Integrating strategic issues into strategic management

The notion of a ‘strategic issues’ is rather pervasive in the field of planning in both conceptual [5, 19] and practical contexts. For instance, sometime ago the Wall Street Journal [41] reported that at least 50 large firms have created positions of ‘issues management director’; a dramatic increase in the number of such positions. ‘True’ strategic issues have a readily apparent importance to any organization; yet the process of identifying such issues and of integrating them into strategic planning and management is not well developed. Most treatments of strategic issues deal only with specific segments of the overall process through which relevant issues may be initially identified and finally translated into appropriate strategy [e.g. 5, 17]. This paper demonstrates that it is practical to develop a comprehensive process of ‘strategic issue management’ (SIM) that will facilitate the systematic identification, assessment and analysis of such issues. Such a process can ensure that issue-related factors are fully integrated into the formulation and implementation of strategy and plans. As such, SIM is a process whereby strategic issues may become an integral element of strategic management.     

Work rehabilitation programs: a 1997 survey

By adapting to the changing health care environment, legislative reforms, and consumer needs, work rehabilitation programs have experienced a metamorphosis. This study surveyed occupational therapists currently employed in work programs to ascertain a current demographic profile of work rehabilitation programs. Respondents indicated the delivery of services in the areas of prevention, assessment and rehabilitation. The majority of work rehabilitation programs in this study provide services in the form of ergonomics, education and training, and job analyses at the worksite. The area of work injury prevention services is forecasted for increased growth among work rehabilitation programs.     

INTERVENTION STRATEGIES: PREDICTING FAMILY THERAPY OUTCOME*

A pre-defined list of family therapy intervention strategies was used to predict post-therapy perceived life happiness and marital happiness among husbands and wives. Clients presented with both child and marriage-focused problems. The data were analyzed separately for husbands and wives. In general, favorable outcome for husbands was associated with active restructuring operations on the part of the therapist. Prediction of outcome for wives was less clear. However, wives did appear to respond favorably to less active interventions such as actualizing transactional patterns and reframing.     

A Comparison of Child-sex-abuse-related and Mental-disorder-related Suicide in a Six-year Cohort of Regional Suicides: The Importance of the Child Protection-Psychiatric Interface

Correspondence to: Professor Colin Pritchard, Department of Mental Health, School of Medicine, Southampton University, Royal South Hants Hospital, Southampton SO14 0YG, UK. E-mail: cp1{at}soton.ac.uk Summary The study compares Mental-Disorder-Related (MDR) suicide rateswith Child-Sex-Abuse-Related (CSAR) suicide of ‘Victims’and ‘Perpetrators’ of child sex abuse, based uponan examination of all Coroners’ inquest files over a six-yearperiod (n = 1,017). Census data, psychiatric case register andpolice records were used to calculate the potential MDR andCSAR populations. There were five main findings: (i) male andfemale CSAR victim suicide rates were 2.2. and 2.5 times theGeneral Population Suicide Rate (GPSR), respectively; (ii) everyfemale, and 80 per cent of male CSAR victim suicides, also hada mental disorder but none of the CSAR perpetrator suicides;(iii) male and female MDR suicide rates were 5 and 6 times theCSAR Victim rates; (iv) the sex abuser perpetrators’ suiciderate was more than 3 times the male MDR rate; (v) the intra-and extra-familial perpetrator suicide rates, were 25 and 78times the GPSR, respectively. Possible explanations for thesesurprising results are briefly discussed. They confirm the overrepresentationof people with mental disorder amongst suicides, and identifyan overrepresentation of CSAR suicides, particularly perpetrators.The results have implications for suicide prevention programmes,whilst highlighting the importance of the child protection-psychiatricinterface, and indicates the futility of simple explanationsin an area of practical and moral complexity.     

Ergonomic recommendations and their role in cardiac sonography

Musculoskeletal disorders (MSDs) have been recognized as a serious hazard to the health and safety of sonographers. Recommendations have been made on ways to reduce and prevent the frequency and severity of these disorders. The purpose of this study was to ascertain the impact ergonomics has had on the prevalence of MSDs among cardiac sonographers. Three hundred randomly selected Registered Diagnostic Cardiac Sonographers were surveyed. Eighty-one respondents completed the survey. The majority of the sample population was female with an average age of 40 and job tenure between 6-15 years. Ninety percent of respondents reported musculoskeletal pain/discomfort while scanning. Seventy-three percent of respondents perceived a need for ergonomic interventions. The majority of respondents were aware of previously recommended ergonomic interventions and had implemented what was feasible. Still, the experience of pain and discomfort, and incidence of MSDs remains exceptionally high for this occupation. It appears that recommended ergonomic interventions have not had a significant impact on improving the health and safety of cardiac sonographers.     

Machine-component group formation in group technology

A new Rank Order Cluster Algorithm is discussed which provides a simple, effective and efficient analytical technique for the formation of machine-component groupings. The method is specifically developed for computer application although it is possible for it to be used for manual computation, if required, particularly for smaller problems.     

A Comparative Analysis of Propositions Describing Social Movement Organizations*

Natural history, observational, and interview data from a study of two anti-pornography crusades and the social movement organizations which created and directed them are used to assess nine propositions formulated by Zald and Ash (1966) concerning the structure and dynamics of social movement organizations. The Zald-Ash propositions were formulated from the literature on national, established social movement organizations. This paper explores the applicability of the propositions to those organizations which are small and emerging. The propositions are generally supported. Discrepancies are accounted for by the significant influence of leadership orientation, goal specificity, and incentive structure in determining other structural and dynamic characteristics of small or emerging social movement organizations.     

Gay youth and gay adults: bridging the generation gap

Recent discussion of lesbian, gay, bisexual, and trans (LGBT) youth has included two emphases: the burgeoning trend toward youth-supportive organizations and focus on risk factors experienced by these youth. In practice, the two are intertwined: the need for youth-supportive endeavors is typically demonstrated by appeals to the risks LGBT youth face. Relatively little attention has been given to relationships between youth and adults in LGBT communities. This article employs data from a long-term qualitative study with LGBT youth, supported by information from numerous other settings to suggest that a failure on the part of both groups fully to comprehend the experience of the other hampers the optimal functioning of everyone involved. In particular, we suggest that the discourse about the dangers faced by LGBT youth, despite its being thoroughly well-intentioned. may actually place these teens at greater risk.     

Evaluating risk: global fees and episodic care

In 1999, two articles in The Physician Executive -- "Part I: Global Theory and the Nature of Risk (July-August)." and "Part II: Towards a Choice-Based Model of Managed Care (October-November)" -- outlined the flaws of orthodox managed care theory and highlighted the unique advantages of moving to a genuinely market-based model, which included the concept of direct contracting for integrated episodes of care. This follow-up focuses on comparing an episode contracting system to a traditional capitated program and outlines the features that make this approach much more attractive to physicians, payers, and most importantly patients.