Building Health Insurance Literacy: Evidence from the Smart Choice Health Insurance™ Program

With the passage of the Patient Protection and Affordable Care Act (ACA) of 2010, the health insurance literacy of Americans became a critical issue. In response, a consumer education program was created and tested by university researchers and educators associated with Cooperative Extension. This article draws extensively on the emerging literature on health insurance literacy and on data from participants in the Smart Choice Health Insurance? program. The intent of the study was to understand socio-demographic and environmental variables that predict initial health insurance literacy and gains in health insurance literacy. A standardized instrument measuring health insurance literacy was used to collect the data. Multivariate analysis showed higher income consumers demonstrated greater initial health insurance literacy scores compared to middle income consumers, whereas younger, male and lower educated consumers reported lower initial health insurance literacy. After participating in the Smart Choice Health Insurance? program, consumers who made greater gains in their health insurance literacy tended to be female, higher income, and consumers residing in states that showed supportiveness of the ACA. The findings highlight the importance of considering sociodemographic characteristics in program design and delivery, as well as how contextual issues, such as the political environment, might impact the delivery of educational efforts. Findings from the analyses help inform ways to adapt and tailor educational opportunities that focus on health insurance literacy for a range of consumers.     

Gambling-related problems across life domains: an exploratory study of non-treatment-seeking weekly gamblers

This study uses content analysis to provide a qualitative exploration of how life roles are affected by frequent (i.e. at least weekly) gambling, based on in-depth interviews with a community sample of 161 non-treatment-seeking frequent gamblers. Over half (51.6%) of the participants indicated problems associated with gambling and 131 examples were identified. The majority of problems were relational (50.4%), followed by financial (19.8%), work (13.7%), and school related (8.4%). Slightly less than half of participants (41.7%) reported losses due to gambling and 92 examples were provided. The most frequently reported loss was identity related (54.3%), which included self-esteem/shame (38.0%), estrangement from family (34.0%), estrangement from friends (16.0%), and estrangement from work colleagues (6.0%). Additional losses included health (29.3%) and financial (8.7%). Almost two-thirds of participants (64.6%) reported difficulty concentrating in family (18.4%), work (16.8%), and school (9.6%) activities, whereas general concentration problems comprised an additional 48.8% of the examples provided. Half of participants (49.1%) discussed behavioral withdrawal due to gambling, which included withdrawal from work (44.3%), relationships (24.5%), school (15.1%), and personal (6.6%) activities. These findings paint a complex picture of how gambling interferes with different life roles for some frequent gamblers, identifying important areas for future research and practice.     

Lung Cancer Risk from Radon in Marcellus Shale Gas in Northeast U.S. Homes

The amount of radon in natural gas varies with its source. Little has been published about the radon from shale gas to date, making estimates of its impact on radon‐induced lung cancer speculative. We measured radon in natural gas pipelines carrying gas from the Marcellus Shale in Pennsylvania and West Virginia. Radon concentrations ranged from 1,520 to 2,750 Bq/m³ (41–74 pCi/L), and the throughput‐weighted average was 1,983 Bq/m³ (54 pCi/L). Potential radon exposure due to the use of Marcellus Shale gas for cooking and space heating using vent‐free heaters or gas ranges in northeastern U.S. homes and apartments was assessed. Though the measured radon concentrations are higher than what has been previously reported, it is unlikely that exposure from natural gas cooking would exceed 1.2 Bq/m³ (<1% of the U.S. Environmental Protection Agency's action level). Using worst‐case assumptions, we estimate the excess lifetime (70 years) lung cancer risk associated with cooking to be 1.8×10^?4 (interval spanning 95% of simulation results: 8.5×10^?5, 3.4×10^?4). The risk profile for supplemental heating with unvented gas appliances is similar. Individuals using unvented gas appliances to provide primary heating may face lifetime risks as high as 3.9×10^?3. Under current housing stock and gas consumption assumptions, expected levels of residential radon exposure due to unvented combustion of Marcellus Shale natural gas in the Northeast United States do not result in a detectable change in the lung cancer death rates.     

The Ebb and Flow of Environmentalism

This essay examines the pattern of ebb and flow in the environmental movement in the United States. Although the movement has experienced periods of expansion and contraction over the last century, environmentalism has sustained significant mobilization with the evolution of its organizational forms and tactics. Mass demonstrations and other forms of public protest defined the emergence of the modern environmental movement in the 1960s and early 1970s, and grassroots action remains important, particularly in response to the urgency of climate change. However, the movement has also relied increasingly on institutionalized organizational forms and conventional tactics such as litigation and lobbying. Some critics argue that decentralized networks and disruptive tactics are essential for inspiring a new era of impassioned environmental activism, while others contend that the complexity of current environmental problems requires more formalized structures and focused legislative advocacy. We conclude that the diversity of organizational forms and activities in the environmental movement has maintained the movement over many decades, and that this diversity can aid in effecting comprehensive change.     

The Intersubjective Experience of the Physical Body in the Clinical Setting of Eating Disorders

This paper will illuminate one dimension of self-disclosure as it relates to the inescapable presence of the body in treatment, and the female clinician’s ability to bring her physical body into clinical discussions during an encounter with a female client with an eating disorder. Although the clinical literature on eating disorders validates that transference and countertransference issues are particularly powerful, it generally neglects the exploration of these issues specific to the body’s physical presentation. Since body dissatisfaction is increasingly normative for women today, female clinicians need to have a theoretical road map on which to rely when they encounter a shared body experience. Thus, in order to encourage discussions of the therapist’s body in clinical social work practice, the body needs to be situated in a larger theoretical framework within which it can be explained and located; this framework is object relations theory viewed through an intersubjective lens. Concepts from object relations theory will demonstrate the importance of the body in the clinical exchange by highlighting the parallel between Winnicott’s ‘good enough’ mother and the ‘good enough’ therapist’s body. When the therapist is able to judiciously invite discussions of her body into the clinical arena, the client is given the opportunity to move from object relating to object usage. A case presentation exemplifies how this conceptual framework can be applied to clinical social work practice, strengthening the relationship between knowing and doing.     

Improving Weight of Evidence Approaches to Chemical Evaluations

Federal and other regulatory agencies often use or claim to use a weight of evidence (WoE) approach in chemical evaluation. Their approaches to the use of WoE, however, differ significantly, rely heavily on subjective professional judgment, and merit improvement. We review uses of WoE approaches in key articles in the peer‐reviewed scientific literature, and find significant variations. We find that a hypothesis‐based WoE approach, developed by Lorenz Rhomberg et al., can provide a stronger scientific basis for chemical assessment while improving transparency and preserving the appropriate scope of professional judgment. Their approach, while still evolving, relies on the explicit specification of the hypothesized basis for using the information at hand to infer the ability of an agent to cause human health impacts or, more broadly, affect other endpoints of concern. We describe and endorse such a hypothesis‐based WoE approach to chemical evaluation.     

Testofen,a specialised Trigonella foenum-graecum seed extract reduces age-related symptoms of androgen decrease,increases testosterone levels and improves sexual function in healthy aging males in a double-blind randomised clinical study

This study examined the effect of Testofen, a specialised Trigonella foenum-graecum seed extract on the symptoms of possible androgen deficiency, sexual function and serum androgen concentrations in healthy aging males. This was a double-blind, randomised, placebo-controlled trial involving 120 healthy men aged between 43 and 70 years of age. The active treatment was standardised Trigonella foenum-graecum seed extract at a dose of 600?mg/day for 12 weeks. The primary outcome measure was the change in the Aging Male Symptom questionnaire (AMS), a measure of possible androgen deficiency symptoms; secondary outcome measures were sexual function and serum testosterone. There was a significant decrease in AMS score over time and between the active and placebo groups. Sexual function improved, including number of morning erections and frequency of sexual activity. Both total serum testosterone and free testosterone increased compared to placebo after 12 weeks of active treatment. Trigonella foenum-graecum seed extract is a safe and effective treatment for reducing symptoms of possible androgen deficiency, improves sexual function and increases serum testosterone in healthy middle-aged and older men.     

Need Fulfillment in Polyamorous Relationships

Polyamory is characterized by simultaneous consensual romantic relationships with multiple partners. Polyamory allows individuals to fulfill their relationship needs with multiple romantic partners, yet researchers have not identified how having needs met in one romantic relationship may be related to relationship outcomes in a concurrent relationship. Polyamorous individuals (N=1,093) completed online measures of need fulfillment, relationship satisfaction, and commitment for two concurrent romantic relationships. Participants reported high levels of need fulfillment and satisfaction in both relationships. Need fulfillment with one partner negatively predicted approximately 1% of the variance in relationship satisfaction with the other partner; however, there was no association between need fulfillment with one partner and commitment to the other. Generally, the findings suggest that polyamorous relationships are relatively independent of one another. This study provides initial evidence that polyamory may be a viable and fulfilling alternative way of conducting intimate relationships.     

Leveraging the common and outsourcing the distinct: institutional difference and multinational company identity in emerging economies

ABSTRACT

This paper explores the challenges of outsidership faced by multinational companies (MNCs) accessing emerging economies. The paper departs from popular conceptualisations of culture drawing instead on social identity theory as part of an institutions-based view, to explain how employing a singularities approach can allow the identification of commonalities of Indianness and Australianness that can be leveraged to ameliorate negative socially embedded business norms that pose a challenge to MNC success in emerging economies. This study shows that despite recognised formal (regulatory) and informal (cultural) differences, managers of Australian MNCs operating in India were able to innovatively identify and exploit cultural commonalties/singularities to ease cultural adjustment and mitigate intergroup conflict, allowing them to achieve an innovative institutional fit. The paper discusses how, using this approach, sole-venture MNCs can access many of the benefits provided by collaborative entry modes while preserving MNC identity. We further propose that the singularities approach can provide a valuable starting point to develop culturally appropriate competence training initiatives.     

Predicting perceptions of sexual harassment based on type of resistance and belief in token resistance

This study examined perceptions of sexual harassment based on belief in women's use of token resistance and a victim's physical or verbal resistance to unwanted sexual attention, described in experimentally manipulated vignettes. Findings from 541 undergraduates revealed that a stronger belief in token resistance was associated with weaker perceptions of sexual harassment. Results showed that any type of resistance led to stronger perceptions of sexual harassment than no resistance at all, except for those with a stronger belief in women's use of token resistance. Perceptions among those with a stronger belief strengthened only when there were two forms of resistance offered simultaneously. These findings extend the literature by investigating the influence of physical resistance on sexual harassment perceptions.