Hospital costs associated with thyroidectomy performed with a Harmonic device compared to conventional techniques: a systematic review and meta-analysis

Objectives: Harmonic devices have become a world-wide standard for dissection and hemostasis in thyroidectomy. Numerous systematic reviews have reported superior operating times, blood loss, post-operative pain, length of stay, and overall safety outcomes. What has not been extensively evaluated in a robust manner is their economic impact. The purpose of this study is to evaluate the hospital costs associated with open thyroidectomy using Harmonic devices compared with conventional techniques for hemostasis. Methods: A systematic review of Medline, Scopus, and CENTRAL was performed from January 1, 2000 to May 23, 2014 without language restrictions for randomized clinical trials comparing Harmonic surgical devices to conventional methods in thyroidectomy. The main outcome measure was total reported costs. Costs were pooled using the ratio of means and a random effects model. Sensitivity analyses assessed whether differences in patient and trial characteristics, healthcare setting, or choice of statistical model affected outcomes. Results: Seven studies met the inclusion criteria. A total of 476 participants had procedures performed with Harmonic devices and 478 with conventional monopolar electrosurgery and clamp, cut and tie techniques. Compared with conventional techniques, Harmonic devices reduced total reported costs by 10% (p?=?0.007), resulting in a $229?US dollars (USD) absolute reduction from mean baseline costs. Results remained relatively robust to additional sensitivity analyses. Conclusions: This systematic review and meta-analysis demonstrates that the Harmonic family of surgical devices is associated with a reduction in total reported costs in thyroidectomy compared with conventional techniques. A large portion of the overall savings derives from a reduction in operative costs.     

Long-term mortality following injury in working-age adults: a systematic review

Priorities for prevention activities and planning for services depend on comprehensive knowledge of the distribution of the injury-related burden in the community. The aim of this systematic review was to quantify the effect of being injured, compared with not being injured, on long-term mortality in working age adults. Cohort studies were selected that were population-based, measured mortality post-discharge from inpatient treatment, included a non-injured comparison group and related to working-age adults. Data synthesis was in tabular and text form with a meta-analysis not being possible because of the heterogeneity between studies. Eleven studies met the inclusion criteria. All studies found an overall positive association between injury and increased mortality. While the greatest excess mortality was evident during the initial period post-injury, increased mortality was shown in some studies to persist for up to 40 years after injury. Due to the limited number of injury types studied and heterogeneity between studies, there is insufficient published evidence on which to calculate population estimates of long-term mortality, where injury is a component cause. The review does suggest there is considerable excess mortality following injury that is not accounted for in current methods of quantifying injury burden, and is not used to assess quality and effectiveness of trauma care.     

Management of collaborative research: collaboration and exploitation under the UK's information engineering advanced technology programme

An evaluation of a large government-supported programme of research in information technology has enabled a detailed analysis to be made of motives, participant characteristics, management styles and exploitation routes in a large number of collaborative research projects. One particularly successful collaborative structure is discussed in detail. The analysis also highlights a series of issues which must be addressed by programme adminstrators, including the need to strike a balance between rigidity and flexibility in the definition and management of collaborative research programmes.     

Beyond the world of packaged goods: assessing the relevance of integrated marketing communications for retail and consumer service marketing

Product and packaged goods marketers have responded to changing consumer and media environments by adopting integrated approaches to marketing communication. The value and utility of such approaches likely extend to a wide range of marketers, but there have been few published attempts to examine the viability of the integrated marketing communication concept in retail and service marketing. This study addresses this void by using a seven-stage model of integrated marketing communications to examine the media and message delivery practices of national and regional retailers and consumer service marketers. The results of a national mail survey found many of these marketers using such key integrated marketing communication elements as multiple media, databases, individual-level consumer information and behavioural response measures in their media and message delivery practices. Few, however, were using these elements in a strategic or coordinated fashion. Integrated approaches thus appear to have much value in retail and service marketing, particularly as a means for coordinating media and message delivery elements in a fashion that provides a way to link behavioural responses to media vehicles and advertising messages.     

Assessing holiday satisfaction of Australian travellers in Vietnam: An application of the HOLSAT model

The hotel business model has been diversified in response to the various needs of consumers. Many previous studies focused on the alteration factors of the hotel business model from the consumer's point of view. Although it is one of the factors that affect alteration of the hotel business model, the manager's perspective is also an important alteration factor. This article emphasizes that it is necessary to consider not only the consumer side, but also the management side based on two approaches of the strategy theory: the positioning approach and the resource-based approach.

Surveys were conducted by mail in order to gather information regarding what managers in Japan consider to be important components of a hotel. As a result, “location” was found to be the most important component, followed by “annex facilities” and “deployment system”. Once the components were ordered according to their relative importance, a strong relationship was found between the managers' preferences and the characteristics of “syukuhakusyutai-type” hotels, which are ‘direct management’ (DM) hotels located usually in the city. In Japan, the number of “syukuhakusyutai-type” hotels has recently increased, therefore capturing the spotlight in the hotel industry. However, the results of this research are not compared with those of much previous research conducted on hotel choice attributes, because the measured variables differed significantly.     

Strategic timing of earnings announcements?

Using firm‐specific regressions, I show that earnings response coefficient differ across firms. However, there is no evidence of differential earnings response coefficient to a certain earnings announcement time. By switching to a different announcement time from its preferred time, a firm does not gain a softer market reaction. I compare research results from a firm‐specific method and from a pooled time‐series and cross‐sectional method and demonstrate that they differ significantly due to large heterogeneity across firms. I suggest that researchers should adopt a firm‐specific approach to avoid misleading results and to achieve improved estimations.     

Conditions and intervention strategies for the deliberate acceleration of socio-technical transitions: lessons from a comparative multi-level analysis of two historical case studies in Dutch and Danish heating

ABSTRACT

Policy-oriented transition frameworks such as Strategic Niche Management, Transition Management, and Technological Innovation Systems offer limited analytical traction on deliberately accelerated socio-technical transitions. Using the Multi-Level Perspective as guiding framework, we therefore inductively explore the political acceleration of socio-technical transitions by investigating two deliberately accelerated heating transitions: the transition from coal and oil to natural gas in the Netherlands (1948–1973), and the transition from oil to district heating in Denmark (1945–1990), to draw lessons about the conditions and intervention strategies that facilitate rapid socio-technical change. We find that both cases were characterised by weakened regimes, stabilised niche-innovations, focusing events, and consensus between policymakers and business actors. User resistance was also low in both cases, partly because of public policies. Different focusing events in each case produced problem-driven versus opportunity-driven transition pathways; the former destabilised existing regimes but generated future-oriented uncertainty, while the latter facilitated rapid closure.     

The political economy of gender disparity in musical markets

This paper examines the role and functioning of women withinthe music industry from a broadly economic perspective whichstarts from standard notions of biological differences and theoriesof discrimination. Disparities in employment as a musician andoutput as a composer are considered. It is clear that femalerepresentation deviates considerably from parity. While consciousdiscrimination at the point of trade seems not to be a largefactor in this, unconscious discrimination in early musicalcapital investment sets in motion a chain of events which limitfemale performance in musical markets.     

The Industry Council Plan as an Instrument of Reconstruction

This paper looks at the doctrines of ‘Wicca’, or what might be termed as pagan or white magic by its adherents, in terms of the economics of religion. The primary focus of the paper is the issue of the degree of product differentiation involved from established religion in terms of two things: the concept of God (or deities) and the ideas of sin. The main contribution of the paper is that it presents (for the first time ever, so far as the author is aware) an economic analysis of the doctrine of a ‘rebound’ effect of any attempts to do harm to other people through the practice of magic. Some basic microeconomic concepts suggest that the moral force of this rebound law is a difficult one to sustain except under very unreasonable assumptions.     

THE IMPACT OF THE INDONESIAN FINANCIAL CRISIS ON CHILDREN: AN ANALYSIS USING THE 100 VILLAGES DATA

This paper examines the impact of the Asian financial crisis on children in Indonesia. Specifically, data from four rounds of the 100 Villages Survey are used to examine changes in school attendance rates, child labour force participation and health status. The paper also examines ways in which households are coping with the crisis. The findings provide little evidence that the crisis has had a dramatic negative impact on children. School attendance dropped slightly after the onset of the crisis but has since rebounded to higher than pre-crisis levels. Fewer children are now working, although the older children who are working and not attending school seem to be working longer hours. Comparisons of child health status indicators over time are complicated by changes in the questionnaire but appear to show a relatively stable pattern of child health.