1,720,963 research outputs found
Primary care providers’ influence on opioid use and its adverse consequences
No full textPrimary care is the most frequently utilized health service and is the source of nearly half of all opioids prescribed in the United States. This paper studies the impact of exposure to high prescribing primary care providers (PCP) on opioid use, opioid use disorder, and mental health. Using electronic health records, we exploit within-facility quasi-random assignment of providers, who differ in their opioid prescribing tendency, to 650,000 new patients enrolling in care with the Veterans Health Administration. We find that assignment to a PCP who prescribes opioids at a 2.54 percentage point (pp) higher rate (equivalent to the average difference between a 90th and 10th percentile prescriber within a facility) increases the probability of long-term opioid use by 20% (or 0.43 pp) and development of opioid use disorder by 4% (or 0.035 pp). Veterans’ mental health deteriorates: the three-year likelihood of a depression diagnosis increases by 1.3% (or 0.31 pp). We find that PCPs with more cautious prescribing behavior rely more on non-opioid pain management and adhere more to clinical recommendations on naloxone distribution
Pathways into opioid dependence: evidence from practice variation in emergency departments
No full textWe use practice variation across physicians to uncover the role of medical care in causing opioid dependence. Using health records of 2 million US veterans with emergency department visits, we find that quasi-random assignment to a top (versus bottom) decile prescribing provider significantly increases subsequent opioid use and misuse rates. Instrumental variable results show that opioid prescription receipt leads to a 20 percent increase in the probability of long-term prescription opioid use and sizable increases in the development of opioid use disorder and opioid overdose mortality. We find suggestive evidence of transition into illicit opioids due to prescription opioid exposure
Experimental evidence on the effectiveness of nonexperts for improving vaccine demand
No full textWe experimentally vary signals and senders to identify which combination will increase vaccine demand among a disadvantaged population in the United States—Black and White men without a college education. Our main finding is that laypeople (nonexpert
concordant senders) are most effective at promoting vaccination, particularly among those least willing to become vaccinated. This finding points to a trade-off between the higher qualifications of experts on the one hand and the lower social proximity to low-socioeconomic-status populations on the other hand, which may undermine credibility in settings of low trust
The Welfare Effects of Social Media
No full textThe rise of social media has provoked both optimism about potential societal benefits and concern about harms such as addiction, depression, and political polarization. In a randomized experiment, we find that deactivating Facebook for the four weeks before the 2018 US midterm election (i) reduced online activity, while increasing offline activities such as watching TV alone and socializing with family and friends; (ii) reduced both factual news knowledge and political polarization; (iii) increased subjective well-being; and (iv) caused a large persistent reduction in post-experiment Facebook use. Deactivation reduced post-experiment valuations of Facebook, suggesting that traditional metrics may overstate consumer surplus
The health of democracies during the Pandemic : results from a randomized survey experiment
No full textConcerns have been raised about the "demise of democracy," possibly accelerated by pandemic-related restrictions. Using a survey experiment involving 8,206 respondents from 5 Western democracies, we find that subjects randomly exposed to information regarding civil liberties infringements undertaken by China and South Korea to contain COVID-19 became less willing to sacrifice rights and more worried about their long-term erosion. However, our treatment did not increase support for democratic procedures more generally despite our prior evidence that pandemic-related health risks diminished such support. These results suggest that the start of the COVID-19 crisis was a particularly vulnerable time for democracies
Civil Liberties in Times of Crisis
No full textWe study people's willingness to trade off civil liberties for increased health security in the context of the COVID-19 pandemic by deploying representative surveys involving around 550,000 responses across 15 countries. We document significant heterogeneity across groups in willingness to sacrifice rights: citizens disadvantaged by income, education, or race are less willing to sacrifice rights than their more advantaged peers in every country. Leveraging naturally occurring variation and experimental approaches, we estimate a one standard deviation increase in health insecurity increases willingness to sacrifice civil liberties by 68–83 percent of the difference between the average Chinese and US citizen
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
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