A Mixed Effects Model of Crop Yields for Purposes of Premium Determination

Farm income is highly variable due to annual price and yield uncertainties. The federally subsidized crop insurance program is an important tool for managing this risk, and has grown from a relatively modest program to one that encompasses the majority of productive cropland in the country. The success of this program depends on identification of actuarially fair insurance premium rates, which in turn depends on accurate estimation of farm-level yield distributions. We use the confidential U.S. Department of Agriculture Risk Management Agency (RMA) panel dataset to estimate farm-specific distributions of yields and actually fair crop insurance premiums. Our ongoing work includes using the difference between our estimated actually fair premiums and RMA's to predict which insurance contracts farmers select. Ultimately, we will predict potential efficiency gains from using our empirical model for premium determination.Yield, Crop Insurance, Policy, Mixed Model, Agricultural and Food Policy,

Making progress on the global crisis of obesity and weight management

No abstract available

Inventory of Cognitive Distortions: Validation of a Measure of Cognitive Distortions Using a Community Sample

The purpose of this study was to examine and evaluate further the psychometric properties of a self-report inventory of cognitive distortions using a nonclinical, community sample. A group of 474 individuals were contacted via the social networking site, Facebook, and through a college list-serve and were asked to complete multiple measures and also to send the link to other individuals, thus utilizing a snowball sample. The measures used included the Inventory of Cognitive Distortions (ICD), Dysfunctional Attitude Scale (DAS), Perceived Stress Scale (PSS), and a brief questionnaire to collect demographic information on each participant. Results revealed positive psychometric properties for the Inventory of Cognitive Distortions and were generally consistent with findings from the initial study, which utilized a clinical sample in order to examine the factor structure. Internal consistency reliability analysis of the total scale was found to be strong with a Coefficient Alpha of .97, which is consistent with the previous study (alpha = .98). Factor analysis revealed 12 factors, eight of which closely resemble factors from the original study. The eight common factors included, Magnification, Fortune-Telling, Externalization of Self-Worth, Perfectionism, Emotional Reasoning, Minimization, Comparison to Others and Emotional Reasoning and Decision Making. Four new factors were identified, including Discounting the Positive and Personalization, Absolutistic or Dichotomous Thinking, Should Statements, and Catastrophizing. The ICD correlated significantly with both the DAS (p \u3c .001) and PSS (p \u3c .001) measures. The current study also examined differences in overall levels of cognitive distortions as measured by the ICD across three demographic variables, gender, age, and level of education. Females were found to endorse significantly higher levels of cognitive distortions than COGNITIVE DISTORTIONS vii males (p = .006); however, the effect size was relatively small (d = -0.30). Participants who were within 18-29 years of age indicated significantly higher levels of cognitive distortions than individuals 41-85 years of age (p \u3c .001, η2 = 0.35 – large effect size), and there was generally a gradual decrease in cognitive distortions across the age ranges. Level of cognitive distortions was not influenced by level of education (p = .68). Last, participants’ levels of cognitive distortions were able to predict, significantly, levels of perceived stress (p \u3c .001). Future research should include continued testing of the ICD with a larger clinical population, include the ability to assess changes in cognitive distortions over time during treatment, and examine the overall utility of the ICD to the practicing clinician

FOUNDATIONS: Rebuilding After Mental Breakdown

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A computer-based intervention may be effective for treating bereavement as measured by scores of prolonged grief, anxiety, depression, and cognitive distortions.

Many people suffer from complications due to grieving the death of a loved one, an experience known as bereavement. In addition to the emotional suffering, complications can lead to functional impairment, negatively impacting relationships, work, and health of those who grieve. Although there are evidence-based interventions for bereavements, there are barriers to treatment, including costs and accessibility. Computer-based interventions are empirically demonstrated to overcome these barriers. The present study aims to test the effectiveness of a computer-based single-session treatment for bereavement. It is hypothesized that individuals who complete a computer-based CBT intervention for bereavement will experience a significant decrease in distress surrounding their loss compared to their pre-intervention scores and that this positive outcome will be maintained at three-month follow-up. Researchers will recruit adult participants (ages 18-85) who self-report suffering from bereavement. Recruitment via various social media and email announcements will offer the opportunity to win a gift card for their participation in the study. Potential participants reporting active substance use, psychotic symptoms, and/or severe mental health problems will be excluded. Participants meeting inclusion criteria will participate in the study via REDCap, by completing a demographic questionnaire as well as the pre-intervention measures of the Prolonged Grief Scale (PG-13), the Patient Health Questionnaire (PHQ-9), the General Anxiety Disorder Scale (GAD-7), and the Inventory of Cognitive Distortions (ICD). Participants will then have the opportunity to participate in a computer-based treatment, a pilot CBT/ACT intervention, validating the significance of their loss and reframing the aggrieved individual’s life as an opportunity to honor the departed loved one. After completing treatment, participants will complete all four measures again and at a three-month follow-up interval. Multivariate analysis of variance (MANOVA) will be computed to check for significance in differences between pre- and post-intervention scores on the aforementioned measures. It is hoped that the results of this study will provide empirical support for a single session, computer-based treatment for bereavement

Development and Validation of a Tool to Measure Patient Assessment of Clinical Compassion

Importance: Clinician compassion is a vital element of health care quality. Currently, there appears to be no validated and feasible method for health care organizations to measure patient assessment of clinician compassion on a large scale. Objective: To develop and validate a tool for measuring patient assessment of clinician compassion that can be used in conjunction with the Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS) survey. Design, Setting, and Participants: This prospective cohort study took place from June 1 to August 30, 2018, at a US academic health care system among a pilot cohort consisting of 3325 adult patients and a validation cohort consisting of 3483 adult patients, both of whom had an outpatient clinic visit and completed the CG-CAHPS survey. Main Outcomes and Measurements: After a comprehensive literature review, 12 candidate survey items were developed. Face and construct validity were performed. Candidate items were disseminated to patients in conjunction with the CG-CAHPS survey in a series of 2 studies: (1) exploratory factor analysis in one cohort to determine the factor structure and the most parsimonious set of items; and (2) validity testing in a second cohort using confirmatory factor analysis. Reliability was tested using Cronbach α. Convergent validity was tested with patient assessment of clinician communication and overall satisfaction questions from CG-CAHPS survey. Results: Overall, 6493 patient responses were analyzed. The mean (SD) age was 60 (15) years, 4239 patients (65.3%) were women, and 5079 (78.2%) were white. Exploratory factor analyses identified a 5-item compassion measure to be the most parsimonious. Confirmatory factor analyses found good fit. The compassion measure demonstrated good internal consistency (α = 0.94) and convergent validity (clinician communication: ρ = 0.44; overall satisfaction: ρ = 0.52) but reflected a patient experience domain (compassionate care) distinct from what is currently captured in the CG-CAHPS survey. Conclusions and Relevance: A simple 5-item tool to measure patient assessment of clinician compassion was developed and validated for use in conjunction with CG-CAHPS survey

Validation of a 5-Item Tool to Measure Patient Assessment of Clinician Compassion in Hospitals

BACKGROUND: We previously validated a 5-item compassion measure to assess patient experience of clinician compassion in the outpatient setting. However, currently, there is no validated and feasible method for health care systems to measure patient experience of clinician compassion in the inpatient setting across multiple hospitals. OBJECTIVE: To test if the 5-item compassion measure can validly and distinctly measure patient assessment of physician and nurse compassion in the inpatient setting. DESIGN: Cross-sectional study between July 1 and July 31, 2020, in a US health care network of 91 community hospitals across 16 states consisting of approximately 15,000 beds. PATIENTS: Adult patients who had an inpatient hospital stay and completed the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. MEASUREMENTS: We adapted the original 5-item compassion measure to be specific for physicians, as well as for nurses. We disseminated both measures with the HCAHPS survey and used confirmatory factor analysis for validity testing. We tested reliability using Cronbach\u27s alpha, as well as convergent validity with patient assessment of physician and nursing communication and overall hospital rating questions from HCAHPS. RESULTS: We analyzed 4756 patient responses. Confirmatory factor analysis found good fit for two distinct constructs (i.e., physician and nurse compassion). Both measures demonstrated good internal consistency (alpha \u3e 0.90) and good convergent validity but reflected a construct (compassionate care) distinct from what is currently captured in HCAHPS. CONCLUSION: We validated two 5-item tools that can distinctly measure patient experience of physician and nurse compassion for use in the inpatient hospital setting in conjunction with HCAHPS

Conformational Preferences of 3-(Dimethylazinoyl)propanoic Acid as a Function of pH and Solvent; Intermolecular versus Intramolecular Hydrogen Bonding

The conformational equilibrium of 3-(dimethylazinoyl)propanoic acid (DMAPA, azinoyl = N^+(O^−) has a weak pH-dependence in D_2O, with a slight preference for trans in alkaline solutions. The acid ionization constants of the protonated amine oxide and carboxylic functional groups as determined by NMR spectroscopy were 7.9 × 10^(−4) and 6.3 × 10^(−6), respectively. The corresponding value of K_1/K_2 of 1.3 × 10^2 is not deemed large enough to provide experimental NMR evidence for a significant degree of intramolecular hydrogen bonding in D_2O. Conformational preferences of DMAPA are mostly close to statistical (gauche/trans = 2/1) in other protic solvents, e.g., alcohols. However, the un-ionized form of DMAPA appears to be strongly intramolecularly hydrogen-bonded and gauche in aprotic solvents

Problem-solving teletherapy for adults with visual impairment: A feasibility study to improve access and treatment

Introduction: Adults with visual impairment are at increased risk of developing depression and experiencing a decreased quality of life, as compared to vision intact adults. However, there are many barriers to accessing health problems for this population. Purpose: The purpose of the study is to explore the impact of a virtual group-based intervention utilizing strategies from motivational interviewing and cognitive-behavioral problem-solving therapy to improve attendance and treatment outcome for adults with visual impairment. Specifically, the study will focus on improving previously demonstrated low rates of attendance, as well as improving depression, quality of life, problem-solving skills; and reducing cognitive distortions. Hypotheses: H1: It is hypothesized that the virtual group treatment, based on problem-solving therapy, will lead to an increase in attendance for adults with visual impairment, as compared to similar in vivo intervention. H2: It is hypothesized that the intervention will result in improvement in problem-solving skills and quality of life for adults with visual impairment. H3: It is hypothesized that the virtual group-based intervention will reduce depressive symptoms and frequency of cognitive distortions in visually impaired adults. Proposed Methods: Participants will be recruited on a voluntary basis from a non-profit organization that provides services for adults with visual impairment and blindness in a large metropolitan city in the Northeastern United States. Attendance will be operationalized as the percent of sessions attended by participants. Problem-solving skills will be operationalized as scores on the Social Problem-Solving Inventory, Revised (SPSI-R). Quality of life is operationalized as scores on the Quality of Life Inventory (QOLI). Depression will be operationalized as scores on the Patient Health Questionnaire (PHQ-9). Cognitive distortions will be operationalized as total scores on the Inventory of Cognitive Distortions (ICD). Proposed Analyses: The study will be a single subject, multiple-baseline design observed across group participants. This feasibility study was designed to examine the effect of a PST intervention on individuals with visual impairment to increase attendance, problem-solving skills, and quality of life, and to decrease depression and cognitive distortions. Attendance from this group will be compared to a previous, brief PST pilot group to determine if the more accessible teletherapy platform will increase engagement/attendance in the current group. Implications: It is hoped that results from this study will inform how teletherapy can be used to reduce barriers to attending treatment for adults with visual impairment. Additionally, it is hoped that the study will inform clinical assessment and treatment for adults with visual impairment

Does public interest in specific injuries increase when they occur during mixed martial arts bouts? A study of Google search patterns

Introduction: Mixed martial arts (MMA) is a combat sport that combines fighting techniques from many disciplines, such as wrestling, boxing, karate, Muay Thai, and Brazilian Jiu Jitsu. In the early 1990s MMA entered the United States as the Ultimate Fighting Championship (UFC). Both the internet and social media have advanced the popularity of MMA and have increased the public's exposure to fighting injuries. Here we examine injuries from popular UFC bouts and observe whether the volume of Google searches for specific injuries increases after the associated fights.Study Design: Our sample of injuries was gathered from "Sherdog's Top 10 Worst UFC Injuries" available from www.sherdog.com. Injury information, the injured fighter's name, date of injury, and the popularity of the fighter (measured by number of Twitter followers) were gathered from Google Trends searches.Results: Searches for the fighter and for the injury (i.e., an alignment) had a co-occurring pattern in 9 of 10 cases. The percent change in search interest for injuries increased in 9 of 10 cases (Mdn = 446%, IQR: 168.75%-1643.75%).Conclusions: Search interest in fighters and injuries appears to increase shortly after injury occurrence, possibly providing an opportunity for the timely dissemination of evidence-based information about particular injuries by sports medicine personnel. This study highlights how investigation of public search interest may ultimately have a positive impact on health care outcomes