The Management of Risk in the Global Service Economy 1

The effects of the transformation to a service economy on the management of vulnerability and uncertainty are discussed. After discussing the notion and role of risks in different kinds of cultural and economic environments, he closes with a plea for closer cooperation between entrepreneurs, engineers and economists: together they can transform the risks and vulnerabilities of the modern service economy into a challenge for progress.     

减少医师自卫医学行为的对策研究

根据自卫医学行为产生的原因,减少自卫医学行为有两个思路,一个是减轻医师的法律责任,另一个是化解医师在法律责任下所面临的风险。根据第二个思路,应该采取下面的措施:建立医师责任保险制度;建立医疗责任保险制度;实施医疗风险管理;提高医师个人的执业素养。     

Some considerations on the capacity to be alone

This paper considers the lack of coherence of the psychoanalytic theories of the primary and secondary process. As a consequence, the interplay of primary and secondary process modes of thought cannot be conceptualised properly. Firstly, we summarize the results of an elsewhere-made metapsychological re-examination of both principles of mental functioning, and argue that Rapaport's distinction between a drive and a conceptual organization of memory, elaborated on by Siegfried Zepf is an extremely useful means of understanding primary and secondary process activity. As a central thesis, we state that primary process operates by affects, whilst secondary process utilizes concepts. The second part of the paper makes an attempt to show the dialectical relationship of affective and conceptual thought in the functioning of the living psyche. Temporarily dominating mental functioning, primary and secondary process thinking each utilize the other as a means, but never work purely within the psychic apparatus. It is shown that it is the specific interplay of primary and secondary process activity, which produces new adaptive substitutive formations. Some basic assumptions about the concepts of regression and progression are made to elucidate the shift from secondary to primary process dominance and vice versa.     

Some brief considerations on the relationship between theory and practice

The present crisis in models of training and in psychoanalytical education in general can be linked to the gulf that has come to be created between analytical theory and clinical practice. The paper(1) examines the historical facts that have led to this split and suggests the need to return to the models of Freud and Jung. Both these fathers of depth psychology stressed the dangers inherent in the dogmatic use of theory and both insisted that theory must always spring from and be able to account for clinical practice rather than vice versa, as is so often the case today. The paper also looks at how theory should be taught in our analytical institutes in order to ensure that what we transmit to our candidates is not knowledge in the form of dogma but rather a way of proceeding that will enable them to think creatively about their clinical practice and thus produce new knowledge, essential if depth psychology is to remain relevant to our post-modern culture.     

Fatigue risk management based on self-reported fatigue: Expanding a biomathematical model of fatigue-related performance deficits to also predict subjective sleepiness

Biomathematical models of fatigue can be used to predict neurobehavioral deficits during sleep/wake or work/rest schedules. Current models make predictions for objective performance deficits and/or subjective sleepiness, but known differences in the temporal dynamics of objective versus subjective outcomes have not been addressed. We expanded a biomathematical model of fatigue previously developed to predict objective performance deficits as measured on the Psychomotor Vigilance Test (PVT) to also predict subjective sleepiness as self-reported on the Karolinska Sleepiness Scale (KSS). Four model parameters were re-estimated to capture the distinct dynamics of the KSS and account for the scale difference between KSS and PVT. Two separate ensembles of datasets – drawn from laboratory studies of sleep deprivation, sleep restriction, simulated night work, napping, and recovery sleep – were used for calibration and subsequent validation of the model for subjective sleepiness. The expanded model was found to exhibit high prediction accuracy for subjective sleepiness, while retaining high prediction accuracy for objective performance deficits. Application of the validated model to an example scenario based on cargo aviation operations revealed divergence between predictions for objective and subjective outcomes, with subjective sleepiness substantially underestimating accumulating objective impairment, which has important real-world implications. In safety-sensitive operations such as commercial aviation, where self-ratings of sleepiness are used as part of fatigue risk management, the systematic differences in the temporal dynamics of objective versus subjective measures of functional impairment point to a potentially significant risk evaluation sensitivity gap. The expanded biomathematical model of fatigue presented here provides a useful quantitative tool to bridge this previously unrecognized gap.     

Ethical considerations in the management of military related concussion

Since the year 2000 over 300,000 military service members have been diagnosed with mild traumatic brain injury/concussion. Consequently, this injury has become the subject of increased awareness and study within the military healthcare environment. Although single and/or isolated concussions typically heal in a relatively rapid fashion with limited to no long-term sequelae, there is debate in the field about the impact of repeat concussion. To this end, various ethical challenges arise when managing patients with such injuries. Several papers outlining these issues with regard to athletes have been published in the sports medicine literature. However, because providers caring for military service members must make return-to-duty-decisions, practice within the military setting results in a number of unique ethical considerations. More specifically, management of service members with a history of repeat concussion and increasingly complicated recoveries, as well as the potential for premature return-to-duty are topics of concern for military health care providers. Using the American Psychological Association ethical principles and standards, the current article outlines various ethical challenges to concussion management in the military setting. The ethical principles of Beneficence and Nonmaleficence and Respect for People’s Rights and Dignity, as well as the 3 related ethical standards of Competence, Avoiding Harm, and Conflict of Interest are discussed. Policy changes are highlighted as a proximal solution to these ethical challenges.     

Participatory management: Maintaining staff performance in a university housing cooperative

To apply behavior analysis to normal adults in non institutional settings, we may have to encourage their participation in the design and implementation of behavioral technology. This study evaluates a technology by which the members of a student housing cooperative manage their own staff with a minimum of supervision by one of the program designers. This staff management system consisted of prompts, self-reports, spot checks, and contingent rent reductions. Six resident staff members performed substantially more of their assigned tasks when this system was used. In addition, the management system was acceptable to the members, was affordable, and maintained high levels of staff performance during a 5-year follow-up. Participation by the members in the design and implementation of this system appears to have been useful in helping the behavior analysts to develop an unusually durable management system.     

Brain extracellular space: Some considerations on the role it plays in brain function

The role of the extracellular space of the mammalian brain is reviewed. Special consideration is given to the question of ion accumulation in brain extracellular space. This issue is discussed in terms of the nerve theory of Hodgkin and Huxley. A brief review of this theory is included. Extracellular space is described not as a large unchanging compartment, but as a dynamic compartment in which ion concentrations are continuously changing. The consequences of some of these dynamic changes are discussedvis a vis altered brain states such as seizures and spreading depression.     

Task clarification, performance feedback, and social praise: Procedures for improving the customer service of bank tellers

Customer service for bank tellers was defined in terms of 11 verbal behavior categories. An audio-recording system was used to track the occurrence of behaviors in these categories for six retail banking tellers. Three behavior management interventions (task clarification, performance feedback, and social praise), applied in sequence, were designed to improve overall teller performance with regard to the behavioral categories targeted. Clarification was accomplished by providing clear delineation of the various target categories, with specific examples of the behaviors in each. Feedback entailed presentation of ongoing verbal and visual information regarding teller performance. Praise consisted of verbal recognition of teller performance by branch managers. Results showed that clarification effects emerged quickly, producing an overall increase in desired behaviors of 12% over baseline. Feedback and praise effects occurred more gradually, resulting in overall increases of 6% and 7%, respectively. A suspension of all procedures led to a decline in overall performance, whereas reinstatement of feedback and praise was again accompanied by performance improvement. These findings extend the generality of behavior management applications and help to distinguish between possible antecedent and consequent effects of performance feedback.     

The Academic Productivist Regime: Affective Dynamics in the Moral-Political Economy of Publishing

With proliferating neoliberal modes of science governance, publishing has become more important. Recent studies point to researchers’ feeling of exhaustion and anxiety as responses to academic performance regimes. Yet how affects underpin publishing in scientific cultures and communities, and what this implies for STS scholarship has remained underexplored. Drawing on insights from ethnographic fieldwork and the cultural studies of affect, this article traces the role of emotions, including hope, contempt, and excitement for understanding the new academic productivist regime at a Czech research institution. While junior researchers’ orientations are fostered through rendering publications objects of hope, a moral-political economy intersects with geopolitical history and values of research organization to shape the publication practices of many senior scientists. An affective labor of combat and equanimity is necessary for managing these orientations that are corporeally energized by a dynamic of thrill. This four-pronged approach makes palpable how emotions render scientists’ bodies hopeful, combative and excited while intersecting with ideals of meritocratic research organization and assessment. Frustration and failure are never entirely absent but serve as an immanent driving force for a publishing culture that thrives on adrenaline, combativeness, and hope. This makes it difficult to leverage failures towards criticism of the academic productivist regime—both for the scientists differently affected within the institution and STS researchers. Different engagements with this regime require a more capacious accounting for the pleasure and thrill generated by the uncertainty of publication outcome as well as by unacknowledged practices of care.     

Token‐economy‐based contingency management increases daily steps in adults with developmental disabilities

Adults with developmental disabilities are less likely to meet physical activity guidelines than typically developing counterparts. Contingency management (CM) interventions increase physical activity in sedentary adults. The current study systematically replicated previous research among sedentary adults diagnosed with developmental disabilities living in a residential group home, using a token economy in the context of a CM intervention. Using a changing criterion design, participants (N = 4) were given tokens contingent on meeting increasing step goals over 8 weeks, tracked via a Fitbit Flex?. CM increased the number of steps substantially for three of four participants. These findings extend previous research supporting the use of token‐based CM interventions for increasing daily steps among individuals with developmental disabilities. Because the current study was conducted in a residential group home setting, it may offer a long‐term sustainable approach to improving the health of some individuals living with developmental disabilities.     

马克思政治经济学语境中的价值哲学

马克思通过政治经济学批判完成了他的重建形而上学工作。由此,他把政治经济学当作一种价值哲学来研究,他的政治经济学中的每一个范畴都体现着他的价值哲学思想。本文着重以其中的货币、价值属性和商品拜物教三个范畴分析马克思有关价值存在、价值主体性和价值意识的原理。     

医保DIP改革与医疗服务供给的伦理思考：冲突与对策

区域点数法总额预算下的按病种分值支付（diagnosis-intervention packet,DIP）是当前国内医保支付方式改革的最大热点,但尚需完善。对医疗服务供给侧结构性改革的主要目标进行了梳理,以此为基础对DIP改革的潜在伦理问题进行了分析,认为DIP多劳多得的激励机制不利于机构间协作,控费导向支付机制不利于服务行为规范,等级系数设置和低费用偏好机制不利于机构服务能力提升。从制定连续服务支付策略、提高病种分组精细程度、统一各类医保支付政策及构建能力导向支付机制等方面提出了DIP改革的优化策略。

     

Introduction to the special issue on the intersection of professional selling and service

As organizational operations continue to evolve in response to increasing customer demands, frontline research has begun to consider how traditionally separate organizational functions may be complementary to firm performance. Specifically, as sales and service activities become increasingly intertwined within the frontline role, this special issue explores how the sales and service functions interact within an organization. The articles contained in this special issue consider the interaction of sales and service with respect to customer, employee, and firm outcomes. After introducing evolving thought in the area, we provide an overview of five articles that make up this special issue. We conclude by offering additional areas of research.     

Influences on the perceived risk of purchasing online

This paper examines whether the perceived risk of online purchasing by consumers varies with the frequency of previous purchases, satisfaction with previous purchase experiences, the good/service orientation of an intended purchase and the level of purchase decision involvement required. No association was found between the frequency of online purchasing and perceived risk, although satisfaction with prior internet purchases was negatively associated with the perceived risk of intended purchases, but only for low‐involvement products. Differences in perceived risk were associated with whether the intended purchase was a good or service and whether it was a high or low‐involvement product. Analysis of consumer perceived risks, disaggregated by type of risk and purchase situation, provides insight into impediments that may hinder the expansion of consumer purchasing using the internet. Copyright © 2004 Henry Stewart Publications.     

Managing Employees in the Service Sector: A Literature Review and Conceptual Development

Our economy is slowly shifting from a manufacturing base to a service base. Yet, management literature has been slow to respond. We know little about the unique challenges faced by managers in the service sector. This paper reviews literature on research on management practice and employee perceptions that lead to positive customer outcomes. Specifically, relational coordination efforts by a manager are suggested to lead to specific employee behaviors that have been correlated with customer outcomes. This literature review and conceptual development are presented here in hopes that future research will take a deeper look at the challenges faced by service sector managers.     

Spaces of the Religious Economy: Negotiating the Regulation of Religious Space in Singapore

Over the past three decades, the theory of religious economy has been established, applied, debated, developed, and rejected. It has proven to be as divisive as any "general theory" of religion should be, and yet its core tenets continue to engage and unite scholars around the world. In response to broader shifts within the sociology of religion, this article reframes religious economy by advancing a spatial approach to its theorization. A spatial approach can help develop new perspectives on the regulation of religion, and the resistant agency of religious groups. With a focus on the "secular monopoly" of Singapore, it demonstrates how the restricted supply of land for religious purposes increases competition between religious groups. To overcome restrictions, religious groups pursue strategies of spatial and organizational boundary crossing. This has led to the closer regulation of space, and highlights the recursive interplay between the regulation and praxis of religion in Singapore.