946 research outputs found
Risk-sharing schemes worldwide: a landscape analysis of health outcomes-based reimbursement agreements
Social Justice and Rationing Social Services
This paper discusses the ethical implications of different mechanisms used by social agencies to ration scarce social services. Mechanisms such as queing, creaming, and triage are discussed from the perspective of two theories of social justice; i.e., John S. Mill and John Rawls. The purpose of the paper is to encourage more explicit examination of the assumptions that underlie the distribution of social services. It is the authors\u27 contention that the present decision making process is almost entirely based on intuition, political expedience, and tradition, and that systematic ethical analysis would give stronger justification to rationing decisions
Merging Ahead, Increase Speed: A Pilot of Funder-Driven Nonprofit Restructuring
Nonprofit agencies face increasing competition for scarce funding resources. Many agencies are considering ways to restructure themselves, often via mergers and acquisitions, as a way to become more effective and competitive. This case study examines a pilot initiative in Cleveland, Ohio, in which philanthropic funders invited and supported nonprofits in the pursuit of significant restructuring efforts. Health and human service nonprofits were recruited into a three-phase facilitated pilot that assisted the agency executive directors and boards in determining what type of restructuring was feasible and desirable. Overall, 75 nonprofits participated in some part of the pilot, 17 of which formally explored a restructuring opportunity within the pilot year, and eight of which ultimately consolidated. The study highlights key learnings from the initiative and the implications for the nonprofit sector in the promotion of restructuring discussions
Taking it to Scale: Evaluating the Scope and Reach of a Community-Wide Initiative on Early Childhood
In implementing broad community initiatives, the ability to assess the delivery of services is a distinct challenge. Yet, understanding both the magnitude and cross-usage of services by target populations is often a precursor to effective program evaluation, program improvement and additional program planning. This research examines the extent to which a comprehensive early childhood initiative successfully reached young children and their families in a large urban county. By linking birth records and administrative datasets at the level of the individual child, the study tracks the experiences of children in respect to engagement in program services and their receipt of public benefits. The study shows both the rapid growth in programs and the reach of the program elements to the majority of newborns in the target county after 5.5 years. The research highlights the challenges of effectively using individual-level data from a variety of sources for the purposes of documenting program receipt by participants
Getting Ready for School: Piloting Universal Prekindergarten in an Urban County
Investments in high-quality early care and education have been shown to reap societal benefits across the lives of the children served. A key intervention point is in the lives of 3- to 5-year olds during the period prior to entering kindergarten. Many jurisdictions have developed broad-based prekindergarten initiatives. This study reports on a pilot universal prekindergarten program in 24 sites in the Cleveland, Ohio area. Child assessment data were collected on 204 children from early care classrooms for 3- to 5-year olds across 3 time points by trained observers using 2 standardized instruments. Changes in achievement scores were shown to be significantly predicted by race, parental education level, and whether the family spoke English as a second language, with largest gains shown among children who were most behind at baseline. The findings serve to illuminate the developmental trajectory of children before kindergarten and how data can be used to inform practice and policy
Weak lensing minima and peaks: Cosmological constraints and the impact of baryons
We present a novel statistic to extract cosmological information in weak
lensing data: the lensing minima. We also investigate the effect of baryons on
the cosmological constraints from peak and minimum counts. Using the
\texttt{MassiveNuS} simulations, we find that lensing minima are sensitive to
non-Gaussian cosmological information and are complementary to the lensing
power spectrum and peak counts. For an LSST-like survey, we obtain
credible intervals from a combination of lensing minima and peaks that are
significantly stronger than from the power spectrum alone, by , ,
and for the neutrino mass sum , matter density ,
and amplitude of fluctuation , respectively. We explore the effect of
baryonic processes on lensing minima and peaks using the hydrodynamical
simulations \texttt{BAHAMAS} and \texttt{Osato15}. We find that ignoring
baryonic effects would lead to strong () biases in inferences
from peak counts, but negligible () for minimum counts,
suggesting lensing minima are a potentially more robust tool against baryonic
effects. Finally, we demonstrate that the biases can in principle be mitigated
without significantly degrading cosmological constraints when we model and
marginalize the baryonic effects.UK Science and Technology Facilities Council (grant number ST/N000927/1)
Covariant transverse-traceless projection for secondary gravitational waves
Second-order tensor modes induced by nonlinear gravity are a key component of
the cosmological background of gravitational waves. A detection of this
background would allow us to probe the primordial power spectrum at otherwise
inaccessible scales. Usually, the energy density of these gravitational waves
is studied within perturbation theory in a particular gauge -- a connection
between our physical spacetime and a fictitious background. It is a widely
recognized issue that the second-order, scalar-induced gravitational waves are
gauge dependent. This issue arises because they are not well-defined as tensors
in the physical spacetime at second-order and are thus unphysical. In this
paper, we propose the covariant transverse-traceless projection of the
extrinsic curvature to study cosmological gravitational waves on a spatial
hypersurface. We define a new energy density which is based purely on spacetime
tensors, independent of perturbation theory, and thus is gauge invariant by
definition. We show that, in the context of second-order perturbation theory,
this new energy density contains only propagating modes in the constant-time
hypersurface in the Newtonian gauge. We further show that we can recover the
same gravitational waves after a transformation to the synchronous gauge, so
long as we correctly identify the Newtonian hypersurface.Comment: 14 pages, 2 figure, major revisio
Space to Learn and Grow: Assessing the Capacity of a Regional Early Care and Education System
As communities across the United States work to meet the early care and education needs of young children, more research is needed to inform decision making at many levels. One key dimension of this is having clarity about the relative availability of care in light of demographic trends and geographic dispersion. The present study demonstrates a method to examine the capacity of early care programs to serve the children in a large urban county. The study takes stock of the existing early care system by comparing where the child care slots are and where the demand is—all at the neighborhood level. The existing capacity to meet the needs of 3–5 year olds could provide slots for approximately 70% of all children, though there are spatial imbalances in the location of supply and demand. The study illustrates the effective use of administrative and Census-based data to inform policy planning for children and identifies several key implications for this type of effort
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