"Quicker and sicker" under Medicare's prospective payment system for hospitals: new evidence on an old issue from a national longitudinal survey

Medicare's prospective payment system for hospitals (PPS), introduced in the USA in 1983, replaced cost reimbursement with a system of fixed rates which created incentives for hospitals to control costs. Previous studies found that elderly patients were discharged from hospital "quicker and sicker" under PPS and concluded that families were coping at home. We analyse a national longitudinal survey, the first National Health and Nutrition Examination Survey and its Epidemiologic Followup Study, which includes data on more outcomes over a longer period than earlier studies. We find that the rate of admission to nursing homes from the community in the first weeks after a hospital discharge more than tripled under PPS, suggesting that families were not always able to cope. As another response to sicker patients, discharges directly to nursing homes from hospitals, which jumped initially under PPS, may have risen further when payment rates were tightened in the early 1990s. Hospital readmissions fell after the first few years. Our findings are strengthened by the fact that we control for patients' health using health information collected independently of hospital admission.     

Predictors of registered nurses' willingness to remain in nursing

A major question about the adequacy of the future supply of nurses is how many will stay in the profession. The relationship between scheduling and propensity to stay or leave the nursing profession was examined in this study. This analysis suggests there are definite characteristics of the work schedules that can influence a nurse's inclination to stay or leave the profession. This is not simply a question of "overwork," but of matching work schedules and hours as closely as possible to employee expectations. This suggests management needs to find a way to pay attention when nurses request changes in hours. The mere fact of changing schedules will not solve the nursing shortage, but it is one action within the management control of any organization employing nurses that could have a positive effect on retention.     

Effects of age, need for cognition, and affective intensity on advertising effectiveness

This paper explores how individual characteristics of age, need for cognition (NFC), and affective intensity (AI) interact with each other and with advertising appeal frames (i.e., rational, positive-emotional, negative-emotional) to influence ad attitudes, involvement, and recall. The mixed design study reveals that younger adults recall emotional messages, especially negative ones, better than rational ones, but recall does not differ for older adults across appeal frames. Older adults prefer rational and positive messages to negative-emotional messages but ad attitudes do not differ among younger adults across appeal frames. Finally, age interacts with AI, but not NFC, to influence ad responsiveness. Both age and AI influence ad attitudes such that older adults exhibit the most positive ad attitudes across all appeal frames.     

The paradox of plows and productivity: an agronomic comparison of cereal grain production under Iroquois hoe culture and European plow culture in the seventeenth and eighteenth centuries

Iroquois maize farmers in the seventeenth and eighteenth centuries produced three to five times more grain per acre than wheat farmers in Europe. The higher productivity of Iroquois agriculture can be attributed to two factors. First, the absence of plows in the western hemisphere allowed Iroquois farmers to maintain high levels of soil organic matter, critical for grain yields. Second, maize has a higher yield potential than wheat because of its C4 photosynthetic pathway and lower protein content. However, tillage alone accounted for a significant portion of the yield advantage of the Iroquois farmers. When the Iroquois were removed from their territories at the end of the eighteenth century, US farmers occupied and plowed these lands. Within fifty years, maize yields in five counties of western New York dropped to less than thirty bushels per acre. They rebounded when US farmers adopted practices that countered the harmful effects of plowing.     

Digital sport entrepreneurial ecosystems

The entrepreneurial ecosystems literature has increasingly explored network relationships between different stakeholders, as well as the role of context. This article addresses the challenge of including a sport context in the entrepreneurial ecosystem literature thereby contributing to the sport entrepreneurship literature by bringing insights from entrepreneurship ecosystem research. In‐depth interviews of football stakeholders in the sport entrepreneurship ecosystem are conducted in terms of understanding the emergence of digital sport start‐ups. The issues raised help explore the changing nature of digital entrepreneurial ecosystems to take into account new sport technological advances. Mixed embeddedness theory is used as the conceptual foundation to understand sport digital entrepreneurial ecosystems. Key management practices are identified in terms of sport start‐ups participating in entrepreneurial ecosystems. The article concludes by making suggestions for future research.     

Meanings of leisure for older people: an Australian study of line dancing

In Australia and in many parts of the world, older people participate in line dancing. Our phenomenological study explored whether attending a regular line dancing class might offer a group of older people opportunities for active and successful ageing. Our research investigated the meanings and practices fostered in a community line dancing class in Melbourne. We gathered data via an interview with the teacher of the group, observation of a class and two focus group interviews with 25 members. Data were analysed using Interpretative Phenomenological Analysis that is reported thematically under headings of: Belief in the efficacy of line dancing, Physical and emotional benefits, YouTube clips as instructional reinforcement and promotion, and Socialising. The findings show that participation in the class offered older student’s opportunities for dance and music engagement, active and successful ageing, health and well-being, social connection and purposeful leisure. The teacher of the class modelled serious and successful leisure and advocates for dance as holistic training for older people. We position our participants on a continuum of leisure engagement that ranges from the casual to the serious. Further research is required to support arguments for the efficacy of dance as a leisure pursuit for older adults.     

Equal access to hospitality services for guests with mobility impairments under the Americans with Disabilities Act: Implications for the hospitality industry

The hospitality operator's obligation to comply with the ADA has provided the necessary impetus to ensure that hospitality services are provided in a non-discriminatory manner. The ADA requires modification of hospitality policies and procedures to ensure that guests with disabilities are provided services in a manner equivalent to those provided to able-bodied guests. This article provides the hospitality operator with a framework for training front-line employees and offers recommendations for analyzing how current policies and procedures could be modified in a way that limits potential liability as well as more effectively meets the needs of guests with mobility impairments.     

Strategic Interaction in a Repeated Game: Evidence from NCAA Football Recruiting

We analyze decisions to comply or cheat on NCAA recruiting regulations in the context of repeated interactions. Teams possess private information about resources devoted to football programs, recruiting effort made by rival programs, and rival program behavior. We test for evidence that the behavior of NCAA Division IA football programs conforms to predictions from repeated game theoretic models using panel data from IA football over the period 1978–2005. We find anecdotal and empirical support for strategic interaction. The presence of in-conference rivals under NCAA sanctions increases the probability of a team being placed under future sanctions.     

Political hazards and entry modes of Chinese investments in Africa

Africa has achieved the fastest growth rate of inward foreign direct investment (FDI) recently. Yet heightened political hazards present substantial challenges to foreign firms in Africa. This study examines the entry strategies that firms may take to mitigate such hazards by exploring the relationship between political hazards and entry mode choices in Africa. We further consider how an investing firm’s host country experience and foreign aid provided by its home country government to host countries in Africa can influence this relationship. In a sample of listed Chinese firms’ investments in Africa from 2000 to 2014, we find that Chinese firms tend to use the joint venture mode when political hazards are high in an African country. This relationship is weakened when they accumulate host country experience and when the Chinese government’s foreign aid to an African country increases. Our findings point to firm-level strategies to mitigate political hazards as well as instruments available to home country governments to help their multinational firms operating in host countries characterized by unstable political environments.     

Are lodging customers ready to go green? An examination of attitudes,demographics, and eco-friendly intentions

This study attempted to answer the following research questions: (1) Do eco-friendly attitudes affect hotel customers’ environmentally friendly intentions to visit a green hotel, to spread word-of-mouth about a green hotel, and to pay more for a green hotel?; (2) If so, which facet of attitudes has the greatest impact?; (3) How do their expressed intentions differ across gender, age, education, and household income?; (4) How do such expressed intentions differ based on the existence of previous experience staying at a green hotel? A total of 422 cases were used to answer the research questions. Findings indicate that customers’ green attitudes are, in general, significantly associated with their expressed intentions to visit a green hotel, to spread word-of-mouth about a green hotel, and to pay more for it. Gender differences in such intentions were found, and the intentions were affected by their previous experiences with a green hotel. However, the eco-friendly intentions did not significantly differ across age, education, and household income.