Development of Lifetime Comorbidity in the World Health Organization World Mental Health Surveys

Context: Although numerous studies have examined the role of latent variables in the structure of comorbidity among mental disorders, none has examined their role in the development of comorbidity. Objective: To study the role of latent variables in the development of comorbidity among 18 lifetime DSM-IV disorders in the World Health Organization World Mental Health Surveys. Design: Nationally or regionally representative community surveys. Setting: Fourteen countries. Participants: A total of 21 229 survey respondents. Main Outcome Measures: First onset of 18 lifetime DSM-IV anxiety, mood, behavior, and substance disorders assessed retrospectively in the World Health Organization Composite International Diagnostic Interview. Results: Separate internalizing (anxiety and mood disorders) and externalizing (behavior and substance disorders) factors were found in exploratory factor analysis of lifetime disorders. Consistently significant positive time-lagged associations were found in survival analyses for virtually all temporally primary lifetime disorders predicting subsequent onset of other disorders. Within-domain (ie, internalizing or externalizing) associations were generally stronger than between-domain associations. Most time-lagged associations were explained by a model that assumed the existence of mediating latent internalizing and externalizing variables. Specific phobia and obsessive-compulsive disorder (internalizing) and hyperactivity and oppositional defiant disorders (externalizing) were the most important predictors. A small number of residual associations remained significant after controlling the latent variables. Conclusions: The good fit of the latent variable model suggests that common causal pathways account for most of the comorbidity among the disorders considered herein. These common pathways should be the focus of future research on the development of comorbidity, although several important pairwise associations that cannot be accounted for by latent variables also exist that warrant further focused study.

Twelve-Month Prevalence of and Risk Factors for Suicide Attempts in the World Health Organization World Mental Health Surveys

Objective: Although suicide is a leading cause of death worldwide, clinicians and researchers lack a data-driven method to assess the risk of suicide attempts. This study reports the results of an analysis of a large cross-national epidemiologic survey database that estimates the 12-month prevalence of suicidal behaviors, identifies risk factors for suicide attempts, and combines these factors to create a risk index for 12-month suicide attempts separately for developed and developing countries. Method: Data come from the World Health Organization (WHO) World Mental Health (WMH) Surveys (conducted 2001-2007), in which 108,705 adults from 21 countries were interviewed using the WHO Composite International Diagnostic Interview. The survey assessed suicidal behaviors and potential risk factors across multiple domains, including socio-demographic characteristics, parent psychopathology, childhood adversities, DSM-IV disorders, and history of suicidal behavior. Results: Twelve-month prevalence estimates of suicide ideation, plans, and attempts are 2.0%, 0.6%, and 0.3%, respectively, for developed countries and 2.1%, 0.7%, and 0.4%, respectively, for developing countries. Risk factors for suicidal behaviors in both developed and developing countries include female sex, younger age, lower education and income, unmarried status, unemployment, parent psychopathology, childhood adversities, and presence of diverse 12-month DSM-IV mental disorders. Combining risk factors from multiple domains produced risk indices that accurately predicted 12-month suicide attempts in both developed and developing countries (area under the receiver operating characteristic curve = 0.74-0.80). Conclusions: Suicidal behaviors occur at similar rates in both developed and developing countries. Risk indices assessing multiple domains can predict suicide attempts with fairly good accuracy and may be useful in aiding clinicians in the prediction of these behaviors. J Clin Psychiatry 2010;71(12):1617-1628 (C) Copyright 2010 Physicians Postgraduate Press, Inc.

Childhood adversities and adult psychopathology in the WHO World Mental Health Surveys

Background Although significant associations of childhood adversities with adult mental disorders are widely documented, most studies focus on single childhood adversities predicting single disorders. Aims To examine joint associations of 12 childhood adversities with first onset of 20 DSM-IV disorders in World Mental Health (WMH) Surveys in 21 countries. Method Nationally or regionally representative surveys of 51 945 adults assessed childhood adversities and lifetime DSM-IV disorders with the WHO Composite International Diagnostic Interview (CIDI). Results Childhood adversities were highly prevalent and interrelated. Childhood adversities associated with maladaptive family functioning (e.g. parental mental illness, child abuse, neglect) were the strongest predictors of disorders. Co-occurring childhood adversities associated with maladaptive family functioning had significant subadditive predictive associations and little specificity across disorders. Childhood adversities account for 29.8% of all disorders across countries. Conclusions Childhood adversities have strong associations with all classes of disorders at all life-course stages in all groups of WMH countries. Long-term associations imply the existence of as-yet undetermined mediators.

Associations of serious mental illness with earnings: results from the WHO World Mental Health surveys

Background Burden-of-illness data, which are often used in setting healthcare policy-spending priorities, are unavailable for mental disorders in most countries. Aims To examine one central aspect of illness burden, the association of serious mental illness with earnings, in the World Health Organization (WHO) World Mental Health (WMH) Surveys. Method The WMH Surveys were carried out in 10 high-income and 9 low- and middle-income countries. The associations of personal earnings with serious mental illness were estimated. Results Respondents with serious mental illness earned on average a third less than median earnings, with no significant between-country differences (chi(2)(9)=5.5-8.1, P=0.5-0.79). These losses are equivalent to 0.3-0.8% of total national earnings. Reduced earnings among those with earnings and the increased probability of not earning are both important components of these associations: Conclusions These results add to a growing body of evidence that mental disorders have high societal costs. Decisions about healthcare resource allocation should take these costs into consideration.

Childhood adversities as risk factors for onset and persistence of suicidal behaviour

Background Suicide is a leading cause of death worldwide, but the precise effect of childhood adversities as risk factors for the onset and persistence of suicidal behaviour (suicide ideation, plans and attempts) are not well understood. Aims To examine the associations between childhood adversities as risk factors for the onset and persistence of suicidal behaviour across 21 countries worldwide. Method Respondents from nationally representative samples (n = 55 299) were interviewed regarding childhood adversities that occurred before the age of 18 years and lifetime suicidal behaviour. Results Childhood adversities were associated with an increased risk of suicide attempt and ideation in both bivariate and multivariate models (odds ratio range 1.2-5.7). The risk increased with the number of adversities experienced, but at a decreasing rate. Sexual and physical abuse were consistently the strongest risk factors for both the onset and persistence of suicidal behaviour, especially during adolescence. Associations remained similar after additional adjustment for respondents` lifetime mental disorder status. Conclusions Childhood adversities (especially intrusive or aggressive adversities) are powerful predictors of the onset and persistence of suicidal behaviours.

Treatment of suicidal people around the world

Background Suicide is a leading cause of death worldwide; however, little information is available about the treatment of suicidal people, or about barriers to treatment. Aims To examine the receipt of mental health treatment and barriers to care among suicidal people around the world. Method Twenty-one nationally representative samples worldwide (n=55 302; age 18 years and over) from the World Health Organization`s World Mental Health Surveys were interviewed regarding past-year suicidal behaviour and past-year healthcare use. Suicidal respondents who had not used services in the past year were asked why they had not sought care. Results Two-fifths of the suicidal respondents had received treatment (from 17% in low-income countries to 56% in high-income countries), mostly from a general medical practitioner (22%), psychiatrist (15%) or non-psychiatrist (15%). Those who had actually attempted suicide were more likely to receive care. Low perceived need was the most important reason for not seeking help (58%), followed by attitudinal barriers such as the wish to handle the problem alone (40%) and structural barriers such as financial concerns (15%). Only 7% of respondents endorsed stigma as a reason for not seeking treatment. Conclusions Most people with suicide ideation, plans and attempts receive no treatment. This is a consistent and pervasive finding, especially in low-income countries. Improving the receipt of treatment worldwide will have to take into account culture-specific factors that may influence the process of help-seeking.

Caracterización de las empresas que colaboran con centros tecnológicos

En este trabajo procedemos a caracterizar las empresas que colaboran con centros tecnológicos. Las investigaciones empíricas de Cassiman & Veugelers (1998b) y Bayona (2000), junto a los enfoques teóricos del cambio tecnológico y de las motivaciones para colaborar tecnológicamente, serán los principales referentes para la formulación de hipótesis acerca del perfil de las empresas que colaboran con centros tecnológicos. Los datos procedentes de la Encuesta sobre Estrategias Empresariales de 1998 serán utilizados para elaborar el perfil de empresa – usuario y aportar así algunas intuiciones sobre las motivaciones específicas en la selección de un centro tecnológico en lugar de un cliente o un proveedor para una colaboración tecnológica. La búsqueda de recursos públicos y servicios tecnológicos concretos, así como una mayor confianza, parecen motivar la elección de dicha institución para colaborar en una alianza tecnológica.

Innovación tecnológica y resultado exportador: un análisis empírico aplicado al sector textil-confección español

En los últimos años, la relación entre tecnología y resultado exportador ha sido objeto de algunos estudios centrados en explicar la relación existente entre los distintos indicadores de las actividades tecnológicas y la performance internacional de las empresas. Sin embargo, la mayoría de las investigaciones centradas en este tema tienden a aproximar la estrategia innovadora de una empresa a partir de sus gastos en actividades de I+D cuando, en realidad, el concepto de innovación tecnológica podría resultar más amplio que la mera realización formal de actividades de I+D. En este trabajo en primer lugar se identifican aquellos factores que aproximan, de una forma más exhaustiva, las actividades de innovación tecnológica que realiza una empresa y, en segundo lugar, se averiguará su relación con el resultado exportador de la misma. Los resultados que se obtienen son satisfactorios ya que demuestran que la probabilidad y la intensidad exportadora de las empresas españolas del sector textil-confección dependen no sólo de sus inversiones en I+D, sino también de otras variables vinculadas a su estrategia innovadora.

Collaboration strategies and technological innovation: a contractual perspective of the relationship between firms and techonological centers

In this paper, a theoretical framework for analyzing the selection of governance structures for implementing collaboration agreements between firms and Technological Centers is presented and empirically discussed. This framework includes Transaction Costs and Property Rights’ theoretical assumptions, though complemented with several proposals coming from the Transactional Value Theory. This last theory is used for adding some dynamism in the governance structure selection. As empirical evidence of this theoretical explanation, we analyse four real experiences of collaboration between firms and one Technological Center. These experiences are aimed to represent the typology of relationships which Technological Centers usually face. Among others, a key interesting result is obtained: R&D collaboration activities do not need to always be organized through hierarchical solutions. In those cases where future expected benefits and/or reputation issues could play an important role, the traditional more static theories could not fully explain the selected governance structure for managing the R&D relationship. As a consequence, these results justify further research about the adequacy of the theoretical framework presented in this paper in other contexts, for example, R&D collaborations between firms and/or between Universities or Public Research Centers and firms.

Las Sendas del cambio tecnológico en la agricultura española contemporánea

Los procesos de cambio técnico en la agricultura no se han empezado a tratar de forma directa hasta fechas recientes. Con frecuencia, además, su tratamiento ha estado condicionado por supuestos y consideraciones que no permiten explicar las causas que los impulsaron ni sus características diferenciales, ya sea por aceptar acríticamente los postulados neoclásicos de la teoría económica o por utilizar unos referentes sobre las posibilidades de innovación y el comportamiento de los agentes económicos, poco adaptados a la diversidad de realidades agrarias. En primer lugar, que la evolución del cambio técnico en la agricultura española ha estado caracterizada por la coexistencia de procesos contínuos y discontínuos de diferente entidad y, por tanto, por la coexistencia de complejas líneas de conexión entre las diversas ofertas tecnológicas que se han ido articulando a lo largo del tiempo y la eclosión de cambios técnicos radicales. En segundo lugar, pondremos de relieve la existencia de constelaciones técnicas diferenciadas para los diversos ámbitos ambientales del Estado Español, especialmente para el período anterior a 1936, y la significativa ampliación que experimentaron seguidamente las posibilidades reales de innovación desde mediados del siglo XX, con la difusión de las nuevas técnicas de la Revolución Verde. Por último y con respecto a las circunstancias que han impulsando la transformación del sector agrario español hasta el momento presente, destacaramos la política económica del Estado y la actividad de las instituciones públicas, identificables con lo que se conoce hoy en día como sistema nacional de innovación.

El impacto de Internet en los medios de comunicación y la industria del deporte.

Atès que la presència de l'esport a Internet cada cop és més recurrent, aquest treball es centra en l'impacte d'Internet en les relacions existents entre alguns dels actors més importants a la indústria de l'esport a Europa: - Organitzacions esportives, que són productors del producte esportiu base; - Mitjans de comunicació, que comuniquen temes esportius; - Organitzacions comercials, que promocionen els seus productes a través de l'esport i els mitjans de comunicació (tot incloent els patrocinadors esportius); - Fans / consumidors del producte base de l' esport. Amb l'anàlisi de l'estructura i continguts d'una mostra de 27 llocs web d'aquestes organitzacions, i després de considerar els conceptes i teories sobre la comunicació a Internet, l'emergència del comerç electrònic i l'e-marketing, i com poden relacionar-se amb la indústria esportiva i la transmissió de missatges esportius, s'estableixen les conclusions sobre quin és l'impacte d'Internet a la indústria esportiva, quan som propers a l'inici de la convergència entre la televisió digital i Internet.

Innovation and internasionalisation. A focus on the Spanish exporting firms

International markets are very competitive so innovation seems unavoidable. Some authors describe internationalisation as being an innovation of the firm. In this research these two phenomena will be studied, through a multiple case study method, focusing on the existence of a reciprocal relationship between the processes of internationalisation and innovation.

L'Efecte dels raigs gamma sobre les pastanagues: recerca i innovació a la cuina del segle XXI

Conferència inagural de la 11a Setmana de la Ciència celebrada el 2006 al Palau Robert

Innovation sources and productivity in Catalonian firms: a quantile regression analysis

This paper explores the effects of two main sources of innovation -intramural and external R&D- on the productivity level in a sample of 3,267 Catalonian firms. The data set used is based on the official innovation survey of Catalonia which was a part of the Spanish sample of CIS4, covering the years 2002-2004. We compare empirical results by applying usual OLS and quantile regression techniques both in manufacturing and services industries. In quantile regression, results suggest different patterns at both innovation sources as we move across conditional quantiles. The elasticity of intramural R&D activities on productivity decreased when we move up the high productivity levels both in manufacturing and services sectors, while the effects of external R&D rise in high-technology industries but are more ambiguous in low-technology and knowledge-intensive services. JEL codes: O300, C100, O140. Keywords: Innovation sources, R&D, Productivity, Quantile regression

Industrial districts, innovation and I-district

The I-district effect hypothesis establishes the existence of highly intense innovation in Marshallian industrial districts due to the presence of external localization economies. However, industrial districts are characterized by specific manufacturing specializations in such a way that this effect could be due to these dominant specializations. The objective of this research is to test whether the effect is explained by the conditions of the territory or by the industrial specialization and to provide additional evidence of the existence and causes of the highly intense innovation in industrial districts (I-district effect). The estimates for Spain of a fixed effects model interacting territory and industry suggest that the high innovative performance of industrial districts is maintained across sectors whereas the industrial specialization behaves differently depending on the type of local production system in which it is placed. The I-district effect is related to the conditions of the territory more than to the industrial specialization. The territory is a key variable in explaining the processes of innovation and should be considered a basic dimension in the design of innovation and industrial policies.