Integrating ethical enquiry and health technology assessment: limits and opportunities for efficiency and equity

This paper aims at discussing some contributions, limitations and opportunities that efficiency and equity studies could make to form a better understanding of ethical issues involved in health technology assessment (HTA). Prenatal detection of Down syndrome is used as a case study for further discussions regarding efficiency and equity, as well as other ethical principles including beneficence, non-maleficence and autonomy. The development and use of adequate methods and the need for context appraisal are two imperative issues in this field of knowledge. The analysis of ethical implications in HTA should account for both. Economic evaluation methodologies have great potential in the assessment of some key ethical principles such as efficiency and equity but are of limited use concerning other fundamental principles. Social and individual values play a prominent role in this respect.     

Quality strategies in supply chain alliances of disposable items

This paper studies a single-product distribution channel where a supplier manufactures items of a given type, some of which are defective, that are sold by a retailer who only detects a subset of the defective items, passing the rest along to customers. We conjecture the structure of the demand and cost functions, assuming customers to have a decreasing marginal aversion to bad quality while both the supplier and the retailer make marginally increasing efforts to avoid bad quality. This allows us to deduce several implicit parameters of a cost model based on observable data, such as the share of the channel margin. Once the parameters of the model are available, we analyze the result of vertical integration. Although we confirm the well-known fact that vertical integration improves the quality perceived by the customer, we characterize the supplier's decision of whether or not to provide a better quality in terms of the individual channel margins. As an alternative, we derive the conditions under which the supplier and the retailer may devise a mutually beneficial transfer contract that simultaneously increases their profit and improves quality.     

Research project on advocacy and autism

This article presents the findings of a qualitative research project about the difficulties in accessing advocacy faced by adults labelled as having autism and Asperger's Syndrome in the Northwest of England. It is also an example of partnership working between three organisations. The article examines both the process of team-led (emancipatory) research and the project findings. Seven main themes emerged throughout the research: late diagnosis and lack of service support; bad experiences with systems of care; feelings of 'not belonging' (identity issues); barriers around communication and sensitivity towards individuals; lack of awareness and access to advocacy and rights; difficulties of 'fitting into' what is already available; and interest in developing knowledge around advocacy. Examination of the main themes pointed to a disturbing link between poor service response, episodes of crisis and mental ill health. The Carlisle People First Research Team is made up of 6 researchers who are labelled as having 'learning difficulties' who work in partnership with one other researcher.     

Improved model selection criteria for SETAR time series models

The purpose of this paper is threefold. First, we obtain the asymptotic properties of the modified model selection criteria proposed by Hurvich et al. (1990. Improved estimators of Kullback-Leibler information for autoregressive model selection in small samples. Biometrika 77, 709–719) for autoregressive models. Second, we provide some highlights on the better performance of this modified criteria. Third, we extend the modification introduced by these authors to model selection criteria commonly used in the class of self-exciting threshold autoregressive (SETAR) time series models. We show the improvements of the modified criteria in their finite sample performance. In particular, for small and medium sample size the frequency of selecting the true model improves for the consistent criteria and the root mean square error (RMSE) of prediction improves for the efficient criteria. These results are illustrated via simulation with SETAR models in which we assume that the threshold and the parameters are unknown.     

Marriage and gender inequality: work–family arrangements of Portuguese and British highly qualified women

This article examines work–family reconciliation processes in order to understand if, over the course of marital life, women become socially closer or further away from their partner. Drawing on work–life interviews with highly qualified women in Portugal and Britain, we compare these processes in two societies with different historical and social backgrounds. Findings reveal three main configurations of social (in)equality which emerge during married life: growing inequality in favour of the man, in favour of the woman or equality between spouses. With due attention to the importance of national specific factors, we present three main conclusions. First, (in) equality is built up over the course of marital life and female strategies for reconciling family and work are at the core of this process. Second, the national specificities can mould the effects of cross-national gender mechanisms. Third, the intersection between cross-cultural phenomena such as conservative attitudes towards domestic work and national specificities (such as the availability of part-time options) is a rather complex process which needs further research.     

Ridge Regression and Generalized Maximum Entropy: An improved version of the Ridge–GME parameter estimator

In this article, the Ridge–GME parameter estimator, which combines Ridge Regression and Generalized Maximum Entropy, is improved in order to eliminate the subjectivity in the analysis of the ridge trace. A serious concern with the visual inspection of the ridge trace to define the supports for the parameters in the Ridge–GME parameter estimator is the misinterpretation of some ridge traces, in particular where some of them are very close to the axes. A simulation study and two empirical applications are used to illustrate the performance of the improved estimator. A MATLAB code is provided as supplementary material.     

Sexual Beliefs and Sexual Functioning: The Mediating Role of Cognitive Distraction

Dysfunctional sexual beliefs are vulnerability factors for sexual dysfunction. This cross-sectional study aimed to test the mediating role of cognitive distraction on the relationship between dysfunctional sexual beliefs about sexual functioning shared by men and women and sexual function. The authors used a sample of 421 cisgender heterosexual participants involved in a monogamous relationship. The hypothesized mediation model was tested using a bootstrapped cross product of coefficients approach. Results showed a significant negative, indirect effect between dysfunctional sexual beliefs and women's sexual function through cognitive distraction. The discussion of this study highlights the importance of cognitive factors in sexual functioning.     

Organizational cynicism: Spillover effects on supervisor–subordinate relationships and performance

Organizational cynicism has grown in contemporary Western organizations. However, its impact on interpersonal relationships and consequently on organizational functioning remains understudied. The present study addresses these gaps by: a) exploring the spillover effect of organizational cynicism on supervisor–subordinate relationships, and b) examining if the spillover effect extends to employee performance. Specifically, it examines if affective commitment to the supervisor mediates the relationship between the PSS × organizational cynicism interaction effect and performance (i.e., mediated-moderation). Data were collected from both employees and supervisors (N = 274) from 45 organizations. Our results generally support our hypotheses. This study provides evidence that organizational cynicism interferes in the relationship employees develop with their supervisors, with consequences to performance. This study opens new avenues for research on organizational cynicism and carries implications for theory and practice.     

Bats in urban areas of Brazil: roosts,food resources and parasites in disturbed environments

Urbanization is a widespread intense land use that generally results in biodiversity decline. Among the taxa capable to adapt to urban landscapes, bats are particularly ubiquitous. Brazil has one of the world’s largest diversity of bat species and one of the highest urbanization rates of the world. Yet, few studies have synthesized the biology of bats in urban environments, especially in Brazil. To fill this gap, we systematically reviewed the published scientific literature on the bat fauna found in urban areas of Brazil. The knowledge of urban bats is still incipient and heterogeneously spatially distributed, mostly concentrated in the southeastern region of the country. The assembled list of 84 urban species, of which nineteen are new species records for urban areas (including one new family), represents 47% of the bat richness registered in the country. Thirty-one bat species (37%) were captured exclusively inside forest fragments. Moreover, we provide information on the resources used within the urban matrix by summarizing the roosting sites for 38 bat species, as well as 31 plants consumed by at least twelve bat species. Regarding parasitological aspects, we listed eleven zoonotic parasites hosted by 27 bat species and discussed their potential to become a public health threat. Likewise, we considered the different features linked to urbanization, including impacts on immunity, body condition and susceptibility to acquiring parasites, as possible bat conservation issues. Finally, we defined an agenda for bat studies in urban areas of Brazil.