Labor Supply under Disability Insurance

There has been a significant recent growth in the Social Security Administration's Disability Insurance (DI) program, both in the number of covered workers under the program and in the amount of monthly benefits, One possible factor causing this growth has been labor supply disincentives under the pro- gram. The labor supply decision by an individual involves the effect of the disability benefit structure (potential benefits) on labor force participation. Probit estimates from the 1969 original sample of the Longitudinal Retirement History Study (LRHS) indicated an elasticity of participation with respect to benefits of -0031 for married men aged 58-63, and -.023 for all men of the same age group. The magnitude of these estimates are much less than those found by authors such as Parsons, and suggest relatively insignificant efficiency losses in terns of reduced work effort.

Labor Force Entry and Exit of Older Men: A Longitudinal Study

The labor force participation rate of older men under age 65 has shown a significant recent decline. Cross-sectional studies linking early retirement to increased Social Security income have also made explicit or implicit temporal projections of changes in participation in response to changes in benefits. However, use of cross-sectional estimates for projection purposes may run into several problems, including temporal dependence of the participation decision. This paper uses 2-year longitudinal data for men aged 58-62 in 1969 in order to trace changes in labor force behavior near retirement age. Results indicate significant effects of poor health, initial assets, and initial pension eligibility on the probabilities of exit and entry from the labor force. Social Security benefits are found to have insignificant or unexpected effects. The results also indicate evidence of temporal dependence of participation, suggesting caution in interpreting projections of cross-section estimates.

The efficacy of ‘debriefing’ after childbirth: Is there a case for targeted intervention?

To review the efficacy of debriefing interventions for reducing posttraumatic stress (PTS) and/ or depressive symptoms in postnatal women. Background: Techniques referred to as debriefing have been adapted for use within maternity care settings to prevent the development of PTS symptoms or depression. There is a requirement to disaggregate methods and approaches used by existing studies, rather than review the research as a whole, to identify elements that may contribute to an efficacious intervention and to clarify what is currently a confused position. Methods: Papers assessing the utility of providing a brief psychological intervention involving discussion of a birth with the mother and a professional, to reduce symptoms of PTS or depression, were reviewed. Discussions could be structured or unstructured, and involve any aspect of discussing the birth, responses and coping strategies. Results: Nine papers (eight studies) were reviewed. While the majority of studies reported findings indicating that debriefing was ineffective for reducing PTS or depressive symptoms, there was evidence indicating that targeted interventions (for women who experienced a traumatic birth) were efficacious. Conclusion: There may be potential utility in providing a debriefing intervention for women who perceive their childbirth experience to have been traumatic. A diversity of approaches termed ‘debriefing’ highlight a requirement to consider alternative terminology; the term ‘childbirth review’ is suggested as a useful alternative. Further research evaluating the efficacy of debriefing using a targeted approach for trauma perception is recommended

Mechatronics applied to scale model decoration

The European toy industry is very heavily dependent on manual labour and therefore vulnerable to Far Eastern competitors, who have the advantage of lower labour costs. Automation is Europe's best hope of beating off this oriental challenge. The aim of the project described within this thesis is to investigate the replacement of a traditionally manual series of operations by flexible automation to provide the basis for higher productivity and a greater degree of responsiveness to product change, leading to Just In Time Manufacture with reduced Work In Progress, while still retaining the high quality traditionally associated with the product. This thesis presents one of the first working attempts to this end, represented by a proof-of­concept cell designed and commissioned for investigating the many problems and possibilities associated with the decoration of scale models of cars and trains. The cell was designed using the Mechatronics approach which means that the various mechanical, electrical and electronic and computing possibilities have been taken into account from the start of the design stage. The proof-of-concept cell consists of five stations which provide the necessary means of loading the models in the cell, identifying the models and their orientation, decorating the models, inspecting the decorated models and finally palletising them for assembly. The industrial partners for the project were Hornby Hobbies Limited, J-L Automation and Staubli Unimation. Because this project centres around the present decoration operations at Hornby Hobbies Limited, which is heavily dependant on pad printing, an overview of pad printing is included. This will give the reader a background to the problems faced during the project. Before describing the proof-of-concept cell and its hardware and software components, the present factory based method and the constraints put on the project by Hornby Hobbies Limited are explained so that the reasons for choices within the cell will be more readily understood. A brief history of Scalextric is also included so that the reader may also understand some of the historical problems associated with the product. The result of this mechatronic approach are two fold: a) the efficiency of the cell is improved because the individual parts are working at optimal efficiency b) the cell has a greater degree of flexibility because of the re-programming facilities embedded in each of its component parts. This Mechatronic investigation has led to new concepts for pad printing and assembly operations and these are described in detail in the conclusions

Health Care Incentives under Disability Insurance

This paper examines one of the possible factors which has contributed to the significant recent growth in the Social Security Administration's Disability Insurance program: that of health care incentives under the program. The examination of health care incentives involves a 2-period, 2-state insurance model under uncertainty which incorporates two general types of insurance. One form of insurance is disability insurance, and the other is the individual; "own" insurance or own risk bearing -- which is represented by acute care and preventive care expenditures. The model predicts a positive effect of disability insurance on acute care, while the extent to which disability insurance discourages preventive care depends largely on the effect of preventive care on the price of disability insurance. Regression estimates using data from the 1969 Longitudinal Retirement History Study(LRHS) indicate an elasticity of prescription drug expenditures (acute care) with respect to benefits of about .5, and an elasticity of use of X-rays and inoculations (preventive care) with respect to benefits of about -.004.

The experience and impact of traumatic perinatal event experiences in midwives: A qualitative investigation

Background: Through their work midwives may experience distressing events that fulfil criteria for trauma. However, there is a paucity of research examining the impact of these events, or what is perceived to be helpful/unhelpful by midwives afterwards. Objective: To investigate midwives’ experiences of traumatic perinatal events and to provide insights into experiences and responses reported by midwives with and without subsequent posttraumatic stress symptoms. Design: Semi-structured telephone interviews were conducted with a purposive sample of midwives following participation in a previous postal survey. Methods: 35 midwives who had all experienced a traumatic perinatal event defined using the Diagnostic and Statistical Manual of Mental Disorders (version IV) Criterion A for posttraumatic stress disorder were interviewed. Two groups of midwives with high or low distress (as reported during the postal survey) were purposefully recruited. High distress was defined as the presence of clinical levels of PTSD symptomatology and high perceived impairment in terms of impacts on daily life. Low distress was defined as any symptoms of PTSD present were below clinical threshold and low perceived life impairment. Interviews were analysed using template analysis, an iterative process of organising and coding qualitative data chosen for this study for its flexibility. An initial template of four a priori codes was used to structure the analysis: event characteristics, perceived responses and impacts, supportive and helpful strategies and reflection of change over time codes were amended, integrated and collapsed as appropriate through the process of analysis. A final template of themes from each group is presented together with differences outlined where applicable. Results: Event characteristics were similar between groups, and involved severe, unexpected episodes contributing to feeling ‘out of a comfort zone.’ Emotional upset, self-blame and feelings of vulnerability to investigative procedures were reported. High distress midwives were more likely to report being personally upset by events and to perceive all aspects of personal and professional lives to be affected. Both groups valued talking about the event with peers, but perceived support from senior colleagues and supervisors to be either absent or inappropriate following their experience; however, those with high distress were more likely to endorse this view and report a perceived need to seek external input. Conclusion: Findings indicate a need to consider effective ways of promoting and facilitating access to support, at both a personal and organisational level, for midwives following the experience of a traumatic perinatal event

What are the characteristics of perinatal events perceived to be traumatic by midwives?

Objective: there is potential for midwives to indirectly experience events whilst providing clinical care that fulfil criteria for trauma. This research aimed to investigate the characteristics of events perceived as traumatic by UK midwives. Methods: as part of a postal questionnaire survey conducted between December 2011 and April 2012, midwives (n=421) who had witnessed and/or listened to an account of an event and perceived this as traumatic for themselves provided a written description of their experience. A traumatic perinatal event was defined as occurring during labour or shortly after birth where the midwife perceived the mother or her infant to be at risk, and they (the midwife) had experienced fear, helplessness or horror in response. Descriptions of events were analysed using thematic analysis. Witnessed (W; n=299) and listened to (H; n=383) events were analysed separately and collated to identify common and distinct themes across both types of exposure. Findings: six themes were identified, each with subthemes. Five themes were identified in both witnessed and listened to accounts and one was salient to witnessed accounts only. Themes indicated that events were characterised as severe, unexpected and complex. They involved aspects relating to the organisational context; typically limited or delayed access to resources or personnel. There were aspects relating to parents, such as having an existing relationship with the parents, and negative perceptions of the conduct of colleagues. Traumatic events had a common theme of generating feelings of responsibility and blame Finally for witnessed events those that were perceived as traumatic sometimes held personal salience, so resonated in some way with the midwife's own life experience Key conclusions: midwives are exposed to events as part of their work that they may find traumatic. Understanding the characteristics of the events that may trigger this perception may facilitate prevention of any associated distress and inform the development of supportive interventions

Reflective Functioning on the Parent Development Interview: Validity and reliability in relation to socio-demographic factors

he Reflective Functioning coding of the Parent Development Interview (PDI-RF) is a widely used method for assessing a caregivers’ capacity for mentalization. However, little is known about its psychometric properties. The aim of this study was to examine the distributions and discriminant and criterion validity of the PDI-RF scale in relation to a number of demographic and socioeconomic factors. Mothers of infants and toddlers (N = 323) from low, medium, and high-risk samples were interviewed with the PDI and transcripts were coded for RF. Demographic and socio-economic data were recorded. The PDI-RF scale showed high inter-rater reliability, internal consistency, and criterion validity. Modest associations with some sociodemographic variables and PDI-RF were found, but together these only accounted for a small amount of variance in the measure, suggesting adequate discriminant validity. Overall, the scale had good psychometric properties, although some caveats for its use were identified

Racial Segregation as a Social Determinant of Health: Evidence from the State of Georgia

Background: Despite decades of research, determining the causes of racial disparities in health remains a pernicious problem in the public health arena. Challenges include further refining definitions of health as well as expanding frameworks for social determinants of health to include relevant and related predictors. Racial segregation as a social determinant of health is understudied but of growing interest in the discourse on health disparities. This paper explores empirically the relationship between racial segregation and other predictors of social determinants of health and their collective impact on health outcomes defined in both objective and subjective terms. Methods: Ordinary least squares regression analysis was used to analyze health outcomes from the Robert Wood Johnson 2018 County Health Rankings for Georgia. At the county level we considered two distinct categories of health outcomes as the dependent variables, including objective measures of health status such as age-adjusted mortality and more subjective measures from the person’s perspective of quality of life such self-reported health. The independent variables representing racial segregation included the black-white segregation and non-white-white segregation indices. Results: Our findings are that racial segregation is not significantly associated with objective health outcome measures. Conversely and surprisingly, counties with higher levels of black-white and nonwhite-white segregation show better self-reported health. Control variables have the expected impact on health outcomes based on previous literature. Conclusions: While segregation does not suggest poorer health status, the findings of higher quality of life assessment is concerning as a person’s perspectives on their health predicts healthy behaviors and access to needed care. We suggest that racial segregation is an important addition to social determinants of health frameworks and models and worthy of continued multidisciplinary research on a national basis