9,056 research outputs found
The profitability and risk effects of allowing bank holding companies to merge with other financial firms: a simulation study
Bank mergers ; Bank holding companies ; Nonbank activities
Investigating the banking consolidation trend
This paper examines whether the U.S. banking industry's recent consolidation trend--toward fewer and bigger firms--is a natural result of market forces. The paper finds that it is not: The evidence does not support the popular claims that large banking firms are more efficient and less risky than smaller firms or the notion that the industry is consolidating in order to eliminate excess capacity. The paper suggests, instead, that public policies are encouraging banks to merge, although it acknowledges that other forces may be at work as well.Bank mergers
Managing the Regulatory State: The Experience of the Bush Administration
This Article traces the history of Presidential management of the regulatory state up to the administration of President George W. Bush. It focuses on the latter\u27s implementation of smarter regulation, an approach to regulation based on unfunded mandates on the private sector implemented through the Office of Management and Budget, an organization within the Executive Office of the President. It finds cost-benefit analysis an essential, yet often neglected, tool for implementing efficient and effective regulations. It concludes the policies promoted under President Bush\u27s OMB have effectively cut costs by streamlining the rule-making process and discouraging adopting new federal rules, but cautions there is still a sea of overlapping regulations and conflict over turf among agencies causing the administrative state to steadily rise in cost
Improving responses to depression and related disorders: evaluation of a innovative, general, mental health care workers training program
<p>Abstract</p> <p>Background</p> <p>Australian General Practitioners have been beneficiaries of extensive training in mental health care delivery over the last few years but less so other workers who support those with mental illness. Training is needed as it is widely recognised that the most effective interventions to prevent and treat mental disorders are often not readily available. The Mental Health Aptitudes into Practice (MAP) training package is a broad, innovative, interdisciplinary, general mental health training aimed at improving responses to individuals with depression and related disorders. The modular structure of this training program meant that such training could be targeted at those with varied backgrounds. Two hundred and seventy one days of free MAP training was delivered across Victoria in 2004/2005. The evaluation reported here assessed whether changes occurred in the trainees' confidence, mental health literacy, attitudes towards effective treatments, mental health knowledge and skills and community mental health ideology following training.</p> <p>Methods</p> <p>These elements were assessed using pen and paper tests prior, immediately following, 6 months after and then 12 months after the training. Trainees' confidence, mental health literacy and social distance were measured using scales that have been used in evaluations of Mental Health First Aid Training. Community mental health ideology was measured using a sub-scale of the Community Attitudes to the Mentally Ill (CAMI) scale. The trainees' knowledge and skills were accessed using instrumentation specifically designed for this evaluation.</p> <p>Results</p> <p>Following training, participants had more confidence in their ability to work with those who have mental health issues and less desire for social distance from them. Participants' knowledge and skills in relation to the treatment of mental disorders increased. These changes were observed immediately after training. The limited existing evidence suggests these changes were sustained six and twelve months later.</p> <p>Conclusions</p> <p>MAP training can be used to develop the capacity and capabilities of mental health workers.</p
<i>Rehabilitation doxa</i> and practitioner judgment. An analysis of symbolic violence on health care provision in the Scottish prison system
This paper presents an analysis of the symbolic conditions which govern health care provision in the Scottish prison system. The paper considers the wider context of Scottish prisons, where health care provision follows a similar structure both in juvenile and adult prisons. Our intention is to provoke a debate about the doxa (Bourdieu, 1977), which underlies decision making in respect of health care in prison, in a political environment where pragmatism, allied to the ‘pathologisation’ of social policies, health and criminal justice has been a hegemonic force.<br/
Disease activity and cognition in rheumatoid arthritis : an open label pilot study
Acknowledgements This work was supported in part by NIHR Newcastle Biomedical Research Centre. Funding for this study was provided by Abbott Laboratories. Abbott Laboratories were not involved in study design; in the collection, analysis and interpretation of data; or in the writing of the report.Peer reviewedPublisher PD
Gaining Compliance and Losing Weight: The Role Of the Service Provider In Health Care Services
This research provides and empirically tests a conceptualization of health care services in which customer compliance outside of the service organization is necessary for successful health outcomes. Using data from service providers and customers in a weight-loss clinic, the authors examine the provider\u27s role in gaining customer compliance. They find that provider expertise and attitudinal homophily play a role in bringing about customer role clarity, ability, and motivation. This study demonstrates that compliance leads to goal attainment, which results in satisfaction. More important, compliance also leads to satisfaction directly; consumers who comply with program requirements have greater satisfaction with the program
A Presynaptic Kainate Receptor Is Involved in Regulating the Dynamic Properties of Thalamocortical Synapses during Development
AbstractPrevious studies have shown that pharmacological activation of presynaptic kainate receptors at glutamatergic synapses facilitates or depresses transmission in a dose-dependent manner. However, the only synaptically activated kainate autoreceptor described to date is facilitatory. Here, we describe a kainate autoreceptor that depresses synaptic transmission. This autoreceptor is present at developing thalamocortical synapses in the barrel cortex, specifically regulates transmission at frequencies corresponding to those observed in vivo during whisker activation, and is developmentally down regulated during the first postnatal week. This receptor may, therefore, limit the transfer of high-frequency activity to the developing cortex, the loss of which mechanism may be important for the maturation of sensory processing
Updating the evidence for the role of corticosteroids in severe sepsis and septic shock: a Bayesian meta-analytic perspective
Introduction: Current low (stress) dose corticosteroid regimens may have therapeutic advantage in severe sepsis and septic shock despite conflicting results from two landmark randomised controlled trials (RCT). We systematically reviewed the efficacy of corticosteroid therapy in severe sepsis and septic shock. Methods: RCTs were identified (1950-September 2008) by multiple data-base electronic search (MEDLINE via OVID, OVID PreMedline, OVID Embase, Cochrane Central Register of Controlled trials, Cochrane database of systematic reviews, Health Technology Assessment Database and Database of Abstracts of Reviews of Effects) and hand search of references, reviews and scientific society proceedings. Three investigators independently assessed trial inclusion and data extraction into standardised forms; differences resolved by consensus. Results:Corticosteroid efficacy, compared with control, for hospital-mortality, proportion of patients experiencing shock-resolution, and infective and non-infective complications was assessed using Bayesian random-effects models; expressed as odds ratio (OR, (95% credible-interval)). Bayesian outcome probabilities were calculated as the probability (P) that OR ≥1. Fourteen RCTs were identified. High-dose (>1000 mg hydrocortisone (equivalent) per day) corticosteroid trials were associated with a null (n = 5; OR 0.91(0.31-1.25)) or higher (n = 4, OR 1.46(0.73-2.16), outlier excluded) mortality probability (P = 42.0% and 89.3%, respectively). Low-dose trials (<1000 mg hydrocortisone per day) were associated with a lower (n = 9, OR 0.80(0.40-1.39); n = 8 OR 0.71(0.37-1.10), outlier excluded) mortality probability (20.4% and 5.8%, respectively). OR for shock-resolution was increased in the low dose trials (n = 7; OR 1.20(1.07-4.55); P = 98.2%). Patient responsiveness to corticotrophin stimulation was non-determinant. A high probability of risk-related treatment efficacy (decrease in log-odds mortality with increased control arm risk) was identified by metaregression in the low dose trials (n = 9, slope coefficient -0.49(-1.14, 0.27); P = 92.2%). Odds of complications were not increased with corticosteroids. Conclusions: Although a null effect for mortality treatment efficacy of low dose corticosteroid therapy in severe sepsis and septic shock was not excluded, there remained a high probability of treatment efficacy, more so with outlier exclusion. Similarly, although a null effect was not excluded, advantageous effects of low dose steroids had a high probability of dependence upon patient underlying risk. Low dose steroid efficacy was not demonstrated in corticotrophin non-responders. Further large-scale trials appear mandated.15 page(s
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