Agency, Interrupted: Does Organizational Restructuring Improve Managerial Gender Parity? Testing a Disruption Hypothesis

New Public Management theories and policies have pressured healthcare organizations toward structural, rather than cultural, changes to improve performance. However, in the pluralistic and complex settings of healthcare organizations, senior managers play a key role in setting the strategic direction and often lead organizations toward ambiguous and conflicting goals. From this view, senior management team culture might influence organizational performance. This study has two aims: to test whether and how senior management team culture influences performance and to investigate whether a specific culture type is most effective in fostering better organizational performance in a Beveridge-type health system. We assess senior management culture through the Competing Values Framework and use multivariate regression analysis to test the relationship between dominant culture type and two different measures of organizational performance: attractiveness and annual net income. In all, 529 senior managers from 59 healthcare organizations responded (53% response rate). The results show that dominant rational and hierarchical culture types are associated with better performance: the former is associated with higher attractiveness, and the latter, with better financial results. Enhancing a specific performance dimension might require a cultural change rather than a structural change. From this perspective, general directors and senior managers should be appointed according to the best match between the culture and the primary organizational goals. Organizations and policy makers should tactically use the training of top managers and leading health professionals to reinforce or shape leadership aptitudes consistent with an organizational culture that supports the expected performance.

The puzzling relationship between international development and gender equity: The case of STEM postsecondary education in Cambodia

This study analyses affirmative action data to assess whether progress has been made in women's representation in management in Australian banks since the passing of the Affirmative Action (Equal Opportunity for Women) Act (AA/EO) in 1986. The findings show that, since 1988/9, women have continuously increased, albeit weakly, their representation at supervisory, middle-management and senior-management levels in large banks. However, women are still concentrated at supervisory level and constitute less than 6 per cent of senior management. In the small banks, women's representation in management, which at 36.20 per cent in 1995/6 is still more than twice that in the large banks, has continuously decreased since 1992/3. It was also found that restructuring and downsizing did not reduce the number of traditional layers of management in large banks. Consequently, the study of women's representation in management is still relevant. Downsizing in Australia, however, is expected to continue and de-layering of management levels in banking may eventually occur. As a result, when the trends in women's representation in management are considered within the context of the Australian banking industry, it is concluded that women's managerial representation is unlikely to reach 50 per cent. Implications for organizations and for aspiring women managers are discussed.

In a case-control surveillance program, first trimester medication use was studied in relation to gastroschisis. There were 76 cases of gastroschisis which were compared with 2,142 controls with other major malformations. For pseudoephedrine use, we found a significantly elevated relative risk of 3.2 (95% confidence interval, 1.3-7.7), with adjustment for confounding. Multivariate relative risks for analgesic/antipyretics and another decongestant were as follows: salicylates, 1.6 (0.9-2.7); acetaminophen, 1.7 (1.0-2.9); ibuprofen, 1.3 (0.4-3.7); and phenylpropanolamine, 1.5 (0.4-5.4). No increases in risk were identified for use of antihistamines, antibiotics, oral contraceptives, or spermicides. Because salicylates, pseudoephedrine, and phenylpropanolamine are vasoactive, the elevated risks for these drugs support the hypothesis of vascular disruption in the etiology of gastroschisis. We therefore examined maternal use of vasoactive medications in relation to a second case group of 416 infants with hetereogeneous defects suspected to have a vascular etiology. Relative risks for salicylates, ibuprofen, pseudoephedrine, phenylpropanolamine, and other decongestants approximated unity. These positive associations must be considered tentative. They have not been reported previously and should be confirmed independently. Also, acetaminophen, which may be taken for the same indications as salicylates and decongestants, but is not thought to be vasoactive, was associated with gastroschisis, suggesting that identified associations may be due to an underlying maternal illness.

In a case-control surveillance program, first trimester medication use was studied in relation to gastroschisis. There were 76 cases of gastroschisis which were compared with 2,142 controls with other major malformations. For pseudoephedrine use, we found a significantly elevated relative risk of 3.2 (95% confidence interval, 1.3-7.7), with adjustment for confounding. Multivariate relative risks for analgesic/antipyretics and another decongestant were as follows: salicylates, 1.6 (0.9-2.7); acetaminophen, 1.7 (1.0-2.9); ibuprofen, 1.3 (0.4-3.7); and phenylpropanolamine, 1.5 (0.4-5.4). No increases in risk were identified for use of antihistamines, antibiotics, oral contraceptives, or spermicides. Because salicylates, pseudoephedrine, and phenylpropanolamine are vasoactive, the elevated risks for these drugs support the hypothesis of vascular disruption in the etiology of gastroschisis. We therefore examined maternal use of vasoactive medications in relation to a second case group of 416 infants with hetereogeneous defects suspected to have a vascular etiology. Relative risks for salicylates, ibuprofen, pseudoephedrine, phenylpropanolamine, and other decongestants approximated unity. These positive associations must be considered tentative. They have not been reported previously and should be confirmed independently. Also, acetaminophen, which may be taken for the same indications as salicylates and decongestants, but is not thought to be vasoactive, was associated with gastroschisis, suggesting that identified associations may be due to an underlying maternal illness.

Approximately a decade ago, at the commencement to what has now become my vocation – namely teaching local government managers – a close colleague and myself ‘discovered’ the theory of public value creation that was initially set out by Mark Moore in his 1995 book Creating Public Value: Strategic Management in Government and subsequently published a few articles on it. Reflecting on teaching the theory for the ensuing decade, three consistent themes emerge from my engagement with students. First, the appeal of the theory as we originally encountered it, in both its parabolic form and in its more advanced articulation, as a theory of public management; also, as a theory of the state. Second, students are consistently drawn to the ethical dimension of the theory. Here, the author demonstrates this appeal by way of an example from the work of one of his recent students. Third, the author provides an account of what has emerged as a potential problem – that the theory has an emotivistic appeal. The author argues that this potential problem can be countered by a thorough understanding of the work, and ensuing developments.

Contents: Introduction: questioning the new public management, Mike Dent, John Chandler and Jim Barry. Context and Theory of the New Public Management: New public management and the professions in the UK: reconfiguring control?, Mike Dent and Jim Barry. Variations Between Sectors: Does 'Best Value' represent best value? local government middle management perspectives, Linda Keen What do we want from social care managers? aspirations and realities, Jeanette Henderson and Janet Seden Have you seen my assessment schedule? Proceduralization, constraint and control in social work with children and families, Paul Michael Garrett New police management, performance and accountability, Beverly Metcalf. Hydra-Headed New Public Management: The Case of the National Health Service: Dilemmas beyond the glass ceiling...: the performances of senior women managers in the National Health Service, Alison Linstead and Geraldine Catlow Can the public sector learn? the importation of 'Patient-Focused Care' in an NHS hospital trust, Chris Howorth, Frank Mueller and Charles Harvey 'It's a leap of faith, isn't it?' managers' perceptions of PFI in the NHS, Sally Ruane New forms of 'Out of Hours' care: from collaboration to competitive entrepreneurialism, Catrina Alferoff and Mike Dent. New Public Management as Contested Terrain: The new public management and higher education: a human cost?, Elisabeth Berg, Jim Barry and John Chandler A bit of a laugh: nurses' use of humour as a mode of resistance, Sharon C. Bolton. The Limits of New Public Management: Uses and limitations of performance measurement in the civil service: an assessment of the Singapore and New Zealand experiences, David Seth Jones Making a 'success' out of failure: darker reflections on private and public management, Tony Cutler Index.

Understanding Associations Between Serious Mental Illness and HIV Among Patients in the VA Health System

The purpose of this paper is to understand how the introduction of a patient-centered model (PCM) in Italian hospitals affects the pre-existent configuration of clinical work and interacts with established intra/inter-professional relationships. Qualitative multi-phase study based on three main sources: health policy analysis, an exploratory interview study with senior managers of eight Italian hospitals implementing the PCM, and an in-depth case study that involved managerial and clinical staff of one Italian hospital implementing the PCM. The introduction of the PCM challenges clinical work and professional relationships, but such challenges are interpreted differently by the organisational actors involved, thus giving rise to two different "narratives of change". The "political narrative" (the views conveyed by formal policies and senior managers) focuses on the power shifts and conflict between nurses and doctors, while the "workplace narrative" (the experiences of frontline clinicians) emphasises the problems linked to the disruption of previous discipline-based inter-professional groups. Medical disciplines, rather than professional groupings, are the main source of identification of doctors and nurses, and represent a crucial aspect of clinicians' professional identity. Although the need for collaboration among medical disciplines is acknowledged, creating multi-disciplinary groups in practice requires the sustaining of new aggregators and binding forces. This study suggests further acknowledgment of the inherent complexity of the political and workplace narratives of change rather than interpreting them as the signal of irreconcilable perspectives between managers and clinicians. By addressing the specific issues regarding which the political and workplace narratives clash, relationship of trust may be developed through which problems can be identified, mutually acknowledged, articulated, and solved.

Comparatively little attention has been paid to public value’s specific applicability to local government. This article addresses this gap in four ways. First, by reflecting on some of the reasons for its appeal to local government managers who encounter public value as graduate students. Second, by examining the greater suitability of public value to local government, as demonstrated by the debate about it as a theory of public management. Third, by identifying the putative limits of this appeal, specifically those arising from measuring public value. Fourth, by explaining how these putative limits are overcome by way of revisiting the theory.

Perceptions of facial dominance, trustworthiness and attractiveness predict managerial pay awards in experimental tasks

BackgroundFractal theory, developed by Benoit B. Mandelbrot in 1983, serves to describe intricate patterns in nature that traditional geometry finds challenging to measure. This theory employs the fractal dimension as...

Local transit agencies in the United States have expressed reservations about the Urban Mass Transportation Administration's data reporting requirements under Section 15 of the Urban Mass Transportation Act of 1964, as amended. These reservations result from perceived differences between local and national priorities for transit management and performance monitoring. The estimation of total annual passenger miles has been a point of particular concern, because of the cost of collecting passenger mile data and its apparent lack of utility to local transit agencies. An alternative methodology for producing the required passenger miles statistic was developed by the Orange County Transit District in California. Evaluation of this methodology reveals that passenger mile data could be useful in planning local transit services. The ability to produce reliable passenger mile estimates for route level demand analysis is available through modification of existing local data collection and analysis procedures using appropriate information technologies. Coordination between UMTA and local agencies would make the integration of passenger mile data collection and analysis into local transit service planning both feasible and more desirable. The use of passenger miles data in local service evaluation could yield significant improvements in transit productivity, due to the broader range of consumer behavior represented by this measure.

This dissertation is a collection of essays that incorporate institutional analysis into Economics of Gender research. I specifically consider the role of institutional arrangements in the economic status of women, opportunities the institutional arrangements create for women, and outcomes of changes in institutional arrangements that affect women. In chapter 2 I investigate the relationship between income distribution inequality and labor mobility, as globalization is viewed in the existing literature as aiding income inequality by allowing greater capital mobility but not mobility of labor. The literature argues that globalization creates changes in bargaining power for labor and capital owners thus decreasing income share received by labor. I find that while male mobility is indeed negatively related to labor share, female mobility has a positive association with labor share. In chapter 3 I estimate the relationship between the institutions of economic freedom and women's share of managers. The motivation is policymakers' concerns with low female representation in leadership positions, which among others include women in corporate management. I find a positive relationship between the two, implying that less regulated markets provide incentives that favor less gender discrimination for this type of employment. In chapter 4, jointly with Andrew Young, we seek to explain the relationship between female suffrage rights and government growth while taking spatial dependence effects into account. Women and men have different preferences when it comes to publicly provided goods. Specifically women prefer higher government spending on health and education. Literature has linked this distinction in preferences and women suffrage rights to government growth in the U.S. At the same time, local governments have been shown to engage in yardstick competition creating spatial spillovers. We find no relationship between government overall spending and taxation levels with suffrage rights implementation, after we control for spatial correlation. We additionally find that spending on social services by a state has a positive association with suffrage rights being implemented in that state and neighboring states. For example, that granting female suffrage rights in one state is associated with higher government spending on social services in neighboring states.

6 - Management Support and Responsibilities