Disparities in Hospital Services Utilization Among Patients with Mental Health Issues: A Statewide Example Examining Insurance Status and Race Factors from 1999-2010

There exist many disconnects between the mental and general health care sectors. However, a goal of the Affordable Care Act (ACA) of 2010 is to change this by improving insurance access and the intersection of mental and general health care. As insurance status intersects with race, the present study examines how race, insurance status, and hospital mental health services utilization differ across groups within the state of New Jersey. The present study aims to determine trends in hospital mental health care utilization by insurance status and race from 1999 to 2010. The rate of self-pay for mental health disorders in the Black population was significantly higher than the rate for Whites and Asians during this period. However, though Asian mental health utilization increased the most over the 11-year period, the Asian population had the slowest growth in self-pay rates. ANOVA tests demonstrated significant differences in the rate of self-pay mental health cases between race groups (

AIOps for a Cloud Object Storage Service

With the growing reliance on the ubiquitous availability of IT systems and services, these systems become more global, scaled, and complex to operate. To maintain business viability, IT service providers must put in place reliable and cost efficient operations support. Artificial Intelligence for IT Operations (AIOps) is a promising technology for alleviating operational complexity of IT systems and services. AIOps platforms utilize big data, machine learning and other advanced analytics technologies to enhance IT operations with proactive actionable dynamic insight. In this paper we share our experience applying the AIOps approach to a production cloud object storage service to get actionable insights into system's behavior and health. We describe a real-life production cloud scale service and its operational data, present the AIOps platform we have created, and show how it has helped us resolving operational pain points.Comment: 5 page

Toward Better Management of Flood Losses: Flood Insurance in a Wetter World

Flood is the most frequent and costly of U.S. natural disasters with losses expected to increase due to climate change. The National Flood Insurance Program (NFIP) mandates flood insurance purchase for properties with federally backed mortgages in the 100-year floodplain. We propose that mandatory flood insurance purchase be extended to all property in the 500-year floodplain. Following flood events, payments would be directly provided for more properties that suffer flood loss, reducing federal disaster aid spending. The mandate could put more pressure on local governments to increase their Community Rating System score, such as through infrastructure investments and management practices that reduce flood risk. The expanded requirement would not address the inaccuracies of maps used to price flood insurance (and used by local governments to make long-term planning decisions) but may affect floodplain development by making more explicit the costs and risks of building and living in high-risk areas

Can Strategic Risk Management Contribute to Enterprise Risk Management? A Strategic Management Perspective

Within the discipline of enterprise risk management (ERM), strategic risk management (SRM) has become a subject of increasing interest to practitioners and academics. To our knowledge, the term “strategic risk management” first appeared in the management literature in 1985 and 1986 (Jammine, 1985; Figenbaum & Thomas, 1986) and in the academic finance literature in 1990 (Rawls and Smithson, 1990), although early usage of the term did not clearly relate to later conceptions. The phrase has been in use even longer than ERM (Bromiley, McShane, Nair, and Rustambekov, 2014). Even with this longevity, the meaning of the term remains unclear, with confusion increasing with the advent of ERM. For example, does SRM mean the management of a specific category of risks known as “strategic risks” (AICPCU, 2013) or does SRM mean strategic actions/responses taken to mitigate major uncertainties facing the enterprise? Can any type of risk potentially become a strategic risk, or are only certain types of risk strategic? Is SRM a separate type of risk management or a subset of ERM

Ketamine treatment for individuals with treatment-resistant depression: a longitudinal qualitative interview study of patient experiences

Background Ketamine has recently received considerable attention regarding its antidepressant and anti-suicidal effects. Trials have generally focused on short-term effects of single intravenous infusions. Research on patient experiences is lacking. Aims To investigate the experiences over time of individuals receiving ketamine treatment in a routine clinic, including impacts on mood and suicidality. Method Twelve fee-paying patients with treatment-resistant depression (6 females, 6 males, age 21-70 years; 11 reporting suicidality and six self-harm) who were assessed as eligible for ketamine treatment participated in up to three semi-structured interviews: before treatment started, a few weeks into treatment and two or more months later. Data were analysed thematically. Results Most participants hoped that ketamine would provide respite from their depression. All experienced improvement in mood following initial treatments, ranging from negligible to dramatic, and eight a reduction in suicidality. Improvements were transitory for most participants, although two experienced sustained consistent benefit and two had sustained but limited improvement. Some participants described hopelessness when treatment stopped working, paralleled by increased suicidal ideation for three. The transient nature and cost of treatment were problematic. Eleven participants experienced side-effects, which in two cases were significant. Suggestions for improving treatment included closer monitoring and adjunctive psychological therapy. Conclusions Ketamine treatment was generally experienced as effective in improving mood and reducing suicidal ideation in the short-term, but the lack of longer-term benefit was challenging for participants, as was treatment cost. Informed consent procedures should refer to the possibilities of relapse and of associated increased hopelessness and suicidality

Risk and System-of-Systems: Toward a Unified Concept

The scope of this paper is the survey of both fundamental and most recent publications in system-of-systems, business and insurance, as well as risk analysis, modeling, and management for the purpose of better describing the concept of risk in recognition of emergence and complexity which characterizes many systems within the concern of engineering and business managers. The ultimate goal is to provide engineering and business managers the necessary perspective on the concept of risk and in its management for the next generation of sustainable systems - including various descriptions of risk and discussion of the relevance of properties of system-of-systems to sustainable management of risks in engineered systems. The result shows that to address a truly sustainable management of risk, there has to be a change in paradigm from traditional description of risk to that of a more holistic perspective

A large National Institute for Health Research (NIHR) Biomedical Research Centre facilitates impactful cross-disciplinary and collaborative translational research publications and research collaboration networks: a bibliometric evaluation study

Background The evaluation of translational health research is important for various reasons such as the research impact assessment, research funding allocation, accountability, and strategic research policy formulation. The purpose of this study was to evaluate the research productivity, strength and diversity of research collaboration networks and impact of research supported by a large biomedical research centre in the United Kingdom (UK). Methods Bibliometric analysis of research publications by translational researchers affiliated with the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre (BRC) from April 2012 to March 2017. Results Analysis included 2377 translational research publications that were published during the second 5-year funding period of the NIHR Oxford BRC. Author details were available for 99.75% of the publications with DOIs (2359 of 2365 with DOIs), and the number of authors per publication was median 9 (mean  = 18.03, SD  = 3.63, maximum  = 2467 authors). Author lists also contained many consortia, groups, committees, and teams (n  = 165 in total), with 1238 additional contributors, where membership was reported. The BRC co-authorship i.e., research collaboration network for these publications involved 20,229 nodes (authors, of which 1606 nodes had Oxford affiliations), and approximately 4.3 million edges (authorship linkages). Articles with a valid DOIs (2365 of 2377, 99.5%) were collectively cited more than 155,000 times and the average Field Citation Ratio was median 6.75 (geometric mean  = 7.12) while the average Relative Citation Ratio was median 1.50 (geometric mean  = 1.83) for the analysed publications. Conclusions The NIHR Oxford BRC generated substantial translational research publications and facilitated a huge collaborative network of translational researchers working in complex structures and consortia, which shows success across the whole of this BRC funding period. Further research involving continued uptake of unique persistent identifiers and the tracking of other research outputs such as clinical innovations and patents would allow a more detailed understanding of large research enterprises such as NIHR BRCs in the UK