Wheelchair users as consumers: accessibility of supermarkets in Gaborone,Botswana

Even though some accessibility standards have been set in Botswana to create accessible public buildings including supermarkets by wheelchair users, architectural barriers are still found in these places. The purpose of the study was to assess the interior and exterior accessibility of supermarkets by wheelchair users including determining their shopping experiences. The research used a mixed model study design in which data were collected using an observation checklist to assess 30 supermarkets alongside in‐depth interviews with six wheelchair users. The quantitative data were analysed using the computer software Statistical Packages for Social Sciences 19.0 and qualitative data were grouped into emerging themes. The findings indicated that in the exterior, all supermarkets did not have directional arrows to the disabled parking. However, all the supermarkets had an accessible wide entrance and suitable non‐slippery flooring. The interior revealed that all supermarkets did not have appropriate devises to assist wheelchair users to pick items from higher shelves and in some supermarkets, till counters were high for wheelchair users. From the interviews, the emerging themes were loss of freedom to shop, poor maintenance for disability facilities and disregard for disability parking spaces. In conclusion, while supermarkets had made some provision for wheelchair users from the parking lot to the entrance, there was less accessibility inside the supermarkets. There is need for an Act in Botswana that will ensure accessibility of public spaces.     

The Ancient City of Pingyao:Where the Time Stops

It is a common night in May, I found myself wandering in the Ancient City of Pingyao. If not those neon light, I would even doubt that I had gone back to the ancient times.Located on the eastern banks of the Fen River, and in the south-western edge of the Taiyuan basin, Pingyao Ancient City is the outstanding example of Chinese Han nationality cities during Ming and Qing Dynasties.     

The bright side of co‐opted boards: Evidence from firm innovation

This study documents a positive and robust effect of co‐opted boards on firm innovation. This effect is mainly driven by co‐opted independent directors. Firms with more co‐opted independent directors are associated with lower sensitivities of CEO pay and turnover to performance. It suggests that co‐opted boards promote innovation by insulating managers’ career concerns from innovation risk and supporting incentive contracts that motivate innovation. Overall, our study provides new evidence on co‐opted boards benefiting firm innovation.     

Opening up the firm: What explains participation and effort in voluntary carbon disclosure by global businesses? An analysis of internal firm factors and dynamics

A voluntary climate initiative that has emerged over the past two decades as an institutional arrangement for corporations around the globe to signal and demonstrate their proactive climate leadership is the CDP (formerly known as the Carbon Disclosure Project). Unlike the extant literature that has emphasized stakeholder and regulatory pressures, this paper argues that voluntary carbon disclosure is both beneficial and costly for corporations with respect to the existence of supportive management structures, explicit CSR practices, and the existence of complementary assets. Moreover, there is variation between European firms and other global businesses because of Europe's distinctive national business systems framework in conjunction with global supply chain imperatives. Empirically, this study employs a novel discrete‐continuous modeling approach to distinguish between a corporation's decision to disclose and the linked but subsequent decision of how much to disclose climate change information. Results indicate that the main drivers of participation in voluntary carbon disclosure by the Global 500 firms is the existence of senior managers and executive‐level officers and the adoption of ESG principles by global businesses. Conditional on participation, European Union‐based and other global businesses that articulate a corporate vision for environmental sustainability, adopt ESG principles, and invest in complementary assets disclose climate change strategies and emissions at higher levels than companies without these internal firm capabilities. This study has implications for national climate policy and global climate change governance more generally, both of which increasingly focus on concrete climate solutions by corporations.     

A United Kingdom-based economic evaluation of ranibizumab for patients with retinal vein occlusion (RVO)

Objective:

This study compares the cost-effectiveness of intravitreal ranibizumab vs observation and/or laser photocoagulation for treatment of macular edema secondary to retinal vein occlusion in a UK-based model.

Methods:

A Markov model was constructed using transition probabilities and frequency of adverse events derived using data from the BRAVO, CRUISE, and HORIZON trials. Outcomes associated with treatments and health states were combined to predict overall health costs and outcomes for cohorts treated with each option.

Results:

In branch retinal vein occlusion, ranibizumab produced a gain of 0.518 quality-adjusted life years at an incremental cost of £8141, compared with laser photocoagulation. The incremental cost-effectiveness ratio was £15,710 per quality-adjusted life year, and the incremental cost per month free from blindness was £658. In central retinal vein occlusion, ranibizumab produced a gain of 0.539 quality-adjusted life years at an incremental cost of £9216, compared with observation only. The incremental cost-effectiveness ratio was £17,103, and the incremental cost per month free from blindness was £423.

Conclusions:

These incremental cost-effectiveness ratios are below the £20,000–30,000 range typically accepted as a threshold for cost-effectiveness. This suggests that ranibizumab may be regarded as a cost-effective therapy for patients with macular edema secondary to retinal vein occlusion, relative to grid laser photocoagulation (for BRVO) and observation (for CRVO). Limitations include sparse data for utilities associated with the severity of visual impairment in the WSE in patients with RVO. A lack of direct comparative evidence between ranibizumab and the dexamethasone intravitreal implant for the treatment of BRVO and CRVO and the infeasibility of an indirect comparison due to significant heterogeneity in trial designs prevented the inclusion of this treatment as a comparator in the Markov model.     

Advanced practice nurse outcomes 1990-2008: a systematic review

Advanced practice registered nurses have assumed an increasing role as providers in the health care system, particularly for underserved populations. The aim of this systematic review was to answer the following question: Compared to other providers (physicians or teams without APRNs) are APRN patient outcomes of care similar? This systematic review of published literature between 1990 and 2008 on care provided by APRNs indicates patient outcomes of care provided by nurse practitioners and certified nurse midwives in collaboration with physicians are similar to and in some ways better than care provided by physicians alone for the populations and in the settings included. Use of clinical nurse specialists in acute care settings can reduce length of stay and cost of care for hospitalized patients. These results extend what is known about APRN outcomes from previous reviews by assessing all types of APRNs over a span of 18 years, using a systematic process with intentionally broad inclusion of outcomes, patient populations, and settings. The results indicate APRNs provide effective and high-quality patient care, have an important role in improving the quality of patient care in the United States, and could help to address concerns about whether care provided by APRNs can safely augment the physician supply to support reform efforts aimed at expanding access to care.