A Spatial Approach to Addressing Weather Derivative Basis Risk: A Drought Insurance Example

Risk and Uncertainty,

Integration of Naturalistic Driving Characteristics into Crash Forecasting Models

While highway safety has steadily improved throughout the United States, highway crashes and the resulting losses continue to be a significant concern in Louisiana. Louisiana consistently lags behind the country in many key areas of highway safety. To improve the conditions of roads in Louisiana, the Louisiana Department of Transportation and Development (LADOTD) has begun to implement the Highway Safety Manual (HSM) to evaluate existing and expected safety conditions and how to allocate limited improvement funds. However, as the HSM was developed using aggregated national statistics, it is not always able to reflect the conditions present on specific Louisiana roadways. The goal of this research was to address the limitations of applying the HSM predictive method in Louisiana, by creating and testing an HSM crash modification factor (CMF) founded on naturalistic driving behavior. The intent of this new CMF was to identify abrupt braking and evasive maneuvers in specific freeway segments because these conditions have been demonstrated to be strong predictors of high crash potential. The CMF was applied to the HSM predictive method to more accurately and reliably forecast crashes on Louisiana freeways. This research was conducted on freeway segments in Baton Rouge and showed that naturalistic driving behavior correlated with the HSM predicted crash frequency and also demonstrated that use of the crash modification factor affects the predicted crash frequency

Adherence to prophylaxis in adolescents and young adults with severe haemophilia: a qualitative study with healthcare professionals

© 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Aim: to examine healthcare professionals’ (HP) perceptions and experiences in relation to adherence to prophylactic treatment among young people living with haemophilia (YPH). Methods: All HPs in four haemophilia centres across England and Wales were invited to participate, and all HPs who agreed to take part (n = 6) were interviewed. Interviews were audio-recorded, transcribed and then analysed using Interpretative Phenomenological Analysis (IPA). Results: HPs estimate that generally young people with haemophilia keep to their treatment regimen well, although they also recognise that adherence may fluctuate with many patients going through shorter periods of non-adherence. The increasingly personalised or flexible approach to prophylaxis makes it harder to assess adherence. The main themes identified through IPA included (1) HPs’ suggest that adherence fluctuates (2) Non-adherence is mainly driven by lifestyle and developmental, social and family factors, and (3) Education, HPs’ sensitivity to individual needs, and psychological and peer support are key facilitators of good adherence. Conclusion: The increasingly flexible approach to prophylaxis requires a new way of thinking about, and assessment of, adherence. More personalised treatment regimen can be more complicated and may, therefore, lead to accidental non-adherence. The results of this study with HPs complement those of a previous qualitative study with patients but place greater emphasis on a broader perspective on understanding drivers of non-adherence as well as understanding strategies to improve adherence in the minority of patients who appear to struggle.Peer reviewedFinal Published versio

Intensive care unit acquired muscle weakness: when should we consider rehabilitation?

Muscle weakness is highly prevalent during acute critical illness, with the poor exercise performance that occurs after critical illness being recognized as a consequence of skeletal muscles weakness. Advanced techniques to measure peripheral muscle strength are available, but they have limited use in the clinical setting. Simple volitional methods to assess strength are limited because they rely on patient motivation, which can be problematic in the critical care setting. At present, the mechanisms that underlie skeletal muscle wasting and weakness are poorly understood, but use of rehabilitation early in critical illness appears to have beneficial effects on outcome. The future direction will be to determine the underlying mechanisms as well as developing rehabilitation programmes during both the acute and the post critical illness stages

The Long-Run Impacts of Same-Race Teachers

Black primary-school students matched to a same-race teacher perform better on standardized tests and face more favorable teacher perceptions, yet little is known about the long-run, sustained impacts of student-teacher demographic match. We show that assigning a black male to a black teacher in the third, fourth, or fifth grades significantly reduces the probability that he drops out of high school, particularly among the most economically disadvantaged black males. Exposure to at least one black teacher in grades 3-5 also increases the likelihood that persistently low-income students of both sexes aspire to attend a four-year college. These findings are robust across administrative data from two states and multiple identification strategies, including an instrumental variables strategy that exploits within-school, intertemporal variation in the proportion of black teachers, family fixed-effects models that compare siblings who attended the same school, and the random assignment of students and teachers to classrooms created by the Project STAR class-size reduction experiment

Structural vulnerability to narcotics-driven firearm violence: An ethnographic and epidemiological study of Philadelphia's Puerto Rican inner-city.

BackgroundThe United States is experiencing a continuing crisis of gun violence, and economically marginalized and racially segregated inner-city areas are among the most affected. To decrease this violence, public health interventions must engage with the complex social factors and structural drivers-especially with regard to the clandestine sale of narcotics-that have turned the neighborhood streets of specific vulnerable subgroups into concrete killing fields. Here we present a mixed-methods ethnographic and epidemiological assessment of narcotics-driven firearm violence in Philadelphia's impoverished, majority Puerto Rican neighborhoods.MethodsUsing an exploratory sequential study design, we formulated hypotheses about ethnic/racial vulnerability to violence, based on half a dozen years of intensive participant-observation ethnographic fieldwork. We subsequently tested them statistically, by combining geo-referenced incidents of narcotics- and firearm-related crime from the Philadelphia police department with census information representing race and poverty levels. We explored the racialized relationships between poverty, narcotics, and violence, melding ethnography, graphing, and Poisson regression.FindingsEven controlling for poverty levels, impoverished majority-Puerto Rican areas in Philadelphia are exposed to significantly higher levels of gun violence than majority-white or black neighborhoods. Our mixed methods data suggest that this reflects the unique social position of these neighborhoods as a racial meeting ground in deeply segregated Philadelphia, which has converted them into a retail endpoint for the sale of astronomical levels of narcotics.ImplicationsWe document racial/ethnic and economic disparities in exposure to firearm violence and contextualize them ethnographically in the lived experience of community members. The exceptionally concentrated and high-volume retail narcotics trade, and the violence it generates in Philadelphia's poor Puerto Rican neighborhoods, reflect unique structural vulnerability and cultural factors. For most young people in these areas, the narcotics economy is the most readily accessible form of employment and social mobility. The performance of violence is an implicit part of survival in these lucrative, illegal narcotics markets, as well as in the overcrowded jails and prisons through which entry-level sellers cycle chronically. To address the structural drivers of violence, an inner-city Marshall Plan is needed that should include well-funded formal employment programs, gun control, re-training police officers to curb the routinization of brutality, reform of criminal justice to prioritize rehabilitation over punishment, and decriminalization of narcotics possession and low-level sales