Unique Claims Research Articles

Knowledge of universals

ABSTRACT The Indian realists argue for the unique claim that universals are perceptible. The possibility of allowing perceptual access to universals puts pressure on the Nyāya theory of perception. The Nyāya philosophers introduced the notion of nirvikalpaka pratyakṣa (non-conceptual perception) to accommodate the perceptibility of universals. Since there is no direct introspective evidence for non-conceptual perception, it is difficult, if not impossible, to specify the content of nirvikalpaka pratyakṣa or non-conceptual perception. This paper addresses this concern by turning to Ned Block's work in contemporary philosophy of perception. Using Block's arguments, I propose that we have an independent empirical route to specify the content of a non-conceptual perception which is not subject to the ‘myth of the given’ objection.

Does environmental regulation matter for healthcare utilisation in China? An interrupted time series study.

In recent years, China has implemented a series of environmental regulation policies to improve air quality, but the health effects of these policy changes need to be accurately clarified and quantified. The objective of this study was to empirically examine the effects of levying construction dust pollution fees on healthcare utilisation in a southern city of China. The study used a unique administrative insurance claim dataset from the city's Urban Employee Basic Medical Insurance scheme between 2013 and 2015. The sample included 69,961 enrolees. An interrupted time series design was employed to investigate whether and how the healthcare utilisation of enrolees changed after the policy change. The results showed that this environmental regulation policy did not affect the inpatient utilisation of enrolees but did negatively impact outpatient utilisation. In addition, outpatient utilisation of chronic disease coverage decreased for patients with chronic diseases, including diabetes and hypertension. This study provides evidence that enhancing environmental regulations helps reduce medical costs, which can benefit China and other developing countries to improve environmental quality and promote public health.

Dispensed drugs during pregnancy in outpatient care between 2015 and 2021 in Switzerland: a retrospective analysis of Swiss healthcare claims data.

We aimed to evaluate the utilisation of all prescribed drugs during pregnancy dispensed in outpatient care in Switzerland between 2015 and 2021. We conducted a descriptive study using the Swiss Helsana claims database (2015-2021). We established a cohort of pregnancies by identifying deliveries and estimating the date of the last menstrual period. We analysed the drug burden during a 270-day pre-pregnancy period, during pregnancy (overall and by trimester), and during a 270-day postpartum period. Subsequently, we quantified 1) the median number of drug dispensations (total vs. unique drug claims); and 2) the prevalence of exposure to at least one dispensed drug and the number of dispensed drugs (0, 1, 2, 3, 4, and ≥5); and 3) the 15 most frequently dispensed drugs were identified during each period, overall and stratified by maternal age. Among 34,584 pregnant women (5.6% of all successful pregnancies in Switzerland), 87.5% claimed at least one drug (not including vitamins, supplements, and vaccines), and 33.3% claimed at least five drugs during pregnancy. During trimester 1 alone, 8.2% of women claimed at least five distinct drugs. The proportion of women who claimed prescribed drugs was lower pre-pregnancy (69.1%) and similar postpartum (85.6%) when compared to during pregnancy (87.5%). The most frequently claimed drugs during pregnancy were meaningfully different during pregnancy than before and after. This study suggests that 8 of 10 women in Switzerland are exposed to prescribed drugs during pregnancy. Most drugs dispensed during pregnancy are comparatively well investigated and are considered safe. However, the high drug burden in this vulnerable patient population underlines the importance of evidence on the benefit-risk profile of individual drugs taken during pregnancy.

Characteristics and spending patterns of high-cost child patients: findings from Fujian in China

BackgroundThe health condition during childhood has been shown to influence an individual’s health and socioeconomic status in adulthood. Understanding the concentration and persistence patterns in children’s healthcare expenditures is crucial for providing risk protection and promoting the well-being of children. Studies regarding the concentration and persistence of health expenditures have focused mainly on elderly individuals in developed regions. To gain insights into factors that contribute to childhood health expenditures, this article examined children with high costs (that is, in the top 10% of the expenditure distribution) and explored the characteristics and spending patterns that distinguished them from other patients in the context of the largest developing economy—China.MethodsBy using a unique individual-level administrative claims dataset over a 5-year observation period, this study identified spending concentrations and the proportion of children whose costs remained high over five years using a linear probability model and logit regression analysis.ResultsTeenagers from 12 to 17 years old were more likely to persist in the high-cost group than any other age groups in the study. Pediatric complex chronic conditions and other severe health ailments were predictive factors for entry into and persistence in the high-cost category. More than half of the total health expenditures were attributed to children in the top 10% expenditure group. In addition, risk protection and healthcare insurance support for high-cost children was found to be inadequate, particularly for children from low-income families.ConclusionsHealthcare support for children impacts individual development and family financial status. This study described the characteristics and spending patterns of children patients in the largest developing country. The fact that over half of total expenditures are concentrated toward 10% of patients makes it valuable to consider relevant support for this group, especially for families whose medical costs are higher than income.

Efficacy Analysis of Online Artificial Intelligence Fact-Checking Tools

Investments in artificial intelligence (AI) spurred development of online fact-checking tools; positioned to potentially serve as more accurate alternatives or appendages to search engines and/or nascent chatbots. This study analyzed the efficacy of four AI tools (ClaimBuster, Full Fact, TheFactual - IsThisCredible?, and Google’s Fact-Check Explorer) in producing accurate readings measured by a consensus of independent fact-checking organizations. 10 unique claims were inputted into each tool to produce individual fact-check reports, resulting in 40 fact-check reports being conducted. The results reflect an efficacy rating of 100% regarding the ability of the selected tools to produce an overall accurate reading with 89% of reports producing a unanimous determination. Additionally, recommendations were made to further map and analyze the efficacy of AI fact-checking. These findings support the notion that AI can play an effective role in aiding online truth-seeking when its determinations depend on transparently referencing its source of independent human fact-checkers.

Analysing a private city being built from scratch through a social and environmental justice framework: A research agenda.

A growing body of scholarship examines new cities being built from scratch that are developed and governed by the private sector. While this scholarship explores discourse and rhetoric, economic objectives, and some social and environmental impacts of new private cities, scholars to date have not taken a social or environmental justice approach to analysing new city projects. In this article we examine Forest City, a private city project being built on artificial islands off the coast of Malaysia by one of China's largest property development companies, and its unique governance and claims to being 'eco', despite the significant environmental damage it has caused. Intended as a lush and exclusive gated enclave for Chinese nationals, Forest City is a productive case study through which to consider the consequences of a private city using the frameworks of social and environmental justice. We suggest more critical research that engages with social and environmental justice is needed on the many emerging projects branded as eco-cities of the future, a troubling claim that signals a growing normalisation of mega-scale privatisation and loose or absent regulations regarding social inclusivity and environmental protection.

Comparative effectiveness and healthcare utilization for ambulatory cardiac monitoring strategies in Medicare beneficiaries

Objective data comparing the diagnostic performance of different ambulatory cardiac monitors (ACMs) are lacking. To assess variation in monitoring strategy, clinical outcomes and healthcare utilization in patients undergoing ambulatory monitoring without a pre-existing arrhythmia diagnosis. Using the full sample (100%) of Medicare claims data, we performed a retrospective cohort study of diagnostic-naïve patients who received first-time ACM in 2017 to 2018 and evaluated arrhythmia encounter diagnosis at 3-months, repeat ACM testing at 6 months, all-cause 90-day emergency department (ED) and inpatient utilization, and cost of different strategies: Holter; long-term continuous monitor (LTCM); non-continuous, event-based external ambulatory event monitor (AEM); and mobile cardiac telemetry (MCT). We secondarily performed a device-specific analysis by manufacturer, identified from unique claim modifier codes. ACMs were used in 287,789 patients (AEM = 10.3%; Holter = 53.8%; LTCM = 13.3%; MCT = 22.5%). Device-specific analysis showed that compared to Holter, AEM, MCT, or other LTCM manufacturers, a specific LTCM (ZioⓇ XT 14-day patch, iRhythm Technologies, San Francisco, CA) had the highest adjusted odds of diagnosis and lowest adjusted odds of ACM retesting. Findings were consistent for specific arrhythmia diagnoses of ventricular tachycardia, atrioventricular block, and paroxysmal atrial fibrillation. As a category, LTCM was associated with the lowest 1-year incremental health care expenditures (mean Δ$10,159), followed by Holter ($10,755), AEM ($11,462), and MCT ($12,532). There was large variation in diagnostic monitoring strategy. A specific LTCM was associated with the highest adjusted odds of a new arrhythmia diagnosis and lowest adjusted odds of repeat ACM testing. LTCM as a category had the lowest incremental acute care utilization. Different monitoring strategies may produce different results with respect to diagnosis and care.

Political Violence: An Evaluation of Turkey's 1970s And 1990s

Purpose: The aim of this research is to examine the relationship between political violence and political power in Turkey. In this respect, the study focuses on the periods of the 1970s and 1990s, when violence was most intense in Turkish political history.
 Design/Methodology: Secondary data analysis is carried out in the research, and the equivalent of political violence in the Turkish sample is examined based on the literature on Turkish political life and political theory. In this respect, the violence between the 1970s and the 1990s is qualitatively compared with the comparison method.
 Findings: As a result of the analyzes, it was concluded that there is a positive relationship between political instabilities and political violence, and it was seen that economic crises and fragile coalitions increased social marginalization and unrest and led to an increase in political violence.
 Limitations: The sample is limited to the 1970s and 1990s, which are the two periods when political violence was experienced most intensely in the political history of Turkey and the two periods most associated with violence in the literature on political life. 
 Originality/Value: Although political violence is a subject that is studied theoretically and especially based on individual acts of violence, studies of the period as a whole are very limited in terms of violence. However, there is no study in the literature comparing two different historical periods. In this respect, the study has a unique quality and claims to fill a gap in the literature.

Category Mistakes Electrified

Occurrences of sentences that are traditionally considered category mistakes, such as ‘The red number is divisible by three’, tend to elicit a sense of oddness in assessors. In attempting to explain this oddness, existing accounts in the philosophical literature commonly claim that occurrences of such sentences are associated with a defect or phenomenology unique to the class of category mistakes. It might be thought that recent work in experimental psycholinguistics—in particular, the recording of event-related brain potentials (patterns of voltage variation in the brain)—holds the potential to shed new light on this debate. I review the relevant experimental results, before arguing that they present advocates of accounts of category mistakes with a dilemma: either the uniqueness claims should be rejected, or the experimental technique in question cannot be used to test existing accounts of category mistakes in the manner that philosophers might hope.

Social medical insurance integration and health care disparities in China: Evidence from an administrative claim dataset

Health care disparities continue to coexist with universal health coverage in China due to the fragmentation of social medical insurance. In this study, a pilot city located in Southeast China that integrated employee and resident medical insurance programs in 2017 is used to evaluate the impacts of employee–resident medical insurance integration on health care disparities in hospital utilization and expenditure. We use a unique administrative insurance claim dataset from 2015 to 2017 and adopt the propensity score matching and difference-in-differences (PSM-DID) regression approach. The results show that in general, employees utilize more inpatient services and receive more reimbursement than residents. However, after the policy change, the medical insurance benefits for residents greatly improved. Thus, they significantly increased their frequency of inpatient utilization and used more services per admission, which increased total inpatient expenditure and reimbursement by 10.65% and 9.94%, respectively. However, the corresponding figures for employees remained at their historical levels, thus reducing the health care disparities between these two groups. These findings provide empirical evidence to support the integration of the social medical insurance system in China and can serve as a reference for governments in low- and middle-income countries seeking to improve equality in their medical security systems.

On the Logical Structure of Best Explanations

AbstractStandard articulations of Inference to the Best Explanation (IBE) imply the uniqueness claim that exactly one explanation should be inferred in response to an explanandum. This claim has been challenged as being both too strong (sometimes agnosticism between candidate explanatory hypotheses seems the rational conclusion) and too weak (in cases where multiple hypotheses might sensibly be conjointly inferred). I propose a novel interpretation of IBE that retains the uniqueness claim while also allowing for agnostic and conjunctive conclusions. I then argue that a particular probabilistic explication of explanatory goodness helpfully guides us in navigating such options when using IBE.

Generic Price Regulation and Drug Expenditures: Evidence From Canada

ObjectivesRapid growth in pharmaceutical spending is a major challenge in Canada. To control rising costs, the Canadian government implemented a generic pricing policy in 2013, which reduced prices for some prescription generic drugs by roughly 50%. This article explores the effects of the Canadian pricing policy on drug expenditures and drug utilization among seniors. MethodsUsing a unique prescription claims data, this article adopts a difference-in-differences methodology to estimate the policy effects, and it further investigates the mechanisms by exploring the demand-side incentives and the role of health insurance design with a triple-difference approach. ResultsExploiting the policy variation across drugs and provinces, the results suggest that the policy has reduced drug expenditure per capita, largely because of the inelastic demand among seniors. Although the policy leads to lower out-of-pocket costs for seniors facing coinsurance than for those with a fixed copayment, individual utilization and total demand display no differences across cost sharing. ConclusionsThe price regulation in Canada was successful in reducing drug expenditures per capita. The success rests on the interaction with demand-side regulations and demand incentives. The evidence of cost containment in Canada can provide some insights to other countries with similar needs and priority.

Is Religion Special?

Religion makes unique claims (e.g., the existence of supernatural agents) not found in other belief systems, but is religion itself psychologically special? Furthermore, religion is related to many domains of psychological interest, such as morality, health and well-being, self-control, meaning, and death anxiety. Does religion act on these domains via special mechanisms that are unlike secular mechanisms? These could include mechanisms such as beliefs in supernatural agents, providing ultimate meaning, and providing literal immortality. We apply a critical eye to these questions of specialness and conclude that although it is clear that religion is psychologically important, there is not yet strong evidence that it is psychologically special, with the possible exception of its effects on health. We highlight what would be required of future research aimed at convincingly demonstrating that religion is indeed psychologically special, including careful definitions of religion and careful attention to experimental design and causal inference.

African Jurisprudence as Historical Co-extension of Diffused Legal Theories

African jurisprudence, like African philosophy, continues to be hotly debated. This article contends that the debate straddles the uniqueness claim which either emphasises the existence or possibility of a peculiar legal framework on the continent, and a historical co-extensional position reiterating that African jurisprudence is a continuum of other legal traditions. The article argues that there is no uniquely African jurisprudence, and that what obtains within the structures of jurisprudence on the continent also exists within various legal traditions elsewhere, and as such can at best be described as ‘jurisprudence in Africa’ rather than ‘African jurisprudence’. It defends this thesis through analytic and comparative explications of the content of natural law theory and legal positivism as experienced on the continent. It concedes that relics of the colonial legal experience create contestations that inform scholars’ calls for a return to traditional legal systems. It concludes that a reconstructive jurisprudence in Africa must take cognisance of the continent’s historical and evolutionary legal experiences, but that a unified or monolithic theory may not be sufficient to address the choice of functional jurisprudence.
 
 Keywords
 African jurisprudence, jurisprudence in Africa, African legal evolution, diffused legal theories

Commentary: Dear Federal Chief Nursing Officer: Why Canada Needs You.

Calls for national-level chief nursing officers are over a century old. However, global uptake of these roles and Canadian opportunities for nurses to lead in federal health policy environments have been limited. The absence of such a role in Canada limits connection to global activities, reduces Canadian capacity to participate as a member state in World Health Organization-led nursing activities and, within our borders, leaves the healthcare system without national leadership to coordinate and liaise with senior nurses across our provinces and territories for the benefit of our citizens and systems. In this article, a brief history of global advocacy for state or national level chief nursing officer roles and examples of federal chief nursing officers, in the Canadian context, offers a consideration of the unique contribution of nursing knowledge and leadership to health policy - extending arguments for nursing leadership in the policy arena beyond traditional arguments of strength in numbers or unique claims to caring. Findings from a Canadian national project by the Global Nursing Leadership Institute further illuminate the concrete steps we need to take toward enabling full-spectrum nursing leadership in policy, where policy science, political competency, identification of policy nurses and a revitalization of organizational structures across the country can extend the vision for nursing leadership in policy beyond a single seat at a single table.

Effects of establishing a financing scheme for outpatient care on inpatient services: empirical evidence from a quasi-experiment in China

The relationship between outpatient and inpatient care is central to the current healthcare reform debate especially in developing countries. Despite the importance of this relationship to health policy makers, empirical evidence, particularly evidence that can be interpreted as causal is limited and inconclusive. This paper examines the effects of establishing a financing scheme for outpatient care on inpatient utilization and expenditure in China's Urban Employee Basic Medical Insurance scheme. Under a quasi-experimental design, we use a unique administrative insurance claim dataset and conduct a difference-in-differences analysis. Our results indicate that after the policy change, total number of admissions and total inpatient expenditure of the enrollees decreased by 0.47% and 6.05% respectively, which imply outpatient and inpatient care are substitutes, and the reduction in cost-sharing can release the underuse of the outpatient care, so as to reduce those excessive demands for inpatient care. Moreover, we present evidence that the effects on the admissions of Ambulatory Care Sensitive Conditions which should be sensitive to outpatient care intervention are relatively limited because of the lower reimbursement cap, inadequate capacity of the local primary care providers and stickiness in patients' healthcare-seeking behaviors. While the enrollees aged over 55 and retirees are more vulnerable to the medical prices, and the enrollees living in the central districts are more responsive because of the better and more accessible primary care.

Inward Groans and Unknown Tongues

Abstract The following article examines the reception of Rom. 8.26 in early North American Pentecostal literature. The author will review the variety of perspectives offered on the passage from various early Pentecostal publications, noting how their reception betrayed an intuitive grasp of key interpretative questions that continue to dominate scholarly work on Paul’s unique claims about pneumatic intercession. While many early Pentecostals interpreted Rom. 8.26 as another reference to glossolalic prayer, not all did. Nevertheless, the interpretative connections made by early Pentecostals reveal a dynamic hermeneutical practice that integrated lived pneumatic experiences with close intertextual readings of Scripture in response to important interpretative issues.

Temporal Trends in Prescribing of Bone-Directed Therapies in the United States, 2009–2020

Multiple new osteoporosis therapies, including some with novel mechanisms of action, have been introduced in the past decade. However, little is known about temporal trends in prescribing these new medications. Using claims data from the Clinformatics Data Mart (Optum, Inc.), we determined the number of enrolled individuals over age 50 who were prescribed any osteoporosis medication during each quarter between January 1, 2009 and March 31, 2020. Of all individuals receiving therapy, we then calculated the percent receiving each medication. In subgroup analyses, we limited the population to (1) only those with ICD codes for osteoporosis in the current or previous three quarters and without codes for active malignancy during the current or previous quarter, and (2) only those with ICD codes from an oncology provider for active malignancy likely to metastasize to bone during the current or previous quarter. In the all-user cohort, a total of 15.48 million unique prescription or medication administration claims from 1.46 million unique individuals during the study period were analyzed. Of these, 89% were women and 71% over the age of 65, with a mean age of 69. Alendronate was the most common medication used, representing >50% of all treated individuals, and its use increased over time. Percent of users receiving zoledronic acid doubled during this period but remained <5%. Use of other bisphosphonates declined steadily. By comparison, after its approval in 2010, denosumab use increased rapidly, reaching 10% of users in 2015 and 15% of users in 2018. Percent of individuals treated with raloxifene declined after 2013. Use of teriparatide, abaloparatide, and romosozumab remained less than 2% throughout the study period. Trends in the osteoporosis cohort paralleled those in the all-user cohort. In the malignancy cohort, alendronate and zoledronic acid were each used in approximately 30% of individuals at the onset of the study, and both declined over the decade. By contrast, denosumab use rapidly increased after introduction and surpassed use of either bisphosphonate by 2013. Denosumab use continued to increase over time and reached approximately 50% of all bone-directed medication use in the malignancy cohort. Use of other medications, mainly alternate bisphosphonates, was low and declined throughout the study period. In a privately insured cohort between 2009–2020, denosumab use increased significantly in both osteoporosis and malignancy populations, outpacing gains in use of other agents, despite guidelines suggesting that either bisphosphonates or denosumab could be considered first-line therapy for osteoporosis.

Novel Studies on Thermo-Mechanical Properties of Structural Glass with and without Lamination

The attractiveness of glass is something that occupied the world market with a unique claim. It has many applications that go beyond the provision of visual aesthetics, which includes a view of the inside and out. Due to extreme levels of clarity, structural glazing may be so transparent that it may go unnoticed by design or make a strong visual impact such as the focal point of a building. This paper focused on structural glass with various laminated/laminated conditions that were used to investigate the Dynamic Mechanical Properties. The storage modulus (G'), loss modulus (G'') and damping factor (tan delta) were determined at various levels, ranging from room temperature to elevated temperatures (250 °C) to understand the behavior of glass structure with and without laminated glass over a range of temperatures. The G' &amp; G'' were tested to understand the effect of bonding, fracture behavior between the pure glass and laminated glass to observe the response with respect to temperature. Results are found that G' and G'' improve over a range of temperatures for laminated glass with enlightening fracture behavior. Laminated glass also has a major influence on the damping factor, but it also depends on the laminated thickness and materials. Thermo-Mechanical Properties of laminated glass are more improved, without affecting the transferability of glass.

Antichrist. Nietzsche et le Royaume

Esta contribución plantea una sola pregunta: ¿quién es el Anticristo de Nietzsche? A partir de la figura del Nuevo Testamento en el Evangelio de Juan y las indicaciones apocalípticas en la Segunda Epístola de Pablo a los Tesalonicenses, estudia al Anticristo en el libro de 1888 como una inversión del anatema de Lutero contra Roma y el papado en 1520, ahora vuelto contra el cristianismo mismo. Una lucha tan despiadada tiene el significado de Reino y redención como apuesta única.