Amino acid formula as a new strategy for diagnosing cow’s milk allergy in infants: is it cost-effective?

Aims: To estimate the cost-effectiveness of a new strategy that uses an amino acid formula in the elimination diet of infants with suspected cow’s milk allergy (CMA).

Materials and methods: This pharmacoeconomic study was developed from the perspective of the Brazilian Public Healthcare System. The new strategy proposes using an amino acid formula in the diagnostic elimination diet of infants (≤24 months) with suspected CMA. The rationale is that infants who do not respond to the amino acid formula do not suffer from CMA. Patients with a positive oral challenge test receive a therapeutic elimination diet based on Brazilian Food Allergy Guidelines. This approach was compared to the current recommendations of the Brazilian Food Allergy Guidelines. A decision model was constructed using TreeAge Pro 2012 software. Model inputs were based on a literature review and the opinions of a panel of experts. A univariate sensitivity analysis of incremental cost-effectiveness ratios was performed.

Results: The mean cost per patient of the new amino acid formula strategy was R$3,341.57, while the cost of the current Brazilian guidelines strategy was R$3,641.08. The mean number of symptom-free days per patient, which was used as an indicator of effectiveness, was 900.6 and 875.7 days, respectively. The new strategy is, therefore, dominant. In the sensitivity analysis, the dominance was maintained with parameter variation.

Limitations: In the absence of information in the literature, some premises were defined by a panel of specialists.

Conclusions: The new strategy, which uses an amino acid formula in the elimination diagnostic diet followed by an oral food challenge, is a dominant pharmacoeconomic approach that has a lower cost and results in an increased number of symptom-free days.     

Fashion consumer profiles in the Portuguese market: involvement,innovativeness, self‐expression and impulsiveness as segmentation criteria

This study identified fashion consumer profiles among Portuguese young adults. The work was based on four constructs: fashion involvement, fashion innovativeness, self‐expression through fashion products and impulsiveness. Another purpose of this study was to test these instruments in this cultural context in order to contribute to the generalizability of the scales. A cluster analysis uncovered three groups: Moderates, Apathetic and Enthusiasts. On the whole, this study proposes a new way of segmenting Portuguese fashion consumers and demonstrates that the four constructs employed can be used in different cultural contexts.     

INSOLVENCY PREDICTION IN THE PRESENCE OF DATA INCONSISTENCIES

In this paper we use data inconsistencies as an indicator of financial distress. Traditional models for insolvency prediction normally ignore inconsistent data, either by removing or replacing it. Instead of removing that information, we propose a new variable to capture it; using it together with traditional accounting variables (based on financial ratios) for the purpose of insolvency prediction. Computational tests use three datasets based on the financial results of 2033 Brazilian Health Maintenance Organizations over 7 years (2001 to 2007). Sixteen classification methods were used to evaluate whether or not the new variable impacted solvency prediction. Tests show a statistically significant improvement in classification accuracy – average results improve 1.3 (p = 0.003) and 1.8 (p = 0.006) percentage points, for 10‐fold and leave‐one‐out cross‐validations respectively. In addition, the analysis of false positives and false negatives shows that the new variable reduces the potentially harmful misclassification of false negatives (i.e. financially distressed companies being classified as financially healthy) and also reduces the estimated overall error rate. Regarding the extensibility of the results, even though this work uses data from Brazilian companies only, the calculation of the financial ratios variables, as well as the inconsistencies, could be extended to most companies worldwide subject to governmental accounting regulations aligned with the International Financial Reporting Standards. Copyright © 2014 John Wiley & Sons, Ltd.     

Competition and diversification in public and private higher education

The development of mass higher education and growing competition between higher education institutions has given increasing visibility to the issue of diversification. This article analyses the issue of programme diversification, using a panel of 181 Portuguese higher education institutions over the period 1995 to 2007, by comparing the behaviour of public and private institutions. The results show that the legal status of institutions is the major determinant of programme diversification, as private institutions are far more specialized than their public counterparts. The study also evaluates the role of other institutional variables, such as the institution’s size, age, location, institutional mission and research intensity, to explain differences in the diversification behaviour of higher education institutions. The results provide important insights, as competition has been thought to improve the performance of higher education institutions.     

Long‐Term Impact of Minimum Wages on Workers’ Careers: Evidence from Two Decades of Longitudinal Linked Employer–Employee Data

We analyze the impact of high youth minimum wages, relying on two decades of linked employer–employee data and a major law change. Alternative treatment/control groups follow from two strands of the literature, one tracking low‐skilled workers employed before the law change, who are eligible for a large wage increase, and one tracking the employment of full cohorts, whether working or in school when the law changed. High minimum wages led to a short‐term wage gain, which faded over time. They did not jeopardize employment prospects. Changes in the hours worked by part‐time workers point to increased job attachment.     

Micro Foundations for Wage Flexibility: Wage Insurance at the Firm Level*

To what extent do firms insulate their workers' wages from fluctuations in product markets? Which firm and worker attributes are associated with wage flexibility at the micro level? We first rely on Guiso, Pistaferri and Schivardi (2005) to estimate dynamic models of sales and wages, finding that in Portugal, workers' wages respond to permanent shocks on firm performance, as opposed to transitory shocks. We then explore the factors associated with wage flexibility, finding that collective bargaining and minimum wages are associated with higher wage insurance by the firm, while the threat of firm bankruptcy reduces it. Managers receive less protection against permanent shocks than other workers.     

Survival of new firms in the Brazilian franchising segment: an empirical study

This paper investigates the survival patterns of Brazilian franchising firms for the period 1994–1999. First, we considered the (percentage) survival of newly created franchisors in the following years. Survival functions were obtained by means of the Kaplan–Meier estimator for the selected sectors and they indicated sharp declines in the survival rates over time but with differential patterns across sectors. Finally, an econometric analysis based on the Cox proportional hazard model considered the explanatory variables pertaining to size, age and support regarding the legal aspects, location choice and training. The evidence indicates that the supports provided by the franchisor have a positive impact on the probability of survival of new firms, whereas there is partial evidence favoring a positive effect of firm size on survival.     

Survey Into the Seafood Consumption Preferences and Patterns in the Portuguese Population: Education,Age, and Health Variability

A survey into the seafood consumption preferences and patterns in the Portuguese population was carried out. Consumers were asked to state their preferences toward different kinds of fish products, to indicate their consumption frequencies of a total of 23 products, to mention the average meal portion, and to inform about the usual culinary treatments applied to the raw products. It was observed that the sensory characteristics of each product and cultural habits seem to influence serving size. For horse mackerel and canned sardines, an inverse correlation between education level and consumption frequency was found. Moreover, the consumption frequency of soaked cod, the main salted and dried fish in the Portuguese market, decreased with higher education. Older consumers were much fonder of wild fish and much more unwilling to consume farmed fish than the younger ones. It was also found that obese people deviate from other weight groups in that their preferences and consumption quantities are displaced to foods other than seafood.     

Rural credit and agricultural supply in Brazil

The objective of this study is to determine the financing impact of total expenditure on the use of agriculture inputs (fertilizers, labor, and pesticides), and the output of cotton, rice, beans, corn, soybean, and wheat in Brazil. We study the period 1976–2005. The analysis is based on duality applied to the production theory. The output supplies and conditioned input demands are estimated from a translog multi‐output, multi‐input restricted profit function, where the total production credit is used as proxy of the total expenditure. Farmer expectations with respect to crop prices are incorporated to the estimation based on the quasi‐rational expectation model. The output and input responses to the total expenditure are positive and statistically significant except for cotton, wheat, fertilizer, and pesticides. The short‐run output supply response to own prices is inelastic, except for wheat, which presents elastic response to its price. Acreage has a positive impact on the output supply and it is influenced by land productivity. The main conclusion is that farmers face budget restrictions to purchase inputs, and a government credit program might increase the agricultural supply.