Patient-initiated switching between private and public inpatient hospitalisation in Western Australia 1980 – 2001: An analysis using linked data

BACKGROUND: The aim of the study was to identify any distinct behavioural patterns in switching between public and privately insured payment classifications between successive episodes of inpatient care within Western Australia between 1980 and 2001 using a novel 'couplet' method of analysing longitudinal data. METHODS: The WA Data Linkage System was used to extract all hospital morbidity records from 1980 to 2001. For each individual, episodes of hospitalisation were paired into couplets, which were classified according to the sequential combination of public and privately insured episodes. Behavioural patterns were analysed using the mean intra-couplet interval and proportion of discordant couplets in each year. RESULTS: Discordant couplets were consistently associated with the longest intra-couplet intervals (ratio to the average annual mean interval being 1.35), while the shortest intra-couplet intervals were associated with public concordant couplets (0.5). Overall, privately insured patients were more likely to switch payment classification at their next admission compared with public patients (the average rate of loss across all age groups being 0.55% and 2.16% respectively). The rate of loss from the privately insured payment classification was inversely associated with time between episodes (2.49% for intervals of 0 to 13 years and 0.83% for intervals of 14 to 21 years). In all age groups, the average rate of loss from the privately insured payment classification was greater between 1981 and 1990 compared with that between 1991 and 2001 (3.45% and 3.10% per year respectively). CONCLUSION: A small but statistically significant reduction in rate of switching away from PHI over the latter period of observation indicated that health care policies encouraging uptake of PHI implemented in the 1990s by the federal government had some of their intended impact on behaviour

Development of a health care policy characterisation model based on use of private health insurance

OBJECTIVE: The aim of this study was to develop a policy characterisation process based on measuring shifts in use of private health insurance (PHI) immediately following implementation of changes in federal health care policy. METHOD: Population-based hospital morbidity data from 1980 to 2001 were used to produce trend lines in the annual proportions of public, privately insured and privately uninsured hospital separations in age-stratified subgroups. A policy characterisation model was developed using visual and statistical assessment of the trend lines associated with changes in federal health care policy. RESULTS: Of eight changes in federal health care policy, two (introduction of Medicare and Lifetime Health Cover) were directly associated with major changes in the trend lines; however, minor changes in trends were associated with several of the other federal policies. Three types of policy effects were characterised by our model: direction change, magnitude change and inhibition. Results from our model suggest that a policy of Lifetime Health Cover, with a sanction for late adoption of PHI, was immediately successful in changing the private: public mix. The desired effect of the 30% rebate was immediate only in the oldest age group (70+ years), however, introduction of the lifetime health cover and limitations in the model restricted the ability to determine whether or if the rebate had a delayed effect at younger ages. CONCLUSION: An outcome-based policy characterisation model is useful in evaluating immediate effects of changes in health care policy

Automating the application of smart materials for protein crystallization

The fabrication and validation of the first semi-liquid nonprotein nucleating agent to be administered automatically to crystallization trials is reported. This research builds upon prior demonstration of the suitability of molecularly imprinted polymers (MIPs; known as 'smart materials') for inducing protein crystal growth. Modified MIPs of altered texture suitable for high-throughput trials are demonstrated to improve crystal quality and to increase the probability of success when screening for suitable crystallization conditions. The application of these materials is simple, time-efficient and will provide a potent tool for structural biologists embarking on crystallization trials. © 2015, IUCR. All rights reserved

Of Time, Renewal, and Scholarship: Volume 11 (2021) Wrapped

This editorial discusses the articles published and the activities undertaken by The Comics Grid: Journal of Comics Scholarship during 2021, and calls for research system-wide cultural changes and wider contextual awareness in order to make scholarly communication fairer and up to the challenges of our time

Spiral cracks in drying precipitates

We investigate the formation of spiral crack patterns during the desiccation of thin layers of precipitates in contact with a substrate. This symmetry-breaking fracturing mode is found to arise naturally not from torsion forces, but from a propagating stress front induced by the fold-up of the fragments. We model their formation mechanism using a coarse-grain model for fragmentation and successfully reproduce the spiral cracks. Fittings of experimental and simulation data show that the spirals are logarithmic, corresponding to constant deviation from a circular crack path. Theoretical aspects of the logarithmic spirals are discussed. In particular we show that this occurs generally when the crack speed is proportional to the propagating speed of stress front.Comment: 4 pages, 5 figures, RevTe

Can quantum fractal fluctuations be observed in an atom-optics kicked rotor experiment?

We investigate the parametric fluctuations in the quantum survival probability of an open version of the delta-kicked rotor model in the deep quantum regime. Spectral arguments [Guarneri I and Terraneo M 2001 Phys. Rev. E vol. 65 015203(R)] predict the existence of parametric fractal fluctuations owing to the strong dynamical localisation of the eigenstates of the kicked rotor. We discuss the possibility of observing such dynamically-induced fractality in the quantum survival probability as a function of the kicking period for the atom-optics realisation of the kicked rotor. The influence of the atoms' initial momentum distribution is studied as well as the dependence of the expected fractal dimension on finite-size effects of the experiment, such as finite detection windows and short measurement times. Our results show that clear signatures of fractality could be observed in experiments with cold atoms subjected to periodically flashed optical lattices, which offer an excellent control on interaction times and the initial atomic ensemble.Comment: 18 pp, 7 figs., 1 tabl

Arnol'd Tongues and Quantum Accelerator Modes

The stable periodic orbits of an area-preserving map on the 2-torus, which is formally a variant of the Standard Map, have been shown to explain the quantum accelerator modes that were discovered in experiments with laser-cooled atoms. We show that their parametric dependence exhibits Arnol'd-like tongues and perform a perturbative analysis of such structures. We thus explain the arithmetical organisation of the accelerator modes and discuss experimental implications thereof.Comment: 20 pages, 6 encapsulated postscript figure

Housing Affordability in a Resource Rich Economy: The Case of Kuwait

This paper seeks to test the impact of new policies introduced to the Kuwaiti housing market to improve affordability. In 2008, the Kuwaiti parliament introduced two policies: a tax on empty lands and the other on forbidding companies to own or develop residential lands or houses. We constructed the housing affordability index and the price-to-income multiplier to measure housing affordability performance. We used observations from 2004 until 2017. We found that affordability has worsened over time regardless of the new policies introduced in 2008. Housing in Kuwait became “severely unaffordable” (equivalent to London in the U.K., San Diego in U.S. and Toronto in Canada). Even with its unique condition, as a rich country, small population and availability of white land and other resources, the affordability worsened over time. Introducing new policies without solving the central issue of housing supply challenges seems not worth it. This paper is the first of its kind on the Kuwait housing market, and it provides a valuable foundation for future research on this market and similar markets in the region

Morphological Instabilities in a growing Yeast Colony: Experiment and Theory

We study the growth of colonies of the yeast Pichia membranaefaciens on agarose film. The growth conditions are controlled in a setup where nutrients are supplied through an agarose film suspended over a solution of nutrients. As the thickness of the agarose film is varied, the morphology of the front of the colony changes. The growth of the front is modeled by coupling it to a diffusive field of inhibitory metabolites. Qualitative agreement with experiments suggests that such a coupling is responsible for the observed instability of the front.Comment: RevTex, 4 pages and 3 figure