Vulnerability and Agenda: Context and Process in Project Management

This paper explores how the project management role is conditioned by the context in which change is progressed. The argument draws on Pettigrew's (1985, 1987) contextual and processual view of change, a view which does not clarify the management implications of contextual variation. Using data from a two-stage research design combining diary and survey methods, four context dimensions are identified, concerning ‘interlocking’, ‘shifting sands’, ‘ownership’ and ‘senior management view’. For analytical purposes, two extreme contexts are characterized as exposing the project manager to high and low levels of ‘vulnerability’ respectively. Project management literature typically offers a rational-linear account of change, and concentrates on ‘content’ and ‘control’ agendas, concerning technical expertise on the one hand, and planning, budgeting and monitoring techniques on the other. Sociological analyses reveal the limitations of the rational-linear account, and focus on the political and cultural dimensions of the ‘process’ agenda. The data suggest how contextual variation affects the relative priority of these agendas. The management implications of these findings are explored, for project management selection, career progression, and the development of diagnostic skills and ‘agenda management’ strategies.     

THE EFFICACY AND EFFECTIVENESS OF MARITAL AND FAMILY THERAPY: A PERSPECTIVE FROM META-ANALYSIS

This article reviews the major findings from a multiproject meta-analysis of the effects of marital and family therapy (MFT). Across 163 randomized trials, MFT demonstrates moderate, statistically significant, and often clinically significant effects. No orientation is yet demonstrably superior to any other, nor is MFT superior to individual therapy. Cost effectiveness information is scant in these 163 studies, but supportive. Randomized experiments yield very different answers from nonrandomized experimental studies of the effects of MFT, calling into question whether we should mix the two in reviews. We have also found several new differences in the ways that marital therapy (MT) and family therapy (FT) studies are conducted, making them harder to compare. Finally, important questions still exist about whether any psychotherapy, including MFT, yet has sufficient information about how well research generalizes to everyday clinical practice.     

A screening system for tardive dyskinesia: development and implementation.

1. Most diagnosed cases of tardive dyskinesia (TD) are mildly inconvenient to the patient, but some can be severe or life-threatening. The primary goal of intervention should be early identification of abnormal movements related to TD and the prescribing of an appropriate medication regimen. 2. Unless specific training occurs and a specific monitoring system is in place, TD movements may be missed. However, not all movements are necessarily related to TD. 3. Although screening and monitoring are valuable, nothing is more important than prevention. New medications must be developed that do not carry the risk of TD, and other approaches to treat TD must be developed.     

Student perceptions of the danger of drug use: a factor analysis.

Australian secondary school students from three Year levels were asked to rate the danger involved in various uses of alcohol, tobacco, inhalants, marijuana and other illicit drugs. These ratings were then factor analyzed for each Year level. The results showed a more refined discrimination among the older students, with type of drug and frequency of use being important considerations. Familiarity was a major consideration for the younger students. The cognitive factors derived from the data are consistent with expectations based on the gateway theory of drug use.     

Dutch tax simplification: Unique in an international setting?

The Dutch reformed individual income tax was implemented on January 1, 1990. The rationale of the tax reform is described, and the major changes are discussed and compared to developments abroad. As far as rate reduction and base-broadening are concerned, the Netherlands has followed the trend in international tax reforms. The Dutch tax reform process, however, focussed more on simplification than in other Western countries.     

The analysis of incomplete data using stochastic covariates

In the development of many diseases there are often associated random variables which continuously reflect the progress of a subject towards the final expression of the disease (failure). At any given time these processes, which we call stochastic covariates, may provide information about the current hazard and the remaining time to failure. Likewise, in situations when the specific times of key prior events are not known, such as the time of onset of an occult tumour or the time of infection with HIV-1, it may be possible to identify a stochastic covariate which reveals, indirectly, when the event of interest occurred. The analysis of carcinogenicity trials which involve occult tumours is usually based on the time of death or sacrifice and an indicator of tumour presence for each animal in the experiment. However, the size of an occult tumour observed at the endpoint represents data concerning tumour development which may convey additional information concerning both the tumour incidence rate and the rate of death to which tumour-bearing animals are subject. We develop a stochastic model for tumour growth and suggest different ways in which the effect of this growth on the hazard of failure might be modelled. Using a combined model for tumour growth and additive competing risks of death, we show that if this tumour size information is used, assumptions concerning tumour lethality, the context of observation or multiple sacrifice times are no longer necessary in order to estimate the tumour incidence rate. Parametric estimation based on the method of maximum likelihood is outlined and is applied to simulated data from the combined model. The results of this limited study confirm that use of the stochastic covariate tumour size results in more precise estimation of the incidence rate for occult tumours.     

Benefits of preventive dentistry in children: Cost factors and public policy

Dental caries in children is now recognized as a preventable disease. The use of fluoride and sealants has produced a major reduction in caries prevalence among school aged children in the United States and other countries. A portion of the child population who are educationally and socioeconomically disadvantaged are not fully receiving these benefits. Public policy, insurance and medicaid groups must be made aware of these preventative measures and strategies developed to implement them.     

ACCOUNTING PRACTICES AND ORGANIZATIONAL DECISION MAKING

In this paper we argue for the importance of a sociologically informed study of organizational accounting practices. By making the nexus between accounting and decision making problematic, instead of given, we move issues of interpretation and hierarchical control to the center stage of understanding the social construction of accounting practices. We suggest that inductive case studies of the organizational setting is a promising methodological strategy for identifying how accounting operates as an organizational control system. We focus on debates and proceedings of the board of directors as an overlooked source of data on decision making and organizational practices. We show how accounting practices are part of the strategic control system that functions to interpret the environment and direct the adaptation of the organization in a manner particular to the substantive rationality of corporate decision makers. We illustrate these contentions with a case study of accounting practice changes over a six year period.     

HIV-infected woman. Illness cognition assessment.

1. Special attention is particularly important in addressing the mental health needs of HIV-infected women. These needs may involve issues such as concerns about present or future pregnancy; child-rearing, often as single parents; poverty, illicit drug use or addiction; and the potential lack of support services. 2. Diagnosis of HIV infection in women may be overlooked, as the clinical signs that routinely trigger the suspicion of HIV illness in men are often interpreted to reflect depression or psychological factors, such as stress or overwork, rather than raise the suspicion of HIV infection in women. 3. Understanding a woman's illness cognition is an important component of designing strategies that can enhance coping. The picture a woman generates regarding her illness is a composite of her experiences and responses, and determines to a large extent what she will do in response to her illness.