Population Pressure and Fertility Changes in Costa Rica, 1906-1970

The demographic history of Costa Rica in the twentieth century is examined in the context of a model of dynamic adjustment to changing child survival probabilities and micro-level population pressure. Micro-level population pressure is viewed as resulting from a couple having children beyond its current optimal family size, given current prices and its income. Cantonal regression analyses for the time periods, 1927-1950, 1951-1953 to 1961-1963, and 1961-1963 to 1970 lend support to the hypothesis that the secular fertility decline in Costa Rica is a dynamic adjustment to high completed family size and increasing child survival probabilities

Contingent Valuation Methodology in the Natural Resource Damage Regulatory Process: Choice Theory and the Embedding Phenomenon

In their most recent article on the use of Contingent Valuation Methodology ( CVM ) in the natural resource damages assessment ( NRDA ) process, the authors take issue with the CVM components of the National Oceanic and Atmospheric Administration\u27s ( NOAA ) proposed NRDA rules. In particular, the authors argue that NOAA\u27s proposed NRDA process does not comport with basic tenets of choice theory and that the CVM safeguards created by NOAA are not adequate to address the inherent, and perhaps irreconcilable, flaws in CVM assessments. To illustrate their arguments, the authors examine and criticize NOAA\u27s treatment and general disregard of the embedding phenomenon. The author\u27s argue that the existence of the embedding phenomenon in CVM valuations demonstrates the inappropriateness of CVM as a regulatory tool in the NRDA process

The Use of Contingent Valuation Methodology in Natural Resource Damage Assessments: Legal Fact and Economic Fiction.

The creation of comprehensive statutory schemes for protection of the environment has required the legal system to focus on the definition problems associated with environmental goods and with the physical, tmeporal, and aesthetic considerations related to such goods. Clearly, the events of the twentieth century have taught us that individual physical components of the natural environment, such as streams, forests, wildlife, and biota, do not exist in isolation. Instead, these components are part of the interrelated environmental systems that may, in turn, impact other environmental systems. Likewise, damage to one or more of the components of a system can result in a loss to humans of these environmental goods or the Uses provided by the system

Feeding styles and responsiveness in mothers with eating disorders

Eating disorders such as anorexia nervosa and bulimia nervosa represent a significant public health problem for young women in particular, affecting an estimated 2.4% of women of childbearing age in the United States. The children of mothers with eating disorder histories appear to be at especially high-risk for developing eating problems themselves. Yet, little research has investigated how mothers with such histories interact with their young children in the feeding environment. The objective of this project was to provide a comprehensive view of maternal responsiveness in mothers with histories of eating disorders across observational, self-report, and physiologic domains. A case-control pilot study was conducted of 25 mothers with histories of eating disorders with children ages 6-36 months and 25 healthy control mothers matched for child age and child sex. No significant differences were detected between mothers with histories of eating disorders and controls on observed responsiveness to child receptiveness cues during feeding, responsiveness to child fullness cues during feeding or maternal sensitivity during play. Mothers with histories of eating disorders reported less restrictive feeding styles than control mothers (t(47)= –2.08, p<0.05) and scored highest on responsive feeding out of all feeding styles. No significant differences were detected in child diet composition between mothers with histories of eating disorders and controls, but mothers with histories of eating disorders were more likely to report taking a special approach to feeding involving restriction of certain food types or components, such as limiting processed foods (88% mothers with histories of eating disorders and 60% control mothers; OR= 4.89, 95%CI=1.15- 20.79). Lastly, mothers with histories of eating disorders reported greater parenting stress (t(47)= 2.15, p<0.04) and displayed a blunted stress response (decreased vagal reactivity) during interactions with their children (F(1,43)= 7.18, p<0.02). These findings indicate that greater attention should be given to the influence of stress on parenting in general and the feeding environment specifically for mothers with histories of eating disorders. Future studies of mothers with histories of eating disorders should include larger more diverse samples and should continue to evaluate responsive feeding behavior as children grow older and the feeding environment becomes more complex

Inadequate sensitivity of laboratory risk indicator to rule out necrotizing fasciitis in the emergency department

Introduction: Necrotizing fasciitis (NF) is a life-threatening illness, particularly when surgical debridement is delayed. The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score was developed to identify patients at higher risk for NF. Despite limited information in this regard, the LRINEC score is often used to rule out NF if negative. We describe the sensitivity of the LRINEC score in emergency department (ED) patients for the diagnosis of NF. Methods: We conducted a chart review of ED patients in whom coding of hospital discharge diagnoses included NF. We employed standard methods to minimize bias. We used laboratory data to calculate the LRINEC score, and confirmed the diagnosis of NF via explicit chart review. We then calculated the sensitivity of a positive LRINEC score (standardly defined as six or greater) in our cohort. We examined the role of patient characteristics in the performance of the LRINEC score. Finally, we performed sensitivity analyses to estimate whether missing data for c-reactive protein (CRP) results were likely to impact our results. Results: Of 266 ED patients coded as having a discharge diagnosis of NF, we were able to confirm the diagnosis, by chart review, in 167. We were able to calculate a LRINEC score in only 80 patients (due to absence of an initial CRP value); an LRINEC score of 6 or greater had a sensitivity of 77%. Sensitivity analyses of missing data supported our finding of inadequate sensitivity to rule out NF. In sub-analysis, NF patients with concurrent diabetes were more likely to be accurately categorized by the LRINEC score. Conclusion: Used in isolation, the LRINEC score is not sufficiently sensitive to rule out NF in a general ED population. © 2016 Koenig et al

Population Pressure and Fertility Changes in Costa Rica, 1906-1970

The demographic history of Costa Rica in the twentieth century is examined in the context of a model of dynamic adjustment to changing child survival probabilities and micro-level population pressure. Micro-level population pressure is viewed as resulting from a couple having children beyond its current optimal family size, given current prices and its income. Cantonal regression analyses for the time periods, 1927-1950, 1951-1953 to 1961-1963, and 1961-1963 to 1970 lend support to the hypothesis that the secular fertility decline in Costa Rica is a dynamic adjustment to high completed family size and increasing child survival probabilities