treatment effects were found in several domains, including a reduction in DBT graduates' depressive symptoms and emotion dysregulation, and an increase in their partners' relationship satisfaction and confidence in their graduate spouses' ability to regulate emotions.     

Racial disparity in Minnesota's child protection system

Minnesota has been recognized by several studies as a state with a significant amount of racial disparity in its child protection system. This study, using 2001 data from Minnesota's Social Services Information Service, was conducted to determine at which of the six decision points in Minnesota's child welfare system racial disparities are statistically significant. The authors employ a nested model to examine a child's journey through the Minnesota child protection system. Using binary logistic regression, they are able to determine the odds that a child belonging to a particular racial or ethnic group would progress to the next decision point.     

An exponential model of female sterility

It is suggested that a useful component of a fertility simulation would be proportions of females sterile by age. Data on this phenomenon are rather limited, but they indicate that proportional sterility may not easily be described by a simple function. We propose that rates of becoming sterile may be adequately described by an exponential function utilizing proper parameter values. Such exponential-model rates form the basis for computation of a fecundity decrement table presented in this paper. Sterility proportions from the table are compared to some empirical data.     

Capital investment in neighborhoods: Theories which inform national urban policy in the United States

This article addresses two fundamental issues in the design and implementation of federal urban policies: (i) the shifting priorities of urban policy characterizing urban renewal, the Community Development Act, and recent neighborhood-oriented redevelopment efforts and (ii) the sociological theories which underlie such priorities. The first part of the article traces the shift in priority of national urban policy from an earlier focus on economic redevelopment and housing assistance for the economically disadvantaged to the more recent thrust toward neighborhood rehabilitation, revitalization, and stabilization. The central role of private sector economic involvement in the new urban strategies is discussed and the triage model of urban development is proposed to explain recent urban policy efforts. In the latter part of the article the sociological theories underlying many of the new urban policies are shown to contain inherent contradictions and inadequacies which were largely ignored by policy-makers. The authors conclude that the articulation between these theories of neighborhood dynamics and the present urban policy focus dooms recent programs, once again, to failure.     

The impact of state-level restrictions on abortion

This research examines 23 different laws passed by state governments in an effort to restrict the number of abortions. It assesses both laws passed and laws actually enforced after the Supreme Court permitted states to restrict access to abortion in 1989. None of the policy actions by state governments has had a significant impact on the incidence of abortion from 1982 to 1992. Abortion rates continue to reflect past abortion rates, the number of abortion providers, whether the state funds abortions for Medicaid-eligible women, urbanism, and racial composition of the population. Recent restrictive policies have not affected these trends.     

The geometry of justice: Three existence and uniqueness theorems

Various intuitive notions of justice are characterized in terms of geometry. Three approaches to justice (Utilitaran, Rawlsian and Nash) are considered. A set of qualities which we might want a justice approach to have is presented. Three different subsets of these qualities are shown to be uniquely satisfied (out of all possible approaches) by a different one of the three approaches considered.     

Rurality and well-being during the middle years of life

Popular stereotypes and theorizing by social scientists suggest that rural people are more satisfied with their communities and happier with their life situations than are their nonrural counterparts. This enhanced well-being is believed to result at least partly from the presence of kinship and friendship ties in the local community and the adherence to traditional religious beliefs. Data from a panel study of nearly 1200 middle aged persons from Pennsylvania surveyed in 1971 and 1984 provided indices of community satisfaction and happiness. When income was controlled, country residents expressed slightly higher levels of community satisfaction than did town or urban dwellers in both time periods. Happiness was not related to residence location. Income was a relatively more important predictor of community satisfaction and happiness among urban than among country residents, while number of friends was relatively more important for rural residents. Number of kin living nearby and adherence to traditional religious beliefs were not related to well-being regardless of residence location.     

Integrating dose estimation into a decision‐making framework for model‐based drug development

Model‐informed drug discovery and development offers the promise of more efficient clinical development, with increased productivity and reduced cost through scientific decision making and risk management. Go/no‐go development decisions in the pharmaceutical industry are often driven by effect size estimates, with the goal of meeting commercially generated target profiles. Sufficient efficacy is critical for eventual success, but the decision to advance development phase is also dependent on adequate knowledge of appropriate dose and dose‐response. Doses which are too high or low pose risk of clinical or commercial failure. This paper addresses this issue and continues the evolution of formal decision frameworks in drug development. Here, we consider the integration of both efficacy and dose‐response estimation accuracy into the go/no‐go decision process, using a model‐based approach. Using prespecified target and lower reference values associated with both efficacy and dose accuracy, we build a decision framework to more completely characterize development risk. Given the limited knowledge of dose response in early development, our approach incorporates a set of dose‐response models and uses model averaging. The approach and its operating characteristics are illustrated through simulation. Finally, we demonstrate the decision approach on a post hoc analysis of the phase 2 data for naloxegol (a drug approved for opioid‐induced constipation).