ECONOMIC SCIENCE AND POLITICAL INFLUENCE

When policymakers and private agents use models, the economists who design the model have an incentive to alter it in order to influence outcomes in a fashion consistent with their own preferences. I discuss some consequences of the existence of such ideological bias. In particular, I analyze the role of measurement infrastructures such as national statistical institutes, the extent to which intellectual competition between different schools of thought may lead to polarization of views over some parameters and at the same time to consensus over other parameters, and finally how the attempt to preserve influence can lead to degenerative research programs.     

Six Propositions on Public Participation and Their Relevance for Risk Communication

New societal obligations for communicating risk information are emerging in a variety of contexts. This article draws upon the lengthy societal experience with citizen participation programs to identify how risk communication efforts may be effectively structured and implemented. Six major propositions address such themes as means/ends differences in expectations, the timing of the program, the role of credibility and trust, the need for technical and analytical resources, differing thresholds of public involvement, and limitations upon current understandings. Key conclusions for the design of risk communication programs are set forth.     

Building Strategic Technology Alliances for Teaching and Learning

There is a major need for higher education to confront intense competition, enhance academic programs to meet the challenges of this competition, and to develop new teaching and learning strategies to meet the demands of the global marketplace. Technology and the Internet are intended to break down the barriers of time and space and enable more students to participate and collaborate with faculty and other students. Critical thresholds must be met in order to use technology to communicate, collaborate, and transform teaching and learning. Strategic technology alliances establish a partnership between technology vendors and higher education that will achieve these thresholds to meet the teaching and learning needs of the 21st century student. This revised version was published online in July 2006 with corrections to the Cover Date.     

Why an MBA?

As physicians move into medical management, leaving clinical practice behind to play a major role in managing physician performance and clinical processes, they are having to deal in the business world. Physician executives are donning the pinstripe suit instead of the white coat, and adding a business acumen to their clinical skills. Many have opted to pursue executive MBA programs to learn the business competencies they need to manage health care organizations. This article summarizes the educational opportunities available in executive MBA programs and discusses the value of business training for aspiring physician executives.     

Advancing Risk‐Informed Decision Making in Managing Defense Nuclear Waste in the United States: Opportunities and Challenges for Risk Analysis

An omnibus spending bill in 2014 directed the Department of Energy to analyze how effectively Department of Energy (DOE) identifies, programs, and executes its plans to address public health and safety risks that remain as part of DOE's remaining environmental cleanup liabilities. A committee identified two dozen issues and associated recommendations for the DOE, other federal agencies, and the U.S. Congress to consider, as well as other stakeholders such as states and tribal nations. In regard to risk assessment, the committee described a risk review process that uses available data, expert experience, identifies major data gaps, permits input from key stakeholders, and creates an ordered set of risks based on what is known. Probabilistic risk assessments could be a follow‐up from these risk reviews. In regard to risk management, the states, in particular, have become major drivers of how resources are driven. States use different laws, different priorities, and challenge DOE's policies in different ways. Land use decisions vary, technology choices are different, and other notable variations are apparent. The cost differences associated with these differences are marked. The net result is that resources do not necessarily go to the most prominent human health and safety risks, as seen from the national level.     

Exposure Assessment of Heavy Metals Resulting from Farmland Application of Wastewater Sludge in Tianjin, China: The Examination of Two Existing National Standards for Soil and Farmland-Used Sludge

Land application is one of the major methods of managing municipal sludge in China. The sludge is used for fertilizing and conditioning soil, but due to the high concentration of heavy metals and other chemicals that it contains, improper use of sludge will lead to the contamination of farmland soil. To provide guidance on the application of sludge in China, the Control Standards for Pollutants in Sludge for Agricultural Use (CSPSAU) were enacted, and implemented in 1985. Afterwards, the National Environment Quality Standards for Soil (NEQSS) were also formulated and put into effect in 1996. In this article, these two national standards were examined by means of exposure assessment. The main exposure pathway to humans that was considered was dietary intake of crops grown on the sludge-applied farmland. Five major types of agricultural crops (rice, wheat, tuber roots, vegetables, and fruits) and three groups of exposure population (the urban individual group, the rural sludge-applying individual group, and the rural sludge nonapplying individual group) were assessed. This case study in Tianjin, China, shows the necessity of reexamining the national standards of the CSPSAU and the NEQSS in the context of risk assessment. More comprehensive surveys and monitoring programs assessing heavy metals contained in farmland soils and crop tissues will be necessary for examining the risks to human health.     

Efforts to implement national health reform in the United States

Beginning in this issue and carrying forth during the year, the author will trace the history of the development of a national health policy in the United States. In beginning this new feature, Physician Executive recognizes the potential impact of national health reform on physician executives and the need to contribute to informed discussion on the current national health reform debate. In this first article, the authors sets the stage for the series, establishing the historical precedents for national health care reform and some of the groundrules for the articles to follow.     

Environmental information disclosure and stakeholder involvement: Searching for common ground

In a recent national summit hosted by The Vanderbuilt Center for Environmental Management Studies, high level corporate, environmental, and government officials came together to discuss the growing trend towards the disclosure of environmental information as a tool to increase public accountability. Both regulators and environmentalists showed interest in continuing to utilize and, in many cases expeand, existing environmental information disclosure programs. The summit was viewed as a catalyst in the ongoing national discussion of the efficacy of this evolving area of government policy. This article highlights some of the key results of this event and offers suggested next steps to address credibility and effectiveness in environmental information disclosure.     

Planning for disasters

Although in Great Britain the risk of large scale natural disasters is less than in some other countries, there is an increasing risk of the type of catastrophe bred by the complexities of modern industry and by political unrest. The author makes no apology for quoting the Belfast experience at some length.While individual rescue services show a high level of efficiency there appears to be a need to improve the overall co-ordination of the community's response to disaster. Techniques of communication are often inadequate. The importance of rehearsal requires to be stressed.There may be a case for establishing a national committee to review the country's readiness and to give direction and advice.     

Governing Diversity: The Impact of Social Heterogeneity on Human Service Delivery

The social environment in which government is embedded has wide implications for public administration. The increasing social heterogeneity in the United States poses various puzzles for the governance structure in public human service programs. Apart from major political and policy changes, contracting out service delivery is considered to be a more appropriate managerial response. Therefore, social heterogeneity in a jurisdiction would be positively associated with the use of contractual networks in service delivery. Using data from a national survey of human service contracting, this study finds that states with higher degrees of social heterogeneity use service contractual networks more often. This further highlights the imperative of capacity building for public administrators when using contractual networks.     

Pre-certification: lessons from diagnostic imaging

Recently, managed care has received a great deal of criticism from the public and press, some of it richly deserved. One of the areas of greatest concern is pre-certification requirements and possible denial of services. Experience with programs of this sort in diagnostic imaging suggests that, implemented correctly, the consultative interface created by a pre-certification program can be of tremendous value in physician education. Appropriate behavior modification programs need to be crafted with an educational rather than economic bias and the methodology not be totally abandoned simply because it has been misused by some. The pre-certification process can be used as a vehicle to disseminate information about rapidly emerging new therapies and technologies.     

The Benefits and Costs of Disclosing Information about Risks: What Do We Know about Right‐to‐Know?

Following the attacks of September 11, 2001, the Environmental Protection Agency and other government agencies removed information from their web sites that they feared could invite attacks on critical public and private infrastructure. Accordingly, the benefits and costs of environmental information disclosure programs have come under increasing scrutiny. This article describes a framework for examining these benefits and costs and illustrates the framework through brief case studies of two information disclosure programs: risk management planning and materials accounting. The article outlines what we know and still need to find out about information disclosure programs in order to appropriately balance benefits and costs.     

Mechanistic Insights Aid the Search for CFC Substitutes: Risk Assessment of HCFC-123 as an Example

An international consensus on the need to reduce the use of chlorofluorocarbons (CFCs) and other ozone-depleting gases such as the halons led to the adoptions of the 1987 Montreal Protocol and Title VI of the 1990 Clean Air Act Amendments, "Protecting Stratospheric Ozone." These agreements included major provisions for reducing and eventually phasing out production and use of CFCs and halons as well as advancing the development of replacement chemicals. Because of the ubiquitous use and benefits of CFCs and halons, an expeditious search for safe replacements to meet the legislative deadlines is of critical importance. Toxicity testing and health risk assessment programs were established to evaluate the health and environmental impact of these replacement chemicals. Development and implementation of these programs as well as the structural-activity relationships significant for the development of the replacement chemicals are described below. A dose-response evaluation for the health risk assessment of the replacement chemical HCFC-123 (2,2-dichloro-1,1,1-trifluoroethane) is also presented to show an innovative use of physiologically based pharmacokinetic (PBPK) modeling. This is based on a parallelogram approach using data on the anesthetic gas halothane, a structural analog to HCFC-123. Halothane and HCFC-123 both form the same metabolite, trifluoroacetic acid (TFA), indicative of the same metabolic oxidative pathway attributed to hepatotoxicity. The parallelogram approach demonstrates the application of template model structures and shows how PBPK modeling, together with judicious experimental design, can be used to improve the accuracy of health risk assessment and to decrease the need for extensive laboratory animal testing.     

A necessary dialogue: a South African case study exploring the role of national HRD in HIV/AIDS non-government organizations

This article makes the case for a coordinated and multi-faceted national level response to the HIV/AIDS crisis in South Africa from the field of human resource development (HRD), arguing that national policy debate on this issue must include the development of human resources in HIV/AIDS non-governmental organizations (NGOs). An exploration of potential connections between HIV/AIDS and HRD was conducted with a qualitative case study in Port Elizabeth, South Africa. Through this study, four major thematic categories emerged in connection to the work of NGOs involved in the management of HIV/AIDS, government policy, and the emerging theory and practice of national human resource development (NHRD). In addition, findings pointed to the need for HRD research to be conducted in HIV/AIDS related NGOs given their front-line roles in both policy and practice. Initial suggestions for dialogue between NGOs involved with managing HIV/AIDS and the HRD research and practice community are made along with recommendations for stronger linkages between NHRD and HIV/AIDs.     

Local Resources and Procurement Practices in Humanitarian Supply Chains: An Empirical Examination of Large‐Scale House Reconstruction Projects

Different procurement decisions taken by relief organizations can result in considerably different implications in regards to transport, storage, and distribution of humanitarian aid and ultimately can influence the performance of the humanitarian supply chain and the delivery of the humanitarian aid. In this article, we look into what resources are needed and how these resources evolve in the delivery of humanitarian aid. Drawing on the resource‐based view of the firm, we develop a framework to categorize the impact of local resources on the configuration of humanitarian supply chains. In contrast to other papers, the importance of localizing the configuration of the humanitarian supply chain is not only conceptually recognized, but empirical investigations are also provided. In terms of methodology, this article is based on the analysis of secondary data from two housing reconstruction projects. Findings indicate that the use of local resources in humanitarian aid has positive effects on programs’ overall supply chain performance and these effects are not only related to the macroeconomic perspective, but benefits expand to improvements related to the use of knowledge. At the same time, it was found that local sourcing often comes with a number of problems. For example, in one of the cases, significant problems existed, which were related to the scarcity of local supplies. Both housing reconstruction projects have indicated the continuous need for changes throughout the programs as a dynamic supply chain configuration is important for the long‐term sustainability of reconstruction aid.     

National programmes to promote youth training

The importance of education and training to this country's national performance is increasingly recognized. The introduction of the Youth Training Scheme, offering a year's workbased foundation training to 16- and 17-year-old entrants to the labour market, marks a major advance on Britain's poor record in this field. This article describes the Scheme's aims and mode of operation, traces its long gestation and reviews the progress during its first year. It relates the Scheme to wider national objectives for the development of training and to complementary initiatives in education, and discusses how it might be evaluated.     

Optimizing Risk Analysis Relating to External Safety in The Netherlands

Risk analyses in The Netherlands have been optimized so that they now express risks in a numerical form suitable for comparison to national safety standards. This factor is more important to national government than to local authorities; other factors relevant for local authorities are given less emphasis or even completely omitted from the results of the analysis. From a comparison of 16 risk analyses carried out during the last decade, it became clear that in the last 5 years the methods of risk analyses related to external safety have become unified. Results are now presented in terms of individual risk contours and in terms of F-N curves (accident frequency vs. exceeded number of fatalities). This unification seems to be a result of government policy. First, the implementation of the post-Seveso-directive (501/82/EC) in The Netherlands obliges a number of industries to provide the authorities with a quantitative risk assessment. Second, the government has set standards for the maximum permissible risk in residential areas. A unified type of risk analysis is a tool to achieve both these policies. From interviews with local government authorities, however, it has become clear that they need and use some quantitative risk information that is not provided by the unified analysis. They feel they need figures that provide insight into the effects of incidents and into the way effects may change as a result of safety measures. Ultimately, government policy may mean that local officials receive less information than before.     

What to do next

Why do we work? While there may be some obvious, practical answers to this question, like needing to make money to survive, there are other reasons that people work. These include working: to have stimulation and excitement--to meet new challenges and have variety in your life; for love and affection--to be with colleagues, clients, customers and to provide security and protection for family and friends; and to leave a thumbprint on the world and change individuals, systems, and institutions. For quality life, it is necessary not only to work but to enjoy your work. For physicians considering careers in medical management, the key to success is being truly excited about management activities. If you are heading towards management, you need to view some of the tasks as fun or you probably won't stay with it very long.     

European Integration and the Integration of European Labour Markets1

Abstract. Will European economic and monetary union bring about a unification of European labour markets, and is there likely to be a convergence of patterns of labour market organisation among Community countries? The evidence discussed suggests that a major increase in unskilled mobility across the EC is unlikely, at least concerning EC citizens. Among skilled labour, a major increase in international mobility is also unlikely on account of differences in skill organisation among countries. In contrast, the integration of European capital is causing some integration of enterprise internal labour markets across national borders as firms seek to integrate their managerial and technical workforces. In the “high-tech” area, skills are in a state of flux, and the possibility that European labour markets will emerge is much stronger than for other categories.     

Regulating the domestic air travel in India: an umpire's game

This paper analyses the competitive strategies available to an Indian airline in a scenario where the entry of private domestic airlines has only recently been allowed. The Calcutta-Delhi route is initially analysed as an example—where there are three major players competing. The fare charged by each airline being the same, the number of departures is used as one of the major competitive weapons. Game theory is used here as a useful tool to analyse such situations. The equilibrium behaviour of the airlines is studied and the possibility of the game being played at the focal point is then analysed.All over the world, airlines have had a long history of economic regulation of both their national and international operations with governments often regarding regulation as necessary—both to achieve a comprehensive route network and to achieve stable markets. The game formulated is then analysed from the point of view of the regulating body and it is found that the game-theoretic framework is able to provide powerful insights regarding regulatory interventions. Two types of interventions, viz. fare regulation as well as the introduction of a licence fee per flight, are analysed and their ability to shift the Nash equilibrium to the focal point are studied. Finally, the problem is generalised and some results are obtained which are applicable to any route with any number of operators as long as the basic nature of the competitive situation remains the same. Use of the game-theoretic approach as a powerful tool to decide regulatory interventions is thus highlighted.