A response to “the emotional consequences of physical child abuse” by Annaclare van Dalen

The author responds to the article by Annaclare van Dalen (1989), disputing her statement that there is little in the literature about the emotional consequences of child abuse. The author reviews the pertinent literature, which is abundant. The author disagrees with van Dalen's statement that the child experiences physical abuse outside the body, and with the statement that the child experiences sexual abuse as pleasurable. In addition the author disagrees with van Dalen's sharp differentiation between physical abuse and sexual abuse, and proposes that sexual abuse be regarded as a variant of physical abuse.     

What to Do at Low Doses: A Bounding Approach for Economic Analysis

To quantify the health benefits of environmental policies, economists generally require estimates of the reduced probability of illness or death. For policies that reduce exposure to carcinogenic substances, these estimates traditionally have been obtained through the linear extrapolation of experimental dose-response data to low-exposure scenarios as described in the U.S. Environmental Protection Agency's Guidelines for Carcinogen Risk Assessment (1986). In response to evolving scientific knowledge, EPA proposed revisions to the guidelines in 1996. Under the proposed revisions, dose-response relationships would not be estimated for carcinogens thought to exhibit nonlinear modes of action. Such a change in cancer-risk assessment methods and outputs will likely have serious consequences for how benefit-cost analyses of policies aimed at reducing cancer risks are conducted. Any tendency for reduced quantification of effects in environmental risk assessments, such as those contemplated in the revisions to EPA's cancer-risk assessment guidelines, impedes the ability of economic analysts to respond to increasing calls for benefit-cost analysis. This article examines the implications for benefit-cost analysis of carcinogenic exposures of the proposed changes to the 1986 Guidelines and proposes an approach for bounding dose-response relationships when no biologically based models are available. In spite of the more limited quantitative information provided in a carcinogen risk assessment under the proposed revisions to the guidelines, we argue that reasonable bounds on dose-response relationships can be estimated for low-level exposures to nonlinear carcinogens. This approach yields estimates of reduced illness for use in a benefit-cost analysis while incorporating evidence of nonlinearities in the dose-response relationship. As an illustration, the bounding approach is applied to the case of chloroform exposure.     

The dilemma of recognition: Administrative categories and cultural diversity

Governments around the world combat inequality by means of group-specific redistribution. Some pursue redistribution that benefits groups, but also wish to avoid accentuating or even recognizing group distinctions. This poses a dilemma that they try to resolve by adjusting the category system used to target redistribution. There are three types of adjustment: accommodation (the multicultural approach), denial (the ideal-typical liberal solution), and replacement (a compromise). In replacement the targets of redistributive policies are constructed to avoid accentuation or recognition of inconvenient group distinctions, but still allow redistribution that benefits these groups. Replacement is increasingly in demand around the world because the disadvantages of multiculturalism are becoming apparent while denial is hard to sustain in the face of group inequality. The actual effect of replacement is little researched and less understood, however. Does it resolve the dilemma of recognition? Two examples–India and Nigeria–where replacement has been tried ever since the 1950s cast doubt on its viability.     

Benchmark Analysis: Shopping with Proper Confidence

We discuss the issue of using benchmark doses for quantifying (excess) risk associated with exposure to environmental hazards. The paradigm of low-dose risk estimation in dose-response modeling is used as the primary application scenario. Emphasis is placed on making simultaneous inferences on benchmark doses when data are in the form of proportions, although the concepts translate easily to other forms of outcome data.     

MEANINGFUL REGRESSION AND ASSOCIATION MODELS FOR CLUSTERED ORDINAL DATA

Many proposed methods for analyzing clustered ordinal data focus on the regression model and consider the association structure within a cluster as a nuisance. However, the association structure is often of equal interest—for example, temporal association in longitudinal studies and association between responses to similar questions in a survey. We discuss the use, appropriateness, and interpretability of various latent variable and Markov models for the association structure and propose a new structure that exploits the ordinality of the response. The models are illustrated with a study concerning opinions regarding government spending and an analysis of stability and change in teenage marijuana use over time, where we reveal different behavioral patterns for boys and girls through a comprehensive investigation of individual response profiles.     

National survey evidence on disasters and relief: Risk beliefs, self-interest, and compassion

A nationally representative sample of respondents estimated their fatality risks from four types of natural disasters, and indicated whether they favored governmental disaster relief. For all hazards, including auto accident risks, most respondents assessed their risks as being below average, with one-third assessing them as average. Individuals from high-risk states, or with experience with disasters, estimate risks higher, though by less than reasonable calculations require. Four-fifths of our respondents favor government relief for disaster victims, but only one-third do for victims in high-risk areas. Individuals who perceive themselves at higher risk are more supportive of government assistance.     

Monitoring and evaluation of loveLife's AIDS prevention and advocacy activities in South Africa, 1999–2001

loveLife is the largest effort ever launched in South Africa to change adolescent sexual behaviour with the aim of reducing the rate of HIV infection among 15–20 year olds by 50%, reducing other STIs, and reducing the incidence of teenage pregnancy. loveLife combines high-powered media awareness and education, development of adolescent-friendly reproductive health services, and outreach and support programmes. The 5-year research and evaluation plan includes a multi-year comprehensive observational study, tracking change in a range of behavioural indicators and in sexual health outcomes. In its first 2 years, loveLife reached more than 4 million youth. Sixty-two percent of youth and 59% of their parents/guardians recognize the brand, while the vast majority of parents (97%) and youth (89%) exposed to loveLife, identified loveLife as being positive. Challenges in the next years are the continued roll out of the programme, and the development of institutional support and behaviour change.