A Tiered Framework for Risk‐Relevant Characterization and Ranking of Chemical Exposures: Applications to the National Children's Study (NCS)

A challenge for large‐scale environmental health investigations such as the National Children's Study (NCS), is characterizing exposures to multiple, co‐occurring chemical agents with varying spatiotemporal concentrations and consequences modulated by biochemical, physiological, behavioral, socioeconomic, and environmental factors. Such investigations can benefit from systematic retrieval, analysis, and integration of diverse extant information on both contaminant patterns and exposure‐relevant factors. This requires development, evaluation, and deployment of informatics methods that support flexible access and analysis of multiattribute data across multiple spatiotemporal scales. A new “Tiered Exposure Ranking” (TiER) framework, developed to support various aspects of risk‐relevant exposure characterization, is described here, with examples demonstrating its application to the NCS. TiER utilizes advances in informatics computational methods, extant database content and availability, and integrative environmental/exposure/biological modeling to support both “discovery‐driven” and “hypothesis‐driven” analyses. “Tier 1” applications focus on “exposomic” pattern recognition for extracting information from multidimensional data sets, whereas second and higher tier applications utilize mechanistic models to develop risk‐relevant exposure metrics for populations and individuals. In this article, “tier 1” applications of TiER explore identification of potentially causative associations among risk factors, for prioritizing further studies, by considering publicly available demographic/socioeconomic, behavioral, and environmental data in relation to two health endpoints (preterm birth and low birth weight). A “tier 2” application develops estimates of pollutant mixture inhalation exposure indices for NCS counties, formulated to support risk characterization for these endpoints. Applications of TiER demonstrate the feasibility of developing risk‐relevant exposure characterizations for pollutants using extant environmental and demographic/socioeconomic data.     

Replication: Revisiting Tversky and Shafir’s (1992) Disjunction Effect with an extension comparing between and within subject designs

Does uncertainty about an outcome influence decisions? The sure-thing principle (Savage, 1954) posits that it should not, but Tversky and Shafir (1992) found that people regularly violate it in hypothetical gambling and vacation decisions, a phenomenon they termed “disjunction effect”. Very close replications and extensions of Tversky and Shafir (1992) were conducted in this paper (N = 890, MTurk). The target article demonstrated the effect using two paradigms in a between-subject design: here, an extension also testing a within-subject design, with design being randomly assigned was added. These results were consistent with the original findings for the “paying to know“ problem (original: Cramer’s V = 0.22, 95% (CI) [0.14, 0.32]; replication: Cramer’s V = 0.30, 95% CI [0.24, 0.37]), yet not for the “choice under risk” problem (original: Cramer’s V = 0.26, 95% CI [0.14, 0.39]; replication: Cramer’s V = 0.11, 95% CI [−0.07, 0.20]). The within-subject extension showed very similar results. Implications for the disjunction effect and judgment and decision-making theory are discussed, and a call for improvements on the statistical understanding of comparisons of between-subject and within-subject designs is introduced. All materials, data, and code are available on https://osf.io/gu58m/.     

Smoking during pregnancy,stigma and secrets: Visual methods exploration in the UK

BackgroundMoral judgements are commonly directed towards mothers through reference to health behaviour in pregnancy, and working-class mothers are particularly subject to this moral gaze.AimTo gain an in-depth understanding of the health issues affecting 10 low income pregnant women from deprived areas of south Wales, UK.MethodsParticipants completed visual activities (timelines, collaging or thought bubbles and dyad sandboxing) prior to each interview. Participants’ visual representations were used in place of a topic guide, to direct the interview. Guided by feminist principles, 28 interviews were completed with 10 women. Data were analysed thematically.FindingsSmoking was discussed at length during interviews, and this paper focuses on this issue alone. Five of the participants had smoked during pregnancy. Negative reactions were directed towards pregnant women who smoked in public, resulting in maternal smoking being undertaken in private. Participants also reported awkward relationships with midwives and other health professionals, including receipt of public health advice in a judgemental tone.DiscussionSmoking during pregnancy is a particularly demonised and stigmatised activity. This stigma is not always related to the level of risk to the foetus, and instead can be seen as a moral judgement about women. We urgently need to move from individualised neo-liberal discourses about the failure of individual smokers, to a more socio-ecological view which avoids victim blaming.ConclusionStigma from friends, family, strangers and health professionals may lead to hidden smoking. This is a barrier to women obtaining evidence based stop smoking support.     

Serious case reviews: The lived experience of Black children

Despite the many high‐profile Black child deaths in England, race as a factor remains a largely underexplored factor of serious case reviews (SCRs). Evidence from analysis of SCRs indicates that race receives limited attention, or is virtually absent. Given that the main function of SCRs is to provide opportunities for learning lessons to improve practice, the way in which issues of race and culture may influence child protection processes for Black children is therefore of critical importance. In this article, we employ content analysis to examine the extent that race and cultural factors are considered in SCRs involving Black children. It is argued that race is often an important factor influencing Black children's experiences of abuse and neglect, as well as their encounters in the child protection system. This article therefore poses two key questions: (a) What questions are asked about race, ethnicity, and culture in SCRs concerning Black children? (b) How did the SCRs extract lessons to be learnt for improving practice to safeguard Black children? By extending the analysis of race and ethnicity in SCRs, this article furthers our understandings of the needs of Black children in the child protection system.     

创业教育的评价体系与价值导向

对某一行为进行评价是规范行为主体的目的性、保障行为过程的科学性、实现行为结果的公益性的有力手段。创业教育的评价体系需包含学校、政府与社会这三大主体和以创业教育理念为统领的九大要素。评价的价值导向是要引导并促成由单纯的就业率评价向就业结构、就业质量、创业尝试评价转向,由毕业之时的就业率评价向若干年后的社会贡献评价转向,由家长期盼的评价向学生自我评价转向,由政府主导的评价向社会主导的评价转向。     

Trust and the Dilemmas of Suicide Risk Assessment in Non-government Mental Health Services

Reducing suicide rates is a national mental health priority as over 2,200 people die from suicide each year in Australia. Increasingly, nongovernment organisations (NGOs) provide services to people experiencing severe and persistent mental illnesses—a significant cohort at risk of suicide. While clinical services are generally seen as the arbiters of risk, little is known of how suicide risk assessments are undertaken in NGOs. This article reports the findings of a survey-based pilot study of 44 frontline workers in mental health-focused NGOs in Tasmania, Australia, with the aim of sketching a preliminary picture of this under-studied terrain. We identified the assessment practices utilised by workers, and the challenges and dilemmas they experienced in navigating issues of trust in suicide risk assessment in contexts where they often felt vulnerable and under-prepared. We argue that these early findings demonstrate the need for organisations to foster cultures of trust to facilitate both the activities of relationship building between practitioners and clients, and those of monitoring risk.     

与国际行政法的产生有关的几个基本问题——基于全球化、全球治理的视角

全球治理的提出源于全球化的推动,而全球治理的提出及实践则使国际行政法的产生、形成成为可能。具体而言,全球公民社会的兴起与国际非政府组织的发展是国际行政法产生的两个现实驱动因素。国际行政法的产生路径可总结为"自下而上"和"自上而下"的路径。国际行政法具有区别于国内行政法的若干明显特征,国际层面相比国内层面的很多特殊性也使得国际行政法的体系化发展面临诸多挑战。这些问题虽然不能忽视,但它们也并非不可克服。虽然国际行政法不如国内行政法成熟,但是如能改进合法性,便能够将超国家机构的全球治理职能发挥得更好。全球治理语境下国际行政法体系的产生、形成是一种历史的必然趋势。     

Changes in risky gambling prevalence among a New Zealand population cohort

Evidence suggests that problem gambling is an unstable state where gamblers move into and out of risk over time. This article looks at longitudinal changes in risky gambling and the factors associated with an increased risk (measured by the Problem Gambling Severity Index [PGSI]) in the current New Zealand context, which has experienced a doubling of the electronic gaming machine (EGM) market over the last two decades. Respondents from a nationally representative baseline sample (n = 2672) were recontacted two years later to assess changes in gambling behaviours. Among the 901 respondents reached at follow-up, average gambling risk increased over time, and the prevalence of those who had at least some level of gambling risk (i.e. low-risk or greater) more than doubled (from 4.7% to 12.4%). The majority (80.2%) of those who were at risk at follow-up had not been at risk at baseline. Multivariate linear regression analyses show that the predictors of low to moderate increased risk include Pacific ethnicity; high neighbourhood deprivation status; baseline frequent, continuous gambler type; baseline PGSI status; and playing EGMs. These findings highlight the need to develop theories of gambling addiction trajectories and to identify the earliest point along the trajectory where public health interventions should occur.     

多维视角下的老年人社会健康影响因素分析

采用全国老年人口健康状况调查项目2002年~2005年纵向数据作为研究样本,对中国老年人社会健康的影响因素进行多维分析。通过结构方程模型,在方法上解决了社会健康的多维性、抽象概念的定量分析和测量误差的问题。研究发现,经济社会因素是影响老年人社会健康的主要方面,其中老年人自身的经济条件是最重要的因素;心理健康是影响老年人社会健康的关键因素,其它因素通过心理健康对社会健康起间接作用;由于社会生活方式的改变,家庭因素对老年人社会健康的直接影响正在弱化,但是家庭因素对老年人社会健康的间接影响依然存在。