The Affordable Care Act: Disparities in Emergency Department and Hospital Use for Mental Health Diagnoses In Young Adults

One of the first provisions of the Affordable Care Act to be implemented allowed young adults to remain on their parents' insurance plans until the age of 26. This study estimated the association between the dependent coverage provision and changes in young adults’ usage of Emergency Department (ED) and Hospital services for psychiatric diagnoses. We utilized a Quasi-Experimental Analysis of ED use and inpatient admissions in California from 2009-2011 for behavioral health diagnosis of individuals aged 19 to 31-years old. Analyses used a difference-in-differences approach comparing those targeted by the ACA dependent provision (19 to 25-year-olds) and those who were not (27 to 31-year-olds), evaluating changes in ED/Inpatient visit rates per 1,000 in California. Primary outcome measures included the quarterly ED/Inpatient visit rates with any psychiatric diagnosis, with subgroup analysis looking at the effects of race and gender on the primary outcome. It was found that while the young adult dependent provision was associated with 0.05 per 1,000 people (p<0.001) fewer psychiatric ED visits among the treatment group (19 to 25-year-olds) compared to the control group (27 to 31-year-olds), this significant reduction in psychiatric ED visits was not seen in males, hispanics, asians or pacific islanders. Furthermore, hispanics, asians, and pacific islanders were the only racial subgroups that did not see gains in the proportion of psychiatric ED visits covered by private insurance. Additionally, inpatient visit rates did not significantly change in the treatment group relative to the control group, however after stratification, rates significantly increased for males, whites, blacks, and mixed/other racial groups. While the source of admission from the ED did not significantly change in the treatment compared to the control group, admissions from sources other than the ED significantly increased overall, as well as for whites, blacks, mixed/other, and females. Ultimately, our research has shown that in one of the earliest aspects of the ACA, gender, and racial disparities exist

Components of attention, reward, and behavioral inhibition and dimensions of behavior disorder in children

Behaviorally disordered and non-disordered pre-adolescent and adolescent boys (8-16 years) were rated on four scales (CD), (SA), (AP) and (AW) of the Revised Behavior Problem Checklist (Quay & Peterson, 1987) and then tested on three tasks assessing behavioral inhibition, impulsivity, and reward-driven behavior. There were no significant correlations between scores on the CD scale and any of the tasks. Scores on the SA scale were significantly correlated with poorer performance on the efficiency ratio of the inhibition task and perseveration on the reward task even after controlling for age and grade. High scorers on the SA scale did not earn as much money and played more cards on the reward task and were less efficient on the inhibition task. Analysis of correlations between scores on the AW scale and the various tasks indicated that high scorers had fewer correct responses on the inhibition task and more errors of omission and commission on the impulsivity task after controlling for age and grade. Analysis of the correlations between scores on the AP scale and the tasks, controlling for age and grade, revealed that high scorers on the AP scale were unrelated to the correct responses on the DRL task and to the errors of commission on the CPT

Por Eso Cuidamos Una Investigación Sobre las Motivaciones Culturales Andinas que Incentivan a la Gente Indígena local a Conservar la Naturaleza en el Parque de la Papa, Pisac, Perú.

La comunidad global ahora enfrenta el reto grande y urgente de conservar la naturaleza. Aunque las consecuencias de la inacción son graves, a mucha gente le falta motivación para actuar. Sin embargo, hay lugares donde personas y comunidades están luchando devotamente con la tarea de vivir sosteniblemente. El Parque de la Papa en Pisac, Perú, es uno de estos lugares. En esta investigación, fui al Parque de la Papa con el objetivo de identificar cuáles son las motivaciones que incentivan a la gente allá a conservar la naturaleza y para determinar cómo estas motivaciones se relacionan a la cultura Andina. En el transcurso de una semana, realicé diez entrevistas en tres de las cinco comunidades del Parque. También hice dos entrevistas con miembros de ANDES (La Asociación para la Naturaleza y el Desarrollo Sostenible), que es la ONG basada en Cusco, Perú, que apoya a la asociación entre las comunidades del Parque. En este, el porque la gente produce la mayoría de su propia comida, la sostenibilidad de su agricultura está claramente asociada con el futuro de su alimentación, así como su soberanía alimentaria y cultural. Para la gente del Parque, su motivación para la conservación está basada en esta relación entre la sostenibilidad y sus necesidades básicas. Ellos son motivados a lograr su propia salud a través de la alimentación y plantas medicinales, y a preservar su cultura y su soberanía a través de la continuación de sus prácticas tradicionales autosuficientes. The global community now faces the difficult and urgent challenge to conserve nature. Although the consequences of inaction are grave, many people lack the motivation to act. Even so, there are places where people and communities are engaging devotedly with the task of living sustainably. The Potato Park in Pisac, Perú, is one of those places. In this investigation, I went to the Potato Park with the objective of identifying the motivations that move the people there to conserve nature and to determine how these motivations relate to the Andean culture. Over the course of one week, I completed ten interviews in three of the five communities of the Park. I also conducted two interviews with members of ANDES (The Association for Nature and Sustainable Development), which is the NGO based in Cusco, Perú, that organizes the association between the communities of the Park. In the Park, because the people produce the majority of their own food, the sustainability of their agriculture is clearly tied to the future of their food supply, as well as their food sovereignty and cultural autonomy. For the people of the Park, their motivation for conservation is based in this relation between sustainability and their basic needs. They are motivated to achieve their own health through food and medicinal plants, and to preserve their culture and sovereignty through the continuation of their traditional, self-sufficient practices