Empirical Evidence on the Use of Credit Scoring for Predicting Insurance Losses with Psycho-social and Biochemical Explanations

An important development in personal lines of insurance in the United States is the use of credit history data for insurance risk classification to predict losses. This research presents the results of collaboration with industry conducted by a university at the request of its state legislature. The purpose was to see the viability and validity of the use of credit scoring to predict insurance losses given its controversial nature and criticism as redundant of other predictive variables currently used. Working with industry and government, this study analyzed more than 175,000 policyholders’ information for the relationship between credit score and claims. Credit scores were significantly related to incurred losses, evidencing both statistical and practical significance. We investigate whether the revealed relationship between credit score and incurred losses was explainable by overlap with existing underwriting variables or whether the credit score adds new information about losses not contained in existing underwriting variables. The results show that credit scores contain significant information not already incorporated into other traditional rating variables (e.g., age, sex, driving history). We discuss how sensation seeking and self-control theory provide a partial explanation of why credit scoring works (the psycho-social perspective). This article also presents an overview of biological and chemical correlates of risk taking that helps explain why knowing risk-taking behavior in one realm (e.g., risky financial behavior and poor credit history) transits to predicting risk-taking behavior in other realms (e.g., automobile insurance incurred losses). Additional research is needed to advance new nontraditional loss prediction variables from social media consumer information to using information provided by technological advances. The evolving and dynamic nature of the insurance marketplace makes it imperative that professionals continue to evolve predictive variables and for academics to assist with understanding the whys of the relationships through theory development.IC2 Institut

Health Information Seeking and its Associated Factors among University Students: A Case in a Middle-Income Setting

This paper aims to describe health information seeking behaviour and identify its associated factors among undergraduate university students in developing countries. An online survey is used to collect data from 138 students. The data is analysed using the multivariate logistic regression analysis method. Results reveal that a substantial number of students have sought health information mostly from the Internet. Health literacy, perceived susceptibility to health problems and alcohol consumption are found to be the significant factors influencing health information seeking behaviour. Results provide an understanding of health information seeking behaviour in developing countries

Gender as an Influencer of Online Health Information-Seeking and Evaluation Behavior

This article contributes to the growing body of research that explores the significance of context in health information behavior. Specifically, through the lens of trust judgments, it demonstrates that gender is a determinant of the information evaluation process. A questionnaire-based survey collected data from adults regarding the factors that influence their judgment of the trustworthiness of online health information. Both men and women identified credibility, recommendation, ease of use, and brand as being of importance in their trust judgments. However, women also take into account style, while men eschew this for familiarity. In addition, men appear to be more concerned with the comprehensiveness and accuracy of the information, the ease with which they can access it, and its familiarity, whereas women demonstrate greater interest in cognition, such as the ease with which they can read and understand the information. These gender differences are consistent with the demographic data, which suggest that: women consult more types of sources than men; men are more likely to be searching with respect to a long-standing health complaint; and, women are more likely than men to use tablets in their health information seeking. Recommendations for further research to better inform practice are offered

Psychological, social and welfare interventions for psychological health and well-being of torture survivors

Background: Torture is widespread, with potentially broad and long-lasting impact across physical, psychological, social and other areas of life. Its complex and diverse effects interact with ethnicity, gender, and refugee experience. Health and welfare agencies offer varied rehabilitation services, from conventional mental health treatment to eclectic or needs-based interventions. This review is needed because relatively little outcome research has been done in this field, and no previous systematic review has been conducted. Resources are scarce, and the challenges of providing services can be considerable. Objectives: To assess beneficial and adverse effects of psychological, social and welfare interventions for torture survivors, and to comp are these effects with those reported by active and inactive controls. Search methods: Randomised controlled trials (RCTs) were identified through a search of PsycINFO, MEDLINE, EMBASE, Web of Science, the Cumulative Index to Nursing and Allied Health Literature (CINA HL), the Cochrane Central Register of Controlled Trials (CENTR AL) and the Cochrane Depression, Anxiety and Neurosis Specialise d Register (CCDANCTR), the Latin American and Caribbean Health Science Information Database (LILACS), the Open System for Information on Grey Literature in Europe (OpenSIGLE), the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) and Published International Literature On Traumatic Stress (PILOTS) all years to 11 April 2013; searches of Cochrane resources, international trial registries and the main biomedical databases were updated on 20 June 2014. We also searched the On line Library of Dignity (Danish Institute against Torture), reference lists of reviews and included studies and the most frequently cited journals, up to April 2013 but not repeated for 2014. Investigators were contacted to provide updates or details as necessary. Selection criteria: Full publications of RCTs or quasi-RCTs of psychological, social or welfare interventions for survivors of torture against any active or inactive comparison condition. Data collection and analysis: We included all major sources of grey literature in our search and used standard methodological procedures as expected by The Cochrane Collaboration for collecting data, evaluating risk of bias and using GRADE (Grades of Recommendation, Assessment, Development and Evaluation) methods to assess the quality of evidence. Main results: Nine RCTs were included in this review. All were of psychological interventions; none provided social or welfare interventions. The nine trials provided data for 507 adults; none involved children or adolescents. Eight of the nine studies described individual treatment, and one discussed group treatment. Six trials were conducted in Europe, and three in different African countries. Most people were refugees in their thirties and forties; most met the criteria for post-traumatic stress disorder (PTSD) at the outset. Four trials used narrative exposure therapy (NET), one cognitive-behavioural therapy (CBT ) and the other four used mixed methods for trauma symptoms, one of which included reconciliation methods. Five interventions were compared with active controls, such as psychoeducation; four used treatment as usual or waiting list/no treatment; we analysed all control conditions together. Duration of therapy varied from one hour to longer than 20 hours with a median of around 12 to 15 hours. All trials reported effects on distress and on PTSD, and two reported on quality of life. Five studies followed up participants for at least six months. No immediate benefits of psychological therapy were noted in comparison with controls in terms of our primary outcome of distress (usually depression), nor for PTSD symptoms, PTSD caseness, or quality of life. At six-month follow-up, three NET and one CBT study (86 participants) showed moderate effect sizes for intervention over control in reduction of distress (standardised me an difference (SMD) -0.63, 95% confidence interval (CI) -1.07 to -0.19) and of PTSD symptoms (SMD -0.52, 95% CI -0.97 to -0.07). However, the quality of evidence was very low, and risk of bias resulted from researcher/therapist allegiance to treatment methods, effects of uncertain asylum status of some people and real-time non-standardised translation of assessment measures. No measures of adverse events were described, nor of participation, social functioning, quantity of social or family relationships, proxy measures by third parties or satisfaction with treatment. Too few studies were identified for review authors to attempt sensitivity analyses. Authors’ conclusions: Very low-quality evidence suggests no differences between psychological therapies and controls in terms of immediate effects on post- traumatic symptoms, distress or quality of life; however, NET and CBT were found to confer moderate benefits in reducing dis tress and PTSD symptoms over the medium term (six months after treatment). Evidence was of very low quality, mainly because non- standardised assessment methods using interpreters were applied, and sample sizes were very small. Most eligible trials also revealed medium to high risk of bias. Further, attention to the cultural appropriateness of interventions or to their psychometric qualities was inadequate, and assessment measures used were unsuitable. As such, these findings should be interpreted with caution. No data were available on whether symptom reduction enabled improvements in quality of life, participation in community life, or in social and family relationships in the medium term. Details of adverse events and treatment satisfaction were not available immediately after treatment nor in the medium term. Future research should aim to address these gaps in the evidence and should include larger sample sizes when possible. Problems of torture survivors need to be defined far more broadly than by PTSD symptoms, and re cognition given to the contextual influences of being a torture survivor, including as an asylum seeker or refugee, on psychological and social health

Social determinants of health information seeking among Chinese adults in Hong Kong

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Personal Health Information Management by College Students: Patterns of Inaction

Introduction. College students\u27 diverse health information management activities are rarely studied within a personal health context. Our study identified an inactive group of college students and their information management activities to understand what factors determine inactivity. Methods. An online questionnaire was distributed to college students enrolled in a state-owned university in the USA between January and March 2017. A total of eighty-four questions on twelve information management activities grouped by seven types of personal health information were used to identify inactive performers within our student sample. Additionally, potential factors regarding demographics, academics, information resource types, and information workload were tested. Analysis. Our study sample includes 1,408 student responses. K-means clustering segmented the sample into two groups (inactive and active). Group differences between inactive and active personal health information managers were compared. Binary logistic regression was also performed to determine key factors predicting inactivity. Results. The inactive group (N=772, 54.80%) identified more male students, less clinic visits, and health information primarily sought through the Internet and mass media. Additionally, the awareness of personal health information management and training perceptions were found to be significant determinants of the inactivity. The inactive group proved to be lacking in most information management activities, except for discarding, and showed less interests in all types of health documents. Conclusion. Based on the inactive personal health information management group, how to collect, organize, retrieve, backup and migrate personal health documents, should be integrated into a formal college curriculum

Examining Psychosocial Interventions for Refugees from Asia: A Meta-Analysis and Systematic Review on Efficacy, Effectiveness, and Cultural Tailoring

Background: Internally displaced persons (IDPs), refugees, and asylum seekers who have experienced forced migration are at a disproportionate disadvantage of experiencing distress and developing mental health problems. Research on psychosocial interventions for refugees indicated positive findings on symptom improvement in depression, posttraumatic stress disorder, and anxiety. However, previous meta-analyses and systematic reviews have primarily focused on randomized control trials (RCTs) to the exclusion of a large body of intervention research. In addition, many previous reviews have included studies that targeted at specific treatment types (e.g., cognitive behavioral therapy, narrative review therapy) or specific mental diagnoses (e.g., major depressive disorder, posttraumatic stress disorder). Furthermore, limited reviews have focused on Asia-origin refugees regarding treatment outcomes and cultural appropriateness. Refugees originating from Asia face unique challenges prior to, during, and after their resettlement process, but limited literature has examined whether interventions are culturally appropriate for this population. Methods: The current study provided a comprehensive review of adult-focused interventions aiming at improving refugees’ psychosocial outcomes. RCTs and NRCTs were both evaluated. Article search was conducted in PsycINFO, PubMed, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), PTSDpubs (formerly Published International Literature of Traumatic Stress [PILOTS]), World Health Organization - Global Index of Medicus, Education: Resources Information Center (ERIC), and ProQuest Dissertations and Theses. The preferred reporting instrument for systematic reviews and meta-analysis (PRISMA) was strictly followed. Meta-analytic synthesis and meta-regression analyses were conducted with outcomes from RCTs, and a narrative review was provided to synthesize outcomes from NRCTs. In addition, cultural tailoring was synthesized in a narrative review to evaluate whether interventions are culturally appropriate for Asia-origin refugees. Results: An initial search of 23,652 articles were found, and following two more recent searches, a final total of 31 articles were included in the current synthesis (20 RCTs, 11 NRCTs). A total of 3,082 participants were included, with a mean age of 40.31 years (SD = 8.01) and mean resettlement length of 6.32 years (SD = 4.88). A broad range of intervention types were observed, and a narrative review was provided on detailed treatment and participant characteristics. Meta-analytic results indicated that when treatments were compared with control groups, refugees’ psychosocial outcomes across multiple domains significantly improved. However, due to high statistical heterogeneity and publication bias in most outcomes, only depressive symptoms at post-intervention (SMD = -0.42) and posttraumatic stress at follow-up (SMD = -0.52) had statistically significant pooled effect sizes. Moreover, meta-regression findings indicated significant subgroup differences among no-treatment control vs. some-treatment control groups, group vs. individual interventions, and requiring symptom threshold vs. no symptom requirement. A narrative review on NRCTs found similar results that interventions significantly improved refugees’ psychosocial outcomes, though some mixed findings were observed. Regarding cultural tailoring, all reported some cultural tailoring in their treatments, though the extent varied across studies. The most commonly tailored treatment components included language adaptation and treatment content tailoring. Discussion: Findings indicated that evaluated interventions significantly improve Asia-origin refugees’ psychosocial outcomes. We also found that all interventions were tailored for refugees and their cultural backgrounds. Future research is needed to better assess efficacy and effectiveness of interventions for different psychosocial outcomes and the added benefit of cultural tailoring. Recommendations for researchers and providers are provided in detail