The foregone risk premium: a communicative and practical method for the evaluation of risk-return profiles in agriculture

Risk considerations have become increasingly important in nowadays agriculture, due to a variety of reasons. Surprisingly, the practice of formalized risk management is not widespread despite the huge amount of scientific literature on this topic. This discrepancy between risk science and extension is described by many authors. This paper presents a communicative method, rooted in financial economics, to evaluate risk-return profiles in a way that is communicative for individual farmers. The method is derived from the modern portfolio theory, in which individual assets are implicitly compared to the risk-return trade-off of that asset with the highest Sharpe ratio. We use this idea to compare individual risk-return profiles to a particular benchmark. The method can be used for evaluating different risk-return profiles of different farms, different risk management instruments and different production systems. To illustrate the communicative nature of our method, it is applied to evaluate risk-return profiles of conventional versus organic cropping systems.Risk and Uncertainty,

Evaluating preference weights for the Asthma Symptom Utility Index (ASUI) across countries

BACKGROUND: The Asthma Symptom Utility Index (ASUI) is a preference-based outcome measure used in US clinical trials and cost-effectiveness studies for asthma. This study evaluated ASUI preference weights in Europe to determine whether the multi-attribute utility function, based on preferences from a US population, is generalizable across countries. METHODS: Data were collected from ninety asthma patients from Italy, France, and the United Kingdom using the Asthma Control Questionnaire, the Asthma Quality of Life Questionnaire, and the ASUI. Subjects rated their preferences for 10 asthma health states using a visual analogue scale (VAS) and a standard gamble (SG) interview. RESULTS: All multi-symptom states showed statistically significant differences (p < 0.001) between countries in mean VAS scores. Mean SG utility scores between the US and France and the US and Italy demonstrated statistically significant differences (p < 0.001) for three states: severe wheeze; moderate cough and wheeze; and moderate cough and dyspnea. Because of these differences, the multi-attribute utility functions derived within countries were somewhat different. Despite these differences, country-specific algorithms captured a similar rank ordering of patients by disease severity, were strongly correlated (r = 0.971 to 0.995), and demonstrated similar relationships with symptom and AQLQ scores. CONCLUSION: Results of this study suggest that the ASUI may be a complementary patient-reported outcome for clinical studies and may be useful for applications in cost-effectiveness studies comparing different asthma treatments

A US Time and Motion Pilot Study of Nebulized COPD Therapy in an Inpatient and a Long-Term Care Setting.

INTRODUCTION: There is a lack of quantitative data on healthcare professionals (HCPs) time dedicated to nebulized chronic obstructive pulmonary disease (COPD) therapy in inpatient and long-term care (LTC) settings. Using time and motion methodology, we quantified HCP time and opportunity costs (time and materials) associated with nebulized COPD therapy in inpatient and LTC settings and estimated efficiencies of changing to once-daily therapy. METHODS: A case report form was built to reflect local nebulization workflow. Primary outcomes were mean active HCP time per predefined task and mean total active HCP time associated with short-acting beta agonist (SABA) and SABA/short-acting muscarinic antagonist (SAMA) combination nebulization processes. RESULTS: Twenty observations occurred within each setting. Inpatient observations included three SABA and 17 SABA/SAMA (from 18 different patients), and LTC observations included five SABA and 15 SABA/SAMA (from eight different patients). Mean total process time was 16.12&nbsp;min in the inpatient setting (95% CI 14.48-17.76) and 21.0&nbsp;min in the LTC setting (95% CI 18.8-23.2), with the actual nebulization comprising over 50% of process time for both. In LTC, CIs suggest a difference by cognitive impairment status: mean 24.1&nbsp;min (95% CI 21.3-26.9) if cognitively impaired versus 19.0&nbsp;min (95% CI 16.1-21.8) if not. In the inpatient setting, the estimated process time/admission was 7.8&nbsp;h; a once-daily nebulized drug would require only 2.3&nbsp;h. In LTC, the estimated process time was 32.1&nbsp;h/month; a once-daily nebulized drug would require only 13.7&nbsp;h/month. Estimated nebulization cost was $243/admission for current versus$72 for once-daily dosing in inpatient, and $1177/month versus$504 in LTC. CONCLUSIONS: The nebulization process for COPD patients in both inpatient and LTC settings consumes considerable HCP time. A switch from SABA or SABA/SAMA to a drug with a once-daily nebulization frequency could generate substantial time savings depending on the setting and site characteristics

The foregone risk premium: a communicative and practical method for the evaluation of risk-return profiles in agriculture

Risk considerations have become increasingly important in nowadays agriculture, due to a variety of reasons. Surprisingly, the practice of formalized risk management is not widespread despite the huge amount of scientific literature on this topic. This discrepancy between risk science and extension is described by many authors. This paper presents a communicative method, rooted in financial economics, to evaluate risk-return profiles in a way that is communicative for individual farmers. The method is derived from the modern portfolio theory, in which individual assets are implicitly compared to the risk-return trade-off of that asset with the highest Sharpe ratio. We use this idea to compare individual risk-return profiles to a particular benchmark. The method can be used for evaluating different risk-return profiles of different farms, different risk management instruments and different production systems. To illustrate the communicative nature of our method, it is applied to evaluate risk-return profiles of conventional versus organic cropping systems

VenSpec-H: Introduction to Instrument and Consortium

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