Have Changes in State Workers’ Compensation Programs Contributed to Rising Social Security Disability Insurance Receipt?

During the 1990s, real outlays on Social Security Disability Insurance (DI) benefits increased nearly 70 percent whereas real Workers’ Compensation (WC) cash benefit spending fell by 12 percent. There has been concern that this relationship between two of the nation’s largest social insurance programs may be due to individuals substituting towards DI as state WC policies tightened. We show this correlation between the national series does not hold within states, the level at which a causal relationship should operate. However, a causal relationship may still exist between the two programs despite a lack of correlation. We then test how regulatory changes in state WC program parameters impact WC outcomes (intended effect) and DI outcomes (unintended effect). We find no compelling evidence of WC tightening causing DI rolls to increase. We conclude it is unlikely that state WC changes were a meaningful factor in explaining the rise in DI

A computational pipeline for the diagnosis of CVID patients

Common variable immunodeficiency (CVID) is one of the most frequently diagnosed primary antibody deficiencies (PADs), a group of disorders characterized by a decrease in one or more immunoglobulin (sub) classes and/or impaired antibody responses caused by inborn defects in B cells in the absence of other major immune defects. CVID patients suffer from recurrent infections and disease-related, non-infectious, complications such as autoimmune manifestations, lymphoproliferation, and malignancies. A timely diagnosis is essential for optimal follow-up and treatment. However, CVID is by definition a diagnosis of exclusion, thereby covering a heterogeneous patient population and making it difficult to establish a definite diagnosis. To aid the diagnosis of CVID patients, and distinguish them from other PADs, we developed an automated machine learning pipeline which performs automated diagnosis based on flow cytometric immunophenotyping. Using this pipeline, we analyzed the immunophenotypic profile in a pediatric and adult cohort of 28 patients with CVID, 23 patients with idiopathic primary hypogammaglobulinemia, 21 patients with IgG subclass deficiency, six patients with isolated IgA deficiency, one patient with isolated IgM deficiency, and 100 unrelated healthy controls. Flow cytometry analysis is traditionally done by manual identification of the cell populations of interest. Yet, this approach has severe limitations including subjectivity of the manual gating and bias toward known populations. To overcome these limitations, we here propose an automated computational flow cytometry pipeline that successfully distinguishes CVID phenotypes from other PADs and healthy controls. Compared to the traditional, manual analysis, our pipeline is fully automated, performing automated quality control and data pre-processing, automated population identification (gating) and deriving features from these populations to build a machine learning classifier to distinguish CVID from other PADs and healthy controls. This results in a more reproducible flow cytometry analysis, and improves the diagnosis compared to manual analysis: our pipelines achieve on average a balanced accuracy score of 0.93 (+/- 0.07), whereas using the manually extracted populations, an averaged balanced accuracy score of 0.72 (+/- 0.23) is achieved

Digital editions of text:Surveying user requirements in the Digital Humanities

This article presents the findings of a web survey designed to better understand the expectations and use of digital editions of texts. The survey, modelled upon a detailed analysis of 242 projects, recorded 218 complete responses, shedding light on user requirements of digital editions. Specifically, the survey indicates that issues of data reuse, licensing, image availability, and comprehensive documentation are the most requested features of digital editions, although ones which seldom are provided. This analysis feeds into previous studies on good practice in building Digital Humanities resources and puts forward practical recommendations for both creators and funders of digital editions in an effort to promote a stronger consideration of user needs. This survey will be of interest to those who produce digital editions of texts, including developers and engineers, and will also be of interest to those who commission and fund these projects, such as universities, libraries, and archives, whose documentary collections are often showcased in digital editions

Opportunities for managing peak train travel demand: a Melbourne pilot study

Melbourne, like many large cities around the world, experiences significant peak congestion on its public transport network. Demand for services in peak times is a key driver of investment in new rolling stock and infrastructure. A way of delaying these significant investments is to better utilize current available resources in non-peak times, by spreading out peak demand over a wider time period.This study used an online survey methodology to investigate the propensity of peak period train passengers commuting for work on Melbourne‟s Pakenham line to shift out of peak travel times to access a better price, service frequency, stopping pattern and train conditions. The main methodology was two Discrete Choice Model exercises (one morning-peak and one afternoon-peak) which systematically varied time of travel, price and service attributes to model customer behaviour under various scenarios.The results support the view that demand can be influenced by price and service attributes, and support the development of detailed business cases for reducing peak demand. Implications are discussed, as well as the challenges in converting these customer behaviour predictions into workable timetables, and in accurately costing the benefits of delays in investments in new rolling stock and infrastructure

L’impact du suicide d’un patient chez des professionnels en santé mentale : Différences entre les femmes et les hommes

Cet article rapporte les résultats d’une recherche réalisée auprès de 141 professionnels en santé mentale pratiquant au Québec et ayant vécu le suicide d’un patient. Les professionnels ont réagi à cet événement différemment en fonction de leur sexe. Les femmes y ont répondu par un niveau de stress élevé au cours du premier mois, alors que les hommes ont dévoilé un niveau de stress faible. Le niveau élevé de stress relevé chez les femmes était accompagné de répercussions initialement plus intenses sur leur pratique professionnelle : tendance accrue à hospitaliser des patients suicidaires ou précautions accrues dans leur traitement, évaluation d’un plus grand nombre de patients comme présentant un risque de suicide, sentiment accru d’impuissance lors de l’évaluation ou du traitement de patients suicidaires, consultation plus fréquente de collègues et de superviseurs, attention accrue aux aspects légaux dans la pratique. L’article tente de mieux comprendre les différences entre les réactions des professionnels observées selon leur sexe, à la lumière des théories de la socialisation et du développement professionnel.This article presents the results of a study of 141 mental health professionals who have experienced a patient’s suicide. Results indicate that mental health professionals reacted to such suicides in different ways according to gender. Women generally responded with elevated stress levels in the first month, while men experienced stress levels that were subclinical on average. The high stress response found in women was also initially accompanied by more profound impacts on their professional practice : increased hospitalizations of suicidal patients or greater precautions in their treatment, increased evaluation of patients as being at risk for suicide, increased helplessness while assessing or treating suicidal patients, more frequent consultation of colleagues and supervisors and more attention to legal issues. Gender differences found in this study are discussed in the light of socialization and professional development theories

The Effect of State Workers' Compensation Program Changes on the Use of Federal Social Security Disability Insurance

In addition to traditional forms of private and public medical insurance, two other large programs help pay for costs associated with ill health. In 2007, Workers Compensation (WC) insurance provided $55.4 billion in medical care and cash benefits to employees who are injured at work or contract a work-related illness, and Social Security Disability Insurance (DI) provided$99 billion to individuals who suffer from permanent disabilities and are unable to engage in substantial gainful activity. During the 1990s, real DI outlays increased nearly 70 percent, whereas real WC cash benefit spending fell by 12 percent. There has been concern that part of this relationship between two of the nation’s largest social insurance programs may be due to individuals substituting towards DI as state WC policies tightened. We test this hypothesis using a number of different WC and DI program parameters. We first show that this negative correlation between the national series does not hold over time within states, the level at which a causal relationship should operate. We then test how regulatory changes in state WC program parameters impact WC outcomes (intended effect) and DI outcomes (unintended effect). We find no compelling evidence of WC tightening causing DI rolls to increase, and conclude it is unlikely that state WC changes were a meaningful factor in explaining the rise in DI.

Impact of guidance on intervention adherence in computerised interventions for mental health problems: A meta-analysis.

Web-based interventions are increasingly used for the prevention, treatment and aftercare of mental disorders. A crucial factor to the efficacy of such online programmes is adherence to the intervention content and procedure. It has been frequently suggested that adherence in web-based interventions is low and little is known about which factors influence adherence. To increase intervention uptake and completion, studies increasingly include interventions with some form of guidance. Guided interventions have been shown to have higher efficacy, however, evidence for the impact on adherence is limited and mixed. This meta-analysis explored the impact of human guidance on intervention completion in web-based mental health interventions. A total of 22 studies were included with interventions primarily targeting symptoms of depression and anxiety disorders. Results showed that guidance significantly increases the average amount of intervention completion [g = 0.29, 95% confidence interval (CI) 0.18-0.40] and the proportion of intervention completers [log odds ratio (OR) = 0.50, 95% CI 0.34-0.66] with small effects. On average, full completion rates were 12% higher in guided intervention groups. This meta-analysis demonstrated that guidance in web-based mental health interventions does increase adherence, but more research is required to better understand the specific mechanisms between guidance, adherence and outcomes.</p

The Relationship between Body Composition, Fatty Acid Metabolism and Diet in Spinal Muscular Atrophy

Acknowledgments: I.B. received a studentship from SMA Angels Charity. M.B.’s SMA research isfunded by SMA Angels Charity, Muscular Dystrophy UK, Action Medical Research and SMA UK. S.H.P.’s SMA research is funded by SMA Europe and Anatomical Society.Peer reviewedPublisher PD