Highest Tiers Research Articles

On being loyal to a casino: The interactive influence of tier status and disordered gambling symptomatology on attitudinal and behavioral loyalty.

Background and AimsCasino loyalty programs are marketing strategies designed to foster attitudinal (i.e., identification and satisfaction) and behavioral (i.e., spending) loyalty among gamblers by offering rewards to members. Casino loyalty programs use a tier-based structure to segment members who spend more money into higher tiers, where they receive better rewards (compared to lower tiered members). Tier-based structures may encourage increased expenditure among patrons, especially among players living with a gambling disorder. The current work aimed to examine whether tier status and disordered gambling symptomatology interact to predict attitudinal and behavioral loyalty.MethodsStudy 1 used a cross-sectional design to examine whether tier status and disordered gambling symptomatology interact to predict self-reported loyalty among a sample of American casino loyalty program members (N = 396). In Study 2, archival player account data from Canadian casino loyalty program members (N = 649) were analyzed to examine whether tier status and disordered gambling symptomatology interact to predict objective measures of behavioral loyalty.ResultsThe greatest effect of tier status on attitudinal and behavioral loyalty was observed among non-problem gamblers in the highest tiers. Tier status, however, did not influence loyalty among members high in disordered gambling symptomatology.DiscussionResults suggest that once gambling has become problematic, loyalty programs may not influence player attitudes and behaviors. Non-problem gamblers may be particularly susceptible to the tiered structure of the programs.ConclusionNon-problem gamblers may benefit from casino loyalty programs in the short-term but longitudinal research is needed to understand the long-term influence of membership.

Gender and Ethnic Diversity in Medical Faculty

In the United States, underrepresented in medicine (URM) physicians are made up from African American, Hispanic, Native American, Alaskan Native, and Hawaiian/Pacific island populations. With the ever-growing diversity in the US population it is critical for not only the physician workforce as a whole, but also the highest tiers of academic medicine, to be reflective of this heterogeneous population. In conjunction with ethnic diversity, it is of the essential for proportional gender representation to be achieved. This increasing diversity is essential not only for equal healthcare among all individuals, but also equal socioeconomic potential for all genders and ethnicities. The US population, based on the data taken from the US Census Bureau, was then compared to the American Association of Medical Colleges (AAMC) Faculty Roster (FAMOUS) data to analyze representation of the medical community to the general US population. The principle metric used in this study was the proportion of faculty from the various gender and ethnic groups to their respective groups in the general population. Women are underrepresented in select departments, leadership roles, and senior faculty positions. Underrepresented in medicine (URM) individuals have not improved enough to reach parity in their representation within the medical community across all metrics. Funding Statement: None. Declaration of Interests: None.

For what it's worth: evaluating revealed preferences for green certification

In a case study that examines the outcomes of a flexible information-based policy, we observe how organizations obtain Leadership in Energy and Environmental Design certification. We use a regression discontinuity analysis to identify practices used to upgrade certification tiers. This analysis reveals preferences for green certification strategies and, we argue, intimates the perceived motivations for green certification. We distinguish practices that potentially confer private gains through returns to efficiency and productivity investments, from practices that only provide public benefits. Data show that organizations strategically certify to avoid high-cost resource use, appeal to key stakeholders, and communicate building and organization quality. Builders upgrading to the highest tiers are more likely to deploy practices with private gains. Results suggest a willingness to extend short time horizons associated with energy-efficiency investments in exchange for marketing benefits. Our discussion notes the capacity for certifications to mitigate market barriers associated with the energy-efficiency gap.

The German Federal Courts Dataset 195002018: From Paper Archives to Linked Open Data

Various reasons explain why Europe lags behind other jurisdictions in Empirical Legal Studies, especially regarding judicial decision-making. One of them is a scarcity of field data, even on the highest tiers of adjudication. Civil law jurisdictions differ markedly from their common law counterparts in the emphasis they place on individual judges. Hence very little empirical data is available on how courts are composed and how that composition changes over time. The present project attempts to change that by easing access to such data and thus lowering the threshold for empirical studies on the composition of the judiciary. It creates a resource for Empirical Legal Scholarship in order to start closing a research gap and to inspire more European scholars to engage with the empirical aspects of civil law adjudication. Several thousand pages of German court documentation were digitized, transcribed into machine-readable tables (ready to be imported into statistics software) and published online. To explore new avenues for sharing public domain data, they were also modeled as linked open data and imported into a prominent data repository.

Evidence ladder and the Journal of the Medical Library Association.

The evidence ladder or pyramid is hierarchical (Table 1). Results from studies in the highest tiers have more strength of evidence and should be counted on more when making decisions.

Does ongoing general practitioner care in elderly patients help reduce the risk of unplanned hospitalization related to Beers potentially inappropriate medications?

To compare estimates of unplanned hospitalizations associated with exposure to Beers potentially inappropriate medications (PIM) in elderly people receiving different levels of ongoing general practitioner (GP) care. Using the pharmaceutical claims and other linked health data of 245,436 Western Australians aged ≥65 years with one or more claims for a medication from a PIM-related drug class (1993-2005), we applied an enhanced case-time-control design to obtain odds ratios (OR) for unplanned hospitalization, from which attributable fractions, numbers, proportions and rates of admissions related to PIM exposure were derived. Overall, 383,150 unplanned hospitalizations ("index subjects") were identified. PIM exposure was associated with a similar relative risk of unplanned hospitalization in elderly people receiving the lowest and highest levels of ongoing GP care, but with a decreasing risk in the three highest tiers; adjusted OR (95% CI; attributable fractions) were 1.15 (1.09-1.21; 12.9%), 1.36 (1.27-1.46; 26.6%), 1.20 (1.15-1.26; 16.9%) and 1.13 (1.09-1.17; 11.4%) for groups from the lowest to highest levels. However, those with higher GP coverage had higher rates of PIM-related hospitalization. Similar patterns were shown for commonly used high-risk PIM (temazepam, diazepam, oxazepam, naproxen and digoxin). Increased requirement for ongoing GP contact in less healthy elderly people appears to help minimize their risk of unplanned hospitalization due to PIM-related harm. GPs should continue to avoid Beers medications in older patients where possible, given their greater predisposition to medication exposure (including PIM) and adverse drug events. Nevertheless, close monitoring of elderly patients who need to use PIM should prove beneficial.

Tiered Pricing: Implications for Library Collections

In recent years an increasing number of publishers have adopted tiered pricing of journals. The design and implications of tiered-pricing models, however, are poorly understood. Tiered pricing can be modeled using several variables. A survey of current tiered-pricing models documents the range of key variables used. A sensitivity analysis identified two main variables: the distribution of the subscriber base across tiers and the price differential between the highest and lowest tiers. Scenarios illustrating the effects of these two variables are presented and analyzed. The results suggest that institutions falling into the highest tiers can experience substantial price increases, particularly if the subscriber distribution is weighted toward the lower tiers of the model. The implications for collection management at institutions of all sizes are considered

Long term dynamics of Dermanyssus gallinae in relation to mite control measures in aviary systems for layers

1. The dynamics of the poultry red mite, Dermanyssus gallinae , in aviary systems for layers were studied in an empirical study in Sweden between 1994 and 1997. Fluctuations were monitored with mite traps at monthly intervals during 3 laying cycles at each of 2 commercial poultry farms. 2. When mites were first detected in the system it then took about 5 months for the populations to reach equilibrium levels around which they fluctuated. Within flocks when the population growth was unaffected by temporary control activities, it was demonstrated that the mite populations were significantly denser in summer than in winter. 3. Current control methods had limited effects as mite populations were only temporarily suppressed. One exception was the control achieved with permethrin impregnated plastic strips, which reduced the population at equilibrium level to approximately 22%, compared with the previous flock. 4. The distribution of mites was patchy horizontally, along the aviary system, at low burden whereas it became more evenly dispersed at equilibrium. 5. Significant differences in vertical mite distributions that correlated with the hybrids used and their rearing conditions were also observed. In flocks with brown hens, mites gathered at the lower tiers, whereas they were found at the highest tiers in association with white hens. As the hens are attacked mainly at night-time the most likely explanation is that the mites adjust their behavioural pattern to the birds' roosting behaviour.