Psychiatric correlates of medical care costs among veterans receiving mental health care

Research on increased medical care costs associated with posttraumatic sequelae has focused on posttraumatic stress disorder (PTSD). However, the provisional diagnosis of Disorders of Extreme Stress Not Otherwise Specified (DESNOS) encompasses broader trauma-related difficulties and may be uniquely related to medical costs. We investigated whether DESNOS severity was associated with greater nonmental health medical care costs in veterans receiving mental health care. Participants were 106 men and 105 women receiving VA outpatient mental health treatment. A standardized interview assessed DESNOS severity. The dependent variables consisted of primary and specialty medical treatment costs. Sequential zero-inflated negative binomial regression was used to evaluate the variance in medical costs accounted for by DESNOS severity, controlling for PTSD severity and established predisposing, enabling, and need-based health care factors. Contrary to our hypothesis, in fully adjusted models, DESNOS severity independently added a significant amount of variance to lower specialty medical care costs, whereas PTSD did not consistently account for significant variance in medical care costs. Greater DESNOS severity appears to be associated with lower specialty medical care costs but not primary care costs. These findings may indicate that patients with DESNOS symptoms are at risk for being underreferred for specialty care.     

Wellbeing,occupational justice and police practice: an ‘affirming environment’?

This paper examines wellbeing and occupational justice within the police profession. The research presented is based on a preliminary study utilising a qualitative methodology in which 14 in-depth interviews were conducted with rank and file police officers in one state of Australia. The data-set reveals that there are many positive aspects to being a police officer, contrary to the ‘dysfunction’ research that exists concerning the police in which corruption and poor performance prevails. The data analysis supports the notion that the practice of the police can be understood through a framework of wellbeing, occupational justice, and positive psychology. Whilst the research yields strong positive aspects in the work police officers engage in, as well as in their working environment, there are challenges within the profession, namely dealing with traumatic events that can hinder wellbeing and occupational justice. This study offers evidence to reflect on current policies and practices in terms of police recruitment, education and training. The study also offers evidence for improving staff retention by building on the principles of wellbeing and occupational justice within police practice.     

‘I Teach Therefore I Am’: Lesbian Studies in the Liberal Academy

The article discusses the origins of Lesbian Studies as arising out of an intellectually engaged grassroots lesbian community and an emergent Women's Studies within the academy. The article contrasts Lesbian Studies in the UK with the USA, which has ‘professionalized’ work in Lesbian and Gay Studies, which concomitantly has produced its own problems. Feminism bequeathed to Lesbian Studies the axiom ‘the personal is political’ and this is discussed as both a positive and a negative inheritance. The academy itself collapses the personal on to the Lesbian Studies lecturer which produces particular pressures from students, colleagues, the institution, and upon one's own intellectual trajectory in the form of the ‘taint’ of subjectivity. Finally the article attempts to identify an ambivalent relationship to liberalism which has made a limited space for Lesbian Studies but also continues to seek to police that sphere.     

Whoever Said that Markets Were Fair?

The popular notion that markets are fair is wrong. Working from theory and behavioral research, the author examines the foundations of markets and their relationship to negotiations. In the process, she demonstrates that there is nothing inherently fair about supply and demand curves or market clearing prices. Although market price information may provide a reasonable standard for resolving a price negotiation, it too has little to do with intrinsic fairness. Markets are efficient and incredibly powerful at organizing people and allocating resources, but the idea that they have anything to do with fairness (or unfairness) is a socially-constructed illusion.     

State Income Tax Treatment of the Elderly

The state and local tax treatment of the elderly varies significantly from state to state. In this article, we analyze the differences in effective tax rates for the state personal income tax for elderly versus non-elderly taxpayers. We find that in a majority of states, the average effective tax rate facing the elderly is significantly lower than that of non-elderly taxpayers. The consequences of this tax rate difference may impact long-term state income tax revenues as the elderly population continues to grow.