110 research outputs found
Why do banks promise to pay par on demand?
We survey the theories of why banks promise to pay par on demand and examine evidence about
the conditions under which banks have promised to pay the par value of deposits and banknotes on
demand when holding only fractional reserves. The theoretical literature can be broadly divided into four
strands: liquidity provision, asymmetric information, legal restrictions, and a medium of exchange. We
assume that it is not zero cost to make a promise to redeem a liability at par value on demand. If so, then
the conditions in the theories that result in par redemption are possible explanations of why banks
promise to pay par on demand. If the explanation based on customers’ demand for liquidity is correct,
payment of deposits at par will be promised when banks hold assets that are illiquid in the short run. If
the asymmetric-information explanation based on the difficulty of valuing assets is correct, the
marketability of banks’ assets determines whether banks promise to pay par. If the legal restrictions
explanation of par redemption is correct, banks will not promise to pay par if they are not required to do
so. If the transaction explanation is correct, banks will promise to pay par value only if the deposits are
used in transactions. After the survey of the theoretical literature, we examine the history of banking in
several countries in different eras: fourth-century Athens, medieval Italy, Japan, and free banking and
money market mutual funds in the United States. We find that all of the theories can explain some of the
observed banking arrangements, and none explain all of them
Teleconsultation service to improve healthcare in rural areas: acceptance, organizational impact and appropriateness
Background: Nowadays, new organisational strategies should be indentified to improve primary
care and its link with secondary care in terms of efficacy and timeliness of interventions thus
preventing unnecessary hospital accesses and costs saving for the health system. The purpose of
this study is to assess the effects of the use of teleconsultation by general practitioners in rural
areas.
Methods: General practitioners were provided with a teleconsultation service from 2006 to 2008
to obtain a second opinion for cardiac, dermatological and diabetic problems. Access, acceptance,
organisational impact, effectiveness and economics data were collected. Clinical and access data
were systematically entered in a database while acceptance and organisational data were evaluated
through ad hoc questionnaires.
Results: There were 957 teleconsultation contacts which resulted in access to health care services
for 812 symptomatic patients living in 30 rural communities. Through the teleconsultation service,
48 general practitioners improved the appropriateness of primary care and the integration with
secondary care. In fact, the level of concordance between intentions and consultations for cardiac
problems was equal to 9%, in 86% of the cases the service entailed a saving of resources and in 5%
of the cases, it improved the timeliness. 95% of the GPs considered the overall quality positively.
For a future routine use of this service, trust in specialists, duration and workload of
teleconsultations and reimbursement should be taken into account.
Conclusions: Managerial and policy implications emerged mainly related to the support to GPs in
the provision of high quality primary care and decision-making processes in promoting similar
services
Variation in the provision and practice of implant-based breast reconstruction in the UK: Results from the iBRA national practice questionnaire
Introduction The introduction of biological and synthetic meshes has revolutionised the practice of implant-based breast reconstruction (IBBR) but evidence for effectiveness is lacking. The iBRA (implant Breast Reconstruction evAluation) study is a national trainee-led project that aims to explore the practice and outcomes of IBBR to inform the design of a future trial. We report the results of the iBRA National Practice Questionnaire (NPQ) which aimed to comprehensively describe the provision and practice of IBBR across the UK. Methods A questionnaire investigating local practice and service provision of IBBR developed by the iBRA Steering Group was completed by trainee and consultant leads at breast and plastic surgical units across the UK. Summary data for each survey item were calculated and variation between centres and overall provision of care examined. Results 81 units within 79 NHS-hospitals completed the questionnaire. Units offered a range of reconstructive techniques, with IBBR accounting for 70% (IQR:50–80%) of participating units' immediate procedures. Units on average were staffed by 2.5 breast surgeons (IQR:2.0–3.0) and 2.0 plastic surgeons (IQR:1.0–3.0) performing 35 IBBR cases per year (IQR:20-50). Variation was demonstrated in the provision of novel different techniques for IBBR especially the use of biological (n = 62) and synthetic (n = 25) meshes and in patient selection for these procedures. Conclusions The iBRA-NPQ has demonstrated marked variation in the provision and practice of IBBR in the UK. The prospective audit phase of the iBRA study will determine the safety and effectiveness of different approaches to IBBR and allow evidence-based best practice to be explored
OGLE-2016-BLG-1190Lb: The First Spitzer Bulge Planet Lies Near the Planet/Brown-dwarf Boundary
We report the discovery of OGLE-2016-BLG-1190Lb, which is likely to be the first Spitzer microlensing planet in the Galactic bulge/bar, an assignation that can be confirmed by two epochs of high-resolution imaging of the combined source–lens baseline object. The planet's mass, M p = 13.4 ± 0.9 M J , places it right at the deuterium-burning limit, i.e., the conventional boundary between "planets" and "brown dwarfs." Its existence raises the question of whether such objects are really "planets" (formed within the disks of their hosts) or "failed stars" (low-mass objects formed by gas fragmentation). This question may ultimately be addressed by comparing disk and bulge/bar planets, which is a goal of the Spitzer microlens program. The host is a G dwarf, M host = 0.89 ± 0.07 M ⊙, and the planet has a semimajor axis a ~ 2.0 au. We use Kepler K2 Campaign 9 microlensing data to break the lens-mass degeneracy that generically impacts parallax solutions from Earth–Spitzer observations alone, which is the first successful application of this approach. The microlensing data, derived primarily from near-continuous, ultradense survey observations from OGLE, MOA, and three KMTNet telescopes, contain more orbital information than for any previous microlensing planet, but not quite enough to accurately specify the full orbit. However, these data do permit the first rigorous test of microlensing orbital-motion measurements, which are typically derived from data taken over <1% of an orbital period
Evidence-based Kernels: Fundamental Units of Behavioral Influence
This paper describes evidence-based kernels, fundamental units of behavioral influence that appear to underlie effective prevention and treatment for children, adults, and families. A kernel is a behavior–influence procedure shown through experimental analysis to affect a specific behavior and that is indivisible in the sense that removing any of its components would render it inert. Existing evidence shows that a variety of kernels can influence behavior in context, and some evidence suggests that frequent use or sufficient use of some kernels may produce longer lasting behavioral shifts. The analysis of kernels could contribute to an empirically based theory of behavioral influence, augment existing prevention or treatment efforts, facilitate the dissemination of effective prevention and treatment practices, clarify the active ingredients in existing interventions, and contribute to efficiently developing interventions that are more effective. Kernels involve one or more of the following mechanisms of behavior influence: reinforcement, altering antecedents, changing verbal relational responding, or changing physiological states directly. The paper describes 52 of these kernels, and details practical, theoretical, and research implications, including calling for a national database of kernels that influence human behavior
Is Forced Swimming Immobility a Good Endpoint for Modeling Negative Symptoms of Schizophrenia? - Study of Sub-Anesthetic Ketamine Repeated Administration Effects
Stable or improved neurological manifestations during miglustat therapy in patients from the international disease registry for Niemann-Pick disease type C: an observational cohort study
Background: Niemann-Pick disease type C (NP-C) is a rare neurovisceral disease characterised by progressive neurological degeneration, where the rate of neurological disease progression varies depending on age at neurological onset. We report longitudinal data on functional disease progression and safety observations in patients in the international NPC Registry who received continuous treatment with miglustat. Methods: The NPC Registry is a prospective observational cohort of NP-C patients. Enrolled patients who received ≥1 year of continuous miglustat therapy (for ≥90 % of the observation period, with no single treatment interruption >28 days) were included in this analysis. Disability was measured using a scale rating the four domains, ambulation, manipulation, language and swallowing from 0 (normal) to 1 (worst). Neurological disease progression was analysed in all patients based on: 1) annual progression rates between enrolment and last follow up, and; 2) categorical analysis with patients categorised as 'improved/stable' if ≥3/4 domain scores were lower/unchanged, and as 'progressed' if <3 scores were lower/unchanged between enrolment and last follow-up visit. Results: In total, 283 patients were enrolled from 28 centers in 13 European countries, Canada and Australia between September 2009 and October 2013; 92 patients received continuous miglustat therapy. The mean (SD) miglustat exposure during the observation period (enrolment to last follow-up) was 2.0 (0.7) years. Among 84 evaluable patients, 9 (11 %) had early-infantile (<2 years), 27 (32 %) had late-infantile (2 to <6 years), 30 (36 %) had juvenile (6 to <15 years) and 18 (21 %) had adolescent/adult (≥15 years) onset of neurological manifestations. The mean (95%CI) composite disability score among all patients was 0.37 (0.32,0.42) at enrolment and 0.44 (0.38,0.50) at last follow-up visit, and the mean annual progression rate was 0.038 (0.018,0.059). Progression of composite disability scores appeared highest among patients with neurological onset during infancy or childhood and lowest in those with adolescent/adult-onset. Overall, 59/86 evaluable patients (69 %) were categorized as improved/stable and the proportion of improved/stable patients increased with age at neurological onset. Safety findings were consistent with previous data. Conclusions: Disability status was improved/stable in the majority of patients who received continuous miglustat therapy for an average period of 2 years
Discourse, interaction and spatial rhythms: locating pedagogic practice in a material world
Evaluation of suitable temperature range for post‐harvest processing of mud crabs through cardiac performance
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