More on Strikes by Public Employees

We have two brief observations on the paper by Messrs. Burton and Krider. First, we suggest that society is not limited to a choice between their strike and no-strike alternatives. Our earlier article argued that the typical municipal political structure is vulnerable to strikes by wvell entrenched public employee unions, and that, given this existing political structure, the no-strike model is preferable to the strike model. We stated, however, that changes in the political structure which reduce the vulnerability of municipal employers to strikes by public employees can be made and that we intended (and we still do intend) to explore these possibilities in a future article. There is, therefore, a third model—one which permits some strikes in conjunction with various changes in municipal political structures. Second, we wish to define what seems to be the principal area of our disagreement with Messrs. Burton and Krider. All agree that the services performed by some public employees are in one way or another essential and that this essentiality is in some sense related to society\u27s ability to tolerate strikes. However, which employees under the Burton-Krider strike model are to have union activities limited depends very much on one\u27s view of essentiality. It is now clear that our vision is different from theirs

The Kalanchoe genome provides insights into convergent evolution and building blocks of crassulacean acid metabolism

Crassulacean acid metabolism (CAM) is a water-use efficient adaptation of photosynthesis that has evolved independently many times in diverse lineages of flowering plants. We hypothesize that convergent evolution of protein sequence and temporal gene expression underpins the independent emergences of CAM from C3 photosynthesis. To test this hypothesis, we generate a de novo genome assembly and genome-wide transcript expression data for Kalanchoë fedtschenkoi, an obligate CAM species within the core eudicots with a relatively small genome (~260 Mb). Our comparative analyses identify signatures of convergence in protein sequence and re-scheduling of diel transcript expression of genes involved in nocturnal CO2 fixation, stomatal movement, heat tolerance, circadian clock, and carbohydrate metabolism in K. fedtschenkoi and other CAM species in comparison with non-CAM species. These findings provide new insights into molecular convergence and building blocks of CAM and will facilitate CAM-into-C3 photosynthesis engineering to enhance water-use efficiency in crops

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

More on Strikes by Public Employees

We have two brief observations on the paper by Messrs. Burton and Krider. First, we suggest that society is not limited to a choice between their strike and no-strike alternatives. Our earlier article argued that the typical municipal political structure is vulnerable to strikes by wvell entrenched public employee unions, and that, given this existing political structure, the no-strike model is preferable to the strike model. We stated, however, that changes in the political structure which reduce the vulnerability of municipal employers to strikes by public employees can be made and that we intended (and we still do intend) to explore these possibilities in a future article. There is, therefore, a third model—one which permits some strikes in conjunction with various changes in municipal political structures. Second, we wish to define what seems to be the principal area of our disagreement with Messrs. Burton and Krider. All agree that the services performed by some public employees are in one way or another essential and that this essentiality is in some sense related to society\u27s ability to tolerate strikes. However, which employees under the Burton-Krider strike model are to have union activities limited depends very much on one\u27s view of essentiality. It is now clear that our vision is different from theirs

Structuring Collective Bargaining in Public Employment

In an earlier article in this Journal, The Limits of Collective Bargaining in Public Employment, we asked whether private sector collective bargaining should serve as the model for collective bargaining in the public sector. We concluded it should not. Our argument was, and is, that a wholesale transplant from one sector to the other is inappropriate. First, market restraints on union power are substantially different in the two sectors. Second, the consequences of such a transplant for the political process are undesirable. A summary of our reasoning follows. In the private sector, a high degree of substitutability between various products generally exists: a price increase of one product relative to others will result in a decrease in the number of units of that product sold as consumers adjust their preferences to changed price relationships. Wage increases which exceed rises in productivity usually result in higher prices. Private sector unions generally face, therefore, a trade-off between the level of benefits they can extract from an employer and the level of employment for union members they can maintain. Even when this is not the case—as with expanding industries or products with inelastic demand curves—the threat of both the substitution of capital (machines) for labor and of competition from non-union employers is a significant restraint on union power. Thus, although the private sector is extremely diverse and contains many exceptions, the costs of collective bargaining are kept within arguably tolerable limits by a market of free consumers

Structuring Collective Bargaining in Public Employment

Initially, and by way of establishing a framework, we address twogeneral questions: first, the extent to which a single structure, at eitherthe state or federal level, should govern municipal labor relations; andsecond, the impact of collective bargaining on the role of governmentand the functions it performs. We then examine at length what mayin short be called the strike problem: what mechanisms can replacethe strike if it is to be prohibited; what sanctions should back up theprohibition; and, if strikes are to be permitted in non-emergency situations,what steps can be taken to reduce the vulnerability of the politicalprocess. Finally, we address the scope of bargaining issue: whatshould be the role of collective bargaining in resolving disputed issueswhich involve terms and conditions of employment but which are alsomatters of political import