Healthcare And The Evolution Of Managed Care Plans

Many consumers and employers are becoming increasingly concerned about the cost, quality, and appropriateness of health care services. This study examines the different managed care systems that integrate financing and delivery of health services. It describes the three most common managed care systems in use today and discusses the issues that medical providers must deal with in contracting with these systems. The study also explores the limitations of the different systems in curtailing the costs of health services or increasing the quality. The research is conducted in current literature. Details of a specific HMO plan are presented. The level at which this HMO could control the cost and maintain the quality of health services is explained. The information on the three managed care systems is shown which indicates the acceptance of the different systems by the consumers and the medical providers. The paper concludes with a look at the long-term possibilities of the managed care market

Description of a new aspidorhynchid fish, <i>Belonostomus lamarquensis</i> sp. nov. (Halecostomi, Aspidorhynchiformes), from the continental Upper Cretaceous of Patagonia, Argentina

Some braincases, a predentary, a few vertebrae and scales of a new aspidorhynchid species, Belonostomus lamarquensis sp. nov., are described from the Upper Cretaceous (Campanian-Maastrichtian) Allen Formation of Patagonia, Argentina. The new species differs from the other Belonostomus species by its flank scales having an anterior smooth region separated by a vertical groove from a posterior region bearing a series of numerous and closely spaced subparallel ridges that end in a deeply crenulated posterior margin. The dermal bones are ornamented with ridges and tubercles, a rare character in Belonostomus. The endocranial bones are completely fused together, except the basisphenoid. Within the Belonostomus species, B. lamarquensis seems closely related to B. hooleyi from the English Lower Cretaceous, which also exhibits dermal bones with ridges and tubercles, and scales morphologically somewhat similar to those of B. lamarquensis

Enhanced charge detection of spin qubit readout via an intermediate state

We employ an intermediate excited charge state of a lateral quantum dot device to increase the charge detection contrast during the qubit state readout procedure, allowing us to increase the visibility of coherent qubit oscillations. This approach amplifies the coherent oscillation magnitude but has no effect on the detector noise resulting in an increase in the signal to noise ratio. In this letter we apply this scheme to demonstrate a significant enhancement of the fringe contrast of coherent Landau-Zener-Stuckleberg oscillations between singlet S and triplet T+ two-spin states.Comment: 3 pages, 3 figure

Landau-Zener-Stuckelberg-Majorana interferometry of a single hole

We perform Landau-Zener-Stuckelberg-Majorana (LZSM) spectroscopy on a system with strong spin-orbit interaction (SOI), realized as a single hole confined in a gated double quantum dot. In analogy to the electron systems, at magnetic field B=0 and high modulation frequencies we observe the photon-assisted tunneling (PAT) between dots, which smoothly evolves into the typical LZSM funnel-shaped interference pattern as the frequency is decreased. In contrast to electrons, the SOI enables an additional, efficient spin-flipping interdot tunneling channel, introducing a distinct interference pattern at finite B. Magneto-transport spectra at low-frequency LZSM driving show the two channels to be equally coherent. High-frequency LZSM driving reveals complex photon-assisted tunneling pathways, both spin-conserving and spin-flipping, which form closed loops at critical magnetic fields. In one such loop an arbitrary hole spin state is inverted, opening the way toward its all-electrical manipulation.Comment: 6 pages, 4 figures, and supplementary materia

Novel technique for thermal lens measurement in commonly used optical components

The absorption of light in transmissive optics cause a thermally induced effect known as thermal lensing. This effect provokes an often undesired change of a laser beam transmitted by the optic. In this paper we present a measurement method that allows us to determine thermal lensing in commonly used optical components. The beam influenced by the thermal lens is expanded into the eigenmodes of an optical cavity, and its modal content is analyzed in the eigenbasis of the cavity. The measured quantity depends neither on beam parameters nor on the position of the optical component under investigation. This method allows, to our knowledge, for the first time the direct measurement of the mode conversion coefficient je2j of the thermal lens

Team Gender Diversity and Investment Decision Making Behavior

We investigate whether the gender composition of a fund management team influences investment decision making behavior. Using an experimental economics approach, we examine the relationship between gender diversity and investment decisions. We find evidence that a male presence increases the probability of selecting a higher risk investment. However, the all male teams are not the most risk seeking. Moreover, having a male presence can increase loss aversion. In the context of workforce composition, these results could have important implications for team investment decisions driven by the assessment of risk and return trade-offs. (JEL: G11

Imaging spectrometry-derived estimates of regional ecosystem composition for the Sierra Nevada, California

The composition of the plant canopy is a key attribute of terrestrial ecosystems, influencing the fluxes of carbon, water, and energy between the land surface and the atmosphere. Terrestrial ecosystem and biosphere models, which are used to predict how ecosystems are expected to respond to changes in climate, atmospheric CO2, and land-use change, require accurate representations of plant canopy composition at large spatial scales. The ability to accurately specify plant canopy composition is important because it determines the physiological and ecological properties of plants (such as leaf photosynthetic capacity, patterns of plant carbon allocation and tissue turnover, and the resulting dynamics of plant demography) that govern the biophysical and biogeochemical functioning of ecosystems. Traditionally, plant canopy composition has been represented in a coarse-grained manner within terrestrial biosphere models, with ecosystems being comprised of a single plant functional type (PFT). However, models are increasingly seeking to represent fine-scale spatial variation in plant functional diversity. In this study, we show how imaging spectrometry measurements can provide spatially-comprehensive estimates of within-biome heterogeneity in PFT composition across a functionally diverse and topographically heterogeneous ~710 km2 area in the Southern Sierra Mountains of California. AVIRIS (Airborne Visible Infrared Imaging Spectrometer) data at 18 m resolution from the recent HyspIRI Preparatory Mission (Hyperspectral InfraRed Imager) were used to estimate the sub-pixel fractions of seven PFTs represented in the ED2 terrestrial biosphere model: Shrub, Oak, Western Hardwood, Western Pine, Cedar/Fir, and High-elevation Pine, plus a Grass/NPV (Non-Photosynthetic Vegetation) fraction using Multiple Endmember Spectral Mixture Analysis (MESMA). ED2 is an individual-based terrestrial biosphere model capable of representing fine-scale sub-pixel ecosystem heterogeneity. Our results show that this methodology captures important elevation-related shifts in canopy composition that occur within the study area that are not resolved by existing multi-spectral land-cover products. These estimates modestly improved when the putative PFT endmembers considered in the mixture analysis were constrained using available geospatial data about the presence and absence of the PFTs in particular areas: the average RMSEs (root-mean-square errors) with the geospatially-constrained versus conventional method were 11.3% and 11.9% respectively, with larger reductions in the bias (i.e. mean error) in the abundances of Oak, Cedar/Fir, and Western Hardwood PFTs (ranging from 2.0% to 7.8%). At the hectare scale around four flux towers in the Southern Sierra Mountains, the overall composition improved from an RMSE of 18.2% (5.0-24.2% for individual PFTs) to RMSE 9.5% (3.3-13.2% for individual PFTs). Downgrading AVIRIS to 30 m resolution resulted in a reduction in accuracy of the constrained method to an RMSE of 12.7% (0-23.7%) with < 1% change in bias for all tree and shrub PFTs. Our results demonstrate that imaging spectrometry measurements from planned satellite missions such as HyspIRI, EnMAP (Environmental Mapping and Analysis Program), and HISUI (Hyper-spectral Imager SUIte) can provide important and much-needed information about fine-scale heterogeneity in the composition of plant canopies for constraining and improving terrestrial ecosystem and biosphere model simulations of regional- and global-scale vegetation dynamics and function

Characterisation of electroless deposited Cobalt by hard and soft X-ray photoemission spectroscopy

Electroless deposited (ELD) cobalt with palladium as a catalyst, and an underlying self-assembled monolayer (SAM) was investigated for potential use in advanced complementary metal oxide semiconductor (CMOS) applications using both hard (HAXPES) and soft (XPS) x-ray photoelectron spectroscopy. HAXPES spectra established the uniformity of the deposited Co film and the nature of the buried Co-Si interface ~20nm below the surface. The Pd is seen to diffuse through the Co following thermal annealing. While the deposited Co film is predominantly metallic, Co-silicide forms at the Co-Si interface upon deposition and decomposes with thermal anneal up to 500°C

Providing Feedback Following Leadership Walkrounds is Associated with Better Patient Safety Culture, Higher Employee Engagement and Lower Burnout

Background There is a poorly understood relationship between Leadership WalkRounds (WR) and domains such as safety culture, employee engagement, burnout and work-life balance. Methods This cross-sectional survey study evaluated associations between receiving feedback about actions taken as a result of WR and healthcare worker assessments of patient safety culture, employee engagement, burnout and work-life balance, across 829 work settings. Results 16 797 of 23 853 administered surveys were returned (70.4%). 5497 (32.7% of total) reported that they had participated in WR, and 4074 (24.3%) reported that they participated in WR with feedback. Work settings reporting more WR with feedback had substantially higher safety culture domain scores (first vs fourth quartile Cohen’s d range: 0.34–0.84; % increase range: 15–27) and significantly higher engagement scores for four of its six domains (first vs fourth quartile Cohen’s d range: 0.02–0.76; % increase range: 0.48–0.70). Conclusion This WR study of patient safety and organisational outcomes tested relationships with a comprehensive set of safety culture and engagement metrics in the largest sample of hospitals and respondents to date. Beyond measuring simply whether WRs occur, we examine WR with feedback, as WR being done well. We suggest that when WRs are conducted, acted on, and the results are fed back to those involved, the work setting is a better place to deliver and receive care as assessed across a broad range of metrics, including teamwork, safety, leadership, growth opportunities, participation in decision-making and the emotional exhaustion component of burnout. Whether WR with feedback is a manifestation of better norms, or a cause of these norms, is unknown, but the link is demonstrably potent