The economic burden of depression among adults with rheumatoid arthritis in the United States

Aims: Depression is the most frequent comorbidity reported among patients with rheumatoid arthritis (RA). Comorbid depression negatively impacts RA patients’ health-related quality-of-life, physical function, mental function, mortality, and experience of pain and symptom severity. The objective of this study was to assess healthcare utilization, expenditures, and work productivity among patients with RA with or without depression.

Materials and methods: Data from adult patients who had at least two visits each related to RA and depression over a 1-year period were extracted from the Truven Health MarketScan research databases. Outcomes comprised healthcare resource utilization, work productivity loss, and direct healthcare costs comparing patients with RA with depression (n?=?3,478) vs patients with RA without depression (n?=?43,222).

Results: Patients with RA and depression had a significantly greater relative risk of hospitalization and number of all-cause and RA-related hospitalizations, utilization of emergency services, days spent in the hospital, physician visits, and RA-related surgeries compared with RA patients without depression. Patients with RA and depression had a higher risk of and experienced more events and days of short-term disability compared with patients without depression. The incremental adjusted annual all-cause and RA-related direct costs were $8,488 (95% CI = $6,793–$10,223) and $578 (95% CI = –$98–$1,243), respectively, when comparing patients with RA and depression vs RA only.

Limitations: The current analysis is subject to the known limitations of retrospective studies based on administrative claims data.

Conclusions: This study suggested increased healthcare utilization, work productivity loss, and economic burden among RA patients due to comorbid depression. These findings emphasize the importance of managing depression and including depression as a factor when devising treatment algorithms for patients with RA.     

Using Industry-Sponsored Game Nights to Educate About Risk and Insurance

As educators in the field of risk management and insurance, we see know- ledge of risk management and insurance as a core business function. However, some colleagues and students see insurance as cold-call sales or companies with a lot of money that continue to raise their prices. So we have to find ways to make our public aware of the usefulness of risk management and insurance in the business world and in private life and of the opportunities that having such knowledge presents to all business majors and business people. One method that is beginning to show dramatic improvements in at least our students' perceptions of the field and the major involves industry-sponsored game nights. While not an academic endeavor nor strictly risk management education, we believe the idea provides a useful tool for opening students' eyes to the need for knowledge of risk management and insurance and of the opportunities that are available in the insurance industry and its related fields. This article discusses the history of such an event at Appalachian State Univer- sity, the current status of the North Carolina Surplus Lines Association (NCSLA) event, and the benefits of the event.     

State Trading Enterprises as an Impediment to Improved Market Access: The Case of the Korean Rice Market

The trade and welfare effects of tariffs are well known. Less well known, and more difficult to analyze, are the economic effects of state trading enterprises (STEs). Despite STEs in importing countries having the potential to limit market access, they are no longer on the agriculture agenda in the Doha Round Negotiations in the WTO, because some Members have asserted that importing STEs do not distort international trade. We evaluate this assertion through the use of a theoretical model of an STE, which is calibrated to data for the Korean rice market. We show that this STE does distort international trade by restricting market access relative to a Cournot benchmark, and that it affects the domestic and international distribution of social welfare. This finding permits the conclusion that an important opportunity is being missed in the negotiations to improve market access, because importing STEs are not on the agenda.     

Forecasting Emerging Market Exchange Rates from Foreign Equity Options

The use of derivatives to infer future exchange rates has long been a subject of interest in the international finance literature. With the recent currency crises in Mexico, Southeast Asia, and Brazil, work on exchange rate expectations in emerging markets is of particular interest. For some emerging markets, foreign equity options are the only liquid exchange‐traded derivatives with currency information embedded in their prices. Given that emerging markets sometimes undergo currency realignment with discrete jumps in their exchange rate, estimation of risk‐neutral probability density functions from foreign equity option data provides valuable evidence concerning market expectations. To illustrate the use of foreign equity options in estimating market beliefs, we consider Telmex options around the 1994 peso devaluation and find evidence that markets anticipated the change in the Mexican government's foreign exchange policy.     

Negotiating the Evolution of the Hr Function: Practical Advice From the Health Care Sector

This paper has two aims. First, to consider explanations for the apparent gap between the paradigm of strategic human resource management on the one hand and actual HR practice on the other. Second, to generate practical advice for senior HR specialists who are aspriring to develop a strategic role for their function. the research underpinning these findings was based on case studies in three hospitals in Adelaide and a comparison of the findings with the situation at Leicester General NHS Trust where the first named author of this article was the HR director and a senior board member. the analysis reveals that specific features of each organisation's history, current structure and management, shape powerfully the nature of the HR function. Moreover, the local shaping factors define the degrees of freedom open to the HR function, so much so, that the notion that it can choose its organisational stance is here challenged.     

Do Unions Affect Employer Compliance with the Law? New Zealand Evidence for Age Discrimination

Over the last thirty years, collective rights to organize into unions, bargain collectively and strike have been weakened in both New Zealand and the UK. At the same time, individual rights to due process and to protection from discriminatory or unjust management decisions have been strengthened, leading some to conclude that collective and individual rights are unrelated, incompatible or mutually exclusive. On the contrary, we use evidence of employer compliance with anti‐age provisions in the New Zealand Human Rights Act to show that the two sets of rights can be highly complementary: the presence of unions strengthens individual protection from discriminatory treatment.     

Unemployment,marginalisation and survival in Greater East London

This article draws on selected findings of one of a series of surveys conducted by the authors in the Eastern Cape province, dealing broadly with labour market issues. Particular attention is accorded to levels of unemployment, the extent of migrancy, the operation of extended networks of support, and survival strategies. This is followed by a brief look at perceptions of crime, and the extent to which crime is seen as an effective survival mechanism by the most marginalised. It is concluded that economic reconstruction in the province should take account of certain prevailing realities, including the operation of extended networks of support and the relative lack of mobility of the most marginalised, the limited capacity of the informal sector to absorb further numbers of the structurally unemployed, and the relative propensity of the most marginalised to engage in crime as a survival strategy.