Physician remuneration schemes, psychiatric hospitalizations and follow-up care: Evidence from blended fee-for-service and capitation models.

Psychiatric hospitalizations could be reduced if mental illnesses were detected and treated earlier in the primary care setting, leading to the World Health Organization recommendation that mental health services be integrated into primary care. The mental health services provided in primary care settings may vary based on how physicians are incentivized. Little is known about the link between physician remuneration and psychiatric hospitalizations. We contribute to this literature by studying the relationship between physician remuneration and psychiatric hospitalizations in Canada\u27s most populous province, Ontario. Specifically, we study family physicians (FPs) who switched from blended fee-for-service (FFS) to blended capitation remuneration model, relative to those who remained in the blended FFS model, on psychiatric hospitalizations. Outcomes included psychiatric hospitalizations by enrolled patients and the proportion of hospitalized patients who had a follow-up visit with the FP within 14 days of discharge. We used longitudinal health administrative data from a cohort of practicing physicians from 2006 through 2016. Because physicians practicing in these two models are likely to be different, we employed inverse probability weighting based on estimated propensity scores to ensure that switchers and non-switchers were comparable at the baseline. Using inverse probability weighted fixed-effects regressions controlling for relevant confounders, we found that switching from blended FFS to blended capitation was associated with a 6.2% decrease in the number of psychiatric hospitalizations and a 4.7% decrease in the number of patients with a psychiatric hospitalization. No significant effect of remuneration on follow-up visits within 14 days of discharge was observed. Our results suggest that the blended capitation model is associated with fewer psychiatric hospitalizations relative to blended FFS

Visual signals and children's communication: negative effects on task outcome

Previous research has found that young children fail to adapt to audio-only interaction (e.g. Doherty-Sneddon & Kent, 1996), and perform difficult communication tasks better face-to-face. In this new study, children aged 6- and 10 year-olds were compared in face-to-face and audio-only interaction. A problem-solving communication task involving description of abstract stimuli was employed. When describing the abstract stimuli both groups of children showed evidence of face-to-face interference rather than facilitation. It is concluded that, contrary to previous research, for some communication tasks access to visual signals (such as facial expression and eye gaze) may hinder rather than help children’s communication

Speaking out about gender imbalance in invited speakers improves diversity.

Omissions of qualified women scientists from major meeting programs continue to occur despite a surge in articles indicating persistent gender-discriminatory practices in hiring and promotion, and calls for gender balance in conference organizing committees

Population-based evaluation of a suggested anatomic and clinical classification of congenital heart defects based on the International Paediatric and Congenital Cardiac Code

<p>Abstract</p> <p>Background</p> <p>Classification of the overall spectrum of congenital heart defects (CHD) has always been challenging, in part because of the diversity of the cardiac phenotypes, but also because of the oft-complex associations. The purpose of our study was to establish a comprehensive and easy-to-use classification of CHD for clinical and epidemiological studies based on the long list of the International Paediatric and Congenital Cardiac Code (IPCCC).</p> <p>Methods</p> <p>We coded each individual malformation using six-digit codes from the long list of IPCCC. We then regrouped all lesions into 10 categories and 23 subcategories according to a multi-dimensional approach encompassing anatomic, diagnostic and therapeutic criteria. This anatomic and clinical classification of congenital heart disease (ACC-CHD) was then applied to data acquired from a population-based cohort of patients with CHD in France, made up of 2867 cases (82% live births, 1.8% stillbirths and 16.2% pregnancy terminations).</p> <p>Results</p> <p>The majority of cases (79.5%) could be identified with a single IPCCC code. The category "Heterotaxy, including isomerism and mirror-imagery" was the only one that typically required more than one code for identification of cases. The two largest categories were "ventricular septal defects" (52%) and "anomalies of the outflow tracts and arterial valves" (20% of cases).</p> <p>Conclusion</p> <p>Our proposed classification is not new, but rather a regrouping of the known spectrum of CHD into a manageable number of categories based on anatomic and clinical criteria. The classification is designed to use the code numbers of the long list of IPCCC but can accommodate ICD-10 codes. Its exhaustiveness, simplicity, and anatomic basis make it useful for clinical and epidemiologic studies, including those aimed at assessment of risk factors and outcomes.</p

A bioeconomic model for the optimization of local canine rabies control

We present a new modeling tool that can be used to maximize the impact of canine rabies management resources that are available at the local level. The model is accessible through a web-based interface that allows for flexibility in the management strategies that can be investigated. Rabies vaccination, sterilization, chemo-contraception, and euthanasia can be specified and limited to specific demographic groups. Additionally, we allowed for considerable complexity in the specification of management costs. In many areas, the costs of contacting additional dogs increases as management effort increases, and this can have important strategic implications. We illustrated the application of the model by examining several alternative management strategies in an area of Mpumalanga Province, South Africa. Our results based on this dog population suggested that puppies should be vaccinated and sterilization would not be optimal if the spatial extent of management is not large (and perhaps not even then). Furthermore, given a sufficient budget, it was evident that vaccination campaigns should be repeated annually

A bioeconomic model for the optimization of local canine rabies control

We present a new modeling tool that can be used to maximize the impact of canine rabies management resources that are available at the local level. The model is accessible through a web-based interface that allows for flexibility in the management strategies that can be investigated. Rabies vaccination, sterilization, chemo-contraception, and euthanasia can be specified and limited to specific demographic groups. Additionally, we allowed for considerable complexity in the specification of management costs. In many areas, the costs of contacting additional dogs increases as management effort increases, and this can have important strategic implications. We illustrated the application of the model by examining several alternative management strategies in an area of Mpumalanga Province, South Africa. Our results based on this dog population suggested that puppies should be vaccinated and sterilization would not be optimal if the spatial extent of management is not large (and perhaps not even then). Furthermore, given a sufficient budget, it was evident that vaccination campaigns should be repeated annually

Detection in coincidence of gravitational wave bursts with a network of interferometric detectors (I): Geometric acceptance and timing

Detecting gravitational wave bursts (characterised by short durations and poorly modelled waveforms) requires to have coincidences between several interferometric detectors in order to reject non-stationary noise events. As the wave amplitude seen in a detector depends on its location with respect to the source direction and as the signal to noise ratio of these bursts are expected to be low, coincidences between antennas may not be so likely. This paper investigates this question from a statistical point of view by using a simple model of a network of detectors; it also estimates the timing precision of a detection in an interferometer which is an important issue for the reconstruction of the source location, based on time delays.Comment: low resolution figure 1 due to file size problem

Using XR (extended reality) for behavioral, clinical, and learning sciences requires updates in infrastructure and funding

Extended reality (XR, including Augmented and Virtual Reality) creates a powerful intersection between information technology and cognitive, clinical, and education sciences. XR technology has long captured the public imagination, and its development is the focus of major technology companies. This article demonstrates the potential of XR to (1) deliver behavioral insights, (2) transform clinical treatments, and (3) improve learning and education. However, without appropriate policy, funding, and infrastructural investment, many research institutions will struggle to keep pace with the advances and opportunities of XR. To realize the full potential of XR for basic and translational research, funding should incentivize (1) appropriate training, (2) open software solutions, and (3) collaborations between complementary academic and industry partners. Bolstering the XR research infrastructure with the right investments and incentives is vital for delivering on the potential for transformative discoveries, innovations, and applications

Measuring Lensing Magnification of Quasars by Large Scale Structure using the Variability-Luminosity Relation

We introduce a technique to measure gravitational lensing magnification using the variability of type I quasars. Quasars' variability amplitudes and luminosities are tightly correlated, on average. Magnification due to gravitational lensing increases the quasars' apparent luminosity, while leaving the variability amplitude unchanged. Therefore, the mean magnification of an ensemble of quasars can be measured through the mean shift in the variability-luminosity relation. As a proof of principle, we use this technique to measure the magnification of quasars spectroscopically identified in the Sloan Digital Sky Survey, due to gravitational lensing by galaxy clusters in the SDSS MaxBCG catalog. The Palomar-QUEST Variability Survey, reduced using the DeepSky pipeline, provides variability data for the sources. We measure the average quasar magnification as a function of scaled distance (r/R200) from the nearest cluster; our measurements are consistent with expectations assuming NFW cluster profiles, particularly after accounting for the known uncertainty in the clusters' centers. Variability-based lensing measurements are a valuable complement to shape-based techniques because their systematic errors are very different, and also because the variability measurements are amenable to photometric errors of a few percent and to depths seen in current wide-field surveys. Given the data volume expected from current and upcoming surveys, this new technique has the potential to be competitive with weak lensing shear measurements of large scale structure.Comment: Accepted for publication in Ap

The Erotic and the Vulgar: Visual Culture and Organized Labor's Critique of U.S. Hegemony in Occupied Japan

This essay engages the colonial legacy of postwar Japan by arguing that the political cartoons produced as part of the postwar Japanese labor movement’s critique of U.S. cultural hegemony illustrate how gendered discourses underpinned, and sometimes undermined, the ideologies formally represented by visual artists and the organizations that funded them. A significant component of organized labor’s propaganda rested on a corpus of visual media that depicted women as icons of Japanese national culture. Japan’s most militant labor unions were propagating anti-imperialist discourses that invoked an engendered/endangered nation that accentuated the importance of union roles for men by subordinating, then eliminating, union roles for women