Unlike other aspects of the American health experience, there is a current void of information on expensive illness experiences. This paper is designed to fill this void and prrsents an analysis of the incidence and cost of catastrophic illness in the United States. Catastrophic illness is defined as an illness episode for which a person incurs $5,000 or more of medical expenses in a calendar year. This information is used to provide a framework for focusing the debate about catastrophic and national health insurance. 相似文献
Freehand sketching is one of the most important and commonly used methods of generating and sharing budding ideas during the conceptual development portion of the preliminary phase of design. To develop one’s skills, prolonged practice, acquiring instant feedback and suggestions while practicing are invaluable. The two key and indispensable parts of learning draftsmanship are viewing and commenting on large numbers of free hand sketches. However, due to insufficient educational resources, instructors must spend most of their time engaged in class-room teaching, reducing the time allotted for one-on-one discussion and specialized assistance. Furthermore, the lack of sketch grading criteria can prevent students from developing proper insights into the essentials of sketching. As a result, students neither receive personalized feedback nor acquire adequate training in critiquing freehand sketching skills. These factors decrease learning effectiveness and negatively impact learning motivation. In order to solve this problem, this research has created a discussion platform on Facebook that utilizes the learning characteristics essential to developing proficiency in freehand sketching. It includes practice, observation, and comments. It has been found that this cultivates the subjects’ ability to judge freehand sketch quality and increases learning motivation and effectiveness through the process of peer-assessment. After participating in the one-semester teaching experiment, the abilities of the experimental group were significantly better than those of the control group, demonstrating that the online sketch discussion platform has a significant impact on freehand sketch learning. 相似文献
The study adopts a relationship perspective to examine and better understand customers' interactions with service firms' contact personnel, physical environment and customer environment and their influence on the relationship quality, that is trust and satisfaction, and consequently loyalty. The conceptual model, which integrates relational and evaluative perspectives, is validated in the Asian context of personalized service through findings from a survey of 325 respondents. The findings at the aggregate level indicate that while the physical environment is an important determinant of both trust and satisfaction in personalized service encounters, the customer environment influences only satisfaction but not trust. Service contact personnel's friendliness and knowledge of customers strongly influence relationship quality; while expertise, similarity and disclosure influence trust but not satisfaction. Both relationship trust and satisfaction were found to significantly influence loyalty to the service provider. At the disaggregate level, trust was found to be a stronger predictor of loyalty for high-end service providers while satisfaction was a stronger predictor of loyalty for low-end service providers. The implications for high-end and low-end service providers to enhance loyalty by strategically leveraging on key customer-firm antecedents of relationship trust and satisfaction are discussed. 相似文献
Recent research has provided important insights on consumers’ preferences for prepayment mechanisms and on its impact on consumption of a given product or service. However, little is known about how prepayment influences future purchases of goods and services. We consider this question in a contractual setting within the services industry, involving different purchasing decisions over time. Based on a large-scale empirical test, we find that prepay customers make fewer changes to their cross-buying levels (i.e., the number of different services they buy from the company) from one contractual period to another, and that this effect is more salient for the firm's new customers. We propose possible explanatory mechanisms for this effect. For instance, based on mental budgeting theory, we suggest that prepayment customers may set mental budgets and track expenditures against this budget leading them to resist further investments. Alternatively, prepayment customers may be more certain about their consumption behavior leading to fewer changes over time.
One of the primary objectives of both adoption of IFRS and convergence between IFRS and U.S. GAAP is to increase financial statement comparability. Using a unique setting in Germany, we compare the effectiveness of these two approaches in achieving this desired outcome. Our empirical tests show that both adoption and convergence lead to an increase in comparability after the new enforcement regulation in 2005. However, difference‐in‐differences tests show that adoption does not lead to a significant incremental increase in comparability beyond convergence. The findings of this study should be of interest to regulators and standard setters as they assess alternative methods of aligning domestic standards with IFRS. 相似文献
Fertilizer use in Nigeria is estimated at 13 kg/ha, which is far below the 200 kg/ha recommended by the Food and Agricultural Organization (FAO). The objective of this investigation was to identify the determinant factors of farmers’ participation in Nigeria's Growth Enhancement Support Scheme (GESS). In addition, we determined the impact of the GESS on fertilizer use in rural areas. A total of 1,200 rural farmers were sampled across the six geopolitical zones of Nigeria. Results from the use of a recursive bivariate probit model indicated that GESS significantly impacted on the access and usage of fertilizer among the rural farmers; and that contact with extension agents, ownership of mobile phones, power for charging phone batteries, value output, mobile network coverage, ability to read and write were positive determinants of rural farmers’ participation in the GESS; whereas increased distance to registration and collection centers, and cultural constraints to married women reduced farmers’ tendency to participate in the GESS. The findings suggest that farmers’ participation in the GESS is a critical factor for raising fertilizer use in Nigeria. This implies that food security in sub‐Saharan Africa can be achieved by increasing the participation of rural farmers in the GESS. 相似文献