Genetics for clinicians: from candidate genes to whole genome scans (technological advances).

Human genetics has progressed at an unprecedented pace during the past 10 years. DNA microarrays currently allow screening of the entire human genome with high level of coverage and we are now entering the era of high-throughput sequencing. These remarkable technical advances are influencing the way medical research is conducted and have boosted our understanding of the structure of the human genome as well as of disease biology. In this context, it is crucial for clinicians to understand the main concepts and limitations of modern genetics. This review will describe key concepts in genetics, including the different types of genetic markers in the human genome, review current methods to detect DNA variation, describe major online public databases in genetics, explain key concepts in statistical genetics and finally present commonly used study designs in clinical and epidemiological research. This review will therefore concentrate on human genetic variation analysis.

A Structural Analysis of the Health Expenditures and Portfolio Choices of Retired Agents

Richer and healthier agents tend to hold riskier portfolios and spend proportionally less on health expenditures. Potential explanations include health and wealth effects on preferences, expected longevity or disposable total wealth. Using HRS data, we perform a structural estimation of a dynamic model of consumption, portfolio and health expenditure choices with recursive utility, as well as health-dependent income and mortality risk. Our estimates of the deep parameters highlight the importance of health capital, mortality risk control, convex health and mortality adjustment costs and binding liquidity constraints to rationalize the stylized facts. They also provide new perspectives on expected longevity and on the values of life and health.

Parallel Research, Multiple Intellectual Property Right Protection Instruments, and the Correlation among R&D Projects, September 2005

The choice of a research path in attacking scientific and technological problems is a significant component of firms’ R&D strategy. One of the findings of the patent races literature is that, in a competitive market setting, firms’ noncooperative choices of research projects display an excessive degree of correlation, as compared to the socially optimal level. The paper revisits this question in a context in which firms have access to trade secrets, in addition to patents, to assert intellectual property rights (IPR) over their discoveries. We find that the availability of multiple IPR protection instruments can move the paths chosen by firms engaged in an R&D race toward the social optimum.

Do welfare benefits affect womens' choices of adult care giving?

The efficacy of social care, publicly and universally provided, has been contested from two different points of view. First, advocates of targeting social policy criticized the Matthew’s effect of universal provision and; second, theories arguing in favour of heterogeneous rationalities between men and women and, even different preferences among women, predict that universal provision of services is limiting women’s choices more than home allowances. The author tests both hypotheses and concludes that, at least in the case of adult care, women’s choices are significantly affected by women’s social positions and by the availability of public services. Furthermore, targeting through means-test eligibility criteria has no significant effect on inequality but, confirming the redistributive paradox, reduces women’s options.

Cyclical Skill-Biased Technological Change

Over the past two decades, technological progress has been biased towards making skilled labor more productive. The evidence for this finding is based on the persistent parallel increase in the skill premium and the supply of skilled workers. What are the implications of skill-biased technological change for the business cycle? To answer this question, we use the CPS outgoing rotation groups to construct quarterly series for the price and quantity of skill. The unconditional correlation of the skill premium with the cycle is zero. However, using a structural VAR with long run restrictions, we find that technology shocks substantially increase the premium. Investment-specific technology shocks are not skill-biased and our findings suggest that capital and skill are (mildly) substitutable in aggregate production.

On Consumer Decision Strategies: New Approaches for Studying and Aiding Preferential Choices

This dissertation focuses on the strategies consumers use when making purchase decisions. It is organized in two main parts, one centering on descriptive and the other on applied decision making research. In the first part, a new process tracing tool called InterActive Process Tracing (IAPT) is pre- sented, which I developed to investigate the nature of consumers' decision strategies. This tool is a combination of several process tracing techniques, namely Active Information Search, Mouselab, and retrospective verbal protocol. To validate IAPT, two experiments on mobile phone purchase de- cisions were conducted where participants first repeatedly chose a mobile phone and then were asked to formalize their decision strategy so that it could be used to make choices for them. The choices made by the identified strategies correctly predicted the observed choices in 73% (Experiment 1) and 67% (Experiment 2) of the cases. Moreover, in Experiment 2, Mouselab and eye tracking were directly compared with respect to their impact on information search and strategy description. Only minor differences were found between these two methods. I conclude that IAPT is a useful research tool to identify choice strategies, and that using eye tracking technology did not increase its validity beyond that gained with Mouselab. In the second part, a prototype of a decision aid is introduced that was developed building in particular on the knowledge about consumers' decision strategies gained in Part I. This decision aid, which is called the InterActive Choice Aid (IACA), systematically assists consumers in their purchase decisions. To evaluate the prototype regarding its perceived utility, an experiment was conducted where IACA was compared to two other prototypes that were based on real-world consumer decision aids. All three prototypes differed in the number and type of tools they provided to facilitate the process of choosing, ranging from low (Amazon) to medium (Sunrise/dpreview) to high functionality (IACA). Overall, participants slightly preferred the prototype of medium functionality and this prototype was also rated best on the dimensions of understandability and ease of use. IACA was rated best regarding the two dimensions of ease of elimination and ease of comparison of alternatives. Moreover, participants choices were more in line with the normatively oriented weighted additive strategy when they used IACA than when they used the medium functionality prototype. The low functionality prototype was the least preferred overall. It is concluded that consumers can and will benefit from highly functional decision aids like IACA, but only when these systems are easy to understand and to use.

Participation of nurses in the execution of clinical research protocol about technological innovation

AbstractOBJECTIVETo report the nurse's experience of inclusion in interdisciplinary clinical study about technological innovation, involving people with spinal cord injury.METHODDescriptive experience report. The empirical support was based on notes about perspectives and practice of clinical research, with a multi-professional nursing, physical education, physiotherapy and engineering staff.RESULTThe qualification includes the elaboration of the document for the Ethics Committee, familiarization among the members of staff and with the studied topic, and also an immersion into English. The nurse's knowledge gave support to the uptake of participants and time adequacy for data collection, preparation and assistance of the participants during the intervention and after collection. Nursing theories and processes have contributed to reveal risky diagnoses and the plan of care. It was the nurse's role to monitor the risk of overlapping methodological strictness to the human aspect. The skills for the clinical research must be the object of learning, including students in multidisciplinary researches.CONCLUSIONTo qualify the nurse for clinical research and to potentialize its caregiver essence, some changes are needed in the educational system, professional behavior, attitude and educational assistance.

Technological competencies in cardiovascular nursing education

Abstract OBJECTIVE To identify the perception of the coordinators of the Specialization Courses in Cardiovascular Nursing about inserting content from Information and Communication Technology (ICT) and analyze them in relation to the technological competencies and regarding its applicability, relevance and importance in assisting, teaching and management. METHOD Descriptive study with 10 coordinators of the Specialization course in Cardiologic Nursing, who replied to the questionnaire for the development of technological competency adapted from the Technology Initiative Guidelines Education Reforms (TIGER), and analyzed using the Delphi technique for obtaining consensus and scored according to the relevance, pertinence and applicability using Likert scale according to degree of agreement. RESULTS Six courses developed ICT content. The contents of the TIGER were considered relevant, pertinent and applicable. CONCLUSION The coordinators recognize the need for technological competencies of the Cardiovascular Nurse for healthcare applicability.

Skill-biased technological change and the business cycle

Over the past two decades, technological progress in the United States hasbeen biased towards skilled labor. What does this imply for business cycles?We construct a quarterly skill premium from the CPS and use it to identifyskill-biased technology shocks in a VAR with long-run restrictions. Hours fallin response to skill-biased technology shocks, indicating that at least part of thetechnology-induced fall in total hours is due to a compositional shift in labordemand. Skill-biased technology shocks have no effect on the relative price ofinvestment, suggesting that capital and skill are not complementary in aggregateproduction.

Expertise and finance: Mergers motivated by technological change

This paper argues that a large technological innovation may lead to a merger wave by inducing entrepreneurs to seek funds from technologically knowledgeable firms -experts. When a large technological innovation occurs, the ability of non-experts (banks) to discriminate between good and bad quality projects is reduced. Experts can continue to charge a low rate of interest for financing because their expertise enables them to identify good quality projects and to avoid unprofitable investments. On the other hand, non-experts now charge a higher rate of interest in order to screen bad projects. More entrepreneurs, therefore, disclose their projects to experts to raise funds from them. Such experts are, however, able to copy the projects and disclosure to them invites the possibility of competition. Thus the entrepreneur and the expert may merge so as to achieve product market collusion. As well as rationalizing mergers, the model can also explain various forms of venture financing by experts such as corporate investors and business angels.

Technological change and the wealth of nations

We discuss a unified theory of directed technological change and technologyadoption that can shed light on the causes of persistent productivity differencesacross countries. In our model, new technologies are designed in advanced countries and diffuse endogenously to less developed countries. Our framework is richenough to highlight three broad reasons for productivity differences: inappropriatetechnologies, policy-induced barriers to technology adoption, and within-countrymisallocations across sectors due to policy distortions. We also discuss the effectsof two aspects of globalization, trade in goods and migration, on the wealth ofnations through their impact on the direction of technical progress. By doing so,we illustrate some of the equalizing and unequalizing forces of globalization.

How different are returns to education? Evidence from German school choices

This study presents estimates of returns to post-secondary educationand wage differentials among graduates fromdifferent secondary schoolsin Germany. I use an empirical model that captures the basic features ofthe German education system. It controls for selection into post-secondaryeducation and treats latter as endogenous in the wage equation. Myresults show that OLS estimates are severely biased. The direction ofthe bias depends on the secondary school type. Annual returns topost-secondary education differ significantly: they are eight timeshigher for graduates from the highest secondary school than for graduatesfrom the lowest secondary school.

European research funding and regional technological capabilities: Network composition analysis

We use network and correspondence analysis to describe the compositionof the research networks in the European BRITE--EURAM program. Our mainfinding is that 27\% of the participants in this program fall into one oftwo sets of highly ``interconnected'' institutions --one centered aroundlarge firms (with smaller firms and research centers providing specializedservices), and the other around universities--. Moreover, these ``hubs''are composed largely of institutions coming from the technologically mostadvanced regions of Europe. This is suggestive of the difficulties of attainingEuropean ``cohesion'', as technically advanced institutions naturally linkwith partners of similar technological capabilities.