Does quality affect patients’ choice of Doctor? Evidence from England

Reforms giving users of public services choice of provider aim to improve quality. But such reforms will work only if quality affects choice of provider. We test this crucial prerequisite in the English health care market by examining the choice of 3.4 million individuals of family doctor. Family doctor practices provide primary care and control access to non-emergency hospital care, the quality of their clinical care is measured and published and care is free. In this setting, clinical quality should affect choice. We find that a 1 standard deviation increase in clinical quality would increase practice size by around 17%

Hemispheric bases for emotion and memory

The goal of this Research Topic was to bring together diverse scientific perspectives on lateralized brain mechanisms underlying emotion, motivation, and memory. The Topic resulted in eight articles, three of which report original research and five of which review and synthesize past research with the aim of developing new hypotheses and theory. A range of international experts with diverse backgrounds, theoretical perspectives, and experimental methods contributed to the Topic. Contributions strongly reflect this diversity, ranging from examining pupil dilation in response to viewing Rembrandt portraits to understanding how caffeine supplementation influences levels of spatial processing. In all cases, the authors developed strong, empirically guided insights into the lateralized brain mechanisms underlying behavioral effects. Two primary themes emerge to guide and constrain continuing research

Hemispheric bases for emotion and memory

The goal of this Research Topic was to bring together diverse scientific perspectives on lateralized brain mechanisms underlying emotion, motivation, and memory. The Topic resulted in eight articles, three of which report original research and five of which review and synthesize past research with the aim of developing new hypotheses and theory. A range of international experts with diverse backgrounds, theoretical perspectives, and experimental methods contributed to the Topic. Contributions strongly reflect this diversity, ranging from examining pupil dilation in response to viewing Rembrandt portraits to understanding how caffeine supplementation influences levels of spatial processing. In all cases, the authors developed strong, empirically guided insights into the lateralized brain mechanisms underlying behavioral effects. Two primary themes emerge to guide and constrain continuing research

Public service markets: their economics, institutional oversight and regulation

Public services in the UK have been transformed over the past 25 years with the introduction of market oriented solutions into their provision. This has been characterised by a shift away from state provision to independent providers, and by the introduction of competition and choice. This shift was partly ideologically motivated and partly driven by budget cutting considerations following the financial crisis. As such it has been lacking a comprehensive economic justification or method of analysis. It is now commonly accepted that the language of economic markets is essential to frame arguments about how effectively public services are achieving their intended outcomes. Using market language and concepts may not always be comfortable for those from a traditional policy-making background. It can nevertheless be very useful when designing investigations into the effectiveness and value for money in the mechanisms of delivery of such services, whenever these services entail a degree of user choice as is currently the case in large parts of health, social care and education (referred to as competition in the market). Our paper wants to provide a conceptual basis on the way of thinking in these terms. We provide a description of the current state and then comment on the desirability of this quasi market approach. Uniquely in the literature, we analyse the expected and desired developments by distinguishing between choice and compulsory merit goods. In choice merit goods markets many users are unable to choose effectively because of the existence of a number of demand side or supply side market failures. Moreover, conflicts may exist between how service users actually make choices, and policy objectives such as universality or equity which may not be achieved simply by ‘leaving it to the market’. The users of compulsory merit goods are typically a minority and unable to internalise the full social benefits of their actions; hence it may be welfare-enhancing for society to coerce them ‘consume’ these services. As choice cannot be an objective, the commissioning (competition for the market) or direct provision by the state of such goods may meet public policy objectives more effectively than the market mechanism alone. Building on these foundations the paper discusses when public service markets are likely to be an effective method of achieving public policy objectives, and when they may not be. Our paper analyses the implications for the institutional and legal framework, funding oversight and regulation of public service markets as a result of their transformation into quasi-markets. The paper concludes with some suggestions for those charged with overseeing public service markets in practice based on this analysis

Phase II study of TP300 in patients with advanced gastric or gastro-oesophageal junction adenocarcinoma

Background: TP300, a recently developed synthetic camptothecin analogue, is a highly selective topoisomerase I inhibitor. A phase I study showed good safety and tolerability. As camptothecins have proven active in oesophago-gastric adenocarcinomas, in this phase II study we assessed the efficacy and safety of TP300 in patients with gastric or gastro-oesophageal junction (GOJ) adenocarcinomas. Methods: Eligible patients had metastatic or locally advanced gastric or Siewert Types II or III GOJ inoperable adenocarcinoma. Patients were chemotherapy naïve unless this had been administered in the perioperative setting. TP300 was administered as a 1-h intravenous infusion every 3 weeks (a cycle) for up to 6 cycles at a starting dose of 8 mg/m2 with intra-patient escalation to 10 mg/m2 from cycle 2 in the absence of dose-limiting toxicity. Tumour responses (RECIST 1.1) were assessed every 6 weeks. Toxicity was recorded by NCI-CTCAE version 3.0. Using a modified two-stage Simon design (Stage I and II), a total of 43 patients were to be included providing there were 3 of 18 patients with objective response in Stage I of the study. Results: In Stage I of the study 20 patients (14 males, 6 females), median age 67 years (range 40 − 82), performance status ECOG 0/1, with GC [14] or GOJ carcinoma [6] were enrolled. Of the 16 evaluable patients, 11 received the planned dose increase to 10 mg/m2 at cycle 2, 2 decreased to 6 mg/m2, and 3 continued on 8 mg/m2. There were no objective responses after 2 cycles of treatment. Twelve patients had stable disease for 1 − 5 months and 4 had progressive disease. Median progression free survival (PFS) was 4.1 months (CI [1.6 − 4.9]), median time to progression (TTP) was 2.9 months (CI [1.4 − 4.2]). Grade 3/4 toxicities (worst grade all cycles) included 7 patients (35 %) with neutropenia, 4 patients (20 %) with anaemia, 2 patients (10 %) with thrombocytopenia, and 3 patients (15 %) with fatigue. This study was terminated at the end of Stage I due to a lack of the required (3/18) responders. Conclusions: This study of TP300 showed good drug tolerability but it failed to demonstrate sufficient efficacy as measured by radiological response

Role of Farmer Knowledge in Agroecosystem Science: Rice Farming and Amphibians in the Philippines

Rice (Oryza sativa) agriculture provides food and economic security for nearly half of the world’s population. Rice agriculture is intensive in both land and agrochemical use. However, rice fields also provide aquatic resources for wildlife, including amphibians. In turn, some species may provide ecosystem services back to the farmers working in the rice agroecosystem. The foundation for understanding the complexity of agroecosystem–human relationships requires garnering information regarding human perceptions and knowledge of the role of biodiversity in these rice agroecosystems. Understanding farmer knowledge and perceptions of the ecosystem services provided by wildlife in their fields, along with their understanding of the risks to wildlife associated with agrochemical exposure, can inform biodiversity preservation efforts. In June and July 2014, we used focus groups and structured and semi-structured interviews that engaged 22 individuals involved in rice agriculture operations in Laguna, Philippines, a village close to the International Rice Research Institute in Los Baños, Philippines, to learn more about farmer perceptions and knowledge of amphibians in their rice fields. We found that many, though not all farm workers (managers, tenants, and laborers) noted declines in amphibian populations over time, expressed how they incorporated frogs and toads (Anura) into their daily lives, and recognized the value of amphibians as ecosystem service providers. Specifically, farmers noted that amphibians provide pest-management through consumption of rice pests, act as biomonitors for pesticide-related health outcomes, and provide a local food and economic resource. Some farmers and farm workers noted the general cultural value of listening to the “frogs sing when it rains.” Overall, our findings demonstrate that farmers have an understanding of the value of amphibians in their fields. Future efforts can support how engagement with farmers and farm workers to evaluate the value of wildlife in their fields can lead to directed education efforts to support biodiversity conservation in agroecosystems

Analysis of colorectal cancers in British Bangladeshi identifies early onset, frequent mucinous histotype and a high prevalence of RBFOX1 deletion

PMCID: PMC3544714This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited

Professional Writing in the English Classroom: Literature-Based Professional Writing: An Oxymoron Whose Time Has Come

The article discusses a study regarding the integration of professional writing in English classes. It mentions the proposal of the National Council of Teachers of English (NCTE) in its annual convention on associating professional writing with literature. It also states that connecting literature with technical writing in English classrooms provides students with opportunities to absorb real life writing experiences

Chemical Toxicants in Water: A \u3ci\u3eGeoHealth\u3c/i\u3e Perspective in the Context of Climate Change

The editorial focuses on four major themes contextualized in a virtual GeoHealth workshop that occurred from June 14 to 16, 2021. Topics in that workshop included drinking water and chronic chemical exposure, environmental injustice, public health and drinking water policy, and the fate, transport, and human impact of aqueous contaminants in the context of climate change. The intent of the workshop was to further define the field of GeoHealth. This workshop emphasized on chemical toxicants that drive human health. The major calls for action emerged from the workshop include enhancing community engagement, advocating for equity and justice, and training the next generation