Using a comprehensive sample of U.S. non-profit hospitals from 2011 to 2015, we examine the effects of state community benefits regulation on the amount of charity care provided by and the operational efficiency of U.S. non-profit hospitals. First, we document that, under such regulations, non-profit hospitals provide more charity care and less compensated care as a proportion of net revenue. We infer from these findings that CBR has the potential to increase both non-profit hospitals’ amount of charity care and their (...) efficiency of operations. Second, by examining variation in CBR types, we find no differences between having provision or having reporting requirements on the amount of charity care offered. Moreover, when we consider CBR with both provision and reporting requirements, the combination of these two requirements does not incrementally enhance charity care offerings, suggesting that the requirements may serve as substitutes with comparable effect. Lastly, we show that several state-level characteristics influence the relationship between CBR and charity care: CBRs in states with a higher gross domestic product and percentage of revenue received in taxes have incrementally lower associations with charity care, while hospitals in states where populations have, on average, higher household incomes have greater associations between CBR and charity care. Our findings highlight the effects that state-enacted regulation can have on socially beneficial behavior by non-profits. (shrink)

Each state’s Medicaid Fraud Control Unit prosecutes billing fraud cases against individual healthcare providers who fraudulently bill Medicaid for services provided. Once an individual is convicted of billing fraud, the Office of Inspector General for the Department of Health and Human Services may exclude the individual from billing any federal government healthcare program, including Medicaid. Excluded individuals are added to a public list of exclusions, which restricts their ability to practice professionally. Prompted by criminology research into the impact of policing (...) resources, we test whether these government enforcement initiatives against fraud serve as a deterrent to would-be fraudulent billers. We document that key enforcement proxies, the staffing level and budget of an MFCU, are positively associated with the yearly number of exclusions added at the state level. Our results are consistent with the exclusion list not being a deterrent but provide support for MFCUs’ fraud detection efforts. This paper provides industry-specific fraud insights for auditors and other individuals involved in public policy, specifically Medicaid, and introduces a novel dataset to the accounting fraud research literature. (shrink)

Justo antes de la pandemia por COVID-19, la Organización Mundial de la Salud definió unas prioridades de trabajo para la década 2020-2030. Un grupo interdisciplinario de profesionales de la salud reflexiona sobre estas prioridades, determinando unas categorías de análisis y, desde una perspectiva bioética, analiza cada una de ellas, ve su pertinencia, algunos eventos causales, las implicaciones que pueden tener si no son enfrentadas adecuadamente y hace sugerencias sobre la forma de llevarlas a cabo. En esta primera entrega se analiza (...) el primer grupo de prioridades estratégicas: “poblaciones más sanas”. En las conclusiones se destaca la conveniencia de acometer cada una de ellas de una manera colaborativa, gubernamental y privada; de reestructurar el sector salud con base en estas prioridades, aprovechando la experiencia obtenida en la lucha contra el COVID-19. La relación del ser humano con el medio ambiente también debe cambiar, apelando a la responsabilidad humana por el cuidado del planeta. (shrink)

Publicación compilatoria que recoge los avances que en los últimos tiempos se han producido en materia normativa sobre acceso a los recursos genéticos, en un intento por implementar los principios del Convenio sobre la Diversidad Biológica (1992).

There is an increasing demand by society that university students demonstrate competitive skills to enable them to achieve greater success when entering the workplace. Creativity and life satisfaction correlate positively with academic performance, productivity, and excellence in the working environment. The presence of creativity and emotional intelligence in the curriculum and teaching methods in Spanish universities, however, is surprisingly lacking. Studies that examine gender differences in these variables provide conflicting results. The purpose of our research is to analyse the changes (...) produced in both creativity and life satisfaction in university students by a positive emotional and creative intervention and explore individual differences by gender. The methodology used was a quasi-experimental pre- test/post- test design with experimental/control groups. Three hundred university students from the Community of Madrid completed three exercises that evaluated creativity and life satisfaction. The results show significantly higher results in creativity and life satisfaction in women, who continued to achieve high results after the intervention. Finally, we discuss the need for emotional and creative education in universities and focus on the employability and the guarantee of equal opportunities through the development of these competencies. (shrink)

Despite spending more on health care than every other industrialized country, the U.S. ranks 37th in health outcomes. These differences cannot be explained away with differences in age and income, or even with quality of care. And, the rate of growth in health care spending in the U.S. continues to increase. The share of the Gross Domestic Product attributable to health care grew from 9% in 1980 to more than 17% in 2011. Health care costs are projected to account for (...) more than one-fifth of our economy by 2021. Despite spending more and more, the U.S. does not have better health outcomes than other countries. Worse, our increasing spending is largely attributable to preventable conditions. More than 85 cents of every dollar spent on health in the U.S. are spent on the treatment and management of chronic diseases, such as those caused by preventable conditions related to obesity and tobacco use. (shrink)

The Hooks et al. review of microbiota-gut-brain literature provides a constructive criticism of the general approaches encompassing MGB research. This commentary extends their review by: highlighting capabilities of advanced systems-biology “-omics” techniques for microbiome research and recommending that combining these high-resolution techniques with intervention-based experimental design may be the path forward for future MGB research.

A survey is given of the concepts of interaction (force) and matter, i.e., of process and substance. The development of these concepts, first in antiquity, then in early modern times, and finally in the contemporary system of quantum field theory is described. After a summary of the basic phenomenological attributes (coupling strengths, symmetry quantities, charges), the common ground of concepts of quantum field theory for both interactions and matter entities is discussed. Then attention is focused on the gauge principle which (...) has been developed to describe all interaction fields in the same way, and hopefully to unite them all into one unified field. While a similar unification of all fundamental types of matter fields (quarks and leptons) into one family may be possible (SU 5), there still remains at this level a duality between interaction quanta (bosons with spin 1) and matter particles (fermions with spin 1/2). Whether this duality may be removed in some future supersymmetric theory is not discussed in this paper. Nor is Quantum Gravitation discussed, though the analogy of the gauge principle for the three fundamental non-gravitational interactions (hadronic, electromagnetic and weak) to Einstein's principle of equivalence for gravitation in spacetime is noted. However, the equivalence concept is applied not to spacetime but to the internal spaces for the matter (or charge) fields which are the sources between which the fundamental interactions operate. The gauge principle states that a change in the measures of the internal space charge of gauge or phases of the matter fields is equivalent to, and can be compensated by, suitably introduced interaction fields. From such an interaction field, the gauge potential field in the internal space, one may derive a gauge force field by exterior differentiation.Geometrically, the collection of all internal spaces, one over each point of spacetime, constitutes a fiber bundle. The gauge potential field represents a connection on the fiber bundle, and the gauge force field is the curvature (calculated by taking the exterior derivative of the connection and adding to it the exterior product of the connection with itself). Thus, just as gravitational force is interpreted as spacetime curvature, so the three other fundamental forces are interpretable as internal space curvature. The Standard Model which unites the three non-gravitational fields into an SU c 3 ×SU 2×U 1 structure, and the grand unified model, SU 5, are discussed briefly, and difficulties are noted. Finally it is suggested that a composite model, based on more subtle structure, may be needed to remove the present obscurities and difficulties that stand in the way of a unified theory. (shrink)

The purpose of this study is to investigate the role of school principal trustworthiness components (i.e., ability, integrity, benevolence) in helping shape teacher trust and affective commitment within schools. Using data from 1,026 teachers in Spain and structural equation modeling (via EQS 6.3), this study establishes how a principal’s integrity and benevolence are key in determining, both directly and indirectly (via trust in the principal), teachers’ affective commitment to their school. It also reveals that the perceived ability of a principal (...) is not effective in generating trust or affective commitment to the school in teachers. As a contribution to the literature, these findings reveal that the ethical trustworthiness (benevolence, integrity) of principals is key in engendering trust and affective commitment to schools. Thus, to shape work environments that are high in trust and commitment, principals should focus on behaving in ways that make their integrity and benevolence manifest to their teachers. (shrink)

Moral Seduction Theory suggests that auditors are morally compromised by the perceived consequences of their opinions. The root of the auditing problem appears to result in an unintentional bias rather than in dishonesty. Although important accounting reforms have been taken to deal with auditors' trustworthiness, their lack of independence has not been adequately addressed. The new regulation (Sarbanes-Oxley Act) is a consequence of an incorrect understanding of the main true source of auditor's biases. We have developed a cognitive approach by (...) connecting the Throughput Model (TM) to the Moral Seduction Theory. This approach allows a better understanding of how conflicts of interest lead auditors to avoid the issuance of warning signals to stakeholders. We have tested our model by conducting a hypothetical scenario with eighty experienced auditors from international accounting firms. Our results confirm auditors' unintentional reluctance to issue qualified audit opinions alerting investors due to their fear of precipitating clients' final bankruptcy. The main implication is that, more than a regulation, effort should be made in monitoring those conflicts of interest to reduce unintentional bias. (shrink)

The purpose of this essay is to both discuss commands as a species of speech act and to discuss commands within the broader framework of how they are used and ...

Cognitive symptoms after COVID-19 have been increasingly recognized several months after the acute infection and have been designated as “brain fog.” We report a patient with cognitive symptoms that started immediately after COVID-19, in which cerebrospinal fluid biomarkers were highly suggestive of Alzheimer’s disease. Our case highlights the need to examine patients with cognitive symptoms following COVID-19 comprehensively. A detailed assessment combining clinical, cognitive, and biomarker studies may help disentangle the underlying mechanisms associated with cognitive dysfunction in each case. The (...) investigation of neurodegenerative processes in an early stage, especially in older patients, is probably warranted. (shrink)

In this paper, I will identify two problems of trust in an AI-relevant context: a theoretical problem and a practical one. I will identify and address a number of skeptical challenges to an AI-relevant theory of trust. In addition, I will identify what I shall term the ‘scope challenge’, which I take to hold for any AI-relevant theory of trust that purports to be representationally adequate to the multifarious forms of trust and AI. Thereafter, I will suggest how trust-engineering, a (...) position that is intermediate between the modified pure rational-choice account and an account that gives rise to trustworthy AI, might allow us to address the practical problem of trust, before identifying and critically evaluating two candidate trust-engineering approaches. (shrink)