bluuebunny/crossref_metadata_2025 huggingface dataset:
Capacity Utilization, Inflation, and Monetary Policy: The Duménil and Lévy Macro Model and the New Keynesian Consensus
Authors: Lavoie Marc , Kriesler Peter
Published: January 2008

The article considers the adjustment toward long-run equilibrium within the Duménil and Lévy macro model, with modifications. Findings show that long-run convergence to fully adjusted positions with normal utilization is not achieved when a more realistic reaction function is proposed. Classical equilibrium occurs when a vertical Phillips curve is substituted, but the model is isomorphic to the “new consensus” model and to features of “new” endogenous growth theory.

JEL classification: E12, E40, E52, E58
Romantic Fantasies, Cross-Gender Friendships, and Romantic Experiences in Adolescence
Authors: Tuval-Mashiach Rivka , Walsh Sophie , Harel Shirley , Shulman Shmuel
Published: January 2008

Findings of this study, conducted on 142 adolescents (67 ninth graders and 75 eleventh graders), show that romantic experiences among adolescents are manifested in different forms: romantic fantasies, cross-gender friendships, and sustained interactions with a romantic partner. These three forms of experience are manifested differently across age and gender. Romantic fantasies, although not accompanied by any actual interaction, are emotionally intense and probably constitute one of the modes of romantic experience.
The Influence of Family and Peer Risk Networks on Drug Use Practices and Other Risks among Mexican American Noninjecting Heroin Users
Authors: Valdez Avelardo , Neaigus Alan , Kaplan Charles D.
Published: January 2008

Noninjecting heroin use (NIU) is spreading among social networks of young Mexican American polydrug users. This article examines the influence of family and peer networks on NIU behavior and other drug practices and risks. This study delineates the extent to which a culturally relevant modification of the “network facilitation” theoretical approach can increase both a theoretical and practical understanding of drug use and related risk behaviors. Using the methods of analytic ethnography, it identifies, describes, and explains variations in the social networks among this marginalized population and how specific aspects of Mexican American culture ( familismo, and collectivismo) affects risk behaviors.
Setting Goals and Taking Ownership
Authors: Karakowsky Leonard , Mann Sara L.
Published: January 2008

The purpose of this theoretical article is to explore the psychological processes underlying employee participation in goal setting. Specifically, it presents a conceptual model that attempts to illustrate the potential pattern of causal self-attributions generated following the performance of participatively set goals. This article addresses two important questions: What are the cognitive consequences for employees who participate in setting their own performance goals? Do employees feel more personally responsible for the outcomes of their job performance if they have participated in the setting of their work goals? Theoretical assertions are summarized in the form of research propositions.
What Do Leaders Recall About Their Multisource Feedback?
Authors: Smither James W. , Brett Joan F. , Atwater Leanne E.
Published: January 2008

We examined 145 leaders' recall of their multisource feedback (MSF) 9 months after receiving the feedback. Leaders recalled more strengths than weaknesses, but these memories had only a small relationship with the actual feedback received. Leaders were more likely to recall feedback related to their consideration of employees and performance orientation than feedback related to developing and recognizing employees, and they were more likely to recall feedback from supervisors and direct reports than peers. Self versus other rating discrepancies were unrelated to recall, and recall of MSF was not related to subsequent improvement in MSF.
Communicator Style and Social Style
Authors: Snavely William B. , McNeill John D.
Published: January 2008

The purpose of this empirical study was to examine the interface between two key models of communication style: social style and communicator style. Social style is based on a two-by-two matrix composed of two dimensions of observable patterns of behavior: assertiveness and emotiveness. Communicator style was established in the communication discipline and involves nine factors and one global assessment of communicator image. The current study measured self-assessments of social style and communicator style by 852 individuals to test the theoretical interface of the models. Factor analysis confirmed the social style dimensions and some of the communicator style dimensions. The resulting components were factored, resulting in four dimensions of transactional style: emotive, assertive, relaxed, and accurate. Regression results indicate three of the dimensions are predictive of communicator self-image and explain nearly 36% of the variance.
Research-as-if-Practice
Authors: Jonsdottir Helga
Published: January 2008

Living with the symptoms of lung disease is challenging. The impact difficult breathing has on individuals and their families is frequently underestimated, with health care limited to managing physical manifestations of the origins of difficult breathing. This study describes a distinct approach to family nursing practice named partnership, which is based on a participatory worldview. Five couples in which the wife had severe breathing difficulties participated in the study. The research process is described as as-if-practice. The partnership process was illustrated in the theme “finding coherence in life with symptoms and treatment regimens.” The outcome of the process was illustrated in the interrelated themes of “living life fully and taking things as they come” and “efficient use of health care.” The study shows how the meaning that unfolded in the process reveals the insights of all participants into the families' health predicaments and what can be done with that insight.
The Adapted Cities Framework
Authors: Carr Jered B. , Karuppusamy Shanthi
Published: January 2008

Analysts are calling attention to a new era of municipal reform and to the convergence of the mayor-council and council-manager forms of government. H. George Frederickson, Gary Johnson, and Curtis Wood have proposed a new framework that explains the nature and extent of this convergence. The authors think this “adapted cities” framework is a potentially important advance in the understanding of municipal structure but note that empirical scholars have largely ignored the framework. This stems from the lack of a process for coding cities into this framework and from difficulties in operationalizing its categories. The authors contribute to this important topic by presenting a general process for coding cities on council-manager and mayor-council platforms into the adapted cities framework.
A New Model for Infrastructure Service Life With Applications to Bridge Assessment and Management
Authors: Chang Julius , Garvin Michael J.
Published: January 2008

Service life is a critical, yet somewhat nebulous consideration in the management of infrastructure assets. Although often defined in terms of deterioration and time to physical failure, infrastructure service life is also defined by nonphysical factors such as increasing loads and alternate levels of evaluation. A new conceptual model is presented defining infrastructure service life as a function of physical and nonphysical factors. The model reflects, for example, the idea that an asset can be evaluated at different performance levels, with accompanying trade-offs in moving from a lower level to a higher one. In addition, the model recognizes that alternative performance evaluation techniques can influence a decision maker's perception of serviceability and remaining service life. Several applications illustrate how the model offers a fresh perspective on bridge service life, a key consideration given the trend toward ever-increasing truck loads. Results described have various implications for policy making and infrastructure asset management.
Changing Project Delivery Strategy
Authors: Migliaccio Giovanni C. , Gibson G. Edward , O'Connor James T.
Published: January 2008

For organizations such as departments of transportation, other public agencies, and private companies, adopting a new approach to procure services for delivery of construction projects requires significant organizational changes; modifications to both their work processes and existing organizational structures may be needed. Building on findings from a study of public owner organizations that have implemented the design-build method for delivering highway projects, the have developed a conceptual framework for helping owner organizations implement a change in their project delivery strategy. They further refined this framework by comparatively studying four transportation projects in the United States. In addition, many experts in the implementation of the design-build method for transportation projects participated in a Delphi study to validate the developed framework. In this article, the authors present findings from these studies, including application to the construction industry and to other industries.
An Examination of Strategic Planning in American Law Enforcement Agencies
Authors: Zhao Jihong “Solomon" , Thurman Quint C. , Ling Ren
Published: January 2008

Strategic planning in police departments represents a significant departure from a traditionally reactive orientation to one that is more proactive in nature. This study followed an inductive reasoning approach to investigate the implementation of strategic planning in American law enforcement agencies and then develop theoretical models that might capture variation across organizations. Based on the initial results from telephone interviews and selective site visits, we were able to identify two key dimensions that seemed to differentiate the implementation of strategic planning among these law enforcement agencies. As a consequence, four styles of strategic planning emerged. This article discusses the development of strategic planning in U.S. police agencies and implications for the future.
Evidence of Betting Market Intraseason Efficiency and Interseason Overreaction to Unexpected NFL Team Performance 1988-2006
Authors: Sapra Steven G.
Published: January 2008

A structural model is derived describing the relationship between the probability that the favored team is victorious and the point spread through the use of a "no-arbitrage'' condition. A series of probit models are developed that show that NFL wagering markets were efficient within season during the period 1988-2006 and that the point spread is a statistically significant indicator of probability of victory. A team-level excess performance metric is estimated, termed an NFL Alpha, that indicates the extent to which a team's on-the-field performance exceeded betting market expectations. Finally, it is shown that there exists a market overreaction effect for NFL Alphas across seasons.
Intelligent Design and the Attack on Scientific Inquiry
Authors: Tierney William G. , Holley Karri A.
Published: January 2008

This article considers the question of intelligent design in relation to the principles of scientific inquiry and academic freedom. The authors examine the structure of research as a task of events to advance knowledge; an individual, interpretive process; and a social/public discourse. Using this framework, they consider how the advancement of intelligent design has occurred outside the traditional structure of knowledge production in the academy. They consider the influence on ideology as well as the public role in scientific knowledge. By enabling ideologies to operate outside of the balance of scientific inquiry and peer review, the process of knowledge production is reduced to a biased power struggle manipulated by personal agendas.
Whatever Works: Doing Science for George W. Bush
Authors: House Ernest R.
Published: January 2008

The Bush administration has systematically suppressed and distorted scientific findings to conform to its ideological agenda. Unfortunately, this practice has carried into educational research and evaluation, including the Institute of Education Sciences' What Works Clearing Clearinghouse, a unit that purports to screen studies that are "scientific."
Revisiting the Question of Evidence
Authors: Dimitriadis Greg
Published: January 2008

The Right has done much of its work in the name of scientific "objectivity," wildly deploying a popular discourse around "the real world" to achieve a range of specific ends. Complicating this are the long-standing critiques of "objectivity" and "reality" itself among many on the Left. Although such critiques can help us unmask some of these agendas, they leave us little space to contest them in new ways, to offer our own counterclaims about the "the real world" and its demands. The author suggests here that progressives can usefully interrupt this Rightist discourse by revisiting "common sense" connections between research methodology and epistemological orientation- particularly those around quantitative methodology.
Embedded Science: Critical Analysis of Abstinence-Only Evaluation Research
Authors: McClelland Sara I. , Fine Michelle
Published: January 2008

Since 1982, more than US$1 billion have been spent through federally sponsored abstinence-only-until-marriage (AOUM) programs, including nearly $800 million between 2001 and 2006, during the presidency of George W. Bush. With this increased funding has come pressure to evaluate the impact of AOUM programs. In 1998, a federally funded evaluation of AOUM programming was commissioned to assess its impact on young people. Because the abstinence policies and the evaluation of their success derive from the federal government, the authors identify the troubling potential of "embedded science." Using a recent example of research in the field of abstinence-only education (Maynard et al., 2005), the authors identify a number of practices and consequences of embedding research science within existing public policy. They find that when evaluation research is overly embedded, it tends to be dominated by political ideologies, information is omitted, and critique is virtually absent.
The Choice of Two Mothers: Disability, Gender, Sexuality, and Prenatal Testing
Authors: Atkins Chloë G. K.
Published: January 2008

This article employs an autoethnographic method in describing and analyzing the moral dilemmas faced by two lesbian mothers when they contemplated prenatal, genetic testing options during two pregnancies. It focuses on the inconsistencies in their decision-making processes-that is, that these same parents opt to do amniocentesis for one pregnancy but choose not for another one fewer than 2 years later. The discussion highlights the influence that contextual factors have on the discrepancy in their reasoning and behavior. By critiquing both the mothers' rationales and clinicians' approaches to these procedures, the article seeks to show that the weakness of employing ethical and counseling paradigms and discussions in highly contextual, real-life situations.
Conceptualizing Oppression in Educational Theory: Toward a Compound Standpoint
Authors: De Lissovoy Noah
Published: January 2008

This article analyzes three paradigms of oppression that are influential in progressive approaches in educational research: oppression as cultural hegemony, oppression as capitalist accumulation, and oppression as discursive effect. It argues that these different models, and their strengths and weaknesses, are connected to different philosophical standpoints (ways of understanding reality and criteria of truth that are historically and socially situated). Faced with the intractability of educational injustices, it is necessary to bring the power of diverse critical positions together. The author proposes the construction of a "compound standpoint," grounded in a materialist framework, and describes how oppression can be understood more richly and accurately from this position.
Beyond the Front Porch: Regionalist Ideals in the New Urbanist Movement
Authors: Talen Emily
Published: January 2008

The historical lineage of New Urbanism is often narrowly limited to the traditional town-planning techniques of John Nolen and Raymond Unwin. This paper focuses on the historical basis of the regional, polycentric city concepts that are an essential part of the New Urbanist manifesto. I focus primarily on the regionalism of Patrick Geddes, Lewis Mumford, Clarence Stein, and Benton MacKaye, and the principles laid out in the Regional Planning Association of America (RPAA) in the 1920s. I begin with a brief overview of the main principles of regionalism, culminating in the ideas of the RPAA, and then analyze how these ideas either connect or conflict with New Urbanism and its particular brand of the regionalist paradigm. An essential question for New Urbanists is how their particular version of regionalism stands up against earlier versions, and whether theirs will have a better chance of being implemented.
Themed Review: Clinical Interventions to Promote Physical Activity in Youth
Authors: Meriwether Rebecca A. , Lobelo Felipe , Pate Russell R.
Published: January 2008

National recommendations call for children and adolescents to accumulate at least 60 minutes of moderate to vigorous physical activity on most days of the week and for physicians to counsel their patients about physical activity. Physical inactivity tracks from childhood into adulthood, and among youth, it is associated with unfavorable risk factor profiles that promote the development of cardiovascular and metabolic chronic diseases. Few studies of clinical interventions to promote physical activity in children and youth have been published, and the paucity of evidence describing effective interventions and significant barriers limit delivery of counseling. However, existing studies provide evidence about elements of counseling most likely to be effective to guide clinical interventions and inform future research. Based on a literature review, this article offers guidance for incorporating physical activity promotion into clinical care, identifies gaps in current evidence, and suggests methodologic considerations for future research.
Patient Education: This Practitioner's Ignorance of Diet, Nutrition, and Exercise: A Call to Education
Authors: Miner Martin
Published: January 2008

The delivery of preventive health care services in the wellness visits of children and adolescents fails to adequately identify the child and adolescent overweight and at risk for obesity and its subsequent comorbidities. There are multiple competing issues and barriers addressed in this article. However, a brief inventory of exercise and dietary and nutritional guidance is presented for the primary care clinician. Included are the appropriate history, physical exam, and laboratory evaluation that should encompass any child or adolescent at risk for obesity.
Residual stresses simulation for friction stir welded joint
Authors: Li T. , Shi Q.Y. , Li H.-K.
Published: January 2008

As a solid state joining technique, friction stir welding (FSW) can produce high strength, low distortion joints efficiently. Compared to fusion welding, residual stresses in FSW joints are expected to be low due to a relatively low heat input. However, apart from the heat input, the force from the tool also plays an important role in the development of welding stresses. In the present paper, a semicoupled thermomechanical finite element model containing both thermal load and mechanical load was established to simulate the development of welding stresses during FSW process; an autoadapting heat source model was employed in the thermal analysis; the fixture was also included in the mechanical analysis model. The simulation results showed that due to the effect of the tool force, the longitudinal residual tensile stresses became smaller and were asymmetrically distributed at different sides of the weld centre; the peak of the tensile residual stresses at the retreating side was lower than that at the advancing side. Calculated and experimental results were compared.
Hybrid laser/arc welding process for controlling bead profile
Authors: Cho M.H. , Farson D. , Lim Y.C. , Choi H.W.
Published: January 2008

A laser hybrid welding process in which a defocused laser beam is applied beside a gas metal arc weld (GMAW) pool to modify the bead shape was studied. The present paper aims to produce welds with improved toe geometry and better fatigue life than those made with GMAW alone and to apply a numerical simulation to help configure the hybrid process. First, stationary hybrid welds were made to validate weld bead shape predictions and to characterise the spreading of the arc weld deposit to the laser heated spot. Next, the travelling hybrid process was configured with the aid of simulations and fatigue test specimens were welded. Proper application of the laser heat input induced molten metal to spread to the laser heated area, increasing the fillet weld leg length. This produced a larger weld toe angle that decreased the stress concentration and increased the fatigue life of the welds relative to standard mean values.
Effect of welding time on microstructure and tensile shear load in resistance spot welded joints of AZ31 Mg alloy
Authors: Wang Y.R. , Mo Z.H. , Feng J.C. , Zhang Z.D.
Published: January 2008

Magnesium alloys are becoming widely recognised as the candidates to replace steel and aluminium alloys, especially in automotive industries and thereby they have potential to be widely used. In the present paper, resistance spot welding (RSW) was performed on 1 mm thick AZ31B magnesium alloy sheets. The effect of welding time on the microstructure and tensile shear load was investigated. Some interesting characteristics for nugget growth were observed during the RSW of Mg alloy. The nuggets were initiated in the first cycle, grown rapidly in the following 2–4 cycles and reached a plateau after around 6 cycles. The microstructure of the nugget consisted of non-equilibrium a -phase dendrites surrounded by a certain amount of β -Mg17 Al12 precipitated in the grain boundaries. With increased welding time, the size and shape of grains in the nugget would be more uniform and the width of corona bonds would be larger. Tensile shear tests showed that the tensile shear load of the joints increased with increasing welding time when the welding time was, <10 cycles. The maximum tensile shear load is up to 1980 N.
Crack initiation and kinking behaviours of spot welded coach peel specimens under cyclic loading
Authors: Daneshpour S. , Kokabi A.H. , Ekrami A.A. , Motarjemi A.K.
Published: January 2008

The present study is carried out to investigate fatigue crack initiation and kinking behaviours of spot welded coach peel (CP) specimens of low carbon steel sheets subjected to cyclic loading by experimental and finite element analysis methods. Evaluations of fatigue crack growth stages were performed by crack tip plastic strains and J integral analyses and also by microhardness measurements on process zone. According to the experimental and analytical results, fatigue crack initiation and growing stages in the spot welded CP specimens can be divided to three stages. Stage I corresponds to ‘gap sharpening stage’ observed at the beginning steps of cyclic loading with crack growing on the interface plane between the overlapped sheets. Stage II corresponds to kinked crack initiation and propagation through the sheet thickness observed after applying a certain number of loading cycles. Stage III corresponds to crack propagation through the width of the specimens observed at the final step of the fatigue crack propagation. The FE results of the crack paths and crack locations are in good agreement with those of experimental observations.
Organ-derived dendritic cells have differential effects on alloreactive T cells
Authors: Kim Theo D. , Terwey Theis H. , Zakrzewski Johannes L. , Suh David , Kochman Adam A. , Chen Megan E. , King Chris G. , Borsotti Chiara , Grubin Jeremy , Smith Odette M. , Heller Glenn , Liu Chen , Murphy George F. , Alpdogan Onder , van den Brink Marcel R. M.
Published: January 2008

Dendritic cells (DCs) are considered critical for the induction of graft-versus-host disease (GVHD) after bone marrow transplantation (BMT). In addition to their priming function, dendritic cells have been shown to induce organ-tropism through induction of specific homing molecules on T cells. Using adoptive transfer of CFSE-labeled cells, we first demonstrated that alloreactive T cells differentially up-regulate specific homing molecules in vivo. Host-type dendritic cells from the GVHD target organs liver and spleen or skin- and gut-draining lymph nodes effectively primed naive allogeneic T cells in vitro with the exception of liver-derived dendritic cells, which showed less stimulatory capacity. Gut-derived dendritic cells induced alloreactive donor T cells with a gut-homing phenotype that caused increased GVHD mortality and morbidity compared with T cells stimulated with dendritic cells from spleen, liver, and peripheral lymph nodes in an MHC-mismatched murine BMT model. However, in vivo analysis demonstrated that the in vitro imprinting of homing molecules on alloreactive T cells was only transient. In conclusion, organ-derived dendritic cells can efficiently induce specific homing molecules on alloreactive T cells. A gut-homing phenotype correlates with increased GVHD mortality and morbidity after murine BMT, underlining the importance of the gut in the pathophysiology of GVHD.
Identification of human minor histocompatibility antigens based on genetic association with highly parallel genotyping of pooled DNA
Authors: Kawase Takakazu , Nannya Yasuhito , Torikai Hiroki , Yamamoto Go , Onizuka Makoto , Morishima Satoko , Tsujimura Kunio , Miyamura Koichi , Kodera Yoshihisa , Morishima Yasuo , Takahashi Toshitada , Kuzushima Kiyotaka , Ogawa Seishi , Akatsuka Yoshiki
Published: January 2008

Minor histocompatibility (H) antigens are the molecular targets of allo-immunity responsible both for the development of antitumor effects and for graft-versus-host disease (GVHD) in allogeneic hematopoietic stem cell transplantation (allo-HSCT). However, despite their potential clinical use, our knowledge of human minor H antigens is largely limited by the lack of efficient methods of their characterization. Here we report a robust and efficient method of minor H gene discovery that combines whole genome association scans (WGASs) with cytotoxic T-lymphocyte (CTL) assays, in which the genetic loci of minor H genes recognized by the CTL clones are precisely identified using pooled-DNA analysis of immortalized lymphoblastoid cell lines with/without susceptibility to those CTLs. Using this method, we have successfully mapped 2 loci: one previously characterized (HMSD encoding ACC-6), and one novel. The novel minor H antigen encoded by BCL2A1 was identified within a 26 kb linkage disequilibrium block on chromosome 15q25, which had been directly mapped by WGAS. The pool size required to identify these regions was no more than 100 individuals. Thus, once CTL clones are generated, this method should substantially facilitate discovery of minor H antigens applicable to targeted allo-immune therapies and also contribute to our understanding of human allo-immunity.
Policy Responses to Complex Issues
Authors: Weaver Jerry L.
Published: January 2008

There is a considerable body of literature that documents the higher infant mortality among American Blacks. This disparity has been attributed to many socioeconomic factors such as poor pre-and postnatal maternal health care, poor nutrition, inadequate housing, and so forth. Yet a careful examination of the data reveals that infant mortality is higher for Blacks regardless of socioeconomic condition. The present paper explores possible roots of this higher mortality rate in the centuries of nutritional deprivation suffered by Blacks in America. If a sizeable fraction of the higher Black rates is a result of historical forces, it is questionable if traditional social welfare approaches and programs will markedly improve the situation. Indeed, a new set of interventions are called for to attack the picture of inequality and injustice that emerges from current U.S. infant mortality figures.
A Reconsideration of Long-Term-Care Policy
Authors: Brecher Charles , Knickman James
Published: January 2008

This article describes current problems in the financing and delivery of long-term care, and assesses several proposals for reform. Proposed financing changes are found to differ in their objectives, with some reforms seeking to shift from greater to lesser government support, and others seeking to replace current public efforts with expanded entitlements. Organizational reforms hold promise of more equitable allocation of public expenditures for long-term care, but are not likely to reduce such spending. Thus difficult choices cannot be avoided.
What Do We Know About Rate-Setting?
Authors: Eby Charles L. , Cohodes Donald R.
Published: January 2008

State regulation of hospital revenue is one approach to cost containment on which there is voluminous evaluative data from the “laboratory of the states”; yet these data are sufficiently complex and ambiguous that they are claimed by both proponents and opponents of rate-setting as support for their respective cases. This paper summarizes the evidence, concluding that mandatory rate-setting has generally constrained hospital costs where it has been implemented. However, were rate-setting established in additional states, it is not clear that comparable results would be realized. It is still less clear that rate-setting would constrain health care costs more than would increased competition and selective contracting.
Reforming Medicare Provider Payment
Authors: Vladeck Bruce C.
Published: January 2008

The basic thesis of this paper is that, in the short to medium term (that is to say, the politically relevant term), fee-for-service payment will be the dominant form of Medicare transaction–and that is not such a bad thing. Capitated arrangements will grow, and should be encouraged, especially for long-term-care services, but for reasons to be discussed, it would be a mistake to put too many policy eggs into that basket. As the nascent Prospective Payment System (PPS) for hospital care reveals, fee-for-service payment can take almost an infinite variety of forms, and the connection between the choice of form and the cost impact is highly variable and somewhat uncertain. PPS needs considerable improvement; so, unquestionably, does the current nonsystem of physician payment. An analysis of potential improvements in both arenas will constitute the bulk of this discussion. That emphasis reflects not only the personal predilections of the author, but also the contention that those are the most sensible things to talk about.
Medicaid: Taking Stock
Authors: Davidson Stephen M.
Published: January 2008

In the last few years, Medicaid has attracted more than casual attention, one reflection of which is the fact that JHPPL has published five papers on the program in its last few issues. This paper, a sixth, takes a broader view of the program than is typically the case. After a critique of the five recent articles, I discuss several questions raised by them and reach the following conclusions: First, the states do not invest enough in producing program data suitable for policy analysis and research. One lesson: Better data and analysis can help the states to avoid expensive mistakes. Second, those policy analyses that have been offered fail to give sufficient attention to the political dimension of policy. That is one reason why policy choices produce unexpected effects. Third, since Medicaid is a relatively small player in the vast medical care market, incentives adopted by Medicaid officials throughout the country rarely have the desired effects. Finally, as long as Medicaid remains the principal mechanism to provide access to health care for the poor, it must be made as efficient and effective as possible. Yet, for both political and economic reasons, Medicaid can never be what its original planners had hoped, the vehicle for providing the poor with reliable access to mainstream medical care.
The American States and Canada: A Comparative Analysis of Health Care Spending
Authors: Thorpe Kenneth E.
Published: January 2008

Most comparisons of the relative effectiveness of cost containment in the Canadian and U.S. health systems trace Canada's greater success to its single-payer approach. However, these studies ignore the substantial variation that exists in hospital and personal health care spending among both the American states and the provinces and territories of Canada. Four American states have adopted all-payer hospital rate setting: one other uses competitive bidding. All five show rates of growth in per capita hospital spending comparable to (and in some cases, lower than) the Canadian jurisdictions. Hospital spending, as a percentage of state gross domestic product (GDP), declined or remained constant in four of the five states. In four out of the five, growth in per capita spending on personal care, as a percentage of GDP, remained or fell below the national average. By contrast, in Canada, per capita spending on both hospitals and personal health care increased as a percentage of GDP in ten out of eleven jurisdictions. In each of the U.S. states, government played a central role in structuring the terms of payment and thus strengthened the hand of purchasers over providers. This strategy, rather than specifically a single-payer or universal health insurance approach, seems to be the key to limiting the growth in health costs to the growth in state or national income.
Certificate-of-Need Deregulation and Indigent Hospital Care
Authors: Campbell Ellen S. , Fournier Gary M.
Published: January 2008

For almost twenty years certificate-of-need (CON) regulations have protected existing hospitals from unrestricted competition in services. Although the explicit purpose of CON regulation was to prevent hospitals from duplicating services and investing in costly excess capacity, it has been unsuccessful in accomplishing this goal. On the other hand, CON policies have, we suggest, been pursued with the implicit aim of “cross subsidization,” that is, regulators have used their power to issue licenses and restrict competition in order to create an incentive to hospitals to provide high levels of care to the indigent population. Posner (1971) has noted that to achieve cross subsidization, entry into lucrative services must be restricted. We present evidence that CON licenses have been used to promote the internal subsidization of indigent care in probit analysis, based on data from Florida spanning the period 1983- 89. While this method of financing indigent care may be preferred by legislators who do not want to face the political consequences of raising taxes to pay for the service, it has troubling implications for the hospital provision of indigent care, especially in an era of CON deregulation.
Tax-Deductible Alcohol: An Issue of Public Health Policy and Prevention Strategy
Authors: Mosher James F.
Published: January 2008

In 1982 U.S. businesses will spend over $10 billion (12 percent of the total retail alcohol market) on alcoholic beverages which will be consumed by top executives, professionals, and other white-collar employees in a variety of business and personal settings. The Internal Revenue Service, through a series of vaguely defined tax deduction categories, permits these expenditures to be deducted from corporate and individual taxes as “ordinary and necessary” to the conduct of business, costing U.S. taxpayers between $3 and $5 billion annually in lost tax receipts. This article examines the scope and legal underpinnings of the IRS tax expenditure policy; its impact on drinking habits and drinking problems among the nation's business and professional elite; the arguments for permitting the subsidization of corporate drinking habits; reform measures that are available to policymakers; and the barriers to effective implementation.
Obtaining Replacements: The Organizational Framework of Organ Procurement
Authors: Prottas Jeffrey M.
Published: January 2008

In the last ten years there has grown up, in the United States, the most extensive organ procurement system in the world. This system, consisting of approximately 120 organ procurement agencies, retrieved 4435 cadaveric kidneys for transplant purposes in 1981. The nation's organ procurement agencies vary greatly in terms of size, organizational structure, and effectiveness. On average, those agencies not formally part of a transplant hospital appear to be the more effective. This can be accounted for by their superior operational flexibility and their pursuit of a “marketing” strategy. Success in organ procurement requires that medical professionals in non-transplant hospitals, and the potential donors' families, be motivated to assist in the organ procurement process.
Power and Cost Containment in a Danish Public Hospital
Authors: Saltman Richard B.
Published: January 2008

The assumption that hospital decision-making is hierarchical in character underpins the policy formulation process in public as well as pluralist national health care systems. This article's analysis of decision-making in a Danish public hospital reinforces the contrary assertion: that effective authority in acute-care hospitals rests in an amorphous power relationship among the hospital's several occupational groups, in which physicians clearly have the upper hand. After a brief introduction to this Danish hospital, the article develops a detailed portrait of its informal power structure and of the different occupational groups' permanent power-maximizing strategies. Subsequently, the article assesses the impact of these strategies upon two recent efforts to contain the hospital's costs: a decision to close an expensive specialty clinic, and an attempt to shrink the hospital's size by transferring less sick elderly patients to a newly created rehabilitation facility. The study's findings suggest that efforts to impose hospital cost containment by exclusively political means are unlikely to succeed.
A Unified Modeling and Solution Framework for Vehicle Routing and Local Search-Based Metaheuristics
Authors: Irnich S.
Published: January 2008

This paper presents a new unified modeling and heuristic solution framework for vehicle-routing problems (VRPs) with complex side constraints. The work is focused on strong modeling capabilities as well as efficient solution procedures to be used in all kinds of metaheuristics. From the modeling point of view, the framework covers a variety of standard VRP types with classical constraints such as capacity, distance, route length, time window, pairing, and precedence constraints, but also nonstandard “rich” VRPs. From the methodological point of view, local search (LS) is the key solver engine to be used in heuristic solution procedures. First and foremost, the framework introduces two generic techniques for the efficient exploration of edge- and node-exchange neighborhoods. New preprocessing methods allow 𝒪(nk) neighborhoods to be searched in time complexity 𝒪(nk), i.e., without an additional effort for feasibility testing in the worst case. Moreover, for accelerating LS in the average case, Irnich et al. [Irnich, S., B. Funke, T. Grünert. 2006. Sequential search and its application to vehicle-routing problems. Comput. Oper. Res. 33 2405–2429] have introduced sequential search that is here adapted to cope with rich VRPs (complex side constraints). Computational tests on different types of VRPs indicate that the proposed techniques are highly efficient. Sequential search procedures outperform the currently most efficient search methods, which are based on lexicographic search, on large-scale instances and for nearly all types of neighborhoods by factors of between 10 and 1,000.
Integrating the Promotional and Service Roles of Retail Inventories
Authors: Balakrishnan Anantaram , Pangburn Michael S. , Stavrulaki Euthemia
Published: January 2008

In some retail contexts, higher inventories not only improve service levels, but also stimulate demand by serving as a promotional tool (e.g., by increasing product visibility). Motivated by a building-products retailer's practice of stocking large quantities of products to stimulate demand, we study inventory management and pricing policies when demand is uncertain but increases with stocking quantity. We first characterize the profit-maximization policy for a stochastic inventory model with a general inventory-dependent demand distribution and given price, and show that demand stimulation (by inventories) has the effect of increasing the target service level beyond the classical newsvendor model's critical fractile ratio. To underscore the importance of considering both demand stochasticity and inventory influence, we consider two functionally oriented benchmark policies—a demand-driven policy and a critical fractile policy—that might, respectively, represent marketing and inventory managers' viewpoints. Our numerical analysis reveals that the optimal policy can generate considerably higher profits than the two complementary functional perspectives. Moreover, we prove that the optimal stocking quantity always exceeds the critical fractile solution and can even exceed the demand-driven stocking quantity. We also address the problem of jointly optimizing both stocking quantity and price for demand-stimulating products using a multiplicative model to represent the influence of price and stocking quantity on the demand distribution. For this model, we show that the pricing and stocking decisions can be determined sequentially, with the optimal policy setting higher prices and stock levels than both the functional policies.
Simple Methods for Shift Scheduling in Multiskill Call Centers
Authors: Bhulai Sandjai , Koole Ger , Pot Auke
Published: January 2008

This paper introduces a new method for shift scheduling in multiskill call centers. The method consists of two steps. First, staffing levels are determined, and next, in the second step, the outcomes are used as input for the scheduling problem. The scheduling problem relies on a linear programming model that is easy to implement and has short computation times, i.e., a fraction of a second. Therefore, it is useful for different purposes and it can be part of an iterative procedure: for example, one that combines shifts into rosters.
Strategic Inventory Placement in Supply Chains: Nonstationary Demand
Authors: Graves Stephen C. , Willems Sean P.
Published: January 2008

The life cycle of new products is becoming shorter and shorter in all markets. For electronic products, life cycles are measured in units of months, with 6- to 12-month life cycles being common. Given these short product life cycles, product demand is increasingly difficult to forecast. Furthermore, demand is never really stationary because the demand rate evolves over the life of the product. In this paper, we consider the problem of where in a supply chain to place strategic safety stocks to provide a high level of service to the final customer with minimum cost. We extend our model for stationary demand to the case of nonstationary demand, as might occur for products with short life cycles. We assume that we can model the supply chain as a network, that each stage in the supply chain operates with a periodic review base-stock policy, that demand is bounded, and that there is a guaranteed service time between every stage and its customers. We consider a constant service time (CST) policy for which the safety stock locations are stationary; the actual safety stock levels change as the demand process changes. We show that the optimization algorithm for the case of stationary demand extends directly to determining the safety stocks when demand is nonstationary for a CST policy. We then examine with an illustrative example how well the CST policy performs relative to a dynamic policy that dynamically modifies the service times. In addition, we report on numerical tests that demonstrate the efficacy of the proposed solution and how it would be deployed.
Interday Forecasting and Intraday Updating of Call Center Arrivals
Authors: Shen Haipeng , Huang Jianhua Z.
Published: January 2008

Accurate forecasting of call arrivals is critical for staffing and scheduling of a telephone call center. We develop methods for interday and dynamic intraday forecasting of incoming call volumes. Our approach is to treat the intraday call volume profiles as a high-dimensional vector time series. We propose first to reduce the dimensionality by singular value decomposition of the matrix of historical intraday profiles and then to apply time series and regression techniques. Our approach takes into account both interday (or day-to-day) dynamics and intraday (or within-day) patterns of call arrivals. Distributional forecasts are also developed. The proposed methods are data driven, appear to be robust against model assumptions in our simulation studies, and are shown to be very competitive in out-of-sample forecast comparisons using two real data sets. Our methods are computationally fast; it is therefore feasible to use them for real-time dynamic forecasting.
Usage Restriction and Subscription Services: Operational Benefits with Rational Users
Authors: Randhawa Ramandeep S. , Kumar Sunil
Published: January 2008

This paper studies a rental firm that offers reusable products to price- and quality-of-service–sensitive customers—Netflix or Blockbuster can be thought of as the canonical example. Customers' perception of quality is determined by their likelihood of obtaining the product or service immediately upon request. We study the alternatives of offering either a subscription option that limits the number of concurrent rentals in return for a flat fee per-unit time, or a pay-per-use option with no such restriction. Customers are assumed to desire a nominal usage rate of the product, which they meet by adjusting their request rate in either option. Thus, they have a higher request rate in the subscription option. We propose a Markov chain model for customer behavior under the subscription option equivalent to the standard Poisson model under the pay-per-use option. In a large market setting, assuming exponential demand, we show that using the subscription option is more profitable for the firm. Further, via a numerical study, we show that this assumption is not essential for the result to hold. However, we show that the subscription option does not necessarily dominate the pay-per-use option in quality of service. The firm manages the trade-off between price and quality of service better in the subscription option. Moreover, we show that social welfare and the consumer surplus can also be higher in the subscription option, indicating that both the firm and the consumers can benefit from the subscription option.
Facility Location with Stochastic Demand and Constraints on Waiting Time
Authors: Baron Opher , Berman Oded , Krass Dmitry
Published: January 2008

We analyze the problem of optimal location of a set of facilities in the presence of stochastic demand and congestion. Customers travel to the closest facility to obtain service; the problem is to determine the number, locations, and capacity of the facilities. Under rather general assumptions (spatially distributed continuous demand, general arrival and service processes, and nonlinear location and capacity costs) we show that the problem can be decomposed, and construct an efficient optimization algorithm. The analysis yields several insights, including the importance of equitable facility configurations (EFCs), the behavior of optimal and near-optimal capacities, and robust class of solutions that can be constructed for this problem.