131 research outputs found

    A comprehensive test of order choice theory: recent evidence from the NYSE

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    We perform a comprehensive test of order choice theory from a sample period when the NYSE trades in decimals and allows automatic executions. We analyze the decision to submit or cancel an order or to take no action. For submitted orders we distinguish order type (market vs. limit), order side (buy vs. sell), execution method (floor vs. automatic), and order pricing aggressiveness. We use a multinomial logit specification and a new statistical test. We find a negative autocorrelation in changes in order flow exists over five-minute intervals supporting dynamic limit order book theory, despite a positive first-order autocorrelation in order type. Orders routed to the NYSE’s floor are sensitive to market conditions (e.g., spread, depth, volume, volatility, market and individual-stock returns, and private information), but those using the automatic execution system (Direct+) are insensitive to market conditions. When the quoted depth is large, traders are more likely to “jump the queue” by submitting limit orders with limit prices bettering existing quotes. Aggressively-priced limit orders are more likely late in the trading day providing evidence in support of prior experimental results

    Blood investigation results at a primary health care centre in Malta : a brief evaluation

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    Background This evaluation was based at Mosta Health Centre with a particular focus on the blood investigation results clinic. Objectives To get a clinical profile of the patients being seen at the clinic, to assess whether risk assessment tools are being used in the management of dyslipidaemia and to evaluate patient feedback about the clinic. Method This consisted of a cross-sectional observational study carried out over a five-week period between the end of October and the end of November 2017. Data was collected retrospectively immediately after completion of the clinic on three random days every week. Data collection was divided into two lists of patients – those who attended and those who failed to attend their appointment. A patient questionnaire was also handed to patients to fill in after attending their appointment. Data was inputted in Excel 2010 and analysed using Statistical Package for Social Sciences (SPSS) 22. Results A total of 181 patients had a registered appointment at the blood investigation results clinic during the period of data collection. Seventy-five per cent of these patients attended for their appointment, with 62.2% being females. Routine blood investigations were taken in 80.7% of patients, thyroid function tests in 71.9% and glycosylated haemoglobin in 31.9%. Fourteen point eight per cent of patients had tumour markers booked, and a significant association was found between gender and whether tumour markers were ordered. A risk assessment tool was used in only 21% of the patients seen at the clinic for a lipid profile result, with the majority of General Practitioners (GPs) using the QRISK¼2 cardiovascular disease calculator. Seventy eight patient satisfaction questionnaires were filled in during the period of data collection, and the percentage of patients who gave a very positive response (>8) for questions 1, 2 and 3 was 92%, 89% and 97% respectively. Conclusion Patient attendance at the blood investigation results clinic at Mosta Health Centre during the period under review was reasonably good, and patients were overall satisfied by the service provided. Tumour markers were found to be ordered more frequently in male patients, due to the common request for the PSA test. Risk assessment tools were used by GPs in only 14% of the total number of patients seen at the clinic, and the QRISK¼2 cardiovascular disease calculator was the most commonly used tool.peer-reviewe

    Patient attendance at a primary health care centre in Malta : a cross-sectional observational study

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    Introduction The aim of the study was to describe the reason for consultation of patients attending the General Practitioner (GP) service at a major local health centre and also to get a clinical profile of the patients making use of such health service. This study is based in the publiclyfunded primary health system in Malta and focuses on Mosta Health Centre. Methodology This was a cross-sectional observational study carried out in January 2017. Only the patients seen in the GP clinics were included. All six authors are practicing GPs. All the patients that the authors encountered in the GP clinics were included in the study. The fact that all authors work in different shifts and days allowed for a broad and random inclusion of patients. Patients attending out-ofhours and in weekends were also included. A pilot oneweek period of data collection was carried out. Thereafter, all six authors had an Excel spreadsheet uploaded on the work computer system in the GP consulting rooms, so that patient data was inputted in real-time at the end of each consultation. Data was inputted in Excel 2010 and analysed using the Statistical Package for the Social Sciences (SPSS) 22. Results A total of 820 patients were included in the study. 51.8% of patients were females, whilst 74.8% of patients were born in Malta. 50.2% of patients raised more than one issue during a single consultation, whilst the most common co-morbidity noted was hypertension. The most common reasons for consultation were related to the respiratory and musculoskeletal systems. Various significant associations were observed, most importantly being between the time of attendance and number of issues brought up during a consultation; between being born in Malta and number of issues brought up during a consultation; and between age and number of issues brought up during a single consultation. Conclusion This study involved 820 patients attending Mosta Health Centre over a one-month period during winter 2017. During a single episode of care (visit), Maltese nationals consult for a greater number of issues. In addition, they have a greater number of co-morbidities than non-Maltese nationals. People attending between 08.00 and 17.00 hours tend to present with a greater number of issues for management. Suggestions for service development have been put forward in the discussion. Ideally, such studies should be conducted independently in different health centres given the notable differences in the catchment areas, and during different months of the year.peer-reviewe

    Learning through a Smokescreen: CEO Compensation over Tenure

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    ABSTRACT In this paper we investigate the dynamics of executive compensation over the tenure of the CEO in a firm, where shareholders learn about a CEO's ability and the quality of the CEO-firm job match in the presence of reporting distortions. Career concerns are very high in the early years of tenure because of incomplete information and shareholders update their beliefs using current firm performance which, as suggested by Fudenberg and Tirole (1995), may be distorted by CEOs to maximize the expected length of their tenure. We consider the dynamics of CEO compensation using 1,624 completed tenure spells in 1,023 firms from 1992 to 2009 and use JEL classifications: G3; G32; G38; J22; K2

    A time and motion study of patients presenting at the accident and emergency department at Mater Dei Hospital

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    <p>Abstract</p> <p>Background</p> <p>To carry out a time and motion study of patients presenting at the Emergency Department (ED) by measuring waiting times at the ED dept throughout the day. The objectives were:</p> <p indent="1">‱ to determine whether waiting times are prolonged, and</p> <p indent="1">‱ if prolonged, at which station(s) bottlenecks occur most often in terms of duration and frequency.</p> <p>Results will be compared to the United Kingdom guidelines of stay at the emergency department.</p> <p>Methods</p> <p>A group of 11 medical students monitored all patients who attended ED between 0600 hours on the 25<sup>th </sup>August and 0600 hours on the 1st September 2008. For each 24 hour period, students were assigned to the triage room and the 3 priority areas where they monitored all patient-related activity, movement and waiting times so that length of stay (LOS) could be recorded. The key data recorded included patient characteristics, waiting times at various ED process stages, tests performed, specialist consultations and follow up until admitted, discharged, or referred to another hospital area. Average waiting times were calculated for each priority area. Bottle-necks and major limiting factors were identified. Results were compared against the United Kingdom benchmarks - i.e. 1 hour until first assessment, and 4 hours before admitting/discharge.</p> <p>Results</p> <p>1779 patients presented to the ED in the week monitored. As expected, patients in the lesser priority areas (i.e. 2 & 3) waited longer before being assessed by staff. Patients requiring laboratory and imaging investigations had a prolonged length of stay, which varied depending on specific tests ordered. Specialty consultation was associated with longer waiting times. A major bottleneck identified was waiting times for inpatient admission.</p> <p>Conclusions</p> <p>In conclusion, it was found that 30.3% of priority 1 patients, 86.3% of priority 2 patients and 76.8% of priority 3 patients waited more than 1 hour for first assessment. We conclude by proposing several changes that may expedite throughput.</p

    GYNOCARE Update: Modern Strategies to Improve Diagnosis and Treatment of Rare Gynecologic Tumors—Current Challenges and Future Directions

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    More than 50% of all gynecologic tumors can be classified as rare (defined as an incidence of ≀6 per 100, 000 women) and usually have a poor prognosis owing to delayed diagnosis and treatment. In contrast to almost all other common solid tumors, the treatment of rare gynecologic tumors (RGT) is often based on retrospective studies, expert opinion, or extrapolation from other tumor sites with similar histology, leading to difficulty in developing guidelines for clinical practice. Currently, gynecologic cancer research, due to distinct scientific and technological challenges, is lagging behind. Moreover, the overall efforts for addressing these challenges are fragmented across different European countries and indeed, worldwide. The GYNOCARE, COST Action CA18117 (European Network for Gynecological Rare Cancer Research) programme aims to address these challenges by creating a unique network between key stakeholders covering distinct domains from concept to cure: basic research on RGT, biobanking, bridging with industry, and setting up the legal and regulatory requirements for international innovative clinical trials. On this basis, members of this COST Action, (Working Group 1, “Basic and Translational Research on Rare Gynecological Cancer”) have decided to focus their future efforts on the development of new approaches to improve the diagnosis and treatment of RGT. Here, we provide a brief overview of the current state of-the-art and describe the goals of this COST Action and its future challenges with the aim to stimulate discussion and promote synergy across scientists engaged in the fight against this rare cancer worldwide

    The IDENTIFY study: the investigation and detection of urological neoplasia in patients referred with suspected urinary tract cancer - a multicentre observational study

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    Objective To evaluate the contemporary prevalence of urinary tract cancer (bladder cancer, upper tract urothelial cancer [UTUC] and renal cancer) in patients referred to secondary care with haematuria, adjusted for established patient risk markers and geographical variation. Patients and Methods This was an international multicentre prospective observational study. We included patients aged ≄16 years, referred to secondary care with suspected urinary tract cancer. Patients with a known or previous urological malignancy were excluded. We estimated the prevalence of bladder cancer, UTUC, renal cancer and prostate cancer; stratified by age, type of haematuria, sex, and smoking. We used a multivariable mixed-effects logistic regression to adjust cancer prevalence for age, type of haematuria, sex, smoking, hospitals, and countries. Results Of the 11 059 patients assessed for eligibility, 10 896 were included from 110 hospitals across 26 countries. The overall adjusted cancer prevalence (n = 2257) was 28.2% (95% confidence interval [CI] 22.3–34.1), bladder cancer (n = 1951) 24.7% (95% CI 19.1–30.2), UTUC (n = 128) 1.14% (95% CI 0.77–1.52), renal cancer (n = 107) 1.05% (95% CI 0.80–1.29), and prostate cancer (n = 124) 1.75% (95% CI 1.32–2.18). The odds ratios for patient risk markers in the model for all cancers were: age 1.04 (95% CI 1.03–1.05; P < 0.001), visible haematuria 3.47 (95% CI 2.90–4.15; P < 0.001), male sex 1.30 (95% CI 1.14–1.50; P < 0.001), and smoking 2.70 (95% CI 2.30–3.18; P < 0.001). Conclusions A better understanding of cancer prevalence across an international population is required to inform clinical guidelines. We are the first to report urinary tract cancer prevalence across an international population in patients referred to secondary care, adjusted for patient risk markers and geographical variation. Bladder cancer was the most prevalent disease. Visible haematuria was the strongest predictor for urinary tract cancer
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