Explaining Accessibility and Satisfaction Related to Healthcare: A Mixed-Methods Approach

Accessibility and satisfaction related to healthcare services are conceived as multidimensional concepts. These concepts can be studied using objective and subjective measures. In this study, we created two indices: a composite healthcare accessibility index (CHCA) and a composite healthcare satisfaction index (CHCS). To calculate the CHCA index we used three indicators based on three components of multidimensional healthcare accessibility: availability, acceptability and accessibility. In the indicator based on the component of accessibility, we included an innovative perceived time-decay parameter. The three indicators of the CHCA index were weighted through the application of a principal components analysis. To calculate the CHCS index, we used three indicators: the waiting time after the patient arrives at the healthcare service, the quality of the healthcare, and the healthcare service supply. These three indicators making up the CHCA index were weighted by applying an analytical hierarchy process. Three kinds of regressions were subsequently applied in order to explain the CHCA and CHCS indices: namely the Linear Least Squares, Ordinal Logistic, and Random Forests regressions. In these regressions, we used different independent social and health-related variables. These variables represented the predisposing, enabling, and need factors of people´s behaviors related to healthcare. All the calculations were applied to a study area: the city of Quito, Ecuador. Results showed that there are health-related inequalities in regard to healthcare accessibility and healthcare satisfaction in our study area. We also identified specific social factors that explained the indices developed. The present work is a mixed-methods approach to evaluate multidimensional healthcare accessibility and healthcare satisfaction, incorporating a pluralistic perspective, as well as a multidisciplinary framework. The results obtained can also be considered as tools for healthcare and urban planners, for more integrative social analyses that can improve the quality of life in urban residents.     

Intensities of mobility: kinetic energy,commotion and qualities of supercommuting

This paper explores the intensities of long-distance commuting journeys in order to understand how bodily sensibilities become attuned to the regular mobilities which they undertake. More people are travelling farther to and from work than ever before, owing to a variety of factors which relate to complex social and geographical dynamics of transport, housing, lifestyle, and employment. Yet, the experiential dimensions of long-distance commuting have not received the attention that they deserve within research on mobilities. Drawing from fieldwork conducted in Australia, Canada, and Denmark this paper aims to further develop our collective understanding of the experiential particulars of long-distance workers or ‘supercommuters’. Rather than focusing on the extensive dimensions of mobilities that are implicated in broad social patterns and trends, our paper turns to the intensive dimensions of this experience for supercommuters by developing an understanding of embodied kinetic energy, commotion and quality. Exploring how experiences of supercommuters are constituted by a range of different material and bodily forces enables us to more sensitively consider the practical, technical, and affective implications of this increasingly prevalent yet underexplored travel practice.     

Attachment Disturbances Delay Language Acquisition in Internationally Adopted Children

Cross-sectional research on internationally adopted children has indicated an association between early attachment disturbances and language deficits. Raaska et al. (2013 Raaska, H., Elovainio, M., Sinkkonen, J., Stolt, S., Jalonen, I., Matomäki, J., … Lapinleimu, H. (2013). Adopted children's language difficulties and their relation to symptoms of reactive attachment disorder: FinAdo study. Journal of Applied Developmental Psychology, 34(3), 152–160.[Crossref], [Web of Science ®] , [Google Scholar]) have speculated that this relationship is likely bidirectional. In an attempt to elucidate the causal relationship between these two risk factors, the attachment disturbances and language skills of 44 internationally adopted children were assessed in a cross-lagged structural equation model. Greater attachment disturbances at wave 1 predicted less gain in language by wave 2. In contrast, language at wave 1 was not predictive of attachment disturbances at wave 2. These results suggest that early attachment problems may present an important risk for later language development and should be an immediate and primary focus of post-adoptive intervention for families adopting internationally.     

Fundamental accrued capital gains and the measurement of top incomes: an application to Chile

Most previous studies of income inequality have either ignored capital gains or have used taxable realized capital gains to estimate top incomes. Neither of these approaches is fully satisfactory. We apply for the first time a new methodology that allows us to account for fundamental accrued capital gains as part of the top incomes in a theoretically consistent manner. We estimate the shares of the super-rich in Chile showing that accrued capital gains have a large impact on these estimates. Also, the top income shares estimated using fundamental capital gains appear to exhibit a more stable and presumably more plausible time profile than estimates based on capital gains derived from asset market variations.     

Parents' Family Time and Work Schedules: The Split‐Shift Schedule in Spain

This study used data on couples from the 2003 Spanish Time Use Survey (N = 1,416) to analyze how work schedules are associated with family, couple, parent–child, and non‐family leisure activities. Spain is clearly an interesting case for the institutionalized split‐shift schedule, a long lunch break rooted in the traditional siesta that splits the workday between morning and evening. Results showed strong negative associations between the split shift and both family and parent–child activities. The evening shift was negatively associated with couple and family time, but not with parent–child time. Women spent much more time than men in parent–child activities for all work categories, and they were more responsive to the spouse's work hours. Men were substantially more active than women in non‐family leisure, considering both individuals' and their spouses' work schedules. Altogether, this study has important implications for scientific and public policy debates.     

Assessment of a hybrid reform path: Social and labour policies in Uruguay, 1985–2005

Since Uruguay's return to democracy in 1985, a shift in economic and social policy has radically changed the country. The outcomes have been shaped by adjustment to international circumstances “by default”, stop‐go market reforms and the inconsistent pace and content of reforms. Unlike other countries in the region, Uruguay has not followed a resolutely neo‐liberal course, but rather a hybrid one. The end result has been a liberal labour regime coupled with a three‐dimensional social policy balancing the market, the old corporatist welfare State and the new welfare state targeting specific beneficiaries.     

Access to Land,Rural Development and Public Action: The When and the How

After being marginalised in the 1980s, land‐reform policies came back to national and international development agendas during the 1990s, resulting in a revival of academic research on the subject. This article reviews the empirical literature on access to land, rural development and public action for evidence on when and how the state should intervene in the allocation of rural land. The review suggests that positive impacts are obtained if, and only if, public actions on the allocation of land are carried out under certain conditions and in a certain way. The article ends by highlighting the need to elaborate empirical models that take into consideration opportunity costs and interactions, and that integrate individual responses with aggregate effects.