Reoperations in intramedullary fixation of pertrochanteric hip fractures

Objective: This study evaluated the frequency of reoperation within 1 year of initial intramedullary fixation for patients with pertrochanteric hip fracture and compared 1-year healthcare resource utilization and cost burden for patients with and without reoperation.

Methods: This is a retrospective evaluation of medical claims from the US Centers for Medicare and Medicaid Standard Analytic File. Patients aged ≥65?years who underwent fixation with an intramedullary implant for a pertrochanteric fracture between 2013 and 2015 were included. Healthcare resources that were evaluated included skilled nursing facility (SNF), inpatient rehabilitation facility (IRF), readmissions, and outpatient hospital visits. All-cause payments for these services comprised overall cost burden. Generalized Linear Models were used to evaluate healthcare resources and cost burden over 1-year post-surgery and to adjust for confounding between patients with and without a reoperation.

Results: A total of 6,423 Medicare patients were included in the analysis. Mean (SD) age was 82.4 (7.8) years, 76.0% were female, and 93.3% were white. A second hip surgery within 1 year after the index fixation procedure was performed in 414 patients (6.4%): 121 (29.2%) contralateral, 115 (27.8%) ipsilateral, and 178 (43.0%) without specified laterality. After adjusting for confounding factors, Medicare patients with ipsilateral reoperations had statistically significantly higher readmissions (100% vs 32.5%, p?p?=?0.018), admissions to a SNF (88.5% vs 80.4%, p?=?0.024), and admissions to an IRF (38.8% vs 22.0%, p?p?Conclusions: Patients who require a second hip surgery after initial fixation with an intramedullary implant for pertrochanteric hip fractures have significantly higher 1-year healthcare resource utilization and 63.5% higher costs than patients without reoperation.     

CLARIFYING FUNDS STATEMENTS — THE TWO ENTITY TEST

A major shortcoming of the funds statement prepared under a resources concept is that the meaning of the term “resources” is unclear. A transaction test is usually adopted to identify entries involving funds, but it is apparent from published reports and from the Australian profession's recent exposure draft that substantial confusion remains. One response has been to reject the broader concepts in favour of narrower definitions such as cash or working capital. In this article, however, it is argued that an all resources funds statement, properly defined, has an important contribution to make. A “two entity” test is proposed which is claimed to be tighter and closer to the spirit of the original resources concept than the present transaction test.     

Cultural influence on corporate and governmental involvement in accounting policy determination in Japan

This study examines the impact of culture on the motivation for, and mode of involvement of, the corporations and the government in accounting policy determination in Japan. Three propositions are developed and evaluated against the events that occurred in the formulation and implementation of the 1976 ordinances on consolidation. Data are derived from source documentation and personal interviewing. Cultural determinants are seen to position the corporations and bureaucracy as influential and conflicting interest groups in accounting standard-setting in Japan and to predetermine a mode of conflict resolution in policy determination that maintains the “balance of forces” between those parties.     

Unequal jobs or unequal pay?

This article draws on new data to consider whether women would benefit most from upgrading the skill levels of their jobs or from achieving equal pay for work of equal value. It looks in detail at skill, gender, and whether work is full-time or part-time, concluding that reassessment of the value of women's jobs would be of greater immediate financial benefit to women than upgrading the skill level of their jobs unless this upgrading gave them access to men's jobs at men's pay and benefit rates.     

The role of market research for charities: Identifying target groups and developing successful relationships

No one can find friends by sitting at home, and no relationship can develop without plenty of interaction between the people involved. However, charities with large numbers of donors and volunteers cannot be expected to have day-to-day contact with more than a handful of their key supporters. This paper illustrates how market research can be used by charities as the conduit between charities and their supporters — not only to show how the relationship between the two sides can be developed to best effect, but also to identify the most appropriate target groups to find new support.     

Towards more disorganised decentralisation? Collective bargaining in the public sector under pay restraint

While sector‐level collective bargaining can provide the institutional leverage to sustain and improve employment standards, a proliferation of disorganised local settlements may reduce its effectiveness. This article examines this proposition for local government in the UK, highlights the risks of a ‘destructive’ disorganisation of employment relations and calls for a renewal of articulation mechanisms between sector and local levels of collective bargaining.     

Work–life policies and female faculty representation in US doctoral‐granting economics departments

This article examines the relationships between work–life policies and female faculty representation and promotion at US doctoral‐granting economics departments. The data were collected in 2012 on tenure‐track and tenured full‐time faculty from 125 departments and updated in 2018 to include promotion status. Variables include individuals and their educational backgrounds, professional experience and publications. Only publications and experience are statistically significant for predicting academic rank for the female subsample, and the impact of publications is much larger for women compared with men. Work–life policies differ in explaining the representation of women across academic ranks. Dual‐career policies have a positive effect on female representation at the assistant and associate levels but do not have a statistically significant impact at the full professor level. National Science Foundation ADVANCE grantee universities have increased female representation across all ranks, but the effect is the smallest at the full professor level. Work–life policies are insignificant in predicting promotion.     

The North American–European Union Dispute Over Beef Produced Using Growth Hormones: A Major Test for the New International Trade Regime

At the time, the negotiation of the SPS agreement was seen as a major accomplishment of the Uruguay Round. One of the first major tests of both the SPS and the WTO’s new dispute settlement system was the long standing and acrimonious dispute between the EU and the US and Canada over trade in beef produced using hormones. Both the SPS and the disputes system performed as expected but the EU, the loser in the case, has chosen to ignore the WTO Panel’s ruling and accept retaliation. As a result, the credibility of the WTO is threatened and the outcome suggests that new negotiations may be required. The issues in the case are outlined and implications for trade in biological products drawn.