Cultural Values: Can They Explain Differences in Health Utilities between Countries?

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The Better than Dead Method: Feasibility and Interpretation of a Valuation Study

Background Traditionally, the valuation of health states worse than being dead suffers from two problems: [1] the use of different elicitation methods for positive and negative values, necessitating arbitrary transformations to map negative to positive values; and [2] the inability to quantify that values are time dependent. The Better than Dead (BTD) method is a health-state valuation method where states with a certain duration are compared with being dead. It has the potential to overcome these problems. Objectives To test the feasibility of the BTD method to estimate values for the EQ-5D system. Methods A representative sample of 291 Dutch respondents (aged 18-45 years) was recruited. In a web-based questionnaire, preferences were elicited for a selection of 50 different health states with six durations between 1 and 40 years. Random-effects models were used to estimate the effects of socio-demographic and experimental variables, and to estimate values for the EQ-5D. Test-retest reliability was assessed in 41 respondents. Results Important determinants for BTD were a religious life stance [odds ratio 4.09 (2.00-8.36)] and the educational level. The fastest respondents more often preferred health-state scenarios to being dead and had lower test-retest reliability (0.45 versus 0.77 and 0.84 for fast, medium and slow response times, respectively). The results showed a small number of so-called maximal endurable time states. Conclusion Valuating health states using the BTD method is feasible and reliable. Further research should explore how the experimental setting modifies how values depend on time

Mateship and Money-Making: Shearing in Twentieth Century Australia

After the turmoil of the 1890s shearing contractors eliminated some of the frustration from shearers recruitment. At the same time closer settlement concentrated more sheep in small flocks in farming regions, replacing the huge leasehold pastoral empires which were at the cutting edge of wool expansion in the nineteenth century. Meanwhile the AWU succeeded in getting an award for the pastoral industry under the new arbitration legislation in 1907. Cultural and administrative influences, therefore, eased some of the bitter enmity which had made the annual shearing so unstable. Not all was plain sailing. A pattern of militancy re-emerged during World War I. Shearing shed unrest persisted throughout the interwar period and during World War II. In the 1930s a rival union with communist connections, the PWIU, was a major disruptive influence. Militancy was a factor in a major shearing strike in 1956, when the boom conditions of the early-1950s were beginning to fade. The economic system did not have satisfactory mechanisms to cope. Unionised shearers continued to be locked in a psyche of confrontation as wool profits eroded further in the 1970s. This ultimately led to the wide comb dispute, which occurred as wider pressures changed an economic order which had not been seriously challenged since Federation, and which the AWU had been instrumental in shaping. Shearing was always identified with bushworker ‘mateship’, but its larrikinism and irreverence to authority also fostered individualism, and an aggressive ‘moneymaking’ competitive culture. Early in the century, when old blade shearers resented the aggressive pursuit of tallies by fast men engaged by shearing contractors, tensions boiled over. While militants in the 1930s steered money-makers into collectivist versions of mateship, in the farming regions the culture of self-improvement drew others towards the shearing competitions taking root around agricultural show days. Others formed their own contracting firms and had no interest in confrontation with graziers. Late in the century New Zealanders arrived with combs an inch wider than those that had been standard for 70 years. It was the catalyst for the assertion of meritocracy over democracy, which had ruled since Federation

On Monoids Related to Braid Groups and Transformation Semigroups

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Advancements in natural products chemistry : chemical constituents of Aplysilla pallida, Aplysilla rosea, Aplysilla var. sulphurea, Orthoscutilla maculata, and approaches to the synthesis of aplysulphurin

OBJECTIVES: Both stressors and stress vulnerability factors together with immune and hypothalamus-pituitary-adrenal (HPA) axis activity components have been considered to contribute to disease fluctuations of chronic inflammatory diseases, such as rheumatoid arthritis (RA). The aim of the present study was to investigate whether daily stressors and worrying as stress vulnerability factor as well as immune and HPA axis activity markers predict short-term disease activity and symptom fluctuations in patients with RA. METHODS: In a prospective design, daily stressors, worrying, HPA axis (cortisol) and immune system (interleukin (IL)-1beta, IL-6, IL-8, interferon (IFN)-gamma, tumour necrosis factor alpha) markers, clinical and self-reported disease activity (disease activity score in 28 joints, RA disease activity index), and physical symptoms of pain and fatigue were monitored monthly during 6 months in 80 RA patients. RESULTS: Multilevel modelling indicated that daily stressors predicted increased fatigue in the next month and that worrying predicted increased self-reported disease activity, swollen joint count and pain in the next month. In addition, specific cytokines of IL-1beta and IFN-gamma predicted increased fatigue 1 month later. Overall, relationships remained relatively unchanged after controlling for medication use, disease duration and demographic variables. No evidence was found for immune and HPA axis activity markers as mediators of the stress-disease relationship. CONCLUSIONS: Daily stressors and the stress-vulnerability factor worrying predict indicators of the short-term course of RA disease activity and fatigue and pain, while specific cytokines predict short-term fluctuations of fatigue. These stress-related variables and immune markers seem to affect different aspects of disease activity or symptom fluctuations independently in RA

The validity of basic assumptions underlying models for time-limit tests: design and analysis of speed-accuracy trade-off experiments

Contains fulltext : mmubn000001_248391208.pdf (publisher's version ) (Open Access)Promotores : E. Roskam (†) en J. Ellis, [T. Bezembinder, plaatsvervangend Promotor]101 p

Benchmarking European rail freight transport companies.

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Updating meta-analyses leads to larger type I errors than publication bias.

Item does not contain fulltextOBJECTIVE: To estimate the extent to which the practice of periodically updating meta-analyses causes inflation of the type I error and then to compare the estimate with the inflation caused by publication bias. We also present a simple method to adjust for the inflation associated with updating meta-analyses. STUDY DESIGN AND SETTING: Simulations were used to estimate the error rates. RESULTS: In general, updating meta-analyses caused 2- to 5-fold inflation of the type I error rates, which exceeded the inflation caused by publication bias. As a rule of thumb, the results of a meta-analysis are robust up to 5, 10, 15, or 22 updates, if the P-value multiplied by 4, 6, 8, or 10 remains below the desired significance level. CONCLUSION: Meta-analyses are likely to be updated until a clear conclusion is reached. Therefore, it is important to take the inflation of the error rate into account to interpret the results correctly

Response to letter. A treatment should be evaluated by small trials [letter to the editor]

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