Caregiver priorities for endpoints to evaluate treatments for Prader-Willi syndrome: a best–worst scaling

Abstract

Objectives: Prader-Willi syndrome (PWS) is a rare genetic disorder associated with varying degrees of hyperphagia, obesity, intellectual disability, and anxiety across the affected individuals’ lifetimes. This study quantified caregiver priorities for potential treatment endpoints to identify unmet needs in PWS.

Methods: The authors partnered with the International Consortium to Advance Clinical Trials for PWS (PWS-CTC) and a diverse stakeholder advisory board to develop a best–worst scaling instrument. Seven relevant endpoints were assessed using a balanced incomplete block design. Caregivers were asked to determine the most and least important of a sub-set of four endpoints in each task. Caregivers were recruited nationally though patient registries, email lists, and social media. Best–worst score was calculated to determine caregiver priorities; ranging from 0 (least important) to 10 (most important). A novel kernel-smoothing approach was used to analyze caregiver endpoint priority variations with relation to age of the PWS individual.

Results: In total, 457 caregivers participated in the study. Respondents were mostly parents (97%), females (83%), and Caucasian (87%) who cared for a PWS individual ranging from 4–54 years. Caregivers value treatments addressing hyperphagia (score?=?7.08, SE?=?0.17) and anxiety (score?=?6.35, SE?=?0.16) as most important. Key variations in priorities were observed across age, including treatments targeting anxiety, temper outbursts, and intellectual functions.

Conclusions: This study demonstrates that caregivers prioritize hyperphagia and, using a novel method, demonstrates that this is independent of the age of the person with PWS. This is even the case for parents of young children who have yet to experience hyperphagia, indicating that these results are not subject to a hypothetical bias.     

The performance of venture capital investments: Do investors overreact?

Using a unique proprietary data set of over 5400 realized and unrealized venture capital investments between 1980 and 2005, we examine the impact of demand-related factors, e.g. entrepreneurial activity, as well as supply-related factors, i.e. money provided by VC investors, on the return of individual VC investments. This way, we are able to shed more light on the question whether volatile VC investment returns are rather driven by fundamental changes with regard to the number of attractive investment opportunities or by the overreaction by investors. We find that rising demand for VC, i.e. an increase in entrepreneurial activity, results initially in higher returns. However, our results also indicate that overreaction on the supply side can be observed, destroying deal-level results. Overfunding, specifically overinvesting seems to be a recurring characteristic of the VC industry. In fact, contra-cyclical investment strategies yield highest deal-level returns.     

Predictive safety analytics: inferring aviation accident shaping factors and causation

This paper illustrates the development of an object-oriented Bayesian network (OOBN) to integrate the safety risks contributing to an in-flight loss-of-control aviation accident. With the creation of a probabilistic model, inferences about changes to the states of the accident shaping or causal factors can be drawn quantitatively. These predictive safety inferences derive from qualitative reasoning to conclusions based on data, assumptions, and/or premises, and enable an analyst to identify the most prominent causal factors leading to a risk factor prioritization. Such an approach facilitates a mitigation portfolio study and assessment. The model also facilitates the computation of sensitivity values based on perturbations to the estimates in the conditional probability tables. Such computations lead to identifying the most sensitive causal factors with respect to an accident probability. This approach may lead to vulnerability discovery of emerging causal factors for which mitigations do not yet exist that then informs possible future R&D efforts. To illustrate the benefits of an OOBN in a large and complex aviation accident model, the in-flight loss-of-control accident framework model is presented.     

An Investigation of the Relationship between Use of International Accounting Standards and Source of Company Finance in Germany

This study examines the relationship between use of international accounting standards and companies’ source of finance. We investigate the proposition contained in Nobes’ (1998) model that postulates outsider companies (those with a higher level of public finance) in weak equity–outsider markets (capital markets where public equity finance is not the dominant source of finance) are more likely to change their type of accounting system from one focused on information for creditors and tax authorities to one that meets the needs of external financiers. We found strong support for Nobes’ model. Using 408 German listed companies at 1999, we observed that companies with more outsider finance (the proportion of shares held by outsiders and the presence of public debt) were more likely to use international standards (U.S. GAAP or IAS). The results indicate the importance of controlling for source of finance at the company rather than country level in cross‐country studies investigating the benefits of adoption of international standards.     

The revaluation of assets as a signalling device: a theoretical and an empirical analysis

In many countries, firms can choose whether or not to report a revaluation in the financial statements. An analytical model is developed to indicate conditions in which it is more likely that successful firms will choose not to revalue assets as a credible signal to potential investors. These industry settings include a high variance in performance and low equity-to-debt ratios. The empirical results for Belgium confirm that successful firms are less likely to revalue assets in those industries. However, only the revaluation of fixed tangible assets and not financial assets seems to be a credible signal. Finally, the results support the choice to revalue, but not the amount of revaluation, as a signalling device.     

Global trauma and public feelings: Viewing images of catastrophe

Scholars have begun to discuss new digital viewing contexts, but few have explored processes involved in responding to images of catastrophe. Many assume that cognition (meaning) is primary in image‐reception, but I’ll show the complex interaction of cognition and affect. Drawing on research in psychology and cultural studies, I explore how proliferation of images may produce a culture of trauma. I define, analyze and critique three kinds of possible response to images of catastrophe. These are: a) secondary or vicarious trauma (VT), a response in which the viewer is shocked to the extent of being emotionally over‐aroused; b) what I call “empty empathy,” to indicate the fleeting nature of empathic emotions that viewers often experience; and finally c) witnessing – a response that transforms the viewer in a positive pro‐social manner, and that, unlike the first sorts of response, involves ethics along with empathy. The argument is supported by images drawn from the war in Iraq, Hurricane Katrina and recent art by Witkin and Harden.     

Improving Ethical Attitudes or Simply Teaching Ethical Codes? The Reality of Accounting Ethics Education

ABSTRACT

Ethical instruction is critical in accounting education. However, does accounting ethics teaching actually instil core ethical values or simply catalogue how students should act when confronted with typical accounting ethical dilemmas? This study extends current literature by distinguishing between moral/ethical and legal/ethical matters and then re-evaluating the effectiveness of ethics training. A cohort of final-year accounting students with significant ethical training evaluated ethical scenarios. Half were moral (non-legal) and half contained legal as well as moral components. After further ethical instruction they re-evaluated the scenarios. Ethical attitudes towards legal/moral issues improved, but attitudes towards moral-only issues did not. This questions previous studies which purport to demonstrate the effectiveness of ethical instruction and queries the benefits of accounting ethics education. Are fundamental ethical principles being ignored in an effort to prevent more obvious accounting wrongdoings? Accounting ethics training needs to be reassessed if true ethical improvement is to be achieved.     

Fast fashion: response to changes in the fashion industry

The fashion apparel industry has significantly evolved, particularly over the last 20 years. The changing dynamics of the fashion industry have forced retailers to desire low cost and flexibility in design, quality, and speed to market, key strategies to maintain a profitable position in the increasingly demanding market. This article reviews the literature on changes that have happened in the fashion apparel industry since the 1990s, highlighting the emergence of a concept of ‘throwaway’ or fast fashion. It describes fast fashion from a supplier as well as a consumer's perspective, and draws attention to several potential research issues.     

The Impact of Corporate Governance on IFRS Adoption Choices

We investigate the association between corporate governance strength and EU listed firms' choices with respect to International Financial Reporting Standards (IFRS) adoption in 2005. We measure governance strength by aggregating variables such as board independence, board functioning and audit committee effectiveness. The firms exhibit heterogeneity in both compliance and disclosure quality; some firms do not even meet the minimum disclosure requirements. Regression results show that stronger governance firms disclose more information, comply more fully and use IAS 39's carve-out provision less opportunistically. These findings are germane to accountants, managers and regulators in countries soon to adopt IFRS.     

Acculturation and Individualism as Predictors of Work‐Family Conflict in a Diverse Workforce

Ethnic and cultural diversity is an increasing reality in the US workplace. The current study highlights the importance of acknowledging the culturally heterogeneous nature of ethnic groups, and the need to focus on social identity characteristics such as cultural values when assessing group differences. We demonstrate that cultural values (i.e., individualism) contribute to employees' experiences of work‐family conflict beyond the effects of ethnicity. Specifically, we introduce a model informed by social identity theory that explains why acculturation is related to work‐family conflict. The model was tested with a sample of 309 employed Caucasian and Hispanic Americans. An empirical test of our model provides evidence that individualism mediates the relationship between language‐ and social‐based acculturation and work‐family conflict, even when controlling for ethnicity. Additionally, alternative models further reveal that the effects of acculturation and individualism contribute to work interfering with family. As an implication of the current study, we suggest that researchers and organizational managers should consider the cultural values of their diverse workforce when implementing policies that affect conflict between work and family. © 2013 Wiley Periodicals, Inc.