on the efficiency of team-based meritocracies

According to theory a pure meritocracy is efficient because individual members are competitively rewarded according to their individual contributions to society. However, purely individually based meritocracies seldom occur. We introduce a new model of social production called “team-based meritocracy” (TBM) in which individual members are rewarded based on their team membership. We demonstrate that as long as such team membership is both mobile and competitively based on contributions, individuals are able to tacitly coordinate a complex and counterintuitive asymmetric equilibrium that is close to Pareto-optimal, possibly indicating that such a group-based meritocracy could be a social structure to which humans respond with particular ease. Our findings are relevant to many contemporary societies in which rewards are at least in part determined via membership in organizations such as for example firms, and organizational membership is increasingly determined by contribution rather than privilege.social stratification, meritocracies, mechanism design, non-cooperative games, experiment, team production

Configuring the Older Non-User: Between Research, Policy and Practice of Digital Exclusion

Older adults face significant barriers when accessing the Internet. What can be done to address these barriers? This article analyses existing strategies to tackle the age-related digital divide on three different levels: research, policy and practice. It analyses (1) scientific conceptualisations that are used when studying Internet use and non-use in later life, (2) policies that address older adults’ Internet (non-)use in Austria and (3) characteristics of older Austrian non-users of the Internet based on the Survey of Health, Ageing and Retirement in Europe (SHARE, wave 6). Analysis shows that Austrian policy tends to emphasise the individual responsibility to learn digital technologies, while placing a lower priority on structural issues, such as investments in infrastructure. However, SHARE data shows that only a small percentage of older non-users of the Internet is in fact reached with such interventions. Thus, this article suggests that policy needs to base its strategies on more refined understandings of Internet use and non-use in later life as well as a more nuanced image of the older non-user. A perspective of critical-cultural gerontology, as laid out in this article, highlights that technology adoption is a domestication process that takes place in the everyday lives of older adults, and it is these processes that interventions that tackle the age-related digital divide should take as a starting point

Assistive Technology and Mobile ICT Usage Among Oldest-Old Cohorts: Comparison of the Oldest-Old in Private Homes and in Long-Term Care Facilities

This study examines technology adoption among oldest-old cohorts (80+) in private homes and long-term care facilities and analyzes relationships between individual characteristics, the living environment, and different kinds of assistive technologies (AT) and information and communication technologies (ICT). The data analysis is based on a representative survey of the oldest-old group's quality of life and well-being in North Rhine-Westphalia, Germany (N = 1,863; age range: 80-103; 12.7% long-term care). Descriptive and multiple binary logistic regression analyses were conducted. Fewer than 3% of people in long-term care used internet-connected ICT devices. AT and ICT device adoption is associated with the living environment and individual characteristics (e.g., functional health, chronological age, education, and technology interest), and different patterns of ICT and AT use can be observed. These results indicate that individual characteristics and the living environment are both decisive in the use of technology among the oldest-old group

The use of mobile devices for physical activity tracking in older adults’ everyday life

Objective: The tracking of one’s own physical activity with mobile devices is a way of monitoring and motivating oneself to remain healthy. Older adults’ general use of mobile devices for physical activity tracking has not yet been examined systematically. The study aimed to describe the use of physical activity trackers, smartwatches and smartphones, or tablets for tracking physical activity and to examine the reasons for the use of these technologies. Methods: Participants aged ≥50 years (N = 1013) living in Switzerland were interviewed in a telephone survey. To address the research questions, we calculated descriptive frequency distributions, tested for differences between groups, and performed logistic regression analyses. Results: Descriptive and multivariate analyses showed that (a) 20.5% of participants used mobile devices for physical activity tracking; (b) men, younger individuals, those with a strong interest in new technology, and those who frequently exercised had a higher likelihood of using mobile devices for physical activity tracking; and (c) participants more often agreed with reasons for use relating to tracking physical activity and motivating oneself to remain healthy than they did with reasons relating to social factors. Conclusions: The study presented representative data about the actual use of mobile tracking technology in persons over 50 years of age. Today, mainly active and younger elderly (mostly men) with a high interest in technology are using tracking technologies. Results indicate a need for further studies on motivational and usability aspects regarding the use of mobile health tracking devices by older adults

Organizational Influences on Interdisciplinary Interactions during Research and Design of Large-Scale Complex Engineered Systems

The design of large-scale complex engineered systems (LaCES) such as an aircraft is inherently interdisciplinary. Multiple engineering disciplines, drawing from a team of hundreds to thousands of engineers and scientists, are woven together throughout the research, development, and systems engineering processes to realize one system. Though research and development (R&D) is typically focused in single disciplines, the interdependencies involved in LaCES require interdisciplinary R&D efforts. This study investigates the interdisciplinary interactions that take place during the R&D and early conceptual design phases in the design of LaCES. Our theoretical framework is informed by both engineering practices and social science research on complex organizations. This paper provides preliminary perspective on some of the organizational influences on interdisciplinary interactions based on organization theory (specifically sensemaking), data from a survey of LaCES experts, and the authors experience in the research and design. The analysis reveals couplings between the engineered system and the organization that creates it. Survey respondents noted the importance of interdisciplinary interactions and their significant benefit to the engineered system, such as innovation and problem mitigation. Substantial obstacles to interdisciplinarity are uncovered beyond engineering that include communication and organizational challenges. Addressing these challenges may ultimately foster greater efficiencies in the design and development of LaCES and improved system performance by assisting with the collective integration of interdependent knowledge bases early in the R&D effort. This research suggests that organizational and human dynamics heavily influence and even constrain the engineering effort for large-scale complex systems

Zdravljenje bolezni prebavil v Srednji in Vzhodni Evropi : podatki, ki jih zdravniki v primarni zdravstveni oskrbi sami sporočajo

Background. Gastrointestinal disorders account for 7-10% of all consultations in primary care. General practitioners’ management of digestive disorders in Central and Eastern European countries is largely unknown. Aims. To identify and compare variations in the self-perceived responsibilities of general practitioners in the management of digestive disorders in Central and Eastern Europe. Methods. A cross-sectional survey of a randomized sample of primary care physicians from 9 countries was conducted. An anonymous questionnaire was sent via post to primary care doctors. Results. We received 867 responses; the response rate was 28.9%. Over 70% of respondents reported familiarity with available guidelines for gastrointestinal diseases. For uninvestigated dyspepsia in patients under 45 years, the "test and treat" strategy was twice as popular as "test and scope". The majority (59.8%) of family physicians would refer patients with rectal bleeding without alarm symptoms to a specialist (from 7.6% of doctors in Slovenia to 85.1% of doctors in Bulgaria; p<0.001). 93.4% of respondents declared their involvement in colorectal cancer screening. In the majority of countries, responding doctors most often reported that they order fecal occult blood tests. The exceptions were Estonia and Hungary, where the majority of family physicians referred patients to a specialist (p<0.001). Conclusions. Physicians from Central and Eastern European countries understood the need for the use of guidelines for the care of patients with gastrointestinal problems, but there is broad variation between countries in their management. Numerous efforts should be undertaken to establish and implement international standards for digestive disorders’ management in general practice.Uvod. 7-10 % vseh posvetov v primarni zdravstveni oskrbi se nanaša na bolezni prebavil. O zdravljenju bolezni prebavil s strani splošnih zdravnikov v Srednji in Vzhodni Evropi ni na razpolago veliko podatkov. Cilji. Ugotoviti in primerjati razlike v samozaznani odgovornosti splošnih zdravnikov pri zdravljenju bolezni prebavil v Srednji in Vzhodni Evropi. Metode. Naredili smo presečne ankete na randomiziranem vzorcu splošnih zdravnikov v primarni zdravstveni oskrbi iz devetih držav. Po pošti smo zdravnikom v primarni zdravstveni oskrbi poslali anonimni vprašalnik. Rezultati. Prejeli smo 867 odgovorov, stopnja odzivnosti je bila 28,9 %. Več kot 70 % anketirancev je v odgovorih navedlo, da so seznanjeni z razpoložljivimi smernicami za bolezni prebavil. Za neraziskano dispepsijo pri bolnikih, mlajših od 45 let, je bila dvakrat bolj priljubljena strategija »testiranja in zdravljenja« kot pa strategija »testiranja in gastroskopije«. Večina (59,8 %) zdravnikov v primarni zdravstveni oskrbi bi bolnike z rektalnimi krvavitvami brez znakov alarma napotila k specialistu (od 7,6 % zdravnikov v Sloveniji do 85,1 % zdravnikov v Bolgariji; p<0.001). 93,4 % anketirancev je potrdilo svojo udeležbo pri presejalnih pregledih za odkrivanje raka debelega črevesa in danke. V večini držav so zdravniki najpogosteje poročali, da naročajo testiranje za odkrivanje prikritih krvavitev v blatu. Izjema pri tem sta bili Estonija in Madžarska, kjer večina zdravnikov v primarni zdravstveni oskrbi napoti paciente k specialistu (p<0.001). Zaključki. Zdravniki iz Srednje in Zahodne Evrope razumejo potrebo po uporabi smernic za nego bolnikov z boleznimi prebavil, vendar pa je pri obravnavi veliko razlik med posameznimi državami. Treba si je prizadevati in sprejeti ukrepe za vzpostavitev in izvajanje mednarodnih standardov za obravnavo bolezni prebavil v splošni praksi

Socio-Technical Perspective on Interdisciplinary Interactions During the Development of Complex Engineered Systems

This study investigates interdisciplinary interactions that take place during the research, development, and early conceptual design phases in the design of large-scale complex engineered systems (LaCES) such as aerospace vehicles. These interactions, that take place throughout a large engineering development organization, become the initial conditions of the systems engineering process that ultimately leads to the development of a viable system. This paper summarizes some of the challenges and opportunities regarding social and organizational issues that emerged from a qualitative study using ethnographic and survey data. The analysis reveals several socio-technical couplings between the engineered system and the organization that creates it. Survey respondents noted the importance of interdisciplinary interactions and their benefits to the engineered system as well as substantial challenges in interdisciplinary interactions. Noted benefits included enhanced knowledge and problem mitigation and noted obstacles centered on organizational and human dynamics. Findings suggest that addressing the social challenges may be a critical need in enabling interdisciplinary interaction

Nagła śmierć sercowa z powodu zakrzepowej plamicy małopłytkowej

Cardiac abnormalities may constitute an important and unrecognized cause of mortality and morbidity in patients with thrombotic thrombocytopenic purpura (TTP). We report a case of 29-year-old female with rapid acute TTP ending with sudden death and not preceded by cardiac symptoms.Cardiac abnormalities may constitute an important and unrecognized cause of mortality and morbidity in patients with thrombotic thrombocytopenic purpura (TTP). We report a case of 29-year-old female with rapid acute TTP ending with sudden death and not preceded by cardiac symptoms

Relevance of Activity Tracking With Mobile Devices in the Relationship Between Physical Activity Levels and Satisfaction With Physical Fitness in Older Adults: Representative Survey

Background: Physical activity has been shown to positively affect many aspects of life, and the positive relationship between physical activity levels and health is well established. Recently, research on the interrelationship between physical activity levels and subjective experiences has gained attention. However, the underlying mechanisms that link physical activity levels with subjective experiences of physical fitness have not been sufficiently explained. Objective: This study aimed to explore the role of physical activity tracking (PAT) in the relationship between physical activity levels and satisfaction with physical fitness in older adults. It is hypothesized that higher levels of physical activity are associated with a higher satisfaction with physical fitness in older adults and that this positive association is stronger for older people who use mobile devices for PAT. Methods: As part of this study, 1013 participants aged 50 years or older and living in Switzerland were interviewed via computer-assisted telephone interviews. Bivariate and multivariate analyses were applied. The interaction effects between physical activity levels and PAT were evaluated using multiple linear regression analysis. Results: Descriptive analyses showed that 719 participants used at least 1 mobile device and that 136 out of 719 mobile device users (18.9%) used mobile devices for PAT. In the multivariate regression analysis, frequent physical activity was found to have a positive effect on satisfaction with physical fitness (beta=.24, P<.001). A significant interaction effect between physical activity levels and PAT (beta=.30, P=.03) provides some first evidence that the positive effects of physical activity on satisfaction with physical fitness can be enhanced by PAT. Conclusions: The results indicate the potential of PAT to enhance the physical fitness of older adults. However, the results also raise new issues in this context. Recommendations for further research and practice include the acquisition of longitudinal data, a more detailed observation of durations of use, and the development of devices for PAT considering health psychology and gerontology theories

The development of academic family medicine in central and eastern Europe since 1990

Background: Since the early 1990s former communist countries have been reforming their health care systems, emphasizing the key role of primary care and recognizing family medicine as a specialty and an academic discipline. This study assesses the level of academic development of the discipline characterised by education and research in central and eastern European (CEE) countries. Methods: A key informants study, using a questionnaire developed on the basis of a systematic literature review and panel discussions, conducted in 11 central and eastern European countries and Russia. Results: Family medicine in CEE countries is now formally recognized as a medical specialty and successfully introduced into medical training at undergraduate and postgraduate levels. Almost all universities have FM/GP departments, but only a few of them are led by general practitioners. The specialist training programmes in all countries except Russia fulfil the recommendations of the European Parliament. Structured support for research in FM/GP is not always available. However specific scientific organisations function in almost all countries except Russia. Scientific conferences are regularly organised in all the countries, but peer-reviewed journals are published in only half of them. Conclusions: Family medicine has a relatively strong position in medical education in central and eastern Europe, but research in family practice is less developed. Although the position of the discipline at the universities is not very strong, most of the CEE countries can serve as an example of successful academic development for countries southern Europe, where family medicine is still not fully recognised