Defining Susceptibility for Microbial Risk Assessment: Results of a Workshop

An interdisciplinary workshop was convened by the George Washington University in June 2001 to discuss how to incorporate new knowledge about susceptibility to microbial pathogens into risk assessment and management strategies. Experts from government, academic, and private sector organizations discussed definitions, methods, data needs, and issues related to susceptibility in microbial risk assessment. The participants agreed that modeling approaches need to account for the highly specific nature of host-pathogen relationships, and the wide variability of infectivity, immunity, disease transmission, and outcome rates within microbial species and strains. Concerns were raised about distinguishing between exposure and dose more clearly, interpreting experimental and outbreak data correctly, and using thresholds and possibly linearity at low doses. Recommendations were made to advance microbial risk assessment by defining specific terms and concepts more precisely, designing explicit conceptual frameworks to guide development of more complex models and data collection, addressing susceptibility in all steps of the model, measuring components of immunity to characterize susceptibility, reexamining underlying assumptions, applying default methods appropriately, obtaining more mechanistic data to improve default methods, and developing more biologically relevant and continuous risk estimators. The interrelated impacts of selecting specific subpopulations and health outcomes, and of increasing model complexity and data demands, were considered in the contexts of public policy goals and resources required. The participants stated that zero risk is unattainable, so targeted and effective risk reduction and communication strategies are essential not only to raise pubic awareness about water quality but also to protect the most susceptible members of the population.     

Investigating the economic and demographic determinants of sporting participation in England

We provide a detailed statistical investigation into the economic and demographic factors that determine sporting participation in England. Using data from the 1997 health survey of England we fit random-effects probit models that take into account unobservable household preferences for sporting activities, as well as the economic and demographic characteristics of respondents. Our main results from the multivariate analysis are that sporting participation is positively related to household income, the educated participate in sports to a greater extent than the uneducated, there is no evidence of regional differentials in sporting participation and household preferences play an important role in the decision to participate in sports.     

Does “fighting back” make a difference? The case of the Canadian auto workers union

Union revitalization requires mutually reinforcing efforts in organizing, political action, and collective bargaining. We examine the experience of the Canadian Auto Workers (CAW). In addition to membership growth, three bargaining outcomes are analyzed: (1) wage gains; (2) the ability to resist a trend towards longer duration collective agreements; and, (3) success in negotiating same-sex spousal recognition. In each of these areas the CAW has articulated a policy and then made gains in both absolute and relative terms. The CAW’s renewal strategy links these bargaining goals with social activism and membership growth through mergers and new organizing.     

Household income histories and child mental health trajectories

Although it is widely accepted that low household income is associated with worse child mental health, less is known about whether income histories, often differentiated into stable and dynamic components, also matter. Using longitudinal data from the Child Supplement of the National Longitudinal Study of Youth, comprising the repeated measures of children ages 4 to 14 from 1986 to 1998 inclusive, I estimate generalized linear mixed models to evaluate the influence of household income histories on child depression and antisocial behavior over time. Results indicate that, at initial interview, low household income is associated with higher levels of depression and antisocial behavior; subsequent improvements in household income reduce child mental health problems. Further, the effect of initial household income on the rate of change in child depression attenuates as children grow older, whereas for antisocial behavior the effect of initial household income becomes stronger over time. These findings highlight the importance of understanding the ways in which children are influenced by their families' income histories.     

Intimate sexual victimization among women with protective orders: types and associations of physical and mental health problems

Intimate sexual violence was examined among a sample of women who had recently obtained protective orders against male partners using three groups: no sexual victimization (n = 368), sexual insistence (n = 114), and threatened and/or forced sex (n = 117). Differences in childhood sexual abuse as well as types of partner psychological abuse, stalking, and severe physical violence experiences were found across the groups. Multivariate analysis showed that women with no sexual victimization had significantly fewer mental health problems than women who had experienced sexual insistence and women who had been threatened or forced to have sex. Findings from this study underscore the importance of health, mental health, and criminal justice professionals assessing for a range of sexually abusive acts when working with victims of partner violence.     

Workplace discrimination and missing limbs: the national EEOC ADA research project

Using the Integrated Mission System of the Equal Employment Opportunity Commission, the employment discrimination experience of Americans with missing limbs is documented. Researchers compare and contrast the key dimensions of workplace discrimination involving Americans with missing limbs and persons with back and other non-paralytic orthopedic impairments. Specifically, the researchers examine demographic characteristics of the charging parties; the industry designation, location, and size of employers against whom complaints are filed; the nature of discrimination (i.e., type of adverse action) alleged to occur; and the legal outcome or resolution of these complaints. Findings indicate that persons with missing limbs were more likely to encounter discrimination if they were male, under 20 or over 65 years of age, and White or Native American. They were also more likely to encounter more frequent discrimination when they worked for employers in the Southern United States, those with 200 or fewer employers, or whose industry designation involved manufacturing, construction, or transportation. Finally, the nature of job discrimination experienced by Americans with missing limbs is more likely to involve hiring, promotion, or job training than other issues. Implications for policy and advocacy are addressed.     

Women, work and childcare: where have we been? Where are we going?

Working mothers who simultaneously manage a job, raise children, and maintain a home may find the endeavor to be physically and emotionally challenging. By means of a case study, this paper explores the impact of work-related injury on one mother's ability to meet the physical demands of childcare and homemaking tasks without jeopardizing her physical recovery or job security. Following a musculoskeletal injury at work, the subject received traditional occupational therapy intervention as well as specific education regarding ergonomic childcare techniques. Her ability to perform routine homemaking and childcare tasks was assessed prior to and following treatment using the ErgoMomics MOMS (Measure of Musculoskeletal Symptoms) survey. The case study suggests that educating mothers in ergonomic techniques related to vocational as well as avocational tasks may be beneficial in helping them manage the dual demands of family life and career. Additional informal interviews were conducted with twelve mothers, ages thirty-five to sixty-eight, in order to frame the case study within a wider historical perspective concerning the role of work in women's lives.     

Vocational implications of post-polio syndrome

Of more than 1,000,000 survivors of poliomyelitis living in the United States, about 80% experience symptoms associated with post-polio syndrome (PPS). New weakness, fatigue, and pain are the most common symptoms that may appear years after acute polio. PPS is reported to be the most prevalent progressive neuromuscular disease in North America. The physical symptoms of PPS can be severe enough to decrease an individual's quality of life, significantly alter work function, and impose lifestyle changes. The psychological implications of battling once again with a disease that had stabilized decades ago can be devastating. Rehabilitation physicians and counselors knowledgeable of post-polio syndrome and its possible impact on employment can have a positive influence on persons with PPS.