Air Toxics and Health Risks in California: The Public Health Implications of Outdoor Concentrations

Of the 188 hazardous air pollutants (HAPs) listed in the Clean Air Act, only a handful have information on human health effects, derived primarily from animal and occupational studies. Lack of consistent monitoring data on ambient air toxics makes it difficult to assess the extent of low-level, chronic, ambient exposures to HAPs that could affect human health, and limits attempts to prioritize and evaluate policy initiatives for emissions reduction. Modeled outdoor HAP concentration estimates from the U.S. Environmental Protection Agency's Cumulative Exposure Project were used to characterize the extent of the air toxics problem in California for the base year of 1990. These air toxics concentration estimates were used with chronic toxicity data to estimate cancer and noncancer hazards for individual HAPs and the risks posed by multiple pollutants. Although hazardous air pollutants are ubiquitous in the environment, potential cancer and noncancer health hazards posed by ambient exposures are geographically concentrated in three urbanized areas and in a few rural counties. This analysis estimated a median excess individual cancer risk of 2.7E-4 for all air toxics concentrations and 8600 excess lifetime cancer cases, 70% of which were attributable to four pollutants: polycyclic organic matter, 1,3 butadiene, formaldehyde, and benzene. For noncancer effects, the analysis estimated a total hazard index representing the combined effect of all HAPs considered. Each pollutant contributes to the index a ratio of estimated concentration to reference concentration. The median value of the index across census tracts was 17, due primarily to acrolein and chromium concentration estimates. On average, HAP concentrations and cancer and noncancer health risks originate mostly from area and mobile source emissions, although there are several locations in the state where point sources account for a large portion of estimated concentrations and health risks. Risk estimates from this study can provide guidance for prioritizing research, monitoring, and regulatory intervention activities to reduce potential hazards to the general population. Improved ambient monitoring efforts can help clarify uncertainties inherent in this analysis.     

Mentoring At-Risk Latino Children and Their Parents: Impact on Social Skills and Problem Behaviors

The Family Mentoring Project, which provided approximately one year of mentoring for at-risk 10-year old Latino children and their parents, aimed to provide not only service but empirical evaluation of the program's impact. This University-community partnership offered individual mentoring, a group educational component for children and parents, and group social/recreational activities. A pre- and post-test analysis of 11 non-mentored and 20 mentored youth revealed positive gains on social skills for mentored children as reflected in self-ratings and mothers' ratings on the Social Skills Rating Scale (SSRS). Also based on the SSRS, mothers reported decreases in three problem behaviors for mentored children. In addition, by post-testing, the mentored children and their mothers compared very favorably with the SSRS standardized samples on both skills and problem behaviors. The findings suggest that bicultural competence may be fostered by programs that provide consistent and long-term mentoring, involve the children's families, include group educational components, and bring families and mentors together for social/recreational events.     

Emerging Patterns of Care Management: Arrangements for Older People in England

One of the key objectives of the community care legislation, implemented in the UK in 1993, was the development of care management systems. Subsequent studies based on limited samples of local authorities have indicated that there is much variation in the forms and types of arrangements being developed. This paper explores whether typologies of care management arrangements for older people can be discerned through the analysis of a series of key indicators. Data were drawn from a survey of all English local authorities, undertaken as part of the PSSRU study: Mapping and Evaluation of Care Management Arrangements for Older People and Those with Mental Health Problems. Care management arrangements were categorized using a limited number of key indicators chosen on an empirical and an a priori basis. This resulted in the formulation of six categories of care management arrangements for older people, within which approximately 80 per cent of local authorities could be included.     

Improving the Quality of Outcome Evaluation Plans

Nonprofit agencies are struggling to meet new funder demands in outcome evaluation. This study is the first of its kind to examine factors that contribute to agency progress in this area. Path analysis is used to examine chains of influence among five predictors of success as well as three control variables. Study findings indicate that agency culture, technology, management support, and involvement are key predictors of quality. Nonprofit managers who want to succeed in the new era of accountability should consider the potential impact of these factors on the quality of outcome evaluation plans in their agencies.     

Informing Debate or Fuelling Dispute? Media Communication of Reconfiguration in Scotland's Rural Maternity Care

Public reaction to the UK's ongoing health sector reform often results in dilution of policy‐makers’ goals. Public participation in health service decision‐making is advocated in policy, but precisely how to do it and what role public opinion should have in formulating reform strategy is ambiguously described. Public opinion is formed through many influences, including media reporting. This paper examines how reconfiguration at a rural maternity unit at Caithness General Hospital in Wick, Scotland, was communicated in national and local media and considers potential implications of media communication on public participation in policy decision‐making. Content analysis of arguments for and against change revealed a high level of reporting of commentators against change in regional newspapers. Qualitative analysis identified emergent themes about how maternity service reconfiguration was portrayed. These included framing opposition between management and local people, and change drivers receiving superficial coverage. Findings suggest that media portrayal of the public role in change may promote an adversarial rather than a participative stance. More finely tuned understanding of the relationship between the reporting of change and public reaction should be attained as this could affect how planned social policy evolves into actual practice.     

Beyond Assessment: Social Work Intervention in Family Court Enquiries

Most parents or carers who separate or divorce are able to makearrangements themselves about where their children will resideand how the children’s contact with the non-resident parentwill be managed. A further group of parents or carers are ableto come to agreement with the assistance of community- or court-baseddispute resolution/ mediation services. There are times, however,when disputes cannot be resolved without recourse to the courtsand, when this happens, the court will normally request thata welfare report be prepared by a CAFCASS (Children and FamilyCourt Advisory and Support Service) practitioner. While theboundary between assessment and intervention in social workis often less than clear, the commissioning of a court welfarereport in family proceedings strongly suggests an assessmentfocus and appears to carry little expectation that the practitionershould intervene in order to meet the needs of the childrenor adults involved. This article presents recent research findingsthat illustrate ways in which CAFCASS practitioners do go beyondthe assessment role expected of them in the course of the enquiriesthey undertake. Implications for policy and practice in thisarea of social work are then discussed.     

Re-distributed manufacturing and the food-water-energy nexus: opportunities and challenges

Abstract

Addressing the intersection of two important emerging research areas, re-distributed manufacturing (RDM) and the food-energy-water (FEW) nexus, this work combines insights from engineering, business and policy perspectives and explores opportunities and challenges towards a more localized and sustainable food system. Analysis centred on two specific food products, namely bread and tomato paste reveals that the feasibility and potential of RDM vary with the type of food product and the supply chain (SC) components. Physically, energy efficiency, water consumption and reduction of waste and carbon footprint may be affected by scale and location of production activities and potentials of industrial symbiosis. From the business perspective, novel products, new markets and new business models are expected in order for food RDM to penetrate within the established food industry. Studies on policies, through the lens of public procurement, call for solid evidence of envisioned environmental, social and economic benefits of a more localized food system. An initial integrated framework is proposed for understanding and assessing food RDM and the FEW nexus.