Editorial

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Editorial

Ohne Zusammenfassung

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Why the econometrician is in good spirits: a workshop through the looking glass

Vita brevis, ars longa (or...life is too short for abstracts).

Siege and Response: Reception and Benefits of Residential Children’s Mental Health Services for Parents and Siblings

This paper presents the results of a qualitative study with 29 parents of children who have been in residential mental health care. It examines three main patterns identified by parents: (a) the importance of respite, (b) feeling welcomed and understood, and (c) improved personal and family functioning. It argues that benefits for parents and siblings of placed children deserve equal valuation with the needs of children in residential care and that the processes of achieving such gains are independent considerations from creating systems of care for troubled children or engaging family members in treatment plans for these children.

Can Mediterranean diet really influence obesity? Evidence from propensity score matching

Worldwide obesity rates have stimulated interest in healthy dietary patterns. One well-known dietary pattern is the Mediterranean diet, which has been linked with several beneficial health effects. However, concerns have also been raised regarding the Mediterranean diet’s role in promoting weight gain. We explored the effect of the Mediterranean diet on body mass index using the propensity score matching approach. We found no statistically significant average treatment effect on the treated and therefore cannot confirm that a causal link exists between Mediterranean diet and body mass index.

The quality of life of Palestinians living in chronic conflict: assessment and determinants

This study assessed the quality of life (QoL) of Palestinians living in conditions of chronic conflict and examined its determinants. An adapted World Health Organization quality of life (WHOQoL-Bref) instrument was used in a representative sample of 1,008 adults. Factor analysis and multiple regression were conducted to determine associations between demographic and socioeconomic characteristics and scores of extracted principal determinants, and estimated overall and domain-specific QoL scores. Men, older persons and those less educated reported lower QoL than their counterparts. Negative associations were also found with higher distress and fear levels, and lower financial and freedom status. The chronic and entrenched conflict over generations resulted in lower QoL for the population of the Occupied Palestinian Territory.

How Young People with Disabilities Conceptualize The Body,Sex and Marriage in Urban India: Four Case Studies

Historically in India as elsewhere in the world, there has been a deep-rooted cultural antipathy to persons with disabilities. They have been portrayed as medical anomalies, helpless victims and a lifelong burden for family and society. While today there is a general recognition in India of the need to enhance educational and employment opportunities for persons with disabilities in order to promote economic self-reliance and independent living, their sexual needs, dreams and aspirations are more or less invisible. Sexual and reproductive rights are considered irrelevant for persons with disabilities. Using qualitative data, this paper discusses notions of sexual identity among urban Indian youth through four case studies of college students in Delhi. Gender emerges as a key analytical category in perceptions of sexuality among young men and women with visual and loco-motor disabilities. The paper does not claim to capture the complex reality of disabled sexuality in India, but highlights some key issues in a hitherto largely under-research domain. But the author’s analysis carries added value, since she herself has low vision; thus conferring a reflexive angle to the research.

Choice determinants of the mobility in the Dutch health insurance market

We estimate a Logit model for the choice determinants of the mobility in the Dutch market for health insurance in 2006. The results highlight that socio-economic, geographical, and health-related factors matter in the decision to switch health care insurer. Moreover, previous contact with the insurer and the former type of health policy are also of influence.

Contractual design and PPPs for hospitals: lessons for the Portuguese model

Recently the Portuguese Government announced the launching of public–private partnerships (PPPs) to build hospitals with the distinctive feature that infrastructure construction and clinical activities management will be awarded to separate private parties. Also, one of the parties will be in charge of providing soft facilities. We explore alternative configurations of contracts and assess whether the equilibrium allocations attain the first-best solution.

Maternal Employment and Overweight Among Hispanic Children of Immigrants and Children of Natives

This research examines the relationship between maternal employment and child overweight among fifth grade Hispanic and non-Hispanic white children. Data from the Early Childhood Longitudinal Study Kindergarten (ECLS-K) cohort fifth grade sample (N = 4,360) were analyzed. OLS regression models were estimated predicting percentile BMI as a function of maternal employment, ethnicity, parental nativity status, income, and the interactions of employment, ethnicity/nativity, and income. Among Hispanic children of immigrants, maternal employment is associated with lower percentile BMI and this association strengthens at higher levels of income. Among Hispanic children of natives and non-Hispanic whites, maternal employment is beneficial (i.e. associated with lower percentile BMI) among low-income children but detrimental among high-income children, but this pattern is significantly greater in strength for Hispanics than non-Hispanic whites. Thus, maternal employment is associated with worse health outcomes only in the case of Hispanic children of natives, and maternal employment is associated with the best outcomes for Hispanic children of mothers from high-income families. We speculate that among children of immigrants, maternal employment may signify and/or accelerate assimilation towards middle- or upper-class American values of healthy weight and body size. Diet, meal regularity and supervision, and childcare did not mediate the relationship between maternal employment and overweight.

Ungleichheit in der Mundgesundheit

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Editorial

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Eating and Body Image Disturbances in Male-to-Female and Female-to-Male Transsexuals

The aim of the study was to discover whether persons with Gender Identity Disorder (GID) differed from controls of both sexes and from persons with eating disorders in terms of the degree of eating and body image disturbance, self-esteem, and depression. A total of 88 self-identified male-to-female transsexuals (MtF), 43 female-to-male transsexuals (FtM), 62 females with an eating disorder, 56 male controls, and 116 female controls completed the Eating Disorder Examination Questionnaire, Eating Disorder Inventory, Body Checking Questionnaire, Drive for Muscularity Scale, Rosenberg Self-Esteem Scale, and Beck Depression Inventory. MtF showed higher scores on restrained eating, eating concerns, weight concerns, shape concerns, drive for thinness, bulimia, body dissatisfaction, and body checking compared to male controls, and concerning some variables also compared to female controls. FtM displayed a higher degree of restrained eating, weight concerns, shape concerns, body dissatisfaction, and body checking compared to male controls. Furthermore, participants with GID showed higher depression scores than did controls, whereas no differences concerning drive for muscularity and self-esteem were found. Between MtF and FtM, the only significant difference emerged for body checking, with MtF displaying higher scores. Although it was shown that on these variables the values for persons with GID were lower than for those with eating disorders, these data lead us to speculate that persons with GID might be at a higher risk of eating disturbances. Therefore, the implementation of prevention programs might help persons with GID to avoid developing a clinically relevant eating disorder.

Total costs of injury from accidents in the home and during education, sports and leisure activities: estimates for Norway with assessment of uncertainty

Injury accidents occurring in the home, during educational, sports or leisure activities were estimated from samples of hospital data, combined with fatality data from vital statistics. Uncertainty of estimated figures was assessed in simulation-based analysis. Total economic costs to society from injuries and fatalities due to such accidents were estimated at approximately NOK 150 billion per year. The estimated costs reveal the scale of the public health problem and lead to arguments for the establishment of a proper injury register for the identification of preventive measures to reduce the costs to society.

Knowledge of HIV Risk Factors Among Immigrants in Thailand

This study is based on a sample of 3,374 immigrants from Cambodia and Myanmar who worked in 17 different provinces in Thailand. Many immigrants workers had not even heard of HIV/AIDS before coming to Thailand, but most have received instruction about HIV/AIDS from some source in Thailand, and a large majority are now aware of HIV/AIDS. While immigrant workers in Thailand are fairly knowledgeable about the risk factors for HIV transmission, important gaps remain. Women, persons with less than five years of education, seafarers, agricultural workers, those who do not personally know anyone affected by HIV/AIDS, and those who have not yet received instruction in HIV/AIDS are the ones most likely to have gaps in their knowledge of HIV/AIDS risk factors.

Swings, Hammocks, and Rocking Chairs as Secure Bases During A Day in the Life in Diverse Cultures

We explored a range of familial supports in the development of “strong” young children. We videotaped one full day in the life of each of five 30-month-old girls in Thailand, Canada, Peru, Italy, and the United Kingdom. A social-interactional conceptual framework guided our interpretive methodology. The diverse cultural tools brought to bear by both the child and her caregivers that appeared to enhance robust responses to the vicissitudes of everyday life are illustrated and analyzed as developing foundations of thriving. Toddlers and their caregivers enlisted soothing resources that exemplify microsystemic support that promoted the autonomy and social maturity valued by the families. Such factors appear to be associated with developing psychosocial well-being and resilience.

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Conducting multilevel analyses in medical education

A significant body of education literature has begun using multilevel statistical models to examine data that reside at multiple levels of analysis. In order to provide a primer for medical education researchers, the current work gives a brief overview of some issues associated with multilevel statistical modeling. To provide an example of this technique, we then present a multilevel analysis examining the relationship between two individual-level variables and the “cross-level” interaction between this relationship and a school-level variable. In offering this discussion and example of multilevel modeling, we hope to provide medical educators with a basic introduction to multilevel statistics, including the advantages of utilizing these techniques.