Gender and the 'New Paradigm' of Health

This article provides a critical review of literature on the relationship between gender and the 'new paradigm' of health. An overview of the feminist critique of health is given, from the Women's Health Movement of the late 1960s and early feminist debates about medicalisation, to more recent discussions about structural inequalities between men and women, eating disorders, and AIDS. I then go on to explore the feminist response to the so-called 'new paradigm' of health (an approach that emphasises health promotion, individual responsibility for health, and body-monitoring). Arguments that health promotion initiatives target women and confirm their position as principal guardians of health within the family are considered, as well as literature on the breast cancer awareness campaign. I then explore the growing body of literature on masculinity and health, and its account of the relationship between gender and current ideas about healthiness. Finally, I offer up some suggestions for the direction a new feminist critique of health might take.     

Dementia Problem Behavior and the Production of Informal Caregiving Services

Informal caregivers of individuals with Alzheimer's disease spend a considerable amount of time providing care. In this paper, we use Grossman's health production and Becker's time allocation models to develop a model of informal care provision to elderly dementia patients. In our model, time inputs produce caregiving services, which provides utility to the caregiver, but reduces leisure. We assume that time is less productive of services on the margin as the disease progresses. In this framework, an increase in patients' disease severity does not necessarily increase informal caregiver time input. The cost of formal care establishes a reservation price for informal caregiving. When the costs of informal caregiving rise above this reservation level, the patient is institutionalized. We test empirically the effect of deterioration in the patients' condition, proxied by both disease severity and dementia problem behavior, on informal caregiving time. We find that dementia-related problem behaviors and functional limitations significantly increase inputs of informal caregiving time. Patients' problem behavior exerts a modifying effect on functional limitations, and patients' comorbidities have no effect on informal caregiving time.     

Using the lessons learned from US and English law to create a regulatory framework for charities in evolving democracies

The evolving democracies of Eastern Europe and the former USSR republics are keenly interested in establishing charities. They have little law on this issue because their former governments did not encourage the development of charities. This article compares US and English regulation of charities and proposes a regulatory framework based on what the authors believe are the best attributes of both. Although the framework is based on the common law system, it can be adapted to the civil law systems of the Eastern European nations and the former USSR republics. The article includes such issues as developing a body of law, tax relief and creating a regulatory agency.Mr Hopkins is a lawyer with Powers, Pyles & Sutter, 1275 Pennsylvania Ave., N.W., Washington, D.C. 20007, and author ofThe Law of Tax-Exempt Organizations (1992a).Ms Moore is also a lawyer, 5908 N. 35th St., Arlington, Virginia 22207.The authors would like to thank Mssrs Kersi Shroff and Stephen F. Clarke, Senior Legal Specialists, American-British Law Division, Library of Congress, and Mr. William H. Morris, an attorney at Steptoe & Johnson, Washington, D.C., for their kind assistance during the researching of this article.     

A simultaneous-equations model of the relationship between public sector bargaining legislation and unionization

This paper estimates a simultaneous-equations model with public sector bargaining laws and union membership treated as jointly-determined variables. The extent of public sector unionization has a significant positive influence on the passage of prolabor bargaining legislation and bargaining legislation has strong, independent effects on the extent of public sector unionization. We gratefully acknowledge the research support provided by Minbo Kim and Parisun Chantonahom.     

Dose-Response and Risk Assessment of Airborne Hexavalent Chromium and Lung Cancer Mortality

This study evaluates the dose-response relationship for inhalation exposure to hexavalent chromium [Cr(VI)] and lung cancer mortality for workers of a chromate production facility, and provides estimates of the carcinogenic potency. The data were analyzed using relative risk and additive risk dose-response models implemented with both Poisson and Cox regression. Potential confounding by birth cohort and smoking prevalence were also assessed. Lifetime cumulative exposure and highest monthly exposure were the dose metrics evaluated. The estimated lifetime additional risk of lung cancer mortality associated with 45 years of occupational exposure to 1 microg/m3 Cr(VI) (occupational exposure unit risk) was 0.00205 (90%CI: 0.00134, 0.00291) for the relative risk model and 0.00216 (90%CI: 0.00143, 0.00302) for the additive risk model assuming a linear dose response for cumulative exposure with a five-year lag. Extrapolating these findings to a continuous (e.g., environmental) exposure scenario yielded an environmental unit risk of 0.00978 (90%CI: 0.00640, 0.0138) for the relative risk model [e.g., a cancer slope factor of 34 (mg/kg-day)-1] and 0.0125 (90%CI: 0.00833, 0.0175) for the additive risk model. The relative risk model is preferred because it is more consistent with the expected trend for lung cancer risk with age. Based on statistical tests for exposure-related trend, there was no statistically significant increased lung cancer risk below lifetime cumulative occupational exposures of 1.0 mg-yr/m3, and no excess risk for workers whose highest average monthly exposure did not exceed the current Permissible Exposure Limit (52 microg/m3). It is acknowledged that this study had limited power to detect increases at these low exposure levels. These cancer potency estimates are comparable to those developed by U.S. regulatory agencies and should be useful for assessing the potential cancer hazard associated with inhaled Cr(VI).     

Child‐Care Usage and Mother‐Infant “Quality Time”

Mothers' time‐use patterns were compared in families in which infants spent more than 30 hours per week in child care (In‐Care group; n= 143) versus 0 hours per week (At‐Home group; n= 183) from birth to 6 months of age. In‐Care group mothers spent about 12 fewer hours per week interacting with their infants, for about 32% less time; fathers of these infants were more involved in caregiving. The groups did not differ in the quality of mother‐infant interaction. In the In‐Care group, quantity of interaction was related to greater separation anxiety and concerns about effects of maternal employment. Time‐use data were not related to child outcomes at 15 months of age. Results suggest that the effect of extensive time spent apart on the quantity and quality of mother‐infant interaction may be smaller than anticipated.     

African American Children's Adjustment: The Roles of Maternal and Teacher Depressive Symptoms

This study examined the unique and interactive roles of mother and teacher depressive symptoms in child adjustment in 277 African American single mother‐headed families, as well as whether the associations differed depending on the age and gender of the child. Findings revealed a significant association between maternal depressive symptoms and child depressive symptoms in girls, but not boys. Moreover, the combination of higher levels of both mother and teacher depressive symptoms was associated with the highest level of child depressive symptoms and, for younger children, externalizing symptoms. The importance of considering the multiple social contexts in which children interact is discussed.     

In Whose Backyard?: Concern About Siting a Nuclear Waste Facility*

Proponents of hazardous and nuclear waste depositories label opponents to local siting of such facilities “NIMBYs” (Not In My Backyard). This study assesses the extent to which the NIMBY label and the strategies of industry proponents to reduce opposition function on a reasonable set of assumptions. Using survey data and multiple regression techniques, the levels of concern of residents living in the county selected as the site of a low level radioactive waste disposal facility (imminent threat condition) are compared with a statewide sample (hypothetical threat condition). Consistent with proponents' theoretical assumptions, the levels of concern are greater for respondents under conditions of imminent threat than of hypothetical threat. However, within the host county, levels of concern are lowest, albeit most polarized, in the community closest to the proposed site. A conflict theory approach enhances an understanding of these findings by suggesting that within the most proximate community levels of concern are lowest for citizens who stand to gain the most economic benefits from the facility but highest for those citizens who are least likely to derive tangible gains.     

Outcome Expectations in Prolonged Conflicts: Perceptions of Sense of Control and Relative Deprivation

How do feelings of deprivation and a sense of control influence future expectations on the parts of Jews, Arabs, and Palestinians? We assumed that all non-Jews, but especially Palestinians, are discriminated against in Israel and that awareness of discrimination may have two related effects. First, it may strengthen feelings of relative deprivation among members of the group being discriminated against. Second, awareness of discrimination may lower the sense of control among the disadvantaged, because their life experiences diminish their ability to exercise authority and influence in order to direct and regulate their choices. However, when analyzing expectations, previous studies focused either on relative deprivation or on sense of control, not on both. Assuming that the two are related, we included both to analyze outcome expectations. We also present an alternative approach to sense of control to include an expressive dimension of control in addition to the traditional instrumental dimension. As expected, the findings indicate that Palestinians have the strongest feelings of personal deprivation and the lowest future expectations. Jews feel the lowest personal deprivation and have the highest expectations.     

AN ALGORITHM FOR THE CONSTRUCTION OF OPTIMAL OR NEAR-OPTIMAL CHANGE-OVER DESIGNS

This paper presents an algorithm for the construction of optimal or near optimal change-over designs for arbitrary numbers of treatments, periods and units. Previous research on optimality has been either theoretical or has resulted in limited tabulations of small optimal designs. The algorithm consists of a number of steps:first find an optimal direct treatment effects design, ignoring residual effects, and then optimise this class of designs with respect to residual effects. Poor designs are avoided by judicious application of the (M, S)-optimality criterion, and modifications of it, to appropriate matrices. The performance of the algorithm is illustrated by examples.