The Impact of Tax Risk and Persistence on Investment Decisions

There is evidence that tax rates have varied considerably through time. In the postwar years, changes in business taxation in the U.S. have occurred at a pace of approximately every three years. The purpose of this research is to examine the implications of tax risk and persistence on irreversible investment decisions.

Development of a long term monitoring network of sensitive clay slopes in Québec in the context of climate change

The Government of Québec recently initiated the deployment of a vast groundwater pressures monitoring network in postglacial marine clays to document their variations in time and improve our understanding of the relationship between failure initiation and climate in clay slopes. This project aims at evaluating the impacts of climate change on clay-slope stability and how it can be integrated in landslide risk management to improve public safety. Hydrogeological data will be acquired at sites located throughout the Québec Province’s post-glacial clay deposits to create a public georeferenced index of typical hydrogeological conditions. The project goes beyond the characterization of groundwater pressures and their variations in clay slopes. Indeed, slope deformation will be measured at several sites. Also, two sites in flat terrain will be instrumented in order to evaluate mechanical properties of clay layers in simple 1-D conditions and groundwater recharge. The unsaturated clay crust in slopes susceptible to superficial landslides will be characterized and instrumented. The current lifetime of the monitoring project has been set to a period of 25 years.

Shared decision making in patients with low risk chest pain: prospective randomized pragmatic trial.

OBJECTIVE: To compare the effectiveness of shared decision making with usual care in choice of admission for observation and further cardiac testing or for referral for outpatient evaluation in patients with possible acute coronary syndrome. DESIGN: Multicenter pragmatic parallel randomized controlled trial. SETTING: Six emergency departments in the United States. PARTICIPANTS: 898 adults (aged \u3e17 years) with a primary complaint of chest pain who were being considered for admission to an observation unit for cardiac testing (451 were allocated to the decision aid and 447 to usual care), and 361 emergency clinicians (emergency physicians, nurse practitioners, and physician assistants) caring for patients with chest pain. INTERVENTIONS: Patients were randomly assigned (1:1) by an electronic, web based system to shared decision making facilitated by a decision aid or to usual care. The primary outcome, selected by patient and caregiver advisers, was patient knowledge of their risk for acute coronary syndrome and options for care; secondary outcomes were involvement in the decision to be admitted, proportion of patients admitted for cardiac testing, and the 30 day rate of major adverse cardiac events. RESULTS: Compared with the usual care arm, patients in the decision aid arm had greater knowledge of their risk for acute coronary syndrome and options for care (questions correct: decision aid, 4.2 v usual care, 3.6; mean difference 0.66, 95% confidence interval 0.46 to 0.86), were more involved in the decision (observing patient involvement scores: decision aid, 18.3 v usual care, 7.9; 10.3, 9.1 to 11.5), and less frequently decided with their clinician to be admitted for cardiac testing (decision aid, 37% v usual care, 52%; absolute difference 15%; P CONCLUSIONS: Use of a decision aid in patients at low risk for acute coronary syndrome increased patient knowledge about their risk, increased engagement, and safely decreased the rate of admission to an observation unit for cardiac testing.Trial registration ClinicalTrials.gov NCT01969240

Field performance of four vibrating-wire piezometer installation methods

Vibrating wire piezometers provide a number of advantages over the traditional hydraulic piezometer design. There are many methods and configurations for installing vibrating-wire piezometers, with the most common being: single piezometers in sand packs (SP), multilevel piezometers in sand packs (MLSP), and fully-grouted multilevel piezometers using either bentonite (FGB) or cement-bentonite grout (FGCB). This study assesses the performance of these four different installation methods for vibrating wire piezometers at a field site possessing complex stratigraphy, including glacial and marine sediments. Pore pressure data recorded between December 2017 and July 2019 were analyzed to accomplish this objective. Data indicate that SP, MLSP, and FGB piezometers performed well. This determination is based on the fact that piezometers installed at the same depth with these arrangements recorded similar pressure variations that were coherent with the hydrogeological setting. Of the two fully-grouted installations using cement-bentonite grout, one installation failed completely due to a hydraulic short circuit, caused either by shrinkage of the grout or flow occurring along the wires of the embedded instruments. While the FGB-type piezometers used in this study worked correctly, the lack of standard methods concerning both the construction of fully-grouted piezometers is concerning. Furthermore, the lack of a standard method for mixing cement-bentonite grout likely contributed to the failure of the FGCB installations. Thus, due to the lack of guidance for both construction and grout preparation, the use of a bentonite grout removes a degree of uncertainty when fully-grouted installation techniques are used

Hydrogeology of a complex Champlain Sea deposit (Quebec, Canada) : implications for slope stability

The thick sequences of marine clayey deposits which blanket the St. Lawrence Lowlands in south-eastern Canada are highly susceptible to landslides. With 89% of the population of the Province of Quebec living in this region, improving our understanding of the mechanisms causing landslides in these sediments is a matter of public security. To accomplish this goal, instruments were deployed at a field site in Sainte-Anne-de-la-Pérade, Quebec, Canada to monitor atmospheric, soil, and groundwater conditions. Field and laboratory measurements of soil geotechnical and hydraulic properties were also performed. Results indicate that the groundwater and pore pressure dynamics at the site cannot be explained using simplified site conceptual models. Further analysis indicates that groundwater dynamics and pore pressures in the massive clay deposits on-site are determined by (i) the highly-heterogeneous nature of the local geological materials (ii) the contrasting hydraulic and geotechnical properties of these materials, (iii) the presence of two unconfined aquifers at the site, one surficial and one at depth, and (iv), the presence of the Sainte-Anne River. These results were used to create a new conceptual model which illustrates the complex groundwater flow system present on site, and shows the importance of including hydrogeologic context in slope stability analysis

Interim modelling analysis to validate reported increases in condom use and assess HIV infections averted among female sex workers and clients in southern India following a targeted HIV prevention programme

OBJECTIVES: This study assesses whether the observed declines in HIV prevalence since the beginning of the 'Avahan' India HIV/AIDS prevention initiative are consistent with self-reported increases in condom use by female sex workers (FSWs) in two districts of southern India, and provides estimates of the fraction of new infections averted among FSWs and clients due to increases in condom use in commercial sex after 2004. METHODS: A deterministic compartmental model of HIV/sexually transmitted infection (STI) transmission incorporating heterogeneous sexual behaviour was developed, parameterised and fitted using data from two districts in Karnataka, India. Three hypotheses of condom use among FSWs were tested: (H(0)), that condom use increased in line with reported FSW survey data prior to the Avahan initiative but remained constant afterwards; (H(1)) that condom use increased following the Avahan initiative, in accordance with survey data; (H(2)) that condom use increased according to estimates derived from condom distribution data. The proportion of fits to HIV/STI prevalence data was examined to determine which hypothesis was most consistent. RESULTS: For Mysore 0/36/82.7 fits were identified per million parameter sets explored under hypothesis H(0)/H(1)/H(2), respectively, while for Belgaum 9.7/8.3/0 fits were identified. The HIV epidemics in Belgaum and Mysore are both declining. In Mysore, increases in condom use during commercial sex between 2004 and 2009 may have averted 31.2% to 47.4% of new HIV infections in FSWs, while in Belgaum it may have averted 24.8% to 43.2%, if there was an increase in condom use. DISCUSSION: Increased condom use following the Avahan intervention is likely to have played a role in curbing the HIV epidemic in Mysore. In Belgaum, given the limitations in available data, this method cannot be used alone to decide if there has been an increase in condom use

Effectiveness of the Chest Pain Choice decision aid in emergency department patients with low-risk chest pain: study protocol for a multicenter randomized trial

BACKGROUND: Chest pain is the second most common reason patients visit emergency departments (EDs) and often results in very low-risk patients being admitted for prolonged observation and advanced cardiac testing. Shared decision-making, including educating patients regarding their 45-day risk for acute coronary syndrome (ACS) and management options, might safely decrease healthcare utilization. METHODS/DESIGN: This is a protocol for a multicenter practical patient-level randomized trial to compare an intervention group receiving a decision aid, Chest Pain Choice (CPC), to a control group receiving usual care. Adults presenting to five geographically and ethnically diverse EDs who are being considered for admission for observation and advanced cardiac testing will be eligible for enrollment. We will measure the effect of CPC on (1) patient knowledge regarding their 45-day risk for ACS and the available management options (primary outcome); (2) patient engagement in the decision-making process; (3) the degree of conflict patients experience related to feeling uninformed (decisional conflict); (4) patient and clinician satisfaction with the decision made; (5) the rate of major adverse cardiac events at 30 days; (6) the proportion of patients admitted for advanced cardiac testing; and (7) healthcare utilization. To assess these outcomes, we will administer patient and clinician surveys immediately after each clinical encounter, obtain video recordings of the patient-clinician discussion, administer a patient healthcare utilization diary, analyze hospital billing records, review the electronic medical record, and conduct telephone follow-up. DISCUSSION: This multicenter trial will robustly assess the effectiveness of a decision aid on patient-centered outcomes, safety, and healthcare utilization in low-risk chest pain patients from a variety of geographically and ethnically diverse EDs. TRIAL REGISTRATION: NCT01969240