Informal caregiving remains a significant phenomenon in the United States with a high opportunity cost, although it remains more economical (in the aggregate) than skilled paid care.

We use nationally representative household data from India to establish the intergenerational effect of early marriage on a broad set of health and educational investments and outcomes, and to explicate the underlying mechanisms. The empirical strategy utilizes variation in age at menarche to obtain exogenous variation in the age at marriage. We find that delayed marriage results in significantly better child health and educational outcomes. We further analyze a subsample of uneducated child brides to show that the age at marriage matters by itself, independently of its effects via the woman's educational attainment and her marriage market outcome. From a household-decision-making perspective, the effects appear to be due (at least in part) to a reduction in desired and actual fertility as a result of later marriage, which may be associated with a quantity/quality tradeoff.

recommendation for their use. Despite the lack of guidelinebased recommendations and little evidence to support IABP use, the study by Inohara et al 2 finds that IABPs continue to be used frequently and that their use is associated with increased inhospital mortality.Although there has been enthusiasm about newer PVADs (eg, Impella LP2.5 [Abiomed Europe GmbH] and TandemHeart [Cardiac Assist]), initial studies regarding their use to treat cardiogenic shock have not shown any significant survival benefit compared with IABPs and observed increased bleeding and a tendency toward more limb ischemia from the use of larger sheaths with PVADs. 7 Similar to IABPs, no net benefit was demonstrated in hemodynamically stable patients with an implanted PVAD undergoing high-risk angioplasty, another common clinical scenario for the use of PVADs. 8 Why is there reluctance to abandon these invasive, expensive, and seemingly ineffective therapies? The answer might be multifactorial. Cardiogenic shock complicating myocardial infarction remains a formidable foe and is associated with 40% to 50% in-hospital mortality. 9 In this setting, only early revascularization has shown improved survival. In some of these critically ill patients, it may seem reasonable to use mechanical circulatory support devices as salvage therapy. However, they offer little benefit in reducing clinical events, and have high costs and significant complication rates. Inohara et al 2 confirm previous findings that IABPs and PVADs are being increasingly used in patients without indications for their use. Although the precise reasons for such excessive use remain to be established, misaligned financial incentives might have a role. Furthermore, continued use of IABPs may be due to established routines or treatment protocols, with commission bias tending toward action rather than inaction. 10 Based on available data, the use of these invasive and expensive mechanical circulatory support devices should be critically appraised and limited because of significant complication rates associated with their use and a lack of evidence demonstrating any benefit. In the use of IABPs and PVADs, it seems appropriate to conclude that perhaps less is more.

This paper examines the impact of a property rights reform in rural China that allowed farmers to lease out their land. We find the reform led to increases in land rental activity in rural households. Our results indicate that the formalization of leasing rights resulted in a redistribution of land toward more productive farmers. Consequently, output and aggregate productivity increased by 8 and 10%, respectively. We also find that the reform increased the responsiveness of land allocation across crops to changes in crop prices.

A key prediction of models of dynamic labor demand is that restrictions on …ring attenuate …rms' employment responses to economic ‡uctuations. We provide the …rst direct empirical test of this prediction using data on industrial …rms in India. We exploit the fact that ‡uctuation in rainfall within districts, through its e¤ects on agricultural productivity, generates variation in local demand and local labor supply. Using a measure of labor regulation strictness, we compare factories' input and output responses to these shocks in pro-worker and pro-employer districts. Our results con…rm the theory's predictions: industrial employment is more sensitive to shocks in areas where labor regulations are less restrictive. We verify that our results are robust to controlling for endogenous …rm placement and vary across factory size in the pattern predicted by the institutional features of labor laws in India.