Markets or Monopolies? Considerations for Addressing Health Care Consolidation in California

Over the past three decades, markets for health insurers and providers have gone through waves of consolidation. As of 2018, 95% of metropolitan areas in the United States had highly concentrated hospital markets. Markets for health insurers are also highly concentrated. Between 2006 and 2014, the combined market share of the top four insurers climbed from 74% to 83%. The coronavirus pandemic appears to be fueling another round of consolidation — especially acquisition of providers by private equity firms.Markets or Monopolies? Considerations for Addressing Health Care Consolidation in California compiles the latest research and data on California's health care systems and shows that consolidation is not limited to any one system, market segment, or geographic region in the state: Most markets across California are highly concentrated. Hospital markets, in particular, are now approaching "monopoly levels" in many California counties. In addition, there is mounting evidence that mergers of health care companies are resulting in increased prices for health care services, with little or no improvement in quality for consumers.The report highlights several actions policymakers could consider, given significant consolidation. For example, California's attorney general has the authority to block transactions that transfer a "material amount of the assets" only for nonprofit health facilities. To increase scrutiny of provider mergers in California, policymakers could require all health care providers — not just nonprofit ones — to provide written notice to, and obtain the written consent of, the attorney general.  Policymakers could also expand the authority of state regulatory agencies to include "affordability standards" when they review health insurance plans for sale in California

Using Social Media to Generate and Collect Primary Data: The #ShowsWorkplaceCompassion Twitter Research Campaign

BACKGROUND: Compassion is a core value embedded in the concept of quality in healthcare. The need for compassion toward healthcare staff in the workplace, for their own health and well-being and also to enable staff to deliver compassionate care for patients, is increasingly understood. However, we do not currently know how healthcare staff understand and characterize compassion toward themselves as opposed to patients. OBJECTIVE: The aim of this study was to use social media for the generation and collection of primary data to gain understanding of the concept of workplace compassion. METHODS: Tweets that contained the hashtag #ShowsWorkplaceCompassion were collected from Twitter and analyzed. The study took place between April 21 and May 21, 2016. Participants were self-selecting users of the social media service Twitter. The study was promoted by a number of routes: the National Health Service (NHS) England website, the personal Twitter accounts of the research team, internal NHS England communications, and via social media sharing. Participants were asked to contribute their views about what activities, actions, policies, philosophies or approaches demonstrate workplace compassion in healthcare using the hashtag #ShowsWorkplaceCompassion. All tweets including the research hashtag #ShowsWorkplaceCompassion were extracted from Twitter and studied using content analysis. Data concerning the frequency, nature, origin, and location of Web-based engagement with the research campaign were collected using Bitly (Bitly, Inc, USA) and Symplur (Symplur LLC, USA) software. RESULTS: A total of 260 tweets were analyzed. Of the 251 statements within the tweets that were coded, 37.8% (95/251) of the statements concerned Leadership and Management aspects of workplace compassion, 29.5% (74/251) were grouped under the theme related to Values and Culture, 17.5% (44/251) of the statements related to Personalized Policies and Procedures that support workplace compassion, and 15.2% (38/251) of the statements concerned Activities and Actions that show workplace compassion. Content analysis showed that small acts of kindness, an embedded organizational culture of caring for one another, and recognition of the emotional and physical impact of healthcare work were the most frequently mentioned characteristics of workplace compassion in healthcare. CONCLUSIONS: This study presents a new and innovative research approach using Twitter. Although previous research has analyzed the nature and pattern of tweets retrospectively, this study used Twitter to both recruit participants and collect primary data

LFV and Dipole Moments in Models with A4 Flavour Symmetry

It is presented an analysis on lepton flavour violating transitions, leptonic magnetic dipole moments and electric dipole moments in a class of models characterized by the flavour symmetry A4 x Z3 x U(1)_FN, whose choice is motivated by the approximate Tri-Bimaximal mixing observed in neutrino oscillations. A low-energy effective Lagrangian is constructed, where these effects are dominated by dimension six operators, suppressed by the scale M of new physics. All the flavour breaking effects are universally described by the vacuum expectation values of a set of spurions. Two separate cases, a supersymmetric and a general one, are described. An upper limit on the reactor angle of a few percent is concluded.Comment: 10 pages, 1 figure. Adapted from a talk given at "DISCRETE'08: Symposium on Prospects in the Physics of Discrete Symmetries", December 11-16 2008, Valencia, Spai

Electron doping as a handle to increase the Curie temperature in ferrimagnetic Mn3Si2X6 (X=Se, Te)

Funding: L.Q. acknowledges the support of China Scholarship Council. P.B. and S.P. acknowledge financial support from the Italian Ministry for Research and Education through PRIN-2017 projects ‘Tuning and understanding Quantum phases in 2D materials—Quantum 2D’ (IT-MIUR Grant No. 2017Z8TS5B) and ’ToWards fErroElectricity in Two dimensions- TWEET’ (IT-MIUR Grant No. 2017YCTB59), respectively. P.K. and S.P. acknowledge support from the Royal Society through the International Exchange grant IEC\R2\222041. PK acknowledges support from The Leverhulme Trust via Grant No. RL-2016-006, and the UK Engineering and Physical Sciences Research Council via Grant No. EP/X015556/1.By analysing the results of ab initio simulations performed for Mn3Si2X6 (X=Se, Te), we first discuss the analogies and the differences in electronic and magnetic properties arising from the anion substitution, in terms of size, electronegativity, band widths of p electrons and spin-orbit coupling strengths. For example, through mean-field theory and simulations based on density functional theory, we demonstrate that magnetic frustration, known to be present in Mn3Si2Te6, also exists in Mn3Si2Se6 and leading to a ferrimagnetic ground state. Building on these results, we propose a strategy, electronic doping, to reduce the frustration and thus to increase the Curie temperature (TC). To this end, we first study the effect of electronic doping on the electronic structure and magnetic properties and discuss the differences in the two compounds, along with their causes. Secondly, we perform Monte Carlo simulations, considering from first to fifth nearest-neighbor magnetic interactions and single-ion anisotropy, and show that electron doping efficiently raises the TC.PostprintPeer reviewe

Diffuse versus square-well confining potentials in modelling AA@C60_{60} atoms

Attention: this version-$2$ of the manuscript differs from its previously uploaded version-$1$ (arXiv:1112.6158v1) and subsequently published in 2012 J. Phys. B \textbf{45} 105102 only by a removed typo in Eq.(2) of version-$1$; there was the erroneous factor "2" in both terms in the right-hand-side of the Eq.(2) of version-$1$. Now that the typo is removed, Eq.(2) is correct. A perceived advantage for the replacement of a discontinuous square-well pseudo-potential, which is often used by various researchers as an approximation to the actual C$_{60}$ cage potential in calculations of endohedral atoms $A$@C$_{60}$, by a more realistic diffuse potential is explored. The photoionization of endohedral H@C$_{60}$ and Xe@C$_{60}$ is chosen as the case study. The diffuse potential is modelled by a combination of two Woods-Saxon potentials. It is demonstrated that photoionization spectra of $A$@C$_{60}$ atoms are largely insensitive to the degree $\eta$ of diffuseness of the potential borders, in a reasonably broad range of $\eta$'s. Alternatively, these spectra are found to be insensitive to discontinuity of the square-well potential either. Both potentials result in practically identical calculated spectra. New numerical values for the set of square-well parameters, which lead to a better agreement between experimental and theoretical data for $A$@C$_{60}$ spectra, are recommended for future studies.Comment: 11 pages, 4 figure

LittleDarwin: a Feature-Rich and Extensible Mutation Testing Framework for Large and Complex Java Systems

Mutation testing is a well-studied method for increasing the quality of a test suite. We designed LittleDarwin as a mutation testing framework able to cope with large and complex Java software systems, while still being easily extensible with new experimental components. LittleDarwin addresses two existing problems in the domain of mutation testing: having a tool able to work within an industrial setting, and yet, be open to extension for cutting edge techniques provided by academia. LittleDarwin already offers higher-order mutation, null type mutants, mutant sampling, manual mutation, and mutant subsumption analysis. There is no tool today available with all these features that is able to work with typical industrial software systems.Comment: Pre-proceedings of the 7th IPM International Conference on Fundamentals of Software Engineerin

The double main sequence of Omega Centauri

Recent, high precision photometry of Omega Centauri, the biggest Galactic globular cluster, has been obtained with Hubble Space Telescope. The color magnitude diagram reveals an unexpected bifurcation of colors in the main sequence (MS). The newly found double MS, the multiple turnoffs and subgiant branches, and other sequences discovered in the past along the red giant branch of this cluster add up to a fascinating but frustrating puzzle. Among the possible explanations for the blue main sequence an anomalous overabundance of helium is suggested. The hypothesis will be tested with a set of FLAMES@VLT data we have recently obtained (ESO DDT program), and with forthcoming ACS@HST images.Comment: 4 pages, 2 figures, Mem.S.A.It., Milano, 19-23 April 2004, in pres

The floor in the interplanetary magnetic field: Estimation on the basis of relative duration of ICME observations in solar wind during 1976-2000

To measure the floor in interplanetary magnetic field and estimate the time- invariant open magnetic flux of Sun, it is necessary to know a part of magnetic field of Sun carried away by CMEs. In contrast with previous papers, we did not use global solar parameters: we identified different large-scale types of solar wind for 1976-2000 interval, obtained a fraction of interplanetary CMEs (ICMEs) and calculated magnitude of interplanetary magnetic field B averaged over 2 Carrington rotations. The floor of magnetic field is estimated as B value at solar cycle minimum when the ICMEs were not observed and it was calculated to be 4,65 \pm 6,0 nT. Obtained value is in a good agreement with previous results.Comment: 10 pages, 2 figures, submitted in GR