PHYSICIAN PAYMENT AND PRENATAL CARE ACCESS FOR HETEROGENEOUS PATIENTS

Changes in prospective payments to reimburse physicians for serving Medicaid patients have been rising in many States. Policy makers anticipate that higher fees will increase access to services. This paper explores whether physicians respond to the increased payment by increasing access differentially by patient type. Physicians may gain from serving only those patients expected to be of low medical risk and cost. Empirical tests using Medicaid data from 1988 to 1991 for prenatal care provision in Washington State show fees are significant in improving access to care for the average patient with significantly greater improvement for Hispanics and single patients. ( JEL I11, I18)     

Understanding Collaborative Value Creation by Environmental Nonprofit and Renewable Energy Business Partnerships

Many environmental nonprofit organizations (ENPOs) seek to create sustainability value by promoting environmental principles and influencing policymakers to support pro-environmental legislation. One strategy used by ENPOs to enhance the value creation process is the development of partnerships with businesses. Semi-structured interviews with leaders of six national ENPOs in the United States were conducted to examine the sources and types of value created by collaborations with renewable energy businesses, and the partnership processes and outcomes that are most desirable. The goal was to understand how and why ENPOs seek partnerships, what the potential benefits are, and whether or not ENPO leadership orientation, as characterized by their perceptions of the political opportunity structure, political ideology, and environmental philosophy, led to different views of partnerships for sustainability value creation. The finding that differences in the partnership perspectives of the ENPO leadership did not directly link to differences in the leadership orientations suggests that none of the orientations precluded partnering in general and may even have been enablers in some cases.     

Recruitment and retention of ethnically diverse long-term family caregivers for research

The inclusion of ethnically diverse long-term care family caregivers is significant in research, particularly in social work research because of the importance placed on diverse populations. However, the inclusion of diverse populations poses a set of unique recruitment and retention challenges for researchers. This process can be particularly complicated when multiple long-term care recruitment partners are utilized and when the project involves a multi-phase data collection plan with different minority recruitment needs for each phase. In our work we learned that: (a) research teams should plan for gender and ethnic differences in the ways that family caregivers think about and approach research involvement, (b) socioeconomic disadvantages and ethnic differences have both independent and interactive effects on research participation, (c) physical and emotional "costs," as well as financial costs, of caregiver participation should be given more attention in informed consent procedures, and (d) agency collaboration for minority recruitment and retention requires continuous nurturing and sustained effort by all members of the research team.     

Mental health service utilization in children adopted from US foster care,US private agencies and foreign countries: Data from the 2007 National Survey of Adoption Parents (NSAP)

Aims

In this analysis, we (1) described the rate of mental health service utilization for children from domestic foster care adoption, domestic private adoption, and international adoption and (2) analyzed the effect of common risk factors on mental health service utilization.

Data

As part of the 2007 National Survey on Adoptive Parents (NSAP), parents with children 5–17 years old (N = 1722) were asked if their children had received mental health services and how helpful these services were. Parents also provided data on the children's demographics and likelihood of pre-adoption adversity (e.g., abuse).

Results

For boys, mental health services were utilized by 52.4% of domestic foster care adoptees, 41.0% domestic private adoptees, and 40.0% of international adoptees. For girls, the corresponding rates were 36.3%, 24.8%, and 30.9% respectively. Parents reported that the services were very helpful for about half of the children. Logistic regression analyses showed that adoptees from domestic foster care were more likely than international adoptees to have received mental health services, but there was no difference between domestic private adoptees and international adoptees. Older age at placement, older age at assessment, having special health care needs, and being male all increased the odds for having received mental health services.     

Tissue Dosimetry for Reactive Metabolites

In recent pharmacokinetically based risk assessments for methylene chloride, Andersen et al. argued that total reactive metabolite (TRM) divided liver weight was the proper measure of dose to target tissue, while the EPA argued that TRM divided by body weight to the two-thirds power was more appropriate. We demonstrate that the proper tissue metric for a reactive metabolite is dependent upon the mode of deactivation: metabolic or spontaneous. It is argued that the most appropriate measure of tissue dosimetry is: (1) TRM divided by the three-fourths power of body weight if the reactive metabolite is metabolically deactivated; or (2) TRM divided by body weight if the reactive metabolite is spontaneously deactivated.     

Knowledge-Based Representations of Risk Beliefs

Beliefs about risks associated with two risk agents, AIDS and toxic waste, are modeled using knowledge-based methods and elicited from subjects via interactive computer technology. A concept net is developed to organize subject responses concerning the consequences of the risk agents. It is found that death and adverse personal emotional and sociological consequences are most associated with AIDS. Toxic waste is most associated with environmental problems. These consequence profiles are quite dissimilar, although past work in risk perception would have judged the risk agents as being quite similar. Subjects frequently used causal semantics to represent their beliefs and "% of time" instead of "probability" to represent likelihoods. The news media is the most prevalent source of risk information although experiences of acquaintances appear more credible. The results suggest that "broadly based risk" communication may be ineffective because people differ in their conceptual representation of risk beliefs. In general, the knowledge-based approach to risk perception representation has great potential to increase our understanding of important risk topics.     

Spousal caregiving when the adult day services center is closed.

Of those spousal caregivers who identified a time when they most needed assistance, morning or afternoon time periods appeared to be most problematic. Spousal caregivers who reported receiving respite time on the weekends identified adult children as the informal support person most often available. However, more than half of the caregivers reported having no respite time during the weekend. Differences in the ways spousal caregivers spent their respite time on the weekends, if available, varied by gender, length of tenure as a caregiver, and age.     

Recent Suicide Attempts Across Multiple Social Identities Among Gay and Bisexual Men: An Intersectionality Analysis

This study draws from intersectionality to describe variations in recent suicide attempts (RSA) among gay and bisexual men (GBM) across sociodemographics. Using survey data, logistic regression modeling explored RSA in two analytical stages: (1) the individual effects of each sociodemographic were measured; (2) two-way interaction terms between sociodemographics were tested and added to the models created in stage A. In stage A, only education and income achieved significance. In stage B, the study found that (a) education and income interacted significantly such that the odds of RSA increased for those with a lower income and a lower education; (b) sexual orientation and partnership status interacted, resulting in decreased odds among bisexual men in heterosexual partnerships; and (c) income and education interacted with geography; the effects of these variables were significant only among urban men. These findings suggest that GBM are at unequal risk of RSA according to intersecting sociodemographics.     

A psychometric analysis of the Ottawa self-injury inventory-f

Objective: This study seeks to evaluate the psychometric properties of the Ottawa Self-Injury Inventory-Functions (OSI-F) for assessing nonsuicidal self-injury (NSSI), a condition for further study in the DSM-5. Participants: Participants included 345 students who indicated a history of self-injury in a university counseling center over six semesters from August 2009 to May 2012. Method: Participants completed the OSI-F as a measure on the psychological intake for the university counseling center. Results: Factor analysis, Cronbach's alpha coefficients, independent sample t tests, and correlations were examined and demonstrated adequate reliability and validity. Conclusions: A three-factor solution emerged from the restructured OSI-F relating to Affect Regulation, Exhilaration, and Release. Affect regulation dimensions were predictive of continuing to self-injure and related to depression, anxiety, and overall mental health. Additionally, women were more likely to attribute self-injuring to affect regulation.     

I Wish: Multigenerational Regrets and Reflections on Teaching Children About Money

Millennials are struggling to meet current financial challenges. As we strive to improve financial capability in future generations, it is important that we look to the primary source of financial education: parents. This qualitative, multigenerational study explored what Millennials and their parents and grandparents (N?=?153) wish they had been taught about finances by their parents, as well as what parents and grandparents wish they had taught their children. Thematic content coding of the interviews revealed three core “I Wish” themes: “Practical Knowledge,” “Financial Stewardship,” and “Open Communication.” These findings can assist researchers, family life educators, financial educators, parents, and future parents to enhance the financial education provided by parents in the home.