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.     

Unfolding implementation in industrial market segmentation

Market segmentation is an important method of strategic marketing and constitutes a cornerstone of the marketing literature. It has undergone extensive scientific inquiry during the past 50 years. Reporting on an extensive review of the market segmentation literature, the challenging task of implementing industrial market segmentation is discussed and unfolded in this article. Extant literature has identified segmentation implementation as a core challenge for marketers, but also one, which has received limited empirical attention. Future research opportunities are formulated in this article to pave the way towards closing this gap. The extent of implementation coverage is assessed and various notions of implementation are identified. Implementation as the task of converting segmentation plans into action (referred to as execution) is identified as a particularly beneficial focus area for marketing management. Three key elements and challenges connected to execution of market segmentation are identified — organization, motivation, and adaptation.     

The relationship between leader–member exchange and employee outcomes: review of past themes and future potential

Management Review Quarterly - Research on leader–member exchange (LMX) has gained momentum with a large number of studies investigating its impact on multiple levels. This article...     

Differences in the determinants and targeting of antidumping: China and India compared

Despite both being developing countries, China and India have markedly contrasting patterns in their use and targeting of antidumping (AD) measures. We explore the factors driving AD use by these two countries, considering in turn macroeconomic, strategic and other determinants. We find more regular or systematic features of AD use by China, while India displays a less systematic pattern of AD use. Economic growth, AD club effect and free trade agreement participation are shown to constrain AD use by China. Compared to India, AD use by China is also more sensitive across industries. Furthermore, China targets developed countries more than developing countries, while India is less discriminating with respect to the country type it targets.     

A natural experiment for identifying the impact of ‘natural’ trade barriers on exports

The paper investigates the relative importance of trade policy and ‘natural’ sources of export taxation in Malawi, a landlocked African economy. These sources of export taxation are in turn used to explore how export supply would respond to trade liberalisation as opposed to measures which lower other international trade costs. The findings indicate that trade policy barriers are now only a limited source of ‘true’ export taxation and that trade policy reform needs to be complemented with reforms to reduce international trade, including transport, costs.     

Different roads: changes in industrial and employee relations in the Czech Republic and East Germany* since 1989

This article examines the differential impact of post Communist restructuring on industrial and employee relations in the Czech Republic and East Germany. It reviews the pre and post Communist systems of industrial relations and personnel management in the two countries and draws on original survey data to examine how this influences employee relations at organisation level.     

Future perspectives on the role of extended producer responsibility within a circular economy: A Delphi study using the case of the Netherlands

Extended producer responsibility (EPR) is a proposed policy approach to promoting the circular economy (CE) within the European Union. This research used a policy Delphi to explore perspectives on improving EPR policies to further contribute to the CE goals of the Netherlands. Both the potential improvement and critical reflections discussed by CE and EPR experts and practitioners from this study contribute to a more detailed understanding of the future governance of CE practices. We present various activities to improve EPR and insights from Delphi participants that emerged from the study. This paper shows that whilst actors agree, in essence, that there is a need for modifying EPR, what the specific changes to the form are and to whom the new responsibilities apply is contested.     

The impact of environmental management systems on financial performance in fashion and textiles industries

With rising environmental concerns from consumers and stakeholder groups, environmental management has become an important responsibility for today's fashion and textiles manufacturers. The production of fashion and textiles related products often requires high levels of energy and water consumption, and emits large quantities of pollutants to the environment. Therefore, the adoption of environmental management systems (EMSs) is important and could have a significant impact on these firms' operational performance. This study presents empirical evidence on the performance impact of EMS adoption in the fashion and textiles related industries (FTIs). Although EMSs have emerged as a passport to business in the FTIs, their actual impacts on firms' financial performance have not been explored. We reveal that the adoption of ISO 14000, the most popular EMS, improves manufacturers' profitability in the FTIs over a three-year period as measured by return-on-assets (ROA). Based on our sample, we find that profitability improvement started during the implementation stage and continued at least one year after the firm obtained ISO 14000 certification. We also find that profitability improvement is mainly due to improvement in cost efficiency, measured by return-on-sales (ROS). Specifically, certified firms improved up to 2.9% in ROA and 3.3% in ROS over the three-year period since they implemented ISO 14000. We conclude that there is a positive impact of EMS adoption on firms' financial performance in the FTIs.     

Give peas a chance: Transformations in food consumption and production systems

Food production chains can be organised in a variety of ways. Conventional ‘industrial’ agricultural practices are based on advanced breeding techniques and major inputs of chemical fertilisers and pesticides. Food produced in this way is transport-intensive, requires high-energy processing, relies on modern retailing systems and demands high-tech kitchens. Many argue that the industrialised systems should be dismantled and replaced with alternative methods of agriculture, food processing and distribution that emphasise social and environmental sustainability. This paper looks at the environmental and social sustainability of different strategies for food systems by analysing the whole chain of production, processing, distribution and consumption activities of the production of frozen peas, a vegetable that is ‘symbolic’ of modern food systems and the UK diet.     

The application of Operation and Technology Roadmapping to aid Singaporean SMEs identify and select emerging technologies

In order to aid Singaporean SMEs identify and select emerging technologies for business benefit, a modified process of the Cambridge T-Plan methodology has been introduced and applied to a pilot sample of 30 companies in a variety of manufacturing sectors. This fast and simple process takes the company through five key steps to enable them to create their first Operation and Technology Roadmap (OTR). The paper explains the background to the approach and focuses on the initial benefits identified by a survey of the pilot companies.