Randomized, controlled trial of topical exit-site application of honey (Medihoney) versus Mupirocin for the prevention of catheter-associated infections in hemodialysis patients

The clinical usefulness of hemodialysis catheters is limited by increased infectious morbidity and mortality. Topical antiseptic agents, such as mupirocin, are effective at reducing this risk but have been reported to select for antibiotic-resistant strains. The aim of the present study was to determine the efficacy and the safety of exit-site application of a standardized antibacterial honey versus mupirocin in preventing catheter-associated infections. A randomized, controlled trial was performed comparing the effect of thrice-weekly exit-site application of Medihoney versus mupirocin on infection rates in patients who were receiving hemodialysis via tunneled, cuffed central venous catheters. A total of 101 patients were enrolled. The incidences of catheter-associated bacteremias in honey-treated (n = 51) and mupirocin-treated (n = 50) patients were comparable (0.97 versus 0.85 episodes per 1000 catheter-days, respectively; NS). On Cox proportional hazards model analysis, the use of honey was not significantly associated with bacteremia-free survival (unadjusted hazard ratio, 0.94; 95% confidence interval, 0.27 to 3.24; P = 0.92). No exit-site infections occurred. During the study period, 2% of staphylococcal isolates within the hospital were mupirocin resistant. Thrice-weekly application of standardized antibacterial honey to hemodialysis catheter exit sites was safe, cheap, and effective and resulted in a comparable rate of catheter-associated infection to that obtained with mupirocin (although the study was not adequately powered to assess therapeutic equivalence). The effectiveness of honey against antibiotic-resistant microorganisms and its low likelihood of selecting for further resistant strains suggest that this agent may represent a satisfactory alternative means of chemoprophylaxis in patients with central venous catheters.

Swash-aquifer interaction in the vicinity of the water table exit point on a sandy beach

The coupling of sandy beach aquifers with the swash zone in the vicinity of the water table exit point is investigated through simultaneous measurements of the instantaneous shoreline (swash front) location, pore pressures and the water table exit point. The field observations reveal new insights into swash-aquifer coupling not previously gleaned from measurements of pore pressure only. In particular, for the case where the exit point is seaward of the observation point, the pore pressure response is correlated with the distance between the exit point and the shoreline in that when the distance is large the rate of pressure drop is fast and when the distance is small the rate decreases. The observations expose limitations in a simple model describing exit point dynamics which is based only on the force balance on a particle of water at the sand surface and neglects subsurface pressures. A new modified form of the model is shown to significantly improve the model-data comparison through a parameterization of the effects of capillarity into the aquifer storage coefficient. The model enables sufficiently accurate predictions of the exit point to determine when the swash uprush propagates over a saturated or a partially saturated sand surface, potentially an important factor in the morphological evolution of the beach face. Observations of the shoreward propagation of the swash-induced pore pressure waves ahead of the runup limit shows that the magnitude of the pressure fluctuation decays exponentially and that there is a linear increase in time lags, behavior similar to that of tidally induced water table waves. The location of the exit point and the intermittency of wave runup events is also shown to be significant in terms of the shore-normal energy distribution. Seaward of the mean exit point location, peak energies are small because of the saturated sand surface within the seepage face acting as a "rigid lid'' and limiting pressure fluctuations. Landward of the mean exit point the peak energies grow before decreasing landward of the maximum shoreline position.

Refining exceptions using King and Morgan's exit construct

In this paper we discuss the refinement of exceptions. We extend the Guarded Command Language normally used in the refinement calculus, with a simple exception handling statement, which we model using King and Morgan's exit statement (1995). We derive some variants of King and Morgan's refinement laws for their exit statement, and illustrate the approach with an example of a refinement of a simple program.

Determinants of entry and exit in the foreign owned sector of UK manufacturing

This paper examines the extent to which foreign entry and exit in the UK is related to domestic industry characteristics. The units of analysis are firm numbers, and thus entry and exit at the industry level are treated as being generated by Poisson processes. This therefore uses quasimaximum likelihood estimation, to estimate entry and exit functions simultaneously. The results demonstrate that foreign entry is attracted by industry level profitability and performance, but that firm specific 'ownership' advantages are also important. The results also demonstrate that inward investors that are motivated by the desire to exploit firm-specific assets, are unlikely to be more transient than domestic firms. This however, cannot be said of those foreign entrants who are attracted to the UK by location advantage or investment incentives.

Exits, entrances and entrepreneurship : an exploration of economic theories of entrepreneurship through new independent entry and infant exit

The thesis began as a study of new firm formation. Preliminary research suggested that infant death rate was considered to be a closely related problem and the search was for a theory of new firm formation which would explain both. The thesis finds theories of exit and entry inadequate in this respect and focusses instead on theories of entrepreneurship, particularly those which concentrate on entrepreneurship as an agent of change. The role of information is found to be fundamental to economic change and an understanding of information generation and dissemination and the nature and direction of information flows is postulated to lead coterminously to an understanding of entrepreneurhsip and economic change. The economics of information is applied to theories of entrepreneurhsip and some testable hypotheses are derived. The testing relies on etablishing and measuring the information bases of the founders of new firms and then testing for certain hypothesised differences between the information bases of survivors and non-survivors. No theory of entrepreneurship is likely to be straightforwardly testable and many postulates have to be established to bring the theory to a testable stage. A questionnaire is used to gather information from a sample of firms taken from a new micro-data set established as part of the work of the thesis. Discriminant Analysis establishes the variables which best distinguish between survivors and non-survivors. The variables which emerge as important discriminators are consistent with the theory which the analysis is testing. While there are alternative interpretations of the important variables, collective consistency with the theory under test is established. The thesis concludes with an examination of the implications of the theory for policy towards stimulating new firm formation.

A study of the relationship between exit, voice, loyalty and neglect and commitment in India

Drawing on exit, voice, loyalty and neglect (EVLN) literature, this study examines direct and interactive associations between organizational-level commitment and team-level commitment and the use of EVLN by managers in India. The study is based on a survey of 200 managers and supervisors from seven Indian firms. The findings on the use of voice are consistent with the past research in Western countries, but challenge the prevailing assumption about the use of voice in high power distance societies. The results also indicate that team-level commitment moderates the association between organizational-level commitment and the use of EVLN.

A kivonulás-tiltakozás-hűség fogalomhármas közgazdaságtani relevanciája a 21. században = The relevance of "exit, voice and loyalty" theory in 21st-century economics

A dolgozat a politikatudomány és közgazdaság-tudomány határán álló kivonulás-tiltakozás-hűség modell lényegét járja körbe. Az Albert O. Hirschman által felépített gondolati keret szemléleti frissessége és sajátos megközelítési módja rendkívül termékenyítően hatott az elmúlt évtizedekben a társadalomtudományok fejlődésére. Mégis viszonylag periferikus helyet foglal el a közgazdaság-tudományon belül, miközben például a rendszerváltás és az azt követő társadalmi feszültségek megjelenése szempontjából is sokoldalúan használható fogalmi keretről van szó. A válság indukálta turbulens környezet még inkább rávilágít arra, hogy ma is időszerű perspektívát kínál a hanyatlás politikai gazdaságtana, azaz hasznos elemzési kapaszkodó nyújt az úgynevezett Hirschman-trilemma a társadalmi és gazdasági folyamatok értelmezéséhez. ________ The article concerns the "exit, voice, and loyalty" concept, which straddles the border of political science and economics. This theoretical framework, invented by Albert O. Hirschman, has exercised a fruitful influence in the social sciences in the last few decades, through its fresh features and original approach. However, it holds a peripheral position in economics and plays an undervalued role in eco-nomic education in Hungary, even though it can be flexibly applied in analyses of such phenomena as the economic transition and the ensuing social tensions. Moreover the very turbulence of the conditions brought about by the crisis show that the political economy of decline offers a relevant perspective, so that the Hirschman trilemma is a practical analytical tool for understanding social and economic processes.

A „kivonulás, tiltakozás, hűség” koncepció és a „kapitalizmus változatai” elmélet közti kapcsolat (The connection between the ‘Exit, Voice, and Loyalty’ conception and the ‘Varieties of Capitalism’ theory)

Tanulmányunkban az Albert 0. Hirschman által kialakított „kivonulás, tiltakozás, hűség” koncepció metaelméleti felhasználásával a „kapitalizmus változatai” elméletet vesszük bírálat alá. Egyrészt arra mutatunk rá, hogy már a különböző piacgazdasági modellek tipologizálásához használt vállalatelméleti dimenziójú elemzések is építkeznek a Hirschman-trilemmából, másrészt arra hívjuk fel a figyelmet, hogy olyan sajátos eszközről van szó, amely a tőke- és munkaerő-piaci folyamatok elemzésére támaszkodva új perspektívát is kínál a kapitalista gazdaságok komparatív vizsgálatához. A dolgozat terjedelmi okokból az empirikus kutatásokat megalapozó elméleti alapozásra szorítkozik. ____ In our study we deal with the critical analysis of the “varieties of capitalism” theory by using the “exit, voice, and loyalty” meta-theory invented by Albert O. Hirschman. The paper emphasizes that on the one hand the analyses of the theory of the firm and business used for the classification of distinct market models are also building upon the “Hirschman trilemma”, and on the other hand, it draws attention to the fact that the Hirschmanian method based on labor market and capital market offers a new perspective for the comparative analysis of capitalist economies. The focus of the article is only the theoretical foundation of empirical studies as a result of limitation of scope.

Three essays on entrepreneurial motivation, entry, exit and monetary rewards

This dissertation analyzes rewards and motivations of self-employment. In light of recent research contributions of Barton Hamilton (2000), which find entrepreneurship not as financially rewarding as wage work, my dissertation attempts to both verify and explain this claim. The first essay proposes a theoretical model of evolution of erroneous earnings expectations on part of a nascent entrepreneur. Inability to observe, survey, and take into account all of the returns to entrepreneurship prior to business entry creates a biased set of beliefs on part of the potential entrants. Using Bayesian learning, a nascent entrepreneur starting out with correct perception of profit distribution arrives at erroneous beliefs by incorporating limited information collected from existing businesses. An observed distribution of surviving businesses would exhibit higher earnings because of previous, unobserved, business failure entrepreneur get an overly positive view of her profit potential. Hence, the chapter offers a unique method of modeling overconfidence. The second essay undertakes dynamic empirical comparison of earnings received by business owners and their wage counterparts. Using Survey of Income and Program Participation (SIPP) I examine both short and long run returns to entrepreneurship comparing theses rewards to wage earners returns. I pay particular attention to transitions into and out of business ownership. I estimate entire earnings distribution. To characterize dynamic aspect of changes to individuals’ earnings I split the income distribution into five income quintiles and follow survey participants over the period of seven years. I find that period-to-period transitions to be Markovian. I find business tenure to be short, business ownership is costly in the short and rewarding in the long run. The third essay considered different reporting schemes applied to the self-employed. It is another empirical investigation of entrepreneurial earning uses Panel Study of Income Dynamics (PSID). I find entrepreneurs while reporting lower than wage workers earnings enjoy significant consumption premiums. I observe evidence of income underreporting by entrepreneurs. This finding suggests a need for better earning comparison metrics and proposes to use consumption rather than income metrics for future comparisons.