Effects of family planning and health services on women��s welfare: evidence on dowries and intra-household bargaining in Bangladesh

This paper demonstrates how the availability of family planning and maternal and child health services alters the structure of intra-household bargaining. The overall welfare gains from such programs are likely to be large, but when women obtain access to services only through marriage, some of these gains may be partially offset by changes in their bargaining power and in the dowries that they pay their husbands. I examine these marriage market effects using a family planning and health services program in rural Bangladesh, finding that compared to women without program access, women in the treatment area are 35% less likely to be able to make purchases without permission from their husbands or another household member. Moreover, a difference-in-difference specification confirms that women pay 14% higher dowries in order to obtain husbands with access to the program. The fact that adjustments are made both before and within marriage suggests that marital contracts in rural Bangladesh are negotiated along multiple margins.     

Family members' experiences with viewing in the wake of sudden death

Sudden deaths leave families in crisis and interacting with many professionals from notification through to burial. Whether to view the deceased is often central to discussion. Practice guidelines have evolved over time regarding where, when, how, and why viewing should or should not occur. Unfortunately, there is much contradiction in existing recommendations and a marked absence of a supporting evidence base for the practice of viewing itself, and the influence of this practice on the overall bereavement process. Using a qualitative approach, this study explored the perspectives and experiences of the suddenly bereaved with respect to: viewing or not having viewed; whether or not their viewing experiences have impacted on their bereavement process; and explored particular aspects of their experience such as interactions with various professionals. Results of this study are clustered and presented under three core themes: viewing specifics; intrapersonal responses; and professional interactions.     

Becoming en‐wheeled: the situated accomplishment of re‐embodiment as a wheelchair user after spinal cord injury

This paper discusses the creative process of re‐embodiment experienced by physically disabled adults who become wheelchair users. Interviews and observational data of adults (rehabilitation patients and persons living in the community) who use wheelchairs show how they redefine, re‐examine or modify past experiences, abilities, lifestyles and habits in their efforts towards re‐embodiment. The aim of this paper is to document the process of learning to use a wheelchair and making it a part of one's embodied existence. The paper shows that this process involves the negotiation of past and new habits, abilities and ways of doing. It argues against conceptualizing disability as an all encompassing state of being. Rather, the competence and abilities required to achieve wheelchair embodiment are analyzed as a situated accomplishment with social and political consequences.     

Emotional Dysregulation: The Key to a Treatment Approach for Violent Mentally Ill Individuals

Prior research has suggested that psychopathy, substance abuse, and the presence of a personality disorder increase an individual's risk for violence toward others. Substantial clinical literature has established emotional dysregulation as a risk marker for violence toward self. It is hypothesized that emotional dysregulation may be an important component in a constellation of risk markers for violence toward others and may interact with psychopathy and substance abuse in individuals with personality disorders to enhance risk for violence. If these hypothesized relationships exist, it suggests that the development of an intervention approach which directly targets these factors may hold promise. A potential intervention approach based on dialectical behavioral therapy, with case illustrations, is provided.     

Further Evidence for the Use of Career Subtypes in Defining Career Status

Four groups of career-decided students differentiated by the level of comfort they reported with their career choices (Uncomfortable, Somewhat Comfortable, Moderately Comfortable, Very Comfortable) and two groups of career-undecided students differentiated by the level of the problem they perceived their indecision to be (Not Serious, Serious) were compared using three measures of career status and two measures of anxiety. Generally, the results seriously challenge the use of decided versus undecided groupings in defining career status and suggest that many career-decided students may benefit from career intervention. Further investigation of career subtypes, examining both quantitative and qualitative dimensions of career status, is recommended.     

Development and validation of a tool to improve physician identification of elder abuse: the Elder Abuse Suspicion Index (EASI)

This study aimed to develop and validate a brief tool for physician use to improve suspicion about the presence or absence of elder abuse. A literature review on elder abuse, obstacles to its identification, limitations of detection tools, and characteristics of screeners employed by physicians were used to generate elder abuse detection questions for critique by 31 doctors, nurses, and social workers in focus groups. Six resulting questions became the Elder Abuse Suspicion Index (EASI) administered by 104 family doctors to 953 cognitively intact seniors in ambulatory-care settings. Findings were compared to a recognized, detailed elder abuse Social Work Evaluation (SWE) later administered to participants by social workers blinded to the results of the EASI. The EASI had an estimated sensitivity and specificity of 0.47 and 0.75, usually took less than 2 minutes to ask, and 97.2% of doctors felt it would have some or big practice impact. This research is a first phase in the development and validation of a user-friendly tool that might sensitize physicians to elder abuse and promote referrals of possible victims for in-depth assessment by specialized professionals.     

The effect of ergonomic intervention on neck/shoulder and low back pain

The aim of this study was to examine the effect of two types of ergonomic intervention on pain and pain-related disability in the neck/shoulder and low back regions. A cohort of 492 subjects of various occupations with non-specific neck/shoulder or low back pain was followed over a five to six year period. The study subjects were classified into four intervention groups: no ergonomic intervention, educational worksite intervention, workplace intervention, and combined workplace and educational worksite intervention. The group with no ergonomic intervention was used as the reference group. The changes in pain intensity and pain-related disability from baseline to follow-up in each of the three groups with intervention were compared to the changes in the reference group. During the follow-up, 39% of the subjects had received ergonomic intervention. The average change in pain intensity and pain-related disability was smaller in the educational worksite intervention group than in the reference group. The average reduction of pain intensity and pain-related disability did not differ between the two other intervention groups and the reference group. Thus, for subjects still at work, ergonomic intervention seemed to be ineffective for reducing neck/shoulder and low back pain and pain-related disability.