Medical care, living conditions, and children's well-being

We examine the effect of medical care and living conditions on children's physical and psychological well-being. We develop a causal model in which living conditions (including the socioeconomic status of the family and the social-psychological aspects of family functioning) may affect well-being both directly, and indirectly through medical care. We find that families in the higher social classes and families that function well tend to go to large prepaid groups where they receive good medical care. High quality technical care of illness, in turn, improves physical health. The quality of psychotherapeutic care, on the other hand, has no effect on psychological well-being. For this aspect of health, the effect of living conditions is largely direct, rather than indirect by way of medical care. Families characterized by high levels of functioning have children who are psychologically healthy. In addition, physical health affects psychological well-being, but not vice versa.     

The four-parameter logit life table system

Summary Brass's model life table system, which is a two parameter system based on the logit transformation of survivorship values, has been widely and successfully used to describe age patterns of mortality in many populations. As more reliable information has become available for populations with mortality patterns which differ in important ways from the assumed standard pattern of mortality, a more flexible model system is needed. This paper shows how Brass's system can be expanded into a four-parameter model, and evaluates the performance of the new system by examining how well it can fit observed life table data.     

The Decline of marital fertility in Japan

Summary Studies concerning the demographic history of Tokuwara and Meiji Japan suggest that fertility rose substantially before declining during the twentieth century. Were the motivations and circumstances which held down natality during the feudal period similar to those which account for the modern fertility decline and the low birth rate obtaining in the Japan of to-day? The thesis of this paper is that the pre-modern situation was fundamentally different from the modern one. During the Tokugawa era infanticide and abortion were used, independently of parity, to eliminate weak offspring whose chances of survival were deemed poor. Desired natality generally exceeded natural fertility. With the rise of income per head during the Meiji period the population's need for these desparate practices vanished. To-day parity-specific control characterizes fertility. Parityspecific control was diffused throughout Japan in response to declining desired fertility. Desired fertility fell significantly below natural fertility sometime during the late nineteenth or early twentieth century and the wish to reduce actual fertility to the desired level stimulated the adoption of parity-specific control. The speed of decline in marital fertility was partially governed by official policies toward contraception and abortion, contraception and abortion.     

The management of offshore resources—Some implications of the 200-mile limit

This article examines in depth the strategic implications for those States who have recently declared 200 mile off-shore resource management zones. The authors, in a comprehensive and stimulating paper, examine the implications of so-calling a nation's offshore limit. It is an appropriate name for a nation's offshore limit since the primary reason for many nations declaring a 200 mile limit has been the abundance of resources which have often been found within those limits either in the sea or the sea bed itself. This paper reviews the current background of off-shore resource management and outlines suitable roles for adoption by the coastal States in the management of their off-shore renewable and non-renewable resources. Furthermore, it examines the contentious but nonetheless central issue of the benefits and costs which accrue through coastal state jurisdiction. The authors also examine an appropriate resource management process and the implications of resource use conflicts within the off shore limit as well as defining these conflicts on the basis of ‘stakeholder’ interests and introduces a new concept of the maximization of economic equity amongst competing stakeholders. The problem remains that the measurement of economic equity perhaps leaves the States concerned within a situation of only having defined the problem; the political process has then to deal with any reallocation measures that may be deemed appropriate.     

Health education evaluation and beliefs and practices in rural Tamil Nadu

This paper reports the findings of 2 studies in North Arcot District of Tamil Nadu, one of which was an evaluation of health education programs. A wide range of information is made available on the local Tamil names for allopathic diseases, their etiology, beliefs related to preventive and curative practices, significance and medical consequences of recourse to doctors and practitioners of indigenous systems of medicine. The attitude survey covers a variety of topics about which not much is known -- immunization, sanitation, environment, antenatal care and allopathic medicine. The data suggest that allopathic treatment is preferred for most diseases, although traditional or spiritual methods continue to be used for certain diseases, many of which are believed to be the cause of infant and child mortality.     

The solipsist patient

The aim of this paper is to widen the clinician's understanding of a narcissistic type, the solipsist (one alone with the self) who is treatable because he or she is the healthiest of narcissists yet a challenge to psychotherapy because the solipsist allows no one to be with him or her. Countertransference is discussed as a primary factor for the therapist to understand and control. The handling of the transference is seen as the key to therapeutic success and is illustrated by case examples.