Health Profiles and Profile-Specific Health Expectancies of Older Women and Men: The Netherlands

SUMMARY

This study focuses on gender differences in health profiles, and examines which health profiles drive gender differences in remaining life expectancy in women and men aged 65 and over in The Netherlands. Data from the first two cycles of the Longitudinal Aging Study Amsterdam (n = 2,141 and 1,659, respectively) were used to calculate health profiles for individuals of 65–85 years. For both women and men, six profiles were found: I. cancer; II. “other” chronic diseases; III. cognitive impairment; IV. frailty or multimorbidity; V. cardiovascular diseases; and VI. good health. The further characterization of these types showed some gender differences. Remaining life expectancy for women was greater than for men in each health profile. A decomposition into health expectancies showed that both women and men could expect to live about 5 years in good health from age 66. The greatest gender differences in years spent with health problems were found for profile IV and for profile III. Their greater number of years spent in these health states have direct consequences for the type and cost of care women need.     

A general method to determine sampling windows for nonlinear mixed effects models with an application to population pharmacokinetic studies

Optimal design methods have been proposed to determine the best sampling times when sparse blood sampling is required in clinical pharmacokinetic studies. However, the optimal blood sampling time points may not be feasible in clinical practice. Sampling windows, a time interval for blood sample collection, have been proposed to provide flexibility in blood sampling times while preserving efficient parameter estimation. Because of the complexity of the population pharmacokinetic models, which are generally nonlinear mixed effects models, there is no analytical solution available to determine sampling windows. We propose a method for determination of sampling windows based on MCMC sampling techniques. The proposed method attains a stationary distribution rapidly and provides time-sensitive windows around the optimal design points. The proposed method is applicable to determine sampling windows for any nonlinear mixed effects model although our work focuses on an application to population pharmacokinetic models.     

Phase I monitoring of generalized linear model-based regression profiles

In some industrial applications, the quality of a process or product is characterized by a relationship between the response variable and one or more independent variables which is called as profile. There are many approaches for monitoring different types of profiles in the literature. Most researchers assume that the response variable follows a normal distribution. However, this assumption may be violated in many cases. The most likely situation is when the response variable follows a distribution from generalized linear models (GLMs). For example, when the response variable is the number of defects in a certain area of a product, the observations follow Poisson distribution and ignoring this fact will cause misleading results. In this paper, three methods including a T²-based method, likelihood ratio test (LRT) method and F method are developed and modified in order to be applied in monitoring GLM regression profiles in Phase I. The performance of the proposed methods is analysed and compared for the special case that the response variable follows Poisson distribution. A simulation study is done regarding the probability of the signal criterion. Results show that the LRT method performs better than two other methods and the F method performs better than the T²-based method in detecting either small or large step shifts as well as drifts. Moreover, the F method performs better than the other two methods, and the LRT method performs poor in comparison with the F and T²-based methods in detecting outliers. A real case, in which the size and number of agglomerates ejected from a volcano in successive days form the GLM profile, is illustrated and the proposed methods are applied to determine whether the number of agglomerates of each size is under statistical control or not. Results showed that the proposed methods could handle the mentioned situation and distinguish the out-of-control conditions.     

Assessing departure from dose linearity under a repeated measures incomplete block design

Dose proportionality/linearity is a desirable property in pharmacokinetic studies. Various methods have been proposed for its assessment. When dose proportionality is not established, it is of interest to evaluate the degree of departure from dose linearity. In this paper, we propose a measure of departure from dose linearity and derive an asymptotic test under a repeated measures incomplete block design using a slope approach. Simulation studies show that the proposed method has a satisfactory small sample performance in terms of size and power.     

Deservingness in the eye of the beholder: A vignette study on the moderating role of cultural profiles in supporting activation policies

People support welfare policy if its beneficiaries are perceived as deserving of support. This study found that individuals’ cultural worldviews play a role in assessing the deservingness of welfare recipients. We investigated whether four different cultural profiles find some beneficiaries to be more deserving than others and how this relates to support for social rights (welfare benefit, retraining, job coach) and obligations (mandatory volunteering). A Dutch vignette experiment showed that reasons for supporting social rights differ between people with different cultural profiles: equality advocates grant support if beneficiaries are needy, while the centre and trusting groups do so when beneficiaries reciprocate. We found that irrespective of deservingness, people with equality‐advocating and trusting profiles tend to be more supportive of social rights, whereas socially discontented citizens tend to emphasise the importance of obligations. In general, obliging beneficiaries to do volunteer work was deemed appropriate by almost all respondents in the study, whereas their cultural values determined the ways in which they considered social rights to have been earned.     

From Problems to Personal Resilience

SUMMARY

This paper reviews data on select areas relevant to the status, functioning, and general well-being of African American Youth. Practitioners in both policy and clinical intervention must assert a greater role in helping these adolescents grow, develop, and become prepared to take their rightful place in American Society. Attention is afforded the African American Family, particularly Black youth and the threats, both historical and contemporary, which confront their ability to survive, cope, and sustain a resilient presence. Conflict theory is used to understand how this population interfaces with oppression, and a resilience framework, coupled with group as a method are presented as strategies for working with Black adolescents. The authors proffer that a justice-based model is useful in supporting this resilience framework within a group approach.     

Bayesian Estimation of Pharmacokinetic and Pharmacodynamic Parameters in a Mode-of-Action-Based Cancer Risk Assessment for Chloroform

Chloroform is a carcinogen in rodents and its carcinogenicity is secondary to events associated with cytotoxicity and regenerative cell proliferation. In this study, a physiologically based pharmacokinetic/pharmacodynamic (PBPK/PD) model that links the processes of chloroform metabolism, reparable cell damage, cell death, and regenerative cellular proliferation was developed to support a new cancer dose-response assessment for chloroform. Model parameters were estimated using Markov Chain Monte Carlo (MCMC) analysis in a two-step approach: (1) metabolism parameters for male and female mice and rats were estimated against available closed chamber gas uptake data; and (2) PD parameters for each of the four rodent groups were estimated from hepatic and renal labeling index data following inhalation exposures. Subsequently, the resulting rodent PD parameters together with literature values for human age-dependent physiological and metabolism parameters were used to scale up the rodent model to a human model. The human model was used to predict exposure conditions under which chloroform-mediated cytolethality is expected to occur in liver and kidney of adults and children. Using the human model, inhalation Reference Concentrations (RfCs) and oral Reference Doses (RfDs) were derived using an uncertainty factor of 10. Based on liver and kidney dose metrics, the respective RfCs were 0.9 and 0.09 ppm; and the respective RfDs were 0.4 and 3 mg/kg/day.     

Work and occupational profile of Eastern African immigrants in the United States: a historical overview

This paper discusses the trends and patterns of emigration from Eastern Africa, otherwise known as the Horn of Africa. In particular, the paper focuses on the countries that collectively account for most African immigrants to the United States (US), namely Eritrea, Ethiopia, Sudan, and Somalia. Using a review of literature, the paper provides some explanation of the history of immigration from East Africa to the US, and an examination and discussion of the root causes, the trends, and patterns resulting in refugees and immigration to the country. An explanation of the causes for this is offered by drawing connections to the work and occupational profiles of these immigrants, once they are in the US, within a historical context. This historical perspective analysis paves the way for more research on immigration and HRD.