Thursday, December 27, 2018

Cultivation theory holds that the media is responsible for the public’s crime trend perceptions; but it is likely that the cultivation effect of media has been overstated in the previous research

Media consumption and crime trend perceptions: a longitudinal analysis. Luzi Shi, Sean Patrick Roche & Ryan M. McKenna. Deviant Behavior, https://doi.org/10.1080/01639625.2018.1519129

ABSTRACT: For over two decades, despite the downward crime trend, the American public has persisted in believing crime is on the rise. Cultivation theory holds that the media is responsible for the public’s crime trend perceptions. Previous cultivation studies heavily rely on cross-sectional data, which may lead to spurious conclusions due to reverse causation and omitted variable bias. This study aims to address these issues by utilizing longitudinal analyses. Drawing on three waves of the 2008–2009 American National Election Survey, we test the cultivation hypothesis using traditional OLS, OLS with lagged crime trend perceptions, fixed effects, and dynamic panel models. Newspaper and TV news consumption are related to crime trend perceptions in traditional OLS models. In other models, media consumption is not related to crime trend perceptions. The results do not support the cultivation hypothesis. It is likely that the cultivation effect of media has been overstated in the previous cross-sectional research.

Hospital Readmissions Reduction Program & rising deaths: Why are policies that profoundly influence patient care not rigorously studied before widespread rollout?

Did This Health Care Policy Do Harm? Rishi K. Wadhera, Karen E. Joynt Maddox and Robert W. Yeh. The New York Times, Dec 21 2018. https://www.nytimes.com/2018/12/21/opinion/did-this-health-care-policy-do-harm.html

A well-intentioned program created by the Affordable Care Act may have led to patient deaths.


Excerpts with almost no supplementary data. Check the original for the full text with links:



         The authors are cardiologists and health policy researchers.
No patient leaves the hospital hoping to return soon. But a decade ago, one in five Medicare patients who were hospitalized for common conditions ended up back in the hospital within 30 days. Because roughly half of those cases were thought to be preventable, reducing hospital readmissions was seen by policymakers as a rare opportunity to improve the quality of care while reducing costs.

In 2010, the federal agency that oversees Medicare, the Centers for Medicare and Medicaid Services, established the Hospital Readmissions Reduction Program under the Affordable Care Act. Two years later, the program began imposing financial penalties on hospitals with high rates of readmission within 30 days of a hospitalization for pneumonia, heart attack or heart failure, a chronic condition in which the heart has difficulty pumping blood to the body.

At first, the reduction program seemed like the win-win that policymakers had hoped for. Readmission rates declined nationwide for target conditions. Medicare saved an estimated $10 billion because of the reduction in hospital admissions. Based on those results, many policymakers have called for expanding the program.

But a deeper look at the Hospital Readmissions Reduction Program reveals a few troubling trends. First, since the policy has been in place, patients returning to a hospital are more likely to be cared for in emergency rooms and observation units. This has raised concern that some hospitals may be avoiding readmissions, even for patients who would benefit most from inpatient care.

Second, safety-net hospitals with limited resources have been disproportionately punished by the program because they tend to care for more low-income patients who are at much higher risk of readmission. Financially penalizing these resource-poor hospitals may impede their ability to deliver good care.

Finally, and most concerning, there is growing evidence that while readmission rates are falling, death rates may be rising.

In a new study [https://jamanetwork.com/journals/jama/fullarticle/2719307] of approximately eight million Medicare patients hospitalized between 2005 and 2015 that we conducted with other colleagues, we found that  the Hospital Readmissions Reduction Program was associated with an increase in deaths within 30 days of discharge among patients hospitalized for heart failure or pneumonia, though not for a heart attack.

The study [...] found that although post-discharge deaths for patients with heart failure were increasing in the years before the program, the trend accelerated after the program was established. Death rates following a pneumonia hospitalization were stable before the Hospital Readmissions Reduction Program, but increased after the program began.

For both conditions, the increase in deaths after the program were concentrated in those patients who had not been readmitted to the hospital after discharge. If we assume that the program was directly responsible for these increases in mortality and that prior trends would have continued unabated, the program may have resulted in 10,000 more deaths among patients with heart failure and pneumonia.

Our findings build upon a smaller-scale study by independent research groups that has also shown that the program was associated with an increase in post-discharge death [...].

How might this have happened? Though policymakers assumed that reductions in readmissions under the program were solely due to improvements in quality of care, our findings suggest otherwise. It is possible that some hospitals treated patients in the emergency room or in an observation unit when they would have benefited most from an inpatient readmission. It is also possible that shifting clinicians’ focus to readmissions distracted them from working to reduce mortality, since the readmissions penalties are over 10 times higher than the financial penalties for high death rates.

We don’t know exactly why we see the patterns we do. And another recent study reported that although deaths after discharge were increasing for heart failure and pneumonia, they did not accelerate under the program. They argue that other changes could have been responsible for the trend, such as an increase in the medical complexity of patients who were admitted to the hospital.

While the problem is complex, the short-term answer is simple — err on the side of caution. Further expansion of the program, from six conditions to all conditions warranting hospitalization, as some policymakers have advocated, makes little sense given legitimate concerns our study and others raise about its repercussions.

In the long term, the Centers for Medicare and Medicaid Services should conduct an investigation into the patterns we and others report. All possibilities should be considered, from coding changes to inappropriately turning patients away from the emergency room to changes in risk factors among Medicare patients. The agency must also engage physicians and patients to understand how this program has influenced “on the ground” care.

More broadly, this continuing debate about the Hospital Readmissions Reduction Program highlights a bigger issue: Why are policies that profoundly influence patient care not rigorously studied before widespread rollout?

[...]

Rishi K. Wadhera is a cardiology fellow at Harvard Medical School. Karen E. Joynt Maddox is a cardiologist at the Washington University School of Medicine in St. Louis. Robert W. Yeh is a cardiologist and director of the Smith Center for Outcomes Research in Cardiology at Beth Israel Deaconess Medical Center.
A version of this article appears in print on Dec. 22, 2018, on Page A23 of the New York edition with the headline: A Harmful Health Care Policy?.

On consumer finance, personal characteristics, & health, many prefer to remain in a state of active ignorance even when information is freely available

Ho, Emily and Hagmann, David and Loewenstein, George F., Measuring Information Preferences (September 14, 2018). http://dx.doi.org/10.2139/ssrn.3249768

Abstract: Advances in medical testing and widespread access to the internet have made it easier than ever to obtain information. Yet, when it comes to some of the most important decisions in life, people often choose to remain ignorant for a variety of psychological and economical reasons. We design and validate an information preference scale to measure an individual’s desire to obtain or avoid information that may be unpleasant, but could improve their future decisions. The scale measures information preferences in three domains that are psychologically and materially consequential: consumer finance, personal characteristics, and health. We present tests of the scale’s reliability and validity and show that the scale predicts a real decision to obtain (or avoid) information in each of the three domains, as well as in the domain of politics, which is not explicitly measured in the scale. We find that across settings, many respondents prefer to remain in a state of active ignorance even when information is freely available, and that information preferences are a stable trait but can differ across domains. (Under R&R at Management Science)

Keywords: Information Avoidance, Scale Development, Information Preference, Health, Consumer Finance
JEL Classification: D83, D91, C90, I12

5-year-olds judged conventional eaters more positively than unconventional eaters, judge ingroup & outgroup members negatively for unconventional choices

Children judge others based on their food choices. Jasmine M. DeJesus et al. Journal of Experimental Child Psychology, Volume 179, March 2019, Pages 143-161. https://doi.org/10.1016/j.jecp.2018.10.009

Highlights
•    5-year-olds judged conventional eaters more positively than unconventional eaters.
•    Unconventional foods were judged as negatively as disgust elicitors.
•    Children judge ingroup and outgroup members negatively for unconventional choices.
•    Children appreciate food choice as a behavior conveying social meaning.

Abstract: Individuals and cultures share some commonalities in food preferences, yet cuisines also differ widely across social groups. Eating is a highly social phenomenon; however, little is known about the judgments children make about other people’s food choices. Do children view conventional food choices as normative and consequently negatively evaluate people who make unconventional food choices? In five experiments, 5-year-old children were shown people who ate conventional and unconventional foods, including typical food items paired in unconventional ways. In Experiment 1, children preferred conventional foods and conventional food eaters. Experiment 2 suggested a link between expectations of conventionality and native/foreign status; children in the United States thought that English speakers were relatively more likely to choose conventional foods than French speakers. Yet, children in Experiments 3 and 4 judged people who ate unconventional foods as negatively as they judged people who ate canonical disgust elicitors and nonfoods, even when considering people from a foreign culture. Children in Experiment 5 were more likely to assign conventional foods to cultural ingroup members than to cultural outgroup members; nonetheless, they thought that no one was likely to eat the nonconventional items. These results demonstrate that children make normative judgments about other people’s food choices and negatively evaluate people across groups who deviate from conventional eating practices.

Wednesday, December 26, 2018

Constipated people tend to be obstinate, excessively concerned with hygiene, & inclined toward retaining possessions; diarrhoeic people tend to be careless, disorganized, & disposed to share their possessions with others

Consumer behaviour and the toilet: Research on expulsive and retentive personalities. Gianluigi Guido, Russell W. Belk, Cristian Rizzo, Giovanni Pino. Journal of Consumer Behaviour, https://doi.org/10.1002/cb.1709

Abstract: During the last five decades, a number of studies have attempted to draw from psychoanalytic theory to examine the relationship between evacuation disorders and a person's character. According to Freud's original conceptualization, early or harsh toilet training leads children to develop an anal retentive personality, characterized by the tendency to control their bowels as well as their material possessions; by contrast, liberal toilet training leads children to develop an anal expulsive personality, characterized by the tendency to excessively relieve faeces, as well as be being careless, messy, and inclined to dispose of old products and buy new ones. Although toilet training may not be responsible, these sets of traits do cohere. To empirically examine these hypotheses, we studied the personality traits and consumption habits of people suffering from different bowel disorders. By means of semistructured interviews, we analysed the personality characteristics, sociodemographic backgrounds, and peculiar consumption habits of people suffering from constipation and diarrhoeic syndromes. The results show that constipated people tend to be obstinate, excessively concerned with hygiene, and inclined toward retaining possessions, whereas diarrhoeic people tend to be careless, disorganized, and disposed to share their possessions with others. We discuss the theoretical and practical implications of these results and indicate avenues for future research.

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It is amazing, Freudianism doesn't die...

Tuesday, December 25, 2018

Is Islam Compatible with Free-Market Capitalism? An Empirical Analysis, 1970–2010: Capitalistic policies and institutions, it seems, may travel across religions more easily than culturalists claim

Is Islam Compatible with Free-Market Capitalism? An Empirical Analysis, 1970–2010. Indra de Soysa. Politics and Religion, https://doi.org/10.1017/S1755048318000780

Abstract: Are majority-Muslim countries laggards when it comes to developing liberal economic institutions? Using an Index of Economic Freedom and its component parts, this study finds that Muslim-dominant countries (>50% of the population) are positively associated with free-market capitalism. Protestant dominance is also positively correlated, but the association stems from just two components of the index, mainly “legal security and property rights protection.” Surprisingly, Protestant countries correlate negatively with “small government” and “freedom to trade,” two critical components of free-market capitalism. Muslim dominance shows positive correlations with all areas except for “legal security and property rights.” The results are consistent when assessing similar variables measuring property rights and government ownership of the economy collected by the Varieties of Democracy Project. Capitalistic policies and institutions, it seems, may travel across religions more easily than culturalists claim.

Consumers’ intelligence scores & their choice to co-own & lease their cars are linked; can be explained by higher social trust in people & institutions, their financial standing & tendency to seek savings

Sharing-Dominant Logic? Quantifying the Association between Consumer Intelligence and Choice of Social Access Modes. Jaakko Aspara Kristina Wittkowski. Journal of Consumer Research, ucy074, https://doi.org/10.1093/jcr/ucy074

Abstract: With sharing economy and access-based consumption, consumers increasingly access goods through social access modes other than private ownership—such as co-ownership, leasing, or borrowing. Prior research focuses on consumers’ attitudinal motivations and consumption-cultural use experiences pertaining to such social exchange-based access modes. In so doing, prior research has overlooked the influence that consumers’ fundamental, even biologically-shaped cognitive traits may have on their choice of access modes. To fill this research gap, this study analyzes a big data set of more than 30,000 new car registrations by male consumers in Finland, including cognitive test data from the Finnish Defense Forces and covariates from other governmental sources. The field data suggests that consumers’ intelligence scores and their choice to co-own and lease their cars are positively associated. Econometric evidence further suggests that the association between intelligence and choice of social exchange-based access modes can be explained by intelligent consumers’ higher social trust in people and institutions, as well as two circumstantial mechanisms: their financial standing and tendency to seek savings. The findings from the field data are supported by an additional survey study (n = 460). Implications for the evolution of markets and consumption, as well as human intelligence and cooperation, are discussed.

Keywords: Access, ownership, cognitive ability, intelligence, sharing, social exchange

There is considerable evidence to suggest that aesthetic experiences engage a distributed set of structures in the brain, and likely emerge from the interactions of multiple neural systems

Internal Orientation in Aesthetic Experience. Oshin Vartanian. In The Oxford Handbook of Spontaneous Thought: Mind-Wandering, Creativity, and Dreaming, edited by Kalina Christoff and Kieran C.R. Fox. May 2018, DOI: 10.1093/oxfordhb/9780190464745.013.17

Abstract: There is considerable evidence to suggest that aesthetic experiences engage a distributed set of structures in the brain, and likely emerge from the interactions of multiple neural systems. In addition, aside from an external (i.e., object-focused) orientation, aesthetic experiences also involve an internal (i.e., person-focused) orientation. This internal orientation appears to have two dissociable neural components: one component involves the processing of visceral feeling states (i.e., interoception) and primarily engages the insula, whereas the other involves the processing of self-referential, autobiographical, and narrative information, and is represented by activation in the default mode network. Evidence supporting this neural dissociation has provided insights into processes that can lead to deep and moving aesthetic experiences.

Keywords: aesthetics, self-referential, interoception, narrative, default mode network

Fear extinction does not prevent post-traumatic stress or have long-term therapeutic benefits in fear-related disorders unless extinction memories are easily retrieved at later encounters with the once-threatening stimulus

Dopamine-dependent prefrontal reactivations explain long-term benefit of fear extinction. A. M. V. Gerlicher, O. Tüscher & R. Kalisch. Nature Communications, volume 9, Article number: 4294 (2018), https://www.nature.com/articles/s41467-018-06785-y

Abstract: Fear extinction does not prevent post-traumatic stress or have long-term therapeutic benefits in fear-related disorders unless extinction memories are easily retrieved at later encounters with the once-threatening stimulus. Previous research in rodents has pointed towards a role for spontaneous prefrontal activity occurring after extinction learning in stabilizing and consolidating extinction memories. In other memory domains spontaneous post-learning activity has been linked to dopamine. Here, we show that a neural activation pattern — evoked in the ventromedial prefrontal cortex (vmPFC) by the unexpected omission of the feared outcome during extinction learning — spontaneously reappears during postextinction rest. The number of spontaneous vmPFC pattern reactivations predicts extinction memory retrieval and vmPFC activation at test 24 h later. Critically, pharmacologically enhancing dopaminergic activity during extinction consolidation amplifies spontaneous vmPFC reactivations and correspondingly improves extinction memory retrieval at test. Hence, a spontaneous dopamine-dependent memory consolidation-based mechanism may underlie the long-term behavioral effects of fear extinction.

Those with very rare genetic condition Urbach-Wiethe Disease had significantly more pleasant and significantly shorter and less complex dreams than controls; n o differences threat or danger levels

The Role of the Basolateral Amygdala in Dreaming. Yvonne Blake et al. Cortex, https://doi.org/10.1016/j.cortex.2018.12.016

Abstract: Neuroimaging studies have repeatedly shown amygdala activity during sleep (REM and NREM). Consequently, various theorists propose central roles for the amygdala in dreaming - particularly in the generation of dream affects, which seem to play a major role in dream plots. However, a causal role for the amygdala in dream phenomena has never been demonstrated. The traditional first step in determining this role is to observe the functional effects of isolated lesions to the brain structure in question. However, circumscribed bilateral amygdala lesions are extremely rare. Furthermore, the treatment of the amygdala as a unitary structure is problematic, as the basolateral and centromedial amygdala (BLA and CMA) may serve very different functions.

We analysed 23 dream reports collected from eight adult patients with bilateral calcification of the BLA as a result of a very rare genetic condition called Urbach-Wiethe Disease (UWD). We compared these dream reports to 52 reports collected from 17 matched controls. Given that the BLA has been implicated in various affective processes in waking life, we predicted that the emotional content of the patients’ dreams would differ from that of controls. Due to the exploratory nature of this research, a range of different dream characteristics were analysed.

A principal components analysis run on all data returned three key factors, namely pleasantness, length and danger. The UWD patients’ dream reports were significantly more pleasant and significantly shorter and less complex than control reports. No differences were found in levels of threat or danger.

The results support some current hypotheses concerning the amygdala’s role in dreaming, and call others into question. Future research should examine whether these UWD patients show generally impaired emotional episodic memory due to BLA damage, which could explain some of the current findings.

Attraction to the similars: For all three relations, friendships, casual/short-term, & long-term, what counts is political views, career goals, food preferences, travel desires, & music preferences

 Domains of Similarity and Attraction in Three Types of Relationships. Stanislav Treger, James N. Masciale. Interpersona, 2018, Vol. 12(2), 254–266, doi:10.5964/ijpr.v12i2.321

Abstract: For decades, social scientists have observed that people greatly desire a partner who is similar to themselves. Less is known, however, about whether particular similarity domains (e.g., music preferences) may uniquely influence relationship formation. We address this gap by examining people’s preferences for 18 similarity domains in three types of relationships: friendships, casual/short-term, and long-term. The most important similarity domains, across the three relationship types, were political views, career goals, food preferences, travel desires, and music preferences. General similarity was most important in long-term rather than in friendships and casual/short-term relationships, with the latter two relationship types not differing from one another. This pattern emerged for all similarity domains with four exceptions: preferences for books, video games, computer brands, and cell phone brands. No sex differences emerged in similarity domains except in preferences in video games and brands of cell phones and computers. Men rated these domains to be more important than did women. All three of these differences were of relatively small effect size. We tie this work into the larger body of research on similarity and preferences for partner traits.

Keywords: attraction, mate preferences, similarity