\u3cem\u3eCaremark\u3c/em\u3e\u27s Butterfly Effect

In 1996, the Delaware Court of Chancery detailed the minimum standard for corporate boards of directors (“board”) with regard to corporate compliance programs and monitoring protocols. The landmark Caremark decision held that directors would not face liability for a breach of fiduciary duties unless they failed to implement a system of controls and compliance, or knowingly failed to monitor that system. In order to bring a successful Caremark claim, plaintiffs must prove that the board operated in bad faith by failing to exercise oversight in a sustained or systemic way. The Delaware Court of Chancery opinion noted that the theory underpinning a Caremark claim is one of the most difficult for plaintiffs to prove. As a result, boards have enjoyed nearly unlimited protection, regardless of events occurring at the company on their watch. However, this longstanding protection has begun to wane in the past four years. This Article contributes to the analysis of the recent shift in Caremark claims in three ways. First, the Article details the recent evolution of the Caremark standard for corporate compliance required by corporate board members. Second, the Article analyzes how Caremark’s evolution will impact the Directors & Officers (“D&O”) insurance market and what that means for corporate executives. D&O insurance plays a critical role in protecting directors and officers, who have until recently been seemingly beyond the reach of successful shareholder litigation. While the success of bringing a Caremark claim is still very much an uphill battle, the risk calculus has shifted, and this shift is seen in D&O insurance. Finally, the Article discusses the impact of the Caremark standard within current regulatory trends that corporate executives need to continue to monitor. Given the likelihood of increasing regulations in new areas, including environmental, social, and corporate governance (ESG) and cybersecurity, the pressure for corporate compliance and board action will continue to increase. The result: an increase in the number of Caremark claims, further oversight expectations on directors and officers, and additional pressure on D&O insurance coverage

On the quantification of operational supply chain resilience

Operational disruptions impact a supply chain\u27s ability to match supply and demand. To remain competitive, supply chains need to be resilient and thus capable of rapidly and effectively recovering from operational disruptions. Supply chain resilience is inherently multidimensional, as it spans across multiple tiers, and thus is difficult to quantify. Extant research has measured the transient response through a single-dimension or single-organisation as a proxy for operational resilience. Whilst this greatly simplifies the analysis, it is also potentially misleading, as an erroneous selection of metric(s) may lead to an inaccurate evaluation of the transient response. This research extends the understanding of operational resilience via quantitative evaluation of multiple transient response measures across multiple tiers; the objective being to construct a multidimensional, multi-echelon operational supply chain resilience metric. The study utilises disruptions as experimental inputs for a serial supply chain simulation model; results are obtained for individual measurements of the transient response across multiple supply chain tiers. Analysis indicates that individual dimensions of resilience can adequately explain the transient response at the single-firm level, whilst aggregation of multiple resilience dimensions across multiple tiers has greater capacity to holistically capture the performance response to supply chain disruptions

5-2-1 Criteria: A Simple Screening Tool for Identifying Advanced PD Patients Who Need an Optimization of Parkinson’s Treatment

Objective. 5- (5 times oral levodopa tablet taken/day) 2- (2 hours of OFF time/day) 1- (1 hour/day of troublesome dyskinesia) criteria have been proposed by a Delphi expert consensus panel for diagnosing advanced Parkinson’s disease (PD). The aim of the present study is to compare quality of life (QoL) in PD patients with “5-2-1 positive criteria” vs QoL in PD patients without “5-2-1 positive criteria” (defined as meeting ≥1 of the criteria). Methods. This is a cross-sectional, observational, monocenter study. Three different instruments were used to assess QoL: the 39-Item Parkinson’s Disease Quality of Life Questionnaire Summary Index Score (PDQ-39SI); a subjective rating of perceived QoL (PQ-10); and the EUROHIS-QOL 8-Item Index (EUROHIS-QOL8). Results. From a cohort of 102 PD patients (65.4 ± 8.2 years old, 53.9% males; disease duration 4.7 ± 4.5 years), 20 (19.6%) presented positive 5-2-1 criteria: 6.9% for 5, 17.6% for 2, and 4.9% for 1. 37.5% (12/32) and 25% (5/20) of patients with motor complications and dyskinesia, respectively, presented 5-2-1 negative criteria. Both health-related (PDQ-39SI, 25.6 ± 14 vs 12.1 ± 9.2; p<0.0001) and global QoL (PQ-10, 6.1 ± 2 vs 7.1 ± 1.3; p=0.007; EUROHIS-QOL8, 3.5 ± 0.5 vs 3.7 ± 0.4; p=0.034) were worse in patients with 5-2-1 positive criteria. Moreover, nonmotor symptoms burden (Non-Motor Symptoms Scale total score, 64.8 ± 44.8 vs 39.4 ± 35.1; p<0.0001) and autonomy for activities of daily living (ADLS scale, 73.5 ± 13.1 vs 89.2 ± 9.3; p<0.0001) were worse in patients with 5-2-1 positive criteria. Patient’s principal caregiver’s strain (Caregiver Stain Index, 4.3 ± 3 vs 1.5 ± 1.6; p<0.0001), burden (Zarit Caregiver Burden Inventory, 28.4 ± 12.5 vs 10.9 ± 9.8; p<0.0001), and mood (Beck Depression Inventory II, 12.2 ± 7.2 vs 6.2 ± 6.1; p<0.0001) were worse in patients with 5-2-1 positive criteria as well. Conclusions. QoL is worse in patients meeting ≥1 of the 5-2-1 criteria. This group of patients and their caregivers are more affected as a whole. These criteria could be useful for identifying patients in which it is necessary to optimize Parkinson’s treatment