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Hattis  Dale  Banati  Prerna  Goble  Rob  Burmaster  David E. 《Risk analysis》1999,19(4):711-726
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.  相似文献   
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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.  相似文献   
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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.  相似文献   
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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.  相似文献   
68.

Background

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

Aims

To determine (1) women’s views about when they should be asked about antenatal health factors as recommended in the Australian antenatal guidelines; and (2) the time required to provide recommended care using a clinical scenario.

Methods

In Phase 1, pregnant women attending an outpatient obstetrics clinic at a public hospital were surveyed about preferred screening for antenatal risk factors during visit(s). In Phase 2, a hypothetical clinical scenario of a woman attending her first antenatal visit with a practising midwife was video-recorded to extrapolate the time taken to ask about and offer assistance to manage clinical, screening and lifestyle risk factors.

Findings

Most women (96%) perceived they should be asked about each of the risk factors at least once (i.e. at first visit). Total time taken to ask about all risk factors was 52 min. More time was spent discussing clinical (11 min) than lifestyle factors (4 min). Adjusting for the estimated prevalence of each risk factor, the time taken to offer assistance was 8 min per woman. Average time required for detecting and offering assistance to manage risk factors is 60 min per average risk woman.

Conclusion

Women are willing to be asked about risk factors; however this process is time-consuming. Strategies to streamline visits and prioritise recommendations so time-efficient yet comprehensive care can be delivered are needed, particularly when factors require monitoring over time and for those who may be ‘at-risk’ for multiple factors.  相似文献   
69.
Clark  Rob  Snawder  Kara 《Social indicators research》2020,148(3):705-732

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.

  相似文献   
70.
This paper provides an historical analysis of the National Country Music Muster, a country music festival held in a forest outside of Gympie, a town in rural southeast Queensland, Australia, between the period 1982 and 2006 (the first twenty-five years of the event). This article analyses the origins of the Muster, demonstrating how local events are often developed as a result of regional traditions and assets, or ‘countryside capital’ (Garrod et al., 2006). While this countryside capital was used to develop the Muster, this paper will demonstrate the event created its own capital, which the Gympie community has then utilised. The Muster has enabled the development of community capacity in three key ways: community not-for-profit groups have received increased income through participation as volunteers at the Muster; collaborative efforts between groups have developed senses of community on site; and the Muster has fostered social capital development by encouraging volunteer groups to work on site, all of which, of course, ensures the Muster continues to operate. Additionally, the Muster has provided the impetus for the creation of two country music focused cultural institutions in Gympie, as well as several spin-off events, which seek to capitalise on the increased traffic through town during the Muster period. Each of these institutions and spin off events has helped embed country music within Gympie’s cultural economy. Further, they provide a clear demonstration of a rural community actively and creatively deploying its cultural capital in order both to buttress itself against fluctuations in the town’s fortunes and to assert a locally relevant country identity.  相似文献   
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