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11.
为了缩减销售成本,一些制药企业将营销服务外包给合约销售公司(contract sales organization,CSO).由于CSO的营销努力不可合同化,制药企业需要基于市场销量来激励CSO的营销努力.然而,市场销量受制药企业定价决策的影响,因此CSO将面临制药企业提高定价的道德风险.此外,药品营销难度信息可能是CSO的私人信息,这使得制药企业面临逆向选择问题.当制药企业将营销服务外包给多个CSO时,由于制药企业针对同一药品在不同市场的售价相同,其定价决策对多个CSO所服务市场的销量具有共同的影响.相对绩效的激励契约能够消除共同不确定因素对代理人产出的影响,从而更有利于激励代理人付出高水平的努力.因此依据信息甄别的博弈模型,分析基于个体绩效与基于相对绩效的激励契约的有效性.研究发现:1)药品营销难度信息对称时,基于相对绩效的激励契约占优于基于个体绩效的激励契约,且可以获得全局最优的营销努力和期望利润;2)药品营销难度信息不对称时,两种激励契约均不能获得全局最优的营销努力和期望利润.数值分析表明,药品营销难度的先验概率,市场价格敏感性和高低类型药品营销难度差异的变化会影响制药企业的契约选择,较高的市场价格敏感性和较低的高低类型药品营销难度差异使得基于相对绩效的激励契约更有效. 相似文献
12.
In this paper, we focus on the problem of factor screening in nonregular two-level designs through gradually reducing the number of possible sets of active factors. We are particularly concerned with situations when three or four factors are active. Our proposed method works through examining fits of projection models, where variable selection techniques are used to reduce the number of terms. To examine the reliability of the methods in combination with such techniques, a panel of models consisting of three or four active factors with data generated from the 12-run and the 20-run Plackett–Burman (PB) design is used. The dependence of the procedure on the amount of noise, the number of active factors and the number of experimental factors is also investigated. For designs with few runs such as the 12-run PB design, variable selection should be done with care and default procedures in computer software may not be reliable to which we suggest improvements. A real example is included to show how we propose factor screening can be done in practice. 相似文献
13.
Katie Palmer du Preez Maria Bellringer Janet Pearson Nicki Dowling Aino Suomi Jane Koziol-Mclain 《International Gambling Studies》2018,18(3):477-494
Elevated rates of family violence among treatment-seeking problem gamblers compared to general population estimates have been reported in Spain, Canada and Australia. This study examined the occurrence of family violence among 454 problem gambling help-seeking clients (370 gamblers, 84 affected others) recruited through 3 national gambling treatment services in New Zealand. Measures used were the Problem Gambling Severity Index, and a modified version of the HITS Scale which assessed physical, emotional, verbal and sexual abuse. Past-year family violence among gamblers in this sample was 46.8% for victimization, 41.2% for perpetration and 55.0% for any form of family violence. Among affected others the occurrence was 65.5% for victimization, 57.1% for perpetration and 71.4% for any form of violence. The most common type of violence was verbal intimate partner violence. Affected others and women gamblers reported higher rates of violence victimization and perpetration. These findings underscore the importance of screening gambling help-seeking clients for family violence, and the development of prevention and treatment programmes to address violence in this population, with particular attention to affected others and women gamblers. Future research should assess coercive control and the gendered nature of family violence among problem gambling help-seekers. 相似文献
14.
Katarzyna Kulej-Lyko Jacek Majda Stephan von Haehling Wolfram Doehner Monika Lopuszanska Alicja Szklarska 《The aging male》2016,19(4):221-230
Background: Testosterone (TT) and dehydroepiandrosterone sulphate (DHEAS) are neurosteroids and their deficiencies constitute the hormone risk factors promoting the development of depression in elderly otherwise healthy men. We investigated the link between hypogonadism and depression in accordance with age and concomitant diseases in men with systolic HF using the novel scale previously dedicated for elderly population.Methods: We analysed the prevalence of depression and severity of depressive symptoms in population of 226 men with systolic HF (40–80 years) compared to 379 healthy peers. The severity of depression was assessed using the Polish long version of Geriatric Depression Scale (GDS).Results: In men aged 40–59 years the severity of depressive symptoms was greater in NYHA classes III–IV compared to NYHA classes I–II and reference group. In men aged 60–80 years depressive symptoms were more severe in NYHA class III-IV compared to controls (all p?≤?0.001). In multivariate logistic regression model in men aged 40–59 years advanced NYHA class was associated with higher prevalence of mild depression (OR?=?2.14, 95%CI: 1.07–4.29) and chronic obstructive pulmonary disease (COPD) with higher prevalence of severe depression (OR?=?69.1, 95%CI: 2.11–2264.3). In men aged 60–80 years advanced NYHA class and TT deficiency were related to higher prevalence of mild depression (respectively: OR?=?2.9, 95%CI: 1.3–6.4; OR?=?3.6, 95%CI: 1.2–10.63).Conclusion: TT deficiency, COPD and advanced NYHA class were associated with higher prevalence of depression in men with systolic HF. 相似文献
15.
Shiow-Ru Chang Wei-An Lin Ho-Hsiung Lin Ming-Kwang Shyu Ming-I Lin 《Women and birth : journal of the Australian College of Midwives》2018,31(6):e403-e411
Background
The association between sexual function and depression has yet to be examined in a prospective cohort study with prolonged postpartum follow-up.Aim
We investigated whether sexual dysfunction predicted depressive symptoms during the 24-month postpartum period and examined the influence of obstetric factors.Methods
This prospective 2-year cohort study with repeated measures included 196 participants who were recruited in a medical center in Taipei, Taiwan (2010–2011). Data on participants’ personal characteristics, sexual function, and depression symptoms at 4–6 weeks and at 3, 6, 12, and 24 months postpartum were collected and then assessed using the Female Sexual Function Index and the Center for Epidemiologic Studies Depression Scale.Results
After adjusting for time and covariates, women with sexual dysfunction had a 1.62-fold (95% confidence interval [CI]: 1.05–2.50-fold) higher estimated odds ratio (OR) for depressive symptoms during the entire 24 months after childbirth than did women without sexual dysfunction. Risk factors for depressive symptoms were a higher pain score (OR: 1.33, 95% CI: 1.13–1.57), a medical condition (OR: 1.65, 95% CI: 1.00–2.73), and severe perineal laceration (OR: 4.67, 95% CI: 1.37–15.92). Sexual satisfaction during the entire 24 months after childbirth (OR: 0.81, 95% CI: 0.70–0.95) and the highest personal income level (OR: 0.33, 95% CI: 0.11–0.99) were factors protecting against higher-scoring depressive symptoms.Conclusions
Our study provides robust evidence that sexual dysfunction and poor satisfaction, together with severe perineal laceration, greater pain, and a medical condition, predict depressive symptoms during the 24-month postpartum period. 相似文献16.
Timothy F. Platts-Mills Joseph A. Dayaa Bryce B. Reeve Kayla Krajick Laura Mosqueda Jason S. Haukoos 《Journal of elder abuse & neglect》2018,30(4):247-270
Emergency departments (EDs) are an important health care setting for the identification of elder abuse (EA). Our objective was to develop an ED-based tool to identify EA. The initial tool included a brief cognitive assessment, questions to detect multiple domains of EA, and a physical examination. Refinement of the tool was based on input from clinical experts and nurse and patient feedback. The revised tool, which included 15 questions about EA, was then tested in an academic ED. We calculated the inter-rater reliability, sensitivity, and specificity of individual EA questions. Among ED patients age≥65 (N = 259), 17 (7%) screened positive for suspicion of EA. We identified a combination of six questions that cover the included domains of EA, demonstrated good or excellent inter-rater reliability, and had a sensitivity and specificity of 94% (95% confidence interval (CI) 71–100%) and 90% (95% CI 85–93%), respectively. These results inform a proposed screening tool for multisite validation testing. 相似文献
17.
拥有正向的身体意象才易维持身心健康,对台湾大学生身体意象知觉落差的现状研究发现:四成的大学生存在身体意象知觉落差;性别、身心状况、学习满意度对大学生身体意象知觉落差有显著影响。身体意象是重要的公共与教育议题,了解影响大学生身体意象知觉落差因素,不仅有助于个人的自我正确认知,也有助于学校防治策略的制定。 相似文献
18.
When early testing indicates a hearing loss, parents find themselves on a roller-coaster of experiences leaving little time or space for reflection. This study is based on interviews with families in the Flemish region of Belgium, one of the earliest in the world to introduce universal neonatal screening for hearing loss. Starting from a phenomenological approach, we explore parents’ accounts of their experiences in order to uncover the meanings of early parenting of a child identified with a label. Soon after birth, these parents encounter a different world in which intertwined discourses construct parenthood with a deaf child. During the process of becoming a parent, representations of deafness as impairment were omnipresent. In contrast to a medical and technological perspective that insists on the need to intervene as fast as possible, it is argued that the private and social implications of rapid intervention require explicit consideration. 相似文献
19.
Azijada Srkalović Imširagić Dražen Begić Livija Šimičević Žarko Bajić 《Women and birth : journal of the Australian College of Midwives》2017,30(1):e17-e23
Background
Following childbirth, a vast number of women experience some degree of mood swings, while some experience symptoms of postpartum posttraumatic stress disorder.Aim
Using a biopsychosocial model, the primary aim of this study was to identify predictors of posttraumatic stress disorder and its symptomatology following childbirth.Methods
This observational, longitudinal study included 372 postpartum women. In order to explore biopsychosocial predictors, participants completed several questionnaires 3–5 days after childbirth: the Impact of Events Scale Revised, the Big Five Inventory, The Edinburgh Postnatal Depression Scale, breastfeeding practice and social and demographic factors. Six to nine weeks after childbirth, participants re-completed the questionnaires regarding psychiatric symptomatology and breastfeeding practice.Findings
Using a multivariate level of analysis, the predictors that increased the likelihood of postpartum posttraumatic stress disorder symptomatology at the first study phase were: emergency caesarean section (odds ratio 2.48; confidence interval 1.13–5.43) and neuroticism personality trait (odds ratio 1.12; confidence interval 1.05–1.20). The predictor that increased the likelihood of posttraumatic stress disorder symptomatology at the second study phase was the baseline Impact of Events Scale Revised score (odds ratio 12.55; confidence interval 4.06–38.81). Predictors that decreased the likelihood of symptomatology at the second study phase were life in a nuclear family (odds ratio 0.27; confidence interval 0.09–0.77) and life in a city (odds ratio 0.29; confidence interval 0.09–0.94).Conclusion
Biopsychosocial theory is applicable to postpartum psychiatric disorders. In addition to screening for depression amongst postpartum women, there is a need to include other postpartum psychiatric symptomatology screenings in routine practice. 相似文献20.
《Women and birth : journal of the Australian College of Midwives》2015,28(3):e31-e35
BackgroundThe Edinburgh Postnatal Depression Scale (EPDS) is well accepted for detecting symptoms of postnatal depression. The aim of this study was to examine psychometric properties and to evaluate structural models of the Serbian translation of EPDS in pregnant and postpartum women.MethodsThe original English version of the EPDS was translated into Serbian, and checked by means of back-translation. Data were collected via an anonymous online questionnaire posted on a Serbian website devoted to pregnancy topics. The study sample included 201 women (76 pregnant, 125 postpartum). The internal consistency of the scale was measured by Cronbach's α coefficient. Principal component analysis was used to determine scale dimensions while confirmatory factor analysis was used to evaluate model fit.FindingsCronbach α coefficient was 0.84 and 0.83 in pregnant and postpartum women, respectively, which indicated good internal consistency of the Serbian EPDS. Three dimensions of the scale were revealed in both groups of women. Goodness of fit indices described good and excellent model in pregnant and postpartum women, respectively. High level of depression symptoms (score ≥13) was recorded in 27.6% and 24.8% (p > 0.05) of pregnant and postpartum women, respectively. Moderate level of depression symptoms (score 10–12) was recorded in 21.1% and 16.8% (p > 0.05) of pregnant and postpartum women, respectively.ConclusionThe Serbian translation of the EPDS showed good consistency and good model characteristics in pregnant and postpartum women. However, cut-off values, sensitivity and specificity of the scale should be determined in the further studies with more representative samples of women. 相似文献