Models of Management System Standards: A Review of the Integration Issues

The subject of Integrated Management Systems in terms of quality, environmental and occupational health and safety management has become of increasing interest to researchers and business alike during the last 3 years or so. This paper focuses on a review of the various models of integration found in the academic literature and also those advocated by the standards bodies, such as the British Standards Institution and the International Organization for Standardization. A number of writers advocate alignment of ISO 9001 and ISO 14001 and present models to facilitate this; however, integration into a single standard is, in general, not favoured. Various models have been developed to overcome these difficulties, but the authors believe that none is completely satisfactory. It is considered that a model of integration based on the EFQM Model for Business Excellence will allow the limitation of the standards to be overcome and the total systems approach to integration to be facilitated.     

Improving Cancer Dose–Response Characterization by Using Physiologically Based Pharmacokinetic Modeling: An Analysis of Pooled Data for Acrylonitrile-Induced Brain Tumors to Assess Cancer Potency in the Rat

Historically, U.S. regulators have derived cancer slope factors by using applied dose and tumor response data from a single key bioassay or by averaging the cancer slope factors of several key bioassays. Recent changes in U.S. Environmental Protection Agency (EPA) guidelines for cancer risk assessment have acknowledged the value of better use of mechanistic data and better dose–response characterization. However, agency guidelines may benefit from additional considerations presented in this paper. An exploratory study was conducted by using rat brain tumor data for acrylonitrile (AN) to investigate the use of physiologically based pharmacokinetic (PBPK) modeling along with pooling of dose–response data across routes of exposure as a means for improving carcinogen risk assessment methods. In this study, two contrasting assessments were conducted for AN-induced brain tumors in the rat on the basis of (1) the EPA's approach, the dose–response relationship was characterized by using administered dose/concentration for each of the key studies assessed individually; and (2) an analysis of the pooled data, the dose–response relationship was characterized by using PBPK-derived internal dose measures for a combined database of ten bioassays. The cancer potencies predicted for AN by the contrasting assessments are remarkably different (i.e., risk-specific doses differ by as much as two to four orders of magnitude), with the pooled data assessments yielding lower values. This result suggests that current carcinogen risk assessment practices overestimate AN cancer potency. This methodology should be equally applicable to other data-rich chemicals in identifying (1) a useful dose measure, (2) an appropriate dose–response model, (3) an acceptable point of departure, and (4) an appropriate method of extrapolation from the range of observation to the range of prediction when a chemical's mode of action remains uncertain.     

Societal Response to Hurricane Mitch and Intra‐ versus Intergenerational Equity Issues: Whose Norms Should Apply?

Late in the 1998 hurricane season, Central America was slammed by a devastating hurricane. Honduras, Nicaragua, El Salvador, Guatemala, and Belize were greatly impacted by Hurricane Mitch, one of the deadliest storms to affect the region in the past 200 years. The economies of each of these countries were badly affected. In the case of Honduras — at the time the fourth‐poorest country in Latin America — its president suggested that 50 years of progress had been wiped out by the floods and mudslides associated with this relatively short‐lived storm system. Humanitarian assistance poured into the region in the first months following the disaster. As of mid‐2000, various national, bilateral, international, and nongovernmental programs were in progress or on the drawing board for recovery, reconstruction, and renewed development of the worst affected countries. Using Honduras as a case study, some of the ethical issues that abound in the decisions of whom to help, when, and how to help them in the wake of such an extreme climate‐related human tragedy are examined. Should development assistance be focused on those who have been directly and adversely affected by this storm, or should the emphasis be on reducing the risk of exposure by future generations to such disasters? Is there yet another approach that seeks to protect future generations from similar harm while at the same time assisting present‐day victims to get through their hardships?     

Pharmacokinetic Principles for Dose-Rate Extrapolation of Carcinogenic Risk from Genetically Active Agents

Neither experimental animal exposures nor real-life human exposures are delivered at a constant level over a full lifetime. Although there are strong theoretical reasons why all pharmacokinetic processes must "go linear" at the limit of low dose rates, fluctuations in dose rate may produce nonlinearities that either increase or decrease actual risks relative to what would be expected for constant lifetime exposure. This paper discusses quantitative theory and specific examples for a number of processes that can be expected to give rise to pharmacokinetic nonlinearities at high dose rates–including transport processes (e.g., renal tubular secretion), activating and detoxifying metabolism, DNA repair, and enhancement of cell replication following gross toxicity in target tissues. At the extreme, full saturation of a detoxification or DNA repair process has the potential to create as much as a dose² dependence of risk on dose delivered in a single burst, and if more than one detoxification step becomes fully saturated, this can be compounded. Effects via changes in cell replication rates, which appear likely to be largely responsible for the steep upward turning curve of formaldehyde carcinogenesis in rats, can be even more profound over a relatively narrow range of dosage. General suggestions are made for experimental methods to detect nonlinearities arising from the various sources in premarket screening programs.     

Statistical modeling of selected aspects of the childbearing process with application to world fertility survey countries∗

The childbearing process should be monitored in developing countries experiencing high population growth rates and high levels of maternal and infant mortality. A mathematical model for estimation of certain aspects of the childbearing process, which requires only data on age‐specific fertility rates, is developed. Synthetic maternal childbearing indices, namely, mean ages at first and last birth, length of reproductive life span, inter‐birth spacing, and proportion of childless women, in addition to the well‐known mean age at childbearing, for the WFS countries are obtained using the proposed model. The indices are free from age truncation effects, and, under certain assumptions, provide information about a cohort's completed fertility before the women stop reproducing. The effects of women's residence and education on fertility are also examined.     

Grouping Tests for Misspecification: An Application to Housing Demand

We consider several grouping tests for regression misspecification, with reference to housing-demand function estimation. We compare three existing test procedures, demonstrate modifications necessary in most applications, and propose a fourth test to distinguish between two categories of potential specification error. The test procedures are evaluated in artificial simulations of alternative errors. Finally, we apply the tests to FHA home purchase data. We reject the hypothesis that household and grouped regressions differ only by sampling error or random mismeasurement of household income or price. Our results have implications for choices among test procedures and interpretations of previous housing-demand analysis.     

Independent Mental Health Advocacy: A Model of Social Work Advocacy?

ABSTRACT

Advocacy has received less attention in social work research than other aspects of social work practice. This paper draws attention to two tensions in social work advocacy; between worker-led advocacy and person-led advocacy, and between individual advocacy and system level advocacy. We argue that human-rights-based social workers must choose a person-led approach over a worker-led approach while advocating with both systems and individuals. This argument is made by drawing on findings of an evaluation of Independent Mental Health Advocacy (IMHA) in Victoria, Australia. It is shown that social work training had not prepared social workers for rights-based, person-led advocacy and that social workers in public mental health services were struggling to maintain the rights of people in their services even with assistance from IMHA.

IMPLICATIONS

• Independent Mental Health Advocacy (IMHA) is a model of advocacy influenced by social work theory and delivered in part by social-work-trained advocates.

• Social work training is not preparing social workers for person-led, human-rights-based advocacy.

• Public mental health social workers are struggling to maintain the rights of people in mental health services even with the support of external advocacy services.

     

Parental Divorce and College Students’ Persistence and Degree Attainment

The purpose of this study is to analyze whether college students from divorced families are more or less likely than their peers to persist and graduate in 4, 5, or 6 years. Utilizing data from the 2007 Cooperative Institutional Research Program survey of first-year students, the results of multinomial logistic regression analyses suggest that students whose parents were divorced were significantly less likely to graduate in 4, 5, or 6 years. These findings held controlling for demographic variables, precollege academic indicators, college experiences, and academic motivation.