The cost of vaginal birth at home,in a birth centre or in a hospital setting in New South Wales: A micro-costing study

BackgroundWomen want greater choice of place of birth in New South Wales, Australia. It is perceived to be more costly to health services for women with a healthy pregnancy to give birth at home or in a birth centre. It is not known how much it costs the health service to provide care for women planning to give birth in these settings.AimThe aim of this study was to determine the direct cost of giving birth vaginally at home, in a birth centre or in a hospital for women at low risk of complications, in New South Wales.MethodsA micro-costing design was used. Observational (time and motion) and resource use data collection was undertaken to identify the staff time and resources required to provide care in a public hospital, birth centre or at home for women with a healthy pregnancy.FindingsThe median cost of providing care for women who plan to give birth at home, in a birth centre and in a hospital were similar (AUD $2150.07, $2100.59 and $2097.30 respectively). Midwifery time was the largest contributor to the cost of birth at home, and overhead costs accounted for over half of the total cost of BC and hospital birth. The cost of consumables was low in all three settings.ConclusionIn this study, we have found there is little difference in the cost to the health service when a woman has an uncomplicated vaginal birth at home, in a birth centre or in a hospital setting.     

Gays and lesbians in local races: a study of electoral viability

Although lesbians and gays are more visible in the political arena than in the past, there is little published research on their electoral viability. This article helps to fill that void by presenting results of experimental research featuring respondents' reactions to a hypothetical candidate for a non-partisan city council seat. Sex and sexual orientation of the candidates were manipulated so that six categories were tested: a straight woman, a lesbian, a woman rumored to be lesbian, a straight man, a gay man, and a man rumored to be gay. The findings suggest that openly gay and lesbian candidates are seen as less viable than straight candidates or those rumored to be homosexual. Hence, the extent to which a candidate portrays his or her sexual orientation appears to make a difference in the chance to win elective office.     

Fate of a mutant emerging at the initial stage of evolution

A simple system was constructed and used in the experimental elucidation of the fate of a mutant emerging in a population. ThreeEscherichia coli strains having the same genetic background except for their glutamine synthetase gene were used as model competitors. The difference in the enzyme gene were introduced by random mutation. Competition between these bacterial strains was carried out and observed in a continuous liquid culture. In most cases, the competitors stably coexist either in a steady state or in an oscillating state. In addition, the competition between the strains was found to be a deterministic process and not a stochastic one. These results showed that an emerging mutant in a population, be it a closely related one to the original members, can attain a state of stable coexistence even in a homogeneous environment. The ability of each of the emerging mutants to maintain its stable coexistence with the original population gives rise to the accumulation of various mutants in a population. Therefore, evolution starts from gradual accumulation of various mutants in the population, which in turn leads to the diversification of the population. As our experimental system is a minimum model for the various competitions in the natural ecosystem, the observed competitive coexistence is proposed to be a general phenomenon in nature.     

The age distribution of an industrial group (Scottish Railwaymen)

The age structure of the workers in an old-established industry, and the problems which might arise from it, formed the subject of the investigation. It was found that the group was atypical in that, in addition to having a higher average age than that of the total working population of Scotland, the age distribution was bimodal, with a marked excess in the S o + and a marked deficiency in the 3 5-44 age group. The bimodality was due to high recruitment after the first world war, followed by a low one a few years later. The bimodality was especially marked among footplatemen.

On the basis of age structure it is very difficult to identify grades to which older workers might be transferred. Certain receiving grades which " accommodate " the less healthy (and potentially also the older workers) were found to be relatively small in size compared with the operating grades, footplatemen or signalmen.

Projections were made to explore some of the repercussions of converting the age structure of a bimodal distribution to a standard, the working population of Scotland. There were three assumptions on total size : maintaining the size, a slow fall to 70% and a rapid fall to 70%. Within each of these there were three assumptions on sickness absence, drawn from experience of Scottish railwaymen and particularly footplatemen. These effects are described in the paper. They are not policy recommendations of what should happen ; they are indications of what might happen in certain circumstances. In a bimodal distribution it is easy to effect a reduction in total numbers by a reduction in recruitment, but the consequential longer term fluctuations in numbers are substantial and in sickness absence more so.

Those concerned with problems arising from recruitment, redundancy and age structures of working populations could get useful information by using appropriately realistic assumptions.     

Cohort Trends in Premarital First Births: What Role for the Retreat From Marriage?

We examine cohort trends in premarital first births for U.S. women born between 1920 and 1964. The rise in premarital first births is often argued to be a consequence of the retreat from marriage, with later ages at first marriage resulting in more years of exposure to the risk of a premarital first birth. However, cohort trends in premarital first births may also reflect trends in premarital sexual activity, premarital conceptions, and how premarital conceptions are resolved. We decompose observed cohort trends in premarital first births into components reflecting cohort trends in (1) the age-specific risk of a premarital conception taken to term; (2) the age-specific risk of first marriages not preceded by such a conception, which will influence women’s years of exposure to the risk of a premarital conception; and (3) whether a premarital conception is resolved by entering a first marriage before the resulting first birth (a “shotgun marriage”). For women born between 1920–1924 and 1945–1949, increases in premarital first births were primarily attributable to increases in premarital conceptions. For women born between 1945–1949 and 1960–1964, increases in premarital first births were primarily attributable to declines in responding to premarital conceptions by marrying before the birth. Trends in premarital first births were affected only modestly by the retreat from marriages not preceded by conceptions—a finding that holds for both whites and blacks. These results cast doubt on hypotheses concerning “marriageable” men and instead suggest that increases in premarital first births resulted initially from increases in premarital sex and then later from decreases in responding to a conception by marrying before a first birth.     

Mobility and sociality in proximity-sensitive digital urban ecologies: ‘Timid encounters’ and ‘seam-sensitive walks’

This paper is a case study of the use of a proximity-sensitive game played on mobile gaming terminals, in Japan and in France, Dragon Quest 9, and of distinctive forms of mobility and urban encounters which emerge around it. We show how players, when assembled together, walk the ‘connected walk,’ that is they adopt a particular gait, slower than the usual walking pace, with repeated pauses which appears as a tentative and exploratory kind of mobility oriented towards the random occurrence of proximity-based screen-mediated events, and therefore both adjusted to and constitutive of the proximity-sensitive hybrid ecology as a serendipitous place, to be experienced as such. With respect to urban encounters, we have identified a characteristic tension, relevant to locative media in general, in which concerns with potential identification and recognition ‘in the game’ contrasts with the interaction order of urban traffic encounters, characterized by ‘civil inattention.’ This gives rise to the phenomenon of ‘timid encounters,’ in which players strive to experience game encounters with other players a few meters away, while trying to elude visual or verbal recognition.     

Participatory Partnerships: Engaging and Empowering to Enhance Environmental Management and Quality of Life?

It is generally believed that, when partnerships with civil society are created, members of the public become engaged in defining and solving problems, and as a result become empowered through enhanced understanding of substantive problems, and of the processes used by society to deal with them. In this context, two fundamental assumptions related to a partnership approach deserve examination. First, partnerships assume a shared vision among partners, and a willingness to work together in a spirit of collaboration and cooperation. However, humans often are competitive, protective and defensive, attributes unlikely to lead to collaboration and cooperation. Second, advocates of a participatory approach advocate, or assume, that citizens will become empowered through being part of a partnership process. If partnerships are to be encouraged, we need to know if such a transformation actually occurs. Two experiences in Canada, one dealing with shared decision making during a resource and land use management process in British Columbia, and the other focused on an environmental impact assessment process in Manitoba, provide evidence that challenges whether these assumptions are easily satisfied.     

The Level and Age Pattern of Mortality in Bandafassi (Eastern Senegal): Results From a Small-Scale and Intensive Multi-Round Survey

The data collected in the Bandafassi demographic study in Eastern Senegal, a small-scale intensive and experimental follow-up survey of a population of about 7,000 in 1983, were analysed to derive an estimated life table. The use of multi-round surveys, combined with anthropological methods to estimate ages and collect genealogies, has resulted in unusually reliable data. Taking into account the uncertainty of the estimates due to the small size of the population, mortality was high, with life-expectancy at birth close to 31 years; a pattern of infant and child mortality close to that observed in other rural areas of Senegal, with a very high level or mortality between ages six months and three years; a seasonal pattern in child mortality with two high-risk periods, the rainy season and the end of the dry season; an adult mortality pattern similar to that described in model life tables for developed countries; no significant difference by sex or ethnic group. The Bandafassi population study and a few similar studies suggest that one possible way to improve demographic estimates in countries where vital registration systems are defective would be to set up a sample of population laboratories where intensive methods of data collection would continue for extended periods.     

Adolescent migration and the 1990s nuptiality transition in Mali

Attempts to explain the rise in women's age at marriage across Africa have focused mainly on determinants in the urban environment, notably women's education and the economic recession. In our study, we examined the migration of adolescent girls as a factor in the transition to a later age of marriage in rural Mali, using an analysis of data from a longitudinal survey conducted over 20 years. The findings show a close correlation between the rise in labour migration and the onset of this nuptiality transition. Continuing changes in marriage patterns include not only its postponement but also a breakdown in the marriage formalization process. Two main mechanisms are documented: a direct one, as migration enables young women to choose the timing of their marriage and is a source of empowerment; and an indirect one, as migration challenges family marriage conventions and contributes to elders disengaging from control over marriage and young people.     

Regional variation in acceptance of Indonesia's family planning program

Indonesia's family planning program is regarded as a major success.Survey data from 1997 reveal that rates of contraceptive use vary dramatically amongIndonesia's 27 provinces, from a high of 67 percent of ever married women currently using contraceptives in the province of North Sulawesi, to a low of 19 percent current users in East Timor and28 percent in Aceh. This study uses both a quantitative analysis of the 1997 Indonesia Demographic and Health Survey, and a qualitative study carried out in July of 2000 to understand regionalvariation. The study identified a small number of factors that show a clear relation with levels of contraceptive use. Media exposure and education are the strongest and most consistent predictors of levels of contraceptive use, and appear to be the surest strategies for promoting family change. But the study also showed that the process of social change is subjectto culturally and historically specific local factors whose presence and importance is difficult to predict. Our study of regional variation in contraceptive use illustrates the range and complexityof obstacles faced by Indonesia's leaders in attempting to forge a single nation fromsuch a diverse and far-flung population. Although the creation of Indonesia in the space of just half a century is a monumental achievement, the project is clearly not yet complete.     

A DEA Approach to Measure the Quality-of-Life in the Municipalities of the Canary Islands

The notion of the quality of life has always intrigued economists, sociologists and other researchers in the area of social science. Since the genesis of the definition of Gross Domestic Product (GDP) as a truthful measure of well-being and economic development, other sophisticated methodologies have been proposed in the literature to measure the quality-of-life (QOL) that extend in a multidimensional way this complex concept. Measuring QOL in municipalities consists in finding a set of comparable attributes that can be weighted by some metric in order to construct a synthetic index. Thus, the narrow vision obtained by a single measure as the GDP, in which differences in the QOL cannot be fully analyzed, is overcome. Based upon a refinement of data envelopment analysis (DEA)—the cross-efficiency method, the current paper develops a synthetic QOL index that is based in 19 partial indicators which present the tradeoffs of different dimension for the 87 municipalities of the Canary Islands in Spain. Marginal rates of substitution are calculated to evaluate the tradeoffs on QOL dimensions. A method is also proposed to determine the scores chart of each municipality which can be used as a tool to policy makers in order to establish a program of improving the ranking position of the municipality identifying the critical QOL factors.     

Gerechtigkeit: Die Wahrheit der Demokratie

It seems reasonable, that Badiou declares, it should be possible to find a fixed point in the universe, from which democracy and social justice could be justified in away to which truth could be attributed. For, the point of departure can only be found in the human life-form. And the human life-form must be understood as a fact. For facts, however, we claim truth. From the truth of the human life-form a second statement of truth can be derived: the constructivity of the social order. This, finally, leads to the postulate of the democratic order of society and its justice. For philosophers it might seem unthinkable to derive a normative postulate from a fact. However, in an epistemological refined thinking in a world that has become secular the procedure is not unavoidable. Furthermore it makes good sense to declare that the human life-form (a fact) demands democracy (a normative postulate).     

Was Hercules Happy? Some Answers from a Functional Model of Human Well-being

The article proposes a functional approach as a framework for the analysis of human well-being. The model posits that the adaptive role of hedonic feelings is to regulate stability and homeostasis in human systems, and that these feelings basically are created in states of equilibrium or assimilation. To regulate change and growth, a distinct set of feelings exists, which may be labeled eudaimonic feelings. Eudaimonic feelings are produced to motivate behavior in challenging environments, when a quick return to equilibrium is dysfunctional, or when accommodation of cognitive structures is needed for a stimulus or event to be perceived as meaningful. It was hypothesized that a trait-like concern for evaluation of outcomes in terms of goodness or badness, referred to as hedonic orientation, will moderate the relation between equilibrium/assimilation and hedonic feelings. The model also includes the concept of eudaimonic orientation, reflecting a stable tendency to get involved in challenging activities and to create and strive after demanding goals. It was hypothesized that a eudaimonic, and not a hedonic, orientation moderates hedonic feelings in challenging episodes. Three different studies gave empirical support to the model.     

The integrative potential of a fertility model: An analytical test

Abstract In an earlier paper a working model of marital fertility was presented.(1) That model grew out of a close study of Becker's economic model for fertility analysis.(2) Becker's model was modified in several respects in order to meet a number of major objections levelled against it by Judith Blake, Deborah Freedman, and others.(3) The purpose of the present paper is to examine how far the model presented earlier can serve as a 'binder' for the interpretative schemes now available in the literature on fertility differentials. More specifically, the objective is to identify the underlying explanatory factors of a number of analytical hypotheses concerning fertility differentials, and to examine whether the factors thus identified can be located in the fertility model presented in the earlier paper.(4) Little attention will be paid to the causal directions, if any, recognized in the hypotheses studied, nor will we attempt to provide a systematic review of empirical findings.     

人口老龄化背景下的养老金危机--基于四维的视角

进入21世纪,人口老龄化作为一种全球性趋势正在给世界各国带来巨大的负担和成本,尤其是老龄化带来养老金的收支不平衡以及养老金模式的不可持续,给养老保险体系带来巨大挑战。而深层次的养老金危机深刻地影响着每个国家的财政收支、经济发展,甚至造成对政府的信任危机。以往的研究一般把养老金收支不平衡作为衡量养老金危机的一个重要标准。这种仅仅注重财务、而忽视其安全、公平和信任等因素的分析不利于我们把握养老金改革的重点,也不利于我们对于我国现行人口政策的反思。本文从养老金的财务、安全、公平和信任四个角度去分析我国的养老金危机,并进一步提出了对未来养老金改革应该要注意的一些原则性问题。     

Inklusion in die Moderne – Zum systemischen Verständnis des ‚Sozialen‘ in der Sozialen Marktwirtschaft

Social inclusion is the market’s blind spot: the number of members of a society that are included in a society through the economy and under what conditions is irrelevant to the logic and functionality of an economic system. It is not, however, possible to lead a reasonably meaningful life—a requisite in our modern age—without any material basis. Accordingly, political measures should be called for when people’s autonomous way of life is threatened by a lack of inclusion in the market and society. Such a political, normative-based, inclusion-seeking solution has already been laid out in the initial concept of the social market economy. This paper aims at showing how the fundamental concern of the social market economy with social issues can be brought up to date within the idea of built-in inclusion thanks to a modern approach to the theory of justice.     

How female education affects reproductive behavior in urban Pakistan

Although Pakistan remains in a pretransitional stage (contraceptive prevalence of only 11.9% among married women in 1992), urban women with post-primary levels of education are spearheading the gradual move toward fertility transition. Data collected in the city of Karachi in 1987 were used to determine whether the inverse association between fertility and female education is attributable to child supply variables, demand factors, or fertility regulation costs. Karachi, with its high concentration of women with secondary educations employed in professional occupations, has a contraceptive prevalence rate of 31%. Among women married for less than 20 years, a 10-year increment in education predicts that a woman will average two-fifths of a child less than other women in the previous 5 years. Regression analysis identified 4 significant intervening variables in the education-fertility relationship: marriage duration, net family income, formal sector employment, and age at first marriage. Education appears to affect fertility because it promotes a later age at marriage and thus reduces life-time exposure to the risk of childbearing, induces women to marry men with higher incomes (a phenomenon that either reduces the cost of fertility regulation or the demand for children), leads women to become employed in the formal sector (leading to a reduction in the demand for children), and has other unspecified effects on women's values or opportunities that are captured by their birth cohort. When these intervening variables are held constant, women's attitude toward family planning loses its impact on fertility, as do women's domestic autonomy and their expectations of self-support in old age. These findings lend support to increased investments in female education in urban Pakistan as a means of limiting the childbearing of married women. Although it is not clear if investment in female education would have the same effect in rural Pakistan, such action is important from a human and economic development perspective.     

Multiple dimensions of attitudes about homosexuality: development of a multifaceted scale measuring attitudes toward homosexuality

Attitudes toward homosexuality are complex. To get a comprehensive view on the attitudes of people, different dimensions need to be included in research. Based on a review of the literature, we distinguish five dimensions: acceptance of homosexuality in a general sense; attitude toward equal rights; reactions to homosexuality "at close quarters"; reactions to homosexuality in public; and so-called modern homonegativity. In a study on a representative sample of Dutch Defence personnel (N = 1,607) we tested this model. Structural equation modeling of several items measuring the attitude toward homosexuality offers a six factor solution. These six factors are more or less comparable to the five dimensions we distinguished. The dimension "reactions to homosexuality at close quarters" is, however, empirically split in a dimension on affective reactions to homosexuality and homosexual persons in general and a dimension on affective reaction to homosexual friends or acquaintances.     

Tolerance at arm's length: the Dutch experience

With respect to pedophilia and the age of consent, the Netherlands warrants special attention. Although pedophilia is not as widely accepted in the Netherlands as sometimes is supposed, developments in the judicial practice showed a growing reservedness. These developments are a spin-off of related developments in Dutch society. The tolerance in the Dutch society has roots that go far back in history and is also a consequence of the way this society is structured. The social changes of the sixties and seventies resulted in a "tolerance at arm's length" for pedophiles, which proved to be deceptive when the Dutch government proposed to lower the age of consent in 1985. It resulted in a vehement public outcry. The prevailing sex laws have been the prime target of protagonists of pedophile emancipation. Around 1960, organized as a group, they started to undertake several activities. In the course of their existence, they came to redefine the issue of pedophilia as one of youth emancipation.     

Effect of Financial Inclusion on Poverty and Vulnerability to Poverty: Evidence Using a Multidimensional Measure of Financial Inclusion

This study examines the effect of financial inclusion on poverty and vulnerability to poverty of Ghanaian households. Using data extracted from the seventh round of the Ghana Living Standards Survey in 2016/17, a multiple correspondence analysis is employed to generate a financial inclusion index, and three-stage feasible least squares is used to estimate households’ vulnerability to poverty. Endogeneity associated with financial inclusion is resolved using distance to the nearest bank as an instrument in an instrumental variables probit technique. Results showed that while 23.4% of Ghanaians are considered poor, about 51% are vulnerable to poverty. We found that an increase in financial inclusion has two effects on household poverty. First, it is associated with a decline in a household’s likelihood of being poor by 27%. Second, it prevents a household’s exposure to future poverty by 28%. Female-headed households have a greater chance of experiencing a larger reduction in poverty and vulnerability to poverty through enhanced financial inclusion than do male-headed households. Furthermore, financial inclusion reduces poverty and vulnerability to poverty more in rural than in urban areas. Governments are encouraged to design or enhance policies that provide an enabling environment for the private sector to innovate and expand financial services to more distant places. Government investment in, and regulation of, the mobile money industry will be a necessary step to enhancing financial inclusion in developing countries.