Three Essays on Incentive Design

We present three distinct works on the subject of incentive design. The first focuses on a fundamental aspect of all principal-agent models, the participation constraint. We endogenise the constraint, allowing the agent to influence his outside option, albeit at some detriment to the project he is contracted to work upon. We compare the optimal contract to the literature on the supposed trade-off between risk and incentives. We find support for the Prendergast (2002) observation of a positive relationship between the two variables and ofer an explanation through the use of said influence activities. The second contribution introduces another principal-agent framework for models with both adverse selection and moral hazard, with the novel inclusion of limited liability. Described in a target-setting environment, the findings are related to and support the use of tenure contracts in academia. This is justified by the fact that pooling equilibria maximise the value to the principal and fully separating equilibria are implemented with non-monotonic wage structures. Finally, in opposition to conventional literature, those of low type make rent gains over and above their reservation utility, while the high types break even. The final chapter studies organisational design and allocation of control. We offer conditions whereby firms would wish to integrate, or profit-share, with another, given varying degrees of control allocation. We show that integration comes at a lower cost for the decision-making firm when control is contractible as opposed to transferable. Also we show that the level of incompatibility between firms, unrelated to financial gain, can affect the integration decision.ESR

Three essays on incentive design

We present three distinct works on the subject of incentive design. The first focuses on a fundamental aspect of all principal-agent models, the participation constraint. We endogenise the constraint, allowing the agent to influence his outside option, albeit at some detriment to the project he is contracted to work upon. We compare the optimal contract to the literature on the supposed trade-off between risk and incentives. We find support for the Prendergast (2002) observation of a positive relationship between the two variables and ofer an explanation through the use of said influence activities. The second contribution introduces another principal-agent framework for models with both adverse selection and moral hazard, with the novel inclusion of limited liability. Described in a target-setting environment, the findings are related to and support the use of tenure contracts in academia. This is justified by the fact that pooling equilibria maximise the value to the principal and fully separating equilibria are implemented with non-monotonic wage structures. Finally, in opposition to conventional literature, those of low type make rent gains over and above their reservation utility, while the high types break even. The final chapter studies organisational design and allocation of control. We offer conditions whereby firms would wish to integrate, or profit-share, with another, given varying degrees of control allocation. We show that integration comes at a lower cost for the decision-making firm when control is contractible as opposed to transferable. Also we show that the level of incompatibility between firms, unrelated to financial gain, can affect the integration decision.EThOS - Electronic Theses Online ServiceESRCGBUnited Kingdo

The international experience of in-situ recovery of the DCD heart: a multicentre retrospective observational study.

BackgroundHeart transplantation is an effective treatment offering the best recovery in both quality and quantity of life in those affected by refractory, severe heart failure. However, transplantation is limited by donor organ availability. The reintroduction of heart donation after the circulatory determination of death (DCD) in 2014 offered an uplift in transplant activity by 30%. Thoraco-abdominal normothermic regional perfusion (taNRP) enables in-situ reperfusion of the DCD heart. The objective of this paper is to assess the clinical outcomes of DCD donor hearts recovered and transplanted from donors undergoing taNRP.MethodThis was a multicentre retrospective observational study. Outcomes included functional warm ischaemic time, use of mechanical support immediately following transplantation, perioperative and long-term actuarial survival and incidence of acute rejection requiring treatment. 157 taNRP DCD heart transplants, performed between February 2, 2015, and July 29, 2022, have been included from 15 major transplant centres worldwide including the UK, Spain, the USA and Belgium. 673 donations after the neurological determination of death (DBD) heart transplantations from the same centres were used as a comparison group for survival.FindingstaNRP resulted in a 23% increase in heart transplantation activity. Survival was similar in the taNRP group when compared to DBD. 30-day survival was 96.8% ([92.5%-98.6%] 95% CI, n = 156), 1-year survival was 93.2% ([87.7%-96.3%] 95% CI, n = 72) and 5-year survival was 84.3% ([69.6%-92.2%] 95% CI, n = 13).InterpretationOur study suggests that taNRP provides a significant boost to heart transplantation activity. The survival rates of taNRP are comparable to those obtained for DBD transplantation in this study. The similar survival may in part be related to a short warm ischaemic time or through a possible selection bias of younger donors, this being an uncontrolled observational study. Therefore, our study suggests that taNRP offers an effective method of organ preservation and procurement. This early success of the technique warrants further investigation and use.FundingNone of the authors have a financial relationship with a commercial entity that has an interest in the subject

The international experience of in-situ recovery of the DCD heart: a multicentre retrospective observational study.

BACKGROUND: Heart transplantation is an effective treatment offering the best recovery in both quality and quantity of life in those affected by refractory, severe heart failure. However, transplantation is limited by donor organ availability. The reintroduction of heart donation after the circulatory determination of death (DCD) in 2014 offered an uplift in transplant activity by 30%. Thoraco-abdominal normothermic regional perfusion (taNRP) enables in-situ reperfusion of the DCD heart. The objective of this paper is to assess the clinical outcomes of DCD donor hearts recovered and transplanted from donors undergoing taNRP. METHOD: This was a multicentre retrospective observational study. Outcomes included functional warm ischaemic time, use of mechanical support immediately following transplantation, perioperative and long-term actuarial survival and incidence of acute rejection requiring treatment. 157 taNRP DCD heart transplants, performed between February 2, 2015, and July 29, 2022, have been included from 15 major transplant centres worldwide including the UK, Spain, the USA and Belgium. 673 donations after the neurological determination of death (DBD) heart transplantations from the same centres were used as a comparison group for survival. FINDINGS: taNRP resulted in a 23% increase in heart transplantation activity. Survival was similar in the taNRP group when compared to DBD. 30-day survival was 96.8% ([92.5%-98.6%] 95% CI, n = 156), 1-year survival was 93.2% ([87.7%-96.3%] 95% CI, n = 72) and 5-year survival was 84.3% ([69.6%-92.2%] 95% CI, n = 13). INTERPRETATION: Our study suggests that taNRP provides a significant boost to heart transplantation activity. The survival rates of taNRP are comparable to those obtained for DBD transplantation in this study. The similar survival may in part be related to a short warm ischaemic time or through a possible selection bias of younger donors, this being an uncontrolled observational study. Therefore, our study suggests that taNRP offers an effective method of organ preservation and procurement. This early success of the technique warrants further investigation and use. FUNDING: None of the authors have a financial relationship with a commercial entity that has an interest in the subject

The international experience of in-situ recovery of the DCD heart: a multicentre retrospective observational study.

peer reviewed[en] BACKGROUND: Heart transplantation is an effective treatment offering the best recovery in both quality and quantity of life in those affected by refractory, severe heart failure. However, transplantation is limited by donor organ availability. The reintroduction of heart donation after the circulatory determination of death (DCD) in 2014 offered an uplift in transplant activity by 30%. Thoraco-abdominal normothermic regional perfusion (taNRP) enables in-situ reperfusion of the DCD heart. The objective of this paper is to assess the clinical outcomes of DCD donor hearts recovered and transplanted from donors undergoing taNRP. METHOD: This was a multicentre retrospective observational study. Outcomes included functional warm ischaemic time, use of mechanical support immediately following transplantation, perioperative and long-term actuarial survival and incidence of acute rejection requiring treatment. 157 taNRP DCD heart transplants, performed between February 2, 2015, and July 29, 2022, have been included from 15 major transplant centres worldwide including the UK, Spain, the USA and Belgium. 673 donations after the neurological determination of death (DBD) heart transplantations from the same centres were used as a comparison group for survival. FINDINGS: taNRP resulted in a 23% increase in heart transplantation activity. Survival was similar in the taNRP group when compared to DBD. 30-day survival was 96.8% ([92.5%-98.6%] 95% CI, n = 156), 1-year survival was 93.2% ([87.7%-96.3%] 95% CI, n = 72) and 5-year survival was 84.3% ([69.6%-92.2%] 95% CI, n = 13). INTERPRETATION: Our study suggests that taNRP provides a significant boost to heart transplantation activity. The survival rates of taNRP are comparable to those obtained for DBD transplantation in this study. The similar survival may in part be related to a short warm ischaemic time or through a possible selection bias of younger donors, this being an uncontrolled observational study. Therefore, our study suggests that taNRP offers an effective method of organ preservation and procurement. This early success of the technique warrants further investigation and use. FUNDING: None of the authors have a financial relationship with a commercial entity that has an interest in the subject

COVID-19 literature project

A component for students to describe their review of the COVID-19 literatur