The economic burden of depression among adults with rheumatoid arthritis in the United States

Aims: Depression is the most frequent comorbidity reported among patients with rheumatoid arthritis (RA). Comorbid depression negatively impacts RA patients’ health-related quality-of-life, physical function, mental function, mortality, and experience of pain and symptom severity. The objective of this study was to assess healthcare utilization, expenditures, and work productivity among patients with RA with or without depression.

Materials and methods: Data from adult patients who had at least two visits each related to RA and depression over a 1-year period were extracted from the Truven Health MarketScan research databases. Outcomes comprised healthcare resource utilization, work productivity loss, and direct healthcare costs comparing patients with RA with depression (n?=?3,478) vs patients with RA without depression (n?=?43,222).

Results: Patients with RA and depression had a significantly greater relative risk of hospitalization and number of all-cause and RA-related hospitalizations, utilization of emergency services, days spent in the hospital, physician visits, and RA-related surgeries compared with RA patients without depression. Patients with RA and depression had a higher risk of and experienced more events and days of short-term disability compared with patients without depression. The incremental adjusted annual all-cause and RA-related direct costs were $8,488 (95% CI = $6,793–$10,223) and $578 (95% CI = –$98–$1,243), respectively, when comparing patients with RA and depression vs RA only.

Limitations: The current analysis is subject to the known limitations of retrospective studies based on administrative claims data.

Conclusions: This study suggested increased healthcare utilization, work productivity loss, and economic burden among RA patients due to comorbid depression. These findings emphasize the importance of managing depression and including depression as a factor when devising treatment algorithms for patients with RA.     

Capital asset pricing model in Portugal: Evidence from fractal regressions

We examine risk profiles of the Portuguese stock market index component stocks using a novel approach to the classical capital asset pricing model (CAPM). Specifically, we estimate the CAPM via fractal regressions that allow studying the marginal effects at selected scales. In this way, we can reveal whether the risk is perceived differently by market participants with different investment horizons. Apart from the analysis itself, we provide new statistical insights into the issue of separating and comparing the scale-specific effects with statistical validity. We find several stocks deviating from an expected risk perception homogeneity across investment horizons. This is true for both analysed periods, i.e. before and after the global financial crisis. There are also several stocks that changed their relationship to the market portfolio in between, which has strong implications for possible portfolio construction. The proposed methodology is not limited to financial topics but can be used in any discipline where the scale-specific marginal effects might be of interest.     

The Structure of Problem Structuring Conversations: A Boundary Games Approach

One of the questions associated with facilitated problem structuring is how the micro level of actors’ multimodal communications, contributes to the emergence of a macro level, framing the possibilities for action in a workshop. This paper shows a way to study this macro level, building the visualization of the conversations’ structure starting from a boundary games theory micro analysis of the interactions. Our empirical evidence comes from following a group of academic consultants working to define a value proposition for their activity. We focus on analyzing two out of nine workshops that were felt diametrically opposite in terms of facilitation and achievements. Moving from the micro towards an upward level, three configurations building the structure are identified—shifting, branching and converging. The work carried out allows us to: (1) visualize the structure of conversations in a problem structuring context, (2) highlight the role of multimodal communications in building the conversations and (3) construct an interpretation bridging the micro and macro readings of a workshop. This knowledge is useful for facilitators guiding the dynamic of a workshop and for researchers looking forward to understanding how micro level interactions build higher levels of the social phenomenon of intervention.     

Public debt and economic growth in Spain, 1851–2013

In this paper we investigate the long-run relationship between public debt and economic growth in the Spanish economy for the period 1851–2013. We develop a cliometric analysis of the debt–growth nexus using novel time series methods. We find some support for a negative relationship between both variables, but no clear evidence of a debt threshold. The estimated long-run elasticity in a one-break model shows a tendency to decrease over time from a nonsignificant 0.011 to a ?0.070, indicating that a 10 percentage increase in the public debt-to-GDP ratio is associated with 0.70 percentage points lower real economic growth. Indeed, we find for the first subsample (1851–1939) either “decoupling” or “saturation,” while in the second subsample (1940–2000) the long-run elasticity coefficient becomes negative and significant. When we extend our analysis up to 2013, we find a break in 1971 coinciding with the twilight of Franco’s dictatorship and the Spanish transition to democracy.     

Structural comparisons of networks and model-based detection of small-worldness

In this paper, we consider the problem of assessing the “level of small-worldness” of a graph and of detecting small-worldness features in real networks. After discussing the limitations of classical approaches, based on the computation of network indicators, we propose a new procedure, which involves the comparison of network structures at different “observation scales”. This allows small-world features to be caught, even if “hidden” deeply into the network structure. Applications of the procedure to both simulated and real data show the effectiveness of the proposal, also in distinguishing between different small-world models and in detecting emerging small-worldness in dynamical networks.     

Target‐Setting,Pay for Performance,and Quality Improvement: A Case Study of Ontario Hospitals’ Quality‐Improvement Plans

This study examines whether difficult targets and quality indicators in executives' pay‐for‐performance (P4P) plans affect performance. The impact of target‐setting and P4P plans on quality improvement in the public sector is unclear. The Ontario government initiated the Quality Improvement Plan (QIP), which requires hospitals to set targets for quality indicators annually and link executive pay to target achievement since 2011. Analyzing Health Quality Ontario's database and hospitals' 2012–2013 QIPs, this study shows greater quality improvement in hospitals with difficult targets than hospitals with easy targets or without assigned targets; however, the positive impact disappears for high‐performance hospitals relative to their peers. We find no significant effect of the use of quality indicators in executives' P4P plans on quality improvement. Copyright © 2018 ASAC. Published by John Wiley & Sons, Ltd.     

Consumer Law and Policy in Ghana

This paper presents a picture of the landscape of consumer law and policy in Ghana and reviews the scope of protection of consumer interests with specific regard to product safety and liability, consumer sales, and telecommunication services. It assesses the legislative and policy framework on consumer contracts, product safety, and unfair commercial practices; discusses the role of national agencies in enforcing safety standards; and highlights some critical consumer issues in telecommunications service delivery. The paper examines the regulatory framework on other consumer issues such as advertising, labelling, and marketing of consumer products; terms and conditions of consumer contracts; and after sales services including the enforcement of guarantees, warranties, refund, and return policies. The paper also discusses the extent of external influence on the development of consumer law and policy in Ghana and reviews the level of interaction with other legal systems and supranational bodies in the three focal areas. The contribution also explores areas of Ghana’s consumer protection framework which could benefit from guidance from the EU transnational model on consumer protection and makes recommendations for the enhancement of the emerging legislative and policy regime on consumer protection in Ghana.     

Impact of Online Customer Reviews on Sales Outcomes: An Empirical Study Based on Prospect Theory

This study examines the influence of the valence of online customer reviews on sales outcomes based on prospect theory. Numerous studies have revealed the importance of customer reviews in online marketing. However, only few studies have explored the impact of online customer reviews on sales outcomes in the dynamic process. Prior studies in behavioral economics literature have indicated that people differently value gains and losses and that losses have more emotional impact than an equivalent amount of gains. This study verifies whether prospect theory applies to the relation between online customer reviews and sales outcomes. Relevant data were collected from Amazon.co.jp, and three statistical models were employed to investigate the relation between the two factors. Major findings confirm that negative customer reviews considerably impact online sales than positive reviews. Furthermore, the findings indicate that the marginal effects of positive and negative reviews decrease with the increase in their volume. The results of this study will enable marketers to compare the relative sales effects of different types of customer reviews and improve the effectiveness of customer service management.