Family Intervention and Health Care Costs for Kansas Medicaid Patients with Schizophrenia

Despite a number of studies investigating the effect of pharmacotherapy on treatment costs for schizophrenia patients, there has been little attention given to the effect of family intervention. In this study, data from the Kansas Medicaid system were used to analyze healthcare costs for 164 schizophrenia patients who had participated in family intervention. Structural equation modeling was used to test two competing views of the role of family intervention in treatment. The results showed that a model including direct and indirect effects of family intervention provided a better fit to the data. Family intervention had a significant indirect effect on general medical costs (through other psychological treatment) that showed a savings of $586 for each unit increase in the provision of these services. In addition, the total indirect effects for family intervention showed a $580 savings for general medical costs and $796 for hospitalization costs (for each unit increase).     

Monitoring the complexities: Nuclear power and public opinion

Interaction between organizations and stakeholders today takes place on virtual and physical ‘issue arenas’. This study examined opinions on nuclear power and asked who are the players discussing nuclear power in Finland? Through content analysis, surveys and interviews, the study concluded that politicians, power companies and regulators were the ones with voice, as NGOs and citizens were hardly heard. The paper suggests the future role of PR practitioners to be to find the right issue arenas and facilitate corporate voice and reputation on those arenas.     

Estimating heritability for cause specific mortality based on twin studies

There has been considerable interest in studying the magnitude and type of inheritance of specific diseases. This is typically derived from family or twin studies, where the basic idea is to compare the correlation for different pairs that share different amount of genes. We here consider data from the Danish twin registry and discuss how to define heritability for cancer occurrence. The key point is that this should be done taking censoring as well as competing risks due to e.g.  death into account. We describe the dependence between twins on the probability scale and show that various models can be used to achieve sensible estimates of the dependence within monozygotic and dizygotic twin pairs that may vary over time. These dependence measures can subsequently be decomposed into a genetic and environmental component using random effects models. We here present several novel models that in essence describe the association in terms of the concordance probability, i.e., the probability that both twins experience the event, in the competing risks setting. We also discuss how to deal with the left truncation present in the Nordic twin registries, due to sampling only of twin pairs where both twins are alive at the initiation of the registries.     

Job continuity among new mothers

In the early 1990s, both state and federal governments enacted maternity-leave legislation. The key provision of that legislation is that after a leave of a limited duration, the recent mother is guaranteed the right to return to her preleave employer at the same or equivalent position. Using data from the National Longitudinal Survey of Youth, we correlate work status after childbirth with work status before pregnancy to estimate the prevalence, before the legislation, of returns to the preleave employer. Among women working full-time before the pregnancy, return to the prepregnancy employer was quite common. Sixty percent of women who worked full-time before the birth of a child continued to work for the same employer after the child was born. Furthermore, the labor market behavior of most of the remaining 40% suggests that maternity-leave legislation is unlikely to have a major effect on job continuity. Compared with all demographically similar women, however, new mothers have an excess probability of leaving their jobs.     

Ideas, private institutions and American welfare state 'exceptionalism': the case of health and old-age insurance, 1915–1965

Traditional theories of welfare state development divide into two camps: societal accounts and institutional accounts. The aim of the present article is to amend and enrich the institutional approach to US social policy by reconsidering key aspects of the genesis of the American welfare state: 1) showing that concepts such as 'policy feedback' and 'path dependence' need to be extended to encompass the effect of private social policies; and 2) taking policy paradigms and agenda setting more seriously than is the norm in institutional scholarship. The empirical analysis is divided into two parts. The first part explores the activities of the American Association for Labor Legislation (AALL) in the decade beginning in 1910 and the genesis of Social Security in the 1930s, while the second part examines the effect of the private benefit developments on policy choices between 1935 and 1965.