Challenges and Dilemmas of Civil Society movements in India

Civil Society spaces provide citizens opportunities to frame their collective identities and interests through the formation of voluntary interest groups and organisations set to specific purposes. In the west, historically these interest groups have contributed to the development of political thought that assisted to forge the economic interests of emerging bourgeoisie. This paper situated in the context of India begins with a thematic perspective and reviews the challenges that emerge as a result of the demands that emerge within the civil society space. The paper considered three broad range organizations for this review such as the Narmada Bachao Andolan (Save the river Narmada Campaign); National Alliance for People's Movement (NAPM); and the Self‐Employed Women's Association (SEWA). The authors see civil society as a conciliating place—where individual interests appear to mingle with societal requirements while providing adequate representation to the marginalized groups and expression of concerns around economic and environmental rights.     

Impact of baseline ECG collection on the planning, analysis and interpretation of 'thorough' QT trials

The current guidelines, ICH E14, for the evaluation of non-antiarrhythmic compounds require a 'thorough' QT study (TQT) conducted during clinical development (ICH Guidance for Industry E14, 2005). Owing to the regulatory choice of margin (10 ms), the TQT studies must be conducted to rigorous standards to ensure that variability is minimized. Some of the key sources of variation can be controlled by use of randomization, crossover design, standardization of electrocardiogram (ECG) recording conditions and collection of replicate ECGs at each time point. However, one of the key factors in these studies is the baseline measurement, which if not controlled and consistent across studies could lead to significant misinterpretation. In this article, we examine three types of baseline methods widely used in the TQT studies to derive a change from baseline in QTc (time-matched, time-averaged and pre-dose-averaged baseline). We discuss the impact of the baseline values on the guidance-recommended 'largest time-matched' analyses. Using simulation we have shown the impact of these baseline approaches on the type I error and power for both crossover and parallel group designs. In this article, we show that the power of study decreases as the number of time points tested in TQT study increases. A time-matched baseline method is recommended by several authors (Drug Saf. 2005; 28(2):115-125, Health Canada guidance document: guide for the analysis and review of QT/QTc interval data, 2006) due to the existence of the circadian rhythm in QT. However, the impact of the time-matched baseline method on statistical inference and sample size should be considered carefully during the design of TQT study. The time-averaged baseline had the highest power in comparison with other baseline approaches.     

Diabetes mellitus in Native Americans: The problem and its implications

Since World War II, diabetes has become one of the most common serious diseases among Native Americans. Rates of diabetes and its complications, which include premature death, renal failure, and limb amputation, are substantially higher among Native Americans than among the US general population, and the frequency of diabetes among Native Americans is increasing. Several potentially modifiable factors, including obesity, dietary composition, and physical inactivity, are thought to be contributing to these high rates. The potential benefit from prevention of diabetes is considerable, and a population-based approach may be the most effective way of achieving sustainable lifestyle changes among Native Americans. Estimation of the social and economic costs of diabetes and assessment of the marginal costs and benefits of various diabetes control measures can support resource allocation decisions aimed at improving the health of Native American people.     

Sample size calculation for the Power Model for dose proportionality studies

There are several approaches to assess or demonstrate pharmacokinetic dose proportionality. One statistical method is the traditional ANOVA model, where dose proportionality is evaluated using the bioequivalence limits. A more informative method is the mixed effects Power Model, where dose proportionality is assessed using a decision rule for the estimated slope. Here we propose analytical derivations of sample sizes for various designs (including crossover, incomplete block and parallel group designs) to be analysed according to the Power Model.     

Region of Birth and Disability Among Recent U.S. Immigrants: Evidence from the 2000 Census

This study aimed to test the “healthy immigrant” hypothesis and assess health heterogeneity among newly arrived working-age immigrants (18–64 years) from various regions of origin. Using the 5% sample of the 2000 U.S. Census (PUMS), we found that, compared with their native-born counterparts, immigrants from all regions of the world were less likely to report mental disability and physical disability. Immigrants from selected regions of origin were, however, more likely to report work disability. Significant heterogeneity in disabilities exists among immigrants: Those from Eastern Europe and Southeast Asia reported the highest risk of mental and physical disability, and those from East Asia reported the lowest risk of physical disability. Furthermore, Mexican immigrants reported the lowest risk of mental disability, and Canadian immigrants reported the lowest risk of work disability. Socioeconomic status and English proficiency partially explained these differences. The health advantage of immigrants decreased with longer U.S. residence.     

Transformational Leadership and Value System Congruence

This study looked at the relationship between transformational leadership and three types of value system congruence – leader-organization congruence, leader-follower congruence,and follower-organization congruence, separately for terminal and instrumental values. Findings indicate that follower's terminal value system congruence with leader is positively related to transformational leadership, and this relationship remains significant even after controlling for leader-organization or follower-organization terminal value system congruence. Leader-organization congruence does not also moderate the relationship between transformational leadership and leader-follower congruence, in the case of both terminal and instrumental values. Leader-organization instrumental value system congruence is positively related to leader-follower instrumental value system congruence. No relationship is seen between transformational leadership and follower-organization congruence in the case of both terminal and instrumental values. Leader-follower congruence does not mediate the relationship between transformational leadership and follower-organization congruence.     

Strategic Management of Operations in the Emergency Department

This study is based on the analysis of field data on the revenues and patient flows that we collected on all adult emergency department (ED) visits to a level‐1 trauma, tertiary referral center. Our objective was to provide researchers in operations a rich overview of the processes, resources, and metrics of financial and operations performance in the ED. We analyze how patients, physicians, hospitals/physician employer groups, and payers are party to the value created and financial workflow of the ED. A waterfall model for professional services revenue is developed that highlights the impacts of changes in processes, resources, scale, complexity, and mix of patients treated in the ED. We also discuss future implications of new compensation models and potential scenarios that will focus upon controlling costs while maximizing population health and patient satisfaction. These models will necessitate re‐engineering of operations in the ED from a strategic perspective. Four major thrusts for selecting the capacity portfolio in the ED operations to align the interests of all the stakeholders are recommended. New avenues for research are also identified.