Managing in the Trenches of Consumer Care: The Challenges of Understanding and Initiating the Advance Care Planning Process

To better understand how community-based long-term care providers define advance care planning and their role in the process, we conducted 8 focus groups with 62 care managers (social workers and registered nurses) providing care for Ohio's Medicaid waiver program. Care managers shared that most consumers had little understanding of advance care planning. The care managers defined it broadly, including legal documentation, social aspects, medical considerations, ongoing communication, and consumer education. Care managers saw their roles as information providers, healthcare team members, and educators/coaches. Better education, resources, and coordination are needed to ensure that consumer preferences are realized.     

Roles of the institute of medicine in providing health science policy advice

Studies conducted by the Institute of Medicine (IOM) are one way that government agencies can get presumably neutral advice on health science policy issues. The traditional IOM study is undertaken using a committee of experts supported by professional staff on issues of particular importance related to health policy. The report is usually a consensus document from the group of experts who have various points of view on the topic. After a report is prepared, it undergoes an independent review process to assure that the conclusions are based on the best available science and vigorous analysis of the data. IOM reports make recommendations for further actions that could be undertaken by a diverse audience, and do not just provide a series of options as is done in reports from the Office of Technology Assessment.     

Pregnant women's attitudes toward the abortion of defective fetuses

A survey asked 190 pregnant women their opinions on whether a hypothetical other woman would be justified in having an abortion under ten different circumstances, four of which related to abnormalities of the fetus. They were then asked whether they would be justified in having an abortion under these same circumstances. Also assessed were these women's views concerning the justifiability of abortion for a specific group of fetal abnormalities, neural tube defects. Respondents were more likely to view abortion as justifiable for a hypothetical other than for themselves. However, there was no evidence that pregnant women's views about abortion are more conservative than those of the general public. The majority of respondents considered abortion of a defective fetus to be justified, both for themselves and for others. The best predictor of abortion attitudes was respondent's views about the ideal number of children in a completed family.This research was supported by a grant from Maternal and Child Health Research, Bureau of Community Health Services, DHHS. Reprint requests should be sent to Dr. Ruth Faden at the Johns Hopkins University School of Hygiene and Public Health, Division of Health Education, 615 N. Wolfe Street, Baltimore, MD 21205.     

A routine-based framework implementing workload control to address recurring disturbances

Abstract

This research focuses on responsiveness in high variety manufacturing environments. To achieve it, the article proposes to develop Dynamic Response Capabilities (DRCs) of the manufacturing system defined as the abilities to readjust the planned operating parameters of workload, capacity, and lead time, in the wake of disturbances. To inform their development, built on the Workload Control theory, a routine-based framework is proposed. The framework supports an integrated approach for the implementation of adaptive decision-making routines for workload, capacity, and lead time readjustments at different stages in the order fulfilment process. Findings from two empirical cases show the appropriateness of the framework to develop and utilise DRCs in different settings of disturbances. Results of a simulation study, with one of the case companies, also shows the effectiveness of the framework to drive performance improvements in presence of recurring disturbances leading to demand variability.     

2 Old Assumptions,New Work

Abstract

We review the literature on nonstandard work with three aims: to portray the breadth and nature of the research and theorizing to date, to document the challenges and opportunities this domain poses to both practice and theory, and to bring the study of nonstandard work more to the center stage of micro-OB. After defining nonstandard work and documenting scholarly interest in it, we discuss the literature on the experience of nonstandard workers, on managing the nonstandard workforce, as well as that on managing the interface between standard and nonstandard workers. We analyze the themes that are raised in these literatures and point to new research questions that need to be addressed. Research on nonstandard work can enhance our understanding of the nature of work, the relationship between individuals and organizations, and how organizations and individuals can undertake these new work forms.     

Relational Strains and Delinquency: Assessing the Gendering of Emotions’ Claims among Chinese Adolescents*

This study assesses the gendering of emotions’ claims in an understudied population, that is, adolescents in mainland China. Specifically, it examines gender variations in the emotional reactions to relational strains and gendered responses to emotions with types of delinquency. Data drawn from over 500 middle‐school students from an urban city in China yield results in support of general strain theory in most respects, but culture‐specific patterns are noted. In general, Chinese boys and girls respond to different domains of relational strains, and relational strains are more strongly associated with depression than anger. Furthermore, boys respond to relational strains with anger more often than do girls, whereas girls and boys are about equal in responding to strains with depression. Gender differences are observed concerning responses to emotions with delinquency. Boys are more likely than girls to use aggression in response to anger and depression, whereas no gender differences are manifested in the reaction to emotions with non‐aggressive delinquency. Gender patterns are also noted in the assessment of negative emotions as mediators of the strain–delinquency relationship. We address these findings along with other observations in light of general strain theory and sociocultural factors pertinent to mainland China.     

Performance measurement: a critical analysis of the literature with respect to total quality management

This paper represents a comprehensive review of the literature on performance measurement. The roadmap used for this analysis is from the evolution of performance measurement, to the way it is currently defined and how it is applied from a corporate-wide perspective. One useful contribution of this review is a special focus on performance measurement in a non-financial, non-traditional sense. This discussion was further amplified by referring to newly developed tools and techniques and by highlighting critical factors of success in the application of performance measurement.
The key factors from this literature review reveal that, although interest in the area of measurement is growing significantly, this is not reflected by the tangible and credible experiences in the organizations concerned. There is a concurrent view amongst various writers that there are both hard and soft issues reflecting, for instance, the lack of strategic thinking and goal clarity, putting measurement systems in the driving seat and therefore trusting unreliable designs and not focusing on the true ethos of modern measurement towards continuous improvement and thereby not engaging employees and neglecting the culture change aspects.
The paper concludes by highlighting the dearth in research in the important field of performance measurement and, in particular, the design and implementation of performance measurement systems that cover all the essential aspects through an integrated perspective.