A network approach to public goods

Abstract We study settings where each agent can exert costly effort that creates nonrival, heterogeneous benefits for some of the others. For example, municipalities can forgo consumption to reduce pollution. How do the prospects for efficient cooperation depend on asymmetries in the effects of players' actions? We approach this question by analyzing a network that describes the marginal benefits agents can confer on one another. The first set of results explains how the largest eigenvalue of this network measures the marginal gains available from cooperating; as an application, we describe the players whose participation is essential to achieving any Pareto improvement on an inefficient status quo. Next, we examine mechanisms all of whose equilibria are Pareto efficient and individually rational; an outcome is called robust if it is an equilibrium outcome in every such mechanism. Robust outcomes exist and correspond to the Lindahl public goods solutions. The main result is a characterization of effort levels at these outcomes in terms of players' centralities in the benefits network. It entails that an outcome is robust if and only if agents contribute in proportion to how much they value the efforts of those who help them

The Psychological Experience of Frontline Perioperative Health Care Staff in Responding to COVID-19: Qualitative Study

BackgroundThe rapid spread of the novel coronavirus (COVID-19) has presented immeasurable challenges to health care workers who remain at the frontline of the pandemic. A rapidly evolving body of literature has quantitatively demonstrated significant psychological impacts of the pandemic on health care workers. However, little is known about the lived experience of the pandemic for frontline medical staff. ObjectiveThis study aimed to explore the qualitative experience of perioperative staff from a large trauma hospital in Melbourne, Australia. MethodsInductive thematic analysis using a critical realist approach was used to analyze data from 9 semistructured interviews. ResultsFour key themes were identified. Hospital preparedness related to the perceived readiness of the hospital to respond to the pandemic and encompassed key subthemes around communication of policy changes, team leadership, and resource availability. Perceptions of readiness contributed to the perceived psychological impacts of the pandemic, which were highly varied and ranged from anger to anxiety. A number of coping strategies were identified in response to psychological impacts which incorporated both internal and external coping mechanisms. Finally, adaptation with time reflected change and growth over time, and encompassed all other themes. ConclusionsWhile frontline staff and hospitals have rapidly marshalled a response to managing the virus, relatively less consideration was seen regarding staff mental health in our study. Findings highlight the vulnerability of health care workers in response to the pandemic and reinforce the need for a coordinated approach to managing mental health

Platelet versus fresh frozen plasma transfusion for coagulopathy in cardiac surgery patients.

BackgroundPlatelets (PLTS) and fresh frozen plasma (FFP) are often transfused in cardiac surgery patients for perioperative bleeding. Their relative effectiveness is unknown.MethodsWe conducted an entropy-weighted retrospective cohort study using the Australian and New Zealand Society of Cardiac and Thoracic Surgeons National Cardiac Surgery Database. All adults undergoing cardiac surgery between 2005-2021 across 58 sites were included. The primary outcome was operative mortality.ResultsOf 174,796 eligible patients, 15,360 (8.79%) received PLTS in the absence of FFP and 6,189 (3.54%) patients received FFP in the absence of PLTS. The median cumulative dose was 1 unit of pooled platelets (IQR 1 to 3) and 2 units of FFP (IQR 0 to 4) respectively. After entropy weighting to achieve balanced cohorts, FFP was associated with increased perioperative (Risk Ratio [RR], 1.63; 95% Confidence Interval [CI], 1.40 to 1.91; PConclusionIn perioperative bleeding in cardiac surgery patient, platelets are associated with a relative mortality benefit over FFP. This information can be used by clinicians in their choice of procoagulant therapy in this setting

Core-selecting package auctions

Core, Stable matching, Marriage problem, Auctions, Core-selecting auctions, Menu auctions, Proxy auctions, Package bidding, Combinatorial bidding, Incentives, Truncation strategies, D44, C78,