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Claims
Kinds of Claims Terms modified by Claims Selected AbstractsPOPULATION AGING AND INTERNATIONAL DEVELOPMENT: ADDRESSING COMPETING CLAIMS OF DISTRIBUTIVE JUSTICEDEVELOPING WORLD BIOETHICS, Issue 1 2007MICHAL ENGELMAN ABSTRACT To date, bioethics and health policy scholarship has given little consideration to questions of aging and intergenerational justice in the developing world. Demographic changes are precipitating rapid population aging in developing nations, however, and ethical issues regarding older people's claim to scarce healthcare resources must be addressed. This paper posits that the traditional arguments about generational justice and age-based rationing of healthcare resources, which were developed primarily in more industrialized nations, fail to adequately address the unique challenges facing older persons in developing nations. Existing philosophical approaches to age-based resource allocation underemphasize the importance of older persons for developing countries and fail to adequately consider the rights and interests of older persons in these settings. Ultimately, the paper concludes that the most appropriate framework for thinking about generational justice in developing nations is a rights-based approach that allows for the interests of all age groups, including the oldest, to be considered in the determination of health resource allocation. [source] The limitations of randomized controlled trials in predicting effectivenessJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 2 2010Nancy Cartwright PhD FBA Abstract What kinds of evidence reliably support predictions of effectiveness for health and social care interventions? There is increasing reliance, not only for health care policy and practice but also for more general social and economic policy deliberation, on evidence that comes from studies whose basic logic is that of JS Mill's method of difference. These include randomized controlled trials, case,control studies, cohort studies, and some uses of causal Bayes nets and counterfactual-licensing models like ones commonly developed in econometrics. The topic of this paper is the ,external validity' of causal conclusions from these kinds of studies. We shall argue two claims. Claim, negative: external validity is the wrong idea; claim, positive: ,capacities' are almost always the right idea, if there is a right idea to be had. If we are right about these claims, it makes big problems for policy decisions. Many advice guides for grading policy predictions give top grades to a proposed policy if it has two good Mill's-method-of difference studies that support it. But if capacities are to serve as the conduit for support from a method-of-difference study to an effectiveness prediction, much more evidence, and much different in kind, is required. We will illustrate the complexities involved with the case of multisystemic therapy, an internationally adopted intervention to try to diminish antisocial behaviour in young people. [source] Human Dignity and the Claim of Meaning: Athenian Tragic Drama and Supreme Court OpinionsJOURNAL OF SUPREME COURT HISTORY, Issue 1 2002James Boyd White I am going to bring together what may seem at first to be two extremely different institutions for the creation of public meaning, namely classical Athenian tragedy and the Supreme Court opinion.1 My object is not so much to draw lines of similarity and distinction between them, as a cultural analyst might do, as to try to capture something of what I believe is centrally at work in both institutions, in fact essential to what each at its best achieves. I can frame it as a question: How is it that the best instances of each genre (for I will be talking only about the best) work to resist the ever,present impulse to trivialize human life and experience,certainly well known in our own era-and instead confer upon the individual, and his or her sufferings and struggles in the world, a kind of dignity? I think that something like this is in fact the core of the most important achievements of both institutions, and that in both cases it is simultaneously imaginative (or literary) and political in nature. [source] Taurek's No Worse ClaimPHILOSOPHY AND PUBLIC AFFAIRS, Issue 1 2008WEYMA LÜBBE First page of article [source] The Law: President Bush's First Executive Privilege Claim: The FBI/Boston InvestigationPRESIDENTIAL STUDIES QUARTERLY, Issue 1 2003CHARLES TIEFER President George W. Bush staked out an array of positions in protection of government secrecy, including his first use of executive privilege in a congressional investigation. He invoked privilege in a House committee inquiry in December 2001, with respect to Justice Department deliberative documents bearing on serious abuses by the Boston Federal Bureau of Investigation. The ensuing dispute came to a climax in a March 2002 bearing at which the committee invited this author to analyze previous parallel oversight situations. Soon thereafter, the Bush administration effectively surrendered its attempted executive privilege claim and provided the key documents that bad been withheld. [source] Staking Her Claim: Buffy the Vampire Slayer as Transgressive Woman WarriorTHE JOURNAL OF POPULAR CULTURE, Issue 3 2001Francis H. Early First page of article [source] ARE PATIENTS' DECISIONS TO REFUSE TREATMENT BINDING ON HEALTH CARE PROFESSIONALS?BIOETHICS, Issue 3 2005Peter Murphy ABSTRACT When patients refuse to receive medical treatment, the consequences of honouring their decisions can be tragic. This is no less true of patients who autonomously decide to refuse treatment. I distinguish three possible implications of these autonomous decisions. According to the Permissibility Claim, such a decision implies that it is permissible for the patient who has made the autonomous decision to forego medical treatment. According to the Anti-Paternalism Claim, it follows that health-care professionals are not morally permitted to treat that patient. According to the Binding Claim it follows that these decisions are binding on health-care professionals. My focus is the last claim. After arguing that it is importantly different from each of the first two claims, I give two arguments to show that it is false. One argument against the Binding Claim draws a comparison with cases in which patients autonomously choose perilous positive treatments. The other argument appeals to considered judgments about cases in which disincentives are used to deter patients from refusing sound treatments. [source] CEO Compensation and Stakeholders' Claims,CONTEMPORARY ACCOUNTING RESEARCH, Issue 3 2005ALKA ARORA Abstract The traditional view that a corporation exists solely to serve the interests of the firm's shareholders has given way to a changing view that recognizes the importance of corporate constituents in addition to shareholders. Prior studies demonstrate a significant association between the sensitivity of CEO compensation and a firm's stock prices. However, the association between CEO compensation and the claim of other primary stakeholders (customers, employees, suppliers) has not been examined. The purpose of this study is to investigate whether the adoption of long-term incentive plans aligns the interest of the CEO with the interest of the primary stakeholders in the firm. Using the fixed-effect regression, our results indicate a significant association between the change in CEO compensation and the claims of the customers, shareholders, and employees. We contribute to the literature by demonstrating that the managers are accountable not only to the shareholders but also to primary stakeholders. [source] Liquid-based cytology: is this the way forward for cervical screening?CYTOPATHOLOGY, Issue 2 2002R. P. MOSELEY Liquid-based cytology: is this the way forward for cervical screening? Liquid-based cytology (LBC) is currently being marketed as an alternative methodology to replace the conventional PAP smear in cervical cytology. A substantial body of literature exists in support of LBC, some of which is at least partially sponsored by product manufacturers. The majority of published literature in support of LBC employs Bethesda reporting terminology. In this study we have analysed published raw data and presented this in NHSCSP terminology. Claims relating to sensitivity, specificity and smear adequacy have then been considered with reference to this data. Our analysis of existing data does not support the nationwide implementation of LBC at present. Further studies are recommended in order to evaluate the place of this technology within the NHSCSP. [source] Religious Claims in Public: Lutheran ResourcesDIALOG, Issue 4 2006Cynthia Moe-Lobeda Abstract:, A cacophony of religious voices seeking to influence public culture, opinion, and policy pervades the public discourse in the United States today. Some publicly-oriented religious claims are appropriate while others are not. Sorely needed are criteria for making that distinction. This essay asks: What are criteria for appropriate and valid use of religious claims, language, and symbols in deliberation about public policy? What particular gifts do Lutheran traditions bring to shaping those criteria? The essay then draws upon Lutheran theological resources to propose theologically grounded criteria for appropriate and valid use of religious language, claims, and symbols in public discourse. [source] A Parimutuel Market Microstructure for Contingent ClaimsEUROPEAN FINANCIAL MANAGEMENT, Issue 1 2005Jeffrey Lange G10; G13; G14 Abstract Parimutuel principles are widely used as an alternative to fixed odds gambling in which a bookmaker acts as a dealer by quoting fixed rates of return on specified wagers. A parimutuel game is conducted as a call auction in which odds are allowed to fluctuate during the betting period until the betting period is closed or the auction ,called'. The prices or odds of wagers are set based upon the relative amounts wagered on each risky outcome. In financial microstructure terms, trading under parimutuel principles is characterised by (1) call auction, non-continuous trading; (2) riskless funding of claim payouts using the amounts paid for all of the claims during the auction; (3) special equilibrium pricing conditions requiring the relative prices of contingent claims equal the relative aggregate amounts wagered on such claims; (4) endogenous determination of unique state prices; and (5) higher efficiency. Recently, a number of large investment banks have adopted a parimutuel mechanism for offering contingent claims on various economic indices, such as the US Nonfarm payroll report and Eurozone Harmonised inflation. Our paper shows how the market microstructure incorporating parimutuel principles for contingent claims which allows for notional transactions, limit orders, and bundling of claims across states is constructed. We prove the existence of a unique price equilibrium for such a market and suggest an algorithm for computing the equilibrium. We also suggest that for a broad class of contingent claims, that the parimutuel microstructure recently deployed offers many advantages over the dominant dealer and exchange continuous time mechanisms. [source] An Epidemiologic Study of Closed Emergency Department Malpractice Claims in a National Database of Physician Malpractice InsurersACADEMIC EMERGENCY MEDICINE, Issue 5 2010Terrence W. Brown MD Abstract Objectives:, The objective was to perform an epidemiologic study of emergency department (ED) medical malpractice claims using data maintained by the Physician Insurers Association of America (PIAA), a trade association whose participating malpractice insurance carriers collectively insure over 60% of practicing physicians in the United States. Methods:, All closed malpractice claims in the PIAA database between 1985 and 2007, where an event in an ED was alleged to have caused injury to a patient 18 years of age or older, were retrospectively reviewed. Study outcomes were the frequency of claims and average indemnity payments associated with specific errors identified by the malpractice insurer, as well as associated health conditions, primary specialty groups, and injury severity. Indemnity payments include money paid to claimants as a result of settlement or court adjudication, and this financial obligation to compensate a claimant constitutes the insured's financial liability. These payments do not include the expenses associated with resolving a claim, such as attorneys' fees. The study examined claims by adjudicatory outcome, associated financial liability, and expenses of litigation. Adjudicatory outcome refers to the legal disposition of a claim as it makes its way into and through the court system and includes resolution of claims by formal verdict as well as by settlement. The study also investigated how the number of claims, average indemnity payments, paid-to-close ratios (the percentage of closed claims that resolved with a payment to the plaintiff), and litigation expenses have trended over the 23-year study period. Results:, The authors identified 11,529 claims arising from an event originating in an ED, representing over $664 million in total liability over the 23-year study period. Emergency physicians (EPs) were the primary defendants in 19% of ED claims. The largest sources of error, as identified by the individual malpractice insurer, included errors in diagnosis (37%), followed by improper performance of a procedure (17%). In 18% of claims, no error could be identified by the insurer. Acute myocardial infarction (AMI; 5%), fractures (6%), and appendicitis (2%) were the health conditions associated with the highest number of claims. Over two-thirds of claims (70%) closed without payment to the claimant. Most claims that paid out did so through settlement (29%). Only 7% of claims were resolved by verdict, and 85% of those were in favor of the clinician. Over time, the average indemnity payments and expenses of litigation, adjusted for inflation, more than doubled, while both the total number of claims and number of paid claims decreased. Conclusions:, Emergency physicians were the primary defendants in a relatively small proportion of ED claims. The disease processes associated with the highest numbers of claims included AMI, appendicitis, and fractures. The largest share of overall indemnity was attributed to errors in the diagnostic process. The financial liability of medical malpractice in the ED is substantial, yet the vast majority of claims resolve in favor of the clinician. Efforts to mitigate risk in the ED should include the diverse clinical specialties who work in this complex environment, with attention to those health conditions and potential errors with the highest risk. ACADEMIC EMERGENCY MEDICINE 2010; 17:553,560 © 2010 by the Society for Academic Emergency Medicine [source] ,MOVING AROUND': THE SOCIAL AND SPATIAL MOBILITY OF YOUTH IN LUSAKAGEOGRAFISKA ANNALER SERIES B: HUMAN GEOGRAPHY, Issue 3 2008Katherine V. Gough ABSTRACT Claims have recently been made for a ,mobilities paradigm' which is challenging the relative ,a-mobile' focus of much of the social sciences. The agenda drawn up for this mobilities paradigm is clearly based on Northern trends with little consideration of the South. African populations have always been mobile but little is known about the mobility of urban populations and in particular of the youth, who constitute a large proportion of the population. This paper explores the daily and residential mobility of young people in Lusaka building upon interviews held with low- and middle-income youth. The aim is to contribute to discussions of: how mobility varies by gender and class; the links between spatial mobility and social and economic mobility; the nature of the relationship between patterns of mobility and residential structure; and how examining mobility can illuminate many other aspects of young people's lives. Overall the picture emerging from Lusaka is rather bleak. In a context of spiralling economic decline and rising HIV/AIDS rates, the social mobility of youth is predominantly downwards which is reflected in the residential and daily mobility patterns of the young people. There is a strong link between young people's mobility and their livelihoods, an aspect of mobility that is widespread in the South but largely overlooked by the emerging mobilities paradigm. [source] Does size matter for dispersal distance?GLOBAL ECOLOGY, Issue 4 2007David G. Jenkins ABSTRACT Aim, The aim of this study is to answer the questions: (1) do small organisms disperse farther than large, or vice versa; and (2) does the observed pattern differ for passive and active dispersers? These questions are central to several themes in biogeography (including microbial biogeography), macroecology, metacommunity ecology and conservation biology. Location, The meta-analysis was conducted using published data collected worldwide. Methods, We collected and analysed 795 data values in the peer-reviewed literature for direct observations of both maximal dispersal distance and mass of the dispersing organisms (e.g. seeds, not trees). Analysed taxa ranged in size from bacteria to whales. We applied macroecology analyses based on null models (using Monte Carlo randomizations) to test patterns relative to specific hypotheses. Results, Collected dispersal distance and mass data spanned 9 and 21 orders of magnitude, respectively. Active dispersers dispersed significantly farther (P < 0.001) and were significantly greater in mass (P < 0.001) than passive dispersers. Overall, size matters: larger active dispersers attained greater maximum observed dispersal distances than smaller active dispersers. In contrast, passive-disperser distances were random with respect to propagule mass, but not uniformly random, in part due to sparse data available for tiny propagules. Conclusions, Size is important to maximal dispersal distance for active dispersers, but not for passive dispersers. Claims that microbes disperse widely cannot be tested by current data based on direct observations of dispersal: indirect approaches will need to be applied. Distance,mass relationships should contribute to a resolution of neutral and niche-based metacommunity theories by helping scale expectations for dispersal limitation. Also, distance,mass relationships should inform analyses of latitudinal species richness and conservation biology topics such as fragmentation, umbrella species and taxonomic homogenization. [source] Unsettling connections: transnational networks, development and African home associationsGLOBAL NETWORKS, Issue 2 2009CLAIRE MERCER Abstract With the transnational turn in the social sciences attention has now turned to ,global civil society', ,transnational civil society', ,transnational networks' and, most recently, ,migrant' or ,diasporic civil society'. Claims are being made about the developmental potential of these new configurations of civil society, and the global connections forged by migrant and diaspora associational life have been reified into things called ,networks' for the purpose of enrolling them into development policy. In this article, we challenge the network model through an analysis of transnational Cameroonian and Tanzanian home associations. The idea of a network suggests an overly robust and ordered set of linkages for what are in effect often loose and transient connections. African home associations draw attention to the historically-embedded and mundane ways in which forms of associational life can be ,transnational' outside the formalized structures and Eurocentric development hierarchies created by international NGOs and other development institutions. Although they form largely invisible connections operating outside these hierarchies, African home associations unsettle assumptions about the geography of civil society and its relationship with development. Close attention to the histories and geographies of African home associations reveals that power and agency more often lie with migrants and elites within Africa than with the transnational diaspora. [source] Effect of an Expenditure Cap on Low-Income Seniors' Drug Use and Spending in a State Pharmacy Assistance ProgramHEALTH SERVICES RESEARCH, Issue 3 2009Christine E. Bishop Objective. To estimate the impact of a soft cap (a ceiling on utilization beyond which insured enrollees pay a higher copayment) on low-income elders' use of prescription drugs. Data Sources and Setting. Claims and enrollment files for the first year ( June 2002 through May 2003) of the Illinois SeniorCare program, a state pharmacy assistance program, and Medicare claims and enrollment files, 2001 through 2003. SeniorCare enrolled non-Medicaid-eligible elders with income less than 200 percent of Federal Poverty Level. Minimal copays increased by 20 percent of prescription cost when enrollee expenditures reached $1,750. Research Design. Models were estimated for three dependent variables: enrollees' average monthly utilization (number of prescriptions), spending, and the proportion of drugs that were generic rather than brand. Observations included all program enrollees who exceeded the cap and covered two periods, before and after the cap was exceeded. Principle Findings. On average, enrollees exceeding the cap reduced the number of drugs they purchased by 14 percent, monthly expenditures decreased by 19 percent, and the proportion generic increased by 4 percent, all significant at p<.01. Impacts were greater for enrollees with greater initial spending, for enrollees without one of five chronic illness diagnoses in the previous calendar year, and for enrollees with lower income. Conclusions. Near-poor elders enrolled in plans with caps or coverage gaps, including Part D plans, may face sharp declines in utilization when they exceed these thresholds. [source] Assessing Treatment Effects of Inhaled Corticosteroids on Medical Expenses and Exacerbations among COPD Patients: Longitudinal Analysis of Managed Care ClaimsHEALTH SERVICES RESEARCH, Issue 6 2008Manabu Akazawa Objective. To assess costs, effectiveness, and cost-effectiveness of inhaled corticosteroids (ICS) augmenting bronchodilator treatment for chronic obstructive pulmonary disease (COPD). Data Sources. Claims between 1997 and 2005 from a large managed care database. Study Design. Individual-level, fixed-effects regression models estimated the effects of initiating ICS on medical expenses and likelihood of severe exacerbation. Bootstrapping provided estimates of the incremental cost per severe exacerbation avoided. Data Extraction Methods. COPD patients aged 40 or older with ,15 months of continuous eligibility were identified. Monthly observations for 1 year before and up to 2 years following initiation of bronchodilators were constructed. Principal Findings. ICS treatment reduced monthly risk of severe exacerbation by 25 percent. Total costs with ICS increased for 16 months, but declined thereafter. ICS use was cost saving 46 percent of the time, with an incremental cost-effectiveness ratio of $2,973 per exacerbation avoided; for patients ,50 years old, ICS was cost saving 57 percent of time. Conclusions. ICS treatment reduces exacerbations, with an increase in total costs initially for the full sample. Compared with younger patients with COPD, patients aged 50 or older have reduced costs and improved outcomes. The estimated cost per severe exacerbation avoided, however, may be high for either group because of uncertainty as reflected by the large standard errors of the parameter estimates. [source] When is Statistical Evidence Superior to Anecdotal Evidence in Supporting Probability Claims?HUMAN COMMUNICATION RESEARCH, Issue 4 2009The Role of Argument Type First page of article [source] Applying Organizational Justice: Questionable Claims and Promising SuggestionsINDUSTRIAL AND ORGANIZATIONAL PSYCHOLOGY, Issue 2 2009JERALD GREENBERG With an eye toward promoting applications of organizational justice, I respond to commentaries on my focal article (Greenberg, 2009a). Specifically, I challenge questionable claims regarding (a) characterization of applied research, (b) why we don't conduct more applied justice research, (c) moral versus instrumental rationales for promoting justice, (d) the validity of intervention studies, and (e) interpretations of Lewin's classic observation about the practical value of theory. I also identify and comment upon two suggestions for promoting applied justice research: (a) promoting cooperation between researchers and practitioners and (b) conducting comprehensive, integrative interventions. [source] Stereotypes, Bias, and Personnel Decisions: Strange and StrangerINDUSTRIAL AND ORGANIZATIONAL PSYCHOLOGY, Issue 4 2008FRANK J. LANDY Research on stereotyping as related to workplace evaluations and decisions has been going on for more than 30 years. Recently, implicit association theory has emerged as a less conscious manifestation of stereotyping mechanisms. In this article, I review the relevance of research on both stereotyping and one of the more popular tests of implicit associations, the Implicit Association Test (IAT). Claims have been made that both stereotyping research and, more recently, IAT research provide theoretical and empirical support for the argument that protected demographic groups (e.g., ethnic minorities, women) are the victims of biased personnel decisions and evaluations. My review of the literature suggests that both stereotyping and IAT research study designs are sufficiently far removed from real work settings as to render them largely useless for drawing inferences about most, but not all, forms of employment discrimination. [source] Unions and the Duration of Workers' Compensation ClaimsINDUSTRIAL RELATIONS, Issue 4 2005MICHELE CAMPOLIETI This paper examines the effect of union status on workers' compensation claim duration in Canada. I find that unionized workers have shorter claims than nonunionized workers and that relatively little of this difference can be attributed to differences in worker or job characteristics. I interpret this as being consistent with a strong union effect that reduces union member's claim duration. Plausible explanations for this finding and directions for future research are also discussed. [source] Autoimmune disease concomitance among inflammatory bowel disease patients in the United States, 2001-2002INFLAMMATORY BOWEL DISEASES, Issue 6 2008Russell Cohen MD Abstract Background: Recent studies suggest that inflammatory bowel disease (IBD) may share an underlying pathogenesis with other autoimmune diseases. Methods: Two United States data sets with patient-level medical and drug claims were used to explore the occurrence of autoimmune diseases in patients with IBD, particularly Crohn's disease (CD) and ulcerative colitis (UC), with that in controls. From 2001 to 2002 IBD patients were identified using International Classification of Diseases, 9th revision, diagnosis codes in the IMS Health Integrated Administration Claims Database and the Market Scan Commercial Claims and Encounters Database. Controls were selected by matching on sex, age, Census Bureau region, and length of previous medical insurance coverage. Odds ratios (ORs) evaluated the risk relationship between IBD patients and controls within an estimated Mantel-Haenszel 95% confidence interval. Sensitivity analysis tested the case identification method used to select IBD patients. Results: The risk for ankylosing spondylitis (AS) was substantially increased across both data sets: OR (95% confidence interval [CI]) of 7.8 (5.6,10.8) in IMS Health and 5.8 (3.9,8.6) in MarketScan. The risk for rheumatoid arthritis (RA) was 2.7 (2.4,3.0) and 2.1 (1.8,2.3), respectively; for multiple sclerosis (MS); the ORs were 1.5 (1.2,1.9) and 1.6 (1.2,2.1), respectively. There was no increased risk for type 1 diabetes mellitus, and the results for psoriatic arthritis (PsA) were inconsistent. The sensitivity analysis supported these findings. Conclusions: A much higher risk for RA, AS, PsA, and MS was observed in IBD patients compared with controls. Prospective epidemiologic studies are needed to confirm these findings and explore the pathogenic mechanism of this relationship. (Inflamm Bowel Dis 2008) [source] In Search of the Audit Society: Some Evidence from Health Care, Police and SchoolsINTERNATIONAL JOURNAL OF AUDITING, Issue 1 2000Mary Bowerman Claims that we are moving towards an ,audit society' (Power 1994, 1997) are fuelled by the emergence of a wealth of audit and other performance monitoring initiatives. To date, however, very little empirical evidence has been gathered on the precise nature, role and scope of this ,society'. This paper draws on academic literature, official and unofficial reports and interviews with auditors, inspectors and auditees across three major public service organisations. The paper argues that audit is just one aspect of a broader, but rapidly evolving, ,performance measurement society'; other important elements of which include the growth of inspection and self-assessment. Public sector audit emerges as an increasingly questionable function. The remainder of the paper dismantles some of the myths associated with its practice, particularly regarding its public visibility and contribution in terms of enhancing processes of public service delivery, management and accountability. [source] Sovereignty in the Balance: Claims and Bargains at the UN Conferences on the Environment, Human Rights, and WomenINTERNATIONAL STUDIES QUARTERLY, Issue 4 2000Kathryn Hochstetler States vary the content and subject matter of their claims to sovereignty. In an analysis of when states invoked sovereignty at recent UN World Conferences on the environment (1992), human rights (1993), and women (1995), the authors revise and extend Litfin's (1997) notion of bargains among components of sovereignty. At the conferences, states invoked sovereignty in debates over cultural and religious values, economics, and increased international accountability. The authors interpret the debates based on how four elements of sovereignty,autonomy, control, and legitimacy in the eyes of other states and nonstate actors,are traded by states through implicit or explicit bargaining. They identify patterns that vary by issue area. The authors argue that nongovernmental organizations as well as other states may legitimate or delegitimate states' sovereign claims. They find that countries of the global South made more sovereignty claims of all kinds than Northern states. And, sovereignty bargains may be struck more easily over power and economics than social values. [source] Qualitative Analysis of Medicare Claims in the Last 3 Years of Life: A Pilot StudyJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 1 2005Amber E. Barnato MD Objectives: To study end-of-life care of a representative sample of older people using qualitative interpretation of administrative claims by clinicians and to explore whether this method yields insights into patient care, including continuity, errors, and cause of death. Design: Random, stratified sampling of decedents and all their Medicare-covered healthcare claims in the 3 years before death from a 5% sample of elderly fee-for-service beneficiaries, condensation of all claims into a chronological clinical summary, and abstraction by two independent clinicians using a standardized form. Setting: United States. Participants: One hundred Medicare fee-for-service older people without disability or end-stage renal disease entitlement who died in 1996 to 1999 and had at least 36 months of continuous Part A and Part B enrollment before death. Measurements: Qualitative narrative of the patient's medical course; clinician assessment of care continuity and apparent medical errors; cause, trajectory, and place of death. Results: The qualitative narratives developed by the independent abstracters were highly concordant. Clinicians felt that 75% of cases lacked continuity of care that could have improved the quality of life and the way the person died, and 13% of cases had a medical error identified by both abstracters. Abstracters disagreed about assignment of a single cause of death in 28% of cases, and abstracters and the computer algorithm disagreed in 43% of cases. Conclusion: Qualitative claims analysis illuminated many problems in the care of chronically ill older people at the end of life and suggested that traditional vital statistics assignation of a single cause of death may distort policy priorities. This novel approach to claims review is feasible and deserves further study. [source] On Some Recent Claims for the Efficacy of Cognitive Therapy for People with Intellectual DisabilitiesJOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 1 2006Peter Sturmey Background, Many authors have expressed concern regarding the efficacy of psychotherapy, including psychotherapy for people with intellectual disabilities. Materials and Methods, Recently, many authors have made claims for the effectiveness of cognitive therapy for treating people with intellectual disabilities. During this debate, applied behaviour analysis has been misrepresented by incorrectly labelling behavioural as cognitive techniques, repeated misrepresentations of behaviourism and attributing the efficacy of treatment packages to cognitive components of undemonstrated efficacy when it is more parsimonious to attribute efficacy to behavioural elements of known efficacy. Conclusions, This article documents and corrects these errors. [source] Panbiogeography from tracks to ocean basins: evolving perspectivesJOURNAL OF BIOGEOGRAPHY, Issue 4 2001John R. Grehan Misconceptions arising from efforts to translate panbiogeography into terms used in other biogeographic and evolutionary theories are discussed with respect to Cox's (1998, Journal of Biogeography, 25, 813,828) critique of panbiogeography. Croizat's rejection of ,Darwinian dispersal' applies only to efforts to utilize this concept as a general explanation for biogeographic patterns. The conceptual difference between distribution and panbiogeographic dispersal maps is illustrated to show that Croizat did not synonymize distribution and dispersal. Croizat's position on continental drift and plate tectonics does not support Cox's (1998) claim that Croizat ,for a long time' refused to accept the theory of plate tectonics. The methodological relationship between panbiogeographic analysis and geology suggests an independence of methodology that prevents geological theory from falsifying panbiogeographic predictions. Panbiogeographic predictions for the eastern Pacific are shown to be in agreement with current historical geological models. Claims by Cox (1998) that the panbiogeographic method is variable and questionable are evaluated with respect to the biogeographic homology of primitive frogs, ratite birds, and southern beeches to demonstrate the consistent application of minimal distance, main massing, phylogenetic affinity and baseline criteria. Panbiogeographic classification concepts are contrasted with the Darwinian system (supported by Cox) utilizing a concept of unitary geographical area based on the language of Roman military rule. Inconsistent positions expressed in recent critiques of panbiogeography may indicate an underlying and implicit acceptance of the empirical and theoretical progress generated by panbiogeography within modern biogeography. ,The formation of groups has an invigorating effect in all spheres of human striving, perhaps mostly due to the struggle between the convictions and aims represented by the different groups' (Einstein, 1938. Collier's, 26 November). [source] Ehealth: Market Potential and Business StrategiesJOURNAL OF COMPUTER-MEDIATED COMMUNICATION, Issue 4 2001Pamela Whitten Due to the economic and social priorities afforded health services in the United States, research on new delivery modalities such as the Internet is gaining in popularity. Claims of the Internet's potential range from a promise to revolutionize the fundamental way health care is delivered to a tool for empowering patients through enhanced interaction with providers (Rice, 2001). Even though a great amount of attention has been given to e-health activity, the preponderance of publications to date has focused on the Internet as a source of health information. However important this form of e-health is, this type of service simply does not face the same constraints that must be addressed by those actually delivering health care services or tightly regulated pharmaceutical products. In this paper, we examine e-health by focusing explicitly on the delivery of health care products and services. Our examination of e-health activity is guided by two broad research questions. First, we ask what the potential is for the development of online health care services by examining its potential in major health care service and product sectors. Second, based upon case studies of two online health service firms, we seek to understand the emerging strategies of firms that are attempting to enter the health care market with an entirely online approach. Our examination of current e-health trends, as well as our two case studies, demonstrates the tremendous potential for health-related commercial activity on the Internet. However, our examination of the barriers facing ehealth from the US health system also pointed out the almost insurmountable challenges. We therefore conclude that a "click and mortar" model may perhaps be the optimal strategy for e-health. [source] The Impact of Damage Caps on Malpractice Claims: Randomization Inference with Difference-in-DifferencesJOURNAL OF EMPIRICAL LEGAL STUDIES, Issue 1 2007John J. Donohue III We use differences-in-differences (DID) to assess the impact of damage caps on medical malpractice claims for states adopting caps between 1991,2004. We find that conventional DID estimators exhibit acute model sensitivity. As a solution, we offer (nonparametric) covariance-adjusted randomization inference, which incorporates information about cap adoption more directly and reduces model sensitivity. We find no evidence that caps affect the number of malpractice claims against physicians. [source] The Save the Children Fund and the Russian Famine of 1921,23: Claims and Counter-Claims about Feeding "Bolshevik" Children,JOURNAL OF HISTORICAL SOCIOLOGY, Issue 1 2009LINDA MAHOOD Drawing on literature on the social construction of social problems, this paper examines the British Save the Children Fund's claims making activities regarding support for child famine victims in Russia in 1921,23. It examines 1) how the Fund constructed famine in Russia as a social problem that was worthy of British, and wider international, support and attention; 2) the rhetorical strategies used by the Fund to construct the causes of the famine for the British public; and 3) the claims the Fund made about why Britons should care about starving children in Russia. We also attend to counter-claims made about the Fund and its involvement with Russia. We used unpublished letters, memos and reports from The Save the Children Fund archives to examine how the Fund responded to attacks on its activities coming from Russian émigrés and from The Daily Express. We suggest that the examination of this case through the concept of claims making offers a lens to understand how children in distress in the early 20th century became the objects of British, and wider international aid. [source] | |||||||||||||||||||||||||||||||||||||||||||||||||