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.     

Innovation in work practices: a practice perspective

Dynamic capability theory argues that organizations' internal capabilities enable sustained competitive advantage. Innovations in work practices (commonly termed ‘high performance’, ‘high commitment’ or ‘high involvement’ practices) are an important source of these internal capabilities but research evidence shows low levels of penetration. Using a practice perspective, case study analysis of 7 establishments in the aerospace sector identifies three themes that are under-attended to in current research on innovations in work practices: industry and production context; distributed nature of management activity, and social embeddedness. Implications for future research are discussed.     

Rational plunging and the option value of sequential investment: The case of petroleum exploration

The potential to invest sequentially in related assets creates a tradeoff between diversification and concentration. Loading a portfolio with correlated assets has the potential to inflate variance, but also creates information spillovers and real options that may augment total return and mitigate variance. We examine this tradeoff in the context of petroleum exploration. Using a simple model of geological dependence, we show that the value of learning options creates incentives for investors to plunge into dependence; i.e., to assemble portfolios of highly correlated exploration prospects. Risk-neutral and risk-averse investors are distinguished not by the plunging phenomenon, but by the threshold level of dependence that triggers such behavior. Aversion to risk does not imply aversion to dependence. Indeed the potential to plunge should be larger for risk-averse investors than for risk-neutral investors. We test the empirical validity of our theory by examining bidding activity in petroleum lease sales. We find significant plunging behavior across a broad sample of oil companies. We also find that privately-held firms pursue even more concentrated (less diversified) prospect portfolios than publicly-held firms—which we attribute to risk aversion rather than size.     

Voluntary association membership of outdoor recreationists: An exploratory study

Abstract

Research on the political activity of outdoor recreationists has focused primarily on their associational affiliations and concern for the environment. This article reviews literature on theories of collective behavior, recreation motivations, and environmental concern. The study considers outdoor recreation as a social movement and investigates relationships between incentives for voluntary membership in environmental and outdoor recreation associations, motivations for participation in outdoor recreation activities, and environmental concern. Members of associations were found to be significantly different than nonmembers on several variables including value for outdoor recreation, incentives for association membership, intellectual motivations for outdoor recreation, environmental concern, education level, and age. Results suggest that association efforts to obtain instrumental benefits, or public goods that accrue to all of society, are a primary incentive for outdoor recreationists to join voluntary associations. A common thread of intellectual pursuit distinguished members from nonmembers, suggesting that intellectual benefits may help define the relationship between outdoor recreation and associational affiliation behaviors.     

Promoting Tourism,Projecting Power: The Role of Television Commercials

This paper analyzes television commercials (TVCs) launched by Korea Tourism Organization (KTO) from 1999 to 2012. By repeating shots of traditional and Korean popular (k-pop) culture, high-tech machinery, and sportsmanship, it is fair to say that Korean tourism TVCs both reflected and fueled the fad a target audience has for Korea. Hence the commercials not only promoted tourism, they were also projecting national power in general and cultural power in particular. It is surmised that through power projection the TVCs intend to create a country halo effect so that the country’s products and services may enjoy an aspired added value.     

Factors Influencing the Physically Active Leisure of Children and Youth: A Qualitative Study

A phenomenological framework guided data collection and analysis of the prevalent influences on attitudes and behaviors of elementary, junior, and secondary school students towards their physically active leisure. Twenty-two students participated in individual in-depth interviews. Parental influence and outdoor play effected choice and level of physically active leisure for elementary students. Opportunities for organized and non-structured physically active leisure and friends were significant for junior students. Academic responsibilities and organized physically active leisure were influential for secondary students. Common threads were parental influence and the belief that the students were too old to start new activities. These findings highlight the importance of providing opportunities in safe environments for children and youth to participate in a variety of structured and non-structured forms of physically active leisure.