Risk adjustment for hospital use using social security data: cross sectional small area analysis

Objectives: To identify demographic and socioeconomic determinants of need for acute hospital treatment at small area level. To establish whether there is a relation between poverty and use of inpatient services. To devise a risk adjustment formula for distributing public funds for hospital services using, as far as possible, variables that can be updated between censuses. Design: Cross sectional analysis. Spatial interactive modelling was used to quantify the proximity of the population to health service facilities. Two stage weighted least squares regression was used to model use against supply of hospital and community services and a wide range of potential needs drivers including health, socioeconomic census variables, uptake of income support and family credit, and religious denomination. Setting: Northern Ireland. Main outcome measure: Intensity of use of inpatient services. Results: After endogeneity of supply and use was taken into account, a statistical model was produced that predicted use based on five variables: income support, family credit, elderly people living alone, all ages standardised mortality ratio, and low birth weight. The main effect of the formula produced is to move resources from urban to rural areas. Conclusions: This work has produced a population risk adjustment formula for acute hospital treatment in which four of the five variables can be updated annually rather than relying on census derived data. Inclusion of the social security data makes a substantial difference to the model and to the results produced by the formula.

Climate drivers for peatland palaeoclimate records

Reconstruction of hydroclimate variability is an important part of understanding natural climate change on decadal to millennial timescales. Peatland records reconstruct 'bog surface wetness' (BSW) changes, but it is unclear whether it is a relative dominance of precipitation or temperature that has driven these variations over Holocene timescales. Previously, correlations with instrumental climate data implied that precipitation is the dominant control. However, a recent chironomid inferred July temperature record suggested temperature changes were synchronous with BSW over the mid-late Holocene. This paper provides new analyses of these data to test competing hypotheses of climate controls on bog surface wetness and discusses some of the distal drivers of large-scale spatial patterns of BSW change. Using statistically based estimates of uncertainty in chronologies and proxy records, we show a correlation between Holocene summer temperature and BSW is plausible, but that chronologies are insufficiently precise to demonstrate this conclusively. Simulated summer moisture deficit changes for the last 6000 years forced by temperature alone are relatively small compared with observations over the 20th century. Instrumental records show that summer moisture deficit provides the best explanatory variable for measured water table changes and is more strongly correlated with precipitation than with temperature in both Estonia and the UK. We conclude that BSW is driven primarily by precipitation, reinforced by temperature, which is negatively correlated with precipitation and therefore usually forces summer moisture deficit in the same direction. In western Europe, BSW records are likely to be forced by changes in the strength and location of westerlies, linked to large-scale North Atlantic ocean and atmospheric circulation. (C) 2009 Elsevier Ltd. All rights reserved.

Drivers of sales performance: a contemporary meta-analysis. Have salespeople become knowledge brokers?

It has been 25 years since the publication of a comprehensive review of the full spectrum of salesperformance drivers. This study takes stock of the contemporary field and synthesizes empirical evidence from the period 1982–2008. The authors revise the classification scheme for sales performance determinants devised by Walker et al. (1977) and estimate both the predictive validity of its sub-categories and the impact of a range of moderators on determinant-sales performance relationships. Based on multivariate causal model analysis, the results make two major observations: (1) Five sub-categories demonstrate significant relationships with sales performance: selling-related knowledge (ß=.28), degree of adaptiveness (ß=.27), role ambiguity (ß=-.25), cognitive aptitude (ß=.23) and work engagement (ß=.23). (2) These sub-categories are moderated by measurement method, research context, and salestype variables. The authors identify managerial implications of the results and offer suggestions for further research, including the conjecture that as the world is moving toward a knowledge-intensive economy, salespeople could be functioning as knowledge-brokers. The results seem to back this supposition and indicate how it might inspire future research in the field of personal selling.

Drivers of Supply Network Governance: An Explorative Study of the Dutch Chemical Industry.

The authors identify a number of drivers of supply network governance, a widely appraised governance form aimed at reaping the benefits of both vertical integration and market exchange. Case studies conducted in the Dutch chemical industry are used to explore these drivers. The findings identify interdependence of organizational activities and asset-specific investments as the key drivers of supply network governance in the chemical industry. Firms enjoy relational rents and tend to share knowledge in supply network relationships, however these factors seem to strengthen supply network relationships rather than create them.