An innovation to improve health outcomes in Amajuba district,KwaZulu-Natal,South Africa

Systems’ thinking places high value on understanding the context. This study focused on the collection of disaggregated data in order to understand the context, to facilitate improvement of health outcomes. The aim of this article was to assess the implementation of municipal ward-based health data collection (disaggregated data) and health care workers’ perceptions of this data collection process. This cross-sectional study used mixed methods in Amajuba district. The participants were professional nurses at the Primary Health Care level. Of the 131 respondents, 123 (93.9%) collected municipal ward-based health data, and found it useful. Opportunities for improving data collection were identified. Disaggregation of the data at ward level contributes to a better understanding of the target population’s health, assists planning for health needs and enables provision of targeted interventions in order to improve health outcomes, to prevent financial regression and waste of health resources.     

Leadership competencies: An exploratory study of what is important now and what has changed since the terrorist attacks of 9/11

This exploratory study attempts to identify the leadership competencies that managers believe are needed to be successful across different managerial levels and organization types (manufacturing, finance, insurance, and banking, health, transportation, communications, and utilities, wholesale and retail trade, private nonprofit, and public) and presents an analysis of whether changes in the importance of certain leadership competencies over time coincided with the 9/11 terrorist attacks in the United States. Our findings suggest that the leadership competencies leading employees and resourcefulness were the most important across all managerial levels and organization types studied. Moreover, leadership competencies important (or not important) for one managerial level or organization type seem to be important (or not important) for others. Furthermore, leadership competencies important before 9/11 remained important immediately after 9/11, 2 years after 9/11, and are still important today. These findings may have implications for leadership training and development, selection, and succession planning.     

Issues in measuring success in community-based Indigenous tourism: elites,kin groups,social capital,gender dynamics and income flows

Tourism development is a key feature of the neoliberal economic development model. Through a mix of state and private investment, Indigenous communities in Mexico are encouraged to transform local cultural and environmental resources into tourist consumption sites. The process results in a shift toward reliance on tourism, in place of farming, leaving households with few alternative earning strategies amidst fluctuating tourist arrivals and income, confounding the relationship between tourism and sustainability and questioning the utility of tourism as a sustainable tool for development. This article analyses a community-based Indigenous tourism project in a rural Maya village in Mexico's Yucatan, and discusses strategies employed at household level to navigate the arrival of tourism. Funding agencies assessed this project based on a triple bottom line metric that accounts for ecological health, financial sustainability, and its relationship to local social capital; however, these fail to account for differences between local and non-local conceptions of authenticity, indigeneity, and success. From a social perspective, the project has exacerbated existing tensions and has arguably widened the gap between the politically and economically powerful and less powerful, marginalized families in the community. Questions about policy, governance systems, and elite domination and kin group control are raised.     

Permanent and Temporary Components of Stock Prices: Evidence from Assessing Macroeconomic Shocks

This paper outlines a simple macro model with overlapping wage contracts to investigate how the temporary and permanent components of stock price movements may be related to aggregate macro-economic supply and demand disturbances. In the content of the model, we show that aggregate demand shocks have only temporary effects on real stock prices, while supply shocks may affect the level of real stock prices permanently. Moreover, the temporary component in U.S. stock prices, identified by placing appropriate structural restrictions on a vector autoregressive system estimated for the postwar period, is statistically significant. This evidence supports the mean-reversion hypothesis that stock prices are not pure random walks. The finding is robust to the choice of variables used in the vector autoregressive system and periodicity.     

Search Quality and Revenue Cannibalization by Competing Search Engines

Consumers are attracted by high‐quality search results. Search engines, though, essentially compete against themselves because consumers are induced to substitute away from advertisement links when their organic counterparts are of high quality. I characterize the effect of such revenue cannibalization upon equilibrium quality when search engines compete for clicks. Cannibalization provides an incentive for quality degradation, engendering low‐quality equilibria—even when provision is costless. When consumers exhibit loyalty there is a ceiling above which result quality cannot rise, regardless of what the maximum feasible quality happens to be. Seemingly procompetitive developments may exert downward pressure on equilibrium quality.     

Proximity, knowledge integration and innovation: an agenda for agent-based studies

In this paper, we develop a theoretical model able to capture some of the main features that govern knowledge sharing and innovation. We pursue our target developing an agent-based model in which the social network of interactions is specified as a knowledge resource, and knowledge integration is seen as the process by which the resource can be applied to innovation. The results of the simulation exercises show that the initial architecture of acquaintance networks is a crucial factor for innovation. Innovating has proven to be more than simply equating endowments of initial skills with firm performance. In fact, the performance of the system showed high sensitivity to the arrangement of the firm’s initial location in the social network. Moreover, the way in which acquaintance networks were mobilized emerged as a key determinant of innovation patterns. The model presented here is a relatively theoretical, stylized model and we employ it to draw some general, albeit preliminary conclusions, while illustrating some of the theory relevant to the issues discussed. It is argued that the model might serve the purpose of setting an agenda for further research along this line of investigation—that is, knowledge integration patterns and firms partnerships formation.     

THE HARROD–BALASSA–SAMUELSON HYPOTHESIS: REAL EXCHANGE RATES AND THEIR LONG‐RUN EQUILIBRIUM*

Frictions and perturbations may influence currency values in the short run, but it is generally acknowledged that real‐exchange rates eventually settle toward equilibrium. The puzzle then is how gradually this parity is reached given the fluidity in foreign exchange markets. Persistent differences in the relative productivity of countries—a broad characterization of the Harrod–Balassa–Samuelson hypothesis—may help explain this puzzle. This article introduces methods to estimate equilibrium adjustment paths semiparametrically, and then sort how each of these components influences the dynamics of exchange rates. This is done in a dynamic panel setting by introducing novel local projections methods for cointegrated systems. Productivity shocks affect dynamics, and after adjusting for these factors, adjustment toward equilibrium is relatively rapid.     

Primary vs secondary prophylaxis with pegfilgrastim for the reduction of febrile neutropenia risk in patients receiving chemotherapy for non-Hodgkin’s lymphoma: cost-effectiveness analyses

Objective:

Evaluate the cost-effectiveness of primary vs secondary prophylaxis (PP vs SP) with pegfilgrastim to reduce the risk of febrile neutropenia (FN) in Non-Hodgkin’s Lymphoma (NHL) patients receiving myelosuppressive chemotherapy from a US payer perspective.

Methods:

A Markov model was used to compare PP vs SP with pegfilgrastim in a cohort of patients receiving six cycles of cyclophosphamide, vincristine, doxorubicin, and prednisone (CHOP) or CHOP plus rituximab (CHOP-R) chemotherapy. Model inputs, including efficacy of pegfilgrastim in reducing risk of FN and costs, were estimated from publicly available sources and peer-reviewed publications. Incremental cost-effectiveness was evaluated in terms of net cost per life-year saved (LYS), per quality-adjusted life-year (QALY) gained, and per FN event avoided over a lifetime horizon. Deterministic and probabilistic analyses were performed to assess sensitivity and robustness of results.

Results:

Lifetime costs for PP were $5000 greater than for SP; however, PP was associated with fewer FN events and more LYs and QALYs gained vs SP. Incremental cost-effectiveness ratios (ICERs) for PP vs SP for CHOP were $13,400 per FN event avoided, $29,500 per QALY gained, and $25,800 per LYS. CHOP-R results were similar ($15,000 per FN event avoided, $33,000 per QALY gained, and $28,900 per LYS). Results were most sensitive to baseline FN risk, cost per FN episode, and odds ratio for reduced relative dose intensity due to prior FN event. PP was cost-effective vs SP in 85% of simulations at a $50,000 per QALY threshold.

Limitations:

In the absence of NHL-specific data, estimates for pegfilgrastim efficacy and relative risk reduction of FN were based on available data for neoadjuvant TAC in patients with breast cancer. Baseline risks of FN for CHOP and CHOP-R were assumed to be equivalent.

Conclusions:

PP with pegfilgrastim is cost-effective compared to SP with pegfilgrastim in NHL patients receiving CHOP or CHOP-R.     

The employability of new graduates: a study of differences between UK universities

The non-stationarity tests of Phillips-Perron (1988) (PP tests) suggest that Australian macroeconomic output possesses a stochastic rather than a deterministic log-linear trend. Kwiatkowski et al. (1991) argue that such tests have low power and propose the KPSS test, in which the null is stationary. However, the KPSS test results reinforce the PP findings for Australia. Cochrane (1988) variance ratio (VR) tests further suggest that there may be a very strong random-walk component in the Australian business cycle. Rappoport and Reichlin (1989), however, argue that all such tests are biased in favour of the stochastic trend alternative if there are trend breaks in the data. Following up on this point, the paper finds that, in Australia's case, the stochastic trend alternative is statistically dominated when the data are allowed to be characterized by a probabilistic, regime-switching, segmented trend specification. Therefore, to the extent that real business-cycle theories of the business cycle gain support from stochastic trends in real output, this latter piece of Australian evidence does not strengthen their case.