Horizontal Mergers in the United States Health Field: Some Practical Realities

2000 ◽  
Vol 13 (3) ◽  
pp. 137-151 ◽  
Author(s):  
T. P. Weil
Keyword(s):  
The United States ◽  
Horizontal Mergers ◽  
Health Networks ◽  
General Management ◽  
The Past ◽  
Regulatory Strategies ◽  
The Us ◽  
Integration Of Services ◽  
Health Field

During the past decade, ‘merger mania’ has been a striking trend in the US health field as a strategy to improve the integration of services, to reduce expenses, and to increase the ability of providers to manage risk-based payment. However, during the past quarter of a century limited operational and fiscal evidence has been published in both the health and general management literature that strongly supports the efficacy of horizontal mergers. This article further argues that a likely scenario over the next decade, in spite of disappointments among these mergers in effecting significant cost reductions, is for the US health networks to continue acquiring additional providers and insurers. After these alliances gain significant market penetration, they are expected to behave as oligopolists. For these mergers to eventually achieve their earlier projected savings, the health field's leadership will be forced to implement cost-cutting measures such as: more vigorously coordinating the network's key clinical services to reduce competition for revenues among the partners within an alliance, closing superfluous hospitals and centralizing expensive tertiary services, encouraging surplus physicians to relocate to under-served areas, and providing direction to carefully integrate the best elements of what the competitive and regulatory strategies are able to offer to improve access, social equity, quality of care, and to reduce total health expenditures.

Models, markets, and power: political economy and the Asia-Pacific, 1989–1999

2000 ◽  
Vol 26 (4) ◽  
pp. 493-507 ◽  
Author(s):  
MICHAEL MASTANDUNO
Keyword(s):  
Political Economy ◽  
Emerging Economies ◽  
Domestic Politics ◽  
The United States ◽  
Asia Pacific ◽  
The Past ◽  
The Us ◽  
Us Hegemony

The political economy of the Asia-Pacific region has been transformed over the past decade. Three important developments are (1) the demise of the US–Japan economic rivalry and the associated competition over the most appropriate model of capitalism; (2) challenges to the ‘Washington Consensus’ on the optimal foreign economic strategy for emerging economies; and (3) the renewal of US hegemony in the context of a unipolar international structure. An understanding of these developments requires attention to the interaction of international and domestic forces. These developments suggest that a major challenge facing governments in the region will be to manage the tension between the state and the market. They also suggest that the United States is well positioned to play the role of regional stabilizer in the Asia-Pacific. Whether it does so effectively will depend on its domestic politics and the quality of its statecraft.

The Riddle of a Common History

2009 ◽  
Vol 1 (1) ◽  
pp. 93-116 ◽  
Author(s):  
Mauricio Tenorio-Trillo
Keyword(s):  
United States ◽  
Common Ground ◽  
The United States ◽  
History Textbooks ◽  
Recent History ◽  
History Textbook ◽  
The Past ◽  
The Us ◽  
Constant Part ◽  
Intrinsic Component

By identifying two general issues in recent history textbook controversies worldwide (oblivion and inclusion), this article examines understandings of the United States in Mexico's history textbooks (especially those of 1992) as a means to test the limits of historical imagining between U. S. and Mexican historiographies. Drawing lessons from recent European and Indian historiographical debates, the article argues that many of the historical clashes between the nationalist historiographies of Mexico and the United States could be taught as series of unsolved enigmas, ironies, and contradictions in the midst of a central enigma: the persistence of two nationalist historiographies incapable of contemplating their common ground. The article maintains that lo mexicano has been a constant part of the past and present of the US, and lo gringo an intrinsic component of Mexico's history. The di erences in their historical tracks have been made into monumental ontological oppositions, which are in fact two tracks—often overlapping—of the same and shared con ictual and complex experience.

Precarious Work and Young Workers in the United States

2018 ◽  
Author(s):  
Arne L. Kalleberg
Keyword(s):  
Labor Market ◽  
The United States ◽  
Young Workers ◽  
Severe Problem ◽  
Precarious Work ◽  
The Great Recession ◽  
The Us ◽  
Training Opportunities ◽  
And Training

This chapter discusses how the growth of precarious work and the polarization of the US labor market have produced major problems for the employment experiences of young workers. A prominent indicator of young workers’ difficulties in the labor market has been the sharp increase in their unemployment rates since the Great Recession. Another, equally if not more severe, problem faced by young workers today is the relatively low quality of the jobs that they were able to get. Other problems include the exclusion of young workers from the labor market and from education and training opportunities; the inability to find jobs that utilize their education, training, and skills; and the inability to obtain jobs that provide them with an opportunity to get a foothold in a career that would lead to progressively better jobs and thus be able to construct career narratives.

Abstract P183: 20-year Secular Trend of Cardiovascular Disease Comorbidities in the United States, 1997-2016

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Dianjianyi Sun ◽  
Tao Zhou ◽  
Xiang Li ◽  
Yoriko Heianza ◽  
Xiaoyun Shang ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Secular Trend ◽  
Adult Population ◽  
The United States ◽  
The Past ◽  
The Us ◽  
Metabolic Conditions ◽  
Respiratory Conditions ◽  
The U.S ◽  
Chronic Comorbidities

Background: Cardiovascular disease (CVD) has been the number one cause of death and disability in the US and globally for decades, and its comorbidity complicates the management of CVD. However, little is known about the secular trend of CVD comorbidities in national representative populations in the last 20 years. Methods: Prevalence of CVD and nine major chronic comorbidities was estimated using data from 1,324,214 adults aged 18 years and older in the National Health Interview Survey (NHIS) from 1997 through 2016, with age-standardized to the U.S. population in the year 2000. Results: CVD prevalence in the US adult population significantly declined in the past twenty years (from 6.6% in 1997 to 5.9% in 2016, P trend <0.01in Figure a). And such trend was shown in women and whites (P trend <0.01), but not in men and blacks (P trend >0.05). We ranked the nine major chronic comorbidities (high to low) in the CVD patients (Figure b.), including (1) hypertension, (2) respiratory conditions, (3) nervous system conditions, (4) digestive conditions, (5) diabetes, (6) cancer, (7) genitourinary conditions, (8) circulatory conditions, and (9) endocrine/nutritional/metabolic conditions. From 1997 to 2016, the prevalence of CVD comorbidities including hypertension (38.8% to 50.2%), digestive conditions (17.0% to 27.1%), diabetes (10.0% to 19.2%), cancer (9.4% to 12.8%), and genitourinary conditions (4.1% to 5.2%) continuingly increased (all P trend <0.01), while respiratory conditions declined (35.9% to 27.6%, P trend <0.01). Similar trends of CVD comorbidities were observed among subgroups stratified by gender or by race. Conclusions: CVD prevalence in the U.S. adults have declined significantly in the past two decades, but rates of CVD comorbidities including hypertension, digestive conditions, diabetes, cancer, and genitourinary conditions increased substantially.

Before American History: Nationalist Mythmaking and Indigenous Dispossession

2021 ◽  
Author(s):  
Christen Mucher
Keyword(s):  
Knowledge Production ◽  
American History ◽  
New Spain ◽  
The United States ◽  
Material Base ◽  
Historical Knowledge ◽  
The Past ◽  
British America ◽  
The Us ◽  
Ruling Elites

Before American History examines the project of settler nationalism from the 1780s to the 1840s in two of North America’s republics—the US and Mexico—through an analysis of historical knowledge production. As the US and Mexico transformed from European colonies into independent republics—and before war scarred them both—antiquarians and historians compiled and interpreted archives meant to document America’s Indigenous pasts. Before American History approaches two iconic imaginings of the past—the carved Sun Stone and the mounded earthwork—as archives of nationalist power and Indigenous dispossession as well as objects that are, at their material base, Indigenously-produced but settler-controlled and settler-interpreted. In making the connection between earthworks built by an allegedly vanished people merely peripheral to US citizens and the literal touchstone of Mexicans’ history, Before American History details how Mexican and US nationalists created national histories out of Indigenous pasts and thereby wrote Indigenous pasts out of their national histories and out of national lands. It uncovers how the manipulation of Indigenous pasts and (mis)interpretations of “American Antiquities”—Indigenous documents, objects and monuments—served the purposes of a trans-imperial/transnational network of creole ruling elites, first in New Spain and British America, and later in Mexico and the United States, as they struggled to construct new political, geographic, and historical orders.

scholarly journals State-of-the-art Structural Interventions in Heart Failure

2019 ◽  
Vol 5 (3) ◽  
pp. 147-154 ◽  
Author(s):  
Jeffrey Park ◽  
Hussam S Suradi
Keyword(s):  
Heart Failure ◽  
Acute Decompensated Heart Failure ◽  
Structural Heart Disease ◽  
Decompensated Heart Failure ◽  
Structural Interventions ◽  
The Past ◽  
Effective Interventions ◽  
The Us ◽  
Multiple Trials

Heart failure (HF) is a leading cause of hospitalisation and healthcare costs worldwide. Acute decompensated heart failure accounts for more than 1 million hospitalisations in the US. Despite advances in the quality of acute and chronic HF disease management, gaps in knowledge about effective interventions to support the transition of care for patients with HF remain. Despite multiple trials of promising therapies, standard care consists of decongestion with IV diuretics and haemodynamic support with vasodilators and inotropes and this has remained largely unchanged during the past 45 years. Newer advances in medical innovations and structural heart disease interventions have now given promise to improved survival, outcomes and quality of life for patients with advanced HF of multiple aetiologies. In this article, we focus on structural interventions in the treatment of patients with HF.

scholarly journals Will China Become a Global Technological Giant?

2018 ◽  
Vol 48 (3) ◽  
pp. 77-82
Author(s):  
Marcin Piatkowski
Keyword(s):  
Public Support ◽  
Managerial Practices ◽  
The Past ◽  
Support For Innovation ◽  
The Us ◽  
Lectual Property ◽  
Technology Absorption ◽  
China Today ◽  
Remarkable Progress

The article argues that China has achieved a remarkable progress in promoting technology absorption and innovation over the past decade. China today spends 2.1 percent of GDP on R&D, more than the OECD average. By 2020, China together with the US will be responsible for more than half of the world’s R&D spending. These two countries may thus largely de-cide about the speed and direction of mankind’s technological progress. Despite the pro-gress, however, China still faces several challenges to becoming a global technological giant. To face these challenges, China would be well advised to increase the quality of innovation outputs, strengthen efficiency of public support for innovation, further strengthen intel-lectual property rights, and help enhance managerial practices of Chinese firms.

scholarly journals The Value of Citizen Science in Increasing Our Knowledge of Under-Sampled Biodiversity: An Overview of Public Documentation of Auchenorrhyncha and the Hoppers of North Carolina

2021 ◽  
Vol 9 ◽  
Author(s):  
Kyle D. Kittelberger ◽  
Solomon V. Hendrix ◽  
Çağan Hakkı Şekercioğlu
Keyword(s):  
North Carolina ◽  
Citizen Science ◽  
Spatial Scales ◽  
The United States ◽  
Undescribed Species ◽  
The Past ◽  
Global Biodiversity ◽  
Temporal And Spatial

Due to the increasing popularity of websites specializing in nature documentation, there has been a surge in the number of people enthusiastic about observing and documenting nature over the past 2 decades. These citizen scientists are recording biodiversity on unprecedented temporal and spatial scales, rendering data of tremendous value to the scientific community. In this study, we investigate the role of citizen science in increasing knowledge of global biodiversity through the examination of notable contributions to the understanding of the insect suborder Auchenorrhyncha, also known as true hoppers, in North America. We have compiled a comprehensive summary of citizen science contributions—published and unpublished—to the understanding of hopper diversity, finding over fifty previously unpublished country and state records as well as dozens of undescribed and potentially undescribed species. We compare citizen science contributions to those published in the literature as well as specimen records in collections in the United States and Canada, illuminating the fact that the copious data afforded by citizen science contributions are underutilized. We also introduce the website Hoppers of North Carolina, a revolutionary new benchmark for tracking hopper diversity, disseminating knowledge from the literature, and incorporating citizen science. Finally, we provide a series of recommendations for both the entomological community and citizen science platforms on how best to approach, utilize, and increase the quality of sightings from the general public.

scholarly journals Publication Trends on Mitophagy in the World and China: A 16-Year Bibliometric Analysis

2021 ◽  
Vol 9 ◽  
Author(s):  
Jingli Chen ◽  
Xin Li ◽  
Yifan Jia ◽  
Zhongyuan Xia ◽  
Jishi Ye
Keyword(s):  
Bibliometric Analysis ◽  
Cell Biology ◽  
Developed Countries ◽  
The United States ◽  
Research Progress ◽  
Publication Trends ◽  
Quality Of Results ◽  
The Past ◽  
The World

In the past 16 years, research on mitophagy has increasingly expanded to a wider range of subjects. Therefore, comprehensively analyzing the relevant progress and development trends on mitophagy research requires specific methods. To assess the hotspots, directions, and quality of results in this field worldwide, we used multiple tools to examine research progress and growing trends in research on the matter during the last 16 years (from 2005 to 2020). We also compared the quantity and quality of the literature records on mitophagy published by research institutions in China and other developed countries, reviewed China’s contribution, and examined the gap between China and these developed countries. According to the results of our bibliometric analysis, the United States and its research institutes published the most papers. We identified cell biology as the most commonly researched subject on mitophagy and AUTOPHAGY as the most popular journal for research on mitophagy. We also listed the most cited documents from around the world and China. With gradually increased funding, China is progressively becoming prominent in the field of mitophagy; nevertheless, the gap between her and major countries in the world must be closed.

scholarly journals Fungicide Sensitivity of U.S. Genotypes of Phytophthora infestans to Six Oomycete-Targeted Compounds

Plant Disease ◽  
2015 ◽  
Vol 99 (5) ◽  
pp. 659-666 ◽  
Author(s):  
Amanda Saville ◽  
Kim Graham ◽  
Niklaus J. Grünwald ◽  
Kevin Myers ◽  
William E. Fry ◽  
...  
Keyword(s):  
United States ◽  
Phytophthora Infestans ◽  
The United States ◽  
Effective Concentration ◽  
Response Curves ◽  
Baseline Sensitivity ◽  
Fungicide Sensitivity ◽  
The Past ◽  
The Us

Phytophthora infestans causes potato late blight, an important and costly disease of potato and tomato crops. Seven clonal lineages of P. infestans identified recently in the United States were tested for baseline sensitivity to six oomycete-targeted fungicides. A subset of the dominant lineages (n = 45) collected between 2004 and 2012 was tested in vitro on media amended with a range of concentrations of either azoxystrobin, cyazofamid, cymoxanil, fluopicolide, mandipropamid, or mefenoxam. Dose-response curves and values for the effective concentration at which 50% of growth was suppressed were calculated for each isolate. The US-8 and US-11 clonal lineages were insensitive to mefenoxam while the US-20, US-21, US-22, US-23, and US-24 clonal lineages were sensitive to mefenoxam. Insensitivity to azoxystrobin, cyazofamid, cymoxanil, fluopicolide, or mandipropamid was not detected within any lineage. Thus, current U.S. populations of P. infestans remained sensitive to mefenoxam during the displacement of the US-22 lineage by US-23 over the past 5 years.

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