Higher-Order Risk Preferences – Consequences for Test and Treatment Thresholds and Optimal Cutoffs

Higher-order risk attitudes include risk aversion, prudence, and temperance. This paper analyzes the effects of such preferences on medical test and treatment decisions, represented either by test and treatment thresholds or – if the test characteristics are endogenous – by the optimal cutoff value for testing. For a risk-averse decision maker, treatment is a risk reducing strategy since it prevents the low health outcome that forgoing treatment yields in the sick state. As compared to risk neutrality, risk aversion thus reduces both the test and the treatment threshold and decreases the optimal cutoff. Prudence is relevant if a comorbidity risk applies in the sick state. It leads to even lower thresholds and a lower optimal cutoff. Finally, temperance plays a role if the comorbidity risk is left-skewed. It lowers the thresholds and the optimal cutoff even further. These findings suggest that diagnostics in low prevalence settings (e.g. screening) are considered more beneficial when higher-order risk preferences are taken into account.Medical decision making; diagnostic risk; test and treatment thresholds; optimal cutoff; risk aversion; prudence

Belastungen und deren Bewältigung im zweiten Bildungsweg zum allgemeinen Krankenpflegediplom nach § 44 GuKG

Der § 44 des Gesundheits- und Krankenpflegegesetzes (GuKG) ermöglicht PflegehelferInnen eine verkürzte Ausbildung zum Diplom. Während diesem zweiten Bildungsweg (ZBW) erleben die Auszubildenden aus der Hauskrankenpflege eine Fülle von Belastungen, die zu bewältigen sind. Diese Studie stellt anhand von qualitativen Interviews nach Witzel und durch die Zusammenfassende Inhaltsanalyse nach Mayring die ausbildungsbedingten Belastungen und deren Bewältigung von Auszubildenden aus dem Bereich der Hauskrankenpflege am zweiten Bildungsweg in einem Kategoriesystem dar. Die Ergebnisse zeigen, dass die im ZBW Auszubildenden die meisten Belastungen bezüglich der theoretischen Ausbildung angeben. Dabei konnte das Vorwissen der Auszubildenden zu einer, für die verkürzte Ausbildung spezifischen Belastungen werden, da es dieses mit den neuen Informationen zu vereinbaren galt. Im Praktikum erfuhren die SchülerInnen spezifische Belastungen durch ihre Berufserfahrung, wegen welcher sie eher einen Hilfskraftstatus als SchülerInnen Status hatten. Der Privat- und Familienbereich der Aufzuschulenden war von Zeitmangel eingeschränkt. In finanzieller Hinsicht wurden die ehemaligen PflegehelferInnen mit ihren geringen Einkommen und ausbildungsbedingten Ausgaben belastet. Es wurde belastungsspezifische Bewältigung betrieben, die im Zusammenhang mit der Theorieausbildung meist problemorientiert und im Praktikum jedoch meist emotionsorientiert war. Die Bewältigungsmöglichkeiten von Belastungen für den Privatbereich waren durch den Zeitmangel stark eingeschränkt. Im finanziellen Bereich bewirkte die Bewältigung durch Nebenjobs eine Verschiebung der Belastungen in den Privatbereich. Die Unterstützung innerhalb des Ausbildungssystems war eher auf spezifische Probleme der Ausbildung bezogen, während die außerhalb des Ausbildungssystems häufiger unspezifisch im Sinne von emotionaler Unterstützung erfolgte. Diese Arbeit hat gezeigt, dass die Belastungsphänomene von im ZBW Auszubildenden aus der Hauskrankenpflege in Wien viel mit den in der internationalen Literatur beschriebenen Sachverhalten gemeinsam haben, aber durch ihre spezielle Charakteristik trotzdem eine Besonderheit darstellen.Paragraph 44 of the Austrian Health and Nursing law (Gesundheits- und Krankenpflegegesetz - GuKG) allows nursing assistants (PflegehelferInnen) to obtain a diploma during a shortened study period. In the course of second chance education, students are exposed to various forms of stress, which they have to cope with This thesis discusses the specific forms of stress experienced by second-chance nursing students from the home care nursing sector and their corresponding copying strategies. Specifically, it uses qualitative interviews according to Witzel besides Mayrings content analysis, and presents the results in a category system. Results show that the students identify the theoretical part of the education as the most stressful one. In particular, the prior knowledge of the students could become a stressor specific to the shortened study period, because they had to recombine it with new information. During practical placement pupils experienced specific stress due to their former professional experience, because they had rather helper-status than student status. The students’ private and family life was limited by lack of time. Low income and education-induced expenses constituted additional stressors. The students developed coping strategies: with regard to theoretical education, these were mostly problem oriented, while, with regard to practical work placement, they were mostly emotion oriented. The coping strategies for dealing with private stress were strongly limited by the lack of time. Trying to deal with financial problems by taking on additional jobs often caused to shift stress from the financial into the private domain. Support within the educational system was rather limited to specific problems related to the courses, while support from outside the educational system was more often unspecific and emotional. This thesis shows that stress exposure and coping strategies of second chance students from the home care nursing sector in Vienna have much in common with those described in the international literature, but in part also exhibit very specific characteristics

Consequences of voluntary job changes in Germany: A multilevel analysis for 1985-2013

Analyzing the development of the consequences of voluntary job changes in Germany between 1985 and 2013, the study focuses on income gains and job satisfaction increases. Drawing on arguments of the job-search literature on the one hand and the proliferation of choices on the other we investigate whether the returns of job changes have increased or decreased. Results show that income gains have decreased over time while the job satisfaction surplus has remained stable. We further conclude that in determining the outcomes of job changes over time, structural factors seem to be more important than individual ones

Higher-order risk preferences in social settings

We study prudence and temperance (next to risk aversion) in social settings. Previous experimental studies have shown that these higher-order risk preferences affect the choices of individuals deciding privately on lotteries that only affect their own payoff. Yet, many risky and financially relevant decisions are made in the social settings of households or organizations. We elicit higher-order risk preferences of individuals and systematically vary how an individual’s decision is made (alone or while communicating with a partner) and who is affected by the decision (only the individual or the partner as well). In doing so, we can isolate the effects of other-regarding concerns and communication on choices. Our results reveal that the majority of choices are risk averse, prudent, and temperate across social settings. We also observe that individuals are influenced significantly by the preferences of a partner when they are able to communicate and choices are payoff-relevant for both of them. Electronic supplementary material The online version of this article (doi:10.1007/s10683-017-9541-4) contains supplementary material, which is available to authorized users

On energetics of allotrope transformations in transition-metal diborides via plane-by-plane shearing

Transition metal diborides crystallise in the $\alpha$, $\gamma$, or $\omega$ type structure, in which pure transition metal layers alternate with pure boron layers stacked along the hexagonal [0001] axis. Here we view the prototypes as different stackings of the transition metal planes and suppose they can transform from one into another by a displacive transformation. Employing first-principles calculations, we simulate sliding of individual planes in the group IV-VII transition metal diborides along a transformation pathway connecting the $\alpha$, $\gamma$, and $\omega$ structure. Chemistry-related trends are predicted in terms of energetic and structural changes along a transformation pathway, together with the mechanical and dynamical stability of the different stackings. Our results suggest that MnB$_2$ and MoB$_2$ possess the overall lowest sliding barriers among the investigated TMB$_2$s. Furthermore, we discuss trends in strength and ductility indicators, including Young's modulus or Cauchy pressure, derived from elastic constants.Comment: 12 pages, 6 figures, accepted for publication in Vacuum, before proo

An All-Atom Force Field for Dry and Water-Lubricated Carbon Tribological Interfaces

We present a non-reactive force field for molecular dynamics simulations of interfaces between passivated amorphous surfaces and their interaction with water. The force field enables large-scale dynamic simulations of dry and lubricated tribological contacts and is tailored to surfaces with hydrogen, hydroxyl and aromatic surface passivation. To favour its compatibility with existing force-field parameterizations for liquids and allow a straightforward extension to other types of surface passivation species, we adopt the commonly used OPLS functional form. The optimisation of the force-field parameters is systematic and follows a protocol that can be reused for other surface-molecule combinations. Reference data are calculated with gradient- and dispersion-corrected density functional theory and include the bonding structure and elastic deformation of bulk and surface structures as well as surface adhesion and water adsorption energy landscapes. The conventions adopted to define the different force-field atom types are based on the hybridisation of carbon orbitals and enable a simple and efficient parameter optimisation strategy based on quantum-mechanical calculations performed only on crystalline reference structures. Transferability tests on amorphous interfaces demonstrate the effectiveness of this approach. After testing the force field, we present two examples of application to tribological problems. Namely, we investigate relationships between dry friction and the corrugation of the contact potential energy surface and the dependency of friction on the thickness of interface water films. We finally discuss the limitations of the force field and propose strategies for its improvement and extension

Quantitative coronary plaque analysis predicts high-risk plaque morphology on coronary computed tomography angiography: results from the ROMICAT II trial

Semi-automated software can provide quantitative assessment of atherosclerotic plaques on coronary CT angiography (CTA). The relationship between established qualitative high-risk plaque features and quantitative plaque measurements has not been studied. We analyzed the association between quantitative plaque measurements and qualitative high-risk plaque features on coronary CTA. We included 260 patients with plaque who underwent coronary CTA in the Rule Out Myocardial Infarction/Ischemia Using Computer Assisted Tomography (ROMICAT) II trial. Quantitative plaque assessment and qualitative plaque characterization were performed on a per coronary segment basis. Quantitative coronary plaque measurements included plaque volume, plaque burden, remodeling index, and diameter stenosis. In qualitative analysis, high-risk plaque was present if positive remodeling, low CT attenuation plaque, napkin-ring sign or spotty calcium were detected. Univariable and multivariable logistic regression analyses were performed to assess the association between quantitative and qualitative high-risk plaque assessment. Among 888 segments with coronary plaque, high-risk plaque was present in 391 (44.0%) segments by qualitative analysis. In quantitative analysis, segments with high-risk plaque had higher total plaque volume, low CT attenuation plaque volume, plaque burden and remodeling index. Quantitatively assessed low CT attenuation plaque volume (odds ratio 1.12 per 1 mm3, 95% CI 1.04-1.21), positive remodeling (odds ratio 1.25 per 0.1, 95% CI 1.10-1.41) and plaque burden (odds ratio 1.53 per 0.1, 95% CI 1.08-2.16) were associated with high-risk plaque. Quantitative coronary plaque characteristics (low CT attenuation plaque volume, positive remodeling and plaque burden) measured by semi-automated software correlated with qualitative assessment of high-risk plaque features

Compact Hardware Implementations of the SHA-3 Candidates ARIRANG, BLAKE, Grøstl, and Skein

The weakening of the widely used SHA-1 hash function has also cast doubts on the strength of the related algorithms of the SHA-2 family. The US NIST has therefore initiated the SHA-3 competition in order to select a modern hash function algorithm as a ``backup\u27\u27 for SHA-2. This algorithm should be efficiently implementable both in software and hardware under different constraints. In this paper, we present hardware implementations of the four SHA-3 candidates ARIRANG, BLAKE, Grøstl, and Skein with the primary constraint of minimizing chip area

Career Success in Different Countries : Reflections on the 5C Project

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