Time spent on erythropoietin stimulating agents administration in hemodialysis centers in Panama: a time and motion study

Objectives: There is a lack of data in Panama on the potential differences in total healthcare professional (HCP) time between routine administrations of short-acting erythropoietin simulating agents (ESAs) (i.e. epoetin alfa) and continuous erythropoietin receptor activator (CERA) (i.e. methoxy polyethylene glycol–epoetin beta). This study aimed to quantify the HCP time associated with a single administration of epoetin alfa and CERA for the treatment of anemic patients with chronic kidney disease (CKD) on hemodialysis.

Methods: This was a multi-center, cross-sectional study, using a time-and-motion methodology. Costs related to HCP time and consumables usage associated with administration of epoetin alfa and CERA were estimated.

Results: Based on 60 administrations of either CERA or epoetin alfa, the estimated savings in mean total active HCP time were 2.34 (95% confidence interval?=?1.87–2.81) min (–30%) per administration. When extrapolating to a full year’s treatment with intravenous ESA, it would require a total of 20.3 (95% CI?=?19.90–20.71) h of HCP time for epoetin alfa vs 1.1 (95% CI?=?1.01–1.19) h for CERA per patient per year. Estimated savings in active HCP time per patient per year were 19.20 (95% CI?=?19.20–19.21) h (–95%). This, in turn, translates into staff cost efficiency that favors Mircera with an estimated annual saving of $78.24 (95% CI?=?78.24–78.28) (–95%) per patient.

Conclusions: Data from a real-world setting showed that the adoption of CERA could potentially lead to a reduction in active HCP time.

• Highlights

• Few comparative data have explored the costs and potential savings of using long-acting erythropoietin–stimulating agents (ESA) instead of short-acting ESAs to treat anemia in CKD patients on hemodialysis.

• This time-and-motion study shows that use of CERA reduces total healthcare professional time and could represent a save for an institution in a real-world setting in Panama.

     

Spillovers,subsidies, and second‐best socially optimal R&D

This paper provides a thorough second‐best welfare analysis of the standard two‐stage model of R&D/product market competition with R&D spillovers. The planner's solution is compared to the standard non‐cooperative scenario, the R&D cartel, and the cartelized research joint venture (or joint lab). We introduce the notion of a social joint lab, as a way for the planner to avoid wasteful R&D duplication. With no spillovers, the non‐cooperative scenario, the joint lab, and the second‐best planner's solutions coincide. However, with spillovers, all three scenarios yield R&D investments that fall short of the socially optimal level. To shed light on the role of the spillover level on these comparisons, we observe that the gaps between the market outcomes and the planners solutions widen as the spillover parameter increases. Finally, we establish that a social planner and a social joint lab solutions may be achieved starting from any of the three scenarios by offering firms respective suitably weighted quadratic R&D subsidization schedules.     

Work-Integrated Learning in accountancy at Australian universities – forms,future role and challenges

This exploratory study seeks to obtain the views of strategic decision-makers surrounding the implementation of Work-Integrated Learning (WIL) Accountancy programs in Australian universities. Using an online questionnaire with mainly open-ended questions, the results showed most respondents perceived WIL programs as important and should be offered and assessed. Work placements and internships were the prominent forms of WIL; and WIL programs were of varying length but typically long, elective, unpaid, in the middle and/or end of the course/degree, assessed, with students awarded grades and credit points. The most challenging issues identified were the difficulty of finding placements and the resourcing implications. The contributions of the study relate to highlighting the various models of accountancy WIL actually implemented and providing empirical evidence on the challenges faced. Since WIL is perceived as important for the future and should be included in degree courses, the proposed future research could help overcome these challenges.     

Multiple foci of commitment in a professional service firm: balancing complex employment relations

Employees of professional service firms (PSFs) have attachments to multiple groups, which may be either compatible or conflicting: their employer, their clients and their profession. We analyse the antecedents of commitment to these three foci based on a survey of 510 employees in a large PSF in Norway. The main findings are as follows: (1) low quality of internal work relations is negatively associated with employer commitment and draws employees towards external foci of commitment – the clients and the profession; (2) role conflict is associated with stronger commitment to the client organisation and the profession; and (3) autonomy and transferability of skills are associated with stronger commitment to the profession, but does not undermine commitment to the employer. The article contributes to our understanding of the conditions under which employees identify with external groups and when commitment to the employer may be compromised. The findings have implications for how managers can help to increase the commitment of employees involved in complex employment relations.     

教育技术学专业本科生专业态度调查研究——以淮南师范学院为例

专业态度影响学生在校期间的学习状态和毕业生的择业倾向。为全面客观地了解高等师范院校教育技术学专业本科生专业态度的现状,提高教育质量,课题组以淮南师范学院教育技术学专业本科生为调查对象,从入学动机、专业情感、专业认知、行为倾向、对课程设置和就业前景的看法等几个方面进行了调查。根据调查结果,分析了教育技术学专业本科生专业态度的现状,就其存在的问题进行了探讨,并提出了意见与建议。     

经济思想史中的合作行为研究

人类是自然界中唯一可以在大规模群体中与非亲属成员合作的物种,这种独特现象引起了生物学、社会学、人类学、经济学等众多学科的关注,但是,迄今为止的经济学基本上是以"竞争"为主线的,合作却没有获得经济学应有的重视。近二十多年来,合作行为逐渐成为经济学研究的重点领域之一。其实,纵观人类经济思想史,我们可以发现,在经济学发展的历史长河中闪耀着关于合作行为研究的繁星点点,其思想光芒有力地推动了时代的进步和社会的发展,影响着人们生活的方方面面,有的至今依然影响深远,值得我们去回味、总结和借鉴。本文主要从经济思想史的高度对一些著名经济学家关于合作行为的思想进行总结和讨论。     

新形势下高校公共英语教师的学科转型

我国现阶段迫切需要培养具有国际合作意识、国际交流与竞争能力的外向型人才，因此越来越多的高校把纯粹的公共英语教学变为利用英语进行不同学科内容的教学。高校公共英语教师需要更新观念，积极学习，向专业英语和双语教学方向迈进；高校需要通过合理的政策引导公共英语教师实现学科转型。     

When collective action and tenure allocations collide: Outcomes from community forests in Quintana Roo,Mexico and Petén,Guatemala

Based on a comparative case study of four community forestry enterprises in Guatemala and Mexico, we examine the relationship between user group characteristics and state allocation of tenure bundles. Using Schlager and Ostrom's four levels of tenure bundles and collective action theory, we illustrate how tenure bundles and collective action costs interact to either promote or create disincentives for conservation and communal economic benefits. We suggest that in communities with high costs for collective action, a tenure bundle that includes management, withdrawal and exclusion rights yet omits alienation rights may be optimal for community forestry. We also demonstrate how unclear allocation of rights can result in local interpretations of land rights that do support collective action.     

浅谈作为优秀职业经理人的必备条件

职业经理人已逐渐成为国内热门的职业,但是对该职业的研究和分析尚处于初级阶段,本文从四方面阐述了如何成长为一名优秀的职业经理人。     

案例教学法在平面设计课程中的应用

随着计算机的普及，计算机的应用涉及到各个工作领域，各大高校都开设了平面广告等相关专业。随着平面广告所需人才的增多，如何培养出优秀合格的平面设计人才，威了每个平面专业教师深入思考的问题。本论文针对高职高专院校的计算机平面专业学生，在绘图、排版等软件学习过程中遇到的问题，结合自身教学工作，总结出利用案例教学法进行教学的一些方法。