Characteristics of a central change programme within a governmental bureaucracy: a grounded theory study

Purpose The purpose of the paper is to present a theory of organisational change within the setting of a governmental bureaucracy. Design/methodology/approach Orthodox grounded theory is employed in the setting of a change programme in 12 Audit departments of the Dutch Ministries (public-sector). Findings The examined organisational change has specific characteristics. The Dutch ‘ministerial autonomy’ and the clearly recognizable role types of the key figures involved have a strong impact on the change programme and the realisation of its goals. Research limitations/implications Findings are derived on the basis of a substantive case study of the change programme of the Dutch Departmental Audit function. The research sheds new light on characteristics related to the occupational group of Chartered Accountants and characteristics of a governmental bureaucracy and it helps to understand change programmes within this bureaucracy. Practical implications The grounded theoretical model draws attention to the impact of key figures and circumstances on a change programme within the central government. Originality/value The paper builds on theories of organisational change but applies them in the typical context of the Dutch civil service where ministerial autonomy, on the one hand, and a move in the direction of more centrally organised activities (concern idea), on the other, require a difficult balancing act of all players in the change arena.     

Joint modelling of longitudinal outcome and interval-censored competing risk dropout in a schizophrenia clinical trial

The 'Clinical antipsychotic trials in intervention effectiveness' study, was designed to evaluate whether there were significant differences between several antipsychotic medications in effectiveness, tolerability, cost and quality of life of subjects with schizophrenia. Overall, 74 % of patients discontinued the study medication for various reasons before the end of 18 months in phase I of the study. When such a large percentage of study participants fail to complete the study schedule, it is not clear whether the apparent profile in effectiveness reflects genuine changes over time or is influenced by selection bias, with participants with worse (or better) outcome values being more likely to drop out or to discontinue. To assess the effect of dropouts for different reasons on inferences, we construct a joint model for the longitudinal outcome and cause-specific dropouts that allows for interval-censored dropout times. Incorporating the information regarding the cause of dropout improves inferences and provides better understanding of the association between cause-specific dropout and the outcome process. We use simulations to demonstrate the advantages of the joint modelling approach in terms of bias and efficiency.     

Rolling with the shakes: an insight into teenagers’ perceptions of recovery after the Canterbury earthquakes

Natural disasters are harmful worldwide events that inflict multiple psychosocial impacts on disaster-exposed individuals. A significant proportion of affected individuals are teenagers (13–18 years old) who, compared with adults, have been historically overlooked in disaster research. The literature is particularly sparse concerning teenagers’ recovery from natural disasters, specifically what recovery means to them and the contributing factors towards their positive recovery. Therefore, the aim of the current study was to gain deeper insight into this largely unexplored area by conducting five focus groups with teenagers (16–18 years) who experienced at least one of the Canterbury, New Zealand, earthquakes since and including the initial September 2010 earthquake. This study directly asked teenagers about their recovery over the three years after the initial earthquakes, with data being analysed using thematic analysis. Two main themes were identified: (1) perceptions of recovery, with three sub-themes (i) knowledge and being less frightened, (ii) talking about the earthquakes and (iii) shift in perspectives; and (2) contributing factors to recovery, with three sub-themes (i) participation in the community response, (ii) returning to school and (iii) the rebuild of Christchurch. These factors provide insight into how we can better support the recovery process for disaster-exposed teenagers to reduce long-term distress.     

The impact of missing data on the results of a schizophrenia study

Missing data pose a serious challenge to the integrity of randomized clinical trials, especially of treatments for prolonged illnesses such as schizophrenia, in which long‐term impact assessment is of great importance, but the follow‐up rates are often no more than 50%. Sensitivity analysis using Bayesian modeling for missing data offers a systematic approach to assessing the sensitivity of the inferences made on the basis of observed data. This paper uses data from an 18‐month study of veterans with schizophrenia to demonstrate this approach. Data were obtained from a randomized clinical trial involving 369 patients diagnosed with schizophrenia that compared long‐acting injectable risperidone with a psychiatrist's choice of oral treatment. Bayesian analysis utilizing a pattern‐mixture modeling approach was used to validate the reported results by detecting bias due to non‐random patterns of missing data. The analysis was applied to several outcomes including standard measures of schizophrenia symptoms, quality of life, alcohol use, and global mental status. The original study results for several measures were confirmed against a wide range of patterns of non‐random missingness. Robustness of the conclusions was assessed using sensitivity parameters. The missing data in the trial did not likely threaten the validity of previously reported results. Copyright © 2014 John Wiley & Sons, Ltd.     

Prevalence and correlates of diabetes mellitus among homeless veterans nationally in the Veterans Health Administration

Abstract

Background: Homeless people are at high risk for many chronic medical conditions although their risk of diabetes has not been well studied. Current epidemiological studies of diabetes prevalence among homeless adults have been based mostly on self-report data not supported by clinical assessments.

Objectives: To determine the prevalence and risk factors for diabetes mellitus (DM) among homeless veterans in the Veteran Health Administration (VHA).

Methods: The sample included 3?464?364 veterans with documented body mass indexes (BMI), 137?720 (4%) of whom had been homeless. Logistic regression models were used to determine the odds of having DM among homeless veterans compared to non-homeless veterans. Bivariate and multi-variate analyses were then used to identify potential risk factors for DM among homeless veterans.

Results: The prevalence of DM in homeless veterans was 19%. Homeless veterans with DM, compared to those without it were older, more likely to have a BMI?>?40 and more likely to have DM-related co-morbidities.

Conclusions: There is a high prevalence of DM among homeless veterans in the VHA compared to previous reports for homeless adults (8%). Tailored approaches to improve access to DM screening, prevention, and treatment could benefit homeless veterans.     

Out‐of‐Home Placement of Children Exposed to Violence

There is growing concern about the increasing number of children in the USA who are exposed to community violence and the need to remove some of them from their families. This study examines risk factors for out‐of‐home placement among a large pool of children and adolescents who were referred for general clinical assessment following exposure to violence and/or psychological trauma in their communities or homes. Children with greater familial and environmental support and children exposed to incidents involving a non‐parental personal threat were associated with a significantly lower risk of out‐of‐home placement. A greater likelihood of being placed out of home was associated with older age (adolescents), history of mental health service use, involvement with law enforcement agencies, higher clinical ratings of depression or impaired thought processes, lower clinical functioning and greater exposure to traumatic events. Evidence of maltreatment and a threat to life was associated with 13.6 times greater likelihood of being placed out of the home. This study raises an important issue in respect to the children's past use of mental health service and current symptoms. It is not just the risk of violence but also evidence of psychiatric problem that trigger out‐of‐home placement. Further studies are needed to assess the quality and effectiveness of mental health services provided to children exposed to violence. © 2007 The Author(s). Journal compilation © 2007 National Children's Bureau.     

Use of a case study in sequencing/scheduling research

This paper describes a study of an industrial sequencing/scheduling problem. The study contains the definition of the problem, data requirements and examination of solution technique. Definition of the problem is discussed from the aspect of uniqueness of the specific system. Discussion of data requirements includes availability and accuracy, while examination of solution technique considers limitation of time, computer capacity, etc., as well as the possibility of imbedding available algorithms into the solution procedure. Conclusions are presented relative to the use of the case study approach in sequencing/scheduling research.     

Human dynamics: A new approach to human behavior

This paper presents a new approach to analyze human behavior and more precisely human performance. It calls upon a system dynamics methodology to develop a general framework for looking at human beings. As an illustration of the approach, one subsystem is described. The global human system is also briefly presented. The contribution of such an approach is illustrated with an example dealing with the study of a worker performance subject to different types of control.     

What's an Oscar worth?

This article examines the impact of an Academy Award nomination and award for best picture, best actor/actress, and best supporting actor/actress on a film's (i) market share of theaters, (ii) average revenue per screen, and (iii) its probability of survival. The model is estimated using weekly box-office data for a matched sample of nominated and non-nominated films. The results indicate substantial financial benefits for a nomination and award for best picture and best actor/actress. The structure of rewards is consistent with that found in two-stage, single-elimination tournaments.     

Spouse selection and earnings: evidence of marital sorting

This article investigates economic bases for individuals'selection of marriage partners. Its central focus is matching of spouse pairs based on unobservable components of hourly earnings. Using a data extract from the Panel Study of Income Dynamics, we have observations of individuals'wages before and immediately after marriage, along with their spouses'earnings after marriage. We exploit the data to estimate the relation between spouses'wage residuals. The evidence supports positive marital matching on the basis of earnings. The results are robust with respect to variations in the statistical framework of the model.