The impacts of thresholds on risk behavior: What's wrong with index insurance?

Almost universally, implementers of index insurance for low income households have chosen to embed insurance with other interventions designed to improve productivity, with the insurance used almost entirely to make the other interventions possible. A common example is to use the insurance to allow farmers to have access to loans by reducing the probability of weather related defaults. A bundled loan/insurance implementation with overwhelming take-up rates had low insurance take-up rates when researchers unbundled the package, covering the loan default risk, so that the loans could be available without requiring insurance. If low income farmers are highly risk averse, why do they place so little value on risk reducing insurance once their access to productive inputs is secured? In general, why do index insurance implementers targeting the lowest income households nearly universally utilize insurance as a tool to increase productivity instead of using it to reduce variance? We provide a potential explanation driven by optimal risk behavior in the face of income thresholds, illustrating how models of risk aversion may not adequately represent the behavior of those with very low incomes. We show how variance reduction may not be the most important outcome for a low income farmer who lives near the poverty threshold. We show that if a farmer's goal is to avoid falling into a poverty trap, then the lower his income is, the less risk averse he becomes in the mean-variance utility maximization framework regarding the design of index insurance contracts. We begin this paper by introducing a mean-variance utility maximization framework, using a known joint distribution for the index and yield, and then we show how one's risk aversion changes when the mean-variance utility function is switched to a poverty trap avoidance utility function. We argue that one reason farmers don't always seek to minimize variance is that they may be very near a poverty trap threshold, and are therefore less willing to give up additional expected income in exchange for decreased income variance. In this case, it may be best for implementers to utilize insurance to unlock increases in productivity as opposed to variance reduction per se.Agricultural and Food Policy, Agricultural Finance, International Development, D80, O12, O16, Q14,

A resistant case of Kawasaki Disease

Kawasaki disease (KD) is an acute febrile illness of childhood of unknown origin which may cause coronary arteritis and death. The Maltese incidence has been calculated at 3.2/100,000 population 4 years of age, similar to that reported in European communities and far lower than that reported in Asian countries. The use of steroids in this condition remains contentious. We report a resistant case of KD who required two doses of pulsed steroids in addition to standard treatment with aspirin and immunoglobulin.peer-reviewe

Teaching Graduate Trainees How to Manage Client Anger: a Comparison of Three Types of Training

The authors examined the effects of three types of training (supervisor-facilitated training, self-training, biblio-training) on 62 graduate student therapists\u27 state anxiety, self-efficacy for dealing with anger, and helping skills (i.e., reflections and immediacy) in response to videotaped vignettes of angry clients. Training overall was rated as very helpful, and trainees increased in self-efficacy for working with client anger. Supervisor-facilitated training was rated as more helpful than, and was preferred to, self-training and biblio-training; it also led to more reflection of feelings in response to clients. Results suggest that vignettes such as these might be a helpful adjunct to training once students have competency in the basic helping skills

Case Studies of the Attainment of Insight in Dream Sessions: Replication and Extension

To replicate and extend the Hill, Knox, et al. (2007) case study of a client who attained insight in one session of dream work, the authors examined two additional single-session cases: one in which a client gained insight and another in which a client did not. The observations across all three cases suggest that the two clients who acquired insight had positive attitudes toward dreams; were motivated and involved in session; and were nonresistant, trusting, and affectively present but not overwhelmed. The client who did not gain insight questioned the value of dreams and was resistant, untrusting, andf emotionally overwhelmed. Therapist adherence and competence using the dream model, ability to manage countertransference, and effective use of probes for insight distinguished the therapists whose clients gained insight from the therapist whose client did not

Breathing feedback system with wearable textile sensors

Breathing exercises form an essential part of the treatment for respiratory illnesses such as cystic fibrosis. Ideally these exercises should be performed on a daily basis. This paper presents an interactive system using a wearable textile sensor to monitor breathing patterns. A graphical user interface provides visual real-time feedback to patients. The aim of the system is to encourage the correct performance of prescribed breathing exercises by monitoring the rate and the depth of breathing. The system is straightforward to use, low-cost and can be installed easily within a clinical setting or in the home. Monitoring the user with a wearable sensor gives real-time feedback to the user as they perform the exercise, allowing them to perform the exercises independently. There is also potential for remote monitoring where the user’s overall performance over time can be assessed by a clinician

MUSTANG 3.3 Millimeter Continuum Observations of Class 0 Protostars

We present observations of six Class 0 protostars at 3.3 mm (90 GHz) using the 64-pixel MUSTANG bolometer camera on the 100-m Green Bank Telescope. The 3.3 mm photometry is analyzed along with shorter wavelength observations to derive spectral indices (S_nu ~ nu^alpha) of the measured emission. We utilize previously published dust continuum radiative transfer models to estimate the characteristic dust temperature within the central beam of our observations. We present constraints on the millimeter dust opacity index, beta, between 0.862 mm, 1.25 mm, and 3.3 mm. Beta_mm typically ranges from 1.0 to 2.4 for Class 0 sources. The relative contributions from disk emission and envelope emission are estimated at 3.3 mm. L483 is found to have negligible disk emission at 3.3 mm while L1527 is dominated by disk emission within the central beam. The beta_mm^disk <= 0.8 - 1.4 for L1527 indicates that grain growth is likely occurring in the disk. The photometry presented in this paper may be combined with future interferometric observations of Class 0 envelopes and disks.Comment: 19 pages, 3 figures, AJ accepted, in pres

Can a computerised training paradigm assist people with intellectual disabilities to learn cognitive mediation skills? A randomised experiment

Aims: The aim was to examine whether specific skills required for cognitive behavioural therapy (CBT) could be taught using a computerised training paradigm with people who have intellectual disabilities (IDs). Training aimed to improve: a) ability to link pairs of situations and mediating beliefs to emotions, and b) ability to link pairs of situations and emotions to mediating beliefs. Method: Using a single-blind mixed experimental design, sixty-five participants with IDs were randomised to receive either computerised training or an attention-control condition. Cognitive mediation skills were assessed before and after training. Results: Participants who received training were significantly better at selecting appropriate emotions within situation-beliefs pairs, controlling for baseline scores and IQ. Despite significant improvements in the ability of those who received training to correctly select intermediating beliefs for situation-feelings pairings, no between-group differences were observed at post-test. Conclusions: The findings indicated that computerised training led to a significant improvement in some aspects of cognitive mediation for people with IDs, but whether this has a positive effect upon outcome from therapy is yet to be established

Supervisor Self-disclosure: Supervisees\u27 Experiences and Perspectives

Twelve graduate-level supervisees were interviewed regarding their experiences of supervisor self-disclosure (SRSD); data were analyzed using consensual qualitative research. When describing a specific SRSD experience, supervisees reported a range of antecedents (e.g., difficult clinical situation, self-doubt, tension in supervision relationship) followed by supervisor disclosures about clinical experiences or personal information. Supervisees perceived that their supervisors disclosed primarily to normalize, but also to build rapport and to instruct. The SRSDs had mostly positive effects (e.g., normalization), though some negative effects (e.g., deleterious impact on supervision relationship) were reported. Implications of these findings for supervision, training, and research are addressed

Association of Factor V Secretion with Protein Kinase B Signaling in Platelets from Horses with Atypical Equine Thrombasthenia.

BackgroundTwo congenital bleeding diatheses have been identified in Thoroughbred horses: Glanzmann thrombasthenia (GT) and a second, novel diathesis associated with abnormal platelet function in response to collagen and thrombin stimulation.Hypothesis/objectivesPlatelet dysfunction in horses with this second thrombasthenia results from a secretory defect.AnimalsTwo affected and 6 clinically normal horses.MethodsEx vivo study. Washed platelets were examined for (1) expression of the αIIb-β3 integrin; (2) fibrinogen binding capacity in response to ADP and thrombin; (3) secretion of dense and α-granules; (4) activation of the mammalian target of rapamycin (mTOR)-protein kinase B (AKT) signaling pathway; and (5) cellular distribution of phosphatidylinositol-4-phosphate-3-kinase, class 2B (PIK3C2B) and SH2 containing inositol-5'-phosphatase 1 (SHIP1).ResultsPlatelets from affected horses expressed normal amounts of αIIb-β3 integrin and bound fibrinogen normally in response to ADP, but bound 80% less fibrinogen in response to thrombin. α-granules only released 50% as much Factor V as control platelets, but dense granules released their contents normally. Protein kinase B (AKT) phosphorylation was reduced after thrombin activation, but mTOR Complex 2 (mTORC2) and phosphoinositide-dependent kinase 1 (PDK1) signaling were normal. SH2-containing inositol-5'-phosphatase 1 (SHIP1) did not localize to the cytoskeleton of affected platelets and was decreased overall consistent with reduced AKT phosphorylation.Conclusions and clinical significanceDefects in fibrinogen binding, granule secretion, and signal transduction are unique to this thrombasthenia, which we designate as atypical equine thrombasthenia

Managing the high-producing herd. III. Producing high quality milk

Progress in the dairy industry over the past 30 yr can be defined as a movement toward fewer farms, more cows per farm, fewer total cows, more milk per cow, a gradual decline in total annual milk production from 1950 through 1975 followed by a sharp increase through 1985, a decrease in per capita consumption, and an increase in milk quality