Ecosophy and tourism: Rethinking a mountain resort

This paper explores how an ecosophically inspired tourism strategy could enhance a Scottish mountain recreational site threatened by climate change. Drawing on qualitative data, the paper focuses on three research questions concerning: the impact of current infrastructure and management strategies on tourist experiences; tourists’ current interpretations and desires; and how the notion of an ecosophically informed tourist attraction might be realised in the light of these experiences, interpretations and desires. Conclusions indicate that the site is a long way from being an ecosophically inspired tourism resort which might foster an engagement with nature. Insights are provided as to how this might be achieved. Critical to the paper is a consideration of how the ‘packaging’ of tourist experiences militates against a meaningful personal connection with the mountain environment.     

Was It Something I Ate? Implementation of the FDA Seafood HACCP Program

We develop a theoretical model of enforcement and compliance under HACCP regulation and use the FDA's seafood inspection records to examine: (1) if the FDA has targeted its inspections under HACCP regulation; (2) the effects of inspections on compliance with HACCP and plant sanitation standards; and (3) the relationship between compliance with HACCP and preexisting sanitation standards. There is some evidence of targeting based on product risk, but not on past compliance performance. The threat of an inspection increases the likelihood of compliance, but only for sanitation inspections, not for HACCP. HACCP compliance does not improve compliance with sanitation standards.     

Cost-effectiveness of mechanical thrombectomy for acute ischemic stroke: an Australian payer perspective

Aims: The goal of this study was to assess the cost-effectiveness of mechanical thrombectomy (MT) for acute ischemic stroke (AIS) from an Australian payer perspective.

Methods: This study used a Markov model that employed a life-time time horizon, modeling patients from symptom onset of stroke until end of life. Clinical efficacy and safety data were taken from an individual patient level data (IPD) meta-analysis of clinical studies. The treatment effect of MT compared to usual care was measured by changes in modified Rankin Score (mRS). Post-treatment mRS scores were used to determine short- and long-term stroke care costs. Treatment costs were modeled, with health state utility values determined by literature review. All analyses were conducted using Microsoft Excel.

Results: In comparison to usual care, MT is associated with higher costs ($10,666 per patient) and additional quality-adjusted life years (QALYs) (0.8281 per patient), resulting in an incremental cost per QALY of $12,880. Sensitivity analyses demonstrated the reliability of the base case results across a range of assumptions. The higher cost associated with MT is, to an extent, offset by the cost savings resulting from lower stroke care costs due to improved patient outcomes. The life-time cost savings in terms of stroke care costs are estimated to be more than $8,000 per patient for patients who had received MT in combination with usual care.

Limitations: Stroke care costs based on patient disability/functional level were not available and were derived. As a consequence, long-term care costs for patients with poorer outcomes may be under-estimated. Patient outcomes at 90 days were extrapolated to a lifetime horizon, but this approach was supported by long-term evidence on stroke survival.

Conclusions: Mechanical thrombectomy is a cost-effective treatment option for AIS, with clinical benefits translating to short- and long-term cost benefits. This analysis supports rapid update of stroke care pathways to incorporate this therapy as a treatment option.     

Exploring Attitudes and Affiliation Intentions toward Consumers Who Engage in Socially Shared Superstitious Behaviors: A Study of Students in the East and the West

Existing literature on superstitious beliefs focuses on consumer purchasing behavior. However, little is known about how superstition‐based consumption behaviors are socially perceived. This paper investigates students’ attitudes toward consumers who engage in socially shared superstitious behaviors. Two studies show that students from Eastern and Western countries have negative attitudes and lower affiliation intentions toward consumers engaging in socially shared superstitious behaviors. As predicted by social judgment theory, this effect is driven by perceived low competence but not by perceived warmth. These negative attitudes and lower affiliation intentions are moderated by the student's superstitiousness. The managerial implications of social perceptions regarding consumer superstitious behavior are discussed.     

Predictors of high healthcare resource utilization and liver disease progression among patients with chronic hepatitis C

Background:

Since hepatitis C virus therapy is typically prioritized for patients with more advanced disease, predicting which patients will progress could help direct scarce resources to those likely to benefit most. This study aims to identify demographics and clinical characteristics associated with high healthcare resource utilization (HRU) and liver disease progression among CHC patients.

Methods:

Using health insurance claims (January 2001–March 2013), adult patients with ≥2 CHC claims (ICD-9-CM: 070.44 or 070.54), and ≥6 months of continuous insurance coverage before and ≥36 months after the first CHC diagnosis were included. Patients with human immunodeficiency virus were excluded. Generalized estimating equations were used to identify the demographic and clinical characteristics of being in the 20% of patients with the highest HRU. Factors predicting liver disease progression were also identified.

Results:

In the study population (n?=?4898), liver disease severity and both CHC- and non–CHC-related comorbidities and conditions were strong predictors of high healthcare costs, with odds ratios (ORs; 95% confidence interval [CI]) for ≥2 CHC-related and ≥2 non-CHC-related comorbidities/conditions of 2.78 (2.48–3.12) and 2.19 (1.76–2.72), respectively. CHC- and non-CHC-related comorbidities and conditions were also strong predictors of liver disease progression with ORs (95% CI) for ≥2 CHC-related and ≥2 non-CHC-related comorbidities and conditions of 2.18 (1.83–2.60) and 1.50 (1.14–1.97), respectively.

Limitations:

Potential inaccuracies in claims data, information or classification bias, and findings based on a privately insured population.

Conclusion:

This study suggests that CHC patients with high healthcare resource utilization have a high level of comorbidity at baseline and also that non-CHC comorbidities and conditions are strong predictors of high HRU. Non-cirrhotic CHC patients with one or more comorbidities are at high risk of progressing to cirrhosis or end-stage liver disease.     

Fear and the Fama‐French Factors

Investors’ expectations of market volatility, captured by the VIX (the Chicago Board Options Exchange's volatility index, also known as the “investor fear gauge”), affects the expected returns of US equities. Changes in the VIX drive variations in the expected returns of the factors included in the Fama and French three‐factor model augmented with a momentum factor. The market risk premium (R_m– R_f) and the value premium (HML) are especially sensitive to changes in the VIX. An increase in expected volatility is associated with flights to quality and increases in estimated required returns.     

Two-Tier Store Brands: The Benefic Impact of a Value Brand on Perceptions of a Premium Brand

A recent trend in the retail industry is the emergence of multi-tier store brands. In the current article, we contrast consumers’ expectations in a retailing context in which a single store brand is present to one in which two store brands are offered in the same category. We propose that when a retailer offers a single store brand, consumers expect it to be of lower quality even when it is described as a premium brand. On the other hand, quality perception of a premium store brand increases in the presence of a value store brand. Importantly, quality perceptions of a value store brand are not affected by the presence of a premium store brand. In two studies we find support for our hypotheses showing the benefic impact of a value store brand on quality perceptions of a premium store brand.     

The East Asian Crisis and International Capital Markets

This paper reviews the theoretical and empirical evidence about international capital mobility. The authors find that its potential benefits depend on certain assumptions about market structures and institutions. Many of these conditions were absent in the economies worst affected by volatile capital movements. The main features of the recent East Asian financial crisis are described, and the principal distortions that led to the crisis. In some instances, these distortions were due to government policies; in others, they stemmed from market failures that had not been adequately addressed either by individual governments or by international financial institutions.     

Encumbering harvest rights to protect marine environments: a model of marine conservation easements*

We adapt the concept of a conservation easement to a marine environment and explore its use to achieve conservation goals. Although marine environments generally are not owned, those who use them for commercial fishing often are regulated. These regulations grant harvesters rights to use marine environments in specified ways, and the possibility of encumbering these rights to achieve conservation goals creates a potential role for marine easements. We examine this potential under alternative fishery management regimes and find, generally, that marine easements tend to be most effective when harvest rights are delineated most fully. Our analysis suggests ways that marine easements can have flexibility and transactions cost advantages over other approaches to achieve marine conservation goals. We also propose ways in which the design of laws allowing marine easements should follow, or depart from, the design of laws authorising conservation easements on land.