Effects of response cost on the behavior of a million persons: charging for directory assistance in Cincinnati

An interrupted time-series analysis of local directory-assistance calls in the Cincinnati area from 1962 to 1976 revealed a significant reduction in the daily frequency of calls after charges were introduced in 1974. No reductions occurred in the daily frequency of long-distance directory-assistance calls, which remained free. The results attest to the efficacy of response-cost procedures with large subject populations in the natural environment. The applicability of response-cost procedures to social and business problems is discussed

Progressive Neuropsychologic Impairment and Hypoxemia: Relationship in Chronic Obstructive Pulmonary Disease

In previous work we showed that patients with chronic obstructive pulmonary disease (COPD) suffered decrements in neuropsychologic functioning suggestive of organic mental disturbance. This study combined data from two multicenter clinical trials to explore the nature and possible determinants of such neuropsychologic change. Three groups of patients with COPD whose hypoxemia was mild (N = 86), moderate (N =155), or severe (N = 61) were compared with age- and education-matched nonpatients (N = 99). The rate of neuropsychologic deficit rose from 27% in mild hypoxemia to 61% in severe hypoxemia. Various neuropsychologic abilities declined at different rates, suggesting differential vulnerability of neuropsychologic functions to progress of COPD. Multivariate analyses revealed a consistent significant relationship between degree of hypoxemia and neuropsychologic impairment, but the amount of shared variance was small (7%). Increasing age and lower education were also associated with impairment. © 1987, American Medical Association. All rights reserved