Improving the contributions of technology assessment to the health care system of the U.S.A.

Summary Based on 14 case studies of highly effective therapies and the reasons they succeeded less frequently than they could, we propose a variety of steps to improve the health care system of the U.S.A. Whatever proposal emerges from current national debates until innovations are shown to be safe and effective, they should not be supported; when slightly better technologies are much more expensive than other good ones we need to consider appropriate choices carefully; simplified billing and bookkeping would reduce our costs; when a technology is rapidly introduced cautionnary measures may be needed; tracking immunization and repairing their omissions requires a new system; educational programs such as seen effective in hypertension should be applied in other areas such as vaccination; in organ transplantation the nation should consider “presumed consent”; our payment system sometimes creates perverse incentives and therefore needs review; and the preferences of the public in allocation of health resources need to be discovered once the public is informed about the issues. Research supported by Andrew W. Mellon Foundation.     

Farmers,the Practice of Farming and the Future of Agroforestry: An Application of Bourdieu's Concepts of Field and Habitus

Abstract Agroforestry, the practice of raising crops and trees together in ways that are mutually beneficial, provides farmers with an alternative to more conventional farming practices. In this paper, we apply Bourdieu's concepts of “field” and “habitus” in an attempt to better understand the practice of farming and the role that agroforestry may have in farming systems. Analysis is based on qualitative and quantitative interviews of farmers and other key informants in two regions, Fox‐Wyaconda Watershed in northeast Missouri and Scott County in southeast Missouri. Within the field of farming, farmers emphasized the importance of economic, family and rental relations. Important habitus considerations include different interpretations of what constitutes farming and what constitutes forestry. Based on Bourdieu's theoretical framework, we offer three alternative paths of social change that may lead to more widespread utilization of agroforestry.     

Classifying At‐Risk High School Youth: The Influence of Exposure to Community Violence and Protective Factors on Academic and Health Outcomes

Using cluster analysis, 789 predominately Latino and African American high school youth were classified into varying academic at‐risk profiles using self‐reported levels of academic confidence, motivation to attend school, perceived family support, connections with teachers and peers, and exposure to violence. Six clusters emerged, 5 of which were identified as “at‐risk.” The clusters were examined in relation to academic stress, health status, grades, and school retention. Exposure to violence was one distinguishing feature of youth identified as most vulnerable, vulnerable, and resilient; however, youth identified as resilient recorded better academic outcomes.     

A (macro) sociology of fear?

A proper sociological approach to fear is of both empirical and theoretical significance in understanding late modern society. Normally fear has been explored psychologically, as one of the emotions, but recently a sociology of emotions has begun to emerge. Furthermore, there have also been attempts to examine fear macro‐scopically, arguing for the existence of a distinctive ‘culture of fear’ in contemporary societies. Furedi's argument to this effect is explored here, suggesting the need for a more systematic theorising of fear in its social contexts. Via an analysis of the elementary characteristics of fear, a model is constructed of the ‘parameters of fear’. This model serves as a guide to the classes of phenomena within which fear is constituted and negotiated. It is also used to further examine the virtues and failings of ‘culture of fear’ approaches to fearfulness in modern societies.     

Regulating Land Development: Local Market Structures and Structured Markets

Current rounds of economic restructuring together with the changing priorities accorded to agricultural production are leading to significant shifts in rural property and tenure relations. This paper analyzes these processes with reference to rural Britain; it reports on empirical evidence collected in the county of Buckinghamshire in southeast England. Two significant types of new rural land development are considered—small-scale industrial units arising out of the conversion of agricultural buildings and golf course developments and their ancillary leisure-based activities. Post-war productionist forms of regulation and particularly established types of agricultural tenure are now being modified by farmers and nonagricultural interests committed to the development of rural land. New demands and market structures are requiring more diversity and flexibility by which land is owned, occupied, and used. These emergent, more flexible macro tenures are based on new sets of social and political alliances between farmers, developers, and local planning systems. Agricultural land is increasingly being viewed as a capital rather than as a productive asset associated with more volatile and regionally defined markets whose regulation is formative.     

Mapping water quality by local scoring

The mean density of bacteria in a water body is commonly monitored using quantal assay. This paper describes the use of local scoring in estimating the spatial distribution of mean density from quantal assay results at a set of point locations. An application to estimating the mean density of fecal conform bacteria in a coastal pond is presented. Model diagnostics based on a parametric bootstrap are also presented.     

Sex differences in nonverbal expressiveness: Emotional expression,personality, and impressions

Sex differences in expressiveness are well documented, but the reasons for and correlates of these important differences are not well studied. A comprehensive set of emotion-relevant personality measures was administered to 40 female and 39 male undergraduate participants, who were also videotaped in three situations: engaging in natural social interaction, describing a past emotional experience, and posing various emotions. Videotapes were judged by sets of naive observers as to emotion communicated and overall impression. Expressive females, who appeared friendly and dominant in social interaction, were found to have a hostile/aggressive personality (but this was not true of males). Expressive females also tended to look angry/disgusted when describing happy and sad experiences. The findings suggest that nonverbally skilled, charismatic women (but not men) may often possess a dominant/aggressive but self-controlled personality, in a new twist on the theory that sex differences in expressiveness result in part from the oppression of women in society.This research was supported in part by an intramural research grant from University of California, Riverside.     

Mitigating disaster losses through insurance

Losses from natural disasters have increased in recent years due to growth of population in hazard-prone areas and inadequate enforcement of building codes. This article first examines why homeowners have not voluntarily adopted cost-effective protective measures and have limited interest in purchasing insurance. It then proposes a disaster-management program which utilizes insurance coupled with well-enforced building codes to reduce future damage. Banks and financial institutions play a key role in this program by requiring inspections of homes as a condition for a mortgage. New forms of reinsurance coverage against catastrophic losses from natural disasters are necessary to protect insurers against potential insolvency from the next mega-disaster.