The development of implicit leadership theories during childhood: A reconceptualization through the lens of overlapping waves theory.

Implicit leadership theories (ILTs) are people's lay theories, definitions, or conceptualizations of leadership. In adults, they determine what actions we perceive as leadership, influence to whom we grant leadership status, and shape our own behaviors when we want to be seen as leader. Naturally, there has been an enduring interest in how these ILTs develop in children. Current theorizing on the development of leadership conceptualizations in children aligns with a stepwise progression mirroring Piaget's stage-based approach to cognitive development. However, contemporary approaches to cognitive development, such as Siegler's overlapping waves theory (OWT), acknowledge that children's development is linked to cognitive success and failure. This article integrates the findings from empirical studies into children's leadership conceptualizations and reinterprets them against OWT. This reinterpretation resolves findings that align poorly with a stepwise approach and demonstrates a strong fit with OWT. As such, children's leadership conceptualizations develop by generating and testing cognitive approaches-physical-spatiotemporal, functional, socioemotional, and humanitarian-and instead of progressing through these in order and according to age, they display variation and selection, that with experience and exposure, lay down selective combinations, which often engage multiple dimensions simultaneously. Consequently, the development of children's understanding of leaders is nonlinear, can be multidimensional, and is based on trial and error largely in response to their experiences. The article concludes with a discussion of the implications for future research and practice. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

E-cigarette and hookah adoption patterns: Is the harm reduction theory just so much smoke?

AIMS: This paper explores inter-generational changes in consumers smoking product uptake and use patterns after the introduction of e-cigarettes and hookahs. DESIGN: Item Response Theory (IRT) is used to analyze the Health Information National Trends Survey sponsored by the Food and Drug Administration (HINTS-FDA). The survey was fielded in 2015. IRT allows the pattern of product use to be described and help assess whether the new tobacco products (i.e., e-cigarettes, hookahs) serve as gateway to other products or act in harm reduction modality. FINDINGS: The results indicate that the new product alternatives have changed the how tobacco products are adopted in the U.S. In particular, younger respondents were more likely to have engaged in cigar, e-cigarette and water-pipe use than the older cohort. CONCLUSIONS: The introduction of nicotine products previously unavailable in the U.S is creating new modes for smoking initiation in the age groups most likely to begin a new habit. There is little evidence that smokers in the older HINTS cohorts are using the e-cigarette as a smoking cessation tool. The rise of cigar use in the younger cohort may indicate that legal products are being mixed with illicit substances (i.e., 'blunting').

Forecasting the Maturation of Electronic Health Record Functions Among US Hospitals: Retrospective Analysis and Predictive Model.

BACKGROUND: The Meaningful Use (MU) program has promoted electronic health record adoption among US hospitals. Studies have shown that electronic health record adoption has been slower than desired in certain types of hospitals; but generally, the overall adoption rate has increased among hospitals. However, these studies have neither evaluated the adoption of advanced functionalities of electronic health records (beyond MU) nor forecasted electronic health record maturation over an extended period in a holistic fashion. Additional research is needed to prospectively assess US hospitals' electronic health record technology adoption and advancement patterns. OBJECTIVE: This study forecasts the maturation of electronic health record functionality adoption among US hospitals through 2035. METHODS: The Healthcare Information and Management Systems Society (HIMSS) Analytics' Electronic Medical Record Adoption Model (EMRAM) dataset was used to track historic uptakes of various electronic health record functionalities considered critical to improving health care quality and efficiency in hospitals. The Bass model was used to predict the technological diffusion rates for repeated electronic health record adoptions where upgrades undergo rapid technological improvements. The forecast used EMRAM data from 2006 to 2014 to estimate adoption levels to the year 2035. RESULTS: In 2014, over 5400 hospitals completed HIMSS' annual EMRAM survey (86%+ of total US hospitals). In 2006, the majority of the US hospitals were in EMRAM Stages 0, 1, and 2. By 2014, most hospitals had achieved Stages 3, 4, and 5. The overall technology diffusion model (ie, the Bass model) reached an adjusted R-squared of .91. The final forecast depicted differing trends for each of the EMRAM stages. In 2006, the first year of observation, peaks of Stages 0 and 1 were shown as electronic health record adoption predates HIMSS' EMRAM. By 2007, Stage 2 reached its peak. Stage 3 reached its full height by 2011, while Stage 4 peaked by 2014. The first three stages created a graph that exhibits the expected "S-curve" for technology diffusion, with inflection point being the peak diffusion rate. This forecast indicates that Stage 5 should peak by 2019 and Stage 6 by 2026. Although this forecast extends to the year 2035, no peak was readily observed for Stage 7. Overall, most hospitals will achieve Stages 5, 6, or 7 of EMRAM by 2020; however, a considerable number of hospitals will not achieve Stage 7 by 2035. CONCLUSIONS: We forecasted the adoption of electronic health record capabilities from a paper-based environment (Stage 0) to an environment where only electronic information is used to document and direct care delivery (Stage 7). According to our forecasts, the majority of hospitals will not reach Stage 7 until 2035, absent major policy changes or leaps in technological capabilities. These results indicate that US hospitals are decades away from fully implementing sophisticated decision support applications and interoperability functionalities in electronic health records as defined by EMRAM's Stage 7.

Insider versus outsider executive succession: The relationship to hospital efficiency.

BACKGROUND: The relationship between Chief Executive Officer (CEO) succession and hospitals' competitive performance is an area of interest for health services researchers. Of particular interest is the impact on overall strategic direction and health system performance that results from selecting a CEO from inside the firm as opposed to seeking outside leadership. Empirical work-to-date has yielded mixed results. Much of this variability has been attributed to design flaws; however, in the absence of a clear message from the evidence, the preference for hiring "outsiders" continues to grow. PURPOSE: This paper investigates on the extent to which insider CEO succession versus outsider succession impacts hospitals' competitive advantage vis-à-vis a sample of organizations that compete in the same sector. METHODS: A hospital matching protocol based on propensity scores is used to control for endogeneity and makes comparisons of productivity across organizations through the use of stochastic frontier estimation. FINDINGS: Succession negatively impacts hospitals' productivity, and firms with outsider CEO succession events closed the gap toward the competitive advantage frontier faster than comparable firms with insider successions. PRACTICE IMPLICATIONS: More research needs to be done on succession planning and its impact on CEO turnover.