An Alternative Model for Analyzing the Physician-Hospital Relationship in Rural Areas

We introduce a modeling framework called Transaction Cost Economics to help decision makers in rural health care markets choose among alternative organizational relationships in order to more cost-effectively deliver healthcare services. In particular, the hospital-physician relationship is analyzed and the transactional attributes, institutional environment, and market characteristics are identified as key variables influencing the organizational relationship between hospital and physician. As asset specfic investments are made by either the hospital or physician, vertically integrated relationships are more likely to occur. The degree of remoteness of rural areas is also considered to affect the impact of these asset-specific investments.Community/Rural/Urban Development, Health Economics and Policy,

The Organizational Evolution of Markets for Wood Products in the Southern United States

This paper represents the first case study attempt to develop a transaction cost conceptual model to describe industry evolution of the paper and lumber industries in the Southern United States around the late 1800s and early 1900s. We use transaction cost theory to explain the co-evolution of markets for wood products noting that variation in the level and type of investments made in physical and human capital assets needed to manage paper and lumber miller operations had a significant influence on the use of wood dealer systems compared to more vertically organized business arrangements. We identify some testable hypotheses and areas of future research.Industry Evolution, Contracting, Property Rights, Vertical Integration, Forest Products, Industrial Organization, Research Methods/ Statistical Methods, L14, L24, L73, J24,

Analyzing Differences in Rural Hospital Efficiency: A Data Envelopment Analysis Approach

This study analyzes difference in efficiency among the U.S. rural hospitals using a two-stage, semi-parametric approach. Data Envelopment Analysis is used in the first stage to calculate cost, technical and allocative efficiencies of Critical Access Hospitals (CAH) and non-CAH rural hospitals. Following Simar and Wilson (2007), bootstrapped truncated regressions are used in the second stage to infer on relationship between the cost, technical and allocative inefficiencies of hospitals and some environmental variables. The estimated results show that CAHs are less cost, technical and allocative efficient than non-CAH rural hospitals. The results also show that Medicare cost-based reimbursement for CAHs has a negative effect on the efficiency of these hospitals while Medicare prospective payment system for non-CAH rural hospitals has a positive effect on hospital efficiency.efficiency, two-stage, semi-parametric, bootstrap, data envelopment analysis, Health Economics and Policy, I12, I18,

Factors Affecting Outsourcing for Information Technology Services in Rural Hospitals: Theory and Evidence

As health information technology becomes more prevalent for most healthcare facilities, hospitals across the nation are choosing between performing this service in-house and outsourcing to a technology firm in the health industry. This paper examines factors affecting the information technology (IT) outsource decision for various hospitals. Using 2004 data from the American Hospital Association, logistic regression models find that governmental ownership and a proxy variable for hospitals that treat more severe injuries positively impact the probability of outsourcing for IT services.Health Information Technology, Outsourcing, Hospital, Health Economics and Policy, Labor and Human Capital, Research and Development/Tech Change/Emerging Technologies, I12, C140,

The Coase Theorem, or the Coasian Lens? An Application to GMO Regulation

We develop a property rights-transaction costs framework called the Coasian Lens (CL). We argue the CL captures Coase's seminal ideas (1937; 1960) more closely than the Coase Theorem. We use the CL to examine how regulation of genetically modified organisms (GMOs) may affect contract structures in the global agri-food chain.Research and Development/Tech Change/Emerging Technologies,

The distribution of blood eosinophil levels in a Japanese COPD clinical trial database and in the rest of the world.

Background: Blood eosinophil measurements may help to guide physicians on the use of inhaled corticosteroids (ICS) for patients with chronic obstructive pulmonary disease (COPD). Emerging data suggest that COPD patients with higher blood eosinophil counts may be at higher risk of exacerbations and more likely to benefit from combined ICS/long-acting beta2-agonist (LABA) treatment than therapy with a LABA alone. This analysis describes the distribution of blood eosinophil count at baseline in Japanese COPD patients in comparison with non-Japanese COPD patients. Methods: A post hoc analysis of eosinophil distribution by percentage and absolute cell count was performed across 12 Phase II-IV COPD clinical studies (seven Japanese studies [N=848 available absolute eosinophil counts] and five global studies [N=5,397 available eosinophil counts] that included 246 Japanese patients resident in Japan with available counts). Blood eosinophil distributions were assessed at baseline, before blinded treatment assignment. Findings: Among Japanese patients, the median (interquartile range) absolute eosinophil count was 170 cells/mm3(100-280 cells/mm3). Overall, 612/1,094 Japanese patients (56%) had an absolute eosinophil count ≥150 cells/mm3and 902/1,304 Japanese patients (69%) had a percentage eosinophil ≥2%. Among non-Japanese patients, these values were 160 (100-250) cells/mm3, 2,842/5,151 patients (55%), and 2,937/5,155 patients (57%), respectively. The eosinophil distribution among Japanese patients was similar to that among non-Japanese patients. Within multi-country studies with similar inclusion criteria, the eosinophil count was numerically lower in Japanese compared with non-Japanese patients (median 120 vs 160 cells/mm3). Interpretation: The eosinophil distribution in Japanese patients seems comparable to that of non-Japanese patients; although within multi-country studies, there was a slightly lower median eosinophil count for Japanese patients compared with non-Japanese patients. These findings suggest that blood eosinophil data from global studies are of relevance in Japan

Growth of Captive Juvenile Tripletail Lobotes surinamensis

Early-juvenile tripletail Lobotes surinamensis (n = 27; range 45–115 mm TL, 0 = 73.0 mm; range 3.2–34.7 g TW, 0 = 12.9 g) captured in pelagic Sargassum algae off coastal Mississippi in mid-July 1999 were reared in a recirculating seawater system for 210 days. Fish were maintained on a natural light-dark cycle and fed to satiation 3 times per day. Water temperature ranged from 25.2° to 29.0° C and salinity was 28.0‰. All fish were measured for length and weight on days 1, 60, 135 and 210 of the study. Between these dates, mean daily TL growth rates were 2.2 mm/day, 1.2 mm/day, and 1.0 mm/day, respectively, where as 0 daily TW growth rates were 2.9 g/day, 4.3 g/day, and 7.1 g/day. Over the entire study, 0 TL and TW growth rates were 1.4 mm/day and 4.9 g/day, respectively. There was a significant correlation between length and weight vs. date of measurement. At the end of the study, specimens ranged from 272–431 mm TL (0 = 359 mm) and from 443.9–2,380.0 g TW (0 = 1,012.5 g)

Which feedback mechanisms dominate in the high-pressure environment of the Central Molecular Zone?

This article has been accepted for publication in Monthly Notices of the Royal Astronomical Society ©: 2020 The Author(s). Published by Oxford University Press on behalf of the Royal Astronomical Society. All rights reserved. Final published version available at https://doi.org/10.1093/mnras/staa2719.Supernovae (SNe) dominate the energy and momentum budget of stellar feedback, but the efficiency with which they couple to the interstellar medium (ISM) depends strongly on how effectively early, pre-SN feedback clears dense gas from star-forming regions. There are observational constraints on the magnitudes and timescales of early stellar feedback in low ISM pressure environments, yet no such constraints exist for more cosmologically typical high ISM pressure environments. In this paper, we determine the mechanisms dominating the expansion of H ii regions as a function of size-scale and evolutionary time within the high-pressure (P/kB ∼ 107 − 8 K cm−3) environment in the inner 100 pc of the Milky Way. We calculate the thermal pressure from the warm ionised (PHII; 104 K) gas, direct radiation pressure (Pdir), and dust processed radiation pressure (PIR). We find that (1) Pdir dominates the expansion on small scales and at early times (0.01-0.1 pc; 0.1 pc; >1 Myr); (3) during the first ≲ 1 Myr of growth, but not thereafter, either PIR or stellar wind pressure likely make a comparable contribution. Despite the high confining pressure of the environment, natal star-forming gas is efficiently cleared to radii of several pc within ∼ 2 Myr, i.e. before the first SNe explode. This ‘pre-processing’ means that subsequent SNe will explode into low density gas, so their energy and momentum will efficiently couple to the ISM. We find the H ii regions expand to a radius of ∼ 3pc, at which point they have internal pressures equal with the surrounding external pressure. A comparison with H ii regions in lower pressure environments shows that the maximum size of all H ii regions is set by pressure equilibrium with the ambient ISM.Peer reviewe

The Properties of Poor Groups of Galaxies: III. The Galaxy Luminosity Function

We obtain R-band photometry for galaxies in six nearby poor groups for which we have spectroscopic data, including 328 new galaxy velocities. For the five groups with luminous X-ray halos, the composite group galaxy luminosity function (GLF) is fit adequately by a Schechter function with Mstar = -21.6 +/- 0.4 + 5log h and alpha = -1.3 +/- 0.1. We also find that (1) the ratio of dwarfs to giants is significantly larger for the five groups with luminous X-ray halos than for the one marginally X-ray detected group, (2) the composite GLF for the luminous X-ray groups is consistent in shape with that for rich clusters, (3) the composite group GLF rises more steeply at the faint end than that of the field, (4) the shape difference between the field and composite group GLF's results mostly from the population of non-emission line galaxies, whose dwarf-to-giant ratio is larger in the denser group environment than in the field, and (5) the non-emission line dwarfs are more concentrated about the group center than the non-emission line giants. This last result indicates that the dwarfs and giants occupy different orbits (i.e., have not mixed completely) and suggests that the populations formed at a different times. Our results show that the shape of the GLF varies with environment and that this variation is due primarily to an increase in the dwarf-to-giant ratio of quiescent galaxies in higher density regions, at least up to the densities characteristic of X-ray luminous poor groups. This behavior suggests that, in some environments, dwarfs are more biased than giants with respect to dark matter. This trend conflicts with the prediction of standard biased galaxy formation models. (Abridged)Comment: 36 pages, AASLaTeX with 8 figures. Table 1 also available at http://atropos.as.arizona.edu/aiz/papers/all_grp_lf_ascii.dat.final . To appear in Ap

Board governance and management series: What is a healthy board?

The Oklahoma Cooperative Extension Service periodically issues revisions to its publications. The most current edition is made available. For access to an earlier edition, if available for this title, please contact the Oklahoma State University Library Archives by email at [email protected] or by phone at 405-744-6311