Moral Hazard in Repeated Procurement of Services

This paper analyzes repeated procurement of services as a four-stage game divided into two periods. In each period there is (1) a contest stage à la Tullock in which the principal selects an agent and (2) a service stage in which the selected agent provides a service. Since this service effort is non-verifiable, the principal faces a moral hazard problem at the service stages. This work considers how the principal should design the period-two contest to mitigate the moral hazard problem in the period-one service stage and to maximize total service and contest efforts. It is shown that the principal must take account of the agent's past service effort in the period-two contest success function. The results indicate that the optimal way to introduce this `bias' is to choose a certain degree of complementarity between past service and current contest efforts. This result shows that contests with `additive bias' (`multiplicative bias') are optimal in incentive problems when effort cost is low (high). Furthermore, it is shown that the severity of the moral hazard problem increases with the cost of service effort (compared to the cost of contest effort) and the number of agents. Finally, the results are extended to more general contest success functions. JEL classification: C72; D82 Key words: Biased contests; Moral Hazard; Repeated Game; Incentives.

A Theory of Representative Behavior in the Dictator Game

In this paper we present a model of representative behavior in the dictator game. Individuals have simultaneous and non-contradictory preferences over monetary payoffs, altruistic actions and equity concerns. We require that these behaviors must be aggregated and founded in principles of representativeness and empathy. The model results match closely the observed mean split and replicate other empirical regularities (for instance, higher stakes reduce the willingness to give). In addition, we connect representative behavior with an allocation rule built on psychological and behavioral arguments. An approach consistently neglected in this literature. Key words: Dictator Game, Behavioral Allocation Rules, Altruism, Equity Concerns, Empathy, Self-interest JEL classification: C91, D03, D63, D74.

A Sequential Allocation Problem: The Asymptotic Distribution of Resources

In this paper we consider a sequential allocation problem with n individuals. The first individual can consume any amount of some endowment leaving the remaining for the second individual, and so on. Motivated by the limitations associated with the cooperative or non-cooperative solutions we propose a new approach. We establish some axioms that should be satisfied, representativeness, impartiality, etc. The result is a unique asymptotic allocation rule. It is shown for n = 2; 3; 4; and a claim is made for general n. We show that it satisfies a set of desirable properties. Key words: Sequential allocation rule, River sharing problem, Cooperative and non-cooperative games, Dictator and ultimatum games. JEL classification: C79, D63, D74.

Assessment of inflammatory Bowel Disease patient's needs and problems from a nursing perspective

BACKGROUND: In this study, we aimed at assessing Inflammatory Bowel Disease patients' needs and current nursing practice to investigate to what extent consensus statements (European Crohn's and Colitis Organization) on the nursing roles in caring for patients with IBD concur with local practice. METHODS: We used a mixed-method convergent design to combine quantitative data prospectively collected in the Swiss IBD cohort study and qualitative data from structured interviews with IBD healthcare experts. Symptoms, quality of life, and anxiety and depression scores were retrieved from physician charts and patient self-reported questionnaires. Descriptive analyses were performed based on quantitative and qualitative data. RESULTS: 230 patients of a single center were included, 60% of patients were males, and median age was 40 (range 18-85). The prevalence of abdominal pain was 42%. Self-reported data were obtained from 75 out of 230 patients. General health was perceived significantly lower compared with the general population (p < 0.001). Prevalence of tiredness was 73%; sleep problems, 78%; issues related to work, 20%; sexual constraints, 35%; diarrhea, 67%; being afraid of not finding a bathroom, 42%; depression, 11%; and anxiety symptoms, 23%. According to experts' interviews, the consensus statements are found mostly relevant with many recommendations that are not yet realized in clinical practice. CONCLUSION: Identified prevalence may help clinicians in detecting patients at risk and improve patient management. © 2015 S. Karger AG, Basel.

Regional determinants of firm entry in a developing country

We analyse the determinants of firm entry in developing countries using Argentina as an illustrative case. Our main finding is that although most of the regional determinants used in previous studies analysing developed countries are also relevant here, there is a need for additional explanatory variables that proxy for the specificities of developing economies (e.g., poverty, informal economy and idle capacity).We also find evidence of a core-periphery pattern in the spatial structure of entry that seems to be mostly driven by differences in agglomeration economies. Since regional policies aiming to attract new firms are largely based on evidence from developed countries, our results raise doubts about the usefulness of such policies when applied to developing economies. JEL classification: R12, R30, C33. Key words: Firm entry, Argentina, count data models.

Painatuksen UV-stabiilisuuden optimointi fenolihartsatussa paperissa

Tässä diplomityössä tutkittiin painetun paperin ja siitä fenoliformaldehydihartsilla impregnoimalla valmistetun pinnoituskalvon UV-stabiilisuuden parantamis-mahdollisuuksia. Työn kirjallisuusosassa käsitellään painetun pinnoituskalvon valmistusprosessia ja painatuksen UV-valonkestoon vaikuttavia tekijöitä. Painovärin pigmentti, sen määrä ja käsittely, painovärin sideaine sekä fenoliformaldehydihartsi ja sen lisäaineet vaikuttavat pinnoitetun betonoimisvanerin säänkesto-ominaisuuksiin. Erilaisilla epäorgaanisilla valkoisilla pigmenteillä ja kidemuodoilla on erilainen UV-valonkesto ja taitekerroin. Päällystämällä titaanidioksidi esimerkiksi alumiini- tai zirkoniumoksideilla sen UV-valonkestoa voidaan parantaa merkittävästi. UV-hajoaminen voidaan havaita painetun pinnoitteen liituuntumisena. Liituuntumista voidaan pitää veden ja hapen välisenä reaktiona, jota titaanidioksidi ja UV-säteily katalysoivat. Sen takia myös muiden valkoisten epäorgaanisten pigmenttien ominaisuuksia ja käyttöä selvitettiin. Kokeissa käytettiin yhdeksää eri painoväriä, kahta eri paksuista paperia ja kahta eri tyyppistä hartsia. Painovärejä ohennettiin vedellä ja paperin painopuolta vaihdeltiin. Kaikissa painatuksissa käytettiin kolmea eri rasterointiasteen laattaa, jolloin painovärin määrää paperissa saatiin vähennettyä. Painetuista papereista mitattiin densiteetti, värimäärä, pisara-absorptio vedellä ja kontaktikulma hartsilla. Myös painovärin tunkeumaa selvitettiin paperin poikkileikeistä tehtyjen SEM-kuvien avulla. Painetut paperit impregnoitiin fenoliformaldehydihartsilla kalvoksi. Pinnoituskalvot puristettiin vanerin pinnalle laboratoriopuristimella. Koekappaleet altistettiin UV-valolle, sateelle ja pakkaselle sääkaapissa 400 h ajan, mikä vastaa noin 1,5 vuotta ulkona Suomen oloissa. Kappaleista mitattiin kiilto, värinmuutos ja liituuntuminen. Pinnoitteen liituuntumista tapahtui vähiten niissä koepisteissä, joissa painatus oli tehty 30 % rasteroidulla laatallaSäänkestävä TiO2 osoittautui hyväksi, mutta myös ZnO-pigmentillä saatiin hyviä tuloksia. ZnO-koepisteessä liituuntumisreaktio ei ole niin voimakkaasti katalysoitu kuin TiO2-koepisteissä. Paksun paperin painatuspuolella näytti olevan merkitystä säänkestoon. Huopapuolelle painettuna pinnoitteen liituuntuminen oli vähäisempää

Olipa kerran muutos - Narratiivinen tutkimus organisaatiosta sisäisten ja ulkoisten muutospaineiden keskellä

Tutkimus kuvaa tarinallisuuden kautta organisaation sisäistä muutosta organisaation toimiessa muuttuvassa toimintaympäristössä. Teoriaosan keskeisinä käsitteinä ovat sosiaalinen identiteetti organisaatiossa sekä muutosjohtaminen. Tutkimus selvittää, miten jatkuva organisatorinen ja toimintaympäristöllinen muutos vaikuttivat organisaation muutoskykyyn ja sen jäseniin, minkälaista muutosjohtamista organisaatio muutostilanteessa tarvitsee ja millaisia vaikutuksia muutoksilla oli organisaation sisällä esiintyviin sosiaalisiin identiteetteihin. Organisaatiomuutos ilmeni organisaation työntekijöissä erilaisina reaktioina: osa menetti uskonsa organisaatioon, toiset turhautuivat ja kaipasivat vahvistusta toiminnalleen ja kolmansilla työn sujuminen nousi keskiöön. Muutospaineiden keskellä organisaatiossa tarvitaan uskottavaa muutosviestintää ja johtavaa identiteettiä, johon kaikki organisaation jäsenet voivat samaistua. Tämän sosiaalisen identiteetin synnyn mahdollistaa organisaation johdon aktiivinen muutosprosessin johtaminen. Myös keskijohdon rooli johdon muutosviestin vahvistamisessa on tärkeä muutosprosessin onnistumiselle ja sisäistämiselle. Muutoksen johtamisessa on oleellista ottaa ihmisten johtaminen osaksi päivittäistä toimintaa. Organisaation jäsenten tunnepohjaisen sitouttamisen kautta saavutetaan mahdollisuus toteuttaa onnistunut muutosprosessi. Keskijohdon tehtävänä on viestiä ylimmän johdon visio työntekijätasolle uskottavasti, jotta muutokseen sitoudutaan. Muutosprosessin onnistumista tulee seurata ja tukea organisaation johdon taholta.

Management of severe blunt hepatic injury in the era of computed tomography and transarterial embolization: A systematic review and critical appraisal of the literature.

BACKGROUND: During the last decade, the management of blunt hepatic injury has considerably changed. Three options are available as follows: nonoperative management (NOM), transarterial embolization (TAE), and surgery. We aimed to evaluate in a systematic review the current practice and outcomes in the management of Grade III to V blunt hepatic injury. METHOD: The MEDLINE database was searched using PubMed to identify English-language citations published after 2000 using the key words blunt, hepatic injury, severe, and grade III to V in different combinations. Liver injury was graded according to the American Association for the Surgery of Trauma classification on computed tomography (CT). Primary outcome analyzed was success rate in intention to treat. Critical appraisal of the literature was performed using the validated National Institute for Health and Care Excellence "Quality Assessment for Case Series" system. RESULTS: Twelve articles were selected for critical appraisal (n = 4,946 patients). The median quality score of articles was 4 of 8 (range, 2-6). Overall, the median Injury Severity Score (ISS) at admission was 26 (range, 0.6-75). A median of 66% (range, 0-100%) of patients was managed with NOM, with a success rate of 94% (range, 86-100%). TAE was used in only 3% of cases (range, 0-72%) owing to contrast extravasation on CT with a success rate of 93% (range, 81-100%); however, 9% to 30% of patients required a laparotomy. Thirty-one percent (range, 17-100%) of patients were managed with surgery owing to hemodynamic instability in most cases, with 12% to 28% requiring secondary TAE to control recurrent hepatic bleeding. Mortality was 5% (range, 0-8%) after NOM and 51% (range, 30-68%) after surgery. CONCLUSION: NOM of Grade III to V blunt hepatic injury is the first treatment option to manage hemodynamically stable patients. TAE and surgery are considered in a highly selective group of patients with contrast extravasation on CT or shock at admission, respectively. Additional standardization of the reports is necessary to allow accurate comparisons of the various management strategies. LEVEL OF EVIDENCE: Systematic review, level IV.

Les vaccins contre le zona : efficacité, sécurité, et rapport coût/bénéfices [Vaccines against Herpes zoster: Effectiveness, safety, and cost/benefit ratio].

CONTEXT: A vaccination against herpes zoster and its complication is available in France since June 2015. Its exact benefit for public health is still controversial and its level of protection is not optimal. All those reasons seem to suggest a low acceptation rate from general practitioners. OBJECTIVE: To evaluate the effectiveness, the safety, and the cost/benefit ratio of the vaccination against herpes zoster in people aged 50 year or over. DOCUMENTARY SOURCE: Systematic review in Medline and PubMed with research by key words: "herpes zoster vaccine", "zoster vaccine" and "post herpetic neuralgia vaccine". SELECTION OF STUDIES: Randomized and observational studies published in English and French language have been selected by two readers. RESULTS: On 1886 articles identified, 62 studies were included in this systematic review of which 21 randomized trials, 21 observational studies, and 17 medico-economic studies concerned the unadjuvanted vaccine. Considered studies showed an effectiveness of 50% against herpes zoster and 60% on post-herpetic neuralgia incidence of the unadjuvanted vaccine. Five randomized controlled studies were identified for the adjuvanted vaccine. The overall effectiveness of this vaccine was > 90% whatever the age of subjects including those over age 70 and 80. The medico-economic studies conducted in many countries have shown that vaccine policies were beneficial in individuals aged 60 years or over. LIMITATION OF THE WORK: Most of data of effectiveness, and tolerance result from 2 large controlled studies only (SPS and ZEST) for the unadjuvanted vaccine and only one for the adjuvanted vaccine. CONCLUSION: Despite controversy and few uncertainties, the vaccine significantly reduces herpes zoster and its complication incidence. In terms of public health objectives, it reduces the burden of the disease and has a positive medico-economic impact. Preliminary data concerning the adjuvanted vaccine, whilst very promising, are still too limited. Up to now, no group of people with particularly high risk of herpes zoster-related complication who will beneficiate the most of the vaccination has been identified yet and only an age criteria has been considered for the recommendation.

World Polarization in carbon emissions, potential conflict and groups: an updated revision

Typically, conflicts in world environmental negotiations are related, amongst other aspects, to the level of polarization of the countries in groups with conflicting interests. Given the predictable relationship between polarization and conflict, it would seem logical to evaluate the degree to which the distribution of countries – for example, in terms of their CO2 emissions per capita – would be structured through groups which in themselves are antagonistic, as well as their evolution over time. This paper takes the concept of polarization to explore this distribution for the period 1992-2010, looking at different analytic approaches related to the concept. Specifically, it makes a comparative evaluation of the results associated with endogenous multi-polarization measures (i.e. EGR and DER indices), exogenous measures (i.e. Z-K or multidimensional index) and strict bipolarization measures (i.e. Wolfson’s measure). Indeed, the interest lies not only in evaluating the global situation of polarization by comparing the different approaches and their temporal patterns, but also in examining the explanatory capacity of the different proxy groups used as a possible reference for designing global environmental policy from a group premise. JEL codes: D39; Q43; Q56. Key words: polarization; carbon emissions; conflict;

The Determinants of Entrepreneurship in Developing Countries

We address the question of what determines entrepreneurship in developing countries. In particular, because of the influence that this may have on the design of entrepreneurship policies, our main concern is whether the determinants of entrepreneurship are the same and/or have the same impact in developed and developing countries. To this end, we discuss the arguments put forward in the literature in support of the existence of differences in the determinants of entrepreneurship between developed and developing countries. We also analyse the results found in empirical studies on the determinants of formal firm entry (following the World Bank, our proxy of entrepreneurship) in developing countries and compare these results with those typically found in developed countries. Our main conclusion is that policy makers in developing economies should be careful when using evidence from developed countries to design entrepreneurship-promoting policies. Key words: entrepreneurship, developing countries. JEL: O1; O12; L26; M13

When culture does (not) matter: role models and self-efficacy as drivers of entrepreneurial behavior

The correlation between facets of national culture and startup activities has received confirmation in empirical research while many mechanisms behind the correlation remain unclear. We study the interplay between the individualism-collectivism orientation of national culture, the incidence of entrepreneurial role models and selfefficacy understood as the perception of possessing relevant skills and knowledge to become a successful entrepreneur. We find that exposure to entrepreneurial role models offsets self-efficacy as a driver of entrepreneurial intentions. The effect is magnified by the individualistic character of the national culture. Key words: entrepreneurial intentions, role models, self-efficacy, individualism, multilevel regressions

«M'encantaria poder venir a l'estadi a jugar contra el meu equip»: dixi de persona, footing i identitat, una entrevista a Pep Guardiola

Aquest article té dos objectius bàsics. En primer lloc, mostrar la capacitat analítica d'un estudi de cas a l'hora d'estudiar l'expressió de la identitat i dels rols assumits pels participants en la comunicació, posant-la en relació amb els marcs participatius d'Erwing Goffman (1981), d'una banda, i amb la dixi de persona i les seves manifestacions gramaticals (Levinson 1983; Nogué 2008), de l'altra. I en segon lloc, mostrar com l'estructura gramatical pot proporcionar indicadors lingüístics que donen informació sobre la identitat i els rols assumits, posant l'èmfasi en una circumstància concreta: la manera com es reflecteix lingüísticament la col¿lisió entre dos o més rols. Paraules clau: dixi de persona, identitat, rol participatiu, marc participatiu. This article has two main purposes. In the first place, to show how a case study can provide interesting information about the expression of identity and of the different roles assumed by the communication participants. On the one hand, this information is related to the participation frameworks proposed by Erwing Goffman (1981); on the other hand, to person deixis and its grammatical manifestations (Levinson 1983; Nogué 2008). And in the second place, to show how grammatical structure can provide linguistic cues about identity and roles, putting the emphasis on a specific circumstance: the linguistic signs of the collision between two or more of these roles. Key words: person deixis, identity, participation role, participation framework.

Association between Long-Term Exposure to Traffic-Related Air Pollution and Subclinical Atherosclerosis: The REGICOR Study

Background: Epidemiological evidence of the effects of long-term exposure to air pollu tion on the chronic processes of athero genesis is limited. Objective: We investigated the association of long-term exposure to traffic-related air pollu tion with subclinical atherosclerosis, measured by carotid intima media thickness (IMT) and ankle–brachial index (ABI). Methods: We performed a cross-sectional analysis using data collected during the reexamination (2007–2010) of 2,780 participants in the REGICOR (Registre Gironí del Cor: the Gerona Heart Register) study, a population-based prospective cohort in Girona, Spain. Long-term exposure across residences was calculated as the last 10 years’ time-weighted average of residential nitrogen dioxide (NO2) estimates (based on a local-scale land-use regression model), traffic intensity in the nearest street, and traffic intensity in a 100 m buffer. Associations with IMT and ABI were estimated using linear regression and multinomial logistic regression, respectively, controlling for sex, age, smoking status, education, marital status, and several other potential confounders or intermediates. Results: Exposure contrasts between the 5th and 95th percentiles for NO2 (25 μg/m), traffic intensity in the nearest street (15,000 vehicles/day), and traffic load within 100 m (7,200,000 vehicle-m/day) were associated with differences of 0.56% (95% CI: –1.5, 2.6%), 2.32% (95% CI: 0.48, 4.17%), and 1.91% (95% CI: –0.24, 4.06) percent difference in IMT, respectively. Exposures were positively associated with an ABI of > 1.3, but not an ABI of < 0.9. Stronger associations were observed among those with a high level of education and in men ≥ 60 years of age. Conclusions: Long-term traffic-related exposures were associated with subclinical markers of atherosclerosis. Prospective studies are needed to confirm associations and further examine differences among population subgroups.key words: ankle–brachial index, average daily traffic, cardiovascular disease, exposure assessment, exposure to tailpipe emissions, intima media thickness, land use regression model, Mediterranean diet, nitrogen dioxide

Molecular Characteristics of Neuroblastoma with Special Reference to Novel Prognostic Factors and Diagnostic Applications

Molecular Characteristics of Neuroblastoma with Special Reference to Novel Prognostic Factors and Diagnostic Applications Department of Medical Biochemistry and Genetics Annales Universitatis Turkuensis, Medica-Odontologica, 2009, Turku, Finland Painosalama Oy, Turku, Finland 2009 Background: Neuroblastoma, which is the most common and extensively studied childhood solid cancer, shows a great clinical and biological heterogeneity. Most of the neuroblastoma patients older than one year have poor prognosis despite intensive therapies. The hallmark of neuroblastoma, biological heterogeneity, has hindered the discovery of prognostic tumour markers. At present, few molecular markers, such as MYCN oncogene status, have been adopted into clinical practice. Aims: The aim of the study was to improve the current prognostic methodology of neuroblastoma, especially by taking cognizance of the biological heterogeneity of neuroblastoma. Furthermore, unravelling novel molecular characteristics which associate with neuroblastoma tumour progression and cell differentiation was an additional objective. Results: A new strictly defined selection of neuroblastoma tumour spots of highest proliferation activity, hotspots, appeared to be representative and reliable in an analysis of MYCN amplification status using a chromogenic in situ hybridization technique (CISH). Based on the hotspot tumour tissue microarray immunohistochemistry and high-resolution oligo-array-based comparative genomic hybridization, which was integrated with gene expression and in silico analysis of existing transcriptomics, a polysialylated neural cell adhesion molecule (NCAM) and poorly characterized amplicon at 12q24.31 were discovered to associate with outcome. In addition, we found that a previously considered new neuroblastoma treatment target, the mutated c-kit receptor, was not mutated in neuroblastoma samples. Conclusions: Our studies indicate polysialylated NCAM and 12q24.31 amplicon to be new molecular markers with important value in prognostic evaluation of neuroblastoma. Moreover, the presented hotspot tumour tissue microarray method together with the CISH technique of the MYCN oncogene copy number is directly applicable to clinical use. Key words: neuroblastoma, polysialic acid, neural cell adhesion molecule, MYCN, c-kit, chromogenic in situ hybridization, hotspot