Physician Self-Referral and Physician-Owned Specialty Facilities

Outlines issues of self-referral -- physicians referring patients to a group or facility in which they have a financial interest -- and the prevalence of physician-owned facilities, as well as the effects on healthcare quality, cost, and access

Exchange of information about physical education to support the transition of pupils from primary and secondary school

The purpose of this study was to identify how information about physical education is exchanged between secondary schools and their respective feeder primary schools, what information is exchanged and how this information is used. A secondary purpose was to look at whether there is any relationship between schools engaging in liaison activities and exchanging information about physical education, and between exchanging information and the number of associated secondary schools to which pupils are sent or feeder primary schools from which pupils are received. Questionnaires were sent to 177 secondary and 538 feeder primary schools. Responses from 80 secondary schools and 299 primary schools showed that the highest percentage of teachers exchanged information through written documentation, followed by discussion at cross phase liaison meetings. The type of information exchanged by the highest percentage of teachers was identified as generic information about key stage 2 and 3 of the National Curriculum for Physical Education (NCPE) areas of activity and schemes of work, rather than information about the specific physical education content covered or information about individual pupils, such as levels of attainment or ability. Further, results suggest that information may be used for pastoral purposes and that only a small percentage of teachers used the information exchanged to plan for continuity and progression in the physical education curriculum. There was a significant positive relationship between engagement in liaison activities and information received about the physical education curriculum followed by pupils, but a significant negative relationship for primary teachers between the number of different secondary schools to which pupils' progress and knowledge about the key stage 3 schemes of work that Year 6 pupils will follow in their associated secondary schools. These results are discussed in relation to continuity and progression in physical education in the transfer of pupils from primary to secondary schools

Municipal Insolvency: The New Chapter IX of the Bankruptcy Act

In this report we give an introduction to a constructive way of treating systems of polynomial equations and inequalities. We present a method called cylindrical algebraic decomposition (CAD) discovered 1973 by Collins. The method constructs a decomposition of Rn such that a given set of polynomials have constant sign on each component. All concepts needed to understand the algorithm is presented, e.g., polynomial remainder sequences, subresultants, principal subresultant coefficients, Sturm chains and algebraic number representations

Prevailing Wage Laws and Construction Labor Markets

Prevailing wage laws, which require that construction workers employed by private contractors on public projects be paid at least the wages and benefits that are "prevailing" for similar work in or near the locality in which the project is located, have been the focus of an extensive policy debate. We find that the relative wages of construction workers decline slightly after the repeal of a state prevailing wage law. However, the small overall impact of law repeal masks substantial differences in outcomes for different groups of construction employees. Repeal is associated with a sizeable reduction in the union wage premium and a significant narrowing of the black/nonblack wage differential for construction workers.

Immunotherapy in hepatocellular carcinoma: the complex interface between inflammation, fibrosis, and the immune response.

Hepatocellular carcinoma (HCC) is the third leading cause of cancer deaths worldwide and confers a poor prognosis. Beyond standard systemic therapy with multikinase inhibitors, recent studies demonstrate the potential for robust and durable responses from immune checkpoint inhibition in subsets of HCC patients across disease etiologies. The majority of HCC arises in the context of chronic inflammation and from within a fibrotic liver, with many cases associated with hepatitis virus infections, toxins, and fatty liver disease. Many patients also have concomitant cirrhosis which is associated with both local and systemic immune deficiency. Furthermore, the liver is an immunologic organ in itself, which may enhance or suppress the immune response to cancer arising within it. Here, we explore the immunobiology of the liver from its native state to chronic inflammation, fibrosis, cirrhosis and then to cancer, and summarize how this unique microenvironment may affect the response to immunotherapy