Opioid firms face US criminal liability

2019 ◽  
Keyword(s):  
Pain Relief ◽  
Criminal Liability ◽  
Civil Liability ◽  
Illegal Drugs ◽  
Risk Averse ◽  
Corporate Accountability ◽  
Content Type ◽  
Civil Lawsuits ◽  
Settlement Negotiations

Significance Prosecutors seek to expand the reach of a US statute previously applied only to dealers in illegal drugs, to attempt to establish corporate accountability for the crisis that has cost thousands of lives. Impacts These investigations will be independent of the civil liability companies face; parties will likely settle the myriad civil lawsuits. Uncertainty over how to value claims complicates settlement negotiations. Punishing opioids manufacturers and distributors could make firms risk-averse, thereby limiting patients’ access to pain relief.

Safety and efficacy of stereotactic radiosurgery for tumors of the spine

2004 ◽  
pp. 413-418 ◽  
Author(s):  
Deborah L. Benzil ◽  
Mehran Saboori ◽  
Alon Y. Mogilner ◽  
Ronald Rocchio ◽  
Chitti R. Moorthy
Keyword(s):  
Spinal Cord ◽  
Single Dose ◽  
Pain Relief ◽  
Total Dose ◽  
Stereotactic Radiosurgery ◽  
Medical Center ◽  
Primary Tumors ◽  
Content Type ◽  
Increased Risk ◽  
Fine Print

Object. The extension of stereotactic radiosurgery treatment of tumors of the spine has the potential to benefit many patients. As in the early days of cranial stereotactic radiosurgery, however, dose-related efficacy and toxicity are not well understood. The authors report their initial experience with stereotactic radiosurgery of the spine with attention to dose, efficacy, and toxicity. Methods. All patients who underwent stereotactic radiosurgery of the spine were treated using the Novalis unit at Westchester Medical Center between December 2001 and January 2004 are included in a database consisting of demographics on disease, dose, outcome, and complications. A total of 31 patients (12 men, 19 women; mean age 61 years, median age 63 years) received treatment for 35 tumors. Tumor types included 26 metastases (12 lung, nine breast, five other) and nine primary tumors (four intradural, five extradural). Thoracic tumors were most common (17 metastases and four primary) followed by lumbar tumors (four metastases and four primary). Lesions were treated to the 85 to 90% isodose line with spinal cord doses being less than 50%. The dose per fraction and total dose were selected on the basis of previous treatment (particularly radiation exposure), size of lesion, and proximity to critical structures. Conclusions. Rapid and significant pain relief was achieved after stereotactic radiosurgery in 32 of 34 treated tumors. In patients treated for metastases, pain was relieved within 72 hours and remained reduced 3 months later. Pain relief was achieved with a single dose as low as 500 cGy. Spinal cord isodoses were less than 50% in all patients except those with intradural tumors (mean single dose to spinal cord 268 cGy and mean total dose to spinal cord 689 cGy). Two patients experienced transient radiculitis (both with a biological equivalent dose (BED) > 60 Gy). One patient who suffered multiple recurrences of a conus ependymoma had permanent neurological deterioration after initial improvement. Pathological evaluation of this lesion at surgery revealed radiation necrosis with some residual/recurrent tumor. No patient experienced other organ toxicity. Stereotactic radiosurgery of the spine is safe at the doses used and provides effective pain relief. In this study, BEDs greater than 60 Gy were associated with an increased risk of radiculitis.

Dorsal root entry zone lesions for the treatment of post-herpetic neuralgia

1984 ◽  
Vol 60 (6) ◽  
pp. 1258-1262 ◽  
Author(s):  
Allan H. Friedman ◽  
Blaine S. Nashold ◽  
Janice Ovelmen-Levitt
Keyword(s):  
Pain Relief ◽  
Dorsal Root ◽  
Post Herpetic Neuralgia ◽  
Entry Zone ◽  
Dorsal Root Entry Zone ◽  
Content Type ◽  
Root Entry Zone ◽  
Adequate Pain Relief ◽  
Good Pain Relief ◽  
Transcutaneous Nerve Stimulation

✓ Post-herpetic pain was treated in 12 patients using dorsal root entry zone (DREZ) lesions. All patients had failed to receive adequate pain relief from conservative therapy consisting of transcutaneous nerve stimulation, carbamazepine, and/or amitriptyline. Dorsal root entry zone lesions were made to include the involved dermatomes plus one-half of the dermatomes above and below the painful areas. Eight patients reported good pain relief with follow-up periods ranging from 6 to 21 months. A ninth patient obtained satisfactory pain relief, but the superior 1 cm of the original painful area was not included in the distribution of the DREZ lesions. Patients whose lesions were performed using a thermally controlled lesion probe suffered no significant postoperative neurological deficit. Dorsal root entry zone lesions appeared to be a satisfactory treatment for post-herpetic neuralgia in patients who have failed to respond to more conservative modes of therapy.

Loyalty program in Africa: risk-seeking and risk-averse adventurers

2014 ◽  
Vol 69 (2) ◽  
pp. 137-157 ◽  
Author(s):  
Shogo Mlozi
Keyword(s):  
Consumer Behavior ◽  
Consumer Products ◽  
Loyalty Programs ◽  
Risk Averse ◽  
Loyalty Program ◽  
Content Type ◽  
Risk Seeking ◽  
Proposed Model ◽  
First Time ◽  
The Relationship

Purpose – This article aims to test the relationship between expected attractiveness-satisfaction-loyalty for international adventure tourists visiting Tanzania. The proposed model is based on travel consumer behavior theoretical constructs extracted from the literature. Design/methodology/approach – This article aims to test the relationship between expected attractiveness-satisfaction-loyalty for international adventure tourists visiting Tanzania. The proposed model is based on travel consumer behavior theoretical constructs extracted from the literature. Findings – The findings for overall model differed from the moderating factors of high risk, low risk, first-time visit and repeat visit. Also, the results are interesting when satisfaction is tested as a mediator. Practical implications – Practitioners could consider the fact that repeat visits may change tourists’ perceptions toward destination and may even increase their inclination to take on risks. This may impact innovation of consumer products in tourism. Also, policy makers could benefit on how loyalty programs can be developed to increase performance. Originality/value – The study offers specific strategic recommendations toward different groups of tourists (i.e. first-time, repeat visitors, risk averse, risk seeking) and proposes logic for setting up a loyalty program as a long-term strategy for success.

scholarly journals A study of ethnic perception gap on consumer boycott of Korean and Canadian University students

2016 ◽  
Vol 10 (1) ◽  
pp. 55-66 ◽  
Author(s):  
Mie Kyung Jae ◽  
Hyang Ran Jeon
Keyword(s):  
University Students ◽  
Cross Cultural ◽  
Parent Company ◽  
Practical Case ◽  
Corporate Accountability ◽  
Cultural Backgrounds ◽  
Korean Students ◽  
Content Type ◽  
Cross Cultural Comparison ◽  
Influential Variable

Purpose In this paper, the authors aim to offer a cross-cultural comparison of the boycott intentions of university students in Canada with those of students in Korea. Design/methodology/approach The data were collected from students at Inje University and York University via self-administered questionnaire. A t-test found that Canadian students’ answers showed significantly greater scores in ethnocentrism, boycott attitudes prior to reading the target article and motivations related to self-enhancement compared to those acquired from Korean students. However, the motivation of counterarguments and the boycott intentions of Korean students’ toward Rogers, the parent company of Maclean’s magazine, showed significantly higher scores than those gained from Canadian students. Findings The boycott case used in the study is Maclean’s magazine, a Canadian news magazine, which published a controversial article called, “Too Asian? Some frosh don’t want to study at an “Asian” University”. A noticeable gap in each group of students’ boycott attitude and intentions toward Rogers, the parent company of Maclean’s magazine was found. Originality/value In the multiple regression analysis, the boycott motivation of self-enhancement was the most influential variable on boycott intentions. The boycott case examined in this paper is a practical case study of cross-national grouping as well as the perceptional difference of the locus of corporate accountability that comes from cross-cultural backgrounds.

Dose-dependent epidural leakage of polymethylmethacrylate after percutaneous vertebroplasty in patients with osteoporotic vertebral compression fractures

2002 ◽  
Vol 96 (1) ◽  
pp. 56-61 ◽  
Author(s):  
Kyung Sik Ryu ◽  
Chun Kun Park ◽  
Moon Chan Kim ◽  
Joon Ki Kang
Keyword(s):  
Pain Relief ◽  
Epidural Space ◽  
Percutaneous Vertebroplasty ◽  
Vertebral Compression Fractures ◽  
Osteoporotic Vertebral Compression Fractures ◽  
Content Type ◽  
Compression Fractures ◽  
Dose Dependent ◽  
Pmma Cement ◽  
Fine Print

Object. The use of polymethylmethacrylate (PMMA) cement by percutaneous injection in cases requiring vertebroplasty provides pain relief in the treatment of osteoporotic vertebral compression fractures. A retrospective study was performed to assess what caused PMMA cement to leak into the epidural space and to determine if this leakage caused any changes in its therapeutic benefits. Methods. Polymethylmethacrylate was injected into 347 vertebral compression fractures in 159 patients. The cement leaked into the epidural space in 92 (26.5%) of 347 treated vertebrae in 64 (40.3%) of the 159 patients, as demonstrated on postoperative computerized tomography scanning. Epidural leakage of PMMA cement occurred more often when injected above the level of T-7 (p = 0.001) than below. The larger the volume of PMMA injected the higher the incidence of epidural leakage (p = 0.03). Using an injector also increased epidural leakage (p = 0.045). The position of the needle tip within the vertebral body and the pattern of venous drainage did not affect epidural leakage of the cement. Leakage of PMMA into the epidural space reduced the pain relief expected after vertebroplasty. The immediate postoperative visual analog scale scores were higher (and therefore reflective of less pain relief) in patients in whom epidural PMMA leakage occurred (p = 0.009). Three months postoperatively, the authors found the highest number of patients presenting with pain relief, including those in the group with epidural leakage, and at this follow-up stage there were no significant differences between the two groups. Conclusions. The authors found that epidural leakage of PMMA after percutaneous vertebroplasty was dose dependent. The larger amount of injected PMMA, the higher the incidence of leakage. Injecting vertebral levels above T-7 also increased the incidence of epidural leakage. Epidural leakage of PMMA may attenuate only the immediate therapeutic effects of vertebroplasty.

The adoption of CSR practices in Egypt: internal efficiency or external legitimation?

2018 ◽  
Vol 9 (5) ◽  
pp. 642-665 ◽  
Author(s):  
Dina El-Bassiouny ◽  
Peter Letmathe
Keyword(s):  
Corporate Governance ◽  
Sample Size ◽  
Business Environment ◽  
Western World ◽  
Corporate Ethics ◽  
Corporate Accountability ◽  
Governance Mechanisms ◽  
Content Type ◽  
Corporate Governance Mechanisms ◽  
Internal Efficiency

Purpose This study aims to focus on the factors triggering the adoption of corporate social responsibility (CSR) practices in a developing country context. The authors examine whether the adoption of CSR practices is triggered more by internal efficiency forces or external legitimation forces. As early adoptions of new systems are more likely driven by efficiency motives, the authors argue that CSR practices in developing countries at nascent stages are more likely adopted for efficiency rather than legitimation reasons. Design/methodology/approach A cross-sectional sampling design was used to collect data on the CSR practices of top listed Egyptian firms and multinationals operating in Egypt. The sample size is selected based on a purposive criterion sampling method. The final sample size consists of 110 companies operating in Egypt, which includes 54 local and 56 multinational companies. To examine the relationship between the explanatory variables of the study and CSR, multiple regression analysis was used. Findings Using data from 110 top listed local companies and multinational firms operating in Egypt, the results show a significant influence of internal corporate governance on CSR. Yet, the effects of external factors, specifically legal regulations and stakeholder pressures, on CSR are perceived to be insignificant. This finding contrasts studies from industrialized countries in the Western world where firms are often motivated to invest in CSR by external forces. Practical implications The results indicate that the adoption of CSR practices in large firms in Egypt is driven more by internal efficiency gains rather than external legitimacy pressures. The study thus presses the need for the effective enforcement of governmental laws and regulations to strengthen external institutional pressures and demands for socially responsible behavior. Social implications The results of the study indicate a perceived absence of stakeholder pressure for CSR practices. As such, raising awareness for corporate accountability amongst Egyptian consumers, employees and the general public would increase corporate incentives to improve their social and environmental performance. In addition, the concept of CSR must be cultivated in the organizational culture where high value is placed on corporate ethics and managerial values. Originality/value This study provides insights about the predominant drivers of CSR in Egypt on two different levels; the organizational and the business environment. Salient links between CSR, internal corporate governance mechanisms and external drivers such as external stakeholder and legal pressures are explored. The results of the study also emphasize the importance of internal corporate governance mechanisms and how it is perceived to be the main driver of CSR in Egypt as opposed to external influences.

scholarly journals Are entrepreneurs becoming more risk averse?

2019 ◽  
Vol 35 (1) ◽  
pp. 1-2 ◽  
Author(s):  
John J. Oliver ◽  
Newton Velji
Keyword(s):  
Risk Averse ◽  
Corporate Acquisitions ◽  
Content Type ◽  
Industry Consolidation ◽  
Degree Of Consolidation ◽  
The Uk ◽  
The Impact ◽  
Startup Firms ◽  
Production Industry ◽  
Tv Production

Purpose This paper aims to discuss the emerging theme of risk aversion in entrepreneurs following high levels of industry consolidation. Design/methodology/approach This paper is a viewpoint on the authors’ opinion and interpretation of industry consolidation. Findings The UK Independent TV Production Industry has experienced a remarkable degree of consolidation with corporate acquisitions and mergers changing the size, shape and revenue distribution among firms in the industry. In addition, entrepreneurs appear to be more risk averse in terms of entering the industry. Practical implications If the trend in entrepreneurs in the UK TV Production Industry being more risk averse continues, then the number of new startup firms will fall and that could put the future of the industry at jeopardy. Originality/value This paper presents an interesting observation on the impact of consolidation of the UK Independent TV Production Industry, in so far as, entrepreneurs appear to be becoming more risk averse.

scholarly journals British law on corporate bribery

2015 ◽  
Vol 22 (1) ◽  
pp. 16-27 ◽  
Author(s):  
Jonathan Mukwiri
Keyword(s):  
Criminal Liability ◽  
Company Law ◽  
Content Type ◽  
Secondary Sources ◽  
Regulatory Strategy ◽  
Regulatory Approach ◽  
Corporate Criminal Liability ◽  
Corporate Liability ◽  
A Company

Purpose – This paper aims to assess the effectiveness of the Bribery Act 2010 in curbing corporate bribery. Design/methodology/approach – The paper takes a doctrinal focus in assessing UK bribery law using both primary and secondary sources. Findings – This paper finds that the effectiveness of the Bribery Act 2010 in curbing bribery lies in its approach of changing the basis for corporate criminal liability from focusing on the guilt of personnel within the company to focusing on the quality of the system governing the activities of the company. Companies have to address the risks of bribery or risk facing liability for failure to prevent bribery. With its regulatory approach to corporate liability, coupled with its extraterritorial reach, the Bribery Act is likely to change business cultures that facilitate bribery, thereby proving an effective law to corporate bribes. Originality/value – This paper highlights the deficiency of earlier laws in tackling corporate bribery, examines the crime of bribery from a company law perspective and argues that the regulatory strategy in the Bribery Act is likely to be an effective tool against bribery.

Activation of the anterior cingulate cortex by thalamic stimulation in patients with chronic pain: a positron emission tomography study

2000 ◽  
Vol 92 (1) ◽  
pp. 64-69 ◽  
Author(s):  
Karen D. Davis ◽  
Ethan Taub ◽  
Frank Duffner ◽  
Andres M. Lozano ◽  
Ronald R. Tasker ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Chronic Pain ◽  
Pain Relief ◽  
Anterior Cingulate Cortex ◽  
Analgesic Effect ◽  
Anterior Cingulate ◽  
Emission Tomography ◽  
Content Type ◽  
Positron Emission ◽  
Fine Print

Object. Deep brain stimulation (DBS) of the sensory thalamus has been used to treat chronic, intractable pain. The goal of this study was to investigate the thalamocortical pathways activated during thalamic DBS.Methods. The authors compared positron emission tomography (PET) images obtained before, during, and after DBS in five patients with chronic pain. Two of the five patients reported significant DBS-induced pain relief during PET scanning, and the remaining three patients did not report any analgesic effect of DBS during scanning. The most robust effect associated with DBS was activation of the anterior cingulate cortex (ACC). An anterior ACC activation was sustained throughout the 40 minutes of DBS, whereas a more posteriorly located ACC activation occurred at a delay after onset of DBS, although these activations were not dependent on the degree of pain relief reported during DBS. However, implications specific to the analgesic effect of DBS require further study of a larger, more homogeneous patient population. Additional effects of thalamic DBS were detected in motor-related regions (the globus pallidus, cortical area 4, and the cerebellum) and visual and association cortical areas.Conclusions. The authors demonstrate that the ACC is activated during thalamic DBS in patients with chronic pain.

Gamma knife surgery with a dose of 75 to 76.8 Gray for trigeminal neuralgia

2004 ◽  
Vol 100 (5) ◽  
pp. 848-854 ◽  
Author(s):  
Ronald Brisman
Keyword(s):  
Pain Relief ◽  
Trigeminal Neuralgia ◽  
Gamma Knife ◽  
Gamma Knife Surgery ◽  
Recurrent Pain ◽  
Content Type ◽  
Kaplan Meier ◽  
Uniform Manner ◽  
Second Procedure ◽  
Fine Print

Object. The author presents a large series of patients with idiopathic trigeminal neuralgia (TN) who were treated with gamma knife surgery (GKS), at a maximum dose of 75 to 76.8 Gy, and followed up in a nearly uniform manner for up to 4.6 years. Methods. Two hundred ninety-three patients were treated and followed up for at least 6 months (range 0.4–4.6 years, median 1.9 years). At the final follow-up review, there was complete (100%) pain relief without medicines in 64 patients (21.8%), 90% or greater relief with or without small doses of medicines in 86 (29.4%), between 75 and 89% relief in 31 (10.6%), between 50 and 74% relief in 19 (6.5%), and less than 50% relief in 23 patients (7.8%). Recurrent pain requiring a second procedure occurred in 70 patients (23.9%). Kaplan—Meier analysis showed that 100%, 90% or greater, and 50% or greater pain relief was obtained and maintained for 3.5 to 4.1 years in 5.6 , 23.7, and 50.4% patients, respectively. Of 31 patients who described pain relief ranging from 75 to 89%, 80% of patients described it as good and 10% as excellent; of 17 patients who reported between 50 and 74% pain relief, 53% described it as good and none as excellent (p = 0.014). Dysesthesia scores greater than 5 (scale of 0–10, in which a score of 10 represents excruciating pain) occurred in four (3.2%) of 126 patients who had not undergone prior surgery; all these patients obtained either good or excellent relief from TN pain. There were 36 patients in whom the TN had atypical features; these patients were less likely to attain at least 50% or at least 90% pain relief compared with those without atypical TN features (p = 0.001). Conclusions. Gamma knife surgery is a safe and effective way to relieve TN. Patients who attain between 75 and 89% pain relief are much more likely to describe this outcome as good or excellent than those who attain between 50 and 74% pain relief.

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