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Computer architecture. Operating systems --- Sociology of culture --- Computers and civilization. --- Cyberspace --- Internet --- Social aspects. --- Computers and civilization --- Social aspects --- Internet - Social aspects --- Cyberspace - Social aspects
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Starting in the early 1990's, journalists and scholars began responding to and trying to take account of new technologies and their impact on our lives. By the end of the decade, the full-fledged study of cyberculture had arrived. Today, there exists a large body of critical work on the subject, with cutting-edge studies probing beyond the mere existence of virtual communities and online identities to examine the social, cultural, and economic relationships that take place online. Taking stock of the exciting work that is being done and positing what cyberculture's future might look like,
Computers and civilization. --- Cyberspace --- Internet --- Social aspects.
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Cesarean delivery for low-risk pregnancies is generally associated with worse health outcomes for infants and mothers. The interpretation of this correlation, however, is confounded by potential selectivity in the choice of birth mode. We use birth records from California, merged with hospital and emergency department (ED) visits for infants and mothers in the year after birth, to study the causal health effects of cesarean delivery for low-risk first births. Building on McClellan, McNeil, and Newhouse (1994), we use the relative distance from a mother's home to hospitals with high and low c-section rates as an instrument for c-section. We show that relative distance is a strong predictor of c-section but is orthogonal to many observed risk factors, including birth weight and indicators of prenatal care. Our IV estimates imply that cesarean delivery causes a relatively large increase in ED visits of the infant, mainly due to acute respiratory conditions. We find no significant effects on mothers' hospitalizations or ED use after birth, or on subsequent fertility, but we find a ripple effect on second birth outcomes arising from the high likelihood of repeat c-section. Offsetting these morbidity effects, we find that delivery at a high c-section hospital leads to a significant reduction in infant mortality, driven by lower death rates for newborns with high rates of pre-determined risk factors.
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Treatment practices vary widely across hospitals, often with little connection to the medical needs of patients. We assess impacts of these differences in childbirth, where there is broad interest in reducing cesarean deliveries. Using a distance-based design and data from half a million births, we find that infants delivered at hospitals with higher c-section rates are born in better shape, are less likely to be readmitted to the hospital, are exhibit suggestive evidence of improved survival. These benefits are driven by the avoidance of prolonged labors that pose serious risks to infant health. In contrast, we document that these infants are substantially more likely to return to the emergency department for respiratory-related problems in the year after birth, providing some of the first design-based evidence consistent with a large observational literature linking cesarean delivery to chronic reductions in respiratory health.
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We study impacts of the US Department of Veteran Affairs (VA) Disability Compensation program on the health and well-being of the large and rapidly growing population of veterans claiming mental disorders. Our empirical strategy leverages quasi-random assignment of veterans to medical examiners who vary in their assessing tendencies. We find that an additional $1,000 per year in transfers decreases food insecurity and homelessness by 4.1% and 1.3% over five years, while the number of collections on VA debts declines by 6.4%. Despite facing few monetary costs, healthcare utilization increases by 2.5% over the first five years, with greater engagement in preventive care and improved medication adherence. Patient satisfaction surveys suggest that transfers improve communication and trust between veterans and VA clinicians, leading to greater overall satisfaction. Apart from a reduction in self-reported pain, we estimate precise null average effects on mental and physical health, and on mortality. Lastly, those on the margin of claim denial experience worse outcomes on average than other applicants, with suggestive evidence of large treatment effects for this sub-population, highlighting the precarious positions of many marginally (dis)qualified applicants for this program.
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Analyzing data spanning three decades covering the near universe of births, we study county-level differences in Cesarean section (C-section) rates among first-time mothers of singleton births. Our research reveals persistent geographic variation in C- section rates for both low- and high-risk groups. Counties with elevated C-section rates consistently perform more C-sections across mothers at all levels of appropriateness for the procedure. These elevated rates of C-section in high C-section counties are associated with reduced maternal and infant morbidity. We also find that C-section decisions are less responsive to underlying risks for Black mothers relative to white mothers, suggesting potential welfare-reducing disparities.
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