The accuracy and completeness for receipt of colorectal cancer care using Veterans Health Administration administrative data.

BACKGROUND: The National Comprehensive Cancer Network and the American Society of Clinical Oncology have established guidelines for the treatment and surveillance of colorectal cancer (CRC), respectively. Considering these guidelines, an accurate and efficient method is needed to measure receipt of care. METHODS: The accuracy and completeness of Veterans Health Administration (VA) administrative data were assessed by comparing them with data manually abstracted during the Colorectal Cancer Care Collaborative (C4) quality improvement initiative for 618 patients with stage I-III CRC. RESULTS: The VA administrative data contained gender, marital, and birth information for all patients but race information was missing for 62.1% of patients. The percent agreement for demographic variables ranged from 98.1-100%. The kappa statistic for receipt of treatments ranged from 0.21 to 0.60 and there was a 96.9% agreement for the date of surgical resection. The percentage of post-diagnosis surveillance events in C4 also in VA administrative data were 76.0% for colonoscopy, 84.6% for physician visit, and 26.3% for carcinoembryonic antigen (CEA) test. CONCLUSIONS: VA administrative data are accurate and complete for non-race demographic variables, receipt of CRC treatment, colonoscopy, and physician visits; but alternative data sources may be necessary to capture patient race and receipt of CEA tests.

Psychological bonds and their impact on behavioral loyalty in auditor-client relationships

Purpose – The purpose of this paper is to examine the effect of the psychological bond on behavioral loyalty (word-of-mouth, continuance and non-audit services) to audit firms providing services to companies listed on the Polish Stock Exchange. Design/methodology/approach – A model is proposed and tested using structural equation modeling with LISREL. Data were collected from top executives of companies listed on the Warsaw Stock Exchange. Findings – The psychological bond has a positive effect on word-of-mouth, continuance and non-audit services. Research limitations/implications – The current research is limited to the investigation of the psychological bond as an antecedent of behavioral loyalty in Poland. Future research should identify and assess other antecedents and replicate these across different countries. A longitudinal survey across different points in time might reveal more useful information about auditor-client relationships. Practical implications – Auditors need to consider ways in which they can develop the psychological bond with their clients. This bond is the basis for the client believing the audit firm is superior to others, which has been found to lead to behavioral loyalty in this study. In particular, management of the auditor brand and reputation, personal experience of the audit firm and alumni relations are discussed as ways of enhancing the psychological bond among client executives. Originality/value – This study is the first to examine the impact of the psychological bond on behavioral loyalty in auditor-client relationships.

The African National Congress and its Critics: 'Predatory Liberalism', Black Empowerment and Intra-Alliance Tensions in Post-Apartheid South Africa

Post-apartheid South Africa is characterized by centralized, neo-liberal policymaking that perpetuates, and in some cases exaggerates, socio-economic inequalities inherited from the apartheid era. The African National Congress (ANC) leadership’s alignment with powerful international and domestic market actors produces tensions within the Tripartite Alliance and between government and civil society. Consequently, several characteristics of ‘predatory liberalism’ are evident in contemporary South Africa: neo-liberal restructuring of the economy is combined with an increasing willingness by government to assert its authority, to marginalize and delegitimize those critical of its abandonment of inclusive governance. A new form of oligarch power, combining entrenched economic interests with those of a new ‘black bourgeoisie’ promoted by narrowly implemented Black Economic Empowerment policies, diminishes prospects for broad-based socio-economic transformation. Because the new policy environment is failing to resolve tensions between global market demands for increasing market liberalization and domestic popular demands for poverty-alleviation and socio-economic transformation, the ANC leadership is forced increasingly to confront ‘ultra-leftists’ who are challenging its credentials as defender of the National Democratic Revolution which was the cornerstone in the anti-apartheid struggle.

Cross-Border Environmental Governance and EC Law

This article examines the nature and scope of emerging cross-border participatory rights under European Community environmental law. It reviews the legal and political forces that have stimulated the development of such rights and also the specific nature of the rights conferred by three major legislative initiatives: the Community Directives on Environmental Impact Assessment, Integrated Pollution Prevention and Control, and the Water Framework Directive. The article concludes with a case study on Ireland which assesses the likely significance of these cross-border participatory rights for transboundary environmental governance in Ireland.

Summary statistics, educational achievement gaps and the ecological fallacy

Summary statistics continue to play an important role in identifying and monitoring patterns and trends in educational inequalities between differing groups of pupils over time. However, this article argues that their uncritical use can also encourage the labelling of whole groups of pupils as ‘underachievers’ or ‘overachievers’ as the findings of group-level data are simply applied to individual group members, a practice commonly termed the ‘ecological fallacy’. Some of the adverse consequences of this will be outlined in relation to current debates concerning gender and ethnic differences in educational attainment. It will be argued that one way of countering this uncritical use of summary statistics and the ecological fallacy that it tends to encourage, is to make much more use of the principles and methods of what has been termed ‘exploratory data analysis’. Such an approach is illustrated through a secondary analysis of data from the Youth Cohort Study of England and Wales, focusing on gender and ethnic differences in educational attainment. It will be shown that, by placing an emphasis on the graphical display of data and on encouraging researchers to describe those data more qualitatively, such an approach represents an essential addition to the use of simple summary statistics and helps to avoid the limitations associated with them.

Peacebuilding at the Local Level: Refugee Return to Prijedor'

During the 1992-95 war, Prijedor was synonymous with mass killing, ethnic cleansing and detention camps. A decade after the end of the war, international agencies consider this town to be an example of successful foreign intervention. Thousands of Muslim displaced persons (DPs) returned to their pre-war homes, mosques have been rebuilt, and hard-line Serb nationalists have lost much influence. How could Prijedor turn from a hopeless case of ethnic violence to an example of successful intervention? This essay argues that Prijedor's (relative) success is due more to the determination of Muslim DPs than to the international peacebuilding strategy. The initial post-Dayton international intervention exacerbated the problem of internal displacement, raised ethnic tensions and left Prijedor in the hands of the same indicted war criminals responsible for the war. Against the advice of international agencies, which feared a backlash among the Bosnian Serbs, in 1998 Muslim DPs began returning home. Eventually, large-scale return improved ethnic relations and helped marginalize Bosnian Serb extremists. The essay concludes by highlighting the lessons from Prijedor, and identifies the domestic and international contribution to Prijedor's post-settlement success.