Cardiac safety of tiotropium in patients with cardiac events: a retrospective analysis of the UPLIFT® trial.

BackgroundTiotropium is an anticholinergic bronchodilator for symptom relief and reducing exacerbations with an established safety profile in patients with chronic obstructive pulmonary disease (COPD). Using data from the 4-year Understanding Potential Long-term Impacts on Function with Tiotropium (UPLIFT®) study, we re-evaluated the safety of tiotropium HandiHaler® in patients who experienced recent myocardial infarction (MI), heart failure or unstable rhythm disorder during the study.MethodsA post-hoc analysis of all-cause mortality and serious cardiac adverse events (cardiac SAEs), including cardiac deaths and death unknown, was conducted in patients who had experienced cardiac arrhythmia, MI or cardiac failure during UPLIFT® and who completed the study. Descriptive analyses were performed.ResultsMost patients experiencing cardiac events, for which they would have been excluded at baseline, remained in the trial. Kaplan-Meier analyses revealed a trend to later occurrence of cardiac SAEs with tiotropium HandiHaler® versus placebo. Patients who experienced a cardiac event and continued in UPLIFT® were not found to be at subsequently increased risk of all-cause mortality or cardiac SAEs with tiotropium treatment. Evaluation of deaths by major adverse cardiac events composite endpoints also showed that patients treated with tiotropium were not at increased risk of mortality or cardiac SAEs compared with placebo.ConclusionsRisk of cardiac events, mortality or SAEs was not increased by tiotropium in patients experiencing cardiac events for which they would have been excluded at study baseline. The findings support the cardiac safety of tiotropium HandiHaler® in patients with COPD

The development of a measurement instrument for the organizational performance of social enterprises

There is a growing consensus that the adoption of performance measurement tools are of particular interest for social enterprises in order to support internal decision‐making and to answer the demands of accountability toward their stakeholders. As a result, different methodologies to assess the non‐financial performance of social enterprises are developed by academics and practitioners. Many of these methodologies are on the one hand discussions of general guidelines or, on the other hand, very case specific. As such, these methodologies do not offer a functional tool for a broad range of social enterprises. The goal of this article is to fill this gap by developing an instrument suitable for the internal assessment and the external reporting of the non‐financial performance of a diverse group of social enterprises. To reach this goal, we used qualitative (focus groups and a Delphi panel) and quantitative research methods (exploratory and confirmatory factor analysis), involving multiple actors in the field of social entrepreneurship. Focusing on five dimensions of organizational performance (economic, environmental, community, human and governance performance), we offer a set of indicators and an assessment tool for social enterprises

Challenged by great expectations? Examining cross-level moderations and curvilinearity in the public sector job demands–resources model

This article extends the job demands–resources model in the public sector by including (a) cross-level (moderation) effects of job demands and resources, (b) positive and nonlinear effects of job demands, and (c) vitality as a key work engagement concept. Data on expected contributions and developmental rewards in public university colleges (n = 65 teams and n = 219 employees) reveals that individual-level higher expected contributions are associated with higher performance, mediated by vitality. This mediation is stronger in the presence of more team-level developmental rewards, suggesting a cross-level moderated mediation. We find indications for curvilinear effects of expected contributions. Contrary to expectations, these effects do not show inverted U shapes, but rather exponential relations. Our results contribute to “bringing in a psychological perspective” in public administration and suggest that public leaders could apply the job demands–resources model as a practical tool and vitality as a metric to create healthy and effective work environments

The Competitiveness Research Network

Policy-making institutions such as the European Commission, the ECB and the OECD often use unit labor costs as a measure of international competitiveness. The goal of this paper is to examine how well this measure is related to international export performance at the firm level. To this end, we use Belgian firm-level data for the period 1999-2010 to analyze the impact of unit labor costs on exports. We use exports adjusted for their import content. We find a statistically significant negative effect of unit labor costs on export performance of firms with an estimated elasticity of the intensive margin of exports ranging between -0.2 and -0.4. This result is robust to various specifications, including firm, time and sector fixed effects and estimation approaches. We find that this elasticity varies between sectors and between firms, with firms that are more labor-intensive having a higher elasticity of exports with respect to unit labor costs. The micro data also enable us to analyze the impact of unit labor costs on the extensive margin. Our results show that higher unit labor costs reduce the probability of starting to export for non-exporters and increase the probability of exporters stopping. While our results show that unit labor costs have an impact on the intensive margin and extensive margin of firm-level exports, the effect is rather low, suggesting that passthrough of costs into prices is limited or that demand for exported products is not elastic. The latter is consistent with recent trade models emphasizing that not only relative costs, but also demand factors such as quality and taste matter for explaining firm-level exports