Articulation of Asthma and Its Care Among Low-Income Emergency Care Recipients

Low-income minority patients from East St. Louis, Illinois, a depressed midwestern urban city, who had visited acute care settings with asthma symptoms, participated in a focus group. Questions were constructed around the Health Belief Model to characterize participants' experiences in receiving asthma care, their confidence in long-term asthma self-management, barriers they perceived to managing their asthma, and recommendations they would make for improving asthma care in their community. Analysis of comments suggests an appreciable understanding of asthma triggers, limited coping behaviors for asthma symptoms, very limited practice of active asthma management, perception of the health care system as frequently insensitive to their needs or their knowledge of their own care, exchange of well-articulated information regarding how to deal with the system, and an apparent lack of awareness of any potential contribution of patient education or support system.     

Public Attitudes Toward Incentives for Organ Donation: A National Study of Different Racial/Ethnic and Income Groups

Attitudes toward monetary and nonmonetary incentives for living (LD) and deceased donation (DD) among the U.S. general public and different racial/ethnic and income groups have not been systematically studied. We studied attitudes via a telephone questionnaire administered to persons aged 18-75 in the continental United States. Among 845 participants (85% of randomized households), less than one-fifth participants were in favor of incentives for DD (range 7-17%). Most persons were in favor of reimbursement of medical costs (91%), paid leave (84%) and priority on the waiting list (59%) for LD. African Americans and Hispanics were more likely than Whites to be in favor of some incentives for DD. African Americans were more likely than Whites to be in favor of monetary incentives for LD. Whites with incomes less than $20 000 were more likely than Whites with greater incomes to be in favor of reimbursement for deceased donors' funeral expenses or medical expenses. The U.S. public is not generally supportive of incentives for DD, but is supportive of limited incentives for LD. Racial/ethnic minorities are more supportive than Whites of some incentives. Persons with low income may be more accepting of certain monetary incentives.     

从信息经济学的角度看病案信息经济价值

本文从信息经济学的角度出发，分析了病案信息的经济价值、市场需求及其开发利用，揭示了病案信息利用对相关市场参与者的利润、效用、福利增进的机制及在疾病控制中的重大作用，指明了加强病案信息开发的重要性和紧迫性，并提出建议。     

对高等学校创收收入管理的思考

随着我国教育体制改革的推进,高等学校的资金来源也发生了较大变化,创收收入成为高校收入中的很大一部分,高校的各个基层单位的创收收入也在不断增加,对于这部分资金的管理,有着十分重要的现实意义。目前的创收收入管理比较松散,存在很多弊病。需要通过纳入学校财务统一管理、严格创收分配支出管理、制定创收分成比例、定期检查等办法加强管理,使这部分资金得到合理利用,促进高校的教育、教学的发展。     

What Motivates Participation and Dropout Among Low‐Income Urban Families of Color in a Prevention Intervention?*

Low‐income urban parents of color enrolled in a parent training study were interviewed to understand what motivated their participation and what led 30% of them to subsequently drop out. Most enrolled because they wanted to be better parents. Most dropped out because of time and schedule constraints. Retention was higher when parents' motivations for participation matched program goals. Program location and qualities of the recruiter were cited most often as important; financial compensation was cited least often as important.     

Estimates of global research productivity in virology

The quantity and quality of published research in the field of Virology by different world regions was estimated in this study. Using the PubMed database, articles from journals included in the "Virology" category of the "Journal Citation Reports" database of the Institute for Scientific Information for the period 1995-2003 were retrieved. The world was divided into nine regions based on geographic, economic, and scientific criteria. Data on the country of origin of the research was available for 33,425 out of 33,712 articles (99.2% of all articles from the included journals). USA exceeds all other world regions in research production for the period studied (42% of total articles), with Western Europe ranking second (35.7%). The mean impact factor in articles published in Virology journals was highest for the USA (4.60), while it was 3.90 for Western Europe and 3.22 for the rest of the world (seven regions combined). USA and Canada ranked first in research productivity when both gross national income per capita (GNIPC) and population were taken into account. The results of this analysis show a distressing fact; the absolute and relative production of research in the field of Virology by the developing regions is very low, although viral diseases cause considerable morbidity and mortality in these areas. It is evident from this study that developing regions need more help from the developed regions to enhance research infrastructure.     

Psychological distress in high-risk youth with asthma

OBJECTIVE: To examine the relationship between asthma and psychological distress among adolescents already at-risk for adjustment problems secondary to lower economic strata and educational or vocational failure. METHOD: Twenty-five high-risk adolescents with asthma and 25 high-risk controls without asthma 16 to 21 years old completed the Brief Symptom Inventory, the Beck Depression Inventory, and the Beck Anxiety Inventory. RESULTS: Adolescents with asthma had significantly higher scores on multiple measures of psychological distress. Specifically, adolescents with asthma evidenced higher levels of anxiety, depression, and global psychological distress than those without asthma. CONCLUSIONS: High-risk adolescents with asthma may be more likely to experience psychological distress than those without asthma. Our findings suggest that asthma constitutes an additional significant independent stressor or risk factor among adolescents who already are at high risk for multiple adjustment problems.     

Identifying children at risk of intellectual disability in UNICEF’s multiple indicator cluster surveys: Cross-sectional survey

BackgroundResearch on intellectual disability has been criticized for primarily addressing the situation of people in high-income countries.Objective/Hypothesis. To determine whether MICS6 data on ‘functional difficulty associated with learning’ (FDAL) in low- and middle-income countries could be used as a proxy indicator for intellectual disability.MethodsSecondary analysis of nationally representative data collected in Round 6 of UNICEF’s Multiple Indicator Cluster Surveys (MICS) on 244,915 children in 18 middle- and low-income countries.ResultsThe prevalence of FDAL in middle- and low-income countries was broadly similar to the estimated prevalence of intellectual disability in high-income countries. The association between risk of FDAL and household wealth was weak, with alternative measures of developmental delay showing significantly stronger associations with household wealth. The risk of making potential false negative errors in identifying FDAL increases as household wealth and level of maternal education decrease. The risk of making potential false positive errors in identifying FDAL is greater among more highly educated respondents, although this association is only statistically significant among older children.ConclusionsThe use of FDAL as a proxy indicator for intellectual disability cannot be recommended given: (1) it would probably underestimate the overall prevalence of intellectual disability in middle and low income countries; and (2) it is likely to be overestimate prevalence among families with higher socio-economic position (SEP) and underestimate prevalence among families with lower SEP.     

The effects of income on health: Evidence from lottery wins in Singapore

We estimate the causal effects of household income on self-reported health status by exploiting random variations in the amount of lottery prizes won. We find that a S$10,000 (US$7,245) increase in income via lottery wins improves individuals’ health by a standard deviation of 0.18. As possible mechanisms, we find that lottery wins increase household consumption spending and improve overall life satisfaction, but do not change healthcare spending, labor supply, and risky health behavior. Previous studies, which focused on the health effects of lottery prizes in Western European countries with strong social safety nets, do not find positive effects other than those on mental health. By contrast, the current study contributes to the literature by providing new evidence of the positive health effect of income via lottery wins in a country without strong social safety nets.     

Inequities in access to VA’S aid and attendance enhanced pension benefit to help Veterans pay for long‐term care

ObjectiveTo examine characteristics that are associated with receipt of Aid and Attendance (A&A), an enhanced pension benefit for Veterans who qualify on the basis of needing daily assistance, among Veterans who receive pensions.Data sourcesSecondary data analysis of 2016‐2017 national VA administrative data linked with Medicare claims.Study designObservational study examining sociodemographic, medical, and healthcare utilization characteristics associated with receipt of A&A among Veterans receiving pension.Principal findingsIn 2017, 9.7% of Veterans with pension newly received the A&A benefit. The probability of receiving A&A among black and Hispanic pensioners was 4.6 percentage points lower than for white pensioners (95%CI = −0.051, −0.042). Married Veterans receiving pension had a 4.4‐percentage point higher probability of receiving A&A (95%CI = 0.039, 0.048). Most indicators of need for assistance (eg, home health utilization, dementia, stroke) were associated with significantly higher probabilities of receiving A&A, with notable exceptions: pensioners with a diagnosis of Post‐Traumatic Stress Disorder (marginal effect = −0.029 95%CI = −0.037, −0.021) or enrolled in Medicaid (marginal effect = −0.053, 95%CI = −0.057, −0.050) had lower probabilities of receiving A&A. Unadjusted and adjusted rates of receiving A&A among Veterans receiving pension varied by VA medical center.ConclusionsThis study identified potential inequities in receipt of the A&A enhanced pension among a sample of Veterans receiving pension. Increased Veteran outreach, provider education, and VA office coordination can potentially reduce inequities in access to this benefit.