Evaluating the benefits and costs of regulatory reforms: what questions need to be asked?

In 1984, Portney argued that "[w]e should scrutinize proposed reforms of the rulemaking process every bit as carefully as the regulations that process produces." In the 23 years since then, the regulatory process on the federal level has been continuously reformed by statute, by executive order, and by directives from the OMB. Despite the extensive debate on the need for these reforms, there has been very little analysis of the reforms themselves. This paper updates Portney's work on analyzing cost-benefit analysis and expands it to evaluate reforms of the regulatory process. I use as my primary example the recent peer-review guidelines issued by OMB. I argue that we may have reached a point of diminishing returns in regulatory reforms, that the peer-review guidelines likely have costs that exceed their benefits, and that further regulatory reforms merit closer evaluation.     

Medical practice in large-scale organizations.

The traditional role of the physician as the principle resource allocator in the health care system is rapidly giving way to a shared decision-making. As more and more physicians practice in large organizational settings, an adversarial relationship is developing that affects both the quality of care and the efficiency of medical practice.     

Daily Fantasy Football and Self-Reported Problem Behavior in the United States

Traditional, season-long fantasy sport participation has grown considerably since the late 1990s, and in an attempt to capitalize on this growing demand, daily fantasy sports (DFS) providers have created a new game where money changes hands instantly. This change has led some legal commentators and state agencies to believe the game is a form of Internet gambling similar to online poker, blackjack, and sports wagering, and thus, it requires increased regulation or even prohibition. Little is known, however, about the gambling behavior associated with DFS participation. Thus, the purpose of the current study was to examine problem gambling severity in conjunction with DFS participant motives, perceptions, and consumption behavior. Over 500 DFS participants were surveyed, and the results suggest DFS participants behave similarly with participants in other forms of gambling activities. In addition, the findings suggest additional consumer protections may be needed to prevent further problem behavior such as chasing.     

Factors associated with provider self‐efficacy in delivery of evidence‐based programs for children,youth, and families

Investments in training real‐world behavioral health providers in evidence‐based programs (EBPs) can be costly; thus, it is important to understand which providers may be more or less likely to implement such approaches after training. Provider self‐efficacy is associated with implementation of EBPs, but research on factors associated with provider self‐efficacy is less common. An exploratory, cross‐sectional, quantitative survey examined factors associated with provider self‐efficacy among 150 real‐world service providers who reported delivering EBPs to children, youth, or families in one U.S. state. Factors found to be associated with higher self‐efficacy included profession, workplace support, and extent of training received; difficulty engaging families was associated with lower self‐efficacy. Self‐efficacy was found to be associated with program use but not fidelity. Several organization‐level variables were identified as both facilitators and barriers to implementation of EBPs. Implications for research and practice are discussed.     

A discrete model for the segmentation of chains and strings

A statistical model is presented that can be used to represent a discrete breakage process. It considers a fixed length chain or string made up of n +1 pieces joined together. The chain is stressed at each connection or link andrupture occurs at some of the links. Models are developed to answer the question, “what is the expected proportion of chain segments of a given size?” The model is modified to handle those experiments where only thetotal weight of a given size segment is known. Expressions are obtained for the expected value and variance of the number of segments of a given size. The model is used to predict the expected number of segments which results when a fixed length DNA molecule chain is subjected to carcinogenic agents and is applied to industrial examples.     

Insurrectional Arts: Restoring a Politics and Ethics of Attention

Abstract

This chapter is inspired by contrasting passages in two stories. The first is in Jamaica Kincaid's story, ‘The Embassy of Cambodia'. Her narrator, who is following a transversality between two forms of atrocity: those practiced by states, as in the case of Cambodia's Khmer Rouge exterminism and that inflicted on abused migrant domestic workers from third world countries. The narrator notes that people in her village are too distracted to heed peoples’ afflictions: ‘The fact is if we followed the history of every little country in this world?…?we would have no space left in which to live our own lives or to apply ourselves to necessary tasks?…?’. In contrast, in Daniel Alarcon's story, ‘Collectors', a seasoned convict is explaining to his new cell mate how to survive by reading signs as you watch the men in the prison yard:

Did they have their arms at their sides, or crossed in front of them? How widely did they open their mouths when they talked? Could you see their teeth were their eyes moving quickly, side to side? Or slowly, as if taking in every detail?     

Therapy with Infertile Heterosexual Couples: It’s Not About Gender—Or is it?

In spite of medical data that show males are equal to their female partners as a source of a heterosexual couple’s infertility, therapists face many unanswered questions about the extent to which gender influences each partner’s infertility experience in American culture. How is “hers” different from “his?” To what extent should the therapist strive to help the couple define the infertility issue as “ours”? This article explores how the therapist can elicit and be sensitive to gender issues while fostering resilience in the infertile couple.