Update on medications for the treatment of anxiety

It is interesting to note that antidepressants are widely represented in the medications used to treat the anxiety disorders. This has led to speculation about the role of depression, particularly subclinical forms being manifested as anxiety disorders. The specificity of diagnostic categories suggests that, at least for the moment, medications have a very specific and circumscribed role in the treatment of anxiety. This suggests that the difficulties of many anxious patients are not effectively treated with medication or that medication has only a short-term role at best. The next column will review health problems associated with psychotropic treatments for anxiety and discuss strategies for creating a "wedge," ie, introducing adjunct learning experiences along the anxiety gradient in conjunction with pharmacotherapy.     

International law and human rights: trends concerning international migrants and refugees

Not with standing human rights linkages, migrants and refugees are often on the periphery of effective international protection. State sovereignty and self-regarding notions of community are used to deny or dilute substantive and procedural guarantees. Recently, even non- discrimination as a fundamental principle has been questioned, as has the system of refugee protection. This article located both migrants and refugees squarely within the human rights context, contrasting both inalienable rights with the demands of sovereignty, and juxtaposing the 2 in a context of existing and developing international standards. Migration and refugee flows will go on, and the developed world, in particular, must address the consequences - legal, humanitarian, socioeconomic, and cultural. Racism and institutional denials of basic rights daily challenge the common interest. This article shows how the law must evolve, responding coherently to contemporary problems, if the structure of rights and freedoms is to be maintained.     

Migration and development: myths and reality

Recent research on the impact of labor migration on the socioeconomic development of developing countries has provided opportunity to try and resolve some of the long-standing polemics that have pervaded the literature on migration and development. This article focuses on findings concerning the labor, remittance, and social impacts of emigration on countries that have participated in labor emigration. While a great deal more research needs to be done, recent findings confirm that in some situations the sort-term impacts of labor migration on sending countries have been considerable.     

The right to life

In this issue is a lengthy, thought-provoking essay on the issues raised by unwanted pregnancy. Written by Robert Wennberg in 1984 for the Christian Scholar's Review (13:4), the article has been edited and condensed for our purposes and is quite relevant, I believe, for the student health population. Any practitioner who cares for students wrestling with these issues should at least acknowledge the moral and philosophical dilemmas presented. As one who has walked both sides of the argument, I find Wennberg's fair-mindedness compelling. In closing his article, the author raises the question of what will happen when it becomes possible to accomplish an "abortion"--or removal of the fetus from the mother--without killing the fetus. Will this procedure be acceptable to the average single college student? The New York Times, in an article on "High Tech Babies" (February 21, 1986), raised ethical questions posed by the technology of frozen embryos. Who decides what is to be done with frozen embryos? To whom do they belong? Do they have rights? The theoretical issues raised by Wennberg are already forcing themselves upon us. Whether we like it or not, the future is now. Regardless of your beliefs on this controversial topic, I urge you to read this article. Dr. Wennberg has also just completed a book on this subject, Life In The Balance.     

Demographics: people and markets

The basics of demography are now basic to us business as well. Demographics combine demographic data with socioeconomic and geographic factors to help business and other managers know the market for their goods and services. This pamphlet explains market, product, and site analyses, discusses data sources and resources, and includes case studies involving major corporations. Post-war population trends have had an enormous impact on consumer and labor markets, bringing home to business the importance of taking advantage of demographic shifts. Advances in computerized access to data describing changes and increased consciousness of their economic significance has spurred the application of demographic knowledge by managers and the growth of the demographics information industry. The pamphlet describes the resources and methods of demographics including the creation and use of demographic data products.     

The effects of the age and structure of population on family change]

The age structure of a population is one basic factor of population research. It is not only affected by birth, death, immigration, and marriage, but it also reflected in changes of family size. The article analyzed it from two aspects: (1) the age structure of population acts on the size and structure of the family. The younger the age structure, the larger the family size. Otherwise, it is the opposite. According to the 1982 census, 35.4% of the population was 0-14 years in rural areas, and average family size was 4.6; but in urban areas 26.0% of the population was 0-14 years and family size was 3.9. The family was characterized as a nuclear family as industrialization in economic development increased and the population aged. In the 1982 census, 64.7% were nuclear family and 6% were aging population in China. Three- generation families (or more) have decreased dramatically. The change of family size and structure is affected by change of internal family age structure. The younger population (0-14 years) is dependent and 90% live with their parents. The adult population (15-59) years are more affected by marriage, birth and social economic action. Families are established in this age period and give much more effect to fertility. The aging population (over 60) years is facing changes. They appear to be a "Defect" family because the wife or husband has passed away. They change from independent to dependent. 78.3% population over 60 years were dependent on children or social welfare, only 21.7% were independent according to the survey in Beijing Changping County.     

Problems and possibilities of development work among tribals: a participatory evaluation of a voluntary agency in India

Mandal, a church-related non-governmental voluntary agency operating in north-west India's Nasik district since 1966 was evaluated for performance in promoting self-sustaining economic growth and socio- political awareness in its beneficiaries. The research design incorporated 2 questions, the extent to which Mandal had used the integrated approach, and the extent to which it promoted structural change in the village. 2 levels of analysis were used: random samples of 315 individuals (163 beneficiaries and 152 non-beneficiaries) and data from the takatu's office for 20 involved villages and 8 control villages. Quantitative data were sought by examining files and doing closed interviews, and qualitative data were collected by observation and open-ended interviews. The variables used in the analysis were educational level, class category, caste, agricultural investment, family net income, individual consciousness and social participation. It was concluded that on the individual level some positive impact was discernible in terms of family income and agricultural investment. At the village level no quantitative improvement was measurable, but the effect of Mandal was symbolic in that it sets an example for social change. The Mandal has acquired a health, non-partisan secular image for social action.