Disability, Health, and Multiple Chronic Conditions Among People Eligible for Both Medicare and Medicaid, 2005–2010.

Abstract Introduction People who are eligible for both Medicare and Medicaid (dual eligibles) and who have disabilities and multiple chronic conditions (MCC) present challenges for treatment, preventive services, and cost-effective access to care within the US health system. We sought to better understand dual eligibles and their association with MCC, accounting for sociodemographic factors inclusive of functional disability category. Methods Medical Expenditure Panel Survey (MEPS) data for 2005 through 2010 were stratified by ages 18 to 64 and 65 or older to account for unique subsets of dual eligibles. Prevalence of MCC was calculated for those with physical disabilities, physical plus cognitive disabilities, and all others, accounting for sociodemographic and health-related factors. Adjusted odds for having MCC were calculated by using logistic regression. Results Of dual eligibles aged 18 to 64, 53% had MCC compared with 73.5% of those aged 65 or older. Sixty-five percent of all dual eligibles had 2 or more chronic conditions, and among dual eligibles aged 65 or older with physical disabilities and cognitive limitations, 35% had 4 or more, with hypertension and arthritis the most common conditions. Dual eligibles aged 18 to 64 who had a usual source of medical care had a 127% increased likelihood of having MCC compared with those who did not have a usual source of care. Conclusion Attention to disability can be a component to helping further understand the relationship between health and chronic conditions for dual eligible populations and other segments of our society with complex health and medical needs

The Culturally-adapted Early Pathways Program for Young Latino Children in Poverty: A Randomized Controlled Trial

This study used a randomized controlled design with treatment and wait-list conditions to evaluate the efficacy of a culturally adapted version of the Early Pathways program (EP; Fox & Gresl, 2014), an in-home, parent–child therapy program with 137 at-risk Latino children under the age of 6 referred for severe behavior and emotional problems, such as aggression, oppositional behavior, self-injury, and property destruction. EP directly engaged the parent–child dyad, emphasizing parent-directed training, child-led play, psychoeducation, and cognitive–behavioral strategies. Cultural modifications included establishing community partnerships to identify Latino family needs, translation of materials, offering bilingual services, acculturation assessment, and cultural competence training. Multivariate analyses of covariance (MANCOVA) revealed significant differences between the immediate and delayed treatment groups on all posttest measures with the pretest scores as covariates. After the delayed group completed treatment, repeated measures, multivariate analyses of variance (MANOVA) showed significant improvement for both groups on all measures with maintenance at 4- to 6-week follow-up. Outcomes included reduced child behavior problems, increased child prosocial behaviors, improved caregiver limit setting, enhanced caregiver nurturing, improved parent–child relationships, and a decrease in clinical diagnoses following treatment. This study highlights the efficacy of using culturally adapted early intervention services for young Latino children in poverty referred for significant behavior and emotional problems

Why Don't Foreign Firms Cooperate in U.S. Antidumping Investigations?: An Emperical Analysis

Foreign firms face punitive duties if they do not cooperate with the US Department of Commerce (DOC) in antidumping procedures. For example, 37% of all foreign firms involved in antidumping investigations in the US chose faced “facts available” margins for the 1995-2002 period, with average antidumping duties of 31% for cooperating foreign firms, compared to 87% for those who do not. The existing literature has focused on how DOC discretion has led to foreign firm non-cooperation. This paper instead examines individual foreign firm’s decisions about whether to cooperate during this same period. We find evidence that non-cooperation is consistent with a model of foreign firms rationally choosing not to cooperate, rather than solely as a result of investigating authority bias against imports.antidumping, commercial policy, trade policy, facts available

Catastrophic Decays of Compactified Space-Times

Witten long ago pointed out that the simplest Kaluza-Klein theory, without supersymmetry, is subject to a catastrophic instability. There are a variety of string theories which are potentially subject to these instabilities. Here we explore a number of questions: how generic are these instabilities? what happens when a potential is generated on the moduli space? in the presence of supersymmetry breaking, is there still a distinction between supersymmetric and non-supersymmetric states?Comment: Typos corrected, references adde

The interaction between gaze and facial expression in the amygdala and extended amygdala is modulated by anxiety

Behavioral evidence indicates that angry faces are seen as more threatening, and elicit greater anxiety, when directed at the observer, whereas the influence of gaze on the processing of fearful faces is less consistent. Recent research has also found inconsistent effects of expression and gaze direction on the amygdala response to facial signals of threat. However, such studies have failed to consider the important influence of anxiety on the response to signals of threat; an influence that is well established in behavioral research and recent neuroimaging studies. Here, we investigated the way in which individual differences in anxiety would influence the interactive effect of gaze and expression on the response to angry and fearful faces in the human extended amygdala. Participants viewed images of fearful, angry and neutral faces, either displaying an averted or direct gaze. We found that state anxiety predicted an increased response in the dorsal amygdala/substantia innominata (SI) to angry faces when gazing at, relative to away from the observer. By contrast, high state anxious individuals showed an increased amygdala response to fearful faces that was less dependent on gaze. In addition, the relationship between state anxiety and gaze on emotional intensity ratings mirrored the relationship between anxiety and the amygdala/SI response. These results have implications for understanding the functional role of the amygdala and extended amygdala in processing signals of threat, and are consistent with the proposed role of this region in coding the relevance or significance of a stimulus to the observer

Dynamics in atomic signaling games

We study an atomic signaling game under stochastic evolutionary dynamics. There is a finite number of players who repeatedly update from a finite number of available languages/signaling strategies. Players imitate the most fit agents with high probability or mutate with low probability. We analyze the long-run distribution of states and show that, for sufficiently small mutation probability, its support is limited to efficient communication systems. We find that this behavior is insensitive to the particular choice of evolutionary dynamic, a property that is due to the game having a potential structure with a potential function corresponding to average fitness. Consequently, the model supports conclusions similar to those found in the literature on language competition. That is, we show that efficient languages eventually predominate the society while reproducing the empirical phenomenon of linguistic drift. The emergence of efficiency in the atomic case can be contrasted with results for non-atomic signaling games that establish the non-negligible possibility of convergence, under replicator dynamics, to states of unbounded efficiency loss