Healthcare resource utilization by patients with treatment-refractory myasthenia gravis in England

Aims: To examine healthcare resource utilization associated with refractory myasthenia gravis (MG) in England.

Materials and methods: This was a retrospective cohort study of linked data from the Clinical Practice Research Datalink and the Hospital Episode Statistics database collected between 1997 and 2016. Included patients were ≥18?years of age at the index MG diagnosis. Patients with refractory MG were identified using an algorithm based on treatments received. Healthcare resource utilization since the index date was compared between refractory and non-refractory cohorts.

Results: The study included 1149 patients with MG, of whom 66 (5.7%) were refractory. Sex and age at diagnosis did not significantly differ between the refractory and non-refractory cohorts. Rates of healthcare resource utilization per person-year were significantly higher (p?p?Limitations: The algorithm for identifying refractory patients did not include clinical criteria. Also, treatments administered in hospitals or by specialists were not available in the databases.

Conclusions: Patients in England with refractory MG more often visit healthcare providers, are hospitalized and visit an emergency room than patients with non-refractory MG.     

The rise of Mexican entrepreneurial migration to the United States: A mixed‐embeddedness approach

Although many studies have analyzed the behavior of high‐skilled migration to the United States, few have focused on the escalating migration of Mexican entrepreneurs, and particularly on the determinants of this kind of high‐skilled migration. This article addresses this gap through a qualitative approach conforming to quantitative procedures, based on 20 in‐depth interviews applied to Mexican entrepreneurs working and/or living in the United States. Theoretically, a mixed‐embeddedness approach guides this research because it allows examining both the individual characteristics of Mexican entrepreneurs, and the influence of the home and host countries' institutional contexts on their business endeavors. Findings revealed Mexico's institutional weaknesses, such as insecurity, corruption, and bureaucracy, are important drivers of migration but so are the perception of a friendly U.S. fiscal system, the search for a better quality of life, and the appeal of a more transparent business environment.     

Good global citizen? ASEAN’s image building in the United Nations

ABSTRACT

Based on role theory, the article examines the images that ASEAN member governments project of their organization. It rests on a discourse analysis of 198 speeches in the United Nations General Assembly between 1998 and 2017. Findings suggest that ASEAN does not figure as a top priority for delegates and that an overarching ASEAN role conception is missing. However, their addresses reveal parameters on which a collective role conception can be built. Individual ASEAN countries undertake great efforts to project themselves as ‘good global citizens,’ a role conception that could also be applied to ASEAN.     

The impact on stock prices of deferral and elimination of internal control audit requirement for small firms

This paper examines the cumulative market reaction to the events related to deferral of internal control audit requirement under the Sarbanes-Oxley Act of 2002 and its elimination under the Dodd-Frank Act of 2010 for nonaccelerated filers (small firms). We document that small firms experienced negative cumulative abnormal returns around these events; and the differences between the cumulative abnormal returns for small firms and the two control groups (accelerated and large accelerated filers) were negative and significant at the 1% level. These results support the notion that market participants value the reliability of financial information irrespective of the firm size. Within the small firms, we find no firm characteristic significantly explains the market reaction to the events considered. That is, all small firms lost market value in reaction to the events that delayed and eliminated their internal control audit requirement.     

Advancing environmental productivity: Organizational mindfulness and strategies

This study investigates the importance of mindfulness‐based organization systems and policies on the organization's continuous efforts to become a greener company. The study is devised as a pooled cross‐sectional time series analysis of productivity in energy consumption, water utilization, and waste generation and recycling of U.S. companies. The data set taken from U.S. Newsweek 500 recorded 600 companies dispersed into 63 industries during the period of 2012–2014 and provided 1,498 company–industry–year observations. The study found that systems and policies (e.g., deployment of third‐party auditors for its environmental metrics report; linkage of the remuneration of company's senior executive team with the achievement of environmental performance targets; and establishment of a committee at the Board of Directors' level whose mandate includes sustainability of the company in environment‐ and resource‐related matters) connect the company's mindfulness to its effort in improving the environmental quality through the company's productivity in energy consumption, water utilization, and waste generation and recycling. The relationships are positive and significant. Also, systems and policies serve as a motivator for the firm to continue to improve upon the current achievements. The study emphasizes the importance of translating organizational and individual mindfulness into organization policies and systems in order to motivate the organization to continuously improve its productivity in energy consumption, water utilization, and waste generation and recycling leading to improvements in environmental quality.     

The power of positivity? The influence of positive psychological capital language on crowdfunding performance

We extend the entrepreneurship literature to include positive psychological capital — an individual or organization's level of psychological resources consisting of hope, optimism, resilience, and confidence — as a salient signal in crowdfunding. We draw from the costless signaling literature to argue that positive psychological capital language usage enhances crowdfunding performance. We examine 1726 crowdfunding campaigns from Kickstarter, finding that entrepreneurs conveying positive psychological capital experience superior fundraising performance. Human capital moderates this relationship while social capital does not, suggesting that costly signals may, at times, enhance the influence of costless signals. Post hoc analyses suggest findings generalize across crowdfunding types, but not to IPOs.     

Drug‐related violence and the decline in the number of Mexican cross‐border workers

This study examines how variations in homicide rates in Mexico are associated with the likelihood of participating in cross‐border work, that is, living in Mexico but working in the U.S. Based on Mexican census data from 2000, 2010, and 2015, and information on homicides, a series of ordinary least squares models are estimated to analyze the relationship between cross‐border commuting and homicide rates at the individual level. Fixed effects models are also estimated to study this relationship at the municipal level. The results show that from 2000 to 2010 the increase in homicide rates in northern border municipalities in Mexico reduced the likelihood of being a cross‐border worker, while from 2010 to 2015 the decrease in the homicide rate increased the probability that workers engage in cross‐border work. The decline in the number of cross‐border workers is likely in part a result of the escalation in drug‐related violence that may have led them to change their country of residence.     

Cost-effectiveness analysis of ramucirumab treatment for patients with hepatocellular carcinoma who progressed on sorafenib with α-fetoprotein concentrations of at least 400 ng/ml

Abstract

Objective: This study aimed to compare the cost-effectiveness of ramucirumab versus placebo for patients with hepatocellular carcinoma who progressed on sorafenib with α-fetoprotein concentrations (AFP) of at least 400?ng/ml in the United States.

Methods: A Markov model was constructed to assess the cost-effectiveness of ramucirumab. Health outcomes were measured as quality-adjusted life years (QALYs). With TreeAge software, the disease process was modeled as three health states: progression-free survival (PFS), progressive disease (PD), and death. Costs were extracted from the REACH-2 trial, and utility was derived from published literature. Incremental cost-effectiveness ratios (ICERs) were calculated to compare ramucirumab with placebo. Probabilistic sensitivity analyses were developed to examine the robustness of the results.

Results: In the base case analysis, ramucirumab therapy had a cost of $55,508.41 and generated 0.54 QALYs, while placebo therapy had a cost of $761.09 and generated 0.47 QALYs, leading to an additional $54,747.32 in costs and 0.07 QALYs. The ICER was $782,104.57 per QALY, which was much higher than the willingness-to-pay threshold of $100,000 per QALY. According to sensitivity analyses, the utility of PD in the two groups was the dominant parameter influencing the ICER.

Conclusion: Although ramucirumab was associated with prolonged survival for patients with advanced hepatocellular carcinoma who progressed on sorafenib treatment with an AFP of at least 400?ng/ml, it is not a cost-effective treatment from a United States payer perspective.     

Political economy of the US–Mexican tomato trade agreement

We develop a political economy model to analyse the US–Mexican tomato trade agreement by treating the minimum import price as a negotiated settlement. We incorporate the special characteristics of the US–Mexican tomato dispute, namely trade among large countries, the role of competing fresh and processed tomato lobbies, quota revenues accruing to Mexican producers, bargaining for a minimum import price rather than a tariff, and the role of the Canadian tomato market. We show the importance of the size of the lobby group's supply, the weight elected officials' place on national welfare, and the elasticities of export supply and import demand in determining the optimal price wedge. For the United States, larger fresh tomato or cherry–grape tomato supply intensifies the degree of protection awarded to US growers, while US processors work to mitigate this effect. From Mexico's perspective, larger Mexican fresh or cherry–grape output induces a push towards free trade due to the agreement's depressing effect on Mexican prices, while Mexican processors and quota revenues exacerbate the price wedge.     

Decrease in American birth rates makes it imperative for the United States to implement state mandated fertility coverage

In recent years, the prevalence of infertility has increased due to delayed childbearing and an increase in the rate of male infertility. Given the high cost of fertility treatment, this option is not valid for families with a low income, and those who can afford it usually choose to have multiple embryo transfer, which has led to an increase in multiple birth rates and an increase in the cost of perinatal care. Due to the expected increase in infertility and decrease in the national live birth rate, the US should set a plan to fund infertility treatment and lead a policy for single embryo transfer. This will offset the decrease in the national birth rates and decrease expenditure on perinatal and neonatal complications resulting from multiple births.