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Books > Medicine > Other branches of medicine > Environmental medicine
The probability for exposure to damaging radiation, toxic chemicals in the environment and adverse biological agents has increased exponentially today. The more frequent and faster travel that we experience today also escalates the risk of contraction and transmission of potentially deadly infections. This has created a very real and escalating risk for injuries and deaths. This is accentuated in the military and medical staff that is more frequently exposed to radiological, chemical, and biological agents in their normal working environment. Understanding the mechanisms whereby these toxic agents inflict damage to our bodies is essential to prepare us for these challenges. Much of the damage is inflicted through the generation of free radicals and non-radical oxidants which then act through oxidative mechanisms to injury the body. This volume will discuss the damage caused by these radiological, chemical, and biological environmental stressors, the mechanisms through which the damage can occur and the novel strategies that can be used to reduce the injury inflicted by these toxic compounds. Using basic and clinical research approaches, the contents of this book discuss new ideas for the development of bioactive products and environmental approaches to lessen or negate the biological damage inflicted by these noxious compounds.
Since questions about wireless phones andbrain cancer were first raised in early 1993, numerous scientificstudies and reviews have been conducted and published throughout the world with support from industry and government. The most comprehensive colloquium to date covering this science was co sponsored byt he International Committee on WirelessCommunication Health Research and Wireless Technology Research, LLC,a t the University "La Sapienza" ofR omein November 1995. Papers fromt hat colloquium with appropriate updates formt he foundation for the current volume. A follow up tothat colloquium isbeing planned fort he spring of 1999 byt he same group and thereport of that colloquium will bet he basis for Volume II ofthis series. As thescientific story about wireless phones and health effects continues to unfold over the next several years, it is important to evaluate thework ina context t hat isb eneficialt ot he enhancement ofpublic health. Two themesa re critical to an appropriate contextual understanding ofthis science.
In a new era of global health diplomacy, the most important tool for decision-making is negotiation. Globalization is binding countries, issues and people together as never before. In the domain of public health, traditional international concerns like the spread of infectious diseases have been joined by new concerns and challenges in managing the health impacts of trade and intellectual property rights, and by new opportunities to create effective global public health agreements and programs. To address the major health crises of today and to prevent or mitigate them in the future, countries must seek collective agreement and action within and across their borders. However, the world of international negotiation is not the world in which health decision-makers reside or are most comfortable. The goal of this guide is to provide health policy-makers with practical information and negotiation tools, to help them create better international health agreements and programs. "This is the best book I know to help health professionals develop the negotiation skills necessary to meet the challenges of global health diplomacy. It is filled with wise advice and invaluable tools for success." Professor Jeswald W. Salacuse, The Fletcher School of Law and Diplomacy, Tufts University
As part of its "Programme for the prevention of health hazards caused by industrial substances", the Berufsge- nossenschaft der chemischen Industrie (BG Chemie, Em- ployment Accident Insurance Fund of the Chemical Indus- try) began in 1977 to investigate the toxicity of those chemicals which are widely used, have many different ap- plications and are suspected of being dangerous to health, in particular of having long-term effects. The in- vestigations consist of a literature search and - depending on the results - commissions of experimental studies. It is hoped by means of this testing to close gaps in our know- ledge and to increase the scientific validity of the required risk assessments. The results of the toxicological in- vestigations carried out by BG Chemie, and the resulting substance assessments have been published in German since 1987 in the form of 113 "Toxikologische Bewer- tungen" ("Toxicological Evaluations") up to now. In order to make this useful information internation- ally available, BG Chemie began in October 1990 to pub- lish them as a book series in English, of which the fifth vol- ume (containing 12 individual evaluations) is presented here. Therefore for 72 existing chemicals "Toxicological Evaluations" are available in English at the moment, a fur- ther 38 are in preparation and will be published soon.
"Toxicological Evaluations" are critically assessed data and recommendationsfor occupational safety officers, industrial hygienists, and human and animal toxicologists. They are compiled and constantly reviewed under internationally coordinated programms for establishing the risk potential of existing chemicals to prevent health hazards at the working place. Data for the following 61 chemicals have been published in the series: Acrylic acid, Benzalchloride, Benzotrichloride, Benzoylchloride, Benzylchloride, Bromoform, Butynediol, gamma-Butyrolactone, 4-Chloro-2-nitroaniline, Chloro acetic acid methyl ester, Chloroacetamide, o-Chlorobenzotrichloride, p-Chlorobenzotrichloride, o-Chlorobenzotrifluoride, m-Chlorobenzotrifluoride, Chloroformic acid ethyl ester, 4-Chlorophenyl isocyanate, m-Cresidine, N, N'-Di-sec.-butyl-p-phenylenediamine, 1,4-Diaminoanthraquinone, 1,4-Dicyanobutane, Dicyclopentadiene, Diethanolamine, Diethylcarbamoyl chloride, Diethyliene glycol, Diglycidyl ether, Diisopropanolamine, Dimethyl therephthalate, 2,4-Dinitromethylaniline, Ethylene thiourea, 2-Ethylhexanal, 2-Ethylhexanol, Hydrazobenzene, Isopropyl ethylene glycol ether, Maleic acid dimethyl ester, Manganese dioxide, 2-Mercaptobenzothiazole, Methoxyacetic acid, Methylbutadiene -1,3, 3-Methylbutanol-1, 2-Methylpropanol-1, 2-Methylpropene, Monochloroacetic acid, 1,5-Naphthalene diamine, 5-Nitro-2-aminotoluene, m-Nitroaniline, 5-Nitroanisidine, p-Nitrosophenol, Phenyl isocyanate, Phenylglycidyl ether, o-Phthalodinitrile, Propargyl alcohol Sodium hypochlorite, Therephthalic acid, Thiram, Tributyl phosphate, Triethanolamine, Triethylene tetramine, Trimethylphenyl-ammonium chloride, Trimethylquinone, Vinyl fluoride.
This series is dedicated to serving the growing community of scholars and practitioners concerned with the principles and applications of environmental management. Each volume is a thorough treatment of a specific topic of importance for proper management practices. A fundamental objective of these books is to help the reader discern and implement man's stewardship of our environment and the world's renewable resources. For we must strive to understand the relation ship between man and nature, act to bring harmony to it, and nurture an environment that is both stable and productive. These objectives have often eluded us because the pursuit of other individual and societal goals has diverted us from a course of living in balance with the environment. At times, therefore, the environmental manager may have to exert restrictive control, which is usually best applied to man, not nature. Attempts to alter or harness nature have often failed or backfired, as exemplified by the results of imprudent use of herbicides, fertilizers, water, and other agents. Each book in this series will shed light on the fundamental and applied aspects of environmental management. It is hoped that each will help solve a practical and serious environmental problem."
As part of its programme for the prevention of health hazards caused by industrial work substances, the Berufsgenossenschaft der chemischen Industrie (BG Chemie) began in 1977 to investigate the toxicity of those substances which are widely used, have many different applications and are suspected of being dangerous to health, in particular of having long-term effects on health. It is hoped by means of this testing to close gaps in our knowledge and to increase the scientific validity of the required risk assessments. The results of the toxicological investigations carried out by BG Chemie, and the resulting substance assessments have been published in West Ger many since 1987 in the form of "Toxicological Evaluations". In order to make this useful information internationally available, the second volume (containing individual evalua tions of 15 substances) is now being published in English. The first volume containing individual evaluations of 19 substances was published in October 1990. Because of the short time between publishing volumes 1 and 2, printing of the "Introduction" (consisting of a general overview of the programme, lists with names of people involved as well as substances under investigation was abandoned in volume 2. If there more detailed information is required, see volume 1 or contact BG Chemie at first hand. The publication of further individual evaluations and, if necessary, reassess ments of previously published evaluations is planned.
More than 10 years ago, I had the chance to visit the university hospital in Munster, Germany. At the outpatient clinic there, I accidently met a young dermatologist who was devoted to the study of the quantification of irritated skin during his busy daily clinical work. I sensed immediately that this Dr. P. Frosch was conducting his research with the ideals and enthusiasm which were so familiar to me. Soon we found that we shared a similar past experience; we both had begun our careers in dermatological investigation with the same mentor. For me it was more than 25 years ago that I first met Dr. Kligman, Professor at the University of Pennsylvania in Philadelphia, USA. I reminisced that I had been greatly shocked by his initial question ''As a dermatologist, do you want to study living or dead skin?" because, at that time and even today, whenever we cannot collect enough information about the skin with the naked eye, it is invasively removed is common practice to histologically examine a skin sample that from living tissue. Many dermatologists still would never think of studying the living intact skin itself noninvasively with the aid of existing advanced technologies to assess its structural and functional properties. At that time Dr. Kligman intended to build up a system of evaluating the skin from various aspects, using methods that had been unduly neglected in the past and introducing various technological instruments.
ENVIRONMENTAL HYGIENE III deals with the detection and evaluation of environmental pollutants as well as with their relevance to human health. Environmental components are important determinants of the health status of groups at risk and of the general population. The main objective is the early detection and identification of hazardous substances by physical, chemical and biological methods, risk assessment andprotection of human health. Faced with these problems the volume gives an overview on the mulifaceted aspects of environmental hygiene and medicine. Contributions include basic and innovative approaches in the fields of - Experimental cell biology - Cytotoxicity testing - Mutagenicity and carcinogenicity studies - Inhalation toxicity - Human exposure monitoring - Epidemiology - Important harzardous agents - Environmental control, prevention and legislation.
The identification of occupational cancer risk factors and of carcinogens in the workplace is assuming increasing import ance in cancer epidemiology. This book, which contains the proceedings of a symposium held in Vancouver in June 1988, combines overviews by experts on substantive topics and methodologic issues of broad interest in occupational cancer epidemiology. Among the former are state of the art reviews emphasizing recent data and new and innovative analytic approaches. The substantive topics include discussion of cancer risks from exposure to complex organic mixtures, asbestos and man-made fibers, herbicides, radon, and electromagnetic fields. Risk assessment, exposure assessment, and analysis of occupa tional cohort studies are examples of the methodologic issues addressed. This book provides basic information and opens perspectives on new areas of research. In organizing our symposium we were greatly assisted by Betty Fata and Kim Rust of Venue West Conference Ltd. We appreciate the financial support received from the following: Cancer Control Agency of British Columbia Alcan Aluminium Ltd. National Health Research & Development Program Workers' Compensation Board of British Columbia Purdue Frederick Inc. Rhone-Poulenc Pharma Inc. London Drugs Ltd. Ciba-Geigy Canada Ltd. Bristol-Myers Pharmaceutical Group Schering Canada Inc. Hoffmann-La Roche Ltd. Sterling Drug Ltd. Parke-Davis Canada Inc. Beecham Laboratories Pfizer Canada Inc. Roussel Canada Inc."
The protection of human health and food and fiber resources against the ravages of pests of many sorts is a continuous struggle by all people in the world. The use of chemical pesticides as an aid in this struggle is now also global. These chemicals are deliberately added to the environment for the purpose of killing or injuring some form of life. Because pesticides are generally less selectively toxic than would be desired, non-target species, including humans, must be protected from injury by these chemicals. This can only be achieved by thorough understanding of the comparative toxicology of these compounds, and by minimizing human (and other desirable species) exposure. The latter can only be achieved by sound regulatory policies that utilize scientific principles and data, properly tempered by both gaps in that data and sociologic and economic considerations. This book contains the proceedings of the NATO Advanced Study Institute on "Toxicology of Pesticides: Experimental, Clinical and Regulatory Perspectives" held in Riva del Garda on October 6-15, 1986. This NATO-ASI has been promoted by the School of Public Health and Community Medicine, University of Washington at Seattle, by the Institute of Pharmacological Sciences, University of Milano and by the Giovanni Lorenzini Foundation, and has been sponsored by both the Society of Toxicology (USA) and the Italian Society of Toxicology.
Considerable progress in understanding how inhaled minerals cause disease in man has been made in the past two decades. This is mostly due to the great amount of human, animal and cell multidisciplinary studies carried out on silica, asbestos and asbestiforms all around the world. Two previous NATO Workshops on "In Vitro Effects of Mineral Dusts on Cells", have been published in the NATO ASI Series (1985 and 1989). The present NATO-INSERM workshop has focused specifically on a group of silicates, named phyllosilicates because of their sheet structure, of which health related effects have been poorly and sporadically investigated. These silicates are presently largely used as filling materials (kaolin, talc, chlorite), insulating materials (vermiculite, micas), adsorbants (sepiolite, attapulgite) and in many other industrial applications. The estimated annual world production is presently 5.5 million tons of talc (1.8 million for Europe) and only in the United Kingdom about 3.5 million tons of kaolin.
A. AULICIEMS Living organisms respond to atmospheric variability and variation, and over time morphological and process differentiations occur both within individuals and the species, as well as in the environment itself. In systems language, the concern is with the atmospheric process-response system of energy and matter flows within the biosphere. The study of such interactions between living organ isms and the atmospheric environment falls within the field of bioclimatology, alternatively referred to as biometeorology. Amongst the more readily recognizable study areas under the bioclimatolog that investigate the effects of atmospheric variation and ical umbrella are those variability upon 1. Terrestrial and aquatic ecology (zoological, botanical and ethological), natural resource production and management (including silviculture, agri culture, horticulture, and grassland, wetland, and marine systems). 2. Stress, morbidity and mortality in animals and humans (including physiolog ical and psychological adaptations). 3. The built environment (all aspects of planning, urban design, and architec ture). 4. Economic systems and social activities (including organizational, individual, and group behavior and management). In addition, bioclimatology is very much concerned with the feedback loop, that is both 5. The inadvertent modification of the atmosphere by living systems, especially human, i.e., studies of pollution, changes to atmospheric amenity, and the processes of deterioration of landscape (deforestation and desertification), and 6. The advertent modifications of natural energy and matter flows within urban areas and indoor climate constructions."
International cooperation on the health of seafarers began many years ago. As early as 1921, an international convention regarding this matter was presented to govern ments of maritime countries for ratification. The First World Health Assembly, in 1948, recommended that WHO should establish, with the International Labour Of fice, a Joint Committee on the hygiene of seafarers. The first session of this Com mittee, held in 1949, defined the problems affecting the health of seamen and made a number of recommendations. In the opinion of this Joint Committee, the health of seamen called for interna tional attention for a nu mb er of reasons. By the nature of his work, the seafarer is obliged to travel from country to country and is exposed to great variations of cli mate and also to any disease that may be prevalent in the port of call. He may there fore become a carrier of disease, so that the protection of his health is of importance not only to himself and the other members of the crew but also to the populations of other countries he visits. Yet, on account ofthe nature ofhis employment, it is diffi cult to provide the seafarer with the same standard of health care that is gene rally available to other sections of the population."
Environmental Chemistry is a relatively young science. Interest in this subject, however, is growing very rapidly and, although no agreement has been reached as yet about the exact content and limits of this interdisciplinary discipline, there appears to be increasing interest in seeing environmental topics which are based on chemistry embodied in this subject. One of the first objectives of Environ mental Chemistry must be the study of the environment and of natural chemical processes which occur in the environment. A major purpose of this series on Environmental Chemistry, therefore, is to present a reasonably uniform view of various aspects of the chemistry of the environment and chemical reactions occurring in the environment. The industrial activities of man have given a new dimension to Environ mental Chemistry. We have now synthesized and described over five million chemical compounds and chemical industry produces about hundred and fifty million tons of synthetic chemicals annually. We ship billions of tons of oil per year and through mining operations and other geophysical modifications, large quantities of inorganic and organic materials are released from their natural deposits. Cities and metropolitan areas of up to 15 million inhabitants produce large quantities of waste in relatively small and confined areas. Much of the chemical products and waste products of modern society are released into the environment either during production, storage, transport, use or ultimate disposal. These released materials participate in natural cycles and reactions and frequently lead to interference and disturbance of natural systems.
Infant Feeding is about a controversy which fascinated the medical and scientific world, as well as national and international health authorities, politicians, religious groups and consumer organisations, for more than 11 years. It often disturbed public opinion, being concerned, as it is, with nothing less than the life and death of babies. The infant food industry was directly accused of having caused a decline in breast-feeding through the inappropriate marketing of breast milk substitutes. The problem was said to be particularly acute in poor under-developed communities, because illiterate mothers were unable to understand instructions for its use, water was often contaminated and, in order to "stretch" an admittedly expensive product, it was over-diluted. The inevitable result, said the critics of industry, was malnutrition, gastroenteritis and increased infant mortality. These were very serious charges against companies which had until then been generally considered to provide an important contribution to medical progress and child health. One company was to be particularly singled out: Nestle SA, the Swiss multinational. Perhaps it became the target because it was the longest establishment, and served well as a symbol of the whole industry. It is a story which is full of confrontations, intrigue and passionately-held opinions, based, nevertheless, on a sizeable body of medical science. After countless twists and turns, it has some sort of "happy ending". Yet a great deal remains to be said, as will be seen throughout the book.
A good number of misconceptions are currently circulating on the
effects of non-ionizing radiations on our health, which can lead to
an oversimplification of the issue, to potentially dangerous
assumptions or to misleading data analysis. Health effects may be
exaggerated, or on the contrary underplayed. The authors of this
work (doctors, engineers and researchers) have endeavored to supply
validated and easily understandable scientific information on the
electromagnetic fields and their biological and health effects.
After a general review of the physics of the waves and a
presentation of non-ionizing radiations, the authors review the
main emission sources encountered in our daily environment. They
summarize simply but as accurately as possible the current
knowledge on their biological effects.
My introduction to the fascinating phenomena associated with detonation waves came through appointments as an external fellow at the Department of Physics, University College of Wales, and at the Department of Mechanical Engineering, University of Leeds. Very special thanks for his accurate guidance through the large body of information on gaseous detonations are due to Professor D. H. Edwards of University College of Wales. Indeed, the onerous task of concisely enumerating the key features of unidimensional theories of detonations was undertaken by him, and Chapter 2 is based on his initial draft. When the text strays to the use of we, it is a deserved acknow ledgement of his contribution. Again, I should like to thank Professor D. Bradley of Leeds University for his enthusiastic encouragement of my efforts at developing a model of the composition limits of detonability through a relationship between run-up distance and composition of the mixture. The text has been prepared in the context of these fellowships, and I am grateful to the Central Electricity Generating Board for its permission to accept these appointments."
From 11 to 15 July 1977 about 60 physiologists, endo crinologists, ecologists and other biologists from 14 countries convened at the University Montpellier for a symposium on Environmental Endocrinology. This meet ing was organized as a Satellite Symposium of the 27th International Congress of Physiological Sciences, Paris, 18-23 July 1977. This volume is a record of the com munications presented at the symposium. The objectives of the program were to examine the role of the endocrine system in a wide spectrum of adjustments and adaptations to changes in environmental conditions by various spe cies of animals, including man, and to promote an ex change of ideas among investigators who have approached these functions from diverse aspects. The diversity of the information and ideas communicated is great. Of necessity, they represent only an extremely modest se lection of the many facets of endocrine function in the interaction of animals with their environments. Be yond the usefulness of the communications individually, we hope that they collectively demonstrate the substan tial heuristic value of the concept of environmental endocrinology as it was perceived by the participants. We acknowledge gratefully the kindness and sympathy of Professor Jaques ROUZAUD, President of the University of Montpellier II, for his generous extension of the hospitality of the University to the Symposium. We are most grateful to Mrs. Monique VIEU who effected so well the secretarial organization of the Sympos."
Toxicological Evaluations are critically assessed data and recommendations for occupational safety officers, industrial hygienists, and human and animal toxicologists. They are compiled and constantly reviewed under internationally coordinated programs for establishing the risk potential of existing chemicals to prevent health hazards at the working place. In Volume 11, data for the following chemicals are published: o-Phthalodinitrile, Dimethylaminopropionitrile, Anthraquinone, Triisobutylphosphate, 4-Nitro-4'-aminodiphenylamine-2-sulfonic acid, 2,5-Dimethoxy-4-chloreanilino, Antimony-(III)-chloride, Antimony-(V)-chloride, Antimony-(V)-oxide, N, N-Dicyclohexyl-2-benzothiazolesulfenamide, Ethenesulfonic acid, sodium salt.
M. B. KASTAN Cancer is a disease resulting from alterations of cellular genes which cause phe notypic changes in somatic cells. Usually, when we think about genetic diseases, we think about inheriting one or two abnormal genes from our parents and these gene abnormalities confer the disease phenotype. In contrast, in the majority of cancers, no such inherited gene abnormalities can be identified (which does not mean that they do not exist) and there is no obvious family history suggesting an inherited disease. The vast majority of genes which are altered in the cancer cells are not transmitted through the germ line, but rather become abnormal in somatic cells sometime during the lifetime of the individual. Thus, the critical question which arises is "how do these genetic changes occur in somatic cells?." Epidemiologic data suggest that exposure to environmental carcinogens con tributes to the genesis of at least 80% of all human cancers (DOLL and PETO 1981). Thus, it is natural to suspect that the genetic changes in somatic cells which con tribute to the transformed phenotype arise from DNA damage caused by such exposures. Therefore, understanding how cells respond to DNA-damaging agents is likely to be an important component of our understanding of the genesis of human tumors."
Toxicological Evaluations are critically assessed data and recommendations for occupational safety officers, industrial hygienists, and human and animal toxicologists. They are compiled and constantly reviewed under internationally coordinated programs for establishing the risk potential of existing chemicals to prevent health hazards at the working place. In Volume 13, data for the following chemicals are published: Benzyl chloride, Triethylenediamine, 2-Amino-6-methoxybenzothiazol, Fluorobenzene, alpha-Naphthylamine, Triethylphosphite, Diethylphosphite, Diphenyl-2-ethylhexyl phosphate, alpha-Chlorpropionic acid and sodium-alpha-chloropropionate, Zinc ethylphenyl dithiocarbamate, Dimethoxy thiophosphonyl chloride, p-Chlorbenzotrifluoride.
This book is a collection of scientific papers presented at the XVIII International Congress of Aviation and Space Medicine held in Amsterdam, The Netherlands, from 15-18 September 1969. It is dedicated to General E. de Vries and Dr. K. Vaan drager, President and Vice-President of the Congress, who wished that this unsur passed exchange of scientific information by distinguished authorities of the inter national aerospace medical community be made readily available to all as a valuable source of information. I am deeply grateful to the Congress Committee for honoring me with this editorship, to the authors for submitting generally excellent manuscripts and to the publisher for compiling a book of such high quality. This book contains both Main Theme papers, given by invited lecturers, and selected Free Communications at the Congress. Main Themes were 'physiology of atmospheric pressure' (papers by Ernsting, Meijne, Sluijter, Behnke), 'vestibular problems in aviation medicine' (papers by Melvill Jones, Benson, Oosterveld, Groen, Guedry and Benson, Brandt, Henriksson and Nilsson), 'aviation and cardiology' (papers by Blackburn, Wood) and 'space medicine' (paper by Berry). The Free Communications herein focus on many areas of continuing and timely interest to clinicians and investigators in aerospace medicine. Selection and health maintenance of pilots, medical problems in airline passengers, use of the centrifuge as a therapeutic device, and circadian rhythm effects on man's psychophysiological state receive particular attention."
Chemical pesticides continue as a point of major controversy in our society. Increasingly stringent regulatory actions on the part of state and federal agencies, exemplified by the RPAR (Rebuttable Presump tion Against Registration) program of the Environmental Protection Agency, are supported by environmental groups and are generally op posed or viewed with skepticism by agriculturalists. The energy crisis invokes other questions on benefits of pesticides versus nonchemical controls and effects on labor utilization. As DDT and other persistent pesticides have been phased out, the more labile, short-lived chemicals have filled the voids in pest management systems; and effects on nontarget species appear to have declined in recent years as the shift occurred. However, nagging ques tions of the hazard to man and other nontarget species from long-term, low-level exposure to pesticides are frequently raised; and recent suggestions that certain well-known and long-used chemicals cause cancer, increase sterility, and initiate or augment other deleterious effects in test animals have instilled a sense of caution and raised con cern about the continued availability of some pesticides previously considered safe. So the facade of concern and confusion continues. This book is an outgrowth of a symposium at the meeting of the American Association for the Advancement of Science in February, 1978. An introduction has been added, and some of the papers have been modified since presentation."
This book is concerned with the psychological effects of unemployment. In writing it I had two main aims: (1) to describe theoretical approaches that are relevant to understanding unemployment effects; and (2) to present the re sults of studies from a program of research with which I have been closely involved over recent years. In order to meet these aims I have organized the book into two main parts. I discuss background research and theoretical approaches in the first half of the book, beginning with research concerned with the psychological effects of unemployment during the Great Depression and continuing through to a dis cussion of more recent contributions. I have not attempted to review the liter ature in fine detail. Instead, I refer to some of the landmark studies and to the main theoretical ideas that have been developed. This discussion takes us through theoretical approaches that have emerged from the study of work, employment, and unemployment to a consideration of wider frameworks that can also be applied to further our understanding of unemployment effects." |
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