Management of premature menopause

There has been some confusion among women and health professionals since the publication of the Women's Health Initiative and Million Women studies about the management of premature ovarian failure (POF). Both studies were undertaken in women aged 50 and over, and cannot be extrapolated to their younger counterparts, who would normally be producing their endogenous estrogen, since they have functioning ovaries. Estrogen-based replacement therapy is the main stay of treatment for women with POF and is recommended at least until the average age of natural menopause (52 years in the UK). This view is endorsed by regulatory bodies such as the Committee on Safety of Medicines (now the Commission on Human Medicines) in the UK. No evidence shows that estrogen replacement increases the risk of breast cancer to a level greater than that found in normally menstruating women, and women with POF do not need to start mammographic screening early unless other risk factors are present, such as family history.     

Restorative Practices and Child Welfare: Toward an Inclusive Civil Society

Child welfare systems in the United States are failing to include families in making plans, and this reduces their success in stabilizing children's placements and promoting children's well-being. A North Carolina study demonstrates how one restorative practice—family group conferencing (FGC)—advances family participation in child welfare planning. A sample of 27 conferences showed that the 221 family group members outnumbered the 115 service providers at the meetings. Family group members were usually satisfied with the conference process and decision and saw the plans as primarily reached through consensus, following a trusted leader, and bargaining. Satisfaction with the decision was reduced when bargaining was employed. Manipulation was more likely to occur when conference preparations were inadequate.     

Defining Community Care: realities and myths

This article looks critically at the concept of community care and argues that it is unhelpful and redundant. It makes three main points: first, that many care settings have elements of institutional and so-called community care and that there is no clear dichotomy between the two. Second, it is argued that the real distinction is not between the institution and the community but is between the institution and home. Community care is not provided by anonymous, altruistic others but comes from specific individuals (usually women) in domiciliary settings. The concept and definition of “home” are briefly discussed and it is suggested that most care is delivered either in a home , from home or at home. The third argument is that careful individual assessment is required to ensure that dependent people are not offered housing or residential solutions when what they need (and want) is care and services.     

Intergenerational patterns of teenage fertility

One of the frequently cited consequences of teen childbearing is the repetition of early births across generations, which thereby perpetuates a cycle of poverty and disadvantage. We use data from the 1988 National Survey of Family Growth (NSFG), Cycle IV, to examine trends and determinants of the intergenerational teen fertility link for women who reached adolescence between the 1950s and the 1980s. We find that daughters of both white and black teen mothers face significantly higher risks of teen childbearing than daughters of older mothers. We also find, more generally, that patterns of teenage family formation (i.e., both marriage and childbearing behaviors) tend to be repeated intergenerationally. The results suggest that the intrafamily propensity for early childbearing is not inherited biologically, at least not through factors related to the timing of puberty. Rather, the intergenerational patterns appear to operate at least in part through the socioeconomic and family context in which children grow up.     

Decomposition of an aggregate measure of income distribution

Aggregate Gini coefficients, which are measures of the inequality of the distribution of income, can be decomposed in terms of types of income, provided the constituent coefficients are defined over family units ordered according to their total income. This decomposition provides a valuable means of examining cyclical shifts affecting income equality. However, other decompositions associated with specific socio-economic or demographic criteria are shown to yield collective expressions which contain both the distributional coefficients for the particular subgroups into which the population is classified, and significant interaction terms. These interaction terms prevent the identification of a clear relationship between the overall distribution of income and the distribution of income for each of the specified subgroups. Further research in this area should focus on distributions within structurally homogeneous groups, using informal procedures for linking these distributions to form impressions of aggregate developments.     

Is Check-In Checking Out?

Abstract

Technological innovations have made changes in library procedures commonplace. Nonetheless, many librarians have been startled by the University of Nevada at Reno's decision to quit checking in print serials. Four serialists address the future of serials acquisitions in light of the technological advances that continue to transform library procedures. Serials Review 2003; 29:224–229.     

Pseudolikelihood ratio test with biased observations

This paper explores testing procedures with response-related incomplete data, with particular attention centered to pseudolikelihood ratio tests. We construct pseudolikelihood functions with the biased observations supplemented by auxiliary information, without specifying the association between the primary variables and the auxiliary variables. The asymptotic distributions of the test statistics under the null hypothesis are derived and finite-sample properties of the testing procedures are examined via simulation. The methodology is illustrated with an example involving evaluation of kindergarten readiness skills in children with sickle cell disease.     

Additive Nonparametric Regression in the Presence of Endogenous Regressors

In this article we consider nonparametric estimation of a structural equation model under full additivity constraint. We propose estimators for both the conditional mean and gradient which are consistent, asymptotically normal, oracle efficient, and free from the curse of dimensionality. Monte Carlo simulations support the asymptotic developments. We employ a partially linear extension of our model to study the relationship between child care and cognitive outcomes. Some of our (average) results are consistent with the literature (e.g., negative returns to child care when mothers have higher levels of education). However, as our estimators allow for heterogeneity both across and within groups, we are able to contradict many findings in the literature (e.g., we do not find any significant differences in returns between boys and girls or for formal versus informal child care). Supplementary materials for this article are available online.