Sovereign credit ratings

This paper describes sovereign credit ratings in emerging markets both for a specific year and over time, using quantitative explanatory variables. It turns out that rating adjustments have been worse than what economic fundamentals justify for some countries and also more frequently altered, questioning the long-term properties of sovereign ratings. The results support the view that rating changes during the Asian crisis have been procyclical rather than counter-cyclical. Omitted variables, such as soundness of banking sector, social and political factors, can be one reason for this misalignment but cannot explain all. --Dynamic model,panel data,sovereign credit ratings,emerging markets

Error correction in DHSY

In this note, we consider the contradiction between the fact that the best fit for the UK consumption data in Davidson et al. (1978) is obtained using an equation with an intercept but without an error correction term, whereas the equation with error correction and without the intercept has better post-sample forecasting properties than the former equation. This contradiction is explained and the two equations reconciled in a nonlinear framework by applying a smooth transition regression model to the data.consumption equation; model misspecification testing; nonlinearity; smooth transition regression

Efficacy of baby-CIMT: study protocol for a randomised controlled trial on infants below age 12 months, with clinical signs of unilateral CP

BACKGROUND: Infants with unilateral brain lesions are at high risk of developing unilateral cerebral palsy (CP). Given the great plasticity of the young brain, possible interventions for infants at risk of unilateral CP deserve exploration. Constraint-induced movement therapy (CIMT) is known to be effective for older children with unilateral CP but is not systematically used for infants. The development of CIMT for infants (baby-CIMT) is described here, as is the methodology of an RCT comparing the effects on manual ability development of baby-CIMT versus baby-massage. The main hypothesis is that infants receiving baby-CIMT will develop manual ability in the involved hand faster than will infants receiving baby-massage in the first year of life. METHOD AND DESIGN: The study will be a randomised, controlled, prospective parallel-group trial. Invited infants will be to be randomised to either the baby-CIMT or the baby-massage group if they: 1) are at risk of developing unilateral CP due to a known neonatal event affecting the brain or 2) have been referred to Astrid Lindgren Children’s Hospital due to asymmetric hand function. The inclusion criteria are age 3–8 months and established asymmetric hand use. Infants in both groups will receive two 6-weeks training periods separated by a 6-week pause, for 12 weeks in total of treatment. The primary outcome measure will be the new Hand Assessment for Infants (HAI) for evaluating manual ability. In addition, the Parenting Sense of Competence scale and Alberta Infant Motor Scale will be used. Clinical neuroimaging will be utilized to characterise the brain lesion type. To compare outcomes between treatment groups generalised linear models will be used. DISCUSSION: The model of early intensive intervention for hand function, baby-CIMT evaluated by the Hand Assessment for Infants (HAI) will have the potential to significantly increase our understanding of how early intervention of upper limb function in infants at risk of developing unilateral CP can be performed and measured. TRIAL REGISTRATION: SFO-V4072/2012, 05/22/201

Health utilities of type 2 diabetes-related complications: a cross-sectional study in sweden.

This study estimates health utilities (HU) in Sweden for a range of type 2 diabetes-related complications using EQ-5D and two alternative tariffs (UK and Swedish) from 1757 patients with type 2 diabetes from the Swedish National Diabetes Register (NDR). Ordinary least squares were used for statistical analysis. Lower HU was found for female gender, younger age at diagnosis, higher BMI, and history of complications. Microvascular and macrovascular complications had the most negative effect on HU among women and men, respectively. The greatest decline in HU was associated with kidney disorders (-0.114) using the UK tariff and stroke (-0.059) using the Swedish tariff. Multiple stroke and non-acute ischaemic heart disease had higher negative effect than a single event. With the UK tariff, each year elapsed since the last microvascular/macrovascular complication was associated with 0.013 and 0.007 units higher HU, respectively. We found important heterogeneities in effects of complications on HU in terms of gender, multiple event, and time. The Swedish tariff gave smaller estimates and so may result in less cost-effective interventions than the UK tariff. These results suggest that incorporating subgroup-specific HU in cost-utility analyses might provide more insight for informed decision-making

Migraine with aura and risk of cardiovascular and all cause mortality in men and women: prospective cohort study

Objective To estimate whether migraine in mid-life is associated with mortality from cardiovascular disease, other causes, and all causes

Age at diagnosis of type 2 diabetes mellitus and associations with cardiovascular and mortality risks findings from the Swedish National Diabetes Registry

Background: Risk of cardiovascular disease (CVD) and mortality for patients with versus without type 2 diabetes mellitus (T2DM) appears to vary by the age at T2DM diagnosis, but few population studies have analyzed mortality and CVD outcomes associations across the full age range. Methods: With use of the Swedish National Diabetes Registry, everyone with T2DM registered in the Registry between 1998 and 2012 was included. Controls were randomly selected from the general population matched for age, sex, and county. The analysis cohort comprised 318083 patients with T2DM matched with just <1.6 million controls. Participants were followed from 1998 to 2013 for CVD outcomes and to 2014 for mortality. Outcomes of interest were total mortality, cardiovascular mortality, noncardiovascular mortality, coronary heart disease, acute myocardial infarction, stroke, heart failure, and atrial fibrillation. We also examined life expectancy by age at diagnosis. We conducted the primary analyses using Cox proportional hazards models in those with no previous CVD and repeated the work in the entire cohort. Results: Over a median follow-up period of 5.63 years, patients with T2DM diagnosed at ≤40 years had the highest excess risk for most outcomes relative to controls with adjusted hazard ratio (95% CI) of 2.05 (1.81–2.33) for total mortality, 2.72 (2.13–3.48) for cardiovascularrelated mortality, 1.95 (1.68–2.25) for noncardiovascular mortality, 4.77 (3.86–5.89) for heart failure, and 4.33 (3.82–4.91) for coronary heart disease. All risks attenuated progressively with each increasing decade at diagnostic age; by the time T2DM was diagnosed at >80 years, the adjusted hazard ratios for CVD and non-CVD mortality were <1, with excess risks for other CVD outcomes substantially attenuated. Moreover, survival in those diagnosed beyond 80 was the same as controls, whereas it was more than a decade less when T2DM was diagnosed in adolescence. Finally, hazard ratios for most outcomes were numerically greater in younger women with T2DM. Conclusions: Age at diagnosis of T2DM is prognostically important for survival and cardiovascular risks, with implications for determining the timing and intensity of risk factor interventions for clinical decision making and for guideline-directed care. These observations amplify support for preventing/delaying T2DM onset in younger individuals

Range of risk factor levels: control, mortality and cardiovascular outcomes in type 1 diabetes mellitus

Background—Individuals with type 1 diabetes have high risk of cardiovascular complications, but it is unknown to what extent fulfilling all cardiovascular treatment goals is associated with residual risk of mortality and cardiovascular outcomes in type 1 diabetes compared with the general population. Methods—We included all patients with type 1 diabetes aged >=18 years registered in the Swedish National Diabetes Register from January 1, 1998 - December 31, 2014, in all 33,333 patients, each matched for age and sex with 5 controls without diabetes randomly selected from the population. Patients with type 1 diabetes were categorized according to number of risk factors not at target: glycated hemoglobin, blood pressure, albuminuria, smoking and LDL cholesterol. Risk of all-cause mortality, acute myocardial infarction (AMI), heart failure hospitalization (HF) and stroke was examined in relation to the number of risk factors at target.Results—The mean follow-up was 10.4 years in the diabetes group. Overall, 2074 of 33,333 patients with diabetes and 4141 of 166,529 controls died. Risk for all outcomes increased stepwise for each additional risk factor not at target. Adjusted hazard ratios (HR) for patients achieving all risk factor targets compared with controls were 1.31 (95% CI 0.93-1.85) for all-cause mortality; 1.82 (95% CI 1.15-2.88) for AMI; 1.97 (95% CI 1.04-3.73) for HF; and 1.17 (95% CI 0.51-2.68) for stroke. HR for patients versus controls with none of the risk factors meeting target was 7.33 (95% CI 5.08-10.57) for all-cause mortality; 12.34 (95% CI 7.91-19.48) for AMI: 15.09 (95% CI 9.87-23.09) for HF; and 12.02 (95% CI 7.66-18.85) for stroke.Conclusions—A steep graded association exists between decreasing number of CV risk factors at target and major adverse CV outcomes among patients with T1DM. However, risks for all outcomes were numerically higher for T1DM patients compared with controls, even when all risk factors were at target, with risk for AMI and HF statistically significantly so