Managerial Preferences and Competition in Internal Capital Markets

It is often argued that managers follow some preference function. The internal capital market literature, for example, most commonly treats managers as empire builders who receive increased private ben-e ts from having more funds under their control. However, recent empirical work (Bertrand and Mullainathan 2003), shows that some managers might prefer to be left to run a limited number of projects. This "enjoying the quiet life " constitutes an alternative type of man-agerial behavior. In this contribution, we demonstrate how empire building and quiet life preferences work under competition. Our analy-sis shows that quiet life managers can generally only be motivated by threatening them with competition, while empire builders also value enhanced investment prospects. As we also demonstrate, this leads to di¤erent optimal wages in regard to managerial preferences. Ad-ditionally we identify two organizational ways to improve managerial incentives. Namely, by letting managers with di¤erent investment prospects compete for funds and by altering the ex ante distribution of funds among the department managers. Again, results vary signif-icantly with di¤erent managerial preferences

ANTECIPANDO ALGUMAS POSSIBILIDADES EMOLDURADAS PELA IDEIA DE WRONGFUL CONCEPTION NO DIREITO BRASILEIRO

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Community library programs that work: Building youth and family literacy

A collection of versatile best practices for promoting literacy development by utilizing local community connections in school and public libraries. This book provides a fresh approach to learning as well as guidelines for creating dynamic and relevant library programs for children, teens, and families. Organized thematically, each chapter includes relevant topical research and three to eight community-focused approaches. Programs range from small, single-library initiatives in rural communities to multi-site, cross-border initiatives. This resource includes collaborative and locally inspired programs, many of which can be scaled to the budget of any library, school, or community organization

Early modern human behavioural responses to marginal landscapes : Middle Stone Age geoarchaeology in Highland Lesotho

Figure S6. Effect of geographic representation of study patients on outcomes: mortality. Figure S7. Effect of geographic representation of study patients on outcomes: infections. (DOCX 190 kb

New, Useful Criteria for Assessing the Evidence of Infection in Sepsis Research.

OBJECTIVES The Sepsis-3 definition states the clinical criteria for sepsis but lacks clear definitions of the underlying infection. To address the lack of applicable definitions of infection for sepsis research, we propose new criteria, termed the Linder-Mellhammar criteria of infection (LMCI). The aim of this study was to validate these new infection criteria. DESIGN A multicenter cohort study of patients with suspected infection who were admitted to emergency departments or ICUs. Data were collected from medical records and from study investigators. SETTING Four academic hospitals in Sweden, Switzerland, the Netherlands, and Germany. PATIENTS A total of 934 adult patients with suspected infection or suspected sepsis. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Agreement of infection site classification was measured using the LMCI with Cohen κ coefficient, compared with the Calandra and Cohen definitions of infection and diagnosis on hospital discharge as references. In one of the cohorts, comparisons were also made to adjudications by an expert panel. A subset of patients was assessed for interobserver agreement. MEASUREMENTS AND MAIN RESULTS The precision of the LMCI varied according to the applied reference. LMCI performed better than the Calandra and Cohen definitions (κ = 0.62 [95% CI, 0.59-0.65] vs κ = 0.43 [95% CI, 0.39-0.47], respectively) and the diagnosis on hospital discharge (κ = 0.57 [95% CI, 0.53-0.61] vs κ = 0.43 [95% CI, 0.39-0.47], respectively). The interobserver agreement for the LMCI was evaluated in 91 patients, with agreement in 77%, κ = 0.72 (95% CI, 0.60-0.85). When tested with adjudication as the gold standard, the LMCI still outperformed the Calandra and Cohen definitions (κ = 0.65 [95% CI, 0.60-0.70] vs κ = 0.29 [95% CI, 0.24-0.33], respectively). CONCLUSIONS The LMCI is useful criterion of infection that is intended for sepsis research, in and outside of the ICU. Useful criteria for infection have the potential to facilitate more comparable sepsis research and exclude sepsis mimics from clinical studies, thus improving and simplifying sepsis research

Adverse effects of delayed antimicrobial treatment and surgical source control in adults with sepsis: results of a planned secondary analysis of a cluster-randomized controlled trial

BACKGROUND: Timely antimicrobial treatment and source control are strongly recommended by sepsis guidelines, however, their impact on clinical outcomes is uncertain. METHODS: We performed a planned secondary analysis of a cluster-randomized trial conducted from July 2011 to May 2015 including forty German hospitals. All adult patients with sepsis treated in the participating ICUs were included. Primary exposures were timing of antimicrobial therapy and delay of surgical source control during the first 48 h after sepsis onset. Primary endpoint was 28-day mortality. Mixed models were used to investigate the effects of timing while adjusting for confounders. The linearity of the effect was investigated by fractional polynomials and by categorizing of timing. RESULTS: Analyses were based on 4792 patients receiving antimicrobial treatment and 1595 patients undergoing surgical source control. Fractional polynomial analysis identified a linear effect of timing of antimicrobials on 28-day mortality, which increased by 0.42% per hour delay (OR with 95% CI 1.019 [1.01, 1.028], p ≤ 0.001). This effect was significant in patients with and without shock (OR = 1.018 [1.008, 1.029] and 1.026 [1.01, 1.043], respectively). Using a categorized timing variable, there were no significant differences comparing treatment within 1 h versus 1–3 h, or 1 h versus 3–6 h. Delays of more than 6 h significantly increased mortality (OR = 1.41 [1.17, 1.69]). Delay in antimicrobials also increased risk of progression from severe sepsis to septic shock (OR per hour: 1.051 [1.022, 1.081], p ≤ 0.001). Time to surgical source control was significantly associated with decreased odds of successful source control (OR = 0.982 [0.971, 0.994], p = 0.003) and increased odds of death (OR = 1.011 [1.001, 1.021]; p = 0.03) in unadjusted analysis, but not when adjusted for confounders (OR = 0.991 [0.978, 1.005] and OR = 1.008 [0.997, 1.02], respectively). Only, among patients with septic shock delay of source control was significantly related to risk-of death (adjusted OR = 1.013 [1.001, 1.026], p = 0.04). CONCLUSIONS: Our findings suggest that management of sepsis is time critical both for antimicrobial therapy and source control. Also patients, who are not yet in septic shock, profit from early anti-infective treatment since it can prevent further deterioration. Trial registration ClinicalTrials.gov (NCT01187134). Registered 23 August 2010, NCT01187134 SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13054-022-03901-9