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Self-completed questionnaires (usually distributed by post) and visual analogue scales (VAS) are common means for collecting valuations for hypothetical EQ-5D health states. Although opportunities for respondents to comment on aspects of the exercise are often included, these data have rarely been the focus of analyses. This paper, therefore, reports on solicited and unsolicited written comments received in a New Zealand survey in 1999 to which 1360 people responded of whom approximately 50% made comments. The comments were systematically analysed via an inductive process that allowed principal themes to emerge with respect to understanding the peculiarities of respondents' valuations, particularly common 'data problems', and their perceptions as to the adequacy or otherwise of the EQ-5D classification system. From our findings we conclude that the valuation exercise imposes a substantial cognitive burden on respondents and many do not understand it (for a variety of reasons documented in the paper). Also, although there is some evidence for expanding the EQ-5D (generic) health-related quality of life dimensions, more research as to whether this holds for a larger sample and across cultural settings is needed. We offer recommendations for future research into understanding respondents' cognitive processes and possible revisions to the design and administration of the EQ-5D. [ABSTRACT FROM AUTHOR]

Background: The vaccine industry is one of the most important health-related industries. It can be affected by accession to the World Trade Organization (WTO) because of probable dramatic changes in the business environment. Iran has already initiated accession negotiations. Purpose of the study: In this paper, we investigate the position of, challenges to, and opportunities for vaccine manufacturing in Iran with regard to accession to the WTO. Methods: This is a qualitative and cross sectional study. To collect information, we designed a questionnaire and interviewed some of the vaccine industry's key opinion leaders in Iran. Before the interviews were conducted, the questionnaires were sent to these individuals by email. Results: According to the interviewees, the country's main challenges with regard to accession to the WTO are the lack of firm internal intellectual property (IP) rules, not being recognized as pre-qualified by the World Health Organization (WHO), the use of old equipment, and a lack of cooperation with global vaccine companies. Major conclusions: Iran's local vaccine industry, with a long history and international reputation that could be used as an advantage, is faced with several challenges, such as problems with keeping up with Current Good Manufacturing Practice (cGMP), a lack of adequate and meaningful investment in research and development (R&D), and limitations on private sector participation in the production of vaccines. Gradual privatization of the industry, improved international relations, utilization of the R&D power of small hi-tech companies, consistent education of human resources, and modernization of infrastructures and equipment are among the suggested solutions. [ABSTRACT FROM AUTHOR]

Home country re-entry from cross-cultural missionary work abroad may be associated with psychological distress. Re-entrants experience multiple losses including loss of identity which may be associated with personal/relational identity gaps and depersonalization/dehumanization. However, research suggests that some re-entrants are resilient with good mental health, while others are fragile with poor mental health. The aims of this paper are to explore the nature and frequency of re-entering missionaries' identity gaps and their depersonalization/dehumanization in resilient and fragile re-entrants. Fifteen re-entering adult Australian cross-cultural missionary workers from four interdenominational Australian mission organizations completed semi-structured interviews. Results were analysed using modified Consensual Qualitative Research methods. Links were established between personal/relational identity gaps, depersonalization/dehumanization and resilience on re-entry. Implications for re-entrants' care are discussed with suggestions for further research. [ABSTRACT FROM AUTHOR]