A Process for Incorporating Comparative Risk into Environmental Policymaking in Louisiana

The goal of Louisiana's 1990–1991 comparative risk project, also called the Louisiana Environmental Action Plan (LEAP), was to incorporate risk assessment into state environmental planning and policymaking. Scientists, government officials, and citizens were brought together to estimate the relative risk to human health, natural resources, and quality of life posed by 33 selected environmental issues. The issues were then ranked according to their relative estimated risks. It was hoped that this ranking of "comparative risks" would enable state policymakers to target the most important environmental problems and allocate scarce public resources more rationally and efficiently. As a result of the project, the governor issued an Executive Order forming a permanent Public Advisory Committee to continue this type of comparative risk assessment in Louisiana.     

Immigrants' Language Skills and Visa Category1

This article is concerned with the determinants of English language proficiency among immigrants in a longitudinal survey for Australia. It focuses on both visa category and variables derived from an economic model of the determinants of destination‐language proficiency among immigrants. Skills‐tested and economic immigrants have the greatest proficiency shortly after immigration, followed by family‐based visa recipients, with refugees having the lowest proficiency. Other variables the same, these differences disappear by 3.5 years after immigration for speaking skills; and although they diminish, they persist longer for reading and writing skills. The variables generated from the model of destination‐language proficiency (such as schooling and age at migration) are, in part, predictions of visa category, but they are more important statistically for explaining proficiency.     

Joint impact of multiple observations on a subset of variables in multiple linear regression

In multiple linear regression analysis, each observation affects the fitted regression equation differently and has varying influences on the regression coefficients of the different variables. Chatterjee & Hadi (1988) have proposed some measures such as DSSE_ij (Impact on Residual Sum of Squares of simultaneously omitting the ith observation and the jth variable), F_j (Partial F-test for the jth variable) and F_j(i) (Partial F-test for the jth variable omitting the ith observation) to show the joint impact and the interrelationship that exists among a variable and an observation. In this paper we have proposed more extended form of those measures DSSE_IJ, F_J and F_J(I) to deal with the interrelationships that exist among the multiple observations and a subset of variables by monitoring the effects of the simultaneous omission of multiple variables and multiple observations.     

How can David orchestrate resources to enhance firm performance? A dynamic approach to coping with resource constraints

Given that the possession of abundant resources does not always guarantee superior firm performance, this study proposes a dynamic approach to enhancing firm value. Building on the resource orchestration thesis, we investigate how firms facing resource constraints enhance their capabilities over time by orchestrating resources and how this resource orchestration can play a role in improving firm performance. Using the dynamic perspective, this study identifies four resource orchestration modes, which are specified based on how a given firm dynamically allocates its resources to technology (enacted by R&D activities) and marketing (enacted by advertising activities). Accordingly, we claim that firms with resource constraints can enhance their performance by escalating or altering their resources over time. To test our hypotheses, we used a sample of 4078 small and medium-sized enterprises in manufacturing industries between 1984 and 2018. We found that focus escalation for technology positively affects firm performance, captured by Tobin's q, and that focus alternation toward either technology or market is positively related to firm performance. Finally, we discuss the theoretical and practical implications of our findings.     

From quality assurance to continuous quality improvement

To change from punitive and legalistic QA to positive and productive CQI, both attitudes and methods must change. This is a difficult challenge, but potential rewards for both the organization and its individual members suggest that the effort is worthwhile and deserves high priority. Members of the executive/management team will likely turn to physician executives for guidance on how to proceed.     

Mirror, mirror on the wall: reflections from failure to establish a truly uniform national health care policy

When the author gazed into the proverbial mirror and asked if the U.S. health care system was the fairest of them all, it shattered. In this article, Thompson tells why the system is broken and what failure to fix it means to physician executives. He suggests that we, as Americans, must reinvent ourselves by realigning our value systems and and stifling our obsession with profit before trying to reinvent health care.     

Finite mixture models with concomitant information: assessing diagnostic criteria for diabetes

The World Health Organization (WHO) diagnostic criteria for diabetes mellitus were determined in part by evidence that in some populations the plasma glucose level 2 h after an oral glucose load is a mixture of two distinct distributions. We present a finite mixture model that allows the two component densities to be generalized linear models and the mixture probability to be a logistic regression model. The model allows us to estimate the prevalence of diabetes and sensitivity and specificity of the diagnostic criteria as a function of covariates and to estimate them in the absence of an external standard. Sensitivity is the probability that a test indicates disease conditionally on disease being present. Specificity is the probability that a test indicates no disease conditionally on no disease being present. We obtained maximum likelihood estimates via the EM algorithm and derived the standard errors from the information matrix and by the bootstrap. In the application to data from the diabetes in Egypt project a two-component mixture model fits well and the two components are interpreted as normal and diabetes. The means and variances are similar to results found in other populations. The minimum misclassification cutpoints decrease with age, are lower in urban areas and are higher in rural areas than the 200 mg dl^-1 cutpoint recommended by the WHO. These differences are modest and our results generally support the WHO criterion. Our methods allow the direct inclusion of concomitant data whereas past analyses were based on partitioning the data.