Default Option Research Articles

Adjusting Quality Measures For Social Risk Factors Can Promote Equity In Health Care.

Risk adjustment of quality measures using clinical risk factors is widely accepted; risk adjustment using social risk factors remains controversial. We argue here that social risk adjustment is appropriate and necessary in defined circumstances and that social risk adjustment should be the default option when there are valid empirical arguments for and against adjustment for a given measure. Social risk adjustment is an important way to avoid exacerbating inequity in the health care system.

Revisiting optimal investment strategies of value-maximizing insurance firms

We study capital management and investment decisions of a value-maximizing insurance firm with a broad ownership base in a discrete-time setting. We highlight that the valuation measure used to determine the value of the cash flows to shareholders should reflect two economically sound requirements: market-consistency and indifference to idiosyncratic risk. We provide a rigorous construction of this economic valuation measure and use it to derive the optimal capital-management and investment strategies that realize the economic value of the firm. Our objective is to shed light on the controversial question of whether insurers should invest in liquidly-traded risky assets. Decomposing firm value into net tangible value, default option value, and franchise value, we find that whether to take investment risk is optimal or not essentially depends on the tradeoff between the impact of investment risk on the owner’s option to default and on the firm’s franchise value. A variety of numerical examples illustrate how changes in the regulatory and financial environment can result in materially different optimal investment strategies.

HIV Pre-Exposure Prophylaxis, Condoms, or Both? Insights on Risk Compensation Through a Discrete Choice Experiment and Latent Class Analysis Among Men Who Have Sex With Men

ObjectivesWe considered how decision making around human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) among gay, bisexual, and other men who have sex with men (GBMSM) is made in the context of one’s perceived risk of HIV acquisition and the availability of condoms. MethodsWe recruited 648 GBMSM aged 18 years old and residing in Singapore through Grindr. Participants were given information on PrEP and participated in a discrete choice experiment requiring them to choose between 2 baskets of PrEP attributes and compare the chosen “PrEP only” option to default options of “condoms only” or “PrEP with condoms.” Generalized multinomial logit model was used to examine the scaling effect and preference heterogeneity. Latent class analysis was conducted to examine preference heterogeneity in the sample. ResultsLatent class analysis revealed 3 classes of GBMSM: PrEP conservatives (53.9%), moderates (31.1%), and liberals (14.9%). PrEP conservatives were more likely to report greater utility when using condoms only compared with PrEP only, as well as PrEP with condoms, compared with PrEP only, and more likely to report the lowest utility for PrEP as perceived HIV risk increased. PrEP liberals were more likely to report greatest utilities for PrEP only compared with condoms only, as well as PrEP only compared with PrEP with condoms. The utility for PrEP was not affected by perceived risk of HIV or sexually transmitted infections when risks were low. ConclusionThis study provides some evidence for risk compensation among a class of GBMSM who already perceived themselves to be good candidates for PrEP before the discrete choice experiment.

Default options and insurance demand

Default options may provide a low-cost way of influencing behaviour without modifying incentives and constraining choices between alternatives. However, an improved understanding is needed on whether they are effective when individuals have experience with making the choice in practice and have preferences for specific alternatives. We study whether defaults can be used to increase insurance coverage against low-probability/high-impact risks, like floods, and whether past flood insurance purchases and flooding experience moderate the effect of defaults. Our study uses a naturally occurring difference in experience, comparing the surveyed flood insurance choices of 1,187 homeowners, half of whom are in the Netherlands, where flood insurance penetration rates are low and recent flooding caused minor losses, and the other half of whom are in the United Kingdom (UK), where the opposite is true. We find defaults are effective amongst homeowners with little to no flood-related experience: in the Netherlands defaults increase the likelihood of insuring by between 17 and 18 percentage points. Although there is no overall effect of defaults in the UK, defaults increase flood insurance coverage for risk averse individuals, and those who have no reported previous flood experience and have not purchased flood insurance. Anticipated regret about not having insurance coverage in the event of a flood, and perceptions about the insurance cost explain between 34 and 37 percent of the relationship between the default and flood insurance demand. We discuss policy implications of our findings.

Remote Intimacy

Remote Intimacy

Addressing Antibiotic Overuse in the Outpatient Setting: Lessons From Behavioral Economics

Addressing Antibiotic Overuse in the Outpatient Setting: Lessons From Behavioral Economics

Case Analysis and Implication of the Introduction of Default Options for Retirement Pension in Japan

Purpose: While the amount of reserve in retirement pension in Korea has been increasing rapidly, the rate of return is low due to fact that most of the corporate pension reserve is invested in financial products that guarantee the principal and interest. This study focuses on deriving implications for the introduction of domestic default options after investigating the default option system in Japan, which operates mainly under the contract-based governance structure. Research design, data, and methodology: We begin with examining the outline of the Japanese default option system, and the selection criteria and selection process for default option products. Next, after conducting the case studies on Aeon Group and Gunje, we investigate the supervision and participation protection aspects of the Japanese default option system. Results: We suggest that the principle and interest guarantee type is included in the default product requirements through labor-management consultation, and the number of products presented is limited to below an appropriate level to help participations'' selection. The principle and interest guarantee type is included in the default product requirements through labor-management consultation, and the number of products presented to help subscribers'' selection is limited to below an appropriate level. Implications: We draw the implication from the perspective of providing information on default option product selection requirements, setting the period and grace period, imposting a fiduciary duty to employers, and providing information on principal and interest guaranteed products.

Case Analysis and Implication of the Introduction of Default Options for Retirement Pension in Japan

Case Analysis and Implication of the Introduction of Default Options for Retirement Pension in Japan

Työterveyshuollon kirjaamiskäytännöt sairauden liittymisestä työhön ja vaikutuksesta työkykyyn

Työterveyshuollossa on pitkään suositeltu, että työntekijöiden sairauksien liittyminen työhön on aina selvitettävä ja tehtävä siitä kirjaus potilastietojärjestelmään seurannan helpottamiseksi. Kirjaukset tulee tehdä systemaattisesti sisältäen arvioinnit sairauden työhön liittyvyydestä ja vaikutuksesta työkykyyn.
 Tämän tutkimuksen tarkoituksena oli selvittää, kuinka työterveyslääkärit ja työterveyshoitajat kirjaavat potilastietojärjestelmiin arvioinnit sairauden työhön liittyvyydestä ja vaikutuksesta työkykyyn. Sähköinen kysely lähetettiin työterveyslääkäreille ja työterveyshoitajille vuonna 2017 ja siihen vastasi 295 henkilöä.
 Tulokset osoittivat, että suurella osalla vastaajista sairauden työhön liittyvyys ja vaikutus työkykyyn arviointien kirjaaminen potilastietojärjestelmään oli pakotettu toiminto. Työterveyslääkäreille pakotettu toiminto näytti olevan yleisempää kuin työterveyshoitajille. Moni vastaajista ilmoitti kirjaavansa arvioinnin käyttäen potilastietojärjestelmässä olevan valmiin luokituksen oletusvalintaa, kuten ”ei arvioitu” -valintaa. Työterveyshuollon erikoislääkäreitä ja erikoistuvia yleisempää tämä oli työterveyshuollossa työskentelevien yleislääkäreiden keskuudessa.
 Yhtenäinen tapa kirjata sairauden työhön liittyvyyttä ja vaikutusta työkykyyn edistää potilaan työkykyriskien tunnistamista. Kun tieto sairauden työhön liittyvyydestä ja työkyvystä tallennetaan yhteneväisesti potilaskertomukseen, hyödyttää tämä myös työterveyshuollon toteuttamaa ehkäisevää työtä ja työkyvyn tukemista. Tutkimustulosten perusteella voidaan todeta olevan kehitettävää sekä eri potilastietojärjestelmien kirjaamisrakenteissa että työterveyslääkäreiden ja työterveyshoitajien kirjaamistavoissa.

Nudges in SRI: The Power of the Default Option

AbstractWe introduce nudges in order to incite investors to choose Socially Responsible Investment (SRI) funds instead of traditional funds. We have set up two online experiments with a total of 713 US retail investors, using three types of nudges to elicit their effects on investors’ SRI investments level: making SRI the default investment, introducing a SRI explanation message, and priming ethical values by displaying shocking images. Making SRI the default option is the most efficient nudge to influence investors towards SRI. Its effect is twofold. First, around 50% of investors do not opt-out of the default allocation. Second, even investors who opt-out of the default allocation invest more in SRI than those in the control group, an effect that appears driven by anchoring. Although investors subjected to both priming and message content marginally increase their SRI investment, priming or message content in isolation appears to have a non-significant influence. For choice architects who want to steer retail investors towards SRI funds, making them the default option appears to be the most powerful nudge.

Hospital Utilization Outcomes Following Assignment to Outpatient Commitment.

Outpatient civil commitment (OCC) requires people with severe mental illness (SMI) to receive needed-treatment addressing imminent-threats to health and safety. When available, such treatment is required to be provided in the community as a less restrictive alternative (LRA) to psychiatric-hospitalization. Variance in hospital-utilization outcomes following OCC-assignment has been interpreted as OCC-failure. This review seeks to specify factors accounting for this outcome-variation and to determine whether OCC is used effectively. Twenty-five studies, sited in seven meta-analyses and subsequently published investigations, assessing post-OCC-assignment hospital utilization outcomes were reviewed. Studies were grouped by structural pre-determinants of hospital-utilization and OCC-implementation-i.e. deinstitutionalization (bed-availability), availability of a less restrictive alternative to hospitalization, and illness severity. Design quality at study completion was ranked on causal-certainty. In OCC-follow-up-studies, deinstitutionalization associated hospital-bed-cuts, when not taken into account, ensured lower hospital-bed-day utilization. OCC-assignment coupled with aggressive case-management was associated with reduced-hospitalization. With limited community-service, hospitalizations increased as the default option for providing needed-treatment. Follow-up studies showed less hospitalization while on OCC-assignment and more outside of it. Studies using fixed-follow-up periods usually found increased-utilization as patients spent less time under OCC-supervision than outside it. Comparison-group-studies reporting no between-group differences bring more severely ill OCC-patients to equivalent use as less disturbed patients, a success. Mean evidence-rank for causal-certainty 2.96, range 2-4, of 5 with no study ranked 1, the highest rank. Diverse mental health systems yield diverse OCC hospital-utilization outcomes, each fulfilling the law's legal mandate to provide needed-treatment protecting health and safety.

RANS studies of hydrogen-enrichment premixed turbulent flames

In this study, we show numerical predictions of the Zimont and Peter’s turbulent flame speed models for low-swirl Methane/Air/Hydrogen flames [1]. These models are contained as default options within the ANSYS Fluent Premixed reaction model. Two distinct simulation tasks as part of the present study are – non-reacting and reacting flows, for with three different methane mixtures in compositions added with – 0, 40 and 60% hydrogen. The results show that the RANS approach provides a reasonable prediction of the cold flow conditions, whilst the reacting flow conditions, good agreement is reached up to 40% enrichment, except near the recirculation region,.

Reinventing health promotion for healthy default beverage laws in the face of COVID-19.

Shortly after a healthy default beverage (HDB) law took effect in Hawai'i, requiring restaurants that serve children's meals to offer healthy beverages with the meals, the COVID-19 pandemic struck. Efforts to contain the virus resulted in changes to restaurants' operations and disrupted HDB implementation efforts. Economic repercussions from containment efforts have exacerbated food insecurity, limited access to healthy foods, and created obstacles to chronic disease management. Promoting healthy default options is critical at a time when engaging in healthy behaviors is difficult, but important, to both prevent and manage chronic disease and decrease COVID-19 risk. This commentary discusses COVID-19's impact on restaurant operations and healthy eating, and the resulting challenges and opportunities for this promising health promotion intervention.

Bayesian inference of the incompressibility, skewness and kurtosis of nuclear matter from empirical pressures in relativistic heavy-ion collisions

Within the Bayesian statistical framework we infer the incompressibility K 0, skewness J 0 and kurtosis Z 0 parameters of symmetric nuclear matter (SNM) at its saturation density ρ 0 using the constraining bands on the pressure in cold SNM in the density range of 1.3ρ 0 to 4.5ρ 0 from transport model analyses of kaon production and nuclear collective flow in relativistic heavy-ion collisions. As the default option assuming the K 0, J 0 and Z 0 have Gaussian prior probability distribution functions (PDFs) with the means and variances of 235 ± 30, −200 ± 200 and −146 ± 1728 MeV, their posterior most probable values are narrowed down to MeV, − MeV and at 68% confidence level, respectively. The results are largely independent of the prior PDFs of J 0 and Z 0 used. However, if one adopts the strong belief that the incompressibility K 0 has a uniform prior PDF within its absolute boundary of 220–260 MeV as one can find easily in the literature, the posterior most probable values of K 0, J 0 and Z 0 shift to MeV, MeV and MeV, respectively. While the posterior PDFs of the SNM EOS parameters depend somewhat on the prior PDF of K 0 used, the results from using different prior PDFs are qualitatively consistent. The uncertainties of all three parameters are significantly reduced especially for the J 0 and Z 0 parameters compared to their current values.

Partial recall: differences between actual and self-reported annuitization decisions in Sweden

AbstractThis paper reports the results from a large telephone survey of 1,000 retiring white-collar workers in Sweden. Shortly before the interview, the participants at age 65 had a choice of receiving a life annuity by default or opting for a fixed-term payout, with a minimum payout length of 5 years. Large monetary amounts were at stake in the payout decision of the survey participants; the average monthly pension payment under the life annuity amounted to US $280. Comparing the survey responses with administrative records on actual payout choices, I find that a majority of retiring white-collar workers fail to recall their payout decision. The recollection rate is much lower among annuitants (those who chose the default option); only 40% of the annuitants accurately recalled their payout decision compared to 77% of those who opted for a fixed-term payout. Beyond payout choice, few individual characteristics predict successful recollection.

Disentangling preferences and limited attention: Random-utility models with consideration sets

This paper presents a model of choice with limited attention. The decision-maker forms a consideration set, from which she chooses her most preferred alternative. Both preferences and consideration sets are stochastic. While we present axiomatisations for this model, our focus is on the following identification question: to what extent can an observer retrieve probabilities of preferences and consideration sets from observed choices? Our first conclusion is a negative one: if the observed data are choice probabilities, then probabilities of preferences and consideration sets cannot be retrieved from choice probabilities. We solve the identification problem by assuming that an “enriched” dataset is observed, which includes choice probabilities under two frames. Given this dataset, the model is “fully identified”, in the sense that we can recover from observed choices (i) the probabilities of preferences (to the same extent as in models with full attention) and (ii) the probabilities of consideration sets. While a number of recent papers have developed models of limited attention that are, in a similar sense, “fully identified”, they obtain this result not by using an enriched dataset but rather by making a restrictive assumption about the default option, which our paper avoids.

Measuring and Stress-Testing Market-Implied Bank Capital

We propose a methodology for measuring the market-implied capital of banks by subtracting from the market value of equity (market capitalization) a credit-spread-based correction for the value of shareholders' default option. We show that without such a correction, the estimated impact of a severe market downturn is systematically distorted, underestimating the risk of banks with a low market capitalization. We argue that this adjusted measure of capital is the relevant market-implied capital measure for policy makers. We propose an econometric model for the combined simulation of equity and CDS prices, which allows us to introduce this correction in the SRISK framework for measuring systemic risk.

The Impact of a Government Risk Pool and an Opt-Out Framing on Demand for Earthquake Protection

This paper describes the design and analysis of a web-based choice experiment that examines how the demand for earthquake protection in Quebec and British Columbia is influenced by the default option and the structure of the insurance plan. Homeowners in both provinces were given the opportunity to purchase protection against earthquake losses when presented with one of the following options: the current private insurance plan, a high deductible private insurance plan, and a proposed public-private risk pool. The default frame was changed so the homeowner could either opt-in by purchasing this coverage or opt-out of being given this protection and receiving a premium discount. Assigning participants to a public-private risk pool rather than the current private insurance plan increases the likelihood of purchasing earthquake protection by 151%. The opt-out frame leads to a likelihood greater than 1.6 of purchasing coverage relative to the opt-in frame when given the same plan structure. The policy implications of this finding are discussed.

4 Aryl hydrocarbon receptor targets are upregulated in porcine blastocyst-stage embryos that were cultured invitro: A transcriptional analysis

Invitro-produced (IVP) porcine embryos are developmentally delayed compared with those derived invivo. Thus, efforts have been made to modify the current medium for IVP of porcine embryos in an attempt to shift the abundance of target transcripts towards the invivo level. The objective of the current study was to identify differences in mRNA abundance that may account for reduced developmental competence in IVP embryos and to determine whether alterations to maturation and culture media directed the transcriptional profiles of IVP embryos towards an invivo state. Following AI of gilts, an oviduct and tip of the uterine horn were flushed on Day 2 to recover 4-cell stage embryos; these were cultured for 4 days in MU3, generating IVM and invitro-cultured (IVC) blastocyst-stage embryos. On Day 6, the gilts were killed, and the contralateral horns were flushed to obtain invivo-derived (IVV) blastocyst-stage embryos. The third group of blastocyst-stage embryos, referred to as invitro-matured and cultured (IVMC), were created by aspirating cumulus–oocyte complexes from slaughterhouse-derived ovaries, maturing and fertilizing invitro, and culturing for 6 days in MU3. Total RNA was extracted from pools of 10 blastocyst-stage embryos with 3 replicates per group. First- and second-strand cDNA was synthesised and sequenced by using the Illumina platform (Illumina Inc.). After removal of adapters and reads that mapped to porcine rRNA genes and the PhiX genome, reads were mapped to the Sus scrofa genome by using STAR (version 2.7.1a) with default options. Pairwise comparisons were performed to test for differential expression of genes by using the Bioconductor package DESEqn 2. Transcripts were differentially abundant (false discovery rate <0.05) between IVV and IVC embryos (2,450), between IVV and IVMC embryos (3,045), and between IVC and IVMC embryos (262). Pathways related to cell cycle were downregulated in IVC and IVMC compared with IVV embryos, and pathways related to amino acid transport in metabolism were upregulated in IVC and IVMC compared with IVV embryos. Of particular interest, message for cytochrome P450 family 1 subfamily A member 1 (CYP1A1) was only present in the IVC (956 reads) and IVMC (381 reads) embryos but not in the IVV embryos (0 reads). The aryl hydrocarbon receptor (AHR) promotes transcription of CYP1A1, which encodes a monooxygenase involved in xenobiotic metabolism. Moreover, abundance of 12 other AHR targets was increased in IVC and IVMC embryos (false discovery rate <0.05) compared with IVV embryos. Thus, production of porcine embryos invitro may activate AHR, resulting in altered transcriptional profiles and reduced competence. This research was funded by USDA-NIFA (2019-67011-29543).

ВЫЯВЛЕНИЕ ЭФФЕКТИВНЫХ МЕТОДОВ И СПОСОБОВ ДОСТАВКИ ОБРАЗОВАНИЯ СТУДЕНТАМ

We discussed the problems of choosing effective methods and methods of delivering education to students in the paper. This process is very complex and contains a huge range of interacting variables. Nowadays, there is no adequate theory or process to determine effective methods and methods for delivering education to students. As a rule, it is assumed that individual learning is the default option, because of its superiority, and online learning is used only when circumstances do not allow the use of individual learning. However, online learning has become very common and effective in many contexts. Fully online courses are suitable for some types of students better than others: older, more mature students; students with an already high level of education; part-time students who work or with families. In terms of blended learning, the criteria are less clearly defined than for fully online learning. These courses are more suitable for more experienced students with strong motivation. In general, online students need more self-discipline in learning and more motivation to learn to succeed. This does not mean that other types of students cannot benefit from online learning, but additional efforts must be made to develop and support such students on the Internet. In terms of blended learning, the criteria are less clearly defined than for fully online learning. The advantage for students is to increase flexibility, but they should still live close to the educational institution, since this model means attending classes at the university. In addition, blended learning enables the gradual development of self-learning skills, if it is a focused learning strategy. Research also suggests that self-study skills need to be developed while students are at university. In other words, online learning in the form of blended learning should be deliberately introduced and gradually expanded as students work on the training program, so by the time they graduate, they acquire the skills necessary for self-study, which is critical in the digital age .Based on the study, steps are suggested for choosing the necessary method and method of delivering education to students.