Ending Child Marriage in a Generation: What Research is Needed?

In recent years, the obstacles that child marriage poses to development and to the achievement of the Millennium Development Goals have been widely recognized. Varied responses to the problem have been devised. The number of programs testing different approaches to ending child marriage has grown, and many have been evaluated. We are starting to get a sense of what works and the general areas in which investing in research could make a difference.The purpose of this paper is to identify gaps in the research on child marriage in which additional investment could catalyze change. Much remains to understand about child marriage and how to influence it. By mapping out current knowledge of child marriage and the programs designed to address it, and by highlighting questions to which we do not yet know the answers, the paper is intended to generate discussion in the field and clarify what we need to know to bring an end to this deeply harmful practice.The paper also moves us closer to the development of a shared theory of change for this field: given that many organizations are now working in this area, how can their programs and related research be understood -- aligned -- in such a way that their work feeds into a single theory of change?The research gaps on their own should not drive investments in child marriage. A worthy research mandate must also be driven by programmatic and advocacy needs. The recommended areas for research are not meant to provide a definitive menu, but rather to describe the general contours of what we know and what we need to understand better

The immune response to malaria in utero.

Malaria causes tremendous early childhood morbidity and mortality, providing an urgent impetus for the development of a vaccine that is effective in neonates. However, the infant immune response to malaria may be influenced by events that occur well before birth. Placental malaria infection complicates one quarter of all pregnancies in Africa and frequently results in exposure of the fetus to malaria antigens in utero, while the immune system is still developing. Some data suggest that in utero exposure to malaria may induce immunologic tolerance that interferes with the development of protective immunity during childhood. More recently, however, a growing body of evidence suggests that fetal malaria exposure can prime highly functional malaria-specific T- and B-cells, which may contribute to postnatal protection from malaria. In utero exposure to malaria also impacts the activation and maturation of fetal antigen presenting cells and innate lymphocytes, which could have implications for global immunity in the infant. Here, we review recent advances in our understanding of how various components of the fetal immune system are altered by in utero exposure to malaria, discuss factors that may tilt the critical balance between tolerance and adaptive immunity, and consider the implications of these findings for malaria prevention strategies

Bill Kruskal and the Committee on National Statistics

Discussion of ``The William Kruskal Legacy: 1919--2005'' by Stephen E. Fienberg, Stephen M. Stigler and Judith M. Tanur [arXiv:0710.5063]Comment: Published in at http://dx.doi.org/10.1214/088342306000000394 the Statistical Science (http://www.imstat.org/sts/) by the Institute of Mathematical Statistics (http://www.imstat.org

Data Management Roles for Librarians

In this Chapter:● Looking at data through different lenses● Exploring the range of data use and data support ● Using data as the basis for informed decision making ● Treating data as a legitimate scholarly research produc

The Use of the Get Up and Go Test as the Initial Screening Measure for Fall Risk With Community Dwelling Seniors

Falls represent a sizeable public health issue that has serious health-related consequences for both the individual and the medical system at large. Falls are one of the most common events that threaten the independence of older persons with one third of falls occurring in persons over the age of 65 and over 50% in persons over the age of 80 years (2). During an office appointment, senior adults are screened routinely for blood pressure, weight, medication adherence and lab result follow-up. One assessment that is commonly overlooked is evaluating seniors for fall risk. The purpose of this study was to explore the use of the Get Up and Go test (GUGT) as a routine screening measure for community dwelling seniors. The research questions addressed were: 1) Is self-reported fall history related to GUGT scores in community dwelling seniors? 2) Is age related to the GUGT scores for a sample of community-dwelling seniors?; and 3) Is age related to self-reported fall history for a sample of community-dwelling seniors? Recruitment of community-dwelling seniors occurred during a 3-month period at a primary care office setting in the urban San Francisco Bay area. A convenience sample of community-dwelling seniors (N=39) were recruited to participate in the study. All participants were age 65 or older, did not have a history of cognitive or neurological deficits, and were able to ambulate without the use of an assistive device such as a cane, walker or wheelchair. Participants reported fall occurrences for the last 12 months and performed the GUGT. This study did not find statistical relevance between GUGT pass or fail status and fall history. Two groups of participants are of particular interest. Nine participants with a positive fall history were able to pass the GUGT and 8 seniors who reported no fall history failed the GUGT. Consistent with previous studies (12), one fall does not necessarily signify musculoskeletal or neurological deficits and is usually related to environmental hazards. Furthermore, previous studies have shown that a single fall report is a poor predictor of fall risk and that the number of reported falls by patients is not a reliable number due to the patient under-estimating or under-reporting fall occurrences. These findings suggest that fall history may not be a sensitive measure capable of identifying all at risk seniors. Thus if only fall history is used to identify risk, then some at risk community-dwelling seniors will not be identified while others may be identified by fall history but do not exhibit mobility deficits. The relative ease in which the GUGT was performed, with minimum cost, strengthens the position that the GUGT should be performed as part of an annual examination for patients who are over the age of 65. The GUGT results can then become the sixth vital sign for patients over the age of 65 with the initial GUGT result establishing baseline results for future patient fall risk evaluation. Given this evidence, it can be concluded that at the very least, both fall history and the GUGT test should be performed annually on community-dwelling seniors over the age of 65

Do markets underprice natural - resource commodities?

The author examines the efficiency and equity of a market allocation of exhaustible resources and assesses the behavior of scarcity measures, such as relative price and rental rates. She finds little evidence of scarcity or impending shortage. Indeed, the evidence points to falling prices and rents for many commodities. Do markets send the wrong signals? Are resource commodities systematically underpriced? Her conclusions are not completely optimistic. The authors analysis reveals many market failures, any of which would result in inappropriate resource commodity pricing. But,with one exception, she finds no systematic tendency to underprice. The exception concerns the environmental externalities associated with the production and use of natural-resource commodities. Similar externalities lead to underpricing and overuse of all commodities. Mineral commodities, however, are responsible for a large fraction of the pollution that is currently generated, so their underpricing is particularly significant. The market failures associated with common-property and environmental resources can cause market prices to be lower than shadow prices or marginal values. They cannot, however, cause relative resource prices to fall. Falling prices would be associated with a relaxation of environmental standards and a move away from full-social-cost pricing. The tendency, however, is towards increased awareness of environmental damage and increased willingness to pay for its associated costs. Nevertheless, the prices of many natural-resource commodities have fallen in real terms. Factors causing prices to decrease are not associated with market failure, and therefore do not support interference with the market mechanism. Innovations that lower mining and processing costs, discoveries that increase resource stocks, and the provision of lower-cost substitutes are all features of efficiently operating markets.Environmental Economics&Policies,Economic Theory&Research,Access to Markets,Markets and Market Access,Health Economics&Finance

Environmental costs of natural resource commodities : magnitude and incidence

The carrying capacity of our natural environment is an important unpriced input to production. A consensus is growing that users should pay for the environmental damage that they cause. Although most people can accept this policy in principle, many are concerned with magnitude and incidence of its associated costs and the disruptions that would be created during a transition period. Of particular concern is the burden that might be placed on the economics of developing countries. When the industrial world was developing, it was able to benefit from cheap natural-resource commodities. It is fair to expect countries that are trying to imitate this pattern to pay more? Unfortunately there are not reliable estimates of the effects of environmental protection costs on production, consumption, revenues, and foreign exchange. The author explores these issues for the energy and nonfuel-mineral markets, sectors responsible for much of the current industrial pollution. Using a model, the author, examines the consequences of the developing world adopting the environmental standards of the industrialized world. The author assumes: all producers incur clean-up costs; most adjustment is made through changes in prices and quantities, not through altered trade patterns; and the industrialized world increases its environmental expenditures by the same fraction as the developing world. The author finds that increased revenue resources will more than compensate the average developing country for the costs of pollution control, so no assistance or intervention would be required. This assumes, however, that capital markets are perfect, which is far from the case in many developing countries. These imperfections constitute the greatest obstacle to successful environmental regulation. Loans of subsidies from North to South should be considered. Developing country producers should be given access to credit dollars, prices of imported pollution-abatement equipment could be reduced, or aid could be tied to the installation and maintenance of environmental capital. The author finds that environmental protection costs are small. Compliance costs of roughly three percent of product prices lead to changes in export revenues of less than one percent. The principal reason for this result is that mineral commodity demand and supply are inelastic in the long run. As for the incidence of environmental costs, an environmental"tax"is on average progressive, because low-income countries are typically net exporters of mineral commodities, where as high-income countries are net importers.Environmental Economics&Policies,Economic Theory&Research,Energy and Environment,Health Economics&Finance,Consumption

Five criteria for choosing among poverty programs

The author addresses the issue of how to choose among discreet poverty interventions such as food stamp programs, public works, or small enterprise credit schemes where little formal policy modeling is done prior to decisionmaking. The minimum criteria on which to judge the relative merits of poverty programs are the following. Administrative feasibility. This depends on the detailed designof the program, the level of resources available for administration, and the degree of imperfection that can be tolerated. Political feasibility. This depends on how the program is promoted to the public, how coalitions of supporters or detractors are built, and the relative power of beneficiaries, suppliers, and administrators. Collateral effects on the poverty strategy. How will a safety net program affect, for example, the participants'labor supply, participation in other programs, and receipt of private interhousehold transfers, and how will those changes affect markets and government finances? What will be the net effect on poverty reduction. Potential for targeting the poor. Will the program reach significant number of the poor? How much leakage of benefits will there be to the nonpoor? Tailoring the solution to the problem. The program choice should address the real problem. Where the poor have suffered a loss of real wages rather than a loss of jobs, for example, transfers to the working poor may be more relevant than creating jobs. This criterion may seem obvious, but many proposals seem to ignore it. The author illustrates her main points by applying these criteria to a range of poverty programs commonly used in Latin America. General subsidies of food prices, for example, are administratively and politically feasible and lower food costs to the consumer, but they may distort the economy, harming growth. Food stamps are easy to target to the poor, are fairly difficult to administer, depending on program design, but depending on program design, may encourage the use of schools and primary health care. But there is controversy about whether they encourage dependency and diminish the work ethic.Rural Poverty Reduction,Environmental Economics&Policies,Health Economics&Finance,Services&Transfers to Poor,Safety Nets and Transfers