Deriving benefits from conflict resolution: A macrojustice assessment

Effective conflict resolution procedures serve to minimize dysfunctional effects of conflict and maximize functional effects. In the literature on conflict resolution procedures, the effectiveness of procedures has been evaluated primarily from the perspective of the individual. This article suggests that a system-level analysis of the pattern of outcomes resulting from different conflict resolution procedures is a necessary component in formulating a comprehensive framework for the design and evaluation of conflict resolution systems in organizations. The analytic questions addressed by this study concern associations between resolution procedures and outcome patterns in a system created specifically for conflict resolution within organizations: the grievance system. The pattern of outcomes was found to vary with the conflict resolution procedure. It is suggested that this has important implications for effective conflict resolution systems.     

The “Iron Law of Paternalism” in Employee Grievances and Arbitration? A Comparison of Disciplinary and Nondisciplinary Cases

In the criminology literature, the iron law of paternalism suggests that women receive less serious sanctions in the judicial system. This examination of three years of grievance outcomes (n= 1216) and arbitration outcomes (n= 1146) tests this iron law in the context of organizational disciplinary and dispute resolutions. These data, across several levels of outcomes (win, lose, compromise), controlling for the severity of grievances (disciplinary/nondisciplinary) and arbitrations (termination/nontermination) provide no support for the paternalistic thesis. Moreover, we find no support for the paternalistic thesis with regard to either the incidence or length of suspensions as a function of gender.     

Optimal liquidation under stochastic liquidity

We solve explicitly a two-dimensional singular control problem of finite fuel type for an infinite time horizon. The problem stems from the optimal liquidation of an asset position in a financial market with multiplicative and transient price impact. Liquidity is stochastic in that the volume effect process, which determines the intertemporal resilience of the market in the spirit of Predoiu et al. (SIAM J. Financ. Math. 2:183–212, 2011), is taken to be stochastic, being driven by its own random noise. The optimal control is obtained as the local time of a diffusion process reflected at a non-constant free boundary. To solve the HJB variational inequality and prove optimality, we need a combination of probabilistic arguments and calculus of variations methods, involving Laplace transforms of inverse local times for diffusions reflected at elastic boundaries.     

Economic structure and change in the Balkan region: implications for integration,transition and economic cooperation

The purpose of this article is to provide a comprehensive comparative analysis of the economic performance, economic structure and trade relations of the Balkan countries, in order to detect basic trends and developments in the region. On the basis of this analysis, the article evaluates alternative scenarios regarding the prospects of the region in the evolving pan‐European economic order and discusses policy responses to the pressures generated by the interaction of the integration and transition processes in South‐eastern Europe. Le but de cet article est de fournir une analyse comparative compréhensive de la performance et de la structure économiques et des relations commerciales des États balkaniques afin de détecter les tendances et les d? veloppements fondamentaux dans la région. Sur la base de cette analyse, cet article évalue différents scénarios pour l’avenir de la région dans l’ordre économique paneuropéen qui se développe lentement, et discute des réponses politiques aux pressions engendrées par l’action mutuelle des processus d’intégration et de transition en Europe du sud‐est.     

Nilotinib versus dasatinib as second-line therapy in patients with Philadelphia chromosome-positive chronic myeloid leukemia in chronic phase who are resistant or intolerant to imatinib: a cost-effectiveness analysis based on real-world data

Objective: To evaluate the cost-effectiveness of second-line nilotinib vs dasatinib among patients with Philadelphia chromosome-positive chronic myeloid leukemia in chronic phase (Ph+?CML-CP) who are resistant or intolerant to imatinib, from a US third-party perspective.

Methods: A lifetime partitioned survival model was developed to compare the costs and effectiveness of nilotinib vs dasatinib, which included four health states: CP on treatment, CP post-discontinuation, progressive disease (accelerated phase [AP] or blast crisis [BC]), and death. Time on treatment, progression-free survival, and overall survival of nilotinib and dasatinib were estimated using real-world comparative effectiveness data. Parametric survival models were used to extrapolate outcomes beyond the study period. Drug treatment costs, medical costs, and adverse event costs were obtained from the literature and publicly available databases. Utilities of health states were derived from the literature. Incremental cost-effectiveness ratios, including incremental cost per life-year (LY) gained and incremental cost per quality-adjusted life-year (QALY) gained, were estimated comparing nilotinib and dasatinib. Deterministic sensitivity analyses were performed by varying patient characteristics, cost, and utility inputs.

Results: Over a lifetime horizon, nilotinib-treated patients were associated with 11.7 LYs, 9.1 QALYs, and a total cost of $1,409,466, while dasatinib-treated patients were associated with 9.5 LYs, 7.3 QALYs, and a total cost of $1,422,122. In comparison with dasatinib, nilotinib was associated with better health outcomes (by 2.2 LYs and 1.9 QALYs) and lower total costs (by $12,655). Deterministic sensitivity analysis results showed consistent findings in most scenarios.

Limitations: In the absence of long-term real-world data, the lifetime projection could not be validated.

Conclusions: Compared with dasatinib, second-line nilotinib was associated with better life expectancy, better quality-of-life, and lower costs among patients with Ph+?CML-CP who were resistant or intolerant to imatinib.     

Clinical burden and healthcare resource utilization among patients with chronic hypoparathyroidism,overall and by adequately vs not adequately controlled disease: a multi-country chart review

Abstract

Aims: To assess the real-world clinical burden and healthcare resource utilization (HRU) among patients with chronic hypoparathyroidism, overall and by adequately controlled (AC) vs not adequately controlled (NAC) disease, informed by guideline-recommended clinical management targets, including biochemistry and symptoms.

Materials and methods: In this retrospective online chart review, endocrinologists in the US, Canada, the UK, France, Germany, Italy, and Spain were randomly selected to review the medical charts of adult patients with chronic hypoparathyroidism receiving calcium and activated vitamin D. Patients’ demographics, disease characteristics, symptoms, comorbidities, and hypoparathyroidism-related HRU during the 1 year before the review date were assessed. Clinical burden and HRU were compared between patients with NAC and AC hypoparathyroidism.

Results: Of 614 patients with hypoparathyroidism (AC, N?=?442; NAC, N?=?172), the mean age was 43.6?years, and the majority were female (61.6%), Caucasian (78.8%), and had post-surgical hypoparathyroidism (74.4%). Mean duration of hypoparathyroidism was 46.0?months. Hypoparathyroidism-related symptoms and comorbidities were reported in 59.4% and 46.7% of patients, respectively; 90.7% of patients had ≥1 hypoparathyroidism-related HRU event. More patients with NAC (57.6%) vs AC (42.5%) hypoparathyroidism experienced ≥1 comorbidity including calcium/phosphate imbalances, and brain, cardiovascular, metabolic, and renal disorders (all p?<?0.01). More patients with NAC vs AC hypoparathyroidism incurred ≥1 hypoparathyroidism-related hospitalization (27.9% vs 16.3%) and emergency room visits (47.7% vs 38.5%), and patients with NAC vs AC hypoparathyroidism had a higher number of outpatient visits (3.6 vs 2.6; all p?<?0.05), in the 1-year observation period.

Limitations and conclusions: Limitations of this online chart review include possible under-estimation of disease burden, limited sample size, and the inability to rule out selection bias. Findings indicate that patients with chronic hypoparathyroidism experience substantial symptomatic and comorbid burdens resulting in frequent HRU, suggesting an unmet need, particularly in NAC disease.     

Cost reduction from resolution/improvement of carcinoid syndrome symptoms following treatment with above-standard dose of octreotide LAR

Aims: To calculate the cost reduction associated with diarrhea/flushing symptom resolution/improvement following treatment with above-standard dose octreotide-LAR from the commercial payor’s perspective.

Materials and methods: Diarrhea and flushing are two major carcinoid syndrome symptoms of neuroendocrine tumor (NET). Previously, a study of NET patients from three US tertiary oncology centers (NET 3-Center Study) demonstrated that dose escalation of octreotide LAR to above-standard dose resolved/improved diarrhea/flushing in 79% of the patients within 1 year. Time course of diarrhea/flushing symptom data were collected from the NET 3-Center Study. Daily healthcare costs were calculated from a commercial claims database analysis. For the patient cohort experiencing any diarrhea/flushing symptom resolution/improvement, their observation period was divided into days of symptom resolution/improvement or no improvement, which were then multiplied by the respective daily healthcare cost and summed over 1 year to yield the blended mean annual cost per patient. For patients who experienced no diarrhea/flushing symptom improvement, mean annual daily healthcare cost of diarrhea/flushing over a 1-year period was calculated.

Results: The economic model found that 108 NET patients who experienced diarrhea/flushing symptom resolution/improvement within 1 year had statistically significantly lower mean annual healthcare cost/patient than patients with no symptom improvement, by $14,766 (p?=?.03). For the sub-set of 85 patients experiencing resolution/improvement of diarrhea, their cost reduction was more pronounced, at $18,740 (p?=?.01), statistically significantly lower than those with no improvement; outpatient costs accounted for 56% of the cost reduction (p?=?.02); inpatient costs, emergency department costs, and pharmacy costs accounted for the remaining 44%.

Limitations: The economic model relied on two different sources of data, with some heterogeneity in the prior treatment and disease status of patients.

Conclusions: Symptom resolution/improvement of diarrhea/flushing after treatment with an above-standard dose of octreotide-LAR in NET was associated with a statistically significant healthcare cost decrease compared to a scenario of no symptom improvement.     

Union steward locus of control,job, union involvement,and grievance behavior

Discretionary behaviors of union stewards are described. The use (or otherwise) of these behaviors may be a critical index of the number of grievances filed in an organization. Utilization of proactive grievance filing behaviors is systematically associated with steward job involvement, union involvement, and locus of control orientations. This hypothesis received empirical support in this research. Implications for organizational theorists and practitioners alike are discussed.     

A comparison of blue- versus white-collar grievance behavior: A field assessment

This study examines the differences between blue-collar and white-collar employees with respect to grievance behavior in the work place. Specifically, the grievance-filing behavior of blue-collar and white-collar bargaining unit workers-members of the same union local-were compared with respect to number of actions, their severity, and their outcomes. Analyses of these grievances (n=604) indicated gross differences in the grievance-filing activity of these groups. These groups are, however, invariant with respect to severity or outcomes of the contested issues.