Economic impact of introducing TYRX amongst patients with heart failure and reduced ejection fraction undergoing implanted cardiac device procedures: a retrospective model based cost analysis

Background and aims: Infection is a serious and expensive complication of Cardiac Implantable Electronic Device (CIED) procedures. A retrospective based cost analysis was performed to estimate Trust level savings of using the TYRX antibacterial envelope as a primary prevention measure against infection in a tertiary referral centre in South London, UK.

Methods: A retrospective cohort of heart failure patients with reduced ejection fraction undergoing Implantable Cardioverter Defibrillator (ICD) or Cardiac Resynchronization Therapy (CRT) procedures were evaluated. Decision-analytic modelling was performed to determine economic savings of using the envelope during CIED procedure vs CIED procedure alone.

Results: Over a 12?month follow-up period following CIED procedure, the observed infection rate was 3.14% (n?=?5/159). The average cost of a CIED infection inpatient admission was £41,820 and, further to economic analysis, the additional costs attributable to infection was calculated at £62,213.94. A cost saving of £624 per patient by using TYRX during CIED procedure as a primary preventative measure against infection was estimated.

Conclusions: TYRX would be a cost-saving treatment option amongst heart failure patients undergoing ICD and CRT device procedures based on analysis in the local geographical area of South London. If upscaled to the UK population, we estimate potential cost savings for the National Health Service (NHS).     

To Your Health: Health Insurance,Self‐Employment Exit,and Older Entrepreneurs

Drawing on a sample of 5,238 individuals in the Health and Retirement Study, we examined the relationship between having one's own health insurance and exit from self‐employment to employment. Our results indicate that individuals who have health insurance are less likely to exit self‐employment. When self‐employed individuals have their own health insurance, males, relative to females, are more likely to exit self‐employment. Additionally, when self‐employed individuals have their own health insurance, those who do not have health problems that limit work are more likely to exit. We discuss the implications that these findings have on the literature and policymakers.     

Using ESPN 30 for 30 to teach economics

Education in economics has trended away from “chalk and talk” toward alternative pedagogical approaches in recent years. This article documents one such approach used to illustrate economic concepts, the use of film clips from ESPN 30 for 30. This series can be used to augment traditional principles' classes or as real world examples of concepts discussed in upper division economic courses. The ESPN 30 for 30 film series merges three different areas of interests: film, sports, and history. Through these diverse spectrums, ESPN 30 for 30 films provides instructors with another resource to use in classrooms and creates an environment that facilitates active learning activities.     

The role of training in reducing poverty: the case of microenterprise development in India

Self‐employment in general and microenterprise in particular is evolving as a prospective option for income generation and the reduction of poverty in developing economies such as India. However, a lack of skills among the poor has been identified as one of the key hindrances in promoting microenterprises and, therefore, in reducing poverty. Various initiatives have been taken to promote entrepreneurship among the poor and the present study seeks to examine the role of training in this process. The conclusion is that provision of training alone may not always help in promoting entrepreneurship. The training itself must meet the needs of the trainees, and other strategic variables, particularly access to finance, may need to be in play.     

An investigation of the personality traits of scientists versus nonscientists and their relationship with career satisfaction

Drawing on Holland's vocational theory, Schneider's Attraction‐Selection‐Attrition model, and the Big Five/narrow traits model of personality, the present study identified key Big Five and narrow personality traits that both distinguish scientists from members of other occupations and related these to their career satisfaction. A sample of 2,015 scientists had significantly higher levels of openness, intrinsic motivation, and tough‐mindedness, and significantly lower levels of assertiveness, conscientiousness, emotional stability, extraversion, optimism, and visionary style than a sample of nonscientists (n = 78,753). Seven traits were significantly correlated with the career satisfaction of scientists: agreeableness/teamwork, assertiveness, emotional stability, extraversion, openness, optimism, and work drive. Based on these results, a psychological profile of scientists was presented. Findings were discussed in terms of the functional value and person–occupation fit of these traits for the work of scientists. Implications were described for the recruitment, selection, management, and promotion of scientists, as well as their training, development, coaching, counseling, and mentoring.     

How do young firms manage product portfolio complexity? The role of absorptive capacity and ambidexterity

Building a complex portfolio of products can be beneficial for young firms due to increased sales growth and competitiveness. Yet, the benefits from product portfolio complexity (PPC) are often outweighed by rising costs, leading to an inverted U‐shaped relationship between PPC and performance. Recent research has called for an increased understanding of how firms are able to better manage higher levels of PPC. We suggest that absorptive capacity and ambidexterity are vital to enhancing the benefits and mitigating the costs of increasing PPC. Using a sample of 215 young high technology firms, we find support for positive moderating effects of absorptive capacity and ambidexterity on the inverted U‐shaped relationship between PPC and firm performance. Copyright © 2012 John Wiley & Sons, Ltd.     

Direct medical costs of treatment in newly-diagnosed high-grade glioma among commercially insured US patients

Aim: This analysis assessed the direct medical costs of newly-diagnosed, temozolomide (TMZ)-treated glioblastoma (GBM) from the perspective of a US commercial setting.

Materials and methods: The analysis included subjects identified from the IMS PharMetrics LifeLink Plus? claims database from January 1, 2008 to August 31, 2014 who were ≥18 years of age, had ≥1 malignant brain cancer diagnosis, had brain surgery ≤90 days prior to TMZ initiation, had TMZ treatment, and were continuously enrolled for ≥12 months pre-diagnosis and ≥1 month post-diagnosis. Per-patient per-month (PPPM) and cumulative costs from 3 months pre-diagnosis to various post-diagnosis follow-up time points were calculated. Multivariable analyses were used to estimate adjusted mean cost and identify contributors of cost.

Results: The study included 2,921 subjects (median age?=?56 years; 60% male). After diagnosis, the median (interquartile range, IQR) number of inpatient, emergency department, and outpatient visits were 2 (1–4), 1 (1–3), and 19 (13–27); median (IQR) length of stay per hospitalization was 5 (3–9) days. Mean total cumulative costs per patient from 3 months pre-diagnosis to 12 months and to 5 years post-diagnosis were $201,749 (197,490–206,024) and $268,031 (262,877–274,416). Mean (SD) PPPM costs were $818 (1,128) and $7,394 (8,676) pre- and post-GBM diagnosis, respectively. The variables most predictive of cumulative costs included radiation therapy (+$81,732), ≥2 weeks of hospitalization (+$49,629), and ≥7 MRI scans (+$40,105).

Conclusions: The direct medical costs of newly-diagnosed, TMZ-treated GBM in commercially insured patients are substantial, with estimated total cumulative costs of $268,031.     

Financial determinants of systematic risk in real estate investment trusts

Financial theory and empirical evidence suggest that a firm's systematic, or market related, risk is related to its financial conditions. This study empirically investigates the financial determinants of systematic risk for Real Estate Investment Trusts (REITs). The study is an examination of sample of 32 REITs for the period 1976–1978. The results indicate that systematic risk varies directly with financial leverage, business risk, and advisor fee. The explanatory power of the relationship between systematic risk and financial variables exceeds that of previous studies wherein firms were pooled across industry groups. The higher explanatory power observed even with limited data suggests that better estimates of coefficients of financial determinants of systematic risk may be obtained through analysis conducted on an industry by industry basis. Furthermore, such industry-specific analysis provides useful results to practicing financial managers in their financial policy considerations. With the knowledge of how the financial decisions affect the firm's systematic risk, a manager may be able to manipulate those variables so as to reduce the systematic risk for his or her firm and thus increase the market value of the firm's securities.     

Expected Default Probabilities in Structural Models: Empirical Evidence

We apply a set of structural models (Black and Cox 1976; Collin-Dufresne and Goldstein 2001; Ericsson and Reneby 1998; Leland and Toft 1996; Longstaff and Schwartz 1995; Merton 1974) to estimate expected default probabilities (EDPs) for a sample of failed and non-failed UK real estate companies. Results are generally consistent with models’ predictions and estimates of EDPs for different models are closely clustered. The results of z-scores and synthetic ratings misclassify 33% of the total sample in contrast to 8% misclassification by structural models. Further analysis of EDPs based on logistic regressions suggests the observed misclassification of the companies by structural models is due to special company management and/or regulatory circumstances rather than limitations of these models.