A role-reversal in the mother-daughter relationship

Psychoanalytic theorists have noted a particular dynamic in the mother-infant relationship in which the emotional needs of the mother predominate. When this situation occurs, the emotional needs of the infant may go unmet, resulting in impaired self-development. Through an integration of the ideas of mainstream psychoanalytic theorists and feminist psychoanalytic thinkers, this paper proposes the idea that, because of the intensity of the mother-daughter relationship, this dynamic may be more prevalent between mothers and daughters than between mothers and sons. A mother-daughter relationship is described in which the mother comes to depend on her daughter for emotional attunement and response, and the mother's selfobject needs predominate. As a consequence, the daughter is unable to develop a cohesive sense of self and experiences difficulty in achieving separation. Two clinical reports are presented to illustrate the way in which this mother-daughter dynamic manifests itself in the patient's life and in the therapeutic relationship. A negative transference dynamic is described resulting from these patient's fear of duplicating their relationship with their mothers in the therapeutic relationship by having to meet the selfobject needs of the therapist.     

TEACHING PROFESSIONAL WRITING TO FAMILY THERAPISTS: THREE APPROACHES

The authors present three educational approaches designed to demystify the writing process and to support better writing skills among family therapists. One framework is an academic course in professional writing, another is a writing seminar for family therapy and physician trainees within a medical school setting, and the third is a 2-hour continuing education writing workshop for family therapists. Each is replicable within a variety of settings.     

WAGE DISCRIMINATION ACROSS ETHNIC GROUPS: EVIDENCE FROM ISRAEL

We investigate wage differentials between ethnic groups in Israel, proposing a new methodology and an illustration based on the latest Israeli census. By using separate wage equations for the various occupations, our methodology allows us to decompose the wage differential into three components: one reflecting human capital differences; one reflecting wage discrimination; and a third indicating occupational segregation. We find that 70 percent of the wage gap is due to segregation, 26 percent to wage discrimination and only 4 percent to human capital differences. Evidence is also found for the existence of duality in the Israeli labor market.     

BIAS IN LIST-ASSISTED TELEPHONE SAMPLES

A number of researchers have suggested list-assisted samplingfor the selection of telephone households to overcome some ofthe operational difficulties associated with the Mitofsky-Waksbergmethods of random digit dialing (RDD). An advantage of a list-assistedmethod of RDD is that an equal probability systematic sampleof telephone numbers can be selected and the variances of estimatesfrom such a sample are usually lower than from a clustered designlike the Mitofsky-Waksberg method. The main disadvantage ofthe list-assisted method is that it excludes some householdsfrom the sample, thus creating a coverage bias in the estimates.This article describes research on the coverage bias for a particularmethod of list-assisted sampling. The two key determinants ofcoverage bias are the proportion of households that are noteligible for the sample and the differences in the characteristicsof the covered and not covered populations. The results showthat about 4 percent of all households are excluded in nationalsamples using this method of sampling. Furthermore, they showthat the differences between the covered and uncovered populationsare generally not large. The coverage bias resulting from theseconditions may often be small.     

The arithmetic of growth: Methods of calculation

This is a tutorial on the relations between population data and the rates of growth that are calculated from the data. For the calculation of rates of growth, discrete and continuous compounding will be compared so that the reader can see the reasons for using the mathematics of continuous compounding, which is the mathematics of exponential growth. Some properties of exponential growth are developed. Semi-logarithmic graphs will be discussed as a device for representing the size of growing populations and for analyzing the nature of the growth. Illustrative examples will be worked out in order to emphasize applications and utility.     

Migration Patterns and Remittance Transfer in Nepal: A Case Study of Sainik Basti in Western Nepal

International labour migration is a main livelihood strategy for many people in Nepal. This article analyses the migration process from the perspective of migrants and their non‐migrating household members, exploring the institutional regulations that structure the organization of migration and the cash flows involved. The results are based on a case study conducted in Sainik Basti, Western Nepal, in 2002. The article shows that for different destinations there are specific ways of organizing migration. These country specific ways of organizing migration demand specific assets from prospective migrants and their household members and, therefore, influence their choice of destination. Savings are remitted back home mainly by carrying them personally or by using the hundi system. In spite of the risks and difficulties involved, international labour migration often contributes to sustainable livelihoods. The main outcomes of migration are increased financial capital, education of the children, migration‐specific knowledge, and increased social capital. This enlarged asset endowment lowers both investment costs and risks involved in migration, and thereby increases its potential net return. Each act of migration, therefore, facilitates and stimulates subsequent migration.¹     

Multiparameter evidence synthesis in epidemiology and medical decision-making: current approaches

Summary.  Alongside the development of meta-analysis as a tool for summarizing research literature, there is renewed interest in broader forms of quantitative synthesis that are aimed at combining evidence from different study designs or evidence on multiple parameters. These have been proposed under various headings: the confidence profile method, cross-design synthesis, hierarchical models and generalized evidence synthesis. Models that are used in health technology assessment are also referred to as representing a synthesis of evidence in a mathematical structure. Here we review alternative approaches to statistical evidence synthesis, and their implications for epidemiology and medical decision-making. The methods include hierarchical models, models informed by evidence on different functions of several parameters and models incorporating both of these features. The need to check for consistency of evidence when using these powerful methods is emphasized. We develop a rationale for evidence synthesis that is based on Bayesian decision modelling and expected value of information theory, which stresses not only the need for a lack of bias in estimates of treatment effects but also a lack of bias in assessments of uncertainty. The increasing reliance of governmental bodies like the UK National Institute for Clinical Excellence on complex evidence synthesis in decision modelling is discussed.