Introduction Patients with complex care needs (PCCNs) often suffer from combinations of multiple chronic conditions, mental health problems, drug interactions and social vulnerability, which can lead to healthcare services overuse, underuse or misuse. Typically, PCCNs face interactional issues and unmet decisional needs regarding possible options in a cascade of interrelated decisions involving different stakeholders (themselves, their families, their caregivers, their healthcare practitioners). Gaps in knowledge, values clarification and social support in situations where options need to be deliberated hamper effective decision support interventions. This review aims to (1) assess decisional needs of PCCNs from the perspective of stakeholders, (2) build a taxonomy of these decisional needs and (3) prioritise decisional needs with knowledge users (clinicians, patients and managers).
Methods and analysis This review will be based on the interprofessional shared decision making (IP-SDM) model and the Ottawa Decision Support Framework. Applying a participatory research approach, we will identify potentially relevant studies through a comprehensive literature search; select relevant ones using eligibility criteria inspired from our previous scoping review on PCCNs; appraise quality using the Mixed Methods Appraisal Tool; conduct a three-step synthesis (sequential exploratory mixed methods design) to build taxonomy of key decisional needs; and integrate these results with those of a parallel PCCNs’ qualitative decisional need assessment (semistructured interviews and focus group with stakeholders).
Ethics and dissemination This systematic review, together with the qualitative study (approved by the Centre Intégré Universitaire de Santé et Service Sociaux du Saguenay-Lac-Saint-Jean ethical committee), will produce a working taxonomy of key decisional needs (ontological contribution), to inform the subsequent user-centred design of a support tool for addressing PCCNs’ decisional needs (practical contribution). We will adapt the IP-SDM model, normally dealing with a single decision, for PCCNs who experience cascade of decisions involving different stakeholders (theoretical contribution). Knowledge users will facilitate dissemination of the results in the Canadian primary care network.
PROSPERO registration number CRD42015020558.
The empirical literature which explores the effect of wage on job satisfaction typically uses data drawn from social surveys. In these surveys, the amount of wage is reported by the respondents themselves: thus, the explanatory variable of the econometric models may differ from the true wage people earn. Our paper shows that the use of survey data can lead to considerable over-estimation of the importance of wage as a determinant of wage satisfaction. In particular, responses seem to be affected by a recall bias: people who are satisfied with their wage are more likely to over-report their wage in questionnaires. The more satisfied they are the more they over-report (and vice versa unsatisfied people). We name this behavioral disposition “hedonic recall bias”.
This paper presents an overlapping generations model where pollution, private and public health expenditures are all determinants of longevity. Public expenditures, financed through labour taxation, provide both public health and abatement. We study the role of these three components of longevity on welfare and economic stability. At the steady state, we show that an appropriate fiscal policy may enhance welfare. However, when pollution is heavily harmful for longevity, the economy might experience aggregate instability or endogenous cycles. Nonetheless, a fiscal policy, which raises the share of public spending devoted to health, may display stabilizing virtues and rule out cycles. This allows us to recommend the design of the public policy that may comply with the dynamic and welfare objectives.
In polarized committees, majority voting disenfranchises the minority. Allowing voters to spend freely a fixed budget of votes over multiple issues restores some minority power. However, it also creates a complex strategic scenario: a hide-and-seek game between majority and minority voters that corresponds to a decentralized version of the Colonel Blotto game. We offer theoretical results and bring the game to the laboratory. The minority wins as frequently as theory predicts, despite subjects deviating from equilibrium strategies. Because subjects understand the logic of the game — minority voters must concentrate votes unpredictably — the exact choices are of secondary importance, a result that vouches for the robustness of the voting rule to strategic mistakes.
The existing literature debates if the products of better quality are more heavily advertised. This article resolves this contradiction by answering the question of when better quality leads to more advertising. It provides a novel articulation of prior empirical research, modeling the advertising-quality relationship in an optimal control setting. On the supply-side, a firm carries out advertising to promote its product and product innovation policies that improves product quality. On the demand-side, consumers are sensitive to product price, product quality, and advertising expenditure. The paper identifies the conditions that will dictate when the advertising-quality relationship will be positive or negative. The argument is that advertising increases with quality (i.e., positive relationships) if the demand effects (quality and advertising effects on demand) outweigh the supply effect (quality effect on cost). Alternatively, advertising decreases with quality (i.e., negative relationships) if the demand effects are lower than the supply effect. Consequently, despite consumer awareness of quality, a firm may advertise a product of lower quality more to maximize profit.
The widely used Oaxaca decomposition applies to linear models. Extending it to commonly used nonlinear models such as duration models is not straightforward. This paper shows that the original decomposition that uses a linear model can also be obtained by an application of the mean value theorem. By extension, this basis provides a means of obtaining a decomposition formula which applies to nonlinear models which are continuous functions. The detailed decomposition of the explained component is expressed in terms of what are usually referred to as marginal effects. Explicit formulae are provided for the decomposition of some nonlinear models commonly used in applied econometrics including binary choice, duration and Box-Cox models.
Cet article s’intéresse aux inégalités de répartition des salaires et du patrimoine comme programme de recherche macroéconomique. Après un bref aperçu des modèles récents liant inégalités et croissance à long terme d’une part, et inégalités et fluctuations macroéconomiques d’autre part, nous passons en revue la littérature sur les facteurs macroéconomiques à l’origine des inégalités de répartition des salaires et du patrimoine. En guise de conclusion, nous proposons quelques pistes de recherches futures qui nous semblent importantes à mener telles que le rôle des politiques macroéconomiques sur la répartition ou encore celui de la taille des entreprises sur la croissance et leur contribution aux inégalités.
The bootstrap is typically less reliable in the context of time-series models with serial correlation of unknown form than when regularity conditions for the conventional IID bootstrap apply. It is, therefore, useful to have diagnostic techniques capable of evaluating bootstrap performance in specific cases. Those suggested in this paper are closely related to the fast double bootstrap (FDB) and are not computationally intensive. They can also be used to gauge the performance of the FDB itself. Examples of bootstrapping time series are presented, which illustrate the diagnostic procedures, and show how the results can cast light on bootstrap performance.
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The real interest rate at which US firms borrow funds to finance their investment and other expenses has two striking features. It is low when GDP is high (and vice versa) and it is an inverted leading indicator of real economic activity. Low interest rates today forecast future booms in GDP, consumption, investment, and employment. This Rue de la Banque shows that inherent to such correlations is a redistribution channel through which resources typically flow from lending entities to borrowing firms during expansions. Such a redistribution channel is driven by expectations about future levels of the borrowing cost, which accounts for a large share of the volatility of output, investment and other macroeconomic variables during business cycles.