[Show abstract][Hide abstract] ABSTRACT: This study analyses the link between student test scores and the school students attend, the policies and practices of the schools, students' family background and their parents' involvement in their education using data from the 2009 wave of the Program for International Student Assessment. We find that (1) a substantial proportion of the variation of test scores within countries is associated with the school students attend; (2) a sizeable proportion of the school fixed effects is associated with school policies and teaching practices beyond national policies or other mechanisms that sort students of differing abilities among schools; (3) school fixed effects are a major pathway for the link between family background and test scores. The implication is that what schools do is important in the level and dispersion of test scores, suggesting the value of further analysis of what goes on in schools to pin down causal links between policies and practices and test score outcomes.
— Richard B. Freeman and Martina Viarengo
[Show abstract][Hide abstract] ABSTRACT: China's new Labour Contract Law took effect in January 2008 and required firms to give migrant workers written contracts, strengthened labour protections for workers and contained penalties for firms that did not follow the labour code. This article uses survey data of migrant workers in the Pearl River Delta before and after the law, and a retrospective question on when workers received their first labour contract to assess the effects of the law on labour outcomes. The evidence shows that the new law increased the percentage of migrant workers with written contracts, which in turn raised social insurance coverage, reduced the likelihood of wage arrears and raised the likelihood that workers had a union at their workplace.
No preview · Article · Mar 2014 · British Journal of Industrial Relations
[Show abstract][Hide abstract] ABSTRACT: The Great Recession tested the ability of the “great U.S. jobs machine” to limit the severity of unemployment in a major economic downturn and to restore full employment quickly afterward. In the crisis the American labor market failed to live up to expectations. The level and duration of unemployment increased substantially in the downturn, and the growth of jobs was slow and anemic in the recovery. This article documents these failures and their consequences for workers. The U.S. performance in the Great Recession contravenes conventional views of the virtues of market-driven flexibility compared to institution-driven labor adjustments and the notion that weak labor institutions and greater market flexibility offer the best road to economic success in a modern capitalist economy.
No preview · Article · Nov 2013 · The Annals of the American Academy of Political and Social Science
[Show abstract][Hide abstract] ABSTRACT: As the pressure for providing liver transplantation to more and more candidates increases, transplant programs have begun to consider deceased donor characteristics that were previously considered unacceptable. With this trend, attention has focused on better defining those donor factors that can impact the outcome of liver transplantation. This review examines deceased donor factors that have been associated with patient or graft survival as well as delayed graft function and other liver transplant results.
Preview · Article · Feb 2013 · Transplant International
[Show abstract][Hide abstract] ABSTRACT: We discuss ethical issues of organ transplantation including the stewardship tension between physicians' duty to do everything possible for their patients and their duty to serve society by encouraging organ donation. We emphasize consideration of the role of the principles of justice, utility and equity in the just distribution of transplantable organ as scarce resources. We then consider ethical issues of determining death of the organ donor including the remaining controversies in brain death determination and the new controversies raised by circulatory death determination. We need uniformity in standards of death determination, agreement on the duration of asystole before death is declared, and consensus on the allowable circulatory interventions on the newly declared organ donor that are intended to improve organ function. We discuss the importance of maintaining the dead donor rule, despite the argument of some scholars to abandon it.
No preview · Article · Nov 2012 · Progress in cardiovascular diseases
[Show abstract][Hide abstract] ABSTRACT: The model for end-stage liver disease (MELD) driven liver allocation system has been in place for 10 years now. Understanding what the driving forces were, what principles were developed and employed, and assessing how these have stood the test of time will help future policy makers further refine the system.
Prior to development of the MELD system, policymakers had limited data and organ allocation policy development was rarely systematic or evidence-based and was not necessarily centered on the patient. The MELD process focused on patient-specific variables and validation of the risk prediction models to be sure the system would function reasonably well across the spectrum of potential candidates and that it did not impose artificial categorizations of patients. In addition, the transplant community focused on assessing the effects of this policy change which was also something new.
Numerous publications since have reported outcomes for MELD-based liver allocation here in the United States and in many other areas around the world. Some of these reports have suggested changes to the MELD equation or other ways to adapt the system to more accurately reflect the need for transplant. The transparency that this type of system brings allows for much more rigorous assessment of results and for highlighting areas for improvement toward a more fair, equitable, and utilitarian system.
No preview · Article · Apr 2012 · Current opinion in organ transplantation
[Show abstract][Hide abstract] ABSTRACT: The allocation and distribution of deceased donor livers for transplant remains intensely scrutinized because demand far exceeds supply. In the USA, distribution of organs is organized according to a local, regional and national sharing plan. Ongoing assessment of the characteristics and success of these arrangements is necessary to ensure the system is as equitable as possible.
[Show abstract][Hide abstract] ABSTRACT: Donor organ allocation and distribution depend on applying ethical principles of justice, utility and equity in a transparent manner. These ethical principles must be defined in objective ways in order to measure the success of the allocation systems. This chapter will briefly outline how these three ethical principles bear on specific aspects of liver transplantation, distinguish between distribution and allocation, and compare specific distribution and allocation policies that are currently employed for deceased-donor liver grafts.
[Show abstract][Hide abstract] ABSTRACT: Proponents of orthotopic liver transplantation (TXP) for the treatment of hepatocellular carcinoma (HCC) advocate expanding the Milan criteria. We performed a matched analysis comparing patients treated with TXP to patients treated with partial hepatectomy (PHX) for HCC exceeding the Milan criteria.
From the United Network for Organ Sharing registry, we identified 92 US patients with HCC exceeding the Milan criteria who underwent TXP between 2002 and 2005. During the same period, 94 patients with similar tumor size criteria underwent PHX at a single center. Data were analyzed using χ(2), parametric, nonparametric, and Kaplan-Meier methods.
TXP patients were more commonly male (82% vs. 65%, P=0.01) and had a higher Model for End Stage Liver Disease score (median 11 vs. 7, P<0.001). Pathologic cirrhosis (79% TXP vs. 38% PHX, P<0.001), particularly secondary to hepatitis C virus (29% TXP vs. 5% PHX, P<0.001), was more common among TXP patients. Mean cumulative tumor size was 10.0 cm (63% exceeding University of California at San Francisco criteria) among PHX patients compared with 6.4 cm (20% exceeding University of California at San Francisco criteria) for TXP patients (P<0.001). With a median follow-up of 34 months (range, 1-86), 3-year survival was similar between the cohorts (66%±10% for TXP vs. 66%±10% for PHX, P=0.97). Cancer deaths (26/37, 70%) were more prevalent among PHX patients, whereas noncancer deaths (25/37, 68%) were common in TXP patients (P<0.001).
Among heterogeneous patients with HCC who exceed the Milan criteria, TXP and PHX achieve similar overall survival. Further study is needed to ensure appropriate patient selection for these disparate therapies.
No preview · Article · Oct 2010 · American journal of clinical oncology
[Show abstract][Hide abstract] ABSTRACT: Pulmonary arterial hypertension (PAH) associated with portal hypertension [portopulmonary hypertension (PPHTN)] occurs in 2% to 10% of patients with advanced liver disease and carries a very poor prognosis without treatment. Most hepatic transplantation centers consider moderate to severe PPHTN to be a contraindication to liver transplantation because of the high rate of perioperative complications. We present 3 patients with PPHTN who were managed with intravenous prostacyclin therapy followed by living donor liver transplantation (LDLT). These individuals demonstrated subsequent resolution of their pulmonary hypertension and were weaned off all PAH-specific medical therapy. We present their demographics, clinical courses, and hemodynamics. We discuss the potential indications for LDLT and risks with respect to this patient population. Limitations of the Model for End-Stage Liver Disease scoring system and outcome data for this patient population are reviewed. Future studies should be directed toward better defining indications for LDLT in patients with PPHTN, improving medicosurgical management, and assessing long-term outcomes.
Full-text · Article · Aug 2010 · Liver Transplantation