Healthcare costs of stroke and major bleeding in patients with atrial fibrillation treated with non-vitamin K antagonist oral anticoagulants

Objective: To assess long-term healthcare costs related to ischemic stroke and systemic embolism (stroke/SE) and major bleeding (MB) events in patients with non-valvular atrial fibrillation (NVAF) treated with non-vitamin K antagonist oral anticoagulants (NOACs).

Materials and methods: Optum’s Clinformatics Data Mart database from 1/2009–12/2016 was analyzed. Adult patients with ≥1 stroke/SE hospitalization (index date) were matched 1:1 to patients without stroke/SE (random index date), based on propensity scores. Patients with an MB event were matched to patients without MB. All patients had an NOAC dispensing overlapping index date, ≥12?months of eligibility pre-index date, and ≥1 NVAF diagnosis. The observation period spanned from the index date until the earliest date of death, switch to warfarin, end of insurance coverage, or end of data availability. Mean costs were evaluated: (1) per-patient-per-year (PPPY) and (2) at 1, 2, 3, and 4?years using Lin's method.

Results: The cost differences were, respectively, $48,807 and $28,298 PPPY for NOAC users with stroke/SE (n?=?1,340) and those with MB (n?=?3,774) events compared to controls. Cost differences of patients with vs without stroke/SE were $49,876, $51,627, $57,822, and $60,691 at 1, 2, 3, and 4?years post-index, respectively (p?p?Limitations: Limitations include unobserved confounders, coding and/or billing inaccuracies, limited sample sizes over longer follow-up, and the under-reporting of mortality for deaths occurring after 2011.

Conclusions: The incremental healthcare costs incurred by patients with vs without stroke/SE was nearly twice as high as those of patients with vs without MB. Moreover, each additional year up to 4?years after the first event was associated with an incremental cost for patients with a stroke/SE or MB event compared to those without an event.     

Socioeconomic Status,Religion and Health in India: an Examination of Chronic and Communicable Diseases

The literature on socioeconomic status and health suggests that those in higher positions have better health, and those in lower positions have worse health. There is little evidence of an SES gradient in non-industrialized countries, however, and it is uncertain whether the health gradient established in many Western countries would apply in developing countries. In this study, the authors examine patterns in health outcomes by caste and religion in India, a developing country. Results from a nationally representative sample, the Indian Human Development Survey, suggest that while high SES social groups report less communicable disease, they report a higher prevalence of chronic diseases than low SES groups. This study demonstrates the need to examine diseases of affluence among high SES groups in developing countries while also identifying the particular health concerns that are prevalent among low SES groups.     

Standards,learning, and growth in Britain, 1901–2009

This article considers the model of voluntary, consensus based standardization as developed through the British Standards Institution (BSI) and its contribution to learning and productivity growth. It discusses the significant role played by professional engineers in the model's introduction, its extension at home, and its imitation overseas. It is argued that by 1931 the BSI catalogue of standards represented a considerable stock of codified knowledge whose growth reflected underlying aggregate technological opportunities, assisting in their transformation into technological advance. To help validate this claim, a measure of the size of the BSI catalogue of standards is incorporated into an econometric model of aggregate productivity growth in Britain. Findings show that the growth of the standards catalogue is associated with a substantial proportion of labour productivity growth over the period 1931–2009. Estimates relating to the short‐run dynamics involved are consistent with the idea that there are causal linkages running from standards to growth. When interpreting these findings, it is argued that the overall weight of historical evidence points to standardization—coordinated through the BSI—as providing an important path of learning for the British economy over the period considered.     

Post encroachment time threshold identification for right-turn related crashes at unsignalized intersections on intercity highways under mixed traffic

Abstract

Unsignalized intersections in developing countries experience many serious conflicts between cross-traffic due to indiscipline traffic manoeuvrability. Historically, Post Encroachment Time (PET) has gained attention as a proximal indicator to analyze crossing conflicts. However, identifying an appropriate PET threshold to classify critical conflicts for highly heterogeneous traffic scenario is still an unexplored area. Consequently, this study proposes a novel approach of PET threshold identification with proof of application by collecting data from ten intersections located on four-lane intercity highways in the National Capital Region (NCR), India. Both crossing conflicts and right-turn related crash data (for the left-hand drive) are collected. Their correlations are thoroughly studied for each PET threshold using a quantitative technique considering all and individual vehicle categories. Finally, a qualitative analysis is done by ranking the sites based on cumulative PET and related crashes to verify the proposed quantitative technique. A PET threshold of 1?s is obtained from both the techniques which can be used to identify critical conflicts for unsignalized intersections located on four-lane intercity highways. The proposed methodology will serve as an alternative, faster and effective tool to evaluate the hazardousness of unsignalized intersections located on intercity highways under highly heterogeneous traffic condition.     

Disentangling location-based advertising: the effects of location congruency and medium type on consumers' ad attention and brand choice

Research on location-based advertising (LBA) suggests that the merits of LBA lie in the fact that consumers can be targeted with location-congruent ads on their personal mobile devices. However, LBA consists of two underlying constructs: a mobile (vs. point-of-sales) advertising medium and location congruency (vs. location incongruency). This study aims to disentangle these underlying constructs by showing that they differentially affect the efficacy of an ad. Using a virtual reality lab experiment, this study shows that location-congruent ads result in increased choice for the target brand as compared to location-incongruent ads, independent of medium type. However, in location-incongruent situations, mobile ads attracted more attention than point-of-sales display ads. The advantages of LBA thus do not seem to emanate from medium type, but rather from the congruency between the ad and product location. When the ad is received at a different location than the product, the mobile medium is able to enhance consumers' ad attention.     

Foreign direct investment via M&A and domestic entrepreneurship: blessing or curse?

There are conflicting predictions in the literature about the relationship between FDI and entrepreneurship. This paper explores how foreign direct investment (FDI) inflows, measured by lagged cross-border mergers and acquisitions (M&A), affect entrepreneurial entry in the host economy. We have constructed a micro-panel of more than two thousand individuals in each of seventy countries, 2000–2009, linked to FDI by matching sectors. We find the relationship between FDI inflows and domestic entrepreneurship to be negative across all economies. This negative effect is much more pronounced in developed than developing economies and is also identified within industries, notably in manufacturing. Policies to encourage FDI via M&A need to consider how to counteract the prevailing adverse effect on domestic entrepreneurship.     

The Role of Marketing Resources in Radical Innovation Activity: Antecedents and Payoffs

While radical product innovations represent significant engines of firm growth, questions remain over whether marketing helps or hurts (1) a firm's radical product innovation activity and (2) its rewards from radical product innovation activity. By attaching an attention‐based view of the firm to a market‐based assets view of marketing, this paper examines the role of three marketing resources—market knowledge, reputation, and relational resources—on radical innovation activity. Our conceptual framework posits differentiated effects among marketing resources as antecedents of radical innovation activity and as moderators of its impact on firms' financial performance. Using a survey of a broad set of high‐tech business‐to‐business (B2B) firms to test hypotheses, it is found that firms with strong relational resources enjoy a higher propensity for, and stronger financial rewards from, radical innovation activity. Reputational resources come with a trade‐off as they hurt the incidence of radical innovation but enhance its financial rewards. However, market knowledge resources appear to hurt both radical innovation activity and its financial rewards. Our results point to the multifaceted role of marketing in radical innovation activity, which is unlikely to come with a single benefit or liability as prior work often posits. Rather, our research heightens the alertness of managers to assess their firms' marketing strength as a bundle of stocks of several marketing resources. Managers must understand the distinct benefits and drawbacks of each resource in developing and launching radical innovations. Our research underscores the differentiated value of marketing in radical innovation activity in B2B high‐tech contrary to the entrenched idea of a limited or even stifling role of marketing in this context.     

Mutual Caring—Resolving Habituation Through Awareness: Supporting Meaningful Learning From Projects

This study used Grounded Theory methodology and developed an emergent theory of Mutual Caring. The main concern was Habituation to ineffective lessons learned sharing practices. Habituation is resolved through Mutual Caring, a socially and psychologically adaptive process. Mutual Caring involves comfortable conversations, engaging/sharing, and developing self‐confidence, resulting in an enhanced wisdom pool. This paper extends the emphasis on tangible knowledge‐sharing mechanisms. Mutual Caring could lead to better outcomes, such as more accessible and usable knowledge, a project management wisdom pool, and criteria for improved dyadic relationships to enhance project learning.