Catalyzing Fans

This paper proposes the development of Fan Action Committees (“FACs”), which, like their political counterpart ( PACs ), could mobilize and empower fans to play a larger role in the decision-making associated with which “production teams” the talent will work. We outline two institutional options: FACs could directly compensate talent by crowdfunding, or they could make donations to charities favored by talent. We then discuss both obstacles and objections from a variety of policy and legal perspectives ranging from competitive balance to distributive justice. Finally, we consider possible extensions of the FAC model as well as offer some ruminations on why FACs haven’t already developed. Importantly, FACs create the potential for more efficient valuations of talent by registering not only the number of fans but also the intensity of their preferences. This insight, which stresses the upside of price discrimination, has relevance for a wide range of human endeavor where bilateral contracts have third party externalities that are not currently calibrated or adequately valued

Randomized trial of complete versus lesion-only revascularization in patients undergoing primary percutaneous coronary intervention for STEMI and Multivessel Disease

BACKGROUND: The optimal management of patients found to have multivessel disease while undergoing primary percutaneous coronary intervention (P-PCI) for ST-segment elevation myocardial infarction is uncertain.   OBJECTIVES: CvLPRIT (Complete versus Lesion-only Primary PCI trial) is a U.K. open-label randomized study comparing complete revascularization at index admission with treatment of the infarct-related artery (IRA) only.   METHODS: After they provided verbal assent and underwent coronary angiography, 296 patients in 7 U.K. centers were randomized through an interactive voice-response program to either in-hospital complete revascularization (n = 150) or IRA-only revascularization (n = 146). Complete revascularization was performed either at the time of P-PCI or before hospital discharge. Randomization was stratified by infarct location (anterior/nonanterior) and symptom onset (≤3 h or >3 h). The primary endpoint was a composite of all-cause death, recurrent myocardial infarction (MI), heart failure, and ischemia-driven revascularization within 12 months.   RESULTS: Patient groups were well matched for baseline clinical characteristics. The primary endpoint occurred in 10.0% of the complete revascularization group versus 21.2% in the IRA-only revascularization group (hazard ratio: 0.45; 95% confidence interval: 0.24 to 0.84; p = 0.009). A trend toward benefit was seen early after complete revascularization (p = 0.055 at 30 days). Although there was no significant reduction in death or MI, a nonsignificant reduction in all primary endpoint components was seen. There was no reduction in ischemic burden on myocardial perfusion scintigraphy or in the safety endpoints of major bleeding, contrast-induced nephropathy, or stroke between the groups.   CONCLUSIONS: In patients presenting for P-PCI with multivessel disease, index admission complete revascularization significantly lowered the rate of the composite primary endpoint at 12 months compared with treating only the IRA. In such patients, inpatient total revascularization may be considered, but larger clinical trials are required to confirm this result and specifically address whether this strategy is associated with improved survival. (Complete Versus Lesion-only Primary PCI Pilot Study [CvLPRIT]; ISRCTN70913605)

Waste Crime – Waste Risks: Gaps in Meeting the Global Waste Challenge

More than ever, our future depends upon how we manage the future of our waste. As an integrated part of sustainable development, effective waste management can reduce our global footprint. Ignoring or neglecting the challenges of waste, however, can lead to significant health, environmental and economic consequences. A staggering 1.3 billion tonnes of food is produced each year to feed the world’s 7 billion people. Yet, according to the Food and Agriculture Organization (FAO), around US$1 trillion of that food goes to waste. With 200,000 new peoplWaste covers a very wide spectrum of discarded materials ranging from municipal, electrical and electronic, industrial and agricultural, to new types including counterfeit pesticides. It also includes anything in size and scale from decommissioned ships, oil or liquid wastes, hundreds of millions of mobile phones to billions of used car tires. __Recommendations__ - Strengthen awareness, monitoring and information - Strengthen national legislation and enforcement capacities - Strengthen international treaties and compliance measures - Promote prevention measures and synergie

Executive functioning skills and their environmental predictors among pre-school aged children in South Africa and The Gambia

Executive functions (EFs) in early childhood are predictors of later developmental outcomes and school readiness. Much of the research on EFs and their psychosocial correlates has been conducted in high-income, minority world countries, which represent a small and biased portion of children globally. The aim of this study is to examine EFs among children aged 3–5 years in two African countries, South Africa (SA) and The Gambia (GM), and to explore shared and distinct predictors of EFs in these settings. The SA sample (N = 243, 51.9% female) was recruited from low-income communities within the Cape Town Metropolitan area. In GM, participants (N = 171, 49.7% female) were recruited from the rural West Kiang region. EFs, working memory (WM), inhibitory control (IC) and cognitive flexibility (CF), were measured using tablet-based tasks. Associations between EF task performance and indicators of socioeconomic status (household assets, caregiver education) and family enrichment factors (enrichment activities, diversity of caregivers) were assessed. Participants in SA scored higher on all EF tasks, but children in both sites predominantly scored within the expected range for their age. There were no associations between EFs and household or familial variables in SA, except for a trend-level association between caregiver education and CF. Patterns were similar in GM, where there was a trend-level association between WM and enrichment activities but no other relationships. We challenge the postulation that children in low-income settings have poorer EFs, simply due to lower socioeconomic status, but highlight the need to identify predictors of EFs in diverse, global settings. Research Highlights: Assessed Executive Functioning (EF) skills and their psychosocial predictors among pre-school aged children (aged 3–5 years) in two African settings (The Gambia and South Africa). On average, children within each setting performed within the expected range for their age, although children in South Africa had higher scores across tasks. There was little evidence of any association between socioeconomic variables and EFs in either site. Enrichment activities were marginally associated with better working memory in The Gambia, and caregiver education with cognitive flexibility in South Africa, both associations were trend-level significance

General Practitioners involvement in enteral tube feeding at home: a qualitative study

<p>Abstract</p> <p>Background</p> <p>Complex medical treatment is moving from hospital to primary care and General Practitioners (GPs) are increasingly asked to undertake new roles. There are now an estimated 19,500 patients being fed in the UK in the community on enteral tube feeding using a variety of different feeding tubes (Percutaneous endoscopic gastrostomy (PEG), Jejunostomy, or nasogastric (NG). The majority of patients are over the age of 65 years when they had artificial feeding initiated and mainly because of dysphagia. The aim of this study was to explore GPs knowledge, attitudes and skills relating to enteral feeding in the community.</p> <p>Methods</p> <p>Semi-structured one-to-one interviews with a convenience sample of GPs in Northern Ireland.</p> <p>Results</p> <p>Twenty-three GPs in three health boards in Northern Ireland participated in the study. Most found dealing with enteral feeding to be a predominantly negative experience. They had little involvement in patient selection for the procedure and poor or no discharge information. GPs felt inadequately trained, there was poor communication between primary and secondary care and little support. There was anger and frustration among GPs about lack of resources (funding and training), and the perception that primary care was used as a dumping ground.</p> <p>Conclusion</p> <p>Moving complex medical treatment from secondary to primary care has major implications for GPs who should be included in the patient selection process, have adequate discharge information about their patients, be adequately resourced and have appropriate support and training.</p

Spirit, mind and body: the archaeology of monastic healing

Archaeology and material culture are used in this chapter to consider how monastic experience responded to illness, ageing and disability. The approach taken is influenced by the material study of religion, which interrogates how bodies and things engage to construct the sensory experience of religion, and by practice-based approaches in archaeology, which examine the active role of space and material culture in shaping religious agency and embodiment. The archaeology of monastic healing focuses on the full spectrum of healing technologies, from managing the body in order to prevent illness, through to the treatment of the sick and preparation of the corpse for burial

Random Matrix Theories in Quantum Physics: Common Concepts

We review the development of random-matrix theory (RMT) during the last decade. We emphasize both the theoretical aspects, and the application of the theory to a number of fields. These comprise chaotic and disordered systems, the localization problem, many-body quantum systems, the Calogero-Sutherland model, chiral symmetry breaking in QCD, and quantum gravity in two dimensions. The review is preceded by a brief historical survey of the developments of RMT and of localization theory since their inception. We emphasize the concepts common to the above-mentioned fields as well as the great diversity of RMT. In view of the universality of RMT, we suggest that the current development signals the emergence of a new "statistical mechanics": Stochasticity and general symmetry requirements lead to universal laws not based on dynamical principles.Comment: 178 pages, Revtex, 45 figures, submitted to Physics Report

Factors that transformed maize productivity in Ethiopia

Published online: 26 July 2015Maize became increasingly important in the food security of Ethiopia following the major drought and famine that occurred in 1984. More than 9 million smallholder house- holds, more than for any other crop in the country, grow maize in Ethiopia at present. Ethiopia has doubled its maize produc- tivity and production in less than two decades. The yield, currently estimated at >3 metric tons/ha, is the second highest in Sub-Saharan Africa, after South Africa; yield gains for Ethiopia grew at an annual rate of 68 kg/ha between 1990 and 2013, only second to South Africa and greater than Mexico, China, or India. The maize area covered by improved varieties in Ethiopia grew from 14 % in 2004 to 40 % in 2013, and the application rate of mineral fertilizers from 16 to 34 kg/ ha during the same period. Ethiopia ’ s extension worker to farmer ratio is 1:476, compared to 1:1000 for Kenya, 1:1603 for Malawi and 1:2500 for Tanzania. Increased use of im- proved maize varieties and mineral fertilizers, coupled with increased extension services and the absence of devastating droughts are the key factors promoting the accelerated growth in maize productivity in Ethiopia. Ethiopia took a homegrown solutions approach to the research and development of its maize and other commodities. The lesson from Ethiopia ’ s experience with maize is that sustained investment in agricul- tural research and development and policy support by the national government are crucial for continued growth of agricultur