Socially Responsible Investment (SRI) in Relation to Personality Traits

Purpose: The aim of this study is to examine the impact of intellectual capital (human capital, structural capital, and employed capital) on the financial performance of listed insurance companies in the Amman Stock Exchange   Theoretical framework: Intellectual capital has become increasingly important in generating value for companies, and many researchers have linked it to corporate financial performance and strategic competitive advantage.   Design/methodology/approach: The study population consist of 21 insurance companies listed on the Amman Stock Exchange in Jordan during the period of 2011-2020. Intellectual capital was measured using the value added intellectual coefficient model (Pulic, 2000), and its impact on financial performance was analyzed using published financial statements of the insurance companies.   Findings:  The results of the study found a statistically significant positive effect of human and employed capital on financial performance as measured by the rate of return on assets and return on equity. Furthermore, the study revealed a significant positive effect of intellectual capital, specifically human capital, on financial performance measured by market value (Tobin's Q).   Research, Practical & Social implications: The study suggests that insurance companies should treat intellectual capital as a strategic resource and monitor and invest in it periodically for continuous development. The study suggests building a positive organizational culture that supports intellectual capital is recommended   Originality/value:  This study contributes to the understanding of the relationship between intellectual capital and financial performance for the first time in the insurance industry in Amman Stock Exchange. The findings highlight the importance of managing and investing in intellectual capital as a strategic resource to enhance financial performance

CHARACTERIZING MEDICATION ADHERENCE TO AN ORAL GLUCOSE LOWERING DRUG, METFORMIN USING GROUP BASED TRAJECTORY MODELS

Background Medication non-adherence is a major contributor to suboptimal control of chronic diseases. Its consequences include inferior clinical outcomes as well as unnecessary health care costs. Group based trajectory models (GBTM), a type of finite mixture model, can be used to identify distinct trajectories of medication adherence among the patient population. It models adherence as a longitudinal parameter. Objective To characterize patterns of medication adherence among adult patients in the first year of initiating metformin using group based trajectory models, compared to the traditional summary measure of proportion of days covered. Methods We identified patients who initiated metformin, an oral glucose lowering drug, between 1st January to 31st December, 2011 from pharmacy prescription claims in Truven MarketScan Commercial Claims and Encounter database and followed them for a period of 360 days. We evaluated the number of days covered by metformin in 12 30 day periods and generated 12 monthly indicators to indicate whether that month was fully covered (defined as 24 or more days out of the 30 days). We modeled trajectories using group based trajectory models (2 to 6 groups) using these monthly indicators. We also calculated a traditional summary measure, proportion of days covered (PDC). We used Bayesian Information Criterion (BIC), posterior probabilities and clinical relevant interpretations in order to decide the best fit model. Additionally, we compared the accuracy of prediction of adherence of the different summary measures. Results Among 77,279 patients who initiated metformin in 2011, we found that the 5 and 6 group model performed comparably. Overall the 6 group trajectory model summarized long term adherence best (C statistic 0.951) and PDC categorized as 80% or more (value of 1) and less than 80% (value of 0) summarized adherence worst (C statistic 0.767). However, keeping in the mind the relevance of clinical interpretation, we chose the 5 group model to be best fit model. Conclusion Group based trajectory models can be used to summarize medication adherence more accurately than proportion of days covered. This newer method can be used by payers, clinicians and researchers in order to identify groups of patients with distinct adherence patterns and to identify targeted interventions for its improvement

Rosai Dorfman Disease of the Orbit

 Introduction: Rosai-Dorfman disease or Sinus Histiocytosis with massive lymphadenopathy (SHML) is a rare, benign and self-limited histiocytic proliferative disorder which affects mainly lymph nodes and very rarely extranodal sites.Presentation of case: A 60 year old lady with SHML of orbit is described. She underwent excision of the mass, received steroids for 6 weeks and is in remission at 2 years.Conclusion: Though the orbit is a rare site for SHML, the disease should be considered in the differential diagnosis of orbital swellings.

Impact of Additional Chromosomal Aberrations on the Disease Progression of Chronic Myelogenous Leukemia

The emergence of additional chromosomal abnormalities (ACAs) in Philadelphia chromosome/BCR-ABL1 positive chronic myeloid leukemia (CML), is considered to be a feature of disease evolution. However, their frequency of incidence, impact on prognosis and treatment response effect in CML is not conclusive. In the present study, we performed a chromosome analysis of 489 patients in different clinical stages of CML, using conventional GTG-banding, Fluorescent in situ Hybridization and Spectral Karyotyping. Among the de novo CP cases, ACAs were observed in 30 patients (10.20%) with lowest incidence, followed by IM resistant CP (16.66%) whereas in AP and BC, the occurrence of ACAs were higher, and was about 40.63 and 50.98%, respectively. The frequency of occurrence of ACAs were compared between the study groups and it was found that the incidence of ACAs was higher in BC compared to de novo and IM resistant CP cases. Likewise, it was higher in AP patients when compared between de novo and IM resistant CP cases, mirroring the fact of cytogenetic evolution with disease progression in CML. In addition, we observed 10 novel and 10 rare chromosomal aberrations among the study subjects. This study pinpoints the fact that the genome of advanced phase patients was highly unstable, and this environment of genomic instability is responsible for the high occurrence of ACAs. Treatment response analysis revealed that compared to initial phases, ACAs were associated with an adverse prognostic effect during the progressive stages of CML. This study further portrayed the cytogenetic mechanism of disease evolution in CML

Paying for Hemodialysis in Kerala, India: A Description of Household Financial Hardship in the Context of Medical Subsidy.

INTRODUCTION: Many low- and middle-income countries are implementing strategies to increase dialysis availability as growing numbers of people reach end-stage renal disease. Despite efforts to subsidize care, the economic sustainability of chronic dialysis in these settings remains uncertain. We evaluated the association of medical subsidy with household financial hardship related to hemodialysis in Kerala, India, a state with high penetrance of procedure-based subsidies for patients on dialysis. METHODS: Patients on maintenance hemodialysis at 15 facilities in Kerala were administered a questionnaire that ascertained demographics, dialysis details, and household finances. We estimated direct and indirect costs of hemodialysis, and described the use of medical subsidy. We evaluated whether presence of subsidy (private, charity, or government-sponsored) was associated with lower catastrophic health expenditure (defined as ≥40% of nonsubsistence expenditure spent on dialysis) or distress financing. RESULTS: Of the 835 patients surveyed, 759 (91%) reported their households experienced catastrophic health expenditure, and 644 (77%) engaged in distress financing. Median dialysis-related expenditure was 80% (25th-75th percentile: 60%-90%) of household nonsubsistence expenditure. Government subsidies were used by 238 (29%) of households, 139 (58%) of which were in the lowest income category. Catastrophic health expenditure was present in 215 (90%) of households receiving government subsidy and 332 (93%) without subsidy. CONCLUSIONS: Provision of medical subsidy in Kerala, India was not associated with lower rates of household financial hardship related to long-term hemodialysis therapy. Transparent counseling on impending costs and innovative strategies to mitigate household financial distress are necessary for persons with end-stage renal disease in resource-limited settings