Estimating the scope for savings in referrals and drug prescription costs in the general Practice units of a UK primary care trust

This paper explores the potential for cost savings in the general Practice units of a Primary Care Trust (PCT) in the UK. We have used Data Envelopment Analysis (DEA) to identify benchmark Practices, which offer the lowest aggregate referral and drugs costs controlling for the number, age, gender, and deprivation level of the patients registered with each Practice. For the remaining, non-benchmark Practices, estimates of the potential for savings on referral and drug costs were obtained. Such savings could be delivered through a combination of the following actions: (i) reducing the levels of referrals and prescriptions without affecting their mix (£15.74 m savings were identified, representing 6.4% of total expenditure); (ii) switching between inpatient and outpatient referrals and/or drug treatment to exploit differences in their unit costs (£10.61 m savings were identified, representing 4.3% of total expenditure); (iii) seeking a different profile of referral and drug unit costs (£11.81 m savings were identified, representing 4.8% of total expenditure). © 2012 Elsevier B.V. All rights reserved.

Conclusion : on multiple levels of analysis, context, contingency and capital

In this concluding chapter, we bring together the threads and reflections on the chapters contained in this text and show how they relate to multi-level issues. The book has focused on the world of Human Resource Management (HRM) and the systems and practices it must put in place to foster innovation. Many of the contributions argue that in order to bring innovation about, organisations have to think carefully about the way in which they will integrate what is, in practice, organisationally relevant — but socially distributed — knowledge. They need to build a series of knowledge-intensive activities and networks, both within their own boundaries and across other important external inter-relationships. In so doing, they help to co-ordinate important information structures. They have, in effect, to find ways of enabling people to collaborate with each other at lower cost, by reducing both the costs of their co-ordination and the levels of unproductive search activity. They have to engineer these behaviours by reducing the risks for people that might be associated with incorrect ideas and help individuals, teams and business units to advance incomplete ideas that are so often difficult to codify. In short, a range of intangible assets must flow more rapidly throughout the organisation and an appropriate balance must be found between the rewards and incentives associated with creativity, novelty and innovation, versus the risks that innovation may also bring.

Determinants of entry and exit in the foreign owned sector of UK manufacturing

This paper examines the extent to which foreign entry and exit in the UK is related to domestic industry characteristics. The units of analysis are firm numbers, and thus entry and exit at the industry level are treated as being generated by Poisson processes. This therefore uses quasimaximum likelihood estimation, to estimate entry and exit functions simultaneously. The results demonstrate that foreign entry is attracted by industry level profitability and performance, but that firm specific 'ownership' advantages are also important. The results also demonstrate that inward investors that are motivated by the desire to exploit firm-specific assets, are unlikely to be more transient than domestic firms. This however, cannot be said of those foreign entrants who are attracted to the UK by location advantage or investment incentives.

The application of analysis of variance (ANOVA) to different experimental designs in optometry

Analysis of variance (ANOVA) is the most efficient method available for the analysis of experimental data. Analysis of variance is a method of considerable complexity and subtlety, with many different variations, each of which applies in a particular experimental context. Hence, it is possible to apply the wrong type of ANOVA to data and, therefore, to draw an erroneous conclusion from an experiment. This article reviews the types of ANOVA most likely to arise in clinical experiments in optometry including the one-way ANOVA ('fixed' and 'random effect' models), two-way ANOVA in randomised blocks, three-way ANOVA, and factorial experimental designs (including the varieties known as 'split-plot' and 'repeated measures'). For each ANOVA, the appropriate experimental design is described, a statistical model is formulated, and the advantages and limitations of each type of design discussed. In addition, the problems of non-conformity to the statistical model and determination of the number of replications are considered. © 2002 The College of Optometrists.

Elementary units of cortical activity? The rise and fall of the cortical column

The roots of the concept of cortical columns stretch far back into the history of neuroscience. The impulse to compartmentalise the cortex into functional units can be seen at work in the phrenology of the beginning of the nineteenth century. At the beginning of the next century Korbinian Brodmann and several others published treatises on cortical architectonics. Later, in the middle of that century, Lorente de No writes of chains of ‘reverberatory’ neurons orthogonal to the pial surface of the cortex and called them ‘elementary units of cortical activity’. This is the first hint that a columnar organisation might exist. With the advent of microelectrode recording first Vernon Mountcastle (1957) and then David Hubel and Torsten Wiesel provided evidence consistent with the idea that columns might constitute units of physiological activity. This idea was backed up in the 1970s by clever histochemical techniques and culminated in Hubel and Wiesel’s well-known ‘ice-cube’ model of the cortex and Szentogathai’s brilliant iconography. The cortical column can thus be seen as the terminus ad quem of several great lines of neuroscientific research: currents originating in phrenology and passing through cytoarchitectonics; currents originating in neurocytology and passing through Lorente de No. Famously, Huxley noted the tragedy of a beautiful hypothesis destroyed by an ugly fact. Famously, too, human visual perception is orientated toward seeing edges and demarcations when, perhaps, they are not there. Recently the concept of cortical columns has come in for the same radical criticism that undermined the architectonics of the early part of the twentieth century. Does history repeat itself? This paper reviews this history and asks the question.

The use of analysis of variance (ANOVA) in applied microbiology

Experiments combining different groups or factors and which use ANOVA are a powerful method of investigation in applied microbiology. ANOVA enables not only the effect of individual factors to be estimated but also their interactions; information which cannot be obtained readily when factors are investigated separately. In addition, combining different treatments or factors in a single experiment is more efficient and often reduces the number of replications required to estimate treatment effects adequately. Because of the treatment combinations used in a factorial experiment, the DF of the error term in the ANOVA is a more important indicator of the ‘power’ of the experiment than the number of replicates. A good method is to ensure, where possible, that sufficient replication is present to achieve 15 DF for each error term of the ANOVA. Finally, it is important to consider the design of the experiment because this determines the appropriate ANOVA to use. Some of the most common experimental designs used in the biosciences and their relevant ANOVAs are discussed by. If there is doubt about which ANOVA to use, the researcher should seek advice from a statistician with experience of research in applied microbiology.

The impact of stressors and regulatory focus on creativity:a dual level of analysis

Presentation

Managing supply chain knowledge-based linkages for improving operational performance

Purpose: This paper aims to explore the role of internal and external knowledgebased linkages across the supply chain in achieving better operational performance. It investigates how knowledge is accumulated, shared, and applied to create organization-specific knowledge resources that increase and sustain the organization's competitive advantage. Design/methodology/approach: This paper uses a single case study with multiple, embedded units of analysis, and the social network analysis (SNA) to demonstrate the impact of internal and external knowledge-based linkages across multiple tiers in the supply chain on the organizational operational performance. The focal company of the case study is an Italian manufacturer supplying rubber components to European automotive enterprises. Findings: With the aid of the SNA, the internal knowledge-based linkages can be mapped and visualized. We found that the most central nodes having the most connections with other nodes in the linkages are the most crucial members in terms of knowledge exploration and exploitation within the organization. We also revealed that the effective management of external knowledge-based linkages, such as buyer company, competitors, university, suppliers, and subcontractors, can help improve the operational performance. Research limitations/implications: First, our hypothesis was tested on a single case. The analysis of multiple case studies using SNA would provide a deeper understanding of the relationship between the knowledge-based linkages at all levels of the supply chain and the integration of knowledge. Second, the static nature of knowledge flows was studied in this research. Future research could also consider ongoing monitoring of dynamic linkages and the dynamic characteristic of knowledge flows. Originality/value: To the best of our knowledge, the phrase 'knowledge-based linkages' has not been used in the literature and there is lack of investigation on the relationship between the management of internal and external knowledge-based linkages and the operational performance. To bridge the knowledge gap, this paper will show the importance of understanding the composition and characteristics of knowledge-based linkages and their knowledge nodes. In addition, this paper will show that effective management of knowledge-based linkages leads to the creation of new knowledge and improves organizations' operational performance.

What drives the prediction of early reading? An analysis of stimulus and response-type

Purpose: Phonological accounts of reading implicate three aspects of phonological awareness tasks that underlie the relationship with reading; a) the language-based nature of the stimuli (words or nonwords), b) the verbal nature of the response, and c) the complexity of the stimuli (words can be segmented into units of speech). Yet, it is uncertain which task characteristics are most important as they are typically confounded. By systematically varying response-type and stimulus complexity across speech and non-speech stimuli, the current study seeks to isolate the characteristics of phonological awareness tasks that drive the prediction of early reading. Method: Four sets of tasks were created; tone stimuli (simple non-speech) requiring a non-verbal response, phonemes (simple speech) requiring a non-verbal response, phonemes requiring a verbal response, and nonwords (complex speech) requiring a verbal response. Tasks were administered to 570 2nd grade children along with standardized tests of reading and non-verbal IQ. Results: Three structural equation models comparing matched sets of tasks were built. Each model consisted of two 'task' factors with a direct link to a reading factor. The following factors predicted unique variance in reading: a) simple speech and non-speech stimuli, b) simple speech requiring a verbal response but not simple speech requiring a non-verbal-response, and c) complex and simple speech stimuli. Conclusions: Results suggest that the prediction of reading by phonological tasks is driven by the verbal nature of the response and not the complexity or 'speechness' of the stimuli. Findings highlight the importance of phonological output processes to early reading.

A comparative analysis of cultural value orientations of Indians and migrant Indians in the USA

Understanding the cultural value systems of nations is a key factor in anticipating the behaviour of business managers and employees in a specific business environment. Many research studies have acknowledged the impact of culture on communication across nations and its impact on business operations, however no study has attempted to measure and quantify the cultural orientations of people originating from one nation, but working in two different national settings. This study adopted Kluckhohn and Strodtbeck's framework to examine cultural dimensions of a total of 580 Indian respondents comprising two groups: 429 Indian natives living and working in India and 151 Indian migrants living and working in the USA. It initially compares the cultural orientations of the total population of each of the two groups and then examines cultural differences in the same based on demographic characteristics consisting of occupation, gender, age, and level of education. The study found significant cultural value differences between the two groups on both levels of analysis. The theoretical and practical implications of these findings are discussed in detail.

The use of multivariate methods in the identification of subtypes of Alzheimer's disease: a comparison of principal components and cluster analysis

Two contrasting multivariate statistical methods, viz., principal components analysis (PCA) and cluster analysis were applied to the study of neuropathological variations between cases of Alzheimer's disease (AD). To compare the two methods, 78 cases of AD were analyzed, each characterised by measurements of 47 neuropathological variables. Both methods of analysis revealed significant variations between AD cases. These variations were related primarily to differences in the distribution and abundance of senile plaques (SP) and neurofibrillary tangles (NFT) in the brain. Cluster analysis classified the majority of AD cases into five groups which could represent subtypes of AD. However, PCA suggested that variation between cases was more continuous with no distinct subtypes. Hence, PCA may be a more appropriate method than cluster analysis in the study of neuropathological variations between AD cases.

Is it all tough talking at the top? A post-structuralist analysis of the construction of gendered speaker identities of British business leaders within interview narratives

This paper uses a feminist post-structuralist approach to examine the gendered identities of a sample of British business leaders in Britain. While recent national surveys offer many material reasons why women are acutely under-represented as business leaders, the role of language is rarely addressed. This paper explores the ways in which ten senior women and men construct their sense of leadership identities through the medium of interview narratives. Drawing upon two poststructuralist models of analysis (Derrida’s 1987 theory of deconstruction and Bakhtin’s 1927/1981 concept of double-voiced discourse), the paper shows how both females and males are able to shift pragmatically between interwoven corporate discourses, which demand competing cultural allegiances from one moment to the next, allegiances constantly tested by the rapid change and uncertainty that characterise global business. While male leaders experience a relative freedom of movement between different cultural discourses, female leaders are circumscribed by negative and reductive representations of female speech and behaviour. In sum, senior women are required constantly to observe, review, police and repair their use of leadership language, which potentially undermines their confidence and authority as leaders.

A rationale for the optimisation by computer methods of the efficient use of metals and materials

The aim of the research project was to gain d complete and accurate accounting of the needs and deficiencies of materials selection and design data, with particular attention given to the feasibility of a computerised materials selection system that would include application analysis, property data and screening techniques. The project also investigates and integrates the three major aspects of materials resources, materials selection and materials recycling. Consideration of the materials resource base suggests that, though our discovery potential has increased, geologic availability is the ultimate determinant and several metals may well become scarce at the same time, thus compounding the problem of substitution. With around 2- to 20- million units of engineering materials data, the use of a computer is the only logical answer for scientific selection of materials. The system developed at Aston is used for data storage, mathematical computation and output. The system enables programs to be run in batch and interactive (on-line) mode. The program with modification can also handle such variables as quantity of mineral resources, energy cost of materials and depletion and utilisation rates of strateqic materials. The work also carries out an in-depth study of copper recycling in the U.K. and concludes that, somewhere in the region of 2 million tonnes of copper is missing from the recycling cycle. It also sets out guidelines on product design and conservation policies from the recyclability point of view.

Statnote 30 : The one-way analysis of variance (ANOVA):fixed effects model

In Statnote 9, we described a one-way analysis of variance (ANOVA) ‘random effects’ model in which the objective was to estimate the degree of variation of a particular measurement and to compare different sources of variation in space and time. The illustrative scenario involved the role of computer keyboards in a University communal computer laboratory as a possible source of microbial contamination of the hands. The study estimated the aerobic colony count of ten selected keyboards with samples taken from two keys per keyboard determined at 9am and 5pm. This type of design is often referred to as a ‘nested’ or ‘hierarchical’ design and the ANOVA estimated the degree of variation: (1) between keyboards, (2) between keys within a keyboard, and (3) between sample times within a key. An alternative to this design is a 'fixed effects' model in which the objective is not to measure sources of variation per se but to estimate differences between specific groups or treatments, which are regarded as 'fixed' or discrete effects. This statnote describes two scenarios utilizing this type of analysis: (1) measuring the degree of bacterial contamination on 2p coins collected from three types of business property, viz., a butcher’s shop, a sandwich shop, and a newsagent and (2) the effectiveness of drugs in the treatment of a fungal eye infection.