SCREENING FOR CANCER AND MARKET STRUCTURE:A MULTILEVEL ANALYSIS FOR MAMMOGRAM AND PAP-SMEAR UTILIZATION IN THE U.S.

This paper investigates the relationship between health care market structure and utilization of preventive care services, namely mammogram and Papanicolaou (Pap-smear) screening. In addition to their life saving aspects, it is always believed that preventive health care services are important due to their cost-effectiveness which would prevail under managed competition. Yet, the nature of managed competition has been changing as a result of the backlash against it since the mid-1990s. We have yet to provide a clear answer to the question of how market structure affects the utilization of preventive care in general, and how the latest changes in health care market have been affecting it. These are the primary research questions of the paper. These research questions are answered by employing a new methodology that has not been used before. A multilevel modeling technique is employed to study the impact of changes in the structure of health care market on the utilization of mammogram and Pap-smear tests. In addition, an unusual data source, insurance claims data, rather than surveys or discharge data, is used in this study.Mammogram, Pap-Smear, Utilization, Health Care Market, Multilevel Analysis.

Water saturation induced changer in the indirect (Brazilian) tensile strength and the failure mode of some igneous rock materials

The present study concentrates on water induced strength reduction and variation of the failure mode in indirect (Brazilian) tension tests of several igneous rock materials under three moisture cases of oven-dry, air-dry and fully saturated states. In this respect, two andesite and three tuff materials which contain no visible flaws were subjected to indirect tensile strength tests using the Brazilian disc method. Once the tension tests were carried out, photographs of the broken samples were taken to investigate the changes in the failure mode. As a result, it was found that tensile strengths of the samples were highly reduced with the presence of the water and the natural humidity. Additionally, it has been deduced that the failure mode of the samples mainly shifts to central fracturing with the presence of natural moisture and saturation. Although the central crack is the ideal type for the theory of Brazilian tensile strength determination, indefinite contact properties like contact angle and frictions are some notable issues to make only considering failure shapes for the validity of the test results misleading

Assessing efficiency of public health and medical care provision in OECD countries after a decade of reform

The objective of this study was to examine the change in efficiency of health care systems of 34 OECD countries between 2000 and 2012, a period marked by significant health reform in most OECD countries. This paper uses a novel Dynamic Network Data Envelopment Analysis (DNDEA) model to analyze the efficiency of the public health system and the medical care system of these OECD countries independently along with assessing the efficiency of their overall health system. This helps understand the relative priorities for improving the overall health system. The data for this study was obtained from the OECD Health Facts database. The study findings suggest that countries which improved their public health system were more likely to show overall improvement in efficiency

SNOWMASS WHITE PAPER - SLHC Endcap 1.4<y<4 Hadron Optical Calorimetry Upgrades in CMS with Applications to NLC/T-LEP, Intensity Frontier, and Beyond

Radiation damage in the plastic scintillator and/or readout WLS fibers in the HE endcap calorimeter 1.4<y<4 in the CMS experiment at LHC and SLHC will require remediation after 2018. We describe one alternative using the existing brass absorber in the Endcap calorimeter, to replace the plastic scintillator tiles with BaF2 tiles, or quartz tiles coated with thin(1-5 micron) films of radiation-hard pTerphenyl(pTP) or the fast phosphor ZnO:Ga. These tiles would be read-out by easily replaceable arrays of straight, parallel WLS fibers coupled to clear plastic-cladded quartz fibers of proven radiation resistance. We describe a second alternative with a new absorber matrix extending to 1.4<y<4 in a novel Analog Particle Flow Cerenkov Compensated Calorimeter, using a dual readout of quartz tiles and scintillating (plastic, BaF2, or pTP/ ZnO:Ga thin film coated quartz, or liquid scintillator) tiles, also using easily replaceable arrays of parallel WLS fibers coupled to clear quartz transmitting fibers for readout. An Analog Particle Flow Scintillator-Cerenkov Compensated Calorimeter has application in NLC/T-LEP detectors and Intensity Frontier detectors

Accuracy of digital panoramic radiographs on the vertical measurements of dental implants

Amaç: Panoramik radyografi (PR), dental ve iliskili yapilari degerlendirmek için en sik kullanilan tekniktir. Bu çalismanin amaci, dental implant tedavisinin planlanmasinda panoramik radyografik görüntülerin (PRI) dogrulugunu ve anterior, premolar ve posterior bölgeler için bir panoramik cihazin büyütme oranini belirlemekti. Gereç ve Yöntem: Implant cerrahisi sonrasi PRI'lari alinmis olan 83 hasta çalismaya dahil edildi. önceden dikey uzunluklari bilinen toplam 240 adet dental implant (53 anterior, 69 premolar ve 118 molar bölge), PRI'nin büyütme oranini ve dogrulugunu belirlemek için, panoramik sistemin ölçüm araçlari kullanilarak ameliyat sonrasi radyografik görüntüler üzerinde tekrar ölçüldü. Verilerin normal dagilima sahip olmasi nedeniyle, istatistiksel analiz için eslestirilmis t testi kullanildi (p < 0,05). üç bölgenin büyütme orani, implantlarin ölçülen dikey uzunlugunun, implantlarin gerçek dikey uzunluguna orani bulunarak hesaplandi. Bulgular: Implantlarin gerçek dikey uzunlugu ve PRI'dan ölçülen dikey uzunlugu arasinda istatistiksel olarak anlamli fark bulundu (p < 0,05). Bununla birlikte, korelasyon orani tüm bölgeler için 1'e yakin bulundu. Implantlarin gerçek dikey uzunlugu ve PRI'den ölçülen dikey uzunlugu arasindaki fark, ön bölge için 0.50 mm, premolar bölge için 0,97 mm ve molar bölge için 0,83 mm idi. Cliniview™ (Instrumentarium Sti., Tuusula, FINLANDIYA) yazilimi tarafindan düzeltilen panoramik sistemin büyütme orani, tüm bölgeler için 1 civarinda bulundu. Sonuçlar: PRI'lar, kolay ulasilabilir olmalari ve düsük radyasyon dozlari sayesinde, implant cerrahisi planlamasindaki dikey ölçümler için 1 mm'lik güven araligi ile kullanilabilir. © Cumhuriyet University Faculty of Dentistry 2018.Objectives: Panoramic radiography (PR) is the most commonly used technique to evaluate the dental and associated structures. The aim of this study was to determine the accuracy of panoramic radiographic images (PRIs) in planning the dental implant treatment and the magnification rate of a panoramic device for anterior, premolar and posterior regions. Materials and Methods: Eighty-eight patients with PRIs were taken after implant surgery were included to the study. A total of 240 dental implants (53 anterior, 69 premolar, and 118 molar regions) of which actual vertical lengths were known, were re-measured on post-operative radiographic images using the scaling tools of the panoramic system to determine the magnification rate and the accuracy of PRIs. Because the data had normal distribution, the paired t test was used for the statistical analysis (p < 0.05). The magnification rates of the three regions were calculated as the ratio of the radiographically measured vertical length of the implants to the actual vertical length of the implants. Results: A statistically significant difference was found between the actual and measured vertical length of the implants on the PRI (p < 0.05). However, the correlation rate was found close to 1 for all regions. The difference between the actual and measured vertical length of the implants on the PRI was 0.50 mm for the anterior region, 0.97 mm for the premolar region, and 0.83 mm for the molar region. The magnification rate of the panoramic system corrected by Cliniview™ (Instrumentarium Corp., Tuusula, FINLAND) software was found around 1 for all the regions. Conclusions: Due to their readily accessible nature and low radiation dose, PRIs can be used in implant surgery for vertical measurements with 1 mm confidence interval. © Cumhuriyet University Faculty of Dentistry 2018