Partnership, ownership and control: the impact of corporate governance on employment relations

Prevailing patterns of dispersed share ownership and rules of corporate governance for UK listed companies appear to constrain the ability of managers to make credible, long-term commitments to employees of the kind needed to foster effective labour-management partnerships. We present case study evidence which suggests that such partnerships can nevertheless emerge where product market conditions and the regulatory environment favour a stakeholder orientation. Proactive and mature partnerships may also be sustained where the board takes a strategic approach to mediating between the claims of different stakeholder groups, institutional investors are prepared to take a long-term view of their holdings, and strong and independent trade unions are in a position to facilitate organisational change

Incidence of and predictors for antiseizure medication gaps in Medicare beneficiaries with epilepsy: a retrospective cohort study.

BACKGROUND For the two-thirds of patients with epilepsy who achieve seizure remission on antiseizure medications (ASMs), patients and clinicians must weigh the pros and cons of long-term ASM treatment. However, little work has evaluated how often ASM discontinuation occurs in practice. We describe the incidence of and predictors for sustained ASM fill gaps to measure discontinuation in individuals potentially eligible for ASM withdrawal. METHODS This was a retrospective cohort of Medicare beneficiaries. We included patients with epilepsy by requiring International Classification of Diseases codes for epilepsy/convulsions plus at least one ASM prescription each year 2014-2016, and no acute visit for epilepsy 2014-2015 (i.e., potentially eligible for ASM discontinuation). The main outcome was the first day of a gap in ASM supply (30, 90, 180, or 360 days with no pills) in 2016-2018. We displayed cumulative incidence functions and identified predictors using Cox regressions. RESULTS Among 21,819 beneficiaries, 5191 (24%) had a 30-day gap, 1753 (8%) had a 90-day gap, 803 (4%) had a 180-day gap, and 381 (2%) had a 360-day gap. Predictors increasing the chance of a 180-day gap included number of unique medications in 2015 (hazard ratio [HR] 1.03 per medication, 95% confidence interval [CI] 1.01-1.05) and epileptologist prescribing physician (≥25% of that physician's visits for epilepsy; HR 2.37, 95% CI 1.39-4.03). Predictors decreasing the chance of a 180-day gap included Medicaid dual eligibility (HR 0.75, 95% CI 0.60-0.95), number of unique ASMs in 2015 (e.g., 2 versus 1: HR 0.37, 95% CI 0.30-0.45), and greater baseline adherence (> 80% versus ≤80% of days in 2015 with ASM pill supply: HR 0.38, 95% CI 0.32-0.44). CONCLUSIONS Sustained ASM gaps were rarer than current guidelines may suggest. Future work should further explore barriers and enablers of ASM discontinuation to understand the optimal discontinuation rate

Antiseizure medication withdrawal risk estimation and recommendations: A survey of American Academy of Neurology and EpiCARE members

Objective Choosing candidates for antiseizure medication (ASM) withdrawal in well‐controlled epilepsy is challenging. We evaluated (a) the correlation between neurologists' seizure risk estimation (“clinician predictions”) vs calculated predictions, (b) how viewing calculated predictions influenced recommendations, and (c) barriers to using risk calculation.MethodsWe asked US and European neurologists to predict 2‐year seizure risk after ASM withdrawal for hypothetical vignettes. We compared ASM withdrawal recommendations before vs after viewing calculated predictions, using generalized linear models. Results Three‐hundred and forty‐six neurologists responded. There was moderate correlation between clinician and calculated predictions (Spearman coefficient 0.42). Clinician predictions varied widely, for example, predictions ranged 5%‐100% for a 2‐year seizure‐free adult without epileptiform abnormalities. Mean clinician predictions exceeded calculated predictions for vignettes with epileptiform abnormalities (eg, childhood absence epilepsy: clinician 65%, 95% confidence interval [CI] 57%‐74%; calculated 46%) and surgical vignettes (eg, focal cortical dysplasia 6‐month seizure‐free mean clinician 56%, 95% CI 52%‐60%; calculated 28%). Clinicians overestimated the influence of epileptiform EEG findings on withdrawal risk (26%, 95% CI 24%‐28%) compared with calculators (14%, 95% 13%‐14%). Viewing calculated predictions slightly reduced willingness to withdraw (−0.8/10 change, 95% CI −1.0 to −0.7), particularly for vignettes without epileptiform abnormalities. The greatest barrier to calculator use was doubting its accuracy (44%). Significance Clinicians overestimated the influence of abnormal EEGs particularly for low‐risk patients and overestimated risk and the influence of seizure‐free duration for surgical patients, compared with calculators. These data may question widespread ordering of EEGs or time‐based seizure‐free thresholds for surgical patients. Viewing calculated predictions reduced willingness to withdraw particularly without epileptiform abnormalities

Proton Radioactivity Measurements at HRIBF: Ho, Lu, and Tm Isotopes

Two new isotopes, {sup 145}Tm and {sup 140}Ho and three isomers in previously known isotopes, {sup 141m}Ho, {sup 150m}Lu and {sup 151m}Lu have been discovered and studied via their decay by proton emission. These proton emitters were produced at the Holifield Radioactive Ion Beam Facility (HRIBF) by heavy-ion fusion-evaporation reactions, separated in A/Q with a recoil mass spectrometer (RMS), and detected in a double-sided silicon strip detector (DSSD). The decay energy and half-life was measured for each new emitter. An analysis in terms of a spherical shell model is applied to the Tm and Lu nuclei, but Ho is considerably deformed and requires a collective model interpretation

Proton Decay Studies of the Light Lu, Tm and Ho Isotopes

A double-sided Si-strip detector system has been installed and commissioned at the focal plane of the Recoil Mass Spectrometer at the Holifield Radioactive Ion Beam Facility. The system can be used for heavy charged particle emission studies with half-lives as low as a few {micro}sec. In this paper the authors present identification and study of the decay properties of the five new proton emitters: {sup 140}Ho, {sup 141m}Ho, {sup 145}Tm, {sup 150m}Lu and {sup 151m}Lu

First case report of infective endocarditis associated with Microbacterium maritypicum

Microbacterium species are gram positive coryneforms generally considered as a contaminant when identified in gram stain of blood culture, especially when time-to-positivity is longer than 48 h. We encountered a case of infective endocarditis associated with Microbacterium maritypicum bacteremia, which became positive after 48 h of incubation in three out of four bottles. The antimicrobial management is controversial as vancomycin is generally assumed to cover most gram positive bacilli, but our susceptibility result demonstrated minimum inhibitory concentration of 4 μg/mL of vancomycin, indicating non-susceptibility. To the best of our knowledge, this is the first case report of infective endocarditis associated with Microbacterium maritypicum

The usefulness of game theory as a method for policy evaluation

Short abstract Most of today's public policies are formulated and implemented in multi-actor networks. Logically, this has consequences for evaluation methods and approaches. Game theory has long been around as a method that supports a rigorous analysis of the interaction processes among actors. However, so far, it has not been widely applied in the evaluation field. Hence, questions regarding the usefulness of game theory as an evaluation method remain pertinent. This paper explores the usefulness of game theory as a method for evaluations in a networked society, based on an evaluation of coastal policy implementation in the Netherlands