WorldWideScience

Sample records for safe return-to-play decisions

  1. Return to play after infectious mononucleosis.

    Science.gov (United States)

    Becker, Jonathan A; Smith, Julie Anne

    2014-05-01

    Infectious mononucleosis is a disease primarily of adolescence and early adulthood. The risk of splenic injury and chronic fatigue make return-to-play decisions a challenge for the clinician caring for athletes with infectious mononucleosis. Data were obtained from the PubMed and MEDLINE databases through December 2012 by searching for epidemiology, diagnosis, clinical manifestations, management, and the role of the spleen in infectious mononucleosis. Clinical review. Level 4. Infectious mononucleosis is commonly encountered in young athletes. Its disease pattern is variable and can affect multiple organ systems. Supportive care is the cornerstone, with little role for medications such as corticosteroids. Physical examination is unreliable for the spleen, and ultrasound imaging has limitations in its ability to guide return-to-play decisions. Exercise does not appear to place the young athlete at risk for chronic fatigue, but determining who is at risk for persistent symptoms is a challenge. Return-to-play decisions for the athlete with infectious mononucleosis need to be individualized because of the variable disease course and lack of evidence-based guidelines.

  2. Making prudent recommendations for return-to-play in adult athletes with cardiac conditions.

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    Oliveira, Leonardo P J; Lawless, Christine E

    2011-01-01

    Clinicians who treat millions of adult athletes throughout the world may be faced with participation or return-to-play decisions in individuals with known or suspected cardiac conditions. Here we review existing published participation guidelines and analyze emerging data from ongoing registries and population-based studies pertaining to return-to-play decisions for cardiac conditions specifically affecting adult athletes. Considerations related to return-to-play decisions will vary according to age of the athlete, with inherited disorders being the main consideration in younger adult athletes aged 18 to 40 yr, and coronary artery disease being the main consideration in older adult athletes aged 40 yr and older. Although this arbitrary division is based on the epidemiology of underlying heart disease in these populations, the essential return-to-play decision process for both age groups is quite similar. Among the most widely used guidelines to make return-to-play decisions in this group of athletes are the 36th Bethesda Conference Eligibility Recommendations for Competitive Athletes with Cardiovascular Abnormalities. These have long been considered the "gold standard" for determining return-to-play decisions in young athletes in the United States. Other guidelines are available for unique purposes, including The European Society of Cardiology guidelines, and the American Heart Association published recommendations regarding participation of young patients (younger than 40 yr) with genetic cardiovascular diseases in recreational sports. The latter are consistent with the 36th Bethesda guidelines and cover common genetically based diseases such as inherited cardiomyopathies, channelopathy, and connective tissue disorders like Marfan's syndrome. The consensus on masters athletes (older than 40 yr) provides return-to-play decisions for a wide variety of conditioned states, from elite older athletes to walk-up athletes. For any adult athlete with a cardiac condition

  3. Use of the stepwise progression return-to-play protocol following concussion among practicing athletic trainers

    Directory of Open Access Journals (Sweden)

    Jessica Wallace

    2018-04-01

    Full Text Available Purpose: The purpose of this study was to determine whether practicing athletic trainers (ATs were using the stepwise progression to make return-to-play (RTP decisions after concussion and to determine what factors influenced their decision to use the stepwise progression. Methods: A total of 166 ATs (response rate = 16.6% completed a 21-item questionnaire that evaluated participant demographics, methods of concussion management, and RTP decision-making using the stepwise progression. Descriptive statistics and a logistic regression were completed to analyze data. Results: Factors such as education level (p = 0.05 and number of concussions treated (p = 0.05 predicted use of the stepwise progression, whereas sex (p = 0.17, employment setting (p = 0.17, state law (p = 0.86, and years practicing (p = 0.17 did not predict whether ATs were following the stepwise progression. Conclusion: The majority of the ATs from this study are employing the stepwise progression to safely return athletes to play after sustaining a concussion. This demonstrates that ATs are providing a standard of care for concussed athletes across various athletic training settings; however, having a graduate degree and treating more concussions per year are predictors of whether an AT follows all steps of the stepwise progression. Keywords: Athletic trainers, Concussion, Concussion management, Graduate degree, Return to play, Sports medicine, Stepwise progression

  4. Strategic Assessment of Risk and Risk Tolerance (StARRT) framework for return-to-play decision-making.

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    Shrier, Ian

    2015-10-01

    The sport medicine clinician is faced with return-to-play (RTP) decisions for every patient who wants to return to activity. The complex interaction of factors related to history, physical examination, testing, activity and baseline characteristics can make RTP decision-making challenging. Further, when reasoning is not explicit, unnecessary conflict can arise among clinicians themselves, or among clinicians and patients. This conflict can have negative health consequences for the patient. In 2010, a transparent framework for RTP decisions was proposed. However, some have identified limitations to the framework and found difficulties in its implementation. This paper presents a revised framework that addresses the limitations, and provides concrete examples of how to apply it in simple and complex cases. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  5. Return to Play in Athletes Following Ankle Injuries

    OpenAIRE

    Clanton, Thomas O.; Matheny, Lauren M.; Jarvis, Hannah C.; Jeronimus, Anastasia B.

    2012-01-01

    Background: The decision to return to play following an ankle injury is a multifactorial process involving both physical and psychological parameters. The current body of literature lacks evidence-based guidelines to assist in the decision. Objective: This article reviews the evidence to support such testing: the dorsiflexion lunge test, star excursion balance test, agility T-test, and sargent/vertical jump test. The importance of psychological factors is also highlighted. Evidence Acquisitio...

  6. Return to play after hamstring injuries in football (soccer) : A worldwide Delphi procedure regarding definition, medical criteria and decision-making

    NARCIS (Netherlands)

    Van Der Horst, Nick; Backx, F. J.G.; Goedhart, Edwin A.; Huisstede, Bionka M.A.

    2017-01-01

    There are three major questions about return to play (RTP) after hamstring injuries: How should RTP be defined? Which medical criteria should support the RTP decision? And who should make the RTP decision? The study aimed to provide a clear RTP definition and medical criteria for RTP and to clarify

  7. Has the athlete trained enough to return to play safely? The acute:chronic workload ratio permits clinicians to quantify a player's risk of subsequent injury.

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    Blanch, Peter; Gabbett, Tim J

    2016-04-01

    The return to sport from injury is a difficult multifactorial decision, and risk of reinjury is an important component. Most protocols for ascertaining the return to play status involve assessment of the healing status of the original injury and functional tests which have little proven predictive ability. Little attention has been paid to ascertaining whether an athlete has completed sufficient training to be prepared for competition. Recently, we have completed a series of studies in cricket, rugby league and Australian rules football that have shown that when an athlete's training and playing load for a given week (acute load) spikes above what they have been doing on average over the past 4 weeks (chronic load), they are more likely to be injured. This spike in the acute:chronic workload ratio may be from an unusual week or an ebbing of the athlete's training load over a period of time as in recuperation from injury. Our findings demonstrate a strong predictive (R(2)=0.53) polynomial relationship between acute:chronic workload ratio and injury likelihood. In the elite team setting, it is possible to quantify the loads we are expecting athletes to endure when returning to sport, so assessment of the acute:chronic workload ratio should be included in the return to play decision-making process. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  8. Return to Play

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    Mangan, Marianne

    2013-01-01

    Call it physical activity, call it games, or call it play. Whatever its name, it's a place we all need to return to. In the physical education, recreation, and dance professions, we need to redesign programs to address the need for and want of play that is inherent in all of us.

  9. Return to play in elite rugby union: application of global positioning system technology in return-to-running programs.

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    Reid, Laura C; Cowman, Jason R; Green, Brian S; Coughlan, Garrett F

    2013-05-01

    Global positioning systems (GPS) are widely used in sport settings to evaluate the physical demands on players in training and competition. The use of these systems in the design and implementation of rehabilitation and return-to-running programs has not yet been elucidated. To demonstrate the application of GPS technology in the management of return to play in elite-club Rugby Union. Case series. Professional Rugby Union club team. 8 elite Rugby Union players (age 27.86 ± 4.78 y, height 1.85 ± 0.08 m, weight 99.14 ± 9.96 kg). Players wore GPS devices for the entire duration of a club game. Variables of locomotion speed and distance were measured. Differences in physical demands between playing positions were observed for all variables. An analysis of the position-specific physical demands measured by GPS provides key information regarding the level and volume of loads sustained by a player in a game environment. Using this information, sports-medicine practitioners can develop rehabilitation and return-to-running protocols specific to the player position to optimize safe return to play.

  10. Active release technique in hamstrings strain: Rehabilitation and return to play – a case study

    Directory of Open Access Journals (Sweden)

    Hariharasudhan Ravichandran

    2017-01-01

    Full Text Available Hamstring injuries and its rehabilitation in competitive events such as football targets safe and early return to play. This is because hamstring injuries are more related to prolonged recovery time and high rate of re-injury. In this case study, Zakeer Mundampara, 26-year-old footballer of Chennaiyin FC team (Indian super league tournament, who was rehabilitated for Grade 2 hamstring strain was briefed. To describe the importance of conservative rehabilitation in hamstring injuries and report on player's rehabilitation program and clinical outcome. Zakeer Mundampara was conservatively treated with active release technique for 2 weeks duration. Data collected includes passive knee extension test range of motion and verbal rating score. After 2 weeks of rehabilitation, Zakeer Mundampara had nearly full range of pain-free movement, normal gait and trained to run safely. By the 3rd week, he started to perform all sports specific drills. He was rehabilitated and set fit to play after 4 weeks from the date of injury. Active release technique is effective in hamstring injuries. In this case study, rehabilitation program with an emphasis on active release technique is found to be effective in returning the footballer back to play.

  11. Infectious Mononucleosis: Ensuring a Safe Return to Sport.

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    MacKnight, John M.

    2002-01-01

    Clinical properties of infectious mononucleosis include prolonged fatigue, spleen enlargement and fragility, and risk for spleen rupture. Sports medicine practitioners must recognize and manage these clinical features and promote safe, timely return of athletes to sports. Safeguarding against splenic injury and minimizing the duration of…

  12. Return to play after an initial or recurrent concussion in a prospective study of physician-observed junior ice hockey concussions: implications for return to play after a concussion.

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    Echlin, Paul Sean; Tator, Charles H; Cusimano, Michael D; Cantu, Robert C; Taunton, Jack E; Upshur, Ross E G; Czarnota, Michael; Hall, Craig R; Johnson, Andrew M; Forwell, Lorie A; Driediger, Molly; Skopelja, Elaine N

    2010-11-01

    The authors investigated return-to-play duration for initial and recurrent concussion in the same season in 2 teams of junior (16-21-year-old) ice hockey players during a regular season. The authors conducted a prospective cohort study during 1 junior regular season (2009-2010) of 67 male fourth-tier ice hockey players (mean age 18.2 ± 1.2 years [SD], range 16-21 years) from 2 teams. Prior to the start of the season, every player underwent baseline assessments that were determined using the Sideline Concussion Assessment Tool 2 (SCAT2) and the Immediate Post-Concussion Assessment and Cognitive Test (ImPACT). The study protocol also required players who entered the study during the season to complete a baseline SCAT2 and ImPACT. If the protocol was not followed, the postinjury test results of a player without true baseline test results were compared with previously established age- and sex-matched group normative levels. Each game was directly observed by a physician and at least 1 neutral nonphysician observer. Players suspected of suffering a concussion were evaluated by the physician during the game. If a concussion was diagnosed, the player underwent clinical evaluation at the physician's office within 24 hours. The return-to-play decision was based on clinical evaluation guided by the Zurich return-to-play protocol (contained in the consensus statement of international expert opinion at the 3rd International Conference on Concussion in Sport held in Zurich, November 2008). This clinical evaluation and return-to-play protocol was augmented by the 2 tests (SCAT2 and ImPACT) also recommended by the Zurich consensus statement, for which baseline values had been obtained. Seventeen players sustained a physician-observed or self-reported, physician-diagnosed concussion during a physician-observed ice hockey game. The mean clinical return-to-play duration (in 15 cases) was 12.8 ± 7.02 days (median 10 days, range 7-29 days); the mean number of physician office visits

  13. Choosing to Work? Mothers Return-to-Work Decisions, Social Class, and the Local Labor Market

    Directory of Open Access Journals (Sweden)

    Tiina Sihto

    2015-10-01

    Full Text Available The aim of this study is to examine the ways in which social class shapes the return-to-work decisions of Finnish working-class and middle-class mothers, and how these decisions are structured by the constraints and opportunities mothers face in the local labor market. The focus of the study is in the local labor market of the city of Jyväskylä. The data consist of two semi-structured focus group interviews of 14 employed mothers of below school-age children. Using the framework of “gendered moral rationalities,” the study shows that there are similarities in mothers’ experiences, while the structural constraints mothers faced when deciding about the timing of returning back to work differ. The analysis highlights that the differences were not only dependent on social class but also on the situation in the local labor market. For working-class mothers, the most crucial issue was the financial strain that their staying at home caused to their families. For middle-class mothers, finding employment opportunities that would match their educational qualifications in the local labor market had been challenging, which affected their timing of returning back to work. The paper concludes that local labor market plays an important role in mother’s return-to-work decisions and should be explored further in differing geographical contexts.

  14. Return to Play Following Anterior Shoulder Dislocation and Stabilization Surgery.

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    Donohue, Michael A; Owens, Brett D; Dickens, Jonathan F

    2016-10-01

    Anterior shoulder instability in athletes may lead to time lost from participation and decreases in level of play. Contact, collision, and overhead athletes are at a higher risk than others. Athletes may successfully be returned to play but operative stabilization should be considered for long-term treatment of recurrent instability. Open and arthroscopic stabilization procedures for athletes with less than 20% to 25% bone loss improve return to play rates and decrease recurrent instability, with a slightly lower recurrence with open stabilization. For athletes with greater than 20% to 25% bone loss, an open osseous augmentation procedure should be considered. Published by Elsevier Inc.

  15. Return to Play After Hip Arthroscopic Surgery for Femoroacetabular Impingement in Professional Soccer Players.

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    Locks, Renato; Utsunomiya, Hajime; Briggs, Karen K; McNamara, Shannen; Chahla, Jorge; Philippon, Marc J

    2018-02-01

    Arthroscopic hip surgery has been shown to be effective in returning professional athletes back to play at a high level of performance in different sports. Limited information exists regarding professional soccer players and their return to play. To determine the rate and time to return to sport for professional soccer players after hip arthroscopic surgery for the treatment of femoroacetabular impingement (FAI) and to identify possible risk factors associated with a delay in returning to play. Case series; Level of evidence, 4. Professional soccer players who underwent hip arthroscopic surgery for FAI by a single surgeon between 2005 and 2015 were evaluated. Data retrieved from www.mlssoccer.com , www.fifa.com , www.transfermarkt.co.uk , and www.wikipedia.org included information on each player's professional career, participation on the national team, length of professional career before surgery, number of appearances (games) before surgery, time between surgery and first appearance in a professional game, and number of appearances after surgery. Other data were obtained from the patient's medical records. Twenty-four professional soccer players (26 hips) were included. The mean age at surgery was 25.0 ± 4.0 years (range, 19-32 years). A total of 96% of patients were able to return to play at the professional level. The mean time between surgery and the first professional game played was 9.2 months (range, 1.9-24.0 months). On average, players played in 70 games after surgery (range, 0-224). National team players were able to return to play significantly earlier than the rest of the players (median, 5.7 months vs 11.6 months, respectively; P = .018). Severe chondral damage and microfracture did not interfere with return to play. The arthroscopic management of FAI in symptomatic professional soccer players allowed 96% of them to return to play. Players with national team experience were able to return to play earlier than those without it. Severe chondral damage

  16. Return to play after liver and spleen trauma.

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    Juyia, Rushad F; Kerr, Hamish A

    2014-05-01

    Sport-related spleen and liver injuries pose a challenge for the physician. Although rare, these injuries can have serious and even life-threatening outcomes if not accurately diagnosed and managed in a timely fashion. Currently, there are no evidence-based guidelines on duration and intensity of restricted activity and return to play after spleen and liver injury. In addition, there is controversy on follow-up imaging after injury. PubMed was searched using the terms splenic or spleen and trauma and hepatic or liver and trauma from 1980 to 2013. The citations from sentinel papers were also reviewed. Clinical review. Level 3. Ultrasound is ideal in the unstable athlete. Nonoperative management of blunt splenic and hepatic injuries is recommended for hemodynamically stable patients regardless of injury grade, patient age, or presence of associated injuries. Follow-up imaging is not routinely recommended unless clinically indicated. Athletes may engage in light activity for the first 3 months after injury and then gradual return to unrestricted activity as tolerated. High-level athletes may choose splenectomy or serial imaging for faster return to play. Intravenous contrast-enhanced computed tomography is the diagnostic imaging modality of choice in stable athletes with blunt abdominal trauma. C.

  17. Return to play after hamstring injuries in football (soccer): a worldwide Delphi procedure regarding definition, medical criteria and decision-making.

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    van der Horst, Nick; Backx, Fjg; Goedhart, Edwin A; Huisstede, Bionka Ma

    2017-11-01

    There are three major questions about return to play (RTP) after hamstring injuries: How should RTP be defined? Which medical criteria should support the RTP decision? And who should make the RTP decision? The study aimed to provide a clear RTP definition and medical criteria for RTP and to clarify RTP consultation and responsibilities after hamstring injury. The study used the Delphi procedure. The results of a systematic review were used as a starting point for the Delphi procedure. Fifty-eight experts in the field of hamstring injury management selected by 28 FIFA Medical Centres of Excellence worldwide participated. Each Delphi round consisted of a questionnaire, an analysis and an anonymised feedback report. After four Delphi rounds, with more than 83% response for each round, consensus was achieved that RTP should be defined as 'the moment a player has received criteria-based medical clearance and is mentally ready for full availability for match selection and/or full training'. The experts reached consensus on the following criteria to support the RTP decision: medical staff clearance, absence of pain on palpation, absence of pain during strength and flexibility testing, absence of pain during/after functional testing, similar hamstring flexibility, performance on field testing, and psychological readiness. It was also agreed that RTP decisions should be based on shared decision-making, primarily via consultation with the athlete, sports physician, physiotherapist, fitness trainer and team coach. The consensus regarding aspects of RTP should provide clarity and facilitate the assessment of when RTP is appropriate after hamstring injury, so as to avoid or reduce the risk of injury recurrence because of a premature RTP. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  18. ENERGY SYSTEM DEVELOPMENT AND LOAD MANAGEMENT THROUGH THE REHABILITATION AND RETURN TO PLAY PROCESS.

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    Morrison, Scot; Ward, Patrick; duManoir, Gregory R

    2017-08-01

    Return-to-play from injury is a complex process involving many factors including the balancing of tissue healing rates with the development of biomotor abilities. This process requires interprofessional cooperation to ensure success. An often-overlooked aspect of return-to-play is the development and maintenance of sports specific conditioning while monitoring training load to ensure that the athlete's training stimulus over the rehabilitation period is appropriate to facilitate a successful return to play. The purpose of this clinical commentary is to address the role of energy systems training as part of the return-to-play process. Additionally the aim is to provide practitioners with an overview of practical sports conditioning training methods and monitoring strategies to allow them to direct and quantify the return-to-play process. 5.

  19. Arthroscopic Shoulder Surgery in Female Professional Tennis Players: Ability and Timing to Return to Play.

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    Young, Simon W; Dakic, Jodie; Stroia, Kathleen; Nguyen, Michael L; Safran, Marc R

    2017-07-01

    To assess the outcome and time to return to previous level of competitive play after shoulder surgery in professional tennis players. Retrospective case series. Tertiary academic centre. The records of all female tennis players on the Women's Tennis Association (WTA) professional circuit between January 2008 and June 2010 were reviewed to identify players who underwent shoulder surgery on their dominant (serving) shoulder. Primary outcomes were the ability and time to return to professional play and if they were able to return to their previous level of function as determined by singles ranking. Preoperative and postoperative singles rankings were used to determine rate and completeness of return to preoperative function. During the study period, 8 professional women tennis players from the WTA tour underwent shoulder surgery on their dominant arm. Indications included rotator cuff debridement or repair, labral reconstruction for instability or superior labral anterior posterior lesion, and neurolysis of the suprascapular nerve. Seven players (88%) returned to professional play. The mean time to return to play was 7 months after surgery. However, only 25% (2 of 8) players achieved their preinjury singles rank or better by 18 months postoperatively. In total, 4 players returned to their preinjury singles ranking, with their peak singles ranking being attained at a mean of 2.4 years postoperatively. In professional female tennis players, a high return to play rate after arthroscopic shoulder surgery is associated with a prolonged and often incomplete return to previous level of performance. Thus, counseling the patient to this fact is important to manage expectations. Level IV-Case Series.

  20. Does a Syrinx Matter for Return to Play in Contact Sports? A Case Report and Evidence-Based Review of Return-to-Play Criteria After Transient Quadriplegia.

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    Milles, Jeffrey L; Gallizzi, Michael A; Sherman, Seth L; Smith, Patrick A; Choma, Theodore J

    2014-09-01

    Transient quadriplegia is a rare injury that can change the course of an athlete's career if misdiagnosed or managed inappropriately. The clinician should be well versed in the return-to-play criteria for this type of injury. Unfortunately, when an unknown preexisting syrinx is present in the athlete, there is less guidance on their ability to return to play. This case report and review of the current literature illustrates a National Collegiate Athletic Association (NCAA) Division I football player who suffered a transient quadriplegic event during a kickoff return that subsequently was found to have an incidental cervical syrinx on magnetic resonance imaging. The player was able to have a full neurologic recovery, but ultimately he was withheld from football.

  1. Return to Play and Patient Satisfaction After ACL Reconstruction: Study with Minimum 2-Year Follow-up.

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    Nwachukwu, Benedict U; Voleti, Pramod B; Berkanish, Patricia; Chang, Brenda; Cohn, Matthew R; Williams, Riley J; Allen, Answorth A

    2017-05-03

    Return to play and patient satisfaction after anterior cruciate ligament reconstruction (ACLR) have been inconsistently studied. The purposes of this study were to (1) investigate rates and predictors of return to play after ACLR, (2) evaluate patient satisfaction after ACLR, and (3) analyze the relationship between return to play and satisfaction with the result of ACLR. Eligible patients were active athletes included in an institutional ACL registry who had undergone ACLR and had been followed for a minimum of 2 years. A questionnaire was administered to elicit information regarding factors associated with return to play, sports performance, reinjury, and overall patient satisfaction. The Wilcoxon-Mann-Whitney U test was used to compare return to play with patient satisfaction. Multivariable logistic regression was used to identify demographic, sports, and clinical factors associated with return to play. Two hundred and thirty-two patients with a mean age of 26.7 years (standard deviation [SD] = 12.5 years) who had been followed for a mean of 3.7 years were enrolled. Of 231 patients who responded to the return-to-play question, 201 (87.0%) had returned to play, at a mean of 10.1 months; of 175 athletes eligible to return to their prior level of competition, 89.1% had done so. Overall satisfaction was high: 85.4% were very satisfied with the outcome and 98.1% stated that they would have surgery again. Patients were more likely to respond "very satisfied" if they had returned to play (p patient satisfaction are high after ACLR in active athletes. The use of patellar tendon autograft increased the likelihood of returning to play whereas preinjury participation in soccer and lacrosse decreased these odds. Additionally, patients who returned to play were more likely to be very satisfied with the result of the ACLR. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

  2. ACL Return to Sport Guidelines and Criteria.

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    Davies, George J; McCarty, Eric; Provencher, Matthew; Manske, Robert C

    2017-09-01

    Because of the epidemiological incidence of anterior cruciate ligament (ACL) injuries, the high reinjury rates that occur when returning back to sports, the actual number of patients that return to the same premorbid level of competition, the high incidence of osteoarthritis at 5-10-year follow-ups, and the effects on the long-term health of the knee and the quality of life for the patient, individualizing the return to sports after ACL reconstruction (ACL-R) is critical. However, one of the challenging but unsolved dilemmas is what criteria and clinical decision making should be used to return an athlete back to sports following an ACL-R. This article describes an example of a functional testing algorithm (FTA) as one method for clinical decision making based on quantitative and qualitative testing and assessment utilized to make informed decisions to return an athlete to their sports safely and without compromised performance. The methods were a review of the best current evidence to support a FTA. In order to evaluate all the complicated domains of the clinical decision making for individualizing the return to sports after ACL-R, numerous assessments need to be performed including the biopsychosocial concepts, impairment testing, strength and power testing, functional testing, and patient-reported outcomes (PROs). The optimum criteria to use for individualizing the return to sports after ACL-R remain elusive. However, since this decision needs to be made on a regular basis with the safety and performance factors of the patient involved, this FTA provides one method of quantitatively and qualitatively making the decisions. Admittedly, there is no predictive validity of this system, but it does provide practical guidelines to facilitate the clinical decision making process for return to sports. The clinical decision to return an athlete back into competition has significant implications ranging from the safety of the athlete, to performance factors and actual

  3. Current thinking: return to play and transient quadriplegia.

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    Cantu, Robert V; Cantu, Robert C

    2005-02-01

    Athletes that participate in contact and collision sports assume risk of serious injury each time they take the field. For those athletes that have sustained an episode of transient quadriplegia, the decision of whether to return to competition can be a difficult one. Some athletes, realizing how close they may have come to permanent injury, may decide that further participation is not in their best interest. Others may be somewhat undecided, and some may want to return at all costs. As the treating physician, the goal is to identify those athletes who after a single episode of transient quadriplegia are at increased risk for further injury and consequently should discontinue participation in contact sports. Factors that may contribute to that determination include mechanism of injury, prior history of neurologic symptoms or injury, and anatomic features that may predispose to further injury such as disc herniation, fracture, or cervical stenosis.

  4. Does posteromedial chondromalacia reduce rate of return to play after ulnar collateral ligament reconstruction?

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    Osbahr, Daryl C; Dines, Joshua S; Rosenbaum, Andrew J; Nguyen, Joseph T; Altchek, David W

    2012-06-01

    Biomechanical studies suggest ulnohumeral chondral and ligamentous overload (UCLO) explains the development of posteromedial chondromalacia (PMC) in throwing athletes with ulnar collateral ligament (UCL) insufficiency. UCL reconstruction reportedly allows 90% of baseball players to return to prior or a higher level of play; however, players with concomitant posteromedial chondromalacia may experience lower rates of return to play. The purpose of this investigation is to determine: (1) the rates of return to play of baseball players undergoing UCL reconstruction and posteromedial chondromalacia; and (2) the complications occurring after UCL reconstruction in the setting of posteromedial chondromalacia. We retrospectively reviewed 29 of 161 (18%) baseball players who were treated for the combined posteromedial chondromalacia and UCL injury. UCL reconstruction was accomplished with the docking technique, and the PMC was addressed with nothing or débridement if Grade 2 or 3 and with débridement or microfracture if Grade 4. The mean age was 19.6 years (range, 16-23 years). Most players were college athletes (76%) and pitchers (93%). We used a modified four-level scale of Conway et al. to assess return to play with 1 being the highest level (return to preinjury level of competition or performance for at least one season after UCL reconstruction). The minimum followup was 24 months (mean, 37 months; range, 24-52 months). Return to play was Level 1 in 22 patients (76%), Level 2 in four patients (14%), Level 3 in two patients (7%), and Level 4 in one (3%) patient. Our data suggest baseball players with concomitant PMC, may have lower rates of return to the same or a higher level of play compared with historical controls. Level IV, case series. See Guidelines for Authors for a complete description of levels of evidence.

  5. Predicting the intentions of women in domestic violence shelters to return to partners: does forgiveness play a role?

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    Gordon, Kristina Coop; Burton, Shacunda; Porter, Laura

    2004-06-01

    Recent findings indicate that college women's forgiveness of hypothetical dating violence was predictive of their hypothetical decisions to stay in the relationship. This study was designed to evaluate the role of forgiveness in women's intentions to return to their partners from a domestic violence shelter. A sample of 121 women residing in both urban and rural domestic violence shelters filled out a series of questionnaires evaluating demographic information, severity of violence, attributions for violence, psychological constraints (or investment), and forgiveness of the partner. Forgiveness was found to predict intention to return to partner over and above the other variables studied. These findings suggest that the degree to which women are willing to "move on" from the abuse and to let go of their anger toward their partners may play a significant role in their intention to remain in a relationship with their partners.

  6. Return to Play Guidelines Cannot Solve the Football-Related Concussion Problem

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    Johnson, L. Syd M.

    2012-01-01

    Background: High school football players are the single largest cohort of athletes playing tackle football, and account for the majority of sport-related concussions. Return to play guidelines (RTPs) have emerged as the preferred approach for addressing the problem of sport-related concussion in youth athletes. Methods: This article reviews…

  7. Return to Play After Forearm and Hand Injuries in the National Basketball Association.

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    Morse, Kyle W; Hearns, Krystle A; Carlson, Michelle Gerwin

    2017-02-01

    Hand injuries can result in significant time away from competition for professional basketball players. Time to return to play after hand injuries in elite athletes has not been well described. To report the return to play from metacarpal fractures, phalangeal fractures, and thumb ligament tears in National Basketball Association (NBA) players over a 5-year period. Descriptive epidemiology study. The NBA transaction report was analyzed from January 2009 to May 2014. Players were identified if they were added to the inactive list (IL), missed games due to their injury, or underwent surgery as a result of hand injury. Number of games missed due to injury, days spent on the IL, and age at injury were calculated by injury type and location. One hundred thirty-seven injuries were identified: 39 injuries to the hand and 98 injuries to the finger. Three major injury patterns were identified and analyzed: metacarpal fractures (n = 26), phalangeal fractures (n = 33), and thumb ligament tears (n = 9). The type of injury sustained affected return to play ( P basketball players can lead to prolonged periods of time away from competition, especially after surgery. This study provides guidelines on expected return to play in the NBA after these common hand injuries.

  8. Femoroacetabular Impingement in Professional Football Players: Return to Play and Predictors of Career Length After Hip Arthroscopy.

    Science.gov (United States)

    Menge, Travis J; Bhatia, Sanjeev; McNamara, Shannen C; Briggs, Karen K; Philippon, Marc J

    2017-07-01

    Previous studies have shown hip arthroscopy to be a highly effective treatment for symptomatic femoroacetabular impingement (FAI) in a wide range of athletes; however, the rate of return to play and length of career after hip arthroscopy in professional football players are unknown. To determine how many athletes returned to professional football and the number of seasons they played after surgery. Case series; Level of evidence, 4. Fifty-one professional football players (60 hips) underwent hip arthroscopy for FAI between 2000 and 2014 by a single surgeon. Return to play was defined as competing in a preseason or regular season professional football game after surgery. Data were retrospectively obtained for each player from NFL.com , ESPN.com , individual team websites, and/or CFL.ca . We found that 87% (52/60) of the arthroscopic procedures allowed professional football players to return to play in a preseason or regular season game. Athletes who returned played an average of 38 games during 3.2 seasons after arthroscopy, with an average total career length of 7.4 seasons. Ninety-two percent (48/52) of players who returned had a minimum total career length of 3 years. When participants were analyzed by position, linemen were less likely to return after hip arthroscopy compared with other players (odds ratio 5.6; 95% CI, 1.1-35; P = .04). All quarterbacks and tight ends returned to play after surgery. No significant difference in return to play rate was found between athletes who underwent microfracture and those who did not (25% vs 38%, P = .698). Hip arthroscopy for treatment of FAI and associated pathologic abnormalities in professional football players resulted in a high rate of return to play. The study's findings demonstrate that 87% of the arthroscopic procedures allowed professional football players to return to play, linemen were less likely to return compared with other positions, and the presence of microfracture did not significantly affect the return

  9. Educating Providers in Return-to-Play Suggested Guidelines Postconcussion.

    Science.gov (United States)

    Bires, Angela Macci; Leonard, Amanda L; Thurber, Brandon

    As the awareness of concussions increases, it is imperative to be able to evaluate, diagnose, and treat concussed individuals properly to prevent further complications or death. The primary purpose of this study was to compare a provider's current awareness and comfort level as it relates to the return-to-play guidelines for concussions. A secondary aim was to evaluate current protocols that are in use and determine whether they coincide with the suggested guidelines. An educational intervention was implemented to assess the knowledge and confidence of health care providers. The study design was a quantitative, convenient sample, pretest/posttest questionnaire. The questionnaire was administered to participants who were nurse practitioners prior to an educational PowerPoint presentation. At 8 weeks, the posttest was administered. Approximately 19% of individuals were not aware of a graded return-to-play protocols. The findings suggest that the educational intervention increased their confidence levels in making a diagnosis of a concussion, in assessing danger signs, and in understanding when to refer to a specialist. Additional supporting evidence from this study indicates that the educational intervention allowed the participants to achieve a greater comfort level in finding appropriate resources for them and their patients.

  10. Accounting for Heterogeneous Returns in Sequential Schooling Decisions

    NARCIS (Netherlands)

    Zamarro, G.

    2006-01-01

    This paper presents a method for estimating returns to schooling that takes into account that returns may be heterogeneous among agents and that educational decisions are made sequentially.A sequential decision model is interesting because it explicitly considers that the level of education of each

  11. Professional Athletes' Return to Play and Performance After Operative Repair of an Achilles Tendon Rupture.

    Science.gov (United States)

    Trofa, David P; Miller, J Chance; Jang, Eugene S; Woode, Denzel R; Greisberg, Justin K; Vosseller, J Turner

    2017-10-01

    Most Achilles tendon ruptures are sports related. However, few studies have examined and compared the effect of surgical repair for complete ruptures on return to play (RTP), play time, and performance across multiple sports. To examine RTP and performance among professional athletes after Achilles tendon repair and compare pre- versus postoperative functional outcomes of professional athletes from different major leagues in the United States. Cohort study; Level of evidence, 3. National Basketball Association (NBA), National Football League (NFL), Major League Baseball (MLB), and National Hockey League (NHL) athletes who sustained a primary complete Achilles tendon rupture treated surgically between 1989 and 2013 were identified via public injury reports and press releases. Demographic information and performance-related statistics were recorded for 2 seasons before and after surgery and compared with matched controls. Statistical analyses were used to assess differences in recorded metrics. Of 86 athletes screened, 62 met inclusion criteria including 25 NBA, 32 NFL, and 5 MLB players. Nineteen (30.6%) professional athletes with an isolated Achilles tendon rupture treated surgically were unable to return to play. Among athletes who successfully returned to play, game participation averaged 75.4% ( P .05). When individual sports were compared, NBA players were most significantly affected, experiencing significant decreases in games played, play time, and performance. An Achilles tendon rupture is a devastating injury that prevents RTP for 30.6% of professional players. Athletes who do return play in fewer games, have less play time, and perform at a lower level than their preinjury status. However, these functional deficits are seen only at 1 year after surgery compared with matched controls, such that players who return to play can expect to perform at a level commensurate with uninjured controls 2 years postoperatively.

  12. Return to Play After Shoulder Surgery in Throwers.

    Science.gov (United States)

    Thorsness, Robert; Alland, Jeremy A; McCulloch, Colin B; Romeo, Anthony

    2016-10-01

    The throwing athlete's shoulder is a unique, complex entity with challenges in diagnosis and management. The shoulders in these athletes possess unique biomechanics and pathologic conditions. Unfortunately, return to play outcomes are often poor when specifically evaluating overhead athletes, especially with regard to SLAP repair. It is imperative for the surgeon to be cautious when indicating these athletes for surgery, because although they may demonstrate improvements in pain and general function, subtle changes in accuracy or velocity as a result of surgery can significantly affect the success of an overhead throwing athlete at the competitive level. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Hamstring Injuries in the Athlete: Diagnosis, Treatment, and Return to Play

    Science.gov (United States)

    Chu, Samuel K.; Rho, Monica E.

    2016-01-01

    Hamstring injuries are very common in athletes. Acute hamstring strains can occur with high-speed running or with excessive hamstring lengthening. Athletes with proximal hamstring tendinopathy often do not report a specific inciting event; instead they develop the pathology from chronic overuse. A thorough history and examination is important to determine the appropriate diagnosis and rule out other causes of posterior thigh pain. Conservative management of hamstring strains involves a rehabilitation protocol that gradually increases intensity, range of motion and progresses to sport-specific and neuromuscular control exercises. Eccentric strengthening exercises are used for management of proximal hamstring tendinopathy. Studies investigating corticosteroid and platelet-rich plasma injections have mixed results. MRI and ultrasound are effective for identification of hamstring strains and tendinopathy, but have not demonstrated correlation with return to play. The article focuses on diagnosis, treatment and return to play considerations for acute hamstring strains and proximal hamstring tendinopathy in the athlete. PMID:27172083

  14. On-field management and return-to-play in sports-related concussion in children: Are children managed appropriately?

    Science.gov (United States)

    Haran, Harini P; Bressan, Silvia; Oakley, Ed; Davis, Gavin A; Anderson, Vicki; Babl, Franz E

    2016-03-01

    On-field management and return-to-play guidelines aim to ensure the identification and appropriate management of the concussed athlete. Compliance with current guidelines in many settings is unknown. We assessed whether key components of current concussion guidelines are being followed in child athletes. Prospective observational study. Data were collected from children (5-18 years) presenting to a paediatric emergency department with sport-related concussion via researcher-administered surveys in the emergency department and during a follow up phone call. On hospital discharge all patients received a return to sports fact sheet based on the International Concussion in Sports Group. Ninety-three had sustained a concussion (mean age 12.7 (±0.27) years, 83% male). Sports played included Australian Football (47%), soccer (12%), rugby (9%) basketball (8%), other (25%). 82% participated in organised sports. Concussive signs or symptoms included loss of consciousness (41%), disorientation (36%), vomiting (23%), amnesia (30%), headache (60%). For concussive injury in organised sports (n=76), overall 42% were not managed according to recommended guidelines: 19% were not immediately removed from play, 29% were allowed to return to play on the same day and 27% were not assessed by qualified personnel. 93% of parents and 96% of patients were unaware of concussion or return-to-play guidelines from their organisations. Overall, 72% were compliant with provided return-to-play guidelines. Many children with sports related-concussion are not formally assessed on-field and continue to play. On-field concussion management and return to play practices are often suboptimal. Awareness and education of coaches, teachers, parents and children need to be improved. Copyright © 2015 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  15. Return to contact sports following infectious mononucleosis: the role of serial ultrasonography.

    Science.gov (United States)

    O'Connor, Tony E; Skinner, Liam J; Kiely, Patrick; Fenton, John E

    2011-08-01

    Splenic rupture is a rare but potentially fatal complication of infectious mononucleosis. Athletes returning to contact sports following infectious mononucleosis are at potential risk of splenic rupture secondary to abdominal trauma. No clear consensus exists as to when it is safe to allow these athletes to return to contact sports. Suggested periods of abstinence have ranged from 2 weeks to 6 months. We outline our experiences with the use of abdominal ultrasonography at 1 month after the diagnosis of infectious mononucleosis as a means of determining when athletes can safely return to contact sports. Our study group was made up of 19 such patients (mean age: 16.7 yr). We found that 16 of these patients (84%) had normal splenic dimensions on ultrasonography 1 month after diagnosis, and they were therefore allowed to return to contact sports. While the remaining 3 patients had an enlarged spleen at 1 month, their splenic dimensions had all returned to normal when ultrasonographic examination was repeated at 2 months postdiagnosis. We conclude that serial abdominal ultrasonography allows for informed decision making in determining when athletes can safely return to contact sports following infectious mononucleosis.

  16. Return to Play and Performance After Jones Fracture in National Basketball Association Athletes

    Science.gov (United States)

    Begly, John P.; Guss, Michael; Ramme, Austin J.; Karia, Raj; Meislin, Robert J.

    2015-01-01

    Background: Basketball players are at risk for foot injuries, including Jones fractures. It is unknown how this injury affects the future play and performance of athletes. Hypothesis: National Basketball Association (NBA) players who sustain Jones fractures of the base of the fifth metatarsal have high rates of return to play and do not experience a decrease in performance on return to competition when compared with preinjury and with control-matched peers. Study Design: Retrospective cohort study. Level of Evidence: Level 5. Methods: Data on 26 elite basketball players with Jones fractures over 19 NBA seasons (1994-1995 to 2012-2013) were obtained from injury reports, press releases, player profiles, and online public databases. Variables included age, body mass index (BMI), player position, experience, and surgical treatment. Individual season statistics pre- and postinjury were collected. Twenty-six controls were identified by matched player position, age, and performance statistics. Results: The mean age at the time of injury was 24.8 years, mean BMI was 24.7 kg/m2, and the mean experience prior to injury was 4.1 NBA seasons. Return to previous level of competition was achieved by 85% of athletes. There was no change in player efficiency rating (PER) when pre- and postinjury performance was compared. When compared with controls, no decline in PER measured performance was identified. Conclusion: The majority of NBA players sustaining a Jones fracture return to their preinjury level of competition. These elite athletes demonstrate no decrease in performance on their return to play. Clinical Relevance: Jones fractures are well-studied injuries in terms of etiology, diagnosis, and management. However, the effect of these injuries on future performance of athletes is unknown. Using the findings of our study, orthopaedic surgeons may be better prepared to counsel and educate elite athletes who sustain a Jones fracture. PMID:26627111

  17. Return to Play and Performance After Jones Fracture in National Basketball Association Athletes.

    Science.gov (United States)

    Begly, John P; Guss, Michael; Ramme, Austin J; Karia, Raj; Meislin, Robert J

    2016-07-01

    Basketball players are at risk for foot injuries, including Jones fractures. It is unknown how this injury affects the future play and performance of athletes. National Basketball Association (NBA) players who sustain Jones fractures of the base of the fifth metatarsal have high rates of return to play and do not experience a decrease in performance on return to competition when compared with preinjury and with control-matched peers. Retrospective cohort study. Level 5. Data on 26 elite basketball players with Jones fractures over 19 NBA seasons (1994-1995 to 2012-2013) were obtained from injury reports, press releases, player profiles, and online public databases. Variables included age, body mass index (BMI), player position, experience, and surgical treatment. Individual season statistics pre- and postinjury were collected. Twenty-six controls were identified by matched player position, age, and performance statistics. The mean age at the time of injury was 24.8 years, mean BMI was 24.7 kg/m(2), and the mean experience prior to injury was 4.1 NBA seasons. Return to previous level of competition was achieved by 85% of athletes. There was no change in player efficiency rating (PER) when pre- and postinjury performance was compared. When compared with controls, no decline in PER measured performance was identified. The majority of NBA players sustaining a Jones fracture return to their preinjury level of competition. These elite athletes demonstrate no decrease in performance on their return to play. Jones fractures are well-studied injuries in terms of etiology, diagnosis, and management. However, the effect of these injuries on future performance of athletes is unknown. Using the findings of our study, orthopaedic surgeons may be better prepared to counsel and educate elite athletes who sustain a Jones fracture. © 2015 The Author(s).

  18. Sex Differences in Time to Return-to-Play Progression After Sport-Related Concussion.

    Science.gov (United States)

    Stone, Sarah; Lee, Bobby; Garrison, J Craig; Blueitt, Damond; Creed, Kalyssa

    2016-10-03

    Recently, female sports participation has increased, and there is a tendency for women to experience more symptoms and variable presentation after sport-related concussion (SRC). The purpose of this study was to determine whether sex differences exist in time to begin a return-to-play (RTP) progression after an initial SRC. After initial SRC, female athletes (11-20 years old) would take longer to begin an RTP progression compared with age-matched male athletes. Retrospective cohort study. Level 3. A total of 579 participants (365 males [mean age, 15.0 ± 1.7 years], 214 females [mean age, 15.2 ± 1.5 years]), including middle school, high school, and collegiate athletes who participated in various sports and experienced an initial SRC were included and underwent retrospective chart review. The following information was collected: sex, age at injury, sport, history of prior concussion, date of injury, and date of initiation of RTP progression. Participants with a history of more than 1 concussion or injury sustained from non-sport-related activity were excluded. Despite American football having the greatest percentage (49.2%) of sport participation, female athletes took significantly longer to start an RTP progression after an initial SRC (29.1 ± 26.3 days) compared with age-matched male athletes (22.7 ± 18.3 days; P = 0.002). On average, female athletes took approximately 6 days longer to begin an RTP progression compared with age-matched male athletes. This suggests that sex differences exist between athletes, ages 11 to 20 years, with regard to initiation of an RTP progression after SRC. Female athletes may take longer to recover after an SRC, and therefore, may take longer to return to sport. Sex should be considered as part of the clinical decision-making process when determining plan of care for this population. © 2016 The Author(s).

  19. Concussion Symptoms and Return to Play Time in Youth, High School, and College American Football Athletes.

    Science.gov (United States)

    Kerr, Zachary Y; Zuckerman, Scott L; Wasserman, Erin B; Covassin, Tracey; Djoko, Aristarque; Dompier, Thomas P

    2016-07-01

    To our knowledge, little research has examined concussion across the youth/adolescent spectrum and even less has examined concussion-related outcomes (ie, symptoms and return to play). To examine and compare sport-related concussion outcomes (symptoms and return to play) in youth, high school, and collegiate football athletes. Athletic trainers attended each practice and game during the 2012 to 2014 seasons and reported injuries. For this descriptive, epidemiological study, data were collected from youth, high school, and collegiate football teams, and the analysis of the data was conducted between July 2015 and September 2015. The Youth Football Surveillance System included more than 3000 youth football athletes aged 5 to 14 years from 118 teams, providing 310 team seasons (ie, 1 team providing 1 season of data). The National Athletic Treatment, Injury, and Outcomes Network Program included 96 secondary school football programs, providing 184 team seasons. The National Collegiate Athletic Association Injury Surveillance Program included 34 college football programs, providing 71 team seasons. We calculated the mean number of symptoms, prevalence of each symptom, and the proportion of patients with concussions that had long return-to-play time (ie, required participation restriction of at least 30 days). Generalized linear models were used to assess differences among competition levels in the mean number of reported symptoms. Logistic regression models estimated the odds of return to play at less than 24 hours and at least 30 days. Overall, 1429 sports-related concussions were reported among youth, high school, and college-level football athletes with a mean (SD) of 5.48 (3.06) symptoms. Across all levels, 15.3% resulted return to play at least 30 days after the concussion and 3.1% resulted in return to play less than 24 hours after the concussion. Compared with youth, a higher number of concussion symptoms were reported in high school athletes (β = 1.39; 95

  20. Complete avulsion of the adductor longus in a semi-professional football player: Rapid return to play with nonoperative treatment

    Directory of Open Access Journals (Sweden)

    Vince W Lands

    2016-01-01

    Full Text Available The adductor longus has become recognized as one of the more commonly injured muscles in the medial compartment. Acute complete rupture injuries occurring at the proximal aspect of the muscle are less common. Limited data exist regarding management of the injuries in athletes required for return to play and functioning. The current data favors operative management; however, nonoperative treatment may be a viable option. Nonoperative management of avulsion injuries of the proximal adductor longus tendon may prove equal results to surgical repair in return to play and functioning. A semi-professional football player sustained a left groin injury while participating in the play. Due to continued pain, swelling, and suspicion of injury, a magnetic resonance imaging was performed diagnosing a complete tear of proximal adductor longus tendon. Physical examination, strength, and range of motion were recorded until the patient was able to function normally without strength deficit, the range of motion loss, and the return of speed. The player was treated nonoperatively and was eventually allowed to return to play. The time of return to play was 6 weeks. Strength deficit was not appreciated or loss of motion and player was able to return to baseline function. Nonoperative management of complete avulsion injuries of the proximal adductor longus tendon result in faster return to play than operative management even if significant retraction is present.

  1. Return to Play After Hamstring Injuries: A Qualitative Systematic Review of Definitions and Criteria.

    Science.gov (United States)

    van der Horst, Nick; van de Hoef, Sander; Reurink, Gustaaf; Huisstede, Bionka; Backx, Frank

    2016-06-01

    More than half of the recurrent hamstring injuries occur within the first month after return-to-play (RTP). Although there are numerous studies on RTP, comparisons are hampered by the numerous definitions of RTP used. Moreover, there is no consensus on the criteria used to determine when a person can start playing again. These criteria need to be critically evaluated, in an attempt to reduce recurrence rates and optimize RTP. To carry out a systematic review of the literature on (1) definitions of RTP used in hamstring research and (2) criteria for RTP after hamstring injuries. Systematic review. Seven databases (PubMed, EMBASE/MEDLINE, CINAHL, PEDro, Cochrane, SPORTDiscus, Scopus) were searched for articles that provided a definition of, or criteria for, RTP after hamstring injury. There were no limitations on the methodological design or quality of articles. Content analysis was used to record and analyze definitions and criteria for RTP after hamstring injury. Twenty-five papers fulfilled inclusion criteria, of which 13 provided a definition of RTP and 23 described criteria to support the RTP decision. "Reaching the athlete's pre-injury level" and "being able to perform full sport activities" were the primary content categories used to define RTP. "Absence of pain", "similar strength", "similar flexibility", "medical staff clearance", and "functional performance" were core themes to describe criteria to support the RTP decision after hamstring injury. Only half of the included studies provided some definition of RTP after hamstring injury, of which reaching the athlete's pre-injury level and being able to perform full sport activities were the most important. A wide variety of criteria are used to support the RTP decision, none of which have been validated. More research is needed to reach a consensus on the definition of RTP and to provide validated RTP criteria to facilitate hamstring injury management and reduce hamstring injury recurrence. PROSPERO

  2. Athletic pubalgia: Return to play after targeted surgery.

    Science.gov (United States)

    Kajetanek, C; Benoît, O; Granger, B; Menegaux, F; Chereau, N; Pascal-Mousselard, H; Khiami, F

    2018-03-13

    Surgery for athletic pubalgia usually consists in abdominal wall repair combined with routine bilateral adductor tenotomy. We currently confine the surgical procedure to the injured structure(s) (abdominal wall only, adductor tendon only, or both) to limit morbidity and expedite recovery. Outcomes of this à la carte approach are unclear. The objectives of this retrospective study were to determine the return to play (RTP) time, evaluate the potential influence of injury location, and assess the frequency of recurrence or contralateral involvement. À la carte surgery for athletic pubalgia is associated with similar RTP times as the conventional procedure and is not followed by recurrence. Consecutive adults younger than 40 years of age who underwent surgery for athletic pubalgia with injury to the abdominal wall and/or adductor attachment sites between 2009 and 2015 were included. Patients with intra-articular hip disorders, isolated pubic symphysis involvement, or herniation were not eligible. The diagnosis was established clinically then confirmed by at least one imaging technique (ultrasonography plus either a radiograph of the pelvis or magnetic resonance imaging of the pelvis). The criterion for performing surgery was failure of appropriate conservative therapy followed for at least 3 months. Of the 27 included patients, eight had abdominal wall involvement only, seven adductor tendon involvement only, and 12 both. Overall, 25 (92.6%) patients returned to play at their previous level, after a mean of 112±38 days (range, 53-223 days), and experienced no recurrence during the 1-year follow-up. Mean RTP time was significantly shorter in the group with abdominal wall injury only (91.1±21.0 days) compared to the groups with adductor tendon injury only (101.7±42.0 days) or combined injuries (132.5±39.0) (p=0.02). In patients with athletic pubalgia, à la carte surgery confined to the injured structure(s) produces excellent RTP outcomes. RTP time is shortest in

  3. A Functional Return-to-Play Progression After Exertional Heat Stroke in a High School Football Player.

    Science.gov (United States)

    Lopez, Rebecca M; Tanner, Patrick; Irani, Sarah; Mularoni, P Patrick

    2018-03-01

    To present a functional return-to-play (RTP) progression after exertional heat stroke (EHS) in a 17-year-old high school football defensive end (height = 185 cm, mass = 145.5 kg).   The patient had no pertinent medical history but moved to a warm climate several days before the EHS occurred. After completing an off-season conditioning test (14- × 110-yd [12.6- × 99.0-m] sprints) on a warm afternoon (temperature = approximately 34°C [93°F], relative humidity = 53%), the patient collapsed. An athletic trainer (AT) was called to the field, where he found the patient conscious but exhibiting central nervous system dysfunction. Emergency medical services were summoned and immediately transported the patient to the hospital.   Exertional heat stroke, heat exhaustion, exertional sickling, rhabdomyolysis, and cardiac arrhythmia.   The patient was immediately transported to a hospital, where his oral temperature was 39.6°C (103.3°F). He was transferred to a children's hospital and treated for rhabdomyolysis, transaminitis, and renal failure. He was hospitalized for 11 days. After a physician's clearance once the laboratory results normalized, an RTP progression was completed. The protocol began with light activity and progressed over 3 weeks to full football practice. During activity, an AT monitored the patient's gastrointestinal temperature, heart rate, rating of perceived exertion, fluid consumption, and sweat losses.   Documentation of RTP guidelines for young athletes is lacking. We used a protocol intended for the football setting to ensure the athlete was heat tolerant, had adequate physical fitness, and could safely RTP. Despite his EHS, he recovered fully, with no lasting effects, and successfully returned to compete in the final 5 games of the season.   Using a gradual RTP progression and close monitoring, a high school defensive end successfully returned to football practice and games after EHS. This case demonstrates the feasibility of

  4. Variable reporting of functional outcomes and return to play in superior labrum anterior and posterior tear.

    Science.gov (United States)

    Steinhaus, Michael E; Makhni, Eric C; Lieber, Adam C; Kahlenberg, Cynthia A; Gulotta, Lawrence V; Romeo, Anthony A; Verma, Nikhil N

    2016-11-01

    Outcomes assessments after superior labrum anterior and posterior (SLAP) tear/repair are highly varied, making it difficult to draw comparisons across the literature. This study examined the inconsistency in outcomes reporting in the SLAP tear literature. We hypothesize that there is significant variability in outcomes reporting and that although most studies may report return to play, time to return reporting will be highly variable. The PubMed, Medline, Scopus, and Embase databases were systematically reviewed for studies from January 2000 to December 2014 reporting outcomes after SLAP tear/repair. Two reviewers assessed each study, and those meeting inclusion criteria were examined for pertinent data. Outcomes included objective (range of motion, strength, clinical examinations, and imaging) and subjective (patient-reported outcomes, satisfaction, activities of daily living, and return to play) measures. Of the 56 included studies, 43% documented range of motion, 14% reported strength, and 16% noted postoperative imaging. There was significant variation in use of patient-reported outcomes measures, with the 3 most commonly noted measures reported in 20% to 55% of studies. Return to play was noted in 75% of studies, and 23% reported time to return, with greater rates in elite athletes. Eleven studies (20%) did not report follow-up or noted data with <12 months of follow-up. The SLAP literature is characterized by substantial variability in outcomes reporting, with time to return to play noted in few studies. Efforts to standardize outcomes reporting would facilitate comparisons across the literature and improve our understanding of the prognosis of this injury. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  5. A Qualitative Investigation of Return to Sport After Arthroscopic Bankart Repair: Beyond Stability.

    Science.gov (United States)

    Tjong, Vehniah K; Devitt, Brian M; Murnaghan, M Lucas; Ogilvie-Harris, Darrell J; Theodoropoulos, John S

    2015-08-01

    Arthroscopic shoulder stabilization is known to have excellent functional results, but many patients do not return to their preinjury level of sport, with return to play rates reported between 48% and 100% despite good outcome scores. To understand specific subjective psychosocial factors influencing a patient's decision to return to sport after arthroscopic shoulder stabilization. Case series; Level of evidence, 4. Semistructured qualitative interviews were conducted with patients aged 18 to 40 years who had undergone primary arthroscopic shoulder stabilization and had a minimum 2-year follow-up. All patients participated in sport before surgery without any further revision operations or shoulder injuries. Qualitative data analysis was performed in accordance with the Strauss and Corbin theory to derive codes, categories, and themes. Preinjury and current sport participation was defined by type, level of competition, and the Brophy/Marx shoulder activity score. Patient-reported pain and shoulder function were also obtained. A total of 25 patients were interviewed, revealing that fear of reinjury, shifts in priority, mood, social support, and self-motivation were found to greatly influence the decision to return to sport both in patients who had and had not returned to their preinjury level of play. Patients also described fear of sporting incompetence, self-awareness issues, recommendations from physical therapists, and degree of confidence as less common considerations affecting their return to sport. In spite of excellent functional outcomes, extrinsic and intrinsic factors such as competing interests, kinesiophobia, age, and internal stressors and motivators can have a major effect on a patient's decision to return to sport after arthroscopic shoulder stabilization. The qualitative methods used in this study provide a unique patient-derived perspective into postoperative recovery and highlight the necessity to recognize and address subjective and psychosocial

  6. Concussion Incidence and Return-to-Play Time in National Basketball Association Players: Results From 2006 to 2014.

    Science.gov (United States)

    Padaki, Ajay S; Cole, Brian J; Ahmad, Christopher S

    2016-09-01

    Various research efforts have studied concussions in the National Football League, Major League Baseball, and the National Hockey League. However, no study has investigated the incidence and return-to-play trends in the National Basketball Association (NBA), which this study aims to do. Increased media scrutiny and public awareness, in addition to the institution of a league-wide concussion protocol, may have resulted in more conservative return-to-play practices. Descriptive epidemiology study. All concussions to NBA players that were publicly reported in the media from the beginning of the 2006 NBA season to the end of the 2014 season were included. The incidence and return-to-play statistics were generated by synthesizing information from publicly available records. There were 134 publicly reported concussions to NBA players from the beginning of the 2006 season to the conclusion of the 2014 season, resulting in an average of 14.9 concussions per season. The incidence has not changed significantly during this time span. The average games missed after a concussion from 2006 to 2010 was 1.6, significantly less than the 5.0 games missed from 2011 to 2014, following the institution of the NBA concussion protocol (P = .023). Although the incidence of publicly reported concussions in the NBA has not changed appreciably over the past 9 seasons, the time missed after a concussion has. While players often returned in the same game in the 2006 season, the combination of implemented policy, national coverage, medical staff awareness, and player education may have contributed to players now missing an average of 4 to 6 games after a concussion. A multitude of factors has resulted in more conservative return-to-play practices for NBA players after concussions. © 2016 The Author(s).

  7. Can Competitive Athletes Return to High-Level Play After Osteochondral Allograft Transplantation of the Knee?

    Science.gov (United States)

    McCarthy, Mark A; Meyer, Maximilian A; Weber, Alexander E; Levy, David M; Tilton, Annemarie K; Yanke, Adam B; Cole, Brian J

    2017-09-01

    To investigate functional outcomes among competitive athletes undergoing osteochondral allograft (OCA) transplantation of the knee, including rates of return to play (RTP), and factors preventing RTP. A retrospective review identified all competitive athletes (high school, intercollegiate, professional) undergoing isolated femoral condyle OCA from 2004 to 2013. Patient-reported outcome (PRO) questionnaires (Lysholm, International Knee Documentation Committee [IKDC], Knee Injury and Osteoarthritis Outcome Score [KOOS], Western Ontario and McMasters Universities Arthritis Index [WOMAC], 12-Item Short Form Health Survey [SF-12], Tegner, and Marx) and custom RTP surveys were administered. All subsequent reoperations were documented. Thirteen athletes (4 intercollegiate, 9 high-school) were identified with an average follow-up of 5.9 ± 2.5 years. Seven athletes (54%) returned to competitive sport at an average of 7.9 ± 3.5 months, 5 of whom returned to preinjury functional levels. Of the 8 athletes who either did not return to competitive sport or failed to sustain their high level of play, the most common reasons cited were graduation from high school or college (4 patients, 50%) or fear of reinjury (3 patients, 38%). All 4 patients citing graduation as the primary factor preventing return to preinjury level of competitive sport resumed recreational sport without limitations, yielding an adjusted RTP rate of 10 patients (77%) who either returned to competitive play or believed they could return if they had not graduated. At final follow-up, athletes reported significant improvements in all PRO scores except for KOOS-Sport, WOMAC-Stiffness, and SF-12 Mental subscales. There were 3 reoperations at an average of 3.8 ± 3.3 years after the index OCA. There were no instances of graft failure. OCAs provide an adjusted RTP rate of 77% for high-level adolescent athletes. Social factors may be more likely than persistent pain to prevent return to sport. Level IV

  8. Connective tissue injury in calf muscle tears and return to play: MRI correlation.

    Science.gov (United States)

    Prakash, Ashutosh; Entwisle, Tom; Schneider, Michal; Brukner, Peter; Connell, David

    2017-10-26

    The aim of our study was to assess a group of patients with calf muscle tears and evaluate the integrity of the connective tissue boundaries and interfaces. Further, we propose a novel MRI grading system based on integrity of the connective tissue and assess any correlation between the grading score and time to return to play. We have also reviewed the anatomy of the calf muscles. We retrospectively evaluated 100 consecutive patients with clinical suspicion and MRI confirmation of calf muscle injury. We evaluated each calf muscle tear with MRI for the particular muscle injured, location of injury within the muscle and integrity of the connective tissue structure at the interface. The muscle tears were graded 0-3 depending on the degree of muscle and connective tissue injury. The time to return to play for each patient and each injury was found from the injury records and respective sports doctors. In 100 patients, 114 injuries were detected. Connective tissue involvement was observed in 63 out of 100 patients and failure (grade 3 injury) in 18. Mean time to return to play with grade 0 injuries was 8 days, grade 1 tears was 17 days, grade 2 tears was 25 days and grade 3 tears was 48 days (pmuscle tears. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  9. Return to Play and Decreased Performance After Anterior Cruciate Ligament Reconstruction in National Football League Defensive Players.

    Science.gov (United States)

    Read, Connor R; Aune, Kyle T; Cain, E Lyle; Fleisig, Glenn S

    2017-07-01

    Anterior cruciate ligament (ACL) injuries occur commonly in football. Recent work has reported ACL reconstruction (ACLR) as one of several orthopaedic procedures with unfavorable outcomes for professional athletes. The performance impact to defensive players after surgery has not been quantified. To quantify the effect of ACLR on the performance of defensive players by comparing them to a cohort of matched controls as well as to measure the effect of ACLR on athletes' career length in the National Football League (NFL). Case-control and cohort study; Level of evidence, 3. Thirty-eight NFL defensive players with a history of ACLR from 2006 to 2012 were identified. For each injured player, a matched control player was identified. Demographic and performance statistics were collected from the online NFL player database. Players who returned after ACLR (n = 23) were compared with players who did not return (n = 15) using t tests and chi-squared analyses. Similarly, players who returned after ACLR (n = 23) were compared with their matched controls with t tests and chi-squared analyses. Two-way repeated-measures analysis of variance was utilized to test for significant differences between performance before and after the season of the injury for the players in the ACLR group who returned (n = 23) and for their matched controls. Kaplan-Meier analysis was performed to test for differences in the rate of retirement between the groups. For all analyses, P values <.05 were considered significant. Approximately 74% (28/38) of athletes who underwent ACLR returned to play at least 1 NFL game, and 61% (23/38) successfully returned to play at least half a season (ie, 8 games). Athletes in the ACLR group who returned retired from the NFL significantly sooner and more often after surgery than their matched controls. In the seasons leading up to their injury, athletes who successfully returned to play started a greater percentage of their games (81%) and made more solo tackles per

  10. Return to Play After Shoulder Instability Surgery in National Collegiate Athletic Association Division I Intercollegiate Football Athletes.

    Science.gov (United States)

    Robins, R Judd; Daruwalla, Jimmy H; Gamradt, Seth C; McCarty, Eric C; Dragoo, Jason L; Hancock, Robert E; Guy, Jeffrey A; Cotsonis, George A; Xerogeanes, John W; Tuman, Jeffrey M; Tibone, James E; Javernick, Matthew A; Yochem, Eric M; Boden, Stephanie A; Pilato, Alexis; Miley, Jennifer H; Greis, Patrick E

    2017-08-01

    Recent attention has focused on the optimal surgical treatment for recurrent shoulder instability in young athletes. Collision athletes are at a higher risk for recurrent instability after surgery. To evaluate variables affecting return-to-play (RTP) rates in Division I intercollegiate football athletes after shoulder instability surgery. Case series; Level of evidence, 4. Invitations to participate were made to select sports medicine programs that care for athletes in Division I football conferences (Pac-12 Conference, Southeastern Conference [SEC], Atlantic Coast Conference [ACC]). After gaining institutional review board approval, 7 programs qualified and participated. Data on direction of instability, type of surgery, time to resume participation, and quality and level of play before and after surgery were collected. There were 168 of 177 procedures that were arthroscopic surgery, with a mean 3.3-year follow-up. Overall, 85.4% of players who underwent arthroscopic surgery without concomitant procedures returned to play. Moreover, 15.6% of athletes who returned to play sustained subsequent shoulder injuries, and 10.3% sustained recurrent instability, resulting in reduction/revision surgery. No differences were noted in RTP rates in athletes who underwent anterior labral repair (82.4%), posterior labral repair (92.9%), combined anterior-posterior repair (84.8%; P = .2945), or open repair (88.9%; P = .9362). Also, 93.3% of starters, 95.4% of utilized players, and 75.7% of rarely used players returned to play. The percentage of games played before the injury was 49.9% and rose to 71.5% after surgery ( P surgery. Scholarship status significantly correlated with RTP after surgery ( P = .0003). The majority of surgical interventions were isolated arthroscopic stabilization procedures, with no statistically significant difference in RTP rates when concomitant arthroscopic procedures or open stabilization procedures were performed. Athletes who returned to play often

  11. Return to Play and Future ACL Injury Risk Following ACL Reconstruction In Soccer Athletes From the MOON Group

    Science.gov (United States)

    Brophy, Robert H.; Schmitz, Leah; Wright, Rick W.; Dunn, Warren R.; Parker, Richard D.; Andrish, Jack T.; McCarty, Eric C.; Spindler, Kurt P.

    2013-01-01

    Background There is limited information on outcomes and return to play (RTP) after ACL reconstruction (ACLR) in soccer athletes. Hypothesis The purpose of this study was to (i) test the hypotheses that player sex, side of injury and graft choice do not influence RTP, and (ii) define the risk for future ACL injury in soccer players after ACLR. Study design Retrospective cohort study, Level II. Methods Soccer players in a prospective cohort were contacted to determine RTP following ACLR. Information regarding if and when they returned to play, their current playing status, the primary reason they stopped playing soccer (if relevant) and incidence of subsequent ACL surgery was recorded. Results Initially, 72% of 100 soccer athletes (55 male, 45 female) with a mean age of 24.2 years at the time of ACL reconstruction returned to soccer. At average follow up of 7.0 years, 36% were still playing, a significant decrease compared to initial RTP (psoccer athletes had undergone further ACL surgery, including 9 on the contralateral knee and 3 on the ipsilateral knee. In a univariate analysis, females were more likely to have future ACL surgery (20% v. 5.5%, p=0.03). Soccer athletes who underwent ACLR on their non-dominant limb had a higher future rate of contra-lateral ACLR (16%) than soccer athletes who underwent ACLR on their dominant limb (3.5%) (p=0.03). Conclusion Younger and male soccer players are more likely to return to play after ACL reconstruction. Return to soccer following ACLR declines over time. PMID:23002201

  12. Optimal decision making and matching are tied through diminishing returns.

    Science.gov (United States)

    Kubanek, Jan

    2017-08-08

    How individuals make decisions has been a matter of long-standing debate among economists and researchers in the life sciences. In economics, subjects are viewed as optimal decision makers who maximize their overall reward income. This framework has been widely influential, but requires a complete knowledge of the reward contingencies associated with a given choice situation. Psychologists and ecologists have observed that individuals tend to use a simpler "matching" strategy, distributing their behavior in proportion to relative rewards associated with their options. This article demonstrates that the two dominant frameworks of choice behavior are linked through the law of diminishing returns. The relatively simple matching can in fact provide maximal reward when the rewards associated with decision makers' options saturate with the invested effort. Such saturating relationships between reward and effort are hallmarks of the law of diminishing returns. Given the prevalence of diminishing returns in nature and social settings, this finding can explain why humans and animals so commonly behave according to the matching law. The article underscores the importance of the law of diminishing returns in choice behavior.

  13. 'Play Safe' Syndrome among University Adolescents: Implications for ...

    African Journals Online (AJOL)

    This paper investigated the prevalence of sexual activities among university undergraduates who have made regular sexual intercourse part of their lives. This they do with the belief that it is a normal part of their developmental stage as youths and that they only need to learn to 'play safe' (avoiding STDs). Respondents ...

  14. Return to Play After Hamstring Injuries: A Qualitative Systematic Review of Definitions and Criteria

    NARCIS (Netherlands)

    N. van der Horst (Nick); S. van de Hoef (Sander); G. Reurink (Gustaaf); B.M.A. Huisstede (Bionka); F.J.G. Backx (Frank)

    2016-01-01

    textabstractBackground: More than half of the recurrent hamstring injuries occur within the first month after return-to-play (RTP). Although there are numerous studies on RTP, comparisons are hampered by the numerous definitions of RTP used. Moreover, there is no consensus on the criteria used to

  15. Social support from the athletic trainer and symptoms of depression and anxiety at return to play.

    Science.gov (United States)

    Yang, Jingzhen; Schaefer, Julie T; Zhang, Ni; Covassin, Tracey; Ding, Kele; Heiden, Erin

    2014-01-01

    Few empirical studies have examined social support from athletic trainers (ATs) and its buffering effect during injury recovery. To examine the effect of social support received from ATs during injury recovery on reported symptoms of depression and anxiety at return to play among a cohort of collegiate athletes. Cohort study. Two Big 10 Conference universities. A total of 594 injuries sustained by 387 collegiate athletes (397 injuries by 256 males, 197 injuries by 131 females) on 9 sports teams. Data were collected during the 2007-2011 seasons. Social support was measured using the 6-item Social Support Questionnaire. Symptoms of depression were assessed using the Center for Epidemiological Studies Depression Scale. Anxiety was measured by the State-Trait Anxiety Inventory. We used generalized estimation equation regression models to examine the effect of the social support from ATs on the odds of symptoms of depression and anxiety at return to play. In 84.3% (n = 501) of injury events, injured athletes received social support from ATs during their recovery. Of these, 264 (53.1%) athletes reported being very satisfied with this social support. Whether or not athletes received social support from ATs during recovery did not affect the symptoms of depression or anxiety experienced at return to play. However, compared with athletes who were dissatisfied with the social support received from ATs, athletes who were very satisfied or satisfied with this social support were 87% (95% confidence interval = 0.06, 0.30) and 70% (95% confidence interval = 0.13, 0.70) less likely to report symptoms of depression at return to play, respectively. Similar results were observed for anxiety. Our findings support the buffering effect of social support from ATs and have important implications for successful recovery in both the physical and psychological aspects for injured athletes.

  16. Return to Play After Hamstring Injuries : A Qualitative Systematic Review of Definitions and Criteria

    NARCIS (Netherlands)

    van der Horst, Nick; van de Hoef, Sander; Reurink, Gustaaf; Huisstede, Bionka; Backx, Frank

    BACKGROUND: More than half of the recurrent hamstring injuries occur within the first month after return-to-play (RTP). Although there are numerous studies on RTP, comparisons are hampered by the numerous definitions of RTP used. Moreover, there is no consensus on the criteria used to determine when

  17. A conceptual framework for a sports knee injury performance profile (SKIPP) and return to activity criteria (RTAC).

    Science.gov (United States)

    Logerstedt, David; Arundale, Amelia; Lynch, Andrew; Snyder-Mackler, Lynn

    2015-01-01

    Injuries to the knee, including intra-articular fractures, ligamentous ruptures, and meniscal and articular cartilage lesions, are commonplace within sports. Despite advancements in surgical techniques and enhanced rehabilitation, athletes returning to cutting, pivoting, and jumping sports after a knee injury are at greater risk of sustaining a second injury. The clinical utility of objective criteria presents a decision-making challenge to ensure athletes are fully rehabilitated and safe to return to sport. A system centered on specific indicators that can be used to develop a comprehensive profile to monitor rehabilitation progression and to establish return to activity criteria is recommended to clear athletes to begin a progressive and systematic approach to activities and sports. Integration of a sports knee injury performance profile with return to activity criteria can guide clinicians in facilitating an athlete's safe return to sport, prevention of subsequent injury, and life-long knee joint health.

  18. A conceptual framework for a sports knee injury performance profile (SKIPP and return to activity criteria (RTAC

    Directory of Open Access Journals (Sweden)

    David Logerstedt

    2015-10-01

    Full Text Available ABSTRACTInjuries to the knee, including intra-articular fractures, ligamentous ruptures, and meniscal and articular cartilage lesions, are commonplace within sports. Despite advancements in surgical techniques and enhanced rehabilitation, athletes returning to cutting, pivoting, and jumping sports after a knee injury are at greater risk of sustaining a second injury. The clinical utility of objective criteria presents a decision-making challenge to ensure athletes are fully rehabilitated and safe to return to sport. A system centered on specific indicators that can be used to develop a comprehensive profile to monitor rehabilitation progression and to establish return to activity criteria is recommended to clear athletes to begin a progressive and systematic approach to activities and sports. Integration of a sports knee injury performance profile with return to activity criteria can guide clinicians in facilitating an athlete's safe return to sport, prevention of subsequent injury, and life-long knee joint health.

  19. Determinants of Return to Play After the Nonoperative Management of Hamstring Injuries in Athletes: A Systematic Review.

    Science.gov (United States)

    Fournier-Farley, Camille; Lamontagne, Martin; Gendron, Patrick; Gagnon, Dany H

    2016-08-01

    It is important for clinicians to rely on suitable prognosis factors after hamstring injuries because of the high incidence of these injuries and time away from athletic activities. To summarize the current literature on factors that influence return to play after a hamstring injury in athletes. Systematic review. A computer-assisted literature search of CINAHL, MEDLINE, Embase, and EBM Reviews databases (and a manual search of the reference lists of all selected articles) was conducted using keywords related to hamstring injuries and return to play. The literature review criteria included (1) patients with an acute hamstring or posterior thigh injury; (2) a randomized controlled trial, cohort study, case-control study, case series, or prospective or retrospective design; (3) information on rehabilitation, physical therapy, clinical assessment, imaging techniques, and return to play; and (4) studies written in English or French. The search strategy identified 914 potential articles, of which 24 met the inclusion criteria. In terms of the clinical assessment, the following factors were associated with a longer recovery time: stretching-type injuries, recreational-level sports, structural versus functional injuries, greater range of motion deficit with the hip flexed at 90°, time to first consultation >1 week, increased pain on the visual analog scale, and >1 day to be able to walk pain free after the injury. As for magnetic resonance imaging studies, the following factors correlated with a longer recovery time: positive findings; higher grade of injury; muscle involvement >75%; complete transection; retraction; central tendon disruption of the biceps femoris; proximal tendon involvement; shorter distance to the ischial tuberosity; length of the hamstring injury; and depth, volume, and large cross-sectional area. With respect to ultrasound studies, the following factors were associated with a poor prognosis: large cross-sectional area, injury outside the

  20. Magnetic Resonance Imaging in Acute Hamstring Injury: Can We Provide a Return to Play Prognosis?

    NARCIS (Netherlands)

    Reurink, Gustaaf; Brilman, Elisabeth G.; de Vos, Robert-Jan; Maas, Mario; Moen, Maarten H.; Weir, Adam; Goudswaard, Gert Jan; Tol, Johannes L.

    2015-01-01

    Background Sports physicians are increasingly requested to perform magnetic resonance imaging (MRI) of acute hamstring muscle injuries and to provide a prognosis of the time to return to play (RTP) on the basis of their findings. Objectives To systematically review the literature on the prognostic

  1. Being safe: making the decision to have a planned home birth in the United States.

    Science.gov (United States)

    Lothian, Judith A

    2013-01-01

    Although there is evidence that supports the safety of planned home birth for healthy women, less than 1 percent of women in the United States choose to have their baby at home. An ethnographic study of the experience of planned home birth provided rich descriptions of women's experiences planning, preparing for, and having a home birth.This article describes findings related to how women make the decision to have a planned home birth. For these women, being safe emerged as central in making the decision. For them, being safe included four factors: avoiding technological birth interventions, knowing the midwife and the midwife knowing them, feeling comfortable and protected at home, and knowing that backup hospital medical care was accessible if needed.

  2. StaySafe: A self-administered android tablet application for helping individuals on probation make better decisions pertaining to health risk behaviors

    Directory of Open Access Journals (Sweden)

    Wayne E.K. Lehman

    2018-06-01

    Full Text Available This paper describes the development and protocol for feasibility and efficacy testing of a risk reduction intervention designed to improve behavioral health outcomes among drug offenders on probation under community supervision or in residential substance abuse treatment centers. StaySafe is a self-administered tablet-based intervention for teaching better decision-making skills regarding health risk behaviors, especially those involving HIV risks. We are using pre/post, experimental/control group randomized clinical trial (RCT in both community and residential probation settings with goals to 1 assess the feasibility and acceptance of StaySafe by examining participation rates and satisfaction measures, and 2 examine the impact of StaySafe on decision-making skills, confidence and motivation to avoid sex and drug risks, willingness to discuss health risks and concerns with helpful others, and engagement in health risk behaviors.StaySafe consists of 12 brief sessions and utilizes an evidence-based decision-making schema, called WORKIT, which guides participants through steps for identifying the problem and options, evaluating the options and making a decision about which option to carry out. Multiple sessions of StaySafe provide a practice effect so that the WORKIT steps become easily accessible to participants when making decisions. Three of the sessions provide participants a choice of activities designed to provide additional information about HIV and reinforce lessons learned during the WORKIT sessions. Preliminary data demonstrate feasibility and high levels of satisfaction with StaySafe. Keywords: Clinical trial, HIV, Probation, Tablet-based intervention, Decision-making

  3. Return to play criteria after hamstring muscle injury in professional football: a Delphi consensus study.

    Science.gov (United States)

    Zambaldi, Mattia; Beasley, Ian; Rushton, Alison

    2017-08-01

    Hamstring muscle injury (HMI) is the most common injury in professional football and has a high re-injury rate. Despite this, there are no validated criteria to support return to play (RTP) decisions. To use the Delphi method to reach expert consensus on RTP criteria after HMI in professional football. All professional football clubs in England (n=92) were invited to participate in a 3-round Delphi study. Round 1 requested a list of criteria used for RTP decisions after HMI. Responses were independently collated by 2 researchers under univocal definitions of RTP criteria. In round 2 participants rated their agreement for each RTP criterion on a 1-5 Likert Scale. In round 3 participants re-rated the criteria that had reached consensus in round 2. Descriptive statistics and Kendall's coefficient of concordance enabled interpretation of consensus. Participation rate was limited at 21.7% (n=20), while retention rate was high throughout the 3 rounds (90.0%, 85.0%, 90.0%). Round 1 identified 108 entries with varying definitions that were collated into a list of 14 RTP criteria. Rounds 2 and 3 identified 13 and 12 criteria reaching consensus, respectively. Five domains of RTP assessment were identified: functional performance, strength, flexibility, pain and player's confidence. The highest-rated criteria were in the functional performance domain, with particular importance given to sprint ability. This study defined a list of consensually agreed RTP criteria for HMI in professional football. Further work is now required to determine the validity of the identified criteria. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  4. Return to play and performance after anterior cruciate ligament reconstruction in the National Basketball Association: surgeon case series and literature review.

    Science.gov (United States)

    Nwachukwu, Benedict U; Anthony, Shawn G; Lin, Kenneth M; Wang, Tim; Altchek, David W; Allen, Answorth A

    2017-09-01

    To investigate return to play (RTP) and functional performance after anterior cruciate ligament reconstruction (ACLR) in National Basketball Association (NBA) players and to perform a systematic review of the literature to understand RTP after ACLR in professional basketball. NBA players undergoing ACLR between 2008 and 2014 by two surgeons were identified. RTP and performance were assessed based on a review of publically available statistics. A systematic review of the literature was performed using the MEDLINE database. Inclusion criteria were: English language, ACL surgery outcome, professional basketball and RTP outcome. We reviewed studies for RTP rates and RTP performance. Our study included 12 professional basketball players with NBA level experience. Eleven of the 12 players returned to their prior level of play. Eight of the 9 (88.9%) players actively playing in the NBA returned to play in the NBA at a mean 9.8 months. Among players returning to NBA play, during RTP season 1, mean per game statistics decreased for the following: minutes, points, rebounds, assists, steals, blocks, turnovers and personal fouls - none of these changes reached statistical significance. Player efficiency ratings significantly declined from pre-injury (12.5) to the first RTP season (7.6) (p = 0.05). By RTP season 2, player performance metrics approximated pre-injury levels and were not significantly different. Six studies met inclusion criteria; reported RTP rates ranged from 78-86%. Identified studies similarly found a decline in functional performance after RTP. There is a high rate (89%) of return to NBA play for NBA players undergoing ACLR. After RTP, however, there is a quantitative decline in initial season 1 RTP statistics with a significant decrease in player efficiency rating. By RTP season 2, performance metrics demonstrated an improvement compared to RTP season 1 but did not reach pre-injury functional performance, though performance metrics are not significantly

  5. Return to Golf After Lumbar Fusion.

    Science.gov (United States)

    Shifflett, Grant D; Hellman, Michael D; Louie, Philip K; Mikhail, Christopher; Park, Kevin U; Phillips, Frank M

    Spinal fusion surgery is being increasingly performed, yet few studies have focused on return to recreational sports after lumbar fusion and none have specifically analyzed return to golf. Most golfers successfully return to sport after lumbar fusion surgery. Case series. Level 4. All patients who underwent 1- or 2-level primary lumbar fusion surgery for degenerative pathologies performed by a single surgeon between January 2008 and October 2012 and had at least 1-year follow-up were included. Patients completed a specifically designed golf survey. Surveys were mailed, given during follow-up clinic, or answered during telephone contact. A total of 353 patients met the inclusion and exclusion criteria, with 200 responses (57%) to the questionnaire producing 34 golfers. The average age of golfers was 57 years (range, 32-79 years). In 79% of golfers, preoperative back and/or leg pain significantly affected their ability to play golf. Within 1 year from surgery, 65% of patients returned to practice and 52% returned to course play. Only 29% of patients stated that continued back/leg pain limited their play. Twenty-five patients (77%) were able to play the same amount of golf or more than before fusion surgery. Of those providing handicaps, 12 (80%) reported the same or an improved handicap. More than 50% of golfers return to on-course play within 1 year of lumbar fusion surgery. The majority of golfers can return to preoperative levels in terms of performance (handicap) and frequency of play. This investigation offers insight into when golfers return to sport after lumbar fusion surgery and provides surgeons with information to set realistic expectations postoperatively.

  6. Intramuscular tendon involvement on MRI has limited value for predicting time to return to play following acute hamstring injury

    NARCIS (Netherlands)

    van der Made, Anne D.; Almusa, Emad; Whiteley, Rod; Hamilton, Bruce; Eirale, Cristiano; van Hellemondt, Frank; Tol, Johannes L.

    2018-01-01

    Background Hamstring injury with intramuscular tendon involvement is regarded as a serious injury with a delay in return to play (RTP) of more than 50 days and reinjury rates up to 63%. However, this reputation is based on retrospective case series with high risk of bias. Objective Determine whether

  7. Court Decisions Specific to Public School Responses to Student Concussions

    Science.gov (United States)

    Zirkel, Perry A.

    2016-01-01

    This article provides an up-to-date and comprehensive canvassing of the judicial case law concerning the responses to students with concussions in the public school context. The two categories of court decisions are (a) those concerning continued participation in interscholastic athletics, referred to under the rubric of "return to play"…

  8. Return Migration and Working Choices

    OpenAIRE

    TANI, Massimiliano; MAHUTEAU, Stéphane

    2008-01-01

    Collective Action to Support the Reintegration of Return Migrants in their Country of Origin (MIREM) This paper uses the recent survey carried out in the framework of the MIREM project on returnees to Algeria, Morocco and Tunisia and studies the duration of emigration and the labour force status upon returning. The results suggest that age and the year of emigration play a central role in the migration decision, but they do not support the hypothesis that the duration of migration is deter...

  9. INFLUENCE OF THE INVESTMENT DECISIONS ON THE RETURN OF THE COMPANY

    Directory of Open Access Journals (Sweden)

    Pop Mugurel Gabriel Sorin

    2012-12-01

    Full Text Available We propose in this study, to make an analysis of the influence of the investment decision on the return of the company. The goal of our research is the quantification of the influence of investment activity on profitability. Fulfilling such a goal has forced us to research the existing literature in this field, both in our country and abroad, ascertaining the existence of a unitary meaning of the criteria for investment projects’ evaluation. Of course, the realization of such research was possible only after close consideration of the opinions expressed in the relevant literature on this area. Our research aims to be a theoretical-applied one. It is based on comparisons we make between the two criteria for assessing investment projects namely: that of net present value (VAN and internal rate of return (RIR. By creating a suite of phase calculations, based on information from economic and financial documentation of corporate investments, we separated the influence of the policy investment decisions on profitability. We are convinced that the most accurate determination of the influence of policy investment decisions on profitability helps the financial management, facilitating the process of adopting the most appropriate policy decisions that ultimately leads to the objectives formulated by the financial policy. The result of our research is the quantification of the influence of investment policy decisions of the firm on profitability.

  10. Anterior cruciate ligament reconstruction, rehabilitation, and return to play: 2015 update

    Directory of Open Access Journals (Sweden)

    Nyl

    2016-02-01

    Full Text Available John Nyland,1,2 Alma Mattocks,1 Shane Kibbe,2 Alaa Kalloub,2,3 Joe W Greene,4 David N M Caborn2,3 1Athletic Training Program, Kosair Charities College of Health and Natural Sciences, Spalding University, Louisville, KY, USA; 2Department of Orthopedic Surgery, University of Louisville, Louisville, KY, USA; 3Shea Orthopedic Group, Louisville, KY, USA; 4Norton Orthopedic and Sports, Louisville, KY, USA Abstract: Anatomical discoveries and a growing appreciation of the knee as a complex organ are driving innovations in patient care decision-making following anterior cruciate ligament (ACL injury. Surgeons are increasing their efforts to restore combined mechanical-neurosensory ACL function and placing more consideration on when to reconstruct versus repair native anatomical structures. Surgical options now include primary repair with or without reinforcing the injured ACL with suture-based internal bracing, and growing evidence supports biological augmentation using platelet-rich plasma and mesenchymal stem cells to enhance tissue healing. Physical therapists and athletic trainers are increasing their efforts to facilitate greater athlete cognitive engagement during therapeutic exercise performance to better restore nonimpaired neuromuscular control activation amplitude and timing. Knee brace design and use needs to evolve to better match these innovations and their influence on the rehabilitation plan timetable. There is a growing appreciation for the multifaceted characteristics of the rehabilitation process and how they influence neuromuscular, educational, and psychobehavioral treatment goal achievement. Multiple sources may influence the athlete during the return to sports process and clinical outcome measures need to be refined to better evaluate these influences. This update summarizes contemporary ACL surgical, medical, and rehabilitation interventions and future trends. Keywords: arthroscopy, knee, function, outcomes, decision-making 

  11. Planning for outdoor play: Government and family decision-making.

    Science.gov (United States)

    Sterman, Julia J; Naughton, Geraldine A; Bundy, Anita C; Froude, Elspeth; Villeneuve, Michelle A

    2018-03-08

    Despite indisputable developmental benefits of outdoor play, children with disabilities can experience play inequity. Play decisions are multifactorial; influenced by children's skills and their familial and community environments. Government agencies have responsibilities for equity and inclusion of people with disabilities; including in play. This multiple-perspective case study aimed to understand outdoor play decision-making for children with disabilities from the perspectives and interactions of: local government and families of primary school-aged children with disabilities. Five mothers, four local government employees, and two not-for-profit organization representatives participated in semi-structured interviews. Inductive and iterative analyzes involved first understanding perspectives of individuals, then stakeholders (local government and families), and finally similarities and differences through cross-case analysis. Local government focused more on physical access, than social inclusion. Local government met only minimal requirements and had little engagement with families. This resulted in poor understanding and action around family needs and preferences when designing public outdoor play spaces. To increase meaningful choice and participation in outdoor play, government understanding of family values and agency around engagement with local government needs to improve. Supporting familial collective capabilities requires understanding interactions between individuals, play, disability, and outdoor play environments.

  12. Decision-making on Population Return At the End of an Eruption

    Science.gov (United States)

    Woo, G.

    2015-12-01

    If an eruption sequence is protracted and episodic, continuing for many months, or even a number of years, it can be very difficult for authorities to decide when an evacuated population might be allowed to return. A precautionary approach may be appropriate as a general principle, especially if the societal implications are deemed to be manageable. However, where the livelihoods of the evacuees are critically at stake, such as with farmers, and the economic costs of continuing evacuation are high, a risk-informed approach to supporting decision-making might be warranted. Such an approach has been developed, based on concepts drawn from cost-benefit analysis. On any given day during an extended volcanic crisis, a decision-maker may wish to consider whether to allow then for the return of evacuees. A delay of a decision by one day will increase the evacuation cost by one day's worth of accommodation and economic disruption. On the other hand, there is a small chance that there might be an onset to another eruption on this given day, so there would be a safety benefit in the delay. The task of quantifying this safety benefit requires a coherent synthesis of all the volcano monitoring data time series, together with an assessment of the medium and long-term historical and geological data, so that the probability of each of the alternative eruptive scenarios can be scientifically estimated. Bayesian belief networks provide a convenient framework for this synthesis. For each scenario, the potential casualty implications for returned evacuees need to be assessed. The application of this end of eruption methodology is illustrated and compared with the equivalent decision-making procedure at the start of an eruption.

  13. Building uncertainty into cost-effectiveness rankings: portfolio risk-return tradeoffs and implications for decision rules.

    Science.gov (United States)

    O'Brien, B J; Sculpher, M J

    2000-05-01

    Current principles of cost-effectiveness analysis emphasize the rank ordering of programs by expected economic return (eg, quality-adjusted life-years gained per dollar expended). This criterion ignores the variance associated with the cost-effectiveness of a program, yet variance is a common measure of risk when financial investment options are appraised. Variation in health care program return is likely to be a criterion of program selection for health care managers with fixed budgets and outcome performance targets. Characterizing health care resource allocation as a risky investment problem, we show how concepts of portfolio analysis from financial economics can be adopted as a conceptual framework for presenting cost-effectiveness data from multiple programs as mean-variance data. Two specific propositions emerge: (1) the current convention of ranking programs by expected return is a special case of the portfolio selection problem in which the decision maker is assumed to be indifferent to risk, and (2) for risk-averse decision makers, the degree of joint risk or covariation in cost-effectiveness between programs will create incentives to diversify an investment portfolio. The conventional normative assumption of risk neutrality for social-level public investment decisions does not apply to a large number of health care resource allocation decisions in which health care managers seek to maximize returns subject to budget constraints and performance targets. Portfolio theory offers a useful framework for studying mean-variance tradeoffs in cost-effectiveness and offers some positive predictions (and explanations) of actual decision making in the health care sector.

  14. Multivariate Risk-Return Decision Making Within Dynamic Estimation

    Directory of Open Access Journals (Sweden)

    Josip Arnerić

    2008-10-01

    Full Text Available Risk management in this paper is focused on multivariate risk-return decision making assuming time-varying estimation. Empirical research in risk management showed that the static "mean-variance" methodology in portfolio optimization is very restrictive with unrealistic assumptions. The objective of this paper is estimation of time-varying portfolio stocks weights by constraints on risk measure. Hence, risk measure dynamic estimation is used in risk controlling. By risk control manager makes free supplementary capital for new investments.Univariate modeling approach is not appropriate, even when portfolio returns are treated as one variable. Portfolio weights are time-varying, and therefore it is necessary to reestimate whole model over time. Using assumption of bivariate Student´s t-distribution, in multivariate GARCH(p,q models, it becomes possible to forecast time-varying portfolio risk much more precisely. The complete procedure of analysis is established from Zagreb Stock Exchange using daily observations of Pliva and Podravka stocks.

  15. The role of remote voting in encouraging return

    Directory of Open Access Journals (Sweden)

    Djordje Stefanovic

    2015-09-01

    Full Text Available Once there is a genuine possibility of going home, what influences a forced migrant’s decision to return to a pre-conflict residence, often in the face of very difficult conditions? What role can remote voting play?

  16. Groin Injuries (Athletic Pubalgia) and Return to Play.

    Science.gov (United States)

    Elattar, Osama; Choi, Ho-Rim; Dills, Vickie D; Busconi, Brian

    2016-07-01

    Groin pain is a common entity in athletes involved in sports that require acute cutting, pivoting, or kicking such as soccer and ice hockey. Athletic pubalgia is increasingly recognized as a common cause of chronic groin and adductor pain in athletes. It is considered an overuse injury predisposing to disruption of the rectus tendon insertion to the pubis and weakness of the posterior inguinal wall without a clinically detectable hernia. These patients often require surgical therapy after failure of nonoperative measures. A variety of surgical options have been used, and most patients improve and return to high-level competition. PubMed databases were searched to identify relevant scientific and review articles from January 1920 to January 2015 using the search terms groin pain, sports hernia, athletic pubalgia, adductor strain, osteitis pubis, stress fractures, femoroacetabular impingement, and labral tears. Clinical review. Level 4. Athletic pubalgia is an overuse injury involving a weakness in the rectus abdominis insertion or posterior inguinal wall of the lower abdomen caused by acute or repetitive injury of the structure. A variety of surgical options have been reported with successful outcomes, with high rates of return to the sport in the majority of cases. © 2016 The Author(s).

  17. Return-to-Play and Performance Outcomes of Professional Athletes in North America After Hip Arthroscopy From 1999 to 2016.

    Science.gov (United States)

    Schallmo, Michael S; Fitzpatrick, Thomas H; Yancey, Hunter B; Marquez-Lara, Alejandro; Luo, T David; Stubbs, Allston J

    2018-05-01

    The effect of hip arthroscopy on athletic performance compared with preinjury levels for professional athletes in different sports remains unknown. In addition, while return rates have been reported for professional baseball, football, and hockey players, return rates have not been reported for professional basketball players. Professional athletes in 4 major North American sports would be able to return to their sport and preoperative level of performance at a high rate after arthroscopic hip surgery. Descriptive epidemiology study. Major League Baseball (MLB), National Basketball Association (NBA), National Football League (NFL), and National Hockey League (NHL) athletes who underwent hip arthroscopy were identified through a previously reported protocol based on public sources. Successful return to play (RTP) was defined as returning for at least 1 professional regular season game after surgery. Performance scores were calculated by use of previously established scoring systems. Each player served as his own control, with the season prior to surgery defined as baseline. To make comparisons across sports, the authors adjusted for expected season and career length differences between sports and calculated percentage changes in performance. The authors identified 227 procedures performed on 180 professional athletes between 1999 and 2016. Successful RTP was achieved in 84.6% (192/227) of the procedures. Compared with all other athletes, NBA athletes returned at a similar rate (85.7%, P ≥ .999). NFL offensive linemen returned at a significantly lower rate than all other athletes (61.1%, P = .010). NHL athletes returned at a significantly higher rate than all other athletes (91.8%, P = .048) and demonstrated significantly decreased performance during postoperative season 1 compared with baseline (-35.1%, P = .002). Lead leg surgery for MLB athletes (batting stance for hitters, pitching stance for pitchers) resulted in a 12.7% reduction in hitter performance score

  18. Socially disadvantaged women's views of barriers to feeling safe to engage in decision-making in maternity care.

    Science.gov (United States)

    Ebert, Lyn; Bellchambers, Helen; Ferguson, Alison; Browne, Jenny

    2014-06-01

    Although midwifery literature suggests that woman-centred care can improve the birthing experiences of women and birth outcomes for women and babies, recent research has identified challenges in supporting socially disadvantaged women to engage in decision-making regarding care options in order to attain a sense of control within their maternity care encounters. The objective of this paper is to provide an understanding of the issues that affect the socially disadvantaged woman's ability to actively engage in decision-making processes relevant to her care. The qualitative approach known as Interpretative Phenomenological Analysis was used to gain an understanding of maternity care encounters as experienced by each of the following cohorts: socially disadvantaged women, registered midwives and student midwives. This paper focuses specifically on data from participating socially disadvantaged women that relate to the elements of woman-centred care-choice and control and their understandings of capacity to engage in their maternity care encounters. Socially disadvantaged women participants did not feel safe to engage in discussions regarding choice or to seek control within their maternity care encounters. Situations such as inadequate contextualised information, perceived risks in not conforming to routine procedures, and the actions and reactions of midwives when these women did seek choice or control resulted in a silent compliance. This response was interpreted as a consequence of women's decisions to accept responsibility for their baby's wellbeing by delegating health care decision-making to the health care professional. This research found that socially disadvantaged women want to engage in their care. However without adequate information and facilitation of choice by midwives, they believe they are outsiders to the maternity care culture and decision-making processes. Consequently, they delegate responsibility for maternity care choices to those who do belong

  19. Return to football and long-term clinical outcomes after thumb ulnar collateral ligament suture anchor repair in collegiate athletes.

    Science.gov (United States)

    Werner, Brian C; Hadeed, Michael M; Lyons, Matthew L; Gluck, Joshua S; Diduch, David R; Chhabra, A Bobby

    2014-10-01

    To evaluate return to play after complete thumb ulnar collateral ligament (UCL) injury treated with suture anchor repair for both skill position and non-skill position collegiate football athletes and report minimum 2-year clinical outcomes in this population. For this retrospective study, inclusion criteria were complete rupture of the thumb UCL and suture anchor repair in a collegiate football athlete performed by a single surgeon who used an identical technique for all patients. Data collection included chart review, determination of return to play, and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) outcomes. A total of 18 collegiate football athletes were identified, all of whom were evaluated for follow-up by telephone, e-mail, or regular mail at an average 6-year follow-up. Nine were skill position players; the remaining 9 played in nonskill positions. All players returned to at least the same level of play. The average QuickDASH score for the entire cohort was 1 out of 100; QuickDASH work score, 0 out of 100; and sport score, 1 out of 100. Average time to surgery for skill position players was 12 days compared with 43 for non-skill position players. Average return to play for skill position players was 7 weeks postoperatively compared with 4 weeks for non-skill position players. There was no difference in average QuickDASH overall scores or subgroup scores between cohorts. Collegiate football athletes treated for thumb UCL injuries with suture anchor repair had quick return to play, reliable return to the same level of activity, and excellent long-term clinical outcomes. Skill position players had surgery sooner after injury and returned to play later than non-skill position players, with no differences in final level of play or clinical outcomes. Management of thumb UCL injuries in collegiate football athletes can be safely and effectively tailored according to the demands of the player's football position. Therapeutic IV. Copyright © 2014

  20. MRI assessment of calf injuries in Australian Football League players: findings that influence return to play

    International Nuclear Information System (INIS)

    Waterworth, George; Wein, Sara; Rotstein, Andrew H.; Gorelik, Alexandra

    2017-01-01

    Calf muscle strains have become increasingly prevalent in recent seasons of the Australian Football League (AFL) and represent a significant cause of time lost from competition. The purpose of this study was to examine the association between MRI features of calf muscle strains and games missed and to thereby identify parameters that are of prognostic value. A retrospective analysis of MRI scans of AFL players with calf strains referred to a musculoskeletal radiology clinic over a 5-year period (2008-2012) was performed. The muscle(s) and muscle component affected, the site and size of strain, and the presence of an intramuscular tendon tear or intermuscular fluid were recorded. These data were cross-referenced with whether a player missed at least one game. Imaging features of prognostic value were thus identified. Sixty-three athletes had MRI scans for calf muscle strains. Soleus strains were more common than strains of other muscles. Players with soleus strains were more likely to miss at least one game if they had multiple muscle involvement (p = 0.017), musculotendinous junction strains (p = 0.046), and deep strains (p = 0.036). In a combined analysis of gastrocnemius and soleus strains, intramuscular tendon tears were observed in a significantly greater proportion of players who missed games (p = 0.010). Amongst AFL players with calf injuries, there is an association between missing at least one game and multiple muscle involvement, musculotendinous junction strains, deep strain location, and intramuscular tendon tears. In this setting, MRI may therefore provide prognostic information to help guide return-to-play decisions. (orig.)

  1. MRI assessment of calf injuries in Australian Football League players: findings that influence return to play

    Energy Technology Data Exchange (ETDEWEB)

    Waterworth, George; Wein, Sara; Rotstein, Andrew H. [Victoria House Medical Imaging, Prahran, Victoria (Australia); Gorelik, Alexandra [Royal Melbourne Hospital, University of Melbourne, Melbourne Epicentre, Parkville (Australia)

    2017-03-15

    Calf muscle strains have become increasingly prevalent in recent seasons of the Australian Football League (AFL) and represent a significant cause of time lost from competition. The purpose of this study was to examine the association between MRI features of calf muscle strains and games missed and to thereby identify parameters that are of prognostic value. A retrospective analysis of MRI scans of AFL players with calf strains referred to a musculoskeletal radiology clinic over a 5-year period (2008-2012) was performed. The muscle(s) and muscle component affected, the site and size of strain, and the presence of an intramuscular tendon tear or intermuscular fluid were recorded. These data were cross-referenced with whether a player missed at least one game. Imaging features of prognostic value were thus identified. Sixty-three athletes had MRI scans for calf muscle strains. Soleus strains were more common than strains of other muscles. Players with soleus strains were more likely to miss at least one game if they had multiple muscle involvement (p = 0.017), musculotendinous junction strains (p = 0.046), and deep strains (p = 0.036). In a combined analysis of gastrocnemius and soleus strains, intramuscular tendon tears were observed in a significantly greater proportion of players who missed games (p = 0.010). Amongst AFL players with calf injuries, there is an association between missing at least one game and multiple muscle involvement, musculotendinous junction strains, deep strain location, and intramuscular tendon tears. In this setting, MRI may therefore provide prognostic information to help guide return-to-play decisions. (orig.)

  2. MRI assessment of calf injuries in Australian Football League players: findings that influence return to play.

    Science.gov (United States)

    Waterworth, George; Wein, Sara; Gorelik, Alexandra; Rotstein, Andrew H

    2017-03-01

    Calf muscle strains have become increasingly prevalent in recent seasons of the Australian Football League (AFL) and represent a significant cause of time lost from competition. The purpose of this study was to examine the association between MRI features of calf muscle strains and games missed and to thereby identify parameters that are of prognostic value. A retrospective analysis of MRI scans of AFL players with calf strains referred to a musculoskeletal radiology clinic over a 5-year period (2008-2012) was performed. The muscle(s) and muscle component affected, the site and size of strain, and the presence of an intramuscular tendon tear or intermuscular fluid were recorded. These data were cross-referenced with whether a player missed at least one game. Imaging features of prognostic value were thus identified. Sixty-three athletes had MRI scans for calf muscle strains. Soleus strains were more common than strains of other muscles. Players with soleus strains were more likely to miss at least one game if they had multiple muscle involvement (p = 0.017), musculotendinous junction strains (p = 0.046), and deep strains (p = 0.036). In a combined analysis of gastrocnemius and soleus strains, intramuscular tendon tears were observed in a significantly greater proportion of players who missed games (p = 0.010). Amongst AFL players with calf injuries, there is an association between missing at least one game and multiple muscle involvement, musculotendinous junction strains, deep strain location, and intramuscular tendon tears. In this setting, MRI may therefore provide prognostic information to help guide return-to-play decisions.

  3. Other people as means to a safe end: vicarious extinction blocks the return of learned fear.

    Science.gov (United States)

    Golkar, Armita; Selbing, Ida; Flygare, Oskar; Ohman, Arne; Olsson, Andreas

    2013-11-01

    Information about what is dangerous and safe in the environment is often transferred from other individuals through social forms of learning, such as observation. Past research has focused on the observational, or vicarious, acquisition of fears, but little is known about how social information can promote safety learning. To address this issue, we studied the effects of vicarious-extinction learning on the recovery of conditioned fear. Compared with a standard extinction procedure, vicarious extinction promoted better extinction and effectively blocked the return of previously learned fear. We confirmed that these effects could not be attributed to the presence of a learning model per se but were specifically driven by the model's experience of safety. Our results confirm that vicarious and direct emotional learning share important characteristics but that social-safety information promotes superior down-regulation of learned fear. These findings have implications for emotional learning, social-affective processes, and clinical practice.

  4. The Effect of Central Bank Policy Decisions on Stock Market Returns in Chile

    Directory of Open Access Journals (Sweden)

    Andrés A. Acuña

    2015-06-01

    Full Text Available This paper analyzes the stock-market response to monetary policy decisions made by the Central Bank of Chile.  We use a methodology designed for the study of low frequency events and monthly data from September 2001 to December 2013 to estimate the effect of anticipated and unanticipated changes in the Chilean monetary policy interest rate on stock returns.  In contrast to the research findings in the literature for the U.S., we find no evidence that monetary surprises affect Chilean stock returns.

  5. The return to work discussion: a qualitative study of the line manager conversation about return to work and the development of an educational programme.

    Science.gov (United States)

    Cohen, Debbie; Allen, Joanna; Rhydderch, Melody; Aylward, Mansel

    2012-07-01

    To investigate the conversation between line manager and employee about return to work to inform the development of an online interactive educational programme for line managers to improve the effectiveness of their discussions. An inductive qualitative approach, using the principles of action research and motivational interviewing were adopted. The results informed the development of the educational programme for line managers. Middle grade line managers in a large public services employer in the UK. Four discussion groups were conducted over a period of 8 months. Line managers explored the challenges of the return to work interview, analysed their interactions with employees and constructed the content of an educational programme. Multiple methods were used to build engagement with participants, including video and role-play. Nine line managers were recruited across 3 business areas. Managers recognised that their conversations focused on the organisations' policies and procedures and the outcome, rather than the interaction. They recognised the strength of shifting style to shared decision-making and guidance rather than process and instruction. These communication strategies were depicted in the educational programme. The content and flow of the return to work discussion is of high importance and influences employee behaviour and return to work outcomes.

  6. Epidemiology of Sports-Related Concussions in National Collegiate Athletic Association Athletes From 2009-2010 to 2013-2014: Symptom Prevalence, Symptom Resolution Time, and Return-to-Play Time.

    Science.gov (United States)

    Wasserman, Erin B; Kerr, Zachary Y; Zuckerman, Scott L; Covassin, Tracey

    2016-01-01

    Limited data exist among collegiate student-athletes on the epidemiology of sports-related concussion (SRC) outcomes, such as symptoms, symptom resolution time, and return-to-play time. This study used the National Collegiate Athletic Association (NCAA) Injury Surveillance Program (ISP) to describe the epidemiology of SRC outcomes in 25 collegiate sports. Descriptive epidemiology study. SRC data from the NCAA ISP during the 2009-2010 to 2013-2014 academic years were analyzed regarding symptoms, time to resolution of symptoms, and time to return to play. Findings were also stratified by sex in sex-comparable sports (ie, ice hockey, soccer, basketball, lacrosse, baseball/softball) and whether SRCs were reported as recurrent. Of the 1670 concussions reported during the 2009-2010 to 2013-2014 academic years, an average (±SD) of 5.29 ± 2.94 concussion symptoms were reported, with the most common being headache (92.2%) and dizziness (68.9%). Most concussions had symptoms resolve within 1 week (60.1%); however, 6.2% had a symptom resolution time of over 4 weeks. Additionally, 8.9% of concussions required over 4 weeks before return to play. The proportion of SRCs that required at least 1 week before return to play increased from 42.7% in 2009-2010 to 70.2% in 2013-2014 (linear trend, P sports analyses, the average number of symptoms and symptom resolution time did not differ by sex. However, a larger proportion of concussions in male athletes included amnesia and disorientation; a larger proportion of concussions in female athletes included headache, excess drowsiness, and nausea/vomiting. A total of 151 SRCs (9.0%) were reported as recurrent. The average number of symptoms reported with recurrent SRCs (5.99 ± 3.43) was greater than that of nonrecurrent SRCs (5.22 ± 2.88; P = .01). A greater proportion of recurrent SRCs also resulted in a long symptom resolution time (14.6% vs 5.4%, respectively; P time (21.2% vs 7.7%, respectively; P time may indicate changing

  7. Which factors play a role in Dutch health promotion professionals' decision to recruit actively primary schools to use a web-based smoking prevention programme?

    Science.gov (United States)

    Cremers, Henricus-Paul; Oenema, Anke; Mercken, Liesbeth; Candel, Math; de Vries, Hein

    2013-12-03

    Municipal Health Promotion Organisations (MHPOs) play an important role in promoting and disseminating prevention programmes, such as smoking prevention programmes, in schools. This study identifies factors that may facilitate or hinder MHPOs' willingness to recruit actively primary schools to use a smoking prevention programme. In 2011, 31 Dutch MHPOs were invited to recruit schools to use a smoking prevention programme. All MHPO employees involved in smoking prevention activities (n = 68) were asked to complete a questionnaire assessing psychological factors and characteristics of their organisation that might affect their decision to be involved in active recruitment of schools. T-tests and multivariate analysis of variance assessed potential differences in psychological and organisational factors between active and non-active recruiters. A total of 45 professionals returned the questionnaire (66.2%). Active recruiters (n = 12) had more positive attitudes (p = 0.02), higher self-efficacy expectations (p primary schools, compared with non-active recruiters. Organisational factors did not discriminate between active and non-active recruiters. Primarily psychological factors seem to be associated with MHPOs' decision to recruit schools actively. This indicates that creating more positive attitude, self-efficacy beliefs and formation of plans may help in getting more MHPOs involved in active recruitment procedures.

  8. Inactive nurses in Taiwan: human capital, intention to return to hospital nursing, and incentives for returning.

    Science.gov (United States)

    Yu, Hsing-Yi; Tang, Fu-In; Chen, I-Ju; Yin, Teresa J C; Chen, Chu-Chieh; Yu, Shu

    2016-04-01

    To investigate inactive nurses' human capital, intention to return to hospital nursing and incentives for returning. Few studies have discussed the loss of human capital with regard to inactive nurses and how to attract them to return to clinical work. Systematic random sampling was used, with 328 subjects completing the mailed questionnaires, resulting in a response rate of 25.4%. Inactive nurses not only had moderate to high human capital (average years of nursing experience was 10.29, with moderate to high levels of nursing professional commitment and nursing competence) and were young. Forty-three percent of subjects reported intending to return to hospital nursing. Sufficient nurse staffing, greater safety in the working environment, and re-entry preparation programmes were incentives for returning. Recruiting inactive nurses back to hospital work is vital and feasible as inactive nurses had a moderate to high degree of human capital. The most feasible way is offering reasonable working conditions, in particular, providing sufficient staffing, a safe working environment and re-entry preparation programmes. The findings confirm the human capital of inactive nurses and provide concrete directions for nursing managers to follow when recruiting inactive nurses to hospital nursing. © 2015 John Wiley & Sons Ltd.

  9. Differences in decision-making criteria towards the return on marketing investment: A project business perspective

    OpenAIRE

    Smyth, H.; Lecoeuvre, L.

    2015-01-01

    Assessing the value of marketing to a business remains a thorny issue in theory and practice. Decision-making at the finance–marketing interface is under-researched, particularly for project businesses. Confronted by demands of accountability concerning the allocation of resources to meet competitive pressures, the paper examines the quality and extent of dialogue in investment decision-making. The return on investment (ROI) and marketing-specific investment (ROMI) are important factors at th...

  10. Business Return in New Orleans: Decision Making Amid Post-Katrina Uncertainty

    Science.gov (United States)

    Lam, Nina S. N.; Pace, Kelley; Campanella, Richard; LeSage, James; Arenas, Helbert

    2009-01-01

    Background Empirical observations on how businesses respond after a major catastrophe are rare, especially for a catastrophe as great as Hurricane Katrina, which hit New Orleans, Louisiana on August 29, 2005. We analyzed repeated telephone surveys of New Orleans businesses conducted in December 2005, June 2006, and October 2007 to understand factors that influenced decisions to re-open amid post-disaster uncertainty. Methodology/Principal Findings Businesses in the group of professional, scientific, and technical services reopened the fastest in the near term, but differences in the rate of reopening for businesses stratified by type became indistinguishable in the longer term (around two years later). A reopening rate of 65% was found for all businesses by October 2007. Discriminant analysis showed significant differences in responses reflecting their attitudes about important factors between businesses that reopened and those that did not. Businesses that remained closed at the time of our third survey (two years after Katrina) ranked levee protection as the top concern immediately after Katrina, but damage to their premises and financing became major concerns in subsequent months reflected in the later surveys. For businesses that had opened (at the time of our third survey), infrastructure protection including levee, utility, and communications were the main concerns mentioned in surveys up to the third survey, when the issue of crime became their top concern. Conclusions/Significance These findings underscore the need to have public policy and emergency plans in place prior to the actual disaster, such as infrastructure protection, so that the policy can be applied in a timely manner before business decisions to return or close are made. Our survey results, which include responses from both open and closed businesses, overcome the “survivorship bias” problem and provide empirical observations that should be useful to improve micro-level spatial economic

  11. Business return in New Orleans: decision making amid post-Katrina uncertainty.

    Directory of Open Access Journals (Sweden)

    Nina S N Lam

    Full Text Available BACKGROUND: Empirical observations on how businesses respond after a major catastrophe are rare, especially for a catastrophe as great as Hurricane Katrina, which hit New Orleans, Louisiana on August 29, 2005. We analyzed repeated telephone surveys of New Orleans businesses conducted in December 2005, June 2006, and October 2007 to understand factors that influenced decisions to re-open amid post-disaster uncertainty. METHODOLOGY/PRINCIPAL FINDINGS: Businesses in the group of professional, scientific, and technical services reopened the fastest in the near term, but differences in the rate of reopening for businesses stratified by type became indistinguishable in the longer term (around two years later. A reopening rate of 65% was found for all businesses by October 2007. Discriminant analysis showed significant differences in responses reflecting their attitudes about important factors between businesses that reopened and those that did not. Businesses that remained closed at the time of our third survey (two years after Katrina ranked levee protection as the top concern immediately after Katrina, but damage to their premises and financing became major concerns in subsequent months reflected in the later surveys. For businesses that had opened (at the time of our third survey, infrastructure protection including levee, utility, and communications were the main concerns mentioned in surveys up to the third survey, when the issue of crime became their top concern. CONCLUSIONS/SIGNIFICANCE: These findings underscore the need to have public policy and emergency plans in place prior to the actual disaster, such as infrastructure protection, so that the policy can be applied in a timely manner before business decisions to return or close are made. Our survey results, which include responses from both open and closed businesses, overcome the "survivorship bias" problem and provide empirical observations that should be useful to improve micro

  12. Return or relocate? An inductive analysis of decision-making in a disaster.

    Science.gov (United States)

    Henry, Jacques

    2013-04-01

    This paper proposes an inductive analysis of the decision as to whether to return or to relocate by persons in the State of Louisiana, United States, who evacuated after Hurricanes Katrina and Rita in August and September 2005, respectively. Drawing on interviews with evacuees in these events and extensive fieldwork in the impacted area, the paper seeks to identify the folk dimensions of the decision-making process, assess their arrangements, and situate the process in the larger context of risk and resilience in an advanced society. It suggests that, despite the material and emotional upheaval experienced by affected persons, the decision-making process is a rational endeavour combining a definite set of tightly interconnected factors, involving material dimensions and substantive values that can act in concert or in conflict. In addition, it indicates that there are significant variations by geographic areas, homeownership, and kind of decision. Some theoretical implications, practical measures, and suggestions for future research are examined. © 2013 The Author(s). Journal compilation © Overseas Development Institute, 2013.

  13. Perceptions of Domestic Violence: The Effects of Domestic Violence Myths, Victim's Relationship with Her Abuser, and the Decision to Return to Her Abuser

    Science.gov (United States)

    Yamawaki, Niwako; Ochoa-Shipp, Monica; Pulsipher, Craig; Harlos, Andrew; Swindler, Scott

    2012-01-01

    Researchers in this study examined the attitudes toward domestic violence, the victim, and her perpetrator. A total of 194 participants were randomly assigned to one of 4 hypothetical scenarios to evaluate how observers' perceptions were influenced by their own sex and myths about domestic violence, by the victim's decision to return to the…

  14. Predictors of return rate discrimination in slot machine play.

    Science.gov (United States)

    Coates, Ewan; Blaszczynski, Alex

    2014-09-01

    The purpose of this study was to investigate the extent to which accurate estimates of payback percentages and volatility combined with prior learning, enabled players to successfully discriminate between multi-line/multi-credit slot machines that provided differing rates of reinforcement. The aim was to determine if the capacity to discriminate structural characteristics of gaming machines influenced player choices in selecting 'favourite' slot machines. Slot machine gambling history, gambling beliefs and knowledge, impulsivity, illusions of control, and problem solving style were assessed in a sample of 48 first year undergraduate psychology students. Participants were subsequently exposed to a choice paradigm where they could freely select to play either of two concurrently presented PC-simulated slot machines programmed to randomly differ in expected player return rates (payback percentage) and win frequency (volatility). Results suggest that prior learning and cognitions (particularly gambler's fallacy) but not payback, were major contributors to the ability of a player to discriminate volatility between slot machines. Participants displayed a general tendency to discriminate payback, but counter-intuitively placed more bets on the slot machine with lower payback percentage rates.

  15. SECTORAL RISK AND RETURN FOR COMPANIES IN ROMANIA

    Directory of Open Access Journals (Sweden)

    Anis Cecilia

    2012-12-01

    Full Text Available probability that cash flows or return will vary from expectations. Standard corporate finance theory supposes that a company chooses a capital structure that maximizes company value. A fundamental idea in finance is the relationship between risk and return. The greater the amount of risk that an investor is willing to take on, the greater the potential return. The reason for this is that investors need to be compensated for taking on additional risk. Why put capital at significant risk for a return that is no higher than the return on government bonds? Or expect higher than averages returns from low-risk activities? It is impossible to separate measuring the performance of a company from the risks that the management takes to achieve it.In most aspects of company operations, risk assessment plays a different but equally important, role. It is an integral part of informed decision taking in achieving performance. Risk assessment is involved from the highest level in strategic choices about what activities to undertake, what assets to buy or what markets to serve all the way to detailed operational decisions about whether to accept payment in foreign currencies and the adequacy of safety measures in the workplace. It plays a part whether or not an organization is aware of managing risk and many managers feel that their instinct and judgment are enough – a behavior risk. The danger is that this leaves company risk unplanned and unmanaged. This paper proposes a framework where we realized a study cases: we test if return on assets and return on equity has influence on the risk, both on long and short term. For this purposes, we conduct an empirical research that covers 59 selected companies traded at the Bucharest Stock Exchange within the time period 1999-2010. For this study our results reveal that dynamic global risk can be associated to a low intensity with total assets performance of the company’s. Investments efficiency and the

  16. 2016 Consensus statement on return to sport from the First World Congress in Sports Physical Therapy, Bern

    DEFF Research Database (Denmark)

    Ardern, Clare L; Glasgow, Philip; Schneiders, Anthony

    2016-01-01

    evidence to make recommendations for return to sport decision-making, clinical practice and future research directions related to returning athletes to sport. A half day meeting was held in Bern, Switzerland, after the First World Congress in Sports Physical Therapy. 17 expert clinicians participated. 4...... sense of individual factors that may influence the athlete's return to sport, and the Strategic Assessment of Risk and Risk Tolerance framework may help decision-makers synthesise information to make an optimal return to sport decision. Research evidence to support return to sport decisions in clinical...... practice is scarce. Future research should focus on a standardised approach to defining, measuring and reporting return to sport outcomes, and identifying valuable prognostic factors for returning to sport....

  17. Back to Sleep, Tummy to Play

    Science.gov (United States)

    ... Español Text Size Email Print Share Back to Sleep, Tummy to Play Page Content ​What are the 2 most important things to remember about safe sleep practices? Healthy babies are safest when sleeping on ...

  18. Drivers’ decision-making when attempting to cross an intersection results from choice between affordances

    Directory of Open Access Journals (Sweden)

    Geoffrey eMARTI

    2015-01-01

    Full Text Available In theory, a safe approach to an intersection implies that the driver can simultaneously manage two scenarios: they either cross or they must give way to an oncoming vehicle. In this article we formalize the critical time for safe crossing (CTcross and the critical time for safe stopping (CTstop to represent crossing and stopping possibilities, respectively. We describe these critical times in terms of affordances and empirically test their respective contribution to the driver’s decision-making process. Using a driving simulator, three groups of participants drove cars with identical acceleration capabilities and different braking capabilities. They were asked to try to cross an intersection where there was an oncoming vehicle, if they deemed the maneuver to be safe. If not, they could decide to stop or, as a last resort, make an emergency exit. The intersections were identical among groups.Results showed that although the crossing possibilities (CTcross were the same for all groups, there were between-group differences in crossing frequency. This suggests that stopping possibilities (CTstop play a role in the driver’s decision-making process, in addition to the crossing possibilities. These results can be accounted for by a behavioral model of decision making, and provide support for the hypothesis of choice between affordances.

  19. Return to sports participation after articular cartilage repair in the knee: scientific evidence.

    Science.gov (United States)

    Mithoefer, Kai; Hambly, Karen; Della Villa, Stefano; Silvers, Holly; Mandelbaum, Bert R

    2009-11-01

    Articular cartilage injury in the athlete's knee presents a difficult clinical challenge. Despite the importance of returning injured athletes to sports, information is limited on whether full sports participation can be successfully achieved after articular cartilage repair in the knee. Systematic analysis of athletic participation after articular cartilage repair will demonstrate the efficacy of joint surface restoration in high-demand patients and help to optimize outcomes in athletes with articular cartilage injury of the knee. Systematic review. A comprehensive literature review of original studies was performed to provide information about athletic participation after articular cartilage repair. The athlete's ability to perform sports postoperatively was assessed by activity outcome scores, rate of return to sport, timing of the return, level of postoperative sports participation, and the continuation of athletic activity over time. Twenty studies describing 1363 patients were included in the review, with an average follow-up of 42 months. Return to sports was possible in 73% overall, with highest return rates after osteochondral autograft transplantation. Time to return to sports varied between 7 and 18 months, depending on the cartilage repair technique. Initial return to sports at the preinjury level was possible in 68% and did not significantly vary between surgical techniques. Continued sports participation at the preinjury level was possible in 65%, with the best durability after autologous chondrocyte transplantation. Several factors affected the ability to return to sport: athlete's age, preoperative duration of symptoms, level of play, lesion size, and repair tissue morphology. Articular cartilage repair in the athletic population allows for a high rate of return to sports, often at the preinjury level. Return to sports participation is influenced by several independent factors. The findings provide pertinent information that is helpful for the

  20. Estimating the Ex Ante Expected Returns to College

    OpenAIRE

    Andrew J. Hussey; Omari H. Swinton

    2011-01-01

    Rather than estimating the returns to obtaining a college degree, this paper treats the college education decision as an uncertain investment involving varying likelihoods of successful graduation. We predict earnings conditional on both graduating and not graduating from both selective and non-selective institutions, and incorporate estimated individual-specific graduation rates in calculating the ex ante expected returns from college attendance for individuals across the ability distributio...

  1. Concerning temporary method for return transport of plutonium

    International Nuclear Information System (INIS)

    1990-01-01

    One of the urgent matters under deliberation in the Working Group for Nuclear Fuel Cycle, Atomic Energy Comission of Japan, is to develop a method for smooth and safe transport of plutonium to be returned from Britain and France, where spent fuel sent from Japan is reprocessed by contract. Return transport of plutonium from these nations will start in 1992. Preparatory work has been conducted in Japan for air transport of plutonium, which is to be used by Power Reactor and Nuclear Fuel Development Corporation. For this, efforts have been made since 1984 to develop containers for air transport of plutonium. Though the corporation will continue research, it will take considerable time until practical containers are developed, so the material have to be transported by sea for the time being. The corporation should play the leading role in conducting the return transport operation in cooperation with other organizations concerned including power companies. To achieve this, the corporation should be active in making preparations including the development of transport plans. (N.K.)

  2. 2016 Consensus statement on return to sport from the First World Congress in Sports Physical Therapy, Bern.

    Science.gov (United States)

    Ardern, Clare L; Glasgow, Philip; Schneiders, Anthony; Witvrouw, Erik; Clarsen, Benjamin; Cools, Ann; Gojanovic, Boris; Griffin, Steffan; Khan, Karim M; Moksnes, Håvard; Mutch, Stephen A; Phillips, Nicola; Reurink, Gustaaf; Sadler, Robin; Silbernagel, Karin Grävare; Thorborg, Kristian; Wangensteen, Arnlaug; Wilk, Kevin E; Bizzini, Mario

    2016-07-01

    Deciding when to return to sport after injury is complex and multifactorial-an exercise in risk management. Return to sport decisions are made every day by clinicians, athletes and coaches, ideally in a collaborative way. The purpose of this consensus statement was to present and synthesise current evidence to make recommendations for return to sport decision-making, clinical practice and future research directions related to returning athletes to sport. A half day meeting was held in Bern, Switzerland, after the First World Congress in Sports Physical Therapy. 17 expert clinicians participated. 4 main sections were initially agreed upon, then participants elected to join 1 of the 4 groups-each group focused on 1 section of the consensus statement. Participants in each group discussed and summarised the key issues for their section before the 17-member group met again for discussion to reach consensus on the content of the 4 sections. Return to sport is not a decision taken in isolation at the end of the recovery and rehabilitation process. Instead, return to sport should be viewed as a continuum, paralleled with recovery and rehabilitation. Biopsychosocial models may help the clinician make sense of individual factors that may influence the athlete's return to sport, and the Strategic Assessment of Risk and Risk Tolerance framework may help decision-makers synthesise information to make an optimal return to sport decision. Research evidence to support return to sport decisions in clinical practice is scarce. Future research should focus on a standardised approach to defining, measuring and reporting return to sport outcomes, and identifying valuable prognostic factors for returning to sport. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  3. Job demands and decision control predicted return to work: the rapid-RTW cohort study.

    Science.gov (United States)

    Haveraaen, Lise Aasen; Skarpaas, Lisebet Skeie; Aas, Randi Wågø

    2017-02-02

    In order to help workers with long-term sickness absence return to work (RTW), it is important to understand factors that either impede or facilitate employee's reintegration into the labour force. The aim of this study was therefore to examine the impact of psychological work characteristics on time-to first RTW in sick listed employees in Norway. The study was designed as a cohort study of 543 employees participating in 50 different RTW programmes. The Job Content Questionnaire (JCQ) was used to gather information on the psychological work conditions. The participants were followed for up to 18 months after they started treatment in the RTW programme. Survival analyses were used to investigate the association between psychological work conditions and time-to first RTW. Having high psychological job demands (HR = .654; 95% CI: .513-.832) and low decision control (HR = 1.297; 95% CI: 1.010-1.666) were both independent predictors of delayed RTW. Employees in low-strain jobs (low demands/high control) (HR = 1.811; 95% CI: 1.287-2.549) and passive jobs (low demands/low control) (HR = 1.599; 95% CI: 1.107-2.309), returned to work earlier compared to employees in high-strain jobs (high demands/low control). No difference was found for active jobs (high demands/high control). This study revealed that high psychological demands, low control, and being in a high strain job reduced the probability of early RTW in sick listed employees. RTW programmes should therefore increase the focus on these issues.

  4. Exiting the Emergency Medical Services Profession and Characteristics Associated with Intent to Return to Practice.

    Science.gov (United States)

    Cash, Rebecca E; Crowe, Remle P; Agarwal, Riddhima; Rodriguez, Severo A; Panchal, Ashish R

    2018-01-01

    Inadequate staffing of agencies, increasing attrition rates, and frequent turnover of personnel make employee retention an ongoing concern for Emergency Medical Services (EMS). Faced with increasing demand for EMS, understanding the causes underlying turnover is critical. The objectives of this study were to describe the proportion of individuals that left EMS, likelihood of returning to the profession, and key factors contributing to the decision to leave EMS. This was a cross-sectional study of nationally-certified EMS professionals who left EMS. Respondents to a census survey who reported not practicing EMS were directed to a subsection of items regarding their choice to leave EMS. Demographic and employment characteristics, likelihood of returning to EMS, and factors influencing the decision to leave EMS were assessed. Descriptive and comparative statistics (Chi-square and nonparametric test of trend [p-trend]) and univariable odds ratios were calculated. The overall response rate for the full survey was 10% (n = 32,114). A total of 1247 (4%) respondents reported leaving the profession and completed the exit survey. The majority (72%) reported that they will likely return to EMS. A stepwise decrease in the reported likelihood of returning was seen with increasing years of EMS experience (e.g., 2 or less years of experience: 83%; 16 or more years: 52%; p-trend benefits (65%), decision to pursue further education (60%), dissatisfaction with organization's management (54.7%), and desire for career change (54.1%). This cross-sectional study found an attrition rate of approximately 4% among nationally certified EMS professionals; however, the majority reported that they intended to return to the EMS profession. Intention to return to EMS decreased as years of experience and months away from the profession increased. Important factors in the decision to leave EMS included a desire for better pay and benefits and the decision to pursue further education. Targeting the

  5. Marital Status and Return to Work After Living Kidney Donation.

    Science.gov (United States)

    Frech, Adrianne; Natale, Ginny; Hayes, Don; Tumin, Dmitry

    2018-01-01

    Living kidney donation is safe and effective, but patients in need of a transplant continue to outnumber donors. Disincentives to living donation include lost income, risk of job loss, perioperative complications, and unreimbursed medical expenses. This study uses US registry and follow-up data on living kidney donors from 2013 to 2015 to identify social predictors of return to work across gender following living kidney donation. Using logistic regression, we find that predictors of return to work following living kidney donation differ for women and men. Among women, age, education, smoking status, and procedure type are associated with return to work. Among men, education, procedure type, and hospital readmission within 6 weeks postdonation are associated with return to work. Notably, single and divorced men are less likely to return to work compared to married men (odds ratio [OR] for single men 0.51, 95% confidence interval [CI], 0.37-0.69, P donation.

  6. Job demands and decision control predicted return to work: the rapid-RTW cohort study

    Directory of Open Access Journals (Sweden)

    Lise Aasen Haveraaen

    2017-02-01

    Full Text Available Abstract Background In order to help workers with long-term sickness absence return to work (RTW, it is important to understand factors that either impede or facilitate employee’s reintegration into the labour force. The aim of this study was therefore to examine the impact of psychological work characteristics on time-to first RTW in sick listed employees in Norway. Methods The study was designed as a cohort study of 543 employees participating in 50 different RTW programmes. The Job Content Questionnaire (JCQ was used to gather information on the psychological work conditions. The participants were followed for up to 18 months after they started treatment in the RTW programme. Survival analyses were used to investigate the association between psychological work conditions and time-to first RTW. Results Having high psychological job demands (HR = .654; 95% CI: .513–.832 and low decision control (HR = 1.297; 95% CI: 1.010–1.666 were both independent predictors of delayed RTW. Employees in low-strain jobs (low demands/high control (HR = 1.811; 95% CI: 1.287–2.549 and passive jobs (low demands/low control (HR = 1.599; 95% CI: 1.107–2.309, returned to work earlier compared to employees in high-strain jobs (high demands/low control. No difference was found for active jobs (high demands/high control. Conclusion This study revealed that high psychological demands, low control, and being in a high strain job reduced the probability of early RTW in sick listed employees. RTW programmes should therefore increase the focus on these issues.

  7. Predictable return distributions

    DEFF Research Database (Denmark)

    Pedersen, Thomas Quistgaard

    trace out the entire distribution. A univariate quantile regression model is used to examine stock and bond return distributions individually, while a multivariate model is used to capture their joint distribution. An empirical analysis on US data shows that certain parts of the return distributions......-of-sample analyses show that the relative accuracy of the state variables in predicting future returns varies across the distribution. A portfolio study shows that an investor with power utility can obtain economic gains by applying the empirical return distribution in portfolio decisions instead of imposing...

  8. 2016 Consensus statement on return to sport from the First World Congress in Sports Physical Therapy, Bern

    OpenAIRE

    Ardern, Clare L.; Glasgow, Philip; Schneiders, Anthony; Witvrouw, Erik; Clarsen, Benjamin; Cools, Ann; Gojanovic, Boris; Griffin, Steffan; Khan, Karim M.; Moksnes, Havard; Mutch, Stephen A.; Phillips, Nicola; Reurink, Gustaaf; Sadler, Robin; Silbernagel, Karin Gravare

    2016-01-01

    Copyright © 2017 BMJ Publishing Group Deciding when to return to sport after injury is complex and multifactorial—an exercise in risk management. Return to sport decisions are made every day by clinicians, athletes and coaches, ideally in a collaborative way. The purpose of this consensus statement was to present and synthesise current evidence to make recommendations for return to sport decision-making, clinical practice and future research directions related to returning athletes to spor...

  9. Combined SAFE/SNAP approach to safeguards evaluation

    International Nuclear Information System (INIS)

    Engi, D.; Chapman, L.D.; Grant, F.H.; Polito, J.

    1980-01-01

    Generally, the scope of a safeguards evaluation model can efficiently address one of two issues, (1) global safeguards effectiveness, or (2) vulnerability analysis for individual scenarios. The Safeguards Automated Facility Evaluation (SAFE) focuses on (1) while the Safeguards Network Analysis Procedure (SNAP) is directed at (2). SAFE addresses (1) in that it considers the entire facility, i.e., the composite system of hardware and human components, in one global analysis. SNAP addresses (2) by providing a safeguards modeling symbology sufficiently flexible to represent quite complex scenarios from the standpoint of hardware interfaces while also accounting for a rich variety of human decision making. A combined SAFE/SNAP approach to the problem of safeguards evaluation is described and illustrated through an example

  10. Recurrent stingers in an adolescent American football player: dilemmas of return to play. A case report and review of the literature.

    Science.gov (United States)

    Zaremski, Jason L; Horodyski, MaryBeth; Herman, Daniel C

    2017-01-01

    We present the case of a 16-year-old football linebacker with a history of recurrent stingers. Initial physical examination was normal as were cervical spine radiographs. MRI of the cervical spine revealed relative stenosis. Electrodiagnostic testing revealed chronic bilateral neurogenic changes of the superior trunk of the brachial plexus. A Kerr Collar was obtained to minimize head acceleration and force transmission through the neck. While there are return-to-play guidelines for recurrent stingers, there are inconsistencies with those recommendations. Our case highlights the challenges in contact sport athletes with recurrent stingers.

  11. Return Migration to Mexico: Does Health Matter?

    Science.gov (United States)

    Arenas, Erika; Goldman, Noreen; Pebley, Anne R; Teruel, Graciela

    2015-12-01

    We use data from three rounds of the Mexican Family Life Survey to examine whether migrants in the United States returning to Mexico in the period 2005-2012 have worse health than those remaining in the United States. Despite extensive interest by demographers in health-related selection, this has been a neglected area of study in the literature on U.S.-Mexico migration, and the few results to date have been contradictory and inconclusive. Using five self-reported health variables collected while migrants resided in the United States and subsequent migration history, we find direct evidence of higher probabilities of return migration for Mexican migrants in poor health as well as lower probabilities of return for migrants with improving health. These findings are robust to the inclusion of potential confounders reflecting the migrants' demographic characteristics, economic situation, family ties, and origin and destination characteristics. We anticipate that in the coming decade, health may become an even more salient issue in migrants' decisions about returning to Mexico, given the recent expansion in access to health insurance in Mexico.

  12. Application of a General Risk Management Model to Portfolio Optimization Problems with Elliptical Distributed Returns for Risk Neutral and Risk Averse Decision Makers

    NARCIS (Netherlands)

    B. Kaynar; S.I. Birbil (Ilker); J.B.G. Frenk (Hans)

    2007-01-01

    textabstractIn this paper portfolio problems with linear loss functions and multivariate elliptical distributed returns are studied. We consider two risk measures, Value-at-Risk and Conditional-Value-at-Risk, and two types of decision makers, risk neutral and risk averse. For Value-at-Risk, we show

  13. Comparing two instructional methods of role playing and lecture on primigravida females, decision about type of delivery.

    Science.gov (United States)

    Abedian, Zahra; Navaee, Maryam; Sani, Hossein Jafari; Ebrahimzadeh, Saeed

    2017-01-01

    Each mother has the legal right to decide about her delivery, but this decision should be made based on scientific knowledge. Instructions during pregnancy help to choose the proper type of delivery. This study conducted aimed to compare two instructional methods of role playing and lecture on primigravida decision about type of delivery. In this single-blind clinical trial 67 primigravida, 34-36 week were selected using multi-stage sampling and assigned into two groups randomly. Decision-making (before, 2-week after, and at admission in maternity department) was tested by a questionnaire. In role-playing group, advantages and disadvantages of two type delivery were presented by role-playing in 90-min by three scenarios. In lecture group, it was also presented in a 90-min lecture. Data were analyzed by mean difference test, Fisher test, independent and paired t -test. Two groups showed a significant difference in terms of decision at admission to maternity department ( P = 0.000). 75% of lecture group and 100% of role-playing group selected normal delivery. Postintervention knowledge score in lecture group was 18 ± 5.3 and in role-playing group 17.1 ± 4.0. Percent of change in knowledge scores in two groups was significant ( P = 0.001). Participants' attitude, before and after the intervention, in both groups was significant ( P 0.05). In this research, lecture was more effective in raising knowledge level, and role playing was more effective in raising decision to vaginal delivery and reducing elective caesarean section. It is therefore suggested to use both teaching methods altogether for pregnant women to decrease the rate of unnecessary cesarean.

  14. Virtually ‘in the heat of the moment’: insula activation in safe sex negotiation among risky men

    Science.gov (United States)

    Xue, Feng; Droutman, Vita; Barkley-Levenson, Emily; Melrose, A James; Miller, Lynn C; Monterosso, John R; Bechara, Antoine; Appleby, Paul R; Christensen, John L; Godoy, Carlos G; Read, Stephen J

    2018-01-01

    Abstract HIV is most prevalent among men who have sex with men (MSM), and although most MSM use condoms consistently during casual sex, some take risks. To better understand the psychology of those risky decisions, we examined neural correlates of playing a virtual sexual ‘hook up’ game in an functional magnetic resonance imaging scanner in MSM who had, in the past 90 days, been sexually risky (N = 76) or safe (N = 31). We found that during potentially risky sexual choices, previously risky MSM had more right insula activity than previously safe MSM. Real-life sexual risk was related to trait positive and negative urgency. Insula activity that differentiated risky and safe MSM was related to trait positive and negative urgency. Future work should further examine if, and to what extent, insula activation during safe sex negotiation drives MSM’s rash risky sexual decision-making. PMID:29149326

  15. Virtually 'in the heat of the moment': insula activation in safe sex negotiation among risky men.

    Science.gov (United States)

    Smith, Benjamin J; Xue, Feng; Droutman, Vita; Barkley-Levenson, Emily; Melrose, A James; Miller, Lynn C; Monterosso, John R; Bechara, Antoine; Appleby, Paul R; Christensen, John L; Godoy, Carlos G; Read, Stephen J

    2018-01-01

    HIV is most prevalent among men who have sex with men (MSM), and although most MSM use condoms consistently during casual sex, some take risks. To better understand the psychology of those risky decisions, we examined neural correlates of playing a virtual sexual 'hook up' game in an functional magnetic resonance imaging scanner in MSM who had, in the past 90 days, been sexually risky (N = 76) or safe (N = 31). We found that during potentially risky sexual choices, previously risky MSM had more right insula activity than previously safe MSM. Real-life sexual risk was related to trait positive and negative urgency. Insula activity that differentiated risky and safe MSM was related to trait positive and negative urgency. Future work should further examine if, and to what extent, insula activation during safe sex negotiation drives MSM's rash risky sexual decision-making. © The Author (2017). Published by Oxford University Press.

  16. Financial returns on R&D: looking back at history, looking forward to adaptive licensing.

    Science.gov (United States)

    Scannell, J W; Hinds, S; Evans, R

    2015-01-01

    Investment in R&D for drugs launched in the late 1970s to early 1990s generated good returns for investors. R&D was inexpensive. Clinical trial success rates were high. Consumption was increasing. Drug prices were outstripping inflation, which raised profit margins. Tax rates were falling. However, returns on R&D have been falling since the early 1990s given rising clinical trial costs, rising trial failure rates, and lower consumption growth in developed markets. Many investors believe that average financial returns on today's R&D will be below the cost of capital, particularly if US drug price inflation moderates. Thus R&D investment by major drug companies is flat or perhaps falling in real terms. Various regulatory initiatives have tried to streamline clinical development and approval. The latest is Adaptive Licensing (AL). The near-term effect of AL on industry-level financial returns will be modest. AL will, however, be salient for decisions to invest in specific trials and may make it easier for smaller companies to fund development. AL could become more important in the long run if it helps shift industry, regulators, and payers from what has been an increasingly linear model of innovation; predicated on the ideas that basic science predicts, trials test predictions, and trial results form a complete description of a drug's attributes. History shows that many drugs become important because doctors and patients discover utility that was not initially apparent to regulators, payers, or investors. One hope for AL, therefore, is that it will bring more acceptably safe chemical diversity into real world use at lower R&D cost.

  17. Development of a safety decision-making scenario to measure worker safety in agriculture.

    Science.gov (United States)

    Mosher, G A; Keren, N; Freeman, S A; Hurburgh, C R

    2014-04-01

    Human factors play an important role in the management of occupational safety, especially in high-hazard workplaces such as commercial grain-handling facilities. Employee decision-making patterns represent an essential component of the safety system within a work environment. This research describes the process used to create a safety decision-making scenario to measure the process that grain-handling employees used to make choices in a safety-related work task. A sample of 160 employees completed safety decision-making simulations based on a hypothetical but realistic scenario in a grain-handling environment. Their choices and the information they used to make their choices were recorded. Although the employees emphasized safety information in their decision-making process, not all of their choices were safe choices. Factors influencing their choices are discussed, and implications for industry, management, and workers are shared.

  18. Are Returns to Education on the Decline in Venezuela and Does Mission Sucre Have a Role to Play?

    Science.gov (United States)

    Gonzalez, Naihobe; Oyelere, Ruth Uwaifo

    2011-01-01

    Anecdotal evidence points to a falling standard of living for the educated in Venezuela. During this same period, President Hugo Chavez implemented several education reforms. We focus on a major university education reform known as Mission Sucre and its potential impact on returns to university education. First, we show that returns to education…

  19. The role of decision influence and team performance in member self-efficacy, withdrawal, satisfaction with the leader, and willingness to return.

    Science.gov (United States)

    Phillips, J M

    2001-01-01

    This study examines team performance as a moderator of the relationship between decision influence and outcomes relevant to team effectiveness in hierarchical teams with distributed ex pertise. In this type of team staff members have unique roles and make recommendations to the team leader, who ultimately makes the team's final decisions. It is suggested that the positive rela tionship between decision influence and favorable outcomes (e.g., satisfaction) consistently described in the literature is dependent on team performance in this type of team. Specifically, team effec tiveness outcomes are proposed to be consistently more favorable in higher performing than in lower performing teams. Decision influence is proposed to relate positively to member satisfaction with the leader, willingness to return, and self-efficacy and to relate negatively to withdrawal in higher performing teams. The opposite pattern of relationships is expected in lower performing teams. A laboratory study was conducted with 228 undergradu ates performing a computer task as subordinates in 76 four-person teams with a confederate leader. The results generally support the hypotheses and illustrate a dilemma for leaders attempting to manage team effectiveness. Copyright 2000 Academic Press.

  20. Return to Sport After Rotator Cuff Tear Repair: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Klouche, Shahnaz; Lefevre, Nicolas; Herman, Serge; Gerometta, Antoine; Bohu, Yoann

    2016-07-01

    One of the most frequent demands from athletes after rotator cuff tear repair is to return to sport, if possible at the same level of play. The main goal of this study was to determine the rate of return to sport after treatment of rotator cuff tears. Meta-analysis and systematic review. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed to perform this systematic review and meta-analysis of the results in the literature, as well as for the presentation of results. A search of the literature was performed on the electronic databases MEDLINE, Scopus, EMBASE, and the Cochrane Library. The quality of the included studies was evaluated according to the MINORS (Methodological Index for Nonrandomized Studies) checklist. Inclusion criteria were studies in English evaluating return to sport after treatment of traumatic, degenerative, partial or full-thickness rotator cuff tears in patients practicing a sport regularly, whatever the level, all ages and sports included. The main judgment criterion was the number of patients who returned to a sports activity after treatment of a rotator cuff tear. The criterion was analyzed in 2 ways: return to sport (yes/no) and the level of play (identical or higher/lower level). Twenty-five studies were reviewed, including 859 patients (683 athletes), all treated surgically after a mean follow-up of 3.4 years (range, 0.3-13.4 years). The level of sports was recorded in 23 studies or 635 (93%) athletes and included 286 competitive or professional athletes and 349 recreational athletes. The most commonly practiced sports were baseball (224 participants), tennis (104 participants), and golf (54 participants). The overall rate of return to sport was 84.7% (95% CI, 77.6%-89.8%), including 65.9% (95% CI, 54.9%-75.4%) at an equivalent level of play, after 4 to 17 months. Of the professional and competitive athletes, 49.9% (95% CI, 35.3-64.6%) returned to the same level of play. Most

  1. Decision-Making as a Struggle and a Play: On Alternative Rationalities in Schools as Organizations

    Science.gov (United States)

    Salo, Petri

    2008-01-01

    In this article an alternative interpretation of the functions of decision-making and the inherent activities at teachers' meetings at schools are presented. The metaphor of "play" is introduced in order to make the teachers' actions during decision-making comprehensible, not only for outsiders, but more importantly for "involved insiders", such…

  2. Different forms, reasons and motivations for return migration of persons who voluntarily decide to return to their countries of origin.

    Science.gov (United States)

    Callea, S

    1986-03-01

    Although the 1973 oil crisis did not have the drastic effects on immigration which were originally feared, it did end a period of quasi-liberal immigration policy, establish intense and effective international cooperation on immigration, and arouse great interest in immigration studies and research. This paper analyzes the situations arising as a result of the petroleum shortage and focuses on the conditions relating to the return of emigrants to Southern European countries. This new research draws attention to the following fundamental aspects of the immigration problem: 1) the emigrant's return to his homeland cannot be considered a factor in development; it is a positive element in development only if the right socioeconomic conditions exist in the country of origin. 2) Concern for children's education is one of the most common reasons for return. 3) A large percentage of emigrants are satisfied with their work abroad. 4) An emigrant's return potential is wasted due to the slight use that is made of the resources he offers. 5) Returning workers most often want to set up an independent enterprise. 6) Savings are generally used to buy a house or farm. 7) Vocational level does not increase significantly between emigration and returning, though this increase becomes greater the longer the emigrant stays abroad. 8) The number of returning emigrants is too slight to bring about any change in the country of origin. 9) Incentives and subsidies to encourage return have not had a considerable impact on the decision to return. Callea recommends that officials of the country of origin posted abroad be assigned to counsel returning emigrants on finding employment, attending vocational development courses, obtaining housing, accruing interests and savings, and on the problems and perspectives of sociocultural reintegration.

  3. Chasing the deal with the money: Measuring the required risk premium and expected abnormal returns of private equity funds to maximize their internal rate of return

    Directory of Open Access Journals (Sweden)

    Fernando Scarpati

    2013-09-01

    Full Text Available A number of scholars of private equity (“PE” have attempted to assess the ex-post returns, or performance, of PEs by adopting an ex-post perspective of asset pricing. In doing so a set of phenomena has been recognized that is thought to be specific to the PE sector, such as “money-chasing deal phenomenon” (Gompers and Lerner, 2000 and “performance persistence” (Lerner and Schoar, 2005. However, based on their continuing use of an ex-post perspective, few scholars have paid attention to the possible extent to which these and other PE phenomena may affect expected returns from PE investments. To address this problem this article draws on an ex-ante perspective of investment decision-making in suggesting how a number of drivers and factors of PE phenomena may produce “abnormal returns”, and that each of those drivers and factors should therefore be considered in accurately assessing the required risk premium and expected abnormal returns of PE investments. In making these contributions we examined a private equity investment of a regional PE in Italy and administered a telephone questionnaire to 40 PEs in Italy and the UK and found principally that while size is the most important driver in producing abnormal returns illiquidity alone cannot explain the expected returns of PE investments (cf. Franzoni et al., 2012. Based on our findings we developed a predictive model of PE decision-making that draws on an ex-ante perspective of asset pricing and takes into account PE phenomena and abnormal returns. This model extends the work of Franzoni et al. (2012, Jegadeesh et al. (2009, and Korteweg and Sorensen (2010 who did not consider the possible influence of PE phenomena in decision-making and will also help PE managers in making better-informed decisions.

  4. When is return voluntary? Conditions of asylum in Lebanon

    Directory of Open Access Journals (Sweden)

    Amy Keith

    2018-02-01

    Full Text Available The decision of Syrian refugees in Lebanon to return to Syria must not be based on a deteriorating quality of asylum that creates physical, social and material pressures on decisions to return.

  5. Clinical management of musculoskeletal injuries in active children and youth.

    Science.gov (United States)

    Mazer, Barbara; Shrier, Ian; Feldman, Debbie Ehrmann; Swaine, Bonnie; Majnemer, Annette; Kennedy, Eileen; Chilingaryan, Gevorg

    2010-07-01

    To describe how different health care specialists manage musculoskeletal injury in children and examine factors influencing return to play decisions. National survey. Secure Web site hosting online questionnaire. Medical doctors, physical therapists, and athletic therapists who were members of their respective sport medicine specialty organizations. Professional affiliation and the effect of the following factors were examined: pushy parent, cautious parent, protective equipment, previous injury, musculoskeletal maturity, game importance, position played, team versus individual sport, and time since injury. Recommendation of return to activity after common injuries seen in children and adolescents as described in 5 vignettes; consistency of responses across vignettes. The survey was completed by 464 respondents (34%). There were several differences between the professional groups in their recommendations to return to activity. Most factors studied did not tend to influence the decision to return to activity, although protective equipment often increased the response to return sooner. The number of participants who would return a child to activity sooner or later for each factor varied greatly across the 5 vignettes, except for pushy parent or cautious parent. Management practices of sport medicine clinicians vary according to profession, child, clinical factors, and sport-related factors. Decisions regarding return to play vary according to 5 specific characteristics of each clinical case. These findings help establish areas of consensus and disagreement in the management of children with injuries and safe return to physical activity.

  6. Experiences and concerns about 'returning to work' for women breast cancer survivors: a literature review.

    Science.gov (United States)

    Tiedtke, Corine; de Rijk, Angelique; Dierckx de Casterlé, Bernadette; Christiaens, Marie-Rose; Donceel, Peter

    2010-07-01

    To explore how female breast cancer patients experience work incapacity during the treatment and return-to-work phases and how interactions between patients and stakeholders affect this experience. Database search for full text articles published between January 1995 and January 2008 that focused on employed female breast cancer patients, factors related to work incapacity, and returning to work. Only results based on self-report data were included. Studies focusing on treatment, financial factors, rate of return, or absence were excluded. Six articles met the inclusion criteria. Women with breast cancer receive varied reactions but little advice about returning to work. Women were primarily concerned with disclosing the diagnosis to their employer and to relatives. Uncertainties about physical appearance, ability to work, and possible job loss affected the women's decisions about working during the treatment phase. After treatment, most women wanted to regain their 'normal life', but concentration and arm or fatigue problems potentially interfered. Although supportive work environments were helpful, the individual needs of women differed. Employers and employees need to find a balance in defining accommodating work. Many women received favourable support, but some reported feeling discriminated against. Many women re-evaluated the role of work in their lives after being confronted with breast cancer. Work adjustments could help women to keep their jobs during illness and recovery. To resolve women's concerns about returning to work, employers, physicians, and insurance institutions should consider increasing and improving communication with breast cancer patients and playing a more active and supportive role. Copyright (c) 2009 John Wiley & Sons, Ltd.

  7. Negative psychological responses of injury and rehabilitation adherence effects on return to play in competitive athletes: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Ivarsson A

    2017-03-01

    Full Text Available Andreas Ivarsson,1 Ulrika Tranaeus,2,3 Urban Johnson,1 Andreas Stenling 4 1Center of Research on Welfare, Health and Sport, School of Health and Welfare, Halmstad University, Halmstad, 2Performance and Training Unit, The Swedish School of Sport and Health Sciences (GIH, 3Musculoskeletal & Sports Injury Epidemiology Center, IMM, Karolinska Institutet, Stockholm, 4Department of Psychology, Umeå University, Umeå, Sweden Abstract: Previous research offers evidence that psychological factors influence an injured athlete during the rehabilitation process. Our first objective was to conduct a systematic review and meta-analysis of the results from all published studies that examined the relationships among negative affective responses after sport injuries, rehabilitation adherence, and return to play (RTP. The second objective was to use a meta-analytic path analysis to investigate whether an indirect effect existed between negative affective responses and RTP through rehabilitation adherence. This literature review resulted in seven studies providing 14 effect sizes. The results from the meta-analysis showed that negative affective responses had a negative effect on successful RTP, whereas rehabilitation adherence had a positive effect on RTP. The results from the meta-analytic path analysis showed a weak and nonsignificant indirect effect of negative affective responses on RTP via rehabilitation adherence. These results underline the importance of providing supportive environments for injured athletes to increase the chances of successful RTP via a decrease in negative affective responses and increase in rehabilitation adherence. Keywords: affective responses, rehabilitation behaviors, return to play, sport injuries

  8. DESIGNING THE RETURN MIGRATION OF ROMANIAN STUDENTS

    Directory of Open Access Journals (Sweden)

    Magdalena VELCIU

    2017-05-01

    Full Text Available Romanian youth migration is an increasing phenomenon, due to subjective and objective factors as economical reasons, professional carrer and increasingly more international competition for talent. In these circumstances, the present article aims to evaluate determinant factors that contribute to the decision of Romanian graduates to return national labour market. We sustain that young Romanians consider carefully and hardly decide their professional future. A particular attention is given to their personal reasons and motivations as well as family and friends network. For designing returning factors we present the results of a questionnaire survey, asking young pupils and students about their future educational way and personal reasons underlying the decision to study in a foreign country and taking into consideration the returning decision. As far international student migration is seen as a first step to migration for work, our work desires to fight for returning home of Romanian well-educated graduates.

  9. Alcohol Dependence and Altered Engagement of Neural Networks in Risky Decisions

    Directory of Open Access Journals (Sweden)

    Xi eZhu

    2016-03-01

    Full Text Available Alcohol dependence is associated with heightened risk tolerance and altered decision- making. This raises the question as to whether alcohol dependent patients (ADP are incapable of proper risk assessment. We investigated how healthy controls (HC and ADP engage neural networks to cope with the increased cognitive demands of risky decisions. We collected fMRI data while 34 HC and 16 ADP played a game that included safe and risky trials. In safe trials, participants accrued money at no risk of a penalty. In risky trials, reward and risk simultaneously increased as participants were instructed to decide when to stop a reward accrual period. If the participant failed to stop before an undisclosed time, the trial would bust and participants would not earn the money from that trial. Independent Component Analysis was used to identify networks engaged during the anticipation and the decision execution of risky compared with safe trials. Like HC, ADP demonstrated distinct network engagement for safe and risky trials at anticipation. However, at decision execution, ADP exhibited severely reduced discrimination in network engagement between safe and risky trials. Although ADP behaviorally responded to risk they failed to appropriately modify network engagement as the decision continued, leading ADP to assume similar network engagement regardless of risk prospects. This may reflect disorganized network switching and a facile response strategy uniformly adopted by ADP across risk conditions. We propose that aberrant salience network (SN engagement in ADP might contribute to ineffective network switching and that the role of the SN in risky decisions warrants further investigation.

  10. Significance of T2 Hyperintensity on Magnetic Resonance Imaging After Cervical Cord Injury and Return to Play in Professional Athletes.

    Science.gov (United States)

    Tempel, Zachary J; Bost, Jeffrey W; Norwig, John A; Maroon, Joseph C

    2015-07-01

    Cervical cord magnetic resonance imaging (MRI) T2 hyperintensity is used as evidence of cord trauma in the evaluation and management of athletes in contact sports. The long-term pathophysiologic and prognostic value of this finding is poorly understood, especially in return to play (RTP). To examine the significance of T2 hyperintensity in the cervical spinal cord of professional athletes. Retrospective review of MRI T2 hyperintensity findings between 2007 and 2014 in 5 professional athletes. Pertinent examination and demographics, including mechanism of injury, surgical intervention, radiographs, MRI studies, long-term outcomes, and RTP recommendations were collected. Four National Football League players and 1 professional wrestler had prior traumatic neurapraxia that at the time of initial consultation had resolved. MRIs showed congenitally small cervical canal (1) and multilevel spondylosis/stenosis/disc herniation (4) along with focal cord T2 hyperintensity (5). The signal abnormalities were at C3/C4 (3), C4 mid-vertebral body (1), and C5/C6 (1). Four athletes had single-level anterior cervical discectomy and fusion, and 1 was nonoperative. Serial MRI imaging at 3 months after surgery showed hyperintensity partially resolved (4) and unchanged (1), and at 9-months 3 of the 5 completely resolved. Based on the author's RTP criteria, 4 of 5 were released to return to their sport. Clearance for RTP preceded complete resolution of MRI T2 hyperintensity in 3 of 4 athletes. The 2 athletes that have returned to profession sport have not had any additional episodes of neurapraxia or any cervical spine-related complications. MRI T2 hyperintensity in contact sport athletes who are symptom-free with normal examination and no evidence of spinal instability may not be a contraindication to RTP. Additional observations are needed to confirm this observation.

  11. Rehabilitation and return to sport after hamstring strain injury

    Directory of Open Access Journals (Sweden)

    Lauren N. Erickson

    2017-09-01

    Full Text Available Hamstring strain injuries are common among sports that involve sprinting, kicking, and high-speed skilled movements or extensive muscle lengthening-type maneuvers with hip flexion and knee extension. These injuries present the challenge of significant recovery time and a lengthy period of increased susceptibility for recurrent injury. Nearly one third of hamstring strains recur within the first year following return to sport with subsequent injuries often being more severe than the original. This high re-injury rate suggests that athletes may be returning to sport prematurely due to inadequate return to sport criteria. In this review article, we describe the epidemiology, risk factors, differential diagnosis, and prognosis of an acute hamstring strain. Based on the current available evidence, we then propose a clinical guide for the rehabilitation of acute hamstring strains and an algorithm to assist clinicians in the decision-making process when assessing readiness of an athlete to return to sport.

  12. Understanding the stakeholders' intention to use economic decision-support tools: A cross-sectional study with the tobacco return on investment tool.

    Science.gov (United States)

    Cheung, Kei Long; Evers, Silvia M A A; Hiligsmann, Mickaël; Vokó, Zoltán; Pokhrel, Subhash; Jones, Teresa; Muñoz, Celia; Wolfenstetter, Silke B; Józwiak-Hagymásy, Judit; de Vries, Hein

    2016-01-01

    Despite an increased number of economic evaluations of tobacco control interventions, the uptake by stakeholders continues to be limited. Understanding the underlying mechanism in adopting such economic decision-support tools by stakeholders is therefore important. By applying the I-Change Model, this study aims to identify which factors determine potential uptake of an economic decision-support tool, i.e., the Return on Investment tool. Stakeholders (decision-makers, purchasers of services/pharma products, professionals/service providers, evidence generators and advocates of health promotion) were interviewed in five countries, using an I-Change based questionnaire. MANOVA's were conducted to assess differences between intenders and non-intenders regarding beliefs. A multiple regression analysis was conducted to identify the main explanatory variables of intention to use an economic decision-support tool. Ninety-three stakeholders participated. Significant differences in beliefs were found between non-intenders and intenders: risk perception, attitude, social support, and self-efficacy towards using the tool. Regression showed that demographics, pre-motivational, and motivational factors explained 69% of the variation in intention. This study is the first to provide a theoretical framework to understand differences in beliefs between stakeholders who do or do not intend to use economic decision-support tools, and empirically corroborating the framework. This contributes to our understanding of the facilitators and barriers to the uptake of these studies. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  13. Retrospectively exploring the importance of items in the decision to leave the emergency medical services (EMS) profession and their relationships to life satisfaction after leaving EMS and likelihood of returning to EMS.

    Science.gov (United States)

    Blau, Gary; Chapman, Susan

    2011-01-01

    An exit survey was returned by a sample of 127 respondents in fully compensated positions who left the EMS profession, most within 12 months prior to filling out the exit survey. A very high percentage continued to work after leaving EMS. Respondents were asked to rate the importance of each of 17 items in affecting their decision to leave EMS. A higher than anticipated response to a "not applicable" response choice affected the usability of 8 of these items. Nine of the 17 items had at least 65 useable responses and were used for further analysis. Within these 9, stress/burnout and lack of job challenges had the highest importance in affecting the decision to leave EMS, while desire for better pay and benefits had the lowest importance. Desire for career change was positively related to life satisfaction after leaving EMS and negatively related to likelihood of returning to EMS. Stress/burnout was positively related to life satisfaction after leaving EMS. Study limitations and future research issues are briefly discussed.

  14. Non-operative management of a complete anterior cruciate ligament injury in an English Premier League football player with return to play in less than 8 weeks: applying common sense in the absence of evidence

    Science.gov (United States)

    Weiler, Richard; Monte-Colombo, Mathew; Mitchell, Adam; Haddad, Fares

    2015-01-01

    This case report illustrates and discusses the non-operative management of a complete anterior cruciate ligament (ACL) injury in an English Premier League football player, his return to play within 8 weeks and problem-free follow-up at 18 months post injury. When non-operative verses surgical ACL reconstruction is considered there are many fundamental gaps in our knowledge and currently, at elite level, there are no cases in cutting sports within the literature to guide these decisions. When the norm is for all professional footballers to be recommended surgery, it will be very challenging when circumstances and patient autonomy dictate a conservative approach, where prognosis, end points and risk are unclear and assumed to be high. This case challenges current dogma and provides a starting point for much needed debate about best practice, treatment options, research direction and not just at the elite level of sport. PMID:25917066

  15. The Responders’ Gender Stereotypes Modulate the Strategic Decision-Making of Proposers playing the Ultimatum Game

    OpenAIRE

    Fabre, Eve Floriane; Causse, Mickael; Pesciarelli, Francesca; Cacciari, Cristina

    2016-01-01

    Despite the wealth of studies investigating factors affecting decisions, not much is known about the impact of stereotypical beliefs on strategic economic decision-making. In the present study, we used the ultimatum game paradigm to investigate how participants playing as proposer modulate their strategic economic behavior, according to their game counterparts’ stereotypical identity (i.e., responders). The latter were introduced to the participants using occupational role nouns stereotypical...

  16. Measurement of functional capacity requirements to aid in development of an occupation-specific rehabilitation training program to help firefighters with cardiac disease safely return to work.

    Science.gov (United States)

    Adams, Jenny; Roberts, Joanne; Simms, Kay; Cheng, Dunlei; Hartman, Julie; Bartlett, Charles

    2009-03-15

    We designed a study to measure the functional capacity requirements of firefighters to aid in the development of an occupation-specific training program in cardiac rehabilitation; 23 healthy male firefighters with no history of heart disease completed a fire and rescue obstacle course that simulated 7 common firefighting tasks. They wore complete personal protective equipment and portable metabolic instruments that included a data collection mask. We monitored each subject's oxygen consumption (VO(2)) and working heart rate, then calculated age-predicted maximum heart rates (220 - age) and training target heart rates (85% of age-predicted maximum heart rate). During performance of the obstacle course, the subjects' mean working heart rates and peak heart rates were higher than the calculated training target heart rates (t(22) = 5.69 [working vs target, p functional capacity greatly exceeded that typically attained by patients in traditional cardiac rehabilitation programs (5 to 8 METs). In conclusion, our results indicate the need for intense, occupation-specific cardiac rehabilitation training that will help firefighters safely return to work after a cardiac event.

  17. Decision Usefulness Approach Of Accounting Information: Bagaimana Informasi Akuntansi Menjadi Useful ?

    Directory of Open Access Journals (Sweden)

    Zarah Puspitaningtyas

    2010-10-01

    Full Text Available Application of decision usefulness approach to produce accounting information that is relevant and reliable. Relevant information, that has the capacity to affect the confidence of investors about future returns, and should be released in a timely manner.The concept of decision usefulness of accounting information plays an important role in identifying problems for users of financial reports and selection of accounting information that users of financial statements to make the best decision. To apply the concept of decision usefulness is necessary linkages with the various theories in economics and finance. Decision usefulness approach assumes that individual decision makers are rational, that is individuals who will choose the action that will yield the highest expected utility.

  18. The Responders' Gender Stereotypes Modulate the Strategic Decision-Making of Proposers Playing the Ultimatum Game.

    Science.gov (United States)

    Fabre, Eve F; Causse, Mickael; Pesciarelli, Francesca; Cacciari, Cristina

    2016-01-01

    Despite the wealth of studies investigating factors affecting decisions, not much is known about the impact of stereotypical beliefs on strategic economic decision-making. In the present study, we used the ultimatum game paradigm to investigate how participants playing as proposer modulate their strategic economic behavior, according to their game counterparts' stereotypical identity (i.e., responders). The latter were introduced to the participants using occupational role nouns stereotypically marked with gender paired with feminine or masculine proper names (e.g., linguist-Anna; economist-David; economist-Cristina; linguist-Leonardo). When playing with male-stereotyped responders, proposers quickly applied the equity rule, behaving fairly, while they adopted a strategic behavior with responders characterized by female stereotypes. They were also longer to make their offers to female than to male responders but both kinds of responders received comparable offers, suggesting a greater cognitive effort to treat females as equally as males. The present study explicitly demonstrates that gender stereotypical information affect strategic economic decision-making and highlights a possible evolution of gender discrimination into a more insidious discrimination toward individuals with female characteristics.

  19. The Responders’ Gender Stereotypes Modulate the Strategic Decision-Making of Proposers playing the Ultimatum Game

    Directory of Open Access Journals (Sweden)

    Eve Florianne Fabre

    2016-01-01

    Full Text Available Despite the wealth of studies investigating factors affecting decisions, not much is known about the impact of stereotypical beliefs on strategic economic decision-making. In the present study, we used the ultimatum game paradigm to investigate how participants playing as proposer modulate their strategic economic behavior, according to their game counterparts’ stereotypical identity (i.e., responders. The latter were introduced to the participants using occupational role nouns stereotypically marked with gender paired with feminine or masculine proper names (e.g., linguist-Anna; economist-David; economist-Cristina; linguist-Leonardo. When playing with male-stereotyped responders, proposers quickly applied the equity rule, behaving fairly, while they adopted a strategic behavior with responders characterized by female stereotypes. They were also longer to make their offers to female than to male responders but both kinds of responders received comparable offers, suggesting a greater cognitive effort to treat females as equally as males. The present study explicitly demonstrates that gender stereotypical information affect strategic economic decision-making and highlights a possible evolution of gender discrimination into a more insidious discrimination toward individuals with female characteristics.

  20. The Responders’ Gender Stereotypes Modulate the Strategic Decision-Making of Proposers Playing the Ultimatum Game

    Science.gov (United States)

    Fabre, Eve F.; Causse, Mickael; Pesciarelli, Francesca; Cacciari, Cristina

    2016-01-01

    Despite the wealth of studies investigating factors affecting decisions, not much is known about the impact of stereotypical beliefs on strategic economic decision-making. In the present study, we used the ultimatum game paradigm to investigate how participants playing as proposer modulate their strategic economic behavior, according to their game counterparts’ stereotypical identity (i.e., responders). The latter were introduced to the participants using occupational role nouns stereotypically marked with gender paired with feminine or masculine proper names (e.g., linguist-Anna; economist-David; economist-Cristina; linguist-Leonardo). When playing with male-stereotyped responders, proposers quickly applied the equity rule, behaving fairly, while they adopted a strategic behavior with responders characterized by female stereotypes. They were also longer to make their offers to female than to male responders but both kinds of responders received comparable offers, suggesting a greater cognitive effort to treat females as equally as males. The present study explicitly demonstrates that gender stereotypical information affect strategic economic decision-making and highlights a possible evolution of gender discrimination into a more insidious discrimination toward individuals with female characteristics. PMID:26834684

  1. Return to Work After Lumbar Microdiscectomy - Personalizing Approach Through Predictive Modeling.

    Science.gov (United States)

    Papić, Monika; Brdar, Sanja; Papić, Vladimir; Lončar-Turukalo, Tatjana

    2016-01-01

    Lumbar disc herniation (LDH) is the most common disease among working population requiring surgical intervention. This study aims to predict the return to work after operative treatment of LDH based on the observational study including 153 patients. The classification problem was approached using decision trees (DT), support vector machines (SVM) and multilayer perception (MLP) combined with RELIEF algorithm for feature selection. MLP provided best recall of 0.86 for the class of patients not returning to work, which combined with the selected features enables early identification and personalized targeted interventions towards subjects at risk of prolonged disability. The predictive modeling indicated at the most decisive risk factors in prolongation of work absence: psychosocial factors, mobility of the spine and structural changes of facet joints and professional factors including standing, sitting and microclimate.

  2. Co-decision in the European Parliament: Comparing Rationalist and Constructivist Explanations of the Returns Directive

    Directory of Open Access Journals (Sweden)

    Ariadna Ripoll Servent

    2011-02-01

    Full Text Available This study uses rationalist and constructivist explanations of co-decision in the European Parliament (EP. It seeks to understand the change in the policy preferences of the EP during negotiations on the ‘Returns’ directive – dealing with the voluntary or compulsory return of irregular immigrants. This article shows that the introduction of co-decision contributed considerably to the EP’s change of stance on immigration policies. A long-standing advocate of civil liberties in the Area of Freedom, Security and Justice (AFSJ, the EP was expected to raise the standards of protection for third-country nationals. In view of the inability of the EP to construct a more liberal policy, the study uses two institutionalist approaches to understand why the EP was unsuccessful in raising the standards. Therefore, the approaches aim at identifying the logics and layers of change. The empirical application of the models highlights the necessity to integrate rationalist and constructivist understandings of co-decision in order to understand motivations for policy change. Synergies in the direction of change also point to the importance of institutional motivations, in order to understand major changes in the policy preferences of the EP.

  3. Return to sport after shoulder arthroplasty: a systematic review and meta-analysis.

    Science.gov (United States)

    Liu, Joseph N; Steinhaus, Michael E; Garcia, Grant H; Chang, Brenda; Fields, Kara; Dines, David M; Warren, Russell F; Gulotta, Lawrence V

    2018-01-01

    With increasing incidence and indications for shoulder arthroplasty, there is an increasing emphasis on the ability to return to sports. The main goal of this study was to determine the rate of return to sport after shoulder arthroplasty. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed to perform this systematic review and meta-analysis. A search was performed on MEDLINE, Scopus, EMBASE, and the Cochrane Library. The quality of the included studies was evaluated according to the Methodological Index for Nonrandomized Studies checklist. The main judgement outcome was the rate of return to sports activity after shoulder arthroplasty and the level of play upon return (identical or higher/lower level). Thirteen studies were reviewed, including 944 patients (506 athletes), treated with shoulder arthroplasty at an average follow-up of 5.1 years (range, 0.5-12.6 years). The most common sports were swimming (n = 169), golf (n = 144), fitness sports (n = 71), and tennis (n = 63). The overall rate of return to sport was 85.1% (95% CI, 76.5-92.3%), including 72.3% (95% CI, 60.6-82.8%) returning to an equivalent or improved level of play, after 1-36 months. Patients undergoing anatomic total shoulder arthroplasty returned at a significantly higher rate (92.6%) compared to hemiarthroplasty (71.1%, p = 0.02) or reverse total shoulder arthroplasty (74.9%, p = 0.003). Most patients are able to return to one or more sports following shoulder arthroplasty, with anatomic total shoulder arthroplasty having the highest rate of return. IV.

  4. Return Migration among Elderly, Chronically Ill Bosnian Refugees

    DEFF Research Database (Denmark)

    Handlos, Line Neerup; Olwig, Karen Fog; Bygbjerg, Ib Christian

    2015-01-01

    Elderly migrants constitute a considerable share of global return migration; nevertheless, literature on the health aspects of the return migration among these migrants is still scarce. This study explores the significance of return migration among elderly, chronically ill Bosnian refugees from D...... of illness, health did matter. Viewed as physical, social and mental well-being in line with WHO's definition of health, health was indeed one of the most important factors when the decision to return was made....... that physical health, in the sense of the absence of illness and easy access to necessary health-care services and medicines, was not highly prioritized when the decision was made whether or not to return. However, if health is regarded more broadly as involving more than mere physical health and the absence......Elderly migrants constitute a considerable share of global return migration; nevertheless, literature on the health aspects of the return migration among these migrants is still scarce. This study explores the significance of return migration among elderly, chronically ill Bosnian refugees from...

  5. Hamstring Injuries in Professional Soccer Players: Extent of MRI-Detected Edema and the Time to Return to Play.

    Science.gov (United States)

    Crema, Michel D; Godoy, Ivan R B; Abdalla, Rene J; de Aquino, Jose Sanchez; Ingham, Sheila J McNeill; Skaf, Abdalla Y

    Discrepancies exist in the literature regarding the association of the extent of injuries assessed on magnetic resonance imaging (MRI) with recovery times. MRI-detected edema in grade 1 hamstring injuries does not affect the return to play (RTP). Retrospective cohort study. Level 4. Grade 1 hamstring injuries from 22 professional soccer players were retrospectively reviewed. The extent of edema-like changes on fluid-sensitive sequences from 1.5-T MRI were evaluated using craniocaudal length, percentage of cross-sectional area, and volume. The time needed to RTP was the outcome. Negative binomial regression analysis tested the measurements of MRI-detected edema-like changes as prognostic factors. The mean craniocaudal length was 7.6 cm (SD, 4.9 cm; range, 0.9-19.1 cm), the mean percentage of cross-sectional area was 23.6% (SD, 20%; range, 4.4%-89.6%), and the mean volume was 33.1 cm 3 (SD, 42.6 cm 3 ; range, 1.1-161.3 cm 3 ). The mean time needed to RTP was 13.6 days (SD, 8.9 days; range, 3-32 days). None of the parameters of extent was associated with RTP. The extent of MRI edema in hamstring injuries does not have prognostic value. Measuring the extent of edema in hamstring injuries using MRI does not add prognostic value in clinical practice.

  6. Nurses Returning to School: Motivators, Inhibitors and Job Satisfaction.

    Science.gov (United States)

    Harris, Patrick W; Burman, Mary E

    2016-01-01

    Health care employers and national nursing organizations are placing increased emphasis on nurses earning a baccalaureate degree or higher. This study examines the impact of motivators (professional and personal motivation), inhibitors (time constraints and employer discouragement), and job satisfaction on intent to return to school. Approximately half of the employed nurses in Wyoming were surveyed using a mailed questionnaire in the summer of 2013. Perceived employer discouragement and time constraints continued to play a direct role on intent to return to school regardless of nurse motivation or job satisfaction. However, motivation and job satisfaction also contributed to a nurse's intent to return to school. These results suggest that motivation and job satisfaction are significant regarding intent to return to school but can be limited by both perceived discouragement of one's employer and perceived time constraints. In order to meet the increasing demands of a better-educated nursing workforce, a shift in workplace dynamics may be warranted. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Systematic review of prognosis and return to play after sport concussion: results of the International Collaboration on Mild Traumatic Brain Injury Prognosis.

    Science.gov (United States)

    Cancelliere, Carol; Hincapié, Cesar A; Keightley, Michelle; Godbolt, Alison K; Côté, Pierre; Kristman, Vicki L; Stålnacke, Britt-Marie; Carroll, Linda J; Hung, Ryan; Borg, Jörgen; Nygren-de Boussard, Catharina; Coronado, Victor G; Donovan, James; Cassidy, J David

    2014-03-01

    To synthesize the best available evidence on prognosis after sport concussion. MEDLINE and other databases were searched (2001-2012) with terms including "craniocerebral trauma" and "sports." Reference lists of eligible articles were also searched. Randomized controlled trials and cohort and case-control studies were selected according to predefined criteria. Studies had to have a minimum of 30 concussion cases. Eligible studies were critically appraised using a modification of the Scottish Intercollegiate Guidelines Network (SIGN) criteria. Two reviewers independently reviewed and extracted data from accepted studies into evidence tables. Evidence was synthesized qualitatively according to modified SIGN criteria, and studies were categorized as exploratory or confirmatory based on the strength of their design and evidence. After 77,914 records were screened, 52 articles were eligible for this review, and 24 articles (representing 19 studies) with a low risk of bias were accepted. Our findings are based on exploratory studies of predominantly male football players at the high school, collegiate, and professional levels. Most athletes recover within days to a few weeks, and American and Australian professional football players return to play quickly after mild traumatic brain injury. Delayed recovery appears more likely in high school athletes, in those with a history of previous concussion, and in those with a higher number and duration of postconcussion symptoms. The evidence concerning sports concussion course and prognosis is very preliminary, and there is no evidence on the effect of return-to-play guidelines on prognosis. Our findings have implications for further research. Well-designed, confirmatory studies are urgently needed to understand the consequences of sport concussion, including recurrent concussion, across different athletic populations and sports. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights

  8. Evaluating the biological potential in samples returned from planetary satellites and small solar system bodies: framework for decision making

    National Research Council Canada - National Science Library

    National Research Council Staff; Space Studies Board; Division on Engineering and Physical Sciences; National Research Council; National Academy of Sciences

    ... from Planetary Satellites and Small Solar System Bodies Framework for Decision Making Task Group on Sample Return from Small Solar System Bodies Space Studies Board Commission on Physical Sciences, Mathematics, and Applications National Research Council NATIONAL ACADEMY PRESS Washington, D.C. 1998 i Copyrightthe true use are Please breaks...

  9. Economic and accounting rates of return

    NARCIS (Netherlands)

    Feenstra, D.W.; Wang, H.

    2000-01-01

    The rate of return on invested capital is a central concept in financial analysis. The purpose of calculating the rate of return on investment in general is to measure the financial performance, to assess the desirability of a project and to make decisions on the valuation of firms. Financial

  10. Using Role Play to Debate Animal Testing

    Science.gov (United States)

    Agell, Laia; Soria, Vanessa; Carrió, Mar

    2015-01-01

    The use of animals in biomedical research is a socio-scientific issue in which decision-making is complicated. In this article, we describe an experience involving a role play activity performed during school visits to the Barcelona Biomedical Research Park (PRBB) to debate animal testing. Role playing games require students to defend different…

  11. Public health policy decisions on medical innovations: what role can early economic evaluation play?

    Science.gov (United States)

    Hartz, Susanne; John, Jürgen

    2009-02-01

    Our contribution aims to explore the different ways in which early economic data can inform public health policy decisions on new medical technologies. A literature research was conducted to detect methodological contributions covering the health policy perspective. Early economic data on new technologies can support public health policy decisions in several ways. Embedded in horizon scanning and HTA activities, it adds to monitoring and assessment of innovations. It can play a role in the control of technology diffusion by informing coverage and reimbursement decisions as well as the direct public promotion of healthcare technologies, leading to increased efficiency. Major problems include the uncertainty related to economic data at early stages as well as the timing of the evaluation of an innovation. Decision-makers can benefit from the information supplied by early economic data, but the actual use in practice is difficult to determine. Further empirical evidence should be gathered, while the use could be promoted by further standardization.

  12. Safe models for risky decisions

    NARCIS (Netherlands)

    Steingröver, H.M.

    2017-01-01

    In everyday life, we often have to decide between options that differ in their immediate and long-term consequences. Would you, for example, opt for a delicious piece of cake or rather eat a healthy apple? To investigate how people make risky decisions, this thesis focuses on the Iowa gambling task

  13. Return on investment for vendor computerized physician order entry in four community hospitals: the importance of decision support.

    Science.gov (United States)

    Zimlichman, Eyal; Keohane, Carol; Franz, Calvin; Everett, Wendy L; Seger, Diane L; Yoon, Catherine; Leung, Alexander A; Cadet, Bismarck; Coffey, Michael; Kaufman, Nathan E; Bates, David W

    2013-07-01

    In-hospital adverse events are a major cause of morbidity and mortality and represent a major cost burden to health care systems. A study was conducted to evaluate the return on investment (ROI) for the adoption of vendor-developed computerized physician oder entry (CPOE) systems in four community hospitals in Massachusetts. Of the four hospitals, two were under one management structure and implemented the same vendor-developed CPOE system (Hospital Group A), while the other two were under a second management structure and implemented another vendor-developed CPOE system (Hospital Group B). Cost savings were calculated on the basis of reduction in preventable adverse drug event (ADE) rates as measured previously. ROI, net cash flow, and the breakeven point during a 10-year cost-and-benefit model were calculated. At the time of the study, none of the participating hospitals had implemented more than a rudimentary decision support system together with CPOE. Implementation costs were lower for Hospital Group A than B ($7,130,894 total or $83/admission versus $19,293,379 total or $113/admission, respectively), as were preventable ADE-related avoided costs ($7,937,651 and $16,557,056, respectively). A cost-benefit analysis demonstrated that Hospital Group A had an ROI of 11.3%, breaking even on the investment eight years following implementation. Hospital Group B showed a negative return, with an ROI of -3.1%. Adoption of vendor CPOE systems in community hospitals was associated with a modest ROI at best when applying cost savings attributable to prevention of ADEs only. The modest financial returns can beattributed to the lack of clinical decision support tools.

  14. Rehabilitation after labral repair and femoroacetabular decompression: criteria-based progression through the return to sport phase.

    Science.gov (United States)

    Wahoff, Michael; Dischiavi, Steve; Hodge, Jenna; Pharez, Joseph D

    2014-11-01

    Rehabilitation following hip arthroscopy for femoroacetabular impingement (FAI) and labral-chondral dysfunction has evolved rapidly over the past 15 years. There have been multiple commentaries published on rehabilitation following hip arthroscopy without any published standardized objective criteria to address the advancement of the athlete through the phases of rehabilitation. The purpose of this clinical commentary is to describe a criteria driven algorithm for safe integration and return to sport rehabilitation following hip arthroscopy. The criteria based program allows for individuality of the athlete while providing guidance from early post-operative phases through late return to sport phases of rehabilitation. Emphasis is placed on the minimum criteria to advance including healing restraints, patient reported outcomes, range of motion, core and hip stability, postural control, symmetry with functional tasks and gait, strength, power, endurance, agility, and sport-specific tasks. Evidence to support the criteria will be offered as available. Despite limitations, this clinical commentary will offer a guideline for safe return to sport for the athlete while identifying areas for further investigation. 5.

  15. Return to Chernobyl

    Energy Technology Data Exchange (ETDEWEB)

    Nosovsky, Anatolij

    1995-09-01

    Despite the catastrophic accident at the Chernobylsk 4 reactor in 1986, the Ukraine is currently expanding its nuclear industry. The government is committed to increasing the share of nuclear output to 40% of the country`s electric power and the Chernobyl plant is included in this plan. All the Chernobyl reactors were closed down at the time of the accident, but units 1, 2 and 3 had all been restarted after safety modifications by December 1987. A fire in the turbine hall of unit 2 in 1991 resulted in the closure of that reactor and precipitated a political decision to close the entire plant by 1993. The economic consequences of such action and the safe operation of the remaining two reactors led, however, to the reversal of that decision. Work is now far advanced on unit 2 for a restart in 1996 and the management wants to upgrade all three reactors according to IAEA guidelines. Nevertheless, the question of closure of the Chernobyl plant remains in the air. A conditional acceptance of closure by 2000 has been made by the Ukraine provided the shortfall in power is taken up by a new gas-fired station. International finance is being sought for decommissioning, for urgent action on the decaying sarcophagus of unit 4, and for the gas-fired plant. Closure of the plant, given the social upheaval of the accident and recent political events, could contribute to the health of the Ukrainian national psyche. (UK).

  16. Return to Chernobyl

    International Nuclear Information System (INIS)

    Nosovsky, Anatolij.

    1995-01-01

    Despite the catastrophic accident at the Chernobylsk 4 reactor in 1986, the Ukraine is currently expanding its nuclear industry. The government is committed to increasing the share of nuclear output to 40% of the country's electric power and the Chernobyl plant is included in this plan. All the Chernobyl reactors were closed down at the time of the accident, but units 1, 2 and 3 had all been restarted after safety modifications by December 1987. A fire in the turbine hall of unit 2 in 1991 resulted in the closure of that reactor and precipitated a political decision to close the entire plant by 1993. The economic consequences of such action and the safe operation of the remaining two reactors led, however, to the reversal of that decision. Work is now far advanced on unit 2 for a restart in 1996 and the management wants to upgrade all three reactors according to IAEA guidelines. Nevertheless, the question of closure of the Chernobyl plant remains in the air. A conditional acceptance of closure by 2000 has been made by the Ukraine provided the shortfall in power is taken up by a new gas-fired station. International finance is being sought for decommissioning, for urgent action on the decaying sarcophagus of unit 4, and for the gas-fired plant. Closure of the plant, given the social upheaval of the accident and recent political events, could contribute to the health of the Ukrainian national psyche. (UK)

  17. Back to school: drop-out and return to school among youth in Mexico City

    Directory of Open Access Journals (Sweden)

    Emilio Blanco Bosco

    2014-09-01

    Full Text Available This paper addresses the return to school among youngsters in Mexico City that had dropped out of school at some point between the beginning of elementary school and the end of upper secondary level. More than a quarter of these youngsters returned to school, which supports the idea that quitting school does not equal to the end of the educational career. There is a significant association between the socioeconomic origin and the probability of an individual returning to school, although weaker (and in the opposite direction than correlation with the probability of dropping out. Complex, non-linear patterns were found between the return and the moment when the drop out occurred, which questions mainstream theories about educational decisions. It was also found that an important proportion of those who returned to school completed upper secondary education, particularly remarkable among youngsters of lower social origins. The evidence supports the idea of considering both the effects of the social structure and the individual agency, and particularly to take into account the actors’ rationality.

  18. Amount of Minutes Played Does Not Contribute to Anterior Cruciate Ligament Injury in National Basketball Association Athletes.

    Science.gov (United States)

    Okoroha, Kelechi R; Marfo, Kojo; Meta, Fabien; Matar, Robert; Shehab, Ramsy; Thompson, Terry; Moutzouros, Vasilios; Makhni, Eric C

    2017-07-01

    There is limited information on the potential risk factors for sustaining an anterior cruciate ligament (ACL) tear in National Basketball Association (NBA) athletes. This study evaluated 83 NBA players who sustained an ACL injury between 1984 and 2015 to determine the influence of minutes played on injury risk. Minutes played in the injury game, during the season, and over their career were assessed, along with the ability to return to play, player efficiency rating, and playing time after return. Athletes in the NBA played significantly fewer minutes before sustaining an ACL injury (17.1 minutes) than their average minutes per game that season (23.5 minutes; PNBA competition the season following ACL injury. Players who were drafted as lottery picks (draft pick 1 to 15) or those who were starters played significantly more minutes the season following injury than those who were not (both PNBA game did not contribute to the risk of sustaining an ACL injury. Although there was a high rate of return to NBA competition the season following injury, those who were elite athletes played more minutes per game than those who were not. Athletes who returned to play sustained a decrease in player efficiency ratings compared with similar athletes without ACL injury. [Orthopedics. 2017; 40(4):e658-e662.]. Copyright 2017, SLACK Incorporated.

  19. Is Mars Sample Return Required Prior to Sending Humans to Mars?

    Science.gov (United States)

    Carr, Michael; Abell, Paul; Allwood, Abigail; Baker, John; Barnes, Jeff; Bass, Deborah; Beaty, David; Boston, Penny; Brinkerhoff, Will; Budney, Charles; hide

    2012-01-01

    Prior to potentially sending humans to the surface of Mars, it is fundamentally important to return samples from Mars. Analysis in Earth's extensive scientific laboratories would significantly reduce the risk of human Mars exploration and would also support the science and engineering decisions relating to the Mars human flight architecture. The importance of measurements of any returned Mars samples range from critical to desirable, and in all cases these samples will would enhance our understanding of the Martian environment before potentially sending humans to that alien locale. For example, Mars sample return (MSR) could yield information that would enable human exploration related to 1) enabling forward and back planetary protection, 2) characterizing properties of Martian materials relevant for in situ resource utilization (ISRU), 3) assessing any toxicity of Martian materials with respect to human health and performance, and 4) identifying information related to engineering surface hazards such as the corrosive effect of the Martian environment. In addition, MSR would be engineering 'proof of concept' for a potential round trip human mission to the planet, and a potential model for international Mars exploration.

  20. Return Migration among Elderly, Chronically Ill Bosnian Refugees: Does Health Matter?

    Science.gov (United States)

    Handlos, Line Neerup; Olwig, Karen Fog; Bygbjerg, Ib Christian; Kristiansen, Maria; Norredam, Marie Louise

    2015-10-12

    Elderly migrants constitute a considerable share of global return migration; nevertheless, literature on the health aspects of the return migration among these migrants is still scarce. This study explores the significance of return migration among elderly, chronically ill Bosnian refugees from Denmark and the role of health issues in their decision to return. It is based on semi-structured interviews with 33 elderly, chronically ill Bosnian refugees who have moved back to Bosnia and Herzegovina, and 10 elderly, chronically ill Bosnian refugees who have remained in Denmark. The interviews show that physical health, in the sense of the absence of illness and easy access to necessary health-care services and medicines, was not highly prioritized when the decision was made whether or not to return. However, if health is regarded more broadly as involving more than mere physical health and the absence of illness, health did matter. Viewed as physical, social and mental well-being in line with WHO's definition of health, health was indeed one of the most important factors when the decision to return was made.

  1. Teacher's Guide to Canal. The Middlesex Canal: A Role Playing Exercise.

    Science.gov (United States)

    Holmes, Cary W.; Tedesco, Paul H.

    The document consists of a role-playing game and related teacher's guide designed to illustrate decision-making processes leading to the building of the Middlesex Canal in Massachusetts in 1793. The primary educational objective is to involve students in the decision-making process through role play. The game is designed to facilitate…

  2. The decision-making capacity of elderly hospitalized patients: validation of a test on their choice of return home.

    Science.gov (United States)

    Romdhani, Mouna; Abbas, Rachid; Peyneau, Cécile; Koskas, Pierre; Houenou Quenum, Nadège; Galleron, Sandrine; Drunat, Olivier

    2018-03-01

    Elderly hospitalized patients have uncertain or questionable capacity to make decisions about their care. Determining whether an elderly patient possesses decision-making capacity to return at home is a major concern for geriatricians in everyday practice. To construct and internally validate a new tool, the dream of home test (DROM-test), as support for decision making hospitalization discharge destination for the elderly in the acute or sub-acute care setting. The DROM-test consists of 10 questions and 4 vignettes based upon the 4 relevant criteria for decision-making: capacity to understand information, to appreciate and reason about medical risks and to communicate a choice. A prospective observational study was conducted during 6 months in 2 geriatric care units in Bretonneau Hospital (Assistance publique, Hôpitaux de Paris). We compared the patient decision of DROM-test regarding discharge recommendations with those of an Expert committee and of the team in charge of the patient. 102 were included: mean age 83.1 + 6.7 [70; 97], 66.67% females. Principal components analysis revealed four dimensions: choice, understanding, reasoning and understanding. The area under the ROC curve was 0.64 for the choice dimension, 0.59 for the understanding, 0.53 for the reasoning and 0.52 for the apprehension. Only the choice dimension was statistically associated with the decision of the committee of experts (p=0.017). Even though Drom-test has limitations, it provides an objective way to ascertain decision-making capacity for hospitalised elderly patients.

  3. Learning, Play, and Your 1- to 3-Month-Old

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Learning, Play, and Your 1- to 3-Month-Old ... Baby to Learn Print What Your Baby Is Learning After learning to recognize your voice, your face, ...

  4. Learning, Play, and Your 4- to 7-Month-Old

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Learning, Play, and Your 4- to 7-Month-Old ... for Encouraging Learning Print What Your Baby Is Learning By 4 months old, your baby has learned ...

  5. Learning, Play, and Your 8- to 12-Month-Old

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Learning, Play, and Your 8- to 12-Month-Old ... these next few months. What Is My Child Learning? Your little one will make great strides in ...

  6. Return-to-Work Program for Injured Workers: Factors of Successful Return to Employment.

    Science.gov (United States)

    Awang, Halimah; Shahabudin, Sharifah Muhairah; Mansor, Norma

    2016-11-01

    This study examined the factors of successful return to employment among participants in the return to work program (RTW) following work-related injury. Data were obtained from the Social Security Organization database containing 9850 injured workers who underwent RTW in 2010 to 2013. About 65% had successfully returned to employment. Significant factors of successful return include gender, employer interest, motivation, age, intervention duration, and type of injury. Male and motivated employees were more likely to return to employment compared with female and unmotivated employees, respectively. Participants from interested employers were 23.22 times more likely to return to work than those from uninterested employers, whereas participants whose intervention period exceeded 5 months were 41% less likely to return to work compared with those whose intervention period was within 3 months. Appropriate strategy and enhanced collaboration between the stakeholders would improve the proportion of successful return to employment. © 2016 APJPH.

  7. Shaping decisions in volleyball An ecological approach to decision-making in volleyball passing

    NARCIS (Netherlands)

    Barsingerhorn, Annemiek D.; Zaal, Frank T. J. M.; De Poel, Harjo J.; Pepping, Gert-Jan

    2013-01-01

    To extend research on decision-making in sport we addressed the choices volleyball-players are faced with in a simple volleyball pass-return task. We manipulated the distance that eight experienced volleyball players had to cover for successful ball passing, and mapped their passing technique (i.e.,

  8. Interoception drives increased rational decision-making in meditators playing the Ultimatum Game.

    Directory of Open Access Journals (Sweden)

    Ulrich eKirk

    2011-04-01

    Full Text Available Human decision-making is often framed as a competition between cognitive and emotional processes in the brain. Deviations from rational processes are believed to derive from inclusion of emotional factors in decision-making. Here, we investigate whether a group of experienced Buddhist meditators are better equipped to regulate emotional processes compared with controls during economic decision-making in the Ultimatum Game. We show that meditators accept unfair offers on more than half of the trials, whereas controls only accept unfair offers on one-quarter of the trials. By applying fMRI we show that controls recruit the anterior insula during unfair offers. Such responses are powerful predictors of rejecting offers in social interaction. By contrast, meditators display attenuated activity in high-level emotional representations of the anterior insula and increased activity in the lower-level interoceptive representations of the posterior insula. In addition we show that a subset of control participants who play rationally (i.e. accepts >85% unfair offers recruits the DLPFC reflecting increased cognitive demands to accept unfairness, whereas rational meditators by contrast activates the somatosensory cortex and posterior superior temporal cortex (pSTC. In summary, when assessing unfairness, meditators activate a different network of brain areas compared with controls enabling them to uncouple negative emotional reactions from their behavior. These findings highlight the clinically and socially important possibility that sustained training in mindfulness meditation may impact distinct domains of human decision-making.

  9. Evaluation of the return to work and its duration after myocardial infarction

    Directory of Open Access Journals (Sweden)

    Seyyed Jalil Mirmohammadi

    2014-05-01

    Full Text Available BACKGROUND: The evaluation of the ability for return to work among patients after myocardial infarction (MI is subject to controversy. Understanding various factors, which may affect return to work process, will help in promoting effective communication between physicians and patients. Return to work is dependent on such factors as patients’ functional capacity, MI expansion, cardiac muscle function, some psychiatric variables, job satisfaction, economic status, and age. In this study, we aimed to assess the frequency of return to work after first MI attack, and factors affecting it. METHODS: This was a follow-up study performed in Yazd, Iran from September 2007 until September 2010 on 200 patients suffering from their first MI attack. Patients were assessed 6 months and 1-year after MI regarding their cardiac function. Job satisfaction was evaluated by Direct Support Professional job satisfaction questionnaire. RESULTS: Seventy-seven percent of MI patients returned to work after 1-year. Mean time for return to work was 46.00 ± 4.12 days. Sixty percent of patients returned to work during the first 50 days after MI and 50% of them during 40 days after MI. The most common reason for not returning to work was patient’s decision. CONCLUSION: This study showed that a considerable numbers of patients returned to work after 1-year. The only factors which affected the rate of return to work were left ventricular function after MI and job satisfaction.   Keywords: Myocardial Infarction, Return to Work, Left Ventricular Function, Job Satisfaction 

  10. Can we enhance the ability to return to work among workers with stress-related disorders?

    DEFF Research Database (Denmark)

    Lander, Flemming; Friche, Claus; Tornemand, Helle

    2009-01-01

    counselling e.g. on decisions concerning resumption of work, support to families, participation in meetings with the workplace. Basically, the controls and the intervention group share the same access to welfare benefits. The main outcome was time to return to labour market (TTR). RESULTS: The baseline...... characteristics were similar in the two groups. There were no differences in the rate of resuming work between the two groups. About 80% in both groups had returned to the labour market after one year. CONCLUSION: An intervention program with psychological stress management and case management did not improve...

  11. Interoception drives increased rational decision-making in meditators playing the ultimatum game.

    Science.gov (United States)

    Kirk, Ulrich; Downar, Jonathan; Montague, P Read

    2011-01-01

    Human decision-making is often conceptualized as a competition between cognitive and emotional processes in the brain. Deviations from rational processes are believed to derive from inclusion of emotional factors in decision-making. Here, we investigate whether experienced Buddhist meditators are better equipped to regulate emotional processes compared with controls during economic decision-making in the Ultimatum Game. We show that meditators accept unfair offers on more than half of the trials, whereas controls only accept unfair offers on one-quarter of the trials. By applying fMRI we show that controls recruit the anterior insula during unfair offers. Such responses are powerful predictors of rejecting offers in social interaction. By contrast, meditators display attenuated activity in high-level emotional representations of the anterior insula and increased activity in the low-level interoceptive representations of the posterior insula. In addition we show that a subset of control participants who play rationally (i.e., accepts >85% unfair offers) recruits the dorsolateral prefrontal cortex presumably reflecting increased cognitive demands, whereas rational meditators by contrast display elevated activity in the somatosensory cortex and posterior superior temporal cortex. In summary, when assessing unfairness in the Ultimatum Game, meditators activate a different network of brain areas compared with controls enabling them to uncouple negative emotional reactions from their behavior. These findings highlight the clinically and socially important possibility that sustained training in mindfulness meditation may impact distinct domains of human decision-making.

  12. Playing it safe: Patron safety strategies and experience of violence in night-time entertainment districts.

    Science.gov (United States)

    Zhou, Jin; Droste, Nicolas; Curtis, Ashlee; Zinkiewicz, Lucy; Miller, Peter

    2018-03-01

    Incidences of violence are elevated in night-time entertainment districts. Research suggests that safety-related behavioural strategies adopted while drinking can reduce negative alcohol-related outcomes. The current study investigates the use of safety strategies and its association with experiences of violence among patrons from the general population. Patron interviews (N = 3949) were conducted in and around licenced venues in Newcastle (New South Wales) and Geelong (Victoria) during peak trading hours (Friday and Saturday, 21:00-01:00 h). Participants (mean age = 24.3, SD = 5.8; male 54.4%) were asked to report what measures, if any, they used to keep safe when drinking and whether they had been involved in a violent incident in the last 12 months. After controlling for patron demographics and location, the use of multiple (more than one) safety strategies was significantly associated with reduced odds of involvement in a violent incident (odds ratio = 0.64, 95% confidence interval 0.49-0.85, P = 0.002). Significant gender differences were observed in the number and type of safety strategies reported. Increasing the number of safety-related behaviours during drinking occasions is associated with a small but significant reduction in experiencing alcohol-related harms, such as violence. [Zhou J, Droste N, Curtis A, Zinkiewicz L, Miller P. Playing it safe: Patron safety strategies and experience of violence in night-time entertainment districts. © 2017 Australasian Professional Society on Alcohol and other Drugs.

  13. On conservation of renewable resources with stock-dependent return and non-concave production

    International Nuclear Information System (INIS)

    Olson, Lars J.; Roy, Santanu

    1994-05-01

    An analysis is presented of the intertemporal choice foundations underlying the conservation or extinction of renewable resources when the resource production function is non-concave and the immediate return function depends on both current consumption and the size of the resource stock. This case may exhibit nonlinear dynamics and extinction is possible from high stocks even if conservation occurs from lower stocks. The paper focusses on the influence of preferences and the production function on the efficiency of: global conservation, the existence of a safe standard of conservation, or extinction. We show that conservation is efficient under weaker conditions than the 'δ-productivity' requirements derived in models where return function is not stock-dependent. The marginal rate of substitution between investment and the stock plays an important role in addition to the discount factor and the marginal productivity of the resource. Extinction need not be optimal even if the intrinsic growth rate of the resource is less than the external rate of return. Our analysis demonstrates the potential role of taxes, subsidies, demand forces, and harvest costs in determining the efficiency of conservation or extinction. 3 figs., 1 appendix, 24 refs

  14. On conservation of renewable resources with stock-dependent return and non-concave production

    Energy Technology Data Exchange (ETDEWEB)

    Olson, Lars J. [Department of Agricultural and Resource Economics, University of Maryland, College Park, MD (United States); Roy, Santanu [Econometric Institute, Erasmus University, Rotterdam (Netherlands)

    1994-05-01

    An analysis is presented of the intertemporal choice foundations underlying the conservation or extinction of renewable resources when the resource production function is non-concave and the immediate return function depends on both current consumption and the size of the resource stock. This case may exhibit nonlinear dynamics and extinction is possible from high stocks even if conservation occurs from lower stocks. The paper focusses on the influence of preferences and the production function on the efficiency of: global conservation, the existence of a safe standard of conservation, or extinction. We show that conservation is efficient under weaker conditions than the `{delta}-productivity` requirements derived in models where return function is not stock-dependent. The marginal rate of substitution between investment and the stock plays an important role in addition to the discount factor and the marginal productivity of the resource. Extinction need not be optimal even if the intrinsic growth rate of the resource is less than the external rate of return. Our analysis demonstrates the potential role of taxes, subsidies, demand forces, and harvest costs in determining the efficiency of conservation or extinction. 3 figs., 1 appendix, 24 refs.

  15. Return to National Basketball Association Competition Following Anterior Cruciate Ligament and Fibular Collateral Ligament Injuries: A Case Report.

    Science.gov (United States)

    LaPrade, Robert F; O'Brien, Luke; Kennedy, Nicholas I; Cinque, Mark E; Chahla, Jorge

    2017-01-01

    Numerous outcome studies regarding anterior cruciate ligament (ACL) reconstruction demonstrate the ability of athletes to return to a high level of play. However, to our knowledge, there is limited literature regarding return to play following injury to both the ACL and the fibular collateral ligament (FCL). We describe the case of a National Basketball Association (NBA) player who sustained a combined ACL and FCL knee injury and subsequently underwent surgical reconstruction of both affected ligaments. He was able to return to a preinjury level of competition at 9 months postoperatively. It is possible for athletes to return to competitive basketball and maintain a high production level following a single-staged reconstruction of both the ACL and the FCL.

  16. To kill a kangaroo: understanding the decision to pursue high-risk/high-gain resources.

    Science.gov (United States)

    Jones, James Holland; Bird, Rebecca Bliege; Bird, Douglas W

    2013-09-22

    In this paper, we attempt to understand hunter-gatherer foraging decisions about prey that vary in both the mean and variance of energy return using an expected utility framework. We show that for skewed distributions of energetic returns, the standard linear variance discounting (LVD) model for risk-sensitive foraging can produce quite misleading results. In addition to creating difficulties for the LVD model, the skewed distributions characteristic of hunting returns create challenges for estimating probability distribution functions required for expected utility. We present a solution using a two-component finite mixture model for foraging returns. We then use detailed foraging returns data based on focal follows of individual hunters in Western Australia hunting for high-risk/high-gain (hill kangaroo) and relatively low-risk/low-gain (sand monitor) prey. Using probability densities for the two resources estimated from the mixture models, combined with theoretically sensible utility curves characterized by diminishing marginal utility for the highest returns, we find that the expected utility of the sand monitors greatly exceeds that of kangaroos despite the fact that the mean energy return for kangaroos is nearly twice as large as that for sand monitors. We conclude that the decision to hunt hill kangaroos does not arise simply as part of an energetic utility-maximization strategy and that additional social, political or symbolic benefits must accrue to hunters of this highly variable prey.

  17. Return of isotope capsules to the Waste Encapsulation and Storage Facility

    International Nuclear Information System (INIS)

    1994-05-01

    Cesium-137 and strontium-90 isotopes were removed from Hanford Site high-level tank wastes, and were encapsulated at the Hanford Site's Waste Encapsulation and Storage Facility (WESF), beginning in 1974. Over the past several years, radioactive isotope capsules have been sent to other U.S. Department of Energy (DOE)-controlled sites to be used for research and development applications, as well as leased to a number of commercial facilities for commercial applications (e.g., sterilization of medical supplies). Due to uncertainty regarding the cause of the release of a small quantity of cesium-137 to an isolated water basin from a WESF cesium-137 capsule in a commercial facility in Decatur, Georgia, the DOE has determined that it needs to return leased capsules from IOTECH, Incorporated (IOTECH), Northglenn, Colorado; Pacific Northwest Laboratory (PNL), Richland, Washington; and the Applied Radiant Energy Corporation (ARECO), Lynchburg, Virginia; to the WESF Facility on the Hanford Site, to ensure safe management and storage, pending final disposition. All of these capsules located at the commercial facilities were successfully tested during Calendar Year 1993, and none showed any indication of off-normal specifications. Storage at the WESF will continue under the actions selected in the Record of Decision for the Final Environmental Impact Statement: Disposal of Hanford Defense High-Level, Transuranic and Tank Wastes, Hanford Site, Richland, Washington

  18. Second Chances: Making Meaning from Adult Literacy Students Returning to School

    Science.gov (United States)

    Grossman, Helene Joyce

    2012-01-01

    Sokolowski (2000) summarized the phenomenological attitude by saying, "We look at what we normally look through" (p. 50). Through interviews and document analysis, this study looked at the lives of six students and their decision to return to their education to earn a high school diploma. The purpose of this study was to illuminate how…

  19. Using Multimodal Input for Autonomous Decision Making for Unmanned Systems

    Science.gov (United States)

    Neilan, James H.; Cross, Charles; Rothhaar, Paul; Tran, Loc; Motter, Mark; Qualls, Garry; Trujillo, Anna; Allen, B. Danette

    2016-01-01

    Autonomous decision making in the presence of uncertainly is a deeply studied problem space particularly in the area of autonomous systems operations for land, air, sea, and space vehicles. Various techniques ranging from single algorithm solutions to complex ensemble classifier systems have been utilized in a research context in solving mission critical flight decisions. Realized systems on actual autonomous hardware, however, is a difficult systems integration problem, constituting a majority of applied robotics development timelines. The ability to reliably and repeatedly classify objects during a vehicles mission execution is vital for the vehicle to mitigate both static and dynamic environmental concerns such that the mission may be completed successfully and have the vehicle operate and return safely. In this paper, the Autonomy Incubator proposes and discusses an ensemble learning and recognition system planned for our autonomous framework, AEON, in selected domains, which fuse decision criteria, using prior experience on both the individual classifier layer and the ensemble layer to mitigate environmental uncertainty during operation.

  20. How to organise return handling; an exploratory study with nine retailer warehouses

    NARCIS (Netherlands)

    M.B.M. de Koster (René); M.P. de Brito (Marisa); M.A. van de Vendel (Masja)

    2002-01-01

    textabstractAlready for a long time retailers take back products. In this paper we explore the factors contributing to the decision of combining vs. separating inbound and outbound flows during the return handling process. We do so through a comparative analysis of the operations in nine

  1. Super-compactor and grouting. Efficient and safe treatment of nuclear waste

    International Nuclear Information System (INIS)

    Li, Hongyou; Starke, Holger; Muetzel, Wolfgang; Winter, Marc

    2014-01-01

    The conditioning and volume reduction of nuclear waste are increasingly important factors throughout the world. Efficient and safe treatment of nuclear waste therefore plays a decisive role. Babcock Noell designed, manufactured and supplied a complete waste treatment facility for conditioning of the solid radioactive waste of a nuclear power plant to China. This facility consists of a Sorting Station, a Super-Compactor, a Grouting Unit with Capping Device and other auxiliary equipment which is described in more detail in the following article. This article gives an overview of the efficient and safe treatment of nuclear waste. Babcock Noell is a subsidiary of the Bilfinger Power Systems and has 40 years of experience in the field of design, engineering, construction, static and dynamic calculations, manufacturing, installation, commissioning, as well as in the service and operation of a wide variety of nuclear components and facilities worldwide.

  2. Return Migration among Elderly, Chronically Ill Bosnian Refugees

    DEFF Research Database (Denmark)

    Handlos, Line Neerup; Olwig, Karen Fog; Bygbjerg, Ib Christian

    2015-01-01

    Elderly migrants constitute a considerable share of global return migration; nevertheless, literature on the health aspects of the return migration among these migrants is still scarce. This study explores the significance of return migration among elderly, chronically ill Bosnian refugees from...... Denmark and the role of health issues in their decision to return. It is based on semi-structured interviews with 33 elderly, chronically ill Bosnian refugees who have moved back to Bosnia and Herzegovina, and 10 elderly, chronically ill Bosnian refugees who have remained in Denmark. The interviews show...

  3. Implementation Evaluation of "Steering Teens Safe": Engaging Parents to Deliver a New Parent-Based Teen Driving Intervention to Their Teens

    Science.gov (United States)

    Ramirez, Marizen; Yang, Jingzhen; Young, Tracy; Roth, Lisa; Garinger, Anne; Snetselaar, Linda; Peek-Asa, Corinne

    2013-01-01

    Parents play a fundamental role in teaching their children safe driving skills to reduce risk of motor vehicle crashes, the leading cause of death for teens. "Steering Teens Safe" is a new parent-based intervention that equips parents with communication skills to talk about, demonstrate, and practice safe driving behaviors and skills…

  4. Playful Membership

    DEFF Research Database (Denmark)

    Åkerstrøm Andersen, Niels; Pors, Justine Grønbæk

    2014-01-01

    This article studies the implications of current attempts by organizations to adapt to a world of constant change by introducing the notion of playful organizational membership. To this end we conduct a brief semantic history of organizational play and argue that when organizations play, employees...... are expected to engage in playful exploration of alternative selves. Drawing on Niklas Luhmann's theory of time and decision-making and Gregory Bateson's theory of play, the article analyses three empirical examples of how games play with conceptions of time. We explore how games represent an organizational...

  5. 29 CFR 2550.404a-2 - Safe harbor for automatic rollovers to individual retirement plans.

    Science.gov (United States)

    2010-07-01

    ... retirement plans. 2550.404a-2 Section 2550.404a-2 Labor Regulations Relating to Labor (Continued) EMPLOYEE... RETIREMENT INCOME SECURITY ACT OF 1974 RULES AND REGULATIONS FOR FIDUCIARY RESPONSIBILITY § 2550.404a-2 Safe..., whether or not such return is guaranteed, consistent with liquidity; (ii) For purposes of paragraph (c)(3...

  6. Stock Returns and Risk: Evidence from Quantile

    Directory of Open Access Journals (Sweden)

    Thomas C. Chiang

    2012-12-01

    Full Text Available This paper employs weighted least squares to examine the risk-return relation by applying high-frequency data from four major stock indexes in the US market and finds some evidence in favor of a positive relation between the mean of the excess returns and expected risk. However, by using quantile regressions, we find that the risk-return relation moves from negative to positive as the returns’ quantile increases. A positive risk-return relation is valid only in the upper quantiles. The evidence also suggests that intraday skewness plays a dominant role in explaining the variations of excess returns.

  7. Fair play in energy policy decisions: Procedural fairness, outcome fairness and acceptance of the decision to rebuild nuclear power plants

    International Nuclear Information System (INIS)

    Visschers, Vivianne H.M.; Siegrist, Michael

    2012-01-01

    To raise public acceptance of new energy policies, promoting the fairness of the outcomes and of the decision-making procedure has been suggested. Very few studies have examined the role of fairness in public acceptance of rebuilding nuclear power plants. Therefore, using a large mail survey, we investigated the public’s acceptance of the decision to rebuild nuclear power plants in Switzerland by 2020. The study examined the influence of procedural fairness and outcome fairness on the acceptance of this decision, as well as other factors such as risk perception and benefit perception. Additionally, we investigated the moderating influence of general attitudes towards nuclear power on the relation between fairness and decision acceptance. Results indicated that outcome fairness strongly increased decision acceptance, along with general attitudes towards nuclear power and perceived economic benefits. Procedural fairness had only a small impact on decision acceptance. The influence of fairness on decision acceptance did not seem to depend on general nuclear attitudes. Our findings imply that, in the case of rebuilding nuclear power plants, perceived benefits and outcome fairness are important determinants of acceptance of the decision, while procedural fairness only has a limited impact. - Highlights: ► We investigated the role of fairness in the acceptance of a nuclear policy decision. ► Outcome fairness strongly influenced decision acceptance regarding nuclear power plants. ► The role of procedural fairness was relatively small in this respect. ► Also, nuclear attitudes and perceived economic benefits affected decision acceptance. ► Outcome fairness seems more relevant for decision acceptance than procedural fairness.

  8. Workplace disability management programs promoting return-to-work

    DEFF Research Database (Denmark)

    Gensby, Ulrik; Lund, Thomas; Kowalski, Krystyna

    Return-to-work (RTW) following work related injuries or illnesses is receiving continued attention from a wide spectrum of research fields and is an important topic for many policy- and decision-makers. In particular long-term sickness absence is a challenge associated with a series of negative...... is still needed. This review will evaluate the effect of workplace disability management programs promoting RTW - i.e. report on the evidence and describes and combine results from individual studies on workplace disability management programs and explain possible variations in practice....

  9. What role can simulation model predictions play in environmental decisions: carbon dioxide as an example

    International Nuclear Information System (INIS)

    Emanuel, W.R.

    1979-01-01

    Frequently, when an environmental issue requiring quantitative analysis surfaces, the development of a model synthesizing all aspects of the problem and applicable at each stage of the decision process is proposed. A more desirable alternative is to generate models specifically designed to meet the requirements of each level in decision making and which can be adapted in response to the changing status of the environmental issue. Various models of the global carbon cycle constructed to predict levels of CO 2 in the atmosphere as a result of man's activities are described to illustrate this point. In summary, the progression of models developed to analyze the global carbon cycle in resolving the CO 2 /climate issue indicates the changing character of models depending on the immediate role they play in environmental decision making. The dominant and successful role served by models in the carbon cycle problem points to the desirability of this flexible approach

  10. AHP 47: WAITING FOR THE RETURN

    Directory of Open Access Journals (Sweden)

    Rdo rje skyabs རྡོ་རྗེ་སྐྱབས།

    2017-04-01

    Full Text Available "Tshe ring, how many days has your father been away?" "Father's been gone for twenty-one days," Tshe ring replied. "Oh! Twenty-one days isn't a short time. It's time for him to return. I hope he comes back safely and quickly," Tshe ring's grandmother observed, and resumed chanting and spinning her old prayer wheel. ...

  11. Making College Worth It: A Review of the Returns to Higher Education

    Science.gov (United States)

    Oreopoulos, Philip; Petronijevic, Uros

    2013-01-01

    Despite a general rise in the return to college, likely due to technological change, the cost-benefit calculus facing prospective students can make the decision to invest in and attend college dauntingly complex. Philip Oreopoulos and Uros Petronijevic review research on the varying costs and benefits of higher education and explore in full the…

  12. [Return to Work Strategies of Employees who Experienced Depression: Employers and HR's Perspectives].

    Science.gov (United States)

    Corbière, Marc; Lecomte, Tania; Lachance, Jean-Philippe; Coutu, Marie-France; Negrini, Alessia; Laberon, Sonia

    Major depression is one of the leading causes of work disability across the world. In Canada, the lifetime prevalence of depression varies from 10 to 12%. Depression impacts not only the employee who is often stigmatized and can lose his professional identity, but also has consequences on colleagues and supervisors in organizations. In the literature, four models are described from which employers and managers use in their organizations to make decisions regarding the work disability of employees on sick leave: biomedical, financial management, personnel management, and organizational development. These models can also be supported by economic, legal and ethical interests. Even though these models are essential to better understand the decision of employers and HR regarding work disability, information remains scarce regarding the concrete strategies used by these stakeholders to facilitate the return to work for employees on sick leave due to depression.Objectives the aim of this paper is to document, considering employers' and human resources' perspectives, the best strategies to put in place to facilitate the return to work of employees on sick leave due to depression.Method This study was part of a larger study carried out in Canada to assess factors influencing the return to work after a depression-related sick leave, taking into account the viewpoint of four types of stakeholders: employers/human resources, supervisors, unions and people diagnosed with depression. 219 employers (68.5%) and human resources directors (31.5%) from 82.6% organizations having more than 100 employees accepted to answer a telephone semi-structured interview. The question of interest in this study is: In your opinion, what are the best strategies to help an employee who has had a depression to return to work? Coding was influenced by empirical findings and theories related to psychosocial risk factors that the authors use in their respective disciplines as well as return to work

  13. Coordination of a supply chain with consumer return under vendor-managed consignment inventory and stochastic demand

    Science.gov (United States)

    Wu, Zhihui; Chen, Dongyan; Yu, Hui

    2016-07-01

    In this paper, the problem of the coordination policy is investigated for vendor-managed consignment inventory supply chain subject to consumer return. Here, the market demand is assumed to be affected by promotional effort and consumer return policy. The optimal consignment inventory and the optimal promotional effort level are proposed under the decentralized and centralized decisions. Based on the optimal decision conditions, the markdown allowance-promotional cost-sharing contract is investigated to coordinate the supply chain. Subsequently, the comparison between the two extreme policies shows that full-refund policy dominates the no-return policy when the returning cost and the positive effect of return policy are satisfied certain conditions. Finally, a numerical example is provided to illustrate the impacts of consumer return policy on the coordination contract and optimal profit as well as the effectiveness of the proposed supply chain decision.

  14. Improving efficiency of decision making units through BSC-DEA technique

    Directory of Open Access Journals (Sweden)

    Amir Reza Khaki

    2012-01-01

    Full Text Available Performance evaluation is one of the most important techniques to prioritize different decision making units. Data envelopment analysis (DEA, as a non-parametric method, plays an important role for measuring relative efficiency. Balanced score card, on the other hand, is another method to evaluate a business plan based on non-financial perspectives. The integrated BSC-DEA takes advantage of the advantages of both methods' features. In this paper, we propose a BSC-DEA method to rank different decision making units. We consider different financial criteria such as profit-margin, return on assets along with non-financial criteria such as customer satisfaction, advanced services, employee skills to compare the performance of different banks. The results are analyzed and discussed, which could be used for making better decisions.

  15. Decision management - projects subject to uncertainty

    Directory of Open Access Journals (Sweden)

    A.E. Paterson

    2003-12-01

    Full Text Available The human mind is normally unable to grasp more than five to nine aspects relating to the same decision circumstances simultaneously. It has been demonstrated that only between four and eight variables significantly affect return on engineering projects (at the 90% level irrespective of scale. The most powerful means of isolating these significant variables is by computer simulation. This is demonstrated through the application of the interactive CASPAR programme to a simulated mining project. The significant variables are separated into controllable, influence able and uncontrollable categories for decision and control purposes since the nature of the speculative risk differs. The managerial treatment of each category is discussed.

  16. Important factors influencing the return to work after stroke.

    Science.gov (United States)

    Wang, Ying-Chih; Kapellusch, Jay; Garg, Arun

    2014-01-01

    As the field of rehabilitation shifts its focus towards improving functional capacity instead of managing disability, return to work (RTW) and return to the community emerge as key goals in a person's recovery from major disabling illness such as stroke. To compile important factors believed to influence RTW after a stroke. Based on a comprehensive literature review, we clustered similar factors and organized these factors based on the International Classification of Function, Disability and Health (ICF) framework: body functions or structure, activity participation, environmental factors and personal and psychosocial factors. Overall, stroke severity, as assessed by the degree of residual disability such as weakness, neurological deficit or impairments (speech, cognition, apraxia, agnosia), has been shown to be the most consistent negative predictor of RTW. Many factors such as the number of working years remaining until retirement, depression, medical history, and occupation need to be taken into consideration for stroke survivors, as they can influence RTW decision making. Stroke survivors who are flexible and realistic in their vocational goal and emotionally accept their disability appear more likely to return to work. There are many barriers to employment for stroke survivors ranging from physical and cognitive impairments to psychosocial and environmental factors.

  17. Forecasting volatility in gold returns under the GARCH, IGARCH and FIGARCH frameworks: New evidence

    Science.gov (United States)

    Bentes, Sonia R.

    2015-11-01

    This study employs three volatility models of the GARCH family to examine the volatility behavior of gold returns. Much of the literature on this topic suggests that gold plays a fundamental role as a hedge and safe haven against adverse market conditions, which is particularly relevant in periods of high volatility. This makes understanding gold volatility important for a number of theoretical and empirical applications, namely investment valuation, portfolio selection, risk management, monetary policy-making, futures and option pricing, hedging strategies and value-at-risk (VaR) policies (e.g. Baur and Lucey (2010)). We use daily data from August 2, 1976 to February 6, 2015 and divide the full sample into two periods: the in-sample period (August 2, 1976-October 24, 2008) is used to estimate model coefficients, while the out-of-sample period (October 27, 2008-February 6, 2015) is for forecasting purposes. Specifically, we employ the GARCH(1,1), IGARCH(1,1) and FIGARCH(1, d,1) specifications. The results show that the FIGARCH(1, d,1) is the best model to capture linear dependence in the conditional variance of the gold returns as given by the information criteria. It is also found to be the best model to forecast the volatility of gold returns.

  18. Cesium return program lessons learned FY 1994

    International Nuclear Information System (INIS)

    Clements, E.P.

    1994-08-01

    The U.S. Department of Energy (DOE) is returning leased cesium capsules from IOTECH, Incorporated (IOTECH), Northglenn, Colorado, and the Applied Radiant Energy Company (ARECO), Lynchburg, Virginia, to the Waste Encapsulation and Storage Facility (WESF) on the Hanford Site, to ensure safe management and storage, pending final capsule disposition. Preparations included testing and modifying the Beneficial Uses Shipping System (BUSS) cask, preparing an Environmental Assessment (EA), development of a comprehensive Transportation Plan, coordination with the Western Governors' Association (WGA) and the Confederated Tribes of the Umatilla Indian Reservation (CTUIR), and interface with the public and media. Additional activities include contracting for a General Electric (GE) 2000 cask to expedite IOTECH capsule returns, and coordination with Eastern and Midwestern States to revise the transportation plan in support of ARECO capsule returns

  19. Preoperative predictors of returning to work following primary total knee arthroplasty.

    Science.gov (United States)

    Styron, Joseph F; Barsoum, Wael K; Smyth, Kathleen A; Singer, Mendel E

    2011-01-05

    to return to work following a primary total knee arthroplasty, the patient's characteristics, particularly motivation, play a more important role.

  20. Forms of Capital and Habitus in the Decision to Go on Academic Exchange.

    Science.gov (United States)

    Lehmann, Wolfgang; Trower, Holly

    2018-02-01

    Although Canadian universities have made internationalization a strategic priority, only few Canadian students currently participate in any international study opportunities. Drawing on interviews with Canadian students who were about to spend some of their undergraduate education abroad as exchange students, or had recently returned from a study exchange, we argue that despite the importance of relatively high costs associated with international study experiences, cultural factors play a more important role in enabling the decision to study abroad. Being habitually exposed to travel in one's family, and having been encouraged to travel independently as a teenager or young adult emerge as important precursors to our participants' decision to take part in study exchanges. Although one needs to engage critically with university administrators' current preoccupation with internationalization, being exposed to an extended time abroad has shown to have positive effects, especially for otherwise underprivileged students. Given the exploratory nature of this study, we conclude with suggestions for further research aimed at confirming our findings and developing policy. © 2018 Canadian Sociological Association/La Société canadienne de sociologie.

  1. Use of a decision aid for prenatal testing of fetal abnormalities to improve women's informed decision making: a cluster randomised controlled trial [ISRCTN22532458].

    Science.gov (United States)

    Nagle, C; Gunn, J; Bell, R; Lewis, S; Meiser, B; Metcalfe, S; Ukoumunne, O C; Halliday, J

    2008-02-01

    To evaluate the effectiveness of a decision aid for prenatal testing of fetal abnormalities compared with a pamphlet in supporting women's decision making. A cluster randomised controlled trial. Primary health care. Women in early pregnancy consulting a GP. GPs were randomised to provide women with either a decision aid or a pamphlet. The decision aid was a 24-page booklet designed using the Ottowa Decision Framework. The pamphlet was an existing resource available in the trial setting. Validated scales were used to measure the primary outcomes, informed choice and decisional conflict, and the secondary outcomes, anxiety, depression, attitudes to the pregnancy/fetus and acceptability of the resource. Outcomes were measured at 14 weeks of gestation from questionnaires that women completed and returned by post. Women in the intervention group were more likely to make an informed decision 76% (126/165) than those in the control group 65% (107/165) (adjusted OR 2.08; 95% CI 1.14-3.81). A greater proportion of women in the intervention group 88% (147/167) had a 'good' level of knowledge than those in the control group 72% (123/171) (adjusted OR 3.43; 95% CI 1.79-6.58). Mean (SD) decisional conflict scores were low in both groups, decision aid 1.71 (0.49), pamphlet 1.65 (0.55) (adjusted mean difference 0.10; 95% CI -0.02 to 0.22). There was no strong evidence of differences between the trial arms in the measures of psychological or acceptability outcomes. A tailored prenatal testing decision aid plays an important role in improving women's knowledge of first and second trimester screening tests and assisting them to make decisions about screening and diagnostic tests that are consistent with their values.

  2. At return to play following hamstring injury the majority of professional football players have residual isokinetic deficits

    NARCIS (Netherlands)

    Tol, Johannes L.; Hamilton, Bruce; Eirale, Cristiano; Muxart, Patrice; Jacobsen, Philipp; Whiteley, Rod

    2014-01-01

    There is an ongoing debate regarding the optimal criteria for return to sport after an acute hamstring injury. Less than 10% isokinetic strength deficit is generally recommended but this has never been documented in professional football players after rehabilitation. Our aim was to evaluate

  3. Expert Intraoperative Judgment and Decision-Making: Defining the Cognitive Competencies for Safe Laparoscopic Cholecystectomy.

    Science.gov (United States)

    Madani, Amin; Watanabe, Yusuke; Feldman, Liane S; Vassiliou, Melina C; Barkun, Jeffrey S; Fried, Gerald M; Aggarwal, Rajesh

    2015-11-01

    Bile duct injuries from laparoscopic cholecystectomy remain a significant source of morbidity and are often the result of intraoperative errors in perception, judgment, and decision-making. This qualitative study aimed to define and characterize higher-order cognitive competencies required to safely perform a laparoscopic cholecystectomy. Hierarchical and cognitive task analyses for establishing a critical view of safety during laparoscopic cholecystectomy were performed using qualitative methods to map the thoughts and practices that characterize expert performance. Experts with more than 5 years of experience, and who have performed at least 100 laparoscopic cholecystectomies, participated in semi-structured interviews and field observations. Verbal data were transcribed verbatim, supplemented with content from published literature, coded, thematically analyzed using grounded-theory by 2 independent reviewers, and synthesized into a list of items. A conceptual framework was created based on 10 interviews with experts, 9 procedures, and 18 literary sources. Experts included 6 minimally invasive surgeons, 2 hepato-pancreatico-biliary surgeons, and 2 acute care general surgeons (median years in practice, 11 [range 8 to 14]). One hundred eight cognitive elements (35 [32%] related to situation awareness, 47 [44%] involving decision-making, and 26 [24%] action-oriented subtasks) and 75 potential errors were identified and categorized into 6 general themes and 14 procedural tasks. Of the 75 potential errors, root causes were mapped to errors in situation awareness (24 [32%]), decision-making (49 [65%]), or either one (61 [81%]). This study defines the competencies that are essential to establishing a critical view of safety and avoiding bile duct injuries during laparoscopic cholecystectomy. This framework may serve as the basis for instructional design, assessment tools, and quality-control metrics to prevent injuries and promote a culture of patient safety. Copyright

  4. PREMISES OF BEHAVIORAL FINANCE IN RATIONAL DECISION-MAKING

    Directory of Open Access Journals (Sweden)

    Laurentiu Droj

    2016-07-01

    Full Text Available One cannot separate decision from psychology of human being. People see world by perception and this leads to various ways of understanding even the most concrete or certain things. Financial literature reflects the subjective nature of human being in making decisions by classifying decision-making process into being 'rationally' oriented or the opposite, 'irrational', according to individual’s attitude towards risk – 'appetite' or 'aversion'. Process of understanding risk associated with future financial returns implies attaching mental probabilities to it. This activity is always affected by human nature of agents that take financial decisions, therefore bearing risk. Psychological factors such as perception, framing effect, information asymmetry, irrationality, emotions are accompanying every financial decision. Paper intends to study the direct relationship between psychological traits of a human being playing the role of a decisional agent in financial context. Financial decisions are always accompanied by the notion of probability in defining what we call as 'expected' returns that translate into risk associated with financial investments. Empirical analysis done on the financial market reflects that agents use their perception on risk of gaining or losing from a certain financial transaction to decide whether to invest or not. The notion of 'expected utility' has been complementary used with the one of 'prospect value' as financial literature evolved over time and researchers brought new insights into the mechanism of financial decision. This paper studies direct relationship between psychological traits of a human being according to classical and rational decision-making process in the light of the prospect theory and risk attitude regarding financial outcome of decisions. In this sense, an econometric model is tested on the international financial market in order to find out what kind of subjective factors lie hidden in an investor

  5. Playing fair: the contribution of high-functioning recess to overall school climate in low-income elementary schools.

    Science.gov (United States)

    London, Rebecca A; Westrich, Lisa; Stokes-Guinan, Katie; McLaughlin, Milbrey

    2015-01-01

    Recess is a part of the elementary school day with strong implications for school climate. Positive school climate has been linked to a host of favorable student outcomes, from attendance to achievement. We examine 6 low-income elementary schools' experiences implementing a recess-based program designed to provide safe, healthy, and inclusive play to study how improving recess functioning can affect school climate. Data from teacher, principal, and recess coach interviews; student focus groups; recess observations; and a teacher survey are triangulated to understand the ways that recess changed during implementation. Comparing schools that achieved higher- and lower-functioning recesses, we link recess functioning with school climate. Recess improved in all schools, but 4 of the 6 achieved a higher-functioning recess. In these schools, teachers and principals agreed that by the end of the year, recess offered opportunities for student engagement, conflict resolution, pro-social skill development, and emotional and physical safety. Respondents in these four schools linked these changes to improved overall school climate. Recess is an important part of the school day for contributing to school climate. Creating a positive recess climate helps students to be engaged in meaningful play and return to class ready to learn. © 2014, American School Health Association.

  6. Stock returns and foreign investment in Brazil

    OpenAIRE

    Reis, Luciana; Meurer, Roberto; Da Silva, Sergio

    2008-01-01

    We examine the relationship between stock returns and foreign investment in Brazil, and find that the inflows of foreign investment boosted the returns from 1995 to 2005. There was a strong contemporaneous correlation, although not Granger-causality. Foreign investment along with the exchange rate, the influence of the world stock markets, and country risk can explain 73 percent of the changes that occurred in the stock returns over the period. We also find that positive feedback trading play...

  7. A discussion on issues which elderly evacuees after FDNP accident think about for the returning to own hometown

    International Nuclear Information System (INIS)

    Kitajima, Maiko; Otsu, Haruka; Tomisawa, Toshiko

    2017-01-01

    The present study investigated the thoughts of elderly evacuees after the Fukushima Daiichi Nuclear Power Station Accident about for the returning to their hometowns, and discussed the support needed for them. The subjects were 86 elderly people (mean age: 74.2 ± 7.2 years) whose hometown was one city in Fukushima. They completed a questionnaire regarding anxiety about radiation, requirements on return to their hometown, frequency of use of personal dosimetry, and so on. Thirty-nine people answered that they intend to return to their hometown if the evacuation order is lifted. They were mainly worried about the level of radiation and the post-decontamination state. Twenty-one people always use a personal dosimetry, while 34 people use it only on return to their home town temporarily. The rebuilding for evacuees to return to their hometowns needs a construction of a safe living environment such as satisfactory decontamination work and comfortable infrastructure. (author)

  8. Return handling options and order quantities for single period products

    NARCIS (Netherlands)

    D. Vlachos (Dimitrios); R. Dekker (Rommert)

    2000-01-01

    textabstractProducts which are sold through E-commerce or mail sales catalogues tend to have a much higher return rate than traditional products. The returns are especially problematic for seasonal products. To support decision making in these situations we study various options, which may be

  9. Return to rugby after brain concussion: a prospective study in 35 high level rugby players.

    Science.gov (United States)

    Chermann, Jean Francois; Klouche, Shahnaz; Savigny, Alexis; Lefevre, Nicolas; Herman, Serge; Bohu, Yoann

    2014-12-01

    Although guidelines based on expert opinions have been developed for the immediate management and return to play of athletes after a concussion, data are lacking on this issue. Evaluate a standardized management of brain concussion among rugby players to prevent the recurrence. A prospective study was performed from September 2009 to June 2012. All rugby players who had a concussion when playing rugby were included. Patients were managed by a specialized hospital team with a specific protocol developed in collaboration with the medical staff of the rugby clubs included in the study. The series included 35 rugby players, with 23 professionals and 12 high-level players, 30 men and 5 women, mean age 23.1 ± 5.5 years old. The median number of previous concussions was 2 (0-30) episodes. According to the Cantu concussion severity classification, 3 athletes were grade 1, 12 were grade 2 and 20 were grade 3. None of the injured athletes was lost to follow-up. The primary endpoint was the occurrence of a new concussion within 3 months after the first in patients who returned to rugby. Thirty-three patients returned to rugby after a mean 22.1 ± 10 days. The recurrence rate within 3 months was 2/33 (6.1%). The median delay before returning to rugby was 21 (7-45) days. Factors associated with a delayed return to play were young age, initial loss of consciousness, severity Cantu grade 3 and post-concussive syndrome of more than 5 days. Analysis of two failures showed that the initial injury was grade 3 and that both were professional athletes and had a history of concussion. This prospective study validated the study protocol for the management of concussion in rugby players.

  10. The Return to Foreign Aid

    DEFF Research Database (Denmark)

    Dalgaard, Carl-Johan Lars; Hansen, Henrik

    2017-01-01

    We estimate the average rate of return on investments financed by aid and by domestic resource mobilisation, using aggregate data. Both returns are expected to vary across countries and time. Consequently we develop a correlated random coefficients model to estimate the average returns. Across...... different estimators and two different data sources for GDP and investment our findings are remarkably robust; the average gross return on ‘aid investments’ is about 20 per cent. This is in accord with micro estimates of the economic rate of return on aid projects and with aggregate estimates of the rate...

  11. Housing market volatility in the OECD area: Evidence from VAR based return decompositions

    DEFF Research Database (Denmark)

    Engsted, Tom; Pedersen, Thomas Quistgaard

    . For the majority of countries news about future returns is the main driver, and both real interest rates and risk premia play an important role in accounting for housing market volatility. Bivariate cross-country correlations and principal components analyses indicate that part of the return movements have......Vector-autoregressive models are used to decompose housing returns in 18 OECD countries into cash ‡ow (rent) news and discount rate (return) news. Only for two countries - Germany and Ireland - do changing expectations of future rents play a dominating role in explaining housing return volatility...... a common factor among the majority of countries. However, in a minority of countries (Germany, Japan, and the Netherlands) return movements have been basically unrelated to return movements in other countries....

  12. Risky play and children's safety: balancing priorities for optimal child development.

    Science.gov (United States)

    Brussoni, Mariana; Olsen, Lise L; Pike, Ian; Sleet, David A

    2012-08-30

    Injury prevention plays a key role in keeping children safe, but emerging research suggests that imposing too many restrictions on children's outdoor risky play hinders their development. We explore the relationship between child development, play, and conceptions of risk taking with the aim of informing child injury prevention. Generational trends indicate children's diminishing engagement in outdoor play is influenced by parental and societal concerns. We outline the importance of play as a necessary ingredient for healthy child development and review the evidence for arguments supporting the need for outdoor risky play, including: (1) children have a natural propensity towards risky play; and, (2) keeping children safe involves letting them take and manage risks. Literature from many disciplines supports the notion that safety efforts should be balanced with opportunities for child development through outdoor risky play. New avenues for investigation and action are emerging seeking optimal strategies for keeping children "as safe as necessary," not "as safe as possible." This paradigm shift represents a potential for epistemological growth as well as cross-disciplinary collaboration to foster optimal child development while preserving children's safety.

  13. Learning, Play, and Your Newborn

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Learning, Play, and Your Newborn KidsHealth / For Parents / Learning, ... Some Other Ideas Print What Is My Newborn Learning? Play is the chief way that infants learn ...

  14. Insular neural system controls decision-making in healthy and methamphetamine-treated rats.

    Science.gov (United States)

    Mizoguchi, Hiroyuki; Katahira, Kentaro; Inutsuka, Ayumu; Fukumoto, Kazuya; Nakamura, Akihiro; Wang, Tian; Nagai, Taku; Sato, Jun; Sawada, Makoto; Ohira, Hideki; Yamanaka, Akihiro; Yamada, Kiyofumi

    2015-07-21

    Patients suffering from neuropsychiatric disorders such as substance-related and addictive disorders exhibit altered decision-making patterns, which may be associated with their behavioral abnormalities. However, the neuronal mechanisms underlying such impairments are largely unknown. Using a gambling test, we demonstrated that methamphetamine (METH)-treated rats chose a high-risk/high-reward option more frequently and assigned higher value to high returns than control rats, suggestive of changes in decision-making choice strategy. Immunohistochemical analysis following the gambling test revealed aberrant activation of the insular cortex (INS) and nucleus accumbens in METH-treated animals. Pharmacological studies, together with in vivo microdialysis, showed that the insular neural system played a crucial role in decision-making. Moreover, manipulation of INS activation using designer receptor exclusively activated by designer drug technology resulted in alterations to decision-making. Our findings suggest that the INS is a critical region involved in decision-making and that insular neural dysfunction results in risk-taking behaviors associated with altered decision-making.

  15. Safe delivery, Service utilization, Metekel Zone

    African Journals Online (AJOL)

    decision making power of subjects were found to have a statistically significant association with preference of safe delivery ... Studies that focused on maternal mortality and proportion of ...... Anna M, Hannekee M, Frank Odhiambo et.al. Use.

  16. Assessing the Value of Housing Schemes through Sustainable Return on Investment: A Path towards Sustainability-Led Evaluations?

    Directory of Open Access Journals (Sweden)

    Kevin Dean

    2017-12-01

    Full Text Available The 2016 United Nations (UN New Urban Agenda clearly reaffirms the concept that sustainable cities require intertwined environmental and social sustainability. The United Nations Sustainable Development Goal (SDG 11—“Make cities inclusive, safe, resilient, and sustainable”—sets (as a primary target the provision of sufficient affordable housing. Despite the central role that housing plays in ensuring sustainability and the importance of both environmental and social pillars in ensuring sustainable development, current evaluative methods that support decision making on social housing interventions fail to capture all of the socio-environmental value contained in the UN SDG 11. This paper addresses the issue by demonstrating how Sustainable Return on Investment can successfully describe and analyse a range of externalities related to the sustainable value generated by social housing regeneration schemes. To achieve this goal, a single case study strategy has been chosen. Two extant projects—a high-rise housing scheme and an environmental-led program developed by City West Housing Trust (a nonprofit housing association based in the Manchester area—have been assessed in order to monetise their social and environmental value through different methods. The findings show that, historically, the environmental and social value of regeneration schemes have been largely disregarded because of a gap in the evaluation methods, and that there is room for significant improvement for future evaluation exercises.

  17. Linkage of management decision to shareholder's value: EVA concept

    Directory of Open Access Journals (Sweden)

    Shrikant Krupasindhu Panigrahi

    2014-02-01

    Full Text Available In this paper, the author investigated the influence of management decisions like capital structure, dividend policies, remunerations, credit policy decisions and investment decisions on shareholder wealth maximization. To achieve the objective, portfolio theory, capital asset pricing model and modern financial theory providing evidence on the linkage between management decisions to shareholder’s value. Shareholders are only concerned about the value of shares of the company and the amount of return in the form of dividend paid. Thus in order to meet the demands of the shareholders of the company, managers needs to increase their abilities and skills to overcome the organizational goals. Thus the main goal of this paper is to discuss on the role of management decisions towards increasing shareholder’s wealth and meet organizational goals.

  18. The Effects of Age, Priming, and Working Memory on Decision-Making.

    Science.gov (United States)

    Wood, Meagan; Black, Sheila; Gilpin, Ansley

    2016-01-11

    In the current study, we examined the effects of priming and personality on risky decision-making while playing the Game of Dice Task (GDT). In the GDT, participants decide how risky they wish to be on each trial. In this particular study prior to playing the GDT, participants were randomly assigned to one of three priming conditions: Risk-Aversive, Risk-Seeking, or Control. In the Risk-Seeking condition, a fictional character benefitted from risky behavior while in the Risk-Aversive condition, a fictional character benefitted from exercising caution. Although not explicitly stated in the instructions, participants need to make "safe" rather than risky choices to optimize performance on the GDT. Participants were also given Daneman and Carpenter's assessment of working memory task. Interestingly, although older adults self-reported being more cautious than younger adults on the Domain Specific Risk Attitude scale (DOSPERT), older adults made riskier decisions than younger adults on the GDT. However, after controlling for working memory, the age differences on the GDT became insignificant, indicating that working memory mediated the relation between age and risky decisions on the GDT.

  19. The play approach to learning in the context of families and schools: an alternative paradigm for nutrition and fitness education in the 21st century.

    Science.gov (United States)

    Rickard, K A; Gallahue, D L; Gruen, G E; Tridle, M; Bewley, N; Steele, K

    1995-10-01

    An alternative paradigm for nutrition and fitness education centers on understanding and developing skill in implementing a play approach to learning about healthful eating and promoting active play in the context of the child, the family, and the school. The play approach is defined as a process for learning that is intrinsically motivated, enjoyable, freely chosen, nonliteral, safe, and actively engaged in by young learners. Making choices, assuming responsibility for one's decisions and actions, and having fun are inherent components of the play approach to learning. In this approach, internal cognitive transactions and intrinsic motivation are the primary forces that ultimately determine healthful choices and life habits. Theoretical models of children's learning--the dynamic systems theory and the cognitive-developmental theory of Jean Piaget--provide a theoretical basis for nutrition and fitness education in the 21st century. The ultimate goal is to develop partnerships of children, families, and schools in ways that promote the well-being of children and translate into healthful life habits. The play approach is an ongoing process of learning that is applicable to learners of all ages.

  20. Determinant Keputusan investasi dan Pengaruhnya Terhadap Return Saham Pada Perusahaan Manufaktur di Bursa Efek Indonesia

    OpenAIRE

    Silalahi, Alistraja Dison

    2012-01-01

    Determinant investment decision and its influence to return stock. This research aimed to know whether capital structure, ROI, net profit and firm size are influence to investment decision. This research is also to test and analize the influence of capital structure, ROI, net profit and investment decision toward return stock at manufacture companies in Indonesian Stock Exchange. The population in this research is manufacture companies which are registered in Indonesian stock exchange at ...

  1. Remanufacturing lot-sizing under alternative perceptions of returned units' quality

    Directory of Open Access Journals (Sweden)

    Zikopoulos, C.

    2012-01-01

    Full Text Available One of the critical parameters in reverse supply chain management is the increased variability of the quality condition of used, returned products. The volatile nature of returns' quality often dictates the establishment of quality assessment procedures and the development of technologies that facilitate the fast, accurate and inexpensive classification of returns. The appropriate degree in which a firm has to allocate resources for acquiring information on the quality of returned units, naturally, depends on the anticipated improvement of recovery activities' profitability. Therefore, the quantification of the savings associated with confronting or resolving quality uncertainty is a necessary input during the determination of the proper recovery procedures' configuration. In the current paper, we study a remanufacturing system in a multi-period setting in which returns' quality information is exploited during remanufacturing planning. However, in the decision-making process, certain aspects of the problem examined, such as the quantification of shortage cost, are overlooked or simplified. The objective is to examine the advisability of acquiring advanced quality information in order to be used during sub-optimal decision-making processes, in comparison with alternative policies which do not take explicitly into account returns' quality information. Moreover, through an extensive numerical analysis we examine the implications of alternative considerations regarding returned units' quality on remanufacturing planning, lead-time and service-levels and evaluate their impact on the overall system operational cost.

  2. Crew emergency return vehicle - Electrical power system design study

    Science.gov (United States)

    Darcy, E. C.; Barrera, T. P.

    1989-01-01

    A crew emergency return vehicle (CERV) is proposed to perform the lifeboat function for the manned Space Station Freedom. This escape module will be permanently docked to Freedom and, on demand, will be capable of safely returning the crew to earth. The unique requirements that the CERV imposes on its power source are presented, power source options are examined, and a baseline system is selected. It consists of an active Li-BCX DD-cell modular battery system and was chosen for the maturity of its man-rated design and its low development costs.

  3. The return to foreign aid

    DEFF Research Database (Denmark)

    Dalgaard, Carl-Johan Lars; Hansen, Henrik

    We investigate the marginal productivity of investment across countries. The aim is to estimate the return on investments financed by foreign aid and by domestic resource mobilization, using aggregate data. Both returns are expected to vary across countries and time. Consequently we develop...... a correlated random coefficients model, to estimate the average aggregate return on ‘aid investments’ and ‘domestic investments’. Across different estimators and two different sources for GDP and investment data our findings are remarkably robust; the average gross return on ‘aid investments’ is about 20 per...

  4. Return to sport and knee functional scores after anterior cruciate ligament reconstruction: 2 to 10 years' follow-up

    Directory of Open Access Journals (Sweden)

    Sukrom Cheecharern

    2018-04-01

    Full Text Available Background: Anterior cruciate ligament (ACL reconstruction is one of the most common knee ligament reconstruction sustained by sports players. Previous studies have revealed different rates of returning to play sports depending on study sites, subjects, and time to follow-up; however, this subject has not been adequately investigated in Thailand. Objectives: This study aimed to assess the percentage of ACL reconstruction patients who successfully returned to sport activities. Factors associated with being able to return to sport were also determined. Materials and methods: A cross-sectional study was conducted to assess the rates of return to sport of patients who underwent ACL reconstruction between 2005 and 2015. All potential patients were initially contacted via letter or mobile phone and asked to report their long-term follow-up outcomes. Collected data from the interview, including return to sport status, performance following ACL, and reasons for not returning to play (if applicable were then combined with the initial surgical findings and enrollment/follow-up cohort data for analysis. This study was reviewed and approved by the ethics committee of Rajavithi Hospital. Results: A total of 110 participants were recruited, with a mean age of 35.05 ± 9.16 years. Most of the patients were male, single, with bachelor degree education, engaged in “other” occupations, had income up to 10,000 baht/month, were in the social security scheme (54.5%, and had no underlying diseases (85.5%. The mean ± SD of BMI was 25.58 ± 4.30 kg/m2. When classified by whether or not they returned to sports, it was found that sex, education, income and underlying disease of those who returned to sport were significantly different from those of subjects who did not (p < 0.05. At follow-up, 36.4% had returned to sport. The main reasons stated for not returning to sport following ACL were fear of injury, concern about possible long-term effects

  5. Strategy in Regulatory Decision-Making for Management of Progressive Multifocal Leukoencephalopathy

    DEFF Research Database (Denmark)

    Segec, A; Keller-Stanislawski, B; Vermeer, N S

    2015-01-01

    Progressive multifocal leukoencephalopathy (PML) has been observed after the use of several medicines, including monoclonal antibodies. As these drugs play important roles in the therapeutic armamentarium, it is important to address the challenges that this severe adverse reaction poses to the safe...... use of medicines. Considering the need for consistent outcomes of regulatory decisions, the European Medicines Agency Pharmacovigilance Risk Assessment Committee (PRAC) used PML as an example to develop a systematic approach to labeling and risk minimization....

  6. Neural correlates of value, risk, and risk aversion contributing to decision making under risk.

    Science.gov (United States)

    Christopoulos, George I; Tobler, Philippe N; Bossaerts, Peter; Dolan, Raymond J; Schultz, Wolfram

    2009-10-07

    Decision making under risk is central to human behavior. Economic decision theory suggests that value, risk, and risk aversion influence choice behavior. Although previous studies identified neural correlates of decision parameters, the contribution of these correlates to actual choices is unknown. In two different experiments, participants chose between risky and safe options. We identified discrete blood oxygen level-dependent (BOLD) correlates of value and risk in the ventral striatum and anterior cingulate, respectively. Notably, increasing inferior frontal gyrus activity to low risk and safe options correlated with higher risk aversion. Importantly, the combination of these BOLD responses effectively decoded the behavioral choice. Striatal value and cingulate risk responses increased the probability of a risky choice, whereas inferior frontal gyrus responses showed the inverse relationship. These findings suggest that the BOLD correlates of decision factors are appropriate for an ideal observer to detect behavioral choices. More generally, these biological data contribute to the validity of the theoretical decision parameters for actual decisions under risk.

  7. Perceptions of shared decision making and decision aids among rural primary care clinicians.

    Science.gov (United States)

    King, Valerie J; Davis, Melinda M; Gorman, Paul N; Rugge, J Bruin; Fagnan, L J

    2012-01-01

    Shared decision making (SDM) and decision aids (DAs) increase patients' involvement in health care decisions and enhance satisfaction with their choices. Studies of SDM and DAs have primarily occurred in academic centers and large health systems, but most primary care is delivered in smaller practices, and over 20% of Americans live in rural areas, where poverty, disease prevalence, and limited access to care may increase the need for SDM and DAs. To explore perceptions and practices of rural primary care clinicians regarding SDM and DAs. Cross-sectional survey. Setting and Participants Primary care clinicians affiliated with the Oregon Rural Practice-based Research Network. Surveys were returned by 181 of 231 eligible participants (78%); 174 could be analyzed. Two-thirds of participants were physicians, 84% practiced family medicine, and 55% were male. Sixty-five percent of respondents were unfamiliar with the term shared decision making, but following definition, 97% reported that they found the approach useful for conditions with multiple treatment options. Over 90% of clinicians perceived helping patients make decisions regarding chronic pain and health behavior change as moderate/hard in difficulty. Although 69% of respondents preferred that patients play an equal role in making decisions, they estimate that this happens only 35% of the time. Time was reported as the largest barrier to engaging in SDM (63%). Respondents were receptive to using DAs to facilitate SDM in print- (95%) or web-based formats (72%), and topic preference varied by clinician specialty and decision difficulty. Rural clinicians recognized the value of SDM and were receptive to using DAs in multiple formats. Integration of DAs to facilitate SDM in routine patient care may require addressing practice operation and reimbursement.

  8. Making and Executing Decisions for Safe and Independent Living (MED-SAIL): development and validation of a brief screening tool.

    Science.gov (United States)

    Mills, Whitney L; Regev, Tziona; Kunik, Mark E; Wilson, Nancy L; Moye, Jennifer; McCullough, Laurence B; Naik, Aanand D

    2014-03-01

    Older adults prefer to remain in their own homes for as long as possible. The purpose of this article is to describe the development and preliminary validation of Making and Executing Decisions for Safe and Independent Living (MED-SAIL), a brief screening tool for capacity to live safely and independently in the community. Prospective preliminary validation study. Outpatient geriatrics clinic located in a community-based hospital. Forty-nine community-dwelling older adults referred to the clinic for a comprehensive capacity assessment. We examined internal consistency, criterion-based validity, concurrent validity, and accuracy of classification for MED-SAIL. The items included in MED-SAIL demonstrated internal consistency (5 items; α = 0.85). MED-SAIL was significantly correlated with the Independent Living Scales (r = 0.573, p ≤0.001) and instrumental activities of daily living (r = 0.440, p ≤0.01). The Mann-Whitney U test revealed significant differences between the no capacity and partial/full capacity classifications on MED-SAIL (U(48) = 60.5, Z = -0.38, p SAIL as a brief screening tool to identify older adults with impaired capacity for remaining safe and independent in their current living environment. MED-SAIL is useful tool for health and social service providers in the community for the purpose of referral for definitive capacity evaluation. Published by Elsevier Inc.

  9. DECIDE: a Decision Support Tool to Facilitate Parents' Choices Regarding Genome-Wide Sequencing.

    Science.gov (United States)

    Birch, Patricia; Adam, S; Bansback, N; Coe, R R; Hicklin, J; Lehman, A; Li, K C; Friedman, J M

    2016-12-01

    We describe the rationale, development, and usability testing for an integrated e-learning tool and decision aid for parents facing decisions about genome-wide sequencing (GWS) for their children with a suspected genetic condition. The online tool, DECIDE, is designed to provide decision-support and to promote high quality decisions about undergoing GWS with or without return of optional incidental finding results. DECIDE works by integrating educational material with decision aids. Users may tailor their learning by controlling both the amount of information and its format - text and diagrams and/or short videos. The decision aid guides users to weigh the importance of various relevant factors in their own lives and circumstances. After considering the pros and cons of GWS and return of incidental findings, DECIDE summarizes the user's responses and apparent preferred choices. In a usability study of 16 parents who had already chosen GWS after conventional genetic counselling, all participants found DECIDE to be helpful. Many would have been satisfied to use it alone to guide their GWS decisions, but most would prefer to have the option of consulting a health care professional as well to aid their decision. Further testing is necessary to establish the effectiveness of using DECIDE as an adjunct to or instead of conventional pre-test genetic counselling for clinical genome-wide sequencing.

  10. Volatility smile and stochastic arbitrage returns

    OpenAIRE

    Sergei Fedotov; Stephanos Panayides

    2004-01-01

    The purpose of this work is to explore the role that random arbitrage opportunities play in pricing financial derivatives. We use a non-equilibrium model to set up a stochastic portfolio, and for the random arbitrage return, we choose a stationary ergodic random process rapidly varying in time. We exploit the fact that option price and random arbitrage returns change on different time scales which allows us to develop an asymptotic pricing theory involving the central limit theorem for random...

  11. Intramuscular tendon involvement on MRI has limited value for predicting time to return to play following acute hamstring injury.

    Science.gov (United States)

    van der Made, Anne D; Almusa, Emad; Whiteley, Rod; Hamilton, Bruce; Eirale, Cristiano; van Hellemondt, Frank; Tol, Johannes L

    2018-01-01

    Hamstring injury with intramuscular tendon involvement is regarded as a serious injury with a delay in return to play (RTP) of more than 50 days and reinjury rates up to 63%. However, this reputation is based on retrospective case series with high risk of bias. Determine whether intramuscular tendon involvement is associated with delayed RTP and elevated rates of reinjury. MRI of male athletes with an acute hamstring injury was obtained within 5 days of injury. Evaluation included standardised MRI scoring and scoring of intramuscular tendon involvement. Time to RTP and reinjury rate were prospectively recorded. Out of 70 included participants, intramuscular tendon disruption was present in 29 (41.4%) injuries. Injuries without intramuscular tendon disruption had a mean time to RTP of 22.2±7.4 days. Injuries with Injuries with full-thickness disruption took longer to RTP compared with injuries without disruption (p=0.025). Longitudinal intramuscular tendon disruption was not significantly associated with time to RTP. Waviness was present in 17 (24.3%) injuries. Mean time to RTP for injuries without and with waviness was 22.6±7.5 and 30.2±10.8 days (p=0.014). There were 11 (15.7%) reinjuries within 12 months, five (17.2%) in the group with intramuscular tendon disruption and six (14.6%) in the group without intramuscular tendon disruption. Time to RTP for injuries with full-thickness disruption of the intramuscular tendon and waviness is significantly longer (by slightly more than 1 week) compared with injuries without intramuscular tendon involvement. However, due to the considerable overlap in time to RTP between groups with and without intramuscular tendon involvement, its clinical significance for the individual athlete is limited. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  12. Reactive, Safe Navigation for Lunar and Planetary Robots

    Science.gov (United States)

    Utz, Hans; Ruland, Thomas

    2008-01-01

    When humans return to the moon, Astronauts will be accompanied by robotic helpers. Enabling robots to safely operate near astronauts on the lunar surface has the potential to significantly improve the efficiency of crew surface operations. Safely operating robots in close proximity to astronauts on the lunar surface requires reactive obstacle avoidance capabilities not available on existing planetary robots. In this paper we present work on safe, reactive navigation using a stereo based high-speed terrain analysis and obstacle avoidance system. Advances in the design of the algorithms allow it to run terrain analysis and obstacle avoidance algorithms at full frame rate (30Hz) on off the shelf hardware. The results of this analysis are fed into a fast, reactive path selection module, enforcing the safety of the chosen actions. The key components of the system are discussed and test results are presented.

  13. Return to the... past

    International Nuclear Information System (INIS)

    Ammerich, M.

    2009-01-01

    This article goes back over the incidents occurring during the summer 2008, that is to say the uranium release from the Socatri facility in the South of France. From this point, the purpose studies the radiological situation of the Camargue seashore; the levels of radioactivity are from 3 to thirty times higher than these ones expected in this area, but the natural radioactivity with thorium and uranium coming from the granitic massifs erosion brings an important part. It is difficult to make the part between human and natural contribution to ambient radioactivity. However, it appears that to limit the water consumption until the time of dilution played its part was absolutely necessary. Then, because it is question of water, the drinking water is tackled. Some mineral waters go over the recommended limits of doses. A last return to the past with the radioactive watches, but this time with actual watches that activate detection. Two watches contained promethium 147, 147 Pm is a beta emitter but also gamma emitter. To end, in Ireland and Great Britain, some fire detectors contain americium 241. In fact, this article constitutes a summary of different abnormalities around radioactivity. (N.C.)

  14. What's gender got to do with it? Examining masculinities, health and safety and return to work in male dominated skilled trades.

    Science.gov (United States)

    Stergiou-Kita, Mary; Mansfield, Elizabeth; Colantonio, Angela; Moody, Joel; Mantis, Steve

    2016-06-16

    Electrical injuries are a common cause of work-related injury in male dominated skilled trades. In this study we explored how issues of gender, masculinities and institutional workplace practices shape expectations of men and their choices when returning to work following a workplace electrical injury. Twelve workers, who suffered an electrical injury, and twelve employer representatives, completed semi-structured interviews. Using thematic analysis we identified key themes related to how masculinities influenced men's health and safety during the return to work process. Strong identification with worker roles can influence injured workers decisions to return to work 'too early'. A desire to be viewed as a strong, responsible, resilient worker may intersect with concerns about job loss, to influence participants' decisions to not report safety issues and workplace accidents, to not disclose post-injury work challenges, and to not request workplace supports. Institutionalized workplace beliefs regarding risk, de-legitimization of the severity of injuries, and the valorization of the "tough" worker can further re-enforce dominant masculine norms and influence return to work processes and health and safety practices. Workplaces are key sites where gender identities are constructed, affirmed and institutionalized. Further research is warranted to examine how established masculine norms and gendered workplace expectations can influence workplace health and safety in male dominated high risk occupations. Future research should also evaluate strategies that encourage men to discuss post-injury work challenges and request supports when work performance or health and safety issues arise during the return to work process.

  15. The effects of integration and transnational ties on international return migration intentions

    NARCIS (Netherlands)

    de Haas, H.; Fokkema, C.M.

    2011-01-01

    While return migration is receiving increasing attention, there is still insufficient insight into the factors which determine migrants’ intentions and decisions to return. It is often assumed that integration in receiving countries and the concomitant weakening of transnational ties decreases the

  16. Determinants of the return to hometowns after the accident at Fukushima Dai-ichi nuclear power plant: A case study for the village of Kawauchi

    International Nuclear Information System (INIS)

    Orita, M.; Hayashida, N.; Urata, H.; Shinkawa, T.; Endo, Y.; Takamura, N.

    2013-01-01

    The Great East Japan Earthquake in March 2011 destroyed the Fukushima Dai-ichi Nuclear Power Plant (FNPP) and almost all residents in a 20 km radius from the plant eventually evacuated. FNPP reactors were stabilised in December 2011; some evacuees decided to return to their hometowns, and the other evacuees remained. Efforts were made to identify the determinants that affect the decision to return home in order to promote recovery of the surrounding area of FNPP. Seventy one residents who had not returned to hometown and 56 residents who had returned were selected. Logistic regression analysis adjusted for confounding factors showed that being female [odds ratio (OR): 2.43, p=50.03], living in areas with relatively higher ambient doses (OR: 3.60, p=50.01) and expressing anxiety over radiation exposure (OR: 8.91, p < 0.01) were independently associated with decisions not to return. Results of this study suggest the importance of active participation by scientists and local authorities in communicating the risk to the general population involved in returning home. (authors)

  17. The Case for Gold Revisited: A Safe Haven Or A Hedge ?

    Directory of Open Access Journals (Sweden)

    Sudi Apak

    2012-09-01

    Full Text Available This paper attempts to analyze the relation among gold prices and other macroeconomic and financial variables and addresses the question whether gold is a safe haven or a hedge for investors. The study investigates the relationship by using an econometric analysis for top gold exporter and importer countries, for a sample period of 11 years from 2000 to 2011. The results are twofold (i return of silver, USD returns and change in the volatility index influences gold returns positively whereas, Swiss Franc and Canadian Dollar returns influence gold returns negatively regardless of presence of the 2008 crisis. (ii In times of stress, our findings indicate that Swiss Franc, Norwegian Krone and Canadian Dollar function as haven whereas, on average, Swiss Franc, Canadian Dollar and 10 year US treasuries function as a hedge against gold but the results show no evidence for the US dollar.  

  18. 26 CFR 301.6103(h)(2)-1 - Disclosure of returns and return information (including taxpayer return information) to and by...

    Science.gov (United States)

    2010-04-01

    ... administration. 301.6103(h)(2)-1 Section 301.6103(h)(2)-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT... Returns Returns and Records § 301.6103(h)(2)-1 Disclosure of returns and return information (including..., shall, to the extent provided by section 6103(h)(2) (A), (B), and (C) and subject to the requirements of...

  19. Brain network activation as a novel biomarker for the return-to-play pathway following sport-related brain injury: A prospective case study

    Directory of Open Access Journals (Sweden)

    Adam W Kiefer

    2015-11-01

    Full Text Available Children and adolescent athletes are at a higher risk for concussion than adults, and also experience longer recovery times and increased associated symptoms. It has also recently been demonstrated that multiple, seemingly mild concussions may result in exacerbated and prolonged neurologic deficits. Objective assessments and return to play criteria are needed to reduce risk and morbidity associated with concussive events in these populations. Recent research has pushed to study the use of electroencephalography as an objective measure of brain injury. In the present case study, we present a novel approach that examines event related potentials via a brain network activation (BNA analysis as a biomarker of concussion and recovery. Specifically, changes in BNA scores as indexed through this approach, offer a potential indicator of neurological health as the BNA assessment qualitatively and quantitatively indexes the network dynamics associated with brain injury. Objective tools such as these support accurate and efficient assessment of brain injury and may offer a useful step in categorizing the temporal and spatial changes in brain activity following concussive blows, as well as the functional connectivity of brain networks, associated with concussion.

  20. Estimating the Returns to Firm-Sponsored on-the-Job and Classroom Training

    OpenAIRE

    Benoit Dostie

    2010-01-01

    In this paper, we estimate returns to classroom and on-the-job firm-sponsored training in terms of value-added per worker using longitudinal linked employee-employer Canadian data from 1999 to 2006. We estimate a standard production function controlling for endogenous training decisions because of perceived net benefits and time-varying market conditions using dynamic panel GMM methods. We find that employees who undertook classroom training are 11 percent more productive than otherwise simil...

  1. Risky Play and Children’s Safety: Balancing Priorities for Optimal Child Development

    Directory of Open Access Journals (Sweden)

    David A. Sleet

    2012-08-01

    Full Text Available Injury prevention plays a key role in keeping children safe, but emerging research suggests that imposing too many restrictions on children’s outdoor risky play hinders their development. We explore the relationship between child development, play, and conceptions of risk taking with the aim of informing child injury prevention. Generational trends indicate children’s diminishing engagement in outdoor play is influenced by parental and societal concerns. We outline the importance of play as a necessary ingredient for healthy child development and review the evidence for arguments supporting the need for outdoor risky play, including: (1 children have a natural propensity towards risky play; and, (2 keeping children safe involves letting them take and manage risks. Literature from many disciplines supports the notion that safety efforts should be balanced with opportunities for child development through outdoor risky play. New avenues for investigation and action are emerging seeking optimal strategies for keeping children “as safe as necessary,” not “as safe as possible.” This paradigm shift represents a potential for epistemological growth as well as cross-disciplinary collaboration to foster optimal child development while preserving children’s safety.

  2. How do parents and pediatricians arrive at the decision to immunize their children in the private sector? Insights from a qualitative study on rotavirus vaccination across select Indian cities

    Science.gov (United States)

    George, Mathew Sunil; Negandhi, Preeti; Farooqui, Habib Hassan; Sharma, Anjali; Zodpey, Sanjay

    2016-01-01

    ABSTRACT Key debates on improving vaccination coverage tend to focus on factors that affect uptake in the public health system while ignoring the private sector that plays an important role in providing health services in any low or middle-income country setting. Using in-depth interviews, we explored factors that influenced the decision of parents as well as pediatricians working in the private sector across 8 Indian cities on whether their children should be vaccinated with a particular vaccine Pediatricians and their relationship with parents was an important factor that influenced the decision on whether parents vaccinated their children with a particular vaccine or not. The decision to recommend a vaccine is taken on the principle that it is better to be safe than sorry than on any objective assessment of whether a child requires a particular vaccine or not. Family members and social factors also played a major role in the decision-making. According to some parents, vaccinating their child added an aspirational value to their growth. This is especially true of the newer vaccines that are considered optional in India. The cost of a vaccine did not come up as an inhibiting factor in the decision to vaccinate a child. Access to appropriate evidence was limited for both pediatricians and parents and evidence per se played a minimal role in the final decision to vaccinate a child or not. Far more important were the influences of factors such as relationship with the pediatrician, the role of decisions related to vaccination taken by people in the immediate social network. PMID:27880083

  3. How do parents and pediatricians arrive at the decision to immunize their children in the private sector? Insights from a qualitative study on rotavirus vaccination across select Indian cities.

    Science.gov (United States)

    George, Mathew Sunil; Negandhi, Preeti; Farooqui, Habib Hassan; Sharma, Anjali; Zodpey, Sanjay

    2016-12-01

    Key debates on improving vaccination coverage tend to focus on factors that affect uptake in the public health system while ignoring the private sector that plays an important role in providing health services in any low or middle-income country setting. Using in-depth interviews, we explored factors that influenced the decision of parents as well as pediatricians working in the private sector across 8 Indian cities on whether their children should be vaccinated with a particular vaccine Pediatricians and their relationship with parents was an important factor that influenced the decision on whether parents vaccinated their children with a particular vaccine or not. The decision to recommend a vaccine is taken on the principle that it is better to be safe than sorry than on any objective assessment of whether a child requires a particular vaccine or not. Family members and social factors also played a major role in the decision-making. According to some parents, vaccinating their child added an aspirational value to their growth. This is especially true of the newer vaccines that are considered optional in India. The cost of a vaccine did not come up as an inhibiting factor in the decision to vaccinate a child. Access to appropriate evidence was limited for both pediatricians and parents and evidence per se played a minimal role in the final decision to vaccinate a child or not. Far more important were the influences of factors such as relationship with the pediatrician, the role of decisions related to vaccination taken by people in the immediate social network.

  4. Return-to-work coordination programmes for improving return to work in workers on sick leave.

    Science.gov (United States)

    Vogel, Nicole; Schandelmaier, Stefan; Zumbrunn, Thomas; Ebrahim, Shanil; de Boer, Wout El; Busse, Jason W; Kunz, Regina

    2017-03-30

    To limit long-term sick leave and associated consequences, insurers, healthcare providers and employers provide programmes to facilitate disabled people's return to work. These programmes include a variety of coordinated and individualised interventions. Despite the increasing popularity of such programmes, their benefits remain uncertain. We conducted a systematic review to determine the long-term effectiveness of return-to-work coordination programmes compared to usual practice in workers at risk for long-term disability. To assess the effects of return-to-work coordination programmes versus usual practice for workers on sick leave or disability. We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 11), MEDLINE, Embase, CINAHL and PsycINFO up to 1 November 2016. We included randomised controlled trials (RCTs) that enrolled workers absent from work for at least four weeks and randomly assigned them to return-to-work coordination programmes or usual practice. Two review authors independently screened titles, abstracts and full-text articles for study eligibility; extracted data; and assessed risk of bias from eligible trials. We contacted authors for additional data where required. We conducted random-effects meta-analyses and used the GRADE approach to rate the quality of the evidence. We identified 14 studies from nine countries that enrolled 12,568 workers. Eleven studies focused on musculoskeletal problems, two on mental health and one on both. Most studies (11 of 14) followed workers 12 months or longer. Risk of bias was low in 10 and high in 4 studies, but findings were not sensitive to their exclusion.We found no benefits for return-to-work coordination programmes on return-to-work outcomes.For short-term follow-up of six months, we found no effect on time to return to work (hazard ratio (HR) 1.32, 95% confidence interval (CI) 0.93 to 1.88, low-quality evidence), cumulative sickness absence (mean difference (MD) -16.18 work

  5. Strategy in Regulatory Decision-Making for Management of Progressive Multifocal Leukoencephalopathy.

    Science.gov (United States)

    Segec, A; Keller-Stanislawski, B; Vermeer, N S; Macchiarulo, C; Straus, S M; Hidalgo-Simon, A; De Bruin, M L

    2015-11-01

    Progressive multifocal leukoencephalopathy (PML) has been observed after the use of several medicines, including monoclonal antibodies. As these drugs play important roles in the therapeutic armamentarium, it is important to address the challenges that this severe adverse reaction poses to the safe use of medicines. Considering the need for consistent outcomes of regulatory decisions, the European Medicines Agency Pharmacovigilance Risk Assessment Committee (PRAC) used PML as an example to develop a systematic approach to labeling and risk minimization. © 2015 American Society for Clinical Pharmacology and Therapeutics.

  6. Safe discharge: an irrational, unhelpful and unachievable concept

    OpenAIRE

    Goodacre, S

    2006-01-01

    Emergency doctors often decide whether to advise hospital admission or discharge by assessing whether a decision to discharge home is considered safe. This implies that hospital admission may be recommended on the basis of exceeding an arbitrarily defined risk of adverse outcome, rather than weighing the potential benefits, risks and costs of hospital admission. This approach is likely to lead to irrational decision making, unnecessary hospitalisation and unrealistic expectations regarding ri...

  7. Volatility in the Housing Market: Evidence on Risk and Return in theLondon Sub-market

    Directory of Open Access Journals (Sweden)

    Steve Cook

    2017-10-01

    Full Text Available The impact of volatility in housing market analysis is reconsidered via examinaton ofthe risk-return relationship in the London housing market is examined. In addition to providing thefirst empirical results for the relationship between risk (as measured by volatility and returns forthis submarket, the analysis offers a more general message to empiricists via a detailed and explicitevaluation of the impact of empirical design decisions upon inferences. In particular, the negativerisk-return relationship discussed frequently in the housing market literature is examined and shown todepend upon typically overlooked decisions concerning components of the empirical framework fromwhich statistical inferences are drawn.

  8. Characteristics of donors who do or do not return to give blood and barriers to their return

    Science.gov (United States)

    Wevers, Anne; Wigboldus, Daniël H.J.; de Kort, Wim L.A.M.; van Baaren, Rick; Veldhuizen, Ingrid J.T.

    2014-01-01

    Background In the Netherlands about 50% of whole blood donors return to give blood after an invitation to donate. This study aimed to investigate the characteristics of donor return behaviour and to gain insight into the barriers to blood donation reported by the donors themselves. Materials and methods A total of 4,901 whole blood donors were invited to donate in week 39 of 2009. Barriers mentioned by donors who informed the blood bank for not donating were registered for 1 month. Logistic regression analyses assessed relevant characteristics of return behaviour, such as age and blood type, in men and women separately. Results Of the invited donors, 55% returned to give a donation, whereas 45% did not return. Male donors were more likely to return when they were older, had a higher previous return rate and had no past deferrals. The same pattern was found among women, but was less strong. The main barriers were: time constraints (35%), preference to postpone donation due to general physical problems although being eligible to donate (29%), and being ineligible to donate due to medical deferral criteria (9%). Discussion Specific donor characteristics are associated with return behaviour. Not donating due to time constraints could mean that donors do not feel the urgency of donating blood. Interventions targeted to increase commitment among specific donor groups should be tested further. PMID:23522891

  9. Agricultural Returns to Labor and the Origins of Work Ethics

    OpenAIRE

    Fouka, Vasiliki; Schlaepfer, Alain

    2017-01-01

    We examine the historical determinants of differences in preferences for work across societies today. Our hypothesis is that a society’s work ethic depends on the role that labor has played in it historically, as an input in agricultural production: societies that have for centuries depended on the cultivation of crops with high returns to labor effort will work longer hours and develop a preference for working hard. We formalize this prediction in the context of a model of endogenous prefere...

  10. 29 CFR 2550.404a-3 - Safe harbor for distributions from terminated individual account plans.

    Science.gov (United States)

    2010-07-01

    ... RETIREMENT INCOME SECURITY ACT OF 1974 RULES AND REGULATIONS FOR FIDUCIARY RESPONSIBILITY § 2550.404a-3 Safe... rate of return, whether or not such return is guaranteed, consistent with liquidity (except that... liquidity; (v) A statement explaining what fees, if any, will be paid from the participant or beneficiary's...

  11. Pricing, Carbon Emission Reduction, Low-Carbon Promotion and Returning Decision in a Closed-Loop Supply Chain under Vertical and Horizontal Cooperation.

    Science.gov (United States)

    Li, Hui; Wang, Chuanxu; Shang, Meng; Ou, Wei

    2017-11-01

    In this paper, we examine the influences of vertical and horizontal cooperation models on the optimal decisions and performance of a low-carbon closed-loop supply chain (CLSC) with a manufacturer and two retailers, and study optimal operation in the competitive pricing, competitive the low-carbon promotion, the carbon emission reduction, the used-products collection and the profits. We consider the completely decentralized model, M-R vertical cooperation model, R-R horizontal cooperation model, M-R-R vertical and horizontal cooperation model and completely centralized model, and also identify the optimal decision results and profits. It can be observed from a systematic comparison and numerical analysis that the completely centralized model is best in all optimal decision results among all models. In semi-cooperation, the M-R vertical cooperation model is positive, the R-R horizontal cooperation model is passive, and the positivity of the M-R-R vertical and horizontal cooperation model decreases with competitive intensity increasing in the used-products returning, carbon emissions reduction level, low-carbon promotion effort and the profits of the manufacturer and the entire supply chain.

  12. Making college worth it: a review of the returns to higher education.

    Science.gov (United States)

    Oreopoulos, Philip; Petronijevic, Uros

    2013-01-01

    Despite a general rise in the return to college, likely due to technological change, the cost-benefit calculus facing prospective students can make the decision to invest in and attend college dauntingly complex. Philip Oreopoulos and Uros Petronijevic review research on the varying costs and benefits of higher education and explore in full the complexity of the decision to invest in and attend college. Optimal college attainment decisions are different for all prospective students, who diverge in terms of what they are likely to get out of higher education and what specific options might be best for them. Earnings of college graduates depend in important measure on the program of study and eventual occupation they choose. Students uninterested in or unable to complete a four-year college degree appear to benefit from completing a two-year degree. Prospective students may also face both financial constraints, which prohibit them from taking advantage of more education, and information problems and behavioral idiosyncrasies, such as reluctance to take on debt, which keep them from making optimal decisions about attending college. In their discussion of how student debt figures in the college investment, the authors note that some students borrow too little and, as a result, underinvest in their education. Carefully calculating the return on the college investment can help determine the "appropriate" amount of debt. Students are more likely to benefit from postsecondary education the more informed they are about the expenses associated with college and the potential options for financial aid, which can be extremely complex. To make the best college investment, Oreopoulos and Petronijevic stress, prospective students must give careful consideration to selecting the institution itself, the major to follow, and the eventual occupation to pursue. For any particular program at a particular school, anticipated future labor market earnings, the likelihood of completion, the

  13. Factors associated with playing football after anterior cruciate ligament reconstruction in female football players.

    Science.gov (United States)

    Fältström, A; Hägglund, M; Kvist, J

    2016-11-01

    This study investigated whether player-related factors (demographic, personality, or psychological factors) or the characteristics of the anterior cruciate ligament (ACL) injury were associated with the return to playing football in females after ACL reconstruction (ACLR). We also compared current knee function, knee related quality of life and readiness to return to sport between females who returned to football and those who had not returned. Females who sustained a primary ACL rupture while playing football and underwent ACLR 6-36 months ago were eligible. Of the 460 contacted, 274 (60%) completed a battery of questionnaires, and 182 were included a median of 18 months (IQR 13) after ACLR. Of these, 94 (52%) returned to football and were currently playing, and 88 (48%) had not returned. Multiple logistic regression analysis identified two factors associated with returning to football: short time between injury and ACLR (0-3 months, OR 5.6; 3-12 months OR 4.7 vs reference group > 12 months) and high motivation. Current players showed higher ratings for current knee function, knee-related quality of life, and psychological readiness to return to sport (P football after ACLR. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. Achieving Robustness to Uncertainty for Financial Decision-making

    Energy Technology Data Exchange (ETDEWEB)

    Barnum, George M. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Van Buren, Kendra L. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Hemez, Francois M. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Song, Peter [Univ. of Pennsylvania, Philadelphia, PA (United States)

    2014-01-10

    This report investigates the concept of robustness analysis to support financial decision-making. Financial models, that forecast future stock returns or market conditions, depend on assumptions that might be unwarranted and variables that might exhibit large fluctuations from their last-known values. The analysis of robustness explores these sources of uncertainty, and recommends model settings such that the forecasts used for decision-making are as insensitive as possible to the uncertainty. A proof-of-concept is presented with the Capital Asset Pricing Model. The robustness of model predictions is assessed using info-gap decision theory. Info-gaps are models of uncertainty that express the “distance,” or gap of information, between what is known and what needs to be known in order to support the decision. The analysis yields a description of worst-case stock returns as a function of increasing gaps in our knowledge. The analyst can then decide on the best course of action by trading-off worst-case performance with “risk”, which is how much uncertainty they think needs to be accommodated in the future. The report also discusses the Graphical User Interface, developed using the MATLAB® programming environment, such that the user can control the analysis through an easy-to-navigate interface. Three directions of future work are identified to enhance the present software. First, the code should be re-written using the Python scientific programming software. This change will achieve greater cross-platform compatibility, better portability, allow for a more professional appearance, and render it independent from a commercial license, which MATLAB® requires. Second, a capability should be developed to allow users to quickly implement and analyze their own models. This will facilitate application of the software to the evaluation of proprietary financial models. The third enhancement proposed is to add the ability to evaluate multiple models simultaneously

  15. What If I Don't Want to Play God?

    Science.gov (United States)

    Dobrin, Kelly Hykes; Yarnall, Gary Dean

    The authors review technological advances in medicine, such as gene manipulation, amniocentesis, ultra sound, organ transplants, and cloning, and point out ethical and moral dilemmas resulting from such capabilities. Implications of overpopulation are briefly considered. The authors contend that the decision "to play God" has already been made,…

  16. Safe motherhood at risk?

    Science.gov (United States)

    Thompson, A

    1996-12-01

    Health professionals' negative attitudes toward clients often exacerbate the problems women face in terms of health status and access to health care. Thus, the health professionals can themselves be obstacles to women seeking the health care they need. A key challenge to midwives, in addition to providing technically competent services, is gaining insight into the people for whom they are responsible so that childbirth traditions are treated with respect and women are offered dignity. Safe motherhood requires intersectoral collaboration. Many innovative approaches to safe motherhood are based on the community's participation in planning services that meet the needs of women. Other approaches are based on decentralization of services. For example, a large university teaching hospital in Lusaka, Zambia, set up birthing centers around the city to take the pressure off the hospital. Midwives head up these centers, which are close to the women's homes. Decentralization of delivery services has improved the physical and emotional outcomes for mothers and newborns. Midwives must be prepared to articulate concerns about inequalities and deficiencies in the health care system in order to persuade the government to change. Women, including midwives, need to form multidisciplinary alliances to work together to effect change. The front-line workers in maternity care are midwives. They should adopt the following strategies to become even more effective in their efforts to make motherhood safer. They should listen to what women say about their needs. They should scale services to a manageable, human scale. They should learn the skills to become politically active advocates. They should work with other midwives, women, leaders, and other professional groups. Motherhood can be safe when women have more control over their own decision making, the education to liberate themselves to make their own decisions, and access to skilled care.

  17. Modeling Perceived Quality, Customer Satisfaction and Probability of Guest Returning to the Destination

    Directory of Open Access Journals (Sweden)

    Olivera Blagojevic Popovic

    2018-03-01

    Full Text Available In the hotel industry, it is a well-known fact that, despite of quality and variety of services provided, there is a low probability that the guests will return. This research is focused on identifying the basic factors of the hotel offer, which could determine the influence on the correlation between the guests’ satisfaction and the probability of their return. The objective of the article is to explore the relationship between the guests’ satisfaction with the quality hotel services in total (including the tourist offer of the place and the probability of his return to the same destination. The questionnaire method was applied in the survey, and the data were analysed based on factor analysis. Thereafter, the model for forecasting the probability of the guests returning to the destination was established, by using the example of Montenegrin tourism. The model represents a defined framework for the guest’s decision-making process. It identifies two main characteristics of guest experiences: satisfaction and rated quality (of the destination’s overall hotel service and tourist offer. The same model evaluates the impact of the above factors on the probability of the guests’ returning to the same destination. The starting hypothesis was the existence of a high degree of correlation between the guests’ satisfaction (with the destination’s hotel services and tourist offer and the probability of returning to the selected Montenegrin destinations. The research confirmed the above-mentioned hypothesis. The results have revealed that there are significant differences in perceived quality, i.e. satisfaction between the target groups of Eastern and Western European tourists

  18. Income, self-selection, and return and onward interprovincial migration in Canada.

    Science.gov (United States)

    Newbold, K B

    1996-06-01

    "Estimated returns to migration based on comparison of individual migrants may be biased owing to self-selection in the migration process. Using data derived from the 1986 Canadian census, I will study the effects of expected wage differentials in determining the return or onward migration decision of nonnative adults aged 20 to 64 years. Evidence was found that return migrations were in the 'right' direction, as they are observed to respond to provincial economic variables (that is, average employment growth and income levels) in a rational manner. After accounting for self-selectivity, I found that...return migrants...are negatively selected, and experience lower income levels, following the return migration, than onward migrants would have, had they chosen the return migration option. This drop in expected wages decreases the propensity associated with making a return migration. Despite this drop in income, the large proportion selecting the return migration option suggests the importance of the province of birth in the mental map of nonnative migrants." excerpt

  19. Exposure to Free-Play Modes in Simulated Online Gaming Increases Risk-Taking in Monetary Gambling.

    Science.gov (United States)

    Frahn, Tahnee; Delfabbro, Paul; King, Daniel L

    2015-12-01

    This study examined the behavioral effects of practice modes in simulated slot machine gambling. A sample of 128 participants predominantly aged 18-24 years were randomly allocated to 1 of 4 pre-exposure conditions: control (no practice), standard 90% return to player, inflated return to player and inflated return with pop-up messages. Participants in all conditions engaged in monetary gambling using a realistic online simulation of a slot machine. As predicted, the results showed that those players exposed to inflated or 'profit' demonstration modes placed significantly higher bets in the real-play mode as compared to the other groups. However, the groups did not differ in relation to how long they persisted in the real-play mode. Pop-up messages had no significant effect on monetary gambling behavior. The results of this study confirm that exposure to inflated practice or "demo" modes lead to short-term increases in risk-taking. These findings highlight the need for careful regulation and monitoring of internet gambling sites, as well as further research on the potential risks of simulated gambling activities for vulnerable segments of the gambling population.

  20. Coordinating a Supply Chain with Risk-Averse Agents under Demand and Consumer Returns Uncertainty

    Directory of Open Access Journals (Sweden)

    Jian Liu

    2013-01-01

    Full Text Available This paper examines the optimal order decision in a supply chain when it faces uncertain demand and uncertain consumer returns. We build consumer returns model with decision-makers’ risk preference under mean-variance objective framework and discuss supply chain coordination problem under wholesale-price-only policy and the manufacturer’s buyback policy, respectively. We find that, with wholesale price policy, the supply chain cannot be coordinated whether the supply chain agents are risk-neutral or risk-averse. However, with buyback policy, the supply chain can be coordinated and the profit of the supply chain can be arbitrarily allocated between the manufacturer and the retailer. Through numerical examples, we illustrate the impact of stochastic consumer returns and the supply chain agents’ risk attitude on the optimal order decision.

  1. Strength Asymmetry and Landing Mechanics at Return to Sport after ACL Reconstruction

    Science.gov (United States)

    Schmitt, Laura C.; Paterno, Mark V.; Ford, Kevin R.; Myer, Gregory D.; Hewett, Timothy E.

    2014-01-01

    Purpose Evidence-based quadriceps femoris muscle (QF) strength guidelines for return to sport following anterior cruciate ligament (ACL) reconstruction are lacking. This study investigated the impact of QF strength asymmetry on knee landing biomechanics at the time of return to sport following ACL reconstruction. Methods Seventy-seven individuals (17.4 years) at the time of return to sport following primary ACL reconstruction (ACLR group) and 47 uninjured control individuals (17.0 years) (CTRL group) participated. QF strength was assessed and Quadriceps Index calculated (QI = [involved strength/uninvolved strength]*100%). The ACLR group was sub-divided based on QI: High Quadriceps (HQ, QI≥90%) and Low-Quadriceps (LQ, QIkinetic variables were collected during a drop vertical jump maneuver. Limb symmetry during landing, and discrete variables were compared among the groups with multivariate analysis of variance and linear regression analyses. Results The LQ group demonstrated worse asymmetry in all kinetic and ground reaction force variables compared to the HQ and CTRL groups, including reduced involved limb peak knee external flexion moments (p.05). In the ACLR group, QF strength estimated limb symmetry during landing after controlling for graft type, meniscus injury, knee pain and symptoms. Conclusion At the time of return to sport, individuals post-ACL reconstruction with weaker QF demonstrate altered landing patterns. Conversely, those with nearly symmetrical QF strength demonstrate landing patterns similar to uninjured individuals. Consideration of an objective QF strength measure may aid clinical decision-making to optimize sports participation following ACL reconstruction. PMID:25373481

  2. Playful Organizations

    DEFF Research Database (Denmark)

    Pors, Justine Grønbæk; Åkerstrøm Andersen, Niels

    2015-01-01

    intact. In its final sections, the article discusses what happens to conditions of decision-making when organisations do not just see undecidability as a given condition, but as a limited resource indispensable for change and renewal. The article advances discussions of organisational play by exploring...

  3. Return to sports after shoulder arthroplasty

    Science.gov (United States)

    Johnson, Christine C; Johnson, Daniel J; Liu, Joseph N; Dines, Joshua S; Dines, David M; Gulotta, Lawrence V; Garcia, Grant H

    2016-01-01

    Many patients prioritize the ability to return to sports following shoulder replacement surgeries, including total shoulder arthroplasty (TSA), reverse total shoulder arthroplasty (RTSA), and hemiarthroplasty (HA). While activity levels after hip and knee replacements have been well-established in the literature, studies on this topic in the field of shoulder arthroplasty are relatively limited. A review of the literature regarding athletic activity after shoulder arthroplasty was performed using the PubMed database. All studies relevant to shoulder arthroplasty and return to sport were included. The majority of patients returned to their prior level of activity within six months following TSA, RTSA, and shoulder HA. Noncontact, low demand activities are permitted by most surgeons postoperatively and generally have higher return rates than contact sports or high-demand activities. In some series, patients reported an improvement in their ability to participate in sports following the arthroplasty procedure. The rates of return to sports following TSA (75%-100%) are slightly higher than those reported for HA (67%-76%) and RTSA (75%-85%). Patients undergoing TSA, RTSA, and shoulder HA should be counseled that there is a high probability that they will be able to return to their preoperative activity level within six months postoperatively. TSA has been associated with higher rates of return to sports than RTSA and HA, although this may reflect differences in patient population or surgical indication. PMID:27672564

  4. Safe delivery care practices in western Nepal: Does women's autonomy influence the utilization of skilled care at birth?

    Science.gov (United States)

    Bhandari, Tulsi Ram; Kutty, V Raman; Sarma, P Sankara; Dangal, Ganesh

    2017-01-01

    Despite various efforts to increase the utilization of skilled birth attendants (SBA), nearly two-thirds of deliveries take place at home without the assistance of SBAs in Nepal. We hypothesized that the ability of women to take decisions about their own lives-women's autonomy-plays an important part in birth choices. To know this, we conducted a community-based cross-sectional study for assessing women's autonomy and utilization of safe delivery care service in Kapilvastu district of Nepal from June to October 2014. We used multivariate modeling to associate socioeconomic factors and women's autonomy with the utilization of safe delivery care services. Just over one-third of women sought institutional delivery care during the birth of their last child. Out of the total deliveries at health facilities, nearly 58% women visited health facility for self-reported emergency obstructive care. Only 6.2% home deliveries were handled by health workers and 14.7% women used the safe delivery kit for home delivery care. Higher levels of women's education had a strong positive association (odds ratio = 24.11, CI = 9.43-61.64) with institutional delivery care. Stratified analysis showed that when the husband is educated, women's education seems to work partly through their autonomy in decision making. Educational status of women emerged as one of the key predictors of the utilization of delivery care services in Kapilvastu district. Economic status of household and husband's education are other dominant predictors of the utilization of safe delivery care services. Improving the economic and educational status may be the way out for improving the proportion of institutional deliveries. Women's autonomy may be an important mediating factor in this pathway.

  5. Evaluating the Nintendo Wii for assessing return to activity readiness in youth with mild traumatic brain injury.

    Science.gov (United States)

    DeMatteo, Carol; Greenspoon, Dayna; Levac, Danielle; Harper, Jessica A; Rubinoff, Mandy

    2014-08-01

    Adolescents with mild traumatic brain injuries (MTBI) are at substantial risk for repeat injury if they return to activity too soon. Post-concussion symptoms and impaired balance are two factors that limit return to activity. Post-injury assessments that challenge activity tolerance and balance skills are needed to ensure readiness to return to activity. This cross-sectional study evaluated the Nintendo Wii as a measure of exertion (heart rate [HR], respiration rate [RR], and caloric expenditure) and balance testing for youth with MTBI in a clinical setting. Twenty-four youth with MTBI, ages 9-18, played six Wii games. The Bruininks-Oseretsky Test of Motor Proficiency 2nd edition (BOT-2) and the Community Balance and Mobility Scale (CBM) were used as balance indicators. The Wii Fit Running game demonstrated the highest caloric expenditure and HR (p = .010). Frequency counts of balance loss during Wii game play did not correlate with performance on the BOT-2 or the CBM. Type, number, and time since injury were predictive of balance performance on the CBM (p = .008). Findings provide preliminary evidence for the use of the Wii as an exertion challenge to evaluate tolerance for exercise post-concussion. Frequency count of balance loss during Wii game play, however, was not a valid measure of balance impairment post-MTBI.

  6. Concise set of files for smooth return to work in employees with mental disorders.

    Science.gov (United States)

    Yoshitsugu, Kiyoshi; Kuroda, Yuko; Hiroyama, Yuji; Nagano, Nobuhisa

    2013-01-01

    Sick leave due to mental disorders is a societal problem. It carries a high cost in terms of loss of labor productivity and absenteeism. Partial remission increases the risk of relapse after a return to work. There is sometimes a difference between the ability to return to work as judged by a general practitioner (GP) and the needs of the workplace. GPs are the main controllers of treatment and tend to protect their patients. Communication and agreement by GPs and occupational physicians play an effective role in the return to work. However, it requires considerable effort for both of them to make time to do this. We have developed a concise set of files for a smooth return to work. The files consist of three parts: "Suggestions for corresponding with employees taking sick leave"; "Checklist for smooth return to work"; and "Pattern of living". We put them into practice among 20 companies in Japan from January 2012 to October 2013. The companies had 8244 workers in total and 116 workers were on sick-leave due to mental disorders. Our set of files contributed to sharing the written basic policy of return to work among employees on sick leave with mental disorders, GPs, occupational physicians and personnel officers. That sharing led to facilitating a smooth return to work. Although there are differences in the legal and medical systems between Japan and other countries, our concept of sharing the written basic policy may give some help to occupational physicians in other parts of the world as well.

  7. Clinical, information and business process modeling to promote development of safe and flexible software.

    Science.gov (United States)

    Liaw, Siaw-Teng; Deveny, Elizabeth; Morrison, Iain; Lewis, Bryn

    2006-09-01

    Using a factorial vignette survey and modeling methodology, we developed clinical and information models - incorporating evidence base, key concepts, relevant terms, decision-making and workflow needed to practice safely and effectively - to guide the development of an integrated rule-based knowledge module to support prescribing decisions in asthma. We identified workflows, decision-making factors, factor use, and clinician information requirements. The Unified Modeling Language (UML) and public domain software and knowledge engineering tools (e.g. Protégé) were used, with the Australian GP Data Model as the starting point for expressing information needs. A Web Services service-oriented architecture approach was adopted within which to express functional needs, and clinical processes and workflows were expressed in the Business Process Execution Language (BPEL). This formal analysis and modeling methodology to define and capture the process and logic of prescribing best practice in a reference implementation is fundamental to tackling deficiencies in prescribing decision support software.

  8. The impact of consumer returns policies on consignment contracts with inventory control

    DEFF Research Database (Denmark)

    Hu, W.; Li, Y.; Govindan, Kannan

    2014-01-01

    , and then the retailer sets her retail price for selling the product. The vendor gets paid based on net sold units and salvages unsold units as well as returned items in a secondary market. Under the framework, we study and compare two different consignment arrangements: the retailer/vendor manages consignment inventory...... (RMCI/VMCI) programs. To study the impact of return policy, we discuss a consignment contract without return policy as a benchmark. We show that whether or not the vendor offers a return policy, it is always beneficial for the channel to delegate the inventory decision to the vendor. We find...

  9. Development of a decision analytic model to support decision making and risk communication about thrombolytic treatment.

    Science.gov (United States)

    McMeekin, Peter; Flynn, Darren; Ford, Gary A; Rodgers, Helen; Gray, Jo; Thomson, Richard G

    2015-11-11

    Individualised prediction of outcomes can support clinical and shared decision making. This paper describes the building of such a model to predict outcomes with and without intravenous thrombolysis treatment following ischaemic stroke. A decision analytic model (DAM) was constructed to establish the likely balance of benefits and risks of treating acute ischaemic stroke with thrombolysis. Probability of independence, (modified Rankin score mRS ≤ 2), dependence (mRS 3 to 5) and death at three months post-stroke was based on a calibrated version of the Stroke-Thrombolytic Predictive Instrument using data from routinely treated stroke patients in the Safe Implementation of Treatments in Stroke (SITS-UK) registry. Predictions in untreated patients were validated using data from the Virtual International Stroke Trials Archive (VISTA). The probability of symptomatic intracerebral haemorrhage in treated patients was incorporated using a scoring model from Safe Implementation of Thrombolysis in Stroke-Monitoring Study (SITS-MOST) data. The model predicts probabilities of haemorrhage, death, independence and dependence at 3-months, with and without thrombolysis, as a function of 13 patient characteristics. Calibration (and inclusion of additional predictors) of the Stroke-Thrombolytic Predictive Instrument (S-TPI) addressed issues of under and over prediction. Validation with VISTA data confirmed that assumptions about treatment effect were just. The C-statistics for independence and death in treated patients in the DAM were 0.793 and 0.771 respectively, and 0.776 for independence in untreated patients from VISTA. We have produced a DAM that provides an estimation of the likely benefits and risks of thrombolysis for individual patients, which has subsequently been embedded in a computerised decision aid to support better decision-making and informed consent.

  10. Barriers to return to work after burn injuries.

    Science.gov (United States)

    Esselman, Peter C; Askay, Shelley Wiechman; Carrougher, Gretchen J; Lezotte, Dennis C; Holavanahalli, Radha K; Magyar-Russell, Gina; Fauerbach, James A; Engrav, Loren H

    2007-12-01

    To identify barriers to return to work after burn injury as identified by the patient. A cohort study with telephone interview up to 1 year. Hospital-based burn centers at 3 national sites. Hospitalized patients (N=154) meeting the American Burn Association criteria for major burn injury, employed at least 20 hours a week at the time of injury, and with access to a telephone after discharge. Patients were contacted via telephone every 2 weeks up to 4 months, then monthly up to 1 year after discharge. A return to work survey was used to identify barriers that prevented patients from returning to work. A graphic rating scale determined the impact of each barrier. By 1 year, 79.7% of patients returned to work. Physical and wound issues were barriers early after discharge. Although physical abilities continued to be a significant barrier up to 1 year, working conditions (temperature, humidity, safety) and psychosocial factors (nightmares, flashbacks, appearance concerns) became important issues in those with long-term disability. The majority of patients return to work after a burn injury. Although physical and work conditions are important barriers, psychosocial issues need to be evaluated and treated to optimize return to work.

  11. The cost-effectiveness of semi-rigid ankle brace to facilitate return to work following first-time acute ankle sprains.

    Science.gov (United States)

    Fatoye, Francis; Haigh, Carol

    2016-05-01

    To examine the cost-effectiveness of semi-rigid ankle brace to facilitate return to work following first-time acute ankle sprains. Economic evaluation based on cost-utility analysis. Ankle sprains are a source of morbidity and absenteeism from work, accounting for 15-20% of all sports injuries. Semi-rigid ankle brace and taping are functional treatment interventions used by Musculoskeletal Physiotherapists and Nurses to facilitate return to work following acute ankle sprains. A decision model analysis, based on cost-utility analysis from the perspective of National Health Service was used. The primary outcomes measure was incremental cost-effectiveness ratio, based on quality-adjusted life years. Costs and quality of life data were derived from published literature, while model clinical probabilities were sourced from Musculoskeletal Physiotherapists. The cost and quality adjusted life years gained using semi-rigid ankle brace was £184 and 0.72 respectively. However, the cost and quality adjusted life years gained following taping was £155 and 0.61 respectively. The incremental cost-effectiveness ratio for the semi-rigid brace was £263 per quality adjusted life year. Probabilistic sensitivity analysis showed that ankle brace provided the highest net-benefit, hence the preferred option. Taping is a cheaper intervention compared with ankle brace to facilitate return to work following first-time ankle sprains. However, the incremental cost-effectiveness ratio observed for ankle brace was less than the National Institute for Health and Care Excellence threshold and the intervention had a higher net-benefit, suggesting that it is a cost-effective intervention. Decision-makers may be willing to pay £263 for an additional gain in quality adjusted life year. The findings of this economic evaluation provide justification for the use of semi-rigid ankle brace by Musculoskeletal Physiotherapists and Nurses to facilitate return to work in individuals with first-time ankle

  12. FAILURES-TO-LAUNCH AND BOOMERANG KIDS: CONTEMPORARY DETERMINANTS OF LEAVING AND RETURNING TO THE PARENTAL HOME.

    Science.gov (United States)

    South, Scott J; Lei, Lei

    2015-12-01

    The percentage of young American adults residing in their parents' home has increased markedly over recent years, but we know little about how sociodemographic, life-course, and parental characteristics facilitate or impede leaving or returning home. We use longitudinal data from the Panel Study of Income Dynamics' Transition into Adulthood survey to examine the determinants of leaving and returning home among youth who turned age 18 between 2005 and 2011. Findings from event history models show that while leaving and returning home is to some extent a function of normative life-course transitions, characteristics of the parental home (e.g., presence of co-resident siblings, mother's educational attainment) and the degree of family connectivity (e.g., emotional closeness to mother, instrumental help from family) also play important roles. Experiencing physical, including sexual, victimization drives young adults both out of, and back into, the parental home. Having parents in poor physical health encourages young adults to move back home. Overall, the results suggest that a comprehensive explanation for both home-leaving and home-returning will need to look beyond life-course transitions and standard economic accounts to encompass a broader array of push and pull factors, particularly those that bond young adults with their parents.

  13. SAFE/SNAP application to shipboard security

    International Nuclear Information System (INIS)

    Grady, L.M.; Walker, J.L.; Polito, J.

    1981-11-01

    An application of the combined Safeguards Automated Facility Evaluation/Safeguards Network Analysis Procedure (SAFE/SNAP) modeling technique to a physical protection system (PPS) aboard a generic ship is described. This application was performed as an example of how the SAFE and SNAP techniques could be used. Estimates of probability of interruption and neutralization for the example shipboard PPS are provided by SAFE as well as an adversary scenario, which serves as input to SNAP. This adversary scenario is analyzed by SNAP through four cases which incorporate increasingly detailed security force tactics. Comparisons between the results of the SAFE and SNAP analyses are made and conclusions drawn on the validity of each technique. Feedback from SNAP to SAFE is described, and recommendations for upgrading the ship based on the results of the SAFE/SNAP application are also discussed

  14. Malaria burden in irregular migrants returning to Sri Lanka from human smuggling operations in West Africa and implications for a country reaching malaria elimination.

    Science.gov (United States)

    Wickramage, K; Galappaththy, G N L

    2013-05-01

    The number of malaria cases among irregular migrants returning to Sri Lanka has not been investigated. In the first 6 months of 2012 we screened 287 irregular migrants returning from seven West African nations to Sri Lanka for malaria to ascertain the risk of infection during migration. Four men were diagnosed as having malaria: three with Plasmodium falciparum had travelled to Togo and one with P. vivax had travelled to Guinea. The risk of contracting malaria was 14 cases per 1000. Facilitating a safe return with selective screening for at-risk inbound migrants flows is desirable as Sri Lanka advances towards its goal of malaria elimination.

  15. Return to nucleate boiling

    International Nuclear Information System (INIS)

    Shumway, R.W.

    1985-01-01

    This paper presents a collection of TMIN (temperature of return to nucleate boiling) correlations, evaluates them under several conditions, and compares them with a wide range of data. Purpose is to obtain the best one for use in a water reactor safety computer simulator known as TRAC-B. Return to nucleate boiling can occur in a reactor accident at either high or low pressure and flow rates. Most of the correlations yield unrealistic results under some conditions. A new correlation is proposed which overcomes many of the deficiencies

  16. Analisis Pengaruh Perubahan Arus Kas dan Laba Akuntansi Terhadap Return Saham pada Perusahaan Berkapitalisasi Besar

    Directory of Open Access Journals (Sweden)

    Azilia Yocelyn

    2012-01-01

    Full Text Available This study aims to examine whether the changes of cash flows and accounting profit, used by investors to make investment decision, reflected in the companies’ stock return. There are four independent variables includes in this study, that is cash flows from operating, investing, and financing activities, as well as accounting profit. The stock return is calculated by using the geometric mean method. Multiple regression analysis is used to examine the data on the top 97 public companies (based on market capitalization catagory listed in Indonesia Stock Exchange for period 2009-2010. The result reveals that accounting profit disclosure markedly affected the stock return. This implies that investors took into account the publication of accounting profit in their decision making. On the other side, the study cannot prove the association of other independent variables to  the stock return.

  17. Return on investment. What is ROI and how to use it.

    Science.gov (United States)

    Cotter, Steve

    2014-08-01

    Formulated and interpreted correctly, ROI tools and techniques can be very useful for EMS managers when evaluating various competing projects and initiatives within the organization. More so, decision makers and elected bodies responsible for approving the financial support of these initiatives are demanding that they be presented with a more complete picture of the return for any dollars allocated under ever-tightening financial considerations that all organizations face today. ROI can be a powerful tool in supporting your organization when competing for limited dollars.

  18. Joint pricing and inventory replenishment decisions with returns and expediting

    NARCIS (Netherlands)

    Zhu, Stuart X.

    2012-01-01

    We study a single-item periodic-review model for the joint pricing and inventory replenishment problem with returns and expediting. Demand in consecutive periods are independent random variables and their distributions are price sensitive. At the end of each period, after the demand is realized, a

  19. Merging Energy Policy Decision Support, Education, and Communication: The 'World Energy' Simulation Role-Playing Game

    Science.gov (United States)

    Rooney-varga, J. N.; Franck, T.; Jones, A.; Sterman, J.; Sawin, E.

    2013-12-01

    To meet international goals for climate change mitigation and adaptation, as well as energy access and equity, there is an urgent need to explore and define energy policy paths forward. Despite this need, students, citizens, and decision-makers often hold deeply flawed mental models of the energy and climate systems. Here we describe a simulation role-playing game, World Energy, that provides an immersive learning experience in which participants can create their own path forward for global energy policy and learn about the impact of their policy choices on carbon dioxide emissions, temperature rise, energy supply mix, energy prices, and energy demand. The game puts players in the decision-making roles of advisors to the United Nations Sustainable Energy for All Initiative (drawn from international leaders from industry, governments, intergovernmental organizations, and citizens groups) and, using a state-of-the-art decision-support simulator, asks them to negotiate a plan for global energy policy. We use the En-ROADS (Energy Rapid Overview and Decision Support) simulator, which runs on a laptop computer in <0.1 sec. En-ROADS enables users to specify many factors, including R&D-driven cost reductions in fossil fuel-based, renewable, or carbon-neutral energy technologies; taxes and subsidies for different energy sources; performance standards and energy efficiency; emissions prices; policies to address other greenhouse gas emissions (e.g., methane, nitrous oxide, chlorofluorocarbons, etc.); and assumptions about GDP and population. In World Energy, participants must balance climate change mitigation goals with equity, prices and access to energy, and the political feasibility of policies. Initial results indicate participants gain insights into the dynamics of the energy and climate systems and greater understanding of the potential impacts policies.

  20. Pricing, Carbon Emission Reduction, Low-Carbon Promotion and Returning Decision in a Closed-Loop Supply Chain under Vertical and Horizontal Cooperation

    Science.gov (United States)

    Li, Hui; Wang, Chuanxu; Shang, Meng; Ou, Wei

    2017-01-01

    In this paper, we examine the influences of vertical and horizontal cooperation models on the optimal decisions and performance of a low-carbon closed-loop supply chain (CLSC) with a manufacturer and two retailers, and study optimal operation in the competitive pricing, competitive the low-carbon promotion, the carbon emission reduction, the used-products collection and the profits. We consider the completely decentralized model, M-R vertical cooperation model, R-R horizontal cooperation model, M-R-R vertical and horizontal cooperation model and completely centralized model, and also identify the optimal decision results and profits. It can be observed from a systematic comparison and numerical analysis that the completely centralized model is best in all optimal decision results among all models. In semi-cooperation, the M-R vertical cooperation model is positive, the R-R horizontal cooperation model is passive, and the positivity of the M-R-R vertical and horizontal cooperation model decreases with competitive intensity increasing in the used-products returning, carbon emissions reduction level, low-carbon promotion effort and the profits of the manufacturer and the entire supply chain. PMID:29104268

  1. Pricing, Carbon Emission Reduction, Low-Carbon Promotion and Returning Decision in a Closed-Loop Supply Chain under Vertical and Horizontal Cooperation

    Directory of Open Access Journals (Sweden)

    Hui Li

    2017-11-01

    Full Text Available In this paper, we examine the influences of vertical and horizontal cooperation models on the optimal decisions and performance of a low-carbon closed-loop supply chain (CLSC with a manufacturer and two retailers, and study optimal operation in the competitive pricing, competitive the low-carbon promotion, the carbon emission reduction, the used-products collection and the profits. We consider the completely decentralized model, M-R vertical cooperation model, R-R horizontal cooperation model, M-R-R vertical and horizontal cooperation model and completely centralized model, and also identify the optimal decision results and profits. It can be observed from a systematic comparison and numerical analysis that the completely centralized model is best in all optimal decision results among all models. In semi-cooperation, the M-R vertical cooperation model is positive, the R-R horizontal cooperation model is passive, and the positivity of the M-R-R vertical and horizontal cooperation model decreases with competitive intensity increasing in the used-products returning, carbon emissions reduction level, low-carbon promotion effort and the profits of the manufacturer and the entire supply chain.

  2. Do Mothers Want Professional Carers to Love Their Babies?

    Science.gov (United States)

    Page, Jools

    2011-01-01

    This article reports an aspect of a life historical study which investigated the part that "love" played in mothers' decision-making about returning to work and placing their babies in day care. The article begins with a brief discussion of the context, including 21st-century policies in England to encourage mothers to return to the…

  3. Antiherding in Financial Decision Increases Valuation of Return on Investment: An Event-Related Potential Study

    Directory of Open Access Journals (Sweden)

    Cuicui Wang

    2017-01-01

    Full Text Available Using event-related potentials, this study investigated how financial herding or antiherding affected the valuation of subsequent outcomes. For each trial, subjects decided whether to buy the stock according to its net money flow information which could be used to reflect the strength of buying power or selling power of the stock. The return on investment (ROI as feedback included the increase or decrease percentage after subjects’ responses. Results showed that, compared with herding, antiherding induced larger discrepancies of FRN and P300 amplitude between positive ROI and negative ROI, indicating that individuals under antiherding condition had stronger motivation and paid more attention in the evaluation process of ROI. Moreover, only for positive ROI, the amplitudes of FRN and P300 were modulated by two kinds of behaviors. We suggested that individuals making antiherd decisions were more confident with their own ability and choices, which reduced the positive outcome prediction error and gave more mental resources to evaluate positive outcome. However, negative outcomes evoked no different motivational meaning and negative emotion for individuals between herding and antiherding. The study may provide new insights into neurocognitive processes of herding and antiherding in financial market.

  4. Antiherding in Financial Decision Increases Valuation of Return on Investment: An Event-Related Potential Study.

    Science.gov (United States)

    Wang, Cuicui; Jin, Jia; Vieito, João Paulo; Ma, Qingguo

    2017-01-01

    Using event-related potentials, this study investigated how financial herding or antiherding affected the valuation of subsequent outcomes. For each trial, subjects decided whether to buy the stock according to its net money flow information which could be used to reflect the strength of buying power or selling power of the stock. The return on investment (ROI) as feedback included the increase or decrease percentage after subjects' responses. Results showed that, compared with herding, antiherding induced larger discrepancies of FRN and P300 amplitude between positive ROI and negative ROI, indicating that individuals under antiherding condition had stronger motivation and paid more attention in the evaluation process of ROI. Moreover, only for positive ROI, the amplitudes of FRN and P300 were modulated by two kinds of behaviors. We suggested that individuals making antiherd decisions were more confident with their own ability and choices, which reduced the positive outcome prediction error and gave more mental resources to evaluate positive outcome. However, negative outcomes evoked no different motivational meaning and negative emotion for individuals between herding and antiherding. The study may provide new insights into neurocognitive processes of herding and antiherding in financial market.

  5. Return to work for severely injured survivors of the Christchurch earthquake: influences in the first 2 years.

    Science.gov (United States)

    Nunnerley, Joanne; Dunn, Jennifer; McPherson, Kathryn; Hooper, Gary; Woodfield, Tim

    2016-01-01

    This study looked at the influences on the return to work (RTW) in the first 2 years for people severely injured in the 22 February 2011 Christchurch earthquake. We used a constructivist grounded theory approach using semi-structured interviews to collect data from 14 people injured in the earthquake. Analysis elicited three themes that appeared to influence the process of RTW following the Christchurch earthquake. Living the earthquake experience, the individual's experiences of the earthquake and how their injury framed their expectations; rebuilding normality, the desire of the participants to return to life as it was; while dealing with the secondary effects of the earthquake includes the earthquake specific effects which were both barriers and facilitators to returning to work. The consequences of the earthquake impacted on experience, process and outcome of RTW for those injured in the Christchurch Earthquake. Work and RTW appeared key tools to enhance recovery after serious injury following the earthquake. The altered physical, social and economic environment must be considered when working on the return to work (RTW) of individuals with earthquake injuries. Providing tangible emotional and social support so injured earthquake survivors feel safe in their workplace may facilitate RTW. Engaging early with employers may assist the RTW of injured earthquake survivors.

  6. 76 FR 22611 - Specified Tax Return Preparers Required To File Individual Income Tax Returns Using Magnetic...

    Science.gov (United States)

    2011-04-22

    ... Specified Tax Return Preparers Required To File Individual Income Tax Returns Using Magnetic Media... Register on Wednesday, March 30, 2011 (76 FR 17521) providing guidance to specified tax return preparers who prepare and file individual income tax returns using magnetic media pursuant to section 6011(e)(3...

  7. Ethical issues in sports medicine: a review and justification for ethical decision making and reasoning.

    Science.gov (United States)

    Greenfield, Bruce H; West, Charles Robert

    2012-11-01

    Ethical issues present a challenge for health care professionals working with athletes of sports teams. Health care professionals-including the team physician, the physical therapist, and the athletic trainer-are faced with the challenge of returning an athlete to competition as quickly as possible but as safely as possible. Conflicts of interest arise due to conflicting obligations of the team physician to the athlete and other members of the sports organization, including coaches and the team owner. The multiple stakeholders involved in sports teams challenge the traditional notion of confidentiality and autonomy. The aims of this article are to explicate the ethics of sports medicine, highlight the ethical issues, and provide some strategies and suggestions for ethical decision making.

  8. The Returns to Entrepreneurship

    DEFF Research Database (Denmark)

    Van Praag, Mirjam; Raknerud, Arvid

    Empirical studies show low pecuniary returns of switching from wage employment to entrepreneurship. We reconsider the pecuniary gains of this switching by employing a two-stage procedure, where the randomness in the timing of inheritance transfers is used as an exclusion restriction to identify...... causal effects. The model is estimated on data covering the whole Norwegian population of individuals matched to the entire population of firms established in the period 2002-2011. The results indicate that the average returns to entrepreneurship are significantly negative for individuals entering...... entrepreneurship through self-employment and modest, but significantly positive, for incorporated startups....

  9. The effects of peer influence on adolescent pedestrian road-crossing decisions.

    Science.gov (United States)

    Pfeffer, K; Hunter, E

    2013-01-01

    Adolescence is a high-risk period for pedestrian injury. It is also a time of heightened susceptibility to peer influence. The aim of this research was to examine the effects of peer influence on the pedestrian road-crossing decisions of adolescents. Using 10 videos of road-crossing sites, 80 16- to 18-year-olds were asked to make pedestrian road-crossing decisions. Participants were assigned to one of 4 experimental conditions: negative peer (influencing unsafe decisions), positive peer (influencing cautious decisions), silent peer (who observed but did not comment), and no peer (the participant completed the task alone). Peers from the adolescent's own friendship group were recruited to influence either an unsafe or a cautious decision. Statistically significant differences were found between peer conditions. Participants least often identified safe road-crossing sites when accompanied by a negative peer and more frequently identified dangerous road-crossing sites when accompanied by a positive peer. Both cautious and unsafe comments from a peer influenced adolescent pedestrians' decisions. These findings showed that road-crossing decisions of adolescents were influenced by both unsafe and cautious comments from their peers. The discussion highlighted the role that peers can play in both increasing and reducing adolescent risk-taking.

  10. DAMPAK PENYAJIAN KEMBALI EPS DAN CFPS TERHADAP RETURN SAHAM

    Directory of Open Access Journals (Sweden)

    Imelda Sinaga

    2014-04-01

    Full Text Available The problem in this study is whether there is a positive influence of CFPS and EPS before and after restatement in giving positive impact on stock returns. The sample used in EPS before and after the restatement, while as many as 102 samples meanwhile CFPS before and after restatement using 82 sample companies listed on the Stock Exchange. Independent variables used in this study are the earnings per share and cash flow per share and the dependent variables used in this study is the stock return. Test equipment used in this study using multiple regression statistical model           The results of this study demonstrate that EPS before restatement did not impact significantly on the stock returns which indicates that investors have been aware that there is signal to improve the EPS before the restatement. EPS after restatement had no significant effect on return, this indicates that the new information is in accordance with the Market Efficiency hypothesis is that will make the market participants to react and take action to respond that new information. CFPS before and after restatement also had no significant effect on stock returns because investors do not use operating cash flow information as a basic for investment decisions. This can have implications on investors who use financial statements to make right decisions on the location of their assets in the companies that perform restatement as well for the company itself that financial report restatement can be made if it is seen as a form of commitment and sense of responsibility to the market to provide trustable information

  11. Considerations in the Diagnosis and Accelerated Return to Sport of a Professional Basketball Player With a Triceps Surae Injury: A Case Report.

    Science.gov (United States)

    Anloague, Philip A; Strack, Donald S

    2018-05-01

    Study Design Case report. Background Acute injuries of the triceps surae and Achilles tendon are common in sports. Rupture of the plantaris tendon can be challenging to diagnose. There is limited evidence detailing the diagnosis, rehabilitation, and accelerated return to sport of elite professional basketball players who have sustained calf injuries. Case Description A 25-year-old male professional basketball player sustained an injury to his calf during a professional basketball game. This case report details the presumptive diagnosis, graduated progression of intervention, and return to play of a professional athlete with a likely isolated plantaris tendon tear. Outcomes The patient returned to postseason competition 10 days post injury. Objective measures were tracked throughout rehabilitation and compared to baseline assessments. Before returning to play, the athlete showed improvements beyond the minimal clinically important difference for calf girth (2 cm) and numeric pain-rating scale score (4 points, 0-10 scale). Functional testing was conducted that included the Y Balance Test lower quarter and the Functional Movement Screen, with results that exceeded or returned the athlete to preseason levels. Discussion This report details the case of a professional basketball player who returned to competitive play in an accelerated time frame following injury to his calf. Diagnosing a plantaris tendon rupture can be challenging, and anatomical variations of this muscle should be considered. It was demonstrated in this case that physical therapy rehabilitation was helpful in making a treatment-based clinical diagnosis when imaging was unclear. Level of Evidence Therapy, level 5. J Orthop Sports Phys Ther 2018;48(5):388-397. Epub 6 Apr 2018. doi:10.2519/jospt.2018.7192.

  12. Risk-taking on the road and in the mind: behavioural and neural patterns of decision making between risky and safe drivers.

    Science.gov (United States)

    Ba, Yutao; Zhang, Wei; Peng, QiJia; Salvendy, Gavriel; Crundall, David

    2016-01-01

    Drivers' risk-taking is a key issue of road safety. This study explored individual differences in drivers' decision-making, linking external behaviours to internal neural activity, to reveal the cognitive mechanisms of risky driving. Twenty-four male drivers were split into two groups (risky vs. safe drivers) via the Drivier Behaviour Questionnaire-violation. The risky drivers demonstrated higher preference for the risky choices in the paradigms of Iowa Gambling Task and Balloon Analogue Risk Task. More importantly, the risky drivers showed lower amplitudes of feedback-related negativity (FRN) and loss-minus-gain FRN in both paradigms, which indicated their neural processing of error-detection. A significant difference of P300 amplitudes was also reported between groups, which indicated their neural processing of reward-evaluation and were modified by specific paradigm and feedback. These results suggested that the neural basis of risky driving was the decision patterns less revised by losses and more motivated by rewards. Risk-taking on the road is largely determined by inherent cognitive mechanisms, which can be indicated by the behavioural and neural patterns of decision-making. In this regard, it is feasible to quantize drivers’ riskiness in the cognitive stage before actual risky driving or accidents, and intervene accordingly.

  13. Using reliability analysis to support decision making\\ud in phased mission systems

    OpenAIRE

    Zhang, Yang; Prescott, Darren

    2017-01-01

    Due to the environments in which they will operate, future autonomous systems must be capable of reconfiguring quickly and safely following faults or environmental changes. Past research has shown how, by considering autonomous systems to perform phased missions, reliability analysis can support decision making by allowing comparison of the probability of success of different missions following reconfiguration. Binary Decision Diagrams (BDDs) offer fast, accurate reliability analysis that cou...

  14. Are there Diminishing Returns to R&D?

    DEFF Research Database (Denmark)

    Madsen, Jakob B.

    Semi-endogenous models and, to some extent, also Schumpeterian models are based on the assumption of diminishing returns to R&D. This paper shows that the null hypothesis of constant returns to R&D cannot be rejected for the OECD countries......Semi-endogenous models and, to some extent, also Schumpeterian models are based on the assumption of diminishing returns to R&D. This paper shows that the null hypothesis of constant returns to R&D cannot be rejected for the OECD countries...

  15. The effects of emotion on pilot decision-making: A neuroergonomic approach to aviation safety

    OpenAIRE

    Causse, Mickaël; Dehais, Frédéric; Péran, Patrice; Sabatini, Umberto; Pastor, Josette

    2013-01-01

    International audience; Emotion or stress can jeopardize decision-making relevance and cognitive functioning. In this paper we examine plan continuation error (PCE), an erroneous behavior defined as a "failure to revise a flight plan despite emerging evidence that suggests it is no longer safe" (Orasanu, Ames, Martin, & Davison, 2001). Our hypothesis is that negative emotional consequences attached to the go-around decision provoke a temporary impairment of the decision-making process and fav...

  16. Risk factors for early return visits to the emergency department in patients with urinary tract infection.

    Science.gov (United States)

    Jorgensen, Sarah; Zurayk, Mira; Yeung, Samantha; Terry, Jill; Dunn, Maureen; Nieberg, Paul; Wong-Beringer, Annie

    2018-01-01

    Optimal management of urinary tract infections (UTIs) in the emergency department (ED) is challenging due to high patient turnover, decreased continuity of care, and treatment decisions made in the absence of microbiologic data. We sought to identify risk factors for return visits in ED patients treated for UTI. A random sample of 350 adult ED patients with UTI by ICD 9/10 codes was selected for review. Relevant data was extracted from medical charts and compared between patients with and without ED return visits within 30days (ERVs). We identified 51 patients (15%) with 59 ERVs, of whom 6% returned within 72h. Nearly half of ERVs (47%) were UTI-related and 33% of ERV patients required hospitalization. ERVs were significantly more likely (Ppregnancy; skilled nursing facility residence; dementia; psychiatric disorder; obstructive uropathy; healthcare exposure; temperature≥38 °C heart rate>100; and bacteremia. Escherichia coli was the most common uropathogen (70%) and susceptibility rates to most oral antibiotics were below 80% in both groups except nitrofurantoin (99% susceptible). Cephalexin was the most frequently prescribed antibiotic (51% vs. 44%; P=0.32). Cephalexin bug-drug mismatches were more common in ERV patients (41% vs. 15%; P=0.02). Culture follow-up occurred less frequently in ERV patients (75% vs. 100%; PUTI patients may be minimized by using ED-source specific antibiogram data to guide empiric treatment decisions and by targeting at-risk patients for post-discharge follow-up. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Sports participation 2 years after anterior cruciate ligament reconstruction in athletes who had not returned to sport at 1 year: a prospective follow-up of physical function and psychological factors in 122 athletes.

    Science.gov (United States)

    Ardern, Clare L; Taylor, Nicholas F; Feller, Julian A; Whitehead, Timothy S; Webster, Kate E

    2015-04-01

    A return to their preinjury level of sport is frequently expected within 1 year after anterior cruciate ligament (ACL) reconstruction, yet up to two-thirds of athletes may not have achieved this milestone. The subsequent sports participation outcomes of athletes who have not returned to their preinjury level sport by 1 year after surgery have not previously been investigated. To investigate return-to-sport rates at 2 years after surgery in athletes who had not returned to their preinjury level sport at 1 year after ACL reconstruction. Case series; Level of evidence, 4. A consecutive cohort of competitive- and recreational-level athletes was recruited prospectively before undergoing ACL reconstruction at a private orthopaedic clinic. Participants were followed up at 1 and 2 years after surgery with a sports activity questionnaire that collected information regarding returning to sport, sports participation, and psychological responses. An independent physical therapist evaluated physical function at 1 year using hop tests and the International Knee Documentation Committee knee examination form and subjective knee evaluation. A group of 122 competitive- and recreational-level athletes who had not returned to their preinjury level sport at 1 year after ACL reconstruction participated. Ninety-one percent of the athletes returned to some form of sport after surgery. At 2 years after surgery, 66% were playing sport, with 41% playing their preinjury level of sport and 25% playing a lower level of sport. Having a previous ACL reconstruction to either knee, poorer hop-test symmetry and subjective knee function, and more negative psychological responses were associated with not playing the preinjury level sport at 2 years. Most athletes who were not playing sport at 1 year had returned to some form of sport within 2 years after ACL reconstruction, which may suggest that athletes can take longer than the clinically expected time of 1 year to return to sport. However, only 2

  18. Eat, play, view, sleep: Exploring Mexican American mothers' perceptions of decision making for four behaviors associated with childhood obesity risk.

    Science.gov (United States)

    Davis, Rachel E; Cole, Suzanne M; Blake, Christine E; McKenney-Shubert, Shannon J; Peterson, Karen E

    2016-06-01

    This mixed methods study sought to understand who makes decisions about whether preschool-aged Mexican American children engage in eating, outdoor play, sleep, and screen time behaviors. Forty Mexican American mothers of children ages 3-4 participated in two interviews, during which both closed- and open-ended questions elicited perceptions of who made decisions for the four behaviors, as well as who was present, mealtime rules, and food choice values. Interviews were transcribed, coded for emergent themes, and compared across participants. Participants generally perceived themselves to be primary decision makers for all four behaviors; however, food decisions often seemed to be made collaboratively with the child. Fathers were most likely to participate in evening television decisions. Other family members were rarely mentioned. Selecting foods that children liked was a strong food choice value, while cost was rarely mentioned. Participants appeared to have low perceived control over their child's behaviors relative to their perceived roles in decision making. Mothers may be the primary audience for obesity prevention messages for preschool-aged, Mexican American children; however, health promotion programs may need to increase mothers' awareness of their control over children's behaviors. Understanding how children's behaviors are regulated is an important aspect of obesity prevention for low-income, Mexican American children. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Can we enhance the ability to return to work among workers with stress-related disorders?

    Directory of Open Access Journals (Sweden)

    Andersen Johan

    2009-10-01

    Full Text Available Abstract Background Stress-related disorders are widespread and responsible for high societal costs e.g. sick leave payment and reduced productivity. The aim of this study was to evaluate the effect of an intervention program on return to work or labour market. Methods In a controlled interventional study design we compared 72 emotionally distressed patients, who received support during 2006, with 89 control individuals who had also been sick listed for emotional distress. Intervention was provided by trained psychologists and social workers who were in continuous dialog with the patients, providing counselling e.g. on decisions concerning resumption of work, support to families, participation in meetings with the workplace. Basically, the controls and the intervention group share the same access to welfare benefits. The main outcome was time to return to labour market (TTR. Results The baseline characteristics were similar in the two groups. There were no differences in the rate of resuming work between the two groups. About 80% in both groups had returned to the labour market after one year. Conclusion An intervention program with psychological stress management and case management did not improve work capability compared to usual care. Work resumption as a single outcome probably is an insensitive parameter of intervention management quality, and should be supplemented by other data on different aspects of treatment.

  20. Corporate Choice of Banks: Decision Factors, Decision Maker, and Decision Process – First Evidence

    NARCIS (Netherlands)

    Ongena, S.; Tumer Alkan, G.; Vermeer, B.

    2011-01-01

    In this paper, we investigate how firms choose their banks. We focus on the role played by the decision factors, the decision maker and the decision process in determining firm-bank relationships. We have access to a unique survey that was run by a major bank in the Czech Republic. We find that

  1. 26 CFR 20.6018-2 - Returns; person required to file return.

    Science.gov (United States)

    2010-04-01

    ... executor or administrator shall file the return. If there is more than one executor or administrator, the return must be made jointly by all. If there is no executor or administrator appointed, qualified and... decedent situated in the United States is constituted an executor for purposes of the tax (see § 20.2203-1...

  2. Community ambulation: influences on therapists and clients reasoning and decision making.

    Science.gov (United States)

    Corrigan, Rosemary; McBurney, Helen

    2008-01-01

    Community ambulation is an important element of a rehabilitation training programme and its achievement is a goal shared by rehabilitation professionals and clients. The factors that influence a physiotherapist's or health professionals decision making around the preparation of a client for community ambulation and the factors that influence a client's decision to return to walking in their community are unclear. To review the available literature about the factors that have influenced the reasoning and decision making of rehabilitation therapists and clients around the topic of ambulation in the community. Three separate searches of the available literature were undertaken using Ovid, Cinahl, ProQuest, Medline and Ebscohost databases. Databases were searched from 1966 to October 2006.The first search explored the literature for factors that influence the clinical reasoning of rehabilitation therapists. The second search explored the literature for factors that influence client's decision to ambulate in the community. A third search was undertaken to explore the literature for the demands of community ambulation in rural communities. Very few studies were found that explored community ambulation in the context of clinical reasoning and decision making, the facilitators and barriers to a clients return to ambulation in their community or the demands of ambulation in a rural community. Consideration of the environment is key to the successful return to walking in the community of clients with mobility problems yet little literature has been found to guide physiotherapist's decision making about preparing a clients to return to walking in the community. An individual's participation in their society is also a result of the interaction between their personal characteristics and his or her environment. The influence of these characteristics may vary from one individual to another yet the factors that influence a person's decision to return to walking in their community

  3. Playing on the edge

    DEFF Research Database (Denmark)

    Cermak-Sassenrath, Daniel

    2018-01-01

    and specific ways. For instance, gambling for money, party and drinking games, professional play and show sports, art installations, violent and military propaganda computer games, pervasive/mobile gaming, live-action role playing, festivals, performances, and games such as Ghosting and Planking. It is argued......Everything gets more interesting, challenging, or intense the closer it gets to the edge, and so does play. How edgy can play become and still be play? Based on Huizinga’s notion of play, this chapter discusses how a wide range of playful activities pushes the boundaries of play in different...... that in concert with a number of characteristics that mark an activity as play, play is essentially a subjective perspective and individual decision of the player. Huizinga calls this attitude the play spirit, which informs a player’s actions and is in turn sustained by them. Edgy digital or mobile games do...

  4. Manager Experiences with the Return to Work Process in a Large, Publically Funded, Hospital Setting

    DEFF Research Database (Denmark)

    Stochkendahl, Mette Jensen; Myburgh, Corrie; Young, Amanda Ellen

    2015-01-01

    Purpose Previous research on the role of managers in the return to work (RTW) process has primarily been conducted in contexts where the workplace has declared organizational responsibility for the process. While this is a common scenario, in some countries, including Denmark, there is no explicit......, organizational, and policy factors. Instances were observed where supervisors faced the dilemma of balancing ethical and managerial principles with requirements of keeping staffing budgets. Conclusion Although it is not their legislative responsibility, Danish managers play a key role in the RTW process. As has...... been observed in other contexts, Danish supervisors struggle to balance considerations for the returning worker with those of their teams....

  5. A proposed approach to backfit decision-making using risk assessment and benefit-cost methodology

    International Nuclear Information System (INIS)

    O'Donnell, E.P.; Raney, T.J.

    1984-01-01

    This paper outlines a proposed approach to backfit decision-making which utilizes quantitative risk assessment techniques, benefit-cost methodology and decision criteria. In general terms, it is structured to provide an objective framework for decision-making aimed at ensuring a positive return on backfit investment while allowing for inclusion of subjective value judgments by the decision-maker. The distributions of the independent variables are combined to arrive at an overall probability distribution for the benefit-cost ratio. In this way, the decision-maker can explicitly establish the probability or level of confidence that a particular backfit will yield benefits in excess of cost. An example is presented demonstrating the application of methodology to a specific plant backfit. (orig.)

  6. Play to Learn, Play to Create, Play to Innovate

    DEFF Research Database (Denmark)

    Nielsen, Louise Møller; Hansen, Poul H. Kyvsgård; Mabogunje, Ade

    2007-01-01

    When designing or developing products it is a well known principle to use different types of models and prototypes as a driver for the decision making process. But in the pre-conceptual process these types of drivers are often not at hand. Instead the pre-conceptual process is influenced by a large...... it would have on the process. At this stage in the research there are several interesting implications....

  7. Do expectancies of return to work and Job satisfaction predict actual return to work in workers with long lasting LBP?

    Science.gov (United States)

    Opsahl, Jon; Eriksen, Hege R; Tveito, Torill H

    2016-11-17

    Musculoskeletal disorders including low back pain have major individual and socioeconomic consequences as it often leads to disability and long-term sick leave and exclusion from working life. Predictors of disability and return to work often differ, and the dominant knowledge is on predictors for prolonged sick leave and disability. Therefore it is also important to identify key predictors for return to work. The aim of the study was to assess if overall job satisfaction and expectancies of return to work predicts actual return to work after 12 months, among employees with long lasting low back pain, and to assess if there were gender differences in the predictors. Data from the Cognitive interventions and nutritional supplements trial (CINS Trial) was used. Predictors for return to work were examined in 574 employees that had been on sick leave 2-10 months for low back pain, before entering the trial. Data were analysed with multiple logistic regression models stratified by gender, and adjusted for potential confounders. Regardless of gender high expectancies were a strong and significant predictor of return to work at 12 months, while high levels of job satisfaction were not a significant predictor. There were no differences in the levels of expectancies or overall job satisfaction between men and women. However, men had in general higher odds of returning to work compared with women. Among individuals with long lasting low back pain high expectancies of returning to work were strongly associated with successful return to work. We do not know what factors influence individual expectancies of return to work. Screening expectancies and giving individuals with low expectancies interventions with a goal to change expectancies of return to work, such as CBT or self-management interventions, may contribute to increase actual return to work. http://www.clinicaltrials.gov/ , with registration number NCT00463970 . The trial was registered at the 18th of April 2007.

  8. Firm Efficiency and Returns-to-Scale in the Honey Bee Pollination Services Industry.

    Science.gov (United States)

    Jones Ritten, Chian; Peck, Dannele; Ehmke, Mariah; Patalee, M A Buddhika

    2018-04-03

    While the demand for pollination services have been increasing, continued declines in honey bee, Apis mellifera L. (Hymenoptera: Apidae), colonies have put the cropping sector and the broader health of agro-ecosystems at risk. Economic factors may play a role in dwindling honey bee colony supply in the United States, but have not been extensively studied. Using data envelopment analysis (DEA), we measure technical efficiency, returns to scale, and factors influencing the efficiency of those apiaries in the northern Rocky Mountain region participating in the pollination services market. We find that, although over 25% of apiaries are technically efficient, many experience either increasing or decreasing returns to scale. Smaller apiaries (under 80 colonies) experience increasing returns to scale, but a lack of available financing may hinder them from achieving economically sustainable colony levels. Larger apiaries (over 1,000 colonies) experience decreasing returns to scale. Those beekeepers may have economic incentivizes to decrease colony numbers. Using a double bootstrap method, we find that apiary location and off-farm employment influence apiary technical efficiency. Apiaries in Wyoming are found to be more efficient than those in Utah or Montana. Further, engagement in off-farm employment increases an apiary's technical efficiency. The combined effects of efficiency gains through off-farm employment and diseconomies of scale may explain, in part, the historical decline in honey bee numbers.

  9. Applying principles of self-management to facilitate workers to return to or remain at work with a chronic musculoskeletal condition.

    Science.gov (United States)

    Johnston, Venerina; Jull, Gwendolen; Sheppard, Dianne M; Ellis, Niki

    2013-08-01

    It is incumbent on health care professionals to support patients with chronic musculoskeletal conditions to manage the impact of the condition on their life. Work is a positive health behaviour for which self-management skills are essential. In this paper, self-management is defined and the role of clinicians in promoting self-management for return to work is outlined with examples and tips on how the clinician can incorporate self-management into practice. The clinician is ideally placed to assist individuals with chronic musculoskeletal conditions manage to remain at work or return to work. This can be achieved through such activities as the promotion of the core self-management skills of problem-solving, decision making, resource utilisation, developing a cooperative partnership between clinician and patient and making an action plan. Copyright © 2013 Elsevier Ltd. All rights reserved.

  10. Lessons Learned: Mechanical Component and Tribology Activities in Support of Return to Flight

    Science.gov (United States)

    Handschuh, Robert F.; Zaretsky, Erwin V.

    2017-01-01

    The February 2003 loss of the Space Shuttle Columbia resulted in NASA Management revisiting every critical system onboard this very complex, reusable space vehicle in a an effort to Return to Flight. Many months after the disaster, contact between NASA Johnson Space Center and NASA Glenn Research Center evolved into an in-depth assessment of the actuator drive systems for the Rudder Speed Brake and Body Flap Systems. The actuators are CRIT 1-1 systems that classifies them as failure of any of the actuators could result in loss of crew and vehicle. Upon further evaluation of these actuator systems and the resulting issues uncovered, several research activities were initiated, conducted, and reported to the NASA Space Shuttle Program Management. The papers contained in this document are the contributions of many researchers from NASA Glenn Research Center and Marshall Space Flight Center as part of a Lessons Learned on mechanical actuation systems as used in space applications. Many of the findings contained in this document were used as a basis to safely Return to Flight for the remaining Space Shuttle Fleet until their retirement.

  11. [A return on investment tool in tobacco control: what do stakeholders think?].

    Science.gov (United States)

    Muñoz, Celia; Trapero-Bertran, Marta; Cheung, Kei Long; Evers, Silvia; Hiligsmann, Mickaël; de Vries, Hein; López-Nicolás, Ángel

    2016-01-01

    The European EQUIPT study will co-create a return on investment tool in several countries, aiming to provide decision makers with information and justification on the returns that can be generated by investing in tobacco control. This study aimed to identify the needs of potential users in Spain in order to provide information on the transferability of the tool. Telephone interviews with stakeholders were conducted including questions about the implementation of the tool, intended use and tobacco control interventions. Implementing the tool could provide added value to the information used in decision-making to advocate for cost-effective policies. The main drawback would be the training and time needed to learn how the tool works and for internal calculations. Knowledge and ideas from potential users collected in this study could inform the EQUIPT Tool adaptation. Thus, stakeholders could have an instrument that assists them on making healthcare decisions. Copyright © 2015 SESPAS. Published by Elsevier Espana. All rights reserved.

  12. Does graded return-to-work improve sick-listed workers' chance of returning to regular working hours?

    Science.gov (United States)

    Høgelund, Jan; Holm, Anders; McIntosh, James

    2010-01-01

    Using Danish register and survey data, we examine the effect of a national graded return-to-work program on the probability of sick-listed workers returning to regular working hours. During program participation, the sick-listed worker works fewer hours and receives the normal hourly wage for the hours worked and sickness benefit for the hours off work. When the worker's health improves, working hours are increased until the sick-listed worker is able to work regular hours. Taking account of unobserved differences between program participants and non-participants, we find that participation in the program significantly increases the probability of returning to regular working hours. Copyright 2009 Elsevier B.V. All rights reserved.

  13. Earnings Quality Measures and Excess Returns.

    Science.gov (United States)

    Perotti, Pietro; Wagenhofer, Alfred

    2014-06-01

    This paper examines how commonly used earnings quality measures fulfill a key objective of financial reporting, i.e., improving decision usefulness for investors. We propose a stock-price-based measure for assessing the quality of earnings quality measures. We predict that firms with higher earnings quality will be less mispriced than other firms. Mispricing is measured by the difference of the mean absolute excess returns of portfolios formed on high and low values of a measure. We examine persistence, predictability, two measures of smoothness, abnormal accruals, accruals quality, earnings response coefficient and value relevance. For a large sample of US non-financial firms over the period 1988-2007, we show that all measures except for smoothness are negatively associated with absolute excess returns, suggesting that smoothness is generally a favorable attribute of earnings. Accruals measures generate the largest spread in absolute excess returns, followed by smoothness and market-based measures. These results lend support to the widespread use of accruals measures as overall measures of earnings quality in the literature.

  14. To trust or not to trust: social decision-making in post-institutionalized, internationally adopted youth.

    Science.gov (United States)

    Pitula, Clio E; Wenner, Jennifer A; Gunnar, Megan R; Thomas, Kathleen M

    2017-05-01

    Chronic parental maltreatment has been associated with lower levels of interpersonal trust, and depriving environments have been shown to predict short-sighted, risk-averse decision-making. The present study examined whether a circumscribed period of adverse care occurring only early in life was associated with biases in trust behavior. Fifty-three post-institutionalized (PI) youth, adopted internationally on average by 1 year of age, and 33 never-institutionalized, non-adopted youth (M age  = 12.9 years) played a trust game. Participants decided whether or not to share coins with a different anonymous peer in each trial with the potential to receive a larger number of coins in return. Trials were presented in blocks that varied in the degree to which the peers behaved in a trustworthy (reciprocal) or untrustworthy (non-reciprocal) manner. A comparison condition consisted of a computerized lottery with the same choices and probabilistic risk as the peer trials. Non-adopted comparison youth showed a tendency to share more with peers than to invest in the lottery and tended to maintain their level of sharing across trials despite experiencing trials in which peers failed to reciprocate. In contrast, PI children, particularly those who were adopted over 1 year of age, shared less with peers than they invested in the lottery and quickly adapted their sharing behavior to peers' responses. These results suggest that PI youth were more mistrusting, more sensitive to both defection and reciprocation, and potentially more accurate in their trusting decisions than comparison youth. Results support the presence of a sensitive period for the development of trust in others, whereby conditions early in life may set long-term biases in decision-making. © 2016 John Wiley & Sons Ltd.

  15. Safe delivery care practices in western Nepal: Does women’s autonomy influence the utilization of skilled care at birth?

    Science.gov (United States)

    Kutty, V. Raman; Sarma, P. Sankara; Dangal, Ganesh

    2017-01-01

    Despite various efforts to increase the utilization of skilled birth attendants (SBA), nearly two-thirds of deliveries take place at home without the assistance of SBAs in Nepal. We hypothesized that the ability of women to take decisions about their own lives—women’s autonomy—plays an important part in birth choices. To know this, we conducted a community-based cross-sectional study for assessing women’s autonomy and utilization of safe delivery care service in Kapilvastu district of Nepal from June to October 2014. We used multivariate modeling to associate socioeconomic factors and women’s autonomy with the utilization of safe delivery care services. Just over one-third of women sought institutional delivery care during the birth of their last child. Out of the total deliveries at health facilities, nearly 58% women visited health facility for self-reported emergency obstructive care. Only 6.2% home deliveries were handled by health workers and 14.7% women used the safe delivery kit for home delivery care. Higher levels of women’s education had a strong positive association (odds ratio = 24.11, CI = 9.43–61.64) with institutional delivery care. Stratified analysis showed that when the husband is educated, women’s education seems to work partly through their autonomy in decision making. Educational status of women emerged as one of the key predictors of the utilization of delivery care services in Kapilvastu district. Economic status of household and husband’s education are other dominant predictors of the utilization of safe delivery care services. Improving the economic and educational status may be the way out for improving the proportion of institutional deliveries. Women’s autonomy may be an important mediating factor in this pathway. PMID:28771579

  16. IMPLIKASI KOMPONEN LAPORAN ARUS KAS, LABA KOTOR, DAN SIZE PERUSAHAAN TERHADAP EXPECTED RETURN SAHAM

    Directory of Open Access Journals (Sweden)

    Totok Sasongko

    2017-03-01

    Full Text Available Expected return of an investment was the probabilit y rate dist ribut ion on invest -ment returns. Although investors (stockholders did not know exact ly what rate of returnthey would get , they had base on their decisions to invest . Work performance measurementused by stockholders in investment decisions were prof it and cash f low. Besides, investorsalso considered company f inancial characterist ic like company size. The main purpose of thisresearch was to analyze the implicat ion of informat ion cash f low statement , gross prof it ,company size toward expected stock return. Populat ion of this research was manufacturecompanies listed at Jakarta Stock Exchange. The sample was selected by purposive sampling.The analysis data used was a mult i linear regression. The result showed that simultaneously,cash f low component , gross prof it and company size had signif icant ef fect to stock expectedreturns. But part ially, the cash f low f rom operat ion and f inancing didn’t have signif icantef fect to stock expected returns.

  17. PERSONALITY AND CHARACTER PREFERENCE IN ROLE-PLAYING GAMES

    Directory of Open Access Journals (Sweden)

    Pedro José Ramos-Villagrasa

    2010-11-01

    Full Text Available In role-playing games players perform participative and episodic stories. Personality is a psychological construct associated with decision processes in many aspects of life. In this study, we analyzed if Big Five Personality Factors were related to game character preferences in the role-playing game “Dungeons & Dragons”. Results show that Personality is related only in the decision of character’s class. We also study the relationship between Personality and plots in role-playing games (action, intrigue, mystery, and personal relationships. Finally, recommendations to further investigation were given.

  18. Making "ethical safe space" in the translation of contested knowledge: the role of community debate in defining end-of-life decision ethics.

    Science.gov (United States)

    Kaufert, Joseph; Schwartz, Karen; Wiebe, Rhonda; Derksen, Jim; Lutfiyya, Zana M; Richert, Dean

    2013-04-01

    The objectives of this article are, first, to document a unique process of research knowledge translation (KT), which the authors describe as the creation of "ethical safe space," and, second, to document the narratives of forum participants and describe their interaction in a dialogue about vulnerability, the authority of physicians, and the perspective of people with disabilities on the policy. Narrative data from qualitative interviews with individual key informants and focus groups were used to identify speakers with specific expertise on policy, disability perspectives, and bioethical issues, who were invited to participate in the Forum on Ethical Safe Space. The planning workgroup adopted a model for enabling representative participation in the public forum designed to reduce the impact of physical, sensory, financial, language, and professional status barriers. Using the transcripts and keynote speakers' printed texts, primary themes and patterns of interaction were identified reflecting the alternative perspectives. Through the development of a workshop on ethical, legal, and disability-related implications of professional policy guidelines developed by the College of Physicians and Surgeons of Manitoba, we provided a qualitative analysis of the discourse involving experts and disability community members supporting alternative positions on the impact of the policy statement, and discuss ethical, legal, and disability rights issues identified in the public debate. Contested policy and ethical frameworks for making decisions about withdrawing and withholding life supporting treatment may influence both the perspectives of palliative care providers and patients referred to palliative care facilities. An innovative model for KT using a public forum that enabled stakeholders with conflicting perspectives to engage with ethical and professional policy issues asserting the physician's authority in contested decisions involving withdrawing or withholding life

  19. Making It Safe, Making It Legal, and Creating Peace of Mind

    International Nuclear Information System (INIS)

    Strom, Daniel J.

    2001-01-01

    The job of a medical or academic radiation safety officer has three parts: keeping it safe, keeping it legal, and helping people feel that they are safe. Absence of peace-of-mind about radiation protection matters can create very real health effects, even when there is little or no radiation exposure involved. Frightened people may make decisions such as changing jobs (and losing health insurance), terminating a pregnancy, or moving, all of which impact health. Furthermore, frightened people who choose to stick with it may suffer from anxiety, stress, insomnia, and weight loss or even weight gain. Genuinely listening to the concerns of those who benefit from radiation safety services can help to provide peace-of-mind and minimize decisions that are risky to health

  20. Making It Safe, Making It Legal, and Creating Peace of Mind

    Energy Technology Data Exchange (ETDEWEB)

    Strom, Daniel J.

    2001-11-01

    The job of a medical or academic radiation safety officer has three parts: keeping it safe, keeping it legal, and helping people feel that they are safe. Absence of peace-of-mind about radiation protection matters can create very real health effects, even when there is little or no radiation exposure involved. Frightened people may make decisions such as changing jobs (and losing health insurance), terminating a pregnancy, or moving, all of which impact health. Furthermore, frightened people who choose to stick with it may suffer from anxiety, stress, insomnia, and weight loss or even weight gain. Genuinely listening to the concerns of those who benefit from radiation safety services can help to provide peace-of-mind and minimize decisions that are risky to health.

  1. Stochastic arbitrage return and its implications for option pricing

    OpenAIRE

    Fedotov, Sergei; Panayides, Stephanos

    2004-01-01

    The purpose of this work is to explore the role that arbitrage opportunities play in pricing financial derivatives. We use a non-equilibrium model to set up a stochastic portfolio, and for the random arbitrage return, we choose a stationary ergodic random process rapidly varying in time. We exploit the fact that option price and random arbitrage returns change on different time scales which allows us to develop an asymptotic pricing theory involving the central limit theorem for random proces...

  2. [Decision making in cariology

    NARCIS (Netherlands)

    Verdonschot, E.H.A.M.; Liem, S.L.; Palenstein Helderman, W.H. van

    2003-01-01

    By conducting an oral examination, during radiographic examination and in treatment planning procedures dentists make numerous decisions. A dentist will be required to make his decisions explicit. Decision trees and decision analyses may play an important role. In a decision analysis, the

  3. Motivators and barriers to returning to school: RN to BSN.

    Science.gov (United States)

    Romp, Celeste R; Kiehl, Ermalynn M; Bickett, Anette; Bledsoe, Sarah F; Brown, Debbie S; Eitel, Stephanie B; Wall, Mary Patricia

    2014-01-01

    With national emphasis on increasing baccalaureate-prepared nurses, the role of the staff development educator of promoting lifelong learning is ideal for advising and mentoring non-bachelor's-prepared nurses to return to school. However, an understanding of the motivators and barriers for nurses to return to school is essential for success. A descriptive correlational research study was completed to determine the motivators and barriers of returning to school for registered nurses without a bachelor's degree.

  4. Experiences of returning to elite beach volleyball after shoulder injury.

    Science.gov (United States)

    Bele, Sofie; Östenberg, Anna Hafsteinsson; Sjöström, Rita; Alricsson, Marie

    2015-08-01

    The purpose of this study was to examine beach volleyball players' experience regarding shoulder injury and how it affects their return to play. To achieve the research aims a qualitative design with semi-structured interviews had been conducted, five elite beach volleyball players, four men and one woman aged 27-42 participated in the study. All participants had suffered a severe shoulder injury, with absence from training and competing for at least 28 days. The findings of this study indicate that it is the individual's inner motivation, together with a clear goal and support from the community, family, teammate and coach that are the most important factors when going through rehabilitation and getting back to playing beach volleyball after a shoulder injury. All participants had been affected by their injury in some way; some of the participants had been affected in a positive way since they had become mentally stronger and had developed better volleyball technique after rehabilitation. The conclusions of this study indicate that there are three distinct factors that increase the chances of getting back to playing beach volleyball after shoulder injury; it is the players' self motivation, together with a clear goal and support from the community.

  5. Unhappy families: using tabletop games as a technology to understand play in education

    Directory of Open Access Journals (Sweden)

    John Lean

    2018-05-01

    Full Text Available In this article, we argue that tabletop games provide a helpful means of rethinking the affordances of digital games in pedagogy. We argue that tabletop games offer a distinctive technology from digital games in exploring the idea of play as experience, providing a sociable, accessible and tactile platform that can easily be adapted by players to suit their needs. At a workshop session at an international conference on play in education, we used tabletop games to enable discussion and observation of play. This workshop suggested that, rather than a singular definition, tabletop play means different things to different people, and what is ‘counted as’ play depends upon both individual and group interactions. Building upon this discussion, in this article, we return to both tabletop and digital games to discuss the idea of play as experience, especially with regard to the use of technology in educational settings, and how games might be seen as less ‘predictable’ than other technologies. We hope that this discussion provides future inspiration to other scholars who are considering the use of tabletop games in both pedagogical and technological research.

  6. Adaptive Management of Return Flows: Lessons from a Case Study in Environmental Water Delivery to a Floodplain River

    Science.gov (United States)

    Wolfenden, Benjamin J.; Wassens, Skye M.; Jenkins, Kim M.; Baldwin, Darren S.; Kobayashi, Tsuyoshi; Maguire, James

    2018-03-01

    For many floodplain rivers, reinstating wetland connectivity is necessary for ecosystems to recover from decades of regulation. Environmental return flows (the managed delivery of wetland water to an adjacent river) can be used strategically to facilitate natural ecosystem connectivity, enabling the transfer of nutrients, energy, and biota from wetland habitats to the river. Using an informal adaptive management framework, we delivered return flows from a forested wetland complex into a large lowland river in south-eastern Australia. We hypothesized that return flows would (a) increase river nutrient concentrations; (b) reduce wetland nutrient concentrations; (c) increase rates of ecosystem metabolism through the addition of potentially limiting nutrients, causing related increases in the concentration of water column chlorophyll-a; and (d) increase the density and species richness of microinvertebrates in riverine benthic habitats. Our monitoring results demonstrated a small increase in the concentrations of several key nutrients but no evidence for significant ecological responses was found. Although return flows can be delivered from forested floodplain areas without risking hypoxic blackwater events, returning nutrient and carbon-rich water to increase riverine productivity is limited by the achievable scale of return flows. Nevertheless, using return flows to flush carbon from floodplains may be a useful management tool to reduce carbon loads, preparing floodplains for subsequent releases (e.g., mitigating the risk of hypoxic blackwater events). In this example, adaptive management benefited from a semi-formal collaboration between science and management that allowed for prompt decision-making.

  7. Analysis of Market Risk, Financial Leverage, and Firm Size Toward Stock Return on Non-banking Companies Listed in Lq45 Index of Idx

    OpenAIRE

    Tumewu, Ferdinand; Pangemanan, Sifrid S.; Koluku, Rini Feronica

    2015-01-01

    In the world of investment, one underlies the decision of investors is stock returns that are depend on many factors. The purpose of this study was to analyze the effect of Market Risk, Financial Leverage, and Firm Size to Stock Return. By counting these factors, investors can see the effect of stock returns are important in decision making. The research methods associative with regression analysis and classical assumption techniques that include normality, multicollinearity, heteroscedastici...

  8. Research on the robust optimization of the enterprise's decision on the investment to the collaborative innovation: Under the risk constraints

    International Nuclear Information System (INIS)

    Zhou, Qing; Fang, Gang; Wang, Dong-peng; Yang, Wei

    2016-01-01

    Abstracts: The robust optimization model is applied to analyze the enterprise's decision of the investment portfolio for the collaborative innovation under the risk constraints. Through the mathematical model deduction and the simulation analysis, the research result shows that the enterprise's investment to the collaborative innovation has relatively obvious robust effect. As for the collaborative innovation, the return from the investment coexists with the risk of it. Under the risk constraints, the robust optimization method could solve the minimum risk as well as the proportion of each investment scheme in the portfolio on the condition of different target returns from the investment. On the basis of the result, the enterprise could balance between the investment return and risk and make optimal decision on the investment scheme.

  9. Economic analysis of venture capital funds rate of return on venture activity

    Directory of Open Access Journals (Sweden)

    Usatenko O.V.

    2017-08-01

    Full Text Available The research deals with the topic of the analysis of venture capital funds’ rate of return on venture activity. The discovered venture capital funds have such a peculiarity as the involved investors of various types and concentrated financial resources, which lead to advantages in investing. Based on the analyzed scientific approaches to the evaluation of income rate met by various economic entities the paper determines the optimal indicators of such an analysis developed due to the article research. They are supposed to improve significantly the process of making decisions on venture capital investments. The author suggests to evaluate venture capital funds rate of return on venture activity by means of the basic four indicators usually employed for investment efficiency definition: net profit, internal rate of return, return period and return index. The research presents the examination of rates of return on venture activity of venture capital funds being controlled by a single asset management company. Thus, one can estimate not only the rate of return on venture activity, but also the efficiency of control taken by an asset management company.

  10. Measuring the Effect of Exchange Rate Movements on Stock Market Returns Volatility: GARCH Model

    Directory of Open Access Journals (Sweden)

    Abdelkadir BESSEBA

    2017-06-01

    Full Text Available This paper aims to investigate the dynamic links between exchange rate fluctuations and stock market return volatility. For this purpose, we have employed a Generalized Autoregressive Conditional Heteroscedasticity model (GARCH model. Stock market returns sensitivities are found to be stronger for exchange rates, implying that exchange rate change plays an important role in determining the dynamics of the stock market returns.

  11. CRPE: Cesium Return Program Experience FY 1995

    International Nuclear Information System (INIS)

    Clements, E.P.

    1995-11-01

    Since 1945, the chemical reprocessing of irradiated nuclear fuels in the Hanford Chemical Separation areas has resulted in the generation of significant volumes of high-level, liquid, radioactive, by-product materials. However, because these materials were recognized to have beneficial uses, their disposal was delayed. To investigate the possibilities, the By-product Utilization Program (BUP) was initiated. The program mission was to develop a means for the application of radioactive-fission products for the benefit of society. Cs capsules were fabricated and distributed to private irradiation facilities for beneficial product sterilization. In June of 1988, a small leak developed in one of the Cs capsules at a private irradiator facility that is located in Decatur, Georgia. This leak prompted DOE to remove these capsules and to re-evaluate the BUP with the irradiator facilities that were currently using Cs capsules. As a result of this evaluation, a recall was issued to require that all remaining Cs capsules be returned to Hanford for safe management and storage pending final capsule disposition. The WHC completed the return of 309 capsules from a private irradiation facility, located in Northglenn, Colorado, to the Hanford Reservation. The DOE is also planning to remove 25 Cs capsules from a small, private irradiator facility located in Lynchburg, Virginia. This small irradiator facility is currently operational and uses the capsules for the underwater irradiation of wood-flooring products. This report discusses transportation-related activities that WHC has researched, developed, implemented, and is currently managing to ensure the safe and efficient movement of Cs-137 back to the Hanford Reservation

  12. Safe Cockroach Control: A Guide to Setting Up an Integrated Pest Management Program within a School System.

    Science.gov (United States)

    Cowles, Kathleen Letcher; And Others

    Integrated Pest Management (IPM) is a decision-making approach to pest control that has been used successfully on farms, city parks, offices, homes, and schools. IPM programs help individuals decide when treatments are necessary, where treatment would be most helpful, and what combinations of tactics would be most effective, safe, and inexpensive…

  13. Centralization versus decentralization as a risk-return trade-off

    NARCIS (Netherlands)

    Arcuri, A.; Dari-Mattiacci, G.

    2010-01-01

    This paper characterizes the choice between centralization and decentralization as a risk‐return trade‐off and examines it in a model that integrates ideas from committee decision‐making and portfolio theories. Centralization, by pooling expertise, rarely yields erroneous decisions; however, when it

  14. The effects of integration and transnational ties on international return migration intentions

    Directory of Open Access Journals (Sweden)

    Hein de Haas

    2011-12-01

    Full Text Available While return migration is receiving increasing attention, there is still insufficient insight into the factors which determine migrants' intentions and decisions to return. It is often assumed that integration in receiving countries and the concomitant weakening of transnational ties decreases the likelihood of returning. However, according to alternative theoretical interpretations, return migration can also be the outflow of successful integration in receiving countries. Drawing on a data set of four African immigrant groups in Spain and Italy, this articlereviews these conflicting hypotheses by assessing the effects of integration and transnational ties on return migration intentions. The results of the analysis suggest that socio-cultural integration has a negative effect on return migration intentions, while economic integration and transnational ties have more ambiguous and sometimes positive effects. The results provide mixed support for the different hypotheses but question theoretical perspectives that unequivocally conceptualizereturn migration and transnationalism as causes and/or consequences of "integration failure".

  15. Assessment for returning to work after spinal cord injuries and patient's vocational preferences.

    Science.gov (United States)

    Ullah, Mohammad Mosayed; Sarker, Amit; Chowdhury, Suman Kanti

    2015-01-01

    Returning to work after spinal cord injury (SCI) is a complex process due to the nature of injury and its devastating effect on all aspects of patients. This case study report is based on a spinal cord injury centre of Bangladesh. The evaluation examined vocational assessment process and vocational interest of persons with SCI undergoing rehabilitation program in the center. Occupational Therapists were interviewed to understand the existing vocational assessment services. This study also used data from 183 vocational assessment forms to find out the association of vocational interests and other demographic factors. The vocational assessment conducted to gathered information on the physical capacity of the patient and physical environment of patients living area only. The most preferred vocational interest was shop management 39%, and returning to previous job 38%. Vocational trades with the lowest level of interest were computer (2%) and electronics (3%), and 10% of patients at the time of assessment were undecided. A statistically significant association between interest to return to previous job and gender, age, occupation before injury and living area were found. Patients go through a complex process to adapt to a new life after experiencing SCI which is significantly influenced by the rehabilitation professionals around him/her. A comprehensive assessment including psychosocial information and therapist's expertise on facilitations making vocational decision based on the variables can optimize the rehabilitation outcome.

  16. Moral and Ethical Decision Making: Literature Review

    Science.gov (United States)

    2005-08-08

    exploration and elaboration of both rational and intuitive decision making processes. In addition, emotions may also play an important role in...More specifically, it suggests that both rational and intuitive decision making processes are likely to play an important role in ethical decision ...and military literature related to ethical decision making more generally. Specifically, it suggests that both rational and intuitive decision making

  17. The Impact of Sexual Arousal on Sexual Risk-Taking and Decision-Making in Men and Women.

    Science.gov (United States)

    Skakoon-Sparling, Shayna; Cramer, Kenneth M; Shuper, Paul A

    2016-01-01

    Sexual arousal has emerged as an important contextual feature in sexual encounters that can impact safer-sex decision-making. We conducted two experiments that investigated the effects of sexual arousal among male and female participants. Experiment 1 (N = 144) examined the impact of sexual around on sexual health decision-making. Sexually explicit and neutral video clips as well as hypothetical romantic scenarios were used to evaluate the effects of sexual arousal on sexual risk-taking intentions. Men and women who reported higher levels of sexual arousal also displayed greater intentions to participate in risky sexual behavior (e.g., unprotected sex with a new sex partner). Experiment 2 (N = 122) examined the impact of sexual arousal on general risk-taking, using the same videos clips as in Experiment 1 and a modified version of a computerized Blackjack card game. Participants were offered a chance to make either a risky play or a safe play during ambiguous conditions. Increased sexual arousal in Experiment 2 was associated with impulsivity and a greater willingness to make risky plays in the Blackjack game. These findings suggest that, in situations where there are strong sexually visceral cues, both men and women experiencing strong sexual arousal may have lower inhibitions and may experience impaired decision-making. This phenomenon may have an impact during sexual encounters and may contribute to a failure to use appropriate prophylactic protection.

  18. Communication and collaboration among return-to-work stakeholders.

    Science.gov (United States)

    Russell, Elizabeth; Kosny, Agnieszka

    2018-05-17

    Workers who are injured or become ill on the job are best able to return-to-work when stakeholders involved in their case collaborate and communicate. This study examined health care providers' and case managers' engagement in rehabilitation and return-to-work following workplace injury or illness. In-depth interviews were conducted with 97 health care providers and 34 case managers in four Canadian provinces about their experiences facilitating rehabilitation and return-to-work, and interacting with system stakeholders. A qualitative thematic content analysis demonstrated two key findings. Firstly, stakeholders were challenged to collaborate as a result of: barriers to interdisciplinary and cross-professional communication; philosophical differences about the timing and appropriateness of return-to-work; and confusion among health care providers about the workers' compensation system. Secondly, these challenges adversely affected the co-ordination of patient care, and consequentially, injured workers often became information conduits, and effective and timely treatment and return-to-work was sometimes negatively impacted. Communication challenges between health care providers and case managers may negatively impact patient care and alienate treating health care providers. Discussion about role clarification, the appropriateness of early return-to-work, how paperwork shapes health care providers' role expectations, and strengthened inter-professional communication are considered. Implications for Rehabilitation Administrative and conceptual barriers in workers' compensation systems challenge collaboration and communication between health care providers and case managers. Injured workers may become conduits of incorrect information, resulting in adversarial relationships, overturned health care providers' recommendations, and their disengagement from rehabilitation and return-to-work. Stakeholders should clarify the role of health care providers during

  19. Doctors' health: obstacles and enablers to returning to work.

    Science.gov (United States)

    Cohen, D; Rhydderch, M; Reading, P; Williams, S

    2015-08-01

    For doctors returning to work after absence due to ill-health or performance concerns, the obstacles can seem insurmountable. Doctors' perspectives of these obstacles have been investigated. To support them more effectively, the perspectives of organizations that interact with such doctors should also be considered. To explore the obstacles and enablers to doctors' return to work after long-term absence from the perspective of key organizations involved in assessment and support. We identified organizations operating in the field of doctors' health, well-being and performance. We conducted semi-structured, 30-45 min telephone interviews with representatives of the organizations, exploring problems that they had encountered that were experienced by doctors with health or performance concerns returning to work after absence of a month or longer. We analysed our field notes using theoretical analysis. We conducted 11 telephone interviews. Data analysis identified four key themes of obstacles and enablers to returning to work: 'communication', 'return to work', 'finance and funding' and 'relationships and engagement'. Sub-themes relating to the organization and the individual also emerged. Organizations responsible for supporting doctors back to work reported poor communication as a significant obstacle to doctors returning to work after illness. They also reported differences between specialities, employing organizations, occupational health departments and human resources in terms of knowledge and expertise in supporting doctors with complex issues. Clear communication channels, care pathways and support processes, such as workplace advocates, were perceived as strong enablers to return to work for doctors after long-term absence. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  20. 75 FR 76940 - Specified Tax Return Preparers Required To File Individual Income Tax Returns Using Magnetic...

    Science.gov (United States)

    2010-12-10

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service 26 CFR Parts 1 and 301 [REG-100194-10] RIN 1545-BJ52 Specified Tax Return Preparers Required To File Individual Income Tax Returns Using Magnetic... for ``specified tax return prepares,''. FOR FURTHER INFORMATION CONTACT: Keith L. Brau at (202) 622...

  1. 20 CFR 216.24 - Relinquishment of rights to return to work.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Relinquishment of rights to return to work... of rights to return to work. (a) What return to work rights must be given up. Before an individual... work for any railroad employer. (b) When right to return to work is ended. An individual's right to...

  2. 640 Gbit/s return-to-zero to non-return-to-zero format conversion based on optical linear spectral phase filtering

    DEFF Research Database (Denmark)

    Maram, Reza; Kong, Deming; Galili, Michael

    2016-01-01

    We propose a novel approach for all-optical return-to-zero (RZ) to non-return-to-zero (NRZ) telecommunication data format conversion based on linear spectral phase manipulation of an RZ data signal. The operation principle is numerically analyzed and experimentally validated through successful fo...

  3. Mars Sample Return Using Solar Sail Propulsion

    Science.gov (United States)

    Johnson, Les; Macdonald, Malcolm; Mcinnes, Colin; Percy, Tom

    2012-01-01

    Many Mars Sample Return (MSR) architecture studies have been conducted over the years. A key element of them is the Earth Return Stage (ERS) whose objective is to obtain the sample from the Mars Ascent Vehicle (MAV) and return it safely to the surface of the Earth. ERS designs predominantly use chemical propulsion [1], incurring a significant launch mass penalty due to the low specific impulse of such systems coupled with the launch mass sensitivity to returned mass. It is proposed to use solar sail propulsion for the ERS, providing a high (effective) specific impulse propulsion system in the final stage of the multi-stage system. By doing so to the launch mass of the orbiter mission can be significantly reduced and hence potentially decreasing mission cost. Further, solar sailing offers a unique set of non-Keplerian low thrust trajectories that may enable modifications to the current approach to designing the Earth Entry Vehicle by potentially reducing the Earth arrival velocity. This modification will further decrease the mass of the orbiter system. Solar sail propulsion uses sunlight to propel vehicles through space by reflecting solar photons from a large, mirror-like surface made of a lightweight, reflective material. The continuous photonic pressure provides propellantless thrust to conduct orbital maneuvering and plane changes more efficiently than conventional chemical propulsion. Because the Sun supplies the necessary propulsive energy, solar sails require no onboard propellant, thus reducing system mass. This technology is currently at TRL 7/8 as demonstrated by the 2010 flight of the Japanese Aerospace Exploration Agency, JAXA, IKAROS mission. [2

  4. Expected Rate of Return on the Personal Investment in Education of No-Fee Preservice Students

    Science.gov (United States)

    Zhang, Xuemin

    2013-01-01

    Return on personal investment is an important factor affecting the decision to invest in education. This article analyzes the personal education costs of no-fee preservice students, estimates and forecasts the return on their personal education investment, and compares the costs and benefits of for-fee preservice students and nonteaching students.…

  5. Risk-return relationship in a complex adaptive system.

    Directory of Open Access Journals (Sweden)

    Kunyu Song

    Full Text Available For survival and development, autonomous agents in complex adaptive systems involving the human society must compete against or collaborate with others for sharing limited resources or wealth, by using different methods. One method is to invest, in order to obtain payoffs with risk. It is a common belief that investments with a positive risk-return relationship (namely, high risk high return and vice versa are dominant over those with a negative risk-return relationship (i.e., high risk low return and vice versa in the human society; the belief has a notable impact on daily investing activities of investors. Here we investigate the risk-return relationship in a model complex adaptive system, in order to study the effect of both market efficiency and closeness that exist in the human society and play an important role in helping to establish traditional finance/economics theories. We conduct a series of computer-aided human experiments, and also perform agent-based simulations and theoretical analysis to confirm the experimental observations and reveal the underlying mechanism. We report that investments with a negative risk-return relationship have dominance over those with a positive risk-return relationship instead in such a complex adaptive systems. We formulate the dynamical process for the system's evolution, which helps to discover the different role of identical and heterogeneous preferences. This work might be valuable not only to complexity science, but also to finance and economics, to management and social science, and to physics.

  6. Risk-return relationship in a complex adaptive system.

    Science.gov (United States)

    Song, Kunyu; An, Kenan; Yang, Guang; Huang, Jiping

    2012-01-01

    For survival and development, autonomous agents in complex adaptive systems involving the human society must compete against or collaborate with others for sharing limited resources or wealth, by using different methods. One method is to invest, in order to obtain payoffs with risk. It is a common belief that investments with a positive risk-return relationship (namely, high risk high return and vice versa) are dominant over those with a negative risk-return relationship (i.e., high risk low return and vice versa) in the human society; the belief has a notable impact on daily investing activities of investors. Here we investigate the risk-return relationship in a model complex adaptive system, in order to study the effect of both market efficiency and closeness that exist in the human society and play an important role in helping to establish traditional finance/economics theories. We conduct a series of computer-aided human experiments, and also perform agent-based simulations and theoretical analysis to confirm the experimental observations and reveal the underlying mechanism. We report that investments with a negative risk-return relationship have dominance over those with a positive risk-return relationship instead in such a complex adaptive systems. We formulate the dynamical process for the system's evolution, which helps to discover the different role of identical and heterogeneous preferences. This work might be valuable not only to complexity science, but also to finance and economics, to management and social science, and to physics.

  7. Returning to sports after a back injury

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000518.htm Returning to sports after a back injury To use the sharing ... Back pain - returning to sports Which Type of Sport is Best? In deciding when and if to ...

  8. Decision Making in Action: Applying Research to Practice

    Science.gov (United States)

    Orasanu, Judith; Statler, Irving C. (Technical Monitor)

    1994-01-01

    The importance of decision-making to safety in complex, dynamic environments like mission control centers and offshore installations has been well established. NASA-ARC has a program of research dedicated to fostering safe and effective decision-making in the manned spaceflight environment. Because access to spaceflight is limited, environments with similar characteristics, including aviation and nuclear power plants, serve as analogs from which space-relevant data can be gathered and theories developed. Analyses of aviation accidents cite crew judgement and decision making as causes or contributing factors in over half of all accidents. A similar observation has been made in nuclear power plants. Yet laboratory research on decision making has not proven especially helpful in improving the quality of decisions in these kinds of environments. One reason is that the traditional, analytic decision models are inappropriate to multidimensional, high-risk environments, and do not accurately describe what expert human decision makers do when they make decisions that have consequences. A new model of dynamic, naturalistic decision making is offered that may prove useful for improving decision making in complex, isolated, confined and high-risk environments. Based on analyses of crew performance in full-mission simulators and accident reports, features that define effective decision strategies in abnormal or emergency situations have been identified. These include accurate situation assessment (including time and risk assessment), appreciation of the complexity of the problem, sensitivity to constraints on the decision, timeliness of the response, and use of adequate information. More effective crews also manage their workload to provide themselves with time and resources to make good decisions. In brief, good decisions are appropriate to the demands of the situation. Effective crew decision making and overall performance are mediated by crew communication. Communication

  9. A conceptual framework for a sports knee injury performance profile (SKIPP) and return to activity criteria (RTAC)

    OpenAIRE

    Logerstedt, David; Arundale, Amelia; Lynch, Andrew; Snyder-Mackler, Lynn

    2015-01-01

    ABSTRACTInjuries to the knee, including intra-articular fractures, ligamentous ruptures, and meniscal and articular cartilage lesions, are commonplace within sports. Despite advancements in surgical techniques and enhanced rehabilitation, athletes returning to cutting, pivoting, and jumping sports after a knee injury are at greater risk of sustaining a second injury. The clinical utility of objective criteria presents a decision-making challenge to ensure athletes are fully rehabilitated and ...

  10. Training Conservation Practitioners to be Better Decision Makers

    Directory of Open Access Journals (Sweden)

    Fred A. Johnson

    2015-06-01

    Full Text Available Traditional conservation curricula and training typically emphasizes only one part of systematic decision making (i.e., the science, at the expense of preparing conservation practitioners with critical skills in values-setting, working with decision makers and stakeholders, and effective problem framing. In this article we describe how the application of decision science is relevant to conservation problems and suggest how current and future conservation practitioners can be trained to be better decision makers. Though decision-analytic approaches vary considerably, they all involve: (1 properly formulating the decision problem; (2 specifying feasible alternative actions; and (3 selecting criteria for evaluating potential outcomes. Two approaches are available for providing training in decision science, with each serving different needs. Formal education is useful for providing simple, well-defined problems that allow demonstrations of the structure, axioms and general characteristics of a decision-analytic approach. In contrast, practical training can offer complex, realistic decision problems requiring more careful structuring and analysis than those used for formal training purposes. Ultimately, the kinds and degree of training necessary depend on the role conservation practitioners play in a decision-making process. Those attempting to facilitate decision-making processes will need advanced training in both technical aspects of decision science and in facilitation techniques, as well as opportunities to apprentice under decision analysts/consultants. Our primary goal should be an attempt to ingrain a discipline for applying clarity of thought to all decisions.

  11. Reunifying abused or neglected children: Decision-making and outcomes.

    Science.gov (United States)

    Biehal, Nina; Sinclair, Ian; Wade, Jim

    2015-11-01

    Little is known about decision-making regarding the reunification of children in care, or about the consequences of these decisions for the children concerned. This study compared decision-making and outcomes for 149 maltreated children in seven English authorities (68 reunified, 81 who remained in care). Children were followed up six months after their return home or, for those who were not reunified, six months after the 'effective decision' that they should remain in care. They were followed up again four years (on average) after the return or effective decision. Data were extracted from case files at baseline and six month follow-up and were gathered from surveys of social workers and teachers at final follow-up. The two key predictors of reunification were assessments that parental problems had improved and that risks to the child were not unacceptably high. Two-thirds returned to improved family circumstances, sometimes due to a change in the household they returned to, but others were reunified despite persisting concerns. However 35% re-entered care within six months and 63% re-entered at some point during the four-year follow-up period, often due to recurring abuse or neglect. At final follow-up remaining in care was the strongest predictor of positive outcomes on a range of dimensions, even once children's characteristics and histories were taken into account. Outcomes were especially poor for neglected children who were reunified, irrespective of whether reunification was stable or unstable. Results show the potential of the care system to produce positive outcomes for maltreated children. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. The Annapolis Accords on the use of toxicology in decision-making. Annapolis Center Workshop Report.

    Energy Technology Data Exchange (ETDEWEB)

    Gray, G.M.; Baskin, S.I.; Charnley, G.; Cohen, J.T.; Gold, L.S.; Kerkvliet, N.I.; Koenig, H.M.; Lewis, S.C.; McClain, R.M.; Rhomberg, L.R.; Snyder, J.W.; Weekley, L.B.

    2000-12-01

    The science of toxicology plays an important role in identifying safe conditions of use or exposure for many different kinds of environmental agents. The use of toxicologic information in risk assessment requires careful analysis, evaluation of data, and scientific judgment. These Annapolis Accords are intended to guide appropriate use in risk assessment of the scientific information from toxicology. We believe that application of these principles will improve the scientific credibility of risk assessment and the quality of decisions aimed at reducing and eliminating risks to human health and the environment.

  13. Application of the Eisert-Wilkens-Lewenstein quantum game scheme to decision problems with imperfect recall

    International Nuclear Information System (INIS)

    Frackiewicz, Piotr

    2011-01-01

    We investigate implementations of the Eisert-Wilkens-Lewenstein (EWL) scheme of playing quantum games beyond strategic games. The scope of our research is decision problems, i.e. one-player extensive games. The research is based on the examination of their features when the decision problems are carried out via the EWL protocol. We prove that unitary operators can be adapted to play the role of strategies in decision problems with imperfect recall. Furthermore, we prove that unitary operators provide the decision maker with possibilities that are inaccessible for classical strategies.

  14. Application of the Eisert-Wilkens-Lewenstein quantum game scheme to decision problems with imperfect recall

    Energy Technology Data Exchange (ETDEWEB)

    Frackiewicz, Piotr, E-mail: P.Frackiewicz@impan.gov.pl [Institute of Mathematics of the Polish Academy of Sciences, 00-956 Warsaw (Poland)

    2011-08-12

    We investigate implementations of the Eisert-Wilkens-Lewenstein (EWL) scheme of playing quantum games beyond strategic games. The scope of our research is decision problems, i.e. one-player extensive games. The research is based on the examination of their features when the decision problems are carried out via the EWL protocol. We prove that unitary operators can be adapted to play the role of strategies in decision problems with imperfect recall. Furthermore, we prove that unitary operators provide the decision maker with possibilities that are inaccessible for classical strategies.

  15. Stable Versus Unstable Grade II High Ankle Sprains: A Prospective Study Predicting the Need for Surgical Stabilization and Time to Return to Sports.

    Science.gov (United States)

    Calder, James D; Bamford, Richard; Petrie, Aviva; McCollum, Graham A

    2016-04-01

    To investigate grade II syndesmosis injuries in athletes and identify factors important in differentiating stable from dynamically unstable ankle sprains and those associated with a longer time to return to sports. Sixty-four athletes with an isolated syndesmosis injury (without fracture) were prospectively assessed, with a mean follow-up period of 37 months (range, 24 to 66 months). Those with an associated deltoid ligament injury or osteochondral lesion were included. Those whose injuries were considered stable (grade IIa) were treated conservatively with a boot and rehabilitation. Those whose injuries were clinically unstable underwent arthroscopy, and if instability was confirmed (grade IIb), the syndesmosis was stabilized. Clinical and magnetic resonance imaging assessments of injury to individual ligaments were recorded, along with time to return to play. A power analysis estimated that each group would need 28 patients. All athletes returned to the same level of professional sport. The 28 patients with grade IIa injuries returned at a mean of 45 days (range, 23 to 63 days) compared with 64 days (range, 27 to 104 days) for those with grade IIb injuries (P < .0001). There was a highly significant relationship between clinical and magnetic resonance imaging assessments of ligament injury (anterior tibiofibular ligament [ATFL], anterior-inferior tibiofibular ligament [AITFL], and deltoid ligament, P < .0001). Instability was 9.5 times as likely with a positive squeeze test and 11 times as likely with a deltoid injury. Combined injury to the anterior-inferior tibiofibular ligament and deltoid ligament was associated with a delay in return to sports. Concomitant injury to the ATFL indicated a different mechanism of injury-the syndesmosis is less likely to be unstable and is associated with an earlier return to sports. A positive squeeze test and injury to the ATFL and deltoid ligament are important factors in differentiating stable from dynamically unstable grade

  16. Changes and continuities in families with migrant parents who have returned to Antioquia and the Colombian coffeegrowing region

    Directory of Open Access Journals (Sweden)

    Jair Eduardo Restrepo Pineda

    2017-01-01

    Full Text Available This article carries out an approach to the families immersed in a migratory process of international return of their fathers and mothers, allowing to make visible the modification and reconfiguration of their dynamics and how these affect the relations, cohabitation and functioning of family life. Aspects such as authority and decision-making, gender roles and economic supply are the ones that demonstrate greater changes for every member of the family unit. As regards the continuities, it is highlighted the fact that the carer role is still being inherently bound to the women. The return is a dynamic process in which communication, care and economic supply prepare the migrants’ way towards their reincorporation into family life.

  17. Maternal perspectives on the return of genetic results: context matters.

    Science.gov (United States)

    Lakes, Kimberley D; Vaughan, Elaine; Lemke, Amy; Jones, Marissa; Wigal, Timothy; Baker, Dean; Swanson, James M; Burke, Wylie

    2013-01-01

    The objectives of this study were to study maternal preferences for the return of their child's genetic results and to describe the experiences, perceptions, attitudes, and values that are brought to bear when individuals from different racial and cultural backgrounds consider participating in genetic research. We recruited women with diverse sociodemographic profiles to participate in seven focus groups. Twenty-eight percent of participants self-identified as Hispanic; 49% as White, non-Hispanic; and 21% as Asian or Asian American. Focus groups were conducted in English or Spanish and were audio-recorded and transcribed verbatim. Transcripts were analyzed using qualitative thematic methods. Results indicated that preferences and decisions regarding the return of results may depend on both research and individual contextual factors. Participants understood the return of results as a complex issue, where individual and cultural differences in preferences are certain to arise. Another key finding was that participants desired an interpersonal, dynamic, flexible process that accommodated individual preferences and contextual differences for returning results. Our findings indicate a need to have well-developed systems for allowing participants to make and change over time their choices regarding the return of their child's genetic results. Copyright © 2012 Wiley Periodicals, Inc.

  18. Return to Experience and Initial Wage Level

    DEFF Research Database (Denmark)

    Sørensen, Kenneth Lykke; Vejlin, Rune Majlund

    This paper estimates the relationship between initial wage and return to experience. We use a Mincer-like wage model to nonparametrically estimate this relationship allowing for an unobservable individual permanent effect in wages and unobservable individual return to experience. The relationship...

  19. Return-to-work barriers for workers with contact dermatitis.

    Science.gov (United States)

    Holness, D Linn

    2003-12-01

    There is little information available regarding barriers to return-to-work (RTW) in workers with contact dermatitis. The purpose of this study was to survey occupational health and safety personnel to determine their perceptions regarding RTW barriers for workers with contact dermatitis. The study was conducted during an occupational health and safety research conference attended by stakeholders from labour, management, injured workers, government, safety associations, occupational health and safety practitioners and researchers. The attendees were presented with 3 pictures of varying degrees of work-related hand contact dermatitis and were asked to list the 3 key barriers or challenges in RTW for individuals with contact dermatitis. 21 individuals completed the survey. Issues identified in descending order of frequency were concern of ongoing dermatitis, ability to do the job safely, appearance, ability to accommodate, personal protective equipment, fear that the rash was contagious, workplace attitudes and pain. While some of these issues are potentially common to RTW situations in general, others are more specific to health problems which have a visible manifestation. Increased awareness of and attention to these possible barriers to RTW may lead to better RTW outcomes.

  20. 27 CFR 25.211 - Beer returned to brewery.

    Science.gov (United States)

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Beer returned to brewery..., DEPARTMENT OF THE TREASURY LIQUORS BEER Beer Returned to Brewery § 25.211 Beer returned to brewery. (a) General. Beer, produced in the United States, on which the brewer has paid or determined the tax may be...

  1. Managing radioactive waste safely. Engaging Scotland

    International Nuclear Information System (INIS)

    Elrick, D.; Boyes, L.; McCormick, J.

    2002-01-01

    Between January and May 2002 the Scottish Council Foundation undertook a research project to assess 1 the level of public awareness about and interest in engaging the public in decision-making on managing radioactive waste safely in Scotland. This paper presents the main findings from the research that involved 70 people from across Scotland, aged between 14 and over 65 years old, and a literature review of Scottish, UK and international experience in engaging the public

  2. Critical assessment of claims regarding management of feral cats by trap-neuter-return.

    Science.gov (United States)

    Longcore, Travis; Rich, Catherine; Sullivan, Lauren M

    2009-08-01

    Many jurisdictions have adopted programs to manage feral cats by trap-neuter-return (TNR), in which cats are trapped and sterilized, then returned to the environment to be fed and cared for by volunteer caretakers. Most conservation biologists probably do not realize the extent and growth of this practice and that the goal of some leading TNR advocates is that cats ultimately be recognized and treated as "protected wildlife." We compared the arguments put forth in support of TNR by many feral cat advocates with the scientific literature. Advocates promoting TNR often claim that feral cats harm wildlife only on islands and not on continents; fill a natural or realized niche; do not contribute to the decline of native species; and are insignificant vectors or reservoirs of disease. Advocates also frequently make claims about the effectiveness of TNR, including claims that colonies of feral cats are eventually eliminated by TNR and that managed colonies resist invasion by other cats. The scientific literature contradicts each of these claims. TNR of feral cats is primarily viewed and regulated as an animal welfare issue, but it should be seen as an environmental issue, and decisions to implement it should receive formal environmental assessment. Conservation scientists have a role to play by conducting additional research on the effects of feral cats on wildlife and by communicating sound scientific information about this problem to policy makers.

  3. Stochastic arbitrage return and its implication for option pricing

    Science.gov (United States)

    Fedotov, Sergei; Panayides, Stephanos

    2005-01-01

    The purpose of this work is to explore the role that random arbitrage opportunities play in pricing financial derivatives. We use a non-equilibrium model to set up a stochastic portfolio, and for the random arbitrage return, we choose a stationary ergodic random process rapidly varying in time. We exploit the fact that option price and random arbitrage returns change on different time scales which allows us to develop an asymptotic pricing theory involving the central limit theorem for random processes. We restrict ourselves to finding pricing bands for options rather than exact prices. The resulting pricing bands are shown to be independent of the detailed statistical characteristics of the arbitrage return. We find that the volatility “smile” can also be explained in terms of random arbitrage opportunities.

  4. Law Enforcement of Consumer Protection for Safe Food Packaging in The Decisions of Criminal Justice

    Science.gov (United States)

    Wiryani, F.; Herwastoeti; Najih, M.; Haris, A.

    2017-04-01

    The right to a safe food is a human rights protected by the 1945 Constitution and legislation, including the Health Act, the Consumer Protection Act and Food Act. The law governing the rights and obligations of consumers; rights, obligations and responsibilities of businesses, as well as prohibitions and sanctions for businesses that violate. Food consumers aggrieved can file a non-litigation legal action and / or litigation. Non-litigation legal efforts made through negotiation or mediation or through Consumer Dispute Resolution Body (BPSK). The litigation efforts made by filing a lawsuit for damages to the court and / or reporting the case to the criminal law enforcement. This study specifically examines the enforcement of criminal law in the judgment as a safeguard against food consumers. Sanctions provisions setting a strategic role in an effort to make the protection of consumers of food. Patterns general formulation of the maximum penalty in the third Act is not appropriate because it too gives flexibility for the judge to make a decision as low to the Defendant. Facts on society, business agent has a dominant and strong position compared with consumers of food. These favorable conditions business agent position and vice versa less give legal protection to the Consumer Food. Preferably the pattern formulation penalty of criminal acts in the field of food using a specific minimum and maximum public.

  5. An Automated Safe-to-Mate (ASTM) Tester

    Science.gov (United States)

    Nguyen, Phuc; Scott, Michelle; Leung, Alan; Lin, Michael; Johnson, Thomas

    2013-01-01

    Safe-to-mate testing is a common hardware safety practice where impedance measurements are made on unpowered hardware to verify isolation, continuity, or impedance between pins of an interface connector. A computer-based instrumentation solution has been developed to resolve issues. The ASTM is connected to the circuit under test, and can then quickly, safely, and reliably safe-to-mate the entire connector, or even multiple connectors, at the same time.

  6. Return to work following robot-assisted laparoscopic and open retropubic radical prostatectomy: A single-center cohort study to compare duration of sick leave.

    Science.gov (United States)

    von Mechow, Stefanie; Graefen, Markus; Haese, Alexander; Tennstedt, Pierre; Pehrke, Dirk; Friedersdorff, Frank; Beyer, Burkhard

    2018-06-01

    To compare the duration of sick leave in patients with localized prostate cancer after robot-assisted radical prostatectomy (RARP) and open retropubic RP (ORP) at a German high-volume prostate cancer center. The data of 1,415 patients treated with RP at Martini Klinik, Prostate Cancer Center between 2012 and 2016 were, retrospectively, analyzed. Information on employment status, monthly revenues and days of work missed due to sickness were assessed via online questionnaire. Additional data were retrieved from our institutional database. Medians and interquartile ranges (IQR) were reported for continuous data. Cox proportional hazard analysis was performed to compare both surgical techniques for return to work time after RP. Median time elapsed between surgery and return to work comprised 42 days in patients undergoing RARP (IQR: 21-70) and ORP (IQR: 28-84, P = 0.05). In Cox regression analysis, surgical approach showed no impact on return to work time (RARP vs. ORP hazard ratio = 1, 95% CI: 0.91-1.16, P = 0.69). Return to work time was significantly associated with employment status, physical workload and monthly income (all PLimitation of this study is the nonrandomized design in a single-center. As the surgical approach did not show any influence on the number of days missed from work in patients undergoing RP, no superiority of either RARP or ORP could be identified for return to work time in a German cohort. Both surgical approaches are safe options usually allowing the patients to resume normal activities including work after an appropriate convalescence period. Copyright © 2018 Elsevier Inc. All rights reserved.

  7. Return to experience and initial wage level

    DEFF Research Database (Denmark)

    Sørensen, K.L.; Vejlin, R.

    2014-01-01

    This paper estimates the relationship between initial wage and return to experience. We use a Mincer-like wage model to non-parametrically estimate this relationship allowing for an unobservable individual permanent effect in wages and unobservable individual return to experience. The relationshi...

  8. Interoception Drives Increased Rational Decision-Making in Meditators Playing the Ultimatum Game

    OpenAIRE

    Kirk, Ulrich; Downar, Jonathan; Montague, P. Read

    2011-01-01

    Human decision-making is often conceptualized as a competition between cognitive and emotional processes in the brain. Deviations from rational processes are believed to derive from inclusion of emotional factors in decision-making. Here, we investigate whether experienced Buddhist meditators are better equipped to regulate emotional processes compared with controls during economic decision-making in the Ultimatum Game. We show that meditators accept unfair offers on more than half of the tri...

  9. Risk perception, safety goals and regulatory decision-making

    International Nuclear Information System (INIS)

    Hoegberg, Lars

    1998-01-01

    Deciding on 'how safe is safe enough?' includes value judgements with implications of an ethical and political nature. As regulators are accountable to governments, parliaments and the general public, regulatory decision-making should be characterized by transparency with respect to how such value judgements are reflected in risk assessments and regulatory decisions. Some approaches in this respect are discussed in the paper, based on more than fifteen years of experience in nuclear regulatory decision-making. Issues discussed include: (1) risk profiles and safety goals associated with severe reactor accidents--individual health risks, societal risks and risk of losing investments; (2) risk profile-based licensing of the Swedish SFR final disposal facility for low and intermediate level radioactive waste

  10. Return to golf after spine surgery.

    Science.gov (United States)

    Abla, Adib A; Maroon, Joseph C; Lochhead, Richard; Sonntag, Volker K H; Maroon, Adara; Field, Melvin

    2011-01-01

    no published evidence indicates when patients can resume golfing after spine surgery. The objective of this study is to provide data from surveys sent to spine surgeons. a survey of North American Spine Society members was undertaken querying the suggested timing of return to golf. Of 1000 spine surgeons surveyed, 523 responded (52.3%). The timing of recommended return to golf and the reasons were questioned for college/professional athletes and avid and recreational golfers of both sexes. Responses were tallied for lumbar laminectomy, lumbar microdiscectomy, lumbar fusion, and anterior cervical discectomy with fusion. the most common recommended time for return to golf was 4-8 weeks after lumbar laminectomy and lumbar microdiscectomy, 2-3 months after anterior cervical fusion, and 6 months after lumbar fusion. The results showed a statistically significant increase in the recommended time to resume golf after lumbar fusion than after cervical fusion in all patients (p golf after spine surgery depends on many variables, including the general well-being of patients in terms of pain control and comfort when golfing. This survey serves as a guide that can assist medical practitioners in telling patients the average times recommended by surgeons across North America regarding return to golf after spine surgery.

  11. From Planetary Boundaries to national fair shares of the global safe operating space — How can the scales be bridged?

    NARCIS (Netherlands)

    Häyhä, Tiina; Lucas, Paul L.|info:eu-repo/dai/nl/272607444; van Vuuren, Detlef P.|info:eu-repo/dai/nl/11522016X; Cornell, Sarah E.; Hoff, Holger

    2016-01-01

    The planetary boundaries framework proposes quantitative global limits to the anthropogenic perturbation of crucial Earth system processes, and thus marks out a planetary safe operating space for human activities. Yet, decisions regarding resource use and emissions are mostly made at less aggregated

  12. Cognitive-emotional decision making (CEDM): a framework of patient medical decision making.

    Science.gov (United States)

    Power, Tara E; Swartzman, Leora C; Robinson, John W

    2011-05-01

    Assistance for patients faced with medical decisions has largely focussed on the clarification of information and personal values. Our aim is to draw on the decision research describing the role of emotion in combination with health behaviour models to provide a framework for conceptualizing patient decisions. A review of the psychological and medical decision making literature concerned with the role of emotion/affect in decision making and health behaviours. Emotion plays an influential role in decision making. Both current and anticipated emotions play a motivational role in choice. Amalgamating these findings with that of Leventhal's (1970) SRM provide a framework for thinking about the influence of emotion on a patient medical decision. Our framework suggests that a patient must cope with four sets of elements. The first two relate to the need to manage the cognitive and emotional aspects of the health threat. The second set relate to the management of the cognitive and emotional elements of the decision, itself. The framework provides a way for practitioners and researchers to frame thinking about a patient medical decision in order to assist the patient in clarifying decisional priorities. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  13. I. Do chronic pain patients' perceptions about their preinjury jobs determine their intent to return to the same type of job post-pain facility treatment?

    Science.gov (United States)

    Fishbain, D A; Rosomoff, H L; Cutler, R B; Steele-Rosomoff, R

    1995-12-01

    To demonstrate that chronic pain patients' (CPPs') perceptions about their preinjury jobs determine their intent to return to the same type of job post pain facility treatment. A total of 225 CPPs completed a series of rating scales and yes/no questions relating to their preinjury job perceptions and a question relating to intent to return to the same type of preinjury job post-pain facility treatment. The CPPs were broken down into subgroups (males, females, college males, noncollege males, college females, noncollege females), and within each subgroup those not intending to return to the same type of pre-injury job were compared to those intending to return on the preinjury job perception questions. In addition for the whole group, stepwise discriminant analysis was used to predict who planned to return to the preinjury job utilizing the job perceptions questions. Multidisciplinary Pain Center. Consecutive chronic pain patients. For the whole group, CPPs not intending to return were more likely to complain of job excessive physical demands, job satisfaction, and job dislike. Job perception complaints that were significantly different between the intending and not intending to return groups differed between the subgroups. For example, noncollege males not intending to return were more likely to complain of excessive physical demands only versus satisfaction and liking as significant items for college males who did not intend to return. Within the discriminant analysis, the combination of job satisfaction, excessive physical demands, employee conflicts, job liking, job dangerousness, supervisory conflicts, job stress, and age classified 73.46% of the CPPs correctly as to intent to return to the same type of preinjury job. There appears to be a relationship between preinjury job perceptions and intent to return to the same type of job post pain treatment. However, subgroups of CPPs will differ by which job perceptions are important towards making that decision.

  14. Return to the workforce following infective endocarditis

    DEFF Research Database (Denmark)

    Butt, Jawad H.; Kragholm, Kristian; Dalager-Pedersen, Michael

    2018-01-01

    Background The ability to return to work after infective endocarditis (IE) holds important socioeconomic consequences for both patients and society, yet data on this issue are sparse. We examined return to the workforce and associated factors in IE patients of working age. Methods Using Danish...

  15. Evaluation of trade-offs in costs and environmental impacts for returnable packaging implementation

    Science.gov (United States)

    Jarupan, Lerpong; Kamarthi, Sagar V.; Gupta, Surendra M.

    2004-02-01

    The main thrust of returnable packaging these days is to provide logistical services through transportation and distribution of products and be environmentally friendly. Returnable packaging and reverse logistics concepts have converged to mitigate the adverse effect of packaging materials entering the solid waste stream. Returnable packaging must be designed by considering the trade-offs between costs and environmental impact to satisfy manufacturers and environmentalists alike. The cost of returnable packaging entails such items as materials, manufacturing, collection, storage and disposal. Environmental impacts are explicitly linked with solid waste, air pollution, and water pollution. This paper presents a multi-criteria evaluation technique to assist decision-makers for evaluating the trade-offs in costs and environmental impact during the returnable packaging design process. The proposed evaluation technique involves a combination of multiple objective integer linear programming and analytic hierarchy process. A numerical example is used to illustrate the methodology.

  16. The views of migrant health workers living in Austria and Belgium on return migration to sub-Saharan Africa.

    Science.gov (United States)

    Poppe, Annelien; Wojczewski, Silvia; Taylor, Katherine; Kutalek, Ruth; Peersman, Wim

    2016-06-30

    The negative consequences of the brain drain of sub-Saharan African health workers for source countries are well documented and include understaffed facilities, decreased standards of care and higher workloads. However, studies suggest that, if migrated health workers eventually return to their home countries, this may lead to beneficial effects following the transfer of their acquired skills and knowledge (brain gain). The present study aims to explore the factors influencing the intentions for return migration of sub-Saharan African health workers who emigrated to Austria and Belgium, and gain further insight into the potential of circular migration. Semi-structured interviews with 27 sub-Saharan African health workers in Belgium and Austria were conducted. As mentioned by the respondents, the main barriers for returning were family, structural crises in the source country, and insecurity. These barriers overrule the perceived drivers, which were nearly all pull factors and emotion driven. Despite the fact that only a minority plans to return permanently, many wish to return regularly to work in the healthcare sector or to contribute to the development of their source country. As long as safety and structural stability cannot be guaranteed in source countries, the number of return migrants is likely to remain low. National governments and regional organizations could play a role in facilitating the engagement of migrant health workers in the development of the healthcare system in source countries.

  17. When Kahneman meets Manski: Using dual systems of reasoning to interpret subjective expectations of equity returns

    OpenAIRE

    Gouret , Fabian; Hollard , Guillaume

    2011-01-01

    International audience; To understand how decisions to invest in stocks are taken, economists need to elicit expectations relative to expected risk-return trade-off. One of the few surveys which have included such questions is the Survey of Economic Expectations in 1999-2001. Using this survey, Dominitz and Manski find an important heterogeneity across respondents that can hardly be accounted for by simple models of expectations formation. This paper claims that much of the heterogeneity deri...

  18. Sample Return in Preparation for Human Mission on the Surface of Mars

    Science.gov (United States)

    Yun, P.

    2018-04-01

    Returned samples of martian regolith will help the science community make an informed decision in choosing the final human landing site and develop a better human mission plan to meet science criteria and IRSU and civil engineering criteria.

  19. Variables Influencing the Return on Investment in Management Training Programs: A Utility Analysis of 10 Swiss Cases

    Science.gov (United States)

    Chochard, Yves; Davoine, Eric

    2011-01-01

    In this article, we present the utility analysis approach as an alternative and promising approach to measure the return on investment in managerial training programs. This approach, linking economic value with competencies developed by trainees, enables researchers and decision-makers to compare the return on investment from different programs in…

  20. Does well maintained graft provide consistent return to play after medial ulnar collateral ligament reconstruction of the elbow joint in elite baseball players?

    Science.gov (United States)

    Park, Jin-Young; Oh, Kyung-Soo; Bahng, Seung-Chul; Chung, Seok-Won; Choi, Jin-Ho

    2014-06-01

    Several studies have reported the clinical outcomes of medial ulnar collateral ligament (MUCL) reconstruction of the elbow joint in throwing athletes, including the rate of return to sports. However, little has been known about the imaging outcomes after MUCL reconstruction. The aim of this study is to report the clinical and imaging outcomes after MUCL reconstruction using figure of eight fashion in the elite and professional baseball players. This study included 17 baseball players, who underwent MUCL reconstruction between July 2007 and May 2010. The average follow-up period was 48.6 months. Imaging assessment consisted of preoperative plain and stress radiographs, magnetic resonance imaging, and postoperative serial ultrasonography. The clinical assessments were composed of visual analogue scale (VAS) for pain, range of motion, and the Conway scale. The mean VAS score was 6.4 (range, 3 to 8) preoperatively and 2.2 (range, 0 to 4) postoperatively (p returned to sports at the same or higher level compared to preinjury. Serial ultrasonography revealed well-maintained grafts at 3 and 12 months in all of the players. Five out of 17 players showed decreased echogenecity in the common flexor tendon at 3 months, which was considered as remaining tissue swelling and resolved completely at 12 months. All grafts are well-maintained until 12-months based on the ultrasonographic findings, although only 53% of the players returned to preinjury level.

  1. Planning for positive clinical & financial returns with telemonitoring.

    Science.gov (United States)

    Wright, Kristy

    2003-10-01

    Telemonitoring is a burgeoning market in the home care industry. Making the decision to invest in telemonitoring technology can be difficult in the best situations. The financial investment is significant, the risks can be high, and the need to achieve a positive return is critical to future success. In spite of the risks, this relatively new technology in home care holds the promise for the redefinition of the industry.

  2. Decision-support tool for assessing future nuclear reactor generation portfolios

    International Nuclear Information System (INIS)

    Jain, Shashi; Roelofs, Ferry; Oosterlee, Cornelis W.

    2014-01-01

    Capital costs, fuel, operation and maintenance (O and M) costs, and electricity prices play a key role in the economics of nuclear power plants. Often standardized reactor designs are required to be locally adapted, which often impacts the project plans and the supply chain. It then becomes difficult to ascertain how these changes will eventually reflect in costs, which makes the capital costs component of nuclear power plants uncertain. Different nuclear reactor types compete economically by having either lower and less uncertain construction costs, increased efficiencies, lower and less uncertain fuel cycles and O and M costs etc. The decision making process related to nuclear power plants requires a holistic approach that takes into account the key economic factors and their uncertainties. We here present a decision-support tool that satisfactorily takes into account the major uncertainties in the cost elements of a nuclear power plant, to provide an optimal portfolio of nuclear reactors. The portfolio so obtained, under our model assumptions and the constraints considered, maximizes the combined returns for a given level of risk or uncertainty. These decisions are made using a combination of real option theory and mean–variance portfolio optimization. - Highlights: • Decisions to continue or abandon the construction of NPPs • Mean–variance portfolio of nuclear reactors • Sensitivity study of mean–variance portfolio of nuclear reactors

  3. LACK OF AWARENESS ABOUT SAFE BLOOD IN PAKISTANI POPULATION

    Directory of Open Access Journals (Sweden)

    Muhammad Usman

    2014-12-01

    Full Text Available Blood transfusion is a life saving procedure in various transfusion-dependent life threatening conditions and donation of safe blood is a prerequisite for achieving this goal. This study was designed to evaluate the awareness regarding “safe blood” in Pakistani population. This study was conducted at a large scale through a population survey. The test population was divided into two groups i.e. general population and students. The Performa was designed for a general and student population and included 20 questions related to awareness of safe blood. A total of 4900 individuals belonging to different ethnic groups were included in this population survey. Results of social survey were analyzed by using Usman and Moin awareness chart. Results of this study revealed profound unawareness about safe blood in Pakistani population. This study found lack of awareness about safe blood as a major factor that is playing a vital role in the propagation of blood borne diseases in Pakistan. To secure the recipients from blood borne complications through blood donation, it is necessary to create effective awareness about safe blood in Pakistani population.

  4. Serious shoulder injuries in professional soccer: return to participation after surgery.

    Science.gov (United States)

    Hart, David; Funk, Lennard

    2015-07-01

    An evidence base for the management and prevention of shoulder injuries in soccer is lacking. The aim of this study was to demonstrate the type, mechanism and recovery time after surgery associated with serious shoulder injuries sustained in professional soccer to build an evidence base foundation. Fifty-two professional soccer players underwent shoulder surgery for injuries sustained during match play. Of these, 25 fulfilled the inclusion criteria. Data were collected for injury mechanism and type; clinical, radiological and surgical findings and procedures; and return to full participation. Subjects were all managed by the same surgeon. Labral injuries represented the most common injury type affecting 21 (84 %) subjects; two rotator cuff (8 %) and two combined labral/rotator cuff (8 %) injuries were less common. Fourteen (56 %) subjects sustained a high-energy trauma injury in a combined abduction and external rotation position. Six (24 %) subjects sustained a low-energy trauma mechanism in variable positions, while five (20 %) had a gradual onset of symptoms. Twenty-two (88 %) subjects reported a dislocation as a feature of their presentation. All of the subjects with high- and low-energy trauma mechanisms reported a dislocation occurring at the time of injury. Eight (32 %) subjects had sustained a previous significant shoulder injury to the ipsilateral side. Goalkeepers did not sustain low-energy trauma injuries. Outfield players returned to full participation in a mean time of 11.6 weeks, while goalkeepers did so in 11.1 weeks post-surgery. Return to participation time ranged from 7 to 24 weeks with a median of 11 weeks. Professional soccer players can expect a return to participation within 12 weeks post-surgery. The majority of serious shoulder injuries in soccer occur at a positional extreme of external rotation and abduction in high-energy situations, while a significant number occur in low-energy situations away from this position. Most serious shoulder

  5. Blended E-health module on return to work embedded in collaborative occupational health care for common mental disorders: design of a cluster randomized controlled trial.

    Science.gov (United States)

    Volker, Daniëlle; Vlasveld, Moniek C; Anema, Johannes R; Beekman, Aartjan Tf; Roijen, Leona Hakkaart-van; Brouwers, Evelien Pm; van Lomwel, A Gijsbert C; van der Feltz-Cornelis, Christina M

    2013-01-01

    Common mental disorders (CMD) have a major impact on both society and individual workers, so return to work (RTW) is an important issue. In The Netherlands, the occupational physician plays a central role in the guidance of sick-listed workers with respect to RTW. Evidence-based guidelines are available, but seem not to be effective in improving RTW in people with CMD. An intervention supporting the occupational physician in guidance of sick-listed workers combined with specific guidance regarding RTW is needed. A blended E-health module embedded in collaborative occupational health care is now available, and comprises a decision aid supporting the occupational physician and an E-health module, Return@Work, to support sick-listed workers in the RTW process. The cost-effectiveness of this intervention will be evaluated in this study and compared with that of care as usual. This study is a two-armed cluster randomized controlled trial, with randomization done at the level of occupational physicians. Two hundred workers with CMD on sickness absence for 4-26 weeks will be included in the study. Workers whose occupational physician is allocated to the intervention group will receive the collaborative occupational health care intervention. Occupational physicians allocated to the care as usual group will give conventional sickness guidance. Follow-up assessments will be done at 3, 6, 9, and 12 months after baseline. The primary outcome is duration until RTW. The secondary outcome is severity of symptoms of CMD. An economic evaluation will be performed as part of this trial. It is hypothesized that collaborative occupational health care intervention will be more (cost)-effective than care as usual. This intervention is innovative in its combination of a decision aid by email sent to the occupational physician and an E-health module aimed at RTW for the sick-listed worker.

  6. Uncertain programming models for portfolio selection with uncertain returns

    Science.gov (United States)

    Zhang, Bo; Peng, Jin; Li, Shengguo

    2015-10-01

    In an indeterminacy economic environment, experts' knowledge about the returns of securities consists of much uncertainty instead of randomness. This paper discusses portfolio selection problem in uncertain environment in which security returns cannot be well reflected by historical data, but can be evaluated by the experts. In the paper, returns of securities are assumed to be given by uncertain variables. According to various decision criteria, the portfolio selection problem in uncertain environment is formulated as expected-variance-chance model and chance-expected-variance model by using the uncertainty programming. Within the framework of uncertainty theory, for the convenience of solving the models, some crisp equivalents are discussed under different conditions. In addition, a hybrid intelligent algorithm is designed in the paper to provide a general method for solving the new models in general cases. At last, two numerical examples are provided to show the performance and applications of the models and algorithm.

  7. A study on the effect of size and ratio of book value to market value on excessive return

    Directory of Open Access Journals (Sweden)

    Seyed Mohsen Tabatabaei Mozdabadi

    2012-09-01

    Full Text Available Stock market plays an important role on demonstrating economy direction and it provides good opportunities for people who wish to purchase a small portion of different firms' shares. In this paper, we propose an empirical study to measure the impact of the market size and the ratio of book value on market value on excessive return. The study gathers the necessary information from some of active stock shares traded on Tehran Stock Exchange over the period of 2010-2011. The proposed model of this paper uses linear regression analysis to investigate the relationship between the excessive return and other factors. The study divides the information into seven equal groups and fits the regression model using ordinary least square technique. The results indicate that there is a negative relationship between size and excessive return and a positive relationship between the ratio of BV/MV and excessive return. Although the results of both tests are positive, we have to be more cautious about what have reported on the second hypothesis.

  8. Return to work after early part-time sick leave due to musculoskeletal disorders: a randomized controlled trial.

    Science.gov (United States)

    Viikari-Juntura, Eira; Kausto, Johanna; Shiri, Rahman; Kaila-Kangas, Leena; Takala, Esa-Pekka; Karppinen, Jaro; Miranda, Helena; Luukkonen, Ritva; Martimo, Kari-Pekka

    2012-03-01

    The purpose of this study was to assess the effects of early part-time sick leave on return to work (RTW) and sickness absence among patients with musculoskeletal disorders. A randomized controlled trial was conducted in six occupational health units of medium- and large-size enterprises. Patients aged 18-60 years with musculoskeletal disorders (N=63) unable to perform their regular work were randomly allocated to part- or full-time sick leave. In the former group, workload was reduced by restricting work time by about a half. Remaining work tasks were modified when necessary, as specified in a "fit note" from the physician. The main outcomes were time to return to regular work activities and sickness absence during 12-month follow-up. Time to RTW sustained for ≥4 weeks was shorter in the intervention group (median 12 versus 20 days, P=0.10). Hazard ratio of RTW adjusted for age was 1.60 [95% confidence interval (95% CI) 0.98-2.63] and 1.76 (95% CI 1.21-2.56) after further adjustment for pain interference with sleep and previous sickness absence at baseline. Total sickness absence during the 12-month follow-up was about 20% lower in the intervention than the control group. Compliance with the intervention was high with no discontinuations of part-time sick leave due to musculoskeletal reasons. Early part-time sick leave may provide a faster and more sustainable return to regular duties than full-time sick leave among patients with musculoskeletal disorders. This is the first study to show that work participation can be safely increased with early part-time sick leave.

  9. The probability of return conditional on migration duration: evidence from Kosovo

    Directory of Open Access Journals (Sweden)

    Kotorri Mrika

    2017-12-01

    Full Text Available The aim of this paper is to conceptualise the migration duration decision within the expected utility maximisation framework, and from that to derive and estimate an empirical proposition. For this purpose, the conceptual framework in Kotorri (2015 is extended where households decide to return to the home country conditional on their migration duration. In the empirical analysis, the Cox proportional hazards model is employed. This analysis is the first to investigate migration duration based on a random sample stemming from the Kosovo census of population conducted in 2011. The findings suggest rather mixed support for the household approach. The hazard to return decreases with income but not nonlinearly. The results indicate that household return migration behaviour is influenced by demographic characteristics, psychic income, and political factors.

  10. Why do Dolphins Play?

    Directory of Open Access Journals (Sweden)

    Stan A. Kuczaj

    2014-05-01

    Full Text Available Play is an important aspect of dolphin life, perhaps even an essential one. Play provides opportunities for dolphin calves to practice and perfect locomotor skills, including those involved in foraging and mating strategies and behaviors. Play also allows dolphin calves to learn important social skills and acquire information about the characteristics and predispositions of members of their social group, particularly their peers. In addition to helping dolphin calves learn how to behave, play also provides valuable opportunities for them to learn how to think. The ability to create and control play contexts enables dolphins to create novel experiences for themselves and their playmates under relatively safe conditions. The behavioral variability and individual creativity that characterize dolphin play yield ample opportunities for individual cognitive development as well as social learning, and sometimes result in innovations that are reproduced by other members of the group. Although adults sometimes produce innovative play, calves are the primary source of such innovations. Calves are also more likely to imitate novel play behaviors than are adults, and so calves contribute significantly to both the creation and transmission of novel play behaviors within a group. Not unexpectedly, then, the complexity of dolphin play increases with the involvement of peers. As a result, the opportunity to observe and/or interact with other dolphin calves enhances the effects of play on the acquisition and maintenance of flexible problem solving skills, the emergence and strengthening of social and communicative competencies, and the establishment of social relationships. It seems that play may have evolved to help young dolphins learn to adapt to novel situations in both their physical and social worlds, the beneficial result being a set of abilities that increases the likelihood that an individual survives and reproduces.

  11. Aggregate Unemployment Decreases Individual Returns to Education

    Science.gov (United States)

    Ammermueller, Andreas; Kuckulenz, Anja; Zwick, Thomas

    2009-01-01

    Aggregate unemployment may affect individual returns to education through qualification-specific responses in participation and wage bargaining. This paper shows that an increase in regional unemployment by 1% decreases returns to education by 0.005 percentage points. This implies that higher skilled employees are better sheltered from labour…

  12. A decision-making framework to integrate maintenance contract conditions with critical spares management

    International Nuclear Information System (INIS)

    Godoy, David R.; Pascual, Rodrigo; Knights, Peter

    2014-01-01

    Maintenance outsourcing is a strategic driver for asset intensive industries pursuing to enhance supply chain performance. Spare parts management plays a relevant role in this premise since its significant impact on equipment availability, and hence on business success. Designing critical spares policies might therefore seriously affect maintenance contracts profitability, yet service receivers and external providers traditionally attempt to benefit separately. To coordinate both chain parties, we investigated whether the spare components pool should be managed in-house or contracted out. This paper provides a decision-making framework to efficiently integrate contractual conditions with critical spares stockholding. Using an imperfect maintenance strategy over a finite horizon, the scheme maximizes chain returns whilst evaluating the impact of an additional part to stock. As result, an original joint value – preventive interval and stock level – sets the optimal agreement to profitably allocate the components pool within the service contract. Subsidization bonuses on preventive interventions and pooling costs are also estimated to induce the service provider to adjust its policy when needed. The proposed contractual conditions motivate stakeholders to continuously improve maintenance performance and supply practices, thus obtaining higher joint benefits

  13. Returning to Work After Electrical Injuries

    DEFF Research Database (Denmark)

    Stergiou-Kita, M.; Mansfield, E.; Bayley, M.

    2014-01-01

    were conducted with individuals who experienced an electrical injury at the workplace. Participants were recruited from specialized burns rehabilitation programs in Ontario, Canada. Interviews were transcribed verbatim and thematic analysis used to analyze the qualitative interviews. Data regarding......The objective of this study was to gain an understanding of workers' experiences with returning to work, the challenges they experienced, and the supports they found most beneficial when returning to work after a workplace electrical injury. Thirteen semistructured qualitative telephone interviews...

  14. Successful return to sports in athletes following non-operative management of acute isolated posterior cruciate ligament injuries: medium-term follow-up.

    Science.gov (United States)

    Agolley, D; Gabr, A; Benjamin-Laing, H; Haddad, F S

    2017-06-01

    The aim of this study was to report the outcome of the non-operative treatment of high-grade posterior cruciate ligament (PCL) injuries, particularly Hughston grade III injuries, which have not previously been described. This was a prospective study involving 46 consecutive patients who were athletes with MRI-confirmed isolated PCL injuries presenting within four weeks of injury. All had Hughston grade II (25 athletes) or III (21 athletes) injuries. Our non-operative treatment regimen involved initial bracing, followed by an individualised rehabilitation programme determined by the symptoms and physical signs. The patients were reviewed until they had returned to sports-specific training, and were reviewed again at a mean of 5.2 years (3 to 9). The mean time to return to sports-specific training was 10.6 weeks and the mean time to return to full competitive sport was 16.4 weeks (10 to 40). A total of 42 patients (91.3%) were playing at the same or higher level of sport two years after the injury, with a mean Tegner activity score of 9 (5 to 10). At five years, 32 patients (69.5%) were playing at the same or higher level of sport, and 38 patients (82.6%) were playing at a competitive level, with a mean Tegner activity score of 9 (5 to 10). Medium-term review of a series of athletes suggests that commencing the non-operative management of isolated, Hughston grade II and III PCL injuries within four weeks of injury gives excellent functional outcomes with a high proportion returning to the same or higher level of sport. Cite this article: Bone Joint J 2017;99-B:774-8. ©2017 The British Editorial Society of Bone & Joint Surgery.

  15. Role Playing: Using Scenarios to Teach the Interrelatedness of Work and the Family.

    Science.gov (United States)

    Johnson, Julie M.

    1985-01-01

    Describes appropriate goals for the role-playing model and types of social problems amenable to its use: achieving a balance between family and work, unemployment, management of economic resources, family contributions to worker productivity, and life-cycle influences on work decisions, among others. (SK)

  16. The EU-Turkey Deal and the Safe Third Country Concept before the Greek Asylum Appeals Committees

    NARCIS (Netherlands)

    Gkliati, M.

    2017-01-01

    This article discusses the first case law issued on the EU-Turkey deal from April to June 2016, which authoritatively answers the question whether Turkey constitutes a safe third country for refugees. In 390 out of 393 decisions, the Greek Asylum Appeals Committees ruled that Safe Third Country

  17. From Safe Systems to Patient Safety

    DEFF Research Database (Denmark)

    Aarts, J.; Nøhr, C.

    2010-01-01

    for the third conference with the theme: The ability to design, implement and evaluate safe, useable and effective systems within complex health care organizations. The theme for this conference was "Designing and Implementing Health IT: from safe systems to patient safety". The contributions have reflected...... and implementation of safe systems and thus contribute to the agenda of patient safety? The contributions demonstrate how the health informatics community has contributed to the performance of significant research and to translating research findings to develop health care delivery and improve patient safety......This volume presents the papers from the fourth International Conference on Information Technology in Health Care: Socio-technical Approaches held in Aalborg, Denmark in June 2010. In 2001 the first conference was held in Rotterdam, The Netherlands with the theme: Sociotechnical' approaches...

  18. Are medical treatments for individuals and groups like single-play and multiple-play gambles?

    Directory of Open Access Journals (Sweden)

    Michael L. DeKay

    2006-11-01

    Full Text Available People are often more likely to accept risky monetary gambles with positive expected values when the gambles will be played more than once. We investigated whether this distinction between single-play and multiple-play gambles extends to medical treatments for individual patients and groups of patients. Resident physicians and medical students (extit{n} = 69 and undergraduates (extit{n} = 99 ranked 9 different flu shots and a no-flu-shot option in 1 of 4 combinations of perspective (individual patient vs. group of 1000 patients and uncertainty frame (probability vs. frequency. The rank of the no-flu-shot option (a measure of preference for treatment vs. no treatment was not significantly related to perspective or participant population. The main effect of uncertainty frame and the interaction between perspective and uncertainty frame approached significance (0.1 {extgreater} extit{p} {extgreater} 0.05, with the no-flu-shot option faring particularly poorly (treatment faring particularly well when decisions about many patients were based on frequency information. Undergraduate participants believed that the no-flu-shot option would be less attractive (treatment would be more attractive in decisions about many patients, but these intuitions were inconsistent with the actual ranks. These results and those of other studies suggest that medical treatments for individuals and groups are not analogous to single-play and multiple-play monetary gambles, perhaps because many people are unwilling to aggregate treatment outcomes over patients in the same way that they would compute net gains or losses over monetary gambles.

  19. Factors affecting return to driving post-stroke.

    LENUS (Irish Health Repository)

    Tan, K M

    2012-02-01

    BACKGROUND: Stroke can affect a person\\'s ability to drive, an important means of transportation in the developed world. AIMS: To determine percentage of patients and factors associated with return to driving post-stroke in a service with emphasis on driver assessment. METHODS: Retrospective study of patients discharged from the Stroke Service of our 470-bed teaching hospital from 1998 to 2002. RESULTS: Of 72 drivers pre-stroke, 54% recalled a driving assessment and 68% returned to driving. Younger patients (58.6 +\\/- 12.0 vs. 66.5 +\\/- 10.5, p = 0.008) with lower Modified Rankin Score (median 1 vs. 2, p = 0.0001) and normal cognition (55 vs. 43%, p = 0.45) were more likely to resume driving. More patients who were assessed returned to driving than those who were not (74 vs. 61%, p = 0.31). CONCLUSIONS: A relatively high level of return to driving can be achieved post-stroke with a pro-active approach to driver assessment and rehabilitation. A structured assessment and referral programme should be offered where appropriate.

  20. [Sense of Coherence Scale according to Antonovsky as a possible predictor for return to work for cardiac surgery intensive care patients].

    Science.gov (United States)

    Benstoem, C; Wübker, R; Lüngen, M; Breuer, T; Marx, G; Autschbach, R; Goetzenich, A; Schnoering, H

    2018-05-14

    For cardiac surgery patients who were employed prior to surgery, the return to their professional life is of special importance. In addition to medical reasons, such as pre-existing conditions, the success of the operation or postoperative course and patient-intrinsic reasons, which can be assessed with the Sense of Coherence (SOC) scale by Antonovsky, may also play a role in the question of a possible return into working life. In this study 278 patients (invasive coronary artery bypass graft surgery and/or surgery on heart valves, age work. The cohort was stratified according to the time of return to work. Subsequently, the point of maximum sensitivity and specificity was determined for the total SOC score and the prediction power was considered. Of the 278 patients, 61 questionnaires (22%) were considered as eligible and included in the analysis. Of these, 47 participants had returned to work after undergoing cardiac surgery and 14 participants had not. We observed significant differences in SOC values between both groups (146.07 ± 29.76 versus 124.29 ± 28.8, p = 0.020). Patients that returned to work within the first 6 months after surgery showed even higher SOC scores (148.56 ± 28.98, p = 0.034). Patients with an SOC score life after cardiac surgery. The SOC is an easily obtainable score that reliably predicts the probability of return to work after cardiac surgery.

  1. The Returns to Quality in Graduate Education

    Science.gov (United States)

    Stevenson, Adam

    2016-01-01

    This paper estimates the monetary return to quality in US graduate education, controlling for cognitive ability and self-selection across award level, program quality, and field-of-study. In most program types, I cannot reject the hypothesis of no returns to either degree completion or program quality. Important exceptions include master's…

  2. Price and Service Competition of Dual-Channel Supply Chain with Consumer Returns

    Directory of Open Access Journals (Sweden)

    Lili Ren

    2014-01-01

    Full Text Available Products returned by consumers are common in the retail industry and result in additional costs to both the manufacturer and the retailer. This paper proposes dual-channel supply chain models involving consumer returns policies. Also, the price and service competition between retail channel and direct channel is considered in the models. According to the models, we analyze the optimal decisions in both centralized and decentralized scenarios. Then we design a new contract, coordinate the dual-channel supply chain, and enable both the retailer and the manufacturer to be a win-win.

  3. From Planetary Boundaries to national fair shares of the global safe operating space - How can the scales be bridged?

    Science.gov (United States)

    Häyhä, Tiina; Cornell, Sarah; Lucas, Paul; van Vuuren, Detlef; Hoff, Holger

    2016-04-01

    The planetary boundaries framework proposes precautionary quantitative global limits to the anthropogenic perturbation of crucial Earth system processes. In this way, it marks out a planetary 'safe operating space' for human activities. However, decisions regarding resource use and emissions are mostly made at much smaller scales, mostly by (sub-)national and regional governments, businesses, and other local actors. To operationalize the planetary boundaries, they need to be translated into and aligned with targets that are relevant at these smaller scales. In this paper, we develop a framework that addresses the three dimension of bridging across scales: biophysical, socio-economic and ethical, to provide a consistent universally applicable approach for translating the planetary boundaries into national level context-specific and fair shares of the safe operating space. We discuss our findings in the context of previous studies and their implications for future analyses and policymaking. In this way, we help link the planetary boundaries framework to widely- applied operational and policy concepts for more robust strong sustainability decision-making.

  4. Evidence of Macroeconomic Policy Effects over Company-Sector Stock Returns

    Directory of Open Access Journals (Sweden)

    Mara Madaleno

    2014-11-01

    Full Text Available Given that stock markets may act as an economy mirror, it is explored the sensitivity of company-sector-specific stock returns to macroeconomic news reflecting different economic environments for the UK, US, Germany, Japan and Australian markets between March 1993 and February 2013 using monthly data. Results seem to indicate that portfolio investors need to be aware that movements in the market index is the best predictor to forecast stock returns of individual companies and sectors in developed economies. Sentiment influences individual company’s returns of the utilities sector, even if these are considered of limited growth and stable earnings, for UK, USA and Australia, turning investor confidence a relevant variable to be included. Information increases about industrial production have no influence on company and sector stocks, thus not affecting investor’s decision in developed countries. As for Japan, results seem to indicate that the higher the need of oil imports of a country, the higher will be the positive impact of oil price changes over company returns. Finally, the riskless interest rate has no effect on sector stock returns independently of the country under analysis. For developed economies, we confirm the finding that stocks cannot be used as a hedge against inflation.

  5. Getting home safe and sound: occupational safety and health administration at 38.

    Science.gov (United States)

    Silverstein, Michael

    2008-03-01

    The Occupational Safety and Health Act of 1970 (OSHAct) declared that every worker is entitled to safe and healthful working conditions, and that employers are responsible for work being free from all recognized hazards. Thirty-eight years after these assurances, however, it is difficult to find anyone who believes the promise of the OSHAct has been met. The persistence of preventable, life-threatening hazards at work is a failure to keep a national promise. I review the history of the Occupational Safety and Health Administration and propose measures to better ensure that those who go to work every day return home safe and sound. These measures fall into 6 areas: leverage and accountability, safety and health systems, employee rights, equal protection, framing, and infrastructure.

  6. Concussions and Risk Within Cultural Contexts of Play.

    Science.gov (United States)

    Torres Colón, Gabriel Alejandro; Smith, Sharia; Fucillo, Jenny

    2017-06-01

    Concussions are a type of traumatic injury caused by a jolting of the brain that disrupts normal brain function, and multiple concussions can lead to serious long-term health consequences. In this article, we examine the relationship between college students' understanding of concussions and their willingness to continue playing despite the possibility of sustaining multiple head injuries. We use a mixed-methods approach that includes participant observation, cultural domain analysis, and structured interviews. Our research finds that students hold a robust cognitive understanding of concussion yet discursively frame concussions as skeletomuscular injuries. More importantly, students affirm the importance of playing sports for themselves and others, so their decisions to risk multiple concussions must be understood within cultural and biocultural contexts of meaningful social play. We suggest that peoples' decision to risk multiple head injuries should be understood as a desire for meaningful social play rather than an uninformed health risk.

  7. PSA as a tool for decision making

    Energy Technology Data Exchange (ETDEWEB)

    Niehaus, F; Lederman, L

    1986-05-01

    The question on ''How safe is safe enough'' is being responded presently by deterministic criteria. Probabilistic criteria in support to more rational and less emotional decisions in regulatory and licensing issues, rationalization of resource allocation and research prioritization, among others, have a potential which is only marginally being explored. This paper discussed PSA limitations and proposes three areas for the use of PSA in decision making, namely: preventing accidents, mitigating accidents, and defining regulatory requirements. Current activities of the International Atomic Energy Agency in these areas are mentioned. PSA studies depict clearly the uncertainties and this is viewed as a positive aspect, which is unique to the use of probabilistic methods.

  8. A Comparative Study of CAPM and Seven Factors Risk Adjusted Return Model

    Directory of Open Access Journals (Sweden)

    Madiha Riaz Bhatti

    2014-12-01

    Full Text Available This study is a comparison and contrast of the predictive powers of two asset pricing models: CAPM and seven factor risk-return adjusted model, to explain the cross section of stock rate of returns in the financial sector listed at Karachi Stock Exchange (KSE. To test the models daily returns from January 2013 to February 2014 have been taken and the excess returns of portfolios are regressed on explanatory variables. The results of the tested models indicate that the models are valid and applicable in the financial market of Pakistan during the period under study, as the intercepts are not significantly different from zero. It is consequently established from the findings that all the explanatory variables explain the stock returns in the financial sector of KSE. In addition, the results of this study show that addition of more explanatory variables to the single factor CAPM results in reasonably high values of R2. These results provide substantial support to fund managers, investors and financial analysts in making investment decisions.

  9. Safety validation of decision trees for hepatocellular carcinoma.

    Science.gov (United States)

    Wang, Xian-Qiang; Liu, Zhe; Lv, Wen-Ping; Luo, Ying; Yang, Guang-Yun; Li, Chong-Hui; Meng, Xiang-Fei; Liu, Yang; Xu, Ke-Sen; Dong, Jia-Hong

    2015-08-21

    To evaluate a different decision tree for safe liver resection and verify its efficiency. A total of 2457 patients underwent hepatic resection between January 2004 and December 2010 at the Chinese PLA General Hospital, and 634 hepatocellular carcinoma (HCC) patients were eligible for the final analyses. Post-hepatectomy liver failure (PHLF) was identified by the association of prothrombin time 50 μmol/L (the "50-50" criteria), which were assessed at day 5 postoperatively or later. The Swiss-Clavien decision tree, Tokyo University-Makuuchi decision tree, and Chinese consensus decision tree were adopted to divide patients into two groups based on those decision trees in sequence, and the PHLF rates were recorded. The overall mortality and PHLF rate were 0.16% and 3.0%. A total of 19 patients experienced PHLF. The numbers of patients to whom the Swiss-Clavien, Tokyo University-Makuuchi, and Chinese consensus decision trees were applied were 581, 573, and 622, and the PHLF rates were 2.75%, 2.62%, and 2.73%, respectively. Significantly more cases satisfied the Chinese consensus decision tree than the Swiss-Clavien decision tree and Tokyo University-Makuuchi decision tree (P decision trees. The Chinese consensus decision tree expands the indications for hepatic resection for HCC patients and does not increase the PHLF rate compared to the Swiss-Clavien and Tokyo University-Makuuchi decision trees. It would be a safe and effective algorithm for hepatectomy in patients with hepatocellular carcinoma.

  10. Maternal perspectives on postpartum return to the workplace.

    Science.gov (United States)

    Nichols, Mary R; Roux, Gayle M

    2004-01-01

    To describe maternal perceptions about postpartum return to the workplace. The research framework was McCubbin and McCubbin's Resiliency Model of Family Stress, Adjustment, and Adaptation. Employed, postpartum women, who resided in six different states, were recruited from day care and primary care settings to participate in this descriptive study. Seventy-four employed, married women, who returned to the workplace within one year after childbirth. As part of a larger study, perceptions about combining multiple roles after return to the workplace are the focus for this report. Participants responded to open-ended questions about their return to the workplace during the first months after giving birth. Content analysis of those responses resulted in two major categories, Resiliency Challenges: Negative Aspects (role conflict/overload, family stress, family/child issues, finances, psychosocial issues) and Resiliency Building: Positive Aspects (social support, maternal role satisfaction, positive adaptation, career role satisfaction). The data support the premise that employed women view returning to the workforce as having more challenges than they expected because the experience was viewed as being mostly negative. Preparing for return to the workplace is an important, but neglected, topic that needs to be addressed and defined more clearly in the literature. Therefore, future research is needed to identify resources and interventions that will help women experience fewer challenges associated with postpartum employment.

  11. UQ for Decision Making: How (at least five) Kinds of Probability Might Come Into Play

    Science.gov (United States)

    Smith, L. A.

    2013-12-01

    In 1959 IJ Good published the discussion "Kinds of Probability" in Science. Good identified (at least) five kinds. The need for (at least) a sixth kind of probability when quantifying uncertainty in the context of climate science is discussed. This discussion brings out the differences in weather-like forecasting tasks and climate-links tasks, with a focus on the effective use both of science and of modelling in support of decision making. Good also introduced the idea of a "Dynamic probability" a probability one expects to change without any additional empirical evidence; the probabilities assigned by a chess playing program when it is only half thorough its analysis being an example. This case is contrasted with the case of "Mature probabilities" where a forecast algorithm (or model) has converged on its asymptotic probabilities and the question hinges in whether or not those probabilities are expected to change significantly before the event in question occurs, even in the absence of new empirical evidence. If so, then how might one report and deploy such immature probabilities in scientific-support of decision-making rationally? Mature Probability is suggested as a useful sixth kind, although Good would doubtlessly argue that we can get by with just one, effective communication with decision makers may be enhanced by speaking as if the others existed. This again highlights the distinction between weather-like contexts and climate-like contexts. In the former context one has access to a relevant climatology (a relevant, arguably informative distribution prior to any model simulations), in the latter context that information is not available although one can fall back on the scientific basis upon which the model itself rests, and estimate the probability that the model output is in fact misinformative. This subjective "probability of a big surprise" is one way to communicate the probability of model-based information holding in practice, the probability that the

  12. Implementation evaluation of steering teens safe: engaging parents to deliver a new parent-based teen driving intervention to their teens.

    Science.gov (United States)

    Ramirez, Marizen; Yang, Jingzhen; Young, Tracy; Roth, Lisa; Garinger, Anne; Snetselaar, Linda; Peek-Asa, Corinne

    2013-08-01

    Parents play a fundamental role in teaching their children safe driving skills to reduce risk of motor vehicle crashes, the leading cause of death for teens. Steering Teens Safe is a new parent-based intervention that equips parents with communication skills to talk about, demonstrate, and practice safe driving behaviors and skills with their teens. This implementation evaluation focuses on a sample of 83 parents who delivered Steering Teens Safe to their teens. One-, 2- and 3-month follow-up assessments were conducted with intervention parents to evaluate the self-reported quantity and quality of talking about, demonstrating, and practicing safe driving goals with teens; perceived success and benefit of the program; and barriers to implementation. Over 3 months of follow-up, parents discussed driving goals with their teens for a median of 101.5 minutes. The most frequently addressed topics were general safety principles, including distracted driving, driving in bad weather, wearing a seat belt, and being a safe passenger. Parents spent a median of 30 minutes practicing safe driving skills such as changing lanes. Sixty-seven percent of parents talked to their children about rural road safety, but just 36% demonstrated and half practiced these skills with their teens. Barriers to implementation include time and opportunity barriers and resistant attitudes of their teens. However, barriers neither affected frequency of engagement nor parents' perceived benefit and comfort in delivering the program. Parents with time/opportunity barriers also had higher practice and demonstration times than parents without these barriers. Findings indicate high acceptability among parent implementers and promise for real-world delivery. Future studies are needed to assess intervention impact.

  13. Return to work and its relation to financial distress among Iranian cancer survivors.

    Science.gov (United States)

    Ghasempour, Mostafa; Rahmani, Azad; Davoodi, Arefeh; Sheikhalipour, Zahra; Ziaeei, Jamal Evazie; Abri, Fariba

    2015-01-01

    Return to work after treatment completion is important for both cancer survivors and society. Financial distress is one of the factors that may influence the return to work in cancer survivors. However, this relationship has not been well investigated. This study aimed to determine the rate of return to work and its relation to financial distress among Iranian cancer survivors. This descriptive-correlational study was undertaken among 165 cancer survivors who completed their initial treatments and had no signs of active cancer. The Return to Work questionnaire and Financial Distress/Financial Well-Being Scale were used for data collection. Data were analyzed using SPSS statistical software. After initial treatments, 120 cancer survivors (72%) had returned to work, of which 50 patients (42%) had returned to full-time work and 70 (58%) reduced their work hours and returned to part-time work. Cancer survivors also reported high levels of financial distress. In addition, the financial distress was lower among patients who had returned completely to work, in comparison to patients who had quit working for cancer-related reasons (p=0.001) or returned to work as part-time workers (p=0.001). The findings showed that a high percent of Iranian cancer survivors had not returned to their jobs or considerably reduced working hours after treatment completion. Accordingly, due to high levels of financial distress experienced by participants and its relation to return to work, designing rehabilitation programs to facilitate cancer survivor return to work should be considered.

  14. Factors Affecting Farmers’ Decision to Enter Agricultural Cooperatives Using Random Utility Model in the South Eastern Anatolian Region of Turkey

    Directory of Open Access Journals (Sweden)

    Bahri Karlı

    2006-10-01

    Full Text Available Farmers’ decision and perceptions to be a member of agricultural cooperatives in the South Eastern Anatolian Region were investigated. Factors affecting the probability of joining the agricultural cooperatives were determined using binary logit model. The model released that most of variables such as education, high communication, log of gross income, farm size, medium and high technology variables play important roles in determining the probability of entrance. Small farmers are likely expected to join the agricultural cooperatives than the wealthier farmers are. Small farmers may wish to benefit cash at hand, input subsidies, and services provided by the agricultural cooperatives since the risks associated with intensive high-returning crops are high. Some important factors playing pole role in abstention of farmers towards agricultural cooperatives are gross income and some social status variables. In addition, conservative or orthodox farmers are less likely to join agricultural cooperatives than moderate farmers are. We also found that the direct government farm credit programs mainly should be objected to providing farmers to better access to capital markets and creating the opportunity to use with allocation of capital inputs via using modern technology.

  15. Women's attitudes to safe-induced abortion in Iran: Findings from a pilot survey.

    Science.gov (United States)

    Aghakhani, Nader; Cleary, Michelle; Zarei, Abbas; Lopez, Violeta

    2018-01-01

    To explore attitudes to safe-induced abortion among pregnant women in Iran. In Islamic teachings, abortion is generally forbidden. However in specific circumstances, abortion may be permitted and currently, in Iran, the law allows termination of pregnancy only if three specialist physicians confirm that the pregnancy outcome may be harmful for the mother during pregnancy or after birth. Pilot, descriptive survey. A 15-item structured questionnaire focusing on attitudes to safe-induced abortion was developed and pilot tested. Participants were pregnant women who were referred to the Legal Medical Centre (July-December 2015) to obtain permission for abortion. On obtaining their informed consent, the women were asked to respond to each item if they agreed (Yes) or disagreed (No). Only their age, education, employment, marital status and religion were obtained. Of the 80 survey participants referred for a safe-induced abortion, 90% were carrying foetuses with a diagnosed congenital malformation and 10% were experiencing complications of pregnancy that endangered their health. The majority of women (85%) perceived abortion to be dangerous to health; 86% indicated that partners should be involved in decision-making about abortion, while 83% believed that public health officials should have complete control of abortion law. There is a need to improve women's and couples' awareness and practice of effective contraceptive methods. Further research is needed to better understand the complex issues that lead to unintended pregnancies and abortions considering religious beliefs and cultural and legal contexts. © 2017 John Wiley & Sons Ltd.

  16. Nurses' views about returning to practice after a career break.

    Science.gov (United States)

    Durand, Mary Alison; Randhawa, Gurch

    Shortages in nursing staff have led to recruitment campaigns targeting nurses who have left the profession. The present study explored reasons why career-break nurses decide for or against a return to practice, as well as perceptions of nursing following return. Semistructured interview were conducted with 24 nurses who had returned recently to the profession and 28 nurses on a "career break". Findings revealed that those who returned did so when their personal circumstances allowed, and half returned as bank nurses in order to work flexible, family-friendly hours. Some non-returners reported that they could not afford to return because of childcare costs. Although still a caring one, the nurse's role is seen by returners as becoming increasingly technologically and administratively demanding. Flexibility with regard to working practices, increased salaries and demonstrating that it values its staff, were highlighted by interviewees generally as priority issues for the NHS if it wishes to recruit career-break nurses.

  17. Reinforcement Learning in Repeated Portfolio Decisions

    OpenAIRE

    Diao, Linan; Rieskamp, Jörg

    2011-01-01

    How do people make investment decisions when they receive outcome feedback? We examined how well the standard mean-variance model and two reinforcement models predict people's portfolio decisions. The basic reinforcement model predicts a learning process that relies solely on the portfolio's overall return, whereas the proposed extended reinforcement model also takes the risk and covariance of the investments into account. The experimental results illustrate that people reacted sensitively to...

  18. An Empirical Analysis Of Stock Returns And Volatility: The Case Of Stock Markets From Central And Eastern Europe

    Directory of Open Access Journals (Sweden)

    Okičić Jasmina

    2015-04-01

    Full Text Available The main goal of this paper is to investigate the behaviour of stock returns in the case of stock markets from Central and Eastern Europe (CEE, focusing on the relationship between returns and conditional volatility. Since there is relatively little empirical research on the volatility of stock returns in underdeveloped stock markets, with even fewer studies on markets in the transitional economies of the CEE region, this paper is designed to shed some light on the econometric modelling of the conditional mean and volatility of stock returns from this region. The results presented in this paper provide confirmatory evidence that ARIMA and GARCH processes provide parsimonious approximations of mean and volatility dynamics in the case of the selected stock markets. There is overwhelming evidence corroborating the existence of a leverage effect, meaning that negative shocks increase volatility more than positive shocks do. Since financial decisions are generally based upon the trade-off between risk and return, the results presented in this paper will provide valuable information in decision making for those who are planning to invest in stock markets from the CEE region.

  19. A probabilistic approach to cost and duration uncertainties in environmental decisions

    International Nuclear Information System (INIS)

    Boak, D.M.; Painton, L.

    1996-01-01

    Sandia National Laboratories has developed a method for analyzing life-cycle costs using probabilistic cost forecasting and utility theory to determine the most cost-effective alternatives for safe interim storage of radioactive materials. The method explicitly incorporates uncertainties in cost and storage duration by (1) treating uncertain component costs as random variables represented by probability distributions, (2) treating uncertain durations as chance nodes in a decision tree, and (3) using stochastic simulation tools to generate life-cycle cost forecasts for each storage alternative. The method applies utility functions to the forecasted costs to incorporate the decision maker's risk preferences, making it possible to compare alternatives on the basis of both cost and cost utility. Finally, the method is used to help identify key contributors to the uncertainty in forecasted costs to focus efforts aimed at reducing cost uncertainties. Where significant cost and duration uncertainties exist, and where programmatic decisions must be made despite these uncertainties, probabilistic forecasting techniques can yield important insights into decision alternatives, especially when used as part of a larger decision analysis framework and when properly balanced with deterministic analyses. Although the method is built around an interim storage example, it is potentially applicable to many other environmental decision problems

  20. Heads or tails: do stranded fish (mosquitofish, Gambusia affinis know where they are on a slope and how to return to the water?

    Directory of Open Access Journals (Sweden)

    Robert J Boumis

    Full Text Available Aquatic vertebrates that emerge onto land to spawn, feed, or evade aquatic predators must return to the water to avoid dehydration or asphyxiation. How do such aquatic organisms determine their location on land? Do particular behaviors facilitate a safe return to the aquatic realm? In this study, we asked: will fully-aquatic mosquitofish (Gambusia affinis stranded on a slope modulate locomotor behavior according to body position to facilitate movement back into the water? To address this question, mosquitofish (n = 53 were placed in four positions relative to an artificial slope (30° inclination and their responses to stranding were recorded, categorized, and quantified. We found that mosquitofish may remain immobile for up to three minutes after being stranded and then initiate either a "roll" or a "leap". During a roll, mass is destabilized to trigger a downslope tumble; during a leap, the fish jumps up, above the substrate. When mosquitofish are oriented with the long axis of the body at 90° to the slope, they almost always (97% initiate a roll. A roll is an energetically inexpensive way to move back into the water from a cross-slope body orientation because potential energy is converted back into kinetic energy. When placed with their heads toward the apex of the slope, most mosquitofish (>50% produce a tail-flip jump to leap into ballistic flight. Because a tail-flip generates a caudually-oriented flight trajectory, this locomotor movement will effectively propel a fish downhill when the head is oriented up-slope. However, because the mass of the body is elevated against gravity, leaps require more mechanical work than rolls. We suggest that mosquitofish use the otolith-vestibular system to sense body position and generate a behavior that is "matched" to their orientation on a slope, thereby increasing the probability of a safe return to the water, relative to the energy expended.

  1. Bereaved Employee: Returning to Work

    Science.gov (United States)

    ... Work Working Through Grief About Us The Bereaved Employee: Returning to Work By Helen Fitzgerald, CT After ... One employer called a grief therapist to help employees after a co-worker reported the death of ...

  2. After a career break: supporting women returning to ICT

    OpenAIRE

    Herman, Clem

    2011-01-01

    This is a case study of an initiative to support women returning to ICT after a career break, which was run in the UK and Ireland between 2005 and 2011.The article starts by outlining how the UK government’s concern about women failing return to SET careers led to the setting up of a national campaign (RETURN) to address this issue. A brief overview of previous research about women’s reasons for leaving ICT employment and the difficulties and barriers they encounter in returning to work, sets...

  3. The Effect of Exit Strategy on Optimal Portfolio Selection with Birandom Returns

    Directory of Open Access Journals (Sweden)

    Guohua Cao

    2013-01-01

    Full Text Available The aims of this paper are to use a birandom variable to denote the stock return selected by some recurring technical patterns and to study the effect of exit strategy on optimal portfolio selection with birandom returns. Firstly, we propose a new method to estimate the stock return and use birandom distribution to denote the final stock return which can reflect the features of technical patterns and investors' heterogeneity simultaneously; secondly, we build a birandom safety-first model and design a hybrid intelligent algorithm to help investors make decisions; finally, we innovatively study the effect of exit strategy on the given birandom safety-first model. The results indicate that (1 the exit strategy affects the proportion of portfolio, (2 the performance of taking the exit strategy is better than when the exit strategy is not taken, if the stop-loss point and the stop-profit point are appropriately set, and (3 the investor using the exit strategy become conservative.

  4. What stock market returns to expect for the future?

    Science.gov (United States)

    Diamond, P A

    2000-01-01

    In evaluating proposals for reforming Social Security that involve stock investments, the Office of the Chief Actuary (OCACT) has generally used a 7.0 percent real return for stocks. The 1994-96 Advisory Council specified that OCACT should use that return in making its 75-year projections of investment-based reform proposals. The assumed ultimate real return on Treasury bonds of 3.0 percent implies a long-run equity premium of 4.0 percent. There are two equity-premium concepts: the realized equity premium, which is measured by the actual rates of return; and the required equity premium, which investors expect to receive for being willing to hold available stocks and bonds. Over the past two centuries, the realized premium was 3.5 percent on average, but 5.2 percent for 1926 to 1998. Some critics argue that the 7.0 percent projected stock returns are too high. They base their arguments on recent developments in the capital market, the current high value of the stock market, and the expectation of slower economic growth. Increased use of mutual funds and the decline in their costs suggest a lower required premium, as does the rising fraction of the American public investing in stocks. The size of the decrease is limited, however, because the largest cost savings do not apply to the very wealthy and to large institutional investors, who hold a much larger share of the stock market's total value than do new investors. These trends suggest a lower equity premium for projections than the 5.2 percent of the past 75 years. Also, a declining required premium is likely to imply a temporary increase in the realized premium because a rising willingness to hold stocks tends to increase their price. Therefore, it would be a mistake during a transition period to extrapolate what may be a temporarily high realized return. In the standard (Solow) economic growth model, an assumption of slower long-run growth lowers the marginal product of capital if the savings rate is constant

  5. Loss-Averse Retailer’s Optimal Ordering Policies for Perishable Products with Customer Returns

    Directory of Open Access Journals (Sweden)

    Xu Chen

    2014-01-01

    Full Text Available We investigate the loss-averse retailer’s ordering policies for perishable product with customer returns. With the introduction of the segmental loss utility function, we depict the retailer’s loss aversion decision bias and establish the loss-averse retailer’s ordering policy model. We derive that the loss-averse retailer’s optimal order quantity with customer returns exists and is unique. By comparison, we obtain that both the risk-neutral and the loss-averse retailer’s optimal order quantities depend on the inventory holding cost and the marginal shortage cost. Through the sensitivity analysis, we also discuss the effect of loss-averse coefficient and the ratio of return on the loss-averse retailer’s optimal order quantity with customer returns.

  6. A Follow-up Study on Return to Work in the Year After Reporting an Occupational Injury Stratified by Outcome of the Workers' Compensation System

    DEFF Research Database (Denmark)

    Rudbeck, Marianne; Johansen, Jens Peter; Omland, Øyvind

    2017-01-01

    benefits were granted by the municipalities independently of any compensation claim if sick-listed. RESULTS: Claimants with ongoing claims were the group with the largest proportion remaining on disability benefits. Claimants with rejected claims returned to work at the same rate (occupational disease......) or slower (industrial accident) compared to claimants with recognized claim without compensation the subsequent year and at a faster rate after decision. CONCLUSIONS: Compensation claims and proceedings of the workers' compensation system probably increase time to return to work, other factors as health...

  7. Collaborative Platforms Aid Emergency Decision Making

    Science.gov (United States)

    2013-01-01

    Terra. Aqua. Cloudsat. Landsat. NASA runs and partners in many missions dedicated to monitoring the Earth, and the tools used in these missions continuously return data on everything from shifts in temperature to cloud formation to pollution levels over highways. The data are of great scientific value, but they also provide information that can play a critical role in decision making during times of crisis. Real-time developments in weather, wind, ocean currents, and numerous other conditions can have a significant impact on the way disasters, both natural and human-caused, unfold. "NASA has long recognized the need to make its data from real-time sources compatible and accessible for the purposes of decision making," says Michael Goodman, who was Disasters Program manager at NASA Headquarters from 2009-2012. "There are practical applications of NASA Earth science data, and we d like to accelerate the use of those applications." One of the main obstacles standing in the way of eminently practical data is the fact that the data from different missions are collected, formatted, and stored in different ways. Combining data sets in a way that makes them useful for decision makers has proven to be a difficult task. And while the need for a collaborative platform is widely recognized, very few have successfully made it work. Dave Jones, founder and CEO of StormCenter Communications Inc., which consults with decision makers to prepare for emergencies, says that "when I talk to public authorities, they say, If I had a nickel for every time someone told me they had a common operating platform, I d be rich. But one thing we ve seen over the years is that no one has been able to give end users the ability to ingest NASA data sets and merge them with their own."

  8. Leaving from and returning to nursing practice: contributing factors.

    Science.gov (United States)

    Jamieson, Isabel; Taua, Chris

    2009-07-01

    Many nurses leave nursing and never return. Others return after a period of time. Given the global shortage of nurses a better understanding of these movements is needed. The present study focused on nurses who had been out of nursing for more than five years, and explored factors that influenced their leaving and return to practice. All the nurses who had undertaken a Competency Assessment Programme at a given New Zealand tertiary institution during 2005 were invited to participate. Of the 70 questionnaires mailed out 32 (44.5%) were completed and returned. Quantitative data were analysed using Microsoft Excel, and the qualitative data were coded and analysed by means of content analysis. For each, leaving and returning, three key issues emerged. Nurses left for personal reasons, to seek a career change, or because of poor working conditions. They returned when they had the personal freedom to do so, for fiscal reasons, or because they were motivated by some sense of unfinished business. These findings indicate that it is important for educators involved with Competency Assessment Programmes to collaborate with employers in ensuring that there are opportunities for re-entry to positive work environments, with a degree of flexibility that suits the demographic characteristics of those nurses returning to practice.

  9. Application of Markowitz model in analysing risk and return a case study of BSE stock

    Directory of Open Access Journals (Sweden)

    Manas Pandey

    2012-03-01

    Full Text Available In this paper the optimal portfolio formation using real life data subject to two different constraint sets is attempted. It is a theoretical framework for the analysis of risk return choices. Decisions are based on the concept of efficient portfolios. Markowitz portfolio analysis gives as output an efficient frontier on which each portfolio is the highest return earning portfolio for a specified level of risk. The investors can reduce their risks and can maximize their return from the investment, The Markowitz portfolio selections were obtained by solving the portfolio optimization problems to get maximum total returns, constrained by minimum allowable risk level. Investors can get lot of information knowledge about how to invest when to invest and why to invest in the particular portfolio. It basically calculates the standard deviation and returns for each of the feasible portfolios and identifies the efficient frontier, the boundary of the feasible portfolios of increasing returns

  10. Choosing and Using Safe Water Technologies: Evidence from a Field Experiment in Kenya

    OpenAIRE

    Luoto, Jill Emily

    2010-01-01

    This dissertation examines the decision-making of poor rural Kenyan households with respect to the adoption of point-of-use (POU) safe water technologies designed to expand access to safe drinking water in the developing world. Low-cost POU products such as chlorine and filters substantially reduce diarrhea, which kills two million children in poor countries each year. Nevertheless, POU products remain little used in many parts of the developing world, even when they are widely available at s...

  11. Playing to Investigate the Relationship Between Achievement and the Perception of learning

    Directory of Open Access Journals (Sweden)

    Steven Boyd

    2018-03-01

    Full Text Available This paper investigates the relationship between achievement and the perception of enjoyment and learning through the serious game, Playing Property.Playing Property is an audience response game forming the basis of workshops to engage junior high students, of 13 to 15 years old, and enhance their knowledge of property investment. The investigation extends to the analysis of trends in audience response decisions from 14 workshops, conducted over three consecutive years.Emerging findings present significant associations between enjoyment and the perception of learning. The relationship between achievement, measured in accumulated game score, and the responders’ perception of enjoyment is present but less significant. Further analysis supports a deeper relationship between play and learning, one where competition and other game play attributes are more effective in engagement than point scoring or rewarding.A more detailed evaluation may include staged testing of what may be learned and how well that learning endures, in comparison with other forms of teaching.

  12. A scientist's guide to engaging decision makers

    Science.gov (United States)

    Vano, J. A.

    2015-12-01

    Being trained as a scientist provides many valuable tools needed to address society's most pressing environmental issues. It does not, however, provide training on one of the most critical for translating science into action: the ability to engage decision makers. Engagement means different things to different people and what is appropriate for one project might not be for another. However, recent reports have emphasized that for research to be most useful to decision making, engagement should happen at the beginning and throughout the research process. There are an increasing number of boundary organizations (e.g., NOAA's Regional Integrated Sciences and Assessment program, U.S. Department of the Interior's Climate Science Centers) where engagement is encouraged and rewarded, and scientists are learning, often through trial and error, how to effectively include decision makers (a.k.a. stakeholders, practitioners, resource managers) in their research process. This presentation highlights best practices and practices to avoid when scientists engage decision makers, a list compiled through the personal experiences of both scientists and decision makers and a literature review, and how this collective knowledge could be shared, such as through a recent session and role-playing exercise given at the Northwest Climate Science Center's Climate Boot Camp. These ideas are presented in an effort to facilitate conversations about how the science community (e.g., AGU researchers) can become better prepared for effective collaborations with decision makers that will ultimately result in more actionable science.

  13. An analysis of the relation between return and beta for portfolios of Turkish equities

    Directory of Open Access Journals (Sweden)

    Salvatore J. Terregrossa

    2016-12-01

    Full Text Available The present study investigates the possible existence of a systematic relation between beta and excess-return for portfolios of Turkish equities. In the process, no systematic relation is found between beta and realized portfolio excess-return, in an unconditional sense. However, the study does find a systematic relation between realized portfolio excess-return and beta, conditioned upon the sign of realized market-portfolio excess-return. Moreover, an even stronger systematic relation is found between realized portfolio excess-return and beta, conditioned not only upon the sign, but also the magnitude of realized market-portfolio excess-return, with the estimation of the security market plane (SMP model. The study has several useful implications for portfolio managers. Firstly, the empirical findings strongly suggest that employment of the SMP model may generate more accurate estimations of expected asset-return, compared with straightforward application of the capital asset pricing model (CAPM. Enhanced accuracy of expected asset-return, in turn, may lead to more accurate appraisals of asset value, resulting in more profitable investment opportunities and decisions. Employment of the SMP model may thus lead to enhanced efficient-portfolio development, by leading to construction of portfolios with greater expected-return, for a given class of quantifiable-risk.

  14. Virus Alert: Ten Steps to Safe Computing.

    Science.gov (United States)

    Gunter, Glenda A.

    1997-01-01

    Discusses computer viruses and explains how to detect them; discusses virus protection and the need to update antivirus software; and offers 10 safe computing tips, including scanning floppy disks and commercial software, how to safely download files from the Internet, avoiding pirated software copies, and backing up files. (LRW)

  15. The Evaluation of Role-Playing in the Context of Teaching Climate Change

    Science.gov (United States)

    Belova, Nadja; Eilks, Ingo; Feierabend, Timo

    2015-01-01

    Role-plays are a common pedagogical tool in the Social Sciences. As an imitation of societal practices, role-plays are thought to support the development of argumentation and decision-making skills among learners. However, argumentation and decision making are also goals in science education in general and in socioscientific issues-oriented…

  16. Dual Criteria Decisions

    DEFF Research Database (Denmark)

    Andersen, Steffen; Harrison, Glenn W.; Lau, Morten Igel

    2014-01-01

    The most popular models of decision making use a single criterion to evaluate projects or lotteries. However, decision makers may actually consider multiple criteria when evaluating projects. We consider a dual criteria model from psychology. This model integrates the familiar tradeoffs between...... to the clear role that income thresholds play in such decision making, but does not rule out a role for tradeoffs between risk and utility or probability weighting....

  17. Estimating the Accuracy of the Return on Investment (ROI Performance Evaluations

    Directory of Open Access Journals (Sweden)

    Alexei Botchkarev

    2015-12-01

    Full Text Available Return on Investment (ROI is one of the most popular performance measurement and evaluation metrics. ROI analysis (when applied correctly is a powerful tool in comparing solutions and making informed decisions on the acquisitions of information systems. The purpose of this study is to provide a systematic research of the accuracy of the ROI evaluations in the context of information systems implementations. Measurements theory and error analysis, specifically propagation of uncertainties methods, were used to derive analytical expressions for ROI errors. Monte Carlo simulation methodology was used to design and deliver a quantitative experiment to model costs and returns estimating errors and calculate ROI accuracies. Spreadsheet simulation (Microsoft Excel spreadsheets enhanced with Visual Basic for Applications was used to implement Monte Carlo simulations. The main contribution of the study is that this is the first systematic effort to evaluate ROI accuracy. Analytical expressions have been derived for estimating errors of the ROI evaluations. Results of the Monte Carlo simulation will help practitioners in making informed decisions based on explicitly stated factors influencing the ROI uncertainties.

  18. Spondylolysis in Active Adolescents: Expediting Return to Play.

    Science.gov (United States)

    Moeller, James L.; Rifat, Sami F.

    2001-01-01

    Spondylolysis is a common cause of back pain in active adolescents. For prolonged pain, an aggressive workup and specific diagnosis are needed. History and physical exam findings are not diagnostic. Tests beyond radiographs (computed tomography, bone scans, and magnetic resonance imaging) are necessary to determine metabolic activity and full…

  19. Safe sex

    Science.gov (United States)

    ... sex; Sexually transmitted - safe sex; GC - safe sex; Gonorrhea - safe sex; Herpes - safe sex; HIV - safe sex; ... contact. STIs include: Chlamydia Genital herpes Genital warts Gonorrhea Hepatitis HIV HPV Syphilis STIs are also called ...

  20. Return to the workforce following coronary artery bypass grafting

    DEFF Research Database (Denmark)

    Butt, Jawad H; Rørth, Rasmus; Kragholm, Kristian

    2018-01-01

    Background Returning to the workforce after coronary artery bypass grafting (CABG) holds important socioeconomic consequences not only for patients, but the society as well. Yet data on this issue are limited. We examined return to the workforce and associated factors in patients of working age.......0%) patients had returned to the workforce, 614 (10.2%) were on paid sick leave, 267 (4.4%) received disability pension, 250 (4.1%) were on early retirement, 57 (0.9%) had died, and 16 (0.3%) had emigrated. Factors associated with return to the workforce were identified using multivariable logistic regression...

  1. Advising Your Elderly Patients Concerning Safe Exercising

    OpenAIRE

    Myers, Anita

    1987-01-01

    With the emergence of physical activity programs geared specifically to senior citizens, family physicians will increasingly be called on to provide advice or approval concerning their patients' suitability for participation. In addition, family physicians have been identified as having a key role to play in the promotion of exercise for sedentary older adults. To assist the family practitioner in advising elderly patients concerning safe exercise patterns, this article discusses the document...

  2. Sandboxes, Loose Parts, and Playground Equipment: A Descriptive Exploration of Outdoor Play Environments

    Science.gov (United States)

    Olsen, Heather; Smith, Brandy

    2017-01-01

    The purpose of the study was to examine outdoor environments to understand whether or not young children had access to play materials and loose parts to enhance their playful experiences. This study sought to gather the availability of SAFE and quality play opportunities in early childhood outdoor environments. The study took place in one state of…

  3. USING THE SAFE SYSTEM APPROACH TO KEEP OLDER DRIVERS SAFELY MOBILE

    Directory of Open Access Journals (Sweden)

    Jim LANGFORD

    2006-01-01

    Full Text Available In 2003, Australian road transport jurisdictions collectively accepted that the greatest road safety gains would be achieved through adopting a Safe System approach, derived from Sweden's Vision Zero and the Netherlands' Sustainable Safety strategies. A key objective of all three approaches is to manage vehicles, the road infrastructure, speeds, road users and the interactions between these components, to ensure that in the event of crashes, crash energies will remain at levels that minimize the probability of death and serious injury. Older drivers pose a particular challenge to the Safe System approach, given particularly their greater physical frailty, their driving patterns and for some at least, their reduced fitness to drive. This paper has analyzed the so-called ‘older driver problem’ and identified a number of key factors underpinning their crash levels, for which countermeasures can be identified and implemented within a Safe System framework. The recommended countermeasures consist of: (1 safer roads, through a series of design improvements particularly governing urban intersections; (2 safer vehicles, through both the promotion of crashworthiness as a critical consideration when purchasing a vehicle and the wide use of developed and developing ITS technologies; (3 safer speeds especially at intersections; and (4 safer road users, through both improved assessment procedures to identify the minority of older drivers with reduced fitness to drive and educational efforts to encourage safer driving habits particularly but not only through self-regulation.

  4. PSA as a tool for decision making

    International Nuclear Information System (INIS)

    Niehaus, F.; Lederman, L.

    1986-01-01

    The question on ''How safe is safe enough'' is being responded presently by deterministic criteria. Probabilistic criteria in support to more rational and less emotional decisions in regulatory and licensing issues, rationalization of resource allocation and research prioritization, among others, have a potential which is only marginally being explored. This paper discussed PSA limitations and proposes three areas for the use of PSA in decision making, namely: preventing accidents, mitigating accidents, and defining regulatory requirements. Current activities of the International Atomic Energy Agency in these areas are mentioned. PSA studies depict clearly the uncertainties and this is viewed as a positive aspect, which is unique to the use of probabilistic methods. (orig.)

  5. Heroes of Resiliency and Reciprocity: Teachers' Supporting Role for Reconceptualizing Superhero Play in Early Childhood Settings

    Science.gov (United States)

    Harris, Kathleen I.

    2016-01-01

    Superhero play is a specialised form of fantasy play with considerable appeal to young children. During superhero play, children have opportunities to pretend and often to play different types of roles within a safe and caring environment. When guided appropriately in an early childhood classroom, superhero play gives young children opportunities…

  6. Exiting and Returning to the Parental Home for Boomerang Kids.

    Science.gov (United States)

    Sandberg-Thoma, Sara E; Snyder, Anastasia R; Jang, Bohyun Joy

    2015-06-01

    Young adults commonly exit from and return to the parental home, yet few studies have examined the motivation behind these exits and returns using a life course framework. Using data from the National Longitudinal Survey of Youth 1997, the authors examined associations between mental health problems and economic characteristics and exits from (n = 8,162), and returns to (n = 6,530), the parental home during the transition to adulthood. The average age of the respondents was 24 years. The authors found evidence that mental health and economic characteristics were related to home leaving and returning. Emotional distress was associated with earlier exits from, and returns to, the parental home; alcohol problems were associated with earlier returns to the parental home. The findings regarding economic resources were unexpectedly mixed. Greater economic resources were linked to delayed exits from, and earlier returns to, the parental home. The implications of these findings for young adults are discussed.

  7. Steering teens safe: a randomized trial of a parent-based intervention to improve safe teen driving.

    Science.gov (United States)

    Peek-Asa, Corinne; Cavanaugh, Joseph E; Yang, Jingzhen; Chande, Vidya; Young, Tracy; Ramirez, Marizen

    2014-07-31

    Crashes are the leading cause of death for teens, and parent-based interventions are a promising approach. We assess the effectiveness of Steering Teens Safe, a parent-focused program to increase safe teen driving. Steering Teens Safe aimed to improve parental communication with teens about safe driving using motivational interviewing techniques in conjunction with 19 safe driving lessons. A randomized controlled trial involved 145 parent-teen dyads (70 intervention and 75 control). Intervention parents received a 45-minute session to learn the program with four follow-up phone sessions, a DVD, and a workbook. Control parents received a standard brochure about safe driving. Scores were developed to measure teen-reported quantity and quality of parental communication about safe driving. The main outcome measure was a previously validated Risky Driving Score reported by teens. Because the Score was highly skewed, a generalized linear model based on a gamma distribution was used for analysis. Intervention teens ranked their parent's success in talking about driving safety higher than control teens (p = 0.035) and reported that their parents talked about more topics (non-significant difference). The Risky Driving Score was 21% lower in intervention compared to control teens (85% CI = 0.60, 1.00). Interaction between communication quantity and the intervention was examined. Intervention teens who reported more successful communication had a 42% lower Risky Driving Score (95% CI = 0.37, 0.94) than control parents with less successful communication. This program had a positive although not strong effect, and it may hold the most promise in partnership with other programs, such as Driver's Education or Graduated Driver's License policies. ClinicalTrials.gov NCT01014923. Registered Nov. 16, 2009.

  8. Optimising decision making in mastitis control

    OpenAIRE

    Down, P.M.

    2016-01-01

    Mastitis remains one of the most common diseases of dairy cows and represents a large economic loss to the industry as well as a considerable welfare issue to the cows affected. Decisions are routinely made about the treatment and control of mastitis despite evidence being sparse regarding the likely consequences in terms of clinical efficacy and return on investment. The aim of this thesis was to enhance decision making around the treatment and prevention of mastitis using probabilistic meth...

  9. Consensus shaping and safe space public participation processes

    Energy Technology Data Exchange (ETDEWEB)

    Andersson, Kjell [Karita Research AB, Taeaby (Sweden)

    2015-07-01

    map public participation - consultation, consensus shaping processes and safe space. In contrast to consensus shaping processes, in the safe space approach there is no intention to develop solutions together between the implementer and other stakeholders. In comparison with the ladder, the basic approaches offer advantages for the mapping of public participation processes: If you strive for consensus or ''only'' clarity and awareness is a crucial question to be answered before a process is launched as it determines which stakeholders can join and which goals are feasible to reach. It is easier to use in assigning properties to a process, as it more straight-forward to understand if a process is consensus shaping or a safe space than where it is on the ladder. It clarifies better the links between the participation processes and the actual political and/or legal decision-making process. A consensus shaping process should produce real advice (or even decisions) but a safe space is limited to improving the decision making base with enhanced clarity.

  10. Consensus shaping and safe space public participation processes

    International Nuclear Information System (INIS)

    Andersson, Kjell

    2015-01-01

    map public participation - consultation, consensus shaping processes and safe space. In contrast to consensus shaping processes, in the safe space approach there is no intention to develop solutions together between the implementer and other stakeholders. In comparison with the ladder, the basic approaches offer advantages for the mapping of public participation processes: If you strive for consensus or ''only'' clarity and awareness is a crucial question to be answered before a process is launched as it determines which stakeholders can join and which goals are feasible to reach. It is easier to use in assigning properties to a process, as it more straight-forward to understand if a process is consensus shaping or a safe space than where it is on the ladder. It clarifies better the links between the participation processes and the actual political and/or legal decision-making process. A consensus shaping process should produce real advice (or even decisions) but a safe space is limited to improving the decision making base with enhanced clarity.

  11. Labour market outcomes and their Impact on tertiary decisions in Germany

    DEFF Research Database (Denmark)

    Reimer, David

    2011-01-01

    suggest that variations in relative income returns do not seem to affect educational decisions of school leavers while variation in unemployment seems to have significant effects on postsecondary decisions for women only. Furthermore, female students from lower class backgrounds appear to be more...

  12. Safe introduction of new procedures and emerging technologies in surgery: education, credentialing, and privileging.

    Science.gov (United States)

    Sachdeva, Ajit K; Russell, Thomas R

    2007-08-01

    Ongoing horizon scanning is needed to identify new procedures and emerging technologies that should be evaluated for introduction into surgical practice. Following evidence-based evaluation, if a new modality is found ready for adoption in practice, surgeons need education in the safe and effective use of the new modality. The educational experience should include structured teaching and learning, verification of new knowledge and skills, preceptoring or proctoring, and monitoring of outcomes. Credentialing and privileging to perform a new procedure or use an emerging technology should be based on evaluation of knowledge and skills and outcomes of surgical care, and not merely on the numbers of procedures performed. Education of the surgical team is also essential. The entire process involving education, verification of knowledge and skills, credentialing, and privileging must be transparent. Patients need to play a central role in making informed decisions regarding their care that involves use of a new procedure or an emerging technology, and they should participate actively in their perioperative care.

  13. CHINESE SMEs' USES OF FINANCIAL STATEMENTS IN DECISION MAKING

    OpenAIRE

    HOWARD VAN AUKEN; KUI YANG

    2014-01-01

    With a sample of 46 Chinese small to medium-sized enterprises (SMEs), this study examines factors that might affect firms' use of financial statements to make decisions. Financial statements contain insightful information about potential risk and return implications of various decisions. A logit analysis shows that owners of Chinese SMEs use financial statements to make decisions according to the frequency of available financial statement information and their ability to interpret the informa...

  14. Risk-Return Trade-off in Emerging Markets:Evidence from Dhaka Stock Exchange Bangladesh

    Directory of Open Access Journals (Sweden)

    Abu T. Mollik

    2015-03-01

    Full Text Available This paper attempts to measure the risk and return relationship in Dhaka Stock Exchange (DSE. The study reports a statistically significant positive relationship between risk and return both at the individual security level and at the portfolio level, confirming the theoretical predictions and empirical findings on this issue in developed markets. Although portfolio risk and returns are found to be significantly positively related in general, some inconsistencies were revealed in the context of relative risk for high risk portfolios, suggesting the existence of some anomalies or mispricing in high risk assets. These findings have important implications for investment decisions at the DSE in that the investors may be able to create profitable investment strategies using the mispricing information.

  15. The experience of returning to work.

    Science.gov (United States)

    Jansson, Inger; Björklund, Anita

    2007-01-01

    The purpose of this qualitative study was to explore from an environmental perspective the experiences of returning to work of former unemployed sickness absentees. Five separate focus-group interviews were carried out with themes concerning different environmental areas. The findings showed that the participants in their process of being off work and then attempting returning to work experienced a personal transition manifesting itself as a negative self-image, change of life-rhythm and restrictions in their roles and activities. In their progression, the participants experienced a need for reorientation and expressed feelings of alienation, and for that reason felt need of support from a network, especially a professional one. Regarding attitudes in society, the participants reported experiences of social stigmatization, both in mass media and in their immediate social environment, and an increasing egocentricity among their fellow-workers. They perceived their progression back to work as a 'time quarantine' and as a long and destructive wait for support. The findings indicate that the phenomenon of 'returning to work' after unemployment and sick leave could not be reduced to a single issue. It should rather be seen as a dynamic problem with individual and structural, environmental aspects.

  16. An Integrated Decision-Making Model for Categorizing Weather Products and Decision Aids

    Science.gov (United States)

    Elgin, Peter D.; Thomas, Rickey P.

    2004-01-01

    The National Airspace System s capacity will experience considerable growth in the next few decades. Weather adversely affects safe air travel. The FAA and NASA are working to develop new technologies that display weather information to support situation awareness and optimize pilot decision-making in avoiding hazardous weather. Understanding situation awareness and naturalistic decision-making is an important step in achieving this goal. Information representation and situation time stress greatly influence attentional resource allocation and working memory capacity, potentially obstructing accurate situation awareness assessments. Three naturalistic decision-making theories were integrated to provide an understanding of the levels of decision making incorporated in three operational situations and two conditions. The task characteristics associated with each phase of flight govern the level of situation awareness attained and the decision making processes utilized. Weather product s attributes and situation task characteristics combine to classify weather products according to the decision-making processes best supported. In addition, a graphical interface is described that affords intuitive selection of the appropriate weather product relative to the pilot s current flight situation.

  17. Decision Making Processes for a Pregnant Woman Admitted to the Accident and Emergency Department Requiring Emergency Diagnostic X-ray – A Case Study

    Directory of Open Access Journals (Sweden)

    S. Ismanto

    2017-07-01

    Full Text Available The objective of this study is to apply the decision-making processes for a pregnant woman who was involved in a motor vehicle accident and admitted to a private middle-class hospital in the capital of Indonesia requiring radiologic X-ray examination.  It also aims to examine and evaluate the patient who was in her 20th week of gestation in order to provide her with the best emergency care, diagnostic investigations and treatments.The descriptive, normative and prescriptive models of decision-making are demonstrated. The descriptive model used intuition, while the normative model used decision trees as decision options and lastly the prescriptive decision used the information processing theory (IPT to decide on the best emergency care, diagnostic investigations and treatments for the patient. The IPT dominated the decision-making process; hence an X-ray examination was done that was safe for the fetus and the childbearing mother. Decision option was not used since the patient was in pain and could not understand much of the procedure that was explained.  Intuition helped in the decision-making in order to ensure safe and effective practice.

  18. Development of safe routes for children in urban environment

    Science.gov (United States)

    Koryagin, M. E.; Medvedev, V. I.; Strykov, P. G.

    2018-01-01

    The matter of development of safe travel routes for children between school and home is analyzed. The availability of various applications and devices to identify the location of the child and his/her travel routes is noted. The main factors to be taken into account when planning children travel routes are described. The most popular Russian services for route planning, Google, Yandex, and 2GIS, are discussed. These services are shown to have a number of shortcomings which does not allow them to choose really safe routes. A decision on making the route selection by two criteria (the travel time and the probability of an accident) is obtained. As a numerical example, the Pareto area for possible routes is constructed.

  19. Returns to Schooling in Less Developed Countries: New Evidence from Zambia

    DEFF Research Database (Denmark)

    Nielsen, Helena Skyt; Westergård-Nielsen, Niels Chr.

    2001-01-01

    In our analysis of returns to schooling in Zambia, we look at the rural and urban population separately, and estimate the returns to schooling in each region based on a selection model in two stages. For urban areas we find that the returns to primary schooling are nil whereas the returns to scho...... to schooling beyond primary school are higher. For rural areas we find that the returns to primary schooling are positive and no different from the returns to education beyond primary school. Udgivelsesdato: JAN...

  20. Sprint mechanics return to competition follow-up after hamstring injury on a professional soccer player: A case study with an inertial sensor unit based methodological approach.

    Science.gov (United States)

    Setuain, Igor; Lecumberri, Pablo; Izquierdo, Mikel

    2017-10-03

    The present research aimed to describe an inertial unit (IU)-based sprint mechanics evaluation model for assessing players' readiness to return to competition after suffering a grade I hamstring injury. A professional male football player (age 19years; height 177cm; weight 70kg, midfielder, Spanish, 3° Division) with a grade 1 biceps femoris injury was evaluated at pre-season, at return to play after injury and at the end of the competitive season. Sprint mechanics were analyzed via the use of an inertial orientation tracker (Xsens Technologies B.V. Enschede, Netherlands) attached over the L3-L4 region of the subject's lumbar spine. Sprint mechanics such as horizontal components of ground reaction force were assessed in both legs during sprinting actions. Findings and interpretation: Both the coefficient of the horizontal force application (SFV) and the ratio of forces (DRF) applied at increasing velocity were decreased in the injured limb compared with the contralateral healthy limb at the return to play evaluation (73% and 76% reductions, respectively) and returned to symmetrical levels at the end-season evaluation. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Measurement of returns-to-scale using Interval Data Envelopment Analysis models

    DEFF Research Database (Denmark)

    Hatami-Marbini, Adel; Beigi, Zahra Ghelej; Hougaard, Jens Leth

    2018-01-01

    The economic concept of Returns-to-Scale (RTS) has been intensively studied in the context of Data Envelopment Analysis (DEA). The conventional DEA models that are used for RTS classification require well-defined and accurate data whereas in reality observations gathered from production systems may...... be characterized by intervals. For instance, the heat losses of the combined production of heat and power (CHP) systems may be within a certain range, hinging on a wide variety of factors such as external temperature and real-time energy demand. Enriching the current literature independently tackling the two...... problems; interval data and RTS estimation; we develop an overarching evaluation process for estimating RTS of Decision Making Units (DMUs) in Imprecise DEA (IDEA) where the input and output data lie within bounded intervals. In the presence of interval data, we introduce six types of RTS involving...

  2. Managing radioactive waste safely. Engaging Scotland

    International Nuclear Information System (INIS)

    Elrick, D.; Boyes, L.; McCormick, J.

    2002-01-01

    The report presents findings from a study to explore how best to engage the public and other stakeholders in decision-making processes on the safe management of radioactive waste. Scottish Council Foundation conducted extended focus groups with the Scottish public in 4 locations, as well as group and one-to-one interviews with stakeholders from the nuclear industry, environment non-governmental organisations (NGOs), bodies experienced in using other public engagement methods, Community Planning partners and media reporters. A review of literature on public involvement in radioactive waste issues and public engagement more generally was also conducted

  3. RETURNS OF PRIVATE EQUITY COMPARATIVE ANALYSES OF THE RETURNS OF VENTURE CAPITAL AND BUYOUT FUNDS IN EUROPE AND IN THE US

    Directory of Open Access Journals (Sweden)

    Becsky-Nagy Patrícia

    2014-07-01

    Full Text Available This paper focuses on the returns of two segments of Private Equity (PE market in Europe and in the US; Venture Capital (VC and Buyout (BO. Contrary to the publicly traded stocks where information about the trade of securities is public, the measuring of the returns of these asset classes is not unambiguous. The returns of PE investments are considered as confidential information therefore we only have estimations about the real characteristics of the financial performance of the PE industry. Although it is impossible to observe the whole industry it is important to chart its performance because PE plays an essential role in the financing of firms, especially firms at special stages of their lives and the more information the investors and companies have, the more effective PE market can be therefore it can contribute to economic growth, employment, innovation etc. In the literature PE, VC and BO are not distinguished properly and they are often used as synonyms. Despite their similarities, there are significant differences in the features of these types of investments. In this paper the authors present the return characteristics of the PE industry of Europe and the US with regard to the stage-focus of PE funds. The key findings of this paper are that in average the returns of BO funds exceeded the returns of VC funds in the US as well as in Europe. Not just according to the absolute value of the returns, but also according to its risk-return tradeoff BO seems to be a preferable investment. The same statements can be made in case of the European market. The US returns are higher than European VC returns, because compared to the US VC industry the European is undeveloped. On the other hand the gap between the performances of BO funds is not as significant as the difference of VC funds. While in the 90’s US BO funds outperformed the European ones, after the millennia European BO returns were higher. The analysis of returns reveals the

  4. An application of a theory of planned behaviour to determine the association between behavioural intentions and safe road-crossing in college students: perspective from Isfahan, Iran.

    Science.gov (United States)

    Jalilian, Mohsen; Mostafavi, Firoozeh; Mahaki, Behzad; Delpisheh, Ali; Rad, Gholamreza Sharifi

    2015-07-01

    To identify the determinants of behavioural intention towards safe road-crossing among college students. The cross-sectional study was conducted in 2013-14 and comprised students of Isfahan University of Medical Sciences, Isfahan, Iran. A self-administrated questionnaire was distributed among the subjects related to road-crossing based on the theory of planned behaviour. Data was analysed using SPSS 21. Of the 300 questionnaires distributed, 278(92.66%) were returned completed. The mean age of the subjects was 23.16±3.66 years. There were 149(53.6%) females and 129(46.4%) males, with females crossing the street more safely than the males. There was a significant difference between the genders for subjective norms (p=0.001), perceived behavioural control (p=0.002) and behavioural intention (p=0.001), but no differences were traced with respect to attitude towards safe crossing (p=0.597). Results showed a direct and positive correlation between attitude towards safe crossing (r=0.276; p=0.001), subjective norms (r=0.368; p=0.001) and perceived behavioural control (r=0.419; p=0.000) with behavioural intention to safe crossing. The attitude towards safe crossing and perceived behavioural control had significant effect on behavioural intention among college students.

  5. Exploring the return-to-work process for workers partially returned to work and partially on long-term sick leave due to common mental disorders : a qualitative study

    NARCIS (Netherlands)

    Noordik, Erik; Nieuwenhuijsen, Karen; Varekamp, Inge; van der Klink, Jac J.; van Dijk, Frank J.

    2011-01-01

    Purpose. We conducted a qualitative study into the return-to-work process of workers partially on sick leave due to common mental disorders. Our objectives were to describe the barriers to a full return to work, solutions, communicating to the working environment and the aim of a full return to

  6. Pengaruh Indikator Rasio Keuangan Perusahaan Price Earning Ratio (PER dan Price to Book Value (PBV terhadap Return Portfolio Saham di Bursa Efek Jakarta

    Directory of Open Access Journals (Sweden)

    Barbara Gunawan

    2016-02-01

    Full Text Available This emerged during a kind of perception that the financial statements do not quite believable as the basis of capital market investment decisions. Using the results of the ratio of the financial statements as an object to be examined, the study will look at the extent of the influence indicator Price Earning Ratio and Price to Book Value of the Return Portfolio Shares on the Jakarta Stock Exchange. The results showed that of the portfolio is formed, it turns out the low indicators of Price Earning Ratio and Price to Book Value does not affect the portfolio return.

  7. Uncertainty modeling and decision support

    International Nuclear Information System (INIS)

    Yager, Ronald R.

    2004-01-01

    We first formulate the problem of decision making under uncertainty. The importance of the representation of our knowledge about the uncertainty in formulating a decision process is pointed out. We begin with a brief discussion of the case of probabilistic uncertainty. Next, in considerable detail, we discuss the case of decision making under ignorance. For this case the fundamental role of the attitude of the decision maker is noted and its subjective nature is emphasized. Next the case in which a Dempster-Shafer belief structure is used to model our knowledge of the uncertainty is considered. Here we also emphasize the subjective choices the decision maker must make in formulating a decision function. The case in which the uncertainty is represented by a fuzzy measure (monotonic set function) is then investigated. We then return to the Dempster-Shafer belief structure and show its relationship to the fuzzy measure. This relationship allows us to get a deeper understanding of the formulation the decision function used Dempster- Shafer framework. We discuss how this deeper understanding allows a decision analyst to better make the subjective choices needed in the formulation of the decision function

  8. Motivational goals, group identifications, and psychosocial adjustment of returning migrants: The case of Jews returning to Russia.

    Science.gov (United States)

    Tartakovsky, Eugene; Patrakov, Eduard; Nikulina, Marina

    2017-12-01

    The present study investigated the motivational goals, group identifications, and psychosocial adjustment of Jews who returned to Russia after emigrating from the republics of the Former Soviet Union to different countries (n = 151). To gain a deeper understanding of these returning migrants, their traits were compared with those of Jews living in Russia who did not emigrate (n = 935). Compared to locals, returnees reported a higher preference for the openness to change and self-enhancement values and a lower preference for the conservation values; there was no difference in the self-transcendence values. Returning migrants had a relatively weak affiliation with the home country: they had a weaker identification with the home country than with the country of emigration, their identification with Russians was weaker than that among Jews who did not emigrate from Russia, and their intention to emigrate (again) from Russia was greater than that among locals. However, the Jewish identification of returning migrants was similar to that of locals. The adjustment of returning migrants varied across different dimensions: their economic adjustment was better than that of locals; however, the interpersonal adjustment of returnees was less successful than among locals. © 2016 International Union of Psychological Science.

  9. A qualitative study of safe abortion and post-abortion family planning service experiences of women attending private facilities in Kenya.

    Science.gov (United States)

    Penfold, Suzanne; Wendot, Susy; Nafula, Inviolata; Footman, Katharine

    2018-04-24

    To inform improvements in safe abortion and post-abortion family planning (PAFP) services, this study aimed to explore the pathways, decision-making, experiences and preferences of women receiving safe abortion and post-abortion family planning (PAFP) at private clinics in western Kenya. We conducted semi-structured interviews with 22 women who had recently used a safe abortion service from a private clinic. Interviews explored abortion-seeking behaviour and decision-making, abortion experience, use and knowledge of contraception, experience of PAFP counselling, and perceived facilitators of and challenges to family planning use. Respondents discovered their pregnancies due to physical symptoms, which were confirmed using pregnancy testing kits, often purchased from pharmacies. Respondents usually discussed their abortion decision with their partner, and, sometimes, carefully-selected friends or family members. Some reported being referred to private clinics for abortion services directly from other providers. Others had more complex pathways, first seeking care from unsafe providers, trying to self-induce abortion, being turned away from alternative safe facilities that were closed or too busy, or taking time to gather financial resources to pay for care. Participants wanted to use abortion services at facilities reputed for being accessible, clean, medically safe, and offering quick, respectful, private and courteous services. Awareness of reputable clinics was gained through personal experience, and recommendations from contacts and other health providers. Most participants had previously used contraception, with some reports of incorrect use and many reports of side effects. PAFP counselling was valued by clients, but some accounts suggested the counselling lacked comprehensive information. Many women chose contraception immediately following PAFP counselling; but others wanted to delay decision-making about contraception until the abortion was complete

  10. Analysis of factors influencing return to work after total hip arthroplasty.

    Science.gov (United States)

    Truszczyńska, Aleksandra; Rąpała, Kazimierz; Tarnowski, Adam; Kucharczyk, Wojciech

    2013-10-31

    BACKGROUND. Patients who undergo total hip arthroplasty (THA) find it difficult to return to work. OBJECTIVES. Analysis of factors influencing return to work after THA. Assessment of patients' quality of life and its impact on their attitude to work. MATERIAL AND METHODS. We studied patients operated on for degenerative hip disease at the Department of Orthopaedic Surgery of Medical Centre of Postgraduate Education in Otwock between 2007 and 2012. The total number of the patients was 400; however, we chose only those patients who were younger than 65 and still in employment. The study population consisted of 54 of these patients. The mean patient age was 55.89 (±7.424). There were 29 men (57.3%) and 25 women (46.3%). RESULTS. 32 patients (59.3%) returned to work. There was a statistically significant difference regarding the attitude to work and return to work. An overwhelming majority of the patients who returned to work--31 out of 32 (96.6%)--liked their jobs. The 12 patients (22.22%) who did not return to work declared their intention to apply for a disability pension. The patients who returned to work assessed their physical health as better than the patients who did not return to work. CONCLUSIONS. 1. 40.7% of patients after THA did not return to preoperative employment. The reasons for not returning were not medical, because elimination of pain and an increased range of motion made return to work possible. 2. The perception of the quality of physical and psychological health among patients with THA who returned to work was significantly better than among those who did not return.

  11. Exploring the return-to-work process for workers partially returned to work and partially on long-term sick leave due to common mental disorders: a qualitative study

    NARCIS (Netherlands)

    Noordik, Erik; Nieuwenhuijsen, Karen; Varekamp, Inge; van der Klink, Jac J.; Van Dijk, Frank J.

    2011-01-01

    We conducted a qualitative study into the return-to-work process of workers partially on sick leave due to common mental disorders. Our objectives were to describe the barriers to a full return to work, solutions, communicating to the working environment and the aim of a full return to work, all as

  12. Returning to work after cancer: know your rights

    Science.gov (United States)

    ... for you. Ability to return to work as long as you return within 12 weeks. Ability to work fewer hours if you need to. If you cannot do ... can before taking leave. You must schedule your health care visits so they disrupt ... long as the company covers the cost. The Affordable ...

  13. Examination of the behavior of R&D returns using a power law

    NARCIS (Netherlands)

    Casault, Sébastien; Groen, Arend J.; Linton, J.D.; Linton, Jonathan

    2013-01-01

    This paper provides an improved model, based on historical data, that describes the returns on assets that result from R&D efforts to assist managers of public and private R&D activities. Such a model may lead to better decision support tools to monetize the value that may be extracted from R&D,

  14. [Psychiatric Inpatient Treatment and Return to Work].

    Science.gov (United States)

    Mernyi, Lena; Hölzle, Patricia; Hamann, Johannes

    2017-05-12

    Objective People with mental diseases have a high risk of unemployment and they have only limited access to the labor market. The return to work is often associated with fears.The present study aims to provide an overview of the number of hospitalized psychiatric patients with permanent employment. Moreover it should give an insight into the process of return to work, the experiences patients gain and the support they receive. Methods In the participating clinics we measured the number of patients with permanent employment. The main inclusion criteria for further survey were the status of permanent employment and age between 18 and 65. The participating patients were interviewed on two occasions, at the time of inclusion and 3 months after the patient was discharged. The questions addressed working conditions, job satisfaction and the process of return-to-work. For statistical analysis, descriptive statistics (frequencies, means, standard deviations) were used. Results Only 21 % of n = 815 inpatients of the participating hospitals were permanently employed. Many patients did not return to work after being discharged. In many cases the interviewed patients saw a connection between their job and their current episode of illness. In this context patients reported unsatisfying workplace conditions such as long working hours, bad work organization and social conflicts. Conclusions For mentally ill patients, the employment rate in the primary labor market is devastating low. After psychiatric inpatient treatment patients are at high risk to lose their jobs. In order to prevent this development, work-related stress factors should be discussed with inpatients at an early stage and support should be provided during the return-to-work-process. © Georg Thieme Verlag KG Stuttgart · New York.

  15. Returning to work after laparoscopic myomectomy: a prospective observational study.

    Science.gov (United States)

    Huff, Keren O; Aref-Adib, Mehrnoosh; Magama, Zwelihle; Vlachodimitropoulou, Evangelia K; Oliver, Reeba; Odejinmi, Funlayo

    2018-01-01

    Laparoscopic myomectomy offers women many benefits over conventional open surgery, including an expedited recovery and return to employment. Our study evaluates the time taken for women to return to work after laparoscopic myomectomy and identifies factors prolonging recovery to > 8 weeks. We prospectively evaluated 94 women undergoing laparoscopic myomectomy by a single surgeon between January 2012 and March 2015. Women had standardized preoperative counseling and completed a validated return to work questionnaire 3 months postoperatively via telephone, post or in clinic. In all, 71/94 (75.5%) women completed the questionnaire. Results were analyzed comparing women who returned to work in ≤ 8 weeks [43/71 (60.6%)] with those who returned > 8 weeks postoperatively [28/71 (39.4%)]. A higher proportion of Asian and Caucasian women returned to work in ≤ 8 weeks (24/29) compared with black African and Caribbean women (19/42) (p = 0.003). Mean number of fibroids removed (2.59 and 5.75, respectively) was the only significantly differing factor between the two groups (p = 0.004). There was a significant difference in body mass index (BMI) and time to return to normal activity between the ≤ 8-week and > 8-week groups (p = 0.027, p = 0.011, respectively). Logistic regression analysis demonstrated that BMI and time to return to normal activity were the only factors prolonging recovery to > 8 weeks (p = 0.039, p = 0.015, respectively). Time to return to normal activity and BMI significantly influenced the time taken for women to work after laparoscopic myomectomy. Further data would support clinicians in counseling women appropriately and optimizing their postoperative return to employment. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

  16. Which non-technical skills do junior doctors require to prescribe safely? A systematic review.

    Science.gov (United States)

    Dearden, Effie; Mellanby, Edward; Cameron, Helen; Harden, Jeni

    2015-12-01

    Prescribing errors are a major source of avoidable morbidity and mortality. Junior doctors write most in-hospital prescriptions and are the least experienced members of the healthcare team. This puts them at high risk of error and makes them attractive targets for interventions to improve prescription safety. Error analysis has shown a background of complex environments with multiple contributory conditions. Similar conditions in other high risk industries, such as aviation, have led to an increased understanding of so-called human factors and the use of non-technical skills (NTS) training to try to reduce error. To date no research has examined the NTS required for safe prescribing. The aim of this review was to develop a prototype NTS taxonomy for safe prescribing, by junior doctors, in hospital settings. A systematic search identified 14 studies analyzing prescribing behaviours and errors by junior doctors. Framework analysis was used to extract data from the studies and identify behaviours related to categories of NTS that might be relevant to safe and effective prescribing performance by junior doctors. Categories were derived from existing literature and inductively from the data. A prototype taxonomy of relevant categories (situational awareness, decision making, communication and team working, and task management) and elements was constructed. This prototype will form the basis of future work to create a tool that can be used for training and assessment of medical students and junior doctors to reduce prescribing error in the future. © 2015 The British Pharmacological Society.

  17. Adoption of the B2SAFE EUDAT replication service by the EPOS community

    Science.gov (United States)

    Cacciari, Claudio; Fares, Massimo; Fiameni, Giuseppe; Michelini, Alberto; Danecek, Peter; Wittenburg, Peter

    2014-05-01

    B2SAFE is the EUDAT service for moving and replicating data between sites and storage systems for different purposes. The goal of B2SAFE is to keep the data from a repository safe by replicating it across different geographical and administrative zones according to a set of well-defined policies. It is also a way to store large volumes of data permanently at those sites which are providing powerful on-demand data analysis facilities. In particular, B2SAFE operates on the domain of registered data where data objects are referable via persistent identifiers (PIDs). B2SAFE is more than just copying data because the PIDs must be carefully managed when data objects are moved or replicated. The EUDAT B2SAFE Service offers functionality to replicate datasets across different data centres in a safe and efficient way while maintaining all information required to easily find and query information about the replica locations. The information about the replica locations and other important information is stored in PID records, each managed in separate administrative domains. The B2SAFE Service is implemented as an iRODS module providing a set of iRODS rules or policies to interface with the EPIC handle API and uses the iRODS middleware to replicate datasets from a source data (or community) centre to a destination data centre. The definition of the dataset(s) to replicate is flexible and up to the communities using the B2SAFE service. While the B2SAFE is internally using the EPIC handle API, communities have the choice to use any PID system they prefer to assign PIDs to their digital objects. A reference to one or more EUDAT B2SAFE PIDs is returned by the B2SAFE service when a dataset is replicated. The presentation will introduce the problem space of B2SAFE, presents the achievements that have been made during the last year for enabling communities to make use of the B2SAFE service, demonstrates a EPOS use cases, outlines the commonalities and differences between the policies

  18. Computing return times or return periods with rare event algorithms

    Science.gov (United States)

    Lestang, Thibault; Ragone, Francesco; Bréhier, Charles-Edouard; Herbert, Corentin; Bouchet, Freddy

    2018-04-01

    The average time between two occurrences of the same event, referred to as its return time (or return period), is a useful statistical concept for practical applications. For instance insurances or public agencies may be interested by the return time of a 10 m flood of the Seine river in Paris. However, due to their scarcity, reliably estimating return times for rare events is very difficult using either observational data or direct numerical simulations. For rare events, an estimator for return times can be built from the extrema of the observable on trajectory blocks. Here, we show that this estimator can be improved to remain accurate for return times of the order of the block size. More importantly, we show that this approach can be generalised to estimate return times from numerical algorithms specifically designed to sample rare events. So far those algorithms often compute probabilities, rather than return times. The approach we propose provides a computationally extremely efficient way to estimate numerically the return times of rare events for a dynamical system, gaining several orders of magnitude of computational costs. We illustrate the method on two kinds of observables, instantaneous and time-averaged, using two different rare event algorithms, for a simple stochastic process, the Ornstein–Uhlenbeck process. As an example of realistic applications to complex systems, we finally discuss extreme values of the drag on an object in a turbulent flow.

  19. Analysis advanced methods of data bases of industrial experience return

    International Nuclear Information System (INIS)

    Lannoy, A.; Procaccia, H.

    1994-05-01

    This is a presentation, through different conceptions of data bases on industrial experience return, of the principal methods for treatments and analyses of the collected data, going from the frequency statistic and factorial analysis, to the the Bayesian statistical decision theory, which is a real decision assistance tool for responsibles, conceivers and operators. Examples in various fields are given (OREDA: Offshore REliability DAta bank for marine drilling platforms, CEDB: Component Event Data Bank for european electric power industry, RDF 93: reliability of electronic components of ''France Telecom'', EVT: failure EVenTs data bank in the french nuclear power plants by ''EDF''). (A.B.). refs., figs., tabs

  20. Returns to beauty over the life course

    DEFF Research Database (Denmark)

    Jæger, Mads Meier

    ’ facial attractiveness as well as data on SES, marital, and health outcomes from their mid-20s to their mid-60s. I find that beauty has lasting positive returns for women since more beautiful women have higher SES throughout their working life, have a higher probability of being married at age 25......, and marry high-SES husbands. I find no effects of beauty on health and, in general, no returns to beauty for men....

  1. MRI findings and return to play in football: a prospective analysis of 255 hamstring injuries in the UEFA Elite Club Injury Study.

    Science.gov (United States)

    Ekstrand, Jan; Lee, Justin C; Healy, Jeremiah C

    2016-06-01

    The present study evaluated whether the MRI parameters of hamstring injuries in male professional football players correlate with time to return to play (RTP). 46 elite European football teams were followed prospectively for hamstring injuries between 2007 and 2014. Club medical staff recorded individual player exposure and time-loss after hamstring injury. MRI parameters were evaluated by two independent radiologists and correlated with the RTP data. A total of 255 grade 1 and 2 injuries were evaluated in this study. RTP was longer for grade 2 than grade 1 injuries (24±13, 95% CI 21 to 26 days vs 18±15, 95% CI 16 to 20 days; mean difference: 6, 95% CI 2 to 9 days, p=0.004, d=0.39). 84% of injuries affected the biceps femoris (BF) muscle, whereas 12% and 4% affected the semimembranosus (SM) and semitendinosus (ST), respectively. No difference in lay-off time was found for injuries to the three different muscles (BF 20±15 days, SM 18±11 days, ST 23±14 days; p=0.83). The recurrence rate was higher for BF injuries than for SM and ST injuries combined (18% vs 2%, p=0.009). The size of the oedema weakly correlated with time to RTP (r(2)=6-12%). No correlation was found between location of injury and time to RTP. The majority of the intramuscular injuries affected the MT junction (56% in grade 1 and 2 injuries), but no difference in lay-off time was found between the different types of injuries. The radiological grade and size of the oedema correlate with time to RTP for both, grade 1 and 2 injuries. No correlations were found between time to RTP and the location and type of injury. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  2. Nuclear regulatory decision making

    International Nuclear Information System (INIS)

    2005-01-01

    The fundamental objective of all nuclear safety regulatory bodies is to ensure that nuclear utilities operate their plants at all times in an acceptably safe manner. In meeting this objective, the regulatory body should strive to ensure that its regulatory decisions are technically sound, consistent from case to case, and timely. In addition, the regulator must be aware that its decisions and the circumstances surrounding those decisions can affect how its stakeholders, such as government policy makers, the industry it regulates, and the public, view it as an effective and credible regulator. In order to maintain the confidence of those stakeholders, the regulator should make sure that its decisions are transparent, have a clear basis in law and regulations, and are seen by impartial observers to be fair to all parties. Based on the work of a Nuclear Energy Agency (NEA) expert group, this report discusses some of the basic principles and criteria that a regulatory body should consider in making decisions and describes the elements of an integrated framework for regulatory decision making. (author)

  3. Omega-optimized portfolios: applying stochastic dominance criterion for the selection of the threshold return

    Directory of Open Access Journals (Sweden)

    Renaldas Vilkancas

    2016-05-01

    Full Text Available Purpose of the article: While using asymmetric risk-return measures an important role is played by selection of the investor‘s required or threshold rate of return. The scientific literature usually states that every investor should define this rate according to their degree of risk aversion. In this paper, it is attempted to look at the problem from a different perspective – empirical research is aimed at determining the influence of the threshold rate of return on the portfolio characteristics. Methodology/methods: In order to determine the threshold rate of return a stochastic dominance criterion was used. The results are verified using the commonly applied method of backtesting. Scientific aim: The aim of this paper is to propose a method allowing selecting the threshold rate of return reliably and objectively. Findings: Empirical research confirms that stochastic dominance criteria can be successfully applied to determine the rate of return preferred by the investor. Conclusions: A risk-free investment rate or simply a zero rate of return commonly used in practice is often justified neither by theoretical nor empirical studies. This work suggests determining the threshold rate of return by applying the stochastic dominance criterion

  4. Return to sports after ankle fractures: a systematic review.

    Science.gov (United States)

    Del Buono, Angelo; Smith, Rebecca; Coco, Manuela; Woolley, Laurence; Denaro, Vincenzo; Maffulli, Nicola

    2013-01-01

    This review aims to provide information on the time athletes will take to resume sports activity following ankle fractures. We systematically searched Medline (PubMED), EMBASE, CINHAL, Cochrane, Sports Discus and Google scholar databases using the combined keywords 'ankle fractures', 'ankle injuries', 'athletes', 'sports', 'return to sport', 'recovery', 'operative fixation', 'pinning', 'return to activity' to identify articles published in English, Spanish, French, Portuguese and Italian. Seven retrospective studies fulfilled our inclusion criteria. Of the 793 patients, 469 (59%) were males and 324 (41%) were females, and of the 356 ankle fractures we obtained information on, 338 were acute and 18 stress fractures. The general principles were to undertake open reduction and internal fixation of acute fractures, and manage stress fractures conservatively unless a thin fracture line was visible on radiographs. The best timing to return to sports after an acute ankle fracture is still undefined, given the heterogeneity of the outcome measures and results. The time to return to sports after an acute stress injury ranged from 3 to 51 weeks. When facing athletes with ankle fractures, associated injuries have to be assessed and addressed to improve current treatment lines and satisfy future expectancies. The best timing to return to sports after an ankle fracture has not been established yet. The ideas of the return to activity parameter and surgeon databases including sports-related information could induce research to progress.

  5. Enterprise size and return to work after stroke.

    Science.gov (United States)

    Hannerz, Harald; Ferm, Linnea; Poulsen, Otto M; Pedersen, Betina Holbæk; Andersen, Lars L

    2012-12-01

    It has been hypothesised that return to work rates among sick-listed workers increases with enterprise size. The aim of the present study was to estimate the effect of enterprise size on the odds of returning to work among previously employed stroke patients in Denmark, 2000-2006. We used a prospective design with a 2 year follow-up period. The study population consisted of 13,178 stroke patients divided into four enterprise sizes categories, according to the place of their employment prior to the stroke: micro (1-9 employees), small (10-49 employees), medium (50-249 employees) and large (>250 employees). The analysis was based on nationwide data on enterprise size from Statistics Denmark merged with data from the Danish occupational hospitalisation register. We found a statistically significant association (p = 0.034); each increase in enterprise size category was followed by an increase in the estimated odds of returning to work. The chances of returning to work after stroke increases as the size of enterprise increases. Preventive efforts and research aimed at finding ways of mitigating the effect are warranted.

  6. 26 CFR 7.6041-1 - Return of information as to payments of winnings from bingo, keno, and slot machines.

    Science.gov (United States)

    2010-04-01

    ... winnings from bingo, keno, and slot machines. 7.6041-1 Section 7.6041-1 Internal Revenue INTERNAL REVENUE..., keno, and slot machines. (a) In general. On or after May 1, 1977, every person engaged in a trade or... machine play or of $1,500 or more from a keno game shall make an information return with respect to such...

  7. Deep Learning for Video Game Playing

    OpenAIRE

    Justesen, Niels; Bontrager, Philip; Togelius, Julian; Risi, Sebastian

    2017-01-01

    In this article, we review recent Deep Learning advances in the context of how they have been applied to play different types of video games such as first-person shooters, arcade games, and real-time strategy games. We analyze the unique requirements that different game genres pose to a deep learning system and highlight important open challenges in the context of applying these machine learning methods to video games, such as general game playing, dealing with extremely large decision spaces...

  8. Learning about water resource sharing through game play

    Directory of Open Access Journals (Sweden)

    T. Ewen

    2016-10-01

    Full Text Available Games are an optimal way to teach about water resource sharing, as they allow real-world scenarios to be enacted. Both students and professionals learning about water resource management can benefit from playing games, through the process of understanding both the complexity of sharing of resources between different groups and decision outcomes. Here we address how games can be used to teach about water resource sharing, through both playing and developing water games. An evaluation of using the web-based game Irrigania in the classroom setting, supported by feedback from several educators who have used Irrigania to teach about the sustainable use of water resources, and decision making, at university and high school levels, finds Irrigania to be an effective and easy tool to incorporate into a curriculum. The development of two water games in a course for masters students in geography is also presented as a way to teach and communicate about water resource sharing. Through game development, students learned soft skills, including critical thinking, problem solving, team work, and time management, and overall the process was found to be an effective way to learn about water resource decision outcomes. This paper concludes with a discussion of learning outcomes from both playing and developing water games.

  9. Learning about water resource sharing through game play

    Science.gov (United States)

    Ewen, Tracy; Seibert, Jan

    2016-10-01

    Games are an optimal way to teach about water resource sharing, as they allow real-world scenarios to be enacted. Both students and professionals learning about water resource management can benefit from playing games, through the process of understanding both the complexity of sharing of resources between different groups and decision outcomes. Here we address how games can be used to teach about water resource sharing, through both playing and developing water games. An evaluation of using the web-based game Irrigania in the classroom setting, supported by feedback from several educators who have used Irrigania to teach about the sustainable use of water resources, and decision making, at university and high school levels, finds Irrigania to be an effective and easy tool to incorporate into a curriculum. The development of two water games in a course for masters students in geography is also presented as a way to teach and communicate about water resource sharing. Through game development, students learned soft skills, including critical thinking, problem solving, team work, and time management, and overall the process was found to be an effective way to learn about water resource decision outcomes. This paper concludes with a discussion of learning outcomes from both playing and developing water games.

  10. Measuring the Returns to R&D: The Depreciation Problem

    OpenAIRE

    Bronwyn H. Hall

    2007-01-01

    Measuring the private returns to R&D requires knowledge of its private depreciation or obsolescence rate, which is inherently variable and responds to competitive pressure. Nevertheless, most of the previous literature has used a constant depreciation rate to construct R&D capital stocks and measure the returns to R&D, a rate usually equal to 15 per cent. In this paper I review the implications of this assumption for the measurement of returns using two different methodologies: one based on t...

  11. Playful learning in higher education

    DEFF Research Database (Denmark)

    Nørgård, Rikke Toft; Toft-Nielsen, Claus; Whitton, Nicola

    2017-01-01

    in higher education through the metaphor of the ‘magic circle’. This approach stimulates intrinsic motivation and educational drive, creates safe spaces for academic experimentation and exploration, and promotes reflective risk-taking, ideation, and participation in education. We present a model of playful......Increased focus on quantifiable performance and assessment in higher education is creating a learning culture characterised by fear of failing, avoidance of risk, and extrinsic goal-oriented behaviours. In this article, we explore possibilities of a more playful approach to teaching and learning...... learning, drawing on notions of signature pedagogies, field literature, and two qualitative studies on learner conceptions of enjoyment and reasons for disengagement. We highlight the potential of this approach to invite a different mind-set and environment, providing a formative space in which failure...

  12. The Smoothing Hypothesis, Stock Returns and Risk in Brazil

    Directory of Open Access Journals (Sweden)

    Antonio Lopo Martinez

    2011-01-01

    Full Text Available Income smoothing is defined as the deliberate normalization of income in order to reach a desired trend. If the smoothing causes more information to be reflected in the stock price, it is likely to improve the allocation of resources and can be a critical factor in investment decisions. This study aims to build metrics to determine the degree of smoothing in Brazilian public companies, to classify them as smoothing and non-smoothing companies and additionally to present evidence on the long-term relationship between the smoothing hypothesis and stock return and risk. Using the Economatica and CVM databases, this study focuses on 145 companies in the period 1998-2007. We find that Brazilian smoothers have a smaller degree of systemic risk than non-smoothers. In average terms, the beta of smoothers is significantly lower than non-smoothers. Regarding return, we find that the abnormal annualized returns of smoothers are significantly higher. We confirm differences in the groups by nonparametric and parametric tests in cross section or as time series, indicating that there is a statistically significant difference in performance in the Brazilian market between firms that do and do not engage in smoothing.

  13. Return to work and cancer: the Australian experience.

    Science.gov (United States)

    McKay, Georgina; Knott, Vikki; Delfabbro, Paul

    2013-03-01

    Research suggests that for many cancer survivors, returning to work has a range of benefits. However, considerable barriers have been identified as influencing the quality of return to work outcomes. This study explored the perspectives of Australian cancer survivors, managers and employee assistance program (EAP) professionals to gain an understanding of the return to work process and factors that affect the experience. Focus groups and interviews were conducted with cancer survivors (n = 15), managers (n = 12), and EAP professionals / psychologists (n = 4) from public and private sectors. Thematic analysis was used to analyse the data to identify common and unique themes from the three participant groups. A range of drivers were identified including maintaining normality and regaining identity, which could act positively or negatively depending on survivors' coping ability and self awareness. Analysis revealed communication difficulties in the workplace that impact on emotional and practical support. Negotiating an employee's return is complex, influenced by the level of consultation with the employee and use of an ad hoc or structured process. Direct and indirect ways of supporting employees with cancer were identified, as was the need for colleague and manager support. This study supports previous research findings of the impact of cancer on work, and reveals managers' lack of knowledge on how to respond appropriately. The process of returning to work is complex, influenced by employees' and managers' attitudes, communication skills and coping abilities. Areas for workplace interventions to optimise support for the cancer survivor are described.

  14. Interaction between HIV awareness, knowledge, safe sex practice and HIV prevalence: evidence from Botswana.

    Science.gov (United States)

    Ray, Ranjan; Sinha, Kompal

    2012-05-01

    This paper makes methodological and empirical contributions to the study of HIV in the context of Botswana, a country with high HIV prevalence. Comparable evidence is presented from India to put the Botswana results in perspective. The results point to the strong role played by affluence and education in increasing HIV knowledge, promoting safe sex and reducing HIV prevalence. The study presents African evidence on the role played by the empowerment of women in promoting safe sex practices such as condom use. The lack of significant association between HIV prevalence and safe sex practice points to the danger of HIV-infected individuals spreading the disease through multiple sex partners and unprotected sex. This danger is underlined by the finding that females with multiple sex partners are at higher risk of being infected with HIV. These results take on special policy significance in the context of Botswana, where the issue of multiple sex partners has not been adequately addressed in the programme to contain the spread of HIV.

  15. Culling from the actors' perspectives-Decision-making criteria for culling in Québec dairy herds enrolled in a veterinary preventive medicine program.

    Science.gov (United States)

    Haine, Denis; Cue, Roger; Sewalem, Asheber; Wade, Kevin; Lacroix, René; Lefebvre, Daniel; Rushton, Jonathan; Arsenault, Julie; Bouchard, Émile; Dubuc, Jocelyn

    2017-12-01

    The series of events leading to the decision to cull a cow is complex, involving both individual-level and herd-level factors. While the decision is guided by financial returns, it is also influenced by social and psychological factors. Research studies on the motivational and behavioural aspects of farmers' decision utility are sparse, and nonexistent regarding culling expectations and its decision process. Our goal was to identify shared criteria on culling decisions held by dairy producers and farm advisers, with the help of the Q-methodology. Forty-one dairy producers and 42 advisers (17 veterinarians, 13 feed mill advisers, and 12 dairy herd improvement (DHI) advisers) undertook a Q-sort with 40 statements that represented a range of views about cow and herd health, production performance, management issues, and material factors that might impact their culling decision-making process. The sorts were analysed by-person using factor analysis and oblimin rotation. A single view on culling could be identified among dairy producers that can be extended to dairy farm advisers, who showed two variations of the same well-structured, uni-dimensional decision-making process. Udder health, milk production performance, and milk quota management were the key criteria for the culling decision. Farm management parameters (debts, amortization, employees, milking parlour capacity, herd size) did not play any role in the decision process. Three key differences were, however, identified between producers and the two types of advisers. One group of advisers followed the recommendations from mathematical models, where pregnancy is a major determinant of a cow's value. They assessed the cow in a more abstract way than did the other participants, still taking into account udder health and milk production, but adding economic considerations, like the availability of financial incentives and an evaluation of the post-partum health of the cow. Dairy producers were also more concerned

  16. 76 FR 17521 - Specified Tax Return Preparers Required To File Individual Income Tax Returns Using Magnetic Media

    Science.gov (United States)

    2011-03-30

    ... regulations reflect changes made to the law by the Worker, Homeownership, and Business Assistance Act of 2009... definition of a ``specified tax return preparer'' must electronically file Federal income tax returns that... of the Worker, Homeownership, and Business Assistance Act of 2009 (Pub. L. 111-92 (123 Stat. 2984...

  17. 50 CFR 12.34 - Return to the wild.

    Science.gov (United States)

    2010-10-01

    ... 50 Wildlife and Fisheries 1 2010-10-01 2010-10-01 false Return to the wild. 12.34 Section 12.34... SEIZURE AND FORFEITURE PROCEDURES Disposal of Forfeited or Abandoned Property § 12.34 Return to the wild... the wild in suitable habitat within the historical range of the species in the United States with the...

  18. A New Method to Calculate Internal Rate of Return

    Directory of Open Access Journals (Sweden)

    azadeh zandi

    2015-09-01

    Full Text Available A number of methods have been developed to choose the best capital investment projects such as net present value, internal rate of return and etc. Internal rate of return method is probably the most popular method among managers and investors. But despite the popularity there are serious drawbacks and limitations in this method. After decades of efforts made by economists and experts to improve the method and its shortcomings, Magni in 2010 has revealed a new approach that can solves the most of internal rate of return method problems. This paper present a new method which is originated from Magni’s approach but has much more simple calculations and can resolve all the drawbacks of internal rate of return method.

  19. Return to the Workforce After First Hospitalization for Heart Failure

    DEFF Research Database (Denmark)

    Rørth, Rasmus; Wong, Chih; Kragholm, Kristian

    2016-01-01

    Background: Return to work is important financially, as a marker of functional status and for self-esteem in patients developing chronic illness. We examined return to work after first heart failure (HF) hospitalization. Methods: By individual-level linkage of nationwide Danish registries, we...... with lower chance of return to work. Conclusions: Patients in the workforce before HF hospitalization had low mortality but high risk of detachment from the workforce 1 year later. Young age, male sex, and a higher level of education were predictors of return to work....

  20. Testing Commodities as Safe Haven and Hedging Instrument on ASEAN's Five Stock Markets

    Directory of Open Access Journals (Sweden)

    Robiyanto Robiyanto

    2017-08-01

    Full Text Available This study attempts to analyze commodity market instruments such as gold, silver, platinum, palladium, and West Texas Intermediate (WTI crude oil’s potential as hedge and safe haven toward some stock markets in South East Asia such as in Indonesia, Singapore, Malaysia, Philippines, and Thailand. To analyze the data, GARCH (1,1 was applied. The research findings showed that gold, silver, platinum, palladium, and WTI could not play their role as hedging instrument for five South East Asian capital markets. WTI could act as a robust safe haven for most South East Asian capital markets. Gold could do the role as a robust safe haven in Singapore and Malaysia, whereas, platinum and silver consistently could be safe haven only for Singapore Stock Exchange. Palladium could only be safe haven for Philippines Stock Exchange.