Listeria monocytogenes Dose Response Revisited—Incorporating Adjustments for Variability in Strain Virulence and Host Susceptibility

Evaluations of Listeria monocytogenes dose‐response relationships are crucially important for risk assessment and risk management, but are complicated by considerable variability across population subgroups and L. monocytogenes strains. Despite difficulties associated with the collection of adequate data from outbreak investigations or sporadic cases, the limitations of currently available animal models, and the inability to conduct human volunteer studies, some of the available data now allow refinements of the well‐established exponential L. monocytogenes dose response to more adequately represent extremely susceptible population subgroups and highly virulent L. monocytogenes strains. Here, a model incorporating adjustments for variability in L. monocytogenes strain virulence and host susceptibility was derived for 11 population subgroups with similar underlying comorbidities using data from multiple sources, including human surveillance and food survey data. In light of the unique inherent properties of L. monocytogenes dose response, a lognormal‐Poisson dose‐response model was chosen, and proved able to reconcile dose‐response relationships developed based on surveillance data with outbreak data. This model was compared to a classical beta‐Poisson dose‐response model, which was insufficiently flexible for modeling the specific case of L. monocytogenes dose‐response relationships, especially in outbreak situations. Overall, the modeling results suggest that most listeriosis cases are linked to the ingestion of food contaminated with medium to high concentrations of L. monocytogenes. While additional data are needed to refine the derived model and to better characterize and quantify the variability in L. monocytogenes strain virulence and individual host susceptibility, the framework derived here represents a promising approach to more adequately characterize the risk of listeriosis in highly susceptible population subgroups.     

Low fertility and limited diffusion of modern contraception in Italy during the second half of the twentieth century

During the last two decades of the twentieth century, Italy, Greece, Spain, Portugal, and Japan were characterized by very low fertility levels and limited diffusion of the pill, IUD and sterilization for contraceptive purposes. This paradox is discussed for Italy by revisiting the history of contraception and reproduction during the second half of the twentieth century, and by using new data for the end of that century and the early twenty-first century. The main results are: (1) it has been possible to maintain low rates of planned and unplanned fertility without resorting to more effective contraceptive methods thanks to a careful use ofcoitus interruptus; (2) the pace of diffusion of the pill and IUD was so slow because of the opposition to contraception of the Catholic Church, a gender system emphasizing traditional male and female roles, and a medical culture that made physicians reluctant to prescribe the pill for their patients; and (3) the contraceptive patterns of Italian women born after 1960 are more similar to those of their Western counterparts, although new peculiarities appear, for example, substantial reliance on the condom by people living as couples as well as sexually active singles.     

Inclusion of caregiver supports and services in home- and community-based service programs: recent reports from state units on aging

Caregivers have an important role in assisting frail and/or disabled individuals to maintain their independence in the community. Support to assist caregivers in this often stressful and demanding role is critical to sustaining the caregivers' health and ability to provide care. This paper reviews federal policy changes since 2000 that have expanded and enhanced services for informal caregivers. Next, data collected from State Units on Aging and other state agencies are presented to describe the extent to which caregiver services are included in home- and community-based programs under three funding streams (Medicaid waivers, Centers for Medicare and Medicaid Services-funded programs, and state-funded programs). Program characteristics, such as eligibility and consumer-directed options, are included. Finally, the accomplishments and initiatives reported by state respondents related to supporting informal caregivers are also explained. Results indicate that services for informal caregivers are receiving greater attention and are frequently offered under home- and community-based service programs by the states that participated in this study.     

Gender and Degendering in Autobiographical Narratives of Physical Scars

Numerous researchers have explored how individuals alter their bodies to conform to or challenge gendered bodily norms. In contrast, most that live with scars must after the fact either reconcile their changed bodies with those norms or change their ideas to better match their changed bodies. This article uses narratives written by 284 male and female college students to explore the meanings individuals assign to unwanted scars, focusing on what this process tells us about the gendered body. The three most common meanings—scars as reminders of overcoming adversity, reminders of loved ones, and markers of athleticism—occur equally often in narratives written by men and women. The data illustrate how both gendered bodily norms and recent moves toward degendering affect young people’s embodied experiences.     

Cellular Telephones and Driving Performance: The Effects of Attentional Demands on Motor Vehicle Crash Risk

This study examines the effects of conversation mode and split-attention communication training on driving performance. The study is based on an experiment where drivers with and without communication training (pilots vs. nonpilots) completed a simulated driving course while involved in one of three conversation modes: no conversation, conversation with passenger, or conversation on a hands-free cellular telephone. Results indicate that cellular telephone conversations consume more attention and interfere more with driving than passenger conversations. Cell phone conversations lack the nonverbal cues available during close-contact conversations and conversation participants expend significant cognitive resources to compensate for the lack of such cues. The results also demonstrate that communication training may reduce the hazardous effects of cell phone conversations on driving performance.     

Understanding the experiences and needs of South Asian families caring for a child with learning disabilities in the United Kingdom: an experiential–contextual framework

The prevalence of learning disabilities amongst South Asian communities in the United Kingdom is thought to be almost three times higher than in any other community. Despite this, service utilisation amongst this group remains low and working cross-culturally can pose unique challenges for service providers. The experiences of South Asian families caring for a child with learning disabilities within the United Kingdom are multifaceted. This article proposes an experiential–contextual framework for exploring these experiences. The framework incorporates minority experiences as well as medical and social models of disability. The experiential–contextual framework has been applied to understanding important aspects of South Asians experiences, including: the interpretations and understanding of learning disabilities; interactions with healthcare systems; minority group pressures; and the influence of acculturation and diversity within ethnic groups.