U.S. Health Care Spending: Comparison with Other OECD Countries

[Excerpt] The United States spends more money on health care than any other country in the Organization for Economic Cooperation and Development (OECD). The OECD consists of 30 democracies, most of which are considered the most economically advanced countries in the world. According to OECD data, the United States spent $6,102 per capita on health care in 2004 — more than double the OECD average and 19.9% more than Luxembourg, the second-highest spending country. In 2004, 15.3% of the U.S. economy was devoted to health care, compared with 8.9% in the average OECD country and 11.6% in second-placed Switzerland. Why does the United States spend this amount on health care? Economists break health care spending into two parts: price and quantity (which includes the number of visits to health care providers and the intensity of those visits). In terms of quantity, OECD data indicate that the United States has far fewer doctor visits per person compared with the OECD average; for hospitalizations, the United States ranks well below the OECD and is roughly comparable in terms of length of hospital stays. The intensity of service delivery is a different story: the United States uses more of the newest medical technologies and performs several invasive procedures (such as coronary bypasses and angioplasties) more frequently than the average OECD country. In terms of price, the OECD has stated that there is no doubt that U.S. prices for medical care commodities and services are significantly higher than in other countries and serve as a key determinant of higher overall spending. What does the United States get for the money it spends? Said slightly differently, does the United States get corresponding value from the money it spends on health care? The available data often do not provide clear answers. For example, among OECD countries in 2004, the United States had shorter-than-average life expectancy and higher-than-average mortality rates. Does this mean that the U.S. system is inefficient in light of how much is spent on health care? Or does this reflect the greater prevalence of certain diseases in the United States (the United States has the highest incidence of cancer and AIDS in the OECD) and less healthy lifestyles (the United States has the highest obesity rates in the OECD)? These are some of the issues that confound international comparisons. However, research comparing the quality of care has not found the United States to be superior overall. Nor does the U.S. population have substantially better access to health care resources, even putting aside the issue of the uninsured. Although the United States does not have long wait times for non-emergency surgeries, unlike some OECD countries, Americans found it more difficult to make same-day doctor’s appointments when sick and had the most difficulty getting care on nights and weekends. They were also most likely to delay or forgo treatment because of cost. The OECD data and other research provide some insight as to why health care spending is higher in the United States than in other countries, although many difficult research issues remain. This report presents some of the available data and research and concludes with a summary of study findings

Participation : young spice

A brilliant companion to the critically acclaimed 'Spice it Up'. Fun participation activities for the under 11's

Secure and Verifiable Electronic Voting in Practice: the use of vVote in the Victorian State Election

The November 2014 Australian State of Victoria election was the first statutory political election worldwide at State level which deployed an end-to-end verifiable electronic voting system in polling places. This was the first time blind voters have been able to cast a fully secret ballot in a verifiable way, and the first time a verifiable voting system has been used to collect remote votes in a political election. The code is open source, and the output from the election is verifiable. The system took 1121 votes from these particular groups, an increase on 2010 and with fewer polling places

Good places for ageing in place : development of objective built environment measures for investigating links with older people's wellbeing

Background: There is renewed interest in the role of the built environment in public health. Relatively little research to date investigates its impact on healthy ageing. Ageing in place has been adopted as a key strategy for coping with the challenges of longevity. What is needed is a better understanding of how individual characteristics of older people’s residential environments (from front door to wider neighbourhood) contribute to their wellbeing, in order to provide the basis for evidence-based housing/urban design and development of interventions. This research aimed to develop a tool to objectively measure a large range of built environment characteristics, as the basis for a preliminary study of potential relationships with a number of ‘place-related’ functional, emotional and social wellbeing constructs. Methods: Through a review of urban design literature, design documents, and existing measures, a new tool, the NeDeCC (Neighbourhood Design Characteristics Checklist) was developed. It was piloted, refined, and its reliability validated through inter-rater tests. A range of place-related wellbeing constructs were identified and measured through interviews with 200 older people living in a wide variety of rural-urban environments and different types of housing in England. The NeDeCC was used to measure the residential environment of each participant, and significant bivariate relationships with wellbeing variables were identified. Results: The NeDeCC was found to have convincing face and construct validity and good inter-rater and test/ retest reliability, though it would benefit from use of digital data sources such as Google Earth to eliminate the need for on-site survey. The significant relationships found in the study suggest that there may be characteristics of residential environments of potential relevance for older people’s lives that have been overlooked in research to date, and that it may be worthwhile to question some of the assumptions about where and how older people want to live (e.g. villages seem to be positive). They also point to the importance of considering non-linear relationships. Conclusions: The NeDeCC provides the basis for generation of evidence-based design guidance if it is used in prospective controlled studies or ‘natural experiments’ in the future. Ultimately, this will facilitate the creation of better places for ageing in place

3+2 + X: what is the most useful depolarization input for retrieving microphysical properties of non-spherical particles from lidar measurements using the spheroid model of Dubovik et al. (2006)?

The typical multiwavelength aerosol lidar data set for inversion of optical to microphysical parameters is composed of three backscatter coefficients (β) at 355, 532, and 1064 nm and two extinction coefficients (α) at 355 and 532 nm. This data combination is referred to as a 3β+2α or 3+2 data set. This set of data is sufficient for retrieving some important microphysical particle parameters if the particles have spherical shape. Here, we investigate the effect of including the particle linear depolarization ratio (δ) as a third input parameter for the inversion of lidar data. The inversion algorithm is generally not used if measurements show values of δ that exceed 0.10 at 532 nm, i.e. in the presence of non-spherical particles such as desert dust, volcanic ash, and, under special circumstances, biomass-burning smoke. We use experimental data collected with instruments that are capable of measuring δ at all three lidar wavelengths with an inversion routine that applies the spheroidal light-scattering model of Dubovik et al. (2006) with a fixed axis-ratio distribution to replicate scattering properties of non-spherical particles. The inversion gives the fraction of spheroids required to replicate the optical data as an additional output parameter. This is the first systematic test of the effect of using all theoretically possible combinations of δ taken at 355, 532, and 1064 nm as input in the lidar data inversion. We find that depolarization information of at least one wavelength already provides useful information for the inversion of optical data that have been collected in the presence of non-spherical mineral dust particles. However, any choice of δλ will give lower values of the single-scattering albedo than the traditional 3+2 data set. We find that input data sets that include δ355 give a spheroid fraction that closely resembles the dust ratio we obtain from using β532 and δ532 in a methodology applied in aerosol-type separation. The use of δ355 in data sets of two or three δλ reduces the spheroid fraction that is retrieved when using δ532 and δ1064. Use of the latter two parameters without accounting for δ355 generally leads to high spheroid fractions that we consider not trustworthy. The use of three δλ instead of two δλ, including the constraint that one of these is measured at 355 nm does not provide any advantage over using 3+2+δ355 for the observations with varying contributions of mineral dust considered here. However, additional measurements at wavelengths different from 355 nm would be desirable for application to a wider range of aerosol scenarios that may include non-spherical smoke particles, which can have values of δ355 that are indistinguishable from those found for mineral dust. We therefore conclude that – depending on measurement capability – the future standard input for inversion of lidar data taken in the presence of mineral dust particles and using the spheroid model of Dubovik et al. (2006) might be 3+2+δ355 or 3+2+δ355+δ532.Peer reviewe

Shifting to Data Savvy: The Future of Data Science In Libraries

The Data Science in Libraries Project is funded by the Institute for Museum and Library Services (IMLS) and led by Matt Burton and Liz Lyon, School of Computing & Information, University of Pittsburgh; Chris Erdmann, North Carolina State University; and Bonnie Tijerina, Data & Society. The project explores the challenges associated with implementing data science within diverse library environments by examining two specific perspectives framed as ‘the skills gap,’ i.e. where librarians are perceived to lack the technical skills to be effective in a data-rich research environment; and ‘the management gap,’ i.e. the ability of library managers to understand and value the benefits of in-house data science skills and to provide organizational and managerial support. This report primarily presents a synthesis of the discussions, findings, and reflections from an international, two-day workshop held in May 2017 in Pittsburgh, where community members participated in a program with speakers, group discussions, and activities to drill down into the challenges of successfully implementing data science in libraries. Participants came from funding organizations, academic and public libraries, nonprofits, and commercial organizations with most of the discussions focusing on academic libraries and library schools

Potential Vorticity Evolution of a Protoplanetary Disk with An Embedded Protoplanet

We present two-dimensional inviscid hydrodynamic simulations of a protoplanetary disk with an embedded planet, emphasizing the evolution of potential vorticity (the ratio of vorticity to density) and its dependence on numerical resolutions. By analyzing the structure of spiral shocks made by the planet, we show that progressive changes of the potential vorticity caused by spiral shocks ultimately lead to the excitation of a secondary instability. We also demonstrate that very high numerical resolution is required to both follow the potential vorticity changes and identify the location where the secondary instability is first excited. Low-resolution results are shown to give the wrong location. We establish the robustness of a secondary instability and its impact on the torque onto the planet. After the saturation of the instability, the disk shows large-scale non-axisymmetry, causing the torque on the planet to oscillate with large amplitude. The impact of the oscillating torque on the protoplanet's migration remains to be investigated.Comment: 17 pages total with 9 figures (Fig.4,5,9 are in .jpg), accepted to Ap

Capabilities for advanced services: A multi-actor perspective

This paper was published in the journal Industrial Marketing Management and the definitive published version is available at http://dx.doi.org/10.1016/j.indmarman.2016.04.015.Servitization involves manufacturers developing service offerings to grow revenue and profit. Advanced services, in particular, can facilitate a more service-focused organization and impact customers' business processes significantly. However, approaches to servitization are often discussed solely from the manufacturer's perspective; overlooking the role of other network actors. Adopting a multi-actor perspective, this study investigates manufacturer, intermediary and customer perspectives to identify complementary and competing capabilities within a manufacturer's downstream network, required for advanced services. Interviews were conducted with 24 senior executives in 19 UK-based manufacturers, intermediaries and customers across multiple sectors. The study identified six key business activities, within which advanced services capabilities were grouped. The unique and critical capabilities for advanced services for each actor were identified as follows: manufacturers; the need to balance product and service innovation, developing customer-focused through-life service methodologies and having distinct, yet synergistic product and service cultures; intermediaries, the coordination and integration of third party products/services; customers, co-creating innovation and having processes supporting service outsourcing. The study is unique in highlighting the distinct roles of different actors in the provision of advanced services and shows that they can only be developed and delivered by the combination of complex interconnected capabilities found within a network