National Sample Data Research Articles

Perspectives Questionnaire: Measuring propensities to take viewpoints of agent or recipient

This article introduces the Perspectives Questionnaire (PQ), a self-rated measure of propensities to take agent and recipient perspectives in social cognition. Each social interaction involves two separate perspectives – that of an agent (a person who performs an action) and that of a recipient (a person at whom the action is directed and who experiences its effects). Studies with six samples (N = 2037) showed that PQ has a stable, two-factorial structure in two languages (English and Polish) and consists of the agent and recipient subscales. Present studies show both convergent and discriminant validity of PQ. The agent perspective is positively related to agentic orientation and values, the promotion focus and acting for self-interest, as well as with personality traits conducive to action, like conscientiousness, extraversion, and openness to experience. The recipient perspective is related to communal orientation and values and it correlates with personality traits conducive to experiencing, like neuroticism, empathic concern and distress. A Polish national sample data showed that high scores in the agent scale are accompanied by higher life achievements both objective (income, prestige, education) and subjective (life-satisfaction, feelings of success, self-esteem, feelings of control).

Racial and Ethnic Disparities in Homeownership

There are persistent differences in homeownership rates across racial and ethnic groups. Homeownership rates for whites are over 20 percentage points higher than for blacks or Hispanics. This paper uses a model of the housing tenure decision to gain a better understanding of these racial and ethnic differentials in homeownership and employs a decomposition technique that has been applied to labor market discrimination to report the results of the empirical testing of two hypotheses; (1) race (ethnicity) influences the probability of ownership through differences in household endowments (income, education, age, gender, and family type) and market endowments (price and location); and (2) race (ethnicity) directly influences the probability of ownership through racial or ethnic discrimination and other factors that may be correlated with race or ethnicity. We find endowment effects important in explaining the persistent racial and ethnic disparities in homeownership. In brief, logit analysis of 1989 American Housing Survey (AHS) national sample data reveals that 81 percent (78 percent) of the differences between the predicted probability of ownership between black and white households (Hispanic/non-Hispanic) are due to differences in group endowments. Direct effects explain 19 percent of the black-white differentials and 22 percent of the Hispanic/non-Hispanic differentials. Because the direct effects are modeled as residual differences, it must be realized that the residual components could also be capturing the influence of important omitted or harder to measure variables internal to the market process and correlated with race or ethnicity. These include wealth, household location, employment history, credit history, and cultural predisposition toward homeownership.

Prevalence of extraintestinal manifestations in Korean inflammatory bowel disease patients

BackgroundThe prevalence of inflammatory bowel disease (IBD) in South Korea is increasing. Although extraintestinal manifestations (EIMs) are an important factor in the clinical outcomes of IBD patients, EIMs have not yet been investigated in Korea. Thus, we conducted a cross-sectional study to assess the prevalence of EIMs in Korean IBD patients.MethodsThe 2014 claims data from the National Health Insurance System (NHIS) of Korea were used. IBD patients were identified by codes for Crohn disease (CD) and ulcerative colitis (UC) in the NHIS registration system for rare or intractable diseases. International Classification of Diseases, Tenth Edition codes were used to identify EIM cases. To estimate the prevalence of EIMs in the general population of Korea, we used national sample data. Standardized prevalence ratios (SPRs) were calculated to compare the prevalence rates of EIMs among IBD patients to those among the general population of Korea.ResultsA total of 13,925 CD patients and 29,356 UC patients were identified. CD and UC patients were different in terms of demographics and utilization of medication. Among the 17 EIMs investigated, pyoderma gangrenosum, osteomalacia, Sweet syndrome, and scleritis were observed in very few patients. The SPRs were greater than 1 for all EIMs. Aphthous stomatitis, rheumatoid arthritis, and osteoporosis were highly prevalent in both CD and UC patients, but the SPRs of the EIMs were not high.ConclusionThe study confirmed that EIMs are more prevalent among IBD patients than among the general population of Korea. The prevalence of EIMs in IBD patients suggests the need for greater attention and effort in clinical practice.

Mapping individuals' earthquake preparedness in China

Abstract. Disaster preparedness is critical for reducing potential impact. This paper contributes to current knowledge of disaster preparedness using representative national sample data from China, which faces high earthquake risks in many areas of the country. The adoption of earthquake preparedness activities by the general public, including five indicators of material preparedness and five indicators of awareness preparedness, were surveyed and 3245 respondents from all 31 provinces of Mainland China participated in the survey. Linear regression models and logit regression models were used to analyze the effects of potential influencing factors. Overall, the preparedness levels are not satisfied, with a material preparation score of 3.02 (1–5), and awareness preparation score of 2.79 (1–5), nationally. Meanwhile, residents from western China, which has higher earthquake risk, have higher degrees of preparedness. The concern for disaster risk reduction (DRR) and the concern for building safety and participation in public affairs are consistent positive predictors of both material and awareness preparedness. The demographic and socioeconomic variables' effects, such as gender, age, education, income, urban/rural division, and building size, vary according to different preparedness activities. Finally, the paper concludes with a discussion of the theoretical contribution and potential implementation.

Effects of Physician Volume on Readmission and Mortality in Elderly Patients with Heart Failure: Nationwide Cohort Study.

PurposeReadmission and mortality rates of patients with heart failure are good indicators of care quality. To determine whether hospital resources are associated with care quality for cardiac patients, we analyzed the effect of number of physicians and the combined effects of number of physicians and beds on 30-day readmission and 1-year mortality.Materials and MethodsWe used national cohort sample data of the National Health Insurance Service (NHIS) claims in 2002–2013. Subjects comprised 2345 inpatients (age: >65 years) admitted to acute-care hospitals for heart failure. A multivariate Cox regression was used.ResultsOf the 2345 patients hospitalized with heart failure, 812 inpatients (34.6%) were readmitted within 30 days and 190 (8.1%) had died within a year. Heart-failure patients treated at hospitals with low physician volumes had higher readmission and mortality rates than high physician volumes [30-day readmission: hazard ratio (HR)=1.291, 95% confidence interval (CI)=1.020–1.633; 1-year mortality: HR=2.168, 95% CI=1.415–3.321]. Patients admitted to hospitals with low or middle bed and physician volume had higher 30-day readmission and 1-year mortality rates than those admitted to hospitals with high volume (30-day readmission: HR=2.812, 95% CI=1.561–5.066 for middle-volume beds & low-volume physicians, 1-year mortality: HR=8.638, 95% CI=2.072–36.02 for middle-volume beds & low-volume physicians).ConclusionPhysician volume is related to lower readmission and mortality for heart failure. Of interest, 30-day readmission and 1-year mortality were significantly associated with the combined effects of physician and institution bed volume.

One-Year Prospective Audit of Truncal Blocks Using Regional Anesthesia Database App

Aims and Objectives: Truncal blocks like chest and abdominal wall peripheral nerve blocks have been reported to be an effective method of providing analgesia for surgeries on the chest wall and the abdomen. We present results of a prospective audit of the practice and outcomes of these techniques using a novel mobile app and web-based e-audit tool (RAD app and national database ®) to identify safety and quality with description of newer blocks. Design: Prospective single centre audit over a 1-year period using e-clinical audit tool (RAD app and national database®) Setting: 210 bedded NABH accredited multi-speciality Private hospital. Patients: All patients who had Peripheral nerve blocks for chest and abdominal surgeries Measurements: Data on practice, clinical and patient related outcome measures were prospectively entered in the mobile app and web-entries. Data analysis is automated and summary statistics with comparison to national data is presented here. Results: Data analysis is automated and summary statistics with comparison to national data is presented. 147 patients received 199 blocks between 3rd July 2017 to 2nd July 2018.Youngest patient was 1 year old and oldest being 84 years of age. 40% of patients were males and 15.4% of surgeries were for emergency reasons. Few new blocks were added into our practice during this year including the erector spinae plane block, quadratus lumborum block and serratus plane block. The overall quality and safety of these new blocks are comparable to Indian national benchmark and available literature.A number of differences in practice compared to national sample data is identified including greater use of ultrasound in our practice(70% vs 31.6% nationally), significantly, more blocks are done pre-operatively (75% compared to 50% nationally). Outcomes in terms of success rates and post-operative analgesia, opioid consumption are comparable.40% of our patients had opioid free surgery and 85% of the patients had no analgesic requirement in their recovery period.Quality assurance audit data shows that only 63.3% of the patients had correct site check/block specific time-out done. Ultrasound probe cover was not used in 95% of the cases. Patient related outcome measures are reported for the first time showing high rates of satisfaction and likelihood of having regional anaesthesia/analgesia again. Conclusions: This is the first reported audit of peripheral nerve blocks of chest and abdomen in India. This audit was enabled by an e-audit tool (RAD app and database®) which removed many barriers in doing clinical audit in busy day-to-day practice. The audit was done with minimal effort using smart entry system and automated analysis of graphs and charts. The project is ongoing and data from 1st year is reported to identify practice and outcomes of our regional anaesthesia practice. A number of practice changing recommendations are identified to further improve quality and safety of our regional anaesthesia practice. Recommendations: 1. Correct site check and timeout before block to be 100%. STOP before block to be ensured in 100% of patients. 2. Ultrasound Probe cover to ensure sterility is maintained should be achieved in 100%. 3. Ensure more than 90% complete data collection to measure the Patient related outcome measures as accurately as possible. Keywords: Peripheral nerve blocks, Audit, Regional Anaesthesia, Truncal blocks, chest and abdominal wall blocks, Database

The contraceptive revolution in Russia

In the 1960s and 1970s, with the introduction of hormonal contraception, as well as of a new generation of intrauterine contraception, Western countries saw cardinal changes in methods of fertility regulation so significant that the American demographers Ch. Westoff and N. Ryder called them "The contraceptive revolution." By this time, the transition to low fertility in developed countries, as, indeed, in Russia, was completed, and family planning had become a common practice. However, the new technologies significantly increased the effectiveness of birth control, and this change would have important social and demographic consequences. Underestimation of the importance of family planning and underdevelopment of the corresponding services in the USSR and in Russia led to the contraceptive revolution beginning here much later than in the West, not until the post-Soviet years with the arrival of a market economy and information openness. For decades, induced abortion played a key role in the regulation of fertility, and only in the 1990s did modern methods of contraception become widespread and the unfavorable ratio of abortions to births begin to change for the better. The article describes the composition of the contraceptive methods used in countries of European culture and of those in Russia, and attempts to explain the difference between them. Based on national representative sample data, an analysis is made of current practice of contraceptive use in Russia. The conclusion is drawn that the contraceptive revolution in Russia is proceeding rather quickly, but without substantial state support.

Analysis of medical service use of knee osteoarthritis and knee meniscal and ligament injuries in Korea: a cross-sectional study of national patient sample data

BackgroundOsteoarthritis (OA) and meniscal and ligament injuries of the knee are the two most common knee disorders in Korea. The aim of this study was to analyze the demographic characteristics, medical service use and related costs for these disorders, and the results are expected to help inform practitioners, researchers, and policy-makers.MethodsThe present study aimed to evaluate incidence and patient characteristics, and to assess current medical service use, usual care, and medical expenses of knee disorders by analyzing 2014 national patient sample data from the Korean Health Insurance Review and Assessment Service. Data was extracted using 3% stratified sampling from all Korea national health insurance claims submitted in 2014, and analyzed. Usual care for M17 knee osteoarthritis and S83 knee meniscal and ligament injury codes of the International Classification of Diseases, 10th revision (ICD-10) were determined by investigating total number of patients, sociodemographic characteristics, days in care, number of visits, and expenses.ResultsKnee OA showed the highest incidence in females aged ≥60 years, whereas meniscal and ligament injuries of the knee were most prevalent among patients aged <20 years and young adults. Total inpatient care expenses exceeded the cost of ambulatory care for both disorders. Ambulatory care was mainly provided at primary care clinics, with 90% of these visits made to orthopedic specialists. Medical expenses for knee OA and meniscal and ligament injuries were largely due to procedures/surgeries and injections, and procedures/surgeries and hospitalizations, respectively. Total replacement arthroplasty was the most commonly performed surgery for knee OA, while meniscectomy and cruciate ligament reconstruction were the most often performed surgeries for meniscal and ligament injuries. Intra-articular injection rates were 55% in knee OA patients and 3% in meniscal and ligament injury patients. Aceclofenac, diclofenac, and tramadol were the most frequently prescribed analgesics.ConclusionsThe current findings may be used as basic data for establishing medical policies and can benefit researchers and clinicians in recognizing trends and patterns of treatment for knee disorders.

Educational mismatches and labor market outcomes

PurposeEducational mismatches constitute negative impacts on labor markets in most countries, Thailand is no exception. The purpose of this paper is to quantify the degree of educational mismatch in Thailand and its impacts on labor market outcomes.Design/methodology/approachThis study analyzes data obtained from Thailand’s Labor Force Survey to estimate the likelihood of horizontal and vertical mismatches and their impacts on labor market outcomes.FindingsEstimation results reveal the existence of a high level of both vertical and horizontal mismatches in the labor market. The vertical mismatch tends to be most prevalent in the case of graduates with degrees in the social sciences, while the existence of the horizontal mismatch is mostly found in the case of graduates with backgrounds in the physical sciences. Samples with a degree in health science seem to be least impacted by both types of mismatch. Education-job mismatches, either vertical or horizontal mismatches, are found to cause negative impacts on workers’ employment. Findings indicate that workers who encountered either horizontal or vertical educational mismatches tended to have lower monthly incomes than did those without such mismatches. Vertical mismatches seemed to result in lower incomes than did the horizontal mismatches. Furthermore, both types of mismatch are found to not have any significant impact on workers’ employability.Research limitations/implicationsNevertheless, due to different types of mismatches such as skill mismatch or personality mismatch, this paper only quantifies degree mismatch on the context of Thailand only. Nevertheless, different structure of labor market can show different findings.Practical implicationsBoth horizontal mismatch and vertical mismatch can be mitigated with strong collaboration system between colleges/universities and employers. Therefore, the government should further promote better cooperation between universities and the private sector (industry-university linkages) by encouraging more exchanges between high-level executives and students of the private sector and higher-education institutes. More opportunities for students to practice their skills in real workplace settings should be provided, and students should also be able to gain credits from participating in such training. In Thailand, at present there are only a few degree programs that require students to complete an internship.Social implicationsAs for social policy recommendations, to reduce both horizontal and vertical mismatches in practices, it is essential that the education sector promote a life-long learning framework that allows workers whose jobs do not match their educational background (or with their educational attainment) to receive the training and develop the skills required by employers.Originality/valueComparing to other literature in these areas in which survey data from the authors are relied, this paper, however, uses the Thai Labor Force Survey, which is the national representative sample data set. The results found from this paper are therefore useful to be reliable on implying appropriated policy recommendations.

Rethinking the political participation of Hong Kong Christians

PurposeChristian-affiliated social groups and leaders have been active and vocal in movements advocating democracy, equality and social justices. Christians are also specular in the “July 1st Protest” in 2003 and “Umbrella Movement” in 2014. Are Christians, in general, more politically active in Hong Kong? This paper aims to examine these questions from a quantitative viewpoint.Design/methodology/approachThis paper examines the effects of religion and other socio-demographic factors on both electoral and non-electoral participation based on data from the World Value Survey 2013 Hong Kong data set.FindingsInterest in politics and education level are strong predictors of both electoral and non-electoral participation in Hong Kong. Confidence in government is negatively associated with political participation. Religious affiliation is not a predictor of any kinds of political participation. The effects of interest in politics are greater among Protestants and Catholics than people with no religion.Research limitations/implicationsWhile previous surveys show that Christians have a strong presence in political participation, the results suggest that being a Christian is not statistically related to a higher level of political participation. On the other hand, affiliating to Christian churches may provide necessary resources (e.g. networks, skills and knowledge) only to those members who are already interested in politics and thereby facilitate their political participation.Originality/valueBased on national sample data, this study debunks the public perception that “Christianity is politically active” and suggests the possible role of churches in mobilizing politically interested members into political activities.

The gender gap in policy orientation: how relevant is locality?

The notion that policy orientation is gendered has important implications for both policy research and practical policymaking. If men and women differ in their policy orientation, policy action will equally differ depending on which group controls the levers of community politics/policy agenda. However, a substantial question still looms: are gender cleavages in policy orientation inevitable, or, do things change markedly according to locality? This research uses national probability sample data from Afghanistan to examine the extent to which locality shapes gender cleavages in policy orientation. The results posit that locality matters in two significant ways. First, it crystallises women's group interests. Secondly, it promotes policy 'convergence', to the extent that men and women living and operating in the same social space will tend to react to policy similarly. However, such a broad outlook does not preclude gender polarisation on policy matters. Women will align with their group interest even when that interest is at odds with their community's trajectory.

Utilization Patterns of Korean Medicine: An Analysis of the National Health Insurance Cohort Database from 2002 to 2013.

Although Korean Medicine (KM) is an important part of the Korean healthcare system and plays a significant role in chronic and incurable diseases, there is insufficient information about KM utilization. The aim of the study was to identify KM utilization patterns using a national representative sample data. KM users aged 0-80 years and older from the nationally representative sample in the National Health Insurance Service-National Sample Cohort of 778,506 KM users between 2002 and 2013 (were analyzed. Annual changes in utilization patterns were analyzed by sex, nine age groups, five income levels, and numbers of visits and hospitalizations. Utilization patterns by the type of healthcare institution and the top 10 major diseases were studied. Frequencies of KM use differed according to analyses of patients and claims. Women used KM 1.5 times more than did men. Patients in their 40s and 50s made up one third of KM users. In contrast to other studies, high-income groups used KM more than did low-income groups. More than 96% of ambulatory patients used mostly KM clinics, and more than 76% of inpatients used KM hospitals. Musculoskeletal disorders were the main disease treated, which conformed to the results of previous studies. The results suggest that women, people in their 40s and 50s, and people with a relatively high income use KM more often than other patients. Further comparison studies of both Western medicine in Korea and other countries should be conducted.

Analysis of Surgical Pathology Data in the HIRA Database: Emphasis on Current Status and Endoscopic Submucosal Dissection Specimens.

Background:In Korea, medical institutions make claims for insurance reimbursement to the Health Insurance Review and Assessment Service (HIRA). Thus, HIRA databases reflect the general medical services that are provided in Korea. We conducted two pathology-related studies using a HIRA national patient sample (NPS) data (selection probability, 0.03). First, we evaluated the current status of general pathologic examination in Korea. Second, we evaluated pathologic issues associated with endoscopic submucosal dissection (ESD).Methods:The sample data used in this study was HIRA-NPS-2013-0094.Results:In the NPS dataset, 163,372 pathologic examinations were performed in 103,528 patients during the year 2013. Considering sampling weight (33.3), it is estimated that 5,440,288 (163,372 × 33.3) pathologic examinations were performed. Internal medicine and general surgery were the most common departments requesting pathologic examinations. The region performing pathologic examinations were different according to type of medical institution. In total, 490 patients underwent ESD, and 43.4% (213/490) underwent ESD due to gastric carcinoma. The results of the ESD led to a change in disease code for 10.5% (29/277) of non-gastric carcinoma patients. In addition, 21 patients (4.3%) underwent surgery following the ESD. The average period between ESD and surgery was 44 days.Conclusions:HIRA sample data provide the nation-wide landscape of specific procedure. However, in order to reduce the statistical error, further studies using entire HIRA data are needed.

An unequal burden: Poor patient–provider communication and sickle cell disease

ObjectiveTo assess disparities in the quality of healthcare provider communication experienced by African-American adults with and without sickle cell disease (SCD) in the U.S. MethodsPoor provider communication was assessed by the Provider Communication subscale of the Consumer Assessment of Healthcare Plans and Systems survey. The SCD sample was obtained from participants in a multicenter observational study of healthcare experiences. The national African-American sample data was obtained from published national estimates. ResultsThe SCD sample was more likely than the national sample to report poor communication in 3 out of 4 communication domains: listening (22.3% vs. 11.5%, p<0.0001); showing respect (26.1% vs. 9.5%, p<0.0001); and spending enough time (38.3% vs. 16.2%, p<0.0001). Differences were consistent in young, but not old, patients and showed some variation by self-reported health status and education. ConclusionsThe communication difficulties experienced by persons with SCD do not appear reducible to their predominantly African-American race, but may result from more disease-specific factors. Practice implicationsHealthcare providers should take particular care in recognizing and demonstrating recommended communication skills with SCD patients as these patients may be particularly vulnerable to, and cognizant of, poor quality interactions.

Moral identity as moral ideal self: Links to adolescent outcomes.

The purposes of this study were to conceptualize moral identity as moral ideal self, to develop a measure of this construct, to test for age and gender differences, to examine links between moral ideal self and adolescent outcomes, and to assess purpose and social responsibility as mediators of the relations between moral ideal self and outcomes. Data came from a local school sample (Data Set 1: N = 510 adolescents; 10-18 years of age) and a national online sample (Data Set 2: N = 383 adolescents; 15-18 years of age) of adolescents and their parents. All outcome measures were parent-report (Data Set 1: altruism, moral personality, aggression, and cheating; Data Set 2: environmentalism, school engagement, internalizing, and externalizing), whereas other variables were adolescent-report. The 20-item Moral Ideal Self Scale showed good reliability, factor structure, and validity. Structural equation models demonstrated that, even after accounting for moral identity internalization, in Data Set 1 moral ideal self positively predicted altruism and moral personality and negatively predicted aggression, whereas in Data Set 2 moral ideal self positively predicted environmentalism and negatively predicted internalizing and externalizing symptoms. Further, purpose and social responsibility mediated most relations between moral ideal self and the outcomes in Data Set 2. Moral ideal self was unrelated to age but differentially predicted some outcomes across age. Girls had higher levels of moral ideal self than boys, although moral identity did not differentially predict outcomes between genders. Thus, moral ideal self is a salient element of moral identity and may play a role in morally relevant adolescent outcomes.

Who gives birth at health facility in Ethiopia? : result from Ethiopian demographic and health survey 2011

Introduction: In many developing countries, maternal mortality is still high. Although an effort has been made to achieve Millennium Development Goals, the positive results and significant decrease in maternal mortality is yet to come, especially in the sub-Saharan African countries. Ethiopia is a member of sub-Saharan countries with high maternal mortality. Since health education and promotion activities are insufficient, most births take place at home by non-health professionals and the public awareness in health facility delivery remains low. Because of these underlying factors, many Ethiopian women are dying from pregnancy and other pregnancy related causes. It is important to evaluate the women that deliver at health facilities versus the home. Objective: To identify factors associated with health facility births in Ethiopia using demographic characteristics, pregnancy-related factors, and media-related factors and to know users of health facility births. Method: This study used the data from the Ethiopian Demographic and Health Survey (EDHS) 2011, which is a national representative sample data. This study analyzed specific health facility births. The demographic characteristics, pregnancy- related factors, and media-related factors were used as independent variables. Delivery places, the outcome variables were treated as categorical variables both bivariately and multivariately. A logistic regression analysis was conducted to identify factors associated with delivery place. Result: Maternal mortality in Ethiopian still high 676/100,000 per life births. Health facility births were still low. A total of 9,429 home deliveries and 1,467 health facility deliveries were identified from the EDHS 2011. Only 13.5% of pregnant women gave birth at a health facility. Women’s residence regions, residential place, educational level, wealth index, husband/partner education level, antenatal care visit and media exposure were significantly associated with their delivery place choice. Whereas older age, high number of parity and married women were negatively associated with health facility deliveries. The outcome of birth (child alive or not) had no association with delivery place selection. Conclusion: This study verifies the factors associated with health facility births in Ethiopia. Region, place of residence, education level of pregnant women and partner and media exposure had significant association. To promote health facility utilization in birth and decrease maternal mortality special efforts will be needed taking account the significant factors. As a positive tool for breaking regional inequality and health education, media and social media may serve an important role in facilitating health facility births.

스타틴 의약품의 약가인하 효과 및 약물 교체 관련 요인: 건강보험심사평가원 환자표본자료를 이용한 분석

Background: Under the risk of financial sustainability of National Health Insurance, Korean government attempted a series of regulations over pharmaceutical prices. The first price-cut was implemented to the hyperlipidemial treatments, and the prices of statins were reduced on 15th, April in 2009. The purposes of this study are 1) to investigate the impact of this price-cut on pharmaceutical expenditure, and 2) to identify the factors associated with drug-switch among statins. Methods: Using the national patients sample data, this study conducted time series analysis on the expenditures, prices, and volumes of statin drugs. To understand the factors associated with drug-switch, the multinomial logit model was analyzed at the patients level. Results: The results of time series analysis demonstrated that the price-cut of hyperlipidemic medicines did not lead to the reduced expenditure, suggesting the increased volume was the major cause. The multinomial logit analysis identified the switch of healthcare provider as the significant factor that was highly associated with drug-switch, implying the physicians' preference was the major motivation of drug-switch. Conclusion: Without control of utilization, price regulation itself could not reduce pharmaceutical expenditure. This suggests that the pharmaceutical regulations should be implemented on the basis of understanding of provider behaviors. The findings of this study will form the first step for further empirical studies.

Mediating role of perceived organizational politics in relating job characteristics to morale

Organizational politics has been perceived to be an integral part of every work organization. Moreover, the perceptions of employees about the organizational politics are considered to have a significant influence on the morale of employees. However, the nature and degree of this influence may differ from job to job and individual to individual. Thus, the present study tries to investigate the mediating role of organizational politics in between the job characteristics and morale of the employees. Job characteristics included in the study are job ambiguity, skill variety, feedback and autonomy, whereas the morale is a composite construct of job satisfaction and affective commitment. The empirical evidence is based on the national level sample data collected through self administered questionnaires from executives of multitude of Pakistani industries such as health, manufacturing, energy, financial services, education, telecommunication and information technology. The sample comprised of 577 respondents. Structural equation modeling was used to analyze the fitness of casual relationship. Several practical implications are drawn to benefit the practicing managers. Key words: Job characteristics, morale, job satisfaction, affective commitment, organizational politics.

Drinking frequency as a brief screen for adolescent alcohol problems.

Routine alcohol screening of adolescents in pediatric settings is recommended, and could be facilitated by a very brief empirically validated alcohol screen based on alcohol consumption. This study used national sample data to test the screening performance of 3 alcohol consumption items (ie, frequency of use in the past year, quantity per occasion, frequency of heavy episodic drinking) in identifying youth with alcohol-related problems. Data were from youth aged 12 to 18 participating in the annual National Survey on Drug Use and Health from 2000 to 2007. The screening performance of 3 alcohol consumption items was tested, by age and gender, against 2 outcomes: any Diagnostic and Statistical Manual, Fourth Edition alcohol use disorder symptom ("moderate"-risk outcome), and a diagnosis of Diagnostic and Statistical Manual, Fourth Edition alcohol dependence ("high"-risk outcome). Prevalence of the 2 outcomes increased with age: any alcohol use disorder symptom ranged from 1.4% to 29.2%; alcohol dependence ranged from 0.2% to 5.3%. Frequency of drinking had higher sensitivity and specificity in identifying both outcomes, compared with quantity per occasion and heavy episodic drinking frequency. For both outcomes, results indicate the utility of similar cut points for drinking frequency for males and females at each age. Age-specific frequency cut points, however, are recommended for both moderate- and high-risk outcomes to maximize screening performance. Drinking frequency provides an empirically supported brief screen to efficiently identify youth with alcohol-related problems.

Moderating Role of Social Exchange Perceptions between Perceived Organizational Politics and Antisocial Behavior

Organizational politics is a fact of organizational life, which can be seen in almost every type of organization globally. Individuals come together for a common purpose and safeguard self interest. The present study examines the moderating role of social exchange perceptions between perceived organizational politics and antisocial behavior in Pakistani context. The empirical evidence is based on the national level sample data as collected through self-administered questionnaires from executives of multitude of Pakistani industries such as health, manufacturing, energy, financial services, education, telecommunication, and information technology. The sample comprised of 577 respondents. Moderated hierarchical regression was applied to test the interactional effects and hypothesized relationships were confirmed. Several practical implications have been provided for the benefit of practicing managers.