Structural Influences on Racial and Ethnic Disparities in Women's Health Care

This paper summarizes recent research about several structural influences on racial and ethnic disparities in women's health care. While disparities in women's health care access and quality emanate from a number of sources, this paper focuses on the intersection between race/ethnicity and several structural factors (access to insurance coverage, discrimination, neighborhood characteristics, and social isolation). We identify gaps in the literature and suggest directions for future research. Particularly needed are gender studies of the impact of race/ethnicity that transcend the black–white dichotomy, that attend to location, that examine variation in social networks, and that clarify the impact of discrimination on women's health care.     

Mechanics of replacing benefit systems with a basic income: comparative results from a microsimulation approach

Recent debates of basic income (BI) proposals shine a useful spotlight on the challenges that traditional forms of income support are increasingly facing, and highlight gaps in social provisions that largely depend on income or employment status. A universal “no questions asked” public transfer would be simple and have the advantage that no-one would be left without support. But an unconditional payment to everyone at meaningful but fiscally realistic levels would likely require tax rises as well as reductions in existing benefits. We develop a comprehensive BI scenario that facilitates an assessment of the resulting fiscal and distributional effects in a comparative context, undertake a microsimulation study to quantify them, and propose a simple decomposition to identify the mechanisms that drive effects in different country contexts. Results illustrate the challenges, but also the strengths, of existing social protection systems. A BI would fix benefit coverage gaps that exist in many countries, but would require very substantial tax rises if it were to be set at a meaningful level. As support would not be targeted on those most in need, it would not be a cost-effective way of directly reducing income poverty.     

An Anguished Relationship: The White Aged Institutionalized Client and the Non-White Paraprofessional Worker

Surprisingly little has been written about the polarization between the white, aged, institutionalized client and the nonwhite paraprofessional despite the pervasiveness of this phenomena and its adverse effects. This paper explores the discrepancy between cultural values and practice. The ethnocultural factors that influence conflict and provide the background of behavior which is determined by programming that the person carries around with her/himself are discussed. In sum, some pithy questions highlight the view that changed managerial attitudes, more innovative staff development techniques, and changed practice interventions are needed to obviate an intractable wrong.     

Transmuted Weibull distribution: Properties and estimation

In this article, we investigate the potential usefulness of the three-parameter transmuted Weibull distribution for modeling survival data. The main advantage of this distribution is that it has increasing, decreasing or constant instantaneous failure rate depending on the shape parameter and the new transmuting parameter. We obtain several mathematical properties of the transmuted Weibull distribution such as the expressions for the quantile function, moments, geometric mean, harmonic mean, Shannon, Rényi and q-entropies, mean deviations, Bonferroni and Lorenz curves, and the moments of order statistics. We propose a location-scale regression model based on the log-transmuted Weibull distribution for modeling lifetime data. Applications to two real datasets are given to illustrate the flexibility and potentiality of the transmuted Weibull family of lifetime distributions.     

Does antenatal education affect labour and birth? A structured review of the literature

ObjectiveTo undertake a structured review of the literature to determine the effect of antenatal education on labour and birth, particularly normal birth.MethodOvid Medline, CINAHL, Cochrane and Web of Knowledge databases were searched to identify research articles published in English from 2000 to 2012, using specified search terms in a variety of combinations. All articles included in this structured review were assessed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).FindingsThe labour and birthing effects on women attending antenatal education may include less false labour admissions, more partner involvement, less anxiety but more labour interventions.ConclusionThis literature review has identified that antenatal education may have some positive effects on women's labour and birth including less false labour admissions, less anxiety and more partner involvement. There may also be some negative effects. Several studies found increased labour and birth interventions such as induction of labour and epidural use. There is contradictory evidence on the effect of antenatal education on mode of birth. More research is required to explore the impact of antenatal education on women's birthing outcomes.