Uncertainty,Control, and Karl Polanyi’s Protective Response

Post-Keynesian institutionalist economists like Wallace Peterson and John Kenneth Galbraith recognized that the impact of uncertainty on economic wellbeing depends in part on the degree of control people have over the sources and consequences of it. Given the inability of government and other large institutions to reduce uncertainty or to provide citizens with the ability to manage it, mediating structures are considered as an alternative means of promoting economic security. The article concludes by describing and evaluating several of these alternatives.     

When does economic model type become a decisive factor in health technology appraisals? Learning from the expanding treatment options for relapsing–remitting multiple sclerosis

Objectives: Specific economic model types often become de facto standard for health technology appraisal over time. Markov and discrete event simulation (DES) models were compared to investigate the impact of innovative modeling on the cost-effectiveness of disease-modifying therapies (DMTs) in relapsing–remitting multiple sclerosis (RRMS). Fingolimod was compared to dimethyl fumarate (DMF; in highly active [HA] RRMS), alemtuzumab (in HA RRMS) and natalizumab (in rapidly evolving severe RRMS). Comparator DMTs were chosen to reflect different dosing regimens.

Materials and methods: Markov and DES models used have been published previously. Inputs were aligned in all relevant respects, with differences in the modeling of event-triggered attributes, such as relapse-related retreatment, which is inherently difficult with a memoryless Markov approach. Outcomes were compared, with and without different attributes.

Results: All results used list prices. For fingolimod and DMF, incremental cost-effectiveness ratios (ICERs) were comparable (Markov: £4206/quality-adjusted life year [QALY] gained versus DES: £3910/QALY gained). Deviations were observed when long-term adverse events (AEs) were incorporated in the DES (Markov: £25,412 saved/QALY lost, versus DES: £34,209 saved/QALY lost, fingolimod versus natalizumab; higher ICERs indicate greater cost-effectiveness). For fingolimod versus alemtuzumab, when relapse-triggered retreatment was included in the DES, large cost differences were observed (difference between incremental cost is £35,410 and QALY is 0.10).

Limitations: UK payer perspective, therefore societal approach was not considered. Resource utilization and utilities for both models were not derived from the subpopulations; as the focus is on model type, input limitations that apply to both models are less relevant.

Conclusions: Whilst no model can fully represent a disease, a DES allows an opportunity to include features excluded in a Markov structure. A DES may be more suitable for modeling in RRMS for health technology assessment purposes given the complexity of some DMTs. This analysis highlights the capabilities of different model structures to model event-triggered attributes.     

Modeling total cholesterol as predictor of mortality: the low-cholesterol paradox

Elevated total cholesterol is well-established as a risk factor for coronary artery disease and cardiovascular mortality. However, less attention is paid to the association between low cholesterol levels and mortality--the low cholesterol paradox. In this paper, restricted cubic splines (RCS) and complex survey methodology are used to show the low-cholesterol paradox is present in the laboratory, examination, and mortality follow-up data from the Third National Health and Nutrition Examination Survey (NHANES III). A series of Cox proportional hazard models, demonstrate that RCS are necessary to incorporate desired covariates while avoiding the use of categorical variables. Valid concerns regarding the accuracy of such predictive models are discussed. The one certain conclusion is that low cholesterol levels are markers for excess mortality, just as are high levels. Restricted cubic splines provide the necessary flexibility to demonstrate the U-shaped relationship between cholesterol and mortality without resorting to binning results. Cox PH models perform well at identifying associations between risk factors and outcomes of interest such as mortality. However, the predictions from such a model may not be as accurate as common statistics suggest and predictive models should be used with caution.     

Technological problem solving: an investigation of differences associated with levels of task success

International Journal of Technology and Design Education - Research into technological problem solving has shown it to exist in a range of forms and draw upon different processes and knowledge...     

North and South: A Regional Model of the UK

Open Economies Review - We set up a two-region model to study the policy challenge of bringing the North’s income up to the level of the South in the UK. The model focuses on labour costs as...     

Organizational ambidexterity and financial performance in the banking industry: evidence from a developing economy

Journal of Financial Services Marketing - The paper examined the relationship between organizational ambidexterity on the attitude of employees and the financial performance of the banking sector...     

Quaker Business Ethics as MacIntyrean Tradition

Journal of Business Ethics - This paper argues that Quaker business ethics can be understood as a MacIntyrean tradition. To do so, it draws on three key MacIntyrean concepts: community,...     

An Ethical Inquiry of the Effect of Cockpit Automation on the Responsibilities of Airline Pilots: Dissonance or Meaningful Control?

Journal of Business Ethics - Airline pilots are attributed ultimate responsibility and final authority over their aircraft to ensure the safety and well-being of all its occupants. Yet, with the...     

Holidays and economic growth: Evidence from a panel of Indian states

The number of holidays differs significantly across Indian states. Moreover, some of the governing political parties have been accused of using holidays as a tool either to mollify disgruntled workers or to woo voters before the state elections. In this context, this paper explores the relationship between the number of holidays and economic growth across 24 Indian states, spanning the period 2008–2016, by employing a panel model analysis. The paper presents evidence suggesting that holidays seem to affect growth negatively in the rich states but are inconsequential for the growth performance of the poor states.     

The Dynamics of Liquidity in Commercial Property Markets: Revisiting Supply and Demand Indexes in Real Estate

The Journal of Real Estate Finance and Economics - A common definition of liquidity in real estate investment is the ability to sell property assets quickly at full value, as reflected by...