A cross-sectional study assessing the association between online ratings and structural and quality of care measures : results from two German physician rating websites

BACKGROUND: Even though physician rating websites (PRWs) have been gaining in importance in both practice and research, little evidence is available on the association of patients' online ratings with the quality of care of physicians. It thus remains unclear whether patients should rely on these ratings when selecting a physician. The objective of this study was to measure the association between online ratings and structural and quality of care measures for 65 physician practices from the German Integrated Health Care Network "Quality and Efficiency" (QuE). METHODS: Online reviews from two German PRWs were included which covered a three-year period (2011 to 2013) and included 1179 and 991 ratings, respectively. Information for 65 QuE practices was obtained for the year 2012 and included 21 measures related to structural information (N = 6), process quality (N = 10), intermediate outcomes (N = 2), patient satisfaction (N = 1), and costs (N = 2). The Spearman rank coefficient of correlation was applied to measure the association between ratings and practice-related information. RESULTS: Patient satisfaction results from offline surveys and the patients per doctor ratio in a practice were shown to be significantly associated with online ratings on both PRWs. For one PRW, additional significant associations could be shown between online ratings and cost-related measures for medication, preventative examinations, and one diabetes type 2-related intermediate outcome measure. There again, results from the second PRW showed significant associations with the age of the physicians and the number of patients per practice, four process-related quality measures for diabetes type 2 and asthma, and one cost-related measure for medication. CONCLUSIONS: Several significant associations were found which varied between the PRWs. Patients interested in the satisfaction of other patients with a physician might select a physician on the basis of online ratings. Even though our results indicate associations with some diabetes and asthma measures, but not with coronary heart disease measures, there is still insufficient evidence to draw strong conclusions. The limited number of practices in our study may have weakened our findings.

Eight Questions About Physician-Rating Websites: A Systematic Review

Background: Physician-rating websites are currently gaining in popularity because they increase transparency in the health care system. However, research on the characteristics and content of these portals remains limited. Objective: To identify and synthesize published evidence in peer-reviewed journals regarding frequently discussed issues about physician-rating websites. Methods: Peer-reviewed English and German language literature was searched in seven databases (Medline (via PubMed), the Cochrane Library, Business Source Complete, ABI/Inform Complete, PsycInfo, Scopus, and ISI web of knowledge) without any time constraints. Additionally, reference lists of included studies were screened to assure completeness. The following eight previously defined questions were addressed: 1) What percentage of physicians has been rated? 2) What is the average number of ratings on physician-rating websites? 3) Are there any differences among rated physicians related to socioeconomic status? 4) Are ratings more likely to be positive or negative? 5) What significance do patient narratives have? 6) How should physicians deal with physician-rating websites? 7) What major shortcomings do physician-rating websites have? 8) What recommendations can be made for further improvement of physician-rating websites? Results: Twenty-four articles published in peer-reviewed journals met our inclusion criteria. Most studies were published by US (n=13) and German (n=8) researchers; however, the focus differed considerably. The current usage of physician-rating websites is still low but is increasing. International data show that 1 out of 6 physicians has been rated, and approximately 90% of all ratings on physician-rating websites were positive. Although often a concern, we could not find any evidence of "doctor-bashing". Physicians should not ignore these websites, but rather, monitor the information available and use it for internal and ex-ternal purpose. Several shortcomings limit the significance of the results published on physician-rating websites; some recommendations to address these limitations are presented. Conclusions: Although the number of publications is still low, physician-rating websites are gaining more attention in research. But the current condition of physician-rating websites is lacking. This is the case both in the United States and in Germany. Further research is necessary to increase the quality of the websites, especially from the patients’ perspective.

Zero-rating in emerging mobile markets: Free Basics and Wikipedia Zero in Ghana

Despite widespread controversy surrounding zero-rating—that is, the practice of subsidizing mobile data—the field suffers from a lack of inquiry into user understanding of and experience with zero-rated services. This paper explores how Ghanaian mobile users interact with zero-rated mobile applications Free Basics and Wikipedia Zero. Based on semi-structured interviews with users and non-users of the applications, I discuss how mobile phone users perceive Free Basics and Wikipedia Zero, what motivates them to use or not use the applications, and how the availability of the applications influences their data-buying strategies. Findings suggest that respondents, including those who did not actively use the applications, understood and experienced Free Basics and Wikipedia Zero in ways divergent from the providers’ aim of expanding access to online content and services.

Attachment Style, Therapeutic Alliance and Recovery in forensic mental health: the A-STAR study and clinical research portfolio

Background: Research suggests that forensic mental health services and staff can play an important role in the recognition and intervention with attachment-related behaviours to promote engagement and recovery. There is a lack of literature exploring whether the attachment needs of forensic service-users are recognised and, associations between attachment style and factors predictive of recovery. Aims: This study aimed to examine the extent to which service-users and keyworkers agree about service-users’ attachment and to identify whether attachment was associated with service attachment, working alliance, ward climate and recovery. Methods: Twenty-two service-users from low and medium secure forensic services, completed questionnaire measures of their attachment style, service attachment, working alliance, ward climate and experiences of recovery. Nineteen keyworkers completed measures of the service-users attachment style and working alliance. Results: There was strong agreement between service-users and staff for attachment anxiety (ICC=0.71) but poor agreement for attachment avoidance (ICC=0.39). Service attachment was associated with more positive perceptions of staff support (r=0.49) and avoidant attachment was associated with lower ratings of recovery (r=-0.51). Correlations between attachment style and service attachment, working alliance and ward climate were small and non-significant. Conclusions: A focus on staff training to support recognition of the nature and impact of avoidant attachment styles is indicated. The findings suggest that interventions to enhance staff - service-user relationships may be important for service attachment and indeed promotion of a recovery focused orientation amongst service-users high in avoidant attachment may improve wellbeing and outcomes.

An extreme planetary system around HD 219828: one long-period super Jupiter to a hot-Neptune host star

Context. With about 2000 extrasolar planets confirmed, the results show that planetary systems have a whole range of unexpected properties. This wide diversity provides fundamental clues to the processes of planet formation and evolution. Aims: We present a full investigation of the HD 219828 system, a bright metal-rich star for which a hot Neptune has previously been detected. Methods: We used a set of HARPS, SOPHIE, and ELODIE radial velocities to search for the existence of orbiting companions to HD 219828. The spectra were used to characterise the star and its chemical abundances, as well as to check for spurious, activity induced signals. A dynamical analysis is also performed to study the stability of the system and to constrain the orbital parameters and planet masses. Results: We announce the discovery of a long period (P = 13.1 yr) massive (m sini = 15.1 MJup) companion (HD 219828 c) in a very eccentric orbit (e = 0.81). The same data confirms the existence of a hot Neptune, HD 219828 b, with a minimum mass of 21 M⊕ and a period of 3.83 days. The dynamical analysis shows that the system is stable, and that the equilibrium eccentricity of planet b is close to zero. Conclusions: The HD 219828 system is extreme and unique in several aspects. First, ammong all known exoplanet systems it presents an unusually high mass ratio. We also show that systems like HD 219828, with a hot Neptune and a long-period massive companion are more frequent than similar systems with a hot Jupiter instead. This suggests that the formation of hot Neptunes follows a different path than the formation of their hot jovian counterparts. The high mass, long period, and eccentricity of HD 219828 c also make it a good target for Gaia astrometry as well as a potential target for atmospheric characterisation, using direct imaging or high-resolution spectroscopy. Astrometric observations will allow us to derive its real mass and orbital configuration. If a transit of HD 219828 b is detected, we will be able to fully characterise the system, including the relative orbital inclinations. With a clearly known mass, HD 219828 c may become a benchmark object for the range in between giant planets and brown dwarfs.

Study of depressive symptoms according to Zung's self-rating scale on men deprived of freedom in a city of Colombia

Objective: To assess depressive symptoms in men deprived from freedom in a prison in a Colombian intermediate city. Material and Method: A cross sectional study was performed on a sample of three hundred and three patients in the Medium Security penitentiary and Prison Facility of the city of Manizales between April and May 2014. The information was collected through the Zung self-rating depression scale (SDS), subsequently there were established the positive results for depression screening according to the final score of the scale. Results: 303 men deprived from freedom were evaluated, mean age of 32.96 years +/- 10.8 years, 43.5% were living in cohabitation, 38% were single and 10.2% married; 33.7% had a primary education, 58% had secondary or incomplete secondary education, 5.6% reported higher studies; 38.6% (95% CI: 35.8; 41.4) reported symptoms of depression, predominating in ages between 18 to 44 years, no statistically significant differences p> 0.05 between the variables analyzed were found. Conclusions: The results of this study give rise to clinical evaluation, by specialized staff in the area of psychiatry and his intervention, given the characteristics of self-reported depression for this population.

Information Content of Bank Credit Rating Changes: Evidence from Europe

This thesis examines the short-term impact of credit rating announcements on daily stock returns of 41 European banks indexed in STOXX Europe 600 Banks. The time period of this study is 2002–2015 and the ratings represent long-term issuer ratings provided by S&P, Moody’s and Fitch. Bank ratings are significant for a bank’s operation costs so it is interesting to investigate how investors react to changes in creditworthiness. The study objective is achieved by conducting an event study. The event study is extended with a cross-sectional linear regression to investigate other potential determinants surrounding rating changes. The research hypotheses and the motivation for additional tests are derived from prior research. The main hypotheses are formed to explore whether rating changes have an effect on stock returns, when this possible reaction occurs and whether it is asymmetric between upgrades and downgrades. The findings provide evidence that rating announcements have an impact on stock returns in the context of European banks. The results also support the existence of an asymmetry in capital market reaction to rating upgrades and downgrades. The rating downgrades are associated with statistically significant negative abnormal returns on the event day although the reaction is rather modest. No statistically significant reaction is found associated with the rating upgrades on the event day. These results hold true with both rating changes and rating watches. No anticipation is observed in the case of rating changes but there is a statistically significant cumulative negative (positive) price reaction occurring before the event day for negative (positive) watch announcements. The regression provides evidence that the stock price reaction is stronger for rating downgrades occurring within below investment grade class compared with investment grade class. This is intuitive as investors are more concerned about their investments in lower-rated companies. Besides, the price reaction of larger banks is more mitigated compared with smaller banks in the case of rating downgrades. The reason for this may be that larger banks are usually more widely followed by the public. However, the study results may also provide evidence of the existence of the so-called “too big to fail” subsidy that dampens the negative returns of larger banks.

Socio-emotional factors related to the academic difficulties of “star” children of the psychomotricity and intervention program

This study shows the main socio- affective factors related to school difficulties of a group of three girls and three boys identified as "star" in the Programa Psicomotricidad e Intervención (Psychomotor and Intervention Program). The study was developed through a mixed methodology, in which the Human Figure Test, the Kinetic Family Drawing and an interview with the mother of each student were applied. The most important results revealed the existence of family conflicting factors that affect the emotional state of children, generating negative feelings about themselves that affect their social interactions and their school performance.

No relationship between most polymorphisms of steroidogenic acute regulatory (StAR) gene with polycystic ovarian syndrome

Background: Polycystic ovary syndrome (PCOS) is one of the most common endocrine women’s disorders in reproductive age. Hyperandrogenism has a critical role in the etiology of PCOS and it can cause fault in Steroidogenesis process. During steroidogenesis, steroidogenic acute regulatory protein (StAR) seems to increase the delivery of cholesterol through mitochondrial membrane. Therefore, polymorphisms of StAR might effect on this protein and play a role in the etiology of PCOS. Objective: The aim of this study was to investigate the association between StAR SNPs with PCOS. Thus, seven polymorphisms in this gene: rs104894086, rs104894089, rs104894090, rs137852689, rs10489487, rs104894085 were detected. Materials and Methods: In this case control study, 45 PCOS women, 40 male factor/unexplained infertile women, and 40 fertile women as two control groups were participated from 2008-2012. Polymorphisms were detected using restriction fragment length polymorphism (PCR-RFLP) method. Results: Heterozygote genotyping for rs137852689 SNP (amino acid 218 C > T) was only seen in seven PCOS patients, one in normal ovulatory women, and five in male factor/unexplained infertile women (15.5%, 2.5%, 12.5%, respectively) (p= 0.12). While, it has shown no association between other SNPS with PCOs. Conclusion: The RFLP results for seven chosen SNPs, which located in exon 5 and 7 showed normal status in three groups, it means no heterozygous or homozygous forms of selected SNPs were observed. So, it seems evaluation of the active amino acid sites should be investigated and also the study population should be increased.

Credit rating agency regulation after the UK's EU membership referendum

Assesses the implications of the UK's decision to withdraw from the EU for the regulation of its credit rating industry. Discusses the current rules of the Credit Rating Agencies Regulations 2010. Considers how the likelihood that a "post-Brexit" UK will be increasingly dependent on its financial services sector might affect the approach taken towards its regulation.

The universal credit rating group:the viability of a response

The role played by the Big Three credit rating agencies (Standard & Poor’s, Moody’s, and Fitch) in the creation of the recent Financial Crisis has been well documented, as too has their conduct in the aftermath of the Crisis where they contributed to the prolonging of the effects of the systemic breakdown. Also, with a string of record fines and cease-and-desist orders in the wake of the Crisis lending weight to the notion that the Big Three have no plans of performing any more ethically, there are a number of organisations that are endeavouring to provide a better alternative to the stranglehold of the Big Three. In the first instalment of the Viability of a Response series we were introduced to the International Non-Profit Credit Rating Agency who, through the amalgamation of forward-looking and non-profit ideals, intends to inject some much needed ethical consideration into the process of providing ratings that are crucial to the marketplace . In this edition of the series, we will be introduced to the Universal Credit Rating Group (UCRG) which is an alliance between Dagong Global Ratings, RusRating, and Egan-Jones Rating Company. We will start by learning more about this alliance that is due to come into effect in the next few years, and then the article will examine the reality of the situation to come to a conclusion on what the Group’s chances of success may be.

Sub-kiloparsec alma imaging of compact star-forming galaxies at z ~ 2.5: revealing the formation of dense galactic cores in the progenitors of compact quiescent galaxies

We present spatially resolved Atacama Large Millimeter/submillimeter Array (ALMA) 870 μm dust continuum maps of six massive, compact, dusty star-forming galaxies at z ~ 2.5. These galaxies are selected for their small rest-frame optical sizes (r_e,F160W ~ 1.6 kpc) and high stellar mass densities that suggest that they are direct progenitors of compact quiescent galaxies at z ~ 2. The deep observations yield high far-infrared (FIR) luminosities of L_IR = 10^12.3-12.8 L_⨀ and star formation rates (SFRs) of SFR = 200–700 M_⊙ yr^−1, consistent with those of typical star-forming "main sequence" galaxies. The high spatial resolution (FWHM ~ 0 12–0 18) ALMA and Hubble Space Telescope photometry are combined to construct deconvolved, mean radial profiles of their stellar mass and (UV+IR) SFR. We find that the dusty, nuclear IR–SFR overwhelmingly dominates the bolometric SFR up to r ~ 5 kpc, by a factor of over 100× from the unobscured UV–SFR. Furthermore, the effective radius of the mean SFR profile (r_e,SFR ~ 1 kpc) is ~30% smaller than that of the stellar mass profile. The implied structural evolution, if such nuclear starburst last for the estimated gas depletion time of Δt = ±100 Myr, is a 4×increase of the stellar mass density within the central 1 kpc and a 1.6× decrease of the half-mass–radius. This structural evolution fully supports dissipation-driven, formation scenarios in which strong nuclear starbursts transform larger, star-forming progenitors into compact quiescent galaxies.

UNDERSTANDING ESSAY RATING AS A SOCIALLY MEDIATED ACTIVITY: THE CASE OF A HIGH-STAKES ENGLISH TEST IN CHINA

Thesis (Ph.D, Education) -- Queen's University, 2016-09-22 22:05:24.246