Publications by authors named "R G van Kleef"

Prospective payments for health care providers require adequate risk adjustment (RA) to address systematic variation in patients' health care needs. However, the design of RA for provider payment involves many choices and difficult trade-offs between incentives for risk selection, incentives for cost control, and feasibility. Despite a growing literature, a comprehensive framework of these choices and trade-offs is lacking.

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Developmental exposure to carbamates, organophosphates, and pyrethroids has been associated with impaired neurodevelopmental outcomes. Sex-specific differences following chronic insecticide exposure are rather common in vivo. Therefore, we assessed the chronic effects of in vitro exposure to different carbamates (carbaryl, methomyl and aldicarb), organophosphates [chlorpyrifos (CPF), chlorpyrifos-oxon (CPO), and 3,5,6,trichloropyridinol (TCP)], and pyrethroids [permethrin, alpha-cypermethrin and 3-phenoxy benzoic acid (3-PBA)] on neuronal network development in sex-separated rat primary cortical cultures using micro-electrode array (MEA) recordings.

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Nearly all empirical studies that estimate the coefficients of a risk equalization formula present the value of the statistical measure R. The R-value is often (implicitly) interpreted as a measure of the extent to which the risk equalization payments remove the regulation-induced predictable profits and losses on the insured, with a higher R-value indicating a better performance. In many cases, however, we do not know whether a model with R = 0.

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Many health insurance markets are organized by principles of regulated competition. Regulators of these markets typically apply risk equalization (aka risk adjustment) and risk sharing to mitigate risk selection. Risk equalization and risk sharing can have various positive and negative effects on efficiency and fairness.

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Article Synopsis
  • Pesticides, including carbamates, organophosphates, organochlorines, and pyrethroids, are linked to health issues like neurotoxicity, with some studies indicating these effects can vary by sex.
  • In experiments using female and male rat cortical cultures, specific pesticides were found to impact neuronal network function differently, suggesting carbaryl and organophosphates like CPF and CPO reduce neuronal activity, with CPO being the most impactful.
  • The study highlights that certain pesticides can lead to increased or decreased neuronal activity, and that females may be more sensitive to specific compounds like endosulfan, demonstrating the importance of considering sex in neurotoxicity research.
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