Human Interindividual Variability in Parameters Related to Health Risks

This paper reviews existing data on the variability in parameters relevant for health risk analyses. We cover both exposure-related parameters and parameters related to individual susceptibility to toxicity. The toxicity/susceptibility data base under construction is part of a longer term research effort to lay the groundwork for quantitative distributional analyses of non-cancer toxic risks. These data are broken down into a variety of parameter types that encompass different portions of the pathway from external exposure to the production of biological responses. The discrete steps in this pathway, as we now conceive them, are:Contact Rate (Breathing rates per body weight; fish consumption per body weight)Uptake or Absorption as a Fraction of Intake or Contact RateGeneral Systemic Availability Net of First Pass Elimination and Dilution via Distribution Volume (e.g., initial blood concentration per mg/kg of uptake)Systemic Elimination (half life or clearance)Active Site Concentration per Systemic Blood or Plasma ConcentrationPhysiological Parameter Change per Active Site Concentration (expressed as the dose required to make a given percentage change in different people, or the dose required to achieve some proportion of an individual's maximum response to the drug or toxicant)Functional Reserve Capacity–Change in Baseline Physiological Parameter Needed to Produce a Biological Response or Pass a Criterion of Abnormal FunctionComparison of the amounts of variability observed for the different parameter types suggests that appreciable variability is associated with the final step in the process–differences among people in functional reserve capacity. This has the implication that relevant information for estimating effective toxic susceptibility distributions may be gleaned by direct studies of the population distributions of key physiological parameters in people that are not exposed to the environmental and occupational toxicants that are thought to perturb those parameters. This is illustrated with some recent observations of the population distributions of Low Density Lipoprotein Cholesterol from the second and third National Health and Nutrition Examination Surveys.     

'Out of Place', 'Knowing One's Place': space, power and the exclusion of disabled people

Disabled people are marginalised and excluded from 'mainstream' society. In general, our understanding of the processes of exclusion is grounded in time and history. In this paper, it is argued that space, as well as time, is instrumental in reproducing and sustaining disablist practices. Disability has distinct spatialities that work to exclude and oppress disabled people. Spaces are currently organised to keep disabled people 'in their place' and 'written' to convey to disabled people that they are 'out of place'. Furthermore, social relations currently work to spatially isolate and marginalise disabled people and their carers. Disability is spatially, as well as socially, constructed. It is contended that an understanding of society's reaction to, and the experiences of, disability should be framed within an approach that combines a spatialised political economy with social constructivism. Unlike neo-Marxist approaches this approach is centred on notions of power rather than capital. Using this approach, the spatialities of disability are explored.     

On the Margins: disabled people's experience of employment in Donegal, West Ireland

Traditionally, studies of disabled people's access to the labour market have been largely restricted to labour market 'censuses', often conducted by government agencies, and econometric studies. This paper explores disabled people's access to and experiences of employment in Donegal, West Ireland, using a qualitative approach. Twelve disabled people and four non-disabled helpers, divided into two focus groups, were interviewed using an in-depth, informal conversational strategy. A number of different, salient issues were identified in regards to training, and gaining and maintaining employment, ranging from ignorance and discrimination, to poor access (both workplace and transport), to legislation. Respondents identified a number or potential solutions which mainly focused around disability awareness, removing barriers to gaining employment and the implementation of stronger legislation. In the final section, the issues and solutions raised by disabled people are compared to those identified by non-disabled people, collected in a parallel study.     

Humility: Our Current Understanding of the Construct and its Role in Organizations

Since 2000, researchers and practitioners have shown increased interest in humility. This construct has been studied in disciplines ranging from organizational behaviour to positive psychology, culminating in a wealth of information that can now be analysed and reviewed through the lens of humility in organizations. This review begins by reflecting on existing conceptualizations of humility and presenting a summary of findings that reflects a greater consensus in definitional work than some researchers may realize. It then considers the progress that has been made in measuring humility by specifying key measurement strategies. It next synthesizes existing empirical findings on humility to illuminate the uniqueness of the construct. It also shows that researchers have focused on studying dependent variables that exist at multiple organizational levels and that largely comprise pro‐social and relational variables, emotional well‐being, and learning and performance outcomes. The paper concludes with recommendations for future research.     

Screening for recommended antenatal risk factors: How long does it take?

Background

Detection and management of antenatal risk factors is critical for quality care.

Towards Sustainability in Australian Social Work Field Education

The educational framework of Australian social work field education has remained static over the past few decades. Emerging challenges are creating a compelling case for change. These include increasing demand for placements, declining capacity of organisations to provide placement requirements, reduction in practitioners’ incentives and capacity to support student placements and to facilitate a work integrated learning context, and an interrelated web of policies and regulations that constrain adaptation to these changes. In a critical exploration of multiple levels of regulation and policy contexts, we argue that conventional approaches to social work field education are not sustainable given significant changes to the funding arrangements for universities and within the welfare service system. To futureproof integrative learning in social work, we advocate transformation of educational culture, policies, and design toward sustainability.

IMPLICATIONS

• Supervised placements are designed to integrate practice and academic learning but their future use as the single means for achieving this integration will be unsustainable.

• Drawing on an ecological orientation enables social work educators to position sustainability as a key consideration and response to current constraints in higher education and the field.

• Focusing on sustainability across policy, practice, and regulation contexts has potential to generate transformative change that enhances our effectiveness in futureproofing the design of integrative learning in social work.

     

Geospatial Indicators of Space and Place: A Review of Multilevel Studies of HIV Prevention and Care Outcomes Among Young Men Who Have Sex With Men in the United States

Young men who have sex with men (YMSM), particularly YMSM who are racial/ethnic minorities, are disproportionately affected by the human immunodeficiency virus (HIV) epidemic in the United States. These HIV disparities have been linked to demographic, social, and physical geospatial characteristics. The objective of this scoping review was to summarize the existing evidence from multilevel studies examining how geospatial characteristics are associated with HIV prevention and care outcomes among YMSM populations. Our literature search uncovered 126 peer-reviewed articles, of which 17 were eligible for inclusion based on our review criteria. Nine studies examined geospatial characteristics as predictors of HIV prevention outcomes. Nine of the 17 studies reported HIV care outcomes. From the synthesis regarding the current state of research around geospatial correlates of behavioral and biological HIV risk, we propose strategies to move the field forward in order to inform the design of future multilevel research and intervention studies for this population.     

A Cross-National Analysis of Lifespan Inequality, 1950–2015: Examining the Distribution of Mortality Within Countries

Cross-national health research devotes considerable attention to lifespan and survival rate disparities that are found between countries. However, the distribution of mortality across the world is shaped mostly by what happens within countries. We address this striking gap in the literature by modeling length-of-life inequality for individual nation-states. We use life tables from the United Nation’s (2015) World Population Prospects to estimate inequality levels for 200 countries across 13 waves between 1950 and 2015. We find that lifespan inequality is steadily declining across the world, but that each country’s level of inequality, and the rate at which it declines, vary considerably. Our models account for more than 90% of the longitudinal and cross-sectional variation in country-level lifespan inequality during the 1990–2015 period. Maternal mortality is the strongest predictor in our model, while disease prevalence, access to safe water, and health interventions figure prominently, as well. Gross domestic product per capita shows the expected curvilinear association with lifespan inequality, while primary education (both overall enrollment and gender equity in enrollment), external debt, and migration also play critical roles in shaping health outcomes. By contrast, the distribution of political and economic resources (i.e., democracy and income inequality) is less important.

     

Spatial modelling of the two‐party preferred vote in Australian federal elections: 2001–2016

We examine the relationships between electoral socio‐demographic characteristics and two‐party preferences in the six Australian federal elections held between 2001 and 2016. Socio‐demographic information is derived from the Australian Census which occurs every 5 years. Since a census is not directly available for each election, an imputation method is employed to estimate census data for the electorates at the time of each election. This accounts for both spatial and temporal changes in electoral characteristics between censuses. To capture any spatial heterogeneity, a spatial error model is estimated for each election, which incorporates a spatially structured random effect vector. Over time, the impact of most socio‐demographic characteristics that affect electoral two‐party preference do not vary, with age distribution, industry of work, incomes, household mobility and relationships having strong effects in each of the six elections. Education and unemployment are among those that have varying effects. All data featured in this study have been contributed to the eechidna R package (available on CRAN).