The cost-effectiveness of the SPHERE intervention for the secondary prevention of coronary heart disease

Objectives: The Secondary Prevention of Heart disEase in geneRal practicE (SPHERE) trial has recently reported. This study examines the cost-effectiveness of the SPHERE intervention in both healthcare systems on the island of Ireland. Methods: Incremental cost-effectiveness analysis. A probabilistic model was developed to combine within-trial and beyond-trial impacts of treatment to estimate the lifetime costs and benefits of two secondary prevention strategies: Intervention - tailored practice and patient care plans; and Control - standardized usual care. Results: The intervention strategy resulted in mean cost savings per patient of 512.77 (95 percent confidence interval [CI], 1086.46-91.98) and an increase in mean quality-adjusted life-years (QALYs) per patient of 0.0051 (95 percent CI, 0.0101-0.0200), when compared with the control strategy. The probability of the intervention being cost-effective was 94 percent if decision makers are willing to pay €45,000 per additional QALY. Conclusions: Decision makers in both settings must determine whether the level of evidence presented is sufficient to justify the adoption of the SPHERE intervention in clinical practice. Copyright © Cambridge University Press 2010.

Information Disclosure, Market Discipline and the Management of Bank Capital: Evidence from the Chinese Financial Sector

Is there evidence that market forces effectively discipline risk management behaviour within Chinese financial institutions? This study analyses information from a comprehensive sample of Chinese banks over the 1998-2008 period. Market discipline is captured through the impact of four sets of factors namely, market concentration, interbank deposits, information disclosure, and ownership structure. We find some evidence of a market disciplining effect in that: (i) higher (lower) levels of market concentration lead banks to operate with a lower (higher) capital buffer; (ii) joint-equity banks that disclose more information to the public maintain larger capital ratios; (iii) full state ownership reduces the sensitivity of changes in a bank's capital buffer to its level of risk;(iv) banks that release more transparent financial information hold more capital against their non-performing loans. © 2010 Springer Science+Business Media, LLC.

Secondary Transfer Effects of Intergroup Contact: Alternative Accounts and Underlying Processes

Although intergroup contact is one of the most prominent interventions to reduce prejudice. the generalization of contact effects is still a contentious issue This research further examined the rarely studied secondary transfer effect (STE, Pettigrew, 2009) by which contact with a primary outgroup reduces prejudice toward secondary groups that are not directly involved in the contact Across 3 cross-sectional studies conducted in Cyprus (N = 1.653), Northern Ireland (N = 1,973). and Texas (N = 275) and 1 longitudinal study conducted in Northern Ireland (N = 411). the present research sought to systematically rule out alternative accounts of the STE and to investigate 2 potential mediating mechanisms (ingroup reappraisal and attitude generalization) Results indicated that, consistent with the STE. contact with a primary outgroup predicts attitudes toward secondary outgroups. over and above contact with the secondary outgroup, socially desirable responding. and prior attitudes Mediation analyses found strong evidence for attitude generalization but only limited evidence for ingroup reappraisal as an underlying process Two out of 3 tests of a reverse model, where contact with the secondary outgroup predicts attitudes toward the primary outgroup. provide further evidence for an indirect effect through attitude generalization Theoretical and practical implications of these results are discussed, and directions for future research are identified

Avandia (TM) - From molecule to market for type 2 diabetes.

Type 2 diabetes is a disease fast approaching epidemic proportions throughout the world. From insulin sensitizers to PPARg agonists, the lecture will outline the successful medicinal chem. and biol. strategy underpinning the discovery and selection of Avandia, an innovative new medicine for this disease.

Agitating for a design and regeneration agenda in a postconflict city: the case of Belfast

Introduction

Belfast has been a focus of academic attention for the last forty years with most interest centred on various aspects of ‘the Troubles’. Where there has been interest in the built environment, it has largely been about how the ‘security situation’ impacted directly on architecture and on the design and layout of social housing. This paper seeks to go beyond this to explore how the political- administrative culture of ‘the Troubles’ interacted with ‘normal’ market forces to shape the central area of the city, and to consider the responses of a recently formed activist group, known as the Forum for Alternative Belfast (hereafter referred to as the Forum). The paper is written by three of the directors of the Forum.1 Moreover, the empirical research presented here was undertaken by the Forum as part of a campaign to address issues relating to the design, layout and quality of Belfast’s built environment. In the longstanding tradition of participant observation working within an action-research paradigm, the participants have attempted to offer an account that is evidentially and purposefully selfcritical and reflective. It is of course recognised that while this approach offers many positive attributes, such as phenomenological access through immersion in the project, it also has the potential to bring compromise on research detachment and objectivity.2 To address the latter, the authors have attempted
to avoid polemical argument, and to support claims with primary or secondary research evidence. The authors also acknowledge that action-research has a chequered history; however, they would argue
that their approach is faithful to a concept that sees ‘research’ defined as understanding and ‘action’ defined as seeking change. The Forum’s very purpose is to seek change, but to do this requires evidence, collaboration and demonstration. And in this sense, it is a learning process for all participants, including the research activists, government officials, community organisations and students. The authors also recognise the complexity of factors that affect urban management and change, particularly in a city such as Belfast, which has had to cope with political violence for over thirty years. And they appreciate that in the context of conflict, governance is skewed to cope with political realities. Hamdi reminds us, however, that in practice there is an ‘important dialectic between top-down planning, with its formal and designed laws and structures, and bottom-up selforganizing collectivism—those “quantum and emergent systems” which Jane Jacobs argued long ago give cities their life and order.’3

Science for sale in a free market economy: But at what price? ABA and the treatment of autism in Europe.

Educating the public accurately about Applied Behavior Analysis (ABA) is an important undertaking, not least because misconceptions and myths about ABA abound. In this paper we argue that, unfortunately, the efforts of many dedicated professionals and parents to disseminate accurate information about the benefits of ABA for children diagnosed with autism spectrum disorder (ASD) are damaged by a few behavior analysts whose focus seems to be more on monetary gains than social responsibility. We cite examples of the resulting harm to the public image of behavior analysis from a number of European countries. We conclude by calling upon fellow scientists to unite in their opposition to unscrupulous abuses of free market forces for short-term monetary gains that damage the dissemination of the science of behavior analysis and thereby ultimately disadvantage those who should benefit primarily from our science, i.e., some of the most vulnerable citizens of society.