Breastfeeding versus infant formula: the Kenyan case

An Infant Feeding Practices Study (IFPS) in 1982 in Kenya, which included a cross-sectional survey of a weighted sample of 980 low and middle income Nairobi mothers who had given birth in the previous 18 months, found that most women breastfeed their infants for long periods, but many introduce alternate feeding, especially infant formula, in the 1st 4 months (86 and 50% of the infants were breastfed at 6 and 15 months respectively, but 50% of the 2 month-olds and 63% of the 4 month-olds were receiving substitutes, mostly formula). This is done largely out of the belief that infant formula is an additional health benefit. A workshop to discuss the findings of the IFPS and other available data, and to make policy recommendations urged the adoption of a policy of protection, support and promotion of breastfeeding. Since breastfeeding is already widely prevalent in Kenya, protection of breastfeeding should receive the 1st priority in policy related to infant feeding. Attention should be directed at at least 2 influences which help undermine breastfeeding: widespread availability and promotion of breast milk substitutes. Support for breastfeeding is viewed as the 2nd policy priority. Situations where support can play a helpful role are, women's paid employment outside the home, hospital practices, maternal morbidity, and difficulties in breastfeeding. Since promotion is the least cost effective of the 3 options, and most Kenyan women are already motivated to breastfeed, this should be the last priority. Promotion includes reeduction of mothers to make them better aware of the benefits of breastfeeding. The workshop recommended the dissemination of appropriate information, consisting of standarized messages based on clearcut guidelines, using mass media techniques.     

Prostate cancer: a review of common underwriting problems, Part 1

Part 1 of a two-part discussion of Prostate Cancer from an underwriting perspective, covers the epidemiology and screening for prostate cancer. Included is a "Primer on Screening Tests" that discusses problems with digital rectal exam (DRE) and prostate specific antigen (PSA) as screening tests. Approaches to enhancing the use of PSA for screening including age and race specific ranging, PSA density, PSA velocity, free PSA, and complexed PSA are discussed. Arguments for and against the use of PSA for prostate cancer are presented. The widespread use of PSA testing in the insurance setting is contrasted with cautious statements concerning general use of PSA in the clinical preventive care setting. In a future issue, Part 2 will cover staging and follow-up of treated prostate cancer.     

SCIENCE AND HOME ECONOMICS IN THE NINETEENTH CENTURY

Scientists played an important part in the formative years of the nineteenth century when Home Economics was evolving into a coherent discipline. The paper considers the lives and works of six scientists from both sides of the Atlantic: Count Rumford, J. C. Buckmaster, W. Mattieu Williams, E. L. Youmans, Ellen Richards and W. O. Atwater. One connecting theme is in the quality of their advocacy of scientific applications in everyday affairs.     

TOWARDS PRACTICAL GUIDELINES FOR MULTIPLE USE MANAGEMENT*

The general acceptance of multiple use as a desirable management goal has not been matched by practical guidelines to implement and achieve that goal. As Pearse [5] rightly noted, the most serious obstacles to applying multiple use principles are usually the lack of appropriate data and lack of established methodology. This study did not face prohibitive problems in valuing extra-market goods, but as with all multiple use studies, it did face the problem of applying the standard economic model of the multi-product firm. It is hoped this particular empirical application of the model contributes generally to the provision of guidelines for multiple use management.     

America's need for an ‘Ethical Renaissance’

Remember the words of Cain, “Am I my brother's keeper?” God said to him that “his brother's blood cries out from the ground”. What do these words suggest for the role of government? I assert that there is an ethic of accountability, caring and sharing fundamental to individual and corporate life. Creation was provided for all humanity. Until we can grasp a global view of resource stewardship we cannot begin to consider wise utilization. The goal must be an ethical renaissance that will bring security more effective than any military force.     

The Deterrence Effect of Law Enforcement: An Evaluation of Recent Findings and Some New Evidence

Abstract . Six attempts to measure the deterrence effect of law enforcement on certain criminal activities, as well as one by the author, have produced no clear, unequivocal evidence to support the belief that increased public expenditures on law enforcement have a deterrent effect on such activity. Yet the effect may exist. Further research into the measurement of the variables crime and enforcement and upon the nature of the relationship between them must be carried on before definite conclusions can be reached about the existence of the deterrence effect.     

A WHEAT POLICY FOR THE SEVENTIES*

A study of the origins of the wheat surplus problem in Australia suggests that more far-reaching adjustments in national wheat policy are required than those currently envisaged. Ten specific recommendations for the reform of the present policy are outlined. A new form of income stabilisation scheme is proposed.     

On the optimal choice of capital intensity in LDCs with migration

"Sen's classic work on the choice of capital intensity of investment is generalized in the light of new theoretical developments and empirical findings concerning rural-to-urban migration in LDCs. This is done by explicitly incorporating a migration function into the basic choice model. Revised conditions for maximization of surplus are derived and compared with Sen's original condition. Some justification for the particular migration function used in the presence of risk-aversion is suggested."     

The legal challenge to ERISA preemptions

Managed care, once celebrated as a vehicle to halt the increasing cost of health care, has come under increasing fire from patients and health care providers, accused of cutting costs and managing care at the expense of patients. The Employee Retirement Income Security Act of 1974 (ERISA) has been a shield for managed care organizations (MCOs), buffeting them from liability for quality-of-care issues. Lawsuits and legislation are chipping away at the protective shield of ERISA as MCOs find themselves more liable for their decisions and for the care provided by physicians with whom the MCO contracts and provides financial incentives for controlling cost of medical care.     

Reputation Effects in Trading on the New York Stock Exchange

Theory suggests that reputations allow nonanonymous markets to attenuate adverse selection in trading. We identify instances in which New York Stock Exchange (NYSE) stocks experience trading floor relocations. Although specialists follow the stocks to their new locations, most brokers do not. We find a discernable increase in liquidity costs around a stock's relocation that is larger for stocks with higher adverse selection and greater broker turnover. We also find that floor brokers relocating with the stock obtain lower trading costs than brokers not moving and brokers beginning trading post‐move. Our results suggest that reputation plays an important role in the NYSE's liquidity provision process.