If My Blood Pressure Is High,Do I Take It to Heart? Behavioral Effects of Biomarker Collection in the Health and Retirement Study

Starting in 2006, respondents in the biennial U.S. Health and Retirement Study were asked to submit biomarkers every other wave and were notified of several results. Rates of undiagnosed high blood pressure and diabetes according to these biomarkers were 1.5 % and 0.7 %, respectively. An intent-to-treat analysis suggests that collection and notification had small effects on the average respondent and may have reduced health care utilization. Among respondents who received notification of potentially dangerous biomarker levels, subsequent rates of new diagnosis and associated pharmaceutical usage increased by 20 to 40 percentage points, an order of magnitude above baseline. High blood glucose A1C was associated with a 2.2 % drop in weight and an increase in exercise among respondents without a previous diagnosis of diabetes. Notifications appear also to have altered health behaviors by spouses, suggesting household responses to health maintenance. Biomarker collection seems to have altered circumstances for an interesting minority of HRS respondents.     

CAN THE PRESIDENT REALLY AFFECT ECONOMIC GROWTH? PRESIDENTIAL EFFORT AND THE POLITICAL BUSINESS CYCLE

Presidential elections are often seen as referendums on the health of the economy; however, little evidence exists on the president's ability to influence gross domestic product (GDP). This study examines the effect of the incentive to be reelected and the resulting increase in presidential effort on GDP growth. Growth is found to rise in reelection years for first‐term presidents after 1932 and to fall in election years before 1932, when reelection was uncommon, and for second‐term presidents generally. This effect is largest for high‐quality presidents—who probably have the highest return to effort—and is spread across multiple sectors of the economy. (JEL D78, D72, E32, J24)     

Population constraints on pooled surveys in demographic hazard modeling

In non-experimental research, data on the same population process may be collected simultaneously by more than one instrument. For example, in the present application, two sample surveys and a population birth registration system all collect observations on first births by age and year, while the two surveys additionally collect information on women’s education. To make maximum use of the three data sources, the survey data are pooled and the population data introduced as constraints in a logistic regression equation. Reductions in standard errors about the age and birth-cohort parameters of the regression equation in the order of three-quarters are obtained by introducing the population data as constraints. A halving of the standard errors about the education parameters is achieved by pooling observations from the larger survey dataset with those from the smaller survey. The percentage reduction in the standard errors through imposing population constraints is independent of the total survey sample size.     

Assessing accuracy of a continuous screening test in the presence of verification bias

Summary.  In studies to assess the accuracy of a screening test, often definitive disease assessment is too invasive or expensive to be ascertained on all the study subjects. Although it may be more ethical or cost effective to ascertain the true disease status with a higher rate in study subjects where the screening test or additional information is suggestive of disease, estimates of accuracy can be biased in a study with such a design. This bias is known as verification bias. Verification bias correction methods that accommodate screening tests with binary or ordinal responses have been developed; however, no verification bias correction methods exist for tests with continuous results. We propose and compare imputation and reweighting bias-corrected estimators of true and false positive rates, receiver operating characteristic curves and area under the receiver operating characteristic curve for continuous tests. Distribution theory and simulation studies are used to compare the proposed estimators with respect to bias, relative efficiency and robustness to model misspecification. The bias correction estimators proposed are applied to data from a study of screening tests for neonatal hearing loss.     

Personality profiles of factitious disorder imposed by mothers: A comparative analysis

Factitious Disorder Imposed by Another (FDIA) can be difficult to expeditiously identify. Understanding personality characteristics of FDIA perpetrators via psychological assessment may decrease the time between initial abuse and identification of FDIA. Personality characteristics of FDIA mother-perpetrators were examined through a comparative analysis of MMPI-2 profiles. It was predicted that mother-perpetrators would have significantly higher overall profile elevations on the MMPI-2 and elevations on specific clinical scales than a comparative control group. Results indicated that mother-perpetrators displayed significantly higher, elevations on the Psychasthenia (Pt) and Schizophrenia (Sc) scales and a trend toward significantly higher elevation on the Psychopathic Deviate (Pd) scale than the control group. These findings, along with the demographic information obtained, establish a preliminary foundation for understanding an overall profile of mother-perpetrators.