Exposure Reconstruction for the TCDD-Exposed NIOSH Cohort Using a Concentration- and Age-Dependent Model of Elimination

Recent studies demonstrating a concentration dependence of elimination of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) suggest that previous estimates of exposure for occupationally exposed cohorts may have underestimated actual exposure, resulting in a potential overestimate of the carcinogenic potency of TCDD in humans based on the mortality data for these cohorts. Using a database on U.S. chemical manufacturing workers potentially exposed to TCDD compiled by the National Institute for Occupational Safety and Health (NIOSH), we evaluated the impact of using a concentration- and age-dependent elimination model (CADM) (Aylward et al., 2005) on estimates of serum lipid area under the curve (AUC) for the NIOSH cohort. These data were used previously by Steenland et al. (2001) in combination with a first-order elimination model with an 8.7-year half-life to estimate cumulative serum lipid concentration (equivalent to AUC) for these workers for use in cancer dose-response assessment. Serum lipid TCDD measurements taken in 1988 for a subset of the cohort were combined with the NIOSH job exposure matrix and work histories to estimate dose rates per unit of exposure score. We evaluated the effect of choices in regression model (regression on untransformed vs. ln-transformed data and inclusion of a nonzero regression intercept) as well as the impact of choices of elimination models and parameters on estimated AUCs for the cohort. Central estimates for dose rate parameters derived from the serum-sampled subcohort were applied with the elimination models to time-specific exposure scores for the entire cohort to generate AUC estimates for all cohort members. Use of the CADM resulted in improved model fits to the serum sampling data compared to the first-order models. Dose rates varied by a factor of 50 among different combinations of elimination model, parameter sets, and regression models. Use of a CADM results in increases of up to five-fold in AUC estimates for the more highly exposed members of the cohort compared to estimates obtained using the first-order model with 8.7-year half-life. This degree of variation in the AUC estimates for this cohort would affect substantially the cancer potency estimates derived from the mortality data from this cohort. Such variability and uncertainty in the reconstructed serum lipid AUC estimates for this cohort, depending on elimination model, parameter set, and regression model, have not been described previously and are critical components in evaluating the dose-response data from the occupationally exposed populations.     

Happiness has traitlike and statelike properties: A reply to Veenhoven

Veenhoven (1994) contrasted hypotheses of whether happiness is a trait or state, concluding that it is a state variable. This article critiques the conceptual foundation of Veenhoven's paper, and examines technical deficiencies in his review of evidence. Based on previous findings and new analyses, we conclude that happiness has both traitlike and statelike properties, but that individual differences in happiness endure despite its situational reactivity, and explain greater variance than situational effects.     

Evaluation: Stakeholder-focused Criteria

Identifying and selecting suitable criteria is an important consideration in evaluating the performance of public sector organizations. Which criteria are chosen, and how they are weighted, will depend largely on the perspective being taken; different stakeholders (for example, clients, providers or commissioners) are likely to emphasize different criteria. In this paper a number of criteria are identified and an argument is developed to indicate which criteria are likely to be valued by various stakeholders. Furthermore, a number of approaches and mechanisms for evaluation are identified and the links between these, the criteria appropriate to them and the various stakeholders are made explicit. Finally, the issue of politics and the distribution of power between the stakeholders is addressed with a call for greater explicitness in using and balancing criteria (for example, as between professionals and the intended beneficiaries of services). In this way, while recognizing the inherent political nature of performance evaluation, the planning and implementation of services may be improved by a more mutually informed approach to evaluation.     

The Ecology of Family Guidance in Low-Income Mexican-American and European-American Families*

This two-part study applied an ecocultural perspective to socialization of daily and long-term goals in low-income Mexican-American and European-American families with children in third, fifth, and seventh grades. The first part of the study examined family members' participation and parents' socialization goals and guidance strategies for their children's daily household chores and homework activities. The second part of the study examined parents' long-term aspirations and guidance strategies for their children's educational, vocational, and moral development. For daily activities, results showed that in Mexican-American families both parents and siblings played important roles, whereas in European-American families parents were the primary socialization agents. As predicted, in both groups parents' expertise influenced their guidance strategies. Finally, Mexican-American and European-American parents differed in their relative endorsement of gender, relational, and self-reliance goals for household chores. For long-term goals, parents in both groups held high educational, vocational, and moral aspirations for their children. However, some parents of seventh-graders had lower educational and vocational aspirations than those of fifth- and third-graders. Although expertise consistently influenced Mexican-American parents' guidance strategies, the pattern for European-American parents was mixed. The discussion highlights between- and within-group differences in daily and long-term socialization practices with an emphasis on resources and vulnerabilities in the families.     

Interpersonal dependency of preferences

Standard decision theoretic models disregard the phenomenon of interpersonal dependency of preferences. In this paper it is argued that interpersonal dependency of preferences is a serious challenge for standard utility theory. First we sketch the more philosophical aspects of the problem and then, using a simple, formal model for the two-person case, we show that interpersonal dependency of preferences generally results in indeterminacy of preferences (resp. of subjective utility).     

Physician-nurse migration to the United States: regional and health status origins in relation to legislation and policy

This article examines the origins of physicians and nurses who were admitted as permanent immigrants to the US from 1962-1979. Data are mainly from the Immigration and Naturalization Service. Countries used in the developmental analysis are only those whose population was estimated at 1 million or more as of mid-1979, encompassing 99% of the physicians and 97% of the nurses. Life expectancy at birth is the criterion used to differentiate origin countries by developmental dimension of health status. During the study period, health workers constituted about 30% of immigrants admitted to the US; of these, nurses and physicians constituted 72-82% throughout the study period. The period 1962-1979 has 4 distinct phases, marked by important legislative and/or policy changes; 1) 1962-1965, when the McCarran-Walter Act prevailed; 2) ending in 1968, the 2nd phase covers the transition mandated under the 1965 Immigration Act, which encouraged physician immigration; 3) the 3rd phase, 1969-1976, covers the transition to the 1976 Immigration and Nationality Act amendments; and 4) the 4th stage is 1977-1979. Results show that 1) under the McCarran-Walter Act, North America became the dominant physician source; 2) from 1966-1968, Asia attained dominance as the physician source and became even more predominant after 1968; 3) North America produced relatively few physicians in the early 1970s; 4) Europe produced substantially fewer physicians in the 1970s than in the 1960s; 5) South America, Africa, and Oceania were the lowest contributors of physicians; 6) during the McCarran-Walter years, North America and Europe produced almost 90% of nurses admitted into the US; 7) the 1965 Immigration Act and its aftermath resulted in Asia becoming the dominant source of nurses; 8) prior to the 1965 Immigration Act, Canada generated 20% of the aggregate number of physicians; 9) the Philippines surpassed Canada during the transition and India led after the transition; and 10) Canada supplied 30% of the nurses up through the transition, with the Philippines in the lead 1969-1979. Low health status countries were a relatively minor nurse source. Health status at the origin was a far less significant determinant of physician immigration than that of nurses. English language high and low health status country groups produced substantially more physician and nurse immigrants that their corresponding non-English language counterparts. The US attracted more physicians and nurses from less developed countries than more developed countries after 1968.     

Family reunification

The author explores the problem of family reunification in the context of international migration. The focus is on international and national legislation, policies, and provisions concerning family reunification. The need for international cooperation to resolve the problems arising from international migration and the desire to reunite families is noted. (SUMMARY IN FRE AND SPA)     

Therapeutic compliments: setting the stage for successful therapy

Compliments are often viewed primarily as a linear event in which one person expresses approval or admiration of another. Far less attention has been given to the circular nature of compliments and the manner in which they enhance the positions of both the giver and the receiver of the compliment. Therapeutic compliments have proven to be highly effective means of motivating clients, while at the same time increasing therapeutic leverage. This article proposes that compliments should be purposefully given, and that the type of compliment should vary with the stage of therapy and the intended response of the client to the compliment.     

The prediction of learning in family therapy training programs*

Research on family therapy training has produced very little data regarding the kinds of trainees that do best in family therapy training programs. This study attempts to provide some rough and preliminary data on that issue. One hundred and seventy trainees, drawn from seven different structural!strategic training experiences, were evaluated as to how much they learned by taking the Family Therapy Assessment Exercise pre- and posttraining. Their performance was correlated using a hierarchical regression analysis with a number of trainee variables such as amount of conjugal family experience, amount of experience doing family or individual therapy, or prior knowledge of family therapy. The results indicate that, as predicted, conjugal family experience was positively related, and prior knowledge was negatively related to performance. Prior experience doing individual therapy was also positively related to performance.