A Longitudinal Study Exploring Value Changes During the Cultural Assimilation of Japanese Student Pilot Sojourners in the United States

This study explored longitudinally the value changes of Japanese student pilot sojourners attending pilot training in the United States for two years. Throughout their stay in the United States they are exposed to the United States Western culture, and assimilate some of that culture, because in order to achieve equilibrium, they will change some of their values, attitudes and behaviors (move toward the similar) and assimilate some of their new culture. This study explored the cultural assimilation of those pilots by exploring value changes using the Rokeach Value Survey; exploring values upon arrival, after one year in the U.S., after two years in the U.S., and one year after return to the Japan. The research results showed significant cultural assimilation as demonstrated by value changes between time of arrival and departure from the U.S., and continuing one year after return to Japan.     

Complements or Substitutes? Culture–Technology Interactions in Healthcare

The U.S. government recommends that hospitals adopt Computerized Provider Order Entry (CPOE) systems to improve the quality problems that plague U.S. hospitals. However, CPOE studies show mixed results. We hypothesize that CPOE effectiveness depends on the prevalence of patient safety culture within a hospital. Using organizational information processing theory, we describe how patient safety culture and CPOE enable healthcare organizations to better process information. Specifically, we posit that CPOE complements some aspects of patient safety culture and substitutes for others. Using ridge regression, we empirically test this proposition using data from 268 hospitals and multiple data sources. Results show that while CPOE complements the patient safety dimensions of handoffs and transitions, feedback and communication about error, and organizational learning, CPOE substitutes for the dimension of management support for safety, in the context of our dependent variable. As organizations work to implement new systems, this research can help decision‐makers understand how culture impacts such initiatives and account for culture when anticipating effects.     

Quantitative Assessment of Human MRSA Risks from Swine

The public health community, news media, and members of the general public have expressed significant concern that methicillin‐resistant Staphylococcus aureus (MRSA) transmitted from pigs to humans may harm human health. Studies of the prevalence and dynamics of swine‐associated (ST398) MRSA have sampled MRSA at discrete points in the presumed causative chain leading from swine to human patients, including sampling bacteria from live pigs, retail meats, farm workers, and hospital patients. Nonzero prevalence is generally interpreted as indicating a potential human health hazard from MRSA infections, but quantitative assessments of resulting risks are not usually provided. This article integrates available data from several sources to construct a conservative (plausible upper bound) probability estimate for the actual human health harm (MRSA infections and fatalities) arising from ST398‐MRSA from pigs. The model provides plausible upper bounds of approximately one excess human infection per year among all U.S. pig farm workers, and one human infection per 31 years among the remaining total population of the United States. These results assume the possibility of transmission events not yet observed, so additional data collection may reduce these estimates further.     

Effect of economic planning on business decisions

The fact that the United States has not faced an economic perplexity of current dimensions since the depression days hardly needs any emphasis. The current economic slowdown is significant because no recovery measures which may be applied to cure the economy are in sight. Since the Great Depression, especially after World War II, Keynes' economic theories have successfully been applied in the U.S., as also in other countries of the Free World, to put the economy back on path to recovery. Unfortunately, Keynesian measures do not seem to cope with the current economic woes. Apparently, new ways need to be sought and employed to get the economy back on track. Among many new ideas that have been advanced to restore economic growth, one is national economic planning by which the Government would play an active role in setting goals for the economy and devising means to reach them.The purpose of this paper is to report the findings of a study that the author undertook to probe the opinions of chief executive officers of the largest U.S. corporations on the whole idea of national economic planning in the United States. This study is based on interviews with 23 chief executives officers (CEOs) in different industries. Table 1 shows the background of these CEOs. Specifically, the author refers to such questions as: What positive and negative attitudes do the chief executive officers maintain toward national economic planning; what difficulties do they think will have to be surmounted to accomplish national economic planning in the U.S.; what influence may national economic planning have on various business decisions; and how may national economic planning affect corporate strategy?     

National Defense,Environmental Regulation,and Overhead Democracy: A View from the “Greening” of the U.S. Military

This study examines the patterns of politics accompanying efforts to hold the United States military accountable to U.S. environmental and natural resources (ENR) laws in the post-Cold War era. This analysis (1) uses three cases to describe what happened, and why, (2) to test several propositions related to military accountability to ENR laws in the post-Cold War era; (3) to offer a typology of tactics used that may help inform future research on intragovernmental regulation more generally; and (4) argues that public agencies have a responsibility to comply with the regulatory processes that hold them accountable to U.S. ENR laws.     

Aldrin and Dieldrin: A Reevaluation of the Cancer and Noncancer Dose‐Response Assessments

The dose‐response analyses of cancer and noncancer health effects of aldrin and dieldrin were evaluated using current methodology, including benchmark dose analysis and the current U.S. Environmental Protection Agency (U.S. EPA) guidance on body weight scaling and uncertainty factors. A literature review was performed to determine the most appropriate adverse effect endpoints. Using current methodology and information, the estimated reference dose values were 0.0001 and 0.00008 mg/kg‐day for aldrin and dieldrin, respectively. The estimated cancer slope factors for aldrin and dieldrin were 3.4 and 7.0 (mg/kg‐day)^?1, respectively (i.e., about 5‐ and 2.3‐fold lower risk than the 1987 U.S. EPA assessments). Because aldrin and dieldrin are no longer used as pesticides in the United States, they are presumed to be a low priority for additional review by the U.S. EPA. However, because they are persistent and still detected in environmental samples, quantitative risk assessments based on the best available methods are required. Recent epidemiologic studies do not demonstrate a causal association between aldrin and dieldrin and human cancer risk. The proposed reevaluations suggest that these two compounds pose a lower human health risk than currently reported by the U.S. EPA.     

Optimal Tracking and Testing of U.S. and Canadian Herds for BSE: A Value-of-Information (VOI) Approach

The U.S. Department of Agriculture (USDA) tests a subset of cattle slaughtered in the United States for bovine spongiform encephalitis (BSE). Knowing the origin of cattle (U.S. vs. Canadian) at testing could enable new testing or surveillance policies based on the origin of cattle testing positive. For example, if a Canadian cow tests positive for BSE, while no U.S. origin cattle do, the United States could subject Canadian cattle to more stringent testing. This article illustrates the application of a value-of-information (VOI) framework to quantify and compare potential economic costs to the United States of implementing tracking cattle origins to the costs of not doing so. The potential economic value of information from a tracking program is estimated to exceed its costs by more than five-fold if such information can reduce future losses in export and domestic markets and reduce future testing costs required to reassure or win back customers. Sensitivity analyses indicate that this conclusion is somewhat robust to many technical, scientific, and market uncertainties, including the current prevalence of BSE in the United States and/or Canada and the likely reactions of consumers to possible future discoveries of BSE in the United States and/or Canada. Indeed, the potential value of tracking information is great enough to justify locating and tracking Canadian cattle already in the United States when this can be done for a reasonable cost. If aggressive tracking and testing can win back lost exports, then the VOI of a tracking program may increase to over half a billion dollars per year.     

Contractual Integration of Physician and Hospital Services in the U.S.

Using a binary-choice, probabilistic model, this study analyzes data covering the institutional and market characteristics of 759 hospitals in 81 metropolitan statistical are as in the United States to understand why many of them have chosen to contractually integrate with physician and physician group practices. The results support the theory that the contractual integration of physician and hospital services in the U.S. during the 1990s occurred in response to market pressures to circumvent the transaction costs of monitoring physician utilization of hospital resources. They also support the views of Robinson (1997) and Shortell (1997) that the nature of the coordination, the governance structure, and the part to which market mechanisms play are largely determined by the demands for coordination from the market served by the hospital, the capabilities of the hospital to pull physicians into integration arrangements, and the historical context and constraints binding the hospital's decision making. This revised version was published online in July 2006 with corrections to the Cover Date.     

Technology transfer — and the U.S. space program

Using ten years of data in the structured technology transfer program of the United States National Aeronautics and Space Administration as a base, a rough model of the nature and significance of research and development and its movement as technology is presented. Painted in economic hues is the economic return of technology of 7·23 to 1 over an 18 year period, in technical terms—the nature of integrated circuit technology transfer and the public significance of technology transfer to the problems of rechargeable Cardiac Pacemakers. The distinction between natural technology diffusion and intended technology transfer is made to outline the movement of technology through the U.S. economy.     

Planning for hospitals: No focus, no strategy

This is a study of the role of long-range planning and strategic management in 400 hospitals in the United States. It examines not only the structural aspects of planning but also investigates how the data base generated through the planning process is actually used in making operating decisions. In addition to a questionnaire survey of 400 hospitals on the structural aspects of planning, 78 personal interviews with functional heads and hospital administrators were conducted to analyse the operational part of the study. The major findings are that the possibilities and constraints of planning are remarkably similar to those of industrial corporations. The linkage of planning with operational decisions was found to be lacking. There were wide divergences in views between the functional heads and the hospital administrators in terms of internal and external activities, and also in performance reward relationship. These divergences are thought to be counter- productive in realizing the strategic focus of cost containment. Implications of the findings are also discussed.     

Insurer Competition in Health Care Markets

The impact of insurer competition on welfare, negotiated provider prices, and premiums in the U.S. private health care industry is theoretically ambiguous. Reduced competition may increase the premiums charged by insurers and their payments made to hospitals. However, it may also strengthen insurers' bargaining leverage when negotiating with hospitals, thereby generating offsetting cost decreases. To understand and measure this trade‐off, we estimate a model of employer‐insurer and hospital‐insurer bargaining over premiums and reimbursements, household demand for insurance, and individual demand for hospitals using detailed California admissions, claims, and enrollment data. We simulate the removal of both large and small insurers from consumers' choice sets. Although consumer welfare decreases and premiums typically increase, we find that premiums can fall upon the removal of a small insurer if an employer imposes effective premium constraints through negotiations with the remaining insurers. We also document substantial heterogeneity in hospital price adjustments upon the removal of an insurer, with renegotiated price increases and decreases of as much as 10% across markets.     

CONSTITUENCIES OF JOURNALS IN PRODUCTION AND OPERATIONS MANAGEMENT: IMPLICATIONS ON REACH AND QUALITY*

I analyzed the contributions made by members of the following constituencies in terms of the number of articles published in the Journal of Operations Management (JOM), Manufacturing and Service Operations Management (M&SOM), and Production and Operations Management (POM): the top 20 U.S. business schools and the top 7 non‐U.S. business schools as ranked by Business Week or U.S. News and World Report, business and government organizations, U.S. business schools ranked between 21 and 50, non‐U.S. business schools not included above, and U.S. business schools not included above. I also analyzed the contributions made by U.S. business schools with top 10 programs in production and operations management; 9 of which are also in the list of top 20 U.S. business schools. Authors from the schools with top 10 programs in production and operations management contributed 20.2% of the articles published in POM and 3.5% of the articles published in JOM during 1997‐2001. They contributed 24.6% of the articles in the eight issues (from July 2000 through June 2002) of M&SOM. During these periods, authors from the top 27 schools contributed 29.3% of the articles published in POM, 9.4% of the articles published in JOM, and 37.4% of the articles to the eight issues of M&SOM. Also during the same periods, authors from business and government organizations contributed 6.6% of the articles published in POM, 1.9% of the articles published in JOM, and 5.8% of the articles published in the eight issues of M&SOM. The findings reported in this paper reflect the reach of the three journals and the perceptions of various constituencies regarding journal quality. The findings about POM and JOM have a very high degree of validity because both journals are more than 10 years old and have well‐established constituencies. The conclusions about the M&SOM constituencies are tentative because it is about 3 years old, and it is still developing its constituencies.     

Leadership—The NASA approach

The leadership status of the United States in aeronautics and space today is an achievement of the NASA management approach, an extraordinary organizational process in which long-range planning plays a major role. Soviet space exploits served as a catalyst to U.S. space exploration. With a 25 year historical perspective, the author describes the successful U.S. response to the Soviet challenge, i.e. the establishment of NASA and the creation of the NASA approach, a long-range planning process in aeronautics and space, responsive to national policy and purpose.     

Health care costs tied to many issues

Although, in 1990, the United States spent about $750 billion (12.2 percent of the Gross National Product) on health care, 31-37 million people in this country are uninsured. Another 4 million people are thought to be underinsured. We have one of the highest infant mortality rates among developed industrialized nations and rank 19th in health care and well-being among those nations. Our life expectancy is lower than those of some third-world countries. The United States and South Africa are the only two industrialized nations without a national health care policy. In spite of these statistics, U.S. health care costs continue to rise and, by the year 2000, are expected to reach $1.5 trillion (15 to 17.5 percent of the GNP. Per capita spending on health care will reach $5,515 by the year 2000, compared with $2,425 in 1990 and $1,016 in 1980.     

System reform in integrated health systems

As the debate progresses on health care reform and the ultimate form of the U.S. system, important lessons can be drawn from examinations of other health care systems. From the U.S. perspective, European health systems appear to have a certain homogeneity about them. Americans tend to look at all European arrangements as single-source financing systems. Because these systems all provide universal coverage, the assumption is that there must be a strong cohesion and similarity among them. Viewed from the European perspective, the reality appears to be rather different. In this article, the health cae systems of Nordic countries are analyzed in terms of their differences both from other European systems and from the United States approach.     

Top management departures in cross-border acquisitions: Governance issues in an international context

This study examined top management team departures in U.S. manufacturing firms acquired by a foreign multinational during the six-year period following acquisition. Results indicated that greater cultural distance between the United States and the home country of the foreign multinational, higher levels of international integration in the target industry, and poor preacquisition performance in the U.S. target company were related to greater postacquisition top management departures. These effects were moderated significantly by the foreign acquirer’s international business and U.S. acquisition experience and showed different patterns over the short-term, intermediate-term, and long-term. Implications for future research on top management teams involved in cross-border acquisitions are discussed.     

Meet the mandate to measure clinical quality

The mandate for health care organizations to be accountable for quality, as well as price, is now unavoidable. The Joint Commission's ORYX project is requiring every hospital to measure clinical outcomes of a majority of its patients within the next three years. This mandate can be met best with systems of clinical outcomes measurement that provide valid, reliable risk adjustment; yield meaningful information about many different diseases and procedures; and measure more than mortality or cost--all using primarily billing data. New outcomes measurement tools with all of these capabilities are available and have already enabled quality improvement in dozens of hospitals across the U.S.     

Distribution system choice in a service industry: An analysis of international insurance firms operating in the United States

Service firms play an increasingly important role in the global economy. However, the internationalization strategies of such firms, and especially their distribution system choices, have been underexplored in the international management literature. One specific service industry that has internationalized rapidly in recent years is the insurance industry. This paper examines the determinants and performance implications of the choice by international insurance firms between two rival distribution systems: direct writing and independent sales agents. Drawing on the transaction cost theory-based literature on resource commitment, control, and risk, we develop hypotheses on the determinants of the choice between these two distribution systems and on the performance implications of this choice for insurance firms. Analyzing a sample of 168 distribution entries into the United States by insurance firms from six foreign countries over the 1992–2000 period, we find that cultural distance has a U-shaped effect on the probability of direct writing, and that an insurer's intangible assets have a positive effect on this probability. We also find that the direct writing system performs better in terms of profitability, but that the independent agency system performs better in terms of market share growth.     

Global Maize Trade and Food Security: Implications from a Social Network Model

In this study, we developed a social network model of the global trade of maize: one of the most important food, feed, and industrial crops worldwide, and critical to food security. We used this model to analyze patterns of maize trade among nations, and to determine where vulnerabilities in food security might arise if maize availability was decreased due to factors such as diversion to nonfood uses, climatic factors, or plant diseases. Using data on imports and exports from the U.N. Commodity Trade Statistics Database for each year from 2000 to 2009 inclusive, we summarized statistics on volumes of maize trade between pairs of nations for 217 nations. There is evidence of market segregation among clusters of nations; with three prominent clusters representing Europe, Brazil and Argentina, and the United States. The United States is by far the largest exporter of maize worldwide, whereas Japan and the Republic of Korea are the largest maize importers. In particular, the star‐shaped cluster of the network that represents U.S. maize trade to other nations indicates the potential for food security risks because of the lack of trade these other nations conduct with other maize exporters. If a scenario arose in which U.S. maize could not be exported in as large quantities, maize supplies in many nations could be jeopardized. We discuss this in the context of recent maize ethanol production and its attendant impacts on food prices elsewhere worldwide.     

Physicians lead the way at America's top hospitals

The 100 Top hospitals are selected annually based on seven critical parameters for each of the 6,200-plus U.S. hospitals with 25 or more beds. They include the previous year's risk-adjusted patient mortality and complication rates, severity-adjusted average patient lengths of stay, expenses, profitability, proportional outpatient revenue, and asset turnover ratio (a measure of facility and technological pace-keeping ability). The winners are selected from five comparable size groupings--small, medium, large community, teaching, and large academic hospitals. Conspicuous among the winners at every level are physician-led organizations. Even in the majority of hospitals headed by non-physician administrators, however, the managerial capabilities of medical directors are the key to success. The most common characteristic of these award-winning hospitals is that the leadership is working together and communicating the institution's goals effectively to all levels of the organization.