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This study seeks to investigate doctors' desire to change the hospital where they work to sustain higher quality care.

Self‐administered questionnaires were sent to doctors in Aichi Prefecture, Japan. Data were analyzed using univariate and logistic regression analysis and recursive partitioning.

Factors related to doctors' desire to change hospitals, according to logistic regression, were interaction between working hours and satisfaction with the hospital, evaluation, local government hospitals versus private ones, small vs large hospitals, ophthalmology versus internal medicine, desire to continue working as a hospital doctor and age. Additionally, working hours were also found to be related, based on recursive partitioning.

The response rate was low and sampling bias was observed – therefore results need careful interpretation. Also, because this was a cross‐sectional study, causal relationships could not be identified. Desire to change hospitals, but not actual behavior, was measured.

Efforts to prevent doctors from changing hospitals should include considering job satisfaction and workload, doctor evaluation methods, support for career progression and organizational management.

As the hospital doctor shortage in rural areas becomes more serious, exploring doctors' desire to leave their current hospital is meaningful for Japanese hospital managers and hospitals worldwide aiming to provide sustainable and higher quality care.

The objective of the paper is to confirm the feasibility and value of using the balanced scorecard (BSC) to measure performance in two hospitals in different countries.

One hospital from China and another from Japan were chosen and key indicators were selected according to the BSC framework. A comparative hospital performance measurement model was set up using the BSC framework to comprehensively compare hospital performance in two countries.

The BSC was found to be effective for underlining existing problems and identifying opportunities for improvements. The BSC also revealed the hospitals' contribution to performance improvement of each country's total health system.

Hospital performance comparisons between countries using the BSC depend on the selection of feasible and appropriate key performance indicators, which is occasionally limited by data collection problems.

The first use of the BSC to compare hospital performance between China and Japan shows benefits that not only suggests performance improvements in individual hospitals but also reveals effective health factors allowing implementation of valid national health policies.

The purpose of this paper is to describe the relationship between job stress, stress coping ability and performance among Japanese nurses.

Health risk and organization environment as job stress factors, sense of coherence (SOC) as stress coping ability and medical risk indicator and sickness‐absence days as a performance proxy were used to investigate the relationship between stress and performance. Length of professional experience also was included in the investigation.

The findings suggest a possibility that enriching nurses' professional experiences reduces medical risk. There is also a possibility that raising the SOC, while improving organization environment, contributes to reducing sickness‐absence.

A cross‐sectional study of nurses in a single institution was used. In order to generalize the study's results, it will be necessary to conduct multi‐institutional longitudinal studies.

The present study shows key factors affecting medical risk and sickness‐absence leading to a reduced nursing performance.

Measurements of the quality of physician‐patient communication are important in assessing patient outcomes, but the quality of communication is difficult to quantify. The aim of this paper is to develop a computer analysis system for the physician‐patient consultation process (CASC), which will use a quantitative method to quantify and analyze communication exchanges between physicians and patients during the consultation process.

CASC is based on the concept of narrative‐based medicine using a computer‐mediated communication (CMC) technique from a cognitive dialog processing system. Effective and ineffective consultation samples from the works of Saito and Kleinman were tested with CASC in order to establish the validity of CASC for use in clinical practice. After validity was confirmed, three researchers compared their assessments of consultation processes in a physician's office with CASCs. Consultations of 56 migraine patients were recorded with permission, and for this study consultations of 29 patients that included more than 50 words were used.

Transcribed data from the 29 consultations input into CASC resulted in two diagrams of concept structure and concept space to assess the quality of consultation. The concordance rate between the assessments by CASC and the researchers was 75 percent.

In this study, a computer‐based communication analysis system was established that efficiently quantifies the quality of the physician‐patient consultation process. The system is promising as an effective tool for evaluating the quality of physician‐patient communication in clinical and educational settings.

The purpose of this paper is to describe evaluation data and a prototype system named WISDOM used for analyzing information credibility based on natural language processing.

The authors started the Information Credibility Criteria project in April, 2007, mainly to analyze the credibility of information (text) on the web. The project proposes to capture information credibility based on four criteria (content, sender, appearance, and social valuation) and aims to analyze and organize them logically using natural language processing based on predicate argument structure.

The evaluation data described in this paper were developed as learning and verifying data for these various analysis modules and are composed of manually‐annotated data based on each evaluation criteria about several pre‐selected topics such as current events and medical issues. The prototype system WISDOM was developed to provide information credibility from different perspectives.

Users will be able to find credible information more reliably by browsing information using different evaluation criteria and conditions provided by the system.

This chapter explores the opportunities and challenges for Western firms that wish to engage in manufacturing operations in Iran, and particularly in the automotive industry. Although Iran has a long and fruitful history of embracing foreign investment, collaboration with foreign firms suffered in the aftermath of the Islamic Revolution in 1979. The imposition of UN sanctions in 2012, following the disagreements between Iran and leading Western powers over Iran’s nuclear policy, has resulted in a further exodus of foreign manufacturers from Iran, hurting the production quality, adoption of up-to-date technology and alignment to international standards for manufacturing, such as vehicle safety and engine emissions in Iran.

The removal of sanctions, contingent on the success of nuclear negotiations between Iran and leading world powers, could provide Iran with an opportunity to recommence manufacturing collaboration with Western firms. The case of the automotive industry discussed in this chapter indicates some of the challenges that Iran is likely to face if it once again wants to become a player in international markets.

As a movement for alternative means of food production and consumption has grown, so, too, have civic efforts to make alternative food accessible to low-income persons (LIPs). This article examines the impact of alternative food institutions (AFIs) on low-income communities in the United States and Canada, focusing on research published since 2008.

Through a three-stage literature search, I created a database of 110 articles that make empirical or theoretical contributions to scholarly knowledge on the relationship of AFIs to low-income communities in North America. I used an in vivo coding scheme to categorize the impacts that AFIs have on LIPs and to identify predominant barriers to LIPs’ engagement with AFIs.

The impacts of AFIs span seven outcome categories: food consumption, food access and security, food skills, economic, other health, civic, and neighborhood. Economic, social and cultural barriers impede LIPs’ engagement with AFIs. AFIs can promote positive health outcomes for low-income persons when they meet criteria for affordability, convenience and inclusivity.

This review exposes productive avenues of dialogue between health scholars and medical sociology and geography/environmental sociology. Health scholarship offers empirical support for consumer-focused solutions. Conversely, by constructively critiquing the neoliberal underpinnings of AFIs’ discourse and structure, geographers and sociologists supply health scholars with a language that may enable more systemic interventions.

This article is the first to synthesize research on five categories of alternative food institutions (farmers’ markets, CSAs, community gardens, urban farms, and food cooperatives) across disciplinary boundaries.