Rural/Urban Differences in Child Growth and Survival in Bolivia

Abstract Using data from a national survey in Bolivia and from a regional sample of poor communities in two regions of Bolivia, we model the effects of community conditions, household characteristics, and social relations on child health as measured by child mortality and stunted growth. Based on national data, children in rural areas are twice as likely to die before the age of two than are children in large cities, and about one‐third of the children in rural areas are stunted. Including measures of community, household, and maternal characteristics accounts for at least two‐thirds of the urban/rural difference in child health. We conclude that expansion of health services, improvements in household and community sanitation, and socioeco‐nomic development are all needed to overcome the rural disadvantage in child health.     

A screening system for tardive dyskinesia: development and implementation.

1. Most diagnosed cases of tardive dyskinesia (TD) are mildly inconvenient to the patient, but some can be severe or life-threatening. The primary goal of intervention should be early identification of abnormal movements related to TD and the prescribing of an appropriate medication regimen. 2. Unless specific training occurs and a specific monitoring system is in place, TD movements may be missed. However, not all movements are necessarily related to TD. 3. Although screening and monitoring are valuable, nothing is more important than prevention. New medications must be developed that do not carry the risk of TD, and other approaches to treat TD must be developed.     

Recurrent pain in college students.

The authors investigated the prevalence of recurrent pain in a college student sample. Of the 1,564 students surveyed, 467 (29%) indicated that they had experienced recurrent pain at an intensity that was mostly in the mild-to-moderate range. Students who reported having recurrent pain were significantly older and more depressed than students who did not indicate they suffered from recurrent pain. Pain intensity was positively correlated (r = .14) with depression among the students who reported having recurrent pain. Implications of the findings for future research, treatment, and health promotion efforts are discussed.     

A SCALE IN SEARCH OF A CONSTRUCT: COMMENTS ON GAVIN AND WAMBOLDT

The article examines some issues raised in Gavin and Wamboldt's (1992) recent study on the Family-of-Origin Scale (FOS) (Hovestadt, Anderson, Piercy, Cochran, & Fine, 1985). The discussion centers on unresolved concerns regarding the validity and utility of the FOS and on unsubstantiated and potentially misleading claims made in the Gavin and Wamboldt article. A case is made for conceptual and methodological precision in the study of family phenomena.     

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.     

Multicultural perspectives on counseling survivors of rape

The dominant Euro-American culture is a rape-prone culture, as defined by Sanday. Within that culture, rape is both a tool and a consequence of interlocking systems of oppression based on race, ethnicity, class, and sexual orientation. The impact of rape on an individual survivor can only be fully understood in the context of the survivor's own culture, religious beliefs, and experience as an immigrant or refugee. Issues of race, culture, class, and sexual orientation influence every step in the counseling of a rape survivor. Knowledge about the client's culture is essential if accurate assessment and culturally appropriate service are to be provided. Specific examples of the impact of these issues are presented. Ways in which the cultural values implicit in the crisis counseling model may conflict with the client's values and needs are examined.     

The Decline of Barriers to Immigrant Economic and Political Rights in the American States: 1977–20011

State governments exercise significant powers to regulate the economic and social activities of resident aliens. We review the laws of the six leading states of immigrant settlement regulating access of noncitizens to 23 occupations, updating existing studies from 1946–77. Citizenship requirements for these occupations have plummeted, a change we attribute to federal court decisions, advisory opinions of state attorneys general, and state legislative and administrative action. There are numerous additional citizenship requirements in the statutes of the six states, although these appear to be poorly enforced. The authority of states to regulate their political communities is the most important remaining constitutionally valid basis of citizenship requirements. States define their political community broadly, leading to questionable exclusions of noncitizens from important activities.     

Valuation of childhood risk reduction: the importance of age, risk preferences, and perspective.

This article explores two problems analysts face in determining how to estimate values for children's health and safety risk reductions. The first addresses the question: Do willingness‐to‐pay estimates for health risk changes differ across children and adults and, if so, how? To answer this question, the article first examines the potential effects of age and risk preferences on willingness to pay. A summary of the literature reporting empirical evidence of differences between willingness to pay for adult health and safety risk reductions and willingness to pay for health and safety risk reductions in children is also provided. The second dimension of the problem is a more fundamental issue: Whose perspective is relevant when valuing children's health effects—society's, children's, adults‐as‐children, or parents'? Each perspective is considered, followed ultimately by the conclusion that adopting a parental perspective through an intrahousehold allocation model seems closest to meeting the needs of the estimation problem at hand. A policy example in which the choice of perspective affects the outcome of a regulatory benefit‐cost analysis rounds out the article and emphasizes the importance of perspective.     

Stress at work and psychological and immunological parameters in a group of Norwegian female bank employees

This study concerned the immunological correlates of stress and work. Self reported stress, emotional state, ego-strength, and defensiveness were examined in relation to measures of cellular immunity (T-cell response to Con A and number of T4 and T8 cells) and humoral immunity (concentrations of immunoglobulins and complement components in plasma) in a group of 96 Norwegian female bank employees. The analyses showed that workload, the stress factor with the highest group mean, was associated with number of T-cells, while strain due to body posture during work was related to concentrations of IgM and C3. Further, depression was significantly correlated with IgM concentration and T-cell number, and anxiety with C3 concentration. T-cell activity was the immunological parameter most consistently associated with psychological well-being, showing positive correlations with defensiveness and ego-strength and negative correlations with anxiety and depression. In conclusion, T-cell number and concentrations of IgM and C3 were sensitive to both work-related stress experience and emotional distress. Coping abilities, indicated by the MMPI Ego-strength scale and emotional distress, were reflected in T-cell activity; insufficient coping was associated with low T-cell activity.