Patients treated by older physicians die more than patients cared for by younger ones, except those docs treating high volumes of patients

BMJ. 2017 May 16;357:j1797. doi: 10.1136/bmj.j1797.

Physician age and outcomes in elderly patients in hospital in the US: observational study.

Tsugawa Y, Newhouse JP, Zaslavsky AM, Blumenthal DM, Jena AB.

https://doi.org/10.1136/bmj.j1797

Abstract
Objectives To investigate whether outcomes of patients who were admitted to hospital differ between those treated by younger and older physicians.
Design: Observational study.
Setting: US acute care hospitals.

Participants: 20% random sample of Medicare fee-for-service beneficiaries aged ≥65 admitted to hospital with a medical condition in 2011-14 and treated by hospitalist physicians to whom they were assigned based on scheduled work shifts. To assess the generalizability of findings, analyses also included patients treated by general internists including both hospitalists and non-hospitalists.
Main outcome measures 30 day mortality and readmissions and costs of care.

Results: 736 537 admissions managed by 18 854 hospitalist physicians (median age 41) were included. Patients’ characteristics were similar across physician ages. After adjustment for characteristics of patients and physicians and hospital fixed effects (effectively comparing physicians within the same hospital), patients’ adjusted 30 day mortality rates were 10.8% for physicians aged <40 10.7="" 10.9="" 11.1="" 11.3="" 11.5="" 12.1="" 12.5="" 40-49="" 40="" 50-59="" a="" age="" aged="" among="" analyses.="" and="" association="" between="" br="" care="" confidence="" costs="" did="" for="" general="" high="" higher="" however="" in="" internists="" interval="" mortality.="" no="" not="" observed="" of="" older="" patient="" patients="" patterns="" physician="" physicians.="" physicians="" readmissions="" sensitivity="" several="" similar="" slightly="" there="" to="" vary="" volume="" was="" were="" while="" with=""> 

<40 10.7="" 10.9="" 11.1="" 11.3="" 11.5="" 12.1="" 12.5="" 40-49="" 50-59="" a="" age="" aged="" among="" analyses.="" and="" association="" between="" br="" care="" confidence="" costs="" did="" for="" general="" high="" higher="" however="" in="" internists="" interval="" mortality.="" no="" not="" observed="" of="" older="" patient="" patients="" patterns="" physician="" physicians.="" physicians="" readmissions="" sensitivity="" several="" similar="" slightly="" there="" to="" vary="" volume="" was="" were="" while="" with="">Conclusions: Within the same hospital, patients treated by older physicians had higher mortality than patients cared for by younger physicians, except those physicians treating high volumes of patients.

Ethnic and linguistic fractionalization contributes to poverty levels

Ethnic Diversity and Poverty. By Sefa Awawory Churchill, Russell Smyth
https://doi.org/10.1016/j.worlddev.2017.02.032

World Development, Volume 95, July 2017, Pages 285–302

Highlights

.  We examine the relationship between ethnic diversity and poverty.
.  We measure poverty using a wide range of indicators from the World Bank and UNDP. Ethnic diversity is measured by both fractionalization and polarization.
.  Ethnic diversity increases poverty.

Summary: We examine the relationship between ethnic diversity and poverty for a cross-sectional sample of developing countries. We measure diversity using indices of ethnic and linguistic fractionalization, and measure poverty using the multidimensional poverty index (MPI), multidimensional poverty headcount (MPH), intensity of deprivation, poverty gap, and poverty headcount ratio. We find that ethnic and linguistic fractionalization contributes to poverty levels. Specifically, after controlling for endogeneity, we find that a standard deviation increase in ethnic fractionalization is associated with a 0.32-, 0.44- and 0.53-standard deviation increase in the MPI, MPH and the intensity of deprivation, respectively. Moreover, a standard deviation increase in ethnic fractionalization is associated with between a 0.34- and 0.63-standard deviation increase in the population living below $1.90 and $3.10, the poverty gap at $1.90 and $3.10 a day and the headcount ratio at $1.90 and $3.10 a day. Similar results are also observed for linguistic fractionalization with standardized coefficients between 0.53 and 0.93. We find that our results are robust to alternative ways to measure poverty and ethnic diversity including ethnic polarization as well as alternative approaches to address endogeneity.

Key words: ethnic diversity; poverty; fractionalization; polarization

The Effect of Income on Subjective Well-Being: Evidence from the 2008 Economic Stimulus Tax Rebates

The Effect of Income on Subjective Well-Being: Evidence from the 2008 Economic Stimulus Tax Rebates. By Marta Lachowska. In Journal of Human Resources, Oct 2015
https://papers.ssrn.com/sol3/papers.cfm?abstract_id=2682543##

Abstract: This paper uses tax rebate payments from the 2008 economic stimulus to estimate the effect of a one-time change in income on three measures of subjective well-being: life satisfaction, health satisfaction, and affect. The income effect is identified by exploiting the plausibly exogenous variation in the payment schedule of the rebates. Using both ordinary least squares and two-stage least squares estimators, I find that the rebates had a large and positive impact on affect, which is explained by a reduction in feelings of stress and worry. For life satisfaction and health satisfaction, there is weaker evidence of a positive impact. Overall, the results show that a temporary increase in liquidity may enhance emotional well-being and that this effect is relatively stronger for low-income respondents.

Keywords: Subjective well-being, affect, income effect, quasi-experiment, instrumental variable

JEL Classification: I31, H31, E62

On the Size of the Gender Difference in Competitiveness

On the Size of the Gender Difference in Competitiveness. By Silvia Saccardo, Aniela Pietrasz, Uri Gneezy. In Management Science, http://dx.doi.org/10.1287/mnsc.2016.2673

Abstract: We design a new procedure for measuring competitiveness and use it to estimate the magnitude of the gender gap in competitiveness. Before working on a task, participants choose what percentage of their payoffs will be based on a piece-rate compensation scheme; the rest of their payoff is allocated to a competitive compensation scheme. This novel procedure allows us to distinguish between 101 levels of competitiveness, as opposed to the binary measure used in the literature. Whereas the binary measure allows researchers to conclude that about twice as many men as women choose to compete (typically two-thirds versus one-third), the new procedure sheds light on the intensive margin. We find that the intensity of the preference is more extreme than the binary measure could detect. For example, we find that only one-fifth of the most competitive 25% of our participants are women, and the most competitive 10% of our participants are all men. The new procedure also allows us to study the correlation between competitiveness and parameters such as overconfidence, attitudes toward risk, and ambiguity.

Data and the online appendix are available at https://doi.org/10.1287/mnsc.2016.2673.

Keywords: gender; competitiveness; behavioral economics

Perceived warmth and competence of others shape voluntary deceptive behaviour

Perceived warmth and competence of others shape voluntary deceptive behaviour in a morally relevant setting. Br J Psychol. 2017 Mar 9. doi: 10.1111/bjop.12245. By Azevedo RT, Panasiti MS, Maglio R, Aglioti SM.
https://www.ncbi.nlm.nih.gov/pubmed/28276063

Abstract: The temptation to deceive others compares to a moral dilemma: it involves a conflict between the temptation to obtain some benefit and the desire to conform to personal and social moral norms or avoid aversive social consequences. Thus, people might feel different levels of emotional and moral conflict depending on the target of the deception. Here we explored, in a morally relevant setting, how social judgements based on two fundamental dimensions of human social cognition - 'warmth' and 'competence' - impact on the decision to deceive others. Results revealed independent effects for warmth and competence. Specifically, while people are less inclined to deceive for self-gain those individuals they perceive as warm, they also tend to lie more to highly competent others. Furthermore, the perceived warmth and competence modulated the general tendency to reduce deceptive behaviour when there was a risk of disclosure compared to when the lying was anonymous, highlighting the importance of these judgements in social evaluation processes. Together, our results demonstrate that the emotional costs and personal moral standards that inhibit engagement in deceptive behaviour are not stable but rather malleable according to the target and the consequences of the deception.

© 2017 The British Psychological Society.
KEYWORDS: bias; deception; guilt; lie; moral; stereotype content model

Do Globalization and Free Markets Drive Obesity among Children and Youth? An Empirical Analysis, 1990–2013

Do Globalization and Free Markets Drive Obesity among Children and Youth? An Empirical Analysis, 1990–2013

Indra de Soysa & Ann Kristin de Soysa

International Interactions Vol. 0 , Iss. 0,0

http://www.tandfonline.com/doi/abs/10.1080/03050629.2017.1311259?journalCode=gini20&

ABSTRACT: Scholars of public health identify globalization as a major cause of obesity. Free markets are blamed for spreading high calorie, nutrient-poor diets, and sedentary lifestyles across the globe. Global trade and investment agreements apparently curtail government action in the interest of public health. Globalization is also blamed for raising income inequality and social insecurities, which contribute to “obesogenic” environments. Contrary to recent empirical studies, this study demonstrates that globalization and several component parts, such as trade openness, FDI flows, and an index of economic freedom, reduce weight gain and obesity among children and youth, the most likely age cohort to be affected by the past three decades of globalization and attendant lifestyle changes. The results suggest strongly that local-level factors possibly matter much more than do global-level factors for explaining why some people remain thin and others put on weight. The proposition that globalization is homogenizing cultures across the globe in terms of diets and lifestyles is possibly exaggerated. The results support the proposition that globalized countries prioritize health because of the importance of labor productivity and human capital due to heightened market competition, ceteris paribus, even if rising incomes might drive high consumption.

KEYWORDS: Globalization, obesity, trade and FDI, economic freedom

Small association between socioeconomic status and adult fast-food consumption in US

The association between socioeconomic status and adult fast-food consumption in the U.S. By Jay L. Zagorsky , Patricia K. Smith. Economics & Human Biology
http://www.sciencedirect.com/science/article/pii/S1570677X16300363

Highlights
•   Fast-food consumption among adults varies little across SES, measured as income and wealth.
•   Descriptive analyses indicate a weak, inverted U-shaped association between fast-food and SES.
•   Checking nutrition labels frequently and drinking less soda predict less adult fast-food intake.
•    More work hours predict greater fast-food intake.

Abstract: Health follows a socioeconomic status (SES) gradient in developed countries, with disease prevalence falling as SES rises. This pattern is partially attributed to differences in nutritional intake, with the poor eating the least healthy diets. This paper examines whether there is an SES gradient in one specific aspect of nutrition: fast-food consumption. Fast food is generally high in calories and low in nutrients. We use data from the 2008, 2010, and 2012 waves of the National Longitudinal Survey of Youth (NLSY79) to test whether adult fast-food consumption in the United States falls as monetary resources rise (n = 8136). This research uses more recent data than previous fast-food studies and includes a comprehensive measure of wealth in addition to income to measure SES.

Protestant Ethic and Entrepreneurship: Religious Minorities in the Holy Roman Empire

The Protestant Ethic and Entrepreneurship:  Evidence from Religious Minorities in the Former Holy Roman Empire.  By Luca Nunziata, Lorenzo Rocco. European Journal of Political Economy
https://doi.org/10.1016/j.ejpoleco.2017.04.001

Abstract: We investigate the effect of Protestantism versus Catholicism on the decision to become an entrepreneur in former Holy Roman Empire regions. Our research design exploits religious minorities' strong attachment to religious ethic and the predetermined historical determination of religious minorities' geographical distribution in the 1500 s as a result of the “cuius regio eius religio” (whose realm, his religion) rule. We find that today Protestantism increases the probability to be an entrepreneur by around 5 percentage points with respect to Catholicism, a result that survives to a battery of robustness checks. We explicit the assumptions underlying the identification strategy and provide an extensive testing of their validity by making use of several European datasets.

JEL classification:     J24; Z12; J21; Z13

Keywords:    Entrepreneurship; Religion; Culture; Protestantism; Catholicism

Socially excluded consumers tend to rely on affect to process information, and prefer persuasive messages based on feelings

Speaking to the heart: Social exclusion and reliance on feelings versus reasons in persuasion. By Fang-Chi Lu , Jayati Sinh
http://www.sciencedirect.com/science/article/pii/S1057740817300189.

Abstract: The authors of this study identify an alternative frame of communication for persuading people who feel socially excluded to behave in ways that benefit individual and social well-being, regardless of future connection possibilities. The authors suggest that socially excluded (included) consumers tend to rely on affect (cognition) in processing information, and to consequently prefer persuasive messages based on feelings (reasons). The effect occurs because people tend to ruminate about exclusionary events, which depletes self-regulatory resources. Thus, distraction that interferes with rumination can mitigate the social exclusion effect on affective processing. The authors present findings from five studies across various paradigms promoting personal and social well-being (i.e., donating blood, recycling, and consuming healthful foods) and discuss the theoretical and policy implications.

Keywords: Distraction intervention; Emotional versus rational appeals; Persuasion; Social exclusion

Expert ability can actually impair the accuracy of expert perception when judging others' performance

Larson, J. S., & Billeter, D. M. (2017). Adaptation and fallibility in experts' judgments of novice performers. Journal of Experimental Psychology: Learning, Memory, and Cognition, 43(2), 271–288. http://dx.doi.org/10.1037/xlm0000304

These authors show that expert ability can actually impair the accuracy of expert perception in the context of judging the performance of others.

They had individuals with a range of singing experience rank-order recordings of different vocalists singing "Let it Go" from best to worst. The true quality of each vocalist was assessed by applying a Bayesian model to the ranking data, and then judgment accuracy was assessed by comparing these "true" rankings to those given by the judges.

Expert singers were less accurate than intermediate singers at determining the relative quality of low-quality vocalists. A subsequent experiment showed that experts notice more mistakes than intermediate or novice judges, and judge these mistakes more harshly.

The authors interpret these results in terms of adaptation level theory, which suggests that people are better able to discriminate at their own adaptation level. Thus, performance expertise increases the ability to discriminate among top performers, but this reduces the ability to discriminate among lower-level performers.