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.     

The role of the entrepreneurial encounter in the emergence of opportunities: Vallée’s Dallas Buyers Club

ABSTRACT

This paper aims to explore the conceptual potential of the Deleuzian notion of the encounter in order to better understand the genealogy of opportunities. We adopt a processual perspective of opportunities. In order to translate this notion to the domain of entrepreneurship, we analysed and interpreted Jean-Marc Vallée’s Dallas Buyers Club. This film follows the creation of the first club in the United States that illegally allowed HIV-positive people to supply themselves with foreign antiretroviral drugs from Mexico or Japan. The article highlights encounters in this process that disturb the entrepreneur’s belief systems and allow him or her to be open to potential opportunity. It finally explores how the encounter may improve our understanding of the political becoming of opportunities within the entrepreneurial process.     

Unit roots and infrequent large shocks: new international evidence on output

The nature and magnitude of the economic shocks that have affected the per capita GDP of 16 OECD countries are analyzed over a long period using the outlier method. Strong proof of infrequent large permanent and transitory shocks were found, essentially resulting from the two major wars in the twentieth century, the recession in the 1920s, the Great Depression, among others. We also examine the nature of the output trend by combining different tests of non-stationarity on different GDP series corrected by the outliers detected. It is shown that the per capita GDP series cannot reject the unit root hypothesis in 13 of the 16 countries examined. No conclusion could be drawn for the other countries because the test results were contradictory.     

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.     

Optimal Patent Protection in a Two-Sector Economy

This article addresses the issue of optimal patent protection in an economy with a downstream and an upstream sector. The key insight is that higher patent protection in the downstream sector raises the incentives of agents to do R&D in that sector but discourages innovation in the upstream sector because of a market size effect. Hence, higher patent protection in the upstream sector accelerates growth whereas higher patent protection in the downstream sector slows it down. If some innovation is socially desirable, optimal patent protection is necessarily higher in the upstream than in the downstream sector.     

Designing Optimal Crop Revenue Insurance

When the indemnity schedule is contingent on the farmer's price and individual yield, an optimal crop revenue insurance contract depends only on the farmer's gross revenue. However, this design is not efficient if, as is the case with available contracts, the coverage function is based on imperfect estimators of individual yield and/or price. The producer's degree of prudence and the extent of basis risks have important influences on the optimal indemnity schedule. In this broader context, optimal protection is not provided by available U.S. crop insurance contracts and may include combinations of revenue insurance, yield insurance, futures, and options contracts.     

Construct measurement in strategic management research: illusion or reality?

Strategic management research has been characterized as placing less emphasis on construct measurement than other management subfields. In this work, we document the state of the art of measurement in strategic management research, and discuss the implications for interpreting the results of research in this field. To assess the breadth of measurement issues in the discipline, we conducted a content analysis of empirical strategic management articles published in leading journals in the period of 1998–2000. We found that few studies discuss reliability and validity issues, and empirical research in the field commonly relies on single‐indicator measures. Additionally, studies rarely address the problems of attenuation due to measurement error. We close with a discussion of the implications for future research and for interpreting prior work in strategic management. Copyright © 2004 John Wiley & Sons, Ltd.