Beyond resistance: Exploring health managers’ propensity for participatory evaluation in a developing country

The evaluation of interventions is becoming increasing common and now often seeks to involve managers in the process. Such practical participatory evaluation (PPE) aims to increase the use of evaluation results through the participation of stakeholders. This study focuses on the propensity of health managers for PPE, as measured through the components of learning, working in groups, use of judgment and use of systematic methods. We interviewed 16 health managers to determine the meaning they ascribe to these four components in their practice in a developing country, Haïti. We found that learning was often informal and that all managers attached a negative meaning to the use of judgment. Working in groups was favored by all managers, while the health managers viewed the use of systematic methods differently than do evaluators. The administrative health managers generally ranked lower in propensity for PPE than did their clinical colleagues. Implications for the practice of evaluation are discussed in relation to the work styles exhibited by managers in everyday practice, the proactive repetition of actions, the control exercised by formal procedures, and the collective versus “solitary” image of one's environment of action.     

A parallel multi-population genetic algorithm for a constrained two-dimensional orthogonal packing problem

This paper addresses a constrained two-dimensional (2D), non-guillotine restricted, packing problem, where a fixed set of small rectangles has to be placed into a larger stock rectangle so as to maximize the value of the rectangles packed. The algorithm we propose hybridizes a novel placement procedure with a genetic algorithm based on random keys. We propose also a new fitness function to drive the optimization. The approach is tested on a set of instances taken from the literature and compared with other approaches. The experimental results validate the quality of the solutions and the effectiveness of the proposed algorithm.     

Compensation for What? An Analysis of Insurance Strategies for Repairable Assets

We define a repairable asset as an irreplaceable commodity whose quality is at risk, but can be partly restored at a cost. Examples are houses, automobiles and, especially, health, for which standard monetary approaches are oversimplified. To optimize the value of insurance, the insurer and the insured have to agree upon repair strategies (when to fix the asset and how much) and compensation rules (how much money to receive for other goods). We clarify the role of the consumer's preferences in the properties of the contract, and we highlight the relationship between repair strategies and the super- or submodular structure of the repair technology.     

An inclusion-consistent solution to the problem of absurd confidence statements: 1. Consistent exact confidence-interval estimation

An example is given of a uniformly most accurate unbiased confidence belt which yields absurd confidence statements with 100% occurrence. In several known examples, as well as in the 100%-occurrence counterexample, an optimal confidence belt provides absurd statements because it is inclusion-inconsistent with either a null or an all-inclusive belt or both. It is concluded that confidence-theory optimality criteria alone are inadequate for practice, and that a consistency criterion is required. An approach based upon inclusion consistency of belts [C(x) C C C(x), for some x, implies γ ≤ γ for confidence coefficients] is suggested for exact interval estimation in continuous parametric models. Belt inclusion consistency, the existence of a proper-pivotal vector [a pivotal vector T(X, θ) such that the effective range of T(x,.) is independent of x], and the existence of a confidence distribution are proven mutually equivalent. This consistent approach being restrictive, it is shown, using Neyman's anomalous 1954 example, how to determine whether any given parametric function can be estimated consistently and exactly or whether a consistent nonexact solution must be attempted.     

Employee strain and job satisfaction related to an implementation of quality in a public service organization: a longitudinal study

To date, few studies have focused on employee reactions to the quality-related aspects of the introduction of New Public Management (NPM). The aim of this study was to investigate the effects on employee strain and satisfaction of the implementation NPM in a public service organization. The study was designed as an empirical examination of the 'context-dependent approach' ( Edwards, Collinson, & Rees, 1998 ). This approach suggests that effects of an organizational change depend on the context of the implementation, i.e. organizational aspects (implementation strategies), job content and job context dimensions. They employed a single-case longitudinal design. The case was a large municipal service unit responsible for the public housing system of a city in Austria. The sample consisted of 217 employees. Measurements were taken before the organizational change, and at two different times during the change process. While the implementation of NPM can be considered to have been an organizational success (increase in customer satisfaction), it was accompanied by increases in job strain, and, at the same time, mixed results in job satisfaction. Less qualified employees mainly responsible for the customer interface experienced the organizational change most negatively. Using structural equation modelling, the context-dependent approach was empirically confirmed. Job control, role clarity and information were found to be the most important job and organizational resources.     

Exposure of Contractors to Chemical Pollutants During the Maintenance Shut-Down of a Chemical Plant

The exposure of employees of different contracting firms to chemical pollutants was assessed during the five-week biennial maintenance shut-down of an isocyanate (TDI) synthesis plant. This assessment was mainly based on personal sampling, but work-related constraints occasionally required that area samples be used instead. Many tasks were carried out during the shut-down procedure (dismantling of reactors, installation of insulation, refection of kilns, cleaning, painting, electricity, etc.), thereby causing the employees of the contracting firms to be exposed to different kinds of pollutants, including products used or manufactured in the process (solvents, TDI and its synthesis intermediates), and products specific to the contractors' activity (welding fumes, crystalline silica, mineral fibers of heat insulation). The highest level of exposure (mainly to TDI) was found for the mechanical engineering activities undertaken during the dismantling of reactors and for cleaning activities. It was demonstrated that there was much variability in day-to-day exposure levels, and occasionally in the exposure levels encountered during a given shift. Cases of concomitant exposure to TDI (mainly short-term exposures) and other pollutants due to simultaneous activities from different tasks in the same area (co-activity) were also observed. Both the need for, and limitations of personal protective equipment (mainly respiratory) are stressed. Special emphasis is put on the responsibility of the owner of the facilities in helping the contractors in the organization of a health and safety policy.     

Statistical models for the analysis of controlled trials on acute migraine

Specific efficacy criteria were defined by the International Headache Society for controlled clinical trials on acute migraine. They are derived from the pain profile and the timing of rescue medication intake. We present a methodology to improve the analysis of such trials. Instead of analysing each endpoint separately, we model the joint distribution and derive success rates in any criteria as predictions. We use cumulative regression models for each response at a time and a multivariate normal copula to model the dependence between responses. Parameters are estimated using maximum likelihood. Benefits of the method include a reduction in the number of tests performed and an increase in their power. The method is well suited to dose–response trials from which predictions can be used to select doses and optimize the design of subsequent trials. More generally, our method permits a very flexible modelling of longitudinal series of ordinal data. Copyright © 2003 John Wiley & Sons, Ltd.     

Les apprentissages du changement dans l'entreprise polonaise. Entre continuité et rupture

Two major currents of theory have striven to explain the driving force behind the post-Communist transformation in central Europe since 1989. Based on the absolute rationality of actors, the so-called standard approach implies radical public policies that mark a break with the legacy from the preceding period. However it has turned out to be unable to account for the permanence of certain elements from the past. The “path-dependence” approach tries to understand institutional continuities as a reworking of accumulated experiences. However it has not managed to explain phenomena signaling a radical break in behavior patterns. This analysis of a technological change in a Polish firm combines the two dimensions of rupture and continuity by distinguishing between the introduction of change and forms of adaptation and learning by various categories of actors.