Hospital costs associated with thyroidectomy performed with a Harmonic device compared to conventional techniques: a systematic review and meta-analysis

Objectives: Harmonic devices have become a world-wide standard for dissection and hemostasis in thyroidectomy. Numerous systematic reviews have reported superior operating times, blood loss, post-operative pain, length of stay, and overall safety outcomes. What has not been extensively evaluated in a robust manner is their economic impact. The purpose of this study is to evaluate the hospital costs associated with open thyroidectomy using Harmonic devices compared with conventional techniques for hemostasis. Methods: A systematic review of Medline, Scopus, and CENTRAL was performed from January 1, 2000 to May 23, 2014 without language restrictions for randomized clinical trials comparing Harmonic surgical devices to conventional methods in thyroidectomy. The main outcome measure was total reported costs. Costs were pooled using the ratio of means and a random effects model. Sensitivity analyses assessed whether differences in patient and trial characteristics, healthcare setting, or choice of statistical model affected outcomes. Results: Seven studies met the inclusion criteria. A total of 476 participants had procedures performed with Harmonic devices and 478 with conventional monopolar electrosurgery and clamp, cut and tie techniques. Compared with conventional techniques, Harmonic devices reduced total reported costs by 10% (p?=?0.007), resulting in a $229?US dollars (USD) absolute reduction from mean baseline costs. Results remained relatively robust to additional sensitivity analyses. Conclusions: This systematic review and meta-analysis demonstrates that the Harmonic family of surgical devices is associated with a reduction in total reported costs in thyroidectomy compared with conventional techniques. A large portion of the overall savings derives from a reduction in operative costs.     

A survey of network-based analysis and systemic risk measurement

The financial crisis led to a number of new systemic risk measures and a renewed concern over the risk of contagion. This paper surveys the systemic risk literature with a focus on the importance of contributions made by those emphasizing a network-based approach, and how that compares with more commonly used approaches. Research on systemic risk has generally found that the risk of contagion through domino effects is minimal, and thus emphasized focusing on the resiliency of the financial system to broad macroeconomic shocks. Theoretical, methodological, and empirical work is critically examined to provide insight on how and why regulators have emphasized deregulation, diversification, size-based regulations, and portfolio-based coherent systemic risk measures. Furthermore, in the context of network analysis, this paper reviews and critically assesses newly created systemic risk measures. Network analysis and agent-based modeling approaches to understanding network formation offer promise in helping understand contagion, and also detecting fragile systems before they collapse. Theory and evidence discussed here implies that regulators and researchers need to gain an improved understanding of how topology, capital requirements, and liquidity interact.     

Econometric Methods for Modelling Systems With a Mixture of i(1) and i(0) Variables

This paper considers structural models with both I(1) and I(0) variables. The structural shocks associated with either set of variables could be permanent or transitory. We classify the shocks as (P1,P0) and (T1,T0), where P/T distinguishes permanent/transitory, while 1/0 means they are attached to structural equations with either I(1) or I(0) variables as their ‘dependent’ variable. We show that P0 shocks can affect cointegration analysis and provide a formula to compute the permanent component if they are present. Finally, we reformulate a well‐known empirical structural vector autoregression showing the impact of P0 shocks when there are just long‐run parametric and sign restrictions. Copyright © 2015 John Wiley & Sons, Ltd.     

Foreign aid and governance in Africa

This paper investigates the effect of foreign aid on governance in order to extend the debate on foreign aid and to verify common positions from Moyo’s ‘Dead Aid’, Collier’s ‘Bottom Billion’ and Eubank’s ‘Somaliland’. The empirical evidence is based on updated data from 52 African countries for the period 1996–2010. An endogeneity robust instrumental variable Two-Stage-Least Squares empirical strategy is employed. The findings reveal that development assistance deteriorates economic (regulation quality and government effectiveness) and institutional (corruption-control and rule of law) governance, but has an insignificant effect on political (political stability, voice and accountability) governance. While, these findings are broadly in accordance with Moyo and Collier on weak governance, they neither confirm the Eubank position on political governance nor the Asongu stance on the aid-corruption nexus in a debate with Okada and Samreth. The use of foreign aid as an instrument to influence the election and replacement of political leaders in Africa may have insignificant results. It is time to solve the second tragedy of foreign aid and that economists and policy makers start rethinking the models and theories on which foreign aid is used to influence economic, institutional and political governance in recipient countries.     

Sustainability of A Pay‐as‐you‐Go Pension System in A Small Open Economy with Ageing,Human Capital and Endogenous Fertility

The aim of the article is to theoretically investigate if a pay‐as‐you‐go (PAYG) pension system is sustainable in the presence of a declining population and increasing longevity of the retired generation. For this purpose, we use an overlapping generation model with endogenous fertility, endogenous longevity and human capital accumulation in a small open economy. We find that pensions will always increase as long as it is beneficial for parents to invest in human capital. Furthermore, we get the result that the ratio between pension benefits and the consumption of the young generation will strive to a positive limit value, and that a pure PAYG pension system will not run into any solvency problem due to a decreasing fertility rate or ageing.     

Challenging the ‘Million Zeros’: The Importance of Imagination for Business Ethics Education

A recent preoccupation in scholarly research is the capacity of firms in developing country industrial clusters to comply with international corporate social responsibility (CSR) policies and codes of conducts. This research is at an early stage and draws on several—often quite distinct—scholarly traditions. In this paper, we argue that future work in this area would benefit from a more explicit examination of the connection between cluster firms and human rights defined according to the 1948 Universal Declaration of Human Rights and subsequent covenants and treaties. We argue that cluster firms’ adoption of CSR policies, often indiscriminately imposed by global buyers, should be differentiated from firms’ actual human rights practices. Based on this distinction, we elaborate a typology of industrial clusters (low-road, window-dressing, rights-oriented) and identify a set of factors likely to influence their practice. Against this background, we discuss an agenda for future research and elaborate on the potential methodological intricacies related to research on the interface between industrial clusters and human rights.     

Consumer Regulation Strategies: Attenuating the Effect of Consumer References in a Voting Context

Consumption cues (e.g., brands, money, and advertisements) can have powerful effects on cognition, perception, and behavior, yet how people regulate responses to such cues is not well understood. This is surprising given that consumption cues are increasingly present in nontraditional consumer contexts, such as healthcare, education, and politics. This research develops a measure of two types of consumer regulation strategies, cue‐based and budget‐based (studies 1–4), and demonstrates that these strategies influence how people respond to consumption cues in a political context (study 5). Specifically, in a study involving the 2012 American Presidential Election, priming survey participants as consumers (versus citizens) influenced both voting intentions and self‐reported voting behavior, and the newly developed consumer regulation scale was instrumental in detecting this effect. These findings suggest there may be merit in the escalating debate and concern over referring to voters as consumers.