Predictive validity of the UK clinical aptitude test in the final years of medical school:a prospective cohort study

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Distorted policy transfer? South Korea’s adaptation of UK social enterprise policy

This study draws upon communicative processes in policy transfer to consider the ways in which policy may be adapted to context or distorted. The theoretical framework is used to investigate exactly what the South Korean government borrowed from UK social enterprise policy. Despite claims that the UK was the source of both the general policy direction and the particular regulatory device, the Korean government did not learn about the specific contexts of the British policy, nor attempt two-way communication with domestic stakeholders. Rather, the UK policy was interpreted in accordance with the Korean government’s own ideas about how to utilize social enterprise. Historical legacies of top-down decision-making played an important role in this process, as did the state’s role as a regulator which mobilizes the private sector to achieve policy goals. The consequences have been negative for those organizations refused social enterprise status under the Ministry of Labor’s strict approval system, as well as for the original target population: the socially disadvantaged and vulnerable. It is suggested that the model advanced may help to illuminate the reasons why some borrowed policies differ considerably from the originals, and the use of policy transfer as a means of legitimizatio

Examining the types and payments of the disabilities of the insurants in the national farmers' health insurance program in Taiwan

<p>Abstract</p> <p>Background</p> <p>In contrast to the considerable body of literature concerning the disabilities of the general population, little information exists pertaining to the disabilities of the farm population. Focusing on the disability issue to the insurants in the Farmers' Health Insurance (FHI) program in Taiwan, this paper examines the associations among socio-demographic characteristics, insured factors, and the introduction of the national health insurance program, as well as the types and payments of disabilities among the insurants.</p> <p>Methods</p> <p>A unique dataset containing 1,594,439 insurants in 2008 was used in this research. A logistic regression model was estimated for the likelihood of received disability payments. By focusing on the recipients, a disability payment and a disability type equation were estimated using the ordinary least squares method and a multinomial logistic model, respectively, to investigate the effects of the exogenous factors on their received payments and the likelihood of having different types of disabilities.</p> <p>Results</p> <p>Age and different job categories are significantly associated with the likelihood of receiving disability payments. Compared to those under age 45, the likelihood is higher among recipients aged 85 and above (the odds ratio is 8.04). Compared to hired workers, the odds ratios for self-employed and spouses of farm operators who were not members of farmers' associations are 0.97 and 0.85, respectively. In addition, older insurants are more likely to have eye problems; few differences in disability types are related to insured job categories.</p> <p>Conclusions</p> <p>Results indicate that older farmers are more likely to receive disability payments, but the likelihood is not much different among insurants of various job categories. Among all of the selected types of disability, a highest likelihood is found for eye disability. In addition, the introduction of the national health insurance program decreases the likelihood of receiving disability payments. The experience in Taiwan can be valuable for other countries that are in an initial stage to implement a universal health insurance program.</p

Incidence and predictors of onboard injuries among Sri Lankan flight attendants

<p>Abstract</p> <p>Background</p> <p>Occupational injuries among flight attendants have not been given appropriate attention in Sri Lanka. The purpose of this study was to estimate the incidence of onboard injury among Sri Lankan flight attendants and to describe the determinants of onboard injury.</p> <p>Methods</p> <p>A descriptive cross-sectional study was carried out among Sri Lankan flight attendants. All flight attendants undergoing their annual health and first aid training were invited to participate. Flight attendants who flew continuously for a six-month period prior to data collection were included in the study sample. Recall history of injuries for a period of six months was recorded.</p> <p>Results</p> <p>The study sample consisted of 98 (30.4%) male and 224 (69.6%) female flight attendants. The mean age of the study sample was 31 years (SD = 8) and the average duration of service was 10 years (SD = 7). A total of 100 onboard falls, slips or trips in the previous six months were reported by 52 (16.1%) respondents. Of the total sample, 128 (39.8%) cabin crew members reported an injury in the six months preceding the study. This represents a total injury incidence of 795 per 1000 person per year. The leading causes of injury was pulling, pushing or lifting (60.2%). The commonest type of injuries were strains and sprains (52.3%). Turbulence related injuries were reported by 38 (29.7%) flight attendants. The upper limbs (44.5%) and the back (32%) were the commonest sites affected. After controlling for other factors, female flight attendants had 2.9 times higher risk (95% CI 1.2–7.2) of sustaining and injury than males. Irrespective of sex, body weight less than 56 kilograms (OR 2.9, 95% CI 1.4–5.8) and less than seven years of on board experience (OR 10.5, 95% CI 3.6–31.0) were associated with higher risk of injury.</p> <p>Conclusion</p> <p>Work related injury is a major occupational hazard to flight attendants. Appropriate preventive strategies are required to minimize them.</p

Employer Health Insurance Mandates and the Risk of Unemployment

Employer health insurance mandates form the basis of many health care reform proposals. Proponents make the case that they will increase insurance, while opponents raise the concern that low-wage workers will see offsetting reductions in their wages and that in the presence of minimum wage laws some of the lowest wage workers will become unemployed. We construct an estimate of the number of workers whose wages are so close to the minimum wage that they cannot be lowered to absorb the cost of health insurance, using detailed data on wages, health insurance, and demographics from the Current Population Survey (CPS). We find that 33 percent of uninsured workers earn within $3 of the minimum wage, putting them at risk of unemployment if their employers were required to offer insurance. Assuming an elasticity of employment with respect to minimum wage increase of -0.10, we estimate that 0.2 percent of all full-time workers and 1.4 percent of uninsured full-time workers would lose their jobs because of a health insurance mandate. Workers who would lose their jobs are disproportionately likely to be high school dropouts, minority, and female. This risk of unemployment should be a crucial component in the evaluation of both the effectiveness and distributional implications of these policies relative to alternatives such as tax credits, Medicaid expansions, and individual mandates, and their broader effects on the well-being of low-wage workers.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73099/1/j.1540-6296.2008.00133.x.pd

A Longitudinal Analysis of Volunteerism Activities for Individuals Educated in Public and Private Schools

Previous studies offer evidence that U.S. public and private high schools differentially influence volunteerism in adolescence. However, these studies are typically cross-sectional and only consider whether the individual volunteered or not. We address patterns of volunteering from adolescence into adulthood and the kind of volunteering activity in which individuals engage. We also theorize that distinctive civic values within public and private schools together with their respective organizational ties to other civic organizations channel students into particular volunteering activities. Relying on a longitudinal, nationally-representative sample of U.S. adolescents, we track volunteering from adolescence into young adulthood and identify the types of volunteering activities in which respondents engage. Results demonstrate that the likelihood of volunteering changes through the life course, and students from different schooling backgrounds systematically sort into specific volunteering activities as our theories predict

Sociodemographic and geographic characteristics associated with patient visits to osteopathic physicians for primary care

<p>Abstract</p> <p>Background</p> <p>Health care reform promises to dramatically increase the number of Americans covered by health insurance. Osteopathic physicians (DOs) are recognized for primary care, including a "hands-on" style with an emphasis on patient-centered care. Thus, DOs may be well positioned to deliver primary care in this emerging health care environment.</p> <p>Methods</p> <p>We used data from the National Ambulatory Medical Care Survey (2002-2006) to study sociodemographic and geographic characteristics associated with patient visits to DOs for primary care. Descriptive analyses were initially performed to derive national population estimates (NPEs) for overall patient visits, primary care patient visits, and patient visits according to specialty status. Osteopathic and allopathic physician (MD) patient visits were compared using cross-tabulations and multiple logistic regression to compute odds ratios (ORs) and 95% confidence intervals (CIs) for DO patient visits. The latter analyses were also conducted separately for each geographic characteristic to assess the potential for effect modification based on these factors.</p> <p>Results</p> <p>Overall, 134,369 ambulatory medical care visits were surveyed, representing 4.6 billion (NPE) ± 220 million (SE) patient visits when patient visit weights were applied. Osteopathic physicians provided 336 million ± 30 million (7%) of these patient visits. Osteopathic physicians provided 217 million ± 21 million (10%) patient visits for primary care services; including 180 million ± 17 million (12%) primary care visits for adults (21 years of age or older) and 37 million ± 5 million (5%) primary care visits for minors. Osteopathic physicians were more likely than MDs to provide primary care visits in family and general medicine (OR, 6.03; 95% CI, 4.67-7.78), but were less likely to provide visits in internal medicine (OR, 0.37; 95% CI, 0.24-0.58) or pediatrics (OR, 0.21; 95% CI, 0.11-0.40). Overall, patients in the pediatric and geriatric ages, Blacks, Hispanics, and persons in the South and West were less likely to utilize DOs, although there was some evidence of effect modification according to United States Census region.</p> <p>Conclusions</p> <p>Health care reform provides unprecedented opportunities for DOs to reach historically underserved populations and to overcome the "pediatric primary-care paradox."</p

The Professional Solution to the College Bubble

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