Complex home care: part III--economic impact on family caregiver quality of life and patients' clinical outcomes

Family caregivers perform a significant role in the care of patients with chronic illnesses and prescribed life-long complex home care treatments. Both quantitative and qualitative data from this study suggest the mental health burdens and financial costs of home parenteral nutrition (HPN) caregiving are extensive. In this study, the variability in HPN out-of-pocket expenses and the uncertainty of incurring such extensive costs created additional financial worries within already stressed families. Based on these data, interventions to improve caregivers' sleepiness, depression, and physical health could be hypothesized to improve both patients' and caregivers' quality of life and reduce the frequency of patients' catheter-related infections. These specific nursing interventions also could improve caregiver health and subsequently reduce the costs of caregivers' health care.     

OTHER-REGARDING UZAWA PREFERENCES AND LIVING STANDARD CATCH-UP

This paper provides a new rationale for Uzawa preferences based on social choice; instead of positing that poor people are more patient because they are poor, it posits that poor people should be more patient if they wish their living standards to catch up with richer people. To provide a setting for this new rationale, the present paper studies the socially optimal choice of living standards over time by social planners for countries that, from low levels of total factor productivity (TFP), experience a gradual catch-up of their TFP level with that of the leader country. In the TFP catch-up scenario, the socially optimal choice of consumption and saving based on time additive preferences leads to no catch-up of living standards. To generate living standard catch-up we propose other-regarding Uzawa preferences, in which the rate of time preference is influenced by the gap in living standards between follower country and leader country. This other-regarding specification is consistent with recent findings emphasized in behavioural economics. The other-regarding Uzawa preferences form is illustrated quantitatively by simulating a model of the world economy.     

Broadcasting cookery: BBC radio programmes in the 1920s and 1930s

The development of British radio broadcasting technology in the 1920s and 1930s and, equally importantly, the progressively widespread purchase and use of radio sets established a new platform from which to engage and influence the population on a number of matters. The British Broadcasting Corporation's public service principles of programmes to inform, educate and entertain gave rise to various content experiments at a time when there were very few precedents. One such innovation was the cookery talk. This was broadcast live, accomplished without the possibility of practical demonstration, and constituted a new, and abstract, form of communication primarily designed for women in their own homes. In this, women were the earliest and most frequent contributors, and their broadcast content differed from that provided by men. By reference to archive material, this article examines the social context and the thinking behind those early years of radio cookery talks and documents the contributors who were to establish this now‐familiar genre of broadcasting.     

Bronchodilator reliever use and its association with the economic and humanistic burden of COPD: a propensity-matched study

Background and aims: Short-acting bronchodilators are normally used as supplemental relief medication for breakthrough symptoms in COPD patients. The objective of this cross-sectional study was to assess if more frequent vs infrequent use of relief medication in maintenance-treated COPD patients, split by the severity dyspnea, was associated with an increase in the overall disease burden.

Methods: A population-based cross-sectional survey (Adelphi DSP) was conducted among patients with COPD in five European countries. Information was collected on demographic and clinical characteristics, reliever inhaler use, dyspnea (mMRC), health status (CAT, EQ-5D), sleep quality (JSEQ) and healthcare resource use including moderate–severe COPD exacerbations, physician visits, COPD medications and other COPD related resources. The humanistic and economic burden was compared between patients with infrequent reliever use (<1 occasion/week) and more frequent use (≥ 1 occasion/week). The association between increased reliever use and economic burden was also examined after matching patients based on propensity-scores balancing demographic and disease burden characteristics.

Results: Among the 1373 COPD patients prescribed a reliever inhaler, 29% reported using reliever medication ≥1 occasion/week. In the unmatched cohort, more frequent reliever use (n?=?377) compared to infrequent use (n?=?996) was linked to poorer health status (CAT: 25.7 vs 20.0; p?p?p?p?p?=?.0001). In the propensity-score matched population, more frequent reliever use was also associated with significantly higher annual costs for COPD management (€5,034 vs €3,705, p?=?.0327) compared to patients with infrequent reliever use.

Conclusion: In moderate-to-severe COPD, more frequent reliever use is associated with increased exacerbation risk and increased management costs.     

Excess Returns to R&D-Intensive Firms

Recent studies indicate that both current R&D investment levels and current or recent changes in R&D investment are positively associated with subsequent excess (risk-adjusted) stock returns. The tentative explanation offered for these results is that shares of R&D-intensive firms are mispriced because investors fail to see through earnings distortions caused by conservative accounting for R&D costs. However, an alternative explanation is that conventional controls for risk do not completely capture the riskiness of R&D-intensive firms, causing measured excess returns for these firms to be biased upward. This study provides evidence useful for distinguishing between the mispricing and risk explanations for R&D-related excess returns. Overall, our empirical results suggest that the positive association between R&D investment levels and excess returns is more likely to result from failure to control adequately for risk than from mispricing. On the other hand, our results do not rule out the possibility of a second source of excess returns that are due to mispricing and that are associated with changes in the level of R&D investment.     

Rejoinder: Can the downward trend in resource flows be reversed?

The author responds to the article by Maurice Williams and Thomas Stephens (pp 331–41). He criticizes the lack of praise given to the development assistance accomplishments over the past decade. However, pointing to the realism of political feasibility, this article is more pessimistic about resource flows to the Third World in the future.     

Indonesia's New Banking Law

An accumulation of old banking laws was replaced with a single new one early in 1992. The previous focus on the lending side of banks' activities has been replaced by greater emphasis on their deposit mobilisation and intermediation functions. Distinctions between commercial, savings and development banks have been dropped—the only functional distinction remaining being that between banks which offer cheque account services and the much smaller ones which do not. Important changes relating to ownership include placing the state banks on the same legal footing as those from the private sector, allowing them to sell their shares to the public, and permitting foreigners to purchase shares in domestic banks listed on the stock exchange. Those who breach the new law are liable to heavy fines and gaol terms. The law allows the government to require all (not just state) banks to undertake special developmental or equity-oriented programs.