Living with Uncertainty: Acting in the Best Interests of Women

A recent multi-country study on hormonal contraceptives (HC) and HIV acquisition and transmission among African HIV-serodiscordant couples reported a statistically significant doubling of risk for HIV acquisition among women as well as transmission from women to men for injectable contraceptives. Together with a prior cohort study on African women seeking health services, these data are the strongest yet to appear on the HC-HIV risk. This paper will briefly review the Heffron study strengths and relevant biological and epidemiologic evidence; address the futility of further trials; and propose instead an alternative framework for next steps. The weight of the evidence calls for a discontinuation of progestin-dominant methods. We propose here five types of productive activities: (1) scaling injectable hormones down and out of the contraceptive mix; (2) strengthening and introducing public health strategies with proven potential to reduce HIV spread; (3) providing maximal choice to reduce unplanned pregnancy, starting with quality sexuality education through to safe abortion access; (4) expanding provider training, end-user counseling and access to male and female barriers, with a special renewed focus on female condom; (5) initiating a serious research agenda to determine anti-STI/HIV potential of the contraceptive cervical cap. Trusting women to make informed choices is critical to achieve real progress in dual protection.

An evaluation of child welfare inservice training: The relative effectiveness of substance abuse content in improving worker knowledge and attitudes

Given the seriousness of substance abuse as a child welfare problem, the purpose of this study was to examine the relative effectiveness of an inservice training curriculum for child welfare workers. The training was designed to improve worker knowledge and attitudes in working with substance abusing families. Seventy (70) child welfare workers from public and private agencies in two south Florida counties participated in a pretest/posttest control group design that also trained and retested the control group. The literature review supports that the general preparedness of child welfare workers for the issues presented by substance abusing families is in question. Confounding this problem is a lack of understanding of substance abuse dynamics, worker biases, and predispositions. The two research hypotheses focused on whether inservice training could increase worker knowledge and improve worker attitudes in working with this population. Training delivery was in the form of a five-day inservice focusing on an array of substance abuse knowledge and attitudinal topics. Separate knowledge and attitude instruments were developed for the research and were administered, before and after training, to a purposive sample of participants that were randomly assigned to the experimental and control groups. The data analysis supported the research hypotheses but raised a question. Specifically, the experimental group demonstrated significant improvement in posttest scores on both instruments after receiving the training; whereas the control group, with training withheld, also demonstrated a significant improvement at posttest, but only on the knowledge instrument. Although the question was unanswered, when examined at a more critical significance level, only the experimental group remained significant. The hypotheses were reconfirmed when, after training and retesting, the control group also displayed significant improvement on both instruments. The findings support the conclusion that this substance abuse inservice was effective in improving worker knowledge and attitudes regarding working with substance abusing families. As an implication for social work practice, it suggests that similar inservice training can be a viable training resource when formal substance abuse training is unavailable. Additional research is suggested regarding to what degree increased substance abuse knowledge and improved worker attitudes correlate with improved practice.

Effect of child care subsidies on price and quality of care for low -income families

This dissertation examines the effect of regulations, resource and referral agencies, and subsidies on price and quality of care in child care centers. This research is based on a carefully developed conceptual framework that incorporates the factors affecting the demand and supply of child care. The first step in developing this framework is sketching out the structural equations. The structural equations help us understand the underlying behavior of individuals and firms making a decision. The exogenous variables are vector of attributes relating to family characteristics, child characteristics, regulations, subsidy, community characteristics and prices of inputs. Based on the structural equations, reduced form equations are estimated to find the effect of each of the exogenous variables on each of the endogenous variables. Reduced form equations help us answer public policy questions. The sample for this study is from the 1990 Profile of Child Care Settings (PCCS) data in which 2,089 center based programs were interviewed.^ Child/Staff Ratio (Group Level). Results indicate that among subsidies, only the state subsidy per child in poverty has a significant effect on the child/staff ratio at the group level. Presence of resource and referral agencies also increase the child/staff ratio at the group level. Also when the maximum center group size regulation for 25-36 months becomes more stringent, the child/staff ratio at the group level decreases.^ Child/Staff Ratio (Center Level). When the regulations for the maximum child/staff ratio for age groups 13-24 months and 37-60 months become lax, the child/staff ratio for the center increases. As the regulation for maximum group size for infants becomes stringent, the child/staff ratio decreases. An interesting finding is that as the regulations for maximum group size for age groups 13-24 months and 25-36 months become stringent, the child/staff ratio for the center increases. Another significant finding is that when a center is located in a rural area the child/staff ratio is significantly lower.^ Center Weighted Average Hourly Fees. Maximum group size regulations for age groups 25-36 months and 37-60 months have a negative effect on center hourly fee. Maximum child staff regulations for age groups 13-24 months and 37-60 months have a negative effect on center hourly fee. Maximum child staff regulations for age groups 0-12 months and 25-36 months have a positive effect on center hourly fee. Findings also indicate that the center average hourly price is lower when there is a resource and referral agency present. Cost adjusted prekindergarten funds and JOBS child care subsidies have a negative effect on average hourly fee. Cost adjusted social services block grant and state subsidy per child in poverty have a positive effect on the average hourly price. A major finding of this dissertation is the interaction of subsidy and regulatory variables.^ Another major finding is that child/staff ratio at the group level is lower when there is an interaction between geographic location and nature of center sponsorship. ^

Effect of child care subsidies on price and quality of care for low -income families

This dissertation examines the effect of regulations, resource and referral agencies, and subsidies on price and quality of care in child care centers. This research is based on a carefully developed conceptual framework that incorporates the factors affecting the demand and supply of child care. The first step in developing this framework is sketching out the structural equations. The structural equations help us understand the underlying behavior of individuals and firms making a decision. The exogenous variables are vector of attributes relating to family characteristics, child characteristics, regulations, subsidy, community characteristics and prices of inputs. Based on the structural equations, reduced form equations are estimated to find the effect of each of the exogenous variables on each of the endogenous variables. Reduced form equations help us answer public policy questions. The sample for this study is from the 1990 Profile of Child Care Settings (PCCS) data in which 2,089 center based programs were interviewed. Child/Staff Ratio (Group Level): Results indicate that among subsidies, only the state subsidy per child in poverty has a significant effect on the child/staff ratio at the group level. Presence of resource and referral agencies also increase the child/staff ratio at the group level. Also when the maximum center group size regulation for 25-36 months becomes more stringent, the child/staff ratio at the group level decreases. Child/Staff Ratio (Center Level): When the regulations for the maximum child/staff ratio for age groups 13-24 months and 37-60 months become lax, the child/staff ratio for the center increases. As the regulation for maximum group size for infants becomes stringent, the child/staff ratio decreases. An interesting finding is that as the regulations for maximum group size for age groups 13-24 months and 25-36 months become stringent, the child/staff ratio for the center increases. Another significant finding is that when a center is located in a rural area the child/staff ratio is significantly lower. Center Weighted Average Hourly Fees: Maximum group size regulations for age groups 25-36 months and 37-60 months have a negative effect on center hourly fee. Maximum child staff regulations for age groups 13-24 months and 37-60 months have a negative effect on center hourly fee. Maximum child staff regulations for age groups 0-12 months and 25-36 months have a positive effect on center hourly fee. Findings also indicate that the center average hourly price is lower when there is a resource and referral agency present. Cost adjusted prekindergarten funds and JOBS child care subsidies have a negative effect on average hourly fee. Cost adjusted social services block grant and state subsidy per child in poverty have a positive effect on the average hourly price. A major finding of this dissertation is the interaction of subsidy and regulatory variables. Another major finding is that child/staff ratio at the group level is lower when there is an interaction between geographic location and nature of center sponsorship.

Comparison of parental perception and therapist interpretation of child's performance of the Peabody Fine Motor Scale

Public Law 102-119 (Individuals with Disabilities Education Act of 1991), mandates that family members, if they wish, participate in developing a plan of treatment for their child. Traditionally, therapist have not relied on parental assessments based upon the assumption that parents overestimate their child's abilities. The present study compared parental perceptions about the developmental status of their child's fine motor abilities to the therapist's interpretation of a standardized assessment using the Peabody Developmental Motor Scale (Fine Motor). Thirty seven children, enrolled in an early intervention program, and their parents were recruited for the study. The results indicated that the parents and the therapist estimates were highly correlated and showed no significant differences when paired t-tests were computed for developmental ages and scaled scores. However, analyses of variances were significantly correlated for gender and number of siblings.

Use of child safety seats among Mexican parents in a small south Dade community

The purpose of this study was to determine the use and misuse of child safety seats among Mexican parents. Data were collected via personal interview and by use of the SAFE KIDS BUCKLE UP Child Safety Seat Checklist Form. This study used a descriptive comparative design. The convenience sample consisted of 63 Mexican mothers with at least one child under the age of four (index child). The findings showed that Mexican parents tend to misuse or not use child safety seats. Most parents were not aware of the misuse, and receiving prior information on the use of child safety seats had no bearing on its correct use. Factors influencing nonuse include lack of finances, driving short distances, leaving child safety seat at home, and being unaware of the Florida child restraint law. Findings of this study have implications for how nurses need to educate mothers on car safety and help reduce childhood injuries.

Salient factors in child molestation: Moral development, social competence, and type of offender

The current study was designed to build on and extend the existing knowledge base of factors that cause, maintain, and influence child molestation. Theorized links among the type of offender and the offender's levels of moral development and social competence in the perpetration of child molestation were investigated. The conceptual framework for the study is based on the cognitive developmental stages of moral development as proposed by Kohlberg, the unified theory, or Four-Preconditions Model, of child molestation as proposed by Finkelhor, and the Information-Processing Model of Social Skills as proposed by McFall. The study sample consisted of 127 adult male child molesters participating in outpatient group therapy. All subjects completed a Self-Report Questionnaire which included questions designed to obtain relevant demographic data, questions similar to those used by the researchers for the Massachusetts Treatment Center: Child Molester Typology 3's social competency dimension, the Defining Issues Test (DIT) short form, the Social Avoidance and Distress Scale (SADS), the Rathus Assertiveness Schedule (RAS), and the Questionnaire Measure of Empathic Tendency (Empathy Scale). Data were analyzed utilizing confirmatory factor analysis, t-tests, and chi-square statistics. Partial support was found for the hypothesis that moral development is a separate but correlated construct from social competence. As predicted, although the actual mean score differences were small, a statistically significant difference was found in the current study between the mean DITP scores of the subject sample and that of the general male population, suggesting that child molesters, as a group, function at a lower level of moral development than does the general male population, and the situational offenders in the study sample demonstrated a statistically significantly higher level of moral development than the preferential offenders. The data did not support the hypothesis that situational offenders will demonstrate lower levels of social competence than preferential offenders. Relatively little significance is placed on this finding, however, because the measure for the social competency variable was likely subject to considerable measurement error in that the items used as indicators were not clearly defined. The last hypothesis, which involved the potential differences in social anxiety, assertion skills, and empathy between the situational and preferential offender types, was not supported by the data. ^

An investigation of the strategies used by organizations participating in the welfare-to-work network program and correlation of the strategies with the retention data to determine best practices for job retention among former welfare recipients

This ex post facto study (N = 209) examined the relationships between employer job strategies and job retention among organizations participating in Florida welfare-to-work network programs and associated the strategies with job retention data to determine best practices. ^ An internet-based self-report survey battery was administered to a heterogeneous sampling of organizations participating in the Florida welfare-to-work network program. Hypotheses were tested through correlational and hierarchical regression analytic procedures. The partial correlation results linked each of the job retention strategies to job retention. Wages, benefits, training and supervision, communication, job growth, work/life balance, fairness and respect were all significantly related to job retention. Hierarchical regression results indicated that the training and supervision variable was the best predictor of job retention in the regression equation. ^ The size of the organization was also a significant predictor of job retention. Large organizations reported higher job retention rates than small organizations. There was no statistical difference between the types of organizations (profit-making and non-profit) and job retention. The standardized betas ranged from to .26 to .41 in the regression equation. Twenty percent of the variance in job retention was explained by the combination of demographic and job retention strategy predictors, supporting the theoretical, empirical, and practical relevance of understanding the association between employer job strategies and job retention outcomes. Implications for adult education and human resource development theory, research, and practice are highlighted as possible strategic leverage points for creating conditions that facilitate the development of job strategies as a means for improving former welfare workers’ job retention.^

The influence of corporate interests on USAID's development agenda: The case of Haiti

This dissertation is an attempt to use the radical political economy approach, which assumes that there is a connection between a state's strategic interests and the interests of dominant multinational corporations (MNCs) located within a state's territory, to explain continuity in the USAID development agenda and lending patterns during the past 30 years of development aid to Haiti. Employing the qualitative method of "process-tracing," my study concludes that the radical political economy approach has an explanatory power when it comes to understanding continuity in the USAID development agenda and lending patterns during the past 30 years of development aid to Haiti. The evidence shows that USAID has implemented in Haiti, from the 1980s through the post-9/11 Washington Consensus period, neoliberal policies that conform to the political economy of US multinational corporations (US MNCs). Contrary to the claim that the USAID-sponsored post-earthquake development paradigm has departed from previous development strategies, the study has shown that USAID has used the occurrence of the January 2010 earthquake tragedy to accelerate in Haiti the implementation of a neoliberal agenda congenial to the business promotion of multinational investors, particularly US multinational corporations. In terms of the way ahead, the study argues for the implementation of a new development approach articulated by a legitimate Haitian state and primarily intended to promote the socioeconomic development of the poorest Haitians.

The United States and the politics of trade: the banana war with Europe and the Caribbean

This thesis examines the involvement of the United States in the decade-long trade dispute before the World Trade Organization (WTO) over the European Union's preferential banana regime. Washington's justification for bringing this case to the WTO comes from Section 301 of the U.S. trade act, which allows for disputes to be undertaken if U.S. "interests" are violated; however, this is the first case ever undertaken by the United States that does not directly threaten any American banana industry, nor affect any American jobs. Why, then, would the United States involve itself in this European-Caribbean-Latin American dispute? It is the contention of this thesis that the United States thrust itself headlong into this debate for two reasons: domestically, the United States Trade Representative came under pressure, via the White House and Congress, from Chiquita CEO Carl Lindner, who in the past decade donated more than $7.1 million to American politicians to take the case to the WTO. Internationally, the United States used the case as an opportunity to assert its power over Europe, with the Eastern Caribbean islands being caught in the economic crossfire. According to existing literature, in undertaking this case, the United States did as any nation would: it operated within both domestic and international levels, satisfying at each level key interests, with the overall goal of maintaining the nation's best interests.