A vintage model of technology diffusion: The effects of returns to disversity and learning by using

The diffusion of new technologies is a lengthy process and many firms continue to invest in relatively old technologies. This paper develops a vintage model of technology adoption and diffusion that aims at explaining these two phenomena. Our explanation for these phenomena emphasises the relevance of complementarity between different vintages (or, alternatively, returns to diversity) and learning-by- using. The model is characterised by simultaneous investments in vintages of different quality and endogenously determined scrapping of old technologies. We show that the stronger the complementarity between different vintages and the stronger the learning-by-using, the longer it takes before firms scrap (seemingly) inferior technologies

Excision and primary anastomosis for short bulbar strictures : is it safe to change from the transecting towards the nontransecting technique?

Objective: To explore whether it is safe to change from transecting excision and primary anastomosis (tEPA) towards nontransecting excision and primary anastomosis (ntEPA) in the treatment of short bulbar urethral strictures and to evaluate whether surgical outcomes are not negatively affected after introduction of ntEPA. Materials and Methods: Two-hundred patients with short bulbar strictures were treated by tEPA (n=112) or ntEPA (n=88) between 2001 and 2017 in a single institution. Failure rate and other surgical outcomes (complications, operation time, hospital stay, catheterization time, and extravasation at first cystography) were calculated for both groups. Potentially predictive factors for failure (including ntEPA) were analyzed using Cox regression analysis. Results: Median follow-up for the entire cohort was 76 months, 118 months, and 32 months for, respectively, tEPA and ntEPA (p= 3) complication rate was low (1%) and not higher with ntEPA. Median operation time, hospital stay, and catheterization time with tEPA and ntEPA were, respectively, 98 and 87 minutes, 3 and 2 days, and 14 and 9 days. None of these outcomes were negatively affected by the use of ntEPA. Diabetes and previous urethroplasty were significant predictors for failure (Hazard ratio resp. 0.165 and 0.355), whereas ntEPA was not. Conclusions. Introduction of ntEPA did not negatively affect short-term failure rate, high-grade complication rate, operation time, catheterization time, and hospital stay in the treatment of short bulbar strictures. Diabetes and previous urethroplasty are predictive factors for failure

Chronic disease management items in general practice: A population-based study of variation in claims by claimant characteristics

Objective: To describe how Medical Benefits Schedule (MBS) chronic disease (CD) item claims vary by sociodemographic and health characteristics in people with heart disease, asthma or diabetes. Design, setting and participants: A cross-sectional analysi

Behavioural effects of Advanced Cruise Control Use

 In this study, a meta-analytic approach was used to analyse effects of Advanced Cruise Control (ACC) on driving behaviour reported in seven driving simulator studies. The effects of ACC on three consistent outcome measures, namely, driving speed, headway and driver workload have been analysed. The indicators of speed, headway and workload have been chosen because they are assumed to be directly affected by the ACC support, their relationship with road safety is reasonably established and they are the most frequently used outcome measures in the sample of analysed studies. The results suggest that different operational settings of ACC that are important for the level of support provided by the system, are significant for the effects ACC have on various aspects of driving behaviour, i.e. on mean driving speed and mean time headway. The obtained effect sizes clustered in two groups, with more intervening ACCs having the effects of an increased driving speed and decreased mean time headway. These results are further discussed in the context of road safety, especially in the context of behavioural adaptation

Reducing dementia risk by targeting modifiable risk factors in mid-life: study protocol for the Innovative midlife intervention for dementia deterrence (In-MINDD) randomised controlled feasibility trial

Background Dementia prevalence is increasing as populations live longer, with no cure and the costs of caring exceeding many other conditions. There is increasing evidence for modifiable risk factors which, if addressed in mid-life, can reduce the risk of developing dementia in later life. These include physical inactivity, low cognitive activity, mid-life obesity, high blood pressure, and high cholesterol. This study aims to assess the acceptability and feasibility and impact of giving those in mid-life, aged between 40 and 60 years, an individualised dementia risk modification score and profile and access to personalised on-line health information and goal setting in order to support the behaviour change required to reduce such dementia risk. A secondary aim is to understand participants’ and practitioners’ views of dementia prevention and explore the acceptability and integration of the Innovative Midlife Intervention for Dementia Deterrence (In-MINDD) intervention into daily life and routine practice. Methods/design In-MINDD is a multi-centre, primary care-based, single-blinded randomised controlled feasibility trial currently being conducted in four European countries (France, Ireland, the Netherlands and the UK). Participants are being recruited from participating general practices. Inclusion criteria will include age between 40 and 60 years; at least one modifiable risk factor for dementia risk (including diabetes, hypertension, obesity, renal dysfunction, current smoker, raised cholesterol, coronary heart disease, current or previous history of depression, self-reported sedentary lifestyle, and self-reported low cognitive activity) access to the Internet. Primary outcome measure will be a change in dementia risk modification score over the timescale of the trial (6 months). A qualitative process evaluation will interview a sample of participants and practitioners about their views on the acceptability and feasibility of the trial and the links between modifiable risk factors and dementia prevention. This work will be underpinned by Normalisation Process Theory. Discussion This study will explore the feasibility and acceptability of a risk profiler and on-line support environment to help individuals in mid-life assess their risk of developing dementia in later life and to take steps to alleviate that risk by tackling health-related behaviour change. Testing the intervention in a robust and theoretically informed manner will inform the development of a future, full-scale randomised controlled trial

Overestimation of Skills Affects Drivers’ Adaptation to Task Demands

Inadequate self-assessment, and specifically, overestimation of skill, results in insufficient adaptation to task demands, which can manifest itself on different levels of the driving task. A total of 130 drivers (83 novice and 47 experienced drivers) participated in an on-road driving assessment. Their performance in this assessment (i.e., fail or pass) was compared to the participants’ reported confidence in their driving skills (i.e., high or low confidence), resulting in three calibration groups: a) well-calibrated drivers (reported confidence matched performance on assessment), b) overconfident drivers (high confidence but failed assessment) and c) insecure drivers (low confidence but passed assessment). Furthermore, participants completed a questionnaire which focused on choices made on the strategic and manoeuvring level of the driving task. No significant difference was found between the calibration groups for the strategic level. Overconfident drivers reported significantly more violating behaviour than the well-calibrated and the insecure drivers. At the manoeuvring level, overconfident drivers showed significantly less instances of adaptation to traffic complexity. In conclusion, the current study suggests that overconfidence is related to inadequate adaptation to task demands

Automated Quality Control for Sensor Based Symptom Measurement Performed Outside the Lab

The use of wearable sensing technology for objective, non-invasive and remote clinimetric testing of symptoms has considerable potential. However, the accuracy achievable with such technology is highly reliant on separating the useful from irrelevant sensor data. Monitoring patient symptoms using digital sensors outside of controlled, clinical lab settings creates a variety of practical challenges, such as recording unexpected user behaviors. These behaviors often violate the assumptions of clinimetric testing protocols, where these protocols are designed to probe for specific symptoms. Such violations are frequent outside the lab and affect the accuracy of the subsequent data analysis and scientific conclusions. To address these problems, we report on a unified algorithmic framework for automated sensor data quality control, which can identify those parts of the sensor data that are sufficiently reliable for further analysis. Combining both parametric and nonparametric signal processing and machine learning techniques, we demonstrate that across 100 subjects and 300 clinimetric tests from three different types of behavioral clinimetric protocols, the system shows an average segmentation accuracy of around 90%. By extracting reliable sensor data, it is possible to strip the data of confounding factors in the environment that may threaten reproducibility and replicability

The Adaption Test: The Development of a Method to Measure Speed Adaption to Traffic Complexity

To monitor novice driver performance in the first years of solo driving, a test aimed at assessing speed adaptation to the traffic situation was developed and evaluated. The Adaptation Test consisted of 18 traffic scenes presented in two (almost) identical photographs, which differed in one single detail, increasing the situation’s complexity. The difference in reported speed between the two pictures was used as an indication of drivers’ adaptation of speed to the complexity of the traffic situation. A previous study showed that novice, unsafe and overconfident drivers, as identified in an on-road driving assessment, performed worse on the Adaptation Test (i.e. less often reported a lower speed in the more complex situation). The analysis of new data in this paper shows no correlation between performance on the Adaptation Test and self-reported crashes, and that after two years, experienced drivers had improved their performance on the Adaptation Test just as much as novice drivers