Employee behaviour and relationship quality: impact on customers

This paper examines relationship quality as a multidimensional metaconstruct comprising three dimensions; satisfaction, trust and commitment. The role of relationship quality in its nomological network with service orientation as an antecedent construct and consumers' positive behavioural intentions, perceived switching costs and activism as the consequences is explored. Survey data from 728 travellers are used, employing structural equations modelling to test this conceptualisation. It is found that service orientation affects relationship satisfaction and trust, and that the latter influences satisfaction and commitment. In turn, satisfaction, trust and commitment have a positive impact on positive behavioural intentions, trust has a negative impact on activism, and commitment a positive one on perceived switching costs. The implications of this conceptual and empirical understanding of relationship quality are discussed and directions for future research presented.     

Accountants as Emotional Wellbeing Counsellors in Rural Areas

The role of accountants in dealing with the social, emotional and stress‐related problems of their clients is explored using semi‐structured interviews with owner‐accountants and regional development workers. Findings indicate the importance to rural communities and the related public of accountants acting as ‘emotional wellbeing counsellors’; a role they are pressured to accept by their clients and community, and for which they are neither formally educated nor trained. Implications are drawn for effective counselling preparation of accounting graduates and practising accountants by educators and professional associations.     

Measuring the Costs of Custom Products through Better Technology Utilization

This case study details the process of determining the economic feasibility of implementing lean manufacturing in a small mass customization manufacturing company in the medical industry. The case study investigates the information required for a lean implementation and proposes a number of changes to the work procedures (including instrumentation) to obtain the data. A large number of enterprise resource planning systems were evaluated for their suitability to track data in the mass customization environment and the top candidates are compared in the article. The current labor and materials costs are estimated to determine the magnitude of potential savings to support the changes. Based on the analysis the recommended solution has a payback period of approximately two years.     

CAN STATE TAX POLICIES BE USED TO GROW SMALL AND LARGE BUSINESSES?

The existing literature studying the relationship between small business activity and U.S. state tax policy has focused primarily on a few measures of small business. We expand this literature by estimating the effect of state tax policy on small businesses by using broader measures of small business activity using a longitudinal dataset for the U.S. states. We also estimate the relationship between state tax policy and large business activity. Results provide evidence that state tax policy can influence small business firm, establishment, payroll, and employment growth in important ways but provide limited evidence that such policy significantly influences large business growth. (JEL H2, H7, R1)     

The impact of persistence with therapy on inpatient admissions and emergency room visits in the US among patients with multiple sclerosis

Objective:

Disease-modifying therapy (DMT) for multiple sclerosis (MS) can reduce relapses and delay progression; however, poor adherence and persistence with DMT can result in sub-optimal outcomes. The associations between DMT adherence and persistence and inpatient admissions and emergency room (ER) visits were investigated.

Methods:

Patients with MS who initiated a DMT in a US administrative claims database were followed for 1 year. Persistence to initiated DMT was measured as the time from DMT initiation to discontinuation (a gap of >60 days without drug ‘on hand’) or end of 1-year follow-up. Adherence to initiated DMT was measured during the persistent period and was operationalized as the medication possession ratio (MPR). Patients with an MPR <0.80 were considered non-adherent. Claims during the 1-year follow-up period were evaluated for the presence of an all-cause inpatient admission or an ER visit. Adjusted odds ratios (AORs) for inpatient admission or ER visit comparing persistent vs non-persistent and adherent vs non-adherent patients were estimated using logistic regression models adjusted for patient characteristics.

Results:

The final sample included 16,218 patients. During the 1-year follow-up period, 35.3% of patients discontinued their initiated DMT and 13.9% were not adherent while on therapy. During that same period, 10.0% of patients had an inpatient admission and 24.9% had an ER visit. The likelihoods of inpatient admission and ER visit were significantly decreased in persistent patients (AOR [95% CI]?=?0.50 [0.45, 0.56] and 0.65 [0.60, 0.69], respectively) and in adherent patients (AOR [95% CI]?=?0.83 [0.71, 0.97] and 0.86 [0.77, 0.95], respectively).

Conclusions:

Persistence and adherence with initiated DMT are associated with decreased likelihoods of inpatient admission or ER visit, which may translate to improved clinical outcomes.     

Persistence,adherence, and all-cause healthcare costs in atazanavir- and darunavir-treated patients with human immunodeficiency virus in a real-world setting

Objectives:

Atazanavir (ATV) and darunavir (DRV) are protease inhibitors approved for HIV treatment in combination with ritonavir (/r). The objectives of this study were to compare persistence (time to treatment discontinuation/modification), adherence, and healthcare costs among patients with human immunodeficiency virus (HIV) initiating ATV/r or DRV/r.

Methods:

This retrospective cohort study used commercial and Medicaid administrative insurance claims data. Patients initiating ATV/r or DRV/r from 2006–2013 with continuous enrollment for ≥6 months before and ≥3 months after initiation were included. Patients were followed from initiation until discontinuation/modification (≥30 day gap in ATV or DRV or initiation of a new antiretroviral medication), during which time adherence (proportion of days covered [PDC], with PDC ≥80% or 95% considered adherent) and per-patient per-month (PPPM) total healthcare costs were measured. DRV/r patients were propensity score matched to ATV/r patients at a 1:1 ratio to achieve balance on potentially confounding demographic and clinical factors. Commercial and Medicaid samples were analyzed separately, as were antiretroviral (ART)-naïve and experienced patients.

Results:

The final samples comprised 2988 commercially-insured and 1158 Medicaid-insured patients. There were no significant differences in hazards of discontinuation/modification between the ATV/r or DRV/r cohorts. With respect to odds of being adherent, the only marginally significant result was comparing odds of achieving PDC ≥80% among ART-naïve Medicaid patients, which favored ATV/r. All other adherence comparisons were not significant. Although ATV/r cohorts tended to have lower PPPM costs, the majority of these differences were not statistically significant.

Conclusions:

Patients with HIV treated with either ATV/r or DRV/r had similar time to treatment discontinuation/modification, adherence, and monthly healthcare costs. Results were similar across the pre-specified sub-groups. These findings are useful not only as an insight into clinical practice, but also as a resource for healthcare providers and payers evaluating treatment options for HIV+ individuals.     

The Evolution of “Competition”: Lessons for 21st Century Telecommunications Policy

For over a century, assessments of competition or the lack thereof have been central to how public policy treats the telecommunications industry. This centrality continues today. Yet, numerous foundational questions about this concept persist. In this paper, we chronicle how the definition of “competition” has evolved in economics and has been applied in the communications arena. The academic literature on competition hits an important inflection point in the mid-20th century with the development of “workable competition”: a term that is equated to “effective competition.” We find that while the concept of “effective competition” is central to policy formation at the FCC, the Commission’s own applications of “effective competition” are inconsistent. Given the centrality of this concept, and its inconsistent applications to date, we draw upon the seminal contributions to the development of the notion of “effective competition” to offer a modern definition suitable for application in 21st century communications markets.     

A multilevel examination of the relationship between role overload and employee subjective health: The buffering effect of support climates

Although the belief that support alleviates the detrimental effect of job demands on employee health is intuitive, past research has produced an equivocal picture, requiring a renewed evaluation of this relationship. In the present study, we examine three sources of support (from the organization, leader, and team) that employees may draw from to reduce the negative effect of a specific job demand, that is, role overload. Unlike most prior research, we focus on these sources of support at the group level of analysis to determine the relative effectiveness of organizational support climate, leadership climate, and team climate as moderators of the role overload–subjective health relationship. Hierarchical linear modeling of data from 2,288 employees nested in 132 workgroups in a state administration of Switzerland revealed that, after controlling for individual perceptions of support, team climate weakened the negative relationship between role overload and health. We did not find support for the buffering effect of organizational support or leadership climates. The article provides a nuanced test of the support‐buffering hypothesis by simultaneously exploring individual and group‐level sources of support and by demonstrating that some sources of support matter more than others in ameliorating the negative outcomes of role overload.     

IMAGINING A DECOLONIZED CITY IN AND FROM AOTEAROA NEW ZEALAND

Imagining decolonized cities creates space to explore how urban places could strip away colonial dominance and restore the ability of Indigenous people to live, know and be. In this essay, we describe one attempt to create such space. While working in Porirua in Aotearoa New Zealand, we ran an urban design competition, hosted workshops with young people and held a symposium. Through all three phases we drew on utopian thinking to imagine beyond the current constraints of urban form in Aotearoa New Zealand to consider how cities might reflect the diverse realities of Māori. While this approach is an attempt at generating hopeful geographies, it also sat in tension with (post)colonial realities, such as racist attempts by white people to claim Indigeneity, and the ongoing need for land to be returned to Indigenous people. We argue that envisioning how cities might be decolonized is useful and needs to be rooted in the particular politics of place, but this imagining needs to be paired with action to confront persistent colonialism.