Direct costs of glaucoma and severity of the disease:A multinational long term study of resource utilisation in Europe

Background: Resource utilisation and direct costs associated with glaucoma progression in Europe are unknown. As population progressively ages, the economic impact of the disease will increase. Methods: From a total of 1655 consecutive cases, the records of 194 patients were selected and stratified by disease severity. Record selection was based on diagnoses of primary open angle glaucoma, glaucoma suspect, ocular hypertension, or normal tension glaucoma; 5 years minimum follow up were required. Glaucoma severity was assessed using a six stage glaucoma staging system based on static threshold visual field parameters. Resource utilisation data were abstracted from the charts and unit costs were applied to estimate direct costs to the payer. Resource utilisation and estimated direct cost of treatment, per person year, were calculated. Results: A statistically significant increasing linear trend (p = 0.018) in direct cost as disease severity worsened was demonstrated. The direct cost of treatment increased by an estimated €86 for each incremental step ranging from €455 per person year for stage 0 to €969 per person year for stage 4 disease. Medication costs ranged from 42% to 56% of total direct cost for all stages of disease. Conclusions: These results demonstrate for the first time in Europe that resource utilisation and direct medical costs of glaucoma management increase with worsening disease severity. Based on these findings, managing glaucoma and effectively delaying disease progression would be expected to significantly reduce the economic burden of this disease. These data are relevant to general practitioners and healthcare administrators who have a direct influence on the distribution of resources.

End-of-Life care and people with intellectual disabilities: A multi-media educational resource

Aim This study aimed to develop and evaluate a multi-media educational resource in palliative and end-of-life care for specialist palliative care and intellectual disability services which promoted collaborative working. Methods: A mixed methods design involving three phases was used. Qualitative data were obtained from semi-structured interviews with a purposive sample of professionals (n=30) and family carers (n=5) and from two focus groups with people with intellectual disabilities (n=17). Data were content analysed as outlined y Newell and Burnard (2006). This identified training needs and issues, in end-of-life care for this population which were confirmed through quantitative data from services in a regional scoping study analysed using descriptive statistics. A DVD and manual were developed and evaluated with twelve professionals. Data were collected using a solicited diary, the Readiness for Inter-professional Learning Scale, Likert Scales and an evaluation questionnaire. Thematic analysis and descriptive statistics appropriate to data were used.Results: Findings suggest that this resource demonstrates the need for and benefits of partnership working and transferability of this learning to practice could address issues at end-of-life for people with intellectual disabilities. Conclusions: Findings of this study have importance for partnership working and service provision in end-of-life care for this population.

Reconsidering Resource Rights: The Case for a Basic Right to the Benefits of Life-Sustaining Ecosystem Services

In the presence of anthropogenic climate change, gross environmental degradation, and mass abject poverty, many political theorists currently debate issues such as people's right to water, the right to food, and the distribution of rights to natural resources more generally. However, thus far many theorists either focus (somewhat arbitrarily) only on one particular resource (e.g. water) or they treat all natural resources alike, meaning that many relevant distinctions within the group of natural resources are overlooked. Hence, the paper will start with an analysis of the various forms which natural resources can take and how this might influence one's conception of resource rights. In so doing, the paper argues that we have to carefully distinguish between the actual physical resources people might control and how we distribute these, and the life-sustaining benefits each and every person draws from sustainable and functioning ecosystems. Based on this distinction, the paper will argue for a right to the benefits of life-sustaining ecosystem services as a universal basic right every person has. Further distributive claims with respect to particular physical resources would thus be limited by the requirements of such a basic right.

An Investigation towards colossal success of Larsen and Toubro Limited: Human resource management perspective

Larsen and Toubro (L&T) Limited is India’s largest construction conglomerate. L&T’s expertise is harnessed to execute high value projects that demand adherence to stringent timelines in a scenario where disparate disciplines of engineering are required to be coordinated on a critical path. However, no company can acquire such a feat without systematic management of its human resource. An investigation on the human resource management practices in orienting L&T’s success can help to identify some of the ethical human resource practices, especially in the context of Indian market. Accordingly, a well-designed employee satisfaction survey was conducted for assessment of the HRM practices being followed in L&T. Unlike other companies, L&T aims to meet the long-term needs of its employees rather than short-term needs. There were however few areas of concerns, such as yearly appraisal system and equality to treat the employees. It is postulated that the inequality to treat the male and female employees is primarily a typical stereotype due to the fact that construction is conventionally believed to be a male dominant activity. A periodic survey intended to provide 360° feedback system can help to avoid such irregularities. This study is thus expected to provide healthy practices of HRM to nurture the young talents of India. This may help them to evaluate their decisions by analyzing the complex relationship between HRM practices and output of an organization.

Human resource management practices in the multinational company: A test of system, societal, and dominance effects

Does the use of HRM practices by multinational companies (MNCs) reflect their national origins or are practices similar regardless of context? To the extent that practices are similar, is there any evidence of global best standards? The authors use the system, societal, and dominance framework to address these questions through analysis of 1,100 MNC subsidiaries in Canada, Ireland, Spain, and the United Kingdom. They argue that this framework offers a richer account than alternatives such as varieties of capitalism. The study moves beyond previous research by differentiating between system effects at the global level and dominance effects arising from the diffusion of practices from a dominant economy. It shows that both effects are present, as are some differences at the societal level. Results suggest that MNCs configure their HRM practices in response to all three forces rather than to some uniform global best practices or to their national institutional contexts.

Multinational enterprises in Australia: Two decades of international human resource management research reviewed

This paper reviews empirical international human resource management (IHRM) journal articles on foreign- and indigenous-owned multinational enterprises (MNEs) operating in Australia. More specifically, we explore the extent to which papers using Australian data in this area are being published in 53 of the world's leading academic journals and identify the topics that have been researched. We then propose a number of research areas, of Australian and international interest, that researchers could pursue in the future. Our findings point to a picture of limited publications in the leading international journals. There is also support for recent arguments that substantial capacity exists for a greater theoretical contribution by researchers in the IHRM field.

The impact of union presence and strategic human resource management on employee voice in multinational enterprises in Australia

In this article, we examine the use and character of employee voice mechanisms of foreign-owned multinational enterprises operating in Australia, as well as the influence of a strategic human resource management approach and union presence. Findings indicate that foreign-owned multinational enterprises are high-level users of the full range of employee voice mechanisms, with the exceptions of use of employee suggestion schemes, trade union recognition and the use of joint consultation committees across all sites. Using logistic regression analysis, findings show that trade union presence, a strategic human resource management approach, greenfield site and country of origin impact the employee voice approach adopted. High trade union presence is associated with an indirect employee voice approach. A low trade union presence is associated with a direct or a minimalist approach to employee voice. Moreover, a strategic human resource management approach is associated with both direct and dualistic approaches to employee voice. Implications are drawn for theory and practice. © Australian Labour and Employment Relations Association (ALERA) SAGE Publications Ltd, Los Angeles, London, New Delhi, Singapore and Washington DC.

Adaptive Measurement-Based Policy-Driven QoS Management with Fuzzy-Rule-based Resource Allocation

Fixed and wireless networks are increasingly converging towards common connectivity with IP-based core networks. Providing effective end-to-end resource and QoS management in such complex heterogeneous converged network scenarios requires unified, adaptive and scalable solutions to integrate and co-ordinate diverse QoS mechanisms of different access technologies with IP-based QoS. Policy-Based Network Management (PBNM) is one approach that could be employed to address this challenge. Hence, a policy-based framework for end-to-end QoS management in converged networks, CNQF (Converged Networks QoS Management Framework) has been proposed within our project. In this paper, the CNQF architecture, a Java implementation of its prototype and experimental validation of key elements are discussed. We then present a fuzzy-based CNQF resource management approach and study the performance of our implementation with real traffic flows on an experimental testbed. The results demonstrate the efficacy of our resource-adaptive approach for practical PBNM systems

Design and Implementation of a Measurement-Based Policy-Driven Resource Management Framework For Converged Networks

This paper presents the design and implementation of a measurement-based QoS and resource management framework, CNQF (Converged Networks’ QoS Management Framework). CNQF is designed to provide unified, scalable QoS control and resource management through the use of a policy-based network
management paradigm. It achieves this via distributed functional entities that are deployed to co-ordinate the resources of the transport network through centralized policy-driven decisions supported by measurement-based control architecture. We present the CNQF architecture, implementation of the
prototype and validation of various inbuilt QoS control mechanisms using real traffic flows on a Linux-based experimental test bed.