A multi-dimensional assessment of the health needs of homeless infants and pre-school children in Phoenix

The dual purpose of this study was to identify the comprehensive health needs of a selected group of homeless children in Phoenix, Arizona, and to utilize the findings in developing needed services. A non-random sample of 60 infants and pre-school children were given on-site physical, dental, developmental, behavioral, and nutritional assessments. The study included Medicaid's Early Periodic Screening, Diagnosis, and Treatment procedures, complete oral screening, the Denver Developmental and Denver Articulation Screening Test, the Pre-school Behavior Inventory, and parental interviews. Fifty-eight of the 60 children screened needed further evaluation, treatment, or followup services. The most significant problems included low hematocrit readings, inadequate immunizations, and untreated medical and dental problems specific to this age group. Also identified were developmental delays and potential behavior problems. It is imperative that aggressive outreach and followup services be developed to reach homeless children and to insure that needed interventions are provided.     

A bivariate model of claim frequencies and severities

Bivariate claim data come from a population that consists of insureds who may claim either one, both or none of the two types of benefits covered by a policy. In the present paper, we develop a statistical procedure to fit bivariate distributions of claims in presence of covariates. This allows for a more accurate study of insureds' choice and size in the frequency and severity of the two types of claims. A generalised logistic model is employed to examine the frequency probabilities, whilst the three parameter Burr distribution is suggested to model the underlying severity distributions. The bivariate copula model is exploited in such a way that it allows us to adjust for a range of frequency dependence structures; a method for assessing the adequacy of the fitted severity model is outlined. A health claims dataset illustrates the methods; we describe the use of orthogonal polynomials for characterising the relationship between age and the frequency and severity models.     

Development,a Question of Opportunity? A Critique of the 2006 World Development Report: Equity and Development

The World Bank's World Development Report 2006 addresses equity and development, defining equity as respect for equal opportunities combined with the avoidance of absolute deprivation. Equity has up to now remained a marginal issue in development economics. This detailed analysis endeavours to place the subject within the context of the evolution of World Bank thinking and policies. The wealth of the concept is illustrated, the downside being the difficulty in defining it accurately. We also emphasise the gap between the prospects opened up by such an enlargement of development goals and the report's policy recommendations, which are generally merely an extension of the World Bank's traditional analyses.     

Psychological characteristics of volunteers in studies on gambling

Advertisements were published in local newspapers asking for volunteers to participate in a study on gambling. A battery of eleven questionnaires was mailed to the subjects assessing pathological gambling behavior, sociodemographic characteristics, motivation to gamble, erroneous perceptions about gambling, superstitious beliefs, depressive symptoms, social anxiety and avoidance, alcohol and drug abuse, problem-solving skills, and marital satisfaction. Subjects received $10 when they returned the questionnaires fully completed. Response rate was over 95%. Surprisingly, 29% of the respondents met the criterion for probable pathological gambling (score of 5 or more on the SOGS) and a further 16% were identified as potential pathological gamblers (scores of 3 or 4). The potential and probable pathological gamblers showed significant differences on motivational and cognitive variables related to gambling compared to those subjects who showed no signs of pathological gambling. The probable pathological gamblers reported significantly more signs of poor psychosocial functioning than the other two groups, including depressive symptoms, poor problem orientation, drug and alcohol abuse, and interpersonal conflict. The practical and theoretical implications of these results are discussed.     

The "X component" in Shanghai's social security reforms

In 2003, the Shanghai Bureau of Labour and Social Security launched the zhenbao (town insurance) programme, now widely known as 25 plus X. This scheme is regarded as an important experiment in social security reform and has been lauded for extending social security to areas where previously only segments of the population had mandatory coverage. Using data from 103,000 individuals enrolled in 25 plus X, we examine the extent to which the scheme represents an extension in social security coverage. Our analysis suggests that while it does represent an extension of benefits for some, for many it represents a considerable dilution in benefits.     

Dying patients' thoughts of ending their lives: a pilot study of rural New Mexico

Forty-nine hospice patients in rural New Mexico were directly interviewed concerning their thoughts about ending their lives. Thirty-one patients (63%) did not have thoughts of ending their lives, whereas 18 patients (37%) reported having suicidal thoughts. There were no differences between patients with and without thoughts of suicide related to gender; ethnicity; age; education; disease; religion; importance of religion; location of hospice agency; remaining financial, family, or spiritual issues; satisfaction with hospice care; sum of hospice personnel seen; or sum of medical equipment used. There were significant differences between patients with and without thoughts of suicide related to the number of household members (p = .02); the symptoms of trouble sleeping (p = .04) and nervousness (p =.03); and Medicare insurance coverage for hospice care (p =.01). No other symptom, including pain and hopelessness, was significant. Seven (39%) of the 18 patients who thought of ending their lives told someone about these thoughts. There were no variable differences between patients who did and did not tell someone about these thoughts.     

DSM-IV-J Criteria: A Scoring Error That May Be Modifying the Estimates of Pathological Gambling Among Youths

Previous studies have shown that prevalence rates among youths may be inflated due to a problem in understanding the questions of the SOGS-RA and DSM-IV-MR-J. This article reports another reason why prevalence rates of pathological gambling among youths may be inflated. In 1992, Fisher proposed 9 criteria (the DSM-IV-J) for diagnosing pathological gambling among youths, and formulated 12 questions (the Test questions) to identify the presence of these criteria. An analysis of a sample of studies using the DSM-IV-J reveals that some researchers have incorrectly used the 12 Test questions instead of the 9 criteria, which may have led to overestimated prevalence rates among youths. Other measurement issues may also be contributing to the overestimation of problem gambling in young people. The methodological implications of these issues are discussed.