In environmental policymaking, the figurative cake that is wanted both to have and eat lies in achieving dematerialisation, i.e. reducing material resource use, and simultaneously pursuing a pathway lined with economic growth. Under such a scenario, we could have it all: increasing production and international convergence at the highest levels of consumption with a reduced impact on the environment in a lifestyle which could also be enjoyed by generations to come. In the following, we make a case for considering the evidence in contemplating the feasibility of such a utopia by taking social metabolism i.e. the material and energy input of society, into account. 相似文献
Background: Non-vitamin K antagonist oral anticoagulants (NOACs) have been included in international guidelines as important alternatives to vitamin K antagonists (VKAs) for the treatment of venous thromboembolism (VTE) and stroke prevention in non-valvular atrial fibrillation (NVAF). Meanwhile, in the Netherlands, NOACs are widely used next to VKAs. The objective of this study is to estimate the cost-effectiveness of treatment with rivaroxaban compared to VKAs in NVAF and VTE patients in the Netherlands, using data from international prospective observational phase IV studies.
Methods: Two models were developed to represent NVAF and VTE patients, populated with patients from the XANTUS (NCT01606995) and XALIA (NCT01619007) international prospective observational studies. The 1-year cost-effectiveness of rivaroxaban use, compared to VKAs, was explored in a population consisting of NVAF and VTE patients (base case) as well as for four scenarios with sub-populations: NVAF patients only, VTE patients only, NVAF patients with unstable international normalized ratio (INR), and NVAF patients using an INR self-measuring device.
Results: In the base case, rivaroxaban saved €72,350 and gained 21 quality-adjusted life-years (QALYs) in a simulation of 2,000 patients over the use of VKAs. Ergo, rivaroxaban was dominant over VKAs. The probabilistic sensitivity analysis showed a probability of 85% for rivaroxaban being dominant and 100% at a willingness-to-pay threshold of €20,000/QALY. Rivaroxaban appeared to be dominant in all scenarios as well, except for the NVAF-patients-only scenario where the incremental cost-effectiveness ratio (ICER) was €157/QALY.
Conclusions: In patients with NVAF or VTE, rivaroxaban treatment is likely to be cost-effective and a potentially cost-saving alternative to VKA in the Netherlands. 相似文献
We consider a pure exchange, general equilibrium model, with two periods and a finite number of states, commodities, numeraire assets, and households. Participation in the asset markets is restricted in a household specific manner, imposing upper bounds on the amounts of borrowing which can be obtained using assets. Those bounds are assumed to depend on asset and commodity prices. After establishing existence of equilibria, we show that, generically in the set of the economies, equilibria are finite and regular. Then, we restrict our attention to the significant set of economies in which some associated equilibria exhibit a sufficiently high number of strictly binding participation constraints. We prove that, generically in that set, those equilibria are Pareto improvable through a local change of the participation constraints. 相似文献
We analyze whether firms that receive venture capital (VC) at a later date face more financial constraints than a one-by-one matched sample of firms that did not receive VC funding (control group). The aim is to check whether their financial flexibility explains why they decide to seek external equity funding. In contrast with other papers, which focus on the sensitivity of investments to cash flow, we study this issue by applying a dynamic model to analyze the speed of adjustment to their target debt levels prior to receiving the first VC investment. We analyze a representative sample of 237 Spanish unlisted firms that received VC between 1995 and 2007 and its corresponding control group. We find that firms that receive VC funding show a significantly lower speed of adjustment than their matched peers before the initial VC round. It seems that the former are more concerned about funding the required investments than about adjusting the firm's debt ratio to a target level. Our results confirm the role of VC in filling the equity gap in constrained unlisted firms. From a capital structure perspective, VC may become a tool for these companies to balance their capital structure in a growth process. 相似文献
This paper investigates the determinants of a “successful” IPO from a corporate governance perspective upon a representative sample of European listings from 2000 to 2015. We use an extensive dataset of market performance, financial data, and corporate governance characteristics to run the investigation. Differently from previous studies, our analysis embraces both a short‐term perspective and a medium–long‐term perspective, where the board of directors seems to perform different tasks, moving from a value creation to a value protection strategy. Among the others, we find that board size, board independence, and their qualifications, together with their experience in other boards, are associated with a positive performance of the IPO in a short‐term horizon and in the medium–long‐term period, although significant differences emerge among those time perspectives. 相似文献
The airport problem is a widely studied allocation problem, with the aim of providing simple and fair sharing rule for the landing fees. In this note we introduce some fairness criteria and characterize the classical Baker-Thompson allocation rule. 相似文献
Arbeitsschutz als Führungsaufgabe - Eine kurze Unachtsamkeit oder unglückliche Verkettung von Ereignissen und schon ist es passiert: Die Kanüle trifft das Pflegepersonal. Aber: Nadelstichverletzungen lassen sich durch die Verwendung sicherer Produkte und Injektionstechniken reduzieren. Dabei ist die Verbesserung des Arbeits- und Gesundheitsschutzes des medizinischen und pflegerischen Personals eine wichtige Aufgabe der Führungskr?fte. 相似文献
Cooperative Extension Service (also known as Extension) agents may lack adequate content knowledge to meet the demands of the diverse programming in Family and Consumer Sciences (FCS) they are expected to deliver. This article reports on the findings from an assessment of FCS Extension personnel in Mississippi. Two surveys were administered to assess the perceived importance of FCS competencies and the perceived ability to perform them. A rank‐sum score was computed, which was used to determine the relative need for training on various Human Development competencies. Findings show that competencies related to child development, parenting, and family stress and crisis warrant training. 相似文献