Government and industry in France: A contractual approach

This article describes some of the central concerns of medical directors in NHS trusts. It focuses on the issues they face as a result of their dual roles as medical professionals and management professionals. Three aspects of the duality are discussed: the tension in satisfying the demands of the two roles in their own job; the facilitation of other clinicians to come to terms with an enhanced managerial role; and the exploitation of the two roles in managing relationships with all colleagues. The article will inform medical directors, those concerned with the design of education for management clinicians, and those people involved in the wider debate about the benefits of NHS reforms. It concludes that the dual role provides medical directors with a unique potential for making a powerful contribution to the strategic thrust of the organization.     

Leisure Research for Social Justice: A Response to Henderson

Leisure research based on critical theories is an effective path to social justice for groups and communities that are marginalized or oppressed by those in power. In response to Henderson (2011), who frames our work as postpositivist, we argue critical theories are a more appropriate research paradigm to reflect our philosophical positions. Our inquiry into leisure is informed by an emancipatory vision for social change that aims to enact social justice. In this response, we detail our rationale for embracing critical theories as an effective research-based approach to affect social justice. We conclude by suggesting that paradigm proliferation enables researchers to enhance social justice within their communities of concern.     

The nascent entrepreneurship hub: goals, entrepreneurial self-efficacy and start-up outcomes

Entrepreneurship involves human agency. The entrepreneurial process occurs because people are motivated to pursue and exploit perceived opportunities. It is rooted in the theory that action is the result of motivation and cognition. Therefore, this paper applies elements of goal theory and social cognitive theory to develop a motivational model of nascent entrepreneurial start-up outcomes. The objective of this model is to renew attention on motivational constructs in entrepreneurship research. Additionally, it provides predictive value for the likelihood of new firm founding among nascent entrepreneurs. Results suggest that motivational antecedents among nascent entrepreneurs significantly influence the likelihood of quitting the start-up process versus continuing nascent entrepreneurial start-up efforts.     

The endoscopy scheduling problem: A case study with two specialised operating rooms

This research aims to build a feasible and efficient operating program for an endoscopy centre composed of two specialised operating rooms for one week, with the objective of both maximising the utilisation of the operating room and minimising the cost of overtime. First, a tactical planning model was built and solved by a column-generation-based heuristic (CGBH) procedure. Then, a daily scheduling problem is solved by the Gonzalez-Sahni algorithm in order to schedule the surgical cases assigned at the planning stage. Experimental data are randomly generated according to parameters derived from the Croix–Rousse tertiary hospital centre in Lyon, France.     

Incremental net monetary benefit of ocrelizumab relative to subcutaneous interferon β-1a

Aim: Disease-modifying therapies (DMTs) impact the natural history of relapsing forms of multiple sclerosis (RRMS) by reducing annual relapse rates and slowing disability progression. The effect of DMTs on indirect costs has not been consistently explored in cost-effectiveness studies thus far. The value to patients of an emerging DMT, ocrelizumab, was quantified in comparison to subcutaneous interferon beta-1a (IFNβSC) for the prevalent RRMS population with mild-to-moderate disability in the US, based on two Phase 3 trials, OPERA I and OPERA II, of ocrelizumab vs IFNβSC in RRMS.

Materials and methods: A Markov model was developed to compare disability progression as measured by Expanded Disability Status Scale (EDSS) and relapse outcomes over a 30-year horizon for ocrelizumab vs IFNβSC. Direct, indirect, and informal costs (2016?US dollars) and utilities for EDSS health states were obtained from the literature. Hazard ratios for disability progression and relapse rates were estimated from clinical trials. Value was assessed by calculating the net monetary benefit (NMB), defined as the monetary value of discounted quality-adjusted life years (QALYs) minus total costs, where the value of a QALY was $150,000. One-way sensitivity analyses were conducted.

Results: Ocrelizumab was associated with an incremental gain of 0.84 QALYs and cost savings of $287,713 relative to IFNβSC, resulting in an incremental NMB (INMB) of $413,611 per person over 30 years. The INMB increased by $151,763 for those initiating ocrelizumab at EDSS level 1 vs level 4. Influential parameters were QALY value, treatment costs, and disability progression; however, all sensitivity analyses indicated that the INMB for ocrelizumab relative to IFNβSC was ≥$300,000 per person.

Conclusions: Ocrelizumab provides greater value to RRMS patients compared with IFNβSC. Initiating ocrelizumab at lower EDSS levels leads to a greater cumulative value due to slower disability progression, which extends years with higher quality-of-life.     

Exploring the impact of open innovation on national systems of innovation — A theoretical analysis

This paper investigates the impact of open innovation on national systems of innovation. The open innovation concept has become widely established among scholars and practitioners. However, an overview of its impact on national innovation systems is still lacking. Given that the innovating firm is at the core of national innovation systems, a better understanding of shifting innovation strategies at the firm level is of fundamental importance to the actions of policy-makers within the national innovation systems framework. Based on the main analytical approaches of national innovation systems and the current state of open innovation research, we argue that open innovation practices have at least three critical effects on national systems of innovation: (a) they reinforce its importance; (b) they improve its effectiveness; and (c) they diversify its networks.     

What happens after corporate default? Stylized facts on access to credit

In this paper, we investigate what happens to firms after they default on their bank loans. We approach this question by establishing a set of stylized facts concerning the evolution of corporate default and its resolution, focusing on access to credit after default. Using a unique dataset from Portugal, we observe that half of the corporate default episodes last 5 quarters. Most firms continue to have access to credit immediately after resolving default, though only a minority has access to new loans. Firms have more difficulties in regaining access to credit if they are small, if their default was long and severe, if they borrow from only one bank or if they default with their main lender. Further, half of the defaulting firms record another default in the future. We observe that firms with repeated defaults are, on average, smaller and experience longer and more severe defaults.