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Demonstration of a dose‐response relationship for environmental tobacco smoke (ETS) is an important indication of causality. Central to the analysis and interpretation of dose‐response relations as described in epidemiological studies is the relationship between dose and exposure. It must be recognized that in studies of ETS we have only surrogate measures of dose, and these surrogate measures (based on exposure) are imperfect. The question‐based measures of ETS exposure generally have not been standardized, may have limited validity and reliability, and cannot comprehensively describe total ETS exposure, exposure to individual ETS components, nor doses of biologically relevant agents at target sites. Nevertheless, useful data have been yielded in epidemiologic studies linking ETS exposure to increased respiratory infection and symptoms, reduced lung growth in children, and increased lung cancer in nonsmoking adults. The more consistent exposure‐response data for studies on acute health in children may reflect the greater difficulty in measuring exposure in studies of chronic health in adults.SUMMARYFor children, adverse effects have been causally associated with exposure to ETS. The epidemiological evidence and the supporting toxicological data link ETS to increased lower respiratory illness, increased respiratory symptoms, and reduced lung growth. Exposure‐response relationships have been described for these effect; errors in exposure estimates would tend to lessen rather than to exaggerate these relationships. By contrast, in adults, the evidence for adverse cardiopulmonary effects of ETS exposures, other than lung cancer, it's presently less conclusive. Misclassification of exposure may be more severe for adults than for children, and the resulting bias toward the null may obscure effects of respiratory symptoms and lung function. Research on adults is hindered by the difficulty of estimating exposures received in diverse environments over a lengthy period. Continued controversy related to the effects of ETS exposure in the workplace and in public locations provides a rationale for further research. However, more valid methods for assessing the exposures of adults to ETS are needed for such research.

"A comprehensive and innovative guide to teaching, learning and assessment in forensic science education and practitioner training Includes student exercises for mock crime scene and disaster scenarios Addresses innovative teaching methods including apps and e-gaming Discusses existing and proposed teaching methods"--

Summary An evolution of thought and practice regarding the relationship of racism to well-being, healing, and trauma continues within social work and the helping professions. Additionally, empirical research on colorism as a key dimension of racism suggests that colorism negatively impacts the psychological and physical well-being of African Americans. However, few studies have examined well-being among African Americans in the context of historical trauma, through the lens of colorism. In this paper, the intersectionality of colorism and historical trauma is explored to inform culturally responsive social work education, practice, and research regarding African American well-being. It is the first step toward developing a colorist-historical trauma framework. The impact of colorism as a function of historical trauma response transmission among African Americans is presented. Findings Advances in culturally responsive practice in social work address the impact of social determinants of health, such as racism. However, the impact of colorism within systemic racism is often unacknowledged. The authors assert that social work practice must attune to the differentiated socioemotional, political, and economic needs that exist among African Americans due to the impact of colorism and historical trauma. An intersectional lens, such as the colorist-historical trauma framework, is essential for culturally responsive practice. Applications The colorist-historical trauma framework contributes to the professional social work discourse aimed at strengthening effective micro-, meso-, and macro-level practice with African Americans for well-being. Implications for social work practice, research, and education are presented.

The data generated by Yeh et al. on hepatitis B virus, aflatoxin, and primary hepatocellular carcinoma (PHC)in Southern Guangxi, China was used to evaluate the cancer potency of aflatoxin. We examined model fits to these data to explore whether hepatitis B virus (HBV)and aflatoxin intake act together to affect PHC rates in an additive, multiplicative, or interactive fashion, using relative and excess risk model forms. Purely additive models fit the data poorly. Fitted models were checked for plausibility by comparing predictions for the U.S. population with actual PHC incidence rates in the United States, and parameter stability was evaluated. The multiplicative relative risk and the interactive excess risk models provided satisfactory descriptions of the Yeh et al. data and U.S. PHC rates. There is about an eight‐fold difference in the potency estimate for aflatoxin under the multiplicative relative risk (5.7 (mg/kg‐day)‐1)and interactive excess risk models (45.6 mg/kg‐day)‐1). The assumptions and limitations of the various models are discussed.

Introduction: To fulfil its role of coordinating health care, primary health care needs to be well integrated, internally and with other health and related services. In Australia, primary health care services are divided between public and private sectors, are responsible to different levels of government and work under a variety of funding arrangements, with no overarching policy to provide a common frame of reference for their activities. Description of policy: Over the past decade, coordination of service provision has been improved by changes to the funding of private medical and allied health services for chronic conditions, by the development in some states of voluntary networks of services and by local initiatives, although these have had little impact on coordination of planning. Integrated primary health care centres are being established nationally and in some states, but these are too recent for their impact to be assessed. Reforms being considered by the federal government include bringing primary health care under one level of government with a national primary health care policy, establishing regional organisations to coordinate health planning, trialling voluntary registration of patients with general practices and reforming funding systems. If adopted, these could greatly improve integration within primary health care. Discussion: Careful change management and realistic expectations will be needed. Also other challenges remain, in particular the need for developing a more population and community oriented primary health care.

Social work has enhanced its profile in the United States by adopting a particular dialect of scientific inquiry wherein positivism and evidence-based practice are considered gold standards of social work research and practice. This ideological shift permeates doctoral education and research training, as well as social work more broadly. Little attention, however, is paid to the pedagogical approaches used to train doctoral students into a "science of social work," and we know even less about critical methodologies in doctoral education. This collaborative autoethnography weaves together the personal narratives of three doctoral students and one early career faculty member navigating an academic context within a large public university in the United States. We employ a participatory and intersectional approach to analyze narrative data in terms of how our identities interact with the structures relevant to where we study and work. Three themes emerged from our collaborative analysis: becoming disillusioned by disciplinary shortcoming; confronting dissonance with radical solidarity; and making change on the inside using perspectives from the outside. We argue throughout that critical reflexivity is a tool to document, resist, and transform hegemonic discourse that narrowly defines what it means to embody social work research, practice, and education.

The colorist-historical trauma framework offers scholars, practitioners, and educators a new lens with which to more effectively combat racial disparities in society through the understanding of the intergenerational transmission of colorism in the historical trauma response of African Americans. This article applies the colorist-historical trauma framework to the colorism poems of young African Americans who demonstrate that poetry, as a device of healing, can be a useful mechanism of passing on more than the challenges associated with colorism, but also the art of resistance. The results of this thematic analysis produced three emerging concepts about the poetics of 16 young African Americans and have implications for mental health practitioners, educators, and scholars that uplift the healing process of poetry.

The frequency and intensity of extreme weather events have increased in recent decades; one example is Hurricane Sandy. If the frequency and severity continue or increase, adaptation and mitigation efforts are needed to protect vulnerable populations and improve daily life under changed weather conditions. This field report examines the devastation due to Hurricane Sandy experienced in Red Hook, Brooklyn, New York, a neighborhood consisting of geographically isolated low-lying commercial and residential units, with a concentration of low-income housing, and disproportionate rates of poverty and poor health outcomes largely experienced by Black and Latino residents. Multiple sources of data were reviewed, including street canvasses, governmental reports, community flyers, and meeting transcripts, as well as firsthand observations by a local nonprofit Red Hook Initiative (RHI) and community members, and social media accounts of the effects of Sandy and the response to daily needs. These data are considered within existing theory, evidence, and practice on protecting public health during extreme weather events. Firsthand observations show that a community-based organization in Red Hook, RHI, was at the center of the response to disaster relief, despite the lack of staff training in response to events such as Hurricane Sandy. Review of these data underscores that adaptation and response to climate change and likely resultant extreme weather is a dynamic process requiring an official coordinated governmental response along with on-the-ground volunteer community responders.

Anti‐Black racism, both interpersonal and systemic, is pervasive. Individual‐ and neighborhood‐level expressions of anti‐Black racism have been explored in many studies; however, Black youths' experiences of racism across routine activity locations have not been examined as extensively. To address this gap, a Youth Research Advisory Board (YRAB) recruited 75 Black youths (M(SD) = 15.53 (1.77)), living in a segregated neighborhood (93% African American) with 42% of residents living below the poverty line, to participate in research on this topic. Participants in the study completed surveys three times a day for a month (ecological momentary assessment) about their positive and negative emotions and perceptions of racism and social support in routine activity locations (n = 2041). Youths reported more racism when attending school and walking on the street. A relationship between perceptions of racism and social support in routine activity locations and positive and negative momentary emotions was found. This paper will present implications for supporting adolescent development and interrupting anti‐Black racism at the level of routine activity locations, along with opportunities for engaging youth‐led community‐based solutions.

AbstractIntroductionAddressing the intersection between mental health and HIV is critical for the wellbeing of persons living with HIV (PLWH). This systematic review synthesized the literature on mental health interventions for PLWH in low‐ and middle‐income countries (LMICs) to determine intervention components and explore their relationship with intervention effectiveness.MethodsWe included only controlled clinical trials of interventions aiming to improve the mental health of PLWH. We conducted a search in the following databases: PubMed, CINAHL, PsycINFO and EMBASE for eligible studies describing the evaluation of interventions for mental health problems among PLWH in LMICs published through August 2020. Two reviewers independently screened references in two successive stages of title/abstract screening and then full‐text screening for references meeting title/abstract criteria.ResultsWe identified a total of 30 eligible articles representing 6477 PLWH who were assigned to either the intervention arm (n = 3182) or control arm (n = 3346). The mental health interventions evaluated were psychological (n = 17, 56.67%), pharmacological (n = 6, 20.00%), combined psychological and pharmacological (n = 1, 3.33%) and complementary/alternative treatments (n = 6, 20.00%). The mental health problems targeted were depression (n = 22, 73.33 %), multiple psychological symptoms (n = 1, 3.33%), alcohol and substance use problems (n = 4, 13.33%), post‐traumatic stress disorder (n = 1, 3.33%) and HIV‐related neuro‐cognitive impairment (n = 2, 6.67%). Studies of interventions with significant effects had significantly a higher number of active ingredients than those without significant effects [3.41 (2.24) vs. 1.84 (1.46) Mean (SD)] [Mean difference = −1.56, 95% CI = −3.03 to −0.09, p = 0.037].ConclusionsThere continue to be advances in mental health interventions for PLWH with mental illness in LMICs. However, more research is needed to elucidate how intervention components lead to intervention effectiveness. We recommend scale up of culturally appropriate interventions that have been successfully evaluated in low‐ and middle‐income countries.