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    ABSTRACT: We look at the links between the Digit Ratio-the ratio of the length of the index finger to the length of the ring finger-for both right and left hands, and giving in a Dictator Game. Unlike previous studies with exclusively Caucasian subjects, we consider a large, ethnically diverse sample. Our main results are as follows. First, for Caucasian subjects we estimate a significant positive regression coefficient for the right hand digit ratio and a significant negative coefficient for its squared measure. These results replicate the findings of Brañas-Garza et al. (2013), who also observe an inverted U-shaped relationship for Caucasian subjects. Second, we are not able to find any significant association of the right hand digit ratio with giving in the Dictator Game for the other main ethnic groups in our sample, nor in the pooled sample. Third, we find no significant association between giving in the Dictator Game and the left hand digit ratio.
    Frontiers in Behavioral Neuroscience 02/2015; 9:41. DOI:10.3389/fnbeh.2015.00041
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    ABSTRACT: Increasing the adoption of generic drugs has the potential to improve static efficiency in a health system without harming pharmaceutical innovation. However, very little is known about the timing of generic adoption and diffusion. No prior study has empirically examined the differential launch times of generics across a comprehensive set of markets, or more specifically the delays in country specific adoption of generics relative to the first country of (generic) adoption. Drawing on data containing significant country and product variation across a lengthy time period (1999 to 2008), we use duration analysis to examine relative delays, across countries, in the adoption of generic drugs. Our results suggest that price regulation has a significant effect on reducing the time to launch of generics, with faster adoption in higher priced markets. The latter result is dependent on the degree of competition and the expected market size.
    Journal of Health Economics 12/2014; 38. DOI:10.1016/j.jhealeco.2014.04.004
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    ABSTRACT: This paper examines whether there is a switch in total (originator and generic) consumption after generic entry from molecules that face generic competition towards other molecules of the same class, which are still in-patent. Data from six European countries for the time period 1991 to 2006 are used to study the cases of angiotensin-converting enzyme inhibitors and proton pump inhibitors. Empirical evidence shows that patent expiry of captopril and enalapril led to a switch in total (off-patent originator and generic) consumption towards other in-patent angiotensin-converting enzyme inhibitors, whereas patent expiry of omeprazole led to a switch in consumption towards other proton pump inhibitors. This phenomenon makes generic policies ineffective and results in an increase in pharmaceutical expenditure due to the absence of generic alternatives in the market of in-patent molecules. Copyright © 2013 John Wiley & Sons, Ltd.
    Health Economics 05/2014; 23(5). DOI:10.1002/hec.2935
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    ABSTRACT: Objectives.It is commonplace for people to complain about being tired. There have been actually few studies of tiredness in large general population samples, and where studies do exist, the measures often rely on external assessments. We use a diary-based method to overcome these limitations in a representative sample of U.S. residents. Data come from the 2010 American Time Use Survey. Around 13,000 respondents provided a diary about the prior day and rated how tired they felt during selected activities. Regression analysis is used to explain variance in tiredness by age. Regression analysis reveals that tiredness decreases with age. This relationship exists when we control for hours of sleep, gender, self-rated health, ethnic group, number of children, marital status, employment status, level of education, and the amount of time participants spent doing tiring activities.Discussion.Contrary to much previous research, tiredness decreases with age. People who are more than 65 years of age are almost one point on a 0-6 scale less tired than people aged between 15 and 24. Clinical implications and methodological limitations are discussed.
    The Journals of Gerontology Series B Psychological Sciences and Social Sciences 11/2013; 70(4). DOI:10.1093/geronb/gbt118
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    ABSTRACT: Financial incentives have been used in a variety of settings to motivate behaviors that might not otherwise be undertaken. They have been highlighted as particularly useful in settings that require a single behavior, such as appointment attendance or vaccination. They also have differential effects based on socioeconomic status in some applications (e.g. smoking). To further investigate these claims, we tested the effect of providing different types of non-cash financial incentives on the return rates of chlamydia specimen samples amongst 16-24 year-olds in England. In 2011 and 2012, we ran a two-stage randomized experiment involving 2988 young people (1489 in Round 1 and 1499 in Round 2) who requested a chlamydia screening kit from Freetest.me, an online and text screening service run by Preventx Limited. Participants were randomized to control, or one of five types of financial incentives in Round 1 or one of four financial incentives in Round 2. We tested the effect of five types of incentives on specimen sample return; reward vouchers of differing values, charity donation, participation in a lottery, choices between a lottery and a voucher and including vouchers of differing values in the test kit prior to specimen return. Financial incentives of any type, did not make a significant difference in the likelihood of specimen return. The more deprived individuals were, as calculated using Index of Multiple Deprivation (IMD), the less likely they were to return a sample. The extent to which incentive structures influenced sample return was not moderated by IMD score. Non-cash financial incentives for chlamydia testing do not seem to affect the specimen return rate in a chlamydia screening program where test kits are requested online, mailed to requestors and returned by mail. They also do not appear more or less effective in influencing test return depending on deprivation level.
    Social Science [?] Medicine 11/2013; 105(100). DOI:10.1016/j.socscimed.2013.11.018
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    ABSTRACT: Earlier work has shown that the association between the fertility of parents and the fertility of children has become stronger over time in some societies. This article updates and broadens the geographic coverage to assess the magnitude of intergenerational continuities in childbearing in developed and middle-income societies using data for 46 populations from 28 developed countries drawn from a number of recent large-scale survey programs. Robust positive intergenerational fertility correlations are found across these countries into the most recent period, and although there is no indication that the strength of the relationship is declining, the increasing trend does not appear to be continuing.
    Biodemography and Social Biology 11/2013; 59(2):101-26. DOI:10.1080/19485565.2013.833779
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    ABSTRACT: Efforts to support and use comparative effectiveness research (CER), some more successful than others, have been promulgated at various times over the last forty years. Following a resurgence of interest in CER, recent health care reforms provided substantial support to strengthen its role in US health care. While CER has generally captured bipartisan support, detractors have raised concerns that it will to be used to ration services and heighten government control over health care. Such concerns almost derailed the initiative during passage of the health care reform legislation and are still present today. Given recent investments in CER and the debates surrounding its development, the time is ripe to reflect on past efforts to introduce CER in the United States. This article examines previous initiatives, highlighting their prescribed role in US health care, the reasons for their success or failure, and the political lessons learned. Current CER initiatives have corrected for many of the pitfalls experienced by previous efforts. However, past experiences point to a number of issues that must still be addressed to ensure the long-term success and sustainability of CER, including adopting realistic aims about its impact, demonstrating the impact of Patient-Centered Outcomes Research Institute (PCORI) and communicating the benefits of CER, and maintaining strong political and stakeholder support.
    Journal of Health Politics Policy and Law 11/2013; 39(1). DOI:10.1215/03616878-2395199
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    ABSTRACT: Classic preference reversal, where choice and valuation procedures generate inconsistent preference orderings, has rarely been tested in hypothetical health care treatment scenarios. Two studies - the first non-incentivised and the second incentivised - are reported in this article. In both studies, respondents are asked to make decisions that affect themselves (a personal decision making frame) and those for whom they are responsible (a social decision making frame). The results show non-negligible and systematic rates of preference reversal in both frames, although these rates are slightly, but non-significantly, lower in the incentivised condition. Moreover, in both studies, the rate of predicted preference reversal was somewhat higher in the social than in the personal decision making frame, a finding that is explained by greater risk aversion when choosing treatment options for others than when choosing treatments for oneself.
    Journal of Health Economics 10/2013; 32(6):1250-1257. DOI:10.1016/j.jhealeco.2013.10.003
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    ABSTRACT: Universal access to health care in most western European countries has been a given for many decades; however, macroeconomic developments and increased pressure on health care budgets could mean the status quo cannot be maintained. As populations age, a declining proportion of economically active citizens are being required to support a larger burden of health and social care, while increasing availability of novel technologies for extending and improving life continues to push health care costs upwards. With health expenditure continuing to rise as a proportion of national income, concerns are raised about the current and future financial sustainability of Organisation for Economic Co-Operation and Development (OECD) health care systems. Against this backdrop, a discussion about options to fund health care in the future, including whether to raise additional health care finance (and the ways to do so), reallocate resources and/or ration services becomes very pertinent. This study elicits preferences among a group of key stakeholders (payers, providers, government, academia and health-related industry) on the issue of health care financial sustainability and the future funding of health care services, with a view to understanding the different degrees of acceptability between policy interventions and future funding options as well as their feasibility. We invited 842 individuals from academia, other research organisations (eg. think tanks), national health services, providers, health insurance organisations, government representatives and health-related industry and related advisory stakeholders to participate in an online survey collecting preferences on a variety of revenue-generating mechanisms and cost/demand reducing policies. Respondents represented the 28 EU member states as well as Norway, Iceland, Switzerland, Australia, Russian Federation, Canada and New Zealand. We received 494 responses to our survey from all stakeholder groups. Across all groups, the highest preference was for policies to modify lifestyle and implement more extensive screening within risk groups for high burden illnesses. There was a broad consensus not to reallocate resources from social security/education. Between stakeholders, there were differences of opinion between industry/advisory and a range of other groups, with industry being generally more in favour of market-based interventions and an increased role for the private sector in health care financing/delivery. Conversely, stakeholders from academia, government, national health services and insurance were relatively more in favour of more restrictive purchasing of new and expensive technologies, and (to varying extent) of higher income/corporate taxes. Taxes on cigarettes/alcohol were by far considered the most politically feasible option. According to this study, policy options that are broadly acceptable across stakeholder groups with different inherent interests exist but are limited to lifestyle modification, screening interventions and excise taxes on harmful products. Representatives from the private sector tend to view solutions rooted in the private sector as both effective and politically feasible options, while stakeholders from academia and the public sector seem to place more emphasis on solutions that do not disproportionately impact certain population groups.
    Applied Health Economics and Health Policy 10/2013; 11(6). DOI:10.1007/s40258-013-0056-7
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    ABSTRACT: We use evidence from a natural experiment in Greece to study the effect of the announcement of austerity measures on road traffic accidents (RTAs). We use daily RTA data from 2010 and 2011, during which a number of austerity measures were announced, including salary and pension cuts and an increase in direct and indirect taxes. We find that controlling for other factors potentially influencing RTAs, the number of RTAs increased significantly on the first two days following the announcements of austerity measures. We put forward some tentative suggestions for why this happens.
    Risk Analysis 10/2013; 34(3). DOI:10.1111/risa.12123
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