Health Care Expenditures in OECD Countries: A Panel Unit Root and Cointegration Analysis

This paper examines the linkationship between health care expenditures and gdp for 21 oecd countries using panel cointegration techniques. the analysis accounts for the fact that health care expenditures are not solely driven by income, but also by medical progress, where different measures are used. in the extended models, cointegration can be established. the income elasticity is not different from unity, implying that health care is not a luxury good. this finding is robust for alternative proxies of medical progress, and various estimators of the cointegration vector. in addition, cointegration can be detected even between nonstationary common factors.health care expenditures; medical progress, panel cointegration, common factors

Reinforcement Practicality for Middle School Students: A Meta-Analysis

The need for evolving support interventions that can help students in a wide range of settings is an ongoing requirement for middle schools today. Token reinforcement, which is a form of extrinsic motivation and incentivization, is studied within this meta-analysis to determine if significant treatment effects exist overall and if there are studies that show more gains than others. Most studies report significant positive gains individually, but the statistical significance is lost when the studies are reviewed as a whole. Variables such as sample size requirements, treatment effect variation, and session time all influence treatment effect size. Reinforcement has been shown to be a viable strategy for differentiation, but the area of standardization has yet to be adequately addressed within past and present research. Some effect size traits reported from the literature are supported within this meta-analysis, but the sampling, analysis, and interpretation protocols exhibited by certain studies make it difficult to remove bias and confounding within reinforcement studies. Further research avenues and additional considerations are discussed

How to keep drivers engaged while supervising driving automation? A literature survey and categorization of six solution areas

This work aimed to organise recommendations for keeping people engaged during human supervision of driving automation, encouraging a safe and acceptable introduction of automated driving systems. First, heuristic knowledge of human factors, ergonomics, and psychological theory was used to propose solution areas to human supervisory control problems of sustained attention. Driving and non-driving research examples were drawn to substantiate the solution areas. Automotive manufacturers might (1) avoid this supervisory role altogether, (2) reduce it in objective ways or (3) alter its subjective experiences, (4) utilize conditioning learning principles such as with gamification and/or selection/training techniques, (5) support internal driver cognitive processes and mental models and/or (6) leverage externally situated information regarding relations between the driver, the driving task, and the driving environment. Second, a cross-domain literature survey of influential human-automation interaction research was conducted for how to keep engagement/attention in supervisory control. The solution areas (via numeric theme codes) were found to be reliably applied from independent rater categorisations of research recommendations. Areas (5) and (6) were addressed by around 70% or more of the studies, areas (2) and (4) in around 50% of the studies, and areas (3) and (1) in less than around 20% and 5%, respectively. The present contribution offers a guiding organisational framework towards improving human attention while supervising driving automation.submittedVersio

Early right ventricular systolic dysfunction in patients with systemic sclerosis without pulmonary hypertension: a Doppler Tissue and Speckle Tracking echocardiography study

<p>Abstract</p> <p>Background</p> <p>Isovolumetric acceleration (IVA) is a novel tissue Doppler parameter for the assessment of systolic function. The aim of this study was to evaluate IVA as an early parameter for the detection of right ventricular (RV) systolic dysfunction in patients with systemic sclerosis (SSc) without pulmonary hypertension.</p> <p>Methods</p> <p>22 patients and 22 gender- and age-matched healthy subjects underwent standard echocardiography with tissue Doppler imaging (TDI) and speckle tracking strain to assess RV function.</p> <p>Results</p> <p>Tricuspid annular plane systolic excursion (TAPSE) (23.2 ± 4.1 mm vs. 26.5 ± 2.9 mm, p < 0.006), peak myocardial systolic velocity (Sm) (11.6 ± 2.3 cm/s vs. 13.9 ± 2.7 cm/s, p = 0.005), isovolumetric contraction velocity (IVV) (10.3 ± 3 cm/s vs. 14.8 ± 3 cm/s, p < 0.001) and IVA (2.3 ± 0.4 m/s²vs. 4.1 ± 0.8 m/s², p < 0.001) were significant lower in the patient group. IVA was the best parameter to predict early systolic dysfunction with an area under the curve of 0.988.</p> <p>Conclusion</p> <p>IVA is a useful tool with high-predictive power to detect early right ventricular systolic impairment in patients with SSc and without pulmonary hypertension.</p

Successful reduction of intraventricular asynchrony is associated with superior response to cardiac resynchronization therapy

<p>Abstract</p> <p>Background</p> <p>Cardiac resynchronization therapy (CRT) is generally associated with a low to moderate increase of the left ventricular ejection fraction (LVEF). In some patients, however, LVEF improves remarkably and reaches near-normal values. The aim of the present study was to further characterize these so called 'super-responders' with a special focus on the extent of intra- and interventricular asynchrony before and after device implantation compared to average responders.</p> <p>Methods</p> <p>37 consecutive patients who underwent CRT device implantation according to current guidelines were included in the study. Patients were examined by echocardiography before, one day after and six months after device implantation. Pre-defined criterion for superior response to CRT was an LVEF increase > 15% after six months.</p> <p>Results</p> <p>At follow-up, eight patients (21.6%) were identified as super-responders. There were no significant differences regarding age, gender, prevalence of ischemic heart disease and LVEF between average and super-responders at baseline. After six months, LVEF had significantly increased from 26.7% ± 5.7% to 33.1% ± 7.9% (<it>p </it>< 0.001) in average and from 24.0% ± 6.7% to 50.3% ± 7.4% (<it>p </it>< 0.001) in super-responders. Both groups showed a significant reduction of QRS duration as well as LV end-diastolic and -systolic volumes under CRT. At baseline, the interventricular mechanical delay (IVMD) was 53.7 ± 20.9 ms in average and 56.9 ± 22.4 ms in super-responders - representing a similar extent of interventricular asynchrony in both groups (<it>p </it>= 0.713). CRT significantly reduced the IVMD to 20.3 ± 15.7 (<it>p </it>< 0.001) in average and to 19.8 ± 15.9 ms (<it>p </it>= 0.013) in super-responders with no difference between both groups (<it>p </it>= 0.858). As a marker for intraventricular asynchrony, we assessed the longest intraventricular delay between six basal LV segments. At baseline, there was no difference between average (86.2 ± 30.5 ms) and super-responders (78.8 ± 23.6 ms, <it>p </it>= 0.528). CRT significantly reduced the longest intraventricular delay in both groups - with a significant difference between average (66.2 ± 36.2 ms) and super-responders (32.5 ± 18.3 ms, <it>p </it>= 0.022). Multivariate logistic regression analysis identified the longest intraventricular delay one day after device implantation as an independent predictor of superior response to CRT (<it>p </it>= 0.038).</p> <p>Conclusions</p> <p>A significant reduction of the longest intraventricular delay correlates with superior response to CRT.</p

Implementation of seven echocardiographic parameters of myocardial asynchrony to improve the long-term response rate of cardiac resynchronization therapy (CRT)

<p>Abstract</p> <p>Background</p> <p>Cardiac resynchronization Therapy (CRT) is an effective therapy for chronic heart failure with beneficial hemodynamic effects leading to a reduction of morbidity and mortality. The responder rates, however, are low. There are various and contentious echocardiographic parameters of myocardial asynchrony. Patient selection by echocardiographic assessment of asynchrony is thought to improve responder rates.</p> <p>Methods</p> <p>In this small single-center pilot-study, seven established parameters of myocardial asynchrony were used to select patients for CRT: (1) interventricular electromechanical delay (IMD, cut-off ≥ 40 ms), (2) Septal-to-posterior wall motion delay (SPWMD, ≥ 130 ms), (3) maximal difference in time-to-peak velocities between any two of twelve LV segments (Ts-12 ≥ 104 ms), (4) standard deviation of time to peak myocardial velocities (Ts-12-SD, ≥ 34.4 ms), (5) difference between the septal and basal time-to-peak velocity (TDId, ≥ 60 ms), (6) left ventricular electromechanical delay (LVEMD, > 140 ms) and (7) delayed longitudinal contraction (DLC, > 2 segments).</p> <p>16 chronic heart failure patients (NYHA III–IV, LVEF < 0.35, QRS ≥ 120 ms) at least two out of seven parameters of myocardial asynchrony received cardiac resynchronization therapy (CRT-ICD). Follow-up echo examination was after 6 months. The control group was a historic group of CRT patients (n = 38) who had not been screened for echocardiographic signs of myocardial asynchrony prior to device implantation.</p> <p>Results</p> <p>Based on reverse remodeling (relative reduction of LVESV > 15%, relative increase of LVEF > 25%), the responder rate to CRT was 81.2% in patients selected for CRT according to our protocol as compared to 47.4% in the control group (p = 0.04). At baseline, there were on average 4.1 ± 1.6 positive parameters of asynchrony (follow-up: 3.7 [± 1.6] parameters positive, p = 0.52). Only the LVEMD decreased significantly after CRT (p = 0.027). The remaining parameters showed a non-significant trend towards reduction of myocardial asynchrony.</p> <p>Conclusion</p> <p>The implementation of different markers of asynchrony in the selection process for CRT improves the hemodynamic response rate to CRT.</p

The Race to Leadership Effectiveness: A Study on School Organization for High and Low Performing Georgia Schools

With the adoption of such initiatives as No Child Left Behind (NCLB), Common Core State Standards (CCSS), and the College and Career Readiness Performance Index (CCRPI), there is increasing pressure for students to meet and exceed performance expectations. This is easier said than done, especially given that not all organizational structures are helpful to student performance. A quantitative, correlational study was done to determine the relationship between school organization and school performance within Georgia schools. Subgroup comparisons between high and low performing schools were included in analyses. Results showed that high organizational effectiveness was associated with high student performance outcomes. High performing schools had significantly higher organizational effectiveness than low performing schools. The findings of this study help teachers, administrators, and policy makers determine essential organizational themes that help students succeed. The use of positive organizational characteristics is encouraged in order for students to have much better success moving forward

The long run relationship between private consumption and wealth : common and idiosyncratic effects

We investigate the long run relationship between private consump- tion, disposable income and wealth approximated by equity and house price indices for a panel of 15 industrialized countries. Consumption, income and wealth are cointegrated in their common components. The impact of house prices exceeds the effect arising from equity wealth. The long run vector is broadly in line with the life cycle permanent income hypothesis, if house prices are allowed to enter the relationship. At the idiosyncratic level, a long run equilibrium is detected between consumption and income, i.e. the wealth variable can be excluded. The income elasticity in the idiosyncratic relationship is significantly less than unity. Hence, the presence of wealth effects in consumption equations arises from the international integration of asset markets and points to the relevance of risk sharing activities of agents. Without sufficient opportunities, an increase in national saving rates would be expected, leading to a lower path of private consumption expenditures.info:eu-repo/semantics/publishedVersio