Comparative effectiveness of standard endotracheal tubes vs. endotracheal tubes with continuous subglottic suctioning on ventilator-associated pneumonia rates

Ventilator-associated pneumonia (VAP) accounts for the majority of nosocomial pneumonias, which may increase intensive care and prolonged hospital stays. Endotracheal tubes allowing continuous subglottic suctioning may reduce VAP; however, they are more expensive than standard endotracheal tubes not allowing continuous suctioning. he objective of this study was to measure the comparative costs associated with continuous subglottic suctioning endotracheal tubes (CSS-ETT) versus standard endotracheal tubes (S-ETT) among intubated patients and whether cost differential is offset by the occurrence of VAP in patients receiving either type of intubation. A retrospective chart review was conducted for 154 intubated adult patients (77 = S-ETT; 77 = CSS-ETT). The S-ETT group had one case of VAP; the CSS-ETT group had none. The mean total hospital charges were higher for the S-ETT group ($103,600; CSS-ETT= $88,500) (p = 0.3). Although the average number of intubation days and ICU days were greater for the CSS-ETT group, there were no cases of VAP compared to the S-ETT group. ased upon the one S-ETT VAP case and the VAP attributable costs, it is cost effective to use the CSS-ETT.     

Gender and ethnic differences in factors that influence food intake

Abstract The objective of this research was to ascertain the gender-and ethnic-related factors that influence what one eats. This survey was conducted using a validated, pilot-tested questionnaire in 11 states and the District of Columbia, which were participating in the W-182 Western Regional Research project. The results indicated that the factors that influence what one eats differ by gender and ethnicity. Men were very much influenced by likes and dislikes, and by their spouse or significant other. Women were influenced by likes and dislikes, and health. Food likes/dislikes and concerns about health and weight were among the leading four factors for all ethnic groups. Food likes/dislikes were the top factor influencing what is eaten by 51% or more of Asians, Pacific Islanders, Caucasians and Hispanics. Concern about health was the top factor for 62% and 58%, respectively, of African Americans and Native Americans.     

Gerald W. Brock,Telecommunication Policy for the Information Age

Review of Industrial Organization -     

Connecting the Two Faces of CSR: Does Employee Volunteerism Improve Compliance?

In 2004, the United States Sentencing Commission amended the Federal Sentencing Guidelines to allow firms that create “effective compliance and ethics programs” to receive better treatment if prosecuted for fraud. Effective compliance and ethics, however, appear to be limited to activities focused on complying with the firms’ internal legal and ethical standards. We explored a potential connection between the firms’ external corporate social responsibility (CSR) behaviors and internal compliance: Is there an organizationally valid relationship between these two firm activities? That is, when organizations demonstrate CSR with behaviors external to the firm, such as employee volunteerism, are their employees more likely to demonstrate uncompromised legal and ethical compliance behavior internally? We collected data from 164 working professionals enrolled in a top-tier MBA program in the southeastern United States regarding their employer-sponsored volunteer activities and their intentions to comply in various organizational compliance vignettes. We found that employer-sponsored volunteerism is associated with uncompromised compliance choices in one of the three vignettes. This finding indicates preliminary support for further inquiry into the relationship within the firm between external CSR behaviors and policies regarding organizational compliance. Post hoc analyses suggest that employer-sponsored volunteerism is strongly associated with a positive organizational identity, but organizational identity is not associated with the significant compliance vignette. This evidence suggests that the underlying mechanism that connects external CSR behaviors and internal compliance intentions is complex and requires future study.     

The Legal and Economic Evolution of Workers Compensation: Prospects for Enhancing Choice in the System

ABSTRACT: Workers compensation in the United States has been designed as a no-fault system that provides comprehensive medical and income benefits to employees with work-related injuries. Under its no-fault concept and the exclusive remedy doctrine, injured workers relinquish the right to sue their employer in tort in exchange for prescribed, guaranteed benefits that are paid promptly without protracted disputes. However, there is considerable evidence of increasing litigation in and outside the system that is undermining its no-fault principles and siphoning resources away from the efficient delivery of benefits to injured workers. This article reviews the legal and economic developments that are reshaping workers compensation and the threats they pose. The authors argue for a comprehensive reexamination of the structure of the system to resolve the conflicts among its stakeholders and improve its efficiency. Specifically, the authors explore several potential measures that would enhance worker and employer choice to reconcile their interests while restoring the nofault foundation of the system.     

Uber and the Persistence of Market Power

Entry into the taxi industry involves few risks. Entrants have lower costs than the incumbents, sunk costs are small, and modern technology makes it easy to hail a cab using the Internet. Despite large scale entry and low barriers to entry, monopoly power persists. The persistence of monopoly power illustrates that new technologies may not quickly eviscerate monopoly power.     

Probability Updating and the Market for Directors’ and Officers’ Insurance

Over the past decade, much attention has been given to the topics of corporate governance and corporate risk management. One increasingly important insurance product associated with each of these issues is directors’ and officers’ (D&O) liability insurance. Given the interconnectedness that exists between D&O insurance, corporate risk management, and corporate governance, we exploit industry‐specific D&O data to explain how industries most associated with the corporate scandals of the early 2000s adjusted demand patterns during periods of certainty and uncertainty. The rich data set coupled with dramatic changes in the marketplace allows for the testing of insurance demand patterns and enables us to offer insight into the market's response to a unique type of loss shock. The results of this study suggest evidence in favor of demand‐side probability updating, whereby those industries most associated with the corporate scandals of the early 2000s adjusted the demand for D&O insurance during periods of greater uncertainty.     

Pricing of telecommunications services

Recently many scholars have argued that society's welfare would be increased if the price of local telephone service were increased, and the prices for toll and enhanced telecommunication services reduced. In this paper we argue that the telecommunications policy literature has largely ignored the impact of varying technical standards on the cost-of-service. Consequently, the marginal cost of exchange service has been overstated. We also show that most work in this area has overstated the elasticity-of-demand for toll services. Taking into account quality and the appropriate elasticities, we conclude that no clear welfare gains will be achieved by raising the price of exchange service.     

Optimizing Environmental Product Life Cycles

In this paper, we propose a methodology, based on materials accounting and operational research techniques, to assess different industry configurations according to their life cycle environmental impacts. Rather than evaluating a specific technology, our methodology searches for the feasible configuration with the minimum impact. This approach allows us to address some basic policy-relevant questions regarding technology choice, investment priorities, industrial structures, and international trade patterns. We demonstrate the methodology in the context of the European pulp and paper industry. We are able to show that current environmental policy's focus on maximizing recycling is optimal now, but that modest improvements in primary pulping technology may shift the optimal industry configuration away from recycling toward more primary pulping with incineration. We show that this will have significant implications for the amount and type of environmental damage, for the location of different stages in the production chain, and for trade between European member states. We caution policy makers that their single-minded focus on recycling may foreclose investment in technologies that could prove environmentally superior. Finally, we hint that member state governments may be fashioning their environmental policy positions at least in part on some of the trade and industrial implications we find.     

The role of buyer power in oligopoly models: An empirical study

This study investigates whether an industry's profitability and concentration are influenced by structural characteristics of the industries and final markets to which it sells. Very few similar studies have been made, and there is some dispute about their conclusions. This study discusses the methodological problems behind this dispute and the ways in which the specification and data used here avoid these problems. The results show that seller profitability rises with the extent to which buyers are dispersed across many industries, but that no other buyer characteristic exerts a significant influence on either the profitability or the concentration of the selling industry.