Health care network formation and policyholders' welfare

We develop a model in which two insurers and two health care providers compete for a fixed mass of policyholders. Insurers compete in premium and offer coverage against financial consequences of health risk. They have the possibility to sign agreements with providers to establish a health care network. Providers, partially altruistic, are horizontally differentiated with respect to their physical address. They choose the health care quality and compete in price. First, we show that policyholders are better off under a competition between conventional insurance rather than under a competition between integrated insurers (Managed Care Organizations). Second, we reveal that the competition between a conventional insurer and a Managed Care Organization (MCO) leads to a similar equilibrium than the competition between two MCOs characterized by a different objective i.e. private versus mutual. Third, we point out that the ex ante providers’ horizontal differentiation leads to an exclusionary equilibrium in which both insurers select one distinct provider. This result is in sharp contrast with frameworks that introduce the concept of option value to model the (ex post) horizontal differentiation between providers.

Validity of the ice shelf water plume concept beneath Filchner-Ronne Ice Shelf

In winter, brine rejection from sea ice formation and export in the Weddell Sea, offshore of Filchner-Ronne Ice Shelf (FRIS), leads to the formation of High Salinity Shelf Water (HSSW). This dense water mass enters the cavity beneath FRIS by sinking southward down the sloping continental shelf towards the grounding line. Melting occurs when the HSSW encounters the ice shelf, and the meltwater released cools and freshens the HSSW to form a water mass known as Ice Shelf Water (ISW). If this ISW rises, the ‘ice pump’ is initiated (Lewis and Perkin, 1986), whereby the ascending ISW becomes supercooled and deposits marine ice at shallower locations due to the pressure increase in the in-situ freezing temperature. Sandh¨ager et al. (2004) were able to infer the thickness patterns of marine ice deposits at the base of FRIS (figure 1), so the primary aim of this work is to try to understand the ocean flows that determine these patterns. The plume model we use to investigate ISW flow is described fully by Holland and Feltham (accepted) so only a relatively brief outline is presented here. The plume is simulated by combining a parameterisation of ice shelf basal interaction and a multiplesize- class frazil dynamics model with an unsteady, depth-averaged reduced-gravity plume model. In the model an active region of ISW evolves above and within an expanse of stagnant ambient fluid, which is considered to be ice-free and has fixed profiles of temperature and salinity. The two main assumptions of the model are that there is a well-mixed layer underneath the ice shelf and that the ambient fluid outside the plume is stagnant with fixed properties. The topography of the ice shelf that the plume flows beneath is set to the FRIS ice shelf draft calculated by Sandh¨ager et al. (2004) masked with the grounding line from the Antarctic Digital Database (ADD Consortium, 2002). To initiate the plumes, we assume that the intrusion of dense HSSW initially causes melting at the points on the grounding line where the glaciological tributaries feeding FRIS go afloat.

Coalition Formation through Motivation and Trust

Cooperation is the fundamental underpinning of multi-agent systems, allowing agents to interact to achieve their goals. Where agents are self-interested, or potentially unreliable, there must be appropriate mechanisms to cope with the uncertainty that arises. In particular, agents must manage the risk associated with interacting with others who have different objectives, or who may fail to fulfil their commitments. Previous work has utilised the notions of motivation and trust in engendering successful cooperation between self-interested agents. Motivations provide a means for representing and reasoning about agents' overall objectives, and trust offers a mechanism for modelling and reasoning about reliability, honesty, veracity and so forth. This paper extends that work to address some of its limitations. In particular, we introduce the concept of a clan: a group of agents who trust each other and have similar objectives. Clan members treat each other favourably when making private decisions about cooperation, in order to gain mutual benefit. We describe mechanisms for agents to form, maintain, and dissolve clans in accordance with their self-interested nature, along with giving details of how clan membership influences individual decision making. Finally, through some simulation experiments we illustrate the effectiveness of clan formation in addressing some of the inherent problems with cooperation among self-interested agents.

Permian bivalve molluscs from the Gai-As Formation, northern Namibia: systematics, taphonomy and biostratigraphy

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Why entanglement of formation is not generally monogamous

Unlike correlation of classical systems, entanglement of quantum systems cannot be distributed at will: if one system A is maximally entangled with another system B, it cannot be entangled at all with a third system C. This concept, known as the monogamy of entanglement, is manifest when the entanglement of A with a pair BC can be divided as contributions of the entanglement between A and B and A and C, plus a term τABC involving genuine tripartite entanglement and so expected to be always positive. A very important measure in quantum information theory, the entanglement of formation (EOF), fails to satisfy this last requirement. Here we present the reasons for that and show a set of conditions that an arbitrary pure tripartite state must satisfy for the EOF to become a monogamous measure, i.e., for τABC≥0. The relation derived is connected to the discrepancy between quantum and classical correlations, τABC being negative whenever the quantum correlation prevails over the classical one. This result is employed to elucidate features of the distribution of entanglement during a dynamical evolution. It also helps to relate all monogamous instances of the EOF to the squashed sntanglement, an entanglement measure that is always monogamous. © 2013 American Physical Society.

Zero, minimum and maximum relative radial acceleration for planar formation flight dynamics near triangular libration points in the Earth-Moon system

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Structural aspects of postnatal lung development - alveolar formation and growth

The human lung is born with a fraction of the adult complement of alveoli. The postnatal stages of human lung development comprise an alveolar stage, a stage of microvascular maturation, and very likely a stage of late alveolarization. The characteristic structural features of the alveolar stage are well known; they are very alike in human and rat lungs. The bases for alveolar formation are represented by immature inter-airspace walls with two capillary layers with a central sheet of connective tissue. Interalveolar septa are formed by folding up of one of the two capillary layers. In the alveolar stage, alveolar formation occurs rapidly and is typically very conspicuous in both species; it has therefore been termed 'bulk alveolarization'. During and after alveolarization the septa with double capillary networks are restructured to the mature form with a single network. This happens in the stage of microvascular maturation. After these steps the lung proceeds to a phase of growth during which capillary growth by intussusception plays an important role in supporting gas exchange. In view of reports that alveoli are added after the stage of microvascular maturation, the question arises whether the present concept of alveolar formation needs revision. On the basis of morphological and experimental findings we can state that mature lungs contain all the features needed for 'late alveolarization' by the classical septation process. Because of the high plasticity of the lung tissues, late alveolarization or some forms of compensatory alveolar formation may be considered for the human lung.

Federalism and the Concept of Political Territoriality: Towards an Analytical Framework for Comparative Territorial Politics

The core issues comparative territorial politics addresses are how and why territory is used to delimit, maintain, or create political power; and with what kind of consequences for efficiency (output) and legitimacy (input). The aim of this article is to integrate various research strands into the comparative study of territorial politics, with federal studies at its core. As an example of a conceptual payoff, ‘political territoriality’ refers the observer to three dimensions of the strategic use of areal boundaries for political power. By focusing on territory as a key variable of political systems, the actors, processes and institutions are first analytically separated and continuously measured, enhancing internal validity, and then theoretically integrated, which allows more valid external inferences than classic, legal-institutionalist federal studies. After discussing the boundaries and substance of comparative territorial politics as a federal discipline, political territoriality is developed towards an analytical framework applicable to politics at any governmental level. The claims are modest: political territoriality does not serve so much as an explanatory concept as rather an ‘attention-directing device’ for federal studies.

Power Games in Strategy Formation Processes – A Performative Interpretation

The article approaches an understanding of power within strategy formation processes established by verbal and bodily communication. On this note, we examined concepts of power constituted by hierarchy and developed a conceptual framework for a performative interpretation of power. In line with Austin’s (1962) and Butler’s (1990, 1993, 1997) concept of performativity as well as strategy-as-practice research (Balogun et al., 2007; Jarzabkowski & Spee, 2009) we ask: How is persuasion achieved by strategic actors during strategy formation processes? To explore verbal and bodily communication empirically we developed an experimental setting in a small high-tech company located in Germany in December, 2012. The Results indicate that (1) during critical incidents – when perspectives clash – actors use arguments to gain persuasion. (2) The data illustrates that independently of their hierarchical position within the company, strategic actors show an equal distribution of argumentative techniques.

Vasculogenesis: A process of vessel formation and its role during Ewing's sarcoma development

Vasculogenesis is the process by which Endothelial Precursor Cells (EPCs) form a vasculature. This process has been traditionally regarded as an embryological process of vessel formation. However, as early as in the 60's the concept of postnatal vasculogenesis was introduced, with a strong resurface of this idea in recent years. Similarly, previous work on a mouse skin tumor model provided us with the grounds to consider the role of vasculogenesis during tumor formation. ^ We examined the contribution of donor bone marrow (BM)-derived cells to neovascularization in recipient nude mice with Ewing's sarcoma. Ewing's sarcoma is a primitive neuroectodermal tumor that most often affects children and young adults between 5 and 30 years of age. Despite multiple attempts to improve the efficacy of chemotherapy for the disease, the 2-year metastases-free survival rate for patients with Ewing's sarcoma has not improved over the past 15 years. New therapeutic approaches are therefore needed to reduce the mortality rate. ^ The contribution of BM endothelial precursor cells in the development of Ewing's sarcoma was examined using different strategies to track the donor-derived cells. Using a BMT model that takes advantage of MHC differences between donor and recipient mice, we have found that donor BM cells were involved in the formation of Ewing's sarcoma vasculature. ^ Cells responsible for this vasculogenesis activity may be located within the stem cell population of the murine BM. These stem cells would not only generate the hematopoietic lineage but they would also generate ECs. Bone marrow SP (Side Population) cells pertain to a subpopulation that can be identified using flow cytometric analysis of Hoechst 33342-stained BM. This population of cells has HSC activity. We have tested the ability of BM SP cells to contribute to vasculogenesis in Ewing's sarcoma using our MHC mismatched transplant model. Mice transplanted with SP cells developed tumor neovessels that were derived from the donor SP cells. Thus, SP cells not only replenished the hematopoietic system of the lethally irradiated mice, but also differentiated into a non-hematopoietic cell lineage and contributed to the formation of the tumor vasculature. ^ In summary, we have demonstrated that BM-derived cells are involved in the generation of the new vasculature during the growth of Ewing's sarcoma. The finding that vasculogenesis plays a role in Ewing's sarcoma development opens the possibility of using genetically modified BM-derived cells for the treatment of Ewing's sarcomas. ^

Nonsteroidal moulting hormone agonists: effects on protein synthesis and cuticle formation in colorado potato beetle larvae.

Larvae of the Colorado potato beetle, Leptinotarsa decemlineata (Say), that were orally treated with RH-0345 at 0.1 mg l?1, RH-5849 at 10 and 50 mg l?1, tebufenozide at 2 g l?1, and 20-hydroxyecdysone at 2 g l?1, showed symptoms of prematuremoulting, followed by inhibition of ecdysis. In addition, fresh weight gain and total protein content were blocked. The effects on haemolymphal and cuticular polypeptides after PAGE were linked with premature, new epicuticle deposition as was observed under the electron microscope. These observations support the concept that the ecdysteroid-mimicking action of the three nonsteroidal molecules is specific

Community formation among Asian Indians in southeast Florida

Nearly one million Asian Indians have immigrated to the United States. Asian Indians are scattered across wide geographic areas. While some have chosen transnationalism, most are taking the traditional route of building ethnic communities. Using what the West has to offer in terms of communication and transportation technologies, they are constructing communities without geographic boundaries, with the extensive use of the automobile and air transportation, cellular phones, FAX machines, commercial delivery services, multi-party conference phones. Also, they are incorporating the American tradition of immigrant associations into an Asian Indian syncretism of community. In the process there emerges an Asian Indian identity and concept of kinship and community. ^

Rastafarianism and the Nation of Islam as institutions for group-identity formation among blacks in the United States: A case study comparing their approaches

This dissertation explores the Rastafari movement and the Nation of Islam as institutions that provide a group-identity for their adherents. The study seeks to determine the characteristics of the identity that is institutionalized by each movement, and the nature of the institutionalization process. The research was conducted primarily in South Florida where both movements exist. An extensive literature review in conjunction with in-depth field interviews were used as the primary research methodologies. What was of particular interest were the reasons that the members of the movements chose one movement over the other, also the similarities and dissimilarities between the movements in their role as institutions for group-identity formation. The research showed that both movements imbued their members with a sense of pride, high self-esteem and a strong sense of race consciousness. In addition, it showed that there was significant variation in identity orientation within the Rastafari Movement, which contrasted with the Nation of Islam where the identity variations within the movement were negligible. This was due largely to the difference in structure between the movements, the Nation of Islam being a centrally organized movement with one leader while the Rastafari movement is a decentralized polycephalous one. ^ Both movements were found to be millenarian in nature, essentially because of the significant utility of the concept that their members would rise to prominence through God's grace. Additionally, both movements were identified as expressive social movements, since they were determined as being primarily concerned with changing the attitudes of their members rather than effecting structural social change. ^

Rastafarianism and the Nation of Islam as institutions for group-identity formation among blacks in the United States : a case study comparing their approaches

This dissertation explores the Rastafari movement and the Nation of Islam as institutions that provide a group-identity for their adherents. The study seeks to determine the characteristics of the identity that is institutionalized by each movement, and the nature of the institutionalization process. The research was conducted primarily in South Florida where both movements exist. An extensive literature review in conjunction with in-depth field interviews were used as the primary research methodologies. What was of particular interest were the reasons that the members of the movements chose one movement over the other, also the similarities and dissimilarities between the movements in their role as institutions for group-identity formation. The research showed that both movements imbued their members with a sense of pride, high self-esteem and a strong sense of race consciousness. In addition, it showed that there was significant variation in identity orientation within the Rastafari Movement, which contrasted with the Nation of Islam where the identity variations within the movement were negligible. This was due largely to the difference in structure between the movements, the Nation of Islam being a centrally organized movement with one leader while the Rastafari movement is a decentralized polycephalous one. Both movements were found to be millenarian in nature, essentially because of the significant utility of the concept that their members would rise to prominence through God's grace. Additionally, both movements were identified as expressive social movements, since they were determined as being primarily concerned with changing the attitudes of their members rather than effecting structural social change.

Transformer les pratiques professionnelles vis-à-vis des personnes prestataires de l’aide sociale : développement participatif et évaluation d’une formation continue en cabinet dentaire

L’objectif de la présente thèse est de générer des connaissances sur les contributions possibles d’une formation continue à l’évolution des perspectives et pratiques des professionnels de la santé buccodentaire. Prônant une approche centrée sur le patient, la formation vise à sensibiliser les professionnels à la pauvreté et à encourager des pratiques qui se veulent inclusives et qui tiennent compte du contexte social des patients. L’évaluation de la formation s’inscrit dans le contexte d’une recherche-action participative de développement d’outils éducatifs et de transfert des connaissances sur la pauvreté. Cette recherche-action aspire à contribuer à la lutte contre les iniquités sociales de santé et d’accès aux soins au Québec; elle reflète une préoccupation pour une plus grande justice sociale ainsi qu’une prise de position pour une santé publique critique fondée sur une « science des solutions » (Potvin, 2013). Quatre articles scientifiques, ancrés dans une philosophie constructiviste et dans les concepts et principes de l’apprentissage transformationnel (Mezirow, 1991), constituent le cœur de cette thèse. Le premier article présente une revue critique de la littérature portant sur l’enseignement de l’approche de soins centrés sur le patient. Prenant appui sur le concept d’une « épistémologie partagée », des principes éducatifs porteurs d’une transformation de perspective à l’égard de la relation professionnel-patient ont été identifiés et analysés. Le deuxième article de thèse s’inscrit dans le cadre du développement participatif d’outils de formation sur la pauvreté et illustre le processus de co-construction d’un scénario de court-métrage social réaliste portant sur la pauvreté et l’accès aux soins. L’article décrit et apporte une réflexion, notamment sur la dimension de co-formation entre les différents acteurs des milieux académique, professionnel et citoyen qui ont constitué le collectif À l’écoute les uns des autres. Nous y découvrons la force du croisement des savoirs pour générer des prises de conscience sur soi et sur ses préjugés. Les outils développés par le collectif ont été intégrés à une formation continue axée sur la réflexion critique et l’apprentissage transformationnel, et conçue pour être livrée en cabinet dentaire privé. Les deux derniers articles de thèse présentent les résultats d’une étude de cas instrumentale évaluative centrée sur cette formation continue et visant donc à répondre à l’objectif premier de cette thèse. Le premier consiste en une analyse des transformations de perspectives et d’action au sein d’une équipe de 15 professionnels dentaires ayant participé à la formation continue sur une période de trois mois. L’article décrit, entre autres, une plus grande ouverture, chez certains participants, sur les causes structurelles de la pauvreté et une plus grande sensibilité au vécu au quotidien des personnes prestataires de l’aide sociale. L’article comprend également une exploration des effets paradoxaux dans l’apprentissage, notamment le renforcement, chez certains, de perceptions négatives à l’égard des personnes prestataires de l’aide sociale. Le quatrième article fait état de barrières idéologiques contraignant la transformation des pratiques professionnelles : 1) l’identification à l’idéologie du marché privé comme véhicule d’organisation des soins; 2) l’attachement au concept d’égalité dans les pratiques, au détriment de l’équité; 3) la prédominance du modèle biomédical, contraignant l’adoption de pratiques centrées sur la personne et 4) la catégorisation sociale des personnes prestataires de l’aide sociale. L’analyse des perceptions, mais aussi de l’expérience vécue de ces barrières démontre comment des facteurs systémiques et sociaux influent sur le rapport entre professionnel dentaire et personne prestataire de l’aide sociale. Les conséquences pour la recherche, l’éducation dentaire, le transfert des connaissances, ainsi que pour la régulation professionnelle et les politiques de santé buccodentaire, sont examinées à partir de cette perspective.