Differentials in Adult Mortality and Activity Limitation by Years of Education in the United States at the End of the 1990s

This study examines mortality differentials and health disparities between educational groups within the 1998 adult population (ages 25 and older) in the United States. Mortality differentials are measured using average life expectancy and health disparities by expected years without activity limitation. The results indicate that for both sexes, higher education is associated with higher life expectancy. Those with higher levels of education also have higher life expectancy without activity limitation. Adults with higher education can also expect to enjoy a greater percentage of their expected lives free of any form of activity limitation. At each level of education, adult females have a higher level of activity limitation compared to adult males. At the same level of education, adult females expect to enjoy smaller percentages of their remaining lives free of activity limitation compared to adult males of the same age.     

The Infirmary as a Short-Term Psychiatric Facility

Abstract

The purpose of this study was to describe the role of the Oregon State University Infirmary (inpatient unit) in the provision of crisis intervention services for students with emotional problems. The focus was on the working assumptions of the infirmary program, the patient population which utilized the infirmary, the dimensions of treatment, and treatment outcomes.

Data were collected for a three year span on all patients who had contact with the infirmary for problems of an emotional nature. Records were reviewed for demographic variables, presenting symptomatology, diagnosis, treatment, disposition, and outcomes. Comparisons were made between these patients and those who received outpatient services through the Oregon State University Mental Health Clinic.

Demographic data indicated that patients who were treated in the infirmary differed only slightly from either the general student population of the university or from students receiving outpatient services. Presenting symptoms reflected a wide range of emotional problems. The severity of psychopathology was demonstrated by the finding that one-quarter of the patients manifested symptoms of acute psychosis, suicidal preoccupation, acute drug reaction, or toxic alcohol reaction. Consistent with the working assumptions of the program, the focus of treatment was short-term, intensive, and symptom directed. Treatment outcomes as determined by followup data were generally positive.

It was concluded that the infirmary provided an important treatment option which extended rather than duplicated outpatient services. The need for such an option was clearly demonstrated. The study was supportive of the concept that a university infirmary has the potential for utilization as a multipurpose facility.     

Patients' Evaluations of Gynecologic Services Provided by Nurse Practitioners

Abstract

The development, operating principles, and users' evaluations of a broad-based gynecologic program emphasizing effective birth control on a university campus are discussed. A major feature that is explored is the use of nurse practitioners as the primary service providers. The forces that resulted in the formation of the program and the methods used to enhance its effectiveness are described. The evaluations of 3,527 users over a three-year period are indicated by summarizing responses to a questionnaire covering the following topics; whether providing such a service was helpful, likelihood of arranging for the service elsewhere if unavailable at the health center, attitudes of staff, medical procedures used, availability of services, and the opportunity to thoroughly discuss concerns. The evaluations were seen as extremely supportive of both the program and the use of nurse practitioners in this setting.     

Bargaining Solutions as Social Compromises

A bargaining solution is a social compromise if it is metrically rationalizable, i.e., if it has an optimum (depending on the situation, smallest or largest) distance from some reference point. We explore the workability and the limits of metric rationalization in bargaining theory where compromising is a core issue. We demonstrate that many well-known bargaining solutions are social compromises with respect to reasonable metrics. In the metric approach, bargaining solutions can be grounded in axioms on how society measures differences between utility allocations. Using this approach, we provide an axiomatic characterization for the class of social compromises that are based on p-norms and for the attending bargaining solutions. We further show that bargaining solutions which satisfy Pareto Optimality and Individual Rationality can always be metrically rationalized.     

Reacting to the Uncooperative,Severely Disturbed Student: A Survey of Health Center Policies

Abstract

All members of the Pacific Coast College Health Association were surveyed to determine their policies for evaluating and restricting the attendance of severely disturbed students who were not cooperative with mental health intervention.

One hundred of the 135 institutions returned questionnaires. Fifty-eight percent of the respondents reported that they medically exclude or otherwise restrict students due to their emotional condition. Privately funded schools were more likely to restrict than were tax supported schools. The more residential the campus, the more probable the students were to be restricted. The mean number of students excluded during one academic year was 3.15 (range = 0–25). Despite general recognition of the difficulties involved in responding to uncooperative, severely disturbed students, only 7% of the restrictive schools had written policies which detailed the procedures to be followed when considering restricting students for mental health reasons.

The need to develop clear procedures which respond to the needs of the students as well as the institutions was emphasized.

“Acquired Immune Deficiency in Haitians: Opportunistic Infections in Previously Healthy Haitian Immigrants,” JEFFREY VIEIRA, et al. We describe acquired immune deficiency manifested by opportunistic infections in 10 previously healthy heterosexual Haitian men. The opportunistic pathogens included Toxoplasma gondii (in four patients), Cryptococcus neoformans (in one), Pneumocystis carinii (in four patients), and Candida albicans (in three). Six of the patients also had Mycobacterium tuberculosis. Immunologic studies of three patients showed a decrease in the numbers and activity of helper T cells, with normal or increased populations of supporessor T cells. Serologic markers for previous infections from hepatitis A, cytomegalovirus, and herpes simplex virus were detected in several patients. Six of the patients died despite specific antimicrobial therapy. The clinical and immunologic findings in these 10 Haitians are similar to those reported in drug addicts and homosexuals with the acquired immune-deficiency syndrome.     

Pensions as a portfolio problem: fixed contribution rates vs. fixed replacement rates reconsidered

Pay-as-you-go (PAYG) pension schemes can contribute to better intergenerational risk-sharing and diversification. However, different variants of PAYG schemes entail different properties in these respects. In a stochastic 2-OLG model we compare PAYG schemes with fixed contribution rates and such with fixed replacement rates. The literature has shown that the former are preferable to the later from an ex ante perspective. We derive the opposite result for the ex post perspective. Here, schemes with fixed replacement rates are unambiguously preferable: they enhance intergenerational risk-sharing, lead to a higher savings and higher utility levels. We further show that, from an ex ante (veil-of-ignorance), perspective both schemes are non-comparable if the effect that fixed-replacement schemes serve as an insurance device for old-age income is properly accounted for. Received: 7 December 2000/Accepted: 17 May 2001     

Portfolio allocation and asset demand with mean-variance preferences

We analyze the comparative static effects of changes in the means, the standard deviations and the covariance of asset returns in a standard portfolio selection problem when investors have mean variance preferences. Simple and intuitive characterizations in terms of the elasticity of risk aversion are provided.