“Me Against the World”: Parental Uncertainty Management at Home Following Neonatal Intensive Care Unit Discharge

This study explored the uncertainty management processes experienced by parents at home following their child’s discharge from the neonatal intensive care unit (NICU). In-depth, semistructured interviews were conducted with 18 mothers and fathers whose children were cared for and “graduated” from NICU units in seven different hospitals from 6 to 183 days (M = 63.58 days). Interviews revealed three types of parental uncertainties: parental role shift, caring through equipment, and adherence to provider advice. Parents relied on three strategies to manage these uncertainties: reorientation, calibrating appropriate responses, and limiting exposure. Findings highlight how parental experiences, communication interactions, and expectations in the NICU complicate parental uncertainties postdischarge and negatively affect parental perceptions of self-efficacy, readiness, and competency. Our findings suggest that family-centered care can be enhanced by redefining discharge as an ongoing process that necessitates distinct uncertainty management practices to negotiate tensions between protecting preterm children and supporting parents.     

Cultural perceptions of public relations gender roles in Romania

This study examines attitudes about gender roles and their implications for public relations practice in Romania. Results reveal Romanians still hold traditional views, but women held a more liberal view of their role in society and in the workplace. The study supports that history and socio-cultural values are important factors in understanding the context in which attitudes about workplace roles are formed, which can increase understanding of public relations in transitional countries in Europe.     

Immigrants’ Children’s Transition to Secondary School in Italy

Choosing a secondary school represents an important step in the lives of students in Italy, in that it has a strong bearing on their ultimate educational achievement and labor force trajectory. In this article, we analyze the effect of generational status and length of residence on the transition to secondary school among immigrants living in Italy. Using data from the ITAGEN2 follow‐up, we analyze scholastic results from the middle school final exam and the choice of secondary school among the adolescents in Italy. Children of immigrants are more likely to have inferior outcomes on the middle school exam and to enroll in vocational and polytechnic schools. Our multivariate results indicate that, after controlling for the family’s human capital and other key background factors, immigrant students show greater propensity to choose a vocational path. Differences between immigrants and natives in secondary school tracks are also manifested when previous scholastic results are taken into account.     

A right to benefit from international research: a new approach to capacity building in less-developed countries

This article proposes a means by which benefits provided in international research collaborations might be employed to strengthen health care, research, and other capacities in less-developed countries. The Declaration of Helsinki and CIOMS Guidelines define certain expectations of benefits, but these requirements are ambiguous, logistically problematic, and studies suggest they are inconsistently upheld. Drawing on the principle of respect for persons, a right to benefit from hosting externally-sponsored research is proposed. This right guarantees host communities benefits of a certain value, the nature and use of which is controlled by indigenous personnel. Suggestions are made as to how implementation of this right, using structured incentives, may systematically promote capacity building in host communities.     

The effects of management practices on union election returns

This paper examines the importance of management suppression tactics on union activity in the United States. NLRB data on individual certification elections which have recently become available for the period 1972–1976 are merged with structural, demographic, and industry characteristics of the 96 largest SMSAs to ascertain the role of strategy versus structure in explaining union outcomes. The measures of election-generated membership outcomes are voter participation, the margin of pro-union votes, and union wins. Union suppression practices under study include consent elections, election delays, formal objections after unions win a certification election, elections overruled because of management unfair labor practices, elections held by management petition, and the number of unfair labor practice charges per representation election. Five of the six measures of suppression are significant determinants of some facet of union expansion after adjusting for structural characteristics of the area work force.     

Steady-State Solutions to PBPK Models and Their Applications to Risk Assessment I: Route-to-Route Extrapolation of Volatile Chemicals

Although analysis of in vivo pharmacokinetic data necessitates use of time-dependent physiologically-based pharmacokinetic (PBPK) models, risk assessment applications are often driven primarily by steady-state and/or integrated (e.g., AUC) dosimetry. To that end, we present an analysis of steady-state solutions to a PBPK model for a generic volatile chemical metabolized in the liver. We derive an equivalent model that is much simpler and contains many fewer parameters than the full PBPK model. The state of the system can be specified by two state variables-the rate of metabolism and the rate of clearance by exhalation. For a given oral dose rate or inhalation exposure concentration, the system state only depends on the blood-air partition coefficient, metabolic constants, and the rates of blood flow to the liver and of alveolar ventilation. At exposures where metabolism is close to linear, only the effective first-order metabolic rate is needed. Furthermore, in this case, the relationship between cumulative exposure and average internal dose (e.g., AUCs) remains the same for time-varying exposures. We apply our analysis to oral-inhalation route extrapolation, showing that for any dose metric, route equivalence only depends on the parameters that determine the system state. Even if the appropriate dose metric is unknown, bounds can be placed on the route-to-route equivalence with very limited data. We illustrate this analysis by showing that it reproduces exactly the PBPK-model-based route-to-route extrapolation in EPA's 2000 risk assessment for vinyl chloride. Overall, we find that in many cases, steady-state solutions exactly reproduce or closely approximate the solutions using the full PBPK model, while being substantially more transparent. Subsequent work will examine the utility of steady-state solutions for analyzing cross-species extrapolation and intraspecies variability.     

Becoming married, depression, and alcohol problems among young adults

This paper examines three questions regarding the relationship between marriage and mental health, specifically depression and alcohol problems. First, does marriage lead to improved mental health compared to never marrying? Second, do any mental health benefits of marriage primarily accrue to men? Third, what qualitative aspects of marriage are related to psychological disorder? We explore these questions in a longitudinal sample of young adults sampled at age 21 and again at age 24. We find no indication that marriage reduces depression. Married people do report fewer alcohol problems than the never-married but this could be due to the selection of less problematic drinkers into marriage. We also fail to find that men receive disproportionate mental health benefits from marriage. Finally, we find that marital conflict is associated with problem drinking for men and depression for women. The results indicate the importance of considering stage in the life cycle and gender-sensitive indicators of psychological disorder in studies of marriage and mental health.