Screening for serious mental illness in the general population with the K6 screening scale: results from the WHO World Mental Health (WMH) survey initiative

Data are reported on the background and performance of the K6 screening scale for serious mental illness (SMI) in the World Health Organization (WHO) World Mental Health (WMH) surveys. The K6 is a six-item scale developed to provide a brief valid screen for Diagnostic and Statistical Manual of Mental Disorders 4th edition (DSM-IV) SMI based on the criteria in the US ADAMHA Reorganization Act. Although methodological studies have documented good K6 validity in a number of countries, optimal scoring rules have never been proposed. Such rules are presented here based on analysis of K6 data in nationally or regionally representative WMH surveys in 14 countries (combined N = 41,770 respondents). Twelve-month prevalence of DSM-IV SMI was assessed with the fully-structured WHO Composite International Diagnostic Interview. Nested logistic regression analysis was used to generate estimates of the predicted probability of SMI for each respondent from K6 scores, taking into consideration the possibility of variable concordance as a function of respondent age, gender, education, and country. Concordance, assessed by calculating the area under the receiver operating characteristic curve, was generally substantial (median 0.83; range 0.76-0.89; inter-quartile range 0.81-0.85). Based on this result, optimal scaling rules are presented for use by investigators working with the K6 scale in the countries studied. Copyright (c) 2010 John Wiley & Sons, Ltd.

Commercialisation of agriculture in Kenya: Case study of urban bias on food availability in farm households

This study investigates the effect of cash cropping on food availability and examines the determinants of the proportion of income allocated for food expenditures in the Nyeri district in Kenya. Using a Tobit model, the results suggest that in general food expenditure allocations suffer due to cash cropping in Kenya as the lump-sum income flows from this may be used for purchases other than food. Food expenditure also suffers when remittances are irregular. On the other hand, earnings from outside employment for married women living with husbands are positively associated with food expenditure allocations. Amounts of non-cash food output as well as ownership of livestock are negatively associated with food expenditure allocations. These findings indicate that lump sum income may not lead to improved welfare of women and children. Thus, there may be social reasons for increasing non-cash food production especially by women, instead of over emphasizing cash cropping as now seems to be so in public policy.

Poverty - dynamic and sustainability perspectives: Implications for welfare and policy with reference to India

After outlining some comparative features of poverty in India, this article reviews critically recent literature on the dynamics of poverty. On economic efficiency grounds, it rejects the view that the chronically poor are more deserving than the non-chronic poor of poverty assistance. Mechanisms of households and communities for coping with poverty are discussed. The possibility is raised that where poverty has been persistent that rational methods for coping with it are likely to be well established, and less suffering may occur than for households and communities thrown temporarily into poverty. However, situations can also be envisaged where such rational behaviours deepen the poverty trap and create unfavourable externalities for poverty alleviation. Conflict can arise between programmes to alleviate poverty in poor communities and the sustainability of these communities and their local cultures. Problems posed by this are discussed. Furthermore, the impact of market extension on poor landholders is considered. In contrast to the prevailing view that increased market extension and liberalisation is favourable to poor farmers, it is argued that inescapable market transaction cost makes it difficult for the poor to survive as landholders in a fluid and changing market system. The likelihood of poor landholders joining the landless poor rises, and if they migrate from the countryside to the city they face further adjustment hurdles. Consequently, poor landholders may be poorer after the extension of the market system and only their offspring may reap benefits from market reforms.

Linking policies for biodiversity conservation with advances in behavioural economics

Global biodiversity loss and its consequences for human welfare and sustainable development have become major concerns. Economists have, therefore, given increasing attention to the policy issues involved in the management of genetic resources. To do so, they often apply empirical methods developed in behavioral and experimental economics to estimate economic values placed on genetic resources. This trend away from almost exclusive dependence on axiomatic methods is welcomed. However, major valuation methods used in behavioral economics raise new scientific challenges. Possibly the most important of these include deficiencies in the knowledge of the public (and researchers) about genetic resources, implications for the formation of values of supplying information to focal individuals, and limits to rationality. These issues are explored for stated-preference techniques of valuation (e.g., contingent valuation) as well as revealed preference techniques, especially the travel cost method. They are illustrated by Australian and Asian examples. Taking into account behavioral and psychological models and empirical evidence, particular attention is given to how elicitation of preferences, and supply of information to individuals, influences their preferences about biodiversity. Policy consequences are outlined.

General strain theory, situational anger, and social networks: An assessment of conditioning influences

Using a random sample of university students to test general strain theory (GST), this study expanded on previous tests of strain theory in two ways. First, situational anger was measured, a construct that had not been used thus far in assessments of general strain. In addition, this research examined the role of social support networks as a conditioning influence on the effects of strain and anger on intentions to commit three types of criminal behavior (serious assault, shoplifting, and driving under the influence of alcohol [DUI]). The results provided mixed support for GST. While the link between anger and crime was confirmed, the nature of that relationship in some cases ran counter to the theory. Moreover, the evidence indicated that the role of social support networks was complex, and varied as a conditioning influence on intentions to engage in criminal activities. (C) 2001 Elsevier Science Ltd. All rights reserved.

Some new killing trick: Welfare reform and drug markets in a U.S. urban ghetto

Ethnographic data collected over a 5-year period is analyzed to determine how the Personal Responsibility & Work Opportunity Reconciliation Act of 1996 (PRWORA) has affected the lives of young male drug dealers from AIDS-afflicted families residing in Detroit. The data analysis indicated that the participants perceived drug dealing as the only viable employment opportunity for meeting the quotidian & health care needs of their families. The findings also revealed that the participants were highly aware of local political processes & the necessities of caring for relatives living with AIDS. Additional attention is dedicated to exploring the state of MI's rationale for ending the General Assistance Program, the sociocultural foundations of the PRWORA, various stipulations of the PRWORA, & how the PRWORA has augmented the legal vulnerability of welfare recipients. It is concluded that the PRWORA will force many welfare recipients to engage in illicit activities & will generally decrease recipients' health. 59 References. J. W. Parker

The simple economics of risk-sharing agreements between the NHS and the pharmaceutical industry

The Janssen-Cilag proposal for a risk-sharing agreement regarding bortezomib received a welcome signal from NICE. The Office of Fair Trading report included risk-sharing agreements as an available tool for the National Health Service. Nonetheless, recent discussions have somewhat neglected the economic fundamentals underlying risk-sharing agreements. We argue here that risk-sharing agreements, although attractive due to the principle of paying by results, also entail risks. Too many patients may be put under treatment even with a low success probability. Prices are likely to be adjusted upward, in anticipation of future risk-sharing agreements between the pharmaceutical company and the third-party payer. An available instrument is a verification cost per patient treated, which allows obtaining the first-best allocation of patients to the new treatment, under the risk sharing agreement. Overall, the welfare effects of risk-sharing agreements are ambiguous, and care must be taken with their use.

Nonlinear dynamics of the patient’s response to drug effect during general anesthesia

In today’s healthcare paradigm, optimal sedation during anesthesia plays an important role both in patient welfare and in the socio-economic context. For the closed-loop control of general anesthesia, two drugs have proven to have stable, rapid onset times: propofol and remifentanil. These drugs are related to their effect in the bispectral index, a measure of EEG signal. In this paper wavelet time–frequency analysis is used to extract useful information from the clinical signals, since they are time-varying and mark important changes in patient’s response to drug dose. Model based predictive control algorithms are employed to regulate the depth of sedation by manipulating these two drugs. The results of identification from real data and the simulation of the closed loop control performance suggest that the proposed approach can bring an improvement of 9% in overall robustness and may be suitable for clinical practice.

The debate on health in Portugal: governance of health care and the welfare modernization agenda

Comunicação apresentada na "Second Biennial Conference of the Standing Group on Regulation and Governance do ECPR Regulation & Governance, com o tema: (Re)Regulation in the Wake of Neoliberalism’ Consequences of Three Decades of Privatization and Market Liberalization, realizada na Universidade de Utrecht, the Netherlands, de 5 a 7 de Junho de 2008.

Welfare effects of entry into international markets with licensing

We study the effects of entry of a foreign firm on domestic welfare in the presence of licensing, when the entrant is technologically inferior to the incumbent. We show that foreign entry increases domestic welfare for intermediate (respectively, sufficiently large) technological differences between the firms under licensing with fixed fee (respectively, output royalty).

Nonlinear dynamics of the patient’s response to drug effect during general anesthesia

In today’s healthcare paradigm, optimal sedation during anesthesia plays an important role both in patient welfare and in the socio-economic context. For the closed-loop control of general anesthesia, two drugs have proven to have stable, rapid onset times: propofol and remifentanil. These drugs are related to their effect in the bispectral index, a measure of EEG signal. In this paper wavelet time–frequency analysis is used to extract useful information from the clinical signals, since they are time-varying and mark important changes in patient’s response to drug dose. Model based predictive control algorithms are employed to regulate the depth of sedation by manipulating these two drugs. The results of identification from real data and the simulation of the closed loop control performance suggest that the proposed approach can bring an improvement of 9% in overall robustness and may be suitable for clinical practice.