Increased risk of diabetes mellitus among persons with psychotic symptoms:results from the WHO World Health Survey

OBJECTIVE: To analyze with a symptom-based approach the relationship between psychosis and diabetes mellitus in the general population. METHOD: Nationally representative samples from the World Health Organization (WHO) World Health Survey, totaling 224,743 randomly selected adults 18 years and older from 52 countries worldwide, were interviewed to establish the presence of psychotic symptoms and diabetes mellitus. Presence of psychotic symptoms was established using questions pertaining to positive symptoms from the psychosis screening module of the Composite International Diagnostic Interview. Presence of diabetes was established with a response of "yes" to the question, "Have you ever been diagnosed with diabetes (high blood sugar)?" The World Health Survey was conducted between 2002 and 2004. RESULTS: An increasing number of psychotic symptoms was related to increasing likelihood of diabetes mellitus (OR = 1.27; 95% CI, 1.24-1.30). As compared to no symptoms, at least 1 psychotic symptom substantially elevated the risk (OR = 1.71; 95% CI, 1.61-1.81). In people with a lifetime diagnosis of schizophrenia or psychosis, the prevalence of diabetes was higher in those with current psychotic symptoms (7.3% vs 5.2%; OR = 1.65; 95% CI, 1.21-2.26), suggesting that the persistence of symptoms over time could play a central role. After controlling for different potential confounders, there was a clear increase in the probability of having diabetes as the number of psychotic symptoms increased. The relationship between psychotic symptoms and diabetes was tested with multiple mediation models and path analyses for categorical outcomes. Only body mass index appeared as a relevant mediator in a model with a good fit (ie, χ21 = 3.2, P = .0742; comparative fit index = 0.999). CONCLUSIONS: Psychotic symptoms are related to increased rates of diabetes mellitus in nonclinical samples, independent of several potential confounders-including a clinical diagnosis of psychosis or schizophrenia, previous antipsychotic treatment, depression, lifestyle, and individual or country socioeconomic status. The findings highlight the worldwide relevance of the problem and the importance of identifying the specific paths of this association.

Knowledge management in support of enterprise risk management

Risk management and knowledge management have so far been studied almost independently. The evolution of risk management to the holistic view of Enterprise Risk Management requires the destruction of barriers between organizational silos and the exchange and application of knowledge from different risk management areas. However, knowledge management has received little or no attention in risk management. This paper examines possible relationships between knowledge management constructs related to knowledge sharing, and two risk management concepts: perceived quality of risk control and perceived value of enterprise risk management. From a literature review, relationships with eight knowledge management variables covering people, process and technology aspects were hypothesised. A survey was administered to risk management employees in financial institutions. The results showed that the perceived quality of risk control is significantly associated with four knowledge management variables: perceived quality of risk knowledge sharing, perceived quality of communication among people, web channel functionality, and risk management information system functionality. However, the relationships of the knowledge management variables to the perceived value of enterprise risk management are not significant. We conclude that better knowledge management is associated with better risk control, but that more effort needs to be made to break down organizational silos in order to support true Enterprise Risk Management.

Assisting national governments in governance, risk, and compliance:implementation of project management offices

Currently, there are many instances where public sector organizations and government entities collapse and are unable to provide the required services to the public. Such organizations do not have effective mechanisms of control or any specific department which manages projects occurring in the organization. However, this study suggests the incorporation of the Project Management Office (PMO) in public sector organizations for the purpose of managing project management. There are other relevant roles of the PMO discussed in this study. The study is contextualized with respect to Corporate Governance, Risk Management, and Compliance (GRC) and the study shows how PMO can benefit or compliment GRC and provide overall better standards of practice for public sector organizations. The study uses a mixed methodology for data collection and the findings contribute to the body of knowledge regarding PMO's and GRC.

Investigation of factors influencing loyalty – The role of involvement, perceived risk and knowledge

Our research aimed to reveal the effects that can be observed during the buying process of food products and can influence the decisions of customers. We focused on the role of enduring involvement in customers’ behavioural loyalty, that is, the repurchase of food brands. To understand this relationship in a more sophisticated way, we involved two mediating constructs in our conceptual model: perceived risk and perceived knowledge of food products. The data collection was carried out among undergraduate students in frame of an online survey, and we used SPSS/AMOS software to test the model. The results only partly supported our hypothesis, although the involvement effects on loyalty and the two mediating constructs were strong enough, loyalty couldn’t be explained well by perceived risk and knowledge. The roles of further mediating/moderating variables should be determined and investigated in the next section of the research series.

What makes ISAF s/tick: An investigation of the politics of coalition burden-sharing

This paper is interested in conceptualising the often raised issue of over- and under-contributing in coalition operations; that of how and why members of complex coalitions2 may be punching above and below their weight, respectively. To this end, the first section presents a parsimonious baseline assumption regarding what variables may fundamentally inform coalition burden-sharing, to subsequently discuss how much each of these are found to play a role in the Afghanistan context. The second section elaborates on this by assessing the perception and the interpretation of threats by coalition member countries, related to Afghanistan, as this pertains to prioritising other variables within the scheme outlined in the previous section. The third and fourth sections then proceed to examine and further enrich the existing literature on coalition burden-sharing, and provide further insights regarding the operations of the International Security Assistance Force–Afghanistan, and regarding ISAF member-country decisionmaking; the objective here is to generate further refined assumptions, that can permit a preliminary assessment of the phenomenon of uneven burden-sharing in ISAF, complementing the initial baseline expectations.

Does Lost Time Cost You Money and Create High Risk?

The aim of the case study is to express the delayed repair time impact on the revenues and profit in numbers with the example of the outage of power plant units. Main steps of risk assessment: • creating project plan suitable for risk assessment • identification of the risk factors for each project activities • scenario-analysis based evaluation of risk factors • selection of the critical risk factors based on the results of quantitative risk analysis • formulating risk response actions for the critical risks • running Monte-Carlo simulation [1] using the results of scenario-analysis • building up a macro which creates the connection among the results of the risk assessment, the production plan and the business plan.

Anxiety disorders and depression and risk for drug use disorders across the life course: Sex and ethnic contrasts

The present study examined the linkage between mental (i.e., anxiety disorders and depression) and drug use disorders in a multi-ethnic (i.e., 25% Euro-American, 38% Hispanic/Latino, 33% African American, 4% other) sample of adults (N = 1638, age 18–93 years old). Risk for drug use disorders was examined, while attending to methodological issues of prior research including (1) psychiatric comorbidity, (2) variations in risk associated with sex, ethnicity, and age, and (3) temporal order between mental and drug use disorders. ^ Participants were assessed using the Composite International Diagnostic Interview (CIDI; World Health Organization, 1990). A life history calendar (Freedman et al., 1988) was used to aid the ordering of onsets of all disorders assessed. ^ Preliminary analysis indicated anxiety disorders and depression were significant predictors of drug use disorders, but after controlling for comorbidity and temporal order, anxiety disorders and depression were no longer predictive of drug use disorders. Findings are discussed in terms of their usefulness for prevention and treatment of drug use disorders. ^

Essays on international lending and increasing returns to scale

Standard economic theory suggests that capital should flow from rich countries to poor countries. However, capital has predominantly flowed to rich countries. The three essays in this dissertation attempt to explain this phenomenon. The first two essays suggest theoretical explanations for why capital has not flowed to the poor countries. The third essay empirically tests the theoretical explanations.^ The first essay examines the effects of increasing returns to scale on international lending and borrowing with moral hazard. Introducing increasing returns in a two-country general equilibrium model yields possible multiple equilibria and helps explain the possibility of capital flows from a poor to a rich country. I find that a borrowing country may need to borrow sufficient amounts internationally to reach a minimum investment threshold in order to invest domestically.^ The second essay examines how a poor country may invest in sectors with low productivity because of sovereign risk, and how collateral differences across sectors may exacerbate the problem. I model sovereign borrowing with a two-sector economy: one sector with increasing returns to scale (IRS) and one sector with diminishing returns to scale (DRS). Countries with incomes below a threshold will only invest in the DRS sector, and countries with incomes above a threshold will invest mostly in the IRS sector. The results help explain the existence of a bimodal world income distribution.^ The third essay empirically tests the explanations for why capital has not flowed from the rich to the poor countries, with a focus on institutions and initial capital. I find that institutional variables are a very important factor, but in contrast to other studies, I show that institutions do not account for the Lucas Paradox. Evidence of increasing returns still exists, even when controlling for institutions and other variables. In addition, I find that the determinants of capital flows may depend on whether a country is rich or poor.^