Burden of illness for super-refractory status epilepticus patients

Objective: To provide an estimate of the annual number of super-refractory status epilepticus (SRSE) cases in the US and to evaluate utilization of hospital resources by these patients.

Methods: The Premier Hospital Database was utilized to estimate the number of SRSE cases based on hospital discharges during 2012. Discharges were classified as SRSE cases based on an algorithm using seizure-related International Classification of Diseases-9 (ICD-9) codes, Intensive Care Unit (ICU) length of stay (LOS), and treatment protocols (e.g. benzodiazepines, anti-epileptic drugs (AEDs), and ventilator use). Secondary analyses were conducted using more restrictive algorithms for SRSE.

Results: A total of 6,325 hospital discharges were classified as SRSE cases from a total of 5,300,000 hospital discharges. Applying a weighting based on hospital characteristics and 2012?US demographics, this projected to an estimated 41,156 cases of SRSE in the US during 2012, an estimated incidence rate of ～13/100,000 annually for SRSE in the US. Secondary analyses using stricter SRSE algorithms resulted in estimated incidence rates of ～11/100,000 and 8/100,000 annually. The mean LOS for SRSE hospitalizations was 16.5 days (median =11; interquartile range [IQR]?=?6–20), and the mean ICU LOS was 9.3 days (median =6; IQR =3–12). The mean cost of an SRSE hospitalization was $51,247 (median = $33,294; 95% CI = $49,634–$52,861).

Limitations: The analysis uses ICD-9 diagnostic codes and claims information, and there are inherent limitations in any methodology based on treatment protocol, which created challenges in distinguishing with complete accuracy between SRSE, RSE, and SE on the basis of care patterns in the database.

Conclusion: SRSE is associated with high mortality and morbidity, which place a high burden on healthcare resources. Projections based upon the findings of this study suggest an estimated 25,821–41,959 cases of SRSE may occur in the US each year, but more in-depth studies are required.     

Rivaroxaban for non-valvular atrial fibrillation and venous thromboembolism in the Netherlands: a real-world data based cost-effectiveness analysis

Background: Non-vitamin K antagonist oral anticoagulants (NOACs) have been included in international guidelines as important alternatives to vitamin K antagonists (VKAs) for the treatment of venous thromboembolism (VTE) and stroke prevention in non-valvular atrial fibrillation (NVAF). Meanwhile, in the Netherlands, NOACs are widely used next to VKAs. The objective of this study is to estimate the cost-effectiveness of treatment with rivaroxaban compared to VKAs in NVAF and VTE patients in the Netherlands, using data from international prospective observational phase IV studies.

Methods: Two models were developed to represent NVAF and VTE patients, populated with patients from the XANTUS (NCT01606995) and XALIA (NCT01619007) international prospective observational studies. The 1-year cost-effectiveness of rivaroxaban use, compared to VKAs, was explored in a population consisting of NVAF and VTE patients (base case) as well as for four scenarios with sub-populations: NVAF patients only, VTE patients only, NVAF patients with unstable international normalized ratio (INR), and NVAF patients using an INR self-measuring device.

Results: In the base case, rivaroxaban saved €72,350 and gained 21 quality-adjusted life-years (QALYs) in a simulation of 2,000 patients over the use of VKAs. Ergo, rivaroxaban was dominant over VKAs. The probabilistic sensitivity analysis showed a probability of 85% for rivaroxaban being dominant and 100% at a willingness-to-pay threshold of €20,000/QALY. Rivaroxaban appeared to be dominant in all scenarios as well, except for the NVAF-patients-only scenario where the incremental cost-effectiveness ratio (ICER) was €157/QALY.

Conclusions: In patients with NVAF or VTE, rivaroxaban treatment is likely to be cost-effective and a potentially cost-saving alternative to VKA in the Netherlands.     

寻求HR的职业发展阶梯

拓展你的职业生涯,从赢得上司的尊重开始。当人们试图使自己的事业发展更进一步时,许多人将注意力集中到寻找新的雇主、接受更高级的教育和通过专业协会增加自己的交际网络上来。但是,这些方法并不是提升职业生涯的最好方式。对于人力资源从业者,尤其是刚刚开始新的工作或者正处于基层职位的人来说,另一个有效的提升方式是在职发展计划。人力资源从业者可以在工作中磨练重要的技能,并从自己的经理或者主管那里获得职业发展的机会,这其实也是最好的方法之一。     

Getting consumers to eat more whole-grains: The role of policy, information, and food manufacturers

The 2005 Dietary Guidelines were unique because they offered quantitative recommendations for consumption of whole-grains. This case study examines the hypothesis that the changed recommendations were responsible for the recent increase in retail sales and consumption of whole-grain food products. We find that release of the Dietary Guidelines and related media attention did increase availability and sales of whole-grain foods. A large impact on consumption occurred through reformulation of existing products, induced by competition among food suppliers. This study reveals the key role product reformulation plays in inter-firm competition and in realization of dietary changes recommended by public policy.     

Innovation And Inter-Firm Co-Operation: The Case Of The West Midlands

Drawing upon the innovative milieux and industrial districts literature, the paper provides substantial empirical evidence that firms have a greater chance of being innovative if they co-operate with other firms over innovation, albeit undertaking no investment in RLD. This is an important result especially for small firms. In particular, the paper focuses on inter-firm cwperation along the supply chain, using a swey of firms in the West Midlands to investi-gate co-operation over innovation between suppliers and buyers. A probit model is used to test the link between innovation performance and four innovation inputs: R&D expenditure, R&D personnel, networking with suppliers and networking with client firms.     

The effect of commute time on racial earnings inequality: a case study of the Houston metropolitan statistical area

Data from the United States Census confirm a substantial increase in the racial earnings gap between 1980 and 1990. This paper examines data on whites and non-white wage and salary incomes in Houston TX for 1980 and 1990. Data on time travelled to work is used to simulate what would be the impact of shorter commute times on earnings inequality. The central finding is that a reduction in travel time from residence to work would cause a very small reduction in racial earnings and income inequality. This suggests that advances in urban transportation policy alone are not sufficient to solve the problem of racial earnings inequality.     

Too close for comfort? Distinguishing between team intimacy and team cohesion

The authors examine theory and research on team intimacy and team cohesion, and argue that the two have often been confused, merged, and used interchangeably in recent theoretical, empirical, and applied work on team effectiveness. The authors propose distinct definitions to clarify and distinguish between team intimacy and team cohesion, and suggest areas that will aid research and application. Their examination provides a framework for understanding the inconsistent findings in team effectiveness and team building research and thus helps to improve human resource management (HRM) interventions.     

The sociology of innovation and new biotechnologies

Understanding the social processes that support innovations in new biotechnologies presents an interesting challenge. Evidence from the Australian bioindustry reveals how the development and integration of new biotechnologies is a dynamic social process. Our findings highlight how new technology acceptance and integration rested on the micro‐politics of sense‐making and relational networking.     

The Role of Future‐Market Focus in the Early Stages of NPD across Varying Levels of Innovativeness

The concept of future‐market focus (FMF) arose out of the debate about firm size and incumbency in the face of radical or disruptive innovations, and has been demonstrated to have a positive correlation with radical innovation (RI) success. This study examines the relationship between FMF and the processes used in the early stages of NPD for four types of innovation projects: incremental innovations, technological breakthroughs, market breakthroughs, and radical innovations. We found that the future‐market focus of a project team can influence the early stage processes used in a new product innovation project, and does so differentially across levels of innovativeness. In particular, the concept generation process, understanding of market needs, and screening decision criteria are different for low‐ versus high‐FMF projects and there are differences based on the level of innovation. In addition, we found that radical innovation projects rated low in FMF are markedly different than the radical innovation projects described in prior studies.