Overall survival,costs, and healthcare resource use by line of therapy in Medicare patients with newly diagnosed metastatic urothelial carcinoma

Aims: Medicare patients with metastatic or surgically unresectable urothelial carcinoma (mUC) often receive platinum-based chemotherapy as first line of therapy (LOT), but invariably progress, requiring additional LOTs and healthcare resource use (HCRU). To better understand the evolving mUC treatment landscape, the economic burden of chemotherapy-based mUC treatments among US Medicare patients was estimated.

Methods: Newly diagnosed Medicare patients with mUC were identified from the Surveillance, Epidemiology, and End Results (SEER)-Medicare database. Patients were followed from diagnosis to death, disenrollment, or end of study to characterize LOTs (first [LOT1], second [LOT2], and third or greater [LOT3+]). Kaplan-Meier methods were used to estimate overall survival (OS) by LOT. HCRU and mean costs were reported over the follow-up period, LOT duration, and maximum LOT received.

Results: Among 1,873 eligible patients with mUC (median age?=?77?years; median follow-up?=?7.5?months), 1,035 (55%) received no chemotherapy. Among chemotherapy-treated patients, 61% had LOT1 only, 25% had LOT1 and LOT2 only, and 14% had LOT3+. Median OS was 8.1?months, range was 4.3 (untreated) to 29.8 (LOT3+) months. HCRU frequency increased with additional LOTs. Mean cumulative per-patient cost was $82,912 for all patients, increasing with additional LOTs (untreated?=?$57,207; LOT1?=?$99,213; LOT2?=?$125,190; LOT3+?=?$163,884). Mean per patient per month cost was $18,827 for all patients, decreasing with increasing number of LOTs received (untreated?=?$27,211; LOT1?=?$9,601; LOT2?=?$7,325; LOT3+?=?$6,017).

Limitations: Potential for treatment misclassification when using the algorithm defining LOTs and non-generalizability of results to younger patients.

Conclusions: Over 50% of Medicare patients with mUC received no chemotherapy. Among chemotherapy-treated patients, most received only one LOT. Additional LOTs led to higher mean costs and HCRU, but as patients were followed longer, monthly costs decreased. As treatments evolve to include immuno-oncology agents, these findings provide a clinically relevant economic benchmark for mUC treatment across different traditional LOTs.     

Socio-emotional wealth and corporate responses to environmental hostility: Are family firms more stakeholder oriented?

Do family firms care more for different stakeholders than nonfamily firms when operating in a hostile business environment? This study addresses this question and fills the existing void in family business research. It shows that family-controlled firms adopt corporate social responsibility strategies and balance the demands of internal and external interest groups to preserve their socio-emotional wealth while facing fierce competition, resource scarcity, and penurious economic conditions. More specifically, our analysis of an international sample of 956 listed firms from 2006 to 2014 reveals that family firms show a higher level of corporate social responsibility (CSR) performance and better stakeholder orientation than nonfamily firms. Our findings are useful for managers, policymakers, and responsible investors.     

Do banking system transparency and competition affect nonperforming loans in the Chinese banking sector?

The increasing importance of transparency practices and the improving status of bank competition in China are rarely explored in nonperforming loans (NPLs) literature. Thus, the purpose of this study is to examine banking system transparency and competition along with macroeconomic and bank-specific variables as determinants of NPL. We use the two-step system GMM dynamic panel model for Chinese banks based on annual data from 2000 to 2014. Our results indicate that high transparency in the Chinese banking system decreases poor-quality assets but not in the case of government-owned banks, whereas increase in competition increases NPL. Moreover, we find mixed results in the context of macroeconomics and bank-specific variables. Our study has practical implications in risk management practices and macro prudential policies.     

Corporates' strategic responses to economic policy uncertainty in China

Using a novel news‐based index of economic policy uncertainty, this paper studies the impact of economic policy uncertainty on corporate strategic positioning and corporate risk in China from 2009 to 2015. The study also investigates the impact of corporate strategic positioning on corporate risk. The results show that corporate strategic positioning and economic policy uncertainty have a significant positive impact on corporate risk. The results also explain that economic policy uncertainty increases the market risk of the firms irrespective of their corporate strategy. However, it increases the business risk of prospector firms and decreases the business risk of defensive firms. The study may help the firms to formulate and improve their strategic positioning while considering economic policy uncertainty. Our results are robust to alternate proxies of economic policy uncertainty and corporate risk.     

Global Financial Crisis: An African Perspective

This paper reviews the expanding financial turmoil that has been triggered by the Asian crisis. It examines the factors behind the crisis, its impact on African countries and the main lessons and policy implications for African countries. The onset of the Asian crisis seems to have taken everybody by surprise because the Asian countries that were hit by the crisis had been among the most successful in sustaining high rates of economic growth, keeping high saving and investment rates and improving the quality of life of their citizens. However, the emerging consensus is that the Asian crisis is a hybrid of structural and policy distortions (macro- and micro-economic) in the affected economies. The impact of the crisis on African countries was mainly transmitted through declines in export prices and volumes. The low demand for primary commodities induced by the crisis and the large depreciation of Asian currencies appear to have played major roles in depressing commodity prices. With only a few exceptions, the commodities that suffered large price declines are those for which Asia constitutes an important market (e.g. oil) and/or those mostly supplied by Asian countries (e.g. copper, timber and rubber). Africa’s oil-exporting countries, which experienced large deterioration in their terms of trade, were the most affected. For the continent as a whole, export proceeds declined by 9.5 per cent between 1997 and 1998. This was the product of a 7 per cent decline in export prices and a 2.5 per cent decline in the volume of exports. The paper estimates that the crisis has caused the growth rate in the region to slide down by 1.2 percentage points, which indicates a loss of US $6.2 billion using aggregate GDP for 1997 as the base. To put this in an order of magnitude, it is about US $2 billion higher than the annual average flow of FDI to the continent in recent years. For the majority of African countries where the inflow of private capital is small and where public debt is dominant, the traditional risk management policies, such as adopting realistic exchange rates and reducing government deficits and inflation rates, should continue to be major policy tools to prevent financial crisis. However, as the role of private capital increases the design of macroeconomic policies would need to heed the lessons emerging from Asia. One basic lesson is that careful sequencing of domestic and external liberalization is needed. In that, restrictions on the capital account, especially on the more volatile capital flows should be lifted only after the domestic financial sector has been strengthened with adequate regulatory and supervisory institutions. This is particularly true because the Asian crisis has shown that reserves, even at very high levels, can be quickly depleted given the scale and volatility of short-term capital flows. Le présent document analyse le développement de la tourmente financière déclenchée par la crise asiatique. Il examine les causes de cette crise, son impact sur les pays africains, les principaux enseignements à en tirer et ses incidences politiques pour l’Afrique. Le déclenchement de la crise asiatique semble avoir pris tout le monde de court. Les pays asiatiques touchés sont parmi ceux qui avaient enregistré des taux de croissance économique des plus élevés, maintenu des taux d’épargne et d’investissement des plus soutenus, et amélioré le plus la qualité de vie de leurs citoyens. Cependant, de l’avis général, la crise asiatique résulte de la conjonction de distorsions d’ordre structurels et politiques (macro et micro économiques) dans les pays touchés. Son impact sur les pays africains a été principalement ressenti é; travers la baisse des prix et du volume des exportations. Le fléchissement de la demande des produits de base et la forte dépréciation des monnaies asiatiques provoqués par la crise ont manifestement joué un rôle déterminant dans la chute des cours des produits de base. A quelques exceptions près, les produits dont les prix ont sensiblement baissé sont ceux pour lesquels l’Asie constitue un important marché (par exemple le pétrole) et/ ou ceux qui sont essentiellement fournis par les pays asiatiques (cuivre, bois, caoutchouc). Les pays africains exportateurs de pétrole, qui ont subi une détérioration marquée de leurs termes de l’échange, ont été les plus touchés. Pour l’ensemble du continent, les recettes d’exportation ont baissé de 9,5 pour cent entre 1997 et 1998. Cette situation résulte de la baisse de 7 pour cent des prix et de la contraction de 2,5 pour cent du volume des exportations. Ce document estime que la crise a entraîné un ralentissement de croissance de 1,2 point de pourcentage, soit une perte de 6,2 milliards de dollars EU, si l’on utilise comme base le PIB global de 1997. Traduit en ordre de grandeur, ce chiffre est d’environ 2 milliards de dollars supérieur au montant des flux moyens annuels d’IDE obtenus par le continent au cours de ces dernières années. Pour la majorité des Etats africains oú l’apport de capitaux privés est faible, et la dette publique écrasante, les politiques traditionnelles de gestion de risque, comme l’adoption de taux de change réalistes et la réduction des déficits publics et du taux d’inflation, doivent demeurer les principaux moyens d’action pour prévenir les crises financières. Cependant, à mesure qu’augmente le rôle des capitaux privés, la conception des politiques macroéconomiques devrait tenir compte des leçons qui se dégagent de l’expérience asiatique. La principale leçon est qu’il faut faire preuve de prudence dans la programmation de la libéralisation interne et externe. Dans cet esprit, la restriction des mouvements des capitaux, notamment ceux de capitaux les plus volatiles, ne doit être levée qu’après la consolidation du secteur financier au niveau interne avec le concours d’institutions compétentes de réglementation et de contrôle. Cette précaution est d’autant plus nécessaire que la crise asiatique a démontré que les réserves, même à des niveaux très élevés, peuvent s’épuiser rapidement du fait de l’ampleur et de la volatilité des flux des capitaux à court terme.     

Corporate Data and Future Cash Flows

Abstract:   This article examines the ability of current accounting data to explain future cash flows for UK firms, as disclosed under FRS1 (1991). Rather than examining price data — from which cash flow implications have to be inferred — we follow the more direct approach used in several recent US studies, in which actual future cash flow data are examined. Specifically, our methodology is a development of the OLS regression framework employed by Barth et al. (2001) . We provide a replication of their main OLS analysis, and then extend this to deal with fixed effects and time trends in the levels of cash flow data. Our study finds that the disaggregation of earnings into cash flows and accruals, generates superior explanatory power with regard to future cash flows.     

An Investigation of Market Orientation (MO) and Tourism Small and Medium-Sized Enterprises’ (SMEs) Performance in Developing Countries: A Review of the Literature

This paper aims to build a structured literature review of the field of market orientation and its impact on tourism small and medium-sized enterprises (SMEs) performance in developing countries. This literature review will present a comprehensive survey of market orientation (MO) published articles to facilitate good understanding of MO. It serves as an archive and aims to help the scholars and practitioners to explore, analyse, and develop a clear understanding about the different research points and methodologies implemented in previous studies related to MO and its impact on tourism SMEs’ performance. The paper systematically reviews and categorizes the published literature implementing a three-stage methodology, and thereafter analyzes and reviews this literature methodologically. The review covered many areas and identified some factors that drive/hinder market-oriented activities within tourism SMEs. Furthermore, suggestions have been made to understand more thoroughly how market orientation influences tourism SMEs performance in developing economies. A research gap in the area of market orientation and tourism SMEs performance in developing countries was identified. The study provides great benefits for owner-managers, government policy makers, scholars, and educators by clarifying the concept of market orientation and its relationship with performance in the context of tourism SMEs.     

Religious belief and international business negotiations: Does faith influence negotiator behaviour?

Religious observance is widespread and continues to influence managerial behaviour in many parts of the world. However, its role in international business negotiations has not received much scholarly attention. This study explores some of the key ways in which religious belief shapes negotiation behaviour. Focusing specifically on the Islamic context, and drawing on interviews with 27 religiously observant Muslim managers in Malaysia, the study found that commitment to a common religion among negotiators positively influenced certain components of the negotiation process through, for example, the use of religious/emotional appeal, which emphasised their ‘spiritual camaraderie’. In some instances, however, we observed something of a paradox, whereby differing religious beliefs among negotiating counterparts were claimed to actually enhance, rather than hinder, negotiations.     

Why do self-initiated expatriates quit their jobs: The role of job embeddedness and shocks in explaining turnover intentions

Retaining self-initiated expatriates is a challenge for many organizations. Self-made expatriates tend to be mobile. They are willing to manage their own careers and to take up opportunities to live and work in countries of their own choice. Despite their importance as a source of human capital there are few studies on the work experiences of self-initiated expatriates and on the factors that affect their decisions to stay or leave their jobs. This article examined the effects of both job embeddedness and shocks on the turnover intention of self-initiated expatriates. Drawing on a sample of 204 self-initiated expatriates working in public healthcare organizations in the United Arab Emirates we found that both on-the-job embeddedness and shocks played a key role in predicting turnover intentions. The study also revealed that off-the-job embeddedness moderated the relationship between shock and turnover intentions such that self-initiated expatriates were more likely to consider leaving their organizations when they were firmly embedded in their community. We discuss the practical and theoretical implications of these findings.     

Corporate Governance and Sustainability Performance: Analysis of Triple Bottom Line Performance

Given the potential that environmentally oriented anti-consumption (EOA) has in achieving environmental sustainability, the authors draw upon marketing, management, environmental, and psychology studies to conceptualize and delimit EOA, differentiating it from other (related but distinct) phenomena. In addition, the authors review the available literature at the individual (micro) level and summarize research on the antecedents and meanings of broad and specific/strict EOA practices with different targets. Furthermore, the authors propose an agenda for future research, which reflects on EOA not only at the individual (micro) level, but also lays out new opportunities for EOA work at organizational (meso), industry, and national (macro) levels. The work presented here hopes to spark multilevel research on EOA, its antecedents and consequences, and reactions to EOA phenomena.