The Distortion of a Managerial Technique? The Case of Clinical Networks in UK Health Care

Managed networks are increasingly common in the British National Health Service (NHS) as a means of streamlining and standardizing patient care across organizational and professional boundaries. However, there has been limited research regarding whether this technique is the most appropriate management style for delivery of health services. This article draws upon the authors' research on managed clinical networks for cancer in the UK–a model that set out to guide and develop knowledge flows across cancer service providers. It examines how the initial purpose of these networks was distorted by the broader function of New Labour's ‘modernization agenda’, which has ultimately focused on organizational restructuring and adhering to government targets. Our analysis, which develops Lozeau, Langley and Denis's model of the corruption of managerial techniques, suggests that the initial knowledge‐sharing purpose of networks underwent top‐down ‘distortion’ by the demands of central government. This resulted in superficial bottom‐up adoption of the networks model and limited impact upon organizational processes.     

Images of Success: How Illinois Farmers Define the Successful Farmer1

Abstract Farmers' views of farming success help frame their responses to information about farming, including alternative agriculture. A Q-analysis of 68 commercial farmers' subjective images of the successful farmer and the relative importance they accord different personal values and characteristics revealed four “model” images of the successful farmer. The Steward recognizes a moral responsibility to sustain land resources; the Manager succeeds largely by virtue of analytical skill; the Conservative's main goal is long-term preservation of the farm business; and the Agrarian values the rural life style and community participation. Farmers holding the Steward image tended to be older and to farm fewer acres; those with the Manager image included a large proportion of less experienced farmers. Approximately 40 percent of the farmers' views of success did not fit any of the four “model” images. Analysis of the findings suggests that images of success may be associated with life stage or generational differences in farming goals and values.     

Exploring Children's Stereotypes Through Drawings: The Case of Musical Performance

Drawings of 'a person' and of 'a person playing music' were collected from children aged seven to eight years and 10–11 years to discover whether children's musical representations would reflect gender differences evident in musical learning and performance, and the increased gender rigidity with age found in instrument preferences. As in previous drawing studies, same sex figures were overwhelmingly portrayed, although older girls drew more opposite sex figures than the other children. All except the older girls overwhelmingly drew same sex musicians irrespective of the gender stereotype of the instrument portrayed. The older girls drew similar numbers of male and female figures playing masculine instruments. Fewer feminine instruments were drawn by older than by younger boys. The increased gender rigidity with age accords with the results of the preference studies, but gender stereotyping was much weaker. This is discussed in relation to what the different methodologies measure.     

How has the relationship between parental education and child outcomes changed in Australia since the 1980s?

This paper examines how the relationship between parents' educational achievement (a marker of their socio‐economic status) and children's early developmental outcomes has evolved in Australia since the early 1980s. The specific focus of this paper is whether the gradient in children's early developmental outcomes by parents' education has changed since the 1980s. A comparative analysis of two surveys is undertaken that follows Australian cohorts of children through their early years – the Australian Temperament Project (following children born in Victoria in the early 1980s) and the Longitudinal Study of Australian Children (following a representative sample of children born in Australia in 1999). The analysis shows that the relationship between parental education and children's early developmental outcomes does not in general appear to have changed greatly over the years. The gradient associated with behaviour difficulties, persistence in behaviour difficulties over time, and in reading skills has either remained the same or strengthened somewhat, while the gradient associated with social skills has weakened. The paper concludes with a discussion of issues that might explain these trends.     

A model for identifying the potential clientele for substance abuse programs

A model is presented that estimates the rates, numbers, and socio-demographic characteristics of potential clientele for substance abuse programs. Using the synthetic estimates technique and existing bodies of information, the model has been tested and cross validated with substance abuse related problem indicators across the counties of Oregon with good results. The model has both strengths and weaknesses and may be seen as being of greatest value to policymakers, planning agencies, and program administrators in the field of substance abuse and related service programs.     

Observing the Delivery of a Domiciliary Support Service

This paper describes a study of the work of domiciliary support services which have been developed under the All-Wales Strategy for services to people with learning difficulties. The study employed direct observation methodology to describe the pattern of activities of domiciliary support workers and their clients. Twenty-eight sessions were observed, with the work of the domiciliary support worker with each client being observed twice. The pattern of work observed broadly fell into four categories: physical care in the family home, sitting-in, support for skill development and support in community activities. The results revealed that while support workers worked with skill and sensitivity in the family home they require further guidance and support if they are to assist successfully in skill development and community integration activities.     

Managing Strategic Change; The Role of Symbolic Action

As our understanding of processes of strategic management develop, it is clear that the problems of managing major shifts in strategy, which organizations face on occasions, are of a different order to the typically incremental strategy development they follow. It is also recognized that these problems are closely linked to cognitive and cultural dimensions of organizations. Research on the management processes associated with more fundamental strategic change is still sparse, but suggests that it requires substantial cognitive shifts in which intervention, often by new corporate leaders, and political and symbolic, as well as more substantial action, is likely. This paper draws together the author's and other research in related fields, to formalize explanatory models, which link organizational inertia of strategy, more fundamental strategic change, and in particular the symbolic management activities of corporate leaders as strategic change agents.     

The Politics of Disability: A New Approach

This paper will argue that the politics of disability has, so far, been narrowly conceived as part of the processes of party and pressure group activity. These approaches will be examined critically and it will be suggested that they are unlikely to produce substantial political gains in terms of ensuring the full participation of disabled people in society or contribute significantly to improving the quality of their lives. Finally, it will be argued that the politics of disability can only be properly understood as part of the newly emergent social movements of all kinds and it is only within this context that their real significance can be grasped.     

Managers' Perspectives on Making Major Investment Decisions: the Problem of Linking Strategic and Financial Appraisal

Major investment decisions are an important factor shaping strategic change in complex organisations. Traditionally, they have been primarily regarded as the domain of financial theory, with a few notable exceptions. This paper explores how the apparent gulf between strategic and financial appraisal of major investment decisions can be bridged. The approach taken in this research study was to explore linkages between strategic and financial appraisal from managers' own perspectives. These perspectives were examined through a learning process. This enabled managers to reflect and debate on their experiences and issues - upon both strategic and financial theory(s). Unlike many prior studies, this research took a qualitative approach to data analysis and interpretation. This yielded a range of insights - some of these amplified findings in earlier research studies; others suggested a more radical shift in thinking on strategic/financial appraisal linkages towards a closer fusion of the two disciplines.