Comparing post-operative resource consumption following transcatheter aortic valve implantation (TAVI) and conventional aortic valve replacement in the UK

Objective:

To define the in-hospital and 6-month post-discharge resource use, following Transcatheter Aortic Valve Implantation (TAVI) and conventional Aortic Valve Replacement (AVR) surgery within a single UK hospital.

Methods:

A local service evaluation of patients undergoing TAVI or AVR between January 2011 and May 2012 captured data until 6-months post-procedure, collected from hospital records and via a General Practitioner questionnaire. The main end-points were mortality, time in ITU/HDU, hospital length of stay (LoS), discharge destination, re-admission, and post-discharge primary/secondary care resource use. Sub-group analyses were performed for AVR patients aged ≥80 (AVR?≥?80) and with EuroSCORE of ≥10 (AVR ES?≥?10) to allow more direct comparison with ‘TAVI type’ patients.

Results:

Results are given as means (standard deviation) for TAVI (n?=?51), AVR (n?=?188), AVR?≥?80 (n?=?48), and AVR ES?≥?10 (n?=?47), respectively, unless otherwise stated. Age in years was 83.0 (8.1), 71.2 (13.1), 84.1 (2.7), 79.4 (7.1); EuroSCORE was 24.7 (11.9), 8.1 (6.4), 12.0 (6.0), and 16.5 (6.6); post-operative LoS (days) was 11.5 (11.2), 10.9 (10.8), 14.3 (16.7), and 15.2 (17.7). For discharged patients, 0%, 7%, 13%, and 9% had unplanned cardiac-related re-admissions within 30-days of discharge. Time to first readmission was 74.6 (34.0), 35.0 (34.2), 20.8 (9.7), and 22.6 (14.3) days.

Limitations:

This was a single-center retrospective evaluation, not prospectively powered to confirm differences in outcomes.

Conclusions:

Despite TAVI being performed in an older, higher risk population, LoS was similar to AVR. Most strikingly there were no cardiac-related re-admissions within 30-days for TAVI and time to first re-admission was significantly longer. This evaluation suggests that TAVI is clinically appropriate and provides economic advantages in both the hospital and post-discharge setting in this high risk group. Many patients undergoing TAVI are considered unfit for surgery and, hence, TAVI offers a treatment that delivers similar results to traditional AVR without the high risk associated with surgery.     

Random regret minimization for consumer choice modeling: Assessment of empirical evidence

This paper introduces to the field of marketing a regret-based discrete choice model for the analysis of multi-attribute consumer choices from multinomial choice sets. This random regret minimization (RRM) model, which has recently been introduced in the field of transport, forms a regret-based counterpart of the canonical random utility maximization (RUM) paradigm. This paper assesses empirical results based on 43 comparisons reported in peer-reviewed journal articles and book chapters, with the aim of finding out to what extent, when, and how RRM can form a viable addition to the consumer choice modeler's toolkit. The paper shows that RRM and hybrid RRM–RUM models outperform RUM counterparts in a majority of cases, in terms of model fit and predictive ability. Although differences in performance are quite small, the two paradigms often result in markedly different managerial implications due to considerable differences in, for example, market share forecasts.     

Analysis of Consumer Preferences for Quality and Safety Attributes in Artisanal Fruit Juices in Kenya

This study used choice experiment survey data from a random sample of 374 respondents to analyze consumer preferences for quality and safety attributes of artisanal fruit juices in Kenya. Results show that consumers had a positive and significant preference for single fruit juices compared to fruit mixtures, private rather than public inspection of the juices, traceability of fruit origin, and vendor’s health. Additives such as colorants, flavors, and preservatives were not preferred. Consumers were willing to pay premiums of up to 200% for artisanal juices that contain single fruits, lack additives, and are inspected by private agencies. These insights should be incorporated in ensuring that artisanal fruit juice designs comply with food quality and safety requirements. Further, there is a need to license and regulate the artisanal juice preparation and handling and to provide training to the handlers on safety and quality requirements.     

Consumer preferences before and after a food safety scare: An experimental analysis of the 2010 egg recall

In August 2010, more than half a billion eggs were recalled in the U.S. because of a Salmonella outbreak. This study examines the effect of the recall with a unique pair of auction experiments investigating willingness to pay (WTP) for conventional and organic eggs, one conducted shortly before and one right after the recall with the same participants. In addition to the before and after bids, participants bid again after a negative information or balanced information treatment about the event. Accompanying surveys showed consumers had a high level of awareness of the recall but less knowledge of specific details, and viewed information on egg farm conditions as very important in their WTP. While there were no significant before and after differences, WTP for organic eggs significantly increased in the negative information treatment, and balanced information had a positive effect on consumer WTP for conventional eggs.     

Market-based grazing land transfers and customary institutions in the management of rangelands: Two case studies on the Qinghai-Tibetan Plateau

Beginning in the early 1990’s, grazing lands once held in common were contracted to individual households in the rangeland regions of China. The resulting fragmentation of rangelands has led to ecological and social problems. As China seeks to address intractable poverty and rangeland degradation, attention has turned to rental, or transfer, of contracted grazing land as a market-based approach to re-aggregating grazing land into larger units that support economies of scale. However, given that many pastoral regions still maintain community customary institutions, what the relationship between market mechanisms and local customary institutions should be in rangeland management needs further analysis. This paper applies comparative case studies of two types of relationships between market mechanisms and customary institutions: (1) market mechanisms that replace customary institutions in the case of Axi village, and (2) market mechanisms that are embedded within customary institutions in Xiareer village. This allows contrast of the impacts of differing approaches on livelihoods, livestock production, and wealth differentiation among pastoral households. We found that there is a higher level of livestock mortality, lower livestock productivity, and higher livestock production cost in Axi Village compared to Xiareer Village. In addition, household asset levels are higher and there is less income differentiation in Xiareer Village. It is concluded that embedding market mechanisms within customary institutions has had notable benefits for the herders of Xiareer Village, because it is a better fit to the coupled pastoral social-ecological system. Based on these findings, we argue that in pastoral communities where the rangeland transfer system for contracted grazing land has not yet been implemented, it is critical to reconsider China’s current policy approach to pay greater attention to the innovative management systems being developed in local regions. Instead of considering market-based approaches as oppositional to traditional institutions, options that derive from the interaction of market-based and customary institutions should be considered.     

CORPORATE SOCIAL RESPONSIBILITY: A MICROECONOMIC REVIEW OF THE LITERATURE

This paper provides a review of the theoretical and empirical literature on Corporate Social Responsibility (CSR). Depending on whether an individual can be considered as selfish, or whether she has also social preferences, motives for CSR, can be explained in different ways. Furthermore, we explicitly highlight the influence of different Corporate Governance System on CSR as well as the relationship between firms' size and social commitment. Because it is difficult to distinguish between different theories in empirical studies, we argue that an experimental approach might be suitable to test theories of CSR.     

Board Gender Diversity: Challenges and Implications for Corporations in the East African Community

ABSTRACT

East African Community’s (EAC) corporations are required to follow a regional treaty of mainstreaming gender equality. This article discusses challenges encountered by corporate boards of the EAC’s corporations when adding women. Agency and resource dependence theories led the study, while a review of the literature was the methodology. We discuss the benefits of diverse boards and challenges faced when developing this diversity. We show how power distance, masculinity, and certainty avoidance prevent women from corporate boards. Furthermore, we discuss how social orientation and business environment impact women’s participation. The article discusses various strategies to be considered for increasing diversity.     

基于社区认同的社区网格化管理实效分析——以乌鲁木齐市黑甲山片区二道湾东社区为例

乌鲁木齐市自启动网格化城市管理模式试点以来取得了一定成效,但仍存在一些问题。本文通过实地调查分析发现,社区居民认同感的缺乏是导致社区网格化管理诸多难题的重要原因,社区居民认同感低,使得居民对社区工作消极抵制、不愿配合,并易于产生冲突,从而使居民难以真正融入社区。为此,本文提出应从政府、社区和居民三个角度来完善社区网格化管理,使其更好地发挥其积极功能。     

Food preferences as a proxy for adventurousness

Food preferences have been demonstrated to be a proxy measure for adventurousness, in general. This study demonstrates that a single variable of food preferences unveils the four dimensions of adventurousness that are applicable in a general tourism context. The findings suggest that adding this simple semantic differential question to visitor surveys can be a powerful tool to evaluate the critical factor of adventurousness in tourism.     

The moderating role of demographic variables on customer expectations in airport retail patronage intentions of travellers

The international airport retail business is expanding annually, yet most research into traveller’s experience with the aviation industry have centred on aeronautical features. The study gathered information that would guide the understanding of airport customer retail expectations. Specifically, the study examines the effects of product-relevant factors, market-relevant factors, and perceived service quality on retail patronage intentions, taking into account the moderating role of demographic variables. The purposive sample of three hundred and thirty (330) travellers that were selected at the Kotoka International Airport Terminal 1 and 2 (KIA T1&2) in Accra, the capital of Ghana. The findings show that product-relevant factors, market-relevant factors and overall service quality significantly influence airport retail patronage intention. The effect demographic variables was noticeable among older and high-income consumers. Building on previous studies, we find that product-relevant factors, market-relevant factors, and perceived service quality function as viable signals that drives customer expectations.