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This study explores the association between financial knowledge and financial fragility. Data from the 2015 National Financial Capability Study were used to create an index of financial fragility. Relationships between this index and three different measures of financial knowledge were assessed. To mitigate potential endogeneity in the financial knowledge measures, such as neighborhood effect defined as social interactions or characteristics of communities that influence socioeconomic and health behaviors or outcomes of individuals, the neighborhood average education level in US zip code units was used as an instrumental variable. The results from the baseline Ordinary Least Squares regression models and Two Stage Least Squares (2SLS) regression models indicated a negative relationship between financial knowledge and financial fragility; the effect was greater when the instrumental variable was used. Our findings with the neighborhood effect suggest which groups could be a focus for future research as well as offering practical interventions. Further, when designing and implementing educational and behavioral interventions, the knowledge-based approach should gain continued support from financial education, planning, and counseling programs.

We examined the relationship between holding a student loan and financial satisfaction and financial education's moderating role using the 2015 National Financial Capability Study dataset. Households with a student loan had lower levels of financial satisfaction than those without one. We found a moderating role of receiving both formal and informal financial education on the relationship between a student loan and financial satisfaction, regardless of for whom the loans were taken. Our findings confirm the importance of financial education and suggest that receiving a thorough combination of formal and informal education will improve student loan holders' financial satisfaction.

The Survey of Consumer Finances (SCF) has included a 4-level risk tolerance measure since 1983. In 2016, the SCF also included an 11-level risk tolerance measure. We compare the two measures, and develop suggestions for using the new measure. While the new measure is seemingly simpler than the old measure, we demonstrate that it does not have a monotonic relationship with owning stock assets, with a pattern similar to the relationship of the old measure to stock ownership. We also identify complex patterns of factors related to different levels of the new measure, for instance education has a negative relationship at one level but positive at another level. Those using the new measure should consider the complex patterns we demonstrate.

This study used data from the 2015 National Financial Capability Study to analyze the adoption of mobile payments by U.S. households. While 24% of respondents used mobile payments, the mean rate for those under age 25 was 11 times the rate for those 65 and older. State rates ranged from about 9% in Montana to 34% in Washington, DC. Based on a logistic regression, age and an objective financial knowledge score were negatively while risk tolerance and a subjective financial knowledge score were positively related to mobile payment use. The results have implications for marketing of Fintech applications for personal finance, especially in terms of the extremely low mobile payment use by older consumers.

Using the 2007-2009 Survey of Consumer Finances panel dataset, we investigate whether and how changes in perceived income and saving motives are related to demand for household savings in the United States after the Great Recession. Households that perceive their current income as lower, relative to normal years are less likely to save than those who view that their income is the same as the reference point. This result holds only for those who experienced a significant negative income shock during the Great Recession. Among five major saving motives, saving for an emergency is an important factor in explaining the likelihood of saving. This study suggests that financial planners and educators should pay close attention to the role of households' income perception and saving motives and should account for the resulting potential psychological biases in households' saving decisions.

This study analyzed the debt profile of low-income households before and after the Great Recession using the 2007, 2010, and 2013 Survey of Consumer Finances (SCF). We used Heckman selection models to investigate three debt characteristics: (a) the amount of debt, (b) debt-to-income ratio, and (c) debt delinquency. Before and after the Great Recession, results from the selection stage showed the probability of holding debt for households increased as their income level increased (moving into less severe poverty categories); results from the outcome stage indicated households in the most severe poverty category (below 100% of poverty threshold) were less likely to meet debt-to-income ratio guidelines. Following the Great Recession, these lowest income households were more likely to have higher debt and debt delinquency problems.

During the first year of the COVID-19 pandemic, the Republic of Korea (ROK) experienced three epidemic waves in February, August, and November 2020. These waves, combined with the overarching pandemic, significantly influenced trends in spinal surgery. This study aimed to investigate the trends in degenerative lumbar spinal surgery in ROK during the early COVID-19 pandemic, especially in relation to specific epidemic waves. Using the National Health Information Database in ROK, we identified all patients who underwent surgery for degenerative lumbar spinal diseases between January 1, 2019 and December 31, 2020. A joinpoint regression was used to assess temporal trends in spinal surgeries over the first year of the COVID-19 pandemic. The number of surgeries decreased following the first and second epidemic waves (p<0.01 and p = 0.34, respectively), but these were offset by compensatory increases later on (p<0.01 and p = 0.05, respectively). However, the third epidemic wave did not lead to a decrease in surgical volume, and the total number of surgeries remained comparable to the period before the pandemic. When compared to the pre-COVID-19 period, average LOH was reduced by 1 day during the COVID-19 period (p<0.01), while mean hospital costs increased significantly from 3,511 to 4,061 USD (p<0.01). Additionally, the transfer rate and the 30-day readmission rate significantly decreased (both p<0.01), while the reoperation rate remained stable (p = 0.36). Despite the impact of epidemic waves on monthly surgery numbers, a subsequent compensatory increase was observed, indicating that surgical care has adapted to the challenges of the pandemic. This adaptability, along with the stable total number of operations, highlights the potential for healthcare systems to continue elective spine surgery during public health crises with strategic resource allocation and patient triage. Policies should ensure that surgeries for degenerative spinal diseases, particularly those not requiring urgent care but crucial for patient quality of life, are not unnecessarily halted. [ABSTRACT FROM AUTHOR]

Purpose: Financial inclusion can be proxied by banking status. The purpose of this study is to investigate the potential effects of financial capability on the financial fragility of US adults with various banking statuses during the COVID-19 pandemic. Design/methodology/approach: This study utilized the 2021 National Financial Capability Study (NFCS) dataset to investigate the relationship between financial capability and financial fragility among consumers with different banking statuses. The analysis controlled for employment shocks, health shocks and other consumer characteristics. Banking statuses included fully banked, under-banked (utilizing both banking and alternative financial services) and unbanked individuals. Logistic regression analyses were conducted on both the entire sample and subsamples based on banking statuses. Findings: The results showed that financial capability was negatively associated with financial fragility. The magnitude of the potential negative effect of financial capability was the greatest among the fully banked group, followed by the underbanked and unbanked groups. Respondents who were underbanked or unbanked were more likely to experience financial fragility than those who were fully banked. Additionally, respondents who were laid off or furloughed during the pandemic were more likely to experience financial fragility than those without employment shocks. The effect size of financial capability factors was greater than that of COVID-19 shock factors. These results suggest that higher levels of both financial capability and financial inclusion may be effective in reducing the risk of financial fragility. Originality/value: This study represents one of the first attempts to examine the potential effects of financial capability on financial fragility among consumers with various banking statuses during the COVID-19 pandemic. Furthermore, this study offers new evidence to determine whether COVID-19 shocks, as measured by health and employment status, are associated with financial fragility. Additionally, the effect size of financial capability factors is greater than that of COVID-19 shock factors. The results from the 2021 NFCS dataset provide valuable insights for banking professionals and public policymakers on how to enhance consumer financial wellbeing. [ABSTRACT FROM AUTHOR]

In this qualitative study, the experiences of sport spectatorship by people with disabilities who watched the PyeongChang Paralympics were explored to add to the body of knowledge surrounding the legacies and leverage of major mega-sports events, in which the experiences of people with disabilities in non-western contexts have been largely overlooked. Fifteen adults with physical disabilities of Asian origin or heritage participated in semi-structured, in-depth interviews concerning their responses to observing the para-games. Analysis of the interview data yielded five thematic reactions: (1) desire to participate, (2) sense of in-group pride, (3) self-efficacy, (4) disability sports awareness, and (5) social inclusion. Conceptual and practical perspectives are discussed along with suggestions for future research. [ABSTRACT FROM AUTHOR]

Objective: To develop a computerized visuomotor integration system for assessment and training of visual perception impairments and evaluate its safety and feasibility in patients with a stroke. Visual field defects and spatial neglect lead to substantial poststroke impairment. Most diagnostic assessments are anchored in traditional methods, and clinical effects of rehabilitation treatments are limited. Methods: The CoTras Vision system included two evaluations and four training modules. The evaluation modules were based on the Albert's test and Star cancellation test, and training modules were based on visual tracking, central-peripheral integration, and visuomotor perception techniques. Bland–Altman plots for agreement with the traditional paper-and-pencil test were performed, and the modified Intrinsic Motivation Inventory, Patient Satisfaction Questionnaire, and Simulator Sickness Questionnaire were conducted. Results: Ten patients with acute stroke completed the study. Bland–Altman plots revealed good agreements for Albert's test (mean difference, -0.3±4.5) and Star cancellation test (mean difference, 0.3±0.7). The mean±standard deviation scores of the modified Intrinsic Motivation Inventory, Patient Satisfaction Survey, and Simulator Sickness Questionnaire were 84.7±30.6, 40.5±7.9, and 34.0±34.5 respectively. Conclusion: The CoTras Vision system is feasible and safe in patients with stroke. Most patients had a high degree of motivation to use the system and did not experience severe adverse events. Further studies are needed to confirm its usefulness in stroke patients with visual field defects and hemineglect symptoms. Furthermore, a large, well-designed, randomized controlled trial will be needed to confirm the treatment effect of the CoTras Vision system. [ABSTRACT FROM AUTHOR]