Gene-environment interactions and the complexity of human genetic diseases

In the assessment of mortality and morbidity risk, the ability of family history and genetic test results to predict the age of occurrence, severity, and long-term prognosis of 'genetic' diseases is important. An increasing number of gene-gene and gene-environment interactions have been demonstrated in a number of monogenic Mendelian diseases. These interactions can significantly modify the clinical presentation (disease phenotype) of diseases previously regarded purely as 'genetic.' As a result, 'genetic' diseases can be positioned in a continuum between classic Mendelian and complex disease where the extremes, pure genetic or solely non-genetic, do not exist. The position of any given disease in this continuum is defined by three components: the major gene(s) contributing to the phenotype, the variability added by modifier genes and the significance of environmental factors influencing the phenotype. As the predictive value of genetic test results can be significantly influenced by additional genetic and environmental risk factors, a better understanding of these factors may influence the quantification of mortality and morbidity risk.     

Patient intensity in an ambulatory oncology research center: A step forward for the field of ambulatory care--Part II

Nursing leaders in ambulatory care need to objectively quantify patient intensity to balance patient care needs and nursing resources. In this three-part series, current literature on acuity/intensity tools will be reviewed, and the development of an Ambulatory Intensity System (AIS) to objectively quantify nursing care will be described. In this article, the ongoing implementation of the system, its incorporation into the organization's established computerized appointment system, reliability measures, and related performance improvement activities will be discussed.     

Contents of Volume 47

Volume Contents

Contents of Volume 47     

Banks and bubbles: How good are bankers at spotting winners?

This paper examines the bank lending relations of a large sample of technology and nontechnology firms that went public during the 1996–2000 period. We use a unique hand-collected data set to examine the characteristics of firms that establish pre- Initial Public Offering (IPO) bank lending relations and whether post-IPO performance is related to the existence and size of pre-IPO banking relations. We find that the majority of IPO firms have banking relations before they go public. Firms with banking relations are older, more profitable or, in the case of tech firms, have lower losses, and are more likely to have funding from venture capitalists than firms without banking relations. We also find that banks lent aggressively to technology firms in the sense that current earnings and cash flows were significantly less important in determining banking relations for technology firms than for nontechnology firms. Consistent with the importance of so-called soft information in lending decisions, we find that, controlling for ex ante observable risk measures, there is a positive and significant relation between improvements in post-IPO operating performance and the existence and size of pre-IPO banking relations. Overall, our results indicate that firms with the best current and future prospects establish banking relations. Our findings provide an explanation as to why investors could interpret lending relations as a positive signal of firm quality.     

Quality perceptions under evolving information conditions: Implications for diet,health and consumer satisfaction

Consumers’ perception of, and satisfaction with, fruit quality is an important issue for both public policy and commercial reasons. However, because of information problems, consumers cannot easily choose fruits of a quality most likely to satisfy their preferences and health needs. The research reported here employed an experimental auction method to test perceptions of fruit quality by evaluating the willingness to pay (WTP) of consumers for five different varieties of soft citrus under three different information conditions: visual inspection of the fruit before peeling; visual inspection after peeling; and after consumption. Significant differences were found in valuations of the different varieties as consumers gained information. Conclusions are drawn about the value of the methodology and the results themselves, and implications are inferred for policy and for growers and traders. It is argued that product information should be oriented not just towards nutritional education but also towards increasing the pleasure of healthy eating.     

Total Factor Productivity Growth in U.S. Commercial Banking for 1935–1991: A Latent Variable Approach Using the Kalman Filter

This paper studies total factor productivity (TFP) in U.S. commercial banking for 1935–1991. TFP can contain a procyclical bias when some input factors are not freely variable, causing their shadow and market prices to differ. We correct this bias in TFP by decomposing it into its latent stochastic trend and cyclical components by employing the Kalman filter. Using the FDIC's annual aggregate data on U.S. insured commercial banks, we report that the stochastic trend has been positive during 1935–1991, with an average annual growth rate of 2.27%, and that it exhibits a decaying time path. We attribute the positive TFP growth to technical change.     

Development strategy for rural areas

In September 1973, the President of the World Bank, Robert S. McNamara, made a challenging address to the Governors of the Central Banks of the member states of the international Monetary Fund. The main subject in his speech was the problem of poverty particularly in rural areas of developing countries, and the design for a strategy for its abolition.     

Food in sub-Saharan Africa : Trends and policy challenges for the 1990s

The food situation in Africa can be expected to become increasingly serious as the end of the century approaches. The gap between domestic supply and food needs in rapidly widening. Yield-increasing technology becomes essential in view of land scarcity in high-potential areas and sustainability problems in marginal zones. The concern of governments for food self-sufficiency, however, must not divert attention from the primary objective of household food security, which is essentially a question of households' real income. Accelerated rural growth and improved rural health and sanitation services accessible to the poor are central elements for household food security improvement.