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The adjusted mortality for care teams with anesthesiologist assistants was 1.6% (95% CI, 1.4 to 1.8) versus 1.7% for care teams with nurse anesthetists (95% CI, 1.7 to 1.7; difference −0.08; 95% CI, −0.3 to 0.1; P = 0.47). Compared to care teams with nurse anesthetists, care teams with anesthesiologist assistants were associated with non–statistically significant decreases in length of stay (−0.009 days; 95% CI, −0.1 to 0.1; P = 0.89) and medical spending (−$56; 95% CI, −334 to 223; P = 0.70). In their paper, the authors concluded that the specific composition of the anesthesia care team was not associated with any significant differences in mortality, length of stay, or inpatient spending.

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The Journal of the American Society of Anesthesiologists
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Laurence C. Baker
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In this study published in the American Journal of Managed Care, the authors found that premiums for ACA Marketplace plans were higher in rating areas in which physician, hospital, and insurance markets were less competitive. An increase from the 10th to the 90th percentile of physician concentration and hospital concentration was associated with increases of $393 and $189, respectively, in annual premiums for the Silver plan with the second lowest cost. A similar increase in the number of insurers was associated with a $421 decrease in premiums. Physician–hospital integration was not significantly associated with premiums.

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The American Journal of Managed Care
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Maria Polyakova
Laurence C. Baker
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The standard of care treatment for maximally resected, high risk (≥ 40 years old or sub-totally resected) low grade glioma (LGG) patients was established by RTOG 9802, which showed an overall survival (OS) of 13.3 years for patients treated with radiotherapy (RT) + PCV (procarbazine, lomustine [CCNU], vincristine) chemotherapy compared to 7.8 years for RT alone. In the era of value-based health care, cost-effectiveness analyses (CEA) have the potential to inform coverage decisions and patient care. To our knowledge, there has been no study assessing the value of RT+PCV as adjuvant therapy for high risk LGG. We sought to analyze the cost-effectiveness of this strategy.

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Eran Bendavid
Douglas K. Owens
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Volume 101, Issue 2
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The Trump administration's immigration crackdown may be leading to an unintended consequence: a drop-off in benefits enrollment among legal Hispanic immigrants, according to new research by Stanford Health Policy's Marcella Alsan.

This CBS News story about her work notes that an immigration program called Secure Communities, which was rolled out during the Obama administration, is linked to a lower take-up of benefits such as food stamps and health care enrollment.

In a new paper published by the National Bureau of Economic Research, Alsan and Crystal Yang of Harvard Law School found Hispanic households were particularly hard-hit, even those with legal immigration status.

"We find evidence that our results may be driven by deportation fear rather than lack of benefit information or stigma," the researchers wrote.  "Though not at personal risk of deportation, Hispanic citizens may fear their participation could expose non-citizens in their network to immigration authorities. We find significant declines in SNAP and ACA enrollment, particularly among mixed-citizenship status households and in areas where deportation fear is highest."

Read the CBS News story.

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Targeted killing by drones is a systemic driven instrumental practice that overrides societal non-instrumental practices that are essential for international society. Doing so, targeted killing by drones is not simply another form of inflicting violence by technical means to political opponents. It also inflicts the agents applying this practice, tempting them to frame it as a permissible measure to preserve international society. The reliance on drones for targeted killing is a pursuit of non-societal practices that seek individual and retributive justice and anticipatory and preventive self-defence by means of force relying on technological advantage. Eventually, this practice permits military tactics to steer political strategy, mitigating standards and practices agreed on in international society’s norms, rules of conduct, and institutions.

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International Politics
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"What is different today is the speed and extraterritorial reach of disinformation. Over-restriction on content undermines our democratic values, but understanding the mechanisms of manipulation opens up the solutions." Our Eileen Donahoe, Executive Director of CDDRL's Global Digital Policy Incubator, said in the podcast "Digital Media: Combatting Threats in the Era of Fake News." Listen here.

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Soon after Raphael Lemkin coined the term “genocide” in Axis Rule in Occupied Europe in 1944, he began working on a world history of genocide to popularize his neologism. Correspondence with funding organizations and publishers shows that he was soliciting interest in a book on the subject as early as 1947 and that he had produced substantial draft chapters by the following year. Before his death in 1959, he had almost completed the book on genocide in world history but, in marked contrast to the present, publishers were uninterested in the project, which was neither completed nor published. Both Lemkin and his approach were forgotten until the 1980s, when a small group of social scientists founded a marginal field called comparative genocide studies.

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Journal of Genocide Research
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Norman M. Naimark
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1
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Multiplicative interaction models are widely used in social science to examine whether the relationship between an outcome and an independent variable changes with a moderating variable. Current empirical practice tends to overlook two important problems. First, these models assume a linear interaction effect that changes at a constant rate with the moderator. Second, estimates of the conditional effects of the independent variable can be misleading if there is a lack of common support of the moderator. Replicating 46 interaction effects from 22 recent publications in five top political science journals, we find that these core assumptions often fail in practice, suggesting that a large portion of findings across all political science subfields based on interaction models are modeling artifacts or are at best highly model dependent. We propose a checklist of simple diagnostics to assess the validity of these assumptions and offer flexible estimation strategies that allow for nonlinear interaction effects and safeguard against excessive extrapolation. These statistical routines are available in both R and STATA.

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Vincent Tanutama is a research data analyst at the Center on Food Security and the Environment, where he supports the work of Marshall Burke on climate’s impact on economic outcomes such as workers' labor productivity and subnational economic output. Vincent's interest in the environment sprouts from investigating the distribution of rent among bureaucrats in their management of forest and oil palm resources in Indonesia, his country of origin. He has worked at the Indonesian Ministry for Economic Development Planning (Bappenas), The Abdul Latif Jameel Poverty Action Lab (JPAL Southeast Asia), Oxford Policy Management (OPM), and the United Nations Economic and Social Commission for Asia and the Pacific (UNESCAP).  He holds a B.A. in Ethics, Politics and Economics from Yale University.

Research Data Analyst
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