Comparing post-operative resource consumption following transcatheter aortic valve implantation (TAVI) and conventional aortic valve replacement in the UK

Objective:

To define the in-hospital and 6-month post-discharge resource use, following Transcatheter Aortic Valve Implantation (TAVI) and conventional Aortic Valve Replacement (AVR) surgery within a single UK hospital.

Methods:

A local service evaluation of patients undergoing TAVI or AVR between January 2011 and May 2012 captured data until 6-months post-procedure, collected from hospital records and via a General Practitioner questionnaire. The main end-points were mortality, time in ITU/HDU, hospital length of stay (LoS), discharge destination, re-admission, and post-discharge primary/secondary care resource use. Sub-group analyses were performed for AVR patients aged ≥80 (AVR?≥?80) and with EuroSCORE of ≥10 (AVR ES?≥?10) to allow more direct comparison with ‘TAVI type’ patients.

Results:

Results are given as means (standard deviation) for TAVI (n?=?51), AVR (n?=?188), AVR?≥?80 (n?=?48), and AVR ES?≥?10 (n?=?47), respectively, unless otherwise stated. Age in years was 83.0 (8.1), 71.2 (13.1), 84.1 (2.7), 79.4 (7.1); EuroSCORE was 24.7 (11.9), 8.1 (6.4), 12.0 (6.0), and 16.5 (6.6); post-operative LoS (days) was 11.5 (11.2), 10.9 (10.8), 14.3 (16.7), and 15.2 (17.7). For discharged patients, 0%, 7%, 13%, and 9% had unplanned cardiac-related re-admissions within 30-days of discharge. Time to first readmission was 74.6 (34.0), 35.0 (34.2), 20.8 (9.7), and 22.6 (14.3) days.

Limitations:

This was a single-center retrospective evaluation, not prospectively powered to confirm differences in outcomes.

Conclusions:

Despite TAVI being performed in an older, higher risk population, LoS was similar to AVR. Most strikingly there were no cardiac-related re-admissions within 30-days for TAVI and time to first re-admission was significantly longer. This evaluation suggests that TAVI is clinically appropriate and provides economic advantages in both the hospital and post-discharge setting in this high risk group. Many patients undergoing TAVI are considered unfit for surgery and, hence, TAVI offers a treatment that delivers similar results to traditional AVR without the high risk associated with surgery.     

Consumer Protection in Electronic Commerce: Some Remarks on the Jordanian Electronic Transactions Law

It has become increasingly certain that the success of e-commerce in any country depends mainly on the predictability and suitability of the legal framework and whether such framework copes sensibly with the needs of online consumers. For e-commerce to reach its full potential, consumers must have effective protection when shopping online, and their primary rights must be adequately protected. This paper thus explores the way in which the Electronic Transactions Law deals with such rights and determine whether or not this law gives due attention to consumer protection in an online environment. Furthermore, this paper encourages debate of what such law should be in order to enhance legal certainty as well as increase trust in e-commerce in Jordan. This paper, however, is not intended to provide the final answer to all questions and challenges in this regard, but to identify the main components, and provide perspectives on how to deal with such issue.     

Australian Rural Accountants’ Views on How Locally Provided CPD Compares with City-based Provision

Abstract

This paper analyses Australian rural accountants’ attitudes and levels of satisfaction with continuing professional development (CPD), based on whether the CPD was delivered by a professional accounting body in a rural or metropolitan area. The paper responds to prior research that finds rural accountants are dissatisfied with professional accounting bodies [Rural and regional Australian public accounting firm services: Service provision, concerns and tensions. Australian Accounting Review, 23(23), 163–176]. Findings of a survey to which 156 rural accountants responded were that when CPD is delivered into the rural areas, there are greater levels of CPD satisfaction. The study also found that cost was significantly better for rural-delivered CPD and that when more rural-based CPD was attended differences became more significant across a number of satisfaction measures. The findings have important implications for both rural accountants and professional accounting bodies.     

Blockchain for tracking serial numbers in money exchanges

Money exchange is one of the most common day‐to‐day activities performed by humans in the daily market. This paper presents an approach to money tracking through a blockchain. The proposed approach consists of three main components: serial number localization, serial number recognition, and a blockchain to store all transactions and ownership transfers. The approach was tested with a total of 110 banknotes of different currency types and achieved an average accuracy of 91.17%. We conducted a user study in real‐time with 21 users, and the mean accuracy across all users was 86.42%. Each user gave us feedback on the proposed approach, and most of them welcomed the idea.     

How career plateau beliefs and leader interpersonal unfairness harm job performance in dysfunctional organizational settings

Building on social exchange theory and attribution theory, this study unpacks the relationship between employees' perceptions of organizational politics and job performance, considering the mediating effect of career plateau beliefs and the moderating effect of leader interpersonal unfairness. The findings provide empirical support for the theoretical predictions. An important reason for which perceptions of dysfunctional organizational politics reduce job performance is that employees develop beliefs that opportunities for their career development are limited. This mediating role of career plateau beliefs is particularly salient to the extent that employees are exposed to organizational leaders who treat them with disrespect. Organizations can mitigate the risk that highly politicized decision-making processes lead to negative performance outcomes by stimulating fair interpersonal relationships.     

Stadiums and Scheduling: Measuring Deadweight Losses in the Victorian Football League, 1920–70

Over a 50 year period, Australian Rules football's major league, the Victorian Football League, did not always use its largest and best-equipped stadium for regular season games between its most popular teams or schedule those teams to play twice in a regular season. We calculate deadweight losses from the use of capital goods (stadiums) and effects of match scheduling in this professional sports league. Such analysis has not been attempted previously because of the absence of a counterfactual. The welfare losses were significant but not sufficient to threaten the survival of a distance-protected cartel.     

The impact of economic globalisation on unemployment: The Malaysian experience

Malaysia plans to emerge as one of the high-income economies by 2020 through the Economic Transformation Programme. A key component of this programme is to adopt more trade liberalisation policies that can generate a variety of economic activities, particularly more jobs. Although the integration with the world market bears the promise of prosperity for the developing and transitional economies, such integration may also adversely affect such economies. Preceding studies regarding labour market and international trade policies are still inconclusive and raise questions that require further examination; particularly in terms of whether exposure to the external sector can create or destroy jobs. The present study evaluates how Malaysia labour market has responded to the economic globalisation of the country. The study focuses on the long-run impact of economic globalisation on unemployment within the period between 1980 and 2014. The study uses autoregressive distributive lags method to examine the pattern of the relationship. The results show that economic globalisation have significant and positive impact on reducing unemployment in Malaysia in the long run. These findings indicate that policy-makers in Malaysia should facilitate the economy globalisation to maintain the current low level of unemployment rate.