Use of Quality-Adjusted Life Year Weights with Dose-Response Models for Public Health Decisions: A Case Study of the Risks and Benefits of Fish Consumption

Risks associated with toxicants in food are often controlled by exposure reduction. When exposure recommendations are developed for foods with both harmful and beneficial qualities, however, they must balance the associated risks and benefits to maximize public health. Although quantitative methods are commonly used to evaluate health risks, such methods have not been generally applied to evaluating the health benefits associated with environmental exposures. A quantitative method for risk-benefit analysis is presented that allows for consideration of diverse health endpoints that differ in their impact (i.e., duration and severity) using dose-response modeling weighted by quality-adjusted life years saved. To demonstrate the usefulness of this method, the risks and benefits of fish consumption are evaluated using a single health risk and health benefit endpoint. Benefits are defined as the decrease in myocardial infarction mortality resulting from fish consumption, and risks are defined as the increase in neurodevelopmental delay (i.e., talking) resulting from prenatal methylmercury exposure. Fish consumption rates are based on information from Washington State. Using the proposed framework, the net health impact of eating fish is estimated in either a whole population or a population consisting of women of childbearing age and their children. It is demonstrated that across a range of fish methylmercury concentrations (0-1 ppm) and intake levels (0-25 g/day), individuals would have to weight the neurodevelopmental effects 6 times more (in the whole population) or 250 times less (among women of child-bearing age and their children) than the myocardial infarction benefits in order to be ambivalent about whether or not to consume fish. These methods can be generalized to evaluate the merits of other public health and risk management programs that involve trade-offs between risks and benefits.     

Becoming institutional bodies: Socialization into a long-term care home

This paper reports the findings from a phenomenological study examining the lived experience of moving to a long-term care facility and the process of socialization for new residents into the nursing home culture and environment. Three residents were followed over the first six months after moving to a long-term care facility using a series of in depth interviews and participant observation with residents themselves, staff members and family members. This paper focuses on the five institutional level processes related to socialization into the long-term care environment as they were experienced by the new residents. These included: placing the body, defining the body, focusing on the body, managing the body, and relating to the body. The findings point to the importance of place in the construction of institutional bodies in the long-term care context.     

The impact of blatant stereotype activation and group sex-composition on female leaders

The individual and combined impact of blatant stereotype activation and solo status or mixed-sex groups on the self-appraisals, performance, and anxiety of female leaders was examined across three laboratory studies. The first study utilized a two-condition, two-stage design in which female leaders were exposed to a blatant stereotype threat or control condition after which they completed a leadership task. In the second stage, the threatened leaders received a solo status manipulation (leading a group of men) while the control condition did not. In the second study a 2 (blatant threat, no blatant threat) by 2 (solo status, all-female group) fully factorial design was used to test the hypotheses. Finally, in Study 3, a similar factorial design was used with a mixed-sex, rather than solo, condition. Across the studies it was hypothesized and found that receiving a single stereotype threat would result in a positive, stereotype reactance, response. However, when both threats were combined a stereotype vulnerability response was elicited, as expected. Theoretical and practical implications are discussed.     

When work comes home: technology-related pressure and home support

Given the prevalence of workers bringing work home, issues arising from this practice are a central concern of human resource development (HRD) researchers and practitioners. This study investigates factors related to home boundary permeability (the extent to which one’s home domain is interrupted by work-related matters). Specifically, we examine the impact of technology-related pressure on home boundary permeability, and test both positive and negative consequences of home boundary permeability, along with the role of home support. Based on quantitative data from 267 full-time employees in the Midwestern United States, we found technology-related pressure predicted home boundary permeability, even after accounting for a person’s preference for work–home segmentation. Our findings suggest that high home boundary permeability may be a double-edged sword as it was significantly associated with both greater work-to-home conflict and positive spillover. Further, home support was found to play a buffering role in the relationship between home boundary permeability and work-to-home conflict. Suggestions for how HRD and management practitioners can help employees achieve a healthy balance between work and home are offered.