Environmental hazards and the health status of women and children in a riverine community in Nigeria: Nikrowa in Edo State

Nikrowa is a riverine village located in Ovia North-East Local Government Area of Edo State. This paper examines the relationship between the environment and the health status of women and children in the village. Data used in this essay were obtained mainly in focus groups from a study of women and health service utilization in Nikrowa. Women in Nikrowa farm, fish, collect water and firewood, and process and prepare food. They also bear many children. Their hard physical labor causes them to suffer continuous body aches and pains. Environment-related illnesses such as malaria, measles, dysentery, and diarrhea are prevalent among children. The geographical isolation of Nikrowa limits access to modern health care facilities, so traditional therapies are used to treat prevailing illnesses. It is suggested that women have access to fertilizers in order to improve soil fertility and agricultural yields. Fuelwood and adequate and safe water supplies should be made readily available to women. Moreover, access roads to rural areas should be improved to facilitate transport to modern health care facilities, and rural primary health care facilities should be helped to provide efficient services by providing trained staff and ensuring regular supplies of drugs.     

The ascendancy of primary care: permanent or temporary?

The conventional wisdom strongly suggests a health care provider food chain for the future: Primary care physicians (PCPs), principally family practitioners, on the top playing the lead role, distantly followed by specialists, with hospitals and other ancillary services even further down the line. Is this a reasonable expectation? Will PCPs dominate the new systems? Or will they be but one of many equally necessary components of these developing integrated health care delivery organizations? Looking at the various models now developing, it would seem that future integrated delivery systems will utilize both PCPs and specialists, but with strong augmentation from a diverse assortment of other health care professionals, including nonphysician providers, educators, and administrators. To separate the illusion of primary care dominance of the coming health care system from the likely reality, we should first determine what is driving the apparent present demand for primary care physicians. Next, we will examine the possible and probable reactions to that demand from an economic standpoint and from the points of view of both health care professionals and the public. Finally, we must try to picture how health care provider organizations of the future are likely to look and how they will integrate their health care professionals.     

Mirror, mirror on the wall: reflections from failure to establish a truly uniform national health care policy

When the author gazed into the proverbial mirror and asked if the U.S. health care system was the fairest of them all, it shattered. In this article, Thompson tells why the system is broken and what failure to fix it means to physician executives. He suggests that we, as Americans, must reinvent ourselves by realigning our value systems and and stifling our obsession with profit before trying to reinvent health care.     

Nondictatorially independent pairs

Suppose that social welfare function f satisfies the Pareto condition and has complete and transitive values. On a domain satisfying the free quadruple property, if the outcome set X has m< outcomes, then the set of pairs of distinct alternatives on which f satisfies both independence and nondictatorship contains at most the fraction 2/m of all pairs. On a domain satisfying the free six-tuple property, if X is a subset of Euclidean space then the set of pairs on which f satisfies both independence and nondictatorship has Lebesgue measure zero.Campbell's research was financed by the National Science Foundation, grant SES 9209039.     

Home,work and community: skilled international migration and expatriate women in Singapore

While skilled labour migration across international borders is a phenomenon of increasing significance in the age of globalization and an important component in the production of global cities, it has not been given sufficient attention in traditional migration analyses.
Recent research has focused on institutional mechanisms regulating the patterns of skill transfer rather than the individual experience of being part of the international labour circuit. Women, in particular, have usually been relegated to the role of "trailing spouses" and are generally invisible in the migration process.
Using a questionnaire survey and in-depth interviews, this article attempts to reinstate the importance of women's roles by portraying them as active agents who adopt a range of strategies in negotiating the move and coming to terms with the transformations wrought by the move in the domains of home, work and community. It argues that skilled labour migration is a strongly gendered process, producing different sets of experiences for the men and women involved in it.
While international circulation often represents "career moves" for expatriate men, their spouses often experience a devalorization of their productive functions and a relegation to the domestic sphere. As an adaptive strategy, expatriate women often turn to the social and community sphere to reach for grounding in their lives.
The article also points to the diversity of "expatriate experiences": while "western" expatriates tend to recreate a more exclusive world by drawing on strong institutional support, "Asian" expatriates find that they have to navigate much finer social and cultural divides between themselves and the host society.     

Gendered Elements of the Alternative Agriculture Paradigm

Abstract The alternative agriculture paradigm has been a useful device to both define and direct a social movement toward a more sustainable agriculture. But because that paradigm was defined by male movement leaders, it reflects their gendered perspective and may be lacking elements that make it more useful for both women and men. In-depth interviews of women involved in sustainable farming organizations and on family farms experimenting with new practices validated the elements of the Beus and Dunlap paradigm: independence, decentralization, community, harmony with nature, diversity, and restraint, but also suggested the addition of two other elements that the women identified as part of an alternative agriculture vision: quality family life and spirituality. The highly gendered nature of agriculture in the V.S. and Canada, where male identity is highly conflated with the role of farmer in the conventional paradigm, may make it more difficult for men who have just joined the' movement to articulate the aspects of quality family life and spirituality which the women saw as critical.     

Lifestyle Options and Economic Strategies: Subsistence Activities in the Mississippi Delta1

Abstract "Subsistence" and "informal economy" are contrasted in their utility as sociological concepts and their ability to explain a variety of activities in two rural Mississippi Delta communities. Literature on subsistence stresses that the desired outcome of participation is not an increase in income but the social rewards of participation itself. Two underlying dimensions of participation in these activities are documented through the literature and through a confirmatory factor analysis of empirical data: life-style choice and economic strategy. These were constructed into indexes and examined individually and in combination as dependent variables using regressors at the community, household, and individual levels. Community ties were weakly associated with participation in such activities. Whites and those with higher incomes participated more in lifestyle choice oriented activities. Participation in general was statistically related to households needing less weekly income and being of larger size. Potential connections with persistent rural poverty are discussed.     

Power, Politics, and the Framing of Environmental Illness

The medical community, along with other government agencies, has created its own frame of environmental illness. This frame has been generally accepted by the American public. In this paper we discuss framing in general and the factors related to how the environmental illness frame has been constructed and maintained. We offer a brief history of the medical institution and illustrate the frame with its definitions of environmental illness. Qualitative data from a study of Oak Ridge, a contaminated community located in Tennessee, are examined to analyze the consequences of challenging the environmental illness frame. Implications for future research are discussed.