Significance of the Dermal Route of Exposure to Risk Assessment

The skin is a route of exposure that needs to be considered when conducting a risk assessment. It is necessary to identify the potential for dermal penetration by a chemical as well as to determine the overall importance of the dermal route of exposure as compared with inhalation or oral routes of exposure. The physical state of the chemical, vapor or liquid, the concentration, neat or dilute, and the vehicle, lipid or aqueous, is also important. Dermal risk is related to the product of the amounts of penetration and toxicity. Toxicity involves local effects on the skin itself and the potential for systemic effects. Dermal penetration is described in large part by the permeability constant. When permeability constants are not known, partition coefficients can be used to estimate a chemical's potential to permeate the skin. With these concepts in mind, a tiered approach is proposed for dermal risk assessment. A key first step is the determination of a skin-to-air or skin-to-medium partition coefficient to estimate a potential for dermal absorption. Building a physiologically-based pharmacokinetic (PBPK) model is another step in the tiered approach and is useful prior to classical in vivo toxicity tests. A PBPK model can be used to determine a permeability constant for a chemical as well as to show the distribution of the chemical systemically. A detailed understanding of species differences in the structure and function of the skin and how they relate to differences in penetration rates is necessary in order to extrapolate animal data from PBPK models to the human. A study is in progress to examine anatomical differences for four species.     

Who Gets What From Government? Distributional Consequences of Child‐Care Assistance Policies

Given the fragmented structure of child‐care assistance in the United States, it has been difficult to obtain accurate estimates of which families are assisted, through which mechanisms, and at what level. Making use of survey data from New York City, we analyze the distribution of several forms of public child‐care assistance. Results suggest that about 40% of all families with young children receive some form of child‐care assistance. Considering all forms of assistance, the distribution of child‐care help is targeted in both expected and some unexpected ways. Implications of these results are discussed in the context of U.S. child‐care policies governing access and benefit levels.     

Lumpers and Splitters: The Public Opinion Information that Politicians Collect and Use

Are the decisions of American policymakers informed by generaltrends in the public’s ideology or by the public’spolicy-specific preferences? In this article we discuss twoexplanations for the types of public opinion information thatpoliticians collect and use. Using a unique data set of privatepolls from the White House of Richard Nixon, we find that whenopinion data on specific policies were available, the presidentrelied on them and not on general ideology data. On less importantissues, however, we find that the president often chose notto collect policy-specific data and instead relied on generalideology data. The differential collection and use of informationby policymakers reflect varying strategic calculations. Theyalso have profound implications for representative democracyand the demands placed on citizens and governors.     

Pathways between education and health: a causal modelling approach

Summary.  The association of poor education and poor health has been consistently observed in many studies and in various countries. Thus far, studies examining the mechanisms underlying this association have looked at only a limited set of potential pathways. This study simultaneously examines six distinctive pathways, which have been hypothesized to link education and health and found support from previous studies. A causal analysis of education and health was performed using structural equation models. Data were used from six phases of the National Child Development Study, which is based on following up an initial sample of 17416 children who were born in 1958. The association between education and health appears to be explained by a combination of mechanisms: adolescent health and adult health behaviours for men and women, adult social class among men and parental social class among women. We conclude that improvements in population educational attainment may not automatically lead to improvements in population health, and that health policies for improving health and reducing health inequalities need to target specific causal pathways.     

Training with o (observing) and T (treatment) teams in live supervision: reflections in the looking glass*

Working with a treatment and observing team at the same time, behind the oneway mirror, offers a variety of ways to: (a) generate multiple realities; (b) work with two different models of family therapy simultaneously; and (c) provide feedback on the teams' own roles, rules and group process. The process that 6 trainees and two supervisors used with T and O teams to examine their own coevolution as a therapeutic system using the Milan model of family therapy and Ericksonian hypnotherapy is described. The article concludes with a discussion of the advantages and pitfalls of this type of dual supervision.     

Socioeconomic, medical care, and public health contexts affecting infant mortality: a study of community-level differentials in Peru

Socioeconomic, medical care, and public health contexts are examined in Peruvian communities for their relationship to infant mortality. A deviant case analysis is used to uncover characteristics important in the social structure of Peruvian communities. Results from fieldwork in two "deviant" communities suggest that economic diversity, income disparity, social class fluidity, and women's autonomy, along with refined measures of medical care and public health resources, are important in understanding differentials in mortality. Attention is drawn to the community context and to the interplay of socioeconomic determinants affecting infant mortality.     

Remittances from labor migration: evaluations,performance and implications

2 evaluative views of worker remittances draw opposite conclusions. The negative one posits that remittances increase dependency, contribute to economic and political stability and development distortion, and lead to economic decline that overshadows a temporary advantage for a fortunate few. The positive view sees remittances as an effective response to market forces, providing a transition to an otherwise unsustainable development. They improve income distribution and quality of life beyond what other available development resources could deliver. The implications are tested for labor supply countries to Europe and the Middle East. The implications of the negative are not supported. Although the dire predictions of the pessimistic view have not materialized, the converse - contributions of remittances to economic performance - should not be overstated due to a lack of data.     

A relation for the covariances of order statistics from n independent and non-identically distributed random variables

We derive a simple relation satisfied by the covariances of order statistics in the i.i.d. case and then generalize it to the case when the variables are independent and non-identically distributed. This relation could be employed successfully either to check the calculations or to reduce the amount of direct computations involved in evaluating the covariances of order statistics from an outlier model.     

The right to life

In this issue is a lengthy, thought-provoking essay on the issues raised by unwanted pregnancy. Written by Robert Wennberg in 1984 for the Christian Scholar's Review (13:4), the article has been edited and condensed for our purposes and is quite relevant, I believe, for the student health population. Any practitioner who cares for students wrestling with these issues should at least acknowledge the moral and philosophical dilemmas presented. As one who has walked both sides of the argument, I find Wennberg's fair-mindedness compelling. In closing his article, the author raises the question of what will happen when it becomes possible to accomplish an "abortion"--or removal of the fetus from the mother--without killing the fetus. Will this procedure be acceptable to the average single college student? The New York Times, in an article on "High Tech Babies" (February 21, 1986), raised ethical questions posed by the technology of frozen embryos. Who decides what is to be done with frozen embryos? To whom do they belong? Do they have rights? The theoretical issues raised by Wennberg are already forcing themselves upon us. Whether we like it or not, the future is now. Regardless of your beliefs on this controversial topic, I urge you to read this article. Dr. Wennberg has also just completed a book on this subject, Life In The Balance.     

Immigration and the earnings of youth in the U.S.

"This article reports findings that have emerged from an effort made at statistically measuring the effects of immigration on the earnings of U.S.-born youth. The presence of immigrants arriving before 1965 has a positive impact on youth earnings. Recently arrived immigrants impact negatively, however. These results are consistent with recent findings that the skill level of immigrants arriving within the last two decades is lower relative to that of immigrants arriving earlier. The results also show that the negative effects diminish as the youth ages, reflecting skill acquisition and job mobility of the young worker into jobs less vulnerable to competition from immigrant workers."