What is going on when nothing is going on? Exploring the role of the consumer in shaping waiting situations

Research on waiting in services focuses mainly on the role of companies in waiting situations. Much of the existing research envisages the consumer as a passive victim of the delays caused by companies. This article redresses the imbalance in research on waiting by exploring the role of consumers in waiting situations. A qualitative methodology is used, involving data collection through in‐depth interviews and personal diaries, to facilitate an in‐depth analysis of consumers’ waiting experiences. Additionally, a holistic approach is employed with a view to examining the ‘whole’ waiting experience rather than individual or isolated aspects of waiting. The main finding of the study is that consumers play an active and deliberate role in waiting situations. This is the first study to empirically identify the behaviours and initiatives undertaken by consumers when forced to wait for services. The results suggest that consumers play an active role in organising and reducing the real or perceived waiting time. They actively seek information on the length and causes of the wait. And, on occasions, the consumer may also be the cause of the wait or may even increase the delay by their actions. In contrast to most of the existing research on the topic of waiting, this study adopt a qualitative, in‐depth approach, with a multicultural sample, and a focus on the consumer whose role in waiting has previously been overlooked.     

Profiling road transport activity: Emissions from 2000 to 2005 in Ireland using national car test data

This work describes a methodology for determining the average vehicle kilometres travelled by the private national car fleet in Ireland and estimating the disaggregated CO₂ and NO_x emissions from private vehicles in the Irish road transport sector for the period 2000–2005 using national car test records. The developed methodology facilitates the calculation of greatly improved estimates for vehicle kilometres under a range of constraint variables and thereby enables the disaggregated analysis of specific vehicle fleet groups and their associated activity patterns to support evidence-based policy development. The results indicate that while older vehicles are contributing significantly to car NO_x emissions; newer cars produce a higher share of CO₂ emissions than older cars in the vehicle fleet.     

Confirming the timing of phase-based costing in oncology studies: a case example in advanced melanoma

Aims: The utilization of healthcare services and costs among patients with cancer is often estimated by the phase of care: initial, interim, or terminal. Although their durations are often set arbitrarily, we sought to establish data-driven phases of care using joinpoint regression in an advanced melanoma population as a case example.

Methods: A retrospective claims database study was conducted to assess the costs of advanced melanoma from distant metastasis diagnosis to death during January 2010–September 2014. Joinpoint regression analysis was applied to identify the best-fitting points, where statistically significant changes in the trend of average monthly costs occurred. To identify the initial phase, average monthly costs were modeled from metastasis diagnosis to death; and were modeled backward from death to metastasis diagnosis for the terminal phase. Points of monthly cost trend inflection denoted ending and starting points. The months between represented the interim phase.

Results: A total of 1,671 patients with advanced melanoma who died met the eligibility criteria. Initial phase was identified as the 5-month period starting with diagnosis of metastasis, after which there was a sharp, significant decline in monthly cost trend (monthly percent change [MPC]?=?–13.0%; 95% CI?=?–16.9% to –8.8%). Terminal phase was defined as the 5-month period before death (MPC?=?–14.0%; 95% CI?=?–17.6% to –10.2%).

Limitations: The claims-based algorithm may under-estimate patients due to misclassifications, and may over-estimate terminal phase costs because hospital and emergency visits were used as a death proxy. Also, recently approved therapies were not included, which may under-estimate advanced melanoma costs.

Conclusions: In this advanced melanoma population, optimal duration of the initial and terminal phases of care was 5 months immediately after diagnosis of metastasis and before death, respectively. Joinpoint regression can be used to provide data-supported phase of cancer care durations, but should be combined with clinical judgement.     

Real-world utilization of molecular diagnostic testing and matched drug therapies in the treatment of metastatic cancers

Aims: To assess the frequency of biopsies and molecular diagnostic testing (human DNA/RNA analysis), anti-cancer drug use (genomically-matched targeted therapy [GMTT], unmatched targeted therapy [UTT], endocrine therapy [ET], and chemotherapy [CT]), and medical service costs among adults with metastatic cancer.

Methods: Adults diagnosed with metastatic breast, non-small cell lung (NSCLC), colorectal, head and neck, ovarian, and uterine cancer (2010Q1–2015Q1) were identified in the OptumHealth Care Solutions claims database and followed from first metastatic diagnosis for ≥1 month and until the end of data availability. Utilization was assessed for each cancer cohort (all and patients aged ≥65 years); per-patient-per-month (PPPM) medical service costs were assessed for all patients. Testing frequency estimates were applied to Surveillance, Epidemiology, and End Results Program data to estimate the number of untested patients (2010–2014).

Results: Patients with metastatic cancer (n?=?8,193; breast [n?=?3,414], NSCLC [n?=?2,231], colorectal [n?=?1,611], head and neck [n?=?511], ovarian [n?=?275], and uterine [n?=?151]) were 63 years old (mean), with 11.1–22.2 months of observation. Biopsy and molecular diagnostic testing frequencies ranged from 7% (uterine) to 73% (ovarian), and from 34% (head and neck) to 52% (breast), respectively. Few were treated with GMTT (breast, 11%; NSCLC, 9%; colorectal, 6%). Treatment with UTT ranged from 0.7% (uterine) to 21% (colorectal). Biopsy, diagnostic testing, and anti-cancer drug therapy were less frequent for those ≥65 years. Medical service costs (PPPM, mean) ranged from $6,618 (head and neck) to $9,940 (ovarian). The estimated number of untested new patients with metastatic cancer was 636,369 (all) and 341,397 (≥65).

Limitations: In addition to the limitations of claims analyses, diagnostic testing frequency may be under-estimated if patients underwent testing prior to study inclusion.

Conclusions: The low frequency of molecular diagnostic testing suggests there are opportunities to better inform management of patients with advanced cancer, particularly decisions to treat with GMTT.     

The deep roots of economic development in the U.S. states: an application of Putterman and Weil (2010)

The “Deep Roots” literature investigates the effects of ancient cultural variables on economic outcomes. We extend Putterman and Weil’s (Q J Econ 125(4):1627–1682, 2010) inquiry into the effects of State History and Agricultural History to the economic output in ethnically and racially diverse fifty U.S. States. The ethnic and racial differences across the populations of the fifty U.S. states vary considerably due to historical immigration and slave flows that, as a result, produced radically different State History and Agricultural History scores across the states. Results derived from Putterman and Weil’s methodology do not robustly predict per capita levels of economic output across U.S. States. We also investigate the institutions channel, and find that they impact some measures of institutions, but they do not impact the quality of economic institutions which may be essential for promoting economic growth and development.     

Leadership Competencies for Hotel General Managers: The Differences in Age,Education, and Hotel Characteristics

This study was designed to explore the leadership competencies necessary for general managers (GM) in Thailand hotels. The exploratory factor analysis extracted six leadership competency components: leadership, motivational/interpersonal skills, strategic orientation, planning and implementation, team building and ethics, communication skills, flexibility, and concern for the community. The results showed that team building and ethics, leadership, and communication skills are the most important factors for the GMs. In contrast, flexibility and strategic orientation were the least important competencies for them. There were significant differences between leadership competency factors and GMs’ age, education, hotel stars, and hotel locations in diverse aspects.     

Inflation regimes and the stability of the pass-through of wages to consumer prices in Canada

This article has formally identified distinct historical inflation regimes in Canada since 1961 in order to facilitate an investigation of the impact of regime changes on the wage-price dynamics in the economy. Both in and out-of-sample evidence suggest that wage growth exerts an influence on inflation only during a high-inflation regime but inflation exerts a more systematic and quantitatively stronger influence on wage growth regardless of the prevailing inflation regime. Overall, the results do not support either the ‘cost-push’ view of inflation or the ‘new view’ that claims that increased globalization during the 1990s has reduced the feedback from wage growth to inflation by weakening the bargaining power of workers.     

Patent pools and innovation in substitute technologies—evidence from the 19th‐century sewing machine industry

Patent pools, which combine complementary patents of competing firms, are expected to increase overall welfare but potentially discourage innovation in substitutes for the pool technology. This article exploits a new historical data set on changes in patenting and firm entry for a clearly defined pool technology and substitutes in the 19th‐century sewing machine industry. This analysis reveals a substantial increase in innovation for an—albeit technologically inferior—substitute technology. Historical evidence suggests that the creation of a pool‐diverted innovation toward an inferior substitute technology by creating differential license fees and litigation risks.     

Learning Approaches and Outcome‐Based Teaching and Learning: A Case Study in Hong Kong,China

Outcome‐based education is a pedagogical process which focuses on the achievement of certain specified results. Outcome‐based teaching and learning (OBTL), therefore, is concerned with curriculum design and ensuring that the contents, delivery, activities, and assessments are all aligned to help facilitate students to attain specific intended learning outcomes. This study explores whether and how outcome‐based teaching impacts on the learning approaches of one cohort of undergraduate business students at a university in Hong Kong, China to undergo outcome‐based teaching, newly introduced as part of a university‐wide policy to adopt OBTL. The learning approaches of these business students were measured using John Biggs's (1987 Biggs, J. 1987. Student approaches to learning and studying, Melbourne: Australian Council for Educational Research.  [Google Scholar]) Study Process Questionnaire (SPQ) to determine whether these students tended to favor surface learning approaches, deep learning approaches, or achieving learning approaches upon initial entry into the university. Changes in learning approaches were tracked, after a semester's exposure to OBTL, through survey and focus group interview methods. Findings indicated a significant amount of transference between learning approaches deployed by these students, demonstrating a high level of adaptability.     

Avoiding a “me” versus “we” dilemma: Using performance management to turn teams into a source of competitive advantage

Teams are pervasive in today's world of work. Unfortunately, in many cases teams do not live up to their promise and, instead, lead to disappointing results. In this installation of Human Performance, we discuss how to design and implement performance management systems that include a good combination of both “me” and “we” considerations. We offer the following research-based recommendations: (1) use measures of individual and team performance, (2) use measures of processes and outcomes, (3) develop performance measures using input from inside and outside the team, (4) gather performance information using sources from inside and outside the team, (5) foster team learning and development, and (6) reward both individual and team performance. We discuss implementation guidelines for each of these recommendations that will help maximize individual and team performance as well as alignment among individual, team, and organizational goals. Implementing performance management systems following our recommendations will help organizations turn teams into an inimitable and sustainable source of competitive human capital advantage.