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.     

INFORMATION GATHERING IN ORGANIZATIONS: EQUILIBRIUM,WELFARE, AND OPTIMAL NETWORK STRUCTURE

We model an organization as a game in which all agents share a common decision problem and some level of coordination is necessary between individual actions. Agents have individual private information concerning the task they have to perform, and they share this private information through pairwise channels of communication. We analyze how this communication pattern, modeled by means of a network structure, affects individual behavior and aggregate welfare. In the unique equilibrium of this Bayesian game, each agent's optimal action depends on a properly defined knowledge index that measures how the aggregation of information helps him to infer higher‐order beliefs about other's information after communication. Adding communication channels is not always beneficial for the organization because it can lead to mis‐coordination. We single out the geometry of interagent communication links that the manager could implement in order to improve the organization's performance.     

Reliant behavior in the United States and Japan

Japanese economic success is often attributed to culturally reinforced psychological conditioning that promotes interpersonal reliance, cooperation, and a group interest orientation. This article provides direct experimental evidence on differences in behavior among future business people in the United States and Japan. Utilizing a simple, two person extensive form game of perfect information introduced by Selten (1975), we provide evidence that, contrary to some views, the Japanese can be less reliant on the behavior of others and are more likely to take actions at variance with group welfare in some settings. Thus, popular explanations of Japanese economic achievements may require further exploration.     

The state of sexual health services at U.S. Colleges and Universities

Objective: To describe the array of sexual health care services provided at US colleges and universities. Participants: During 2014–2015, 885 colleges were surveyed about their provision of sexual health services. Methods: 55% of colleges responded. Data were weighted and stratified by minority-serving institutions (MSIs), 2-year and 4-year institutions. Results: 70.6% of colleges reported having a health center (HC), of which 73.0% offered STI diagnosis/treatment (4 years vs. 2 years; 77.9% vs. 53.1%) and contraceptive services (70.1% vs. 46.4%), all p < .001. HCs less frequently offered LARC (19.7%), express STI testing (24.4%) and self-collection (31.4%). Condoms were available on 66.8% of campuses. HPV vaccination was available at more 4-year colleges (73.7% vs. 48.5%, p < .003) and non-MSIs (74.4% vs. 58.5, p = .019). Regarding MSM-targeted services, 54.6% offered pharyngeal and 51.8% rectal STI testing. Conclusions: 2-year colleges may require additional support with providing sexual health care. Improvements could entail increasing express testing, extra-genital STI testing, and LARC.     

University efforts to address confidentiality issues for STI services

Abstract

Objective: This study assessed university policies for addressing confidentiality issues for students seeking STI services. Participants: Universities with sponsored health insurance plans (SHIP) and/or wellness centers were selected from a university health services survey in 2017. Methods: STI service coverage and polices for addressing confidentiality issues related to explanation of benefit (EOB) forms were stratified by institution type (4-year versus 2-year) and minority serving institution (MSI) status. Rao-Scott chi-square tests were used to assess for differences in STI service coverage and polices. Results: More non-MSIs (61.6%) had SHIPs compared to MSIs (40.0%, p?<?.001). Only 40.8% of health centers had a policy for addressing EOB-related confidently issues. Of those, the most reported policy was that students could pay out-of-pocket to avoid generating an EOB (36.2%). Conclusions: Reducing confidentiality barriers are important for STI prevention in students. Universities may consider establishing policies for addressing EOB-related confidentiality concerns.     

The Relative Salience of Facial Features When Differentiating Faces Based on an Interference Paradigm

Research on face recognition and social judgment usually addresses the manipulation of facial features (eyes, nose, mouth, etc.). Using a procedure based on a Stroop-like task, Montepare and Opeyo (J Nonverbal Behav 26(1):43?C59, 2002) established a hierarchy of the relative salience of cues based on facial attributes when differentiating faces. Using the same perceptual interference task, we established a hierarchy of facial features. Twenty-three participants (13 men and 10 women) volunteered for the experiment to compare pairs of frontal faces. The participants had to judge if the eyes, nose, mouth and chin in the pair of images were the same or different. The factors manipulated were the target-distractive factor (4 face components?×?3 distractive factors), interference (absent vs. present) and correct answer (the same vs. different). The analysis of reaction times and errors showed that the eyes and mouth were processed before the chin and nose, thus highlighting the critical importance of the eyes and mouth, as shown by previous research.     

Work in unemployment - occupied or preoccupied? A review

This review explores the literature on the concept of work in unemployment and its relationship to health. A range of literature about the activities of unemployed people is reviewed and discussed with reference to three questions: What do unemployed people do?, What activities are associated with the health of unemployed people? and Do unemployed people work? From the literature, two groups of unemployed people are described: those who are characterised by active patterns of activity and those characterised by passive patterns. It is argued that the active group is psychologically healthier than the passive group. Concepts of work in both groups of unemployed individuals are presented, arguing that the active group seeks to replace employment with other work activities and that the passive group are engaged in work also, but that this presents as fret and preoccupation about their situation. These concepts of work are presented in the context of three major theoretical models of the personal impact of unemployment. Finally, implications for practice and directions for future research are suggested.     

Flexible‐Duration Extended Warranties with Dynamic Reliability Learning

Frequent technological innovations and price declines adversely affect sales of extended warranties (EWs) as product replacement upon failure becomes an increasingly attractive alternative. To increase sales and profitability, we propose offering flexible‐duration EWs. These warranties can appeal to customers who are uncertain about how long they will keep the product as well as to customers who are uncertain about the product's reliability. Flexibility may be added to existing services in the form of monthly billing with month‐by‐month commitments or by making existing warranties easier to cancel with pro‐rated refunds. This paper studies flexible warranties from perspectives of both customers and the provider under customers' reliability learning. We present a model of customers' optimal coverage decisions and show that customers' optimal coverage policy has a threshold structure under some mild conditions. We further show that flexible warranties can result in higher profits and higher attach rates in a homogeneous market as well as in a heterogeneous market with multiple segments differing in various dimensions.     

Hispanic Hospice Patients’ Experiences of End-Stage Restlessness

ABSTRACT

End-stage restlessness, or terminal agitation, is experienced by some patients during their final days and is characterized by physical, emotional, or spiritual distress, agitation or anxiety. End-stage restlessness negatively affects the patient’s death experience and can be distressing to the family and care team. Using the 2007 National Home and Hospice Care survey, this study examined factors associated with experiencing end-stage restlessness among non-Hispanic white and Hispanic hospice patients deceased at time of discharge. Results showed that being Hispanic/Latino, experiencing dyspnea, pain, and receiving palliative sedation treatment were risk factors for experiencing end-stage restlessness. The association between pain and restlessness was stronger for Hispanics compared with non-Hispanic whites. The Hispanic population remains underrepresented and little is known about the patient-centered experiences of Hispanic hospice users. Findings indicated that dying Hispanic patients continue to experience pain and other negative symptoms, even when hospice care is in place. Thus, it is important that social workers provide education to interdisciplinary team members about culturally competent practices, and advocate for a patient-centered approach to care.