Fracture incidence among elderly people in institutional care: linking injury surveillance data with a postal code-based register of residential and nursing homes

Fracture prevention strategies will be most cost-effective if targeted at groups of frail elderly people who are at particularly high risk of falls and fractures. Elderly people living in residential and nursing homes are one potential target population, but fracture incidence in this setting remains poorly defined in many countries. We have used the All Wales Injury Surveillance System (AWISS) in a population-based study of people aged over 65 living in the city of Cardiff. We linked a postal code-based register of all care homes in the city with injury data from Cardiff’s only Accident and Emergency department. Cardiff has 47,520 residents aged over 65, and 1,874 (3.9%) live in residential or nursing homes. Fracture incidence was 25/1,000/year overall, and 5/1,000/year for hip fracture. During 1997, the care home residents suffered 162 fractures, 82 of which were of the hip; an incidence of 86/1,000/year overall, 44/1,000/year for hip fracture. Even after adjustment for the age and sex profile of the care home population, fracture incidence remained 2.3 times higher and hip fracture incidence 3.6 times higher than in the general elderly population. Such figures support the potential cost-effectiveness of strategies that prevent fractures in care homes, and are of special interest to those planning intervention studies in this setting.     

Index composition changes and the cost of incumbency

This paper provides evidence of information effects and portfolio rebalancing effects that occur when stocks are added to or excluded from the S&P 500 index and finds that incumbents in the index realize negative excess returns when S&P revises the composition of the index. We also find that for incumbents that are in the same industry as the added firm, the price-pressure effects are mitigated by positive industry-level information and momentum effects. For index exclusions, the magnitude of the loss sustained by incumbents from the same industry as the excluded firm is larger than that realized by the non-industry incumbents, as the negative information and momentum effects reinforce the price-pressure effects. Our results suggest that changes in the composition of the index are not information-free events; however, the portfolio rebalancing effects dominate the industry information effects.     

Community-based tourism enterprises: challenges and prospects for community participation; Khama Rhino Sanctuary Trust,Botswana

This study assesses community participation in a community-based tourism enterprise in Botswana, the Khama Rhino Sanctuary Trust, founded in 1992. Data were collected using structured and semi-structured questionnaires, interviews with key stakeholders and community focus group discussions. Results indicate that although Community-Based Natural Resource Management is popular in many southern African nations, communities still face challenges and constraints which hinder their participation in community-based enterprises. While some other studies in Botswana indicate the value of community-based tourism, 95% of adult residents in the Khama Rhino Sanctuary Trust area did not know who owned the Trust, and 98% had never been to the Trust's lands. There was community disappointment about loss of cattle grazing and other land-related benefits, lack of communication with the community, lack of benefits, the low numbers employed and the slow progress of the project which did not record a profit until 2008. But the Trust now has over 25% of the rhinos in Botswana and has seen visitor numbers rise from 1820 in 1996 to over 21,000 in 2008. Suggestions for the future include appointment of a community liaison officer, training for local people in tourism and management and use of single-community rather than multi-community trusts.     

Direct and indirect transmission of avian influenza: results from a calibrated agent-based model

Journal of Economic Interaction and Coordination - This paper develops an agent-based model of the spread of highly pathogenic avian influenza in a regional poultry sector. Spatially located flocks...     

Information Gathering and Marketing

Consumers have only partial knowledge before making a purchase decision, but can acquire more‐detailed information. Marketing makes it easier or harder for these consumers to do so. When consumers are ex ante heterogeneous, the firm might choose an intermediate marketing strategy for two quite different reasons. First, as a nonprice means of discrimination—it can make information only partially available, in a way that induces some, but not all, consumers to acquire the information. Second, when the firm cannot commit to a given investment in ensuring quality, the marketing and pricing strategy can act as a commitment device.     

Information technology, nurse staffing, and patient needs

As health care organizations increasingly adopt health information technology, time-sensitive data that track patients' requirements for nursing care and nurses' responsiveness to these needs might be available to support evidence-based nurse staffing decisions. care information technologies available in hospitals and on nursing units may provide valuable sources of information that can be translated into usable data. In this study, the usefulness of electronic data obtained from a nurse tracking call light system as a source of information for quality measurement was explored. The findings point to what might be under-utilization of existing health information technology to track patients' needs and nurses' responsiveness, patient census, and patient movements. The authors recommend health information technology be used less as support for other organizational systems and more as an administrative resource that can allow nurse executives to be more actively engaged within and across nursing environments.     

Computer-assisted financial planning: The planner-model interface

Computer-based financial statement generators constitute one of the most widely used class of computer-based decision aids. Surveys reveal most planners using these models are concerned with ease of use, especially greater flexibility, reduced data-entry burden, increased understandability, and enhanced sensitivity analysis. This article includes data generation functions, sensitivity analysis capabilities, and illustrative planner-computer dialogues designed to cope with these problems.     

Public Spending, Land Taxes and Economic Growth: An Empirical Analysis of the Adequacy of Land as a Tax Base

Abstract . Site value taxation is often cited as desirable on efficiency grounds, but is all too often dismissed for alleged lack of revenue potential. This paper empirically tests the revenue adequacy of site value taxation. Revenue adequacy in this study is defined as the ability of the tax base to keep pace with community expenditure needs. The paper concludes that communities with higher than average rates of capital growth and with a relatively constrained land area will find land taxes when subsituted for present property taxes, quite adequate for future as well as present needs.