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BACKGROUND Reimbursement systems that contribute to the cooperation and integration of providers have become increasingly important within the healthcare sector. Reimbursement systems not only serve as payment mechanisms but also provide control and incentive functions. Thus, the design of reimbursement systems is extremely important. OBJECTIVES The aims of this systematic review were to describe and gain a better understanding of the effects of monetary incentives in the setting of physician groups. METHODS In January 2020, we searched the MEDLINE (PubMed), Cochrane Library, CINAHL, PsycINFO, EconLit, and ISI Web of Science databases as well as the gray literature and authors' personal collections. RESULTS We included 21 reviews containing seven different incentive schemes/initiatives. The study settings and outcome measures varied considerably, as did the results within the incentive schemes and initiatives. However, we found positive effects on process quality for two types of incentives pay-for-performance and accountable care organizations. The main limitations of this review were the variations in study settings and outcome measures of the studies included. CONCLUSIONS Monetary incentives in healthcare are often implemented as a control measure and are supposed to increase quality of care and reduce costs. The heterogeneity of the study results indicates that this is not always successful. The results reveal a need for research into the effects of monetary incentives in healthcare.Interest in percutaneous mitral valve repair has increased during recent years. This is mainly driven by the significant number of patients being declined for mitral valve surgery because of a high risk of surgery-related complications or death. In this subset of patients, percutaneous edge-to-edge repair using the MitraClip device (Abbott, Menlo Park, CA, USA) has become an established treatment option, proven to be safe, efficient and associated with improved functional status. In contrast to primary mitral regurgitation (MR), clinical outcomes after mitral valve surgery appear to be less favourable as regards secondary MR due to heart failure. In the MITRA-FR and COAPT trials, patients with moderate to severe and severe secondary MR with reduced left ventricular function received either medical treatment (control group) or MitraClip implantation plus medical treatment (device group). Results were conflicting, with only the COAPT trial showing better clinical outcomes in the device group. However, both trials are now seen as complementary and provide useful information especially regarding patient selection for MitraClip therapy. The goal of this review is to delineate which subset of patients with secondary MR will potentially benefit from percutaneous mitral valve repair.Growing scientific fields often involve multidisciplinary investigations in which the same concepts may have different meanings. Here, we examine the case of 'gesture' in comparative research to depict how conceptual diversity hidden by the label 'gesture' can lead to consistently divergent interpretations in humans and nonhuman primates. We show that definitions of 'gesture' drastically differ regarding the forms of a gesture and the cognitive processes inferred from it, and that these differences emerge from implicit assumptions which have pervasive consequences on the interpretations claimed by researchers. We then demonstrate that implicit assumptions about scientific concepts can be made explicit using a finite set of operational criteria. We argue that developing theoretical definitions systematically associated with operational conceptual boundaries would allow to tackle both the challenges of maintaining high internal coherence within studies and of improving comparability and replicability of scientific results. Temsirolimus We thus offer an easy-to-implement conceptual tool that should help ground valid comparisons between studies and serve scientific inquiry.Studies conducted in the last few decades show that young people have a negative evaluation of politics since they relate it to conventional forms of participation. In addition, they engage in unconventional forms of political participation, though they do not think of them as political practices. In this context, a qualitative study was carried out in order to describe the social representations of politics through the narratives provided by adolescents during an interview based on Piaget's clinical method. The results obtained reveal the coexistence of two representations of politics a conventional and an unconventional one. The representation in which politics is mainly understood as conventional forms of participation appears to be hegemonic, although a polemic unconventional representation was identified. Moreover, in many of the subjects both representations coexist in state of cognitive polyphasia that express a relation of selective prevalence between them, depending on the discursive context they are elicited.The orexinergic system supposedly plays a role in stress circuits for arousing behaviors during anxiety, suggesting that it may play a role also in neural circuits mediating the compulsive behavior characteristic of obsessive-compulsive disorder (OCD). This study aims to investigate the roles of the orexinergic system in the development of OCD behaviors, using as preparation the induction of compulsive checking by chronic treatment with the D2/D3 agonist, quinpirole. Repeated injections of quinpirole (0.5 mg/kg, twice per week for a total of 10 injections) were used to induce compulsive checking. In separate groups of rats, OX1R (SB334867-A; 10 μg i.c.v) and OX2R (TCS-OX2-29; 10 μg i.c.v) receptor antagonists were co-administered together with quinpirole. Checking behavior in a large open field was measured after the first, fifth, and tenth injections of the drugs. SB334867-A attenuated checking behavior and the level of anxiety. TCS-OX2-29 administration ameliorated anxiety but did not block the development of compulsive checking. Orexin 1 receptors seem to play a more critical role than orexin 2 receptors in the induction of compulsive checking. Considering that the quinpirole sensitization model of OCD involves activation of dopamine systems and sensitization to quinpirole, it is suggested that neural interaction between orexigenic and dopamine systems may be important in the pathogenesis of OCD.
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