Search Results (19)

In the United States, access to healthcare is shaped not only by patient need but also by payer policies that determine which providers are reimbursable, how care is sequenced, and what constitutes a legitimate entry point into the system. These gatekeeping functions, while valuable for supporting clinical prioritization, risk stratification, and continuity of care, can also unintentionally reinforce structural inequities and credential hierarchies that delay or limit timely and equitable care, particularly for historically marginalized populations. While reform efforts often focus on expanding benefits or provider networks, fewer address the underlying design of access itself or the rules that govern how patients enter care. It is argued in this paper that a more equitable and efficient healthcare system requires multi-entry care models, in which nurses, behavioral health clinicians, pharmacists, and community health workers may serve as condition-appropriate, reimbursable first points of contact within coordinated care teams. Drawing on evidence from Medicare, Medicaid, the Veterans Health Administration, and commercial payers, these models may support cost containment, improve care coordination, facilitate appropriate utilization, and promote earlier patient engagement. While findings from these models are not uniform across all settings, evidence suggests that outcomes are highly dependent on implementation context, system design, and supporting infrastructure. When implemented with appropriate safeguards (such as interoperable health records, team-based care requirements, and coordinated referral tracking), multi-entry systems can preserve continuity while expanding access. Payers are uniquely positioned to lead this transformation by aligning reimbursement policy with patient needs, supporting team-based care infrastructure, and embedding accountability into access pathways, thereby creating a system that can be more responsive, inclusive, and sustainable. Full article

Background: The COVID-19 pandemic created an urgent need to understand how supply chains can withstand and adapt to severe disruptions. While prior research has highlighted the importance of supply chain resilience and robustness in managing disruptions, less attention has been given to the mechanisms through which firms transform these capabilities into financial outcomes. Drawing on the Resource Orchestration Perspective (ROP), this study proposed that absorptive capacity acts as a cognitive orchestration mechanism that enables firms to more effectively translate resilience and robustness capabilities into financial performance during periods of major disruption. Methods: Using a quantitative approach, this research employed partial least squares structural equation modeling to analyze data from 66 supply chain managers who experienced varying levels of supply chain disruption following the COVID-19 pandemic. Results: Both supply chain resilience and robustness affect organizational absorptive capacity, which, in turn, enhances performance. Conclusions: This study extends ROP and provides new insights into how firms can strategically leverage disruption-related knowledge to enhance performance in turbulent environments by identifying absorptive capacity as a key mechanism linking resilience capabilities to financial outcomes. In practice, it provides managers with valuable insights to prioritize AC development and reduce financial risks associated with disruptions. Full article

This study looks at a selection of newspaper content from 1995 to 2024 that mentions the names of SSRI drugs in passing as jokes, metaphors, or cultural references. These passing mentions of SSRIs are analyzed via qualitative textual analysis, considering stigma and trivialization. The results of the study suggest that stereotypes about SSRIs have been cemented via popular discourse and media coverage and persist today despite nearly 40 years of prescriptions. Mentions of the SSRI drugs in passing suggest the illusion of a post-Prozac society where mental illness has been “fixed” and therefore can be trivialized with little consequence. This work expands upon existing theoretical concepts to propose a new theoretical model—a continuum of trivialization and stigma which may aid researchers in parsing the ways that colloquialization, trivialization and stigma interact and overlap in media texts. Full article

In the National Football League, teams have been subjected to a salary cap, which has prevented teams from paying players in aggregate over a specified value since 1994. The presence of the salary cap provides a unique setting for understanding how tax rates affect the competitiveness of teams. We use data on National Football League teams from 1984 to 2000 to create a difference-in-differences model to estimate the effect of state income taxes on team performance. We use college football teams, who do not pay salaries to their amateur players, as the control group to identify causal estimates. We find that, in the presence of the salary cap, team quality, as estimated by a Simple Rating System value, is significantly lower in high-tax states, particularly after the passage of the salary cap. Our results are robust to numerous specifications of the control group. We also show using a decision tree analysis that teams in high-tax states were more likely to be above average before the salary cap. However, after the salary cap, teams from high-tax states are less likely to be above average. Full article

This study investigates how the rise of commission-free FinTech platforms and the introduction of fractional trading (FT) have altered trading behavior and order book dynamics in the NASDAQ equity market. Leveraging high-frequency ITCH data from highly capitalized stocks—AAPL, AMZN, GOOG, and TSLA—we analyze market microstructure changes surrounding the implementation of FT. Our empirical findings show a statistically significant increase in price levels, average tick sizes, and price volatility in the post-FinTech-FT period, alongside elevated price impact factors (PIFs), indicating steeper and less liquid limit order books. These shifts reflect greater participation by non-professional investors with limited order placement precision, contributing to noisier price discovery and heightened intraday risk. The altered liquidity landscape and increased volatility raise important questions about the resilience and informational efficiency of modern equity markets under democratized access. Our findings contribute to the growing literature on retail trading and provide actionable insights for market regulators and exchanges evaluating the design and oversight of evolving trading mechanisms. Full article

With the recent increase in retail investor participation led by commission-less fintech trading applications and new features like fractional trading, we now have higher volatility and significantly quicker price changes. This makes it hard to make informed trading decisions. Moreover, these effects are exacerbated even further around earnings announcements days. In this paper, we use Nasdaq data feed at a minute frequency and show that there is a significant increase in the slope of the price–volume structure during extended hours (after-hours, or pre-market hours) as compared with the ones observed during regular market times. Our analysis shows that the liquidity is much less during the extended market hours. As such, earnings announcements of stocks during these times have a significantly larger price impact than those stocks that have their earnings announced during regular trading hours. This significant difference can be explained by observing the limit order book structures during these different trading periods. We suggest that the earnings announcements should not be made during extended hours given the significantly lower liquidity and thus, the significantly larger price impact that not only determines the prices for the next trading session but also sets the new “fundamental” price signals for the stocks. Full article

This essay assesses the relevance of Søren Kierkegaard’s non-pseudonymous, edifying writings for considering themes of desire, detachment, and humility within the religious context of Christian spiritual formation. Building on the argument of recent scholars who identify in Kierkegaard’s writings an account of a fundamental desire for God “implanted” in the human being, I explore the influence of this vision on Kierkegaard’s depiction of desire and detachment in his “Discourses on the Lilies and the Birds”. I then turn to how this relates to the perspective of humility that emerges from Kierkegaard’s reflections on the biblical story of “the widow’s mite”. In each case, these edifying writings aim to stir the reader into a process of interrogating faulty self-perceptions based on arbitrary measures of value. I read this mode of communication as able to initiate a “counter-experience”, provoking the reader to reorient her horizon of prior self-valuations so she might come to recognize the hidden significance of things and, ultimately, achieve a more accurate sense of oneself in relation to the authentic source of the self’s desire. Insofar as this reorientation of the self informs the practice of detachment or the development of humility, people might experience this same process in diverse ways. In this respect, the relevance of Kierkegaard’s edifying writings for reflecting on Christian spirituality is not that they provide a thoroughgoing account of detachment or humility that should replace the insights of various spiritual traditions. Rather, I argue that his discourses—when read alongside these traditions—offer a supplemental resource for reflecting on how our positionalities, dispositions, and proximate contexts will inform the divergent ways we might experience the practice of detachment or the manifestation of humility in each new life circumstance. Full article

Urban day-to-day travel systems generally exist in various types of cities. Their modeling is difficult due to the uncertainty of individual travelers in micro travel decision-making. Moreover, with the advent of the information age, intelligent connected vehicles, smartphones, and other types of intelligent terminals have placed urban day-to-day travel systems in an information environment. In such an environment, the travel decision-making processes of travelers are significantly affected, making it even more difficult to give theoretical explanations for urban day-to-day travel systems. Considering that analyzing urban day-to-day travel patterns in an information environment is of great significance for governing the constantly developing and changing urban travel system and, thus, of great importance for the sustainable development of cities, this paper gives a systematic review of the theoretical research on urban day-to-day travel and its development in an information environment over the past few decades. More specifically, the basic explanation of an information environment for urban day-to-day travel is given first; subsequently, the theoretical development of micro decision-making related to individual day-to-day travelers in an information environment is discussed, and the theoretical development related to changes in urban macro traffic flow, which can be recognized as the aggregation effect formed by individual micro decision-making, is also discussed; in addition, the development of understanding different types of traffic information that travelers may obtain in an information environment is discussed; finally, some important open issues related to the deep impact of information environment on urban day-to-day travel systems that require further research are presented. These valuable research directions include using information methods to fit day-to-day travel patterns of cities and implementing macro and micro integrated modeling for urban day-to-day travel systems based on complex system dynamics and even quantum mechanics. Full article

As a core component of small unmanned aerial vehicles (UAVs), GPS is playing a critical role in providing localization for UAV navigation. UAVs are an important factor in the large-scale deployment of the Internet of Things (IoT) and cyber–physical systems (CPS). However, GPS is vulnerable to spoofing attacks that can mislead a UAV to fly into a sensitive area and threaten public safety and private security. The conventional spoofing detection methods need too much overhead, which stops efficient detection from working in a computation-constrained UAV and provides an efficient response to attacks. In this paper, we propose a novel approach to obtain a lightweight detection model in the UAV system so that GPS spoofing attacks can be detected from a long distance. With long-short term memory (LSTM), we propose a lightweight detection model on the ground control stations, and then we distill it into a compact size that is able to run in the control system of the UAV with knowledge distillation. The experimental results show that our lightweight detection algorithm runs in UAV systems reliably and can achieve good performance in GPS spoofing detection. Full article

This research aimed to understand the process adult Colombian adoptees raised in the United States of America go through to define themselves in the context of race and ethnicity. The research followed a qualitative narrative methodology, in which six participants were interviewed twice regarding their experiences with transracial and transnational adoption and their ethnic and racial identity process. The results suggest that identity is a dynamic process. Our research also confirms Colombian’s history of unethical adoptions and its influence on the complexity of identity and loss of adult Colombian adoptees. Throughout the article, the researchers use the term biological family referring to Colombian birth families. However, we acknowledge that other terms (i.e., first, natural, original, etc.) are also used in the adoptee community. Full article

Since FY 2013, as a part of the Affordable Care Act (ACA) program, the Hospital Value-Based Purchasing (HVBP) program has adjusted Medicare’s payments to hospitals based on the total performance score of the hospital. First, the program reduces a portion of the hospital’s Medicare payments in a specific fiscal year, and then, by the end of the same fiscal year, the amount of the payment reductions will be awarded to the hospitals based on the total performance score; thus, the hospitals that do not receive the reward will lose the portion of money reduced by Medicare. In this research, we apply the theory of state dependence and use the dynamic random effect probit model to estimate this effect. The results show that the hospital payment adjustment dynamics have a very significant state dependence effect (0.341); this means that hospitals that received a reward in the previous year are 34.1% more likely to receive a reward this year than the ones that received a penalty in the previous year. Meanwhile, we also find that the state dependence effect varies significantly across hospitals with different ownership (proprietary/government owned/voluntary nonprofit), and the results show that voluntary nonprofit hospitals exhibit the largest effect of state dependence (0.370), while government-owned hospitals exhibit the lowest effect of state dependence (0.293), and proprietary hospitals are in the middle. Among the factors that influence the likelihood that a hospital receives a reward, we find that teaching hospitals with a large number of beds (>400) are less likely be rewarded; in terms of ownership, we find that voluntary nonprofit hospitals are more likely be rewarded; in terms of demographic factors, hospitals where the average household income are higher within the region are more likely be rewarded. Full article

Evidence suggests Colombia’s transnational adoption program maintained systemic problematic practices, some of which were illicit in nature. Examples include child and birthmother trafficking, sale of children, and falsifying or omitting information in adoption documentation. Transnationally adopted Colombian adults encounter significant barriers to accessing their right to know their origins and identity. Despite this, some adult Colombian adoptees are successful in searching for and engaging in birth family reunions. Our study conducted a secondary analysis of an original study on Colombian birth family reunion experiences. We asked the research question, “What discrepancies exist in Colombian transnational adoption narratives?” to perform a directed qualitative content analysis of 17 participant interviews. We found nearly half of our participants reported an illicit practice categorized as child for sale, birthmother trafficking, and abuse of process. Findings underscore the legacy and impact of harmful adoption practices on current adult Colombian transnational adoptees seeking their human right to identity. Full article

In his encyclical Fratelli Tutti, Pope Francis identifies a need to “heal open wounds,” as well as a “need for peacemakers … prepared to work boldly and creatively to initiate processes of healing and renewed encounter.” This paper aims to address the Holy Father’s call to “heal wounds” within our societies by first identifying memory as the primary domain that needs healing, and then proposing the wisdom of St. Bonaventure as providing the remedy. Bonaventure’s Itinerarium Mentis in Deum reveals how affectus acts as a “healing agent” upon memory as the soul ascends to God; if understood primarily as a “healing journey”, Bonaventure’s Itinerarium can shed significant light on the “processes of healing” so desperately needed today. This paper will follow each of the three major “steps” in the soul’s journey to God, as identified in Bonaventure’s Itinerarium, by identifying the role of memory in the first step; the role of affectus and its interplay with memory in the second step; and how affectus acts as a healing agent upon memory in the third step. Concluding thoughts will be offered regarding how this path given by Bonaventure can provide a foundation for building peace in the world today. Full article

This paper demonstrates that the figure of St. Francis of Assisi, as expounded by St. Bonaventure in his work Legenda Major (Major Legend), cannot be understood without certain philosophical and theological keys. Following an expository methodology, we point to Saint Francis as a theological aesthetic model. In this sense, we focus on five characterisations found in the Major Legend, introducing their aesthetic meaning, as well as the philosophical and theological significance of St. Bonaventure. We refer to St. Francis as a contemplator of nature, lover of poverty, an imitator of the crucified Christ, a brother of humankind and a Lord’s knight and minstrel, to conclude that the aesthetic model of St. Francis, as found in St. Bonaventure, can only be understood starting from theological (mystical) and philosophical ascension. Full article

This article explores technology’s integration, assessment, and reflection within a single secondary education program at a Mountain West university. In light of the publication of the Teacher Education Technology Competencies (TETCs), faculty members of a secondary education program focused on existing practices and pathways for expansion to better align with the TETC standards in the future. The purpose of this study was to explore existing practices of incorporating technology into secondary methods coursework and to search for new spaces to implement the TETC guidelines and structure, as well as explore the roles faculty play in the adoption and implementation of technologies. Vignettes authored by faculty in each content area provide a rich depth of faculty experience and dispositions regarding technology integration, as well as spaces for the deeper use of technology based on the TETC recommendations. Key questions emerged about the efficacy of current technology practices, as well as the experiences and dispositions of the faculty within the secondary education program. Findings show that secondary education faculty use domain/content-specific technologies in their course; are expected to be “meta-experts”, both discovering and implementing technology simultaneously; and tend to discover technologies through content-specific interactions and discussions. Full article