Finding a Working Balance Between Competitive and Communal Strategies*

abstract This paper presents a dynamic framework that describes how firms allocate limited resources between improving their competitive position relative to rivals and their communal position shared with rivals. This dynamic framework outlines how organizational field‐level dynamics influence industry attractiveness and thereby alter a firm's incentive to engage in communal strategy relative to competitive strategy. Communal strategy, in turn, can influence the institutions governing an organizational field and thereby shape industry attractiveness. Overall, the interplay between factors exogenous and endogenous to an industry cause change in an organizational field and so determine the nature of the communal environment shared by a firm and its rivals over time. Analysis of this interplay provides insight into the micro‐level drivers of macro‐level change and furthers understanding of the conditions under which rivalrous firms voluntarily contribute to collective betterment of their industry despite collective rationality.     

Toward a bias corrected currency equivalent index

The currency equivalent index measures the discounted economic capital stock of money producing the monetary service flow, but does so under assumptions that cause downward bias. We propose an extension that will correct for a significant amount of this bias.     

Adverse event-related costs for systemic metastatic breast cancer treatment among female Medicaid beneficiaries

Objective: This retrospective study compared the real-world incidence and costs of systemic treatment-related adverse events (AEs) in patients with metastatic breast cancer in a Medicaid population.

Methods: Insurance claims data for adult women who received biologic or chemotherapy (± hormonal therapy) for metastatic breast cancer between 2006–2013 were extracted from the Truven Health MarketScan^® Multi-State Medicaid database. Incidence of AEs (per 100 person years) and average monthly AE-related healthcare costs (per-patient-per-month) during each line of therapy (first or later lines) were estimated. The association between AEs and total all-cause healthcare costs was estimated using multivariable regression.

Results: A total of 729 metastatic breast cancer patients were analyzed. Hematological (202.3 per 100 person years) and constitutional AEs (289.6 per 100 person years) were the most common class of AEs reported. Unadjusted per-patient-per-month AE-related expenditure by class were highest for hematological AEs ($1524), followed by gastrointestinal ($839) and constitutional AEs ($795), with anemia ($942), nausea/vomiting ($699), and leukopenia/neutropenia ($550) having incurred the highest total AE-related costs. Adjusted total all-cause monthly costs increased with the number of AEs ($19,701 for >7 AEs, $16,264 for 4???6 AEs, and $13,731 for 1???3 AEs) compared to no AEs ($5908) (all p?Conclusions: Among metastatic breast cancer patients treated with systemic therapy in a Medicaid population, AEs were associated with significant increases in costs, which increased with the number of AEs experienced. Therapies associated with a lower incidence of AEs may reduce cost burden and improve patient outcomes.     

Precautionary advice about mobile phones: public understandings and intended responses

There is a widespread academic and policy debate about public responses to precaution in public health campaigns. This paper explores these issues in relation to the precautionary stance adopted in the UK around the regulation of mobile telecommunications. The aim of the paper is to examine the nature of attitudes to precaution, and the way in which these, along with other relevant variables, relate to the intention to adopt relevant behaviours. The results from an experimental study (n = 173) indicate that people distinguish between two dimensions of precaution: firstly in relation to its value or necessity per se and secondly as anchored to notions of governance. The two variables differentially relate to other variables including trust and uncertainty, and are predictive of intended behaviour change indirectly, through worry about mobile phone risks. Precautionary advice was generally interpreted as causing concern rather than providing reassurance. The results suggest that precaution may be considered a valuable stance but this does not mean that it is seen as good governance or that it will reduce concern. Whilst the discourse of precaution is aimed at reducing concern, it appears that the uptake of relevant behaviours is largely triggered by worry.