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.     

State Trading Enterprises as an Impediment to Improved Market Access: The Case of the Korean Rice Market

The trade and welfare effects of tariffs are well known. Less well known, and more difficult to analyze, are the economic effects of state trading enterprises (STEs). Despite STEs in importing countries having the potential to limit market access, they are no longer on the agriculture agenda in the Doha Round Negotiations in the WTO, because some Members have asserted that importing STEs do not distort international trade. We evaluate this assertion through the use of a theoretical model of an STE, which is calibrated to data for the Korean rice market. We show that this STE does distort international trade by restricting market access relative to a Cournot benchmark, and that it affects the domestic and international distribution of social welfare. This finding permits the conclusion that an important opportunity is being missed in the negotiations to improve market access, because importing STEs are not on the agenda.     

Forecasting Emerging Market Exchange Rates from Foreign Equity Options

The use of derivatives to infer future exchange rates has long been a subject of interest in the international finance literature. With the recent currency crises in Mexico, Southeast Asia, and Brazil, work on exchange rate expectations in emerging markets is of particular interest. For some emerging markets, foreign equity options are the only liquid exchange‐traded derivatives with currency information embedded in their prices. Given that emerging markets sometimes undergo currency realignment with discrete jumps in their exchange rate, estimation of risk‐neutral probability density functions from foreign equity option data provides valuable evidence concerning market expectations. To illustrate the use of foreign equity options in estimating market beliefs, we consider Telmex options around the 1994 peso devaluation and find evidence that markets anticipated the change in the Mexican government's foreign exchange policy.     

Negotiating the Evolution of the Hr Function: Practical Advice From the Health Care Sector

This paper has two aims. First, to consider explanations for the apparent gap between the paradigm of strategic human resource management on the one hand and actual HR practice on the other. Second, to generate practical advice for senior HR specialists who are aspriring to develop a strategic role for their function. the research underpinning these findings was based on case studies in three hospitals in Adelaide and a comparison of the findings with the situation at Leicester General NHS Trust where the first named author of this article was the HR director and a senior board member. the analysis reveals that specific features of each organisation's history, current structure and management, shape powerfully the nature of the HR function. Moreover, the local shaping factors define the degrees of freedom open to the HR function, so much so, that the notion that it can choose its organisational stance is here challenged.     

Construct measurement in strategic management research: illusion or reality?

Strategic management research has been characterized as placing less emphasis on construct measurement than other management subfields. In this work, we document the state of the art of measurement in strategic management research, and discuss the implications for interpreting the results of research in this field. To assess the breadth of measurement issues in the discipline, we conducted a content analysis of empirical strategic management articles published in leading journals in the period of 1998–2000. We found that few studies discuss reliability and validity issues, and empirical research in the field commonly relies on single‐indicator measures. Additionally, studies rarely address the problems of attenuation due to measurement error. We close with a discussion of the implications for future research and for interpreting prior work in strategic management. Copyright © 2004 John Wiley & Sons, Ltd.     

Corporate Governance and Financial Constraints on Strategic Turnarounds*

abstract The paper extends the Robbins and Pearce (1992 ) two‐stage turnaround response model to include governance factors. In addition to retrenchment and recovery, the paper proposes the addition of a realignment stage, referring specifically to the realignment of expectations of principal and agent groups. The realignment stage imposes a threshold that must be crossed before the retrenchment and hence recovery stage can be entered. Crossing this threshold is problematic to the extent that the interests of governance‐stakeholder groups diverge in a crisis situation. The severity of the crisis impacts on the bases of strategy contingent asset valuation leading to the fragmentation of stakeholder interests. In some cases the consequence may be that management are prevented from carrying out turnarounds by governance constraints. The paper uses a case study to illustrate these dynamics, and like the Robbins and Pearce study, it focuses on the textile industry. A longitudinal approach is used to show the impact of the removal of governance constraints. The empirical evidence suggests that such financial constraints become less serious to the extent that there is a functioning market for corporate control. Building on governance research and turnaround literature, the paper also outlines the general case necessary and sufficient conditions for successful turnarounds.     

Some Determinants of Core Competencies: Evidence from a Binary-Logit Analysis

Despite the increasing recognition of the salience of core competencies in the process of competition, the notion of core competencies has remained largely ambiguous in the literature. Neither is it clear what strategies, institutions, and resources are necessary for developing and sustaining core competencies. This paper uses the binary-logit model to explore the determinants of core competencies, and identifies investment in intangible assets, marketing/promotional activities and firm size as significant determinants of core competencies. An evaluation of the technology strategies of two competence-seeking firms also points to the increasing salience of intangible assets, decentralization/globalization of the R&D function, and the intensive search for knowledge and capabilities.     

Estimating the Impact of Transgenic Bt Cotton on West and Central Africa: A General Equilibrium Approach

West and Central Africa (WCA)’s cotton sector is experiencing rising production costs and lower yields, reversing decades of growth. Declining input use, soil fertility and inefficient chemical pest controls are contributing factors. We evaluate the potential impact of Bt cotton on WCA using a multiregion general equilibrium model and multicountry estimates of Bt-induced productivity. We find that Bt cotton raises growers’ returns, land value and welfare. Released labor from cotton is shifted to food crops hence reducing labor shortage constraints. Overall, results indicate that potential gross benefits from Bt cotton are substantial for WCA cotton sector, and that the economic costs of nonadoption are equally significant.     

Where have all the traditional classroom settings gone?—The use of large scale, public sector projects to illustrate a multidisciplinary approach to problem solving

This work describes the evolution and potential of an elective course for students who have already been exposed to the standard techniques of problem solving as presented in traditional courses. Students apply these techniques to large scale problems in directed mullidisciplinary project teams. In doing so, they are provided with a unique learning experience allowing them to serve as a resource to the community. Course projects described here include the promotion of a railing retail district; the formulation, implementation and monitoring of litter reduction strategies; the economic evaluation of using inmate labor to clean public areas; and economic comparisons of recycling strategies for used tires.