A global economy requires business organizations to cultivate their international holdings by respecting the national differences of their host countries and coordinating efforts for rapid innovation. In this essay we first review relevant literature in the areas of communication and innovation and explore how efforts toward innovative practices are directly related to globalism and business strategy. We then focus on issues associated with national culture, corporate culture, and professional culture that are relevant to strategies for researching business communication in global contexts. Finally, we suggest directions for future work.Prior to the dawning of the new millennium, much was written about innovation, culture, globalism, and strategy. Commentaries on organizational vision, effectiveness, direction, and mission usually noted the necessity to innovate and expand beyond normal limits and borders. Inherent within discussions of innovation and globalism are issues relating to national and organizational culture, and to a lesser extent the professional cultures of members of innovative, globalized business firms. What are the

Black Americans are more likely than whites to choose aggressive medical care at the end of life. We present a retrospective cohort study of 2843 patients who received a counselor-based palliative care consultation at a large US southeastern hospital. Before the palliative consultation, 72.8% of the patients had no restrictions in care, and only 4.6% had chosen care and comfort only (CCO). After the consult, these choices dramatically changed, with only 17.5% remaining full code and 43.3% choosing CCO. Both before and after palliative consultation, blacks chose more aggressive medical care than whites, but racial differences diminished after the counselor-based consultation. Both African American and white patients and families receiving a counselor-based palliative consultation in the hospital make profound changes in their preferences for life-sustaining treatments.

Use of outsourced nurses is often a stop-gap measure for unplanned vacancies in smaller healthcare facilities such as long-term acute-care hospitals (LTACHs). However, the relationship of utilization levels (low, medium, or high percentages) of nonemployees covering staff schedules often is perceived to have negative relationships with quality outcomes. To assess this issue, the authors discuss the outcomes of their national study of LTACH hospitals that indicated no relationship existed between variations in percentage of staffing by contracted nurses and selected outcomes in this post-acute-care setting.

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