Comparison of Chemical Screening and Ranking Approaches: The Waste Minimization Prioritization Tool versus Toxic Equivalency Potentials

Chemical screening in the United States is often conducted using scoring and ranking methodologies. Linked models accounting for chemical fate, exposure, and toxicological effects are generally preferred in Europe and in product Life Cycle Assessment. For the first time, a comparison is presented in this article of two of the prominent, but structurally different methodologies adopted to help screen and rank chemicals and chemical emissions data. Results for 250 chemicals are presented, with a focus on 12 chemicals of interest in the United Nations Environment Programme's Persistent Organic Pollutants global treaty negotiations. These results help to illustrate the significance of described structural differences and to assess the correlation between the methodologies. The scope of the comparison was restricted here to human health, although the insights would be equally useful in the context of the health of ecosystems. Illustrating the current types of chemical screening and emissions comparison approaches, the relative significance of the scenario and structural differences of the Waste Minimization Prioritization Tool (WMPT) and the Toxic Equivalency Potential (TEP) methodologies are analyzed. The WMPT facilitates comparison in terms of key physical-chemical properties. Measures for Persistence, Bioaccumulation, and Toxicity (PBT) are calculated. Each PBT measure is scored and then these scores are added to provide a single measure of relative concern. TEPs account for chemical fate, multipathway exposure, and toxicity using a model-based approach. This model structure is sometimes considered to provide a less subjective representation of environmental mechanisms, and, hence, an improved basis for screening. Nevertheless, a strong relationship exists between the two approaches and both have their limitations.     

试论我国公司集团法律规制的误区

公司集团已成为现代市场经济中大中资本普遍采用的一种企业组织形式。世界各国和地区的公司立法均对公司集团作出了有别于传统单一公司的规定。而我国对公司集团的法律规制尚处于不成熟的阶段,法律效力层次低,现有的规制在公司集团的组建条件、组建程序、内部结构、集团成员企业转投资等方面均存在一定的误区,亟需改进和完善。     

Why do some pregnant women not fully disclose at comprehensive psychosocial assessment with their midwife?

ProblemWhile comprehensive psychosocial assessment is recommended as part of routine maternity care, unless women engage and disclose, psychosocial risk will not be identified or referred in a timely manner. We need to better understand and where possible overcome the barriers to disclosure if we are to reduce mental health morbidity and complex psychosocial adversity.AimsTo assess pregnant women’s attitude to, and reasons for non-disclosure at, comprehensive psychosocial assessment with their midwife.MethodsData from 1796 pregnant women were analysed using a mixed method approach. After ascertaining women’s comfort with, attitude to, and non-disclosure at psychosocial screening, thematic analysis was used to understand the reasons underpinning non-disclosure.Findings99% of participants were comfortable with the assessment, however 11.1% (N = 193) reported some level of nondisclosure. Key themes for non-disclosure included (1) Normalising and negative self-perception, (2) Fear of negative perceptions from others, (3) Lack of trust of midwife, (4) Differing expectation of appointment and (5) Mode of assessment and time issues.DiscussionFactors associated with high comfort and disclosure levels in this sample include an experienced and skilled midwifery workforce at the study site and a relatively advantaged and mental health literate sample. Proper implementation of psychosocial assessment policy; setting clear expectations for women and, for more vulnerable women, extending assessment time, modifying mode of assessment, and offering continuity of midwifery care will help build rapport, improve disclosure, and increase the chance of early identification and intervention.ConclusionsThis study informs approaches to improving comprehensive psychosocial assessment in the maternity setting.     

基于反映象相关矩阵的评价指标筛选方法研究

评价指标间信息重叠高会扭曲评价结果，而已有研究主要基于一个指标与部分指标间相关性降低指标集的信息重叠，指标剔除多且信息重叠降低得慢，极易导致评价信息过度损失。为此，本文首先引入取样适切性量数(MSA)表示一个评价指标与其余全部指标间信息重叠水平，引入KMO检验统计量表示一组评价指标整体信息重叠水平。在此基础上，依次剔除MSA值最大指标，直至剩余指标KMO值不高为止，快速降低评价指标集整体信息重叠。之后，通过剔除偏相关水平高的任两个指标中MSA值较大的一个指标，避免个别指标间信息重叠水平较高。最后，与目前应用最广泛的信息重叠指标筛选方法对比表明：本文方法降低指标集信息重叠效率更高，评价信息损失更少；既不会误删信息重叠水平低的评价指标，亦不会误保留信息重叠水平高的评价指标。     

Disclosure of sensitive material at routine antenatal psychosocial assessment: The role of psychosocial risk and mode of assessment

ProblemWhile routine psychosocial assessment is acceptable to most pregnant women, some women will not fully disclose psychosocial concerns to their clinician.AimsTo assess the impact of psychosocial risk, current symptoms and mode of assessment on women’s honesty of disclosure at psychosocial assessment.MethodsLogistic regression was used to examine associations between disclosure and a range of psychosocial characteristics in women who were ‘always honest’ and ‘not always honest’. Mixed ANOVAs were used to test the influence of mode of assessment and honesty on scores on a repeated measure of psychosocial risk.Findings10.8% (N = 193 of 1788) of women did not fully disclose at psychosocial assessment. Non-disclosure was associated with a mental health history (aOR = 1.78, 95%CI: 1.18–2.67, p < 0.01) and lack of social and partner support (aOR = 1.74, 95%CI: 1.16–2.62, p < 0.05; aOR = 2.08, 95%CI: 1.11–3.90, p < 0.05, respectively). Those reporting not always being honest at face to face assessment showed a greater increase in psychosocial risk score when the assessment was repeated online via self-report, compared to women who were always honest.DiscussionA history of mental health issues and lack of social and partner support are associated with reduced disclosure at face to face assessment. Online self-report assessment may promote greater disclosure, however this should always be conducted in the context of clinician feedback.ConclusionGreater psychosocial vulnerability is associated with a lower likelihood of full disclosure. Preliminary findings relating to mode of assessment warrant further exploration within a clinical context.     

Perinatal mental healthcare: Developing skills in midwifery students

Midwives have a pivotal role in screening for risk factors for mental illness and psychosocial vulnerabilities in women during the perinatal period. They also have a key responsibility to provide women with the appropriate resources to support their mental wellbeing. Midwives can lack confidence and/or feelings of competence regarding these skills.Care of women in the context of their perinatal mental health is a core midwifery skill that deserves practical learning during pre-registration education, just as the more ‘hands on’ skills such as abdominal palpation, labour and birth support or newborn examination. However, there is limited opportunity for students to gain clinical placement experiences that are specific to perinatal mental health (PMH).This discussion paper describes an innovative teaching and learning project that aimed to improve confidence in students’ ability to conduct screening, support, and referral of women experiencing mental ill health. The project involved the development of an Objective Structured Clinical Examination (OSCE) and audio visual resources to support learning and teaching and clinical placement. Feedback was collected to inform the refinement of the first OSCE, and to assist in the design of the audio visual resources that are now displayed publicly on the Australian College of Midwives website at https://www.midwives.org.au/Web/Web/Professional-Development/Resources.aspx?hkey=12c2360e-d8b9-4286-8d0a-50aeaeca9702.     

基于鲁棒优化的突发公共卫生事件精准筛查策略研究

“精准筛查”是落实突发公共卫生事件精准防控工作的基础保障和重要手段，但是如何科学合理地制定突发公共卫生事件精准筛查策略尚未开展深入研究。本文根据传染病传播机理，将待检测群体进行分类，引入“检测效用”刻画各类人群在不同时间检测对突发公共卫生事件传播扩散的抑制程度，建立以检测效用最大化为目标的鲁棒优化模型，并将其转化为易求解的鲁棒等价模型，确定最优的筛查方案。最后通过算例仿真验证模型及其转化方法的可行性和有效性，为突发公共卫生事件的精准筛查策略提供了理论指导和决策支持。