Psychometric validation of anti-clot treatment scale and treatment satisfaction questionnaire for medication version II in Japanese patients with atrial fibrillation

Aims: The Anti-Clot Treatment Scale (ACTS) and Treatment Satisfaction Questionnaire for Medication version II (TSQM-II) are validated treatment satisfaction patient-reported outcome (PRO) instruments. The ACTS includes two domains: Burdens and Benefits; the TSQM-II includes four: Effectiveness, Side Effects, Convenience, and Global Satisfaction. Japanese-language versions of the ACTS and TSQM-II have been developed and linguistically validated. This study aimed to assess their psychometric properties in Japanese patients with atrial fibrillation (AF).

Materials and methods: ACTS and TSQM-II data from 534 patients with AF were collected in a Japanese post-marketing surveillance study of a direct oral-anticoagulant, rivaroxaban. Four key psychometric properties, in line with best practice guidelines from the US Food and Drug Administration, were examined using traditional psychometric methods: acceptability, scaling assumptions, reliability (i.e. internal consistency reliability, test-retest reliability), and construct validity (i.e. convergent validity and known groups).

Results: ACTS Burdens and Benefits and TSQM-II Effectiveness, Convenience, and Global Satisfaction scales were found to be acceptable (e.g. item-level missing data at baseline <4%), with all scales having good internal consistency (Cronbach’s alpha > 0.80). test-retest reproducibility intraclass correlation coefficients for the ACTS Burdens and Benefits were 0.59 and 0.65, respectively, and between 0.54–0.61 for the TSQM-II scales. Known-groups validity for the ACTS and TSQM-II was supported by differences in scale scores by positive and negative impact (p?<?0.05). Correlations between the ACTS and TSQM-II (convergent validity) were lower than expected (range r?=?0.09–0.48), but in line with the original ACTS development study.

Limitations: Evaluation of test-retest reproducibility was limited by assessment period, which was longer (3 months) than recommended guidelines (usually up to 2 weeks).

Conclusions: Overall, Japanese versions of ACTS and TSQM-II scales satisfied internal consistency reliability and traditional validity criteria. Our study supports the ACTS and TSQM-II as appropriate PRO instruments to measure satisfaction with anticoagulant treatment in Japanese patients with AF.

Trial registration: NCT01598051, clinicaltrials.gov; registered April 20, 2012.     

BRAND AGRICULTURE AND ECONOMIC GEOGRAPHY: WHEN ARE HIGHLY DIFFERENTIATED PRODUCTS SUSTAINABLE IN THE REMOTE PERIPHERY?

This paper presents a general equilibrium model of new economic geography, incorporating brand agriculture that produces differentiated agricultural products. Focusing on the core‐periphery space, we show that highly differentiated brand agriculture can be sustained in the periphery even when access to the core market is not particularly good. This result supports the promotion of innovative products in rural areas in order to avoid direct price competition in generic commodities markets under unfavorable conditions.     

Sustainable airline strategy using portfolio theory: A case study of remote islands in Japan

The thin and fluctuated market generally characterizing air transport to remote islands involves greater business risks for airlines. But air transport often plays an important role in the life and economy of such islands. This paper applies portfolio theory to explore how it can reduce business risks to air transport in this context. The concept of Tourism β is introduced to represent the risk associated with each island market relative to overall tourist demand in the region looking as at 31 airports on remote islands in Japan. The results showed that a well-diversified portfolio of multiple remote islands could reduce the score commercial risks for carriers.     

Microcapitalism and the mega-corporation

More than 100 miles from Bangalore, India, there's a rural area called Kuppam where one in three citizens is illiterate, more than half of the households have no electricity, and there's a high rate of AIDS. It's exactly this challenging atmosphere that prompted Hewlett-Packard to choose Kuppam as one of its first "i-communities" initiatives. Through the program, HP creates public-private partnerships to accelerate economic development through the application of technology while simultaneously opening new markets and developing new products and services. HP brings to these initiatives the management disciplines of a successful technology business. For example, it unearths customer needs using an iterative cycle that involves prototyping products and services and then closely observing residents' experiences with them. It fields a diversely talented team that brings many skills to the initiative, including deep technical ability, management acumen, and market knowledge. It takes a systems approach, simultaneously examining all the elements that must come together to create a working solution to a given problem. It establishes a "leading platform" on which other players--comapnies, nonprofits, and government agencies--can build technologies and applications. Practices like these help ensure that HP's investment yields real, sustainable results for the community in question. But HP also sees returns to its own business. In Kuppam, the company is discovering the need for (and developing) new products like a solar-powered digital camera, with printer, that fits in a backpack. By engaging the community and its leaders and working with them to design valuable new tools and capabilities, HP is gaining the knowledge it needs to be a stronger competitor in other developing regions.     

Analytical Solutions for Expected Loss and Standard Deviation of Loss with an Additional Loan

We evaluate the expected loss and the standard deviation of loss of a bank loan, considering the bank’s strategic control of the expected return on the loan. Assuming that the bank supplies an additional loan to minimize the expected loss of the total loan, we provide analytical formulations for the expected loss and the variance of loss with bivariate normal distribution functions. Using a given expected growth rate and interest rates, two thresholds for the asset/liability ratio can specify three cases. The bank supplies an additional loan to decrease the expected loss in two cases: (i) the asset/liability ratio of the firm is low, and its expected growth rate is high; and (ii) the asset/liability ratio of the firm is high, and the lending interest rate is high. The bank maintains the current loan amount when the asset/liability ratio lies between the two thresholds. Depending on the bank’s strategy, the bank can decrease the initial expected loss of the loan. Conversely, the bank would face a greater risk of the standard deviation of loss.     

Global Production Sharing and Sino-US Trade Relations

This paper examines Sino-US trade relations, focusing on the ongoing process of global production sharing, involving splitting of the production process into discrete activities that are then allocated across countries, and the resulting trade complementarities between the two countries in world manufacturing trade. The results suggest that the Sino--US trade imbalance is basically a structural phenomenon resulting from the pivotal role played by China as the final assembly centre in East Asia-centered global production networks.     

The logic of franchise contracts: Empirical results of Japan

This paper examines the factors determining the choice between company-owned outlets and franchising. A number of researchers have based their studies on the data of retail contracting in the US. However, there has been little empirical analysis in the case of Japan. In this paper, we provide a comprehensive assessment of various alternative hypotheses about franchising by using Japanese data. The principal-agent model of franchising that assumes risk-sharing and moral-hazard is supported by our data.     

Firm Efficiency in Cambodia's Garment Industry on the Eve of the Multi‐Fiber Arrangement Termination

Applying a frontier analysis to 2004 firm‐level data, the present paper investigates firm efficiency and its determinants for Cambodia's garment industry. The study finds that firm experience and remuneration are crucial for improving scale efficiency and overall technical efficiency, while effective use of capital and adequate labor‐skill development are important for enhancing a firm's technical capabilities. Foreign‐owned enterprises with a relatively larger share of foreign labor outperform local firms. However, the present study does not reveal evidence of any advantages of a cluster‐type concentration in Phnom Penh and export markets, nor of any positive impacts of product specialization. The findings imply a need to support skill development for workers and local managers at the middle management level, and to streamline foreign direct investment measures to attract greater numbers of efficient foreign enterprises, so as to promote the development of the garment industry as a whole.