Economic burden of tuberculosis and its coping mechanism at the household level in Pakistan

Despite the availability of free medicines under the Directly Observed Treatment Short-course (DOTS) strategy, the treatment of tuberculosis (TB) still involves high costs that push people into poverty. This study aims to assess the resulting economic burden of TB and examine the coping mechanisms practiced at the household level in Pakistan. A cross-sectional study was conducted at TB centers by interviewing 269 patients. Statistical tests and binary logistic regression were used to explore the relationship between catastrophic health expenditures (CHE) and socio-economic factors. Results show that the incidence and intensity of CHE were higher for households in the lower income-quintile. Several coping strategies were practiced and varied among the different income-quintiles. The independent determinants of CHE were as follows: age >40 years, male-patient, location, earner-ratio, patient as the earner, caretaker visits, treatment delay, and co-morbidity. It is recommended that health policymakers develop post-MDGs TB-control strategies to ensure free TB-services with financial protection around the globe.     

Young adults in the United States and Benin reason about gendered cultural traditions

This study explored emerging and young adults’ reasoning about cultural practices in West Africa. American (Study 1, n = 78, M = 20.76 years) and Beninese (Study 2, n = 93, M = 23.61 years) undergraduates were surveyed about their evaluations of corporal punishment, scarification, and schooling restrictions in conditions where the practices had gender‐neutral or gender‐specified targets. In Study 1, the majority (69%) of American participants negatively evaluated the practices, especially when targets were female. However, the majority (73%) assumed the cultural practices were consensual. In Study 2, the majority (76%) of Beninese participants negatively evaluated the practices, and their evaluations did not vary by gender of the target. Few (10%) Beninese participants assumed the cultural practices were consensual. In both studies, emerging and young adults who initially judged practices positively changed their evaluations with a change in consent.     

Deconstructing maternal sensitivity: Predictive relations to mother‐child attachment in home and laboratory settings

Despite the well‐documented importance of parental sensitivity for child development, there is a lack of consensus regarding how best to assess it. We investigated the factor structure of maternal caregiving behavior as assessed at 12 months by the Maternal Behavior Q‐Sort (Pederson & Moran) with 274 mother‐infant dyads. Subsequently, we examined associations between these empirically‐derived dimensions and child attachment, assessed in the home and laboratory (final N = 157). Three dimensions of maternal behavior were identified, corresponding fairly closely to Ainsworth's original scales. They were labeled Cooperation/Attunement, Positivity, and Accessibility/Availability. Only Cooperation/Attunement consistently predicted home‐based attachment at 15 months and 2 years, and at comparable strength to the overall sensitivity score, suggesting that this construct may be central to sensitivity. At 18 months, compared to their primarily secure counterparts, different types of laboratory‐assessed insecure attachment were associated with different patterns of maternal behavior. Mothers in avoidant relationships (n = 18) were low on Cooperation/Attunement and Accessibility/Availability, but fairly high on Positivity. Mothers of disorganized infants (n = 11) were Cooperative/Attuned but somewhat less Positive toward, and less Accessible/Available to, their infants. A multidimensional approach to parental behavior may facilitate the identification of parenting precursors of insecure parent‐child relationships.