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.     

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.     

Characterizations of the Pareto and related distributions

In this note, a class of Pareto distributions is characterized based on the Shannon entropy of k-record statistics. As a consequence of that characterizations of the uniform and exponential distributions are given. Received: October 1999     

The economic growth and foreign direct investment nexus: Does democracy matter? Evidence from African countries

This article investigates the impact of democracy on the foreign direct investment (FDI)–economic growth nexus by considering both a country's current and past political regimes. We apply a linear dynamic panel data model to data from 53 African countries over the period 1989–2014. Standard errors of the estimates are Weidmeijer corrected, following an orthogonal deviations transformation. The results show that the direct impact of FDI on growth is positive and significant. Likewise, the stock of democracy plays a positive and significant role in the growth process. However, the positive impact of FDI on growth decreases with the improvement in the historical experience of a country with democracy. These findings imply that with contemporary efforts to expand political rights in Africa, it is critical to identify alternative channels that facilitate the transmission of the flow of FDI into further and sustainable growth.     

Strategic business risk evaluation for sustainable energy investment and stakeholder engagement: A proposal for energy policy development in the Middle East through Khalifa funding and land subsidies

This article projects business risk through deferent industrial scenarios in concentrated solar investments in the United Arab Emirates (UAE). Nationwide, the government seeks a sustainable solution through energy policy development and engagement of the stakeholders for clean energy generation at wider level in the long run. Support has been extended through various support schemes. In the current study, Monte Carlo simulations and net present value (NPV) risk are used to analyse the return on investment. A 5 MW concave solar panel project is evaluated. We have assessed the impact of local factors on profits through NPV. The study proposes that a higher NPV is expected if the concave solar panel project is financed 50% by Khalifa funding. The study also proposes a robust policy and highlights the opportunity of business profitability if the government subsidises land leasing with respect to each scenario. Additionally, the study also proposes a policy to maintain the interests of investors in the UAE.     

On the optimality of escalating penalties for repeat offences against the academic honour code

Although academic dishonesty has a long history in academia, its pervasiveness has recently reached an alarming level. Academic dishonesty not only undermines the purpose of education and the assessment process but also threatens the creditability of academic records. We propose a framework for analysing students’ behaviour with respect to academic policies and honour codes. We draw an analogy between law enforcement and academic integrity enforcement and highlight similarities and differences. The proposed framework captures major determinants of academic dishonesty reported in the literature, namely detection probability, punishment severity, class average and record of academic deviance. The framework models both students’ development of nonacademic skills to improve their grades and teaching assistants’ development of detection skills, which both affect the detection probability. Our analysis demonstrates that the optimality of escalating penalties is conditional on the offenders and academic policy enforcers learning. Use-case scenarios are presented to facilitate the implementation of our results in classrooms.     

Dynamic linkages among real interest rates in international capital markets

Short-run and long-run dynamic linkages among weekly real interest rates for G-10 countries are examined using a variety of time-series tests. These tests give special attention to the time-series properties of nominal interest rates, ex-ante expected rates of inflation and real interest rates. Term structure information is used to recover a theoretically consistent measure of ex-ante expected inflation. In-sample and out-of-sample Granger causality tests are also examined to evaluate lead/lag relationships among real interest rates. The results provide strong support for well-integrated markets, particularly in the long run. The results imply leadership roles for the US in international asset markets.     

Economic Globalisation and Youth Unemployment – Evidence from African countries

The present study seeks to examine the impact of economic globalisation on youth unemployment for 50 African countries between the period 1994 and 2013. In addition to the economic globalisation measurements, the present study controlled the variables that represent the fluctuations in economic activates; demographic changes, a country’s economic size; the quality of governmental institutions; and labour market regulation. The results of the Arellano-Bond (A-B) GMM technique showed that greater openness to global markets would reflect in a lower youth unemployment rate. Furthermore, the results revealed that rigidity in labour market regulations seemed to reduce the youth unemployment rate. In addition, urbanisation seemed to raise the youth unemployment rate. The findings supported contemporary calls to participate in international trade to facilitate the job creation process.     

Assessing Dynamics of Palm Oil Import Demand: The Case of Six Asian Countries

This article uses annual data to investigate the palm oil import demand in selected Asian countries (India, China, Japan, Bangladesh, Korea, and Pakistan) through using the autoregressive distributed lag (ARDL) technique. The findings of the study show that the palm oil and substitute oils prices and the national income of the importing countries are significant determinants of palm oil demand across the six models. Other factors such as biofuel mandate, trade policies, and exchange rate also proved to be important factors affecting import demand for palm oil in some of these countries.