Disease management programs: program intervention, behavior modification, and dosage effect

Disease management programs provide highly personalized self- management support to consumers afflicted with chronic illnesses. Program interventions include the provision of health information, ongoing motivation, and support for behavior change, adherence to pharmacotherapy, development of self-efficacy, and the distribution of self-care tools. Interactions between program and patients are structured and repetitive over time. Consumer behavior change can result in measurable improvements in quality and medical cost savings from postponement or avoidance of preventable complications. We evaluated the impact on cost and quality of a comprehensive Diabetes Disease Management Program (DDMP) across ten US urban markets. A staggered implementation allowed for ten pre–post and five pair-wise comparisons. The DDMP demonstrated significant improvements in six diabetes-related quality indicators, lower cost, and a dose-response with greater than 6 months participation. We conclude that a DDMP improves quality of care and reduce overall medical costs.     

A production/remanufacture model with returns’ subassemblies managed differently

This paper considers a production-remanufacturing inventory model for a single product, where constant demand is satisfied from the inventory of newly produced and remanufactured items. Although the available models in the literature imply that collected used units (or returns) are disassembled for recovery purposes, these models really do not treat them as such. Contrary, the returns are assumed to be recovered as whole units, perhaps, for simplicity. This assumption may not capture the benefits reaped from product recovery programs. This paper addresses this limitation in the literature and assumes that each unit of a used product is collected and disassembled into components, where these components are sorted into subassemblies, which are fed back into the production-remanufacturing process. The returned subassemblies are remanufactured and reassembled to represent a second source of as-good-as-new units of the end-product. For this multi-component inventory problem, the question that needs to be answered is whether, or not, extreme strategies of either pure remanufacturing or pure production are more economical than a mixed strategy (one that combines both strategies). A mathematical model is developed that accounts for the inventories of subassemblies. The results suggested that not accounting for the disassembled components of a product leads to inappropriate inventory decisions that are not environmentally sound.     

Investment Opportunity Set and Voluntary Disclosure of Prospective Information: A Simultaneous Equations Approach

Abstract:   This paper examines empirically the relationship between the level of disclosure of prospective information and the investment opportunity set for firms in New Zealand. Using a systems (two‐stage least squares) approach that explicitly controls for potential endogeneity between disclosure and IOS, we find that the level of prospective information disclosure is significantly and positively related to IOS in both specifications in our simultaneous analysis. Further, we document that prospective information disclosure is positively related to firm size and new security offerings, and is not related to inside ownership and firm profitability. IOS is positively impacted by a firm's investments in fixed assets and its profitability. Finally, we find that forward looking disclosure levels are positively related to the proportion of outside directors on the board and negatively related to barriers to entry, but these findings are not robust across alternative model specifications.     

Least squares, preliminary test and Stein-type estimation in general vector AR(p) models

In the general vector autoregressive process AR ( p ), multivariate least square estimation (LSE)/maximum likelihood estimation (MLE) of a subset of the parameters is considered when the complementary subset is suspected to be redundant. This may be viewed as a special case of linear constraints of autoregressive parameters. We incorporate this nonsample information in the estimation process and propose preliminary test and Stein-type estimators for the target subset of parameters. Under local alternatives their asymptotic properties are investigated and compared with those of unrestricted and restricted LSE. The dominance picture of the estimators is presented.     

Constraints on assistance to refugees: Some observations from the Sudan

The plight of refugees in Africa is compounded by the fact that they often seek asylum in poor host countries which are as politically and economically fragile as their countries of origin. Attempts to help these refugees become self-sufficient demonstrate the underlying contradictions of all aid programmes.This paper discusses these contradictions in the light of the author's experience in the Sudan. It shows how the concept of ‘humanitarian assistance’ and the relief programmes designed by aid agencies, as well as the laws and regulations designed by governments, have contributed to the increasing powerlessness of the refugee recipients. Refugees themselves have been ignored throughout the decision-making process in the three phases of relief, rehabilitation and development. Aid agencies and host governments often have conflicting goals which result in exacerbation of the refugees' situation.The author suggests that assistance has been directed towards the symptoms of the refugee problem but not the root causes. As a result, there is an urgent need to reassess the assumptions underlying refugee assistance and to propose new strategies and options.