Mostrando recursos 1 - 20 de 118

  1. Socioeconomic Background and Commercial Health Plan Spending

    Chien, Alyna; Newhouse, Joseph Paul; Iezzoni, Lisa I.; Petty, Carter R.; Normand, Sharon-Lise Teresa; Schuster, Mark A.
    BACKGROUND: Risk-adjustment algorithms typically incorporate demographic and clinical variables to equalize compensation to insurers for enrollees who vary in expected cost, but including information about enrollees’ socioeconomic background is controversial. METHODS: We studied 1 182 847 continuously insured 0 to 19-year-olds using 2008–2012 Blue Cross Blue Shield of Massachusetts and American Community Survey data. We characterized enrollees’ socioeconomic background using the validated area-based socioeconomic measure and calculated annual plan payments using paid claims. We evaluated the relationship between annual plan payments and geocoded socioeconomic background using generalized estimating equations (γ distribution and log link). We expressed outcomes as the percentage difference in spending...

  2. Adverse obstetric outcomes during delivery hospitalizations complicated by suicidal behavior among US pregnant women

    Zhong, Qiu-Yue; Gelaye, Bizu; Smoller, Jordan W.; Avillach, Paul; Cai, Tianxi; Williams, Michelle A.
    Objective: The effects of suicidal behavior on obstetric outcomes remain dangerously unquantified. We sought to report on the risk of adverse obstetric outcomes for US women with suicidal behavior at the time of delivery. Methods: We performed a cross-sectional analysis of delivery hospitalizations from 2007–2012 National (Nationwide) Inpatient Sample. From the same hospitalization record, International Classification of Diseases codes were used to identify suicidal behavior and adverse obstetric outcomes. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) were obtained using logistic regression. Results: Of the 23,507,597 delivery hospitalizations, 2,180 were complicated by suicidal behavior. Women with suicidal behavior were...

  3. Personal Care Product Use in Men and Urinary Concentrations of Select Phthalate Metabolites and Parabens: Results from the Environment And Reproductive Health (EARTH) Study

    Nassan, Feiby L.; Coull, Brent A.; Gaskins, Audrey J.; Williams, Michelle A.; Skakkebaek, Niels E.; Ford, Jennifer B.; Ye, Xiaoyun; Calafat, Antonia M.; Braun, Joseph M.; Hauser, Russ
    Background: Personal care products (PCPs) are exposure sources to phthalates and parabens; however, their contribution to men’s exposure is understudied. Objectives: We examined the association between PCP use and urinary concentrations of phthalate metabolites and parabens in men. Methods: In a prospective cohort, at multiple study visits, men self-reported their use of 14 PCPs and provided a urine sample (2004–2015, Boston, MA). We measured urinary concentrations of 9 phthalate metabolites and methylparaben, propylparaben, and butylparaben. We estimated the covariate-adjusted percent change in urinary concentrations associated with PCP use using linear mixed and Tobit mixed regressions. We also estimated weights for...

  4. The Meaning-Enhancing Properties of Psychedelics and Their Mediator Role in Psychedelic Therapy, Spirituality, and Creativity

    Hartogsohn, Ido
    Past research has demonstrated to the ability of psychedelics to enhance suggestibility, and pointed to their ability to amplify perception of meaning. This paper examines the existing evidence for the meaning-enhancing properties of psychedelics, and argues that the tendency of these agents to enhance the perception of significance offers valuable clues to explaining their reported ability to stimulate a variety of therapeutic processes, enhance creativity, and instigate mystical-type experiences. Building upon previous research, which suggested the potential role of psychedelic meaning-enhancement in enhancing placebo response, the paper explores the mechanisms by which the meaning-amplifying properties of psychedelics might also play...

  5. Don’t Good Democracies Need “Good” Citizens? Citizen Dispositions and the Study of Democratic Quality

    Mayne, Quinton; Geißel, Brigitte
    This article advances the argument that quality of democracy depends not only on the performance of democratic institutions but also on the dispositions of citizens. We make three contributions to the study of democratic quality. First, we develop a fine-grained, structured conceptualization of the three core dispositions (democratic commitments, political capacities, and political participation) that make up the citizen component of democratic quality. Second, we provide a more precise account of the notion of inter-component congruence or “fit” between the institutional and citizen components of democratic quality, distinguishing between static and dynamic forms of congruence. Third, drawing on cross-national data,...

  6. Liquidity risk in sequential trading networks

    Kariv, Shachar; Kotowski, Maciej Henryk; Leister, C. Matthew
    This paper studies a model of intermediated exchange with liquidity-constrained traders. Intermediaries are embedded in a trading network and their financial capacities are private information. We characterize our model’s monotone, pure-strategy equilibrium. Agents earn positive intermediation rents in equilibrium. An experimental investigation supports the model’s baseline predictions concerning agents’ strategies, price dynamics, and the division of surplus. While private financial constraints inject uncertainty into the trading environment, our experiment suggests they are also a behavioral speed-bump, preventing traders from experiencing excessive losses due to overbidding.

  7. Pandemic risk: how large are the expected losses?

    Fan, Victoria Y; Jamison, Dean T; Summers, Lawrence H
    Abstract There is an unmet need for greater investment in preparedness against major epidemics and pandemics. The arguments in favour of such investment have been largely based on estimates of the losses in national incomes that might occur as the result of a major epidemic or pandemic. Recently, we extended the estimate to include the valuation of the lives lost as a result of pandemic-related increases in mortality. This produced markedly higher estimates of the full value of loss that might occur as the result of a future pandemic. We parametrized an exceedance probability function for a global influenza pandemic...

  8. The burden of respiratory syncytial virus (RSV) associated acute lower respiratory infections in children with Down syndrome: A systematic review and meta–analysis

    Chan, Markus; Park, John J; Shi, Ting; Martinón–Torres, Federico; Bont, Louis; Nair, Harish
    Background: Acute lower respiratory tract infections (ALRIs) caused by respiratory syncytial virus (RSV) are a leading cause of hospitalization in infants. Numerous risk factors have been identified in the aetiology of severe RSV–associated ALRI necessitating hospitalisation, including prematurity and congenital heart disease. Down syndrome (DS), a common genetic disorder associated with congenital and dysmorphic features, has recently been identified as an independent risk factor for RSV–associated ALRI requiring hospitalisation; however, the disease burden of RSV–associated ALRI in this population has not yet been established. Similarly, the impact of DS as an independent risk factor has not yet been quantified. We...

  9. The Critical Role of Research in Advancing Romani’s Right to Health

    Bhabha, Jacqueline; Matache, Margareta; Marti, Teresa Sorde

  10. Looking Back and Looking Forward on the Iran Deal

    Bunn, Matthew G.

  11. Perceiving Others’ Feelings: The Importance of Personality and Social Structure

    Sherman, Gary D.; Lerner, Jennifer; Renshon, Jonathan; Ma-Kellams, Christine; Joel, Samantha
    Recent research has explored the relationship between social hierarchy and empathic accuracy— the ability to accurately infer others’ mental states. In the current research, we tested the hypothesis that, regardless of one’s personal level of status and power, simply believing that social inequality is natural and morally acceptable (e.g., endorsement of social dominance orientation, or SDO), would be negatively associated with empathic accuracy. In a sample of managers, a group for whom empathic accuracy is a valuable skill, empathic accuracy was lower for those who possessed structural power and also for those who endorsed social dominance, regardless of their structural...

  12. Perceiving Others’ Feelings: The Importance of Personality and Social Structure

    Sherman, Gary D.; Lerner, Jennifer; Renshon, Jonathan; Ma-Kellams, Christine; Joel, Samantha
    Recent research has explored the relationship between social hierarchy and empathic accuracy— the ability to accurately infer others’ mental states. In the current research, we tested the hypothesis that, regardless of one’s personal level of status and power, simply believing that social inequality is natural and morally acceptable (e.g., endorsement of social dominance orientation, or SDO), would be negatively associated with empathic accuracy. In a sample of managers, a group for whom empathic accuracy is a valuable skill, empathic accuracy was lower for those who possessed structural power and also for those who endorsed social dominance, regardless of their structural...

  13. The process of discovery

    Fishman, Jay Alan

  14. Identification of Exogenous Forms of Human-Tropic Porcine Endogenous Retrovirus in Miniature Swine

    Fishman, Jay Alan; Wood, James C.; Quinn, Gary; Suling, Kristen M.; Oldmixon, Beth A.; Van Tine, Brian A.; Cina, Robert; Arn, Scott; Huang, Christine A.; Scobie, Linda; Onions, David E.; Sachs, David H.; Schuurman, Henk-Jan; Patience, Clive
    The replication of porcine endogenous retrovirus subgroup A (PERV-A) and PERV-B in certain human cell lines indicates that PERV may pose an infectious risk in clinical xenotransplantation. We have previously reported that human-tropic PERVs isolated from infected human cells following cocultivation with miniature swine peripheral blood mononuclear cells (PBMC) are recombinants of PERV-A with PERV-C. Here, we report that these recombinants are exogenous viruses in miniature swine; i.e., they are not present in the germ line DNA. These viruses were invariably present in miniature swine that transmitted PERV to human cells and were also identified in some miniature swine that...

  15. Prevention of Infection Due to Pneumocystis spp. in Human Immunodeficiency Virus-Negative Immunocompromised Patients

    Fishman, Jay Alan; Rodriquez, Martin
    Pneumocystis was initially identified in the lungs of rats as a stage in the life cycle of Trypanosoma cruzi (in 1909 by Chagas and in 1910 by Carini). The first case of Pneumocystis infection in humans was described by van der Meer and Brug in 1942 (167); Jirovec has been credited with describing epidemic in- fection in humans in the 1950s (85). Pneumocystis carinii was thought to be a protozoan parasite based on morphologic appearance, proposed life cycle, and antimicrobial susceptibil- ities. Subsequent phylogenic analyses using rRNA sequences suggested that the organism was more closely related to the fungi despite...

  16. The intrinsic value of choice: The propensity to under-delegate in the face of potential gains and losses

    Bobadilla-Suarez, Sebastian; Sunstein, Cass R.; Sharot, Tali
    Human beings are often faced with a pervasive problem: whether to make their own decision or to delegate the decision task to someone else. Here, we test whether people are inclined to forgo monetary rewards in order to retain agency when faced with choices that could lead to losses and gains. In a simple choice task, we show that participants choose to pay in order to control their own payoff more than they should if they were to maximize monetary rewards and minimize monetary losses. This tendency cannot be explained by participants’ overconfidence in their own ability, as their perceived...

  17. Should Governments Invest More in Nudging?

    Benartzi, Shlomo; Beshears, John; Milkman, Katherine L.; Sunstein, Cass R.; Thaler, Richard H.; Shankar, Maya; Tucker-Ray, Will; Congdon, William J.; Galing, Steven
    Governments are increasingly adopting behavioral science techniques for changing individual behavior in pursuit of policy objectives. The types of “nudge” interventions that governments are now adopting alter people’s decisions without coercion or significant changes to economic incentives. We calculated ratios of impact to cost for nudge interventions and for traditional policy tools, such as tax incentives and other financial inducements, and we found that nudge interventions often compare favorably with traditional interventions. We conclude that nudging is a valuable approach that should be used more often in conjunction with traditional policies, but more calculations are needed to determine the relative...

  18. Can States Take Over and Turn Around School Districts? Evidence from Lawrence, Massachusetts

    Schueler, Beth; Goodman, Joshua Samuel; Deming, David James
    The Federal government has spent billions of dollars to support turnarounds of low-achieving schools, yet most evidence on the impact of such turnarounds comes from high-profile, exceptional settings and not from examples driven by state policy decisions at scale. In this paper, we study the impact of state takeover and district-level turnaround in Lawrence, Massachusetts. Takeover of the Lawrence Public School (LPS) district was driven by the state’s accountability system, which increases state control in response to chronic underperformance. We find that the first two years of the LPS turnaround produced large achievement gains in math and modest gains in...

  19. Redistribution in a model of voting and campaign contributions

    Campante, Filipe Robin
    I propose a framework in which individual political participation can take two distinct forms, voting and contributing resources to campaigns, in a context in which the negligible impact of any individual’s actions on aggregate outcomes is fully recognized by all agents. I then use the framework to reassess the relationship between inequality and redistribution. The model shows that, even though each contribution has a negligible impact, the interaction between contributions and voting leads to an endogenous wealth bias in the political process, as the advantage of wealthier individuals in providing contributions encourages parties to move their platforms closer to those...

  20. Redistribution in a model of voting and campaign contributions

    Campante, Filipe Robin
    I propose a framework in which individual political participation can take two distinct forms, voting and contributing resources to campaigns, in a context in which the negligible impact of any individual’s actions on aggregate outcomes is fully recognized by all agents. I then use the framework to reassess the relationship between inequality and redistribution. The model shows that, even though each contribution has a negligible impact, the interaction between contributions and voting leads to an endogenous wealth bias in the political process, as the advantage of wealthier individuals in providing contributions encourages parties to move their platforms closer to those...

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