Subjects’ decision-making process: an empirical analysis on patients’ mobility process and the role of pharmaceutical clinical research

This paper proposes a decision-making process based on trust. Imagining the relationship between patients and physicians, based on the trust that the former put in the latter, which is the effect of experimental activities on the researcher’s (and/or medical center’s) reputation? Is it admissible to suppose a positive correlation between pharmaceutical clinical research and the return in terms of image for the medical care suppliers? This is the research question of this paper. Through empirical analysis, this work supports the proposed decision-making process and tries to answer this open issue. Considering Italy between 2002 and 2006, the analysis concerns the patients’ mobility process among regions and how pharmaceutical research can affect patients’ perception of the quality of medical treatments. Results suggest that mobility is clearly affected by a decision-making process based both on already existing good reputation (i.e., cognitive) and on confirmation of that image (i.e., behavioral). The latter is the phase in which the physician’s effort in the informed consent session of an experimental activity might make the difference in the reputation of the health care suppliers and, therefore, be a key factor in hospitalization choice.     

A methodology for cluster analysis of citation histories

Citations to all the papers (558) published from 1955 to 1964 by a multidisciplinary (natural sciences) research institute within a ‘scientific periphery’ were collected for the 11-year period after a 10-year lapse since the publication years. All the papers were grouped into 31 research topics, three of which had no such late citations at all. For the remaining 28 groups of papers three indicators were defined: ALPHA, the ratio of the number of papers with citations, to the number of all papers of the particular research topic, indicating thus an overall CITATION EFFICACY; BETA, the ratio of the sum of all citations, to the number of the cited papers, indicating CITATION INTENSITY, and GAMMA, expressing the CITATION LONGEVITY for a given research topic as the incidence (number) of cited papers (irrespective of the number of citations) within the 11-year citing period. In addition, three normalized transformations of the indicator BETA were checked. Two-dimensional (without ALPHA) and three dimensional (with ALPHA, GAMMA, and one of the BETA variants) graphical representations together with a pairwise correlation analysis served as preliminary guidance in the latter statistical analyses by (a) Ward's Hierarchical Cluster Analysis and (b) Polar Taxons Analysis. Both of them resulted in good agreement. Thus, the 28 research topics were found to belong to three clusters. Their composition varied slightly for the original BETA and its three normalized values. It was concluded that ALPHA is not a redundant but quite useful indicator, and that one of the normalized BETA-variants appears most suitable for this kind of studies. In the three-dimensional graphs the clusters may be related to scientific merit as judged in a composite way by all the three indicators. This is done with regard to the diagonal joining the indicators' maximal with their minimal values. The citation LONGEVITY (GAMMA) appears to be most important. Cluster stability tests showed fluctuations of few research topics, which was related to their specific features within the given research setting. It emerges on the whole that the research merit of this (peripheral) scientific production is determined neither by the journals status the papers were published in, nor by the authors' institutional status. Rather, it is the very scientific quality of individual papers within a given research topic that is decisive for the citation ‘survival’.     

Coaching models for leadership development: An integrative review

The purpose of this article was to describe and compare coaching models and to address their relevance to the advancement of leadership. Coaching has become a popular strategy for leadership development and change in complex environments. Despite increasing popularity, little evidence describes the necessity and impact of coaching. An integrative literature review from 1996 to 2010, retrieved through seven databases, reference tracking, and consultation with academic networks, led to inclusion of peer‐reviewed articles on coaching models. Themes and critical elements in the selected coaching models were analyzed. The search yielded 1,414 titles. Four hundred twenty‐seven abstracts were screened using inclusion/exclusion criteria, and 56 papers were retrieved for full‐text screening. Ten papers were included: two coaching models from health care settings, seven from business settings, and one from a medical education institution. Critical components of coaching models are: coach–coachee relationship, problem identification and goal setting, problem solving, transformational process, and mechanisms by which the model achieves outcomes. Factors that impact positive coaching outcomes are: coach's role and attributes, selection of coaching candidates and coach attributes, obstacles and facilitators to the coaching process, benefits and drawbacks of external versus internal coaches, and organizational support. The elements of coaching models identified in this review may be used to guide future research on the effectiveness of coaching as a leadership strategy.