Ubuntu: A transformative leadership philosophy

Leadership is about knowledge, skills, and abilities for transformation. It is also increasingly about worldviews or visions of life—beliefs, values, and principles. But worldviews are also ways of life, for beliefs direct us, values guide us, and principles motivate us to certain kinds of action and behavior. How, then, do worldviews have an impact on leadership for transformation? If worldviews are glasses or filters by which we view the world, mental models of the bigger picture, frameworks by which we make sense of the world, and narratives by which we orient our lives, then how do they influence human thoughts, ideas, and behaviors when it comes to transformative leadership? This was the subject matter of an International Leadership Association Conference panel discussion held in November 2009 in Prague, entitled Leadership for Transformation: The Impact of Worldviews. It is also the subject matter of this issue's symposium, in which we bring you the four papers and the response presented at the conference. Members of the panel were characterized by gender, disciplinary, religious, and global diversity. Nathan Harter, organizational leadership professor at Purdue University in the United States, begins the discussion with some preliminary remarks about worldviews. Ali Mohammed Mir, medical doctor and director of programs of Population Council, Pakistan, speaks of leadership from an Islamic perspective. Michael Jones, accomplished composer, pianist, and leadership educator, writer, and speaker from Orillia, Canada, reflects on how a “marriage of mythos and logos” can transform leadership today. Lisa Ncube, originally from Zimbabwe and currently assistant professor of organizational leadership at Purdue University, speaks about Ubuntu as an alternative leadership philosophy emerging from Africa. John Valk, associate professor of worldview studies at Renaissance College, University of New Brunswick, Canada, speaks of leadership for transformation from a Christian worldview perspective. Jonathan Reams, associate professor in the Department of Education at the Norwegian University of Science and Technology in Trondheim, responds to all of the papers and opens a venue for further discussion. We hope that you will find this symposium engaging. We hope it will give food for thought and that it might stimulate further thinking regarding the role worldviews play in leadership for transformation.     

Punishment in a Regulatory Setting: Experimental Evidence from the VCM

To analyze the effectiveness of punishment in inducing regulatory compliance, we modify a standard public goods experiment to include a financial penalty for free riding. The design allows us to vary both punishment probability and severity. We introduce the punishment mechanism in both a one-time and a repeated treatment and find that compliance (contributing to the public good) is increasing in expected punishment cost in both treatments. We also find that punishment severity has a larger effect on behavior than punishment probability. In the repeated treatment, we find that past punishment has a negative rather than positive effect on compliance.     

Making wellness the focus: one employer's story

The rising cost of health care threatens the very fabric of American society. With Americans widely practicing unhealthy life habits, such as using tobacco, eating imprudently and leading a sedentary lifestyle, they are at risk for health conditions that threaten to make them long-term liabilities to their employer. This article tells how one U.S. employer chooses to focus its workforce on wellness.     

Diffusion of environmental business practices: A network approach

The purpose of this research is to build a conceptual foundation that examines network effects on the diffusion of environmental business practices (EBP) among suppliers. This research extends a network perspective to adoption of an environmental business practice across a large network of suppliers. The context of EBP is used to better understand adoption of a complex business practice, with perceived costs that are often greater than the perceived benefit. Variation in the level of structural and relationship embeddedness affect network diffusion of environmental business practices differently. Increased levels of structural and relational embeddedness are proposed to be positively associated with diffusion of EBP. From a practical standpoint, firms that leverage embeddedness may facilitate higher diffusion and adoption of environmental business practices. This facilitation may lead network actors to engage in EBP, and leverage benefits that may stem from these practices. This research introduces the concept of embeddedness to the environmental supply chain literature. Practicing managers can use the findings in this research to better position themselves within a network to diffuse EBP. This research also helps managers understand how supply chain members that are weakly connected to the primary network are important for introducing new ideas and innovations.     

Harmonization relating to auditor independence: the Eighth Directive,the UK and Germany

The European Union Eighth Directive on the approval of auditors covers auditor independence only to a very limited extent. The provisions in the five articles on this subject are far less detailed than they were in the drafts of the directive, so that almost all specific regulation is left to the Member States. An examination of the development of the articles dealing with independence and integrity shows how the need to compromise, in order to reach an agreement, frustrated the intentions of the harmonizers. This paper traces the development of the independence rules in the Eighth Directive from the avant projet through the drafts to the final directive. It assesses the extent to which pre-Eighth Directive regulation in the UK and Germany may have affected the directive and then examines the implementation of the directive in the two countries. It concludes that national culture and accounting traditions prevented harmonization of independence rules through the Eighth Directive.     

Visibility in the workplace: still an essential ingredient for career success?

This article explores the extent to which a variety of different absences from the workplace affect perceptions of employee commitment and loyalty, and ultimately, how this ‘temporary invisibility’ might affect career success. Data were derived from 40 interviews (12 women and 28 men) in a public sector agency in Australia. Findings reveal that absences attract substantial career penalties for many employees, not only in relation to gendered flexible work options such as part-time employment and parental leave, but also traditionally uncontested entitlements such as annual and long service leave.     

Advances in Joint Modelling: A Review of Recent Developments with Application to the Survival of End Stage Renal Disease Patients

The use of joint modelling approaches is becoming increasingly popular when an association exists between survival and longitudinal processes. Widely recognized for their gain in efficiency, joint models also offer a reduction in bias compared with naïve methods. With the increasing popularity comes a constantly expanding literature on joint modelling approaches. The aim of this paper is to give an overview of recent literature relating to joint models, in particular those that focus on the time‐to‐event survival process. A discussion is provided on the range of survival submodels that have been implemented in a joint modelling framework. A particular focus is given to the recent advancements in software used to build these models. Illustrated through the use of two different real‐life data examples that focus on the survival of end‐stage renal disease patients, the use of the JM and joineR packages within R are demonstrated. The possible future direction for this field of research is also discussed.     

You should know better! Do health students have different risk attitudes to unplanned pregnancy and sexually transmitted diseases?

Because healthcare professionals are in the best position to assess, assist and educate those participating in risky sexual behaviour, understanding if (and how) their risk attitudes differ from the wider population is of vital importance. In this study, we explore university health students’ risk attitudes towards unplanned pregnancy and sexually transmitted diseases (STDs). We examine whether university students pursuing health-related degrees, who hypothetically should have more exposure to and understanding of the risks associated with unplanned pregnancy and STD, have more risk averse attitudes to sexual behaviour. We find that health students’ sexual attitudes are significantly more risk averse than those of their nonhealth peers in relation to STDs but not unplanned pregnancy. In line with previous research, age and no previous sexual history (virginity) appear to increase risk-averse attitudes to both unplanned pregnancy and STDs. Moreover, males and singles are more risk seeking in their sexual attitudes. These findings suggest that, because unplanned pregnancy and STDs are ongoing global issues, further research is warranted into the risk attitudes of those healthcare professionals most able to provide education and support for individuals participating in risky sexual behaviour.     

Burden of illness for super-refractory status epilepticus patients

Objective: To provide an estimate of the annual number of super-refractory status epilepticus (SRSE) cases in the US and to evaluate utilization of hospital resources by these patients.

Methods: The Premier Hospital Database was utilized to estimate the number of SRSE cases based on hospital discharges during 2012. Discharges were classified as SRSE cases based on an algorithm using seizure-related International Classification of Diseases-9 (ICD-9) codes, Intensive Care Unit (ICU) length of stay (LOS), and treatment protocols (e.g. benzodiazepines, anti-epileptic drugs (AEDs), and ventilator use). Secondary analyses were conducted using more restrictive algorithms for SRSE.

Results: A total of 6,325 hospital discharges were classified as SRSE cases from a total of 5,300,000 hospital discharges. Applying a weighting based on hospital characteristics and 2012?US demographics, this projected to an estimated 41,156 cases of SRSE in the US during 2012, an estimated incidence rate of ～13/100,000 annually for SRSE in the US. Secondary analyses using stricter SRSE algorithms resulted in estimated incidence rates of ～11/100,000 and 8/100,000 annually. The mean LOS for SRSE hospitalizations was 16.5 days (median =11; interquartile range [IQR]?=?6–20), and the mean ICU LOS was 9.3 days (median =6; IQR =3–12). The mean cost of an SRSE hospitalization was $51,247 (median = $33,294; 95% CI = $49,634–$52,861).

Limitations: The analysis uses ICD-9 diagnostic codes and claims information, and there are inherent limitations in any methodology based on treatment protocol, which created challenges in distinguishing with complete accuracy between SRSE, RSE, and SE on the basis of care patterns in the database.

Conclusion: SRSE is associated with high mortality and morbidity, which place a high burden on healthcare resources. Projections based upon the findings of this study suggest an estimated 25,821–41,959 cases of SRSE may occur in the US each year, but more in-depth studies are required.     

Current and projected patient and insurer costs for the care of patients with non-small cell lung cancer in the United States through 2040

Aims: The objective of this study was to quantify the current and to project future patient and insurer costs for the care of patients with non-small cell lung cancer in the US.

Materials and methods: An analysis of administrative claims data among patients diagnosed with non-small cell lung cancer from 2007–2015 was conducted. Future costs were projected through 2040 based on these data using autoregressive models.

Results: Analysis of claims data found the average total cost of care during first- and second-line therapy was $1,161.70 and $561.80 for patients, and $45,175.70 and $26,201.40 for insurers, respectively. By 2040, the average total patient out-of-pocket costs are projected to reach $3,047.67 for first-line and $2,211.33 for second-line therapy, and insurance will pay an average of $131,262.39 for first-line and $75,062.23 for second-line therapy.

Limitations: Claims data are not collected for research purposes; therefore, there may be errors in entry and coding. Additionally, claims data do not contain important clinical factors, such as stage of disease at diagnosis, tumor histology, or data on disease progression, which may have important implications on the cost of care.

Conclusions: The trajectory of the cost of lung cancer care is growing. This study estimates that the cost of care may double by 2040, with the greatest proportion of increase in patient out-of-pocket costs. Despite the average cost projections, these results suggest that a small sub-set of patients with very high costs could be at even greater risk in the future.