Health care's power brokers in the 21st Century. Interview by Donna Vavala

Health care has undergone turbulent change in the 20th Century. In addition to dramatic pharmaceutical and technological advances, the entire health care delivery system has been significantly improved. Through all the turmoil, hospitals have been at the center of the health care universe. But, as the 21st Century approaches, that may change, too. What will become of hospitals, which for most of this century have played a commanding role? Will managed care organizations and group practices come out on top? And, once the new power broker takes over, what will be the impact on providers, insurers, and the government, and how will their relationships to each other change? Jeff Goldsmith, PhD, President of Health Futures, Inc., Bannockburn, Ill., and health care futurist, examines tomorrow's health care delivery system and makes some eye-opening predictions.     

NONLINEAR TUBE-FITTING FOR THE ANALYSIS OF ANATOMICAL AND FUNCTIONAL STRUCTURES

We are concerned with the estimation of the exterior surface and interior summaries of tube-shaped anatomical structures. This interest is motivated by two distinct scientific goals, one dealing with the distribution of HIV microbicide in the colon and the other with measuring degradation in white-matter tracts in the brain. Our problem is posed as the estimation of the support of a distribution in three dimensions from a sample from that distribution, possibly measured with error. We propose a novel tube-fitting algorithm to construct such estimators. Further, we conduct a simulation study to aid in the choice of a key parameter of the algorithm, and we test our algorithm with validation study tailored to the motivating data sets. Finally, we apply the tube-fitting algorithm to a colon image produced by single photon emission computed tomography (SPECT) and to a white-matter tract image produced using diffusion tensor imaging (DTI).     

留住高绩效员工!——企业必须像管理资产那样对待人力资本

近几年来，企业界兴起了“新型工作合约”，其主题是员工对自己的工作负责，企业为员工提供培训、晋升等各种机会。但无论对企业还是对员工来说，这种合约都没有发挥出应有的作用。领导者对如何在经济动荡时期留住高绩效员工知之甚少。     

为自己打广告

如果不能把产品信息传递给购买人群的话，开发出再好的新产品也毫无意义。你必须告诉人们：“嘿，我来了”，然后给他们一个关注你的理由。同样道理，当你准备启动一项重大的个人项目时，也应该遵循同样的逻辑。别忘了，你是在创造一个全新的自我。如果不发起一轮宣传攻势的话，你觉得你的同事们会买账吗？     

高效管理知识型员工——以员工的愿望和需求为出发点来领导

当今,要管理有着各自专业造诣的人才,领导者得具备特别的管理能力。不过,这可不是你通常会联想到的那些技能噢!一般而言,知识型员工对于自己的本职工作,懂得的都比你多。那么,你要如何管理这些专业知识比你丰富的员工呢？     

Level of physical activity and anthropometric characteristics in old age—results from a national health survey

Advanced age is associated with degenerative changes in body composition. There is evidence suggesting that changes may vary upon differences in lifestyle, environment, or gender. Physical activity engagement is considered an important component of lifestyle definition. There are suggestions that engaging in physical activity might alleviate degenerative body compositional changes. The objective is to assess the relationship between adherence to recommended guidelines of physical activity and anthropometric parameters in Israeli older adults. Anthropometric measures, including height, weight, and waist circumference, were taken, and BMI was calculated, from a random sample of 1,663 elderly adults (799 men and 864 women), aged 74.31 (±6.05) years old. Participants reported their physical activity habits and, based on official guidelines recommendations, they were divided into sufficiently active, insufficiently active, and inactive groups. One-way ANOVA (level of physical activity) for both genders was conducted for each anthropometric variable. In both genders, an association between level of physical activity and weight, waist circumference, and BMI was found, with lower values among the sufficiently active. In addition, a relationship between level of physical activity and height was indicated among women, implying that the more active women were taller than the less active. In addition to the already known health benefits of physical activity in old age, it is possible that adherence to recommended guidelines of physical activity is associated with favorable anthropometric characteristics.     

The value of symmetric and asymmetric indices of segregation constructed from MCD data

People studying rural communities typically limit their analyses to single communities or to comparatively large units, such as counties. This information is important, but it is in local subcounty areas where rural people live and work. We examine the appropriateness of minor civil divisions (MCD's) as a small ecological unit in nonmetropolitan areas to measure segregation between poor and nonpoor people. The index of dissimilarity (D) and P^*-type contiguity indices are evaluated for the nonmetro portions of Mississippi and Wisconsin. MCD's are different in the two states, which affects the interpretation of the indices. We found that segregation, as measured by D, was low in both states. The low value of D in Mississippi may have resulted from how the state's MCD's were delineated. Although the P^* indices are highly correlated with the poverty rate, they do provide more information than the poverty rate alone.     

领导者 请推行前馈!

一直以来，人们都把及时反馈看作领导者必备的一项基本能力。正如员工需要领导者的反馈一样，领导者也能从下属的反馈中获益。员工可以就生产及管理流程的效率提改进建议，同时也能就领导者的领导工作进行反馈。随着近年来360°全方位领导评价法的出现，这种“向上反馈”的方式将变得越来越流行。     

不妨向上质疑

企业诚信，究竟价值几何？每位企业员工似乎都知道，鼓励组织员工的向上质疑性是保证企业经营诚信的关键所在。但是，“质疑”二字，似乎总是说起来容易，做起来难。