Existence of solutions in continuous-time optimal growth models

This paper studies the existence of solutions in continuous time optimization problems. It provides a theorem whose conditions can be easily checked in most models of the optimal growth theory, including those with increasing returns and multi-sector economies.      

Charity E‐volution? An evaluation of the attitudes of UK charities towards website adoption and use

• The objective of the research was to assess attitudes in relation to website adoption and use, across a broad spectrum of UK charities. A survey methodology was adopted for the research, administered using a self‐completion questionnaire. The results reveal that although the majority of responding charities have websites, most appear to be using them to deliver information about the organisation and its mission, rather than acquiring new supporters, raising funds or allowing beneficiaries/clients to interact. However, overall, respondents were positive regarding the use of websites by charities, and most are optimistic about future improvements in their own online performance.

Copyright © 2006 John Wiley & Sons, Ltd.     

Improving Leadership Skills in Physicians: A 6‐Month Retrospective Study

The complex medical environment of today calls for physicians to have an array of leadership skills in addition to a thorough knowledge of their specific practice areas. The American College of Obstetrics and Gynecologists (ACOG) Robert C. Cefalo National Leadership Institute is a 3.5‐day intensive leadership development course targeted to physician leaders. A group of 37 physicians completed the ACOG National Leadership Institute in spring of 2013. At course completion and 6‐month postcourse, participants were asked to complete a retrospective pre‐ and posttest of perceived skill levels in 10 targeted competency areas. Course completion and 6‐month postcourse scores indicated statistically significant improvements in scores on all 10 competency areas, which was supported by a Wilcoxon signed‐rank test of median score difference. Qualitative data gathered at the 6‐month postcourse survey provide examples of how participants had applied their skills. The data presented in the current study suggested that intensive, “short‐burst,” experiential leadership training is an effective approach for leadership skills development in physicians.     

Social Relations and the Differential Local Impact of Global Standards: The Case of International Standards on Auditing

This article contributes to the literature exploring the contextual conditions that lead international standards to produce a differential impact with regard to inducing convergence in local practice. The article documents three types of responses by local audit firms to the implementation of International Standards on Auditing (ISAs) in Russia, namely: (1) those that claim to follow the national auditing standards modelled on ISAs and mandated by audit law; (2) those that voluntarily provide ISA audits in accordance with original ISAs; and (3) those that provide pseudo audits (‘black audits’) and ignore auditing standards. The study investigates a link between these different responses and the degree of the indigenous firms' social embeddedness in relation to the international audit firms that first introduced ISAs to Russia. The article argues that the higher the embeddedness levels the more likely the audit firms will genuinely commit to following the standards. It also shows that social embeddedness is influenced by a number of conditions, including geographical proximity between the indigenous and international audit firms, as well as commonalities in their professional characteristics, such as aspiration to intraprofessional status and target clientele. The study's findings demonstrate that the local impact of international standards is dependent not just on the characteristics of the local institutional environments in which the adopters operate but also on the social structures and relationships within which they are embedded.     

Scrutinizing local public service provision

Set in the context of an expansion of scrutiny by local authorities of local service provision, this article explores the key challenges ahead for managers and politicians in this area of local governance. Drawing on an evaluation of the development of health scrutiny, it outlines the different types of activities health scrutiny committees are engaging in to fulfil their legislative commitments and suggests lessons for the expansion of external scrutiny.     

Is there still a productivity paradox? two methods for a transatlantic comparison

Economic activity accelerated in the United States, in the second part of the cycle, after 1995, within an environment of decreasing inflation. France has followed a qualitatively similar path since 1997, also clearly suggesting the effects of a positive supply shock. The spread of new information and communication technologies (NICT) partly explains these singular events. On one hand, a calculation of contributions to output growth suggests that they would explain about half of the increase in activity in the United States and one-fifth in France. On the other hand, a trend/cycle decomposition reveals that the structural acceleration in output and productivity gains in the United States are very much restricted to industries producing NICT and there is a rather small break in productivity gains. In France, where differences between sectors are not so clear-cut, the diffusion of NICT has been accompanied by a slowdown in trends in productivity gains. In both cases, there is little room left for the effects of the diffusion of technical progress associated with NICT.     

Gender Differences in Italian Children's Capabilities

This paper analyzes children's well-being using the capability approach, with a special focus on gender differences. The two areas analyzed are the capability of senses, imagination, and thought; and the capability of play. Using data from the 2008 Multipurpose Survey on Daily Life released by the Italian National Institute of Statistics, a structural equation model is estimated in which the capabilities are defined as latent variables that are intrinsically interrelated. For each capability, a set of indicators of functionings is utilized and the effects of individual and social conversion factors – including parents’ unpaid work, their level of education, and employment status – are analyzed. The model is applied to Italian girls and boys ages 6–10 in 2008. The analysis confirms that the two capabilities are interrelated. Policies aimed at improving children's achievements in education also improve the capability of play and vice versa. Differences by gender occur in the factors’ effects.     

Luddites, the industrial revolution, and the demographic transition

Technological change was unskilled-labor-biased during the early industrial revolution, but is skill-biased today. This implies a rich set of non-monotonic macroeconomic dynamics which are not embedded in extant unified growth models. We present historical evidence and develop a model which can endogenously account for these facts, where factor bias reflects profit-maximizing decisions by innovators. In a setup with directed technological change, and fixed as well as variable costs of education, initial endowments dictate that the early industrial revolution be unskilled-labor-biased. Increasing basic knowledge then causes a growth takeoff, an income-led demand for fewer but more educated children, and a transition to skill-biased technological change in the long run.     

Exploring Dissuasion as a (Geo)Political Instrument in Irregular Migration Control at the Southern Spanish Maritime Border

This article analyses the evolution and implementation of Spanish policy to control irregular immigration via maritime routes over the past two decades. Starting from the premise that this policy was based on a comprehensive strategy of dissuasion to prevent, contain and hinder the arrival and settlement of irregular immigrants, for analytical purposes the article introduces the concepts of preventive dissuasion, coercive dissuasion and repressive dissuasion to describe actions of diverse categories, hierarchy and scope that sequentially and simultaneously shape and structure the logic behind dissuasion used in different “territorial settings”. Spain has deployed a great deal of this policy – mainly preventive and coercive dissuasion strategies – through bilateral agreements and formal practices with African countries. This article is based on fieldwork carried out between 2008 and 2012 in different Spanish border areas, including interviews with different actors and visits to border posts and surveillance installations.     

Cost-effectiveness of axicabtagene ciloleucel for adult patients with relapsed or refractory large B-cell lymphoma in the United States

Abstract

Purpose: Axicabtagene ciloleucel (axi-cel) was recently approved for treatment of relapsed or refractory (R/R) large B-cell lymphoma (LBCL) following two or more prior therapies. As the first CAR T-cell therapy available for adults in the US, there are important questions about clinical and economic value. The objective of this study was to assess the cost-effectiveness of axi-cel compared to salvage chemotherapy using a decision model and a US payer perspective.

Materials and methods: A decision model was developed to estimate life years (LYs), quality-adjusted life years (QALYs), and lifetime cost for adult patients with R/R LBCL treated with axi-cel vs salvage chemotherapy (R-DHAP). Patient-level analyses of the ZUMA-1 and SCHOLAR-1 studies were used to inform the model and to estimate the proportion achieving long-term survival. Drug and procedure costs were derived from US average sales prices and Medicare reimbursement schedules. Future healthcare costs in long-term remission was derived from per capita Medicare spending. Utility values were derived from patient-level data from ZUMA-1 and external literature. One-way and probabilistic sensitivity analyses evaluated uncertainty. Outcomes were calculated over a lifetime horizon and were discounted at 3% per year.

Results: In the base case, LYs, QALYs, and lifetime costs were 9.5, 7.7, and $552,921 for axi-cel vs 2.6, 1.1, and $172,737 for salvage chemotherapy, respectively. The axi-cel cost per QALY gained was $58,146. Cost-effectiveness was most sensitive to the fraction achieving long-term remission, discount rate, and axi-cel price. The likelihood that axi-cel is cost-effective was 95% at a willingness to pay of $100,000 per QALY.

Conclusion: Axi-cel is a potentially cost-effective alternative to salvage chemotherapy for adults with R/R LBCL. Long-term follow-up is necessary to reduce uncertainties about health outcomes.