Expanding social health protection in Cambodia: An assessment of the current coverage potential and gaps,and social equity considerations

The Royal Government of Cambodia recently launched its National Social Protection Policy framework to strengthen and expand social security and assistance. To inform social health protection policy, we examine socio-economic survey data and administrative coverage data to assess the coverage potential of existing coverage mechanisms and current gaps; and compare equitable contribution rates. Over 53 per cent of the population currently has no social health protection coverage mechanism, and about 16 per cent of the population who do have access to a mechanism are not yet enrolled. Current expansion efforts focus on the formal employee scheme, primarily benefiting individuals from higher income households. In addition, recent coverage expansion to some informal workers leaves significant gaps, particularly among the informal sector. We find out-of-pocket health care expenditure to be an excessive share of income among lower wealth quintile individuals and conclude they are financially vulnerable. Finally, we illustrate that an equitable approach to individual, monthly health care contributions among the lower three quintiles has a severely limited potential for revenue generation, and collection costs could exceed the amount collected. Therefore, we recommend that vulnerable groups should be exempted from contribution payments as social health protection is expanded.     

A generalized Bayesian nonlinear mixed‐effects regression model for zero‐inflated longitudinal count data in tuberculosis trials

In this paper, we investigate Bayesian generalized nonlinear mixed‐effects (NLME) regression models for zero‐inflated longitudinal count data. The methodology is motivated by and applied to colony forming unit (CFU) counts in extended bactericidal activity tuberculosis (TB) trials. Furthermore, for model comparisons, we present a generalized method for calculating the marginal likelihoods required to determine Bayes factors. A simulation study shows that the proposed zero‐inflated negative binomial regression model has good accuracy, precision, and credibility interval coverage. In contrast, conventional normal NLME regression models applied to log‐transformed count data, which handle zero counts as left censored values, may yield credibility intervals that undercover the true bactericidal activity of anti‐TB drugs. We therefore recommend that zero‐inflated NLME regression models should be fitted to CFU count on the original scale, as an alternative to conventional normal NLME regression models on the logarithmic scale.     

试论北方少数民族生殖崇拜的萨满教根基

中国少数民族中较常见的生殖崇拜现象往往和萨满教的性神秘观相关。在萨满教神话、仪式以及萨满教巫术操作过程中几乎都有一些与性有关的内容。在萨满教观念中,性器是一个富有巫术力量的神秘器官。在北方民族萨满教后期发展中,生殖崇拜和祖先崇拜往往结伴而行     

Trends in Women's Career Patterns and in Gender Occupational Mobility in Britain

This paper uses retrospective data from the SCELI surveys to make a detailed investigation of changing career patterns and gender differences in occupational status over the period 1946–86. A summary variable is developed and used to examine the relationships between changing employment trends and respondents' occupational status. Occupational status, as the Hope-Goldthorpe scale value, is measured throughout the life-course and changes over time are examined. The main findings of the study are that despite the increase in women's qualifications and the proportion of women in the workforce, their human capital has not greatly increased although their careers have become increasingly variable. Men and childless women experience occupational status increasing over life-course and time but part-time employed women do not. Class of origin is more important to status for men than for women, while qualifications are important for both. Women's careers are increasingly affected by discontinuity and part-time employment.     

A criterion-referenced multidimensional job-related model prediction capability to perform occupations among persons with chronic pain

OBJECTIVE: The purpose of this prospective study was an exploration of the construct of the criterion-referenced multidimensional job-related model (CMVA) aimed for predicting patients' with chronic pain capability to perform occupations. METHODS: The study samples were 1) participants (n=84) who at present were not performing employed work (median sick-listing period 12 months) because of chronic pain and 2) participants (n = 104) who at present were performing employed work at least 20 hours of a workweek. The participants had experiences of 40 different occupations classified into five of the occupational categories of Jist's Enhanced Dictionary of Occupational Titles. Data were collected through ten assessment instruments and a structured interview, comprising 54 variables and 465 items. Data were analyzed using multiple regression with forward entering of variables. RESULTS: The CMVA model (Adjusted R^2 0.777, F (4, 183) = 164.067; p<0.001) was able to explain 78% of the variance. CMVA contained the aspects; "the work demands-variable, the person-variable of work life values, the environment-variable of social support and the two occupational performances-variables; self-perceived capability to perform work tasks/the simulated work tasks". CONCLUSIONS: The construct of CMVA was robust suggesting that among persons with chronic pain, the predictors focusing on their capability to perform occupations are of great importance.     

A DIFFICULTY WITH MONETARIST MODELS OF HYPERINFLATION

The Cagan, Barro, and Allais analyses of hyperinflation have been shown to be questionable. Their impressive empirical results are a direct result of the method used to solve their models. Their solution does not depend on the input forcing function (the rate of change of the money stock) of their differential equation systems but expresses one dependent variable, real money balances, as a function of another dependent variable, the rate of change of prices. As a result, price changes which are unrelated to changes in the money stock acting through the dynamic structure of the model will incorrectly yield a good fit of the data.     

Do work commutes moderate the association between perceived neighborhood disorder and psychological distress?

ABSTRACT

Although numerous studies show that living in a neighborhood that is characterized by disorder (crime and dilapidation) can be psychologically distressing, very few studies have considered the element of exposure time or duration of exposure to adverse neighborhood environments. In this paper, we explore the intersection of commuting, mental health, and the subjective experience of neighborhood disadvantage and impoverished community life. Using data from the Welfare, Children, and Families project (2001), a probability sample of 1057 low-income women with children living in Boston, Chicago, and San Antonio, we test whether the association between neighborhood disorder and psychological distress is moderated or attenuated by commuting time and distance. Our results show that although neighborhood disorder is associated with higher levels of anxiety, depression, and somatization, disorder tends to be less distressing for residents who are able to spend time away from these environments through longer commuting times and distances. In other words, working away from one’s neighborhood of residence may help to mitigate the adverse psychological consequences of neighborhood disorder. Our findings support previous research on the stress process and neighborhood disorder. Our work builds on the commuting literature by re-conceptualizing commuting time and distance as protective resources for disadvantaged populations.