Doctors under the knife

With Bill Clinton's new reforms only a month away, the health-care system is on the operating table--and the doctors are under the knife. Americans have a love-hate relationship with physicians: they like the care that doctors provide but hold them to blame for the nation's health-care mess. NEWSWEEK looks at how the culture of medicine may change, assesses doctors' fears--and examines the brave new world of HMOs.     

Measuring Economic Integration in Developing Countries: The Case of Central America

This article builds a composite index, the Central American Integration Index (IIC-AMPI), to measure economic integration. This index utilises a robust methodology and conceptual framework. The study shows that IIC-AMPI is responsive to variable changes and resistant to outliers. The findings indicate that the Deep Integration Process initiative dominates the current integration trend, as seen in the regional average score from 2015 to 2017, aligning with Guatemala and Honduras. Nicaragua demonstrates the most consistent progress, while Panama lags behind. The evidence supports the Customs Union as Central America's future integration path, highlighting the index's ability to capture the dynamic reality of economic integration.     

Measuring School-Related Stressors in Adolescents

Some 1620 high school students responded to 68 items that measure adolescent stressors. Thirty-five of the items were based on J. P. Kohn and G. H. Frazer's Academic Stress Scale [1(1986) An Academic Stress Scale: Identification and Rated Importance of Academic Stressors, Psychological Reports, Vol. 59, pp. 415–426] developed in the United States, while the remaining 33 items were developed from P. Strutynski's [(1985) A Survey of Queensland Year 10, 11 and 12 Student Attitudes to Schools and Schooling, State Planning Committee, International Youth Year, Brisbane] lists of the most frequently named problems of 2336 Australian high school students. Confirmatory Factor Analysis was used to test and develop a measurement model developed from an extensive review of previous scales. The High School Stressors Scale emerged from the analytic process and measures nine school-related stressors. For researchers focusing on school-related problems and stressors among adolescents, the HSSS promises to be a very useful instrument. It has sound construct and predictive validity and adequate reliability, as demonstrated by the goodness-of-fit indices the squared multiple correlations.     

Expectations regarding development during adolescence: Parental and adolescent perceptions

The aims of this study were (1) to compare the age-related expectations of parents and adolescents concerning the timing of achievement in a number of developmental tasks, (2) to examine whether personal characteristics of the adolescent affect developmental expectations, and (3) to examine whether discrepancies between the adolescents and the parents expectations are related to the amount of parent-adolescent conflict. The sample consisted of 508 families with adolescents (12–18 years old). During a home visit, a battery of questionnaires was administered individually to mothers, fathers, and adolescents. A new 24-item instrument to assess expectations for adolescents mastery of developmental tasks was developed for this study. Analyses showed that when the expectations of adolescents and those of their parents are compared at aggregate level, parents consistently indicate later ages for the achievement of developmental tasks than adolescents. Although parents have later timetables, parents and adolescents have strikingly similar views of the sequence in which achievement of developmental tasks should occur. The adolescents age appears to be the most potent predictor of developmental timetables, followed by gender, pubertal timing, and temperament, respectively. The amount of conflict within the parent-adolescent relationship was associated with differences in developmental expectations. The utility of the new instrument for research and clinical work is discussed.This research was supported by a grant from the Ministry of Health and Culture (PCOJ).     

“Comorbidity” of behavioral, emotional, and cognitive problems in adolescence

The purpose of this study was to examine in a sample of 11,516 secondary school students the extent to which different behavioral, emotional and cognitive problems (a) reflected one or more underlying common factors; (b) actually cooccurred; and (c) were single problems. Principal Component Analyses were performed and percentagewise techniques were used. PCA demonstrated that one or more general syndromes could not by far account for all of the variance of the variables. The results suggest the existence of adolescent subgroups with divergent comorbidity patterns: those who primarily report one single symptom; those who report concurrent symptoms either exclusively in the category of behavioral problems or exclusively in the category of emotional and cognitive problems; and those who report concurrent symptoms in both categories. This distinction between different subgroups has important theoretical, diagnostic, and treatment implications.