Matrix management in hospitals: testing theories of matrix structure and development.

A study of 315 hospitals with matrix management programs was used to test several hypotheses concerning matrix management advanced by earlier theorists. The study verifies that matrix management involves several distinctive elements that can be scaled to form increasingly complex types of lateral coordinative devices. The scalability of these elements is evident only cross-sectionally. The results show that matrix complexity is not an outcome of program age, nor does matrix complexity at the time of implementation appear to influence program survival. Matrix complexity, finally, is not determined by the organization's task diversity and uncertainty. The results suggest several modifications in prevailing theories of matrix organization.     

The Theory of Socially Embedded Games: The Mathematics of Social Relationships,Rule Complexes,and Action Modalities

In their classic work, Von Neumann and Morgensterndefined a game as simply the totality of the rules which describe it. Theydid not, however, elaborate a theory of rules. Such considerations lead toconceptualizing rules and rule configurations as mathematical objects, specifyingthe principles for combining rules, developing the theory of revising,replacing, and, in general transforming rules and rule complexes. Themathematics is based on contemporary developments at the interface ofmathematics, logic, and computer science. This article, drawing on themathematical theory of rules and rule complexes, extends and generalizes gametheory (GGT). The theory of rule complexes is used to conceptualize andanalyze diverse social relationships, roles, and games as particulartypes of rule complexes. A social role, for instance, is the major basisof an individual's action in a game. It consists of at least four majorcomponents – which are mathematical objects – in the determinationof action: value complex, model of reality (including beliefs and knowledgebases), a repertoire of acts, routines, programs, and strategies, and modalities,role-specific algorithms for determininig or generating action in gamesettings. The article focuses on three types of action modality routineor habitual, normative, andinstrumental modalities. The theory: (1) provides a cultural/institutionalbasis for a theory of gameswhere games, social relationships, and rolesare formalized in terms of rule complexes; (2) explains human action as a formof rule application or rule-following action, which underlies allmodalities of action; (3) formulates the theory that actors construct an action or make choices amongalternative actions by making comparisons and judging similarity (ordissimilarity) between an option or options considered and their norms and values,and, in general, determine whether or not, and to what degree, a value,norm, or goal will be realized or satisfied; (4)reconceptualizes ``game' as a social form and makes a distinction between open and closed games.     

Federal transfers, environmental policy and economic growth

We study the effects of commonly used cross-country transfer programs on uncoordinated national environmental policies, economic growth and natural resources in a federal economy. Natural resources are a federation-wide public good. In each member country, production degrades the environment, but clean-up policy can improve it. Clean-up policy is financed by taxes on polluting firms’ output and cross-country redistributive transfers. We solve for a symmetric Nash equilibrium among national governments. Transfer policies that lead to higher pollution taxes make existence harder, and are harmful not only to growth but also to the environment. The best way to improve environmental quality is to implement a taxation system that stimulates growth and broadens tax bases to finance national clean-up policies.     

ANTI-CORRUPTION STRATEGIES IN INDONESIA

During 19992000 Indonesia pursued many anti-corruption reforms but appeared to achieve little success in reducing the level of corruption, which remained a high profile problem in all branches of government. This article summarises the reform initiatives carried out since 1998 and offers an explanation for their very limited success. Obstacles to reducing corruption in Indonesia include the economic and political constraints facing the current government and the entrenched nature of corruption. The content of the reform program itself may also contribute to the persistence of the problem. The program consists primarily of moves to introduce monitoring and sanctioning mechanisms that are external to particular government organisations. Internal reforms that aim to improve organisational self-discipline have received much less attention. The reform program may thus be inherently incomplete.     

Two ge neral classes of search designs for factor screening experiments with factors at three levels

In this paper, we are presenting general classes of factor screening designs for identifying a few important factors from a list of m (≥ 3) factors each at three levels. A design is a subset of 3^m possible runs. The problem of finding designs with small number of runs is considered here. A main effect plan requires at least (2m + 1) runs for estimating the general mean, linear and quadratic effects of m factors. An orthogonal main effect plan requires, in addition, the number of runs as a multiple of 9. For example, when m=5, a main effect plan requires at least 11 runs and an orthogonal main effect plan requires 18 runs. Two general factor screening designs presented here are nonorthogonal designs with (2m− 1) runs. These designs, called search designs permit us to search for and identify at most two important factors out of m factors under the search linear model introduced in Srivastava (1975). For example, when m=5, the two new plans given in this paper have 9 runs, which is a significant improvement over an orthogonal main effect plan with 18 runs in terms of the number of runs and an improvement over a main effect plan with at least 11 runs. We compare these designs, for 4≤m≤ 10, using arithmetic and geometric means of the determinants, traces, and maximum characteristic roots of certain matrices. Two designs D1 and D2 are identical for m=3 and this design is an optimal design in the class of all search designs under the six criteria discussed above. Designs D1 and D2 are also identical for m=4 under some row and column permutations. Consequently, D1 and D2 are equally good for searching and identifying one important factor out of m factors when m=4. The design D1 is marginally better than the design D2 for searching and identifying one important factor out of m factors when m=5, … , 10. The design D1 is marginally better than the D2 for searching and identifying two important factors out of m factors when m=5, 7, 9. The design D2 is somewhat better than the design D1 for m=6, 8. For m=10, D1 is marginally better than D2 w.r.t. the geometric mean and D2 is marginally better than D1 w.r.t. the arithmetic mean of the maximum characteristic roots.     

Inequality in healthcare R&D outcomes: a model of process disruption

ABSTRACT

The developing world has substantively different healthcare research and development (R&D) needs than the developed world. In this paper it is argued that healthcare inequality is primarily an outcome of the incentives of an innovation system that privileges wealthy markets. Given the difficulties inherent in challenging these incentive structures, it might be the R&D process itself (rather than its incentive structures) that, if disrupted, may ultimately improve access to R&D outcomes for poor populations. The objective of this paper is to spur novel thinking about the problem of healthcare inequality by developing a provocative conceptual model of healthcare R&D process disruption, based on the application of novel technologies to the research process itself, to radically lower the costs of R&D. The model developed here suggests that healthcare inequality might ultimately be mitigated by substantial reductions in time and cost in the biomedical R&D process made possible by novel technologies.     

Examining the Antecedents of Destination Loyalty in a Forest Setting

Loyalty has become a critical part of leisure research due to increasing competition in the field and the recognition of the importance of loyal visitors. To further develop loyalty research, this study looks at the issue of destination loyalty in a forest setting. It specifically focuses on revealing the formation of attitudinal, conative, and behavioral loyalty and the relationship between destination loyalty and related concepts that influence the strength of loyalty: service quality, satisfaction, and activity involvement. Six hypotheses were tested to represent the relationships among six factors. Forest recreationists who perceive high service quality tend to have high satisfaction and activity involvement that lead to destination loyalty. The findings also substantiated the conceptual framework of loyalty formation.