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ABSTRACT Many natural competitors are jointly held by a small set of large institutional investors. In the U.S. airline industry, taking common ownership into account implies increases in market concentration that are 10 times larger than what is “presumed likely to enhance market power” by antitrust authorities. Within‐route changes in common ownership concentration robustly correlate with route‐level changes in ticket prices, even when we only use variation in ownership due to the combination of two large asset managers. We conclude that a hidden social cost—reduced product market competition—accompanies the private benefits of diversification and good governance.

Women and Smoking: A Report of the Surgeon General Get access Nicotine & Tobacco Research, Volume 4, Issue 1, February 2002, Pages 7–20, https://doi.org/10.1080/14622200210135650 Published: 01 February 2002

The great moderation lulled macroeconomists and policymakers alike in the belief that we knew how to conduct macroeconomic policy. The crisis clearly forces us to question that assessment. In this paper, we review the main elements of the precrisis consensus, identify where we were wrong and what tenets of the precrisis framework still hold, and take a tentative first pass at the contours of a new macroeconomic policy framework.

The constructive (in the sense of construing ) and developmental (but throughout the lifespan) framework, whose conceptual roots lie in the work of Piaget, outlines the holistic personality process of systems of making meaning, systems that organize human thought, feeling, and action. In this article Kegan discusses and then applies the model—to a worker in a CETA program and to a psychiatric ward patient—elucidating the perspectives—on mental health and employability—it can open for practitioners .

Medical educators have a responsibility to teach students to communicate effectively, yet ways to accomplish this are not well-defined. Sixty-five percent of medical schools teach communication skills, usually in the preclinical years; however, communication skills learned in the preclinical years may decline by graduation. To address these problems the New York University School of Medicine, Case Western Reserve University School of Medicine, and the University of Massachusetts Medical School collaborated to develop, establish, and evaluate a comprehensive communication skills curriculum. This work was funded by the Josiah P. Macy, Jr. Foundation and is therefore referred to as the Macy Initiative in Health Communication. The three schools use a variety of methods to teach third-year students in each school a set of effective clinical communication skills. In a controlled trial this cross-institutional curriculum project proved effective in improving communication skills of third-year students as measured by a comprehensive, multistation, objective structured clinical examination. In this paper the authors describe the development of this unique, collaborative initiative. Grounded in a three-school consensus on the core skills and critical components of a communication skills curriculum, this article illustrates how each school tailored the curriculum to its own needs. In addition, the authors discuss the lessons learned from conducting this collaborative project, which may provide guidance to others seeking to establish effective cross-disciplinary skills curricula.

This article examines the syndrome of self‐mutilation with specific attention given to self‐mutilation in female adolescents and young adults. Causes, symptoms, types, definitions, and treatments are discussed. Included is an explanation of the lexical and conceptual confusion that accompanies self‐mutilation. Implications and recommendations for counselors are addressed.

In recent years, boards of directors have become more active and independent of management in pursuing shareholder interests. But, up to this point, there has been little empirical evidence that active boards help companies produce higher rates of return for their shareholders. In this article, after describing the new board activism, the authors argue that past failures to document an association between independent boards and superior corporate performance can be explained by two features of the research: its concentration on periods prior to the 1990s (when most boards were largely irrelevant) and its use of unreliable proxies (such as a minimum percentage of outside directors) for a well‐functioning board. The authors hypothesize that an independent and resourceful board takes steps that require management to increase earnings available to investors. To test this hypothesis, the performance of a sample of large U.S. corporations was examined over the period 1991‐1995 using two proxies for the “professionalism” of each company's board: (1) the letter grades (A+ to F) assigned by CalPERS for corporate governance; and (2) a “presence” or “absence” grade based on three key indicators of professional board behavior. Both of these governance metrics were associated in statistically significant ways with superior corporate performance, as measured by earnings in excess of cost of capital and net of the industry average. While acknowledging that such results do not prove causation, the authors conclude that, in the first half of the 1990s, corporations with active and independent boards added significantly more value for shareholders than those with passive, “rubber‐stamp” boards.

The cost-effectiveness of pharmacists and their effect on inpatient health care outcomes were evaluated. For one year, data were collected on all patients receiving care from general medicine and general surgery teams at Walter Reed Army Medical Center, Washington, D.C. Two of five medicine teams and one of three surgery teams included a pharmacist. Teams that included a pharmacist were compared with teams that did not, in terms of patients' length of stay (LOS), mortality, and drug cost per admission. Data were compared for 3081 patients and collected for another 557 who were not included in the comparative study design. Health care teams that included a pharmacist had a shorter log LOS and lower log drug cost per admission but no difference in mortality. The average cost savings for teams that included a pharmacist was $377 per inpatient admission, and the benefit-to-cost ratio was 6.03:1. The inclusion of pharmacists on health care teams was cost-effective and provided a favorable benefit-to-cost ratio.

A survey of school counselors was conducted to measure the relationship of Bandura's (1977b) concept of self‐efficacy with school climate, counselor roles, and a variety of demographic variables. Results indicated that supportive staff and administrators were the strongest predictors of high counselor efficacy expectancy. In addition, outcome expectancy for school counselor behavior was predicted by both a similarly high degree of support from staff and administrators and fewer nonrelated counseling activities performed by school counselors. Discussion of results and implications for research and practice are presented.

In the short time since it became effective for health care organizations, a privacy regulation issued under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) has had a significant adverse impact on the conduct of clinical research in the United States, without a substantial corresponding increase in privacy protection for research participants. Some of the problems associated with HIPAA have been resolved through revisions since the regulation's initial promulgation in December 2000, and other problems can be addressed by better educating health care providers and researchers about its requirements and available alternatives for compliance; however, considerable structural challenges remain. These constitute substantial barriers to research and resulting medical advances. Additional revisions to HIPAA based on the principles and trade-offs reflected in the Common Rule-which responsibly balances an individual's interest in privacy protection with the public interest in gaining knowledge through biomedical research-can go a long way to remedying remaining flaws in the system.

This study analyzes how Socio-economic status (SES) affects student academic performance. The study examines how Socio-economic background affects academic performance. This study can help explain how SES affects academic achievement and guide educational policy and actions to close achievement inequalities.300 varied secondary school pupils was sampled. Parental income, education, and occupation were used to calculate Socio-economic status. Standardized tests and GPAs measured academic performance. Data analysis used correlation and regression analysis. The regression study explored how SES predicted academic outcomes while adjusting for other factors like family engagement and school resources. Correlation analysis examined the relationship between SES and academic achievement. The Socio-economic position appears to affect academic performance. Higher-Socio-economic students fare better academically. However, parental participation and school resources may buffer the SES-academic achievement association. This study suggests focused treatments for low-income students. Policymakers and educators may reduce the achievement gap and promote fair education by understanding how Socio-economic status affects academic performance.

Well-intentioned regulations protecting privacy are denying important information to patient subjects. Advances in information technology mean that a better approach to clinical research is possible.

Artificial intelligence/machine learning models are being rapidly developed and used in clinical practice. However, many models are deployed without a clear understanding of clinical or operational impact and frequently lack monitoring plans that can detect potential safety signals. There is a lack of consensus in establishing governance to deploy, pilot, and monitor algorithms within operational healthcare delivery workflows. Here, we describe a governance framework that combines current regulatory best practices and lifecycle management of predictive models being used for clinical care. Since January 2021, we have successfully added models to our governance portfolio and are currently managing 52 models.

Personally controlled health records (PCHRs) enable patients to store, manage, and share their own health data, and promise unprecedented consumer access to medical information. To deploy a PCHR in the pediatric population requires crafting of access and security policies, tailored to a record that is not only under patient control, but one that may also be accessed by parents, guardians, and third-party entities. Such hybrid control of health information requires careful consideration of both the PCHR vendor's access policies, as well as institutional policies regulating data feeds to the PCHR, to ensure that the privacy and confidentiality of each user is preserved. Such policies must ensure compliance with legal mandates to prevent unintended disclosures and must preserve the complex interactions of the patient-provider relationship. Informed by our own operational involvement in the implementation of the Indivo PCHR, we provide a framework for understanding and addressing the challenges posed by child, adolescent, and family access to PCHRs.

Abstract The contribution of the ad hoc tribunals to international criminal law and international justice has been manifold, both academically and historically, and they will continue to influence the findings and decisions of many other courts (both domestic and international), provoking discussion for many years to come. This volume provides the first comprehensive analysis of the law of international crimes as applied by the ad hoc tribunals for the former Yugoslavia and Rwanda. This book examines the legal and historical significance of some of the most important judicial developments to occur in the last fifty years in international criminal law. It states the law of the tribunals, and provides concrete illustrations of the application of the law to a variety of criminal cases, providing a comprehensive and detailed analysis of this voluminous body of jurisprudence. The primary focus is on the jurisdiction ratione materiae of the tribunals: the definition and application of the law of war crimes, crimes against humanity, and genocide. However, it also examines the tribunals’ jurisdiction ratione personae, insofar as this enables a full understanding of the law of crimes (for instance, in relation to forms of criminal liability).

OBJECTIVE: Digital monitoring technologies (e.g., smart-phones and wearable devices) provide unprecedented opportunities to study potentially harmful behaviors such as suicide, violence, and alcohol/substance use in real-time. The use of these new technologies has the potential to significantly advance the understanding, prediction, and prevention of these behaviors. However, such technologies also introduce myriad ethical and safety concerns, such as deciding when and how to intervene if a participant's responses indicate elevated risk during the study? METHODS: We used a modified Delphi process to develop a consensus among a diverse panel of experts on the ethical and safety practices for conducting digital monitoring studies with those at risk for suicide and related behaviors. Twenty-four experts including scientists, clinicians, ethicists, legal experts, and those with lived experience provided input into an iterative, multi-stage survey, and discussion process. RESULTS: Consensus was reached on multiple aspects of such studies, including: inclusion criteria, informed consent elements, technical and safety procedures, data review practices during the study, responding to various levels of participant risk in real-time, and data and safety monitoring. CONCLUSIONS: This consensus statement provides guidance for researchers, funding agencies, and institutional review boards regarding expert views on current best practices for conducting digital monitoring studies with those at risk for suicide-with relevance to the study of a range of other potentially harmful behaviors (e.g., alcohol/substance use and violence). This statement also highlights areas in which more data are needed before consensus can be reached regarding best ethical and safety practices for digital monitoring studies.

Injections of local anesthetics, saline, "dry needling," or other stimuli at specific, tender loci (trigger or acupuncture points) are reportedly efficacious in treatment of chronic pain syndromes. In a randomized, double-blind crossover study, subjective responses of 15 patients with myofascial syndrome to trigger-point injections of either bupivacaine 0.5%, etidocaine 1%, or physiologic saline without preservative were compared. Responses in six pain-related categories were determined before treatment and 15 minutes, 24 hours, and 7 days after treatment. Trigger-point injections with bupivacaine and etidocaine were generally preferred over saline in several pain-tested categories. Implications and possible mechanisms are discussed.

FOR many years clinicians have noted a correlation between the level of thyroid function and the speed of tendon reflexes. As early as 1924 Chaney, at the Mayo Clinic, attempted to quantitate the slowing of the Achilles reflex in myxedema.1 Although his observations were subsequently proved to be valid, his recording methods were too cumbersome for the average clinician in office practice.Since Chaney's original work several investigators have studied the Achilles reflex in hypothyroidism2 3 4 5 and hyperthyroidism,4 and the biceps reflex has been studied in myxedema.6 Several textbooks have also called attention to the diagnostic importance of the Achilles reflex . . .

Undergraduate students ( n = 102) were given the Community Attitudes Toward the Mentally Ill (CAMI) questionnaire. Significant differences emerged on 3 of the 4 subscales, based on the participants' ranking of their primary source of information about mental illness. Individuals who reported receiving their information primarily from the electronic media reported less tolerance.

The Medicare Hospital Readmissions Reduction Program (HRRP), an initiative of the Affordable Care Act, imposes considerable financial penalties on hospitals with excess thirty-day readmissions for patients with selected high-volume conditions. We investigated the intended impact of the program by examining changes in thirty-day readmissions among Medicare patients admitted for three conditions targeted by the program in New York State, compared to Medicare patients with other conditions and with privately insured patients, before and after the program's introduction. We also examined potential unintended strategic responses by hospitals that might allow them to continue to treat target-condition patients while avoiding the readmission penalty. We found that thirty-day readmissions fell for the three conditions targeted by the HRRP, consistent with the goals of the program. Second, there also was a substantial fall in readmissions for a comparison group although not as large as for the target group, which suggests modest spillover effects in Medicare for other conditions. We did not find strong evidence of unintended effects associated with the program. These early findings suggest that the HRRP is affecting hospitals in the direction intended by the Affordable Care Act.