Risk Compensation or Risk Reduction? Seatbelts,State Laws,and Traffic Fatalities*

Objective. The risk compensation hypothesis suggests that drivers enjoying greater safety will drive more recklessly and thereby impose greater risks on nonoccupants. We provide a test of the risk compensation hypothesis in the context of state seatbelt laws and belt use rates. Methods. Fixed‐effects models with policy and demographic variables are estimated using annual state data from 1985 to 2002 to test the effect of seatbelt laws and seatbelt use rates on logged fatality rates for occupants, pedestrians, motorcyclists, and all nonoccupants in separate models. Results. Contrary to the risk compensation hypothesis, the results indicate that both occupants and nonoccupants enjoy greater safety due to state mandatory use laws and increased safety belt use rates. Conclusion. Overall, seatbelt laws and the higher belt use these laws induce do not increase nonoccupant risk exposure. If anything, these laws and the accompanying increase in belt use result in safer driving behavior.     

Perceptions of and Responses to Stigma

In the last 10 years, interest in the concept of stigma has grown remarkably throughout the social sciences. Today, stigma is an important topic that bridges many disciplines, including sociology, psychology, social psychology, and public health. This literature review primarily addresses perceptions of and responses to stigma from the insider's or target's perspective. The topics examined in this review include the following: defining stigma, public opinion and attitudes toward the stigmatized, measurement of perceptions of stigma and discrimination, the coping strategies employed by stigmatized persons to deal with stigma, the impact of stigma in terms of psychological and behavioral outcomes, explanations of coping strategies and outcomes, and strategies and interventions to reduce stigma. As many of the concerns faced by stigmatized persons are universal, what has been learned in research about one stigmatized group can provide insight into another. Promising directions for future stigma-related research are identified and discussed.     

Wer das Stabilisieren vergisst: Warum eine schöne Abschlusspräsentation noch kein gutes Ende bedeutet

Many organizational change projects fail — despite a well thought out concept, professional project management and a binding implementation timetable. The reason why the expected success doesn’t materialize often lies with the missing maintenance. Once the project is officially completed and the client and project manager withdraw, the manner in which the organization will take up these changes is seldom systematically dealt with. Difficulties often arise when no discrete stabilizing measures are planned. We have derived four central action areas which will be clarified by way of practical examples. It will also be shown what is important to pay attention to in the stabilization phase so that a lasting success of the organizational change project can be ensured.     

NATURAL HEALTH DISCOURSES AND THE THERAPEUTIC PRODUCTION OF CONSUMER RESISTANCE

Social critics of the natural health movement charge that it indoctrinates consumers in a therapeutic consumerist ideology. This "dominated consumer" thesis ignores that socially situated individuals must negotiate a plethora of institutionally specific power structures aiming to classify and govern their identities. Accordingly, resistance toward specific institutional constructions of identity can be produced through marketplace ideologies. I explore this understudied ideological effect by analyzing the narratives of women who are using natural health alternatives to resist their ascribed medico-administrative identities. Natural health's therapeutic ideology enables these women to contest the degenerative implications of their medical diagnoses and, conversely, to reconstruct their chronic illnesses as an opportunity for discovering their inner regenerative potential and expanding their spiritual horizons. This analysis has implications for prior studies suggesting that resistance toward the technocratic and bureaucratic aspects of conventional medicine exemplifies a Foucauldian "care of the self." I argue that a postmodern adaptation of Foucauldian theory is needed to address the complex interrelationships among the care of the self, medical consumerism, and the therapeutic ideology of the natural health marketplace.     

WOMEN'S WORK:

We use in-depth interviews, participant observation, and document analysis to examine women's involvement in the Gulf War Illness movement. We find that women's cumulative grievances of health concerns, financial hardships, and emotional problems opened them to movement recruitment as they surfed the Internet for information and support. The movement's division of labor was influenced not by gender but by health status. Women used the Internet to provide medical information and emotional support to geographically dispersed veterans. Activism transformed women activists by endowing them with a sense of empowerment and a somewhat broadened concern for social justice. Although their transformations disposed the women to become active on related issues, it did not extend to concerns about gender discrimination. We suggest that the next research step is to investigate gender differences in movement processes by surveying activists across a variety of movements to test propositions and to identify the characteristics of other social contexts that structurally instigate a departure from traditional gender roles.     

Dementia Problem Behavior and the Production of Informal Caregiving Services

Informal caregivers of individuals with Alzheimer's disease spend a considerable amount of time providing care. In this paper, we use Grossman's health production and Becker's time allocation models to develop a model of informal care provision to elderly dementia patients. In our model, time inputs produce caregiving services, which provides utility to the caregiver, but reduces leisure. We assume that time is less productive of services on the margin as the disease progresses. In this framework, an increase in patients' disease severity does not necessarily increase informal caregiver time input. The cost of formal care establishes a reservation price for informal caregiving. When the costs of informal caregiving rise above this reservation level, the patient is institutionalized. We test empirically the effect of deterioration in the patients' condition, proxied by both disease severity and dementia problem behavior, on informal caregiving time. We find that dementia-related problem behaviors and functional limitations significantly increase inputs of informal caregiving time. Patients' problem behavior exerts a modifying effect on functional limitations, and patients' comorbidities have no effect on informal caregiving time.     

On the Evolution of Competitive Balance: The Impact of an Increasing Global Search

The Coase theorem maintains that where free-market precepts exist, the allocation of property rights does not impact the distribution of resources. An application to Major League Baseball suggests that institutions such as free agency and the reverse-order amateur draft would not impact player distributions and therefore would not impact competitive balance. The present study finds that the distribution of wins is generally consistent with the precepts of the Coase theorem and therefore suggests a course for those who wish to alter the level of competitive balance: Major League Baseball should increase its focus on expanding the size of its labor pool. (JEL O15 , L83 , C22 )     

私人妨害原则与相邻权、地役权

文章剖析了英美物权法上“使用权”的概念 ,并解释了财产权就像“权利集束”这个常用比喻 ,并对美国普通法上财产法中的有关相邻方之间土地纠纷的法规进行了比较分析 ,其中特别比较了普通法上的私人妨害原则和中国物权法草案第 9章所规定的相邻权的概念 ,并将普通法体系中的各种私人土地使用协议和地役权与中国物权法草案第 16章的内容进行了对比。     

Expectations, Capital Gains, and Income

A theoretical framework for the measurement of income under uncertainty is developed that addresses some long-standing controversies about the treatment of capital gains. The consequences for economic analysis and policy making are potentially serious, because the treatment of capital gains can significantly affect some major macroeconomic aggregates, including national income and savings, balance of payments deficits, government deficits, and depreciation. (JEL O47 , P44 , Q32 )     

Choice of the primary analysis in longitudinal clinical trials

Missing data, and the bias they can cause, are an almost ever‐present concern in clinical trials. The last observation carried forward (LOCF) approach has been frequently utilized to handle missing data in clinical trials, and is often specified in conjunction with analysis of variance (LOCF ANOVA) for the primary analysis. Considerable advances in statistical methodology, and in our ability to implement these methods, have been made in recent years. Likelihood‐based, mixed‐effects model approaches implemented under the missing at random (MAR) framework are now easy to implement, and are commonly used to analyse clinical trial data. Furthermore, such approaches are more robust to the biases from missing data, and provide better control of Type I and Type II errors than LOCF ANOVA. Empirical research and analytic proof have demonstrated that the behaviour of LOCF is uncertain, and in many situations it has not been conservative. Using LOCF as a composite measure of safety, tolerability and efficacy can lead to erroneous conclusions regarding the effectiveness of a drug. This approach also violates the fundamental basis of statistics as it involves testing an outcome that is not a physical parameter of the population, but rather a quantity that can be influenced by investigator behaviour, trial design, etc. Practice should shift away from using LOCF ANOVA as the primary analysis and focus on likelihood‐based, mixed‐effects model approaches developed under the MAR framework, with missing not at random methods used to assess robustness of the primary analysis. Copyright © 2004 John Wiley & Sons, Ltd.