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.     

De Wet en de kansspelen

In the Netherlands all gambling is forbidden except in a few cases specially mentioned in the law. Time and again specialists in probability theory or statistics are called upon to testify as experts in lawsuits against law evaders. This paper discusses the part played by the experts in such legal procedures. It is pointed out that according to Dutch jurisprudence there does not exist an exclusive distinction between games of chance and games of skill. A simple declaration by an expert that a given game is largely based on chance suffices to see the game sentenced as against the law. This and various other related questions are discussed in detail and illustrated by examples taken from personal experience in the courts.     

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.     

Differentiation Among US Colleges and Universities

Colleges and universities in the US differ markedly in their access to economic resources. National data are used here to describe the resulting hierarchy that's reflected in schools' spending on their students, the prices those students pay, and the subsidies they get in consequence. Both historical data and projections based on recent institutional saving suggest that economic disparities among institutions and their students are increasing. In a final section, the paper asks what to make of this: what we can say about the right degree of institutional disparity – whether we have too much, too little, or about the right amount of differentiation.     

Sales compensation governance: the last frontier of corporate reform

The area of sales compensation has remained relatively untouched by recent pressures for compensation reform. This article highlights some of the ways that sales organizations stumble in managing their compensation programs, and why it takes more than a simple tactical fix to address these problems effectively. The authors describe a more structured governance framework that not only identifies and resolves key sales compensation issues, but ultimately safeguards the effectiveness and financial integrity of the sales organization itself.     

Separation of Powers and Appointee Ideology

The traditional view of appointments to executive agencies isthat the president has virtual carte blanche in the selectionof personnel for his "team." Yet many formal models of appointmentsuggest that presidents must accommodate the policy preferencesof senators when making nominations. Several empirical studieshave confirmed that legislative preferences are a significantdeterminant of the ideology of appointees, but these studieshave focused on appointments to the federal judiciary; the researchhas not addressed appointments to executive agencies. Appointmentsto executive agencies from 1936 to 1996 are examined, by employinga special sample of appointees to those positions—thosewho have served in Congress at some point in their careers.For these "bridging" individuals, it is possible to analyzestrictly comparable measures of ideology for the appointees,their nominating presidents, and the senators who voted to confirmthem. A linear regression analysis provides significant supportfor the hypothesis that appointee ideology is affected by variationin the ideological tilt in Congress.     

Does the recent success of some OECD countries in lowering their unemployment rates lie in the clever design of their labor market reforms?

In recent years some OECD countries were successful in loweringthe unemployment rate substantially while other countries werenot. In this paper we investigate to what extent successfulcountries implemented a comprehensive set of institutional reforms.We present a theoretical framework to investigate the relationshipbetween unemployment and labor market institutions (LMI) suchas labor taxes, unemployment benefits, employment protection,union bargaining power and (de)centralization of bargaining.In our empirical analysis of data over the period 1960–99of 17 OECD countries we show that particular combinations ofLMI are responsible for low unemployment rates.