Experiences of African American adolescent fathers

This study examines 1993 Medicare expenditures for enrollees in 63 managed care plans that were reimbursed on a cost basis. We find that government spending for enrollees in cost-reimbursed plans in 1993 was substantially greater than it would have been had these enrollees instead received care in traditional fee-for-service Medicare or in a Medicare risk plan. The increase was due entirely to the much higher expenditures for Part B services under cost reimbursement. The findings suggest that Medicare cost reimbursement of health plans should be eliminated or significantly modified.     

Sexual relationships, risk behaviour, and condom use in the spread of sexually transmitted infections to heterosexual men

Adolescents attending 5 state schools for the deaf responded to a 35-item questionnaire designed to probe their knowledge of AIDS. The 129 students in grades 9-12 had extremely limited core knowledge of AIDS, with the correct answers to only 8 of the 35 questions known by most students in all 4 grades. A minority of males and females knew the answers to most questions, indicating that AIDS education programs for deaf adolescents are urgently needed.     

Medicare spending for elderly beneficiaries who need long-term care

To better understand how elderly people with long-term care needs might be affected by Medicare's greater reliance on risk plans, we examine Medicare spending for this population using data from the Medicare Current Beneficiary Survey. Medicare spending for elderly people with functional limitations is substantially greater than for other beneficiaries, but highly variable. Medicare spends more, however, for community residents with moderate to severe functional limitations than for nursing home residents with similar degrees of limitation. These results raise concerns about the incentives of Medicare risk plans in caring for enrollees with long-term care needs.     

What information do consumers want and need?

This paper reviews information from surveys and focus group studies about how consumers define high-quality care and the types of information they want when making decisions about which health plan to join. The authors also interviewed consumer advocacy groups and persons responsible for disseminating health plan information to Medicare enrollees in various types of managed care plans to learn about the types of plan information that Medicare enrollees most often request. They describe the types of information that should be made available to consumers and the challenges involved in making this information understandable and useful.     

Assessing influenza immunization rates in Medicare managed care plans: a comparison of three methods

BACKGROUND: In an effort to improve care delivered to Medicare beneficiaries, the Health Care Financing Administration (HCFA) has encouraged competitive Medicare risk plans to collaborate on quality improvement projects. PRO-West, a private, nonprofit quality improvement organization, fostered a collaboration of all Medicare risk plans in Washington State in order to assess and improve influenza immunization rates among seniors enrolled in managed care. METHODOLOGY: After the 1994-1995 influenza immunization season, immunization rates were determined for each participating plan from administrative data and medical record review. In the 1995-1996 season, these methods were supplemented with a telephone survey. The survey was used to identify perceived barriers to immunization and to estimate immunization rates. RESULTS: Immunization rates, as estimated by administrative data and medical record review, were similar for both years. The average immunization rate using administrative data for the 1995-1996 flu season was 60.6% (range, 42.8% to 72.3%). The estimated rate increased to 77.8% (95% confidence interval, 75.3% to 80.3%) when the telephone survey data were added. Medical record review contributed little additional information. CONCLUSIONS: Influenza immunization rates for seniors enrolled in Medicare risk plans in Washington State exceed those reported for fee-for-service Medicare beneficiaries. Telephone surveys resulted in higher and probably more valid estimates of influenza immunization rates than did analysis of administrative data and medical records. Plans with lower rates can emulate "benchmark" plans that are explicit about the methods they use to achieve high coverage rates. Medicare risk health plans competing in the same markets can collaborate in quality assessment activities in an effective manner.     

Mental health services in managed care: quality questions remain

Primary care physicians are often the professionals to whom older patients turn for advice about medical coverage in Medicare managed care health plans. To assist in this dialogue, these authors outline current characteristics and financial arrangements for psychiatric and mental health services in Medicare managed care. Advantages and disadvantages of Medicare managed care for enrollees with mental disorders are outlined. Mental health "carve-out" and "carve-in" models are defined, and questions are raised about the number of psychiatrists and other mental health care providers needed to provide appropriate care for a plan's enrollees.     

Memorial consequences of answering SAT II questions.

Many thousands of students take standardized tests every year. In the current research, we asked whether answering standardized test questions affects students' later test performance. Prior research has shown both positive and negative effects of multiple-choice testing on later tests, with negative effects arising from students selecting incorrect alternatives on multiple-choice tests and then believing they were correct (Roediger & Marsh, 2005). In the current experiments, undergraduates and high school students answered multiple-choice questions retired from SAT II tests (that are no longer in the testing pool) on biology, chemistry, U.S. history, and world history, and later answered cued-recall questions about these subjects. In 3 experiments, we observed positive testing effects: More final cued-recall questions were answered correctly if the items had appeared on the initial multiple-choice test. We also sometimes observed negative testing effects: intrusions of multiple-choice distractors as answers on the final cued-recall test. Students who scored well on the initial test benefited from taking the test, but lower achieving students showed either less benefit (undergraduates) or costs from the testing (high school students). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Black applicants' reactions to affirmative action plans: Effects of plan content and previous experience with discrimination.

This study examined the effects of plan content and previous experience with discrimination on Black respondents' reactions to affirmative action plans. Black engineering students (N=1,173) were randomly assigned to 1 of 6 plans implemented by a hypothetical organization and were asked to provide ratings of perceived fairness and intention to pursue a position at the organization. There were significant effects of plan content on perceived fairness and job pursuit intentions, Perceived fairness mediated the effect of content on intentions. Furthermore, previous experience with discrimination interacted with content to affect intentions. Individuals who had experienced relatively more discrimination in the workplace reported stronger intentions to pursue a position at an organization whose plan specified special training opportunities for minorities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Values, valences, and choice: The influences of values on the perceived attractiveness and choice of alternatives.

Hypotheses about relations between values, valences, and choice were tested in a study in which 239 university students completed the Schwartz Value Survey (S. H. Schwartz, 1992) and then responded to 10 hypothetical scenarios, each of which presented them with 2 alternative courses of action assumed to prime different value types from the Schwartz circular structure. For each scenario, participants rated the attractiveness or valence of each alternative and then indicated which one they would choose. Results showed that, as predicted, valences were related to value types, and choice of alternative was a function of both value types and valences. The pattern of relations was consistent with the assumption that values may induce valences on potential actions and outcomes and that value types may be organized into 2 bipolar dimensions, one of which contrasts openness to change with conservation and the other of which contrasts self-enhancement with self-transcendence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Children's referential communication: Components of plans for effective listening.

Investigated the effects of 2 plans on children's listener behavior in a referential communication setting. The design systematically varied the presence and absence of instructions about a plan to engage in comparison activities (comparison plan) and instructions about a plan to request more information if the speaker's message was ambiguous (action plan). 94 elementary school Ss played the role of listener. The speaker was an adult confederate who produced messages of varying informational adequacy. Results show that on an immediate test, Ss who received the action plan asked more questions when the messages were ambiguous and made more correct referent choices than other Ss. These effects persisted on a test administered 2 wks later and were observed both for nameable and abstract stimulus items. No significant effect of the comparison plan was observed. Results suggest that knowing when and how to request additional information is an important listener skill. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of The Science Game: An Introduction To Research In The Behavioral Sciences.

Reviews the book, The Science Game: An Introduction To Research In The Behavioral Sciences by Neil M. Agnew and Sandra W. Pyke (1982). This revised volume by Agnew and Pyke is a delightfully written, ambitious book that strives for a wide inclusion of topics on research methodology rather than concentrating on the small set of issues and methods that many consider fundamental. Moreover, it endeavors this task in the relatively brief span of 260 pages (not counting references and indexes). The strength of such an inclusive approach is that it introduces the student to the reality of the entire enterprise of psychological research. The book is divided into five parts. Part 1 is "Science and Nonscience"; Part 2 is entitled "Sieves of Science"; Part 3 is "From Laboratory to Life"; Part 4 is "The Magic of Numbers"; and Part 5 is entitled "Being Clear and Being Good". Altogether, reading The Science Game was fun, and that in itself is a heady comment about a methodology text. Further, despite some flaws, which are mostly of an order-of-presentation sort, I think that students will enjoy the book and come away from it with some answers and with better questions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Doctors, patients, and perceived job image: an empirical study of stress and nurses in Singapore

The acceptance and sensory characteristics of standard and reduced-fat cookies were evaluated either with or without fat-content information by pre-adolescent children. Results indicate that acceptance ratings were not affected by the fat content or information about fat content when evaluated on nine-point scales. However, when asked to choose which cookie they liked better and to predict how many cookies they would eat (in forced-choice questions), fat content and information about fat content had a significant effect on cookie preference and prospective intake. When no information was available, subjects preferred the cookie with the higher fat content; when information was presented, subjects' preference shifted to the reduced-fat cookie. When asked which cookie they would choose to eat for dessert with hypothetical lunches, a similar shift in choice was observed following a low-fat lunch. The low-fat label was also associated with an increase in perceived healthiness relative to the high-fat label, as indicated on "good for me" scales. The effects of fat content information on cookie preference and prospective consumption were seen in pre-adolescents who indicated a "high concern" for the health consequences of dietary fat. Cookie preference and prospective intake of subjects who indicated a "low concern" were not affected by fat content labeling. Results suggest that fat content and information about fat content may affect food preference and intake in pre-adolescent children.     

Role of Guidance, Reflection, and Interactivity in an Agent-Based Multimedia Game.

The authors investigated whether guidance and reflection would facilitate science learning in an interactive multimedia game. College students learned how to design plants to survive in different weather conditions. In Experiment 1, they learned with an agent that either guided them with corrective and explanatory feedback or corrective feedback alone. Some students were asked to reflect by giving explanations about their problem-solving answers. Guidance in the form of explanatory feedback produced higher transfer scores, fewer incorrect answers, and greater reduction of misconceptions during problem solving. Reflection in the form of having students give explanations for their answers did not affect learning. Experiments 2 and 3 showed that reflection promotes retention and far transfer in noninteractive environments but not in interactive ones unless students are asked to reflect on correct program solutions rather than on their own solutions. Results support the appropriate use of guidance and reflection for interactive multimedia games. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Learning about reflection

Circumcision performed using the Gomco clamp is usually quick and effective, and results in very little bleeding. However, every clinician performing circumcision occasionally has concerns or questions regarding the procedure. Some of the more common concerns regarding the use of the Gomco clamp are technique-related, including choosing the correct size of the Gomco bell and clamp for the procedure, choosing the right method of getting the foreskin properly through the hole of the Gomco base plate, and assessing how much foreskin to remove. Other concerns include poor cosmetic results, contraindications to routine circumcision, and circumcision in an infant whose mother has human immunodeficiency virus. This article reviews the technique of circumcision using the Gomco clamp and answers some of the more common questions.     

Reversal of fortune: commercial HMOs in the Medicaid market

Between 1992 and 1996 the number of health maintenance organizations (HMOs) entering the Medicaid market grew at an average annual rate of approximately 22 percent. Participation among all ownership segments grew, resulting in a broad distribution of beneficiaries across the HMO industry. However, recent declines in financial performance within the industry appear to be more dramatic for plans with many Medicaid members. In addition, growing concerns about rate adequacy and volatility as well as expanding administrative demands raise questions about the long-term commitment of commercial HMOs to Medicaid participation. This paper analyzes operating characteristics and financial performance of licensed commercial HMOs from 1992 through 1996, drawing on indepth interviews with health plan executives and managed care stock analysts.     

Suicidality in nursing home residents: Part II. Special issues.

Professional psychologists working with suicidal nursing home residents often deal with a host of special issues that may not be relevant to other populations. This review article (Part 2 of a series) was written to acquaint professionals with the concept of indirect self-destructive behavior and dealing with ethical concerns. This article also summarizes health care systems issues, including how to involve staff and family members in assessment and management, as well as understanding Medicare/Medicaid related concerns and public policy regarding long-term care. The article concludes with information about training and continuing education offerings for psychologists who need more information about working in nursing home settings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A comparative study of public knowledge and awareness of echinococcus in relation to anti-echinococcus policies of towns in Hokkaido

A population-based comparative study was performed on public awareness and knowledge about the risk of Echinococcosis and the life habits of the people living in 2 towns in eastern Hokkaido, Bekkai and akan. Bekkai has had an anti-echinococcosis policy and Akan has only limited experiences with such countermeasures. The results of the survey were as follows: 1) Compared with the inhabitants in the town of Akan, the residents in Bekkai had significantly higher correct response rates for many questions concerning parasitological knowledge and the risks of echinococcosis, and knew about subjects such as the pathogen, latency period, susceptible organs, the prognosis, the possibility of transmission of echinococcosis from human to human and methods for the sterilization of eggs from infected animals. 2) The rate of correct answers to such questions were approximately 70 to 90% in both towns. However the percentage of correct answers to questions about carrier animals and the question of human susceptibility were relatively low, ie., 45% and 20%, respectively, even in Bekkai. 3) The residents of Akan knew more about carrier animals of echinococcosis than the inhabitants of Bekkai. In Akan woman and persons in their 20's and 30's had lower rates of correct answers. Further health education should be aimed toward such people. 4) Foxes appeared near private homes more frequently in Akan than in Bekkai. More inhabitants of Akan used spring water as drinking water than in Bekkai, while more inhabitants used tap water as drinking water in Bekkai. Only a few inhabitants paid attention to how to prepare vegetables for cooking. This information suggests that echinococcosis may spread in Akan in the near future. 5) Our results suggest that better organized health education programs, the extension of tap water services in Akan, and the establishment of proper methods for disposal of garbage and the afterbirth of cattle are necessary to reduce the presence of foxes in inhabited areas.