Global health resource utilization associated with pacemaker complications

Aim: To estimate health resource utilization (HRU) associated with the management of pacemaker complications in various healthcare systems.

Methods: Electrophysiologists (EPs) from four geographical regions (Western Europe, Australia, Japan, and North America) were invited to participate. Survey questions focused on HRU in the management of three chronic pacemaker complications (i.e. pacemaker infections requiring extraction, lead fractures/insulation breaches requiring replacement, and upper extremity deep venous thrombosis [DVT]). Panelists completed a maximum of two web-based surveys (iterative rounds). Mean, median values, and interquartile ranges were calculated and used to establish consensus.

Results: Overall, 32 and 29 panelists participated in the first and second rounds of the Delphi panel, respectively. Consensus was reached on treatment and HRU associated with a typical pacemaker implantation and complications. HRU was similar across regions, except for Japan, where panelists reported the longest duration of hospital stay in all scenarios. Infections were the most resource-intensive complications and were characterized by intravenous antibiotics days of 9.6?13.5 days and 21.3?29.2 days for pocket and lead infections respectively; laboratory and diagnostic tests, and system extraction and replacement procedures. DVT, on the other hand, was the least resource intensive complication.

Limitations: The results of the panel represent the views of the respondents who participated and may not be generalizable outside of this panel. The surveys were limited in scope and, therefore, did not include questions on management of acute complications (e.g. hematoma, pneumothorax).

Conclusions: The Delphi technique provided a reliable and efficient approach to estimating resource utilization associated with chronic pacemaker complications. Estimates from the Delphi panel can be used to generate costs of pacemaker complications in various regions.     

Reflections on pilgrims' identity,role and interplay with the pilgrimage environment

This article critically analyses the evolving concepts of the identities and roles of pilgrims as well as how their interaction with the pilgrimage environment contributes to a better understanding of the religious journey in the postmodern society. The article concludes that the predominantly theoretical paradigm framing pilgrimage as a tourism phenomenon might be limited and downplays the complexity of the pilgrims' experience nowadays. Alternatively, it proposes to explore the experience in terms of the pilgrims' evolving identity and role based on two universes. The first explores the impact of exposure to different levels of mundane dimensions in everyday life; and the second unveils the possible influences of the Ego–Alter (pilgrim–pilgrimage environment) relationship on pilgrims' identities and roles. The theoretical review and discussion on these reflections develops an alternative experiential spectrum that looks at these identities and roles. This proposed spectrum is constructed by four pilgrim typecasts stretching from the ‘traditional pilgrim’ up to and including the ‘post-postmodern’ one. This spectrum allows a better understanding of the cohabitation of different pilgrim typecasts experiencing the pilgrimage environment simultaneously but with varying levels of religious engagement.     

Careers and wages in the Dutch East India Company

Inter-continental trade brought a novel form of organizing business to early modern Europe: the multinational firm. Headquartered in Europe and operating in Asia, the success of the East India Companies depended largely on the management of overseas outposts and their corresponding labor force. Using a dataset of 115 individuals hired in Europe to work in Asia, I present the internal structure of the careers and wages of civil servants in the Dutch East India Company in the eighteenth century. There were stable career paths, fast tracks in promotions, and sizable returns to tenure. Despite the 300-year-old evidence, the VOC conforms rather well with present personnel practices and theories of internal labor markets.     

Industrial restructuring in Russia: early reactions fo firms to the shock of liberalization1

This paper looks at the reaction of Russian firsm to the shock of liberalization. Firms are exposed to two kinds of shocks. A supply affects their profitability. A demand shock reflects the new expression of consumers and the opening of the country to foreign competition. Econometric tests show that firms adapt to these changes. They react by adjusting their output. They are not able to change their production techniques for lack of fresh capital. Employment is more stable that output: it is preserved by the adjustment of real wages. Therefore, firms with a low share of material inputs are relatively better off.     

The Effect of Fiscal Decentralization on Corruption: A Non‐linear Hypothesis

This study advances the literature on the effect of decentralization on corruption by proposing a theoretical motivation for the hypothesis that the corruption‐minimizing decentralization arrangement prescribes intermediate decentralization degrees: a ‘middle’ decision‐making power of local governors may mitigate the tradeoff between the rent‐seeking incentive for local politicians and the effectiveness of their voters’ monitoring. The estimation of a non‐linear empirical model strongly confirms that a decentralization degree between 15% and 21% minimizes corruption even through different estimation procedures, introduction of control variables and the use of internal and external IV and of alternative decentralization and corruption measurements.     

Trust,regulation, and contracting institutions

This paper demonstrates that trust directly influences contracting efficiency. We document that trust reduces demand for contract regulation and positively relates to a high‐quality contracting environment, supporting a substitution hypothesis. Furthermore, contract regulation no longer leads to poor contracting outcomes. These findings suggest that lack of trust significantly explains inefficient contracting institutions. Based on interaction effects, we note that trust could complement formal enforcement in countries with weak regulation. As regulation increases, trust substitutes for contract regulation. Overall, trust positively promotes efficient contracting by reducing burdensome regulation and providing an alternative to formal contract enforcement.