A Bayesian Evidence Synthesis for Estimating Campylobacteriosis Prevalence

Stakeholders making decisions in public health and world trade need improved estimations of the burden‐of‐illness of foodborne infectious diseases. In this article, we propose a Bayesian meta‐analysis or more precisely a Bayesian evidence synthesis to assess the burden‐of‐illness of campylobacteriosis in France. Using this case study, we investigate campylobacteriosis prevalence, as well as the probabilities of different events that guide the disease pathway, by (i) employing a Bayesian approach on French and foreign human studies (from active surveillance systems, laboratory surveys, physician surveys, epidemiological surveys, and so on) through the chain of events that occur during an episode of illness and (ii) including expert knowledge about this chain of events. We split the target population using an exhaustive and exclusive partition based on health status and the level of disease investigation. We assume an approximate multinomial model over this population partition. Thereby, each observed data set related to the partition brings information on the parameters of the multinomial model, improving burden‐of‐illness parameter estimates that can be deduced from the parameters of the basic multinomial model. This multinomial model serves as a core model to perform a Bayesian evidence synthesis. Expert knowledge is introduced by way of pseudo‐data. The result is a global estimation of the burden‐of‐illness parameters with their accompanying uncertainty.     

An Exposure‐Response Threshold for Lung Diseases and Lung Cancer Caused by Crystalline Silica

Whether crystalline silica (CS) exposure increases risk of lung cancer in humans without silicosis, and, if so, whether the exposure‐response relation has a threshold, have been much debated. Epidemiological evidence is ambiguous and conflicting. Experimental data show that high levels of CS cause lung cancer in rats, although not in other species, including mice, guinea pigs, or hamsters; but the relevance of such animal data to humans has been uncertain. This article applies recent insights into the toxicology of lung diseases caused by poorly soluble particles (PSPs), and by CS in particular, to model the exposure‐response relation between CS and risk of lung pathologies such as chronic inflammation, silicosis, fibrosis, and lung cancer. An inflammatory mode of action is described, having substantial empirical support, in which exposure increases alveolar macrophages and neutrophils in the alveolar epithelium, leading to increased reactive oxygen species (ROS) and nitrogen species (RNS), pro‐inflammatory mediators such as TNF‐alpha, and eventual damage to lung tissue and epithelial hyperplasia, resulting in fibrosis and increased lung cancer risk among silicotics. This mode of action involves several positive feedback loops. Exposures that increase the gain factors around such loops can create a disease state with elevated levels of ROS, TNF‐alpha, TGF‐beta, alveolar macrophages, and neutrophils. This mechanism implies a “tipping point” threshold for the exposure‐response relation. Applying this new model to epidemiological data, we conclude that current permissible exposure levels, on the order of 0.1 mg/m³, are probably below the threshold for triggering lung diseases in humans.     

Improving Risk-Based Decision Making for Terrorism Applications

How can we best allocate limited defensive resources to reduce terrorism risks? Dillon et al.'s Antiterrorism Risk-Based Decision Aid (ARDA) system provides a useful point of departure for addressing this crucial question by exhibiting a real-world system that calculates risk reduction scores for different portfolios of risk-reducing countermeasures and using them to rank-order different possible risk mitigation alternatives for Navy facilities. This comment points out some potential limitations of any scoring system that does not take into account risk externalities, interdependencies among threats, uncertainties that are correlated across targets, and attacker responses to alternative allocations of defensive resources. In at least some simple situations, allocations based on risk reduction scores and comparisons can inadvertently increase risks by providing intelligent attackers with valuable information, or they can fail to reduce risks as effectively as nonscoring, optimization-based approaches. These limitations of present scoring methods present exciting technical challenges and opportunities for risk analysts to develop improved methods for protecting facilities and infrastructure against terrorist threats.     

Could Removing Arsenic from Tobacco Smoke Significantly Reduce Smoker Risks of Lung Cancer?

If a specific biological mechanism could be determined by which a carcinogen increases lung cancer risk, how might this knowledge be used to improve risk assessment? To explore this issue, we assume (perhaps incorrectly) that arsenic in cigarette smoke increases lung cancer risk by hypermethylating the promoter region of gene p16INK4a, leading to a more rapid entry of altered (initiated) cells into a clonal expansion phase. The potential impact on lung cancer of removing arsenic is then quantified using a three‐stage version of a multistage clonal expansion (MSCE) model. This refines the usual two‐stage clonal expansion (TSCE) model of carcinogenesis by resolving its intermediate or “initiated” cell compartment into two subcompartments, representing experimentally observed “patch” and “field” cells. This refinement allows p16 methylation effects to be represented as speeding transitions of cells from the patch state to the clonally expanding field state. Given these assumptions, removing arsenic might greatly reduce the number of nonsmall cell lung cancer cells (NSCLCs) produced in smokers, by up to two‐thirds, depending on the fraction (between 0 and 1) of the smoking‐induced increase in the patch‐to‐field transition rate prevented if arsenic were removed. At present, this fraction is unknown (and could be as low as zero), but the possibility that it could be high (close to 1) cannot be ruled out without further data.     

Human resource practices of multinational organizations in Belgium

This study uses data from a survey of 117 large organizations located in Belgium to examine the relationship between corporate ownership and personnel practices. Results obtained from multivariate analyses supported the general hypothesis that personnel policies and practices vary as a function of ownership and nationality. For example, foreign-owned firms are found to be more advanced in their adoption of methods to gain employee loyalty and commitment than domestic enterprises. In addition to ownership effects, the moderating effects of some key organizational characteristics were examined. This shows that large differences exist with respect to the human resource practices used in firms as a function of management philosophy, creative strategy and industry sector.     

Urban forest cover of the Chicago region and its relation to household density and income

Urban forests and herbaceous open space play a vital role in the environmental and aesthetic health of cities, yet they are rarely identified in land-use inventories of urban areas. To provide information on urban forests and other vegetative land cover in Illinois cities, Landsat Thematic Mapper (TM) data from June 27, 1988, were classified for the Chicago metropolitan region (9,717 km²). Ten land-cover classes were identified, including two types of forestland (occupying 5.8% of the total area), residential land with trees (14.6%) or without trees (7.8%), cropland (37.5%), two types of grassland (7.7%), urban with impervious surfaces (23.1%), water (1.6%), and miscellaneous vegetation (2.1%). Correlation analyses indicated that household income and household density are strongly related to land covers in the region, particularly those with tree cover and urbanized land. Population changes for 1980–1985 and 1985–2010 (projected) show a pattern of increasing density in the urbanized zone concurrent with continued urban sprawl, primarily into current cropland.     

Social theory and the de-escalation of international conflict*

Are we like the mothers and fathers at Jonestown, with the cyanide in place, rehearsing for suicide-murder? Daniel Ellsberg (1981) observes that the marchers protesting nuclear weapons are doing what the mothers and fathers in Jonestown waited too long to say ‘No! Not our children! This is craziness; we won't be part of it.’ He writes that ‘It is none too soon to be saying this to the President/Prime Minister/Chairman Jim Jones's of the world; nor is it, yet, too late.’ How did we get into a place that even resembles Jonestown: And more importantly, how do we get out of it? Social theory should help provide answers to such questions, but does not obviously do so. In the first part of this paper I discuss an emerging theoretical paradigm that has particular relevance for understanding how international conflicts increase and decrease in intensity. Then I apply that paradigm to instances of international conflict de-escalation, focusing on declines in tension and hostility between the Soviet and American governments and the Israeli and Egyptian governments. Finally, I will point to some implications of the discussion for social theory and for international policy.     

Partings and impartings: Toward a nonmedical approach to interruptions and terminations

It is the thesis of this paper that therapy offers a sequence of opportunities for the patient to experience a comfortable oscillation between togetherness and parting: thepetit partings within each hour, those moments of silence or withdrawal, partings at the end of hours, vacations, spontaneous interruptions (when allowed), and, ultimately, termination. A nonauthoritarian method particularly respecting and fostering the patient's self-determination is proposed.     

The identity transformation of biological parents in lesbian/gay stepfamilies

This paper investigates the identity transformation of lesbian and gay biological parents in homosexual stepfamilies. I explore previous models typically used to describe gay and lesbian identity formation, arguing that these models provide little understanding of the experiences of those who have been previously married and have children. Lesbians and gays who leave heterosexual unions and form homosexual stepfamily units undergo a series of transformations. The results show that the transition is relatively positive and less internally stigmatizing and stressful than that experienced by younger, childless lesbians and gays.