Making a mockery of himself yet again, Rahul Gandhi has proven why nobody would want to see him as the 'Next Prime Minister of India'. On his two-day tour of Madhya Pradesh he alleged Chief Minister Shivraj Singh Chauhan and his son to be involved in the infamous Panama Papers. When he saw himself being rounded on his absurd statement he said, "I was confused whether he was maligned in Panama papers or alleged in e-tendering & Vyapam Scam".
Rahul Gandhi has recently been on an accusing spree, all to round the anti-incumbent government under Shivraj's leadership on Vyapam Scam, he has actually welcomed the main accused Dr Gulab Singh Kirar with open arms in his party. When asked questions on this development, Congress seemed to extricate itself from the controversy.
Madhya Pradesh Congress on their twitter handle had posted, "BJP MLA from Tendukheda Sanjay Sharma, former MLA Kamla Pat & Dr Gulab Singh Kirar took the membership of Congress in the presence of Party Supremo Rahul Gandhi". The tweet was later removed when the controversy started making rounds. Congress State Social Media President, Shobha Ojha when questioned on same, denied Kirar's connection to Congress but on the other hand State Congress General Secretary confirmed that Kirar did take up the membership.
Gulab Singh, a resident of Bhind has twice contested Assembly elections as Independent candidate and once contested for the post of President in Nagar Palika, under the banner of Bahujan Samajwadi Party(BSP) but all these three ventures turned out to be a futile exercise. As per reports Kirar is a relative of Chief Minister Shivraj Singh Chauhan, he was also made a minister in later's cabinet. Furthermore as soon as his name plumped up in Vyapam case, he was relieved of all his duties which thus sent a statement from Chauhan's side that no accused would be spared, be it from his ministry or his own relative.
Kirar was accused of resorting to false means as he bribed Vyapam officials for getting his son through PMT (Pre-Medical Test). As the Rahul Gandhi led party seems divided and confused on his membership, Kirar has released a statement saying, "whatever the party claims, I'll still work for the party since I'm its member".
Interestingly, Kirar's inclusion in Congress is being seen as 'Home-coming', claims Pohri MLA Prahlad Bharti who said, 'Gulab Singh is an opportunist and has knocked the doors of every party for a ticket. His nephew Devraj Kirar was trying to seek ticket from Pohri under the banner of Congress.' The doctor confirmed this notion by saying that he has old connections with the Scindia family and his son would be holding the baton of publicity, in Pohri Assembly and will be vouching for Congress.
When asked about Kirar's inclusion in Congress, the party supremo Rahul Gandhi was seen ducking the questions. Well, this isn't something new as Congress has been at the epicenter of corruption and as a party, has a long history of safeguarding the accused.
With BJP already determined for another tenure & Congress already divided into various groups of Scindia, Digvijay & Kamalnath, Kirar's induction is only going to add misery to their ailing fate.


Stick the sticks with sweet and spicy peppers (if you do not like spicy you can skip it), salt and pepper, fry in oil.
Mix the ingredients of the pickle in a pot and boil.
In a casserole, pour rice onto the bottom, put on slices of onion and fried sticks, pour over the hot pickle and put in the oven – bake 180 degrees about 1 hour (I still kept in the closed oven for about 30 minutes) and they were perfect – delicious! !


text:
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Travel Update Covid-19
DUBAI & ARABIA
EXPLORE KWA ZULU-NATAL
EXPLORE AFRICA & BEYOND
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ITINERARY IDEA
DRAKENSBERG MOUNTAINS & MIDLANDS
DURBAN & SURROUNDS
ISIMANGALISO WETLANDS PARK
HLUHLUWE GAME RESERVE
MKUZE FALLS PRIVATE GAME RESERVE
PONGOLA GAME RESERVE
THANDA PRIVATE GAME RESERVE
THE BATTLEFIELDS
Cathedral Peak Hotel
Cathedral Peak Hotel is located in the unspoiled surroundings of the Drakensberg mountain range. The hotel offers a wide variety of accommodation. All hotel rooms provide tea/coffee making...
Cleopatra Mountain Farmhouse
Cleopatra Mountain Farmhouse is located in the heart of the KwaZulu Natal Drakensberg overlooking a lake which in turn is surrounded by gardens with fantastic views over the mountains...
Hartford House
Hartford House is a boutique country house hotel situated in the KwaZulu Natal Midlands. The property forms part of the Summerhill Stud Farm at Mooi River. Accommodation is in 16 spacious and...
Montusi Mountain Lodge
Montusi Mountain Lodge is situated in the KwaZulu Natal Drakensberg, and has a full and uninterrupted view of the Drakensberg's most famous part, the Amphitheatre escarpment. Accommodation is...
Quarters Hotel Florida Road
Quarters Hotel is situated at the corner of Sindile Thusi (formerly Argyle) and Florida Road, in an area often referred to as Durban's "Dining District". Accommodation consists of 23 standard...
The Oyster Box
The Oyster Box is situated overlooking the historical Umhlanga lighthouse on prestigious beachfront near Durban, with views of the Indian Ocean. There are 86 luxurious and individually designed...
Beverly Hills Hotel
The Beverly Hills Hotel is set on the coastline of Umhlanga Rocks, one of the premier coastal locations in South Africa, with spectacular views over the Indian Ocean. The hotel has 89 rooms...
Zimbali Resort
Zimbali Resort is set within a coastal forest reserve on the north coast of KwaZulu-Natal. Situated between the reserve and the sea, the resort's natural beauty is enhanced by the rich Zulu...
Thonga Beach Lodge
Thonga Beach Lodge is situated on the pristine shores of the Elephant Coast, set in a beautiful coastal dune forest with sweeping views of the spectacular beach below. Carefully constructed...
Hilltop Camp
Hilltop Camp is situated on the summit of a forested hill offering fantastic views of the surrounding countryside. The camp, the oldest in KwaZulu Natal, was extensively rebuilt and enlarged in...
Hluhluwe River Lodge is situated on the western boundary of the iSimangaliso Wetland Park and has sweeping views of False Bay and the Hluhluwe River floodplain. Accommodation is in 12 thatched...
Mkuze Falls Lodge
Mkuze Falls Lodge is located along the northern bank of the Mkuze River in the heart of KwaZulu Natal. The lodge has eight luxuriously appointed thatched chalets and one safari suite...
Mkuze Falls Tented Lodge
Mkuze Falls Tented Lodge is for an adventurous experience in five "Hemingway" style East African Tents, each overlooking the Mkuze River. Each tent is completely private and well spaced apart...
Phinda Forest Lodge is set in rare sand forest with glass walls offering a sweeping view of one of the most unique ecosystems on the planet. Accommodation is in 16 air-conditioned glass suites...
Mountain Lodge is situated on the crest of a mountain with dramatic views over the surrounding landscape. Accommodation is in 25 split-level suites, each with en suite bathroom, private sitting...
Phinda Rock Lodge
Rock Lodge is set on a cliff face overlooking Leopard Rock in Phinda Private Game Reserve. Accommodation is in six exceptional suites set on the side of a rocky cliff. Each suite has a spacious...
Vlei Lodge
Vlei Lodge is set on the edge of the forest overlooking an open meadow (or vlei), complete with watering hole. Accommodation is in 6 stilted glass and thatch suites located in the rare...
Zuka Lodge
Zuka Lodge is a sole-use villa accommodating families or groups of up to eight. The lodge includes private ranger/host, tracker, butler, chef and exclusive use of an open 4x4 safari vehicle...
White Elephant Bush Camp
White Elephant Bush Camp is a private, sole-use bush villa located in Pongola Game Reserve and provides an authentic 'back to nature' experience with the emphasis on simplicity, comfort and...
White Elephant Safari Lodge
White Elephant Safari Lodge is located in Pongola Game Reserve and offers classic, décor, with deep verandahs and sweeping views. Guests are accommodated in 8 luxurious safari tents, each with...
Thanda Main Lodge
Thanda Main Lodge is situated 23 km north of Hluhluwe in northern Zululand, on the 14,000 hectare private game reserve. Accommodation consists of nine luxury bush villas each with a private...
Thanda Tented Camp
Thanda Tented Camp is situated 23 km north of Hluhluwe in northern Zululand, on the 14,000 hectare private game reserve. The camp has recently been renovated and is built in a colonial safari...
Fugitives' Drift Guest House
Fugitives' Drift is world famous for its battlefield tours, led by knowledgeable and highly-qualified lecturers, steeped in the history of the region and telling the tale as they were taught to...
Fugitives' Drift Lodge
Fugitives' Drift is world famous for its battlefield tours, led by knowledgeable and highly-qualified lecturers, steeped in the history of the region and telling the tale as they were taught...
Isandlwana Lodge
Isandlwana Lodge is carved into the iNyoni rock overlooking Mount Isandlwana, the site of the historic Anglo-Zulu war battle which took place on the 22nd of January, 1879. Accommodation...
Three Tree Hill Lodge
Three Tree Hill Lodge overlooks the secluded Mfazimnyama Valley of the Spioenkop Game Reserve against the backdrop of the Drakensberg mountains. The lodge consists of 6 standard luxury twin...
Teremok Marine
Along the tropical belt of KwaZulu-Natal, nestled amongst the palm and giant Milkwood trees lies Teremok Marine, a luxurious five-star boutique lodge whose name translates fro...
Canelands Beach Club & Spa
Canelands is a luxurious and elegant 10 bedroom beach club situated in the popular upmarket region of Salt Rock on KwaZulu Natal's North Coast, South Africa. Set literally a step away from th...
Sandals Guest House
Sandals Guest House is located only a short stroll from the beach the vibrant village which abounds in top class restaurants, bars and coffee shops. The guest house offers four rooms, each with&nbs...
Kosi Forest Lodge
Kosi Forest Lodge is Lodge is set in a beautiful sand forest on the banks of Lake Shengeza in the iSimangaliso Wetland Park. The vibrant African town of Manguzi is a 20 minute 4×4 transfer ...
Day 1 - 2: Durban & Surrounds
Meal Basis: Bed & Breakfast
Just outside of Durban is the seaside resort town of Umhlanga Rocks. The tropical weather and lush vegetation make this an enticing holiday destination, attracting visitors from all over the world. It is the perfect location for ocean enthusiasts and outdoor adventurers alike, with great opportunities for diving, swimming, scuba diving, whale watching, dolphin viewing, deep sea fishing and kite boarding.
Day 3 - 4: Drakensberg Mountains & Midlands
Meal Basis: Full Board
An imposing wall of rock that rises to 3000m, creating untold inspiring views and hikes. Known to the Zulus as the Barrier of Spears and to the first European settlers as the Dragon's Mountains. The Ukhahlamba Drakensberg is 1 of 8 South African UNESCO World Heritage sites, uniquely being on for both its significance as a natural resource and for the heritage of the San Paintings. For 1000s of years they hosted the San people and they in turn left their record on the walls on numerous sandstone caves.
Today most of the Drakenberg is protected as a National Park and it is a major attraction for the lover of the outdoors.
KZN is steeped in history and literally littered with battlefields; from the struggles of the Zulu Civil Wars, to their clashes with the Boers and the British and the two wars where South Africa's white tribes fought against one another. The most well-known and well visited sites are those where the legendary Battles of Isandlwana and Rorke's Drift took place on the same day, lodging the Zulus firmly at the top of great warrior nations. Not far from these battlefields are the famous Anglo-Boer War fields of Spioenkop, Colenso and the Siege of Ladysmith, which drew characters like Winston Churchill, Louis Botha and Mohandas Gandhi onto the same stage.
Day 7 - 11: Hluhluwe Game Reserve
Meal Basis: Full Board plus Activities
The Hluhluwe-Umfolozi Game Reserve is the jewel in the crown of the KwaZulu Natal game reserves. Proclaimed in 1895, it is also the oldest game reserve in Africa. Initially two separate reserves, they were joined to create a single 94 000-hectare reserve which is home to one fifth of the world's black and white rhino population. It was here that the internationally acclaimed Operation Rhino started in the 1960s, successfully capturing and relocating white rhino to havens within South Africa and abroad. As a result, this country's white rhino population is now 12 times the 1960 count of 500. Today Hluhluwe-Umfolozi is focusing its efforts on saving the endangered black rhino, whose number in Africa dwindled from 14 000 to a pitiful 2 550 in the 1990s. The Hluhluwe-Umfolozi Game Reserve was the first reserve to introduce walking safaris and its Wilderness Trails are internationally renowned.
This itinerary is a guideline, Africa & Beyond tailor every trip to your individual specifications including all accommodation, flights, transfers & activities, please contact us to discuss your ideas.
ABOUT KWA ZULU-NATAL
South Africa's Zulu Kingdom, KwaZulu Natal, is an increasingly popular destination. It is a unique blend of cultural diversity, sophistication and nature – as well as being home to the historic Battlefields of Isandlwana and Fugitive's Drift.
Flanked by the warm Indian Ocean, the region also has areas of vast, unspoiled beaches and coastline teeming with nature. In Maputaland, a great number of turtles inhabit the waters and breeds include the Leatherback, Loggerhead, Olive Ridley, Green Turtle and Hawkbill. The Big 5 are all found in the province's Game Reserves, and the largest population of Black and White Rhino is also to be found here.
Between May & July the Sardine Run is in full swing. Millions of Sardines are heading north along the coastline, closely followed by Humpback and Southern Right whales, schools of sharks and a plethora of seabirds, all drawn to this annual fishy feast.
or call our experts:
It's a tough job, but ...... 630 dolphins and counting. Julie in Mauritius. https://t.co/vo1OYQ0L4l https://t.co/qqG6DTKel4
For the latest travel advice from the Foreign Commonwealth Development Office (FDO) please visit https://www.gov.uk/government/organisations/foreign-commonwealth-development-office
© 2021 Africa and Beyond Ltd.

redpajama_set_name: RedPajamaCommonCrawl


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text:
Q: IFS change with Bash 4.2 Running these commands gives expected results
$ bash --version
GNU bash, version 4.1.11(2)-release

$ foo=(111 222 333)

$ IFS=, cat <<< "${foo[*]}"
111,222,333

However it appears with Bash 4.2 the IFS value is being ignored
$ bash --version
GNU bash, version 4.2.0(1)-release

$ foo=(111 222 333)

$ IFS=, cat <<< "${foo[*]}"
111 222 333

What is causing this difference?
I found the answer here
http://lists.gnu.org/archive/html/bug-bash/2014-03/msg00065.html
It looks as though this has been an error all along. According to Chet,
redirections should never have had access to the temp environment
(IFS in this case)

A: I find the behaviour of 4.2 correct as word splitting should happen first before evaluation of assignments:
IFS=, cat <<< "${foo[*]}"

I believe the new value of IFS should only affect cat and not <<< "${foo[*]}".
The proper way to do that is
IFS=, eval 'cat <<< "${foo[*]}"'

And for a conservative approach we can use a function:
function t { cat <<< "${foo[*]}"; }
IFS=, t

I also have a guess that it's related to this:
m.  Fixed a bug that caused here documents to not be displayed correctly
    when attached to commands inside compound commands.

Update
Another confusing behavior can be found in 4.2 which is already fixed in 4.3. By doing IFS=, cat <<< "${foo[*]}", "${foo[*]}" expands well as "111 222 333" (not affected by IFS) as shown by cat which is 111 222 333. However when we do IFS=, read bar <<< "${foo[*]}"; echo "$bar", the output would be 111,222,333 and would appear as if "${foo[*]}" expanded as "111,222,333". This inconsistent behavior is no longer happening in Bash 4.3 and Bash 4.3's behavior is probably a fix.

redpajama_set_name: RedPajamaStackExchange


text:
Changing health behaviors using financial incentives: a review from behavioral economics
Ivo Vlaev ORCID: orcid.org/0000-0002-3218-01441,
Dominic King2,
Ara Darzi3 &
Paul Dolan4
Incentives are central to economics and are used across the public and private sectors to influence behavior. Recent interest has been shown in using financial incentives to promote desirable health behaviors and discourage unhealthy ones.
If we are going to use incentive schemes to influence health behaviors, then it is important that we give them the best chance of working. Behavioral economics integrates insights from psychology with the laws of economics and provides a number of robust psychological phenomena that help to better explain human behavior. Individuals' decisions in relation to incentives may be shaped by more subtle features – such as loss aversion, overweighting of small probabilities, hyperbolic discounting, increasing payoffs, reference points – many of which have been identified through research in behavioral economics. If incentives are shown to be a useful strategy to influence health behavior, a wider discussion will need to be had about the ethical dimensions of incentives before their wider implementation in different health programmes.
Policy makers across the world are increasingly taking note of lessons from behavioral economics and this paper explores how key principles could help public health practitioners design effective interventions both in relation to incentive designs and more widely.
The effect of individual behavior on health outcomes is considerable with estimates that up to 40% of premature deaths in the developed world are attributable to unhealthy behaviors, such as smoking, poor diet and sedentary lifestyle [1]. Reducing morbidity and mortality losses in the future is likely to depend as much on motivating changes in behavior as on developing new treatments or technologies and many countries and health systems are now directing resources to this end [2, 3].
A range of tools are at the disposal of policy makers seeking to influence behavior including legislation, price signals (taxes and subsidies) and information campaigns. Although the use of incentives in wider public policy is nothing new, their role in encouraging health behaviors is a relatively recent phenomenon [4]. Incentives can take a number of forms including cash or alternatively vouchers that can then be exchanged for desirable items. The apparent enthusiasm for using incentives to influence health behaviors has come about as the full economic and social costs of unhealthy behaviors have become apparent and with the finding that health behaviors can be significantly affected by the structure of economic incentives that individuals face [5, 6]. Examples of incentive schemes recently implemented in the United Kingdom include the 'Give It Up For Baby' programme in Tayside, Scotland to encourage pregnant smokers to quit the habit and the 'Pounds for Pounds' scheme in Kent, England to influence weight control [7]. In diabetes care, incentive programs directed at patients show promise as a means to influence patient behavior and intermediate outcomes such as weight loss [8].
But widespread concerns do exist and tend to center on the potentially coercive impact of using incentives and the 'unfairness' of rewarding people for doing things that are already in their own interest [9, 10]. We share some of those reservations, but rather than adding further to this normative debate, we will focus herein on positive ways in which we might give incentives the best opportunity to work if and when they are considered appropriate.
We will look to see whether it is possible to provide further guidance on how best to configure and implement incentive schemes using evidence from behavioral economics. Behavioral economics has come to prominence following the publication of Richard Thaler and Cass Sunstein's book Nudge [11], but the science underlying it is built on decades of applied research by the likes of Daniel Kahneman and Amos Tversky [12, 13]. In contrast to economic models of rational choice suggesting that we respond to information and price signals, insights from across the behavioral sciences suggest that human behavior is actually influenced greatly by the context or environment within which many of our decisions are taken. Nowadays 'dual process' theories can be found in social, personality, cognitive, clinical and health psychology [14]. Two general paradigms for behavior change have emerged over the years. The first type aims to change high-order cognitions such as beliefs and attitudes as a route to influencing deliberate responses by using persuasion and education campaigns. The second approach aims to influence lower-order mental processes, thus triggering spontaneous responses, by changing the context or environment within which the person acts without necessarily changing underlying higher-order cognitions such as beliefs and attitudes. In other words, the distinction is between behaviors resulting from internally cued, reflective, and intentional changes versus behaviors resulting from externally cued, automatic and (often subconscious) reactive changes [15].
Governments around the world are taking notice of the potential role behavioral economics could play in designing more effective public policy. A prominent example is the coalition Government in the United Kingdom, who have so far made recommendations on how public behavior around charitable giving and preventive health could be influenced using the Mindspace framework for behavior change [16,17,18,19]. Intelligent design of incentive schemes is one of the key tools in this new 'behavioral' approach.
Financial incentives in healthcare
It is well established that a higher price reduces consumption [20]. So, we see that smoking consumption in Europe has been seen to decrease by about 5% for every 10% increase in the real price of cigarettes and that increasing the price of alcohol is among the most effective options for reducing consumption [21, 22]. Price signals to influence behavior in healthcare can take forms besides traditional 'sin taxes' for example by subsidising healthy behaviors or rewarding adherence to a treatment programme. The increase in the last decade of schemes aimed at changing the health-related behavior of the public has been accompanied by evidence that even small incentives can positively influence choices [23,24,25]. Having said that, a recent review of the evidence for the effects of economic instruments (prices or income) on dietary and physical activity behaviors and corollary outcomes [26] revealed that evidence is limited in terms of the potential for causal inference and yields ambiguous or inconsistent findings (the evidence is also mostly about impacts on diet, with very limited evidence for impacts on physical activity). Those findings highlight the need to implement robustly designed interventions and evaluations of the logic models and programme theories involved.
In clinical psychology, the contextual-change route has taken a substantial share of research, because classical behavior therapy and cognitive-behavioral therapy focus on underlying learning processes and environmental contingencies of reinforcement [27, 28]. Schedules of contingent reinforcement are also a key to the success of rewards (materialised incentives) and often used in behavioral psychology circles. For example, providing contingent rewards is used in interventions developing constructive habits. This reinforcement principle has been successfully employed to treat drug addiction and substance misuse (including smoking and alcohol consumption) and to improve medication compliance [29]. Such interventions usually include earning money or points contingent on the patients' specific behaviors.
The effectiveness and long-term sustainability of behavioral change when incentives are targeted at the more challenging and complex behaviors such as smoking and obesity is less well known [30,31,32,33]. Also, given the opportunity costs of the changed behavior is the same across income groups, we may also expect to see that as £1 to a poor person is worth more than £1 to a rich person, small incentives are also likely to be more effective in low-income groups [34].
A review from behavioral economics
We identified interesting examples from the literature through a search strategy of electronic databases including (PubMed, EMBASE, PsychInfo) using keywords. We reviewed Longitudinal, cross-sectional and retrospective studies of interventions using incentives to change health behaviors, including patients and/or providers of healthcare. We also included systematic reviews of such interventions. Our team independently reviewed articles and compared and discussed interpretations. Results were synthesized under thematic classification and abstraction. Because this is a debate article, we have not provided a review of all those studies. We do no aim to synthesize the evidence. Rather, in our manuscript we offer a theoretical investigation of incentive design and behavior change.
Although success has been seen with a number of financial incentive schemes targeting preventive health behaviors, some financial incentives have not worked at all well, or even at all in the case of reducing levels of obesity [33]. It may be that incentives are unlikely to work at a cost-effective level in changing certain complex behaviors. Another contributing factor could be that too little thought has been put into the design of incentive schemes previously implemented. Roland Fryer has demonstrated how important design is when thinking about how financial incentives can be used to improve educational achievement [35]. In a series of school based randomized trials, incentives were only found to be effective when they were given for inputs to the educational production function. Incentives tied to educational outputs were not effective. Qualitative data suggested that because students do not understand the education production function, they were not able to 'turn their excitement about rewards' into meaningful achievement. The same may be true for people offered incentives to lose weight or stop smoking.
Those choosing the format of incentive schemes will have many options available to them when thinking about design. Let us take a theoretical example of an incentive scheme to encourage participation in a weight-loss programme. The reward may be given for attending classes and it could be given at the beginning of the programme, at its completion or in increasing or decreasing increments as classes are attended. Alternatively, the incentive could be given dependent on actual weight loss targets that result from following the programme. Different scheme designs are likely to lead to different outcomes.
It is important to think about the most effective design of incentive schemes, as our responses can be shaped by a range of predictable biases and heuristics [12, 13, 36]. Behavioral economics provides us with a number of robust psychological phenomena that help explain the decisions we make in a range of settings, including savings, health and education [15, 19]. Evidence suggests that human behavior is led by our very human and fallible brain and the context or environment in which many of our choices are taken. The finding being that small changes in context (nudges) can affect behavior as much as large price changes [11, 37]. Such effects or 'nudges' can be applied to the design of more effective incentive schemes and include the following.
Losses loom larger than gains
It has been demonstrated that we react more to losses than to gains of equivalent magnitude [38], which is embedded into the well-known (Nobel prize winning) Prospect Theory of risky choice. Loss aversion implies that someone who loses £10 from his or her pocket will lose more satisfaction than another person would gain satisfaction from a £10 windfall. Most incentive schemes tend to offer rewards to participants but inducing some feeling of loss if they fail to do something may be more motivating than rewarding them by the same amount. So, instead of providing a £10 reward for each of the ten sessions of a weight loss programme, it may be more effective to provide £100 at the end of the programme, with all missed sessions attracting a more salient and painful £10 loss. Using a behavioral economics framework, one randomised study has shown the short-term effectiveness of such a scheme. Individuals in this programme contributed to a matched deposit contract that rewarded them if they met or exceeded their weight loss goal but led to the loss of the reward if they failed [39]. Loss aversion is one of the most robust phenomenon from behavioral economics and could be used more widely across incentive schemes.
An interesting intervention tested the impact of financial incentives framed as a gain or loss to promote Chlamydia screening in students, mimicking the standard outreach approach to student in halls of residence [40]. This was a in a cluster randomized trial (N = 1060; age 18–24 years). The students were offered (depending on condition) £5 voucher vs. £200 lottery. In the control group the screening rate was 1.5%, while the lottery increased screening to 2.8% and the voucher increased screening to 22.8%. Incentives framed as gains were more effective than loss-framed incentives (10.5% vs. 7.1%, respectively). This work contributes to the literature by testing the predictive validity of Prospect Theory to change health behavior in the field.
In another domain, such a framing manipulation was used to increase factory worker productivity in a field experiment [41]. They find conditional incentives framed as both "losses" and "gains" increase productivity for both individuals and teams. In addition, teams more acutely respond to bonuses posed as losses than as comparable bonuses posed as gains. The total team productivity is enhanced by 1% purely due to the framing manipulation. Another interesting intervention tested the power of loss aversion to improve teacher performance [42]. During the 2010–11 Chicago school year teachers were randomly asked to participate in a pay-for-performance program with "gain" and "loss" treatments. The "gain" group received traditional financial incentives at the end of the year in the form of bonuses linked to student achievement. Those teachers in the "loss" group were paid a lump-sum in advance and asked to give back the money if their students did not meet performance targets. Teachers in both conditions received the same monetary bonus if they reached the same performance targets. This approach resulted in increases in math test scores for the loss condition by an equivalent of increasing teacher quality by more than one standard deviation. The gain treatment yields smaller and statistically insignificant results. The authors attribute the significant difference between the loss and gain condition to the loss aversion framing. Those intervention techniques could be used to improve the productivity of the healthcare workforce too.
Overweighting of small probabilities
There is good evidence that people place more weight on small probabilities than standard economic theory would suggest [43], which is another essential element of Prospect Theory. This helps explain the widespread popularity of lotteries and insurance. Although the tendency to overweight the probability of unlikely but salient outcomes can lead to problem gambling [44], it can also be used to positive effect using lottery based public policy interventions. Lottery based financial incentive programs have been seen to be effective in a weight loss intervention and in improving warfarin adherence and anticoagulation control [45].
Patel et al. [46] tested the effect of different types of lottery-based financial incentives in increasing physical activity among University of Pennsylvania Employees with body mass index ≥27. All participants used smartphones to track their steps per day and received daily feedback on performance for 26 weeks (financial incentive for 13 weeks and then were follow up for 13 weeks without incentives). Daily lottery incentives were designed as a "higher frequency, smaller reward" (1 in 4 chance of winning $5), "jackpot" (1 in 400 chance of winning $500), or "combined lottery" (18% chance of $5 and 1% chance of $50). The outcome measure was the mean proportion of participants who achieved the daily goal of 7000 steps. During the intervention, only the combined lottery incentives was significantly greater than control (0.38 vs. 0.26 mean proportion of participant days that goal was achieved); and there were no significant differences during follow-up. This study shows that interventions need to experiment with designing different types of lottery schemes.
Living for today at the expense of tomorrow
The third phenomenon is hyperbolic discounting also known as 'present bias' [47, 48]. Economists assume that our preferences over today versus tomorrow are the same as those over this time next week and this time in eight days. Although standard discounting simply says that we use the same discount rate in each period, evidence tells us that today looms much larger so that we discount very heavily from the present and less heavily once we think about any time into the future. So given the option, some people would choose to take £18 today rather than £20 tomorrow but would be much less inclined to take the £18 in a week's time than £20 a day later. It has been demonstrated that the immediacy of an incentive can influence outcome of voucher-based incentive programmes for substance misuse [29], and an understanding of hyperbolic discounting should lead those designing schemes to think more carefully about when the actual incentive is given.
The immediacy of financial incentives also show potential for supporting smoking cessation in pregnancy. A review of evidence found that providing vouchers contingent on testing for smoking were effective in reducing smoking rates in late pregnancy, compared to vouchers without testing [49]. Specifically, linking the incentive to the desired outcome was clearly an important feature of the incentive design.
Similarly, an immediate financial incentive has been shown to improve adherence to anti-psychotic medications [50]. This trial offered a £15 incentive to one group of patients for each medication taken, whilst a second group received usual care. The majority of patients and clinicians felt positive about the use of incentives, and the costs were relatively low. Patients receiving the incentive were more likely to take the medication (85% vs 71%). When the incentives stopped, adherence returned to the same level as those who had not received the incentives.
Increasing rather than decreasing payoffs
Incentives have generally been seen to be more effective for one off behaviors like vaccinations [25]. An understanding of hyperbolic discounting is particularly useful for incentive schemes where only a one-off reward is offered. For complex behaviors, multiple incentives may need to be offered at intervals but how should they be given? It has been seen that people respond more to increasing payoffs, as opposed to decreasing or constant ones [51]. This principle has been used to develop successful interventions to treat drug addiction and substance misuse and to improve medication compliance [29]. In those interventions, the patients earn points contingent on submitting urine specimens that are drug-negative or substance-negative. The reward points (incentive) usually begin at a low value and increase with each successive negative test result. If the patient fails to provide a scheduled specimen or provides a drug-positive result, then the voucher's value is reset back to the initial low value from which it could begin to increase again. Such incentive contingency scheme can be used to improve outcomes across a wide range of different behaviors and populations.
Reference points matter
A study from the developing world provides a further phenomenon which is that reference points matter when offering incentives. Evidence from the field, suggests that people care more about what they gain or lose around what they already have rather than what they may end up with. It is known that many people tested for human immunodeficiency viruses (HIV) in the developing world do not pick up their results. This is a major challenge to prevention campaigns and has led to a variety of 'know your status' campaigns. A programme in Malawi has shown that offering incentives can encourage people to pick up their HIV result [52]. The biggest increase in uptake, by around 50%, is observed when the incentive changed from zero and one-tenth of a day's wage. Offering more money still positively affects behavior but to a much lesser degree. This finding is consistent with a 'concave' utility function in economics known as 'diminishing marginal utility of income' (more income impacts us less), but the rate at which utility declines when income rises would have to be extremely steep which is not what traditional economic models would predict. The results suggest that the utility of money is judged relative to reference points that are very contextually and narrowly defined. This finding also suggests that such locally defined reference points could influence decisions around price and the cost-effectiveness of offered incentives.
Ethical concerns
Motivating behavior change in health is much more complex than can be accomplished with a single strategy and offering incentives (both positive and negative) are just one route to achieving improvements in health outcomes. Financial incentives are increasingly seen as an important vehicle to bring about changes in behavior that lead to healthier lifestyles and supporters and critics alike can be passionate about their use. Supporters of incentive schemes generally believe that people should be encouraged where possible into behaviors that promote improved health outcomes and that appropriately targeted incentives can reduce inequalities in health outcomes [4, 25, 53]. Incentive programmes can be seen as an example of symmetric or libertarian paternalism that steer people towards better choices without limiting what those choices are [54]. But there are also legitimate ethical concerns. Monetary compensation has the potential to lead to intrinsic motivation being 'crowded out' or partially destroyed [55], so that when an activity is associated with an external reward, a person may be less inclined to do the activity in the future without further rewards. However, this concern is related to the efficacy of incentives rather than the ethics. More concern comes from the perception that incentives can be seen as a form of bribery and/or coercion and inconsistent with shred social values [56].
Marteau et al. [9] suggest a psychological perspective that can help us think about the appropriateness of using incentives for encouraging participation screening tests. It is known that individuals do not always act according to their long-term goals and interests. We also know that in hindsight people often would prefer to have acted differently. For example, most of us would like to eat more healthy food, drink less, and stop smoking. Still, our behaviours do not match such intentions. Offering people a reward/incentive helps them to align their actions with such preferences. In this way, incentives enhance their autonomy to act according to their true underlying preferences. This may help explain why governments and private organisations increasingly apply financial incentives, or other extrinsic motivations, to improve health [57]. There is also evidence that the public supports incentive schemes that are cost-effective [58, 59].
Consequently, alongside further exploration of the appropriateness of using incentives in health we also need to determine whether or not they work and are cost-effective. At present we do not know what impact different incentive schemes have on various health behaviors or what impact they may have on different socioeconomic groups invited for appointments. If we learn that incentives are unsuccessful and/or are not cost-effective then more broadly implementing these interventions would be considered unwise and would not be advised. Researchers have explored the use of such incentive schemes in a range of settings, and with different populations. The results have varied, suggesting that incentives are context-dependent, and need to be planned carefully according to the needs and preferences of different groups. For example, offering small financial incentives – such as £10 in cash, or the opportunity to win £1000 in a lottery – did not improve attendance at eye screening for people with diabetes [60]. This study recruited people who had not attended their eye screening appointment in the last two years. Patients in the two incentive groups were actually less likely to attend their appointments than those who received the standard invitation. The reasons for this unexpected result were not clear, but all the patients involved were from relatively deprived groups with a history of non-attendance. The researchers also suggested that the offer of an incentive may cause a negative reaction, if the recipient believes that the screening must be unpleasant if they have to be paid to do it. This is supported by the finding that the lottery offer – to win a much larger sum – was associated with the lowest levels of attendance.
Given the promise of incentives to positively motivate behavior, we should not necessarily use legitimate concerns about their wider use in public policy prevent us from studying them in earnest. This article seeks to do this while recognising the concerns about their use. If incentives are shown to be a useful strategy to influence health behavior, a wider discussion will need to be had about the ethical dimensions of incentives before their wider implementation in different health programmes.
Financial incentives are increasingly seen as an important vehicle by which to bring about changes in behavior that can lead to healthier lifestyles. Limited evidence also suggests that appropriately targeted incentives could reduce inequalities in health outcomes [53, 61]. There are lessons that can be learned from a range of disciplines and we have focused on those from behavioral economics in this article.
Policy implications
We cannot give specific advice to policy makers for all individual circumstances, but there are some clear examples of policy and program applications of the general ideas presented in this article.
Financial incentives have been seen to be more effective in increasing performance of infrequent behaviors (e.g. vaccinations, screening) rather than in more sustained behaviors (e.g. smoking, dieting) [62]. Therefore, the incentives-related lessons from behavioral economics should be more readily applied to infrequent behaviors in the first instance. In relation to 'overweighting small probabilities', for example, policy makers and program designers could set up vaccinations incentive programs as lotteries, that is, 'if you vaccinate your child, we will enter your name into a lottery, and you just might win a lot of money'.
Financial incentives for healthy behavior are already being used by large employers or health insurance providers [63, 64]. For example, patients in some states in USA have some benefits reduced or eliminated if they do not participate in health care screenings, keep their medical appointments, take their medications and adhere to health improvement programs as directed by their health care providers [65].
The United States administration also issued a rule that employers can use financial rewards and penalties for workers worth up to 50% of the health insurance premium as an incentive to quit smoking, exercise, eat healthier food, lose weight, and lower cholesterol and blood pressure [66]. In particular, the rule allows, as part employee wellness programs, employers to reward or penalize employees who meet specific standards related to their health (e.g., rewarding employees who do not use tobacco or who achieve a specific cholesterol level, weight or body mass index). In order to avoid wasting public resources, such programs will provide evidence how such incentives schemes work in the longer-term and which method is most cost-effective. Employers can improve the effectiveness of such programs by incorporating the behavioral economics principles discussed in this article.
Evidently, incentive programs directed at both providers and patients have become increasingly widespread. Although we have focused on patients and the public in this article, incentives are also frequently used to target provider behavior as a means to improve quality of care [67]. For example, in 2004 in the United Kingdom, a significant proportion of general practitioners' pay became tied to a quality and outcomes framework [68]. The behavioral principles described here may also be applicable to incentive design on the provider side and have the potential to alleviate some of the problems identified with current programs [67]. Pay-for-performance (P4P) where providers receive financial incentives to carry out specific care or improve clinical outcomes (i.e., performance targets at which the incentive is targeted) has been widely implemented. There is emerging important evidence on P4P, which reveals a mixed picture so far. Studies in both United States [69] and United Kingdom [70] have found that initially positive effects were short lived. In diabetes care for example, the existing literature indicates P4P incentives stimulate initial gains that later tend to level off, while withdrawing the incentives partially reverts the gains [8]. We believe that behavioral re-design of some of those P4P programs is very likely to improve their effectiveness.
Finally, behavioral economics also provides some arguments against using incentives in specific circumstances. Some economists claim that offering monetary incentives may lead to destroying ('crowding-out') genuine ('intrinsic') motivation [55]. There is some evidence from a meta-analysis of experimental studies, which revealed that after a behavior is associated with an external reward, people are less willing to enact the behavior without further external rewards; in other words, extrinsic rewards undermined motivation [71]. So, when designing behavior change interventions, we must consider that badly designed policies can exacerbate the challenges we currently face and lead to unintended consequences, such as when financial incentives crowd-out/suppress intrinsic motivation for healthy behaviors [72, 73].
This is a debate article, so the presentation of the data is fundamentally descriptive and qualitative, because we do no aim to synthesize the evidence. Rather, we offer a theoretical investigation of incentive design and behavior change. Incentives and behavior change perhaps present the best examples of where genuine attempts have been made to span the divide between behavioral science and health policy, because incentives is the 'tool' most often used by the policy makers to influence behavior. However, despite the recent flurry of scientific theories and reports, there are not enough examples of successful transition from science to policy. This article aims to demonstrate that the evidence now exists where the 'behavior incentive design' can stimulate intervention projects informed by a scientific understanding of behavior.
This approach is useful in social sciences but is limited. For example, nudges or economic interventions that show strong effect on the collective behavior of populations are put at the same level with others that show only a tiny, and probably statistically insignificant, trend. At present, we do not have a complete enough picture of which configuration of incentives works best. So, it is worth pinpointing areas which need more research and areas where plenty of robust studies support a given recommendation.
After reviewing the mounting evidence on the uncertain effect of financial incentives to improve health behaviors, Thirumurthy, Asch and Volpp [74] conclude that the principle that individuals respond to incentives has considerable empirical support, but the devil is in the detail, because the magnitude of effects differs substantially based on the nature of the behavior, the size of the incentive, the population involved, the social context, and the design (subtle design choices in how incentives are situated, framed, or deployed can have substantial effects on their success). Therefore, investigating different ways of joining up some of the psychological mechanisms of action – loss aversion, hyperbolic discounting, and increasing payoffs – may lead to real improvements in the efficiency and effectiveness of existing and novel incentive designs. Incentives based on combinations of individual and group goals have also shown promising results. Furthermore, a potentially powerful approach is combining both patient and provider incentives, but whether this is cost-effective has yet to be determined [8].
Further insights from the behavioral sciences could allow us to combine incentive schemes with other policy tools to ensure long term effectiveness. One example are commitment devices [15], which involves individuals making a public decision about the future that results in some additional (social and/or financial) cost if they fail to follow through with that decision (or additional benefit if they successfully do so). As many people revert to past behaviors once the incentive is withdrawn, combining commitment devices with incentives may be useful in ensuring long-term behavior change. There is limited evidence from a Cochrane review that commitment contracts can potentially contribute to improving adherence to diagnostic procedures, therapeutic regimens or health promotion and illness prevention initiatives [75].
The only real way to test further interventions of this 'joined-up' kind is through the proper design and use of field experiments [76]. We would encourage those designing incentive schemes to consider how some of the lessons learnt from smaller scale and more experimental studies can be examined in a more naturalistic setting, thereby avoiding randomisation bias. Rigorous evaluation and dissemination of the outcomes from current and future schemes is also necessary to add to the limited evidence that tells us what does and does not work when using incentives. The ultimate criterion by which to judge the merit of such interventions is whether they improve the health and well-being of the individual; and the more is the latter, the merrier is the incentive scheme [77, 78].
Mokdad AH, Marks JS, Stroup DF, Gerberding JL. Actual causes of death in the United States. J Am Med Assoc. 2004;291(10):1238–45.
Schroeder SA. Shattuck lecture. We can do better--improving the health of the American people. N Engl J Med. 2007;357(12):1221–8.
Darzi A. High quality care for all: NHS next stage review. London: Department of Health; 2008.
Oliver A, Marteau TM, Ashcroft RE. Can financial carrots improve health? J Health Serv Res Policy. 2009;14(1):1–2.
Sindelar JL. Paying for performance: the power of incentives over habits. Health Econ. 2008;17(4):449–51.
Le Grande J, Titmuss R, Srivastava D. Incentives for prevention: health England report no, 3. Oxford: Health England; 2009.
National Institute for Health and Care Excellence (NICE) (2010). The use of incentives to improve health. Citizens Council Reports No 14.
Lorincz IS, Lawson BC, Long JA. Provider and patient directed financial incentives to improve care and outcomes for patients with diabetes. Current Diabetes Reports. 2013;13(2):188–95.
Marteau TM, Ashcroft RE, Oliver A. Using financial incentives to achieve healthy behavior. BMJ. 2009;338:b1415.
Grant R. The ethics of incentives: historical origins and contemporary understandings. Econ Philos. 2002;18:111–39.
Thaler R, Sunstein C. Nudge: improving decisions about health, wealth and happiness. New Haven: Yale University Press; 2008.
Kahneman D. Maps of bounded rationality: psychology for behavioral economics. Am Econ Rev. 2003;93(5):1449–75.
Kahneman D. Thinking. Fast and Slow: MacMillan; 2011.
Vlaev I, Dolan P. Action change theory: a reinforcement learning perspective on behaviour change. Rev Gen Psychol. 2015;19:69–95.
Vlaev I, King D, Dolan P, Darzi A. Theory and practice of 'nudging': changing health behaviors. Public Adm Rev. 2016;76:550–61.
BIT. Giving: Green Paper. London: Cabinet Office; 2010.
BIT. Applying behavioural insight to health. London: Cabinet Office; 2011.
Dolan P, Hallsworth M, Halpern D, King D, Vlaev I. MINDSPACE: influencing behaviour through public policy. London: Cabinet Office; 2010.
Dolan P, Hallsworth M, Halpern D, King D, Metcalfe R, Vlaev I. Influencing behaviour: the mindspace way. J Econ Psychol. 2012;33:264–77.
Kreps D. A course in microeconomic theory. Princeton University Press: Princeton; 1990.
Gallus S, Schiaffino A, La Vecchia C, Townsend J, Fernandez E. Price and cigarette consumption in Europe. Tob Control. 2006;15(2):114–9.
Anderson P, Chisholm D, Fuhr DC. Effectiveness and cost-effectiveness of policies and programmes to reduce the harm caused by alcohol. Lancet. 2009;373(9682):2234–46.
Giuffrida A, Torgerson DJ. Should we pay the patient? Review of financial incentives to enhance patient compliance. BMJ. 1997;315(7110):703–7.
Niza C, Tung B, Marteau TM. Incentivizing blood donation: systematic review and meta-analysis to test Titmuss's hypotheses. Health Psychol. 2013;32(9):941–9.
Sutherland K, Christianson JB, Leatherman S. Impact of targeted financial incentives on personal health behavior: a review of literature. Med Care Res Rev. 2008;65:36–78S.
Shemilt I, Hollands GJ, Marteau TM, Nakamura R, Jebb SA, et al. Economic instruments for population diet and physical activity behaviour change: a systematic scoping review. PLoS One. 2013;8(9):e75070.
Clark DM, Fairburn CG, editors. Science and practice of cognitive behaviour therapy. Oxford: Oxford University Press; 1997.
Wolpe J. The practice of behavior therapy. 4th ed. New York: Pergamon Press; 1990.
Higgins S, Heil S, Plenbani-Lussier J. Clinical implications of reinforcement as a determinant of substance use disorders. Annu Rev Psychol. 2004;55:431–61.
Cahill K, Perera R. Competitions and incentives for smoking cessation. Cochrane Database Syst Rev. 2008;3:CD004307.
Mantzari E, Vogt F, Marteau TM. The effectiveness of financial incentives for smoking cessation during pregnancy: is it from being paid or from the extra aid. BMC Pregnancy Childbirth. 2012;12:24.
Marteau MT, Thorne J, Aveyard P, Hirst J, Sokal R. Financial incentives for smoking cessation in pregnancy: protocol for a single arm intervention study. BMC Pregnancy Childbirth. 2013;13:66.
Paul-Ebhohimhen V, Avenell A. Systematic review of the use of financial incentives in treatments for obesity and overweight. Obes Rev. 2008;9(4):355–67.
Anderson JV, Bybee DI, Brown RM, McLean DF, Garcia EM, Breer ML, Schillo BA. 5 a day fruit and vegetable intervention improves consumption in a low income population. J Am Diet Assoc. 2001;101(2):195–202.
Fryer R. (2010). Financial incentives and student achievement: evidence from randomized trials. NBER working paper no. 15898.
Ariely D. Predictably irrational: the hidden forces that shape our decisions. London: Harper Collins; 2008.
Karlan D, Bertrand M, Mullainathan S, Shafir E, Zinman J. What's advertising content worth? Evidence from a consumer credit marketing field experiment. Q J Econ. 2010;125:263–305.
Kahneman D, Tversky A. Prospect theory: an analysis of decision under risk. Econometrica. 1979;47:263–91.
Volpp KG, John LK, Troxel AB, Norton L, Fassbender J, Loewenstein G. Financial incentive-based approaches for weight loss: a randomized trial. J Am Med Assoc. 2008;300(22):2631–7.
Niza CA, Rudisill C, Dolan P. Vouchers versus lotteries: what works best in promoting chlamydia screening. Appl Econ Perspect Policy. 2014;36:109–24.
Hossain T, List JA. The Behavioralist visits the factory: increasing productivity using simple framing manipulations. Manag Sci. 2012;58:2151–67.
Fryer RG, Levitt SD, List J, Sadoff S. Enhancing the efficacy of teacher incentives through loss aversion: a field experiment. New York, NY: National Bureau of Economic Research; 2012.
Kahneman D, Tversky A. Choices, values and frames. New York: Cambridge University Press and the Russell Sage Foundation; 2000.
Thaler R, Ziemba W. Anomalies: Parimutuel betting markets: racetracks and lotteries. J Econ Perspect. 1988;2(2):161–74.
Volpp KG, Loewenstein G, Troxel AB, Doshi J, Price M, Laskin M, Kimmel SE. A test of financial incentives to improve warfarin adherence. BMC Health Serv Res. 2008;8:272.
Patel MS, Volpp KG, Rosin R, Bellamy SL, Small DS, Heuer J, Sproat S, Hyson C, Haff N, Lee SM, Wesby L, Hoffer K, Shuttleworth D, Taylor DH, Hilbert V, Zhu J, Yang L, Wang X, Asch DA. A randomized, controlled trial of lottery-based financial incentives to increase physical activity among overweight and obese adults. Am J Health Promot. 2018;32(7):1568–75.
Laibson D. Golden eggs and hyperbolic discounting. Q J Econ. 1997;112:443–77.
Frederick S, Loewenstein G, O'Donoghue T. Time discounting and time preference: a critical review. J Econ Lit. 2002;40:350–401.
Cahill K, Hartmann-Boyce J, Perera R. Incentives for smoking cessation. Cochrane Database Syst Rev. 2015;5:CD004307.
Priebe S, Bremner SA, Lauber C, Henderson C, Burns T. Financial incentives to improve adherence to antipsychotic maintenance medication in non-adherent patients: a cluster randomised controlled trial. Health Technol Assessment. 2016;20(70).
Loewenstein G, Prelec D. Preferences for sequences of outcomes. Psychol Rev. 1993;100:91–108.
Thornton R. The demand for, and impact of, learning HIV status. Am Econ Rev. 2008;98(5):1829–63.
Forde I, Zeuner D. Financial incentives to promote social mobility. BMJ. 2009;339:b3219.
Sunstein CR, Thaler RH. Libertarian paternalism is not an oxymoron. University of Chicago Law Review. 2003;70:1159–202.
Frey B, Oberholzer-Gee F. The cost of price incentives: an empirical analysis of motivational crowding-out. Am Econ Rev. 1997;87:350–401.
Shaw J. Is it acceptable for people to be paid to adhere to medication? No. BMJ. 2007;335:233.
Halpern S, Madison K, Volpp K. Patient as mercenaries. Circ Cardiovasc Qual Outcomes. 2009;2(5):514–6.
Giles EL, Robalinoa S, Sniehottaa FF, Adamsa J, McColl E. Acceptability of financial incentives for encouraging uptake of healthy behaviors: a critical review using systematic methods. Prev Med. 2015;73:145–58.
Wadge H, Bicknell C, Vlaev I. Perceived ethical acceptability of financial incentives to improve diabetic eye screening attendance. BMJ Open Diabetes Res Care. 2015;3:e000118.
Judah G, Darzi A, Vlaev I, Gunn L, King D, King D, Valabhji J, Bicknell C. Financial disincentives: a three-armed randomised controlled trial of the effect of financial incentives in diabetic eye assessment by screening (IDEAS) trial. Br J Ophthalmol. 2018;102:1014–20.
Oliver A. Can financial incentives improve health equity? BMJ. 2009;339:b3847.
Mantzari E, Vogt F, Shemilt I, Wei Y, Higgins JP, Marteau TM. Personal financial incentives for changing habitual health-related behaviors: a systematic review and meta-analysis. Prev Med. 2015;75:75–85.
Steinbrook R. Imposing personal responsibility for health. N Engl J Med. 2006;355(8):753–6.
Towers Watson/National Business Group on Health (2012). United States performance in an era of uncertainty: 17th Annual Towers Watson/National Business Group on Health employer survey on purchasing value in health care.
Bishop G, Brodkey AC. Personal responsibility and physician responsibility —West Virginia's Medicaid plan. N Engl J Med. 2006;355(8):756–8.
Pear R. Employers get leeway on health incentives. New York Times. 2013.
Rodwin MA. Financial incentives for doctors. BMJ. 2004;328(7452):1328–9.
Roland M. Linking physicians' pay to the quality of care – a major experiment in the United Kingdom. N Engl J Med. 2004;351(14):1448–54.
Jha AK, Joynt KE, Orav EJ, Epstein AM. The long-term effect of premier pay for performance on patient outcomes. N Engl J Med. 2012;366:1606–15.
Kristensen SR, Meacock R, Turner AJ, et al. Long-term effect of hospital pay for performance on mortality in England. N Engl J Med. 2014;371:540–8.
Deci EL, Koestner R, Ryan RM. A meta-analytic review of experiments examining the effects of extrinsic rewards on intrinsic motivation. Psychol Bull. 1999;125(6):627–68 discussion 692-700.
Mantzari E, Vogt F, Marteau TM. Does incentivising pill-taking 'crowd-out' risk-information processing? Evidence from a web-based experiment. Soc Sci Med. 2014;106:75–82.
Promberger M, Marteau TM. Why and when might financial incentives crowd out intrinsic motivation for healthy behaviors? A comparison with behaviors used in the psychological and economic crowding-out literatures. Health Psychol. 2013;32:950–7.
Thirumurthy H, Asch DA, Volpp KG. The uncertain effect of financial incentives to improve health behaviors. JAMA. 2019;321:1451–2.
Bosch-Capblanch X, Abba K, Prictor M, Garner P. Contracts between patients and healthcare practitioners for improving patients' adherence to treatment, prevention and health promotion activities. Cochrane Database Syst Rev. 2007;2:CD004808.
List J., and I. Basul (2010). Field experiments in labor economics, NBER Working Paper No. 16062.
Promberger M, Dolan P, Marteau TM. Pay them if it works: discrete choice experiments on the acceptability of financial incentives to change health related behavior. Soc Sci Med. 2012;75:2509–14.
Promberger M, Brown RCH, Ashcroft RE, Marteau TM. Acceptability of financial incentives to improve health outcomes in UK and US samples. J Med Ethics. 2011;37:682–7.
Professor I Vlaev was supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care West Midlands (CLAHRC WM) initiative.
No funding was received for producing this paper.
Warwick Business School, University of Warwick, Coventry, UK
Ivo Vlaev
Centre for Health Policy, Imperial College London, London, UK
Dominic King
Department of Surgery and Cancer, Imperial College London, London, UK
Ara Darzi
Department of Psychological and Behavioural Science, London School of Economics, London, UK
All authors made substantial contributions to conception and design of the article, and participated in drafting and revising it. IV and DK conceived and wrote the manuscript. AD and PD reviewed the articles for inclusion in the text, and also reviewed and edited the writing. All authors read and approved the final manuscript.
Correspondence to Ivo Vlaev or Dominic King.
Vlaev, I., King, D., Darzi, A. et al. Changing health behaviors using financial incentives: a review from behavioral economics. BMC Public Health 19, 1059 (2019). https://doi.org/10.1186/s12889-019-7407-8


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/******/ ([
/* 0 */
/***/ function(module, exports) {

	'use strict';

	if (typeof requestAnimationFrame === 'undefined') {
		window.requestAnimationFrame = function (fn) {
			return setTimeout(fn, 100 / 6);
		};
		window.cancelAnimationFrame = function (id) {
			return clearTimeout(id);
		};
	}

	if (typeof console === 'undefined') {
		console = { log: function log() {}, time: function time() {}, timeEnd: function timeEnd() {} };
	}

	var Counter = React.createClass({
		displayName: 'Counter',

		getInitialState: function getInitialState() {
			return {
				text: '123123123'
			};
		},
		componentWillMount: function componentWillMount() {
			console.time('Counter mount');
		},
		componentDidMount: function componentDidMount() {
			console.timeEnd('Counter mount');
		},
		toNum: function toNum(num, callback) {
			var _this = this;

			cancelAnimationFrame(this.rid);
			var COUNT = this.props.COUNT;

			var counting = function counting() {
				var count = _this.props.count;

				switch (true) {
					case count > num:
						COUNT('DECREMENT');
						break;
					case count < num:
						COUNT('INCREMENT');
						break;
					case count === num:
						return callback && callback();
				}
				_this.rid = requestAnimationFrame(counting);
			};
			counting();
		},
		componentWillUpdate: function componentWillUpdate() {
			// debugger
			console.log('willUpdate', 'Counter');
			if (this.state.text === '123123123') {
				this.setState({
					text: '[text set by willUpdate]'
				});
			}
			console.log(this.state.text, 'WillUpdate');
		},
		componentDidUpdate: function componentDidUpdate() {
			console.log(this.state.text, 'DidUpdate');
			this;
			//debugger
			console.log('DidUpdate', 'Counter');
		},
		componentWillReceiveProps: function componentWillReceiveProps(nextProps) {
			var state = this.state;
			console.log('Counter: receiveProps:setState', state === this.state);
		},
		shouldComponentUpdate: function shouldComponentUpdate(nextProps, nextState) {
			console.log('Counter: shouldComponentUpdate');
			return true;
		},
		componentWillUnmount: function componentWillUnmount() {
			console.log('unmount', 'Counter');
		},
		getNum: function getNum(e) {
			var num = parseInt(this.input.value, 10);
			if (typeof num === 'number') {
				this.toNum(num);
			}
		},
		getInput: function getInput(input) {
			this.input = input;
		},
		handleChange: function handleChange(e) {
			var text = e.target.value.replace(/[^\d]+/, '');
			this.setState({ text: text });
		},
		render: function render() {
			var _this2 = this;

			var props = this.props;
			var COUNT = props.COUNT;

			var img = React.createElement('img', {
				src: 'http://ww3.sinaimg.cn/bmiddle/887790fagw1ezs0ci6qjxj20c10go0uf.jpg',
				ref: 'img',
				onLoad: function () {
					console.log('onload this.refs', _this2.refs);
				},
				onError: function () {
					console.log('onerror this.refs', _this2.refs);
				}
			});
			return React.createElement(
				'div',
				{ id: 'abc' },
				Math.random() > 0.5 && img,
				React.createElement(
					'span',
					{ ref: Math.random() > 0.5 ? '' : 'test-ref', 'data-test': 'abaasdf' },
					'count: ',
					props.count
				),
				' ',
				React.createElement(
					'button',
					{ onClick: function () {
							return COUNT('INCREMENT');
						} },
					'+'
				),
				' ',
				React.createElement(
					'button',
					{ onClick: function () {
							return COUNT('DECREMENT');
						} },
					'-'
				),
				' ',
				React.createElement(
					'button',
					{ onClick: function () {
							return COUNT('INCREMENT_IF_ODD');
						} },
					'incrementIfOdd'
				),
				' ',
				React.createElement(
					'label',
					{ htmlFor: 'myinput' },
					'input number:',
					React.createElement('input', {
						type: 'text',
						value: this.state.text,
						onChange: this.handleChange,
						onFocus: function (event) {
							COUNT('INCREMENT');
						},
						ref: this.getInput,
						id: 'myinput',
						name: 'myinput' })
				),
				React.createElement(
					'button',
					{ onClick: this.getNum },
					'run'
				),
				React.createElement(
					'a',
					{ href: 'adbadfasdf' },
					'test link'
				),
				React.createElement('p', { dangerouslySetInnerHTML: { __html: 'test dangerouslySetInnerHTML: ' + Math.random().toString(36).substr(2) } })
			);
		}
	});

	var Example = React.createClass({
		displayName: 'Example',

		getInitialState: function getInitialState() {
			return {
				val: 0,
				test: 0
			};
		},

		componentDidMount: function componentDidMount() {
			var _this3 = this;

			this.setState({ val: this.state.val + 1, test1: 1 });
			console.log('didMount', this.state); // log 1
			this.setState({ val: this.state.val + 1, test2: 2 });
			console.log('didMount', this.state); // log 2

			setTimeout(function () {
				_this3.setState({ val: _this3.state.val + 1 });
				console.log('setTimeout:', _this3.state); // log 3
				_this3.setState({ val: _this3.state.val + 1 });
				console.log('setTimeout:', _this3.state); // log 4
			}, 4);
		},

		render: function render() {
			return React.createElement(
				'p',
				{ ref: 'paragraph' },
				this.state.val
			);
		}
	});

	var Wrap = React.createClass({
		displayName: 'Wrap',

		getInitialState: function getInitialState() {
			return { count: 0 };
		},
		COUNT: function COUNT(type) {
			var count = this.state.count;

			switch (type) {
				case 'INCREMENT':
					count += 1;
					break;
				case 'DECREMENT':
					count -= 1;
					break;
				case 'INCREMENT_IF_ODD':
					if (count % 2 === 0) {
						return;
					}
					count += 1;
					break;
			}
			this.setState({ count: count });
		},
		componentWillMount: function componentWillMount() {
			console.time('Wrap mount');
			// let state = this.state
			// this.setState({
			// 	count: this.props.count
			// })
			// console.log('componentWillMount:setState', state === this.state)
		},
		componentDidMount: function componentDidMount() {
			console.timeEnd('Wrap mount');
			var state = this.state;
			this.setState({
				count: this.props.count * 2
			});
			console.log('componentDidMount:setState', state === this.state);
			console.log(this);
		},
		componentWillUpdate: function componentWillUpdate() {
			// debugger
			console.log('willUpdate', 'Wrap');
		},
		componentDidUpdate: function componentDidUpdate() {
			//debugger
			console.log('DidUpdate', 'Wrap');
		},
		componentWillReceiveProps: function componentWillReceiveProps(props) {
			this.setState({
				count: props.count
			});
			console.log('Wrap:receiveProps');
		},
		shouldComponentUpdate: function shouldComponentUpdate() {
			console.log('Wrap: shouldComponentUpdate');
			return true;
		},
		componentWillUnmount: function componentWillUnmount() {
			console.log('unmount', 'wrap');
		},
		render: function render() {
			var example = React.createElement(Example, { ref: 'example' });
			// let count = Math.random() > 0.5
			// ? <Counter ref="counter" count={ this.state.count } COUNT={ this.COUNT } />
			// : null
			return React.createElement(
				'div',
				null,
				React.createElement(Counter, { ref: 'counter', count: this.state.count, COUNT: this.COUNT }),
				example,
				example
			);
		}
	});

	var wrap = React.createElement(Wrap, { count: 10 });

	var update = function update(count) {
		return React.render(wrap, document.getElementById('container'));
	};

	var num = 10;
	update();

	// const context = {
	//     THIS_IS_IMPORTANT: function() {}
	// }

	// class ContextProvider extends React.Component {
	//     static childContextTypes = context;

	//     getChildContext() {
	//         return this.props.context
	//     }

	//     render() {
	//         return this.props.children
	//     }
	// }

	// class Test extends React.Component {

	//     static contextTypes = context;

	//     // We added THIS constructor
	//     constructor(props) {
	//         super(props)
	//     }

	//     render() {
	//         console.info('This should NOT be undefined:', this.context.THIS_IS_IMPORTANT)
	//         return
Test1

	//     }
	// }

	// // Render HTML on the browser
	// React.render(<ContextProvider context={context}><Test/></ContextProvider>, document.body)

	// class TestRootUpdateAtDidMount extends React.Component {
	// 	componentDidMount() {
	// 		console.log('TestRootUpdateAtDidMount didMount')
	// 		updateName('TestRootUpdateAtDidMount1', () => console.log('TestRootUpdateAtDidMount1 done'))
	// 		updateName('TestRootUpdateAtDidMount2', () => console.log('TestRootUpdateAtDidMount2 done'))
	// 		updateName('TestRootUpdateAtDidMount3', () => console.log('TestRootUpdateAtDidMount3 done'))
	// 	}
	// 	render() {
	// 		let { props } = this
	// 		console.log('render count', props.name)
	// 		return
{props.name} asdfsdf

	// 	}
	// }

	// class TestRootUpdateAtDidMountWrapper extends React.Component {
	// 	state = {
	// 		text: 'TestRootUpdateAtDidMountWrapper text'
	// 	};
	// 	componentDidMount() {
	// 		console.log('TestRootUpdateAtDidMountWrapper didMount')
	// 		this.setState({
	// 			text: 'change at didMount'
	// 		})
	// 		this.setState({
	// 			text: 'change at didMount1'
	// 		})
	// 		updateName('TestRootUpdateAtDidMountWrapper')
	// 	}
	// 	render() {
	// 		let { props } = this
	// 		let children = testCount++ > 0 ? <TestRootUpdateAtDidMount name={props.name} /> : 'init'
	// 		return (

	// 					{this.state.text + ' ' + (this.props.name || 'default name')}
	// 					{children}
	//
)
	// 	}
	// }

	// let testCount = 0

	// let Root = props => {

	// 	return

placeholder
<TestRootUpdateAtDidMountWrapper {...props} />

	// }

	// var globalState = {
	// 	name: 'init'
	// }

	// var updateName = (name, callback) => {
	// 	console.log('updateName', name)
	// 	globalState = {
	// 		...globalState,
	// 		name
	// 	}
	// 	renderTest(callback)
	// }

	// let renderTest = (callback) => {
	// 	React.render(
	// 		<Root {...globalState} />,
	// 		document.getElementById('container'),
	// 		callback
	// 	)
	// }

	// updateName('init')
	// updateName('update')

	// class Test extends React.Component {
	// 	componentWillMount() {
	// 		console.log(this.props.index, 'willMount')
	// 		debugger
	// 	}
	// 	componentDidMount() {
	// 		console.log(this.props.index, 'didMount')
	// 		debugger
	// 	}
	// 	componentWillUnmount() {
	// 		console.log(this.props.index, 'willUnmount')
	// 	}
	// 	render() {
	// 		return
{this.props.index}

	// 	}
	// }

	// var root = (
	//

	// 		<Test index={0} />
	// 		<Test index={1} />
	// 		<Test index={2} />
	//
)

	// React.render(root, document.getElementById('container'))

/***/ }
/******/ ]);

redpajama_set_name: RedPajamaGithub


Discover ŠKODA car of the year awards and find out what were the ŠKODA wins at the 2018 What Car? Car of the Year Awards. View our haul of titles today.
Want to know what impacts your car insurance quote?. costs such as contact centres and online support; 11% = Insurance Premium Tax. For example, in the 2015 Autumn Statement, the government proposed to. 2013 we became the first UK insurer to publish our customers' claims ratings and reviews on our website.
The way you tax your car changed in October 2014 : here's what it means for you. Can I still buy vehicle tax at the Post Office? Yes – the way you buy.
CarInsurance.com's average car insurance rates tool provides average auto. For that, you can use our online quote comparison tool and get matched with.
Cheap Car Insurance Young Convicted Drivers Cheap Insurance for Young Drivers in New York. Young drivers, those between the ages of 16-25, pay the most for car insurance across the US. Because of the. Is sorting young drivers insurance becoming a nightmare? At Adrian Flux, we understand young drivers and can even offer top tips on how to save money on.
Find the lowest car insurance rates in Alberta. Start by comparing quotes from Canada's top car insurance companies.
Vehicle insurance is insurance for cars, trucks, motorcycles, and other road vehicles. Its primary. general insurance companies who also offer online insurance service for the vehicle. They offer their customers instant auto quotes. disc which, prior to 1 October 2014, meant that all motorists in the UK were required to.
We make it Simples™ to compare 20+ Car Insurance quotes in only 3 minutes. If you're looking for better rates on car insurance in Queensland, try our online.
Jan 9, 2018. Our Car Insurance Calculator explains how insurers decide what your cover. more significant: the average cost in September 2015 was just £501 and prices. This costs around £35 an hour, on average, throughout the UK.
Compare real rates from trusted insurers and get the right coverage for you and your. CoverHound new Auto policyholder data from January 2014 through August 2015. of dollars cheaper than any car insurance place I could find online.
Common questions about travel insurance Can I purchase AA Travel Insurance if I don't live in the UK? No. The policy only covers UK residents, so non-UK.
Jul 5, 2018. The average car insurance premium in the UK for comprehensive cover costs. Get car insurance quotes from the 10 best car insurance companies in the UK. Some of them, like Aviva, offer discounts if you buy online. The average cost in spring 2014 was £390 so prices have soared 22.6% since then.


If you want to feel good about Second Life, and the good that it can do for millions around the world, see this machimina.
Parkinson's Disease is a degenerative disorder of the central nervous system. Virtual Reality is currently being researched as a means to reduce the risk of falling that people affected with this disease have. Find out how Second Life has helped 86-year old Fran Seranade walk better, and improve her quality of life at Creations for Parkinson's. This machinima features Fran, and includes a narration by her real life daughter, Barbie Alchemi, chair of the Second Life organization.


text:
Home News ICE lawyers told to dismiss low-priority cases in order to clear backlog...
ICE lawyers told to dismiss low-priority cases in order to clear backlog ahead of surge
The memo, dated Sunday, is the latest in a series of policy changes that have marked a departure from the Trump administration's aggressive enforcement measures. It's also an attempt by the administration to chip away at an immigration court backlog that exceeds 1 million cases. The American Immigration Lawyers Association previously estimated that over 700,000 cases in the backlog are likely low priority cases.
The directive also comes as the Biden administration braces for a surge in border crossings, due in part to the repeal of a public health order on May 23 that allowed them to expel most migrants.
BuzzFeed first reported the DHS memo.
The memo stems from Homeland Security Secretary Alejandro Mayorkas' guidance last year to prioritize certain immigrants for arrest and deportation. The priorities outlined by DHS are threats to national security, public safety and border security. Recent border-crossers, for example, are a priority under the guidance.
"Prosecutorial discretion is an indispensable feature of any functioning legal system. The exercise of prosecutorial discretion, where appropriate, can preserve limited government resources, achieve just and fair outcomes in individual cases, and advance DHS's mission of administering and enforcing the immigration laws of the United States in a smart and sensible way that promotes public confidence," the memo reads.
Immigration arrests in the US have plunged under President Joe Biden compared to his predecessor, who cast a wide net of who was eligible to be taken into custody. Senior ICE officials have emphasized the impact of the pandemic on operations and the focus on serious crimes, like aggravated felonies, as among the reasons for the drop in numbers.
ICE lawyers told to dismiss low-priority cases in order to clear backlog ahead of surge - CNNPolitics
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text:
An Analysis of the Systemic Security Weaknesses of the U. S. Navy Fleet Broadcast System, 1967-1974, as Exploited by CWO John Walker
Posted on March 17, 2018 April 16, 2018 by Divya Aradhya
REACTION to: An Analysis of the Systemic Security Weaknesses of the U. S. Navy Fleet Broadcast System, 1967-1974, as Exploited by CWO John Walker.
In the seven-year period between 1967 and 1974, CWO John Walker ran a spy ring that escaped detection and came to light only because his alcoholic ex-wife reported him out of spite.
The 100-page long thesis, that this paper references to, was written by focusing on finding answers to why the security system of the Navy failed on multiple levels, on multiple instances.
John Walker, born in 1937, grew up with an alcoholic father who eventually abandoned the family after driving them to bankruptcy. Walker spent his teenage years engaged in petty crimes that culminated in a police chase when he was 17. His older brother Arthur Walker, who was in the Navy, convinced the judge to let John join the Navy to "straighten him out". The Navy petty officer who was in charge, allowed him to join, in spite of knowing of his trouble with the law, as he too was of the mind that the Navy would "do him good". This popular and prevalent mindset of the times was the first breakdown in the system that was constructed to screen out troublemakers from the Navy. Clearly, Policy was not in tune with culture.
Walker worked well on his Navy jobs, was quickly promoted, and was even granted Secret clearance within a few years. The process to grant initial Secret clearance consisted of the NAC (National Agencies Check) looking into the FBI's criminal records database and Defense Central Index of Investigations. This was ineffective in John Walker's case and was reduced to a cursory check that brought up no documents of legal aberrations. He was thus successfully granted Secret clearance and access to classified data.
Walker further went on to gain Top Secret clearance. Gaining a Top Secret clearance involved a field investigation by the DIS (Defense Investigative Services). A professional investigator was specifically in charge of interviewing and investigating the nominee's credentials to spot any signs of unreliability. His report would further be analyzed by an adjudicator who would take the final call on granting Top Secret clearance. At the point in time, during his Top Secret clearance review, John Walker had been in the Navy for nine years. The investigator did find out of his juvenile records but brushed it aside as Walker seemed to have a "straight" record at the Navy and had already gained Secret clearance. The investigator interviewed his neighbors and fellow officers with questions about whether Walker had financial trouble, problems with alcohol or drugs, was homosexual, or had any contacts with foreigners. No red flags were raised in any of the interviews.
In reality, at that point in time, John Walker and his wife were alcoholics, domestically abused each other, had serious financial problems, and Walker was a notorious womanizer. However, alcohol consumption was accepted as the norm in the Navy, and the American values of "mind your own business" and do not snitch on a co-worker or neighbor, seemed to have won through. Neither the co-worker nor the neighbors seemed to think any of these factors were indicators of untrustworthiness to the Navy. Hence the checks that were in place to help raise flags in the Top Secret clearance investigation failed completely. The process relied too much on the individual discretion and value system of lay people.
Further, when investigative reports were submitted to the adjudicator, the adjudicator was told to rely on "overall common sense" to pass with clearance request. There were no clearly laid out policies or checklists or even guidelines, and again the decision was solely on an individual's value system, analysis, and discretion.
After obtaining a Top Secret clearance, the candidate was up for reinvestigations every five years, and only then eligible for a renewal of their Top Secret clearance. In the case of John Walker, he was due for a reinvestigation in 1969. He had commenced his spying activities in 1967 and by 1969 his lavish lifestyle (funded by Soviet spying payouts) would have definitely raised red flags. However, the DIS, at that point in time, was facing severe backlogs in processing initial investigations. This caused reinvestigations to suspended for many years and the Top Secret clearance state to be continued unquestioned. This was a grave failure in the Navy security system and operations.
Finally, when John Walker did come up for reinvestigation in 1972, he expected to fail it on multiple levels. He had been living way beyond what the Navy salary would allow, abused alcohol and marijuana, flaunted his affair with numerous women, and his wife had been telling co-workers that he was a spy. John Walker, however, found an all-too-easy solution to remain undetected.
First, he stole the records of a co-worker who had cleared the re-investigation and found that all that was documented was a one-page form stamped with an FBI seal. He got a counterfeit seal made, stole his own records, filled out his own form, stamped it with the fake FBI seal, and refiled the documents. The security officer didn't think twice when he saw that the form was already approved by the FBI, and cleared the reinvestigation.
This clearly proved that the reinvestigation was a routine administrative task that was easily circumvented due to the poor physical security measures, lack of policy and enforcement, and lack of thoroughness and accountability.
Given all the above scenarios, it is easy to understand why the Navy security system failed on multiple levels. First in allowing John Walker to be part of the system, and later in allowing him to have Secret and Top Secret clearance. And finally why reinvestigations failed and his spying ring remained undetected.
However, they are no easy answers to what changes would allow improvements.
Should all juvenile delinquents bear the burden of their youth all their life?
Is alcohol abuse a sign of a spy?
Should people be encouraged to snitch on each other, even if it means false implying someone?
Have laws and social values evolved to encompass humanitarian issues – for instance, if Walker had been found to be homosexual would he have been reported at once, and would that have been acceptable, as a factor, for not being reliable?
Hard questions, with no easy answers. And like everything else, working towards more secure systems, especially those that involve humans, is a work in progress.
Heath, M. (2005). An Analysis of the Systemic Security Weaknesses of the U. S. Navy Fleet Broadcast System, 1967-1974, as Exploited by CWO John Walker. Masters Thesis. Fort Leavenworth, Kansas: U. S. Army Command and General Staff College.
←The Devin Nunes memo to the House Permanent Select Committee on Intelligence
How does a security awareness training policy impact an organization's capability to mitigate risks, threats, and vulnerabilities?→


Winnebago Industries is recalling 816 model year 2017 Winnebago View and Itasca Navion motorhomes manufactured March 21, 2016, to September 15, 2016.
Loose driver and front passenger seat mounting bolts could allow the seats to detach from the mounting pedestals, increasing the risk of injury and crash.
Winnebago will notify owners, and dealers will tighten the seat mounting bolts to the proper specification, free of charge. The manufacturer has not yet provided a notification schedule.
Owners may contact Winnebago customer service at 1-641-585-3535.


Dmitri Sklyarov rarely reads electronic books. "There are almost no e-books in Russian," said Mr. Sklyarov, the 26-year- old Moscow cryptographer who was arrested in Las Vegas last month under a 1998 digital copyright law. "I prefer paper books. They're much . . . Dmitri Sklyarov rarely reads electronic books. "There are almost no e-books in Russian," said Mr. Sklyarov, the 26-year- old Moscow cryptographer who was arrested in Las Vegas last month under a 1998 digital copyright law. "I prefer paper books. They're much easier to carry with me, and can be read anywhere."
In fact, most people still prefer paper books. Unlike music and film, books have yet to be popularly accepted in digital format. Nevertheless, the nascent market has heightened the publishing industry's sensitivity to the potential for digital piracy, enough so that it has initiated the first criminal case under the Digital Millennium Copyright Act of 1998. And Mr. Sklyarov is the first to be charged.


JERSEYVILLE - If Jersey County Board Chairman Don Little doesn't have it already, the notice from Attorney General Lisa Madigan's office informing him of a complaint filed by greatriversmedia.com should be arriving shortly.
The complaint was filed after it was clear that the minutes of the improper meeting in question did not accurately reflect what had occurred and only after attention was brought to this error, no action was taken by the board to investigate or correct the meeting minutes.
This event is not the only violation in recent months by various board committees.
The meeting at issue had in attendance several board members that are up for reelection and appealing for community support, including Chairman Don Little, Sandy Hefner and Gary Krueger. Other board members not up for reelection included Brian Kanallakan and Mary Kirbach. Not one board member spoke out during the incident to stop or discuss Chairman Little's improper actions. Each elected official is supposed to undergo training and certification that they understand the Open Meetings Act.
Other governmental transparency related issues may have occurred over the past year as well.