Death is not an option, how you die is--reflections from a career in oncology nursing

With a combined career of over 60 years in oncology nursing, the authors reflect on the critical elements in the question, "How can we afford to die?" Three high-profile patient scenarios in three different decades promised to improve use of advance directives but did not. Recent societal events, including the debates about health care reform, have brought attention again to end-of-life issues and care. Quickly approaching a "perfect storm" of an aging population, an inefficient and costly illness-oriented health care system, and health care profession shortages, the United States will not be able to afford delivering futile interventions. Nurses, who are consistently seen as the most trusted professionals, must take action in strategies the authors present.     

Financial knowledge among Iranian investors

This research is the first to describe financial knowledge in the Islamic Republic of Iran. Data were collected from a convenience sample of investors in the Tehran Stock Exchange. The data were used to examine objective and subjective knowledge as well as overconfidence in one's financial knowledge. The results indicated that compared with other populations, Iranians did not perform well on either basic or advanced financial knowledge questions, especially when the questions dealt with interest rates. This is likely related to the Islamic law ban on usury‐based investing. Regression analysis indicated that demographic charactristics related to basic financial knowledge were income, labour force status and being a student. Demographic characteristics related to advanced financial knowledge were education, labour force status and age. Higher income and education reduced the odds of being overconfident about one's financial knowledge, while being a student and male increased the odds. The article concludes with recommendations about future research as well as building a national financial education strategy.     

Book Review

This research examines two modes of assessment of environmental health risks and the transformation of these risks into public health issues while relying on the specific case of well‐water toxicity and mega dose of electromagnetic radiation found in one prosperous town in the center of Israel – Ramat ha‐Sharon. Based on official and scientific documentation and interviews conducted at three time periods with randomly selected town residents from contaminated neighborhoods (N = 169), this study shows the discrepancy between the ‘objective’ experts’ standards for assessing environmental health risks and the public’s subjective perception and evaluation of the impact of these risks on their health and well‐being. Even though, by experts’ standards, the well‐water toxicity remained constant over the three interview sessions, Ramat ha‐Sharon town residents’ subjective levels of concern and perception of risk fluctuated as a function of news media and municipality announcements and residents’ perceived ability to minimize the risk. This study also shows the complex and multidisciplinary nature of environmental health risk assessments and the need to relocate them into the broader socioeconomic and political context in which they are embedded.     

Total quality management and human resource systems: an international comparison

This paper takes advantage of a unique international data set to examine the determinants of the adoption and sustainability of total quality management techniques, focusing in particular on the role played by human resource professionals and practices. The data come from a 1991 survey conducted by Ernst and Young and the American Quality Foundation covering the use of TQM tools in the computer, auto, health care and banking industries in Japan, the United States, Canada and Germany.

The research distinguishes between two ways of implementing total quality management – one approach conceptualizes TQM as a relatively limited set of technical engineering changes while the second implements these technical changes as part of a larger transformation of the organization of work. We find support for the second approach in that the number of employees using quality tools and the number of quality tools in use is greater and lasts longer in firms that also have team-based human resource systems for frontline employees, with team structures, suggestion systems, meetings and group rewards. This central finding holds across all countries and industries studied.

We also find that achievement of these changes requires the commitment of organizational stakeholders to incorporate the interests of employees in strategic decision making. Though union presence alone does not predict the adoption or sustainability of these innovations, partnership between management and union does have a positive effect. The level of strategic influence of the human resource department also influences innovation, though in ways that differ across countries and industries.

The findings suggest the value of comparative studies and of research focused at exploring sub-national variation. The findings also suggest the value of a longitudinal study of the sustainability of innovation.     

Explaining regional variation in business births and deaths: U.S. 1976–88

Linear models are developed to determine the relative impact of 15 start-up processes on the annual regional birth rate of new business organizations for all industry sectors in the U.S. over 6 two-year periods. These stable linear models explained from 50–70|X% of the variation in regional firm birth and death rates up to 16 years into the future. Start-up processes that have the most impact involve regional economic diversity; population growth; greater personal wealth; presence of mid-career adults; low unemployment; and greater flexibility in employment relationships. There was a complete absence of any impact of regional variation associated with higher densities of customers, suppliers, workers, R&;D resources; costs of production; or access to national transportation facilities.     

Performance of methods to conduct mediation analysis with time-to-event outcomes

Previous studies have discouraged the use of the Cox proportional hazards (PH) model for traditional mediation analysis as it might provide biased results. Accelerated failure time (AFT) models have been proposed as an alternative for Cox PH models. In addition, the use of the potential outcomes framework has been proposed for mediation models with time-to-event outcomes. The aim of this paper is to investigate the performance of traditional mediation analysis and potential outcomes mediation analysis based on both the Cox PH and the AFT model. This is done by means of a Monte Carlo simulation study and the illustration of the methods using an empirical data set. Both the product-of-coefficients method of the traditional mediation analysis and the potential outcomes framework yield unbiased estimates with respect to their own underlying indirect effect value for simple mediation models with a time-to-event outcome and estimated based on Cox PH or AFT.     

Product—Market Choices and Growth of New Businesses

The relationship between product–market strategies and the growth of new firms is incompletely understood. The lack of understanding reflects the absence of a conceptual framework that would explain why certain product–market strategies achieve specified goals more effectively than do others. Prior research links product and market strategy to business growth, but does not clearly separate product line choices from market choices, and provides little guidance with respect to the sequence in which product and market changes should be made. Richard Cardozo, Karen McLaughlin, Brian Harmon, Paul Reynolds, and Brenda Miller propose a "wave" model of product–market choice, which yields hypotheses they evaluate with data from a subsample of 120 firms drawn from a representative sample of new businesses. Results yield preliminary guidelines for product–market strategy for managers of fledgling businesses.     

Goodwill impairments and chief executive officer tenure

The purpose of this paper is to examine the tenure of the chief executive officers of publicly held companies and their corresponding goodwill impairment decisions. An opportunity for managers to manage earnings exists via the Financial Accounting Standards Board's (FASB) goodwill accounting rules. It is hypothesized that CEOs will recognize this impairment in the early years of their tenure because blame can be placed on prior management's acquisition decisions, expensing goodwill early will make future earnings look better, or an objective evaluation of the reporting unit increases impairments.