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Pediatric value-based payment reform has been hindered by limited return on investment (ROI) for child-focused measures and the accrual of financial benefits to non-health care sectors. States participating in the federally-funded Integrated Care for Kids (InCK) models are required to design child-centered alternative payment models (APMs) for Medicaid-enrolled children. The North Carolina InCK pediatric APM launched in January 2023 and includes innovative measures focused on school readiness and social needs. We interviewed experts at NC Medicaid managed care organizations, NC Medicaid, and actuaries with pediatric value-based payment experience to assess the NC InCK APM design process and develop strategies for future child-focused value-based payment reform. Key principles emerging from conversations included: accounting for payer priorities and readiness to implement measures; impact of data uncertainty on investment in novel measures; misalignment of a short-term ROI framework with whole child health measures; and state levers like mandates and financial incentives to promote implementation. [ABSTRACT FROM AUTHOR]

BACKGROUND: Physical activity is associated with a lower risk of major adverse cardiovascular events, but few individuals achieve guideline-recommended levels of physical activity. Strategies informed by behavioral economics increase physical activity, but their longer-term effectiveness is uncertain. We sought to determine the effect of behaviorally designed gamification, loss-framed financial incentives, or their combination on physical activity compared with attention control over 12-month intervention and 6-month postintervention follow-up periods. METHODS: Between May 2019 and January 2024, participants with clinical atherosclerotic cardiovascular disease or a 10-year risk of myocardial infarction, stroke, or cardiovascular death of ≥7.5% by the Pooled Cohort equation were enrolled in a pragmatic randomized clinical trial. Participants received a wearable device to track daily steps, established a baseline, selected a step goal increase, and were randomly assigned to control (n=151), behaviorally designed gamification (n=304), loss-framed financial incentives (n=302), or gamification+financial incentives (n=305). The primary outcome of the trial was the change in mean daily steps from baseline through the 12-month intervention period. RESULTS: A total of 1062 patients (mean±SD age, 67±8; 61% female; 31% non-White) were enrolled. Compared with control subjects, participants had significantly greater increases in mean daily steps from baseline during the 12-month intervention in the gamification arm (adjusted difference, 538.0 [95% CI, 186.2–889.9]; P =0.0027), financial incentives arm (adjusted difference, 491.8 [95% CI, 139.6–844.1]; P =0.0062), and gamification+financial incentives arm (adjusted difference, 868.0 [95% CI, 516.3–1219.7]; P <0.0001). During the 6-month follow-up, physical activity remained significantly greater in the gamification+financial incentives arm than in the control arm (adjusted difference, 576.2 [95% CI, 198.5–954]; P =0.0028), but it was not significantly greater in the gamification (adjusted difference, 459.8 [95% CI, 82.0–837.6]; P =0.0171) or financial incentives (adjusted difference, 327.9 [95% CI, −50.2 to 706]; P =0.09) arms after adjustment for multiple comparisons. CONCLUSIONS: Behaviorally designed gamification, loss-framed financial incentives, and the combination of both increased physical activity compared with control over a 12-month intervention period, with the largest effect in gamification+financial incentives. These interventions could be a useful component of strategies to reduce cardiovascular risk in high-risk patients. REGISTRATION: URL: https://clinicaltrials.gov; Unique Identifier: NCT03911141. [ABSTRACT FROM AUTHOR]

This paper presents a thorough examination of methane capture from Polish coal mines, contextualized within the framework of the European Union's (EU) climate policy objectives. Through a strategic analysis encompassing the interior of coal mines, the surrounding environment, and the macro environment, this study elucidates the complex dynamics involved in methane emissions and capture initiatives. The key findings include a declining trend in absolute methane emissions since 2008, despite fluctuations in coal extraction volumes, and a relatively stable level of methane capture exceeding 300 million m3/year since 2014. The analysis underscores the critical role of government support, both in terms of financial incentives and streamlined regulatory processes, to facilitate the integration of methane capture technologies into coal mining operations. Collaboration through partnerships and stakeholder engagement emerges as essential for overcoming resource competition and ensuring the long-term success of methane capture projects. This paper also highlights the economic and environmental opportunities presented by methane reserves, emphasizing the importance of investment in efficient extraction technologies. Despite these advancements, challenges persist, particularly regarding the low efficiency of current de-methanation technologies. Recommendations for modernization and technological innovation are proposed to enhance methane capture efficiency and utilization. [ABSTRACT FROM AUTHOR]

Waste classification helps to maximize the recovery of resources, reduce environmental pollution and promote sustainable economic development. To improve the willingness of rural residents to classify waste, based on the background of a rural acquaintance society, this thesis constructed a theoretical model of waste classification cognition, willingness to classify, economic incentives, face consciousness and vernacular identity affecting the willingness of rural residents to classify waste, and put forward seven research hypotheses. With the help of 530 valid surveys of rural residents in Jiangsu Province, the seven hypotheses were verified using structural equation modeling, and the mediating effect of rural residents' willingness to classify waste was examined using the bootstrap method. The results showed that waste classification awareness, knowledge of waste classification, economic incentives, face-saving concepts and local identity all affected rural residents' willingness to classify waste, and all were significant at a 0.01 level. They also showed that face-saving concepts and local identity played partial mediating roles. Strategies to improve rural residents' willingness to classify waste have been proposed, such as multiple incentives to enhance subjective awareness, play the role of face culture in rural areas, strengthen the construction of public culture in rural areas, and improve rural residents' local identity. [ABSTRACT FROM AUTHOR]

Background: Understanding the effectiveness of novel models of care in community-based settings is critical to achieving hepatitis C elimination. We conducted an evaluation of a hepatitis C model of care with financial incentives that aimed to improve engagement across the hepatitis C cascade of care at a sexual health service in Cairns, Australia. Methods: Between March 2020 and May 2021, financial incentives were embedded into an established person-centred hepatitis C model of care at Cairns Sexual Health Service. Clients of the Service who self-reported experiences of injecting drugs were offered an AUD 20 cash incentive for hepatitis C testing, treatment initiation, treatment completion, and test for cure. Descriptive statistics were used to describe retention in hepatitis C care in the incentivised model. They were compared to the standard of care offered in the 11 months prior to intervention. Results: A total of 121 clients received financial incentives for hepatitis C testing (antibody or RNA). Twenty-eight clients were hepatitis C RNA positive, of whom 92% (24/28) commenced treatment, 75% (21/28) completed treatment, and 68% (19/28) achieved a sustained virological response (SVR). There were improvements in the proportion of clients diagnosed with hepatitis C who commenced treatment (86% vs. 75%), completed treatment (75% vs. 40%), and achieved SVR (68% vs. 17%) compared to the pre-intervention comparison period. Conclusions: In this study, financial incentives improved engagement and retention in hepatitis C care for people who inject drugs in a model of care that incorporated a person-centred and flexible approach. [ABSTRACT FROM AUTHOR]

The Hospital Value-based Purchasing program is a financial incentive program for U.S. acute-care hospitals. Its unique challenges call for hospital executives to possess unique leadership competencies. In this national, cross-sectional qualitative study, primary demographic, and textual data were collected using a self-developed survey instrument and analyzed using Minitab and MAXQDA. Final sample size was n = 190. Three major findings emerged. First, executive leadership competencies were perceived to impact U.S. acute-care hospitals' Value-based Purchasing (HVBP) organizational performance. Second, the top five executive leadership competencies that mattered most to these HVBP organizational performance were: organizational awareness, collaboration, team leadership, human resource management, and information and technology management. Finally, U.S. acute-care hospitals' executive leaders recognized managing the HVBP program's specific challenges and thus urged to provide executive leadership competency development programs. [ABSTRACT FROM AUTHOR]

This paper explores the impact of an increasing number of prosumers in electricity supply systems and investigates how market mechanisms can mitigate the negative effects. The Regional Energy Market Model simulates a supply system based on cellular structures, employing agent-based modeling to capture individual behaviors and simulate real market dynamics. This study includes various supply scenarios, such as a solely photovoltaic scenario and a technically diversified scenario with biogas-fueled combined heat and power units. For each scenario, fixed and flexible pricing scenarios are simulated to analyze their effects. The findings reveal that systems heavily reliant on photovoltaics experience negative effects at certain points due to seasonal limitations, while technically diversified supply scenarios demonstrate fewer drawbacks. Flexible pricing systems stimulate demand in a manner beneficial to the system, creating regional added value, and contributing to the balance between generation and consumption, depending on the supply scenario. However, the study underscores that economic incentives alone are insufficient for balancing generation and consumption. The results highlight the importance of exploring opportunities through the interplay of economic incentive mechanisms and technical possibilities. [ABSTRACT FROM AUTHOR]

This study investigates the role of financial information in shaping the intention to adopt (ITA) Residential Rooftop Photovoltaic (RPV) systems in Israel—a country with a surprisingly low RPV adoption rate given the high solar irradiance, and significant governmental support for RPV. We used an online survey of 899 respondents to examine how different presentations of RPV revenues impact both RPV deal comprehension and ITA. Our results align with existing literature on the roles of early technology adopters and pro-environmental characteristics while introducing two novel findings. First, households value their roofs—especially flat ones used for leisure. This negatively impacts ITA. Second, we found a positive correlation between trust in government entities and ITA, underscoring the importance of trust in institutions. Although financial information does enhance RPV deal comprehension, it does not significantly influence ITA. This study concludes that RPV penetration should not be promoted solely by financial incentives, but also by other motivations like environmental concerns, novelty seeking, and improved institutional trust. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Nursing home facilities in Rhode Island face unprecedented challenges today. Most facilities find themselves in a difficult financial position with thin – or negative – operating margins. In addition, Rhode Island enacted new minimum staffing regulations for nursing homes in 2021. Facilities that fail to meet the new staffing requirements would incur significant financial penalties. The persistent shortage of direct care staff, however, limits administrators’ ability to hire the workers needed to meet the required staffing levels. METHODS: We conducted an online survey of nursing home administrators at all of the licensed nursing facilities in Rhode Island over 30 days from September to October 2023. We received responses from 53 out of 77 nursing home administrators, for an overall response rate of 69%. RESULTS: A majority of respondents reported numerous vacancies for clinical staff at their facilities. Most administrators felt that it was difficult to hire new staff, despite a variety of financial incentives to recruit workers. As a result, nursing homes were unable to comply with Rhode Island’s new minimum staffing requirements. CONCLUSION: Nursing homes in Rhode Island continue to experience a chronic staffing shortage. Furthermore, since a majority of nursing homes in Rhode Island have a negative operating margin, enforcing the state’s minimum staffing requirements would impose significant financial hardship on the state’s nursing facilities. [ABSTRACT FROM AUTHOR]

A desire to shift from fossil fuels to non-carbon-emitting energy sources has become an imperative supported by national, state, and local policies. In the U.S., a diverse array of policies at multiple levels of government have helped the solar industry achieve exponential growth. These advancements, however, are mediated by local implementation processes, which might be expected to have a large impact in the context of U.S. federalism. This paper investigates the effects of two countervailing forces – policy incentives and implementation disincentives – on residential solar adoption in New Jersey. The New Jersey case study includes two complementary analyses designed to illuminate policy incentives and implementation disincentives, respectively. The first is an interrupted time-series analysis that evaluates the effects of federal and statewide renewable energy policies on residential photovoltaic (PV) growth. The second is a set of semi-structured in-depth interviews with solar industry experts, providing implementation insights from the solar industry and indirectly portraying residential customers' experiences. Results confirm that market-based instruments at the state-level play a crucial role in increasing the relative financial advantage of these systems and, thus, the attraction of residential solar PV to adopters. In addition, the behaviours of future adopters and the valuation of this technology as an investment in the housing market will impact the spread of residential PV systems in the future. Unfortunately, case study findings also confirm that an absence of standardized solar application procedures and outdated interconnection standards is a significant drag on the adoption rate. This highlights a need for policymakers to place greater emphasis on local implementation pathways in solar policy design. Options to achieve this include more robust ex-ante coordination among state and local levels of government and with industry to standardize implementation processes. While U.S. federalism may at times be constraining, our results suggest that even minimal levels of ex-ante coordination can lead to implementation gains that will have a large impact on solar diffusion outcomes. Federal and state-level financial incentives significantly impact the residential photovoltaic solar adoption rate. The absence of streamlined interconnection application procedures and outdated interconnection standards for the grid limit the residential PV adoption in New Jersey. Our findings underline the importance of paying equal attention to both policy design and to technical standards to underpin implementation processes, especially in the decentralized context of U.S. federalism. [ABSTRACT FROM AUTHOR]

Background Delay discounting is the depreciation in a reward's perceived value as a function of the time until receipt. Monetary incentive programs that provide rewards contingent on meeting daily physical activity (PA) goals may change participants' delay discounting preferences. Purpose Determine if monetary incentives provided in close temporal proximity to meeting PA goals changed delay discounting, and if such changes mediated intervention effects. Methods Inactive adults (n = 512) wore accelerometers during a 12-month intervention where they received proximal monetary incentives for meeting daily moderate-to-vigorous PA (MVPA) goals or delayed incentives for study participation. Delay discount rate and average MVPA were assessed at baseline, end of intervention, and a 24-month follow-up. Using structural equation modeling, we tested effects of proximal versus delayed rewards on delay discounting and whether any changes mediated intervention effects on MVPA. PA self-efficacy was also evaluated as a potential mediator, and both self-efficacy and delay discounting were assessed as potential moderators of intervention effects. Results Proximal rewards significantly increased participants' delay discounting (β = 0.238, confidence interval [CI]: −0.078, 0.380), indicating greater sensitivity to reinforcement timing. This change did not mediate incentive-associated increases in MVPA at the end of the 12-month intervention (β = −0.016, CI: −0.053, 0.019) or at a 24-month follow-up (β = −0.020, CI: −0.059, 0.018). Moderation effects were not found. Conclusions Incentive-induced increases in delay discounting did not deleteriously impact MVPA. This finding may help assuage concerns about using monetary incentives for PA promotion, but further research regarding the consequences of changes in delay discounting is warranted. [ABSTRACT FROM AUTHOR]

Scheduling workload is a demand response strategy for data centers to reshape electricity usage, which provides an opportunity for them to utilize renewable energy. Enhancing the flexibility of workload scheduling would promote the data center to integrate renewable energy. Considering that the improvement of flexibility in workload scheduling is tightly related to the Quality of Service (QoS) required by IT consumers (ITCs), it becomes desirable for the data center to collaborate with them to further facilitate renewable energy integration in demand response programs. This paper proposes a QoS‐based bi‐level demand response model for the data center, where game theory is adopted to resolve the conflict of interest in the collaboration between the data center and ITCs. At the upper level, the data center is a leader who provides differential monetary incentives to ITCs while dispatching workload to integrate renewable energy. At the lower level, ITCs act as followers who adjust the workload's QoS to enhance the flexibility of workload scheduling. Simulation results show that the proposed model can decrease the operating cost of the data center while increasing the utilization of renewable energy. © 2024 Institute of Electrical Engineer of Japan and Wiley Periodicals LLC. [ABSTRACT FROM AUTHOR]

We establish a bus market evolution model to explore the implications of subsidy policies in Hong Kong (HK) for the transition to a zero-emission bus (ZEB) fleet using an unsubsidized case as the benchmark scenario. Using the system dynamics (SD) approach, we capture the intricate feedback mechanisms among market share dynamics, cost considerations, consumer preferences, and competitive interactions within the bus market. These interactions are encapsulated within three pivotal feedback loops: scale economy, public acceptance, and bus market competition. We systematically integrate the HK-specific features of hydrogen buses (H-buses), battery electric buses (E-buses), and diesel buses (D-buses) from technical and economic perspectives and compare them to the benchmark scenario. The results show that only 66% of the bus fleet would be ZEBs by 2050, and this underscores the necessity for governmental financial incentives to expedite the transition to a fully zero-emission fleet. Furthermore, we evaluate various ZEB subsidy policy alternatives in terms of timing, intensity, and recipients. The analysis suggests that policies offering long-term and low-intensity subsidies are most beneficial, taking into account the cumulative effects and inherent delays associated with policy implementation. Importantly, the study highlights the critical balance that policymakers must achieve between short- and long-term objectives, especially given the counter-intuitive outcomes observed in the early stages of policies favoring H-buses exclusively. This study provides valuable policy insights for policymakers and upstream energy companies in HK, with potential applicability in wider real-world contexts. • Zero-emission bus alternatives are analyzed from technical and economic aspects. • Various feedback loops are considered for dynamic market analysis. • A counter-intuitive effect is observed in the hydrogen bus subsidy scenario. • A long-term subsidy with low intensity is recommended. • Tradeoff between short- and long-term policy effects is identified and discussed. [ABSTRACT FROM AUTHOR]

Entertainment-education has been touted as a potent delivery channel for health education campaigns. Yet, there is little evidence of its causal effects. This paper aims to fill the gap in the literature by using a field experiment in India to study two questions on the efficacy of health entertainment-education. First, can health entertainment-education, particularly through films that show role models and draw on emotions, lead to lasting, positive change in health knowledge and behavior? Second, can financial incentives for ex-post health literacy boost the effectiveness of health entertainment-education? The results show that health entertainment-education successfully increased health knowledge (e.g. knowledge about cleanliness and hygiene) by 16 percent. These gains persist almost one year later, although there were no observed impacts on health behaviors. Further, financial incentives do not appear to have any effects. These insights contribute to our knowledge of what works for health education in low-income settings, so that future education campaigns can be crafted with more meaningful impact. [ABSTRACT FROM AUTHOR]

How often do political elites in the U.S. share low-quality news sources? Are there differences between the parties? While past work has investigated individuals sharing low-quality news sources, there are few large-scale analyses of the quality of information shared by political elites. As individuals rely on elite cues to inform their decision-making, officials sharing low-quality sites may increase polarization while providing legitimacy to low-quality outlets. We fill this gap by collecting more than 300,000 links shared on Facebook by U.S. members of Congress and measuring how often each party shares information from known low-quality news sources. We find that members of Congress share more links to low-quality sites than the public, that Republican members share considerably more than Democrats, and that this gap has increased over time. Finally, we investigate the potential mechanisms underlying this partisan gap and find that only Republicans receive increased engagement when sharing low- quality sites, suggesting asymmetric incentives to share low-quality news sources. [ABSTRACT FROM AUTHOR]

The shortage of organs for transplantations is increasing in Europe as well as globally. Many initiatives to the organ shortage, such as opt-out systems for deceased donation and expanding living donation, have been insufficient to meet the rising demand for organs. In recurrent discussions on how to reduce organ shortage, financial incentives and removal of disincentives, have been proposed to stimulate living organ donation and increase the pool of available donor organs. It is important to understand not only the ethical acceptability of (dis)incentives for organ donation, but also its societal acceptance. In this review, we propose a research agenda to help guide future empirical studies on public preferences in Europe towards the removal of disincentives and introduction of incentives for organ donation. We first present a systematic literature review on public opinions concerning (financial) (dis)incentives for organ donation in European countries. Next, we describe the results of a randomized survey experiment conducted in the United States. This experiment is crucial because it suggests that societal support for incentivizing organ donation depends on the specific features and institutional design of the proposed incentive scheme. We conclude by proposing this experiment's framework as a blueprint for European research on this topic. [ABSTRACT FROM AUTHOR]

A robust workforce of locum tenens (LT) physicians is imperative for health service stability. A systematic review was conducted to synthesize current evidence on the strategies used to facilitate the recruitment and retention of LT physicians. English articles up to October 2023 across five databases were sourced. Original studies focusing on recruitment and retention of LT's were included. An inductive content analysis was performed to identify strategies used to facilitate LT recruitment and retention. A separate grey literature review was conducted from June–July 2023. 12 studies were retained. Over half (58%) of studies were conducted in North America. Main strategies for facilitating LT recruitment and retention included financial incentives (83%), education and career factors (67%), personal facilitators (67%), clinical support and mentorship (33%), and familial considerations (25%). Identified subthemes were desire for flexible contracts (58%), increased income (33%), practice scouting (33%), and transitional employment needs (33%). Most (67%) studies reported deterrents to locum work, with professional isolation (42%) as the primary deterrent-related subtheme. Grey literature suggested national physician licensure could enhance license portability, thereby increasing the mobility of physicians across regions. Organizations employ five main LT recruitment facilitators and operationalize these in a variety of ways. Though these may be incumbent on local resources, the effectiveness of these approaches has not been evaluated. Consequently, future research should assess LT the efficacy of recruitment and retention facilitators. Notably, the majority of identified LT deterrents may be mitigated by modifying contextual factors such as improved onboarding practices. [ABSTRACT FROM AUTHOR]

Background: Fee-for-service is a common payment model for remunerating general practitioners (GPs) in OECD countries. In Norway, GPs earn two-thirds of their income through fee-for-service, which is determined by the number of consultations and procedures they register as fees. In general, fee-for-service incentivises many and short consultations and is associated with high service provision. GPs act as gatekeepers for various treatments and interventions, such as addictive drugs, antibiotics, referrals, and sickness certification. This study aims to explore GPs' reflections on and perceptions of the fee-for-service system, with a specific focus on its potential impact on gatekeeping decisions. Methods: We conducted six focus group interviews with 33 GPs in 2022 in Norway. We analysed the data using thematic analysis. Results: We identified three main themes related to GPs' reflections and perceptions of the fee-for-service system. First, the participants were aware of the profitability of different fees and described potential strategies to increase their income, such as having shorter consultations or performing routine procedures on all patients. Second, the participants acknowledged that the fees might influence GP behaviour. Two perspectives on the fees were present in the discussions: fees as incentives and fees as compensation. The participants reported that financial incentives were not directly decisive in gatekeeping decisions, but that rejecting requests required substantially more time compared to granting them. Consequently, time constraints may contribute to GPs' decisions to grant patient requests even when the requests are deemed unreasonable. Last, the participants reported challenges with remembering and interpreting fees, especially complex fees. Conclusions: GPs are aware of the profitability within the fee-for-service system, believe that fee-for-service may influence their decision-making, and face challenges with remembering and interpreting certain fees. Furthermore, the fee-for-service system can potentially affect GPs' gatekeeping decisions by incentivising shorter consultations, which may result in increased consultations with inadequate time to reject unnecessary treatments. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 pandemic unveiled huge challenges in health workforce governance in the context of public health emergencies in Africa. Several countries applied several measures to ensure access to qualified and skilled health workers to respond to the pandemic and provide essential health services. However, there has been limited documentation of these measures. This study was undertaken to examine the health workforce governance strategies applied by 15 countries in the World Health Organization (WHO) Africa Region in responding to the COVID-19 pandemic. Methods: We extracted data from country case studies developed from national policy documents, reports and grey literature obtained from the Ministries of Health and other service delivery agencies. This study was conducted from October 2020 to January 2021 in 15 countries - Angola, Burkina Faso, Chad, Eswatini, Ghana, Guinea, Guinea Bissau, Ivory Coast, Liberia, Mali, Mauritania, Niger, Nigeria, Senegal and Togo. Results: All 15 countries had national multi-sectoral bodies to manage the COVID-19 response and a costed national COVID-19 response plan. All the countries also reflected human resources for health (HRH) activities along the different response pillars. These activities included training for health workers, and budget for the recruitment or mobilization of additional health workers to support the response, and for provision of financial and non-financial incentives for health workers. Nine countries recruited additional 35,812 health workers either on a permanent or temporary basis to respond to the COVID-19 with an abridged process of recruitment implemented to ensure needed health workers are in place on time. Six countries redeployed 3671 health workers to respond to the COVID-19. The redeployment of existing health workers was reported to have impacted negatively on essential health service provision. Conclusion: Strengthening multi-sector engagement in the development of public health emergency plans is critical as this promotes the development of holistic interventions needed to improve health workforce availability, retention, incentivization, and coordination. It also ensures optimized utilization based on competencies, especially for the existing health workers. [ABSTRACT FROM AUTHOR]

People who are homeless are at increased risk of COVID-19 infection, and of poorer associated outcomes. Delivering vaccinations to, and ensuring uptake of multiple doses in, people who are homeless is complex. Financial incentives may improve vaccination uptake, particularly in people who have not received routine vaccinations previously, though evidence about the effect of incentives is limited and variable. This randomized controlled trial (ANZCTR 383156) assessed the effect of a financial incentive (an A$10 grocery voucher) on uptake of the second COVID-19 vaccination in Australian adults who were homeless, and who had received their first dose. Participants were recruited through a vaccination program for people experiencing homelessness between September 2021 and January 2022. They were followed-up for a minimum of 6.5 months. Uptake was measured 'on-time' at 6 weeks, and at any time during the trial period. Vaccination status was checked on the Australian Immunisation Register. Demographic and vaccination program characteristics associated with uptake were also investigated. Eighty-six people consented to participate, and 43 were randomly allocated to each of the 'incentive' and 'no incentive' groups. The incentive slightly increased the likelihood of a participant receiving a second vaccination on-time (risk difference (RD), 11.6 % [95 %CI, −9.0, 32.2 %]; p = 0.27), and at any time during the trial (RD, 14.0 % [95 %CI, –2.2, 30.1 %], p = 0.09). The incentive had a significant positive effect on uptake in people with no previous vaccination history, increasing their likelihood of receiving a second vaccination on-time (RD, 42.3 % [95 %CI, 15.7, 68.8 %]; p = 0.002) and at any time during the trial (RD, 38.7 % [95 %CI, 16.1, 61.3 %], p < 0.001). Financial incentives may increase COVID-19 vaccination uptake in people who are homeless, and particularly those who have no previous vaccination history. Future research should consider alternative incentive values, types, and cost-effectiveness. [ABSTRACT FROM AUTHOR]

Complying with strict PM10 and PM2.5 limit values poses challenges in many European regions, influenced by diverse factors such as natural, regional, and local anthropogenic sources. Urban air pollution, exacerbated by road transport, local industry, and dust resuspension, contrasts with rural areas affected by solid fuel-based local heating and increasing wood burning. This study focuses on village of Sučany, located in Slovakia, analysing PM concentrations during non-heating and heating seasons. The method of analysis relies on the use of the MP101M air quality analyser that utilises beta radiation absorption method. One set of measurements was conducted at five distinct locations during the heating season (18/01/2019 to 28/02/2019) and non-heating season (14/08/2018 to 1/10/2018). Significant differences emerged during the non-heating season with corresponding PM10 averages of 23.0 µg/m3 and PM2.5 at 19.3 µg/m3. In contrast, the PM10 averaged 53.9 µg/m3 and 52.8 µg/m3 during the heating season. The heating season shows PM2.5 contributing up to 98% of total PM10. The distribution of PM10 and PM2.5 pollution and the location of the potential source obtained using polar plots differed during the heating and non-heating seasons. This research underscores the impact of local heating on air quality in a typical Slovak village. The key recommendation for targeted interventions is supporting up-to-date air quality data, education, and financial incentives for citizens in order to implement cleaner and modern heating solutions. [ABSTRACT FROM AUTHOR]

Successful peacekeeping depends heavily on the conflict parties providing unrestricted consent to the intervention. Consent is, however, often withheld or limited by one or more parties who calculate a higher cost to peace than to continued fighting. We highlight the role of international economic incentives in the form of foreign development aid in overcoming hurdles to obtaining consent. We argue that past aid sends a credible signal of future, post-conflict material benefits if the belligerents work toward peace. This conditionality of future benefits thereby incentivizes the belligerents to work toward peace and stability, including providing unrestricted consent to peacekeeping missions. Analyses of 119 post-Cold War civil wars and a brief narrative of East Timor demonstrate that foreign aid significantly and substantially increases the likelihood of unrestricted consent. The findings have implications for the literature on international influences on domestic political contestation and for research on the effectiveness of peacekeeping operations. [ABSTRACT FROM AUTHOR]

We introduce the rejection game, designed to formalize the interaction between interlocutors in a Stalnakerian conversation: a speaker who asserts something and a listener who may accept or reject. The rejection game is similar to other signalling games known to the literature in economics and biology. We point out similarities and differences, and propose an application in linguistics. We uncover basic conditions under which the Gricean maxim of quality emerges from incentives among the players, providing evidence for a functionalist understanding of the Gricean program. [ABSTRACT FROM AUTHOR]

This paper empirically examines the impact of investment treaties on domestic governance in developing countries, through cross‐country quantitative analysis and a detailed qualitative case‐study on Myanmar. We clarify a variety of mechanisms that plausibly link investment treaties to impacts on domestic governance. Considering incentive, acculturative and political economy mechanisms, we find little evidence that the treaties lead to changes in domestic law, institutional structure or policy‐making. The treaties also have surprisingly limited relevance in investor‐state bargaining outside formal adjudicatory processes. Overall, our findings point to a profound decoupling between investment treaties and domestic governance; they also clarify the conditions under which such decoupling can persist, notwithstanding material incentives for states to ensure tighter alignment. Rather than interpreting decoupling as a failure of domestic implementation, our case study suggests that the problem is with the treaties themselves, in that they place obligations on developing countries that cannot realistically be implemented. [ABSTRACT FROM AUTHOR]

Aquaculture can provide foraging habitat for birds, but it can also result in intentional and accidental mortality. We examined an overlooked conflict between razor clam (Sinonovacula spp.) aquaculture and declining shorebirds in southeastern China's Fujian and Zhejiang provinces. We surveyed 6 out of 11 internationally important stopover sites for these shorebirds and monitored shorebird mortality in 2 sites (Xinghua Bay, Yueqing Bay) with razor clam aquaculture. We visited an additional 32 sites in these 2 provinces to determine if there was netting in other razor clam farms. Approximately 8–9 km2 of intertidal foraging habitat was covered by horizontal nets to prevent birds from feeding on young razor clams at Xinghua Bay and Yueqing Bay. We conservatively estimated that 13,676 (2.5th–97.5th percentile 8,330–21,285) individual shorebirds were entangled in the nets at the 2 monitored sites in April and May 2021, including 2 endangered and 7 near‐threatened species. Mortality of 5 species for which we had sufficient data accounted for 0.76% (black‐tailed godwit [Limosa limosa]) to 4.27% (terek sandpiper [Xenus cinereus]) of their total flyway populations. This level of mortality could strongly affect their populations. We found netting at 17 additional razor clam farms, indicating a widespread threat to shorebirds. Although razor clams are typically harvested in late March to early April, nets are left on the mudflats throughout the spring and summer, including when the bulk of shorebird migration takes place. Immediately removing these nets after the clam harvest could prevent most of the spring mortality of shorebirds, although this is unlikely to happen without government regulations or economic incentives. To better assess and mitigate the impacts of this conflict, future research should quantify shorebird mortality at other razor clam farms, including during winter, explore less harmful deterrence methods, and assess the socioeconomic factors driving the conflict. [ABSTRACT FROM AUTHOR]

This article interrogates the development of the European Border and Coast Guard (Frontex) and its implications for the EU's approach to border control coordination. Through the theoretical lens of the principal-agent model, it investigates information asymmetry and friction between stakeholders in the implementation of Frontex's increased competence at the borders. The findings of this article show that the development of Frontex has led to growing incentives for the EU's supranational institutions to steer the agency to pursue their individual objectives, creating new supranational elements in EU border management. [ABSTRACT FROM AUTHOR]

Delusional thoughts such as paranoia and conspiratorial thinking reflect beliefs in others' intentions to do harm. Given the integral role of harm evaluation in moral cognition, a better understanding of how psychosis-prone individuals process others' moral characters may provide insights into social cognitive mechanisms of these types of delusions. An online sample of 293 participants was drawn from the general population, using Amazon Mechanical Turk. Participants performed a moral inference task, where they predicted and judged the binary choices of two fictitious agents ("good" or "bad") to impose harm under different levels of financial incentives. An investment game involving the same agents then examined participants' trust behavior. Psychosis-proneness was measured with the Multidimensional Schizotypy Scale Brief Edition. A set of multiple regressions showed that positive schizotypy was associated with a lower yet more confident pre-experimental expectation of the agent's moral character, lower prediction accuracy of the agent's harm preferences, less belief revision, and undifferentiated perception of the good and bad agents' characters. Positive schizotypy was also related to higher expectations for reciprocity in the investment game, regardless of agent characters. Our findings suggest that inflexible beliefs associated with psychosis-proneness extend beyond negative prior expectations, also reflecting difficulties in moral learning. The resulting undifferentiated moral impressions might contribute to undue suspicion of benevolent individuals and increased gullibility to malicious ones, potentially further strengthening conspiratorial beliefs. [ABSTRACT FROM AUTHOR]

Background: Ductal carcinoma in situ (DCIS) is the most common form of noninvasive breast cancer and is associated with an excellent prognosis. As a result, there is concern about overdiagnosis and overtreatment of DCIS because most patients with DCIS are treated as though they have invasive breast cancer and undergo either breast‐conserving surgery (BCS)—most commonly followed by radiation therapy (RT)—or mastectomy. Little research to date has focused on nonclinical factors influencing treatments for DCIS. Methods: Population‐based data were analyzed from five state cancer registries (California, Florida, New Jersey, New York, and Texas) on women aged 65 years and older newly diagnosed with DCIS during the years 2003 to 2014 using a retrospective cohort design and multinominal logistic modeling. The registry records with Medicare enrollment data and fee‐for‐service claims to obtain treatments (BCS alone, BCS with RT, or mastectomy) were merged. Surgeon practice structure was identified through physician surveys and internet searches. Results: Patients of surgeons employed by cancer centers or health systems were less likely to receive BCS with RT or mastectomy than patients of surgeons in single specialty or multispecialty practices. There also was substantial geographic variation in treatments, with patients in New York, New Jersey, and California being less likely to receive BCS with RT or mastectomy than patients in Texas or Florida. Conclusions: These findings suggest nonclinical factors including the culture of the practice and/or financial incentives are significantly associated with the types of treatment received for DCIS. Increasing awareness and targeted efforts to educate physicians about DCIS management among older women with low‐grade DCIS could reduce patient harm and yield substantial cost savings. There is concern about overdiagnosis and overtreatment of ductal carcinoma in situ, the most common form of noninvasive breast cancer, because it is associated with an excellent prognosis. Nonclinical factors, including practice structure and geography, are associated with the receipt of surgery with radiation therapy and of mastectomy. [ABSTRACT FROM AUTHOR]

Objective: To test the reliability of Medicare claims in measuring vertical integration. We assess the accuracy of a commonly used measure of integration, primary care physician (PCP) practices billing Medicare as a hospital outpatient department (HOPD) in claims. Data Sources and Study Setting: Medicare fee‐for‐service claims, IQVIA, and CPC+ practice surveys for this study. Study Design: We compare measures of integration from Medicare claims to self‐reported indicators of integration from IQVIA and a survey of CPC+ participating practice sites. Data Collection/Extraction Methods: We measure integration by using site‐of‐service billing in the 100% sample of Medicare Carrier claims from 2017–2020. In the IQVIA SK&A (2017–2018), OneKey (2019–2020), and practice survey data (2017–2019), we use self‐reported responses to measure integration. Principal Findings: We find that currently most PCP practices sites that report themselves as being integrated with a health system do not bill as an HOPD. In 2017, 11% of CPC+ practices were identified as being vertically integrated in claims, while the equivalent numbers in SK&A and surveys were 52% and 54% integration, respectively. A t‐test found that both datasets significantly differed from claims (Survey: 41.3%–45.1%; SK&A: 45.3%–51.1%); this gap persists in 2018–2019. Conclusion: Measuring physician‐hospital vertical integration accurately is integral to determining consolidation. The overwhelming majority of PCP practice sites not billing as an HOPD may reflect Medicare regulatory changes that have reduced the financial incentives for doing so. These findings have implications for researchers that study the growth in PCP‐hospital integration in health care markets. [ABSTRACT FROM AUTHOR]

The building sector is significantly contributing to climate change, pollution, and energy crises, thus requiring a rapid shift to more sustainable construction practices. Here, we review the emerging practices of integrating renewable energies in the construction sector, with a focus on energy types, policies, innovations, and perspectives. The energy sources include solar, wind, geothermal, and biomass fuels. Case studies in Seattle, USA, and Manama, Bahrain, are presented. Perspectives comprise self-sufficiency, microgrids, carbon neutrality, intelligent buildings, cost reduction, energy storage, policy support, and market recognition. Incorporating wind energy into buildings can fulfill about 15% of a building's energy requirements, while solar energy integration can elevate the renewable contribution to 83%. Financial incentives, such as a 30% subsidy for the adoption of renewable technologies, augment the appeal of these innovations. [ABSTRACT FROM AUTHOR]

To improve the ecological effectiveness of agri-environment-climate measures (AECM), collective approaches to co-ordinate AECM beyond the farm level have emerged, which are characterised by different levels of co-operation between individual farmers. As participation is voluntary, understanding farmers' perspectives on collective action in the context of these economic incentive instruments is crucial to improve existing or design novel approaches. We conducted a Q study on farmers' viewpoints on collective AECM in the Netherlands, where all AECM have to be realised jointly since 2016. Our results reveal three dominant views on collective AECM: a collective-oriented, a business-oriented and an environment-oriented perspective. Clear preferences for the collective approach show that even in cultures with strong values of independence joint action is possible, as farmers' autonomy can be strengthened through co-operation. Considering different perspectives on collective approaches within the institutional design can help to develop more targeted, and thus successful, incentives. [ABSTRACT FROM AUTHOR]

The electrification of the transport sector to control the carbon footprint has been gaining momentum over the last decade with electric vehicles (EVs) seen as the replacement for conventional internal combustion engines. Economic incentives, subsidies, and tax exemptions are also paving the way for rising EV penetration in the power distribution networks. However, the exponential EV adoption requires careful technical and regulatory analysis of traditional networks to satisfy the network reliability constraints. Therefore, it would be vital to find EV hosting capacity (HC) limits of networks from a multifaceted approach involving various market players, mainly distribution system operators and EV owners. This review provides a systematic categorization of EV hosting capacity evaluation and improvement methods, thus enabling researchers and industry personnel to navigate the advancing landscape of EVs. This novel framework extends beyond the theoretical implication of diverse objective functions and HC improvement methods to the actual numerical values of EV HC across varying geographical settings. Therefore, this unique synthesis of varying aspects of EV HC facilitates the in‐depth understanding of the integration of sustainable energy and transport sector. [ABSTRACT FROM AUTHOR]

The creation of new firms is an important incentive for the economic growth of a country, since it generates employment, it encourages the competition, and promotes innovation. In this work, we investigate the survival of Spanish firms which were created since 2001 and closed down between 2004 and 2012. The information was gathered from Technological Innovation Panel (PITEC), a survey with a focus the technological innovation in Spanish firms. In particular, a Cox regression model with time-dependent covariates was used in order to identify and quantify the determinants of the risk of exit for the firm. The selection bias due to the interval sampling for the firms was corrected by using methods for doubly truncated lifetimes. Interestingly, it is seen how the correction for the selection bias changes both the size and the statistical significance of the effects provided by standard Cox regression. [ABSTRACT FROM AUTHOR]

Background: Medical overuse is defined as health care services that exceed the individual needs of patients and when the potential harms of medical interventions exceed their benefits. It has impacts on patients as well as on health care resources. To address medical overuse, it is important to understand the knowledge and experiences of overuse on the side of patients. Research questions: What is the citizens' understanding of overuse? How do they assess its relevance, causes, consequences and potential solutions? Methods: A quantitative online survey was conducted. The participants were asked to state what they understand by medical overuse. Statements on causes, consequences and possible solutions were evaluated. Recruitment was carried out via a panel of a market research institute (Schlesinger Group). Results: The survey was completed by 406 participants. In terms of age and gender, the sample corresponded to the distribution in the German population. The majority had never heard of medical overuse (58%). About 60% assumed that medical overuse means "too much medicine including overtreatment and overtesting". Medical overuse was mainly suspected for services not covered by the public health insurance system (56%), surgical interventions (45%) and medication prescriptions (37%). Reasons for medical overuse were seen in uncoordinated care and financial incentives, but also in the expectations of patients. The main problem with medical overuse was seen in rising health care costs, while harmful physical and mental consequences for patients were mentioned less often. In order to reduce medical overuse, little importance was attributed to a primary care based system or higher financial contribution of patients. Instead, stricter cost control on the side of physicians and better coordination between care providers were suggested as solutions. Differences in socio-demographic characteristics hardly showed any differences in response behavior. Conclusion: More than half of the respondents had never heard of medical overuse. Overuse was mainly associated with financial causes and consequences. It was not seen that overuse can be harmful for patients directly. The limited awareness of the problem of overuse probably is a barrier to tackling it effectively. Communicating the topic to the public might therefore be an effective start to mitigate medical overuse. Take home message: Many citizens seem not to be familiar with the concept of medical overuse, especially not with the fact that it may directly cause harm to patients. Informing citizens about the harms of medical overuse might be helpful in mitigating it. [ABSTRACT FROM AUTHOR]

Background: In the Lake Victoria basin of western Kenya, malaria remains highly endemic despite high coverage of interventions such as mass distribution of long-lasting insecticidal nets (LLIN), indoor residual spraying (IRS) programs, and improvement of availability and accessibility of rapid diagnostic tests (RDT) and artemisinin-based combination therapy (ACT) at community healthcare facilities. We hypothesize that one major cause of the residual transmission is the lack of motivation among residents for malaria prevention and early treatment. Methods: This study will aim to develop a demand-side policy tool to encourage local residents' active malaria prevention and early treatment-seeking behaviors. We examine the causal impact of a financial incentive intervention complemented with malaria education to residents in malaria-prone areas. A cluster-randomized controlled trial is designed to assess the effect of the financial incentive intervention on reducing malaria prevalence in residents of Suba South in Homa Bay County, Kenya. The intervention includes two components. The first component is the introduction of a financial incentive scheme tied to negative RDT results for malaria infection among the target population. This study is an attempt to promote behavioral changes in the residents by providing them with monetary incentives. The project has two different forms of incentive schemes. One is a conditional cash transfer (CCT) that offers a small reward (200 Ksh) for non-infected subjects during the follow-up survey, and the other is a lottery incentive scheme (LIS) that gives a lottery with a 10% chance of winning a large reward (2000 Ksh) instead of the small reward. The second component is a knowledge enhancement with animated tablet-based malaria educational material (EDU) developed by the research team. It complements the incentive scheme by providing the appropriate knowledge to the residents for malaria elimination. We evaluate the intervention's impact on the residents' malaria prevalence using a cluster-randomized control trial. Discussion: A policy tool to encourage active malaria prevention and early treatment to residents in Suba South, examined in this trial, may benefit other malaria-endemic counties and be incorporated as part of Kenya's national malaria elimination strategy. Trial registration: UMIN000047728. Registered on 29th July 2022. [ABSTRACT FROM AUTHOR]

Background: Numerous studies have highlighted the pivotal role of alterations in the monetary reward system in the development and maintenance of substance use disorder (SUD). Although these alterations have been well documented in various forms of SUD, the electrophysiological mechanisms specific to opioid use disorder (OUD) remain underexplored. Understanding these mechanisms is critical for developing targeted interventions and advancing theories of addiction specific to opioid use. Objectives: To explore abnormalities in monetary reward outcome processing in males with OUD. We hypothesized that control individuals would show higher feedback-related negativity (FRN) to losses, unlike those in the OUD group, where FRN to losses and gains would not differ significantly. Methods: Fifty-seven participants (29 male individuals with OUD [heroin] and 28 male controls) were evaluated. A combination of the monetary incentive delay task (MIDT) and event-related potential (ERP) technology was used to investigate electrophysiological differences in monetary reward feedback processing between the OUD and healthy control groups. Results: We observed a significant interaction between group (control vs. OUD) and monetary outcome (loss vs. gain), indicated by p <.05 and η2p = 0.116. Specifically, control participants showed stronger negative FRN to losses than gains (p <.05), unlike the OUD group (p >.05). Conclusion: This study's FRN data indicate that males with OUD show altered processing of monetary rewards, marked by reduced sensitivity to loss. These findings offer electrophysiological insights into why males with OUD may pursue drugs despite potential economic downsides. [ABSTRACT FROM AUTHOR]

We present a case study of corrupted discourses in medicine. Medicine is a fallible science. Therefore, it is not surprising that mistakes in the assessment of data and early closure of discourse have led to a highly biased view of the Covid-19 crisis. We present two examples of papers which were retracted following criticisms and republished after a lengthy re-reviewing process. One paper discussed the clinical benefits of COVID-19 vaccinations and the potential risk profile of these vaccinations using the Dutch Adverse Drug Reaction Register. The results of this study were not very favorable. The pressure mounted on the publisher of the journal Vaccines (MDPI, Basel) was huge, and the paper was retracted, although none of the classical reasons for retraction were present. The second paper was about carbon dioxide content in inhaled air under face masks in children, which revealed amounts of CO2 inhaled under masks that violate accepted security norms by a factor of six. This paper was also retracted after criticisms were raised online and after a very dubious re-review process. A closer analysis shows that both retractions were politically motivated. We analyze these case studies and conclude that in the era of COVID-19, politics and financial incentives are increasingly replacing scientific discourse. The profit motive in scientific discourse has opened the floodgates to political influences. This makes obvious what has long been a problem: Financial conflicts of interest continue to distort research and play a major role in evaluations of the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

To assess incentive changes on resident publication behavior. In 2020, we demonstrated the positive effect of an unlimited $1000 publishing incentive for Urology residents. Following this publication, institutional changes led to a limit of a single $1000 publishing incentive per resident per year. The PubMed database was assessed to quantify average resident primary authorship and average overall publications. Average primary authorships and total PubMed listings were then compared by year before any incentive (June 2008-June 2016), during unlimited incentive (July 2016-October 2020), and after the limited financial incentive (November 2020-June 2023). Scholarly activity from 30 out of 30 possible residents was evaluated. The average PubMed research participation for the program per year increased significantly from 2.44 preincentive to 8.0 when the incentive was unlimited but decreased to 4.0 when the incentive was limited (P =.026). Similarly, the average PubMed primary resident authorships per year increased from 1.0 preincentive to 6.25 during the unlimited incentive period but decreased to 2.0 when the incentive was limited (P <.001). Our data showed an unlimited monetary incentive resulted in a significant increase in average primary resident authorship and average resident participation for publications to PubMed. The limited monetary incentive model resulted in a significant decrease on resident publication and participation in research compared to unlimited incentives. However, limited monetary incentives have a positive, though restricted, effect on Urology resident publication and participation in research compared to no incentive. [ABSTRACT FROM AUTHOR]

Western donors have progressively increased the amount of foreign aid allocated through bypass channels, particularly for recipients with weak domestic institutions. Rather than giving money directly to recipient governments, aid is given to non-governmental organizations working on the ground in those countries. Explanations for this shift range from increased donor attention to effectiveness, a desire to deliver assistance directly to those in need, and enhanced legitimacy by working with local civil society partners. Donors, however, face a trade-off when deciding whether or not to allocate aid through bypass channels. Because bypass aid is not given directly to the recipient government, the donor has less leverage to prop up friendly regimes or buy policy concessions. We argue that as donors balance competing motivations, geo-strategic incentives can, at times, trump concerns regarding best practices of poverty alleviation. Using data on bypass aid from 2004 to 2019, we find that donor's commitment to good governance is ameliorated in strategically important recipient states. Strategic partners who improve their domestic governance are rewarded with less bypass aid (more government-to-government aid) at higher rates than less strategic recipients. These results highlight potential limitations of the good governance movement in foreign aid. [ABSTRACT FROM AUTHOR]

Financial incentives play a key role in promoting renewable energy investments that can help China achieve the 'dual carbon' goal. The national emissions trading scheme (ETS) and the renewable energy portfolio standard (RPS) are two existing market-based policy instruments that can generate stable expected returns for low-carbon projects. This paper studies the interactive distribution effects of these two market-based instruments. We use the micro-level thermal power plant data to investigate the abatement effects of the national ETS, in which the details show that the existing rate-based ETS will result in higher negative impacts on power units, whose installed capacities are smaller than 400 MW. The interactive distribution effects between the two markets will occur when the permit allocation standards of the national ETS become stricter than the existing ones. Provinces in Eastern China and Northern China will face high pressure on costs in both ETS and RPS markets. When the levels of the permit allocation standards are set as 70% of the existing ones and the carbon price is assumed to be 200 yuan/ton in 2030, the annual market size of the national ETS will be nearly 100 billion yuan, and the annual market size is predicted to be 250 billion yuan. In the existing rate-based national ETS, the China Certified Emission Reduction (CCER) mechanism will have an offsetting effect, which should be taken into serious consideration during the policy-making processes in the future. [ABSTRACT FROM AUTHOR]

The accessibility of legal support for private family matters has been devastated by decades of reform. At the time of the Legal Aid, Sentencing and Punishment of Offenders Act 2012, legal advice supposedly remained available to support those in family mediation via the 'Help with Family Mediation' scheme. However, initial evidence suggests that lawyers rarely engage in the scheme because of a lack of financial incentives. Statistics on Help with Family Mediation are released every financial quarter, but have not been properly scrutinised in academic commentary or public policy. This article outlines findings from the first quantitative study on Help with Family Mediation. The study confirms that the scheme remains largely unavailable and has declined in use since 2016. It reveals that the scheme has dealt with a higher proportion of finance-related disputes over time, with more cases also resulting in a financial benefit. Statistical analysis then confirms a relationship between the type of dispute and whether an agreement is reached in mediation. The article concludes by highlighting the implications of these findings beyond their relevance to lawyers. Altogether, the study demonstrates a need for further research on family justice professionals, as well as family justice data, more widely. [ABSTRACT FROM AUTHOR]

A network meta‐analysis (NMA) including randomized controlled trials (RCTs) was conducted to evaluate the effects of different interventions on smoking cessation. Studies were collected from online databases including PubMed, EMBASE, Cochrane Library, and Web of Science based on inclusion and exclusion criteria. Eligible studies were further examined in the NMA to compare the effect of 14 interventions on smoking cessation. Thirty‐four studies were examined in the NMA, including a total of 14 interventions and 28 733 participants. The results showed that health education (HE; odds ratio ([OR] = 200.29, 95% CI [1.62, 24 794.61])), other interventions (OI; OR = 29.79, 95% CI [1.07, 882.17]) and multimodal interventions (MUIs; OR = 100.16, 95% CI [2.06, 4867.24]) were better than self‐help material (SHM). HE (OR = 243.31, 95% CI [1.39, 42531.33]), MUI (OR = 121.67, 95% CI [1.64, 9004.86]) and financial incentive (FI; OR = 14.09, 95% CI [1.21, 164.31]) had positive effects on smoking cessation rate than smoking cessation or quitting APP (QA). Ranking results showed that HE (83.6%) and motivation interviewing (MI; 69.6%) had better short‐term effects on smoking cessation. HE and MUI provided more smoking cessation benefits than SHM and QA. FI was more effective at quitting smoking than QA. Also, HE and MI were more likely to be optimal smoking cessation interventions. [ABSTRACT FROM AUTHOR]

The Centers for Medicare & Medicaid Services Innovation Center has set the goal for 100% of traditional Medicare beneficiaries to be part of an accountable care relationship by 2030. Barriers to physician participation include lack of substantial financial incentives, intolerable or unpredictable risk, infrastructure costs, and operational complexity. In this article, the authors outline particular challenges that must be addressed to integrate specialty care physicians into accountable care relationships. The Centers for Medicare & Medicaid Services Innovation Center (CMMI) has set the goal for 100% of traditional Medicare beneficiaries to be part of an accountable care relationship by 2030. Lack of meaningful financial incentives, intolerable or unpredictable risk, infrastructure costs, patient engagement, voluntary participation, and operational complexity have been noted by the provider and health care delivery community as barriers to participation or reasons for exiting programs. In addition, most piloted and implemented population-based total cost of care (PB-TCOC) payment models have focused on the role of the primary care physician being the accountability (that is, attributable) leader of a patient's multifaceted care team as well as acting as the mayor of the "medical neighborhood," leaving the role of specialty care physicians undefined. Successful provider specialist integration into PB-TCOC models includes meaningful participation of specialists in achieving whole-person, high-value care where all providers are financially motivated to participate; there is unambiguous prospective attribution and clearly defined accountability for each participating party throughout the care journey or episode; there is a known care attribution transition accountability plan; there is actionable, transparent, and timely data available with appropriate data development and basic analytic costs covered; and there is advanced payment to the accountable person or entity for management of the care episode that is part of a longitudinal care plan. Payment models should be created to address the 7 challenges raised here if specialists are to be incented to join TCOC models that achieve CMMI's goal. [ABSTRACT FROM AUTHOR]

Background: Dysregulated ventral striatum function has been proposed as one important process occurring in individuals with substance use disorder. This study investigates the role of altered reward and loss anticipation, which is an important component of impaired decision-making, impulsivity, and vulnerability to relapse in individuals with amphetamine use disorder (AMP). Aims: To determine whether AMP is associated with blunted striatum, prefrontal cortex, and insula signals during win and loss anticipation. Methods: Participants with and without AMP (AMP+ n = 46, AMP− n = 90) from the Tulsa 1000 study completed a monetary incentive delay (MID) task during functional magnetic resonance imaging. Results: Group main effects indicated that: (1) AMP+ exhibited lower bilateral caudate/putamen and left nucleus accumbens signal than AMP− across anticipation of wins and losses; and (2) AMP+ showed slower reaction times than AMP− during loss anticipation. Group*condition interactions demonstrated that AMP+ exhibited greater right amygdala signal than AMP− while anticipating large wins, a pattern that reversed when anticipating small losses. Left caudate/putamen attenuations in AMP+ during small loss anticipation were also evident. Groups did not differ in prefrontal or insula signals. Conclusions: AMP+ individuals have altered neural processing and response patterns during reward and loss anticipation, potentially reflecting impairments in dopamine function, which may influence their decision-making and reactions to different win/loss scenarios. These findings help to explain why AMP+ have difficulty with decision-making and exhibit a heightened focus on immediate rewards or punishments. [ABSTRACT FROM AUTHOR]

Background: Approximately 37 million individuals in the United States (US) have chronic kidney disease (CKD). Patients with CKD have a substantial morbidity and mortality, which contributes to a huge economic burden to the healthcare system. A limited number of clinical pathways or defined workflows exist for CKD care delivery in the US, primarily due to a lower prioritization of CKD care within health systems compared with other areas (e.g., cardiovascular disease [CVD], cancer screening). CKD is a public health crisis and by the year 2040, CKD will become the fifth leading cause of years of life lost. It is therefore critical to address these challenges to improve outcomes in patients with CKD. Methods: The CKD Leaders Network conducted a virtual, 3 h, multidisciplinary roundtable discussion with eight subject-matter experts to better understand key factors impacting CKD care delivery and barriers across the US. A premeeting survey identified topics for discussion covering the screening, diagnosis, risk stratification, and management of CKD across the care continuum. Findings from this roundtable are summarized and presented herein. Results: Universal challenges exist across health systems, including a lack of awareness amongst providers and patients, constrained care team bandwidth, inadequate financial incentives for early CKD identification, non-standardized diagnostic classification and triage processes, and non-centralized patient information. Proposed solutions include highlighting immediate and long-term financial implications linked with failure to identify and address at-risk individuals, identifying and managing early-stage CKD, enhancing efforts to support guideline-based education for providers and patients, and capitalizing on next-generation solutions. Conclusions: Payers and other industry stakeholders have opportunities to contribute to optimal CKD care delivery. Beyond addressing the inadequacies that currently exist, actionable tactics can be implemented into clinical practice to improve clinical outcomes in patients at risk for or diagnosed with CKD in the US. [ABSTRACT FROM AUTHOR]

In this study, the nexus between Foreign Direct Investment (FDI) and financial deepening is critically examined. The study employed a robust dynamic panel cross‐sectionally augmented distributed lag method for 31 countries in sub‐Saharan Africa (SSA). The results reveal that: (1) a strong significantly positive long run impact of FDI on financial deepening exists; (2) real gross domestic product (GDP), trade openness and government effectiveness stimulate the positive FDI–financial deepening nexus; (3) the strength of the FDI–financial deepening nexus also depends on the percentile position in the income distribution of SSA countries (countries in the upper strata of the income distribution evidently had stronger FDI–financial deepening relations than those in the lower strata and (4) real GDP, trade openness and government effectiveness also enhance financial deepening in SSA. The study recommends that governments in SSA should foster fiscal, financial and regulatory incentives for attracting FDI for improved financial depth in SSA by: strengthening the regulatory frameworks and institutions of governance through the removal of unwarranted governmental interferences in the administration of justice and electoral processes; removing multiple tax regimes; and stabilizing prices and exchange rate volatility via stimulating local productivity and guaranteeing the rule of law, political stability and security of life and property in the region. [ABSTRACT FROM AUTHOR]

College applicants often make dominated choices even when a strategically simple mechanism such as deferred acceptance is in place. We study Hungarian college admissions, where deferred acceptance is used, and still many college applicants make revealed dominated choices: they forgo the free opportunity to receive a tuition waiver. Using two empirical strategies, we show that when admission with a tuition waiver becomes more selective, applicants make more revealed dominated choices. Our results suggest that dominated choices respond to economic incentives. [ABSTRACT FROM AUTHOR]

The merits of routine health screening for cancer and cardiovascular diseases are well established given the strong evidence that early detection can lead to effective interventions. Health systems, insurance providers and public health agencies have incorporated systematic approaches to ensuring that preventive screenings for hypertension, hyperlipidemia and cancers are encouraged, readily accessible and reimbursed. Workplace wellness programs intent on containing preventable healthcare costs have also sponsored age- and risk-adjusted health screenings, often including financial incentives to encourage same. Should we also screen for brain health? Is early detection of value for a condition with no proven treatment or cure? This editorial reviews the pros and cons of testing for cognitive decline, Alzheimer's and related dementias and suggests that with nearly every country in the world getting proportionally older, promoting brain health could emerge as a key intrinsic motivation for promoting healthier lifestyles. I conclude that a person-centered approach to deciding about testing is needed given uncertain evidence connecting health behaviors to cognitive decline. [ABSTRACT FROM AUTHOR]