Patterns of care and burden of chronic idiopathic thrombocytopenic purpura in Brazil

Aims: Although several therapeutic options are available for chronic immune thrombocytopenic purpura (cITP), little is known about the treatment of cITP in Brazil.

Materials and methods: A multi-center, retrospective chart review, observational study was designed to describe the treatment patterns, clinical burden, resources use, and associated costs for adult patients diagnosed with cITP and treated in public and private institutions in Brazil. Patient charts were screened in reverse chronological order based on their last visit post January 1, 2012. (All costs were calculated using 1.00 USD?=?3.9571 BRL, from February 2016.)

Results: Of 340 patient charts screened, 50 patients were eligible for inclusion in the study. Single-drug therapy (prednisone, dexamethasone, or dapsone) was the most commonly used treatment, followed by combination therapies (azathioprine?+?prednisone, azathioprine?+?prednisone?+?danazol, and prednisone?+?dapsone). Splenectomy was performed in 22% of patients after at least first-line treatment. Platelet count and number of bleeding episodes at diagnosis were 31,561.1/mm³ (SD?=?±26,396.1) and 40 episodes, respectively; in first-line, 92,631.1/mm³ (SD?=?±79,955.3) and 19 episodes, respectively; in second-line, 96,950.0/mm³ (SD?=?±76,476.4) and 17 episodes, respectively. Private system patients had a higher median cost compared to public system patients (USD 17.49/month, range?=?0–2,020.77 vs USD 9.51/month, range?=?0–192.64, respectively).

Limitations: This study does not allow conclusions for causal explanations due to the cohort study design, and treatment patterns represent only the practices of physicians who have agreed to participate in the study.

Conclusions: The data indicate that available therapeutic strategies for second- and third-line therapies appear to be limited.     

ESTIMATION OF VALUE AT RISK AND RUIN PROBABILITY FOR DIFFUSION PROCESSES WITH JUMPS

In this paper we give upper bounds for both the Value at Risk   VaR _α,  0 < α < 1  , and for ruin probabilities associated with the supremum of a process driven by a Brownian motion and a compound Poisson process. We obtain lower bounds for the same Value at Risk, and for different cases we discuss the behavior of the bounds for small α. We prove our bounds are "asymptotically" optimal, as α tends to zero. The ruin probabilities obtained are related to other bounds found in recent literature.     

The role of retentions in how marketing managers change their strategic orientation

This study looks at how a marketing organization changed its strategic orientation in response to environmental factors, and at the influence of retentions on the change effort. Retentions are defined , here as the concepts and mental models used by marketing managers when trying to respond to environmental changes. The influence of retentions on strategic orientation and factors affecting how retentions change are studied in the context of how a bank trust department responded to the deregulation of the financial services industry between 1982 and 1984. The dominant retentions held by managers both before and after deregulation are presented, and the events that contributed to the change of the retentions are examined. The results suggest that retentions prior to deregulation focused on external sources of influence and were associated with a defender strategic orientation. Retentions after deregulation, once the organization's strategic orientation stabilized, focused on critical resources and competitors and were associated with an analyser orientation. The adoption of the new retentions lagged deregulation by several years, and the transition did not match the steps prescribed by the marketing and strategic management literature. Instead, the transition took place through an iterative sequence of behaviours and evaluations more characteristic of the organizing model (Weick 1979). Managers changed their retentions incrementally by enacting small changes, evaluating the outcomes of their behaviour, and letting the outcomes redefine their retentions.     

Effects of Collaborative Communication on NPD Collaboration Results: Two Routes of Influence

Although NPD collaboration with external partners has become the next generation in NPD practice, the discussion concerning how to organize collaboration so as to obtain better results is far from over. Since communication is the most important element in successful interfirm exchange, this study focuses on the impact of collaborative communication and its facets—frequency, formality, reciprocal feedback, and rationality—on NPD collaboration results. In order to explain how collaborative communication can best be managed to enhance NPD collaboration results, this research combines the relational and resource‐based views, proposing the existence of two routes of influence: the direct resource‐based route and the indirect relational route mediated by trust. Using a sample of 207 NPD collaboration projects of innovative firms, empirical findings indicate that reciprocal feedback–rationality and frequency play an important role in product quality and adherence to budget and schedule, respectively, even without trust. Moreover, the trust between partners substantially reinforces the positive influence of reciprocal feedback–rationality on NPD collaboration results and makes the effect of formality significant. Therefore, the two alternative routes are confirmed as important paths to new product success, which provides relevant managerial implications.     

Performance signals in the public sector: the case of health care

Although there are no traditional markets and money prices inthe public sector, consumers and providers may respond to signalsof organisational performance. We present a simple dynamic modelof the demand and supply for elective surgery in the UK NationalHealth Service in which waiting time acts as the prime indicatorof performance. The model is tested using a panel of quarterlydata for 123 English health authorities over an eight-year period.We find that supply is increasing and demand is decreasing inmeasures of the previous period waiting time. The results implythat health care systems which are rationed by waiting do respondto indicators of waiting times. The paper adds to the smallbut consistent body of research which demonstrates that publicsector systems respond to important aspects of reported performance.     

Developing Sustainable New Products in the Textile and Upholstered Furniture Industries: Role of External Integrative Capabilities

Environmental sustainability has become one of the key issues for strategy, marketing, and innovation. In particular, significant attention is being paid by companies, customers, media, and regulators to development and consumption of green products. It is argued that through the efficient use of resources, low carbon impacts, and risks to the environment, green products can be essential to help society toward the environmental sustainability targets. The number of green product introductions is rapidly increasing, as demonstrated by the growing number of companies obtaining eco‐labels or third party certifications for their environmentally friendly products. Hundreds of companies representing most of the industries, such as Intel, SC Johnson, Clorox, Wal‐Mart, and Hewlett–Packard, have recently introduced new green products, underlining the need to develop products that create both economic and environmental values for the firm and customers. A review of the literature shows that academic research on green product development has grown in interest. However, to date, only a few empirical studies have addressed the challenge of integrating environmental issues into new product development (NPD). Previous empirical works have mainly focused on a set of activities for the green product development process at the project level. After years of paying no or marginal attention to environmental sustainability issues, most of the companies now generally realize that it would require knowledge and competencies to develop green products on a regular basis. These knowledge and competencies can be varied, such as R&D, environmental know‐how, clean technology/manufacturing process, building knowledge on measuring environmental performance of products, etc., that may be developed internally or can be integrated through external networks. Adopting a resource‐based view of the firm, this article aims at (1) investigating the role of capabilities useful for companies to integrate knowledge and competencies from outside of the firm on green product development in terms of both manufacturing process and product design and (2) understanding whether green product development opens new product, market, and technology opportunities, as well as leads to better financial performance of NPD programs. To this end, a survey was conducted in two Italian manufacturing industries in which environmental issues are becoming increasingly important, namely textiles and upholstered furniture. A questionnaire was sent to 700 firms, and 102 useable questionnaires were returned. Results show that (1) companies engage in developing external integrative capabilities through the creation of collaborative networks with actors along the supply chain, the acquisition of technical know‐how, and the creation of external knowledge links with actors outside the supply chain; (2) external knowledge links play a key role in the integration of environmental sustainability issues into the manufacturing process, whereas capabilities such as the acquisition of technical know‐how and the creation of collaborative networks prove to be more important for integrating environmental issues into product design; and (3) the integration of environmental sustainability issues into NPD programs in terms of product design leads to the creation of new opportunities for firms, such as opening new markets, technologies, and product arenas, though not necessarily leading to improved financial performance of the NPD programs.     

Trade Costs in Bilateral Trade Flows: Heterogeneity and Zeroes in Structural Gravity Models

This paper contributes to the explanation of international trade flows with structural gravity models taking heterogeneity and excess zeroes into account. We introduce a more general hypothesis on the structure of trade costs in Helpman et al. (The Quarterly Journal of Economics, 2008; 123 , 2, 441) theoretical model that is capable of explaining over‐dispersion in trade data. Zero‐inflated negative binomial models are considered to analyse the impact of trade costs, measured in terms of geographical distance and contiguity effects. An analysis related to a sample of 37 countries' trade flows, with heterogeneous effects across sectors and trade‐integrated areas, such as APEC and EU, is presented. The size of exporting and destination economies and cultural and institutional factors are considered as influencing both the extensive and the intensive margin of trade.     

Influence of Affective Traits on Entrepreneur's Goals and Satisfaction

Emotions are important to an individual's behavior. However, affective elements have rarely been included in the analysis of entrepreneurs' behavior. Using a sample of 335 entrepreneurs from multiple industries of the Spanish region of Castile and León, we analyze the role of emotions in entrepreneurs' statement of goals and in their satisfaction with business performance. The results show that positive affective traits influence an entrepreneur to state broad and ambitious goals, and personal negative affective traits influence an entrepreneur to state a narrow set of goals. We also find that positive (negative) affective traits are positively (negatively) related to entrepreneur satisfaction.     

Forecasting the Direction of Policy Rate Changes: The Importance of ECB Words

This paper evaluates the predictive power of different information sets for the European Central Bank (ECB) interest-rate-setting behaviour. We employ an ordered probit model, i.e. a limited dependent variable framework, to take into account the discreteness displayed by policy rate changes. The results show that the forecasting ability of standard Taylor-type variables, such as inflation and output gap, is fairly low both in-sample and out-of-sample, and is comparable to the performance of the random walk model. Instead by using broader information sets that include measures of core inflation, exchange rates, monetary aggregates and financial conditions, the accuracy of the forecasts about ECB future actions substantially improves. Moreover, ECB rhetoric considerably contributes to a better understanding of its policy reaction function. Finally, we find that that the ECB has been fairly successful in educating the public to anticipate the overall future direction of its monetary policy, but has been less successful in signalling the exact timing of rate changes.