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1 – 10 of over 2000Galen H. Smith and Teresa L. Scheid
The race concordance hypothesis suggests that matching patients and health providers on the basis of race improves communication and patients’ perceptions of health care, and by…
Abstract
Purpose
The race concordance hypothesis suggests that matching patients and health providers on the basis of race improves communication and patients’ perceptions of health care, and by extension, encourages patients to seek and utilize health care, which may reduce health disparities. However, relatively few studies have examined the impact of race concordance on the utilization of health services. This chapter is grounded on Andersen’s Emerging Model of Health Services Utilization (Phase 4) and extends that model to include race concordance.
Methodology/approach
The data were collected from a stratified random sample of adult beneficiaries enrolled in North Carolina Medicaid’s primary care case management delivery system in 2006–2007. Propensity score matching techniques were used to sort respondents on their propensity for race concordance and indices were constructed to generate key control variables. Poisson regression was used to examine the impact of race concordance on the utilization of primary care and emergency room care, under the assumption that race concordance would increase the use of primary care and decrease the use of emergency care for minority patients.
Findings
While blacks (compared to whites) used less primary care and had more emergency care visits, race concordance was not a statistically significant predictor of either primary care or emergency room use. However, patients’ satisfaction with their primary care providers was associated with significantly fewer primary care and emergency care visits while trust in one’s provider was associated with more primary care visits.
Research implications
The study findings suggest that the central premises of the race concordance hypothesis require further study to confirm the assumption that better patient – primary care provider relationships result in less utilization of more costly and resource-intensive forms of health care.
Value of chapter
The study makes a valuable contribution by expanding the relatively small body of literature dedicated to exploring the impact of race concordance on health services utilization. Additionally, by virtue of researching the experience of Medicaid enrollees, the study controls for health insurance status.
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Long Chen, Ming Chen, Hengjie Zhang and Xiao-Ming Yan
The purpose of the study is to examine the crossover effect of leader's role overload on employee's negative affect. More importantly, the stuy will identify the buffering role of…
Abstract
Purpose
The purpose of the study is to examine the crossover effect of leader's role overload on employee's negative affect. More importantly, the stuy will identify the buffering role of self-concordance goal on the relationship between leader's role overload and employee's negative affect.
Design/methodology/approach
The study builds the crossover impact of leader's role overload on employee's negative affect as well as the moderating effect of self-concordance goal. By a two-wave and paired data from 51 leaders and 225 employees, the study examines the hypothesis using cross-level analysis.
Findings
Results show that leader's role overload tends to reduce negative affect for employees who pursue high-level self-concordance goal and increase negative affect for employees who pursue low-level self-concordance goal.
Practical implications
It is important for employees to get rid of negative affect in the workplace. The study informs managers the benefits of pursuing self-concordance goals in helping employees alleviate the negative effect of leader's role overload.
Originality/value
Findings of the present study can enrich the literature of the crossover process from leader to employee and offer management strategy for enterprises about how to buffer the damaging effect of leader's role overload on employees.
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This chapter focuses on the development of concordance theory with respect to India's civil–military relations and Pakistan's early yet significant state of discordance, which led…
Abstract
This chapter focuses on the development of concordance theory with respect to India's civil–military relations and Pakistan's early yet significant state of discordance, which led to subsequent domestic military interventions. On a regional level, discordance is far more prevalent, and India operates in a South Asian environment where domestic military interventions are not uncommon – Pakistan, Bangladesh, and Sri Lanka being clear examples.
Moreover, the influence of China in the region cannot be overlooked, since India's defense policy is often a reaction to the role of China and the presence of conventional and nuclear forces. The proliferation of nuclear weapons, in particular, threatens a delicate balance in a highly volatile region where China exerts enormous influence on neighboring states including Pakistan. An argument can be made that India's domestic concordance between the military, the political elites, and the citizenry contributes to the preservation of regional stability, because India has chosen to maintain its regional strength vis-à-vis China and Pakistan, while continuing to search for a peaceful solution to the nuclear issue with allies such as the United States. India's most recent and ongoing nuclear deal with the United States originally struck in 2005 is an example of the delicate synergies taking place to offset potential threats from China, Pakistan, and Iran, while maintaining domestic military and technological strength.
Although India's successful domestic course encourages partnerships among international political and corporate allies, Pakistan's continuous domestic discordance has resulted in recent difficult relations with the United States, India, and Afghanistan. Pakistan's inability to quell al-Quaeda extremism has contributed to a lack of domestic confidence in General Musharraf's political agenda. Musharraf has continued the discordant political and social relationship begun by his predecessor Ayub Khan. As a result of Khan's initial and dramatic alienation of the East Bengali community, Pakistan's military and political elites have never recovered the domestic credibility needed to partner with other political groups and the citizenry – a credibility so vital to domestic concordance and international foreign policy.I do not want my house to be walled in on all sides and my windows to be stuffed. I want the cultures of all the lands to be blown about my house as freely as possible. But I refuse to be blown off my feet by any.– Mahatma Gandhi
Fauzia Syed, Muhammad Waheed Akhtar, Muhammad Kashif, Muhammad Asrar-ul-Haq, Qurt ul ain, Mudassir Husnain and Muhammad Kashif Aslam
This study investigates despotic leadership (DL) as an antecedent to bullying behavior with a mediating role of moral emotions at work. Another aim is to study the moderating role…
Abstract
Purpose
This study investigates despotic leadership (DL) as an antecedent to bullying behavior with a mediating role of moral emotions at work. Another aim is to study the moderating role of self-concordance to buffer the relationship between DL and arousal of moral emotions.
Design/methodology/approach
The authors collected two-source (self-reported and supervisor reported) time-lagged data in the shape of a three-wave survey (i.e. one month time interval for each time) from 242 dyads in the health sector of Pakistan.
Findings
The results revealed that moral emotions mediated the relationship between DL and bullying behavior. Furthermore, self-concordance moderates the relationship between DL and moral emotions, such that the relationship will be stronger in the case of low self-concordance.
Research limitations/implications
Managers need to promote a culture that accommodates diversity of opinion at the organization so that everyone is able to express and share their views openly. Organizations should encourage supervisors to participate in leadership development programs aimed at eliminating DL.
Originality/value
This study establishes the role of self-concordance and moral emotions in the relationship between despotic leadership DL and bullying behavior.
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Previous studies have vague views about whether employees who are required to complete large amounts of work (i.e. role overload) would proactively create a change in their job…
Abstract
Purpose
Previous studies have vague views about whether employees who are required to complete large amounts of work (i.e. role overload) would proactively create a change in their job characteristics (i.e. job crafting), because the cognitive mechanism underlying the nexus between role overload and job crafting is unclear. The aim of this study is to identify why and when role overload has an impact on job crafting.
Design/methodology/approach
This study builds a second-stage moderated mediation model. Using a two-wave panel field study of 213 employee–supervisor matched data, this study examines the proposed hypotheses.
Findings
Results show that role overload decreases construal level, which can determine the tendency of employees to focus on the feasibility (low level of construal) or desirability (high level of construal) of behaviors. Goal self-concordance is the degree to which employees pursue their personal goals based on feelings of personal interests and values. The authors find that goal self-concordance guides employees who have higher levels of construal to exert more effort in job crafting. The authors further find that goal self-concordance moderates the mediating role of construal level. Specifically, for employees in pursuit of self-concordant goals, role overload reduces their construal level, resulting in less effort in job crafting. For employees who do not pursue self-concordant goals, role overload decreases their construal level, thereby improving job crafting.
Originality/value
The findings of this study enrich the literature on role overload and job crafting by revealing the mechanism and boundary conditions of the relationship between role overload and job crafting.
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The purpose is to develop search and detection strategies that maximize the probability of detection of mine-like objects.
Abstract
Purpose
The purpose is to develop search and detection strategies that maximize the probability of detection of mine-like objects.
Design/methodology/approach
The author have developed a methodology that incorporates variational calculus, number theory and algebra to derive a globally optimal strategy that maximizes the expected probability of detection.
Findings
The author found a set of look angles that globally maximize the probability of detection for a general class of mirror symmetric targets.
Research limitations/implications
The optimal strategies only maximize the probability of detection and not the probability of identification.
Practical implications
In the context of a search and detection operation, there is only a limited time to find the target before life is lost; hence, improving the chance of detection will in real terms be translated into the difference between success or failure, life or death. This rich field of study can be applied to mine countermeasure operations to make sure that the areas of operations are free of mines so that naval operations can be conducted safely.
Originality/value
There are two novel elements in this paper. First, the author determine the set of globally optimal look angles that maximize the probability of detection. Second, the author introduce the phenomenon of concordance between sensor images.
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Brian C. Martin, Leiyu Shi and Ryan D. Ward
The purpose of this paper is to examine race, gender and language concordance in terms of importance to primary care.
Abstract
Purpose
The purpose of this paper is to examine race, gender and language concordance in terms of importance to primary care.
Design/methodology/approach
The 2003 Medical Expenditure Panel Survey Household Component (MEPS) was used. Four distinguishing primary care attributes and selected measures were operationalized primarily from a sample subset that identified a usual source of care (USC): accessibility to USC; interface between primary care and specialist services; treatment decisions; and preventive services received from the USC. Bivariate and multivariate results are reported.
Findings
Adjusting for covariates, the following items remained statistically significant: race – choosing primary care physician as USC, USC having office hours, and going to USC for new health problems; gender – choosing primary care physician as USC and USC having office hours; and language – lack of difficulty contacting the USC after hours. However, these items appear to be isolated cases rather than indicators that concordance plays a key role in determining primary care quality. Language barriers/communication issues are the only areas where improvement appears warranted.
Research limitations/implications
While the study has strong accessibility and interpersonal relationship measures, service coordination and comprehensiveness indicators are limited. The analyses' cross‐sectional nature also poses a problem in drawing causal relationships and conclusive findings. Finally, sample size limitations preclude stratified analyses across racial/ethnic groups, an important consideration as the relationships between concordance and quality may vary across groups.
Practical implications
This study indicates that more research is needed in this area to determine future resource allocation and policy direction.
Originality/value
The unique contribution of the study is to suggest that race and gender concordance may not accurately predict primary health care quality.
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Wondwosen Molla, Dirshaye Aragaw, Robel Hussen, Aregahegn Wudneh, Derebe Madoro, Nebiyu Mengistu, Ruth Tilahun, Seid Shumye, Daniel Sisay, Habtamu Endashaw and Temesgen Muche
Achieving optimal nutrition among mothers and children is still a challenge in many developing country settings, including Ethiopia. Study on dietary diversity concordance of…
Abstract
Purpose
Achieving optimal nutrition among mothers and children is still a challenge in many developing country settings, including Ethiopia. Study on dietary diversity concordance of mother-to-child dyads is limited. Hence, this study aims to assess dietary diversity concordance among mother-to-child pairs and its associated factors in Gedeo zone, Southern Ethiopia.
Design/methodology/approach
A community-based cross-sectional study was carried out in Gedeo zone, South Ethiopia, from January 1 to February 15, 2019. A multistage sampling technique was used to select study participants. Data was collected by using a pretested and structured questionnaire. Data entry and analysis were done by Epi data version 3.1 and SPSS version 23.0 software, respectively. Bivariate and multivariate logistic regression models were used. Variables with p < 0.25 at bivariate analysis were chosen for multivariate analysis. Variables with a p-value of <0.05 were considered statistically significant.
Findings
A total of 665 mother and child dyads participated, with a response rate of 98.6%. High concordance of dietary diversity among mother-to-child pairs was 9%. Age of the mother (adjusted odds ratio [AOR] = 0.21; 95% confidence interval [95% CI]: 0.05–0.84), age of the child between 6 and 11 months (AOR = 5.2; 95% CI: 2.3–11.6), being female (AOR = 1.8; 95% CI: 1.0–3.4), previous history of infection (AOR = 4.4; 95% CI: 1.8–11.5), source of food from the market (AOR = 0.34; 95% CI: 0.12–0.81) and rich wealth index (AOR = 5.7; 95% CI: 2.5–12.9) were the significant factors of high concordance of dietary diversity.
Originality/value
The prevalence of high-concordant dietary diversity among mother and children dyads was very low. Therefore, ensuring multisectoral nutrition interventions that focus on both mothers and children should be considered to improve the good dietary diversity practice.
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Sidney Anderson, Steven W. Rayburn and Jeremy J. Sierra
The purpose of this paper is to discuss how, using a futures studies perspective, marketing is uniquely positioned to address future challenges facing health-care service systems.
Abstract
Purpose
The purpose of this paper is to discuss how, using a futures studies perspective, marketing is uniquely positioned to address future challenges facing health-care service systems.
Design/methodology/approach
The futures studies perspective involves predicting probable, preferable and possible futures. Using digital and face-to-face data collection methods, health-care professionals, academics and patients were asked about their perspectives and expectations of health care’s future. Using grounded theory, responses were analyzed to a point of thematic saturation to expose the immediate probable future and a preferred future of health care.
Findings
Patients expressed a desire to participate in health-care delivery, impacting caregivers’ roles. Thus, co-creation of value in this context is contingent on the relationship among stakeholders: patients, patients’ families, caregivers and health-care organizations. Concordance, a type of value co-creation, is an effective way for physicians and patients to ameliorate health outcomes.
Research limitations/implications
Although a more diverse sample would be ideal, insight from health-care professionals, academics and patients across global regions was obtained.
Practical implications
To achieve a preferred future in health care, practitioners should implement a three-pronged approach, which includes health promotion and prevention, appropriate use of technology in health care and concordance.
Originality/value
Using patients, health-care professionals and academics, this research broadens the concept of value co-creation in health care. Additionally, paths (i.e. promotion and prevention, technology use and concordance) to a preferred health-care future are uncovered.
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The purpose of this paper is to test the combined influence of working towards self-concordant goals with goal planning and supervisory support on goal progress and job…
Abstract
Purpose
The purpose of this paper is to test the combined influence of working towards self-concordant goals with goal planning and supervisory support on goal progress and job satisfaction.
Design/methodology/approach
The data were collected among prison guards. The analysis takes into account a multilevel perspective on goals by differentiating between within- and between-person variance.
Findings
The results showed that there was no direct effect of self-concordance on goal progress. Goal progress depended on combining self-concordant goals with conscious planning and receiving supervisory support. Furthermore, it was found that job satisfaction and goal progress influenced each other over time.
Research limitations/implications
The findings confirm that to understand the influence of self-concordant goals within organizations, planning and supervisory support are essential elements for achieving goal progress. This research is the first to confirm the interrelatedness of goal progress and job-satisfaction over time.
Originality/value
The multilevel intra and interpersonal approach provides a more thorough insight into the processes involved with goal striving. It emphasizes the importance of differentiation between the different levels of motivation in Deci and Ryan’s self-determination theory, especially when applied within the work context.
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