Competition or Predation? Schumpeterian Rivalry in Network Markets

We explore the logic of predation and rules designed to prevent it in markets subject to network effects. Although, as many have informally argued, predatory behavior is plausibly more likely to succeed in such markets, we find that it is particularly hard to intervene in network markets in ways that improve welfare. We find that imposition of the leading proposals for rules against predatory pricing may lower or raise consumer welfare, depending on conditions that may be difficult to identify in practice.

Innovation, Rent Extraction, and Integration in Systems Markets

We consider innovation incentives in markets where final goods comprise two strictly complementary components, one of which is monopolized. We focus on the case in which the complementary component is competitively supplied, and in which innovation is important. We explore ways in which the monopoly may have incentives to confiscate efficiency rents in the competitive sector, thus weakening or destroying incentives for independent innovation. We discuss how these problems are affected if the monopolist integrates into the competitive sector.

Innovation, Rent Extraction, and Integration in Systems Markets

We consider innovation incentives in markets where final goods comprise two strictly complementary components, one of which is monopolized. We focus on the case in which the complementary component is competitively supplied, and in which innovation is important. We explore ways in which the monopoly may have incentives to confiscate efficiency rents in the competitive sector, thus weakening or destroying incentives for independent innovation. We discuss how these problems are affected if the monopolist integrates into the competitive sector.

Pediatric residents\u27 use of jargon during counseling about newborn genetic screening results

OBJECTIVE. The goal was to investigate pediatric residents’ usage of jargon during discussions about positive newborn screening test results. METHODS. An explicit-criteria abstraction procedure was used to identify jargon usage and explanations in transcripts of encounters between residents and standardized parents of a fictitious infant found to carry cystic fibrosis or sickle cell hemoglobinopathy. Residents were recruited from a series of educational workshops on how to inform parents about positive newborn screening test results. The time lag from jargon words to explanations was measured by using “statements,” each of which contained 1 subject and 1 predicate. RESULTS. Duplicate abstraction revealed reliability K of 0.92. The average number of unique jargon words per transcript was 20; the total jargon count was 72.3 words. There was an average of 7.5 jargon explanations per transcript, but the explained/ total jargon ratio was only 0.17. When jargon was explained, the average time lag from the first usage to the explanation was 8.2 statements. CONCLUSION. The large number of jargon words and the small number of explanations suggest that physicians’ counseling about newborn screening may be too complex for some parents

A method to quantify residents\u27 jargon use during counseling of standardized patients about cancer screening

Background Jargon is a barrier to effective patient-physician communication, especially when health literacy is low or the topic is complicated. Jargon is addressed by medical schools and residency programs, but reducing jargon usage by the many physicians already in practice may require the population-scale methods used in Quality Improvement. Objective To assess the amount of jargon used and explained during discussions about prostate or breast cancer screening. Effective communication is recommended before screening for prostate or breast cancer because of the large number of false-positive results and the possible complications from evaluation or treatment. Participants Primary care internal medicine residents. Measurements Transcripts of 86 conversations between residents and standardized patients were abstracted using an explicit-criteria data dictionary. Time lag from jargon words to explanations was measured using “statements,” each of which contains one subject and one predicate. Results Duplicate abstraction revealed reliability κ = 0.92. The average number of unique jargon words per transcript was 19.6 (SD = 6.1); the total jargon count was 53.6 (SD = 27.2). There was an average of 4.5 jargon-explanations per transcript (SD = 2.3). The ratio of explained to total jargon was 0.15. When jargon was explained, the average time lag from the first usage to the explanation was 8.4 statements (SD = 13.4). Conclusions The large number of jargon words and low number of explanations suggest that many patients may not understand counseling about cancer screening tests. Educational programs and faculty development courses should continue to discourage jargon usage. The methods presented here may be useful for feedback and quality improvement efforts

Child Health Providers\u27 Precautionary Discussion of Emotions During Communication about Results of Newborn Genetic Screening

Objective To demonstrate a quantitative abstraction method for Communication Quality Assurance projects to assess physicians\u27 communication about hidden emotions after newborn genetic screening. Design Communication quality indicator analysis. Setting Standardized parent encounters performed in practicing physicians\u27 clinics or during educational workshops for residents. Participants Fifty-nine pediatrics residents, 53 pediatricians, and 31 family physicians. Intervention Participants were asked to counsel standardized parents about a screening result; counseling was recorded, transcribed, and parsed into statements (each with 1 subject and 1 predicate). Pairs of abstractors independently compared statements with a data dictionary containing explicit-criteria definitions. Outcome Measures Four groups of precautionary empathy behaviors (assessment of emotion, anticipation/validation of emotion, instruction about emotion, and caution about future emotion), with definitions developed for both definite and partial instances. Results Only 38 of 143 transcripts (26.6%) met definite criteria for at least 1 of the precautionary empathy behaviors. When partial criteria were counted, this number increased to 80 of 143 transcripts (55.9%). The most common type of precautionary empathy was the instruction about emotion behavior (eg, don\u27t be worried ), which may sometimes be leading or premature. Conclusions Precautionary empathy behaviors were rare in this analysis. Further study is needed, but this study should raise concerns about the quality of communication services after newborn screening

Non-technical skills learning in healthcare through simulation education: Integrating the SECTORS learning model and Complexity theory

Background: Recent works have reported the SECTORS model for non-technical skills learning in healthcare. The TINSELS programme applied this model, together with complexity theory, to guide the design and piloting of a non-technical skills based simulation training programme in the context of medicines safety. Methods: The SECTORS model defined learning outcomes. Complexity Theory led to a simulation intervention that employed authentic multi-professional learner teams, included planned and unplanned disturbances from the norm and used a staged debrief to encourage peer observation and learning. Assessment videos of non-technical skills in each learning outcome were produced and viewed as part of a Non-Technical Skills Observation Test (NOTSOT) both pre and post intervention. Learner observations were assessed by two researchers and statistical difference investigated using a student’s t-test Results: The resultant intervention is described and available from the authors. 18 participants were recruited from a range of inter-professional groups and were split into two cohorts. There was a statistically significant improvement (P=0.0314) between the Mean (SD) scores for the NOTSOT pre course 13.9 (2.32) and post course 16.42 (3.45). Conclusions: An original, theoretically underpinned, multi-professional, simulation based training programme has been produced by the integration of the SECTORS model for non-technical skills learning the complexity theory. This pilot work suggests the resultant intervention can enhance nontechnical skills

Becoming Semi-devotional: Creating a Melbourne Beach Poetics

Dogs may well set up a sort of barking at the very idea of a Melbourne beach poetics. Others, sceptical of the use of the term poetics as a means of zhoozhing or shoring up the aesthetics of an inadequate theme, may growl. And what of easy identifications of nature with forms of art? Are they just another form of greenwashing? Can Melbourne beachness be defined only in terms of lack? And what does this beachness mean when the ideal is defined by Fiske, Hodge and Turner in negative terms: ‘no houses, no tents, no sandmining, no road and no way in except in bare feet’

Machine Translation Markers in Post-Edited Machine Translation Output

The author has conducted an experiment for two consecutive years with postgraduate university students in which half do an unaided human translation (HT) and the other half post-edit machine translation output (PEMT). Comparison of the texts produced shows - rather unsurprisingly - that post-editors faced with an acceptable solution tend not to edit it, even when often more than 60% of translators tackling the same text prefer an array of other different solutions. As a consequence, certain turns of phrase, expressions and choices of words occur with greater frequency in PEMT than in HT, making it theoretically possible to design tests to tell them apart. To verify this, the author successfully carried out one such test on a small group of professional translators. This implies that PEMT may lack the variety and inventiveness of HT, and consequently may not actually reach the same standard. It is evident that the additional post-editing effort required to eliminate what are effectively MT markers is likely to nullify a great deal, if not all, of the time and cost-saving advantages of PEMT. However, the author argues that failure to eradicate these markers may eventually lead to lexical impoverishment of the target language