Sustainable Development and Well-Being: A Philosophical Challenge

This paper aims at gaining a better understanding of the inherent paradoxes within sustainability discourses by investigating its basic assumptions. Drawing on a study of the metaphoric references operative in moral language, we reveal the predominance of the ‘well-being = wealth’ construct, which may explain the dominance of the ‘business case’ cognitive frame in sustainability discourses (Hahn et al. in Acad Manag Rev 4015:18–42, 2015a). We incorporate economic well-being variables within a philosophical model of becoming well (Küpers in Cult Organ 11(3):221–231, 2005), highlighting the way in which these variables consistently articulate a combination of ‘objective’ and ‘subjective’ concerns. We then compare this broad understanding of well-being with the metaphors operative in the sustainable development discourse and argue that the sustainability discourse has fallen prey to an overemphasis on the ‘business case’. We proceed to draw on Georges Bataille to challenge the predominance of these value priorities and to explore which mindshifts are required to develop a more comprehensive understanding of what is needed to enable ‘sustainable development’.     

Reoperations in intramedullary fixation of pertrochanteric hip fractures

Objective: This study evaluated the frequency of reoperation within 1 year of initial intramedullary fixation for patients with pertrochanteric hip fracture and compared 1-year healthcare resource utilization and cost burden for patients with and without reoperation.

Methods: This is a retrospective evaluation of medical claims from the US Centers for Medicare and Medicaid Standard Analytic File. Patients aged ≥65?years who underwent fixation with an intramedullary implant for a pertrochanteric fracture between 2013 and 2015 were included. Healthcare resources that were evaluated included skilled nursing facility (SNF), inpatient rehabilitation facility (IRF), readmissions, and outpatient hospital visits. All-cause payments for these services comprised overall cost burden. Generalized Linear Models were used to evaluate healthcare resources and cost burden over 1-year post-surgery and to adjust for confounding between patients with and without a reoperation.

Results: A total of 6,423 Medicare patients were included in the analysis. Mean (SD) age was 82.4 (7.8) years, 76.0% were female, and 93.3% were white. A second hip surgery within 1 year after the index fixation procedure was performed in 414 patients (6.4%): 121 (29.2%) contralateral, 115 (27.8%) ipsilateral, and 178 (43.0%) without specified laterality. After adjusting for confounding factors, Medicare patients with ipsilateral reoperations had statistically significantly higher readmissions (100% vs 32.5%, p?p?=?0.018), admissions to a SNF (88.5% vs 80.4%, p?=?0.024), and admissions to an IRF (38.8% vs 22.0%, p?p?Conclusions: Patients who require a second hip surgery after initial fixation with an intramedullary implant for pertrochanteric hip fractures have significantly higher 1-year healthcare resource utilization and 63.5% higher costs than patients without reoperation.     

Conversations Across Continents: Teaching Business Ethics Online

The paper focuses on an online business ethics course that three professors (Painter-Morland, Fontrodona and Hoffman) taught together, and in which the fourth author (Rowe) participated as a student, from their respective locations on three continents. The course was conducted using Centra software, which allowed for synchronous online interaction. The class included students from Europe, South Africa and the United States. In order to assess the value of synchronous online teaching for ethics training, the paper identifies certain knowledge, skills and capacities that are crucial to the moral development process within individuals. The paper argues that the online teaching method succeeds in creating an environment within which important ethical knowledge and skills might be developed. It provides an in-depth reflection on the advantages and dis-advantages of online teaching and proposes improvements on the way forward. One of the major advantages relates to its ability to facilitate cross-cultural discussion and debate on ethical issues and foster insight into contextual influences on ethics management within an international arena.     

Systemic Leadership and the Emergence of Ethical Responsiveness

The author of this paper argues that the responsibility to nurture and encourage a relationally responsive ethical attitude among the members of an organizational system is shared by all who participate in it. In the dynamic environment of a complex adaptive organizational system where it is impossible to anticipate and legislate for every potential circumstantial contingency, creating and sustaining relationships of trust has to be a systemic capacity of the entire organization. Leadership is socially constructed, as the need for it arises within the complex interactions between individuals and groups within organizations, and can therefore not be described as a set of traits or behaviors possessed by only certain individuals who occupy positions of authority. If the sharing of this kind of relational responsiveness to the everyday realities of organizational life is to be properly understood, it is important to consider it in its concrete institutional manifestations. The last section of this paper therefore explores how an organization, in which leadership is understood in relational terms and is shared by all, looks and functions.     

The Relationship between Identity Crises and Crises of Control

Models of the work-to-family and family-to-work interface were tested in two heterogeneous samples of workers, one from North America (N = 408) and one from China (N = 442), using the same measures translated from English to Chinese using back translation. Consistent with proposed differences in the centrality of work and family, tolerance of work demands, and the availability of family support, work-to-family spillover effects tended to be stronger in the North American sample, whereas family-to-work spillover effects tended to be stronger in the Chinese sample. However, some inconsistencies across cultures did not conform to this generalization. Results point to asymmetric differences between North America and China in the work–family interface. Theoretical implications for resource scarcity and expansionist perspectives are discussed, as well as those for the applicability of work–family interventions across North America and China.     

Surgical treatment,complications, and reimbursement among patients with clavicle fracture and acromioclavicular dislocations: a US retrospective claims database analysis

Abstract

Aims: To assess rates of surgical treatment, post-surgical complications, reoperations, and reimbursement in patients with clavicle fractures and acromioclavicular (AC) dislocations.

Materials and methods: This US retrospective study used data from patients with ≥1 diagnosis of clavicle fracture or AC dislocation (index) between 2012–2016. Surgical treatment was defined as a procedure within 4 weeks after clavicle fracture/AC dislocation. Rates of complications (infection, non-union, mal-union), reoperations (device removal or revisions), and all-cause healthcare reimbursement (adjusted to 2016$) were evaluated 2 years post-index among surgical patients.

Results: A total of 95,243 patients with clavicle fracture and 52,100 patients with AC dislocation were identified. Mean (SD) age for clavicle fracture and AC dislocation was 23.8 (18.6) and 33.0 (15.6) years, respectively. Most clavicle fracture and AC dislocation patients were male (70.9% and 78.0%, respectively), and had few comorbidities (86.4% and 84.8% had a Charlson Comorbidity Index?=?0 and 73.1% and 66.0% had Elixhauser?=?0, respectively). Only 15.2% of clavicle fracture and 5.3% of AC dislocation patients received surgical treatment. Among patients undergoing surgical treatment, 2-year rates of infection, non-union, and mal-union were 1.0%, 4.2%, and 0.9%, respectively, for clavicle fracture, and 2.0%, 0.9%, and 0.1%, respectively, for AC dislocation. Reoperations occurred in 83.0% of clavicle fracture and 67.5% of AC dislocation patients. Mean (SD) 2-year reimbursement was $27,635 ($68,173) for clavicle fracture and $23,096 ($28,746) for AC dislocation.

Limitations: Administrative claims data lack clinical information, limiting inferences that can be made. This data may not be generalizable to other patients.

Conclusions: Rates of surgical treatment for clavicle fractures and AC dislocation and rates of infection, non-union, and mal-union among surgically-treated patients were low. However, surgical patients had high rates of device removal or revision surgery during 2-year follow-up. Improved surgical methods and technologies could reduce non-planned reoperations and device removals, thereby reducing healthcare system costs.     

Reconceptualizing CSR in the Media Industry as Relational Accountability

In this paper, we reconceptualize CSR in the media industries by combining empirical data with theoretical perspectives emerging from the communication studies and business ethics literature. We develop a new conception of what corporate responsibility in media organizations may mean in real terms by bringing Bardoel and d’Haenens’ (European Journal of Communication 19 165--194 2004) discussion of the different dimensions of media accountability into conversation with the empirical results from three international focus group studies, conducted in France, the USA and South Africa. To enable a critical perspective on our findings, we perform a philosophical analysis of its implications for professional, public, market, and political accountability in the media, drawing on the insights of Paul Virilio. We come to the conclusion that though some serious challenges to media accountability exist, the battle for responsible media industries is not lost. In fact, the speed characterizing the contemporary media environment may hold some promise for fostering the kind of relational accountability that could underpin a new understanding of CSR in the media.     

Redefining Accountability As Relational Responsiveness

The way in which accountability is currently employed in business ethics practice is based on a few central assumptions. It is assumed, for instance, that ethical failures result from the deliberate, rational decision-making of moral agents. A second important assumption is that there is a direct cause and effect relationship between the decisions and actions of individuals and the consequences of those decisions. Furthermore, the current approach towards accountability failures relies on the ability on legal sanctions to deter agents from ethical lapses. This paper will argue that these three assumptions do not survive critical interrogation and that our understanding of accountability therefore has to be reconsidered. It will propose that accountability be reconceived as a relational responsiveness towards stakeholders.     

Questioning corporate codes of ethics

This paper argues that corporate Codes of Ethics lose their ability to further moral responsiveness because of the narrow instrumental purposes that inform their adoption and use. It draws on Jacques Derrida's reading of Emmanuel Levinas to argue that, despite the fact that all philosophical language entails a certain violence, corporate Codes of Ethics could potentially play a more meaningful role in furthering ethical questioning within corporations. The paper argues that Derrida's reading of Levinas' notion of ‘the third’ could precipitate the emergence of a broader sense of ethical responsibility towards multiple others within corporations. Codes may also present the opportunity for corporations to engage in the reconsideration of their own purposes in the light of questions of justice towards multiple others. How these changes in the establishment and use of Codes may be accomplished is explored towards the end of the paper.