Development of a Unit Risk Factor for 1,3-Butadiene Based on an Updated Carcinogenic Toxicity Assessment

The Texas Commission on Environmental Quality (TCEQ) has developed an inhalation unit risk factor (URF) for 1,3-butadiene based on leukemia mortality in an updated epidemiological study on styrene-butadiene rubber production workers conducted by researchers at the University of Alabama at Birmingham. Exposure estimates were updated and an exposure estimate validation study as well as dose-response modeling were conducted by these researchers. This information was not available to the U.S. Environmental Protection Agency when it prepared its health assessment of 1,3-butadiene in 2002. An extensive analysis conducted by TCEQ discusses dose-response modeling, estimating risk for the general population from occupational workers, estimating risk for potentially sensitive subpopulations, effect of occupational exposure estimation error, and use of mortality rates to predict incidence. The URF is 5.0 × 10⁻⁷ per μg/m³ or 1.1 × 10⁻⁶ per ppb and is based on a Cox regression dose-response model using restricted continuous data with age as a covariate, and a linear low-dose extrapolation default approach using the 95% lower confidence limit as the point of departure. Age-dependent adjustment factors were applied to account for possible increased susceptibility for early life exposure. The air concentration at 1 in 100,000 excess leukemia mortality, the no-significant-risk level, is 20 μg/m³ (9.1 ppb), which is slightly lower than the TCEQ chronic reference value of 33 μg/m³ (15 ppb) protective of ovarian atrophy. These values will be used to evaluate ambient air monitoring data so the general public is protected against adverse health effects from chronic exposure to 1,3-butadiene.     

An assessment of the quality of developmental day center playgrounds for exceptional children

This study assessed the playgrounds of developmental day care centers and compared them with playgrounds of regular certified day care centers. Twenty playgrounds, randomly selected from the listing of developmental day centers, were compared with a matched sample of 20 playgrounds from certified day care centers in one state. A revision of Frost's Playground Rating System (1978b) was employed to rate the two groups of playgrounds on content, safety, and function. Data were analyzed using an analysis of variance technique. The quality of developmental day center playgrounds for exceptional children was inferior to that of regular day care center playgrounds in terms of playground content. No significant differences were noted on safety or function.     

Raising the "civilized minimum" of pain amelioration for prisoners to avoid cruel and unusual punishment

This Article addresses the problems with our nation's cultural and legal prohibitions against certain pain management treatments. The practice of pain management has not kept pace with the many medical advances that have made it possible for physicians to ameliorate most pain. The Author notes that some patients are denied access to certain forms of treatments due to the mistaken belief that addiction may ensue. Additionally, some individuals are under-treated for their pain to a greater degree than are others. This is especially the case for our nation's prisoners. The Author contends that prisoners are frequently denied effective pain amelioration. He notes, however, that there has been improvement in medical treatment in general for prisoners due to court challenges based on the Eighth Amendment's prohibition against cruel and unusual punishment. Yet, due to the protection of qualified immunity given to jailers and prison health care providers, prisoners cannot bring a claim for negligence or medical malpractice, they must allege a violation of their constitutional rights, a significantly higher legal standard. Prisoners must meet a subjective test showing that there was a deliberate indifference to their medical needs that violates the protection of the Eighth Amendment. The Author concludes that because medical advances have made it possible to alleviate most pain suffering, withholding pain treatment or providing a less effective treatment is tantamount to inflicting pain and should be viewed as a violation of the Eighth Amendment.     

Are we making progress? Not in haematology!

It will be shown, through the presentation of recent research findings, that haematology is a neglected area in terms of sensitive care of the dying. The Australian evidence indicates that scant progress has been made in relation to even the most basic palliative care practices such as sensitive, honest information giving or appropriate referral to the palliative system. Rather, the data show that during terminal trajectory, patients from these diagnostic groups and their families remain trapped in processes within the high-tech, curative system that are not responsive to the needs of the dying.     

A Weighted Composite Dose – Response Model For Human Salmonellosis

This article describes the development of a weighted composite dose – response model for human salmonellosis. Data from previously reported human challenge studies were categorized into two different groups representing low and moderately virulent/pathogenic Salmonella strains based on a disease end point. Because epidemiological data indicate that some Salmonella strains are particularly pathogenic, and in the absence of human feeding study data for such strains, Shigella dysenteriae was used as a proxy for highly virulent strains. Three single-hit dose – response models were applied to the human feeding study data and evaluated for best fit using maximum likelihood estimation: (1) the exponential (E-1pop), (2) the two-subpopulation exponential (E-2pop), and (3) the Beta-Poisson (BP). Based on the goodness-of-fit test, the E-1pop and BP were the best-fit models for low and moderately virulent/pathogenic Salmonella strains, and the E-2pop and BP models were better for highly virulent/pathogenic strains. Epistemic analysis was conducted by determining the degree of confidence associated with the selected models, which was found to be 50%/50% (E-1pop/BP) for low and moderately pathogenic Salmonella strains, and 9.8%/90.2% (E-2pop/BP) for highly virulent strains. The degree of confidence for each component model and variations in the proportion of strains within each virulence/pathogenicity category were incorporated into the overall composite model. This study describes the influence of variation in strain virulence and host susceptibility on the shape of the population dose – response relationship.     

Violence against immigrants in a context of crisis: A critical migration feminist of color analysis

Abstract

The anti-immigration measures and xenophobic sentiments that have spread since the eruption of the financial crisis in 2008 have been significantly detrimental for immigrant survivors of intimate partner violence in the U.S. given that employment opportunities have declined, exploitative work conditions have worsened, immigration controls have increased, and nonprofit service provision have been under stress. Based on interviews with service providers across the nation, participant observation of networks of advocates of immigrant survivors, and an analysis of debates around the reauthorization of the Violence Against Women Act, I present how these dire circumstances have been disadvantageous for immigrants and the movement to end violence against women. In theoretical terms, my research contributes to the body of literature of critical migration studies by linking such perspective with a feminist of color analysis of gender violence and pointing to the persistent strength of interrelated systems and practices of oppression and marginalization of Latin American immigrants and Latino/as in the U.S.     

Resilience in the Face of Disasters: Bridging Micro- and Macro-Perspectives

This paper discusses the use of risk and resilience theory to understand how individuals and communities respond to natural disasters that present ongoing developmental challenges to personal and collective well-being. In the past two to three decades, mental health workers have developed numerous disaster relief strategies; while economists have become expert at estimating risk. These develops are explored.     

The Patient Transit Assistance Scheme: A case for social work advocacy!

Abstract

The Patient Transit Assistance Scheme is one of Queensland Health's initiatives designed to facilitate equity of access for Queensland residents to essential health care services. The purpose of the scheme is to help all Queenslanders, irrespective of where they live, to have access to specialist medical services. It provides direct financial assistance to patients and in some cases their carers, to facilitate access to specialist medical services irrespective of geographic location.

The findings of recent research conducted on social worker involvement with PTAS for patients diagnosed with leukaemia and associated haematological disorders will be used to argue that the problems in relation to the administration of this scheme require serious attention at the level of patient care and health policy.     

The Beginnings of Tool Use by Infants and Toddlers

Children (aged 9, 14, 19, and 24 months) were encouraged to use tools to achieve a demonstrated goal. Each tool was most efficiently applied when held by the handle with the thumb toward the head of the tool in a radial grip. The tools were presented at midline and oriented to the left and right on alternating trials, so the children who managed to grasp a tool in both orientations with the radial grip demonstrated planning of actions in advance. The tools included a spoon, hairbrush, toy hammer, and magnet; the goals were to feed one's self, feed another, brush one's hair, brush another's hair, hit pegs, and retrieve metal objects. Children were found to use more radial grips with the self‐directed tools (i.e., hairbrush‐to‐self and spoon‐to‐self), indicating that they could plan their actions better when directed toward the self than toward an external goal.