Tax attractiveness and the allocation of risk within multinationals

This paper analyzes the impact of countries' tax attractiveness on the allocation of risk within multinational groups. Our dataset contains subsidiaries located in 32 European countries and owned by parents from 90 different countries globally. We show that tax symmetry positively influences the relative amount of risk allocated to subsidiaries. Both time and amount limitations of loss offset rules matter. Higher statutory corporate tax rates in the country of the subsidiary decrease the relative amount of risk taken

Tax attractiveness and the location of patents

This paper analyzes the impact of taxation on the location of patents within multinational groups. Based on groups with parents from 36 countries globally and their patent holdings in 36 European countries, we provide insight into the determinants of three subsequent decisions: (1) the decision of whether to locate patents abroad; (2) in which countries to locate patents; and (3) how many patents to locate in each country. Our findings indicate that multinationals take the tax attractiveness of countries into account when making these decisions. Specifically, we show that the statutory tax rate, the taxation of royalties, R&D incentives, and transfer pricing rules help to explain the patent-location choices of multinationals

Der Einfluss von Bindungsstil und dyadischem Coping auf die partnerschaftliche Beziehungsqualität: Eine Analyse moderierter Mediationseffekte

Die meisten Menschen sind daran interessiert, eine glückliche und befriedigende Partnerschaft zu führen. Die psychologische Forschung hat erbracht, dass vor allem die Kommunikation und das Problemlöseverhalten der Partner in Konfliktsituationen einen entscheidenden Einfluss darauf ausüben, ob eine Paarbeziehung gelingt oder nicht. Seit einiger Zeit werden auch Anpassungsprozesse an Belastungen als wichtige Einflussfaktoren gesehen. Mit dem Konzept des dyadischen Copings liegt ein elaborierter Ansatz zur Belastungsverarbeitung in Partnerschaften vor. Studien zum Effekt dyadischen Copings haben aufgezeigt, dass der partnerschaftliche Umgang mit Belastungen konkurrent und prospektiv mit der Beziehungsqualität zusammenhängt. Ein Manko der bisherigen Forschung zum dyadischen Coping ist die unzureichende Verknüpfung mit anderen Konzepten, die bedeutsam für die Qualität und die Entwicklung von Partnerschaften sind. In den letzten Jahren hat sich das Konzept der Bindung als ein fruchtbarer Ansatz für das Verständnis von Partnerschaften erwiesen. Bindung wird hier verstanden als die bewusst zugängliche kognitive Repräsentation zentraler Merkmale der Paarbeziehung. Der Bindungsstil steht mit zahlreichen partnerschaftsbezogenen Merkmalen in Verbindung, beispielsweise mit der Beziehungsqualität. Im Rahmen der vorliegenden Studie wurde die Hypothese untersucht, dass dyadisches Coping eine Mediatorvariable darstellt und den Effekt des Bindungsstils auf die Beziehungsqualität partiell vermittelt. Daneben wurde explorativ der Frage nachgegangen, ob soziodemographische Merkmale einen vorhandenen Mediationseffekt beeinflussen, d.h. ob moderierte Mediationseffekte bestehen. Hierzu wurde eine Querschnittuntersuchung durchgeführt. Bindungsstil, dyadisches Coping und Beziehungsqualität wurden mittels Selbstbeurteilungsinstrumenten erhoben. In die Regressionsanalysen gingen 192 Personen ein, die sich aktuell in einer Paarbeziehung befanden. Die Ergebnisse bestätigen weitgehend die Annahme, dass dyadisches Coping den Effekt des Bindungsstils auf die Beziehungsqualität partiell vermittelt. Dies gilt insbesondere für das positive dyadische Coping. Dieses wirkte sowohl bei der Bindungsdimension sicher-ängstlich als auch bei der Dimension abhängig-unabhängig als Mediatorvariable. Hingegen fungierte negatives dyadisches Coping nicht als Mediator. Neben diesen beiden wurde auch die neu konstruierte Variable Ratio negatives/positives dyadisches Coping als ein möglicher Mediator untersucht. Für diese Variable zeigten sich Ergebnisse, die denen zum positiven dyadischen Coping vergleichbar sind. Als ein wichtiges Ergebnis ist ferner anzumerken, dass Mediationseffekte fast ausschließlich zu beobachten waren, wenn die Beziehungsqualität im Sinne objektivierbarer, struktureller Merkmale als Kriterium betrachtet wurde. Wurde die Beziehungszufriedenheit, d.h. die subjektive, evaluative Komponente, als Kriterium herangezogen, ergaben sich direkte Effekte des Bindungsstils und nicht vermittelte. Daneben zeigte sich, dass soziodemographische Merkmale einige der erzielten Mediationseffekte moderierend beeinflussen. Trotz der bestehenden Einschränkungen der Studie, die vor allem in dem Querschnittdesign zu sehen sind, lässt sich anhand der erzielten Ergebnisse sagen, dass Bindung und dyadisches Coping bedeutsame Einflussfaktoren der Beziehungsqualität darstellen. Ferner zeigt die Studie erstmals auf, dass dyadisches Coping, welches in erheblichem Maße Prozesse des Helfens und Unterstützens umfasst, den Effekt des eigenen Bindungsstils auf die eigene erlebte partnerschaftliche Beziehungsqualität vermittelt. Als solches weist die Studie auf ein mögliches neues Themenfeld der Forschung zu Bindung, Bewältigung und Unterstützung im Kontext von Partnerschaften hin.Most people are interested in a happy, satisfying intimate relationship. Psychological research has shown that a couple's communication and problem solving behavior are the most influential ingredients of a happy partner relationship. However, recent research has provided support that stressful events and adaptive processes also influence the quality of a couple's relationship. One well-developed concept for describing adaptation to stress in couples is dyadic coping. Research has shown that dyadic coping predicts relationship quality concurrently as well as longitudinally. One limitation of the available research on dyadic coping is the lack of associations with other relevant determinants and processes influencing the success of a relationship. One such concept is attachment, which has received much attention in the recent years. Attachment, as it is understood here, comprises the conscious mental representation of central characteristics of an intimate relationship. Many studies have shown that attachment style is related to diverse relationship characteristics, e.g. relationship quality. This study investigated the hypothesis that dyadic coping partially mediates the effect of attachment style on relationship quality. Additionally, moderated mediation effects were tested, i.e. it was investigated whether certain sociodemographic characteristics would moderate the mediation effect. The study employed a cross-sectional design. Attachment style, dyadic coping, and relationship quality were assessed using self-report questionnaires. The study sample comprised 192 persons living in a lasting, intimate relationship. Regression analyses were conducted to test for mediation effects. The results confirm the general hypothesis that dyadic coping partially mediates the effect of attachment style on relationship quality. This effect occurs when positive dyadic coping is regarded as a mediating variable. This variable partially mediates the effect of the attachment dimensions secure-fearful and dependent-independent. Negative dyadic coping did not act as a mediator. In addition, a relational index, ratio negative/positive dyadic coping, was constructed. The results for this variable paralleled those found for positive dyadic coping. Importantly, the mediating effect of the variables positive dyadic coping and ratio dyadic coping emerged almost exclusively when relationship quality, i.e. the observable and structural aspects of a relationship, was used as the criterion variable. Almost no mediation effects occurred when relationship satisfaction, i.e. the subjective evaluative component, was used as the criterion. Furthermore, sociodemographic characteristics moderated some of the mediation effects. Although the study has some limitations, most importantly the cross-sectional design, the results underline that attachment style and dyadic coping are relevant determinants of the quality of an intimate relationship. Further, it shows that dyadic coping mediates the effects of the personal attachment style on the personal evaluation of the partner relationship. Thus, this study underlines the importance of studying adaptation processes in couples from an attachment and coping framework

The Longitudinal Effect of Vertigo and Dizziness Symptoms on Psychological Distress Symptom-Related Fears and Beliefs as Mediators

Despite the frequent observation that vertigo and dizziness (VD) disorders may trigger or exacerbate secondary psychiatric comorbidities, there is limited understanding of the mechanisms underlying this development. To address this gap, we investigated whether symptom-related fears and cognitions as indicated by questionnaire-based measures are mediators of the longitudinal effect of VD symptoms on anxiety and depression after 1 year. We analyzed data from a large study with patients of a treatment center specialized in vertigo (N = 210). Simple and multiple parallel mediation models strengthened our hypothesis that fear of bodily sensations and cognitions about these symptoms play a mediating role in the relationship between VD symptoms and psychopathology at follow-up after baseline scores of the outcome were controlled for. Results are discussed within a cognitive theory framework and point to the potential benefits of interventions that modify symptom-related beliefs and fears via cognitive psychotherapy in this therapeutically underserved population

From normal response to clinical problem : definition and clinical features of fear of cancer recurrence

Research to date on fear of cancer recurrence (FCR) shows that moderate to high FCR affects 22-87 % of cancer survivors and is associated with higher psychological morbidity (Simard et al J Cancer Surviv 7:300-322, 2013). Despite growing research interest in FCR, the lack of consensus on its definition and characteristics when it reaches a clinical level has impeded knowledge transfer into patient services. In order to address these gaps, expert researchers, policy makers, trainees, and patient advocates attended a 2-day colloquium at the University of Ottawa in August 2015. A Delphi method was used to identify the most relevant definition of FCR, and the attendees generated possible diagnostic characteristics of clinical FCR. After three rounds of discussion and voting, the attendees reached consensus on a new definition of FCR: "Fear, worry, or concern relating to the possibility that cancer will come back or progress." Regarding clinical FCR, five possible characteristics were proposed: (1) high levels of preoccupation, worry, rumination, or intrusive thoughts; (2) maladaptive coping; (3) functional impairments; (4) excessive distress; and (5) difficulties making plans for the future. The new proposed definition of FCR reflects the broad spectrum in which patients experience FCR. A consensual definition of FCR and the identification of the essential characteristics of clinical FCR are necessary to accurately and consistently measure FCR severity and to develop effective interventions to treat FCR. We hope this broad definition can encourage further research and the development of inclusive policies for all cancer patients and survivors who are struggling with this issue.PostprintPeer reviewe

Diversity of cancer-related identities in long-term prostate cancer survivors after radical prostatectomy

BACKGROUND: Individuals affected by cancer need to integrate this experience into their personal biography as their life continues after primary therapy, leading to substantial changes in self-perception. This study identified factors uniquely associated with 5 different cancer-related identities in order to improve the understanding of how self-perception in men affected by prostate cancer is associated with certain clinical and psychosocial characteristics. METHODS: In this cross-sectional study, long-term prostate cancer survivors after radical prostatectomy were asked to choose one of 5 cancer-related identities that described them best. Associations with sociodemographic, clinical, and psychological variables were investigated using multivariable logistic regression. RESULTS: Three thousand three hundred forty-seven men (mean age 78.1 years) surveyed on average 15.6 years after prostatectomy were included. Most men favored the terms “someone who has had cancer” (43.9%) which was associated with a mild disease course, and “patient” (26.3%) which was associated with ongoing therapy and biochemical disease recurrence. The self-descriptions “cancer survivor” (16.8%), “cancer conqueror” (10.9%) and “victim” (2.1%) were less common. “Cancer survivor” was associated with high perceived disease severity (OR: 1.86 [1.44–2.40]). “Cancer survivor” and “cancer conqueror” were related to high benefit finding (OR: 1.89 [1.48–2.40], OR: 1.46 [1.12–1.89] respectively), and only “cancer conqueror” was associated with high well-being (OR: 1.84 [1.35–2.50]). Identification as “victim” was associated with a positive depression screening and low well-being (OR: 2.22 [1.15–4.31], OR: 0.38 [0.20–0.72] respectively) (all p < 0.05). CONCLUSIONS: Although long-term survival is common among men affected by PCa, they display a large diversity in cancer-related identities, which are associated with unique clinical and psychological characteristics. These cancer-related identities and their distinctive properties are associated with psychological well-being even after a long follow-up

Psychiatric comorbidity and psychosocial impairment among patients with vertigo and dizziness

Background: Vertigo and dizziness are often not fully explained by an organic illness, but instead are related to psychiatric disorders. This study aimed to evaluate psychiatric comorbidity and assess psychosocial impairment in a large sample of patients with a wide range of unselected organic and non-organic (ie, medically unexplained) vertigo/dizziness syndromes. Methods: This cross-sectional study involved a sample of 547 patients recruited from a specialised interdisciplinary treatment centre for vertigo/dizziness. Diagnostic evaluation included standardised neurological examinations, structured clinical interview for major mental disorders (SCID-I) and self-report questionnaires regarding dizziness, depression, anxiety, somatisation and quality of life. Results: Neurological diagnostic workup revealed organic and non-organic vertigo/dizziness in 80.8% and 19.2% of patients, respectively. In 48.8% of patients, SCID-I led to the diagnosis of a current psychiatric disorder, most frequently anxiety/phobic, somatoform and affective disorders. In the organic vertigo/dizziness group, 42.5% of patients, particularly those with vestibular paroxysmia or vestibular migraine, had a current psychiatric comorbidity. Patients with psychiatric comorbidity reported more vertigo-related handicaps, more depressive, anxiety and somatisation symptoms, and lower psychological quality of life compared with patients without psychiatric comorbidity. Conclusions: Almost half of patients with vertigo/dizziness suffer from a psychiatric comorbidity. These patients show more severe psychosocial impairment compared with patients without psychiatric disorders. The worst combination, in terms of vertigo-related handicaps, is having non-organic vertigo/dizziness and psychiatric comorbidity. This phenomenon should be considered when diagnosing and treating vertigo/dizziness in the early stages of the disease

Additional Diffusion-Weighted Imaging with Background Body Signal Suppression (DWIBS) Improves Pre-Therapeutical Detection of Early-Stage (pT1a) Glottic Cancer: A Feasibility and Interobserver Reliability Study

Background: Early-stage glottic cancer is easily missed on magnetic resonance imaging (MRI). Diffusion-weighted imaging (DWI) may improve diagnostic accuracy. Therefore, our aim was to assess the value of adding diffusion-weighted imaging with background body signal suppression (DWIBS) to pre-therapeutic MRI staging. (2 Methods: Two radiologists with 8 and 13 years of experience, blinded to each other’s findings, initially interpreted only standard MRI, later DWIBS alone, and afterward, standard MRI + DWIBS in 41 patients with histopathologically proven pT1a laryngeal cancer of the glottis. Results: Detectability rates with standard MRI, DWIBS only, and standard MRI + DWIBS were 68–71%, 63–66%, and 73–76%, respectively. Moreover, interobserver reliability was calculated as good (κ = 0.712), very good (κ = 0.84), and good (κ = 0.69) for standard MRI, DWIBS only, and standard MRI + DWIBS, respectively. Conclusions: Standard MRI, DWIBS alone, and standard MRI + DWIBS showed an encouraging detection rate, as well as distinct interobserver reliability in the diagnosis of early-stage laryngeal cancer when compared to the definitive histopathologic report

Specific feedback makes medical students better communicators

Background: Feedback is regarded a key element in teaching communication skills. However, specific aspects of feedback have not been systematically investigated in this context. Therefore, the aim of this study was to investigate the effectiveness of communication skills training (CST) integrating specific, structured and behavioral feedback. Methods: We condensed best practice recommendations for feedback in a CST for undergraduate medical students and compared the effect of specific, structured and behavior-orientated feedback (intervention group CST-behav) to general, experience-orientated feedback (CST- exp. as our control group) in a randomized controlled trial (RCT). We investigated changes on communication skills evaluated by independent raters, and evaluated by standardized patients (SP). To do that, every student was video-recorded in a pre and post assessment. Results: Sixty-six undergraduate medical students participated voluntarily in our study. Randomization did not result in equally skilled groups at baseline, so valid inter-group comparisons were not possible. Therefore, we analyzed the results of 34 students of our intervention group (CST-behav). Five out of seven domains in communication skills as evaluated by independent raters improved significantly, and there was a significant change in the global evaluation by SP. Conclusions: Although we were unable to make between-group comparisons, the results of the within group pre-post evaluation suggest that specific feedback helps improve communication skills