Competition, insurance mandates, and clinical practices and outcomes at in vitro fertilization clinics.

PURPOSE: The high cost of in vitro fertilization (IVF) procedures coupled with public availability of success rates may influence IVF practice patterns and success rates but may be mitigated by mandated insurance coverage for IVF procedures. This study examined associations of competition with IVF practice patterns and success rates by insurance mandate status. METHODS: We used publicly available 2018 National Assisted Reproductive Technology Surveillance System data from the CDC. We defined competition as distance to nearest clinic and number of clinics within certain radii. We used linear regression to explore associations of competition, insurance mandate status, and interactions between competition and mandate status with clinical practice patterns (e.g., percentage of cycles among patients < 35 years, percentage of cycles using ICSI, average number of embryos transferred) and IVF success rates (e.g., live birth rates). We also assessed the percentage of variation in outcomes explained by our models, R2. RESULTS: For practice patterns, the largest R2 value was 0.3518, meaning only 35.18% of the variability in the practice pattern variable was explained by competition and insurance mandate status. In most cases, the R2 values were less than 0.20, indicating little to no association. Less than 10% of the variability in success rates was explained by competition and insurance mandate status. CONCLUSION: The multiple regression analyses all yielded low R2 values, indicating weak associations. These encouraging results coincide with previous studies, suggesting that competition, even by insurance mandate status, does not have a strong association with IVF practice patterns or success rates.

Is there a cognate advantage for typically developing Spanish-speaking English-language learners?

PURPOSE: Cross-linguistic cognates are words that share form and meaning in two languages (e.g., helicopter-helicóptero); translation equivalents are words that share meaning but not form (e.g., house-casa). Research consistently demonstrates a performance speed and/or accuracy advantage for processing cognates versus noncognates in bilingual adults; studies with children are limited, with equivocal results. We investigated the potential for a cognate advantage for processing expressive and receptive vocabulary in the spoken (vs. written) modality in typically developing Spanish-speaking English-language learners (ELLs). METHOD: Thirty 8- to 13-year-old native Spanish-speaking children learning English as their second language completed standardized vocabulary tests in spoken English. Each test item was classified as a cognate or noncognate based on phonological overlap with its Spanish translation. Group and individual analyses were used to examine the effects of cognates. RESULTS: At the group level, children's test scores were higher for items that were classified as cognates as compared to noncognates of comparable difficulty. However, not all children demonstrated this cognate advantage. Age predicted significant amounts of variance in cognate performance on the receptive test. CONCLUSION: Overall, typically developing Spanish-speaking school-age ELL students demonstrated a cognate advantage. There was also considerable within-group variation in performance. Clinical implications are discussed, and directions for future study are provided.