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--- - |2 Based on data from 1,366 Chinese preschoolers aged 31–77 months from 62 preschools, this study compared differences among four parent–child dyads in parent–child relationships and the associations between parent–child relationships and children's social adaptations. According to the results, the same‐sex dyad and opposite‐sex dyad patterns were tested. The results showed the same‐sex dyad and opposite‐sex dyad patterns in parent–child closeness. Mother–daughter dyads had more closeness than mother–son dyads; father–daughter dyads had more closeness than father–son dyads. The results were more supportive of the same‐sex dyad pattern in the associations between parent–child relationships and social adaptations. Mother–child closeness predicted girls' greater social skills and fewer problem behaviors; father–child conflict predicted boys' worse social skills and greater problem behaviors. - Personal Relationships, EarlyView.

--- - - Personal Relationships, Volume 25, Issue 3, Page 299-301, September 2018.

--- - - Personal Relationships, Volume 25, Issue 3, Page 458-458, September 2018.

--- - |2 This study investigated the relations between attachment‐related individual differences and the adoption of interpersonal goals for conflict in romantic relationships. Additionally, it used the truth and bias model to examine how biased and accurate people are in judging their partner's endorsement of conflict goals, as well as how attachment‐related individual differences moderate this bias and accuracy. Ninety‐four romantic couples completed a measure of attachment‐related individual differences and self ‐ and informant reports of interpersonal conflict goals. Results revealed that individuals endorsed conflict goals consistent with their attachment orientations. Furthermore, they displayed biases when estimating their partner's goals, with some of these biases relating to attachment orientations. These results suggest that attachment‐related individual differences may partially guide conflict‐related goals and partner perceptions. - Personal Relationships, Volume 25, Issue 3, Page 411-432, September 2018.

--- - |2 Utilizing dual logic from a multiple goals and relational turbulence theory, this study examined parents‐in‐law's interaction goals for topic avoidance with their children‐in‐law. Data from 159 parents‐in‐law revealed that multiple and conflicting goals were associated with parents‐in‐law's topic avoidance. Furthermore, relational parameters (i.e., relational uncertainty and partner influence) were associated with the goals in‐laws pursued. Results augment theorizing on a multiple goals perspective, relational turbulence, and topic avoidance, as well as theoretically ground the study of in‐law communication. - Personal Relationships, Volume 25, Issue 3, Page 433-457, September 2018.

--- - |2 Assumed similarity is the tendency to assume that another person is similar to oneself. The present studies examined assumed similarity in intimate relationships regarding the HEXACO personality traits in Denmark (N = 93) and China (N = 236). Specifically, these studies hypothesized that people assume higher similarity with their intimate partners in Honesty‐Humility and Openness to Experience compared to the other four HEXACO traits (Emotionality, Extraversion, Agreeableness, and Conscientiousness). Results from both studies indicate that assumed similarity was higher in Honesty‐Humility compared to Emotionality, Extraversion, Agreeableness, and Conscientiousness. However, assumed similarity in Openness was higher compared to Emotionality and Conscientiousness only. Supplementary analyses indicate no cultural differences between Denmark and China in assumed similarity in Honesty‐Humility and Openness. - Personal Relationships, Volume 25, Issue 3, Page 316-329, September 2018.

--- - |2 Research has established that social support for relationships is an important predictor of well‐being. However, the underlying assumption that social support specifically for relationships is a separate construct from general social support has not been properly tested empirically, nor has the question of whether support processes vary by source (friends vs. family). The current study (N = 1,281) used confirmatory factor analysis and structural equation modeling to address these issues. Support was found for a theoretical model in which social support specifically for relationships predicts relationship well‐being and, in turn, mental and physical health, even while controlling for general social support. Somewhat different patterns were found by source of support (family vs. friends) and by relationship type (same sex vs. mixed sex). - Personal Relationships, Volume 25, Issue 3, Page 374-393, September 2018.

--- - |2 College students (n = 388) participated in a two‐part online study (a survey and an experiment) examining the role of implicit theories in the experience of loneliness. Survey results revealed that lonely people tend to endorse entity theories of social competence and friendship. Experimental results showed that inducing an incremental theory of social competence reduced communication apprehension and increased social engagement among individuals regardless of their levels of loneliness. Inducing an incremental theory of friendship increased social engagement but did not influence the level of communication apprehension or social avoidance. Overall, the results suggest that an incremental theory of social interactions can reduce thoughts that are not conducive to fostering social connections among people in general, including lonely ones. - Personal Relationships, Volume 25, Issue 3, Page 394-410, September 2018.

--- - |2 Romantic partners' daily coping behavior can be viewed as a context for one's own coping. These three studies found that individuals were more likely to cope actively, seek support, or use alcohol, food, and drugs as means of coping when they perceived their partners doing so on a given occasion (Study 1, a cross‐sectional study) and when their partners reported using these strategies (Studies 2 and 3, longitudinal couples studies). These effects were evident regardless of whether or not one partner was dealing with an acute stressor (Study 2) or if both partners were dealing with day‐to‐day hassles (Study 3). Although these patterns are correlational, they raise important questions about how individuals choose to cope with acute stressors. - Personal Relationships, Volume 25, Issue 3, Page 351-373, September 2018.

--- - |2 Transgender people provide a unique opportunity to examine the effect of biological sex versus gender identity on mating preferences. This study aimed at identifying the mate characteristics that are most and least valued by transgender people and at examining to what extent their biological sex or their gender identity determined their mate preferences. A convenience sample of 134 male‐to‐female (MTF) and 94 female‐to‐male (FTM) individuals from Argentina rated Buss's list of 18 mate attributes. Compared to FTM, MTF individuals placed significantly more emphasis on attractiveness and socioeconomic status, whereas FTM, more than MTF individuals, valued partners with a dependable character. Although biological sex differences were present in both groups, providing support to the evolutionary theory, MTF individuals valued the same characteristics as both biological male and female individuals do. - Personal Relationships, Volume 25, Issue 3, Page 330-350, September 2018.

--- - |2 This study examines the links among rejection sensitivity (RS), communication about complaints, and relational satisfaction in intimate relationships. A total of 260 individuals completed an online survey through Amazon Mechanical Turk. RS was positively associated with complaint avoidance and negatively associated with positive politeness and negative politeness when voicing complaints. Furthermore, RS had indirect associations with relational satisfaction, partially mediated through complaint avoidance and positive politeness. The results of this study suggest that communicating complaints openly to one's partner, in concert with positive politeness (i.e., affirming the partner while voicing complaints), may help serve as a buffer against relational dissatisfaction associated with RS. - Personal Relationships, Volume 25, Issue 3, Page 302-315, September 2018.

This study reviews the economic viability of the Rashtriya Swasthya Bima Yojana (RSBY), India's landmark health insurance program for below poverty line (BPL) populations in West Bengal state of India. It addresses the issue through in‐depth analysis of literature, national and state level data, and a number of key stakeholder interviews. The study argues that the market failure conditions of this insurance model will continue to perpetuate losses for not only the state, but also for insurance companies, unless they adjust on a continuous basis for profit by raising the premium rate. This will further deplete state budgets for health care affecting the viability of the scheme in the long run.

Objective To quantify the effect of Medicaid expansions on office‐based care among the newly eligible. Data Source 2008–2014 Medical Expenditure Panel Survey. Study Design The main sample is adults age 26–64 with incomes ≤138% of poverty who were not eligible for Medicaid prior to the Affordable Care Act. For this population, difference‐in‐differences linear probability models compare utilization between expansion and nonexpansion states and between 2008–2013 and 2014. Extraction Methods Medicaid eligibility is simulated using data on family relationships, state of residence, and income. Principal Findings Relative to comparable adults in nonexpansion states, newly eligible adults in expansion states were 9.1 percentage points more likely to have any office‐based primary care physician visit in 2014, a 21.4% increase from 2013 (p‐value = .004); 6.9 percentage points more likely to have a specialist visit, a 25.2% increase from 2013 (p‐value = .036); and 5.1 percentage points more likely to have a visit with a nurse practitioner, nurse, or physician assistant, a 34.5% increase from 2013 (p‐value = .016). Conclusions State Medicaid expansions in 2014 were associated with greater likelihoods of visits with a variety of office‐based providers. The estimated effects are larger among newly eligible compared with previous estimates on broader populations of low‐income adults.

Objective To explore organizations’ experiences providing family planning during the first year of an expanded primary care program in Texas. Data Sources Between November 2014 and February 2015, in‐depth interviews were conducted with program administrators at 30 organizations: 7 women's health organizations, 13 established primary care contractors (e.g., community health centers, public health departments), and 10 new primary care contractors. Study Design Interviews addressed organizational capacities to expand family planning and integrate services with primary care. Data Extraction Interview transcripts were analyzed using a theme‐based approach. Themes were compared across the three types of organizations. Principal Findings Established and new primary care contractors identified several challenges expanding family planning services, which were uncommon among women's health organizations. Clinicians often lacked training to provide intrauterine devices and contraceptive implants. Organizations often recruited existing clients into family planning services, rather than expanding their patient base, and new contractors found family planning difficult to integrate because of clients’ other health needs. Primary care contractors frequently described contraceptive provision protocols that were not evidence‐based. Conclusions Many primary care organizations in Texas initially lacked the capacity to provide evidence‐based family planning services that women's health organizations already provided.

Aim To cross‐culturally adapt and validate the Comprehensive Frailty Assessment Instrument (CFAI) among Chinese community‐dwelling older adults. Methods The Chinese CFAI was developed through forward–backward translations. An urban sample of 1235 community‐dwelling older adults received face‐to‐face interviews to examine the validity (construct validity and criterion validity) and reliability (internal consistency and test–retest reliability). Results The Chinese CFAI achieved semantic and idiomatic equivalence, and showed acceptable reliability and an expected factor structure, except for the social support domain. The exploratory factor analysis extracted five factors explaining 53.8% of the total variance of frailty. The confirmatory factor analysis showed that the data fit well to the second‐order factor theoretical model, with a root mean square error of approximation of 0.05, Tucker‐Lewis Index of 0.93 and Comparative Fit Index of 0.95. The receiver operating characteristic analysis presented an acceptable criterion validity using the Rockwood Frailty Index as an external criterion (area under the curve 0.80), with balanced sensitivity (65.31%) and specificity (81.19%) at the optimal 39‐point frailty cut‐off of the CFAI. Conclusions The Chinese CFAI has good validity and reliability as a practical frailty measure in Chinese community‐dwelling older adults.

Aim The aim of the present study was to investigate the relationship between physical activity (PA) and depressive symptoms in community‐dwelling older Japanese adults. Methods A cross‐sectional study design was used to obtain data from 3191 community‐dwelling older Japanese adults aged 70–95 years. Depressive symptoms were assessed using self‐reported scores on the Geriatric Depression Scale‐15. PA was objectively measured using an accelerometer worn for a maximum of 40 days, and average daily durations of light‐intensity PA (LPA), moderate‐to‐vigorous intensity PA (MVPA) and step count were calculated. PA was compared between participants with and without depressive symptoms by carrying out analysis of covariance and multivariable logistic regression analysis adjusted for all covariates by using propensity scores. Results Depressive symptoms were present in 598 participants (19.6%). A comparison of propensity‐score adjusted PA showed that step count (5059.6 ± 53.7 vs 5003.0 ± 112.1 count/day; P = 0.652) and moderate‐to‐vigorous intensity PA duration (23.0 ± 0.4 vs 23.8 ± 0.7 min/day; P = 0.358) were not significantly different between participants with and without depressive symptoms, respectively. However, participants without depressive symptoms had a significantly higher LPA duration than those with depressive symptoms (39.4 ± 0.3 vs 37.3 ± 0.7 min/day, respectively; P < 0.01). Conclusions The present results suggest that individuals with lower LPA have a higher risk of depressive symptoms. These findings imply that PA recommendations, especially for older adults, should emphasize LPA, which appears to be especially effective at preventing depressive symptoms.

Aim To evaluate the relationship between kidney function without diabetes and components of the frailty phenotype in community‐dwelling Japanese older adults. Methods Participants were 8343 residents who completed baseline assessments, classified into four categories according to eGFR. Frailty status was defined using five criteria: (i) slow gait speed; (ii) muscle weakness; (iii) low physical activity; (iv) exhaustion; and (v) unintentional weight loss. Results After multivariate adjustment, participants with the lowest kidney function were at higher risk of frailty (OR 1.57, 95% CI 1.02–3.50) than those with normal kidney function. In addition, after adjustment for multiple confounders, estimated glomerular filtration rate <30 was associated with a greater risk of the individual frailty components of weight loss (OR 2.14, 95% CI 1.11–4.12), low physical activity (OR 1.35, 95% CI, 1.01–2.54) and slowness (OR 1.82, 95% CI 1.36–3.77) compared with estimated glomerular filtration rate ≥60. Conclusions Lower kidney function was associated with a higher risk of weight loss, low physical activity and slowness among community‐dwelling Japanese older adults.

Scholars have long observed that presidential communication about a marginalized group can help shape that group's reality. Yet most analyses of such communication focus on a relatively small number of texts, making it difficult to identify important changes over time and analyze factors that might explain those changes. The present study proposes an analytic framework that specifies 4 measurable parameters of presidential communication about marginalized groups, as well as 4 explanatory factors. We use this framework to analyze the census of presidents' formal communications about the LGBT community. Results highlight presidents' limited communicative engagement with the LGBT community and the roles that political party, rhetorical context, public opinion, and sociocultural touchstones play in explaining presidential communication about this important group.

Despite the increased attention to eudaimonic media experiences, to date scholars have paid little attention to the specific portrayals responsible for those experiences. Study 1 of this project reports the first systematic content analysis of self‐transcendent media—a particular type of eudaimonic media—using a sample of 100 “inspirational” YouTube videos. The presence of 20 specific elicitors associated with self‐transcendent emotions was examined and reported. In Study 2, respondents provided real‐time self‐transcendent emotional reactions while viewing 3 “inspirational” videos. As expected, ratings significantly increased immediately following exposure to each specific elicitor. Thus, this project reports the first empirical evidence directly linking specific representations to content identified as “inspirational” and directly linking those representations to self‐transcendent emotional reactions.

The 2010 Affordable Care Act extended dependent coverage for adult children up to age 26 in the USA. Since then, considerable studies have assessed its various impacts among young adults. However, little is known about whether there is any change in health care use when young adults age out of dependent coverage. This study examines health care consumption changes among young adults prior to their aging out process. I used data from a large insurance claim database and studied health care utilization of young adults under parents' coverage during a 2‐year period in a difference‐in‐difference framework. I found that young adults had relative reductions in health services use, except ER visits, compared with individuals who stayed under parents' coverage. This pattern was the same for both male and females. Individuals with regular medical needs had greater relative reductions compared with those without regular medical needs. The relative reductions in health care use during the aging out process may have an important impact on young adults' health, especially for those with regular medical needs. More efforts could be made to help them maintain regular medical utilization during the transition.

Objective We examine whether drugs’ excluded versus recommended status on pharmacy benefit manager exclusion lists corresponds to evidence from cost‐effectiveness analyses, lack of evidence, or rebates. Data Sources To find cost‐effectiveness data for drugs on 2016 exclusion lists of CVS Caremark and Express Scripts, we searched the Tufts Cost‐Effectiveness Analysis Registry and the peer‐reviewed literature. Study Design For each excluded and recommended drug, we compared the mean cost‐per‐QALY, and we calculated the difference between the numbers of excluded and recommended drugs for which we could find no cost‐effectiveness evidence. Data Collection As keywords in our searches, we used the brand and generic drug name and “cost‐effectiveness” and “cost‐per‐quality‐adjusted life‐year.” Of 240 retrieved studies, 110 were selected for analysis. Principal Findings The mean cost‐per‐QALY for excluded drugs was higher ($51,611) than the cost‐per‐QALY for recommended drugs ($49,474), but not statistically significant. We could find no cost‐effectiveness evidence in the Registry or peer‐reviewed literature for 23 of the excluded drugs, and no evidence for 5 of the recommended drugs. Conclusions Cost‐effectiveness does not correlate with a drug's excluded or recommended status. Lack of cost‐effectiveness evidence favors a drug's excluded status.

Objective To build and test a model that predicts community discharge probabilities for Medicaid‐eligible nursing home (NH) residents who remain in the nursing home at 90 days after admission and, thus, would be candidates for the Money Follows the Person (MFP) program. Data Source The Minimum Data Set, Medicaid Management Information Systems, and Minnesota Vital Statistics file. Data Cohort of 33, 590 nursing home stays that qualified for Medicaid by the 90th day of their stay from 383 Minnesota nursing homes from July 2011 to June 2013. Study Design Mixed effects logistic regression model to predict community discharge. Principal Findings The scoring system had a high level of accuracy in predicting community discharge for both the fitting and validation cohorts. Subpopulations with severe mental illness or intellectual disability were well represented across the entire score range. Conclusions Findings are being applied in the Minnesota's MFP initiative (Moving Home Minnesota) to target Medicaid‐eligible NH residents for transitioning to the community. This approach could be applied to MFP in other states.

Objective To examine the effects of the penetration of dual‐eligible special needs plans (D‐SNPs) on health care spending. Data Sources/Study Setting Secondary state‐level panel data from Medicare‐Medicaid Linked Enrollee Analytic Data Source (MMLEADS) public use file and Special Needs Plan Comprehensive Reports, Area Health Resource Files, and Medicaid Managed Care Enrollment Report between 2007 and 2011. Study Design A difference‐in‐difference strategy that adjusts for dual‐eligibles’ demographic and socioeconomic characteristics, state health resources, beneficiaries’ health risk factors, Medicare/Medicaid enrollment, and state‐ and year‐fixed effects. Data Collection/Extraction Methods Data from MMLEADS were summarized from Centers for Medicare and Medicaid Services (CMS)'s Chronic Conditions Data Warehouse, which contains 100 percent of Medicare enrollment data, claims for beneficiaries who are enrolled in the fee‐for‐service (FFS) program, and Medicaid Analytic Extract files. The MMLEADS public use file also includes payment information for managed care. Data in Special Needs Plan Comprehensive Reports were from CMS's Health Plan Management System. Principal Findings Results indicate that D‐SNPs penetration was associated with reduced Medicare spending per dual‐eligible beneficiary. Specifically, a 1 percent increase in D‐SNPs penetration was associated with 0.2 percent reduction in Medicare spending per beneficiary. We found no association between D‐SNPs penetration and Medicaid or total spending. Conclusion Involving Medicaid services in D‐SNPs may be crucial to improve coordination between Medicare and Medicaid programs and control Medicaid spending among dual‐eligible beneficiaries. Starting from 2013, D‐SNPs were mandated to have contracts with state Medicaid agencies. This change may introduce new effects of D‐SNPs on health care spending. More research is needed to examine the impact of D‐SNPs on dual‐eligible spending.

Objective To examine associations among substance use disorder (SUD) and measures of length of stay (LOS) and non‐psychiatric medical comorbidity (MEDCO) in older‐adult inpatients with serious mental illness (SMI), hypothesizing SUD would be related to worse clinical outcomes. Methods A cross‐sectional study analyzed medical records from 2010 to 2016 of 7258 inpatients with SMI ≥ age 50, obtained from a 274‐bed psychiatric hospital. Descriptive analyses examined prevalence rates for SUD status (+/−), individual drug classes, and total number of SUDs (polysubstance use disorders). Regression models examined the influence of 2 independent variables of interest: (1) SUD status (+/−) and (2) type of SUD (ie, specific drug), controlling for demographic factors and additional (non‐SUD) psychiatric disorders. Two dependent (outcome) variables were examined: LOS and MEDCO. Results The overall SUD rate was 26%; cocaine was the most common SUD (≈ 10%). SUD status and additional (non‐SUD) psychiatric diagnoses were significantly associated with longer LOS (both P < 0.001). For individual SUDs, cocaine, marijuana, opiates, and alcohol were all significantly associated with LOS (all P < 0.01). SUD status, age, sex, admission status, and race were significantly associated with MEDCO (all P < 0.002). For individual SUDs, barbiturates, opiates, and alcohol were all significantly associated with MEDCO (P < 0.01). Conclusions The prevalence of SUD in this sample underscores concerns related to treating older adults presenting providers with comorbid SUD and SMI. This combination may increase the burden and complexity of care, warranting further investigation into mechanisms and long‐term consequences.

Aim The aim of the present study was to evaluate whether the effect of one‐time brief additional counseling in periodic health examinations (PHE) through the National Screening Program for the Translational Ages in Korea is sustained after 2 years. Methods We collected data from National Screening Program for the Translational Ages participants in 2007 and 2008. To evaluate behavior change after 2 years, we collected the participants’ health behavior data 2 years later (2009 and 2010). We defined the basic group as participants who only received PHE, and the additional group as received PHE and counseling. We carried out propensity score matching to ensure that additional counseling was the only different variable affecting health behavior between the two groups. Results After propensity score matching, 50 630 remaining matched participants were matched for each group. Of these participants, 26.5% (26 855/101 260) were aged 66 years, and 60.9% (61 653/101 260) were men. The additional group showed a significant increase in odds of smoking cessation among the 66‐year‐olds (adjusted OR 1.173, 95% CI 1.003–1.372). This effect was significant, especially when the participants did not have hypertension or hypercholesterolemia (adjusted OR 1.193, 95% CI 1.000–1.423 for hypertension and adjusted OR 1.188, 95% CI 1.009–1.398 for hypercholesterolemia). However, there was no significant association for alcohol drinking and regular exercise. Conclusions The effect of one‐time brief counseling added to a PHE in cigarette smoking was observed only among the 66‐year‐olds. However, the effect was so small that it is doubtful to be clinically relevant. Repeated counseling is required to sustain the effect of the initial motivation of counseling. Geriatr Gerontol Int 2017; ••: ••–••

Many people believe that the abortion debate will end when at some point in the future it will be possible for fetuses to develop outside the womb. Ectogenesis, as this technology is called, would make possible to reconcile pro‐life and pro‐choice positions. That is because it is commonly believed that there is no right to the death of the fetus if it can be detached alive and gestated in an artificial womb. Recently Eric Mathison and Jeremy Davis defended this position, by arguing against three common arguments for a right to the death of the fetus. I claim that their arguments are mistaken. I argue that there is a right to the death of the fetus because gestating a fetus in an artificial womb when genetic parents refuse it violates their rights not to become a biological parent, their rights to genetic privacy and their property rights. The right to the death of the fetus, however, is not a woman's right but genetic parents’ collective right which only can be used together.

This paper presents a copula‐based method for identifying and estimating the coefficient of a binary endogenous regressor in a Poisson regression. The method offers advantages over existing approaches. Most importantly, it relies upon standard maximum likelihood approaches, and it does not require numerical integration. Further, as part of its implementation, the method provides a convenient test for the presence of endogeneity. The empirical application investigates the effect of insurance status (a binary measure) on doctor visits (a count measure).

This study explored how fluctuations in satisfaction and perceived partner commitment were associated with stability measures (e.g., commitment, perceived stability, relational uncertainty, turbulence) in both on‐again/off‐again and noncyclical relationships. Participants completed an initial survey, 8 weekly surveys, and a final survey. Results suggest fluctuation in perceived partner commitment across the weekly surveys was associated with all measures of stability when moderated by relationship type; fluctuation was negatively associated with the stability measures for noncyclical relationships but positively for on–off relationships. For fluctuation in satisfaction, this same pattern was found for commitment only. Overall, fluctuation, particularly in perceived partner commitment, was not viewed as disruptive for on–off partners; rather, fluctuation appeared to foster more steady and viable views of the relationship.

This article examines the “chicken‐egg” two‐way relationships between online consumer reviews and sales, and assesses the dual influencer and indicator roles of online consumer reviews in relation to purchase behavior. Considering the time factor, we adopt the methodology of Granger causality test and track 3,390 products on Amazon.com over a 2‐month period. The results reveal that a causality loop exists between online consumer review volume and sales. Specifically, our findings indicate that the volume of negative consumer reviews drive consumers' purchasing decisions, but the volume of positive consumers reviews only marginally affects purchasing decisions. Also, consumers generate more positive reviews than negative reviews after sales. Our results highlight the importance of negative consumer reviews; negative reviews not only lead to sales, but sales, in turn, lead to higher volume of negative reviews. The findings suggest an alternative strategy for practitioners to address negative online consumer reviews and highlight the awareness effect of online consumer review postings that can later convert into purchase behaviors.

This representative study of German search engine users (N = 1,000) focuses on the ability of users to distinguish between organic results and advertisements on Google results pages. We combine questions about Google's business with task‐based studies in which users were asked to distinguish between ads and organic results in screenshots of results pages. We find that only a small percentage of users can reliably distinguish between ads and organic results, and that user knowledge of Google's business model is very limited. We conclude that ads are insufficiently labelled as such, and that many users may click on ads assuming that they are selecting organic results.

Objective The objective of this literature review was to summarise current research regarding how consumers seek health‐related information from social media. Primarily, we hope to reveal characteristics of existing studies investigating the health topics that consumers have discussed in social media, ascertaining the roles social media have played in consumers’ information‐seeking processes and discussing the potential benefits and concerns of accessing consumer health information in social media. Methods The Web of Science Core Collection database was searched for existing literature on consumer health information seeking in social media. The search returned 214 articles, of which 21 met the eligibility criteria following review of full‐text documents. Conclusion Between 2011 and 2016, twenty‐one studies published explored various topics related to consumer information seeking in social media. These ranged from online discussions on specific diseases (e.g. diabetes) to public health concerns (e.g. pesticide residues). Consumers’ information needs vary depending on the health issues of interest. Benefits of health seeking on social media, in addition to filling a need for health information, include the social and emotional support health consumers gain from peer‐to‐peer interactions. These benefits, however, are tempered by concerns of information quality and authority and lead to decreased consumer engagement.

Objective To investigate the impact on patient waiting times of a role substitution model introducing an advanced allied health practitioner as the first point of contact within a geriatric outpatient context. Methods A pre‐ to postintervention design was used to determine impact over a five‐year period (2008–2012). All patients referred to the geriatric specialist outpatient department were included (n = 1514). Data relating to waiting times were analysed using one‐way ANOVA and post hoc Tukey tests to determine effects on patient waiting times. Results Waiting times were reduced from an average of 82 to as low as 35 days, in a context of increasing referral rates. Medical specialist capacity was increased through improvements to available outpatient times and reduced appointment lengths. Patients seen within their designated triage category timeframe increased from 47 to 86%. Conclusion Health professional substitution in geriatrics can be an effective intervention for reducing patient waiting times and improving access to care.

With cointegration tests often being oversized under time‐varying error variance, it is possible, if not likely, to confuse error variance non‐stationarity with cointegration. This paper takes an instrumental variable (IV) approach to establish individual‐unit test statistics for no cointegration that are robust to variance non‐stationarity. The sign of a fitted departure from long‐run equilibrium is used as an instrument when estimating an error‐correction model. The resulting IV‐based test is shown to follow a chi‐square limiting null distribution irrespective of the variance pattern of the data‐generating process. In spite of this, the test proposed here has, unlike previous work relying on instrumental variables, competitive local power against sequences of local alternatives in 1/T‐neighbourhoods of the null. The standard limiting null distribution motivates, using the single‐unit tests in a multiple testing approach for cointegration in multi‐country data sets by combining P‐values from individual units. Simulations suggest good performance of the single‐unit and multiple testing procedures under various plausible designs of cross‐sectional correlation and cross‐unit cointegration in the data. An application to the equilibrium relationship between short‐ and long‐term interest rates illustrates the dramatic differences between results of robust and non‐robust tests.

We propose imposing data‐driven identification constraints to alleviate the multimodality problem arising in the estimation of poorly identified dynamic stochastic general equilibrium models under non‐informative prior distributions. We also devise an iterative procedure based on the posterior density of the parameters for finding these constraints. An empirical application to the Smets and Wouters () model demonstrates the properties of the estimation method, and shows how the problem of multimodal posterior distributions caused by parameter redundancy is eliminated by identification constraints. Out‐of‐sample forecast comparisons as well as Bayes factors lend support to the constrained model.

This study assessed measures operationalizing concepts in relational turbulence theory (Solomon, Knobloch, Theiss, & McLaren, 2016). Studies of relational turbulence in marriage have used measures developed in research on dating couples; therefore, one goal was evaluating these variables in a general population sample of married individuals (N = 1,469). A second goal addressed problems in measures of relational uncertainty by assessing alternative scales. Third, associations between relational turbulence theory variables and measures of cognitive, emotional, and communicative phenomena were estimated. Fourth, the distinctiveness of relational turbulence measures relative to measures of other relational qualities was assessed. The conclusions advance new, Likert relational uncertainty scales and highlight the validity of relational turbulence constructs as distinctive predictors of cognitions, emotions, and communication.

There is no abstract available for this paper.

Despite its high political interest, the impact of removing user charges for health care in low‐income settings remains a debatable issue. We try to clear up this contentious issue by estimating the short‐term effects of a policy change that occurred in 2006 in Zambia, when 54 of 72 districts removed fees. We use a pooled synthetic control method in order to estimate the causal impact of the policy on health care use, the provider chosen, and out‐of‐pocket medical expenses. We find no evidence that user fee removal increased health care utilisation, even among the poorest group. However, we find that the policy is likely to have led to a substitution away from the private sector for those using care and that it virtually eliminated medical expenditures, thereby providing financial protection to service users. We estimate that the policy was equivalent to a transfer of US$3.2 per health visit for the 50% richest but of only US$1.1 for the 50% poorest.

Aim To investigate whether being part of a community organization interfered with older adults’ overall functionality. The magnitude of responses to a community exercise program based on functional circuits in socially active and socially non‐active older adults was also investigated. Methods A total of 200 older adults aged ≥60 years from Requinoa, Chile, participated in the study. Participants were separated into two groups according to the level of social participation: socially active (SA) and socially non‐active (SNA). During an evaluation, data regarding the presence of comorbidities (Charlson Comorbidity Index), disability level (Modified Health Assessment Questionnaire), dynamic balance (Timed Up and Go test), muscle force (handgrip dynamometry) and sociodemographic conditions were collected. Participants followed an exercise program consisting of a functional exercise circuit including balance, resistance and aerobic exercises, twice a week, for 12 weeks. Results Both the Charlson Comorbidity Index and disability were higher in SNA compared with SA participants on inclusion. Both groups improved disability (Δ–0.25 patients [−0.5 – −0.0625 patients] for SNA and (Δ–0.125 patients [−0.5–0 patients] for SA) and balance (Δ–2 s [−3–0 s] for SNA and (Δ–1 s [−3–0 s] for SA) after training (P < 0.05 for all). Changes from baseline were statistically higher in the SNA group. Handgrip force improved only in participants in the SNA group (Δ1.7 kg [0.6–2.8 kg], P = 0.0001). No differences, however, were observed between the magnitude of improvements of handgrip between groups. Conclusions Although socially non‐active older adults had more comorbidity and disability than their socially active counterparts, they showed a higher response to a community exercise program. Geriatr Gerontol Int 2017; ••: ••–••.

Purpose This study examined the time from breast cancer diagnosis to initiation of treatment among Alaska Native (AN) women. We evaluated the impact of age, cancer stage, and rural/urban residence at diagnosis. Methods We evaluated characteristics of women recorded in the Alaska Native Tumor Registry who received a first diagnosis of breast cancer between 2009 and 2013. Median time from diagnosis to treatment was assessed. Associations of demographic and clinical characteristics with timely initiation of treatment were evaluated using logistic regression and Cox proportional hazards models. Results Two hundred seventy‐eight (278) AN women were diagnosed with invasive breast cancer in years 2009‐2013. Mean age at diagnosis was 56.8 years (SD = 13.0). The median time from diagnosis to initiation of treatment was 23 days (P < .05) with most (94.6%, n = 263) meeting the ≤60‐day guideline target. Time to treatment was not associated with rural/urban residence, age, or stage at cancer diagnosis. Conclusion These findings indicate that most AN women diagnosed with breast cancer within the AN Tribal Health System receive timely treatment after diagnosis.

Background Malaria is a major global health challenge. This study aims to clarify the manner in which contextual factors determine the use and maintenance of bed nets and the extent to which malaria prevention policy is responsive to them in Southern Benin. Methods Semi‐structured interviews and direct observations were undertaken with 30 pregnant women in the municipality of So‐Ava from June to August 2015. Key informants in the Ministry of Health and local community health workers were also interviewed regarding malaria prevention policy formation, and the monitoring and evaluation of bed net interventions, respectively. Data were analyzed through categorical content analysis and grouped into themes. Results The majority of pregnant women participants (80%) declared non‐adherence to instructions for hanging and maintaining insecticide‐treated nets (ITNs). The distributed bed nets were washed like clothes, which affected their bio‐efficacy, and were in poor condition (ie, torn or had holes). Multiple factors contributed to the poor condition of ITNs: Pregnant women's limited understanding of risk including their inability to connect the key environmental factors to personal risk, gendered responsibility for installing bed nets, and lack of public measures that would enable women to re‐treat or access new bed nets as needed. Poverty that determined structural aspects of housing such as the size and quality of homes and access to bed nets exacerbated the challenges. Conclusion Institutionalizing an iterative process of monitoring, review, and responsive adaptation throughout the entire policymaking cycle would better support malaria preventive policy implementation in Benin.

The present study explored the relation between the multidimensional construct of emotion regulation and relationship satisfaction in 104 couples seeking couple or family therapy. Satisfaction was assessed via the Dyadic Satisfaction Subscale of the Dyadic Adjustment Scale, whereas the Difficulties in Emotion Regulation Scale was used to assess the 6 dimensions of emotion regulation (acceptance, goals, impulse, awareness, strategies, clarity). Significant relations were found between relationship satisfaction and acceptance, impulse, awareness, and strategies. Relations were not always found in expected directions, and although actor effects were found for both genders, only women displayed partner effects. Findings point to the importance of considering context when studying emotion regulation and highlight the clinical importance of evaluating its specific dimensions.

Introduction Administration is vital for health care. Its importance may increase as health care systems become more complex, but academic attention has remained minimal. We investigated trends in administrative expenditure across OECD countries, cross‐country spending differences, spending differences between health care system typologies, and differences in the scale and scope of administrative functions across typologies. Methods We used OECD data, which include health system governance and financing‐related administrative activities by regulators, governance bodies, and insurers (macrolevel), but exclude administrative expenditure by health care providers (mesolevel and microlevel). Results We find that governance and financing‐related administrative spending at the macrolevel has remained stable over the last decade at slightly over 3% of total health spending. Cross‐country differences range from 1.3% of health spending in Iceland to 8.3% in the United States. Voluntary private health insurance bears much higher administrative costs than compulsory schemes in all countries. Among compulsory schemes, multiple payers exhibit significantly higher administrative spending than single payers. Among single‐payer schemes, those where entitlements are based on residency have significantly lower administrative spending than those with single social health insurance, albeit with a small difference. Discussion These differences can partially be explained because multi‐payer and voluntary private health insurance schemes require additional administrative functions and enjoy less economies of scale. Studies in hospitals and primary care indicate similar differences in administrative costs across health system typologies at the mesolevel and microlevel of health care delivery, which warrants more research on total administrative costs at all the levels of health systems.

Background Few studies explore stroke survivor views and motivations towards stem cell therapy (SCT). This qualitative study explores the views and motivations of both stroke survivors and their partners/carers towards a proposed 2‐arm Phase III Randomised Controlled Trial (RCT) comparing intracerebral insertion of stem cells with placebo neurosurgery in stroke survivors with disability. Objective To explore views and motivations towards a proposed 2‐arm stem cell trial and identify factors that may impede and enhance participation. Design This study adopts a naturalistic design to explore the complexity of this field, employing a participatory action‐research approach comprising a specialized Conversation (World) Café form of focus group. Data were collected via 5 Conversation Cafés with stroke survivors (age 40‐75) and partners/carers between June and October 2016. Of 66 participants, 53 (31 male, 22 female) were stroke survivors and 13 (6 female, 7 male) were partners/carers. Qualitative data were analysed using a thematic approach. Discussion and Conclusion Stroke survivor views and motivations reflect anticipation of the personal and future benefits of regenerative medicine. Partners/carers sought to balance the value of stroke survivor hope with carrying the weight of hope as carer, a conflict burden adding to known caregiver burden. All participants expressed the need for during and post‐trial psychological support. This study provides a rare opportunity to explore the prospective views and motivations of stroke survivors and their partners/carers towards a proposed Phase III 2‐arm RCT. This adds weight to qualitative evidence exploring capacity, consent, decision making, perceptions of treatment risk and supports required for clinical trial participation.

This work extends the masspersonal communication model (MPCM; O'Sullivan & Carr, 2017) by introducing anticipated interaction as a way to understand variations within the masspersonal continuum. Drawing from Thompson's mediated communication framework (1995), we argue that anticipated interaction paves the way for establishing a communicative relationship between interactants. In social media, this relationship is rooted in a sender's expectations for audience response and the imagined responsive audience. Using experience sampling, we show that anticipated interaction varies across social media. Further, we outline the relational and situational factors associated with expecting response and the specificity of imagined responsive audience. These variations and their sources characterize masspersonal communication as a socially and technologically situated practice shaped by multiple intersecting influences.

This research focuses on the identification of social roles and an investigation of their influence in online context. Relying on a systemic approach for role conceptualization, we investigate member's activity, shared content and position in the network within a consumer to consumer social media‐based community (SMC) around a product. This investigation led to the identification of ten core roles, based on three key elements: object of interest (product, practice, and community), main contribution type (sharing information and seeking information), individual orientation (factual, emotional). We propose an explanation about how these roles, through their positioning, participate in the community dynamics and how they contribute to the creation and diffusion of cookery as a social practice, shaping the periphery around this practice.

Political information sharing in social media offers citizens opportunities to engage with news and express their political views, but how do different patterns of online political information exposure, including both incidental and selective exposure, affect sharing? Using two‐wave panel survey data collected in the United States, we examine the relationship between incidental and selective exposure and their consequent links to political information sharing, across different levels of strength of political party affiliation. Our results demonstrate that incidental exposure to counter‐attitudinal information drives stronger partisans to more actively seek out like‐minded political content, which subsequently encourages political information sharing on social media. The results highlight the need to consider both types of political information exposure when modeling citizens' political behavior online.

Introduction Neuropsychiatric symptoms (NPS) are common at all stages of Alzheimer disease (AD). Delusions in AD are associated with negative clinical consequences and may signal rapid disease progression. Hence, we sought to determine the prevalence of delusions in drug‐naïve (no cholinesterase inhibitor or neuroleptic medications) AD patients. Methods In this meta‐analysis, a search of the EMBASE, MEDLINE, and PsycINFO databases was performed. We selected studies reporting delusion prevalence measured by the Neuropsychiatric Inventory (NPI) in drug‐naïve AD patients. An aggregate delusion event rate with 95% confidence interval (CI) was calculated. The I2 statistic was used to assess the magnitude of between‐study heterogeneity. Single variable meta‐regressions allowed examination of the effect of moderating factors and heterogeneity. Quantitative measures were used to appraise for publication bias. Results We identified 6 studies with 591 participants allowing calculation of the aggregate delusional prevalence rate. Irrespective of dementia severity, the aggregate event rate for delusions was 29.1% (95% CI: 20–41%; I2 = 84.59). No publication bias was observed. Conclusion This meta‐analysis calculates a 29.1% prevalence rate of delusions in AD patients. There is a trend towards increasing delusion prevalence in concordance with increasing severity of dementia. Given delusions are associated with poorer outcomes, the obtained prevalence should motivate clinicians to screen carefully for delusions. Current literature limitations warrant future studies, with sub‐analyses on dementia severity, and other neurobiological factors known to influence the presence of delusions.

The asylum system faces problems on two fronts. States undermine it with populist politics, and migrants use it to satisfy their migration preferences. To address these problems, asylum services should be commodified. States should be able to pay other states to provide determination and protection‐elsewhere. In this article, I aim to identify a way of implementing this idea that is both feasible and desirable. First, I sketch a policy proposal for a commodification of asylum services. Then, I argue that this policy proposal is not only compatible with the right to asylum, but also supported by moral considerations. Despite some undesirable moral features, a market in asylum facilitates the provision of asylum to those who need it.

In this article, I ask whether a principle analogous to the principle of clinical equipoise should govern the design and conduct of RCTs evaluating the effectiveness of policy interventions. I answer this question affirmatively, and introduce and defend the principle of policy equipoise. According to this principle, all arms of a policy RCT must be, at minimum, in a state of equipoise with the best proven policy that is also morally and practically attainable and sustainable. For all arms of a policy RCT, policy experts must either (1) reasonably disagree about whether the trial arms are more effective than this policy, or (2) know that they are.

Purpose To examine the relationship between area population density and community pharmacy‐based Alzheimer's Disease (AD)‐related services: pharmacists’ medication knowledge and counseling, immunizations, and in‐stock cognitive enhancers in 3 predominantly rural regions of the United States. Methods A standardized interview was administered by telephone to a 100% sample of community pharmacies in 3 areas: Northern California/Southern Oregon (n = 206), North and South Dakota (n = 278), and West Virginia (n = 420). Key study outcomes included: pharmacists’ medication knowledge, availability of immunization services, and cognitive enhancers in stock. Respondents were classified by population density (persons/mi2) by pharmacy location to evaluate the relationship between rurality and AD‐related pharmacy services. Chi‐squared and logistic regression analyses were performed using Stata 10.1. Findings Pharmacies in more rural areas (50.1‐100.0, 25.1‐50.0, and ≤25.0 persons/mi2) were about 50% less likely to offer immunizations (95% CI: 0.32‐0.91; 0.32‐0.76; 0.28‐0.80, respectively) compared to the least rural areas (>100.0 persons/mi2). Compared to the least rural areas, pharmacists in the most rural areas (≤25.0 persons/mi2) were less likely to name ≥2 gastrointestinal adverse effects of donepezil (OR = 0.50, 95% CI: 0.31‐0.82) or have memantine XR 28 mg (OR = 0.61, 95% CI: 0.41‐0.89) and other surveyed medications (OR = 0.57, 95% CI: 0.39‐0.82) in stock. Conclusions We found disparities in AD‐related services in community pharmacies located in more rural counties, wherein individuals with AD and their caregivers may face barriers to obtaining quality pharmaceutical care. There is a need to strengthen pharmacists’ knowledge and improve pharmacy services to reduce disparities.