OBJECTIVE. Approximately 4.4 million (7.8%) children in the United States have been diagnosed with attention-deficit/hyperactivity disorder, and 56% of affected children take prescription medications to treat the disorder. Attention-deficit/hyperactivity disorder is strongly linked with low academic achievement, but the association between medication use and academic achievement in school settings is largely unknown. Our objective was to determine if reported medication use for attentiondeficit/hyperactivity disorder is positively associated with academic achievement during elementary school.

METHOD. To estimate the association between reported medication use and standardized mathematics and reading achievement scores for a US sample of 594 children with attention-deficit/hyperactivity disorder, we used 5 survey waves between kindergarten and fifth grade from the nationally representative Early Childhood Longitudinal Study—Kindergarten Class of 1998 –1999 to estimate a first-differenced regression model, which controlled for time-invariant confounding variables.

RESULTS. Medicated children had a mean mathematics score that was 2.9 points higher than the mean score of unmedicated peers with attention-deficit/hyperactivity disorder. Children who were medicated for a longer duration (at 2 waves) had a mean reading score that was 5.4 points higher than the mean score of unmedicated peers with attention-deficit/hyperactivity disorder. The medication-reading association was lower for children who had an individualized education program than for those without such educational accommodation.

CONCLUSIONS. The finding of a positive association between medication use and standardized mathematics and reading test scores is important, given the high prevalence of attention-deficit/hyperactivity disorder and its association with low academic achievement. The 2.9-point mathematics and 5.4-point reading score differences are comparable with score gains of 0.19 and 0.29 school years, respectively, but these gains are insufficient to eliminate the test-score gap between children with attention-deficit/hyperactivity disorder and those without the disorder. Long-term trials are needed to better understand the relationship between medication use and academic achievement.

Objective. To determine whether variation in the representation of minority physicians across geographical areas in California affects the location decisions of minority physicians.

Data Sources. We analyzed data on 9,806 residents and 53,606 patient-care physicians from the 1997–2003 American Medical Association Masterfiles for California along with data from the California Department of Finance, RAND, and other sources.

Study Design. We estimated departure models using linear probability models and destination models using conditional logit. Each model controlled for physician and county characteristics. Parameters of interest include the interactions of physician race/ ethnicity with area-level minority physician representation for the corresponding race/ ethnicity.

Principal Findings. Departure models show that black and Hispanic physicians are more likely to remain in an area as the level of representation of physicians from their respective groups worsens. The destination models show that black, Asian, and Hispanic physicians tend to move to areas where the level of representation is similar to that of their previous location.

Conclusions. Black and Hispanic physicians are influenced by the level of representation of physicians from their respective groups in their location decisions and tend to locate where needed.

The fundamental role that agriculture plays in development has long been recognized. In the seminal work on the subject, agriculture was seen as a source of contributions that helped induce industrial growth and a structural transformation of the economy. However, globalization, integrated value chains, rapid technological and institutional innovations, and environmental constraints have rapidly changed the context for agriculture’s role. We argue that a new
paradigm is needed that recognizes agriculture’s multiple functions for development in that emerging context: triggering economic growth, reducing poverty, narrowing income disparities, providing food security, and delivering environmental services. Yet, governments and donors have neglected these functions of agriculture with the result that agriculture growth has been reduced, 75% of world poverty is rural, sectoral disparities have exploded, food insecurity has returned, and environmental degradation is widespread. Mobilizing these functions requires shifting the political economy to overcome anti-agriculture policy biases, strengthening governance for agriculture, and tailoring priorities to country conditions.

While agriculture is rarely a sensational topic, it has been in the headlines across the world over the last two years, if for the wrong reasons. “The End of Cheap Food”, “The Silent Tsunami”, “Grains Gone Wild”, “Across the Globe, Empty Bellies Bring Rising Anger” have been front page titles in The Economist and The New York Times. This surge of interest in agriculture and what it can do for development has been motivated by a conjunction of negative outcomes: sharply rising food prices with
associated food riots and rising hunger; an approaching deadline for the Millennium Development Goals (MDG) that will not be unmet in most countries, while 75% of world poverty is rural and agriculture has to play a major role if the MDG of halving poverty is to be met; rising rural-urban income disparities creating political tensions in rapidly growing countries such as China and India; threats to the future of the family farm and excessively rapid rural exodus toward urban slums; new demands on agriculture to contribute to energy supply and to deliver environmental services; the destabilization of weather patterns and rising temperatures creating threats to the resilience of farming systems on which the rural poor depend; rising water scarcity and pollution of potable water sources with agro-chemicals associated with the intensification of cropping patterns; loss of biodiversity associated with deforestation and horizontal expansion of extensive farming systems; and pandemics such as the avian flu linking agriculture to human health. Agriculture clearly needs to do a better job for development as the developmental failures of agriculture have reached crisis proportion. Reassessing why agriculture has not been more effectively used for development is thus happening by popular demand.

Yet, can we expect that this reassessment will result in significant changes on the way agriculture is used for development? Or are we to return to “business as usual”, with a continued neglect of agriculture and the associated failed opportunities to use it to
stimulate growth in poor countries, reduce rural poverty, and improve sustainability in resource use, as occurred over the last 25 years following the debt crisis and the policies of the Washington Consensus. The World Development Report 2008 was a call to make better use of agriculture for development. Urgency of the call has been enhanced by the food crisis. Will governments and international development agencies hear the call and stop turning their backs on agriculture? What would it take for agriculture to be effectively used for development and to address the many crisis that have brought it to 2 the headlines? It is the objective of this presentation to raise these questions and discuss answers.

Background: Policymakers have recently proposed ways of providing health care coverage for an increased number of uninsured persons. However, there are few data that show how the incidence and duration of periods in which persons do not have insurance have changed over time.

Methods: We used two data sets from the Survey of Income and Program Participation of the U.S. Census Bureau: one that covered the period from 1983 through 1986 (25,946 persons), and another that covered the period from 2001 through 2004 (40,282 persons). For each set of years, we estimated the probability that a person would be uninsured for some period of time and the probability that a person would subsequently obtain private or public insurance. We also estimated the probabilities that persons in various demographic groups would become uninsured over the course of a year and would remain uninsured for various amounts of time.

Results: The percentage of the population that lost insurance in a 12-month period increased from 19.8% in 1983-1986 to 21.8% in 2001-2004 (P=0.04). The percentage that was uninsured for a period of time increased markedly among persons with the lowest educational level and predominantly represented loss of private coverage. The percentage of new uninsured periods that ended within 24 months increased from 73.8% to 79.7% between the two study periods (P<0.001); increases were seen in all age groups and among persons of all educational levels. Transition from no insurance to private insurance decreased from 65.2% to 59.2% (P<0.001). Transition from no insurance to public insurance increased from 8.7% to 20.4% (P<0.001).

Conclusions: As compared with the years from 1983 through 1986, from 2001 through 2004, more people, particularly those with the lowest educational level, had periods in which they were not insured. The periods without insurance were shorter in 2001-2004 than they were in 1983-1986, since an increase in transitions to public coverage offset a reduction in transitions to private coverage. Our results portend difficulties if private coverage continues to decline and is not offset by further expansions of public insurance.

In lobbying for the job discrimination provisions of the Civil Rights Act (CRA) of 1964, liberal civil rights advocates wanted an administrative job discrimination enforcement regime modeled on the National Labor Relations Board (NLRB), with no private lawsuits. Pivotal conservative Republicans, empowered by a divided Democratic Party and the filibuster in the Senate, defeated an administrative framework and provided instead for private lawsuits with incentives for enforcement, including attorney’s fees for winning plaintiffs. They were motivated by native suspicion toward bureaucratic regulation of business in general, as well as fear that they would not be able to control an NLRB-style civil rights agency in the hands of their ideological adversaries. In the political environment of 1963–64, some meaningful enforcement provisions were necessary, and to conservative Republicans private litigation was preferable to public bureaucracy.

This choice had important self-reinforcing policy feedback effects. Civil rights advocates were initially optimistic about agency implementation and skeptical about the efficacy of private litigation to enforce Title VII, even with attorney’s fees for winning plaintiffs. In the late 1960s and early 1970s, however, civil rights advocates observed an agency lacking the material resources and political will and commitment to carry out its mission. At the same
time, they observed levels of private enforcement that far exceeded their expectations, as well as courts inclined toward broadly proplaintiff interpretations of Title VII. The CRA of 1964’s attorney’s fees provisions also had the effect of contributing funds to civil rights groups that prosecuted lawsuits and of conjuring into being a private, for-profit bar to litigate civil rights claims in general, and job discrimination claims in particular. These developments drove a transformation in the enforcement preferences of civil rights groups toward private litigation, weakening their historic support for administrative implementation. Working together with the burgeoning for-profit civil rights bar, they mobilized to expand the fee-shifting provisions of the CRA of 1964 across the entire field of civil rights, which they accomplished by successfully lobbying for enactment of the Civil Rights Attorney’s Fees Awards Act of 1976. Thus was created the modern civil rights enforcement framework.