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51.

Objective

To identify the predominant culture of an organisation which could then assess readiness for change.

Design

An exploratory design using the Competing Values Framework (CVF) as a self-administered survey tool.

Setting

The Maternity Unit in one Australian metropolitan tertiary referral hospital.

Subjects

All 120 clinicians (100 midwives and 20 obstetricians) employed in the maternity service were invited to participate; 26% responded.

Main outcome measure

The identification of the predominant culture of an organisation to assess readiness for change prior to the implementation of a new policy.

Results

The predominant culture of this maternity unit, as described by those who responded to the survey, was one of hierarchy with a focus on rules and regulations and less focus on innovation, flexibility and teamwork. These results suggest that this unit did not have readiness to change.

Conclusion

There is value in undertaking preparatory work to gain a better understanding of the characteristics of an organisation prior to designing and implementing change. This understanding can influence additional preliminary work that may be required to increase the readiness for change and therefore increase the opportunity for successful change. The CVF is a useful tool to identify the predominant culture and characteristics of an organisation that could influence the success of change.  相似文献   
52.
The 2014 release of a new set of purchasing power parity (PPP) conversion factors (PPPs) for 2011 has prompted a revision of the World Bank’s international poverty line. In revising the line, we have sought to minimize changes to the real purchasing power of the earlier $1.25 line (in 2005 PPPs), so as to preserve the integrity of the goalposts for international targets such as the Sustainable Development Goals (SDGs) and the World Bank’s twin goals – which were set with respect to that line. In particular, the new line was obtained by inflating the same fifteen national poverty lines – originally used by Ravallion et al. (World Bank Econ. Rev. 23(2): 163–184 2009) to construct the $1.25 line – to 2011 prices in local currency units, and then converting them to US dollars using 2011 PPP conversion factors. With a small approximation, this procedure yields a new international poverty line of $1.90 per person per day. In combination with other changes described in the paper, this revision leads to relatively small changes in global poverty incidence for 2011: from 14.5 % using the old method to 14.1 % using the new method. In 2012, the new reference year for the global count, we find 12.7 % of the world’s population, or 897 million people, are living in extreme poverty. There are changes in the regional composition of poverty, but they are also relatively small. This paper documents methodological decisions taken in the process of updating both the poverty line and the consumption and income distributions at the country level, including issues of inter-temporal and spatial price adjustments. It also describes various caveats and limitations of the approach taken.  相似文献   
53.
The influence of competition level on referees’ decision-making was investigated. Referees’ decisions in 90 handball games (30 games X 3 competition levels) were observed in different situations related to the advantage rule, and 100 referees from two different levels of expertise were subsequently asked to offer explanations for the competition-level effects from the first part of the study. Results revealed that at the highest level of competition referees intervened less frequently with sporting sanctions, but more frequently with disciplinary sanctions. These effects were apparent mainly in immediate intervention situations and unsuccessful advantage situations, but not in successful situations. Referees explained these effects of competition level in terms of a player competence stereotype, in addition to referees’ different expertise across competition level. The implications of the findings for understanding how status-related stereotypes impact on intervention behavior are discussed.  相似文献   
54.
Despite a number of studies investigating the effect of pharmacotherapy on treatment costs for schizophrenia patients, there has been little attention given to the effect of family intervention. In this study, data from the Kansas Medicaid system were used to analyze healthcare costs for 164 schizophrenia patients who had participated in family intervention. Structural equation modeling was used to test two competing views of the role of family intervention in treatment. The results showed that a model including direct and indirect effects of family intervention provided a better fit to the data. Family intervention had a significant indirect effect on general medical costs (through other psychological treatment) that showed a savings of $586 for each unit increase in the provision of these services. In addition, the total indirect effects for family intervention showed a $580 savings for general medical costs and $796 for hospitalization costs (for each unit increase).  相似文献   
55.
Intimate partner violence and insecure attachment are therapeutically relevant concepts when working with couples. The link between attachment and intimate partner violence has been examined in the literature, but an area of aggression that often goes unexamined is relational aggression, or using third parties as a means of being aggressive toward a partner. We asked how participants' attachment behaviors were related to their own and partners' relational and physical aggression. We used structural equation modeling to estimate actor–partner interdependence among these relationships in 644 heterosexual couples. Results indicated significant partner paths from attachment to relational aggression, as well as significant actor paths between relational aggression and physical aggression. Implications were discussed. Data for this study were collected from the RELATE assessment.  相似文献   
56.
This paper considers the effect of collective bargaining on the gender pay gap in the printing industry. This sector was subject to multi‐employer bargaining for around 90 years, until 2010. The article analyses gendered collective bargaining processes through the mechanism of symbolic power, that is, the power of interpretation and definition, and utilizes Walton and McKersie's seminal work on bargaining behaviour to understand the processes that have prevented the closing of the pay gap. It finds that symbolic power operates within the sub‐processes of attitudinal structuring and intra‐organizational bargaining to de‐legitimize women's role in equal pay bargaining, alongside distributive bargaining tactics that preclude equal pay bargaining, thereby creating the impression that women are irrelevant to bargaining processes and ensuring relative invisibility for issues of importance to equality bargaining.  相似文献   
57.
Agencies providing residential treatment are encouraged, or even mandated, to collect outcomes data and to implement evidence based practices, yet little guidance has been provided on how to do so using agency administrative data that are collected on an ongoing basis. We examined data on Child and Adolescent Functional Assessment Scale (CAFAS) scores for 1608 admissions to a residential treatment center from 2002 through 2008. CAFAS scores were measured every 90 days, providing multiple CAFAS scores for each individual. Results demonstrated that on average residents improved in functioning over time. Sensitive to the evolving needs of residents who had been entering the program, the treatment center made significant program changes in 2006 to attempt to better serve residents through a broad array of specialized programming. Compared to the overall results, the analysis suggested that residents who entered the program since October 2006 appeared to have made larger improvements in their CAFAS scores. Results were derived by employing multilevel models appropriate for estimating growth trajectories with repeated measures data. Conversations with agency staff suggested that using administrative data, and advanced statistical models, were extremely helpful for organizational decision making and evidence-based programming.  相似文献   
58.
News media coverage of child sexual abuse can help policymakers and the public understand what must be done to prevent future abuse, but coverage tends to focus on extreme cases. This article presents an analysis of newspaper coverage from 2007 to 2009 to describe how the daily news presents and frames day-to-day stories about child sexual abuse. When child sexual abuse receives news attention, the stories focus primarily on the criminal justice details of a specific incident rather than contextual information about causes of and solutions to child sexual abuse, and prevention is rarely addressed. We offer suggestions for strategies that advocates can use to help reporters improve news coverage so that it better contextualizes child sexual abuse and links it to prevention policies.  相似文献   
59.
Research on predictors of treatment outcome among pathological gamblers (PGs) is inconclusive and dominated by studies from Western countries. Using a prospective longitudinal design, the current study examined demographic, clinical, behavioural and treatment programme predictors of gambling frequency at 3, 6 and 12-months, among PGs treated at an addiction clinic in Singapore. Measures included the Hospital anxiety and depression scale, gambling symptom assessment scale (GSAS), personal well-being index (PWI), treatment perception questionnaire and gambling readiness to change scale. Treatment response in relation to changes in symptom severity, personal wellbeing and abstinence were also assessed. Abstinence rates were 38.6, 46.0 and 44.4 % at 3, 6 and 12-months respectively. Significant reductions in gambling frequency, GSAS, and improvement in PWI were reported between baseline and subsequent outcome assessments, with the greatest change occurring in the initial three months. No demographic, clinical, behavioural or treatment programme variable consistently predicted outcome at all three assessments, though treatment satisfaction was the most frequent significant predictor. However, being unemployed, having larger than average debts, poor treatment satisfaction and attending fewer sessions at the later stages of treatment were associated with significantly poorer outcomes, up to 1-year after initiating treatment. These findings show promise for the effectiveness of a CBT-based treatment approach for the treatment of predominantly Chinese PGs. Clinical implications and suggestions for future research are discussed. Taken together, the findings suggest early treatment satisfaction is paramount in improving short-term outcomes, with baseline gambling behaviour and treatment intensity playing a more significant role in the longer term.  相似文献   
60.
In contrast to conventional models of positively “becoming” an identity through social interaction, this article explores the inverse, negational process of “non‐becoming,” whereby actors start but do not continue along an identity career trajectory. Through cumulative attrition, interactions and encounters at key moments create an overall pattern of non‐progression. Using asexuality as an example, we identify three main trajectory stages of non‐awareness, communicative negation and non‐consolidation, each involving interactional contingencies. With a wider applicability to other repudiated identities, this model shows how even negational symbolic social objects (non‐issues, non‐events, and non‐identities) are constituted through social interaction.  相似文献   
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