End-of-life decision making in Europe and Australia - A physician survey

Background: The frequencies with which physicians make different medical end-of-life decisions (ELDs) may differ between countries, but comparison between countries has been difficult owing to the use of dissimilar research methods. Methods: A written questionnaire was sent to a random sample of physicians from 9 specialties in 6 European countries and Australia to investigate possible differences in the frequencies of physicians' willingness to perform ELDs and to identify predicting factors. Response rates ranged from 39% to 68% (N= 10 139). Using hypothetical cases, physicians were asked whether they would ( probably) make each of 4 ELDs. Results: In all the countries, 75% to 99% of physicians would withhold chemotherapy or intensify symptom treatment at the request of a patient with terminal cancer. In most cases, more than half of all physicians would also be willing to deeply sedate such a patient until death. However, there was generally less willingness to administer drugs with the explicit intention of hastening death at the request of the patient. The most important predictor of ELDs was a request from a patient with decisional capacity (odds ratio, 2.1-140.0). Shorter patient life expectancy and uncontrollable pain were weaker predictors but were more stable across countries and across the various ELDs (odds ratios, 1.1-2.4 and 0.9-2.4, respectively). Conclusion: Cultural and legal factors seem to influence the frequencies of different ELDs and the strength of their determinants across countries, but they do not change the essence of decision making.

Myths and Truths: The "Law and Finance Theory" Revisited

The law and finance theory identifies two dominating legal traditions, a common law tradition inherited from England, and a civil law tradition that is going back to 19th century codifications in France, Germany and Scandinavia. Another key notion of the theory is the distinction between insiders (stakeholders, "the State") and outsiders (shareholders as well as creditors). The micro foundation of this approach is the willingness to invest. The innovative addition of the law and finance theory to these ideas lies in the way it combines them with its peculiar view on legal history. The innovative addition of the law and finance theory to these ideas lies in the way it combines them with its peculiar view on legal history. The major conclusion of this theory is that the common law system provides the best basis for financial development and economic growth, followed by Scandinavian and German origin civil law and finally French origin civil law.

Identity barriers to engaging in proenvironmental behaviour

Previous research has shown that engaging in proenvironmental behaviours can have a stygmatising effect for those who take part in those activities. This suggests that the identity consequences of proenvironmental behaviours may act as a barrier to engaging in these types of actions. This idea was investigated in a study assessing whether university students’ preferences for status-related or proenvironmental actions was influenced by prevailing group norms. Participants in the control condition and the status norm condition were equally willing to selfpresent as high status and pro-environment, however, participants in the environmental norm condition were more willing to self-present as pro-environment than status concerned. These results suggest that willingness to engage in pro-environmental behaviours may be higher in contexts where the identity consequences of these actions are positive. Preliminary results from a second study investigating identity consequences of pro-environmental behaviour will also be presented. Implications of the findings for strategies or campaigns aimed at increasing environmentally sustainable behaviour will be discussed.

PASTORAL EM SITUAÇÃO DE RUA Análise das Ações Pastorais da Comunidade Metodista do Povo de Rua na Cidade de São Paulo 1992 2009

A população em situação de rua é um fenômeno urbano, agravado na contemporaneidade por fatores de ordem social, econômica, cultural que agrupa pessoas independentemente da idade, etnia, grau de instrução e gênero, em situação de exclusão social, impedidos à renda e suprimento de suas necessidades vitais, culturais e sociais. Na condição de população sobrante, enfrenta obstáculos ao desenvolvimento de suas capacidades intelectuais, biológicas e culturais; à equidade de garantia de direitos civis, políticos e sociais; à qualidade de vida em harmonia e bem-estar objetivo dos seres humanos; e ao exercício pleno de sua cidadania. A Comunidade Metodista do Povo de Rua - CMPR encontrou o seu espaço no início da década de noventa, ao tempo em que a Prefeitura Municipal de São Paulo, na Legislatura da Prefeita Luíza Erundina, promoveu, através da Secretaria Municipal de Bem-Estar social, o censo para conhecer quem era, como vivia e como era vista a população de rua na cidade de São Paulo. Neste contexto, a Igreja Metodista Coreana Ebenezer oferecia à população uma assistência dominical servindo pão, café com leite e achocolatado na região do Parque Dom Pedro II. Sagrou-se a parceria para a criação da CMPR através do despertar do poder público e da participação da Igreja Metodista Coreana através do Café do Coreano. Foi fundamental a disposição dos Bispos Nelson Campos Leite e Geoval Jacinto da Silva, ambos da Terceira Região Eclesiástica da Igreja Metodista, que iniciaram os trabalhos utilizando a instituição de caráter filantrópico da Igreja Metodista, a AMAS Associação Metodista de Assistência Social. Assim, com sede no Viaduto Pedroso e, por proximidade geográfica, a CMPR vinculou-se a AMAS da Catedral Metodista de São Paulo, atuando em três dimensões: (1) criação da Casa de Convivência, (2) abrigamento no período do inverno; (3) Criação do albergue. O Plano de Ação elaborado pela CMPR que consagrou a criação do Albergue, data da transição 1994/95 e teve como base o Credo Social, o Plano para Vida e Missão da Igreja Metodista e o Plano de Ação encaminhado à Prefeitura, à luz da vertente social do movimento Metodista a partir de João Wesley, estabelecendo que o objetivo geral da CMPR fosse o resgate da cidadania das pessoas que constituem a população de rua. Nesta dimensão, a tese está estruturada em cinco capítulos, inclusa pesquisa de campo que foi aplicada a funcionários e ex-funcionários da CMPR, com objetivo de reunir conteúdos para se analisar as ações pastorais da CMPR na perspectiva da Práxis religiosa, considerando a Práxis filosófica e educacional, a fim de perceber se as ações pastorais são ações criadoras, reflexivas, libertadoras e radicais, e se promovem por meio da CMPR o resgate da cidadania em população de rua na cidade de São Paulo.(AU)

Challenges for expatriate managers:an exploration of cross-cultural management, adjustment, and training issues faced by Anglo-American managers in Hong Kong

This field work study furthers understanding about expatriate management, in particular, the nature of cross-cultural management in Hong Kong involving Anglo-American expatriate and Chinese host national managers, the important features of adjustment for expatriates living and working there, and the type of training which will assist them to adjust and to work successfully in this Asian environment. Qualitative and quantitative data on each issue was gathered during in-depth interviews in Hong Kong, using structured interview schedules, with 39 expatriate and 31 host national managers drawn from a cross-section of functional areas and organizations. Despite the adoption of Western technology and the influence of Western business practices, micro-level management in Hong Kong retains a cultural specificity which is consistent with the norms and values of Chinese culture. There are differences in how expatriates and host nationals define their social roles, and Hong Kong's recent colonial history appears to influence cross-cultural interpersonal interactions. The inability of the spouse and/or family to adapt to Hong Kong is identified as a major reason for expatriate assignments to fail, though the causes have less to do with living away from family and friends, than with Hong Kong's highly urbanized environment and the heavy demands of work. Culture shock is not identified as a major problem, but in Hong Kong micro-level social factors require greater adjustment than macro-level societal factors. The adjustment of expatriate managers is facilitated by a strong orientation towards career development and hard work, possession of technical/professional expertise, and a willingness to engage in a process of continuous 'active learning' with respect to the host national society and culture. A four-part model of manager training suitable for Hong Kong is derived from the study data. It consists of a pre-departure briefing, post-arrival cross-cultural training, language training in basic Cantonese and in how to communicate more effectively in English with non-native speakers, and the assignment of a mentor to newly arrived expatriate managers.

Evidence and implications of multiple paradigms in accounting knowledge production

This paper uses evidence gathered in two perception studies ofAustralasian and British accounting academics to reflect on aspects of the knowledge production systemwithin accounting academe. We provide evidence of the representation of multiple paradigms in many journals that are scored by participants as being of high quality. Indeed most of the journals we surveyed are perceived by accounting academics as incorporating research from more than one paradigm. It is argued that this ‘catholic’ approach by journal editors and the willingness of many respondents in our surveys to score journals highly on material they publish from both paradigm categories reflects a balanced acceptance of the multi-paradigmatic state of accounting research. Our analysis is set within an understanding of systems of accounting knowledge production as socially constructed and as playing an important role in the distribution of power and reward in the academy. We explore the impact of our results on concerns emerging from the work of a number of authors who carefully expose localised 'elites'. The possibilities for a closer relationship between research emerging from a multi-paradigm discipline and policy setting and practice are also discussed. The analysis provides a sense of optimism that the broad constituency of accounting academics operates within an environment conducive for the exchange of ideas. That optimism is dampened by concerns about the impact of local 'elites' and the need for more research on their impact on accounting academe.

Sales manager problem resolution styles:measure development and an examination of their salesperson-related consequences

Personal selling and sales management play a critical role in the short and long term success of the firm, and have thus received substantial academic interest since the 1970s. Sales research has examined the role of the sales manager in some depth, defining a number of key technical and interpersonal roles which sales managers have in influencing sales force effectiveness. However, one aspect of sales management which appears to remain unexplored is that of their resolution of salesperson-related problems. This study represents the first attempt to address this gap by reporting on the conceptual and empirical development of an instrument designed to measure sales managers' problem resolution styles. A comprehensive literature review and qualitative research study identified three key constructs relating to sales managers' problem resolution styles. The three constructs identified were termed; sales manager willingness to respond, sales manager caring, and sales manager aggressiveness. Building on this, existing literature was used to develop a conceptual model of salesperson-specific consequences of the three problem resolution style constructs. The quantitative phase of the study consisted of a mail survey of UK salespeople, achieving a total sample of 140 fully usable responses. Rigorous statistical assessment of the sales manager problem resolution style measures was undertaken, and construct validity examined. Following this, the conceptual model was tested using latent variable path analysis. The results for the model were encouraging overall, and also with regard to the individual hypotheses. Sales manager problem resolution styles were found individually to have significant impacts on the salesperson-specific variables of role ambiguity, emotional exhaustion, job satisfaction, organisational commitment and organisational citizenship behaviours. The findings, theoretical and managerial implications, limitations and directions for future research are discussed.

Will you tolerate this? The impact of affective commitment on complaint intention and postrecovery behavior

Successful complaint management primarily depends on customers' willingness to voice their complaints and on companies' ability to adequately deal with these complaints. This article investigates the impact of one relationship characteristic in the complaint management process: affective commitment. Based on two studies, the authors investigate whether affective commitment moderates the impact of complaint barriers on complaint intention (a) and whether it moderates the link between complaint satisfaction and purchase behavior after the complaint (b). Results show that affectively committed customers exhibit higher complaint intention irrespective of the level of complaint barriers. Furthermore, affectively committed customers display little change in their postrecovery behavior, even after a service failure followed by an unsatisfactory recovery attempt. It seems that these customers are tolerant and want to help the provider improve their business. Affective commitment seems to amplify willingness to help the company by means of voicing dissatisfaction despite considerable efforts in doing so. Moreover, affective commitment buffers the negative effects of service failures on postrecovery behavior. Findings have important implications for managers. They highlight the necessity to measure customers' affective commitment. Based on that, tailored complaint systems can be designed, which help in achieving a more effective allocation of resources for customer recovery.

Assessing the efficacy of structural merger remedies:choosing between theories of harm?

Previous empirical assessments of the effectiveness of structural merger remedies have focused mainly on the subsequent viability of the divested assets. Here, we take a different approach by examining how competitive are the market structures which result from the divestments. We employ a tightly specified sample of markets in which the European Commission (EC) has imposed structural merger remedies. It has two key features: (i) it includes all mergers in which the EC appears to have seriously considered, simultaneously, the possibility of collective dominance, as well as single dominance; (ii) in a previous paper, for the same sample, we estimated a model which proved very successful in predicting the Commission’s merger decisions, in terms of the market shares of the leading firms. The former allows us to explore the choices between alternative theories of harm, and the latter provides a yardstick for evaluating whether markets are competitive or not – at least in the eyes of the Commission. Running the hypothetical post-remedy market shares through the model, we can predict whether the EC would have judged the markets concerned to be competitive, had they been the result of a merger rather than a remedy. We find that a significant proportion were not competitive in this sense. One explanation is that the EC has simply been inconsistent – using different criteria for assessing remedies from those for assessing the mergers in the first place. However, a more sympathetic – and in our opinion, more likely – explanation is that the Commission is severely constrained by the pre-merger market structures in many markets. We show that, typically, divestment remedies return the market to the same structure as existed before the proposed merger. Indeed, one can argue that any competition authority should never do more than this. Crucially, however, we find that this pre-merger structure is often itself not competitive. We also observe an analogous picture in a number of markets where the Commission chose not to intervene: while the post-merger structure was not competitive, nor was the pre-merger structure. In those cases, however, the Commission preferred the former to the latter. In effect, in both scenarios, the EC was faced with a no-win decision. This immediately raises a follow-up question: why did the EC intervene for some, but not for others – given that in all these cases, some sort of anticompetitive structure would prevail? We show that, in this sample at least, the answer is often tied to the prospective rank of the merged firm post-merger. In particular, in those markets where the merged firm would not be the largest post-merger, we find a reluctance to intervene even where the resulting market structure is likely to be conducive to collective dominance. We explain this by a willingness to tolerate an outcome which may be conducive to tacit collusion if the alternative is the possibility of an enhanced position of single dominance by the market leader. Finally, because the sample is confined to cases brought under the ‘old’ EC Merger Regulation, we go on to consider how, if at all, these conclusions require qualification following the 2004 revisions, which, amongst other things, made interventions for non-coordinated behaviour possible without requiring that the merged firm be a dominant market leader. Our main conclusions here are that the Commission appears to have been less inclined to intervene in general, but particularly for Collective Dominance (or ‘coordinated effects’ as it is now known in Europe as well as the US.) Moreover, perhaps contrary to expectation, where the merged firm is #2, the Commission has to date rarely made a unilateral effects decision and never made a coordinated effects decision.

Managing the human resource in Indian SMEs:The role of indigenous realities

This paper discusses how issues of people management are addressed in Indian small and medium enterprises (SMEs). It also highlights the indigenous approaches to human resource management (HRM) that have surfaced in the Indian SME context. The research formulation has been built on the mapping of people-management practices in two SME case studies, one of which is also a family-based organization. The analysis shows that indigenous realities in HRM in Indian SMEs relate mainly to the provision of financial, emotional and social support to the workforce; employee involvement (EI) practices; recruitment; skill development; managing employee relations; and managing vis-à-vis labor law framework. The paper argues that in the sphere of people management in SMEs, the willingness to innovate and formalize the HR systems is constrained by a kind of bounded rationality, i.e., the owners of SMEs mostly believe that they are already doing what is humanly possible in this regard. The analysis has an important message for concerned practitioners—in order to realize their full potential and to progress towards fulfilling their vision; SMEs eventually have to intertwine indigenization and formalization for their people management approaches.

A firm's capability to calibrate supply chain knowledge-antecedents and consequences

This paper proposes a conceptual model for a firm's capability to calibrate supply chain knowledge (CCK). Knowledge calibration is achieved when there is a match between managers' ex ante confidence in the accuracy of held knowledge and the ex post accuracy of that knowledge. Knowledge calibration is closely related to knowledge utility or willingness to use the available ex ante knowledge: a manager uses the ex ante knowledge if he/she is confident in the accuracy of that knowledge, and does not use it or uses it with reservation, when the confidence is low. Thus, knowledge calibration attained through the firm's CCK enables managers to deal with incomplete and uncertain information and enhances quality of decisions. In the supply chain context, although demand- and supply-related knowledge is available, supply chain inefficiencies, such as the bullwhip effect, remain. These issues may be caused not by a lack of knowledge but by a firm's lack of capability to sense potential disagreement between knowledge accuracy and confidence. Therefore, this paper contributes to the understanding of supply chain knowledge utilization by defining CCK and identifying a set of antecedents and consequences of CCK in the supply chain context.

Expatriate-local interactions:an investigation in China

Purpose: This study aims to build on recent research, by investigating and examining how likely it is that Chinese locals (i.e. host country nationals (HCNs)) would offer support to expatriates from India and the USA. Design/methodology/approach: Data were gathered from 222 participants in Chinese organizations, asking them to respond to questions about their willingness to offer support to expatriates. Findings: As predicted, perceived values similarity was significantly related to higher dogmatism, which had a significant positive relationship with ethnocentrism. Further, ethnocentrism had a significant negative relationship with willingness to offer support. Research limitations/implications: All data were collected from the participants at one point in time, so the study's results are subject to common method bias. Also, it only included India and the USA, as the two countries of origin of the expatriates. Practical implications: Given HCNs do not automatically offer support to all expatriates, organizations might consider sending expatriates who are culturally similar to HCNs, as they are more likely to receive support, which will help their adjustment and thus organizational effectiveness. Originality/value: This study adds to the small, but growing, number of empirical investigations of HCN willingness to support expatriates. © Emerald Group Publishing Limited.

The relationship between expatriate job level and host country national categorization:an investigation in the UK

Using data from 493 host country nationals (HCNs) in the UK, we investigated relationships between expatriate gender, national origin, and job level, and HCN characteristics and willingness to help expatriates. Results showed that HCNs from the UK are likely to categorize expatriates as in-group or out-group members based on perceived values similarity, ethnocentrism, and collectivism. This categorization is also likely to affect HCN willingness to provide role information and social support to expatriates. Overall, our results suggest that HCNs would be more likely to provide role-related information to subordinates and peers than supervisors, and social support to male peers regardless of their nationality (i.e. USA vs. India). The analysis contributes to the fields of expatriate management, social categorization, and international human resource management. It also has key messages for multinational companies regarding the development of efficient expatriate management systems. © 2011 Taylor & Francis.

Educational intervention improves anticoagulation control in atrial fibrillation patients:the TREAT randomised trial

Background: Stroke prevention in atrial fibrillation (AF), most commonly with warfarin, requires maintenance of a narrow therapeutic target (INR 2.0 to 3.0) and is often poorly controlled in practice. Poor patient-understanding surrounding AF and its’ treatment may contribute to patient’s willingness to adhere to recommendations. Method: A theory-driven intervention, developed using patient interviews and focus groups, consisting of a one-off group session (1-6 patients) utilising an ‘expert-patient’ focussed DVD, educational booklet, self-monitoring diary and worksheet, was compared in a randomised controlled trial (ISRCTN93952605) against usual care, with patient postal follow-ups at 1, 2, 6, and 12-months. Ninety-seven warfarin-naïve AF patients were randomised to intervention (n=46, mean age (SD) 72.0 (8.2), 67.4% men), or usual care (n=51, mean age (SD) 73.7 (8.1), 62.7% men), stratified by age, sex, and recruitment centre. Primary endpoint was time within therapeutic range (TTR); secondary endpoints included knowledge, quality of life, anxiety/depression, beliefs about medication, and illness perceptions. Main findings: Intervention patients had significantly higher TTR than usual care at 6-months (76.2% vs. 71.3%; p=0.035); at 12-months these differences were not significant (76.0% vs. 70.0%; p=0.44). Knowledge increased significantly across time (F (3, 47) = 6.4; p<0.01), but there were no differences between groups (F (1, 47) = 3.3; p = 0.07). At 6-months, knowledge scores predicted TTR (r=0.245; p=0.04). Patients’ scores on subscales representing their perception of the general harm and overuse of medication, as well as the perceived necessity of their AF specific medications predicted TTR at 6- and 12-months. Conclusions: A theory-driven educational intervention significantly improves TTR in AF patients initiating warfarin during the first 6-months. Adverse clinical outcomes may potentially be reduced by improving patients’ understanding of the necessity of warfarin and reducing their perception of treatment harm. Improving education provision for AF patients is essential to ensure efficacious and safe treatment.

Relationship fading in business-to-consumer context

The objective of this paper is to explain the phenomenon of relationship fading in a business-to-consumer (B2C) context and to identify the key antecedents and drivers in this process. Fading relates to a gradual decline in consumers’ willingness to continue a relationship with a company. Therefore it may help to elucidate the ‘unexplained’ relationship dissolution and customer defection. Led by an assumption that a relationship between a consumer and a brand is like the one between individuals, the paper proposes that the trajectory of relationship fading reflects disaffection processes similar to the ones suggested in marital and romantic relationships between individuals. Stages of the fading process and their characteristics are presented. Academic and practical implications are subsequently presented.