The efficiency of emerging Europe’s banking sector before and after the recent economic crisis

This paper provides estimates for the relative efficiency of banks in emerging Europe before the recent boom, just before the crisis, and right after the crisis, using a Data Envelopment Analysis (DEA). The results suggest that DEA efficiency scores before the recent crisis were strongly linked to the host country’s level of development; were higher for foreign-owned banks; but did not stand out for bank groups with a presence in more than one country. The results also suggest that bank efficiency increased during the precrisis boom, but fell during the crisis. Finally, foreign-owned banks in emerging Europe seem to be less efficient than their mother banks, suggesting that although they may bring some efficiency benefits to their host country, they are highly affected by the local business and operational environment.emerging Europe, macro-financial links, bank sector efficiency

Reduced sensitivity to visual looming inflates the risk posed by speeding vehicles when children try to cross the road

Almost all locomotor animals respond to visual looming or to discrete changes in optical size. The need to detect and process looming remains critically important for humans in everyday life. Road traffic statistics confirm that children up to 15 years old are overrepresented in pedestrian casualties. We demonstrate that, for a given pedestrian crossing time, vehicles traveling faster loom less than slower vehicles, which creates a dangerous illusion in which faster vehicles may be perceived as not approaching. Our results from perceptual tests of looming thresholds show strong developmental trends in sensitivity, such that children may not be able to detect vehicles approaching at speeds in excess of 20 mph. This creates a risk of injudicious road crossing in urban settings when traffic speeds are higher than 20 mph. The risk is exacerbated because vehicles moving faster than this speed are more likely to result in pedestrian fatalities

Cross-cultural effects on drivers' hazard perception

Hazard perception tests are used in several developed countries as part of the driver licensing curriculum, however little research has been done in developing countries where road safety is a primary concern. We conducted a cross-cultural hazard perception study to examine the transferability of hazard perception skills between Malaysia and the UK, using hazard clips filmed in both countries. The results showed that familiarity with both the driving environment and type of hazard facilitated drivers' ability to discriminate hazards in a timely manner, although overall drivers viewed and responded to hazards largely similarly regardless of origin. Visual strategies also appeared to be moderated mainly by the immediate driving environment rather than driver origin. Finally, Malaysian drivers required a higher threshold of danger than UK drivers before they would identify a situation as hazardous, possibly reflecting the more hazardous road environment in Malaysia. We suggest that hazard perception testing in developing countries requires a test where performance cannot be confounded with differing thresholds for hazardousness

The potential of educational comics as a health information medium

Objectives To investigate ways in which educational comics might provide support in dealing with feelings and attitudes towards health conditions, as well as improving understanding of factual information and to identify potential weakness of comics as a medium for health information. Methods Semi-structured interviewees with eleven university students who either had a mental or physical health condition themselves or had a family member with a health condition. Results The result highlighted the potential value of comics as a format for health information. In addition to conveying factual information, comics offer opportunities for self-awareness, reassurance, empathy, companionship and a means to explore the impact of illness on family relationships. However, there are notable barriers to the greater use of comics to provide health information, namely, a lack of awareness of, and easy access to, educational comics, along with the perception that comics are exclusively light-hearted and for children. Conclusions Currently, the full potential of comics in health settings is not being realised. Health information professionals may be in a position to address this issue through identifying, cataloguing, indexing and promoting comics as a legitimate format for health information

Humanising illness: presenting health information in educational comics

Research into the effectiveness of comic books as health education tools overwhelmingly consists of studies evaluating the information learnt as a result of reading the comic, for example using preintervention and postintervention questionnaires. In essence, these studies evaluate comics in the same way in which a patient information leaflet might be evaluated, but they fail to evaluate the narrative element of comics. Health information comics have the potential to do much more than simply convey facts about an illness; they can also support patients in dealing with the social and psychological aspects of a condition. This article discusses how some common elements of educational comics are handled in a selection of comics about diabetes, focusing on the more personal or social aspects of the condition as well as the presentation of factual information. The elements examined include: fears and anxieties; reactions of friends and family; interactions with medical professionals; self-management; and prevention. In conclusion, the article argues that comics, potentially, have many advantages over patient information leaflets, particularly in the way in which they can offer ‘companionship’, helping patients to address fears and negative feelings. However, empirical studies are required to evaluate educational comics in a way which takes account of their potential role in supporting patients in coming to terms with their condition, as well as becoming better informed

The feasibility of a randomised controlled trial of physiotherapy for adults with joint hypermobility syndrome

© Queen’s Printer and Controller of HMSO 2016. Background: Joint hypermobility syndrome (JHS) is a heritable disorder associated with laxity and pain in multiple joints. Physiotherapy is the mainstay of treatment, but there is little research investigating its clinical effectiveness. Objectives: To develop a comprehensive physiotherapy intervention for adults with JHS; to pilot the intervention; and to conduct a pilot randomised controlled trial (RCT) to determine the feasibility of conducting a future definitive RCT. Design: Patients’ and health professionals’ perspectives on physiotherapy for JHS were explored in focus groups (stage 1). A working group of patient research partners, clinicians and researchers used this information to develop the physiotherapy intervention. This was piloted and refined on the basis of patients’ and physiotherapists’ feedback (stage 2). A parallel two-arm pilot RCT compared ‘advice’ with ‘advice and physiotherapy’ (stage 3). Random allocation was via an automated randomisation service, devised specifically for the study. Owing to the nature of the interventions, it was not possible to blind clinicians or patients to treatment allocation. Setting: Stage 1 – focus groups were conducted in four UK locations. Stages 2 and 3 – piloting of the intervention and the pilot RCT were conducted in two UK secondary care NHS trusts. Participants: Stage 1 – patient focus group participants (n = 25, three men) were aged > 18 years, had a JHS diagnosis and had received physiotherapy within the preceding 12 months. The health professional focus group participants (n = 16, three men; 14 physiotherapists, two podiatrists) had experience of managing JHS. Stage 2 – patient participants (n = 8) were aged > 18 years, had a JHS diagnosis and no other musculoskeletal conditions causing pain. Stage 3 – patient participants for the pilot RCT (n = 29) were as for stage 2 but the lower age limit was 16 years. Intervention: For the pilot RCT (stage 3) the advice intervention was a one-off session, supplemented by advice booklets. All participants could ask questions specific to their circumstances and receive tailored advice. Participants were randomly allocated to ‘advice’ (no further advice or physiotherapy) or ‘advice and physiotherapy’ (an additional six 30-minute sessions over 4 months). The physiotherapy intervention was supported by a patient handbook and was delivered on a one-to-one patient–therapist basis. It aimed to increase patients’ physical activity through developing knowledge, understanding and skills to better manage their condition. Main outcome measures: Data from patient and health professional focus groups formed the main outcome from stage 1. Patient and physiotherapist interview data also formed a major component of stages 2 and 3. The primary outcome in stage 3 related to the feasibility of a future definitive RCT [number of referrals, recruitment and retention rates, and an estimate of the value of information (VOI) of a future RCT]. Secondary outcomes included clinical measures (physical function, pain, global status, self-reported joint count, quality of life, exercise self-efficacy and adverse events) and resource use (to estimate cost-effectiveness). Outcomes were recorded at baseline, 4 months and 7 months. Results: Stage 1 – JHS is complex and unpredictable. Physiotherapists should take a long-term holistic approach rather than treating acutely painful joints in isolation. Stage 2 – a user-informed physiotherapy intervention was developed and evaluated positively. Stage 3 – recruitment to the pilot RCT was challenging, primarily because of a perceived lack of equipoise between advice and physiotherapy. The qualitative evaluation provided very clear guidance to inform a future RCT, including enhancement of the advice intervention. Some patients reported that the advice intervention was useful and the physiotherapy intervention was again evaluated very positively. The rate of return of questionnaires was low in the advice group but reasonable in the physiotherapy group. The physiotherapy intervention showed evidence of promise in terms of primary and secondary clinical outcomes. The advice arm experienced more adverse events. The VOI analysis indicated the potential for high value from a future RCT. Such a trial should form the basis of future research efforts. Conclusion: A future definitive RCT of physiotherapy for JHS seems feasible, although the advice intervention should be made more robust to address perceived equipoise and subsequent attrition. Trial registration: Current Controlled Trials ISRCTN29874209. Funding: This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 20, No. 47. See the NIHR Journals Library website for further project information

Road Trauma in Teenage Male Youth with Childhood Disruptive Behavior Disorders: A Population Based Analysis

Donald Redelmeier and colleagues conducted a population-based case-control study of 16-19-year-old males hospitalized for road trauma or appendicitis and showed that disruptive behavior disorders explained a significant amount of road trauma in this group

An overview of the approaches for automotive safety integrity levels allocation

YesISO 26262, titled Road Vehicles–Functional Safety, is the new automotive functional safety standard for passenger vehicle industry. In order to accomplish the goal of designing and developing dependable automotive systems, ISO 26262 uses the concept of Automotive Safety Integrity Levels (ASILs), the adaptation of Safety Integrity Levels. ASILs are allocated to the components and subsystems that can cause system failure and malfunctions that lead to hazards. ASILs allocation is a hard problem consists of finding the optimal allocation of safety levels to the system architecture which must guarantee that the highest safety requirements are met while development cost of the automotive system is kept minimum. There were many successful attempts to solve this problem using different techniques. However, it is worth pointing out that there is an absence of a review that provides an in-depth study of all the existing methods and highlights their merits and demerits. This paper presents an overview of different approaches that were used to solve ASILs allocation problem. The review provides an overview of safety requirements including the related standards followed by a study of the resolution methods of the existing approaches. The study of each approach provides a detailed explanation of the used methodology and a discussion of its strength and weaknesses including the main open challenges