Are symbols useful and culturally acceptable in health-state valuation studies? An exploratory study in a multi-ethnic Asian population

10.2147/PPA.S4142Patient Preference and Adherence2271-27

Effects of mountain gorilla foraging activities on the productivity of their food plant species

Mountain gorillas subsist principally on foliage from the dense herbaceous understorey that is found throughout most of their habitat in the Virunga Volcanoes region. Their foraging activities cause considerable structural damage to this vegetation. Those plant species that are quantitatively most important in the gorillas' diet respond to this damage by increasing primary productivity. At a sample of spots at which gorillas had fed, these species showed significantly higher growth rates over a 6-month interval than they did at nearby spots that had not been touched by the gorillas. Stem densities of herbaceous food species at feeding spots increased markedly both in comparison to their original values and to values for the same species at untouched spots. As a result, spots at which gorillas have fed are likely to become very attractive as future feeding spots. It is unlikely that gorillas ‘manage’ their habitat in any specific fashion, largely because they do not have exclusive use of their home ranges. Their activities appear to maintain habitat productivity over the short term, on a time scale relevant to patterns of area revisits by social groups, and may contribute to long term beneficial alterations of regularly used areas, however. Effects of the type reported here may have been an important aspect of the adaptation by gorillas to terrestrial folivory. RÉSUMEÉ Les gorilles de montagne s'alimentent principalement de feuillages dans le sous-bois herbacÉ dense prÉsent presque partout dans leur habitat de la rÉgion des volcans Virunga. Leurs activitÉs alimentaires causent des dommages structurels considÉrables À cette vÉgÉtation. Les plantes des espÈces qui sont quantitativement les plus importants dans le rÉgime du gorille rÉagissent À ces dÉgats en augmentant leur productivitÉ primaire. Aux postes Échantillons oÙ les gorilles se sont nourris, ces espÈces prÉsentent des taux de croissance significantivement supÉrieurs sur un intervalle de six mois, par rapport aux postes voisins qui n'ont pas ÉtÉ touchÉs par les gorilles. Les densitÉs de tiges des espÈces herbacÉes appÉtÉes aux postes de nourrissage augmentent nettement aussi bien en comparaison avec leurs valeurs antÉrieures qu'avec celles de ces měmes espÈces dans des stations non touchÉes. En consÉquence, les postes oÙ les gorilles se sont nourris ont plus de chance de devenir des futurs postes de nourrissage trÈs attractifs. Il est peu probable que les gorilles ‘gÈrent’ leur habitat d'une quelconque faÇon, surtout parce qu'ils n'ont pas l'utilisation exclusive de leur domaine vital. Leurs activitÉs semblent maintenir À court terme la productivitÉ de leur habitat, sur une Échelle de temps comprenant les visites successives de groupes sociaux, et peuvent contribuer À long terme À des altÉrations bÉnÉfiques pour ces zones rÉguliÉrement frÉquentÉes. Des effets du type rapportÉ ici peuvent avoir ÉtÉ un ÉlÉment important de l'adaptation des gorilles À la folivorie terrestre.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75171/1/j.1365-2028.1987.tb01102.x.pd

Choosing between measures: comparison of EQ-5D, HUI2 and HUI3 in persons with hearing complaints

OBJECTIVES: To generate insight into the differences between utility measures EuroQol 5D (EQ-5D), Health Utilities Index Mark II (HUI2) and Mark III (HUI3) and their impact on the incremental cost-effectiveness ratio (ICER) for hearing aid fitting METHODS: Persons with hearing complaints completed EQ-5D, HUI2 and HUI3 at baseline and, when applicable, after hearing aid fitting. Practicality, construct validity, agreement, responsiveness and impact on the ICER were examined. RESULTS: All measures had high completion rates. HUI3 was capable of discriminating between clinically distinctive groups. Utility scores (n = 315) for EQ-5D UK and Dutch tariff (0.83; 0.86), HUI2 (0.77) and HUI3 (0.61) were significantly different, agreement was low to moderate. Change after hearing aid fitting (n = 70) for HUI2 (0.07) and HUI3 (0.12) was statistically significant, unlike the EQ-5D UK (0.01) and Dutch (0.00) tariff. ICERs varied from 647,209 euros/QALY for the EQ-5D Dutch tariff to 15,811 euros/QALY for HUI3. CONCLUSION: Utility scores, utility gain and ICERs heavily depend on the measure that is used to elicit them. This study indicates HUI3 as the instrument of first choice when measuring utility in a population with hearing complaints, but emphasizes the importance of a clear notion of what constitutes utility with regard to economic analyse

An exploratory analysis of the impact of family functioning on treatment for depression in adolescents.

This article explores aspects of family environment and parent-child conflict that may predict or moderate response to acute treatments among depressed adolescents (N = 439) randomly assigned to fluoxetine, cognitive behavioral therapy, their combination, or placebo. Outcomes were Week 12 scores on measures of depression and global impairment. Of 20 candidate variables, one predictor emerged: Across treatments, adolescents with mothers who reported less parent-child conflict were more likely to benefit than their counterparts. When family functioning moderated outcome, adolescents who endorsed more negative environments were more likely to benefit from fluoxetine. Similarly, when moderating effects were seen on cognitive behavioral therapy conditions, they were in the direction of being less effective among teens reporting poorer family environments

How dynamic capabilities drive performance in the Indian IT industry : the role of information and co-ordination

This study examines key issues and effects of capability management on a fast-growing area of knowledge-intensive global business services &ndash; IT outsourcing and offshoring. An exploratory study is undertaken of Indian companies providing complex process-oriented offshore IT services to their global customers. The analysis of the data related to the service provider side shows that developing dynamic capabilities is strongly driven by management and top-clients and results in the development of business processes and in establishing a strategic partnership with the client organization. Key findings are that information exchange and coordination are the key to a leveraging firm performance.<br /

Quantification of the level descriptors for the standard EQ-5D three-level system and a five-level version according to two methods

Objectives: Our aim was to compare the quantitative position of the level descriptors of the standard EQ-5D three-level system (3L) and a newly developed, experimental five-level version (5L) using a direct and a vignette-based indirect method. Methods: Eighty-two respondents took part in the study. The direct method represented a visual analog scale (VAS) rating of the nonextreme level descriptors for each dimension and each instrument separately. The indirect method required respondents to score 15 health scenarios with 3L, 5L and a VAS scale. Investigated were: (1) equidistance (Are 3L and 5L level descriptors distributed evenly over the VAS continuum?); (2) isoformity (Do the identical level descriptors on 3L and 5L yield similar results?); and (3) consistency between dimensions (Do the positions of similar level descriptors differ across dimensions within instruments?). Results: Equidistance without transformation was rejected for all dimensions for both 3L and 5L but satisfied for 5L after transformation. Isoformity gave mixed results. Consistency between dimensions was satisfied for both instruments and both methods. Discussion: The level descriptors have similar distributions across comparable dimensions within each system, but the pattern differs between 3L and 5L. This methodological study provides evidence of increased descriptive power and a broadened measurement continuum that encourages the further development of an official five-level EQ-5D

International meta-analysis of PTSD genome-wide association studies identifies sex- and ancestry-specific genetic risk loci.

The risk of posttraumatic stress disorder (PTSD) following trauma is heritable, but robust common variants have yet to be identified. In a multi-ethnic cohort including over 30,000 PTSD cases and 170,000 controls we conduct a genome-wide association study of PTSD. We demonstrate SNP-based heritability estimates of 5-20%, varying by sex. Three genome-wide significant loci are identified, 2 in European and 1 in African-ancestry analyses. Analyses stratified by sex implicate 3 additional loci in men. Along with other novel genes and non-coding RNAs, a Parkinson's disease gene involved in dopamine regulation, PARK2, is associated with PTSD. Finally, we demonstrate that polygenic risk for PTSD is significantly predictive of re-experiencing symptoms in the Million Veteran Program dataset, although specific loci did not replicate. These results demonstrate the role of genetic variation in the biology of risk for PTSD and highlight the necessity of conducting sex-stratified analyses and expanding GWAS beyond European ancestry populations

IT controls in the public cloud : success factors for allocation of roles and responsibilities

The rapid adoption of cloud computing by organizations has resulted in the transformation of the roles and responsibilities of staff in managing the information technology (IT) resources (via IT governance controls) that have migrated to the cloud. Hence, the objective of this research is to provide a set of success factors that can assist IT managers to allocate the roles and responsibilities of IT controls appropriately to staff to manage the migrated IT resources. Accordingly, we generated a set of success factors from behavioral and information systems (IS) literature. These success factors were verified using in-depth interviews of executives from the United Arab Emirates (UAE). The empirical intervention suggests that the role allocation is driven predominantly by people’s skills, competencies, organizational strategy, structures, and policies. In addition, the research made clear that the most significant competency and skill for a person allocated to IT controls is to be able to evaluate and manage a cloud service provider, especially in terms of risks, compliance, and security issues related to public cloud technology. The findings of this study not only offer new insights for scholars and practitioners involved in assigning responsibilities but also provide extensions for IT governance framework authorities to align their guidelines to the emerging cloud technology

Health-related quality of life in adults reporting arthritis: analysis from the National Health Measurement Study

BackgroundArthritis is the leading cause of disability in the United States. We assess the generic health-related quality-of-life (HRQOL) among a nationally representative sample of U.S. adults with and without self-reported arthritis.MethodsThe NHMS, a cross-sectional survey of 3,844 adults (35-89 years) administered EuroQol-5D (EQ-5D), Health Utilities Index Mark 2 (HUI2) and 3 (HUI3), SF-36v2™, Quality of Well-being Scale self-administered form (QWB-SA), and the Health and Activities Limitations index (HALex) to each respondent via a telephone interview. Weighted multiple linear regression was used to generate age-gender-arthritis-stratified unadjusted HRQOL means and means adjusted for sociodemographic, socioeconomic covariates and comorbidities by arthritis-age category.ResultsThe estimated population prevalence of self-reported arthritis was 31%. People with arthritis were more likely to be woman, older, of lower socioeconomic status, and had more self-reported comorbidities than were those not reporting arthritis. Adults with arthritis had lower HRQOL on six different indexes compared with adults without arthritis, with overall differences ranging from 0.03 (QWB-SA, age-group 65-74) to 0.17 (HUI3, age-group 35-44; all P-value &lt; .05).ConclusionArthritis in adults is associated with poorer HRQOL. We provide age-related reference values for six generic HRQOL measures in people with arthritis