Economic modelling of costs associated with outcomes reported for type 2 diabetes mellitus (T2DM) patients in the CANVAS and EMPA-REG cardiovascular outcomes trials

Aims: To model direct medical costs associated with reductions in cardiovascular disease (CVD) events in T2DM patients reported in the CANVAS and EMPA-REG trials, which assessed the cardiovascular safety of canagliflozin and empagliflozin, respectively.

Materials and methods: Costs were modeled from a US managed care organization (MCO) perspective for the CVD outcomes included in both trials: three-point major adverse cardiovascular event (MACE) and its components (cardiovascular-related death, nonfatal myocardial infarction, nonfatal stroke), as well as heart failure requiring hospitalization. The rate of CVD events averted (difference between study drug and placebo) was projected to the portion of an MCO T2DM population matching the respective trial’s inclusion criteria. A targeted literature search for paid amounts directly associated with each CVD event provided the unit costs, which were applied to the projected number of events averted, to calculate costs avoided per member per year (PMPY). One-way sensitivity analyses were performed on events averted, unit costs, and percentages of trial-applicable patients.

Results: Based on three-point MACE events averted, costs avoided PMPY of $6.17 (range: $1.27–$10.94) for CANVAS and $2.75 ($0.19–$4.83) for EMPA-REG were estimated. Costs avoided for individual components of MACE ranged from $0.77 to $3.84 PMPY for CANVAS and from -$0.97 (additional costs) to $1.54 for EMPA-REG. PMPY costs avoided for heart failure were $2.72 for CANVAS and $1.32 for EMPA-REG.

Limitations and conclusions: Models assumed independent, non-recurrent outcomes and were restricted to medical costs directly associated with the trial-reported events. The reductions in CVD events in T2DM patients reported for both CANVAS and EMPA-REG project to a positive cost avoidance for these events in an MCO population. The analysis did not include an assessment of the impact on total cost, as the costs associated with adverse events, drug utilization or other clinical outcomes were not examined.     

The True Meaning of ‘Social Justice’: A Catholic View of Hayek

Hayek's well‐known dismissal of the concept of ‘social justice’ is examined and questioned. While basically agreeing with Hayek's critique, the author argues that we should not entirely reject this concept, although it is often used in a vague and emotional way – ‘social justice talk’. Drawing on the tradition of classical liberalism and Catholic social teaching, he makes the case for the true meaning of social justice, which applies to the basic legal and institutional framework of a society rather than the distributional outcomes of market processes.     

Environmentally Sustainable Development through Stakeholder Engagement in Developed and Emerging Countries

This cross‐country study investigates the antecedents and outcomes of corporate environmental responsibility (CER) practices in developed and emerging countries. Based on stakeholder and institutional theory, we conducted an empirical study among firms in Germany, USA, India and China. We found support for a significant positive relationship between regulatory, market and social stakeholder influences, CER practices and business outcomes in the total and individual country samples. Regarding country differences, our data reveal significant similarities and differences between developed and emerging countries. Market stakeholder influences are stronger in developed countries, whereas regulatory and social stakeholder influences do not differ significantly between the two country groups. The relationship between CER practices and positive business outcomes is stronger in emerging than in developed countries. Implications for institutional theory and organizations are outlined. Copyright © 2014 John Wiley & Sons, Ltd and ERP Environment     

Early labor market outcomes of university graduates: Does time to degree matter?

Using university administrative and survey data drawn from the AlmaLaurea Consortium, we analyze the effect of time to degree on the early labor market performance of Italian graduates. The empirical strategy allows identifying separately the impact of elapsed time to degree on the transition from university to work and on earnings from other determinants specific to the academic path completed. Findings suggest that delayed graduation reduces the employment probability (0.8% points for each year of delay), and this effect is still persistent five years after graduation. Once employed, graduates not completing their degree within the minimum period are also penalized in their net monthly earnings, even five years after graduation. The most penalized groups are women and graduates in non-scientific fields.     

How do female directors improve board governance? A mechanism based on norm changes

Prior literature documents that corporate boards with female directors produce better governance outcomes than all-male boards. However, female directors constitute the minority on most boards, which precludes majority voting as the mechanism through which they change board decisions. We identify changing the norms of how the board works as this mechanism. Using the market for norms framework, we explain how female directors are effective even without possessing a board majority or other sources of symbolic power, such as hierarchical authority and social gravitas. Empirically, we show that independent female directors, compared to their male counterparts, are more effective at changing board norms (board processes) and improving governance (board outputs).     

How risky is a random process?

The riskiness of random processes is compared by (a) employing a decision theoretic equivalence between processes and lotteries on path-spaces to identify the riskiness of the former with that of the latter, and (b) using the theory of comparative riskiness of lotteries over vector spaces to compare the riskiness of lotteries on a given path-space. We derive the equivalence used in step (a) and contribute a new criterion to the theory applied in step (b). The validity of the new criterion, which applies second order stochastic dominance to utility distributions, is established by showing its equivalence to the benchmark decision theoretic criterion when comparing the riskiness of lotteries over any vector space. We demonstrate the theory’s tractability via diverse economic applications.     

Curriculum assessment through a capstone course: a case study in hospitality and tourism programs

The purpose of this study was to develop a systematic process that other educational institutions and programs could follow to establish a consistent and accurate evaluation method for a capstone course. Hospitality industry professionals and hospitality management faculty were interviewed through focus-group discussions, and a post-focus-group survey was conducted to determine a weighted percentage for each of the nine determined content domains. A test blueprint for a hospitality management capstone course was developed to measure programmatic student learning outcomes based on the weighted domains determined through this study. The results provide a usable instrument for hospitality and tourism management programs to enhance their current assessment methodology.     

New insights into an old problem – enhancing student learning outcomes in an introductory statistics course

Many students enrolled in first year introductory statistics courses believe learning statistics is a waste of time and fear they will fail. In this study, we explored the impacts on learning outcomes for students in an introductory statistics course by allowing students to arbitrarily choose their own sequence of learning from three key learning activities, namely tutorials, Peer-Assisted Study Sessions and Computer-Managed Learning quizzes. Unlike the old regime where the learning activities followed a strict, rigid sequence, a new regime allowed students to freely choose when, where and how they engaged with the course learning activities. This allowed increased opportunities for students to receive relevant and timely feedback. Using a total of 1187 students enrolled in semester 2 of 2011, 2012 and 2013, data were collected on students’ scores from 7 assessment tasks. Our experimental design ensured as many course features as possible remained constant between the control cohorts (of 2011 and 2012) and the experimental cohort (2013), thereby avoiding potential sample selection problems. The findings showed student learning outcomes in the new regime improved significantly. Interestingly, the effects were found to be greatest in the lower percentile of the score distribution.     

How does growth need strength influence employee outcomes? The roles of hope,leadership, and cultural value

Abstract

Strong growth need is essential if an employee is to be motivated to complete complex and challenging jobs. It is important for organizations to attract employees with high growth need strength and help them achieve positive outcomes. However, limited research has been conducted to examine the mechanism underlying growth need strength’s positive effect on employee outcomes. Based on hope theory, we hypothesized that hope mediates the effect of growth need strength on job performance and affective commitment by transforming employees’ general desire for personal growth into goal-related cognitive thinking, comprising both ‘will’ and ‘ways’. We further hypothesized the moderating effect of transformational leadership, and the joint moderating effect of transformational leadership and individual power distance on the relationship between growth need strength and hope. We tested our hypotheses with data from a sample of 265 subordinate–supervisor dyads from China. Data analysis results supported the mediating role of hope. We found that growth need strength has a stronger effect on hope when transformational leadership is higher, and this effect is the strongest when both transformational leadership and individual power distance are simultaneously higher. The implications of these findings for human resource management research and practice are discussed.     

Together we measure: Improving public service outcomes via the co-production of performance measurement

Not-for-profit organizations (NFPs) aim to deliver public services and achieve outcomes for their beneficiaries. However, little attention has been given to how NFP professionals engage with beneficiaries to develop the performance measures that inform service improvement and accountability. Our findings illustrate how a co-production approach to performance measurement can enhance the meaningfulness of outcome measures, hence supporting service improvement and facilitating ‘collaborations for accountability’ between NFPs and their beneficiaries.