The Role of Geographic Scale in Monitoring Environmental Justice

Utilizing the concept of environmental justice, this paper examines the differential burdens of toxic and hazardous waste facilities locations in low income minority communities. The association between the presence of facilities and socioeconomic characteristics of places are examined for the state of South Carolina at three different spatial scales: counties, census tracts, and census block groups. Three different types of hazardous waste/toxic facilities are also examined: Toxic Release Inventory (TRI) sites, Treatment, Storage, and Disposal sites (TSD), and inactive hazardous waste sites. At the county level, there was some association between the presence of toxic/hazardous waste facilities and race and income. In South Carolina, this translates to a disproportionate burden on White, more affluent communities in metropolitan areas, rather than low income minority communities. At both the census tract and block group levels, there is no association between race and the location of toxic/hazardous waste facilities. There are slight differences in the income levels between tracts and block groups with facilities and those without. This localized ecology of hazard sources must be expanded to include emission/discharge data in order to adequately address environmental justice issues on who bears the burdens of environmental contamination.     

Route-to-Route Extrapolation of the Toxic Potency of MTBE

MTBE is a volatile organic compound used as an oxygenating agent in gasoline. Inhalation from fumes while refueling automobiles is the principle route of exposure for humans, and toxicity by this route has been well studied. Oral exposures to MTBE exist as well, primarily due to ground-water contamination from leaking stationary sources, such as underground storage tanks. Assessing the potential public health impacts of oral exposures to MTBE is problematic because drinking water studies do not exist for MTBE, and the few oil-gavage studies from which a risk assessment could be derived are limited. This paper evaluates the suitability of the MTBE database for conducting an inhalation route-to-oral route extrapolation of toxicity. This includes evaluating the similarity of critical effect between these two routes, quantifiable differences in absorption, distribution, metabolism, and excretion, and sufficiency of toxicity data by the inhalation route. We conclude that such an extrapolation is appropriate and have validated the extrapolation by finding comparable toxicity between a subchronic gavage oral bioassay and oral doses we extrapolate from a subchronic inhalation bioassay. Our results are extended to the 2-year inhalation toxicity study by Chun et al. (1992) in which rats were exposed to 0, 400, 3000, or 8000 ppm MTBE for 6 hr/d, 5 d/wk. We have estimated the equivalent oral doses to be 0, 130, 940, or 2700 mg/kg/d. These equivalent doses may be useful in conducting noncancer and cancer risk assessments.     

ETHICAL DILEMMAS IN FAMILY THERAPY

A review of the literature in the area of ethical dilemmas facing family therapists revealed that there were a number of issues facing family therapists which are not included in the Principles for Family Therapists (1984) of the American Association for Marriage and Family Therapy. Seventy-five family therapists from across the nation responded to a questionnaire which asked what ethical dilemmas they face and how helpful the ethical guidelines are with these dilemmas. Results indicate that family therapists are encountering dilemmas which are not included in the Principles, significantly more often than those that are included. The ethical principles were found to be helpful for those ethical dilemmas attended to by the Principles.     

Social indicators of human nutrition: Measures of nutritional status

The social indicators movement has neglected indicators of nutritional status. This report presents a discussion of the problems of validity, reliability and precision that plague current measures of nutritional status. Additional concerns for technically feasible and economically sound field methods are also expressed. The advantages of the various indicators are outlined. Indicators to measure the distribution of nutritional status across subgroups are presented. Further researcher is suggested.     

Treating bulimia: A combined therapy approach

Bulimia is an increasingly common eating disorder which is separate and distinct from anorexia nervosa. The disorder is characterized by ingestion of large volumes of food, usually followed by self-induced vomiting or laxative abuse. Although sometimes seen as a symptom accompanying obesity or anorexia nervosa, bulimia is often associated with a normal weight and nutritional state. This paper includes a case study which describes 3 years of treatment and illustrates the personality characteristics common to bulimic patients, demonstrating a marked contrast with the classic anorexia nervosa patient. A combined treatment approach is illustrated which (1) emphasizes individual therapy as the means by which long-term changes in personality can be attained and sustained; (2) uses group therapy to provide peer support and behavioral intervention; and (3) utilizes imipramine to decrease panic and alleviate anxiety and depression.     

Client Evaluation of Therapy in an Outpatient Adolescent Service

This paper describes a follow up study of clients involved in individual or family therapy conducted by a Community Health Adolescent Service. The overall effectiveness of therapy is assessed and comparisons are drawn between individual and family therapy, one and two therapists, and client's and therapist's perceptions of outcome.     

Functional Family Therapy And The Treatment Of Inhibited Sexual Desire

Although inhibited sexual desire is very common, the literature indicates that it is extremely difficult to treat successfully. Functional Family Therapy (Alexander & Parsons, 1982) appears to be a promising treatment approach. This paper defines the major goals of Functional Family Therapy and applies these goals to the treatment of inhibited sexual desire, and a case study illustrates the utility of the model.     

Early Intervention with a Mother–Infant Pair: The Impact of an Enduring and Adaptive Relationship

This paper examines the author's treatment of a severely depressed mother–infant pair in a therapeutic nursery. While the direct treatment lasted only nine months, a telephone relationship has continued over fifteen years. Dramatic changes in the pair resulted from the strong therapeutic alliance between mother and therapist, combined with a flexible and adaptive approach, utilizing on demand availability, as described by Winnicott. The convergence of the clinical work with the maturational processes and the sequelae of both mother and infant's early experiences of deprivation are described and explored.     

Constructing Scientific Authorities: Issue Framing of Chlorinated Disinfection Byproducts in Public Health

The practice of chlorine disinfection of drinking water to reduce microbial risks provides substantial benefits to public health. However, increasing concern around potential risks of cancer associated with exposure to chlorinated disinfection byproducts confuses this issue. This article examines the science agenda regarding chlorinated disinfection byproducts (CDBP) and cancer in Canada and the United States, focusing on the social construction of scientific knowledge claims and evidence. Data for this analysis were obtained from published documents as well as from in-depth interviews with epidemiologists and toxicologists centrally involved with the issue in both countries. Results of the analysis suggest that toxicological scientists want to close the door on the "chloroform issue" due to increasing evidence that chloroform is safe at low doses, because epidemiological scientists can no longer move forward the cancer science until significant improvements can be made in assessing human exposures, and because the scientific foci of research on DBP have shifted accordingly. Further, a distinction emerges in terms of how scientific uncertainties are interpreted when they cross-cut disciplines in the context of human health risk assessment. We suggest this tension reflects a balance of how uncertainty and authorities are managed in a mandated science-policy domain. Sufficient evidence was provided to keep the DBP issue on the regulatory agenda and to generate additional research, yet authorities and concomitant interpretations of uncertainty were contested. Such science generation and contestation inevitably influences complex risk assessment processes with respect to what water-related health risks are addressed and how.     

Social networks and changes in contraceptive use over time: evidence from a longitudinal study in rural Kenya

The impacts of social networks on changes in contraception in rural Kenya are investigated using special data from a longitudinal household survey. An analytic model, informed by detailed knowledge of the setting, yielded estimates that indicate that (1) social networks have substantial effects even after unobserved factors (e.g., homophily) that may determine social networks are controlled; (2) controlling for these unobserved factors may substantially alter the estimated effects of networks (these controls were not used in previous studies); (3) network effects are important for both men and women; and (4) network effects are nonlinear and asymmetric, suggesting that networks provide information primarily through social learning, rather than by exerting social influence.