No / This paper investigates the impact of corporate risk levels on aggregated, voluntary and mandatory risk disclosures in the annual report narratives of UK non-financial listed companies. We find that firms characterised by higher levels of systematic, financing risks and risk-adjusted returns and those with lower levels of stock return variability are likely to exhibit significantly higher levels of aggregated and voluntary risk disclosures. The results also show that firms of large size, high dividend-yield, high board independence, low (high) insider (outsider) ownership, and effective audit environments are likely to exhibit higher levels of aggregated and voluntary risk disclosures than other firms. Similarly, mandatory risk disclosures are influenced positively by firm size, dividend-yield and board independence and negatively by high leverage. The results suggest that managers of firms exhibiting greater compliance with mandatory regulations have a greater propensity to make voluntary risk disclosures. When we distinguish between high- and low-risk firms, we find that high-risk firms appear to be more sensitive to underlying risk levels, resulting in more disclosure of both voluntary and mandatory risk information than in the case of low-risk firms. The results generally support the present UK emphasis on encouraging rather than mandating risk disclosure. Nevertheless, under this regime, the voluntary risk disclosures of some firms, e.g., those characterised by higher-volatility market returns, do not reflect their underlying risk levels.

Purpose Lower serum vitamin D levels have been associated with an increased risk of aggressive prostate cancer. Among men with localized prostate cancer, especially with low-or intermediate-risk disease, vitamin D may serve as an important biomarker of disease aggression. The aim of this study was to assess the relationship between adverse pathology at the time of radical prostatectomy and serum 25-hydroxyvitamin D (25-OH D) levels. Methods This cross-sectional study was carried out from 2009 to 2014, nested within a large epidemiologic study of 1,760 healthy controls and men undergoing prostate cancer screening. In total, 190 men underwent radical prostatectomy in the cohort. Adverse pathology was defined as the presence of primary Gleason 4 or any Gleason 5 disease, or extraprostatic extension. Descriptive and multivariate analyses were performed to assess the relationship between 25-OH D and adverse pathology at the time of prostatectomy. Results Eighty-seven men (45.8%) in this cohort demonstrated adverse pathology at radical prostatectomy. The median age in the cohort was 64.0 years (interquartile range, 59.0 to 67.0). On univariate analysis, men with adverse pathology at radical prostatectomy demonstrated lower median serum 25-OH D (22.7 v 27.0 ng/mL, P = .007) compared with their counterparts. On multivariate analysis, controlling for age, serum prostate specific antigen, and abnormal digital rectal examination, serum 25-OH D less than 30 ng/mL was associated with increased odds of adverse pathology (odds ratio, 2.64; 95% CI, 1.25 to 5.59; P = .01). Conclusion Insufficiency/deficiency of serum 25-OH D is associated with increased odds of adverse pathology in men with localized disease undergoing radical prostatectomy. Serum 25-OH D may serve as a useful biomarker in prostate cancer aggressiveness, which deserves continued study. (C) 2016 by American Society of Clinical Oncology

Background: In Oman, 33.3% of women attended late for publicly funded antenatal care in 2015 and 24% did not attend for the recommended 4-6 visits during their pregnancy. This low attendance suggests a need to explore attendance for antenatal care for low-risk pregnant women in Oman. Methodology: An exploratory qualitative design informed by constructivist grounded theory methodology was used in this research. Methods: In-depth semi-structured interviews were conducted with an initial purposive sample of nine pregnant women. The initial analysis enabled theoretical sampling of thirteen non-participant observations during women's appointments, interviews with ten care providers, and six women who booked late after 12 weeks of gestation. A constructivist grounded theory analytical framework of initial, focused and theoretical coding was followed to analyse all the data collected. Findings: The core category consists of five interrelated sub-categories: perceived benefits and value of antenatal care; timing of the first antenatal visit; woman-carer interactions during antenatal care; experiences with antenatal care delivery; and supplementary use of private healthcare. The integral categories explain the social processes and issues surrounding antenatal care. The emergent core category, Navigating antenatal care, reflects the views of the women and their care providers. The women were unhappy with the organisation and physical environment of care but attended their appointments to ensure optimal pregnancy outcome and to alleviate their fears of developing complications. Thus, they used both private and public healthcare and sourced online information in response to their feelings of obligation to protect their fetus. Conclusion: The women appeared disempowered and to lack control over the care they received. Thus, they accepted conditions such as long waiting times in an uncomfortable environment and the disrespect they encountered during their visits. There was a discrepancy between what the women expected and needed from their antenatal care and the actual care and information they received, which did not satisfy their needs. This could be due to a lack of woman-centred care and limited involvement in the plan of care. Thus, women sought further reassurance by accessing private clinics, using online information, and networking with others, which also resulted in a late booking for public antenatal care.

Healthcare organizations are responding to changes in reimbursements by redesigning and re-evaluating existing programs to improve patient outcomes. .One such intervention at the project setting was the re-evaluation of the treatment of patients with low risk for chest pain and implementing a cardiology nurse practitioner (NP) service focusing on the reduction of length of stay (LOS) with the goal of improving patient outcomes. The purpose of this doctor of nursing practice project was to evaluate the effectiveness of a nurse practitioner-led service on the reduction of LOS of patients with low risk for chest pain. An established evidenced-based guideline developed by the American Heart Association for the treatment of patients with low risk for chest pain was adopted by the NP service. The project was guided by both the Donabedian model of quality care and the Aday and Anderson theory of access to medical care. The project design proposal is a comparative study using retrospective data obtained from the medical records of LOS pre- and post-implementation of the project. Implications for social change include improvement in patient care on a national level, not only for patients with low risk for chest pain, but also for patients with other chronic diseases. Streamlining care will improve the financial standing of hospitals as well as provide care that is equal and equitable regardless of race or financial status. The findings of this project have strengthened the role of the APN globally as a social advocate for change, actively participating in designing and implementing programs to improve patients' outcomes.

Purpose: The study examines the risk a rising from the acquisition of shares, and its relation to the expected return. We would like to see how a high-risk portfolio is related to a low-risk portfolio. Although studying the portfolios annual performance. Theory: The theories that have been used in the study are, Capital asset pricing model, CAPM and portfolio theory. Method: The study is based on a quantitative method, the time interval is from 2008 to 2010.The annual reports, historical stock prices for companies and the index are used to perform calculations based on the essay theories. Conclusion: The beta value has positive liner correlation with the expected return. When there are bad times in the world, the companies are negatively affected regardless of industry. The Portfolios developed in the same direction during the time period. / Syfte: Studien undersöker riskens förhållande till avkastningen som uppstår vid investering i aktier. Även hur en högriskportfölj förhåller sig till en lågriskportfölj samt portföljernas årliga utveckling. Teori: De teorier som använts i undersökningen är, Capital assets pricing model– CAPM och portföljteori. Metod: Studien utgår från en kvantitativ metod. Tidsintervallet är från år 2008 till 2010. Årsredovisningar, historiska aktiekurser för bolagen samt index används för att kunna genomföra uträkningar som baseras på uppsatsen teorier. Slutsats: Betavärdet har ett positivt linjärt samband med den förväntade kurstillväxt. Vid dåliga tider i världen drabbas alla bolag negativt oavsett bransch. Portföljerna utvecklades i samma riktning under tidsperioden.

Environmental exposure levels are often sufficiently disparate between populations such that there is little or no overlap, complicating our ability to ascertain the full dose-response curve and as such create informed regulatory policy.I reviewed the literature on methods available to address non- and partially-overlapping exposure distributions, drawing from both epidemiology as well as other relevant disciplines to describe the universe of proposed solutions. I also used the case study of maternal PCB-153 exposure and birthweight, utilizing real-world and simulated data to explore our ability to ascertain “true” dose-response curves from observational data given the limited cohort-specific exposure ranges. I investigated the importance of controlled and uncontrolled confounding as well as the impact of sample size on our ability to ascertain a “true” underlying dose-response curve. Pooling and meta-analysis were useful to increase the heterogeneity of exposure distributions despite imperfect confounding control and heterogenous confounding structures across cohorts. The analyses also serve as continued evidence of the challenges of making population-wide inferences from study samples with restricted exposure ranges as well as the danger of pooling multisite data without sufficiently accounting for heterogeneity in both exposure level and distribution of confounders. These results highlight the limitations of using both individual studies and systematic reviews of environmental chemicals, and emphasize the need for pooling and meta-analysis to widen exposure distributions that in turn permit us to accurately capture the negative effects of these environmental chemicals.

Introduction Prostate cancer (PCa) is the most common cancer among men in Sweden. The clinical course varies considerably, which makes it difficult to predict the prognosis in the individual case. In order to explore the early as well as the late course of the disease, large study groups and population-based cohorts are necessary. Aims To explore factors that influence the long-term outcome of men with low-risk tumours in a population-based register, to predict the long-term course, and to assess the mortality rate for men with prostate cancer (Paper I) To analyse long-term outcome and to investigate factors associated with long-term survival in patients with metastases to the skeleton (Paper II) To analyse early androgen deprivation treatment (ADT) failure and to define clinical predictors associated with short survival due to early ADT failure in prostate cancer patients with bone metastases (Paper III) To analyse the prognostic significance of the extent of bone metastases in relation to other pretreatment variables in prostate cancer patients, and to explore the impact of bone metastases on quality-of-life (Paper IV) Material and methods The study groups were assembled from The South East Region Prostate Cancer Register (SERPCR), and The Scandinavian Prostate Cancer Group (SPCG) Trial No. 5. In the first study, prognostic factors and long-term disease-specific mortality rates of low-risk prostate cancer patients from the early PSA era were analysed. In the second study, patient-related factors, quality-of-life (QoL) and long-term survival in 915 PCa patients with bone metastases (M1b) under ADT, were analysed. In Study III factors predicting primary failure to respond to ADT were identified. Study IV explored the impact of the extent of bone metastases on survival and QoL for these men. Result and conclusions The long-term disease-specific mortality of low-risk localised PCa is low, but the annual mortality rate gradually increases. This indicates that some tumours slowly develop into lethal cancer, particularly in men 70 years or older and with a PSA level ≥ 4 μg/L. From the SPCG Trial No. 5, a subgroup of patients with M1b disease and favourable set of predictive factors survived more than 10 years under ADT with an acceptable QoL. Independent predictors of long-term survival were identified as performance status (PS) < 2, limited extent of bone metastases, and a PSA level < 231 μg/L at the time of enrolment in the trial. However, four independent clinical predictors of early ADT failure could be defined. Men exhibiting these features should be considered for an alternative treatment. Patient grouping based on three categories of extent of bone metastases related to PS, haemoglobin, and QoL at presentation, as independent predictors of mortality, may provide improved accuracy of prognosis.

The Hispanic birthweight paradox, whereby Hispanic women exhibit a comparable or lower risk of bearing a low birthweight infant than their white counterparts despite relative socioeconomic disadvantage, has been observed across a number of research studies. However, the majority of evidence for the paradox has focused on Hispanics in aggregate form or on populations with primarily Mexican ancestry and has relied largely on outcome measures with important methodological shortcomings. Furthermore, studies have identified the variation of birthweight risk among Hispanics by nativity, maternal education and neighborhood composition, but the evidence has been scarce and inconsistent. The overall goal of this dissertation was to investigate the Hispanic health paradox with relation to measures of birthweight and infant size in births to women residing in New York City aged 20 years and older, using birth records for years 2003 through 2007 collected by the Office of Vital Statistics of the New York City Department of Health and Mental Hygiene (N=460,881). The main outcomes of interest in this study were mean birthweight, low birthweight (LBW, defined as < 2500 grams versus ≥ 2500 grams) and small for gestational age (SGA, calculated as the 10th percentile for birthweight at each week of gestational age and by sex). Multilevel logistic models with random effects were used to estimate odds ratios for the association between race/ethnicity and measures of birthweight and infant size, while controlling for individual-level and contextual factors and accounting for the correlation between observations within the same neighborhood. Analyses were conducted with Hispanics as an aggregate group as well as with race/ethnic-nativity subgroups. In addition, effect measure modification by maternal education and by neighborhood proportion of Hispanic population (NPHP) were examined. This research confirmed the Hispanic paradox in SGA analyses for Hispanics overall and for both U.S.-born and foreign-born Hispanics, but not in analyses with LBW or with mean birthweight. As compared to white women, black women exhibited 50% greater risk (OR:1.50;95%CI:1.45,1.55) and Hispanic women comparable risk (OR:1.03;95%CI:1.00,1.06) of having an SGA infant, in a fully adjusted model. With regard to LBW, the risk was more than double for black women (OR:2.25;95%CI:2.16,2.35) and close to 50% greater for Hispanic women (OR:1.46;95%CI:1.40,1.53) as compared to that of their white counterparts. In addition, the mean birthweight of infants born to Hispanic women was significantly lower compared to those born to white women. Furthermore, the relationship between race/ethnicity and all three measures of birthweight and infant size varied by maternal nativity status (p<0.0001), with infants of foreign-born women experiencing more favorable outcomes relative to their U.S.-born counterparts. The paradox with SGA was also apparent across most Hispanic race/ethnicity-nativity subgroups, The odds were greatest among black and Puerto Rican women overall (OR:1.52;95%CI:1.47,1.57 and OR:1.17;95%CI:1.13,1.22, respectively) and lowest among Mexican and South American women overall, (OR:0.91;95%CI:0.87,0.95 and OR:0.85;95%CI:0.80,0.89) as compared to white women in a fully adjusted model. The odds of SGA for infants born to Dominicans, Central Americans and Cubans in the fully adjusted model were similar to those born to whites. In addition, SGA varied by maternal nativity status (p<0.0001), with more favorable SGA odds observed among infants of most foreign-born women, as compared to whites. The exception was U.S.-born Puerto Ricans who consistently exhibited elevated risk of SGA relative to whites. The association of race/ethnicity-nativity with SGA varied by maternal educational attainment (p<0.0001), but the influence varied by subgroup. The observed advantage of foreign birth was stronger among less educated women of all Hispanic subgroups other than Puerto Ricans and Cubans. Similarly, the variation of SGA risk by neighborhood proportion of Hispanic population (NPHP) differed across subgroups (p<0.0001). NPHP did not appear to influence the association between race/ethnicity-nativity and SGA in a consistent pattern, but among black women and US-born Puerto Rican women greater NPHP was associated with a higher risk of SGA. Findings from this study underscore the importance of using SGA an accurate measure of infant size and of conducting analyses disaggregating race/ethnicity and nativity subgroups. Future research should focus on factors that contribute to the resilience of Hispanic subgroups in the face of adverse economic circumstances, such as the role of social support networks and acculturation. Greater understanding of the salubrious circumstances that lower the risk of adverse birth outcomes has major public health benefits, especially for a wide-ranging population of mothers, Hispanic and non-Hispanic, and their infants.

Bakgrund I snart ett halvt sekel har aktier med lågt beta visat sig generera hög avkastning i förhållande till risk. Denna observation brukar benämnas lågriskanomalin och ända sedan fenomenet uppmärksammades av Black 1972 har olika studier försökt förklara orsaken till dess förekomst. Empiriska resultat har inte bara visat på att lågriskaktier presterat bättre än vad teorin förutspår, utan till och med visat på ett negativt samband mellan risk och avkastning. Detta är i rak motsats till traditionella avkastningsmodeller som exempelvis CAPM, vilken hävdar att avkastning är en direkt funktion av systematisk risk – beta. Syfte Syftet med denna uppsats är att undersöka förekomsten av lågriskanomalin på den svenska aktiemarknaden och analysera huruvida anomalin kan förklaras av den tredje ordningens centralmoment, skevhet. Vidare syftar uppsatsen till att testa och analysera möjligheten att hantera skevhetsrisk genom att inkludera denna som en variabel i en tredimensionell optimeringsmodell. Genomförande Studien bygger på insamlad kurshistorik mellan åren 1998–2018 för samtliga aktier som har ingått i indexet OMXSPI. Totalt har 9650 risksorterade portföljer skapats, där loggning genomförts av portföljegenskaper och analysmått. Sambandet mellan lågriskanomalin och skevhetsrisk har testats genom hypotestester baserat på inkluderandet av en tredimensionell optimeringsmodell samt Three-moment CAPM.   Slutsats Resultaten visar att aktier med lägre beta i genomsnitt har presterat signifikant bättre än högbetaaktier sett till både riskjuterad- samt faktiskt avkastning. Förhållandet mellan risk och avkastning har således varit negativt för den undersökta perioden. Vidare påvisas en signifikant riskaversion mot skevhetsrisk, men trots detta tyder samtliga av studiens tester på att skevhet är otillräckligt för att förklara detta fenomen. Genom tredimensionell optimering visas även hur portföljspecifik skevhet kan hanteras utan att ge signifikant försämrad avkastning. Dessa resultat faller i linje med att lågriskanomalin uppstår som en konsekvens av ett ineffektivt utbud- och efterfrågesamband och kan därmed ses som ett argument mot den effektiva marknadshypotesen / Background For nearly half a century, stocks with low beta has shown to generate high return relative to risk. This observation is called the low risk anomaly and ever since it was observed by Black in 1972, different studies have tried to find an explanation for its presence. Empirical results have not only found that low risk stocks outperform in terms of riskadjusted returns, but also that the relationship between risk and return seem to have a negative correlation. This is the exact opposite of what is suggested by traditional financial models, such as CAPM, which claim that return on assets is a direct function of the its systematic risk – beta. Purpose The purpose of this study is to investigate the presence of the low risk anomaly on the Stockholm stock exchange and analyse if it can be explained by the third central moment, skewness. Further we intend to test and analyse if it is possible to control skewness risk by including it as a variable in three-dimensional optimization. Methodology The thesis is conducted by acquiring historical stock prices for the years 1998–2018 for all shares included in the index OMXSPI. To answer the underlying research questions, 9650 risk-sorted portfolios are created where portfolio performance indicators are being logged. Furthermore, the relationship between the low risk anomaly and skewness-based risk is examined through hypothesis testing, which depend on a three-dimensional optimization model as well as the Three-moment CAPM. Results The results of this study show that stocks with low beta has significantly outperformed high-beta stocks in terms of both risk-adjusted as well as actual return. This implies that the relationship between risk and return has been negative during the time period investigated. Furthermore, the results show a significant aversion towards skewness risk. However, all of the tests indicate that skewness is insufficient in the explanation of the low risk anomaly. It has been shown by three-dimensional optimization that it is possible to control portfolio skewness, without a significant loss in return. These results are in line with the conclusion that the low risk anomaly is an effect of inefficiency in supply and demand and can therefore be seen as an argument against the efficient market hypothesis.

The term criminal career is used to describe the course or progress of criminal activity: its onset, duration, termination, severity, and change in severity. Such a term has important implications, given that significant criminal justice, social, and health policies such as crime control, parole, and correctional treatment and management are predicated on achieving the reduction of criminal careers of serious, repeat offenders. Despite its conceptual simplicity, however, criminal career is often treated as having no depth or scope, for example, merely as the number of crimes or length of prison sentence. These indices often give no or little consideration to criminal career parameters and tend to account for only a small portion of the construct of criminal careers. Ideally, a simple metric to measure the onset, duration, termination, severity, and change in severity of a pattern of criminal activities is needed to facilitate the description and measurement of criminal careers of offenders. <p>The Criminal Career Profile (CCP), which uses commonly available criminological information and requires minimal professional skills to execute, can be considered a simple and precise measure of criminal careers. The CCP is a chronological representation on a Cartesian plane of the time in years an offender has spent in prison (y-axis) plotted against the time in years spent out of prison (x-axis) of all incarcerations and time spent in the community. Given that the CCP is a step function, a regression line can be generated. Serious crimes are generally given longer sentences, and more time in than out of prison would generate a steeper regression line. Shallower regression lines result from less time in than out of prison. As such, the CCP regression line can be considered an indication of the seriousness of offending, and the slope or angle of the regression line can be considered a quantitative index of criminal career severity. Larger slopes or angles (used in this Program of Research) suggest more serious criminal careers. Conversely, smaller slopes or angles suggest less serous criminal careers. Taken altogether, the CCP can provide a quantitative measure of criminal careers: its onset (age at first conviction, which is plotted as the first point on a CCP graph), duration (total time in and out of prison since onset), severity (CCP slope/angle), change in severity (change in CCP slope/angle), and termination (end point or when the CCP slope or angle becomes smaller and closer to 0).<p>This Program of Research was done to assess the CCPs validity and utility in measuring offenders criminal career. More specifically, the investigation focused on the seriousness of criminal careers. A number of criteria were used to validate the CCP angles ability to measure criminal career severity. In Study 1, psychopaths and violent recidivists showed a significantly larger CCP angle than nonpsychopaths and violent nonrecidivists, respectively. Finer groupings based on risk (high, medium, and low), a number of risk measures (Psychopathy Checklist Revised, Violence Risk Scale, and Violence Risk Scale Sexual Offender Version), and different types of offenders (i.e. violent, nonviolent, sexual, Dangerous Offenders) were used in Study 2. Two consistent findings across different groups of offenders in Study 2 were CCP angles significantly varied as a function of risk group and correlated with risk ratings. The pattern of results was that larger CCP angles tended to be associated with worse risk groups. In Study 3, both treated offenders and treatment dropouts showed a reduction in CCP angles from pre- to post-treatment. A nonsignificant interaction of group by treatment, however, suggests that post-treatment changes could not be attributed to treatment. Finally, Study 4 showed that CCP angles change with age. Taken altogether, the results of the four studies provided converging evidence for the validity of the CCP as a measure of criminal careers and the CCP angle as a measure of criminal career severity.