Ownership and rent-seeking behavior in specialty health care practices

Specialty health care practices are unique in that they exhibit a wide range of ownership types, from large corporations controlled by third parties to those directly owned by practitioners (physicians, therapists, etc.). Many of these practices also employ licensed assistants whose labor is partially substitutable with those of the practitioners. This paper presents a theoretical model that examines the impact that different levels of ownership have on rent-seeking behavior and efficiency within specialty practices. Our primary focus is on whether lower levels of ownership induce practitioners to extract larger economic rents by substituting their services for those of their assistants. We find that if the practitioners are not required to be technically efficient then they unambiguously respond to lower ownership with rent-seeking. However, requiring the firm to be technically (but not allocatively) efficient, may be sufficient to mitigate this incentive.efficiency

Simpler ISS Flight Control Communications and Log Keeping via Social Tools and Techniques

The heart of flight operations control involves a) communicating effectively in real time with other controllers in the room and/or in remote locations and b) tracking significant events, decisions, and rationale to support the next set of decisions, provide a thorough shift handover, and troubleshoot/improve operations. International Space Station (ISS) flight controllers speak with each other via multiple voice circuits or loops, each with a particular purpose and constituency. Controllers monitor and/or respond to several loops concurrently. The primary tracking tools are console logs, typically kept by a single operator and not visible to others in real-time. Information from telemetry, commanding, and planning systems also plays into decision-making. Email is very secondary/tertiary due to timing and archival considerations. Voice communications and log entries supporting ISS operations have increased by orders of magnitude because the number of control centers, flight crew, and payload operations have grown. This paper explores three developmental ground system concepts under development at Johnson Space Center s (JSC) Mission Control Center Houston (MCC-H) and Marshall Space Flight Center s (MSFC) Payload Operations Integration Center (POIC). These concepts could reduce ISS control center voice traffic and console logging yet increase the efficiency and effectiveness of both. The goal of this paper is to kindle further discussion, exploration, and tool development

Centrifuge Model Tests to Identify Dynamic Properties of Dense Sand for Site Response Calculations

Four centrifuge models, tested on the large centrifuge at UC Davis, are described in this paper. These four experiments involved dense profiles of Nevada Sand (Dr = 90 to 100%) tested in two different model containers. The purpose of the experiments was to evaluate numerical site response procedures by comparison with model test data. In this paper we focus on determining basic material properties of one of the models by using in-flight measurements of shear wave velocity and calculations of stress-strain relationships using data from an extensive array of accelerometers. Shear wave velocity profiles were measured at centrifuge accelerations of approximately 10, 20, and 40 g; and before, during, and after the models were subject to base shaking using the servo-hydraulic shaker in an attempt to identify any influence of shaking history on shear wave velocity. The base shaking included realistic earthquake time histories scaled in frequency and amplitude to simulate motions with low, medium, and high intensity, and motions that included sinusoidal sweeps of different frequencies. A new windowing procedure to compute shear modulus and shear strain amplitude time histories from accelerometer array data is briefly described

Together in electric screams: the frustrations of GUM electronic patient records

Many Genitourinary Medicine (GUM) clinics have shifted from paper to Electronic Patient Records (EPR). While paper has limitations, its natural functionality – e.g. free-form writing, sketching and page-turning – is intuitive and easy to exploit. EPR promises so much, but how easy or intuitive is it in current clinical GUM practice

Impact of HuR inhibition by the small molecule MS-444 on colorectal cancer cell tumorigenesis.

Colorectal cancer (CRC) is the third most common cancer and a leading cause of cancer-related mortality. Observed during CRC tumorigenesis is loss of post-transcriptional regulation of tumor-promoting genes such as COX-2, TNFα and VEGF. Overexpression of the RNA-binding protein HuR (ELAVL1) occurs during colon tumorigenesis and is abnormally present within the cytoplasm, where it post-transcriptionally regulates genes through its interaction with 3\u27UTR AU-rich elements (AREs). Here, we examine the therapeutic potential of targeting HuR using MS-444, a small molecule HuR inhibitor. Treatment of CRC cells with MS-444 resulted in growth inhibition and increased apoptotic gene expression, while similar treatment doses in non-transformed intestinal cells had no appreciable effects. Mechanistically, MS-444 disrupted HuR cytoplasmic trafficking and released ARE-mRNAs for localization to P-bodies, but did not affect total HuR expression levels. This resulted in MS-444-mediated inhibition of COX-2 and other ARE-mRNA expression levels. Importantly, MS-444 was well tolerated and inhibited xenograft CRC tumor growth through enhanced apoptosis and decreased angiogenesis upon intraperitoneal administration. In vivo treatment of MS-444 inhibited HuR cytoplasmic localization and decreased COX-2 expression in tumors. These findings provide evidence that therapeutic strategies to target HuR in CRC warrant further investigation in an effort to move this approach to the clinic

The Impact of A Service-Learning Project on Undergraduate Students’ Faith Development and Spiritual Formation: Outcomes of an Organization and Administrative Behavior Course

Spiritual growth and development is frequently cited as an outcome of participation in service-learning projects.  However, little research has focused on measuring the students' ability to understand the connection between the service-learning experience and their personal faith and the ability to live out their Christian values in the field.  Notably missing from this particularly limited area of study is the Christian values convergence of being able to understand the worth of all people and a desire to be engaged in serving the community. Encompassing both quantitative and qualitative research methods, this study investigates undergraduate business students’ perceptions of the impact of a semester-long urban service-learning project on their spiritual lives and faith formation.  Specific attention is given to exploring the students' perception of faith as demarcated by the Christian praxis of the students' relationship with God and with others

Opportunities for Sustainable Packaging Design: Learning from Pregnancy as a Metaphor

Current packaging use within fast-moving consumer goods (FMCG) produces a lot of unwanted waste that must be dealt with at significant cost, with negative environmental impacts. In the UK, annually, 10.8 million tonnes of packaging wastes are created; only 24% of plastic packaging is currently recycled (defra, 2011). Many packaging designers approach sustainable issues by various methods, however, this effort only reduces damage to the environment because the packaging still produces a lot of waste in a short period with less valued object, which has a negative impact on the environment. Some FMCG packaging, e.g. Method’s refillable bottles or Unilever’s detergent tablets (Unilever, 2000), is designed to promote more sustainable behaviour. However, consumers’ perceptions, behaviour and habits have been attributed (Porter, 1999) to decreases in packaging value, driving less careful behaviour. The emerging field of design for sustainable behaviour (Lockton et al 2008; Wever et al 2008 ) can be applied to packaging (Wever et al, 2009). However, further knowledge is needed, as designers’ intended functions may not match consumers’ perceptions and behaviour. Fundamental interconnections need to be articulated, taking a whole system view (Wright and Meadows, 2009). One innovation approach in packaging design involves learning from other disciplines. This paper suggests translating ideas from human biology –pregnancy practicethrough metaphor to take a holistic view of the packaging life cycle

Scheelite-type NaEr(MoO4)2

Explorations of the A 1+–RE 3+–Mo6+–O2− (A 1+ is an alkali metal cation, RE 3+ is a rare-earth metal cation) quaternary systems prepared by the high-temperature solution growth method led to the title structure, sodium erbium bis­(molyb­date), NaEr(MoO4)2. It is isostructural to the scheelite structure (CaWO4) and is composed of [MoO4]2− tetra­hedra with symmetry and [(Na/Er)O8]14− polyhedra. The [(Na/Er)O8]14− polyhedron is a distorted tetra­gonal anti­prism, also with symmetry, with statistically mixed Na/Er atoms at its centre. There are two sets of Na/Er—O bond lengths [2.420 (4) and 2.435 (3) Å], but just one set of Mo—O bond lengths [1.774 (4) Å]

Evaluating police drug diversion in England: protocol for a realist evaluation

There is increasing international interest in the use of police drug diversion schemes that offer people suspected of minor drug-related offences an educative or therapeutic intervention as an alternative to criminalisation. While there have been randomised trials of some such schemes for their effects on reducing offending, with generally positive results, less is known about the health outcomes, and what works, for whom, in what circumstances and why. This protocol reports on a realist evaluation of police drug diversion in England that has been coproduced by a team of academic, policing, health, and service user partners. The overall study design combines a qualitative assessment of the implementation, contexts, mechanisms, moderators and outcomes of schemes in Durham, Thames Valley and the West Midlands with a quantitative, quasi-experimental analysis of administrative data on the effects of being exposed to the presence of police drug diversion on reoffending and health outcomes. These will be supplemented with analysis of the cost-consequences of the evaluated schemes, an analysis of the equity of their implementation and effects, and a realist synthesis of the various findings from these different methods