Employee perceptions of corporate partnership: An affective-moral quid pro quo

An affective-moral quid pro quo model provided the framework to test the relationship between worker satisfaction, perceptions of employees' citizenship behavior, and corporate commitment to moral-ethical ideals. A total of 198 full-time employees from a wide variety of work settings anonymously completed questionnaires. More than half of the respondents held management or supervisory positions; the number of males and females was nearly equal. Participants who indicated high satisfaction with work, promotions, and co-workers, and who viewed employees in their work setting as altruistic, perceived their organization as committed to employee welfare, employee rights, product quality, and as good corporate citizens.     

A UK analysis of the cost of switching renal transplant patients from an immediate-release to a prolonged-release formulation of tacrolimus based on differences in trough concentration variability

Background and aims:

Randomized controlled trials have shown that a once-daily prolonged-release (PR) tacrolimus formulation (PR tacrolimus; Advagraf), is non-inferior to a twice-daily immediate-release (IR) tacrolimus formulation (IR tacrolimus; Prograf) in terms of biopsy-proven acute rejection, graft failure and mortality in renal transplant recipients. However, relative to IR tacrolimus, PR tacrolimus exhibits reduced tacrolimus trough concentration variability, which has been associated with reduced graft failure. Based on these data, the present study evaluated the cost of switching UK renal transplant patients from IR tacrolimus to PR tacrolimus.

Methods:

UK-specific data on acute rejection, graft failure, and mortality were used to construct a budget impact model to assess the costs of switching from IR tacrolimus to PR tacrolimus on a 1:1?mg:mg basis. The model assumed that 3.1% of patients on PR tacrolimus had high tacrolimus trough concentration variability compared with 17.4% on IR tacrolimus, based on a study comparing PR tacrolimus and IR tacrolimus pharmacokinetics. A relative graft failure risk of 2.38 was applied to high variability patients based on data from a tacrolimus variability study in which 10/148 patients with low variability experienced graft failure, compared with 24/149 in the high variability group. Cost data were taken from the British National Formulary and 2012–2013 NHS tariff information.

Results:

The mean per-patient cost (including tacrolimus, concomitant immunosuppressive medications, dialysis after graft failure, and treatment for acute rejection) was GBP 26,941 (standard deviation [SD]?=?GBP 2765) with PR tacrolimus vs GBP 30,356 (SD?=?GBP 3085) for IR tacrolimus over a 5-year period, corresponding to a saving of GBP 3415 (SD?=?GBP 516) per patient or GBP 341,500 in a hypothetical 100-patient transplant center. Cost savings were driven primarily by lower dialysis costs resulting from the lower proportion of PR tacrolimus patients with high tacrolimus trough concentration variability (leading to lower graft failure risk).

Limitations:

The main limitation of the study was the use of heterogeneous data sources to capture the effect of within-patient variability on graft failure. The most important difference between the studies was the definition of the threshold between low and high within-patient variability. This was explored in sensitivity analyses in which the inter-arm difference in the inter-arm proportions of patients with high and low variability was abolished.

Conclusions:

Converting UK renal transplant recipients from IR tacrolimus to PR tacrolimus was associated with lower pharmacy and dialysis costs.     

Organizational imperatives and cultural modifiers

The different structures may best fit a company as it changes its size or mission or type of business is fairly evident. What may not be so widely known is that certain structures better fit a given national culture than others. National differences have many implications for how the separate divisions of a multinational are organized.     

A cost-utility analysis of prolonged-release tacrolimus relative to immediate-release tacrolimus and ciclosporin in liver transplant recipients in the UK

Background: Calcineurin inhibitors (CNIs) represent the cornerstone of immunosuppressive therapy after liver transplantation. A recent network meta-analysis (NMA) evaluated the relative efficacy of CNIs ciclosporin, prolonged-release (PR) tacrolimus, and immediate-release (IR) tacrolimus in adult liver transplant recipients based on randomized and large observational trials published since 2000. Based on the NMA findings, the present study evaluated the cost-utility of PR tacrolimus relative to ciclosporin or IR tacrolimus in liver transplant recipients in the UK.

Methods: A Markov model was developed to evaluate the cost-utility of immunosuppressive regimens in liver transplant recipients, capturing costs associated with immunosuppression, retransplantation, acute rejection (AR), and cytomegalovirus infection. Mortality, graft loss, and AR odds ratios were derived from the NMA. Costs were taken from the British National Formulary and the NHS National Tariff and expressed in 2016 pounds sterling. Future costs and effects were discounted at 3.5% annually.

Results: Over 25 years, PR tacrolimus resulted in increased life expectancy and quality-adjusted life expectancy (QALE) relative to IR tacrolimus and ciclosporin. Relative to ciclosporin, QALE increased by 1.17 quality-adjusted life years (QALYs) with PR tacrolimus while costs increased by GBP £4645, yielding an incremental cost-effectiveness ratio (ICER) of £3962 per QALY gained. Relative to IR tacrolimus, QALE increased by 0.78 QALYs and costs by £1474, resulting in an ICER of £1889 per QALY gained. Sensitivity analysis showed the analysis to be most sensitive to dosing assumptions.

Conclusions: Based on a UK-specific analysis of the projected cost-utility of PR tacrolimus relative to IR tacrolimus and ciclosporin, PR tacrolimus was cost-effective, improving life expectancy and QALE relative to both IR tacrolimus and ciclosporin, yielding ICERs below £20 000 per QALY gained. The main limitations of the study were data source heterogeneity and omitting the economic and clinical effects of treating aspects of recurrent liver disease.     

Range of employee voice

Voice, recently defined as employees' response to job dissatisfaction, is redefined to encompass a wide range of symbolic communicative behaviors. Variations of employee voice are described in light of the concern for corporate conformity. Voice in the workplace is explained as rooted in moral, political-economic, and psychological grounds. The model presented positions voice on active/passive and constructive/destructive axes. Voice in its various types is described as necessarily instrumental to the ongoing constructing and restructuring process of organizing. This essay concludes with a discussion of the several ways voice is legitimized.     

Equality and the swedish work environment

The tension betweenneed andeffort is at the core of differing interpretations of social equality and inequality. Need-based thinking entails social and economic justice for all within the state regardless of abilities and effort. Effort-based thinking embodies distribution of material resources according to energy expended, abilities, and achievement. The Swedish model for the past five decades has sided with need-based egalitarian mindedness and increasingly has applied that criterion to the quality of working life. Accommodations were made for wealth, a managerial elite, and strong unions. Recently, the country’s overheated economy and pressures for austerity have caused a reassessment of the welfare state.     

Corporate conditions conducive to employee voice: A subordinate perspective

Employees' voice is conceptualized as a necessary condition for organizational success. A model of employee voice is proposed that encompasses employee predispositions, receptivity to employee voice in the microstructure, and affirmative norms for voice in the societal macrostructure. The model was examined by testing the hypothesis that subordinates' satisfaction will be greater when corporate conditions are receptive to employee voice and when the organization is perceived to be committed both to quality in product and quality of employees' work life. a study with 150 employees from a variety of organizations is reported. The results produced rather strong support for the research hypothesis.