Healthcare and economic burden of adverse events among patients with chronic myelogenous leukemia treated with BCR-ABL1 tyrosine kinase inhibitors

Objectives: BCR-ABL1 tyrosine kinase inhibitors (TKIs) are established treatments for chronic myelogenous leukemia (CML); however, they are associated with infrequent, but clinically serious adverse events (AEs). The objective of this analysis was to assess healthcare resource utilization and costs associated with AEs, previously identified using the FDA Adverse Event Reporting System (FAERS) in another study, among TKI-treated patients.

Methods: Adult patients with ≥1 inpatient or ≥2 outpatient ICD-9-CM diagnosis codes for CML and ≥1 claim for a TKI treatment between January 1, 2006 and September 30, 2012 were identified from the Commercial and Medicare MarketScan databases. The first claim for a TKI was designated as the index event. Patients were required to have no TKI treatment during a 12-month baseline period. Healthcare resource utilization and costs associated with select AEs having the strongest association with TKI treatment (femoral arterial stenosis [FAS], peripheral arterial occlusive disease [PAOD], intermittent claudication, coronary artery stenosis [CAS], pericardial effusion, pleural effusion, malignant pleural effusion, conjunctival hemorrhage) were evaluated during a 12-month follow-up period.

Results: The study sample included 2,005 CML patients receiving TKI therapy (mean age?=?56 years; 56% male). Among all evaluated AEs, the highest mean inpatient healthcare costs were observed for FAS ($16,800 per patient) and PAOD ($14,263 per patient), which had total mean medical costs (inpatient?+?outpatient) of $17,015 and $15,154 per patient, respectively. Mean outpatient healthcare costs were highest for CAS ($1,861 per patient), followed by intermittent claudication ($947 per patient), PAOD ($891 per patient), and pleural effusion ($890 per patient). Total mean medical costs for fluid retention-related AEs, including pericardial effusion and pleural effusion, were $2,797 and $1,908 per patient, respectively.

Conclusions: The healthcare costs of AEs identified in the FAERS as having the strongest association with TKI treatment are substantial. Vascular stenosis-related AEs, including FAS and PAOD, have the highest cost burden.     

A Fuzzy Logic based Trend Impact Analysis method

All Trend Impact Analysis (TIA) algorithms in literature conduct the analysis based on direct estimates provided by experts for the probability of occurrence of an unprecedented event as an input to the algorithm. In this paper, we propose an advanced mechanism to generate more justifiable estimates to the probability of occurrence of an unprecedented event as a function of time with different degrees of severity using Fuzzy Logic. We postulate that in some cases it is better not to estimate the probability of occurrence of an unprecedented event directly; but rather estimate it indirectly via its attributes, using Fuzzy Logic. The core idea of the paper is to customize the generic process of reasoning with Fuzzy Logic by adding the additional step of attributes simulation, as unprecedented events do not occur all of a sudden but rather their occurrence is affected by change in the values of a set of attributes, especially when they reach certain threshold values.     

灾害事件、规模与企业慈善捐助:中国背景

近年来,针对灾害事件的企业慈善行为研究是企业社会责任研究的热点问题。文章主要探讨在中国背景下,不同来源国（地区）的企业针对灾害事件的慈善捐助在数量上有无差异,以及国内企业的慈善捐助数量是否受企业财务状况的约束。通过研究收集到的283家国内企业和428家外资企业在5·12汶川地震后的捐助数据,结果发现：（1）不同来源国（地区）的企业在5·12地震后的捐助水平并无明显差异;（2）国内企业的捐助数量主要受到企业规模而非企业利润（ROA）的影响。     

To go or stay home and watch: exploring the balance between motives and perceived constraints for major events: a case study of the 2008 Beijing Olympic Games

The current study offers insight into the role of motivation and constraints on behavioural intentions prior to a mega event. The Psychological Continuum Model framework was used to integrate motivation and leisure constraints theory to examine attraction towards the 2008 Olympic Games. Semi‐structured interviews (N = 47) and a questionnaire (N = 235) distributed in Australia and the USA were used to identify and measure three motivational themes: cultural learning, cultural experience and olympic event interest, and three perceived constraints: structural, interpersonal and intrapersonal. Structural Equation Modelling revealed that motives were positively related to behavioural intentions while constraints were negatively related. Analysis further revealed the interaction between motives and perceived constraints led to two different forms of behavioural intentions; intentions to travel and attend the event vs. stay home to watch the event on TV. Policy and marketing implications are discussed that illustrate the benefits of understanding both motives and perceived constraints for tourism travel. Copyright © 2008 John Wiley and Sons, Ltd.     

Relationship between incidence of fracture and health-related quality-of-life in metastatic breast cancer patients with bone metastases

Abstract

Objective

This retrospective observational study describes treatment patterns and longitudinal health-related quality-of-life (HRQoL) among metastatic breast cancer patients with bone metastasis from nine community oncology clinics.     

The Role of Life Experiences on Perceptions of Leisure During Adulthood: A Longitudinal Analysis

This study examined the life experiences of adults and their effect on perceptions of leisure. Data for this study came from A Study of Leisure during Adulthood (ASOLDA), a 10-year study of the values, attitudes, and perceived freedom in leisure of 84 adults. Individual growth curve modeling was used to explore patterns and change within leisure domains for the sample. Life structure predicted adults’ perceived freedom in leisure while life events were predictive of adults’ leisure attitudes. Data from interviews were used to supplement the survey data to provide a better understanding of the predictors of leisure perceptions in this study.     

Residents' Participation in Events,Events Image,and Destination Image: A Correspondence Analysis

The Algarve, the most renowned Portuguese destination, is usually associated with its main tourist product, sun and beach. In 2007, the Portuguese government launched a program of events called Allgarve, intending to reposition the destination image. Conceived from the tourists' perspective, the Allgarve program was not initially welcomed by residents. Based on data from 384 questionnaires applied to residents in the region, this study examines the dimensions of the Algarve image and the Allgarve image, and shows how participation in Allgarve events is affecting both. The conclusions from this study reinforce the relevance of residents' participation in events in supporting repositioning strategies of a destination image.     

A flexible model for actuarial risks under dependence

Methods for computing risk measures, such as stop-loss premiums, tacitly assume independence of the underlying individual risks. This can lead to huge errors even when only small dependencies occur. In the present paper, a general model is developed which covers what happens in practice in a realistic way. Moreover, it is also flexible, in the sense that it allows application in practice. Accurate and transparent approximations are presented, and the results obtained are illustrated through explicit examples.     

Operational risk,the legal system and governance indicators: a country-level analysis

A total of 4388 operational loss events recorded over three decades in 53 countries are analysed on a country level in terms of the size of the economy, the standard of living, the legal system, the regional factor and six governance indicators. The results show that the average severity of the operational losses incurred by firms located in a particular country is positively related to the size of the economy and the standard of living. The results also show that loss of severity is negatively related to governance indicators, particularly regulatory quality. The frequency of operational loss events is also positively related to the size of the economy.     

Competitive balance versus competitive intensity before a match: is one of these two concepts more relevant in explaining attendance? The case of the French football Ligue 1 over the period 2008–2011

The aim of this article is to investigate the determinants of attendance at French football Ligue 1 matches over the period 2008–2011 with an emphasis on examining the effects of both competitive balance and intensity before a match. Competitive balance is measured by the point difference between the two teams concerned by a match in the championship. Competitive intensity is measured by the point difference for the home team in relation to ranks with sporting stakes. Results show that competitive balance has an insignificant impact whereas competitive intensity has a significantly positive impact. Implications are drawn.