Starting a New Job: The Social and Emotional Experience of People with Intellectual Disabilities

Background Employment is viewed by policy makers as both a human right and as a means of changing the marginalized status of people with intellectual disabilities, with important social and emotional benefits. However, there has been little longitudinal research examining the experience of people with intellectual disabilities in the workplace. Methods Thirty‐five individuals with mild to borderline intellectual disabilities participated in this study. They were recruited from supported employment agencies in Scotland. A longitudinal approach was adopted, with the participants being interviewed around the time of starting their jobs, and again 9–12 months later. Results The content analyses of the semi‐structured interviews indicated that the participants perceived continuing benefits from entering mainstream employment, including more purposeful lives and increased social status. However, over the follow‐up period the participants reported few social opportunities that extended beyond the workplace, and an anxiety about their competence to meet employers’ demands remained a concern for some. Conclusions The discussion addresses the importance of understanding work in relation to the participants’ wider lives, along with the longer‐term role for supported employment agencies to help people achieve their social and emotional goals in a vocational context.     

Determining acute health hazard ratings in the absence of applicable toxicological data

Health, safety, and emergency planning professionals have a responsibility to identify acute hazards associated with chemicals and to find a way to transmit that information to chemical users, emergency responders, and others. Various organizations such as the Department of Energy are considering acute health hazard ratings as triggers that would mandate various activities. A paradigm shift away from a "lists" based approach to determining whether a chemical is sufficiently hazardous to require further analysis for emergency planning purposes is under way. Various toxicological data sources and approaches in use to develop an acute health hazard rating are discussed. Methods of extrapolating data from published and unpublished supporting documentation to develop an acute health hazard rating in the absence of toxicological data by animal species, chemical structure similarities, MSDS estimated values, and data mining are discussed. The process described analyzes applicable data and allows the analyst to determine reasonable health hazard rating numbers for chemicals without published hazard ratings and for mixtures of chemicals. The level and amount of resources available will determine which methods will be used in the process.     

An evaluation of some Trinidadian plant extracts against larvae of Aedes aegypti mosquitoes

In recent times, bioprospecting for plants that show bioactive properties has yielded many chemicals that can be used in controlling mosquitoes. Crude extracts of 4 terrestrial and 3 mangrove plants were assayed against 2-3 larval instars of Aedes aegypti. Among the plants tested, Cordia curassavica showed the highest levels of activity for all the extracts tested. Azadirachta indica showed the least activity, whereas the 2 cultivars of Mangifera indica showed substantial activity for the aqueous extracts. The mangrove species proved to be relatively nontoxic to Ae. aegypti larvae when compared to the terrestrial plants. The results of this study suggest that some common plants in Trinidad may be highly effective in controlling the urban vector of yellow fever and dengue fever, Ae. aegypti.     

Effects of vegetation control on mosquitoes in seasonal freshwater wetlands

Wetland restorations benefit wildlife, but wetland vegetation may promote mosquitoes. We studied the effects of removing joint grass (Paspalum distichum L.) on the abundance and distribution of immature mosquitoes in seasonal freshwater wetlands in California. In 4 >4-ha plots and one 29.8-ha field, joint grass was removed via herbicide and disking. Four untreated plots and one 4.1-ha field were controls. Fields were sampled every 7-14 days in early autumn by taking 75 dips along levees, plus a 25-dip circular transect 6 m from field edges. Untreated plots had 7 times more larvae and 20 times more pupae than did vegetation-removal plots. Similar densities of mosquitoes were found along edges and within fields.     

Prenatal drug use and the production of infant health

We estimate the effect of illicit drug use during pregnancy on two measures of poor infant health: low birth weight and abnormal infant health conditions. We use data from a national longitudinal study of urban parents that includes postpartum interviews with mothers, hospital medical record data on the mothers and their newborns, and information about the neighborhood in which the mother resides. We address the potential endogeneity of prenatal drug use. Depending on how prenatal drug use is measured, we find that it increases low birth weight by 4-6 percentage points and that it increases the likelihood of an abnormal infant health condition by 7-12 percentage points.     

Construction--still booming

The 2007 Hospital Building Survey shows no letup in construction. But some experts see signs of a slowdown.     

Computer-aided diagnosis with potential application to rapid detection of disease outbreaks

Our objectives are to quickly interpret symptoms of emergency patients to identify likely syndromes and to improve population-wide disease outbreak detection. We constructed a database of 248 syndromes, each syndrome having an estimated probability of producing any of 85 symptoms, with some two-way, three-way, and five-way probabilities reflecting correlations among symptoms. Using these multi-way probabilities in conjunction with an iterative proportional fitting algorithm allows estimation of full conditional probabilities. Combining these conditional probabilities with misdiagnosis error rates and incidence rates via Bayes theorem, the probability of each syndrome is estimated.We tested a prototype of computer-aided differential diagnosis (CADDY) on simulated data and on more than 100 real cases, including West Nile Virus, Q fever, SARS, anthrax, plague, tularaemia and toxic shock cases. We conclude that: (1) it is important to determine whether the unrecorded positive status of a symptom means that the status is negative or that the status is unknown; (2) inclusion of misdiagnosis error rates produces more realistic results; (3) the naive Bayes classifier, which assumes all symptoms behave independently, is slightly outperformed by CADDY, which includes available multi-symptom information on correlations; as more information regarding symptom correlations becomes available, the advantage of CADDY over the naive Bayes classifier should increase; (4) overlooking low-probability, high-consequence events is less likely if the standard output summary is augmented with a list of rare syndromes that are consistent with observed symptoms, and (5) accumulating patient-level probabilities across a larger population can aid in biosurveillance for disease outbreaks.