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The purpose of this paper is to expand the empirical literature on the association between non-compete agreement (NCA) enforceability and entrepreneurship by investigating how NCA policies affect different types of entrepreneurship with incorporated and unincorporated businesses.

The authors estimate difference-in-differences regressions based on individual-level data. This allows to control for heterogeneity at the individual level. Additionally, the authors provide graphical evidence using the synthetic control method (SCM).

The authors' findings show that the decrease in the enforceability of NCAs in Massachusetts resulted in a higher rate of unincorporated entrepreneurship among low-wage workers. At the same time, there was no sizable effect on the rate of incorporated entrepreneurship. For Utah, the authors' results indicate that the reform increased both types of entrepreneurship. The findings imply that states can promote entrepreneurial activity by reducing the enforceability of NCAs. The way of changing the enforceability of NCAs matters, as different provisions encourage different types of entrepreneurship in a given state.

The authors contribute to the literature on NCA enforceability effects on entrepreneurship in three ways. First, the authors utilize two quasi-experiments, the NCA policy changes in Utah in 2016 and Massachusetts in 2018, limiting NCAs to one year for all workers. Second, to the authors' knowledge, this is the first individual-level analysis that separates self-employment with incorporated and unincorporated businesses as two different types of entrepreneurship to analyze potentially heterogeneous effects of NCAs. Third, this is the first study to utilize American Community Survey (ACS) data in this literature.

Although conformable devices are commonly designed to couple with the human body for personalized and localized medicine, their applications are expanding rapidly. This paper aims to delineate this expansion and predict greater implications in diverse fields.

Today’s device technologies continue to face fundamental obstacles preventing their seamless integration with target objects to effectively access, evaluate and alter self-specific physical patterns, while still providing physical comfort and enabling continuous data collection. Due to their extreme mechanical compliance, conformable devices permit the query of signals occurring at interfaces so as to decode and encode biological, chemical and mechanical patterns with high resolution, precision and accuracy. These unique and versatile capabilities allow for a marked change in the approach to tackling scientific questions, with the ability to address societal challenges at large.

Here, this study highlights the current state of these devices in a wide range of fields, such as interactive teaching, textiles, robotics, buildings and infrastructure, agriculture, climate and space, and further forecasts essential features of these devices in the near future.

This study justifies conformable devices’ growing utility through a novel quantitative analysis methodology that indexes peer-reviewed journal articles based on specific keywords, whereby this study tracks keyword frequency over time across specific fields in conjunction with conformability-like topics. The resulting trends’ trajectories provide the foundation for this study’s future projections. This study concludes with a perspective on the possible challenges concomitant with a ubiquitous presence of these technologies, including manufacturing, wireless communication, storage, compression, privacy and sharing of data, environmental sustainability, avoidance of inequality and bias and collaboration between stakeholders at all levels of impact.

When wearable and implantable devices first arose in the 1970s, they were rigid and clashed dramatically with our soft, pliable skin and organs. The past two decades have witnessed a major upheaval in these devices. Traditional electronics are six orders of magnitude stiffer than soft tissue. As a result, when rigid electronics are integrated with the human body, severe challenges in both mechanical and geometrical form mismatch occur. This mismatch creates an uneven contact at the interface of soft-tissue, leading to noisy and unreliable data gathering of the body’s vital signs. This paper aims to predict the role that discreet, seamless medical devices will play in personalized health care by discussing novel solutions for alleviating this interface mismatch and exploring the challenges in developing and commercializing such devices.

Since the form factors of biology cannot be changed to match those of rigid devices, conformable devices that mimic the shape and mechanical properties of soft body tissue must be designed and fabricated. These conformable devices play the role of imperceptible medical interfaces. Such interfaces can help scientists and medical practitioners to gain further insights into the body by providing an accurate and reliable instrument that can conform closely to the target areas of interest for continuous, long-term monitoring of the human body, while improving user experience.

The authors have highlighted current attempts of mechanically adaptive devices for health care, and the authors forecast key aspects for the future of these conformable biomedical devices and the ways in which these devices will revolutionize how health care is administered or obtained.

The authors conclude this paper with the perspective on the challenges of implementing this technology for practical use, including device packaging, environmental life cycle, data privacy, industry partnership and collaboration.

The long-term financial stability of hospital systems represents a “grand challenge” in health care. New ownership forms, such as private equity (PE), promise to achieve better financial performance than nonprofit or for-profit systems. In this study, we compare two systems with many similarities, but radically different ownership structures, missions, governance, and merger and acquisition (M&A) strategies. Both were nonprofit, religious systems serving low-income communities – Montefiore Health System and Caritas Christi Health Care.

Montefiore's M&A strategy was to invest in local hospitals and create an integrated regional system, increasing revenues by adding primary doctors and community hospitals as feeders into the system and achieving efficiencies through effective resource allocation across specialized units. Slow and steady timing of acquisitions allowed for organizational learning and balancing of debt and equity. By 2019, it owned 11 hospitals with 40,000 employees and had strong positive financials and low reliance on debt.

By contrast, in 2010, PE firm Cerberus Capital bought out Caritas (renamed Steward Health Care System) and took control of the Board of Directors, who set the system's strategic direction. Cerberus used Steward as a platform for a massive debt-driven acquisition strategy. In 2016, it sold off most of its hospitals’ property for $1.25 billion, leaving hospitals saddled with long-term inflated leases; paid itself almost $500 million in dividends; and used the rest for leveraged buyouts of 27 hospitals in 9 states in 3 years. The rapid, scattershot M&A strategy was designed to create a large corporation that could be sold off in five years for financial gain – not for health care integration. Its debt load exploded, and by 2019, its financials were deeply in the red. Its Massachusetts hospitals were the worst financial performers of any system in the state. Cerberus exited Steward in 2020 in a deal that left its physicians, the new owners, holding the debt.

Through the use of website usability literature and tourism website analysis and experience, this theory proposes that user satisfaction on the website relates to six key drivers. The six drivers are crucial offerings of a tourism website and without successfully applying them the website may fail to meet the requirements of the end user. The six drivers for high website usability include tourist details, site appearance/usability, deals/promotions, segment marketing, foreign focus, and use of social media. This chapter puts the theory to action during an analysis of three northeastern states’ tourism websites. This study analyzes the tourism websites of New York, Massachusetts, and Maine using the six key drivers. The analysis demonstrates areas of strength and development for each state and directly ties back to the six drivers of user satisfaction for tourism websites.

This study aims to examine what patients say is helpful in psychodynamic psychotherapy by analyzing responses to an open-ended question at two time points: three months into treatment and termination.

Participants in this naturalistic study were a diverse group of patients seeking treatment at a psychodynamic psychotherapy training clinic (within a public hospital system). The authors used thematic analysis to categorize patient responses to an open-ended question about what is helpful in their treatment.

The authors found that a majority of patients found their psychotherapy helpful, and patient responses broke down into 16 categories. Themes that emerged from categories were what patients experience or feel, what therapists/therapy provides and what patients do in therapy. The most frequently endorsed category at both three months and termination was embedded within other categories, “mention of an other,” which captured when patients specifically mentioned another person (i.e. the therapist) in their response. The next most frequently endorsed categories were “talking/someone to talk with,” “feeling better/experiencing well-being/improved functioning” and “having regularity/structure” (at three months) and “having attention directed at experience,” “having regularity/structure” and “experiencing the professional role of the therapist” (at termination).

Findings shed light on factors contributing to helpful psychotherapy from patients’ perspectives in their own words. While previous research has shown that the therapy relationship is an important factor in effective therapy, the findings of this study highlight this ingredient in a personal, spontaneous way.

Many individuals in drug treatment courts (DTCs) have co-occurring mental health and substance use disorders (COD), which can negatively impact treatment engagement, behavioral health and criminal justice outcomes. This paper aims to report results of DTC participants with a COD, who received a 12-month wraparound treatment intervention called MISSION-Criminal Justice (MISSION-CJ) alongside DTC to improve treatment engagement and behavioral health outcomes and reduce reincarcerations.

In this pre-post, single-group pilot, 48 clients enrolled and 81% completed 12-month follow-up assessments (N = 39) and weekly MISSION-CJ fidelity for type and intensity of services delivered. Generalized linear mixed models (GLMMs) were computed with a fixed term for fidelity (e.g. high or low MISSION-CJ), time and a fidelity x time interaction term.

Among participants, at 12 months, 81% of the participants remained engaged in treatment at study completion, and 89% had high MISSON-CJ fidelity. Clients demonstrated significant reductions from baseline to 12 months in average nights in jail (B = −0.1849511, p < 0.0344), mental health symptoms via the Behavior and Symptom Identification Scale (BASIS) total and subscale scores (B = −0.121613, p < 0.0186) and trauma symptoms on the PTSD Checklist-5 (PCL-5) (B = −0.928791, p < 0.0138). High MISSION-CJ fidelity further improved criminal justice, and behavioral health outcomes.

This was the first reported 12-month MISSION-CJ trial. While feasible to implement, given the design limitations, future research should include a large randomized controlled trial.

The purpose of this paper is to address the barrier to care experienced by LGBTQIA+ populations by binary language for gender, sexual orientation and relationship status.

The authors review the research that shows linguistic barriers are a significant obstacle to healthcare for LGBTQIA+ communities. The authors describe both a process and revisions for addressing language bias in psychiatric intake/research research materials as well as quantify its impact in an adult psychotherapy clinic in a public hospital.

Patients self-identified their gender, sexual orientation and relationship status in a variety of ways when not presented with binaries and/or pre-established response choices. In addition, the non-response rate to questions decreased and the authors received positive qualitative feedback. The authors also present the revisions to the intake/research materials.

Other healthcare settings/clinicians can revise language in order to remove significant barriers to treatment and in doing so, be welcoming, non-pathologizing and empowering for LGBTQIA+ consumers of mental health services (as well as for non-LGBTQIA+ consumers who are in non-traditional relationships).

This work is one step in improving healthcare and the healthcare experience for LGBTQIA+ communities and for those in non-traditional relationships.

This work is set in a public safety-net hospital providing care for underserved and diverse populations. This paper describes the process of revising psychiatric materials to be more inclusive of the range of self-identity are: gender, sexual orientation and relationship status.