IMPORTANCEWith the global population aging, falls and fall-related injuries are ubiquitous, and several clinical practice guidelines for falls prevention and management for individuals 60 years or older have been developed. A systematic evaluation of the recommendations and agreement level is lacking.OBJECTIVES To perform a systematic review of clinical practice guidelines for falls prevention and management for adults 60 years or older in all settings (eg, community, acute care, and nursing homes), evaluate agreement in recommendations, and identify potential gaps. EVIDENCE REVIEW A systematic review following Preferred Reporting Items for SystematicReviews and Meta-analyses statement methods for clinical practice guidelines on fall prevention and management for older adults was conducted (updated July 1, 2021) using MEDLINE, PubMed, PsycINFO, Embase, CINAHL, the Cochrane Library, PEDro, and Epistemonikos databases. Medical Subject Headings search terms were related to falls, clinical practice guidelines, management and prevention, and older adults, with no restrictions on date, language, or setting for inclusion. Three independent reviewers selected records for full-text examination if they followed evidence-and consensus-based processes and assessed the quality of the guidelines using Appraisal of Guidelines for Research & Evaluation II (AGREE-II) criteria. The strength of the recommendations was evaluated using Grades of Recommendation, Assessment, Development, and Evaluation scores, and agreement across topic areas was assessed using the Fleiss κ statistic. FINDINGSOf 11 414 records identified, 159 were fully reviewed and assessed for eligibility, and 15 were included. All 15 selected guidelines had high-quality AGREE-II total scores (mean [SD], 80.1% [5.6%]), although individual quality domain scores for clinical applicability (mean [SD], 63.4% [11.4%]) and stakeholder (clinicians, patients, or caregivers) involvement (mean [SD], 76.3% [9.0%]) were lower. A total of 198 recommendations covering 16 topic areas in 15 guidelines were identified after screening 4767 abstracts that proceeded to 159 full texts. Most (Ն11) guidelines strongly recommended performing risk stratification, assessment tests for gait and balance, fracture and osteoporosis management, multifactorial interventions, medication review, exercise promotion, environment modification, vision and footwear correction, referral to physiotherapy, and cardiovascular interventions. The strengths of the recommendations were inconsistent for vitamin D supplementation, addressing cognitive factors, and falls prevention education. Recommendations on use of hip protectors and digital technology or wearables were often missing. None of the examined guidelines included a patient or caregiver panel in their deliberations.
We study mechanism design problems in quasi-linear environments where the envelope theorem and revenue equivalence principle fail due to non-convex and nondifferentiable valuations. Despite these obstacles, we obtain a characterization of incentive compatibility based on the familiar Mirrlees representation of the indirect utility and a monotonicity condition on the allocation rule. These conditions pin down the range of possible payoffs as a function solely of the allocation rule, thus providing a revenue inequality. We illustrate the usefulness of our approach in three economic applications where standard techniques do not apply: we derive the optimal selling mechanism in a buyer-seller situation where the buyer has loss-averse preferences; we find a zero payment (hence budget-balanced) efficient mechanism in a public goods location model; and we consider a principal-agent model with ex post non-contractible actions available to the agent.
We study optimal price discrimination when a monopolist faces a continuum of consumers with reference‐dependent preferences. A consumer's valuation for product quality consists of an intrinsic valuation affected by a private state signal (type) and a gain–loss valuation that depends on deviations of purchased quality from a reference point. Following [Kőszegi and Rabin, 2006], we consider loss‐averse buyers who evaluate gains and losses in terms of changes in the consumption valuation, but in our model each buyer evaluates consumption outcomes relative to his own state‐contingent reference quality level. We capture the process by which reference qualities are formed via a reference consumption plan, and use a generalization of the Mirrlees representation of the indirect utility to fully characterize optimal contracts for loss‐averse consumers. We find that, depending on the reference plan, optimal price discrimination may exhibit (i) downward distortions beyond the standard downward distortions due to screening, (ii) efficiency gains relative to second‐best contracts without loss aversion, and (iii) upward distortions above first‐best quality levels without loss aversion. We consider ex ante and ex post consistent contracts in which quality offers by the firm coincide, in expectations or at every state realization, respectively, with the reference quality levels. We find the firm's unique preferred ex ante and ex post consistent contract menu and specify conditions under which, for the second case, it also constitutes the consumers' preferred menu.
Research summarizes the construction of a Police Officer's Tacit Knowledge Inventory (Inventory), a situational judgment test comprised of knowledge gained on-the-job by experienced police officers, and examines if it can play a role in the development of expertise. Correlation and regression analysis was done to establish the Inventory's ability to predict post-Academy graduation performance. Results show that Inventory response patterns correlate with Supervisor ratings; and the Inventory responses correctly predict significant differences between novice patrol officers and experienced police officers.
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