The Demand for Specialty-Crop Insurance: Adverse Selection and Moral Hazard

Risk and Uncertainty,

Desarrollo humano y calidad de vida en la rehabilitación social. Caso: Programa de narcóticos anónimos del centro de privación de libertad de personas adultas en conflicto con la ley varones Quito n°2

El presente trabajo tiene como objetivo general determinar los impactos que el programa de narcóticos anónimos produce en la calidad de vida personal, familiar y en el entorno social de las personas privadas de libertad. Se ubica en el marco de calidad de vida y desarrollo humano. La pregunta general que ha orientado a la investigación es: ¿El Programa de Narcóticos Anónimos al ser una alternativa de rehabilitación social impacta positivamente en la calidad de vida personal, familiar y en el entorno de las personas privadas de libertad? La población objetivo se ajustó a tres destinatarios: las personas privadas de libertad del Centro de Privación de Libertad N°2 de Quito que asisten al grupo de Narcóticos Anónimos, amigos cercanos que compartan la condición de privados de libertad, familiares de los internos partícipes. La recolección de la información se realizó a través de instrumentos diseñados como son: encuesta y entrevista, los mismos que cumplen con el objetivo planteado y fueron aplicados en el Centro antes mencionado. De las conclusiones se infiere que el Programa de Narcóticos Anónimos tiene un impacto positivo en la calidad de vida de las personas privadas de libertad y se manifiesta la necesidad de que el Estado promocione dicha alternativa como una iniciativa de rehabilitación social valiosa para que el fin último de la reinserción social positiva y constructiva se cumpla

Individualising Coaching in Olympic and Paralympic Worlds: An Applied Perspective

This practical advance paper outlines the complexity of simultaneously coaching in Olympic and Paralympic disciplines of canoeing. The paper integrates applied experience from the Tokyo Games with a critical review of disability literature to explore the importance of the creation of shared mental models to inform the development of a performance vision in elite sport. The paper first addresses the design and development of complex performance visions, which underpins the delivery of such elite programmes. Secondly, and perhaps more importantly, the paper addresses the fundamental issue that Paralympic sport is not a microcosm of Olympic sport and that performance visions and coaching processes created in an able-bodied environment cannot be cut, copied, and pasted into a Paralympic setting. Offering applied insight from this unique dual perspective, the paper discusses the complexity of designing a well-structured performance vision. We propose that although such performance visions developed in Olympic and Paralympic contexts share some similarities, the design of shared mental models needs to be bespoke to the performance setting. The paper articulates the additional complexities of shared mental models deployed in a paracanoe setting and offers recommendations as to how we can better support the construction of performance visions in Paralympic sport

The relationship between competence and patient outcome with low-intensity cognitive behavioural interventions

Little is understood about the relationship between therapist competence and the outcomes of patients treated for common mental health disorders. Furthermore, the evidence is yet to extend to competence in the delivery of low-intensity cognitive behavioural interventions. Understanding this relationship is essential to the dissemination and implementation of low-intensity cognitive behavioural interventions. The aim of this study was to explore the relationship between Psychological Well-being Practitioner (PWP) competence and patient outcome within the framework of the British government's Improving Access to Psychological Therapies (IAPT) initiative. Forty-seven PWPs treating 3688 patients participated. Relationships between PWP scores on three observed standardized clinical examinations and reliable change in patients' symptoms of anxiety and depression were explored at two time points: during the year-long training phase, and over a 12-month follow-up. Results indicated that patients treated by qualified PWPs achieved superior outcomes than those treated by trainees. Little support was found for a general association between practitioner competence in delivering low-intensity cognitive behavioural interventions and patient outcome, either during or post-training; however, significantly more patients of the most competent PWPs demonstrated reliable improvement in their symptoms of anxiety and depression than would be expected by chance alone and fewer deteriorated compared with those treated by the least competent PWPs. Results were indicative of a complex, non-linear relationship, with patient outcome affected by PWP status (trainee or qualified) and by competence at its extremes. The implications of these results for the dissemination and implementation of low-intensity cognitive behavioural interventions are discussed

Evaluation of Oral Health Status and Oral Care of Patients with Rheumatoid Arthritis

Objective. Rheumatoid arthritis (RA) and periodontal disease (PD) are common chronic, immunoinflammatory, destructive, and progressive diseases; however, the correlations between those two are not yet widely discussed. The purpose of this study was to evaluate the relationship between the selected demographic and clinical parameters of RA patients and oral health status parameters, on the basis of self-assessment. Materials and Methods. Three hundred patients under treatment were included in the study. Questionnaires were completed by 164 out of 300 patients. Results. A total of 100 females and 64 males took part in the study, with a mean age of 65 ± 11.1 years. In younger patients, the disease activity score (DAS28) was higher, and it was associated with pain or discomfort in the oral cavity and with difficulties in toothbrushing. Discomfort or pain in the oral cavity was to a significant extent associated with the poor gingival state, gingival bleeding, and difficulties in biting or chewing. Conclusions. In RA patients, difficulties in biting or chewing, discomfort or pain in oral cavity, feeling of the presence of movable teeth, and gingival bleeding are indications of periodontal infection. Maintaining awareness of oral health and RA is a key issue in the simultaneous management of proper oral care and RA due to the mutual influence of those two factors

Decision-making in rugby and implications for coach education: the elicited case of naturalistic, differentiated and disruptive decision-making

Decision-making in team sports has attracted significant interest over recent decades by those in pursuit of excellence. None more so than by the three authors who have worked, researched, and supported coach and athlete development in this area cumulatively for over 60 years. This paper therefore presents an amalgamation of learning in the form of a retrospective narrative discussion around the key tenants of Decision Making (DM) with the sport of rugby union being utilised as the exemplar. Specifically, here the first author is asked to reflect upon his life in sport as a rugby player, coach and coach education tutor against various DM frameworks and debates which have shaped his own development. The second and third authors act as critical friends and provide additional research context within each section’s discussion. Interestingly a landscape is presented where Decision Making emphasis has generally been placed upon the offensive phase of the game which has in-turn driven coaching pedagogy and attention of those engaged in these sports. The authors therefore propose that this focus is too limiting, and that coach education provision needs to explore decision-making in more depth to differentiate the types of decisions being made and the DM processes that underpin them. They describe the merit of Naturalistic Decision Making and the use of Shared Mental Models as valuable lenses by which to view DM in team sports and on which to base future coach learning. Finally, the authors introduce an additional element to the team DM arena, that of Disruptive Decision Making and offer rugby exemplars of how NDM and SMMs can provide the foundations upon which coaches should base their practice. The authors make a call to action for coaching to address a wider taxonomy of decision-making within team sports’ training and match contexts. Recommendations are then provided for how coach education might better develop the DM practices of both coaches and their athletes

Psychotherapy mediated by remote communication technologies: a meta-analytic review

<p>Abstract</p> <p>Background</p> <p>Access to psychotherapy is limited by psychopathology (e.g. agoraphobia), physical disability, occupational or social constraints and/or residency in under-served areas. For these populations, interventions delivered via remote communication technologies (e.g. telephone, internet) may be more appropriate. However, there are concerns that such delivery may influence the therapeutic relationship and thus reduce therapy effectiveness. This review aimed to determine the clinical effectiveness of remotely communicated, therapist-delivered psychotherapy.</p> <p>Methods</p> <p>Systematic review (including electronic database searching and correspondence with authors) of randomised trials of individual remote psychotherapy. Electronic databases searched included MEDLINE (1966–2006), PsycInfo (1967–2006), EMBASE (1980–2006) and CINAHL databases (1982–2006). The Cochrane Central Register of Controlled Trials (CENTRAL) and the Cochrane Collaboration Depression, Anxiety and Neurosis Controlled Trials Register (CCDAN-CTR). All searches were conducted to include studies with a publication date to July 2006.</p> <p>Results</p> <p>Thirteen studies were identified, ten assessing psychotherapy by telephone, two by internet and one by videoconference. Pooled effect sizes for remote therapy versus control conditions were 0.44 for depression (95%CI 0.29 to 0.59, 7 comparisons, n = 726) and 1.15 for anxiety-related disorders (95%CI 0.81 to 1.49, 3 comparisons, n = 168). There were few comparisons of remote versus face-to-face psychotherapy.</p> <p>Conclusion</p> <p>Remote therapy has the potential to overcome some of the barriers to conventional psychological therapy services. Telephone-based interventions are a particularly popular research focus and as a means of therapeutic communication may confer specific advantages in terms of their widespread availability and ease of operation. However, the available evidence is limited in quantity and quality. More rigorous trials are required to confirm these preliminary estimates of effectiveness. Future research priorities should include overcoming the methodological shortcomings of published work by conducting large-scale trials that incorporate both clinical outcome and more process-orientated measures.</p

A rapid method for the generation of uniform acellular bone explants: a technical note

<p>Abstract</p> <p>Background</p> <p>Bone graft studies lack standardized controls. We aim to present a quick and reliable method for the intra-operative generation of acellular bone explants.</p> <p>Methods</p> <p>Therefore, ovine cancellous bone explants from the iliac crest were prepared and used to test several methods for the induction of cell death. Over night heat inactivation was used as positive treatment control, methods to be investigated included UV light, or X- ray exposure, incubation in a hypotonic solution (salt-free water) and a short cycle of repeated freezing and thawing.</p> <p>Results</p> <p>Viability of treated and 2 days cultured bone explants was investigated by lactate dehydrogenase assay. Non-treated cultured control explants maintained around 50% osteocyte viability, while osteocyte survival after the positive treatment control was abolished. The most dramatic loss in cell viability, together with a low standard deviation, was a repeated cycle of freezing and thawing.</p> <p>Conclusions</p> <p>To summarize, we present a freeze-thaw method for the creation of acellular bone explants, which is easy to perform, not time-consuming and provides consistent results.</p