Intended and unintended consequences: Changes in opioid prescribing practices following two policies in North Carolina, 2012–2018 – A controlled interrupted time series analysis

Poster presented at the 38th International Conference on Pharmacoepidemiology & Therapeutic Risk Management. Objective: To understand the extent to which unintended prescribing consequences followed implementation of two statewide opioid prescribing policies among privately insured, opioid-naïve individuals in North Carolina between 2012 and 2018

Conceptualising the role of evaluation systems in markets: the case of dominant evaluators

Evaluation is usually an internalized process that is intrinsic to the activities of market actors. Producers evaluate what goods to produce, intermediaries such as distributors and retailers evaluate what goods to promote and stock, while consumers evaluate what goods to buy. In some cases, however, a secondary evaluation market controlled by an external evaluator can emerge as a de-facto gatekeeper exerting a powerful influence over the activities of market actors in the primary market. This article develops a conceptual model of external evaluation that describes: (i) the factors common to primary markets that are dominated by evaluation markets; (ii) the characteristics common to dominant evaluators and their evaluation markets; and (iii) the dynamic processes through which an evaluator can become entrenched in a position of dominance over other market actors. This conceptual model is illustrated through examples drawn from three dominant evaluators and the markets they dominate

Testing the methodology for a dosimetric end-to-end audit of IMRT/VMAT: results of IAEA multicentre and national studies

Introduction: Within an International Atomic Energy Agency (IAEA) co-ordinated research project (CRP), a remote end-to-end dosimetric quality audit for intensity modulated radiation therapy (IMRT)/ volumetric arc therapy (VMAT) was developed to verify the radiotherapy chain including imaging, treatment planning and dose delivery. The methodology as well as the results obtained in a multicentre pilot study and national trial runs conducted in close cooperation with dosimetry audit networks (DANs) of IAEA Member States are presented. Material and methods: A solid polystyrene phantom containing a dosimetry insert with an irregular solid water planning target volume (PTV) and organ at risk (OAR) was designed for this audit. The insert can be preloaded with radiochromic film and four thermoluminescent dosimeters (TLDs). For the audit, radiotherapy centres were asked to scan the phantom, contour the structures, create an IMRT/VMAT treatment plan and irradiate the phantom. The dose prescription was to deliver 4 Gy to the PTV in two fractions and to limit the OAR dose to a maximum of 2.8 Gy. The TLD measured doses and film measured dose distributions were compared with the TPS calculations. Results: Sixteen hospitals from 13 countries and 64 hospitals from 6 countries participated in the multicenter pilot study and in the national runs, respectively. The TLD results for the PTV were all within +/- 5% acceptance limit for the multicentre pilot study, whereas for national runs, 17 participants failed to meet this criterion. All measured doses in the OAR were below the treatment planning constraint. The film analysis identified seven plans in national runs below the 90% passing rate gamma criteria. Conclusion: The results proved that the methodology of the IMRT/VMAT dosimetric end-to-end audit was feasible for its intended purpose, i.e., the phantom design and materials were suitable; the phantom was easy to use and it was robust enough for shipment. Most importantly the audit methodology was capable of identifying suboptimal IMRT/VMAT delivery

Consumer advocacy for luxury brands

© 2018 This paper explores consumer advocacy for luxury brands in relation to brand satisfaction, brand loyalty and luxury brand attachment. Data were collected from an online consumer panel (n = 393) in Australia and were analysed through structural equation modelling. Luxury brand attachment has been found to have a stronger effect on consumer advocacy than that of brand satisfaction and brand loyalty. In addition to the moderating role of brand loyalty, luxury consumers’ dilemma with consumer advocacy has been discussed in this paper. These findings provide insight into the consumer advocacy for luxury branding academics and practitioners

Social Jetlag: Misalignment of Biological and Social Time

Humans show large differences in the preferred timing of their sleep and activity. This so-called “chronotype” is largely regulated by the circadian clock. Both genetic variations in clock genes and environmental influences contribute to the distribution of chronotypes in a given population, ranging from extreme early types to extreme late types with the majority falling between these extremes. Social (e.g., school and work) schedules interfere considerably with individual sleep preferences in the majority of the population. Late chronotypes show the largest differences in sleep timing between work and free days leading to a considerable sleep debt on work days, for which they compensate on free days. The discrepancy between work and free days, between social and biological time, can be described as ‘social jetlag.’ Here, we explore how sleep quality and psychological wellbeing are associated with individual chronotype and/or social jetlag. A total of 501 volunteers filled out the Munich ChronoType Questionnaire (MCTQ) as well as additional questionnaires on: (i) sleep quality (SF-A), (ii) current psychological wellbeing (Basler Befindlichkeitsbogen), (iii) retrospective psychological wellbeing over the past week (POMS), and (iv) consumption of stimulants (e.g., caffeine, nicotine, and alcohol). Associations of chronotype, wellbeing, and stimulant consumption are strongest in teenagers and young adults up to age 25 yrs. The most striking correlation exists between chronotype and smoking, which is significantly higher in late chronotypes of all ages (except for those in retirement). We show these correlations are most probably a consequence of social jetlag, i.e., the discrepancies between social and biological timing rather than a simple association to different chronotypes. Our results strongly suggest that work (and school) schedules should be adapted to chronotype whenever possible.