High-level Leadership Research Articles

Using an experience-based co-design approach to develop strategies for implementing an intravenous iron intervention to treat moderate and severe anemia in pregnancy in Malawi.

In low- and middle-income countries, women experiencing anemia during pregnancy are recommended to take 30mg to 60mg of oral iron daily throughout pregnancy. However, oral iron tablets are often poorly tolerated and slow in correcting anemia, resulting in low adherence, prolonged anemia, and increased risk of adverse maternal and fetal outcomes. An alternative to oral iron is intravenous (IV) iron, commonly used in high-income countries to restore the body's iron stores rapidly. A randomized controlled trial was conducted to investigate the effectiveness and safety of IV iron compared to standard-of-care oral iron supplementation for pregnant women with moderate and severe anemia in the third trimester in Malawi (REVAMP-TT). Using an experience-based co-design approach, our study aimed to identify barriers and facilitators to IV iron use to treat anemia in pregnancy in the primary healthcare system of Malawi, and develop mitigating strategies for the successful implementation of REVAMP-TT. The co-design process involved two phases: i) We conducted an information-gathering exercise to identify barriers and facilitators to IV iron use to treat anemia in pregnancy in the primary healthcare system of Malawi. We interviewed key informants (n = 53) including the policymakers, government partners, healthcare managers, and healthcare providers. We also gathered previous research findings from a formative qualitative study on the perceptions and experiences of IV iron treatment for pregnant women experiencing anemia in Malawi (n = 29). ii) We conducted two co-design workshops with end-users (n = 20) and healthcare providers (n = 20) to confirm and identify the key barriers and facilitators and developed mitigating strategies to inform the successful implementation of the REVAMP-TT trial. We mapped the emerging barriers to the Consolidated Framework for Implementation Research 2.0 (CFIR 2.0) and matched the mitigating strategies to the corresponding Expert Recommendations for Implementing Change (ERIC) compilation. The following were identified as key barriers to IV iron use to treat anemia in pregnancy in the primary healthcare system of Malawi: the cost of IV iron, the lack of available resources and knowledge, local attitudes including myths and misconceptions about IV iron and keeping pregnancy a secret, local conditions, the lack of political will and buy-in from high-level leaders, the lack of capability of healthcare providers to deliver IV iron, and the lack of male involvement to support pregnant women's access to antenatal care. The proposed strategies to mitigate the barriers for the successful implementation of the REVAMP TT trial included providing financial strategy, developing stakeholder relationships, training and educating stakeholders, supporting clinicians, and engaging end-users. The use of the experience-based co-design approach in our study provided a valuable method to expose the potential barriers and facilitators to IV iron use and develop mitigating strategies to successfully implement the REVAMP-TT trial. Engaging both the key informants and end users promoted ownership and consensus among stakeholders and ensured a collaborative environment for sharing deeply rooted real-world experiences and insights. Not only do these findings address the needs of this study, but they also, lay a groundwork for the possible integration of IV iron into routine care in Malawi and provide knowledge for policymakers to make informed decisions on the management of anemia in the primary healthcare systems of Malawi.

Drivers of Iran’s Africa Engagement: An Analysis of High-Level Leadership Visits

The nuanced dynamics of Iran’s engagement with Africa have captivated the attention of a broad spectrum of analysts and academicians. Endeavoring to elucidate the underpinnings of Tehran’s involvement on the continent, these scholars have posited a variety of determinants, yet the empirical validation of these factors remains largely unexplored. Leveraging a comprehensive dataset of Iran’s high-level diplomatic visits to African nations, this study seeks to critically assess the relevance and explanatory capacity of the determinants in the literature. Our findings indicate that ideological imperatives, market needs and access to strategic resources predominantly fuel Iran’s interests in Africa.

First things first: measuring French Medical schools’ deans motivation to engage in smoke-free campus

Abstract Smoke-free campuses (SFC) prohibit smoking and vaping on all university grounds and for all users. Around a hundred of papers was published on that topic revealing how they reduce initiation and increase smoking cessation among students. Whereas it is key for the success of all project, including SFC, very rare research has investigated attitude of high-level leaders of universities toward SFC, their perceived barriers and motivation to adopt it. To fill this gap, we interviewed deans of medical schools in France, where SFC are limited. In-depth individual interviews were conducted on 31 deans and two associate-deans (representing 31 out of 35 French medical schools). Questions rose knowledge of SFC, perception of this measure, self-role to play and other factors influencing implementation. We targeted medical schools because they train future prescribers of smoking cessation, and can act as a model for policy dissemination to other schools. The 23 hours of interviews were analyzed using thematic analysis with Nvivo14. Regarding diffusion in 2023, only one medical school had a SFC, six were implementing it, 23 had no SFC and one abandoned it. 28 held positive attitudes towards SFC, explained by its impact on health and the mission of medical schools. Most of them considered SFC feasible with resources and engagement of students. Identified barriers were competing priority, lack of funding and of support from users and risk of stigmatization of smokers. A majority of deans thought they had a role to play in initiating, promoting and moderating the policy. SFC are recommended by the WHO but there is important room for improvement for their diffusion in France. Yet, a majority of deans we interviewed appeared motivated to adopt it. Solutions to encourage them and overcome barriers must be found. Key messages • Diffusion of SFC among medical schools remains limited in France. • Deans’s positive attitude towards SFC bring hope for a better diffusion of SFC among French universities.

Using the IFASIS (Inventory of Factors Affecting Successful Implementation and Sustainment) to Advance Context-Specific and Generalizable Knowledge of Implementation Determinants: Case Study of a Digital Contingency Management Platform.

Background Contingency management (CM) is the most effective treatment for stimulant use disorder but is underutilized by opioid treatment programs (OTPs), despite the high prevalence of stimulant use in this setting. As part of a state-wide initiative, we piloted a novel assessment, the Inventory of Factors Affecting Successful Implementation and Sustainment (IFASIS), to examine determinants of implementation of a digital CM platform across a set of OTPs. We describe how the IFASIS was used to elucidate both generalizable and context-specific implementation determinants, and to guide the provision of implementation facilitation. Methods Six OTPs received a multi-level implementation strategy (including facilitation) to promote programmatic uptake of a digital CM platform. Pre-implementation, OTPs completed the IFASIS, a 27-item questionnaire that assesses both the valence (positive/negative) and importance of determinants across 4 domains: outside the organization, within the organization, about the intervention, and about intervention recipients. OTP staff completed the IFASIS as a team, identifying consensus ratings during recorded discussions. Transcripts of IFASIS recordings were analyzed using rapid qualitative analysis. Quantitative IFASIS results were aggregated into medians and ranges within and across organizations. Implementation facilitation meeting notes were analyzed to examine how the IFASIS was used to guide facilitation. Results Quantitative ratings and qualitative feedback revealed common barriers to implementation of the digital CM platform, including a lack of sustainable funding sources, absence of external and organizational policies, insufficient higher-level leadership support, and mixed attitudes among staff members toward CM. Common implementation facilitators included enthusiasm and commitment among organization leadership and the perception that the digital CM platform would reduce the workload and burden on OTP counselors. The IFASIS was used to guide facilitation in several ways, including stimulating discussion about barriers and facilitators, brainstorming strategies to address barriers rated as "very important", and identifying facilitators that could be harnessed as part of implementation efforts. Conclusions The IFASIS identified important determinants of CM implementation in OTPs and was instrumental in shaping facilitation. The IFASIS may be a valuable assessment for the implementation science community to identify and address generalizable and context-specific implementation determinants.

Configurational Paths of Preconditions to Transformational Leadership Among Core Hospital Leaders: A Fuzzy-Set Qualitative Comparative Analysis.

Transformational leadership among core hospital leaders boosts medical organizations' competitiveness, adaptability, and sustainability, which is jointly affected by individual, organizational and environmental factors. This study aims to unpack its configurational framework and propose strategies to strengthen core hospital leaders' transformational leadership. Data were collected from an online questionnaire among 31 core hospital leaders. The fuzzy-set qualitative comparative analysis (fsQCA) was used to explore the causal mechanism of high-level transformational leadership. We enrich this mechanism by professional background, critical thinking, initiative spirit, family-work conflict, job satisfaction, subordinates' followership, and work pressure. Result shows initiative spirit is the only necessary condition (consistency=0.911) for the formation of high-level transformational leadership among core hospital leaders. Three configurations are the sufficient conditions that lead to high-level transformational leadership among core hospital leaders with two different professional backgrounds (overall solution consistency= 0.952). Core hospital leaders' initiative spirit is an indispensable condition for improving high-level transformational leadership, emphasizing the necessity for core leaders to be proactive in order to develop such leadership. Besides, the study also uncovered three configurations are the sufficient conditions for core hospital leaders with diverse professional backgrounds to achieve high-level transformational leadership. This finding offers significant insights into hospital management practices, suggesting that core hospital leaders' work should be managed in a personalized manner based on their professional backgrounds, thereby fostering favorable conditions conducive to the development of their high-level transformational leadership capabilities. Furthermore, the central insight of this study is that the formation of high-level transformational leadership contingent upon the collaboration of professional background, critical thinking, initiative spirit, family-work conflict, job satisfaction, subordinates' followership, and work pressure, contributing to a holistic and more rigorous view for the development of transformational leadership.

Healthy Communities for Youth: A Cost Analysis of a Community-Level Program to Prevent Youth Violence

Youth violence is a national public health concern in USA, especially in resource-constrained urban communities. Between 2018 and 2021, the Healthy Communities for Youth (HCFY) program addressed youth violence prevention in select economically marginalized urban communities, with the HCFY program reducing the likelihood of youth-involved violent crime. Leveraging costs from program expense reports, this study analyzes the costs of the HCFY program in order to inform policymaking and the program’s future ongoing implementation. Total HCFY program costs were $821,000 ($290,100 annually including program start-up costs) over the 34-month project period. Operationalization costs contributed the largest share (64.8%), with 45% attributable to intervention coordinators. In the intervention community, the program costs $100 per capita, $1100 per youth-involved crime case, and $8100 per youth-involved violent crime case. Findings were sensitive to the number of youth-involved crime or violent crime cases and costs of high-level program leadership and self-evaluation analysts, with the per youth-involved violent crime case cost ranging between $700 and $1600 over the program period. Analysis of HCFY program costs is an important step in determining the affordability of a community-level program to prevent youth violence in resource-limited urban communities.

Connecting gender balance, crisis resistance and innovativeness in the forestry sector: Women in leadership and management

Much of the research on forestry innovation is based on models of economic rationality that are presumed to be universal and “a-gendered.” This article understands that economic processes are not “neutral” and seeks to produce empirical insights into the perceptions of gender in the male-dominated forestry sector. How does perceived gender balance in a forestry-related organisation contribute to its resilience to economic, ecological, climate-related and other contemporary crises, as well as its innovativeness? To examine the importance attributed to gender balance for resilience and innovation, we undertook a representative web survey amongst the principal Austrian forestry-related companies, institutions and agencies. The results show some links between gender and innovation, but not between gender and resilience. We then complemented the survey with in-depth interviews with high-level female representatives from the Austrian forestry sector, focusing on their personal experiences and opinions as both experts and the sole ones who made it in a sector of skewed gender balance and strong misrepresentation. Our findings reveal a contradiction between the survey results on the importance attributed to gender balance within forestry-sector organisations and the inequalities that successful women in high-level leadership positions reported in the interviews. The article discusses how gendered norms are relevant for economic outcomes and must be integrated into all related research efforts. Our findings challenge academic positions that regard economic issues and societal questions like gender balance to be strictly separated.

Exploring health equity integration among health service and delivery systems in Nova Scotia: perspectives of health system partners

BackgroundAchieving health equity is important to improve population health; however, health equity is not typically well defined, integrated, or measured within health service and delivery systems. To improve population health, it is necessary to understand barriers and facilitators to health equity integration within health service and delivery systems. This study aimed to explore health equity integration among health systems workers and identify key barriers and facilitators to implementing health equity strategies within the health service and delivery system in Nova Scotia, ahead of the release of a Health Equity Framework, focused on addressing inequities within publicly funded institutions.MethodsPurposive sampling was used to recruit individuals working on health equity initiatives including those in high-level leadership positions within the Nova Scotia health system. Individual interviews and a joint interview session were conducted. Topics of discussion included current integration of health equity through existing strategies and perceptions within participant roles. The Consolidated Framework for Implementation Research (CFIR) was used to guide coding and analysis, with interviews transcribed and deductively analyzed in NVivo. Qualitative description was employed to describe study findings as barriers and facilitators to health equity integration.ResultsEleven individual interviews and one joint interview (n = 5 participants) were conducted, a total of 16 participants. Half (n = 8) of the participants were High-level Leaders (i.e., manager or higher) within the health system. We found that existing strategies within the health system were inadequate to address inequities, and variation in the use of indicators of health equity was indicative of a lack of health equity integration. Applying the CFIR allowed us to identify barriers to and facilitators of health equity integration, with the power of legislation to implement a Health Equity Framework, alongside the value of partnerships and engagement both being seen as key facilitators to support health equity integration. Barriers to health equity integration included inadequate resources devoted to health equity work, a lack of diversity among senior system leaders and concerns that existing efforts to integrate health equity were siloed.ConclusionOur findings suggest that health equity integration needs to be prioritized within the health service and delivery system within Nova Scotia and identifies possible strategies for implementation. Appropriate measures, resources and partnerships need to be put in place to support health equity integration following the introduction of the Health Equity Framework, which was viewed as a key driver for action. Greater diversity within health system leadership was also identified as an important strategy to support integration. Our findings have implications for other jurisdictions seeking to advance health equity across health service and delivery systems.

Exploring the Higher-Level Leadership Inside the Student Affairs Department at International Universities in Europe

Student Affairs divisions at universities experience the highest number of turnover in Human Resources: people come to work and do not stay more than a year in their job positions due to burnout, overload of responsibilities, and insufficient resources. Considering that Student Affairs` leadership is hierarchical, Student Deans and Department Directors are often overlooked as people who might experience similar feelings as other workers in the division. There is no research about the experiences of higher-level leaders in Student Affairs. Therefore the main question of this qualitative study was, “What does it mean to be a department head?” In this study, five higher-level leaders in Student Affairs at International Universities in Europe answered a few questions about their meaning, experiences, and desirable changes that they need in their position during the semi-structured interviews. The thematic analysis was used to code the interviews and converge the codes in themes and subthemes. As a result, five themes emerged and included: meaning, responsibility, relationship, mental health, and changes. The findings contribute to a broader understanding of the experience and needs of workers in higher-level leadership positions in Student Affairs to increase the retention rates at Student Affairs. Considering the constantly changing nature of things in Student Affairs, research that includes more universities across Europe is needed to identify and address the needs of professionals specifically in Student Affairs at International Universities.

IHR-PVS National Bridging Workshop for Somalia: An interactive and participatory approach for operationalizing the One Health roadmap

BackgroundNational Bridging Workshops (NBW) are a tool for reviewing collaboration gaps between line ministries relevant to the One Health framework. MethodsThe NBW for Somalia was held on November 11–13, 2023 in Nairobi, Kenya with support from WHO and WOAH. Participants included representatives from the Somali government both national and sub-national (including Ministry of Health; Ministry of Livestock, Forestry and Range; Ministry of Agriculture and Irrigation; and Ministry of Environment and Climate Change). Other participants included representatives from non-governmental organizations, academia and the quadripartite. Structured sessions guided participants through a step-by-step process, starting from identifying gaps to collectively developing solutions. The design of these sessions aimed to foster active engagement and collaboration with the outcomes of each session contributing to the subsequent one. ResultsA total of 60 participants partook in the exercise, representing human health (35%), animal health (27%), agriculture (13%), environmental health (7%) and other relevant sectors (18%). Eighty-three percent of participants represented the national level and 17% the sub-national level. The collaborative effort yielded a joint roadmap comprising 36 activities and 11 objectives. Priority objectives included: development of national joint surveillance systems for selected One Health threats (41/47 votes, or 87% of the total votes); establishment of a high-level ministerial system to govern and coordinate One Health activities (30/47; 64%); and establishment of emergency funding structures for priority zoonotic diseases along with development of a 5-year national investment plan for One Health (27/47; 57%). A total of 94% of activities required low or moderate cost to be implemented, and 90% of activities were identified to have a likely high impact on multisectoral collaboration. The timeline for implementing the activities is projected to span one to two years. ConclusionThe workshop promoted high-level engagement, national ownership, and leadership in addressing health threats at the human-animal-environment interface. The resulting co-created roadmap will be integrated into the National Action Plan for Health Security, supporting ongoing One Health efforts in Somalia.

Implementation of the Open Selection Policy for Primary High-Level Leadership Positions during the Acting Regent Period in Indonesia (Case Study in North Hulu Sungai Regency in 2023)

This research aims to analyze the implementation of the open selection policy for high-level Primary (Pratama) leadership positions during the term of the Regent of Hulu Sungai Utara in 2023. This type of research is descriptive qualitative. Data collection was carried out using observation, interviews, and documentation. The data analysis technique is carried out through four stages, namely data collection, data condensation, data presentation, and conclusion. The results of the research show that the implementation of the open selection for Pratama high leadership positions during the term of Acting Regent of Hulu Sungai Utara has been carried out well in terms of the preparation stage, implementation stage, and monitoring and evaluation stage. Apart from that, looking at aspects of Edward III's implementation theory, namely: 1) Communication, the communication process from the source of information to the resulting impact, influences the efficiency and effectiveness of the implementation of open selection; 2) Resources, emphasizing that the quality and quantity of these resources greatly influences the smoothness and integrity of the implementation of the open selection; 3) Disposition, the process of appointing bureaucrats and the use of incentives as motivation factors; and 4) Bureaucratic Structure, Standard Operating Procedure which is not integrated between government agencies and fragmentation shows that separation in the implementation process can hamper the efficiency and effectiveness of the implementation of open selection and the inauguration of high-level pratama officials.

Inspiring and Preparing Our Future Leaders: Evaluating the Impact of the Early Career Women's Leadership Program.

The number of women in high-level leadership in academic medicine remains disproportionately low. Early career programs may help increase women's representation in leadership. We evaluated the Early Career Women's Leadership Program (ECWLP). We hypothesized that participants would rate themselves as having increased confidence in their leadership potential, improved leadership skills, and greater alignment between their goals for well-being and leading after the program. We also explored the participants' aspirations and confidence around pursuing high-level leadership before and after the program. We surveyed women physicians and scientists before and after they participated in the 2023 ECWLP, consisting of 11 seminars over six months. We analyzed pre- and post-program data using Wilcoxon signed-rank tests. We analyzed answers to open-ended questions with a content analysis approach. 47/51 (92%) participants responded, and 74% answered pre- and post-program questionnaires. Several metrics increased after the program, including women's confidence in their ability to lead (p<0.001), negotiate (p<0.001), articulate their career vision (p<0.001), reframe obstacles (p<0.001), challenge their assumptions (p<0.001), and align their personal and professional values (p=0.002). Perceptions of conflict between aspiring to lead and having family responsibilities (p=0.003) and achieving physical well-being (p=0.002) decreased. Perceived barriers to advancement included not being part of influential networks, a lack of transparency in leadership, and a competitive and individualistic culture. In the qualitative analysis, women described balancing internal factors such as self-doubt with external factors like competing professional demands when considering leadership. Many believed that becoming a leader would be detrimental to their well-being. Beneficial ECWLP components included support for self-reflection, tactical planning to pursue leadership, and creating a safe environment. The ECWLP improved women's confidence and strategic plans to pursue leadership in a way that supported their work-life integration. Early career leadership programs may encourage and prepare women for high-level leadership.

WOMEN EMPLOYMENT AND ENTREPRENEURSHIP: A SYSTEMATIC REVIEW OF TRENDS AND PATTERNS POST UTILIZATION OF NEW MEDIA TECHNOLOGIES

The rapid spread of COVID-19 across the country and the subsequent lockdowns disrupted a substantial number of businesses across the country. Small businesses, especially those owned and operated by women, have been affected by the epidemic, which has exacerbated the situation. In addition, the information gleaned from the applications revealed that despite these challenging circumstances, women had demonstrated remarkably high levels of leadership, happiness, and resilience. In 2020, women initiated twice as many Facebook-based fundraising campaigns as men. Moreover, female-initiated events received twice as many donations, accounting for 64% of the total cash donations. In addition, this research provides information on how businesswomen can utilize social media successfully in their operations, as well as variables that are advantageous to these businesswomen when conducting online business on social media. The objective of this study is to examine the pattern and trend of women's employment and entrepreneurship post utilization of new media. The study reveals that despite the presence of educational and socioeconomic issues, tribal women entrepreneurs have emerged in the last few decades with the aid of government-sponsored economic programs, and they are also improving their society.

CEO reflections on leadership lessons from the global pandemic: back to basics during crisis

PurposeThe current study qualitatively examined the challenges and lessons learned from Chief Executive Officers (CEOs) during the COVID-19 pandemic. The current study draws upon previous crisis leadership research to understand and classify the most important lessons learned from CEOs.Design/methodology/approachA total of 30 in-depth, structured CEO interviews were conducted with large, multi-divisional organizations across market sectors that included healthcare, automotive, steel, agriculture, logistics, distribution, banking, financial services, light manufacturing and industrial services during the COVID-19 pandemic. Three separate judges performed a content analysis, and three main themes (eleven overall lessons) emerged related to high-level leadership lessons learned through the pandemic.FindingsThe leadership lessons that emerged overwhelmingly focused on the importance of emphasizing leadership fundamentals during crisis. CEO’s shared the importance of getting “back to basics” during the pandemic. The current study presents these leadership lessons, along with insights for leadership practices and development, as well as future research. Additionally, questions for reflection are posed to stimulate current and future leaders’ growth and development.Originality/valueThe COVID-19 pandemic has impacted leadership and organizations in an unprecedented manner. Previous research has outlined the leadership traits and behaviors needed to successfully lead through organizational crises. However, little research has examined CEO level lessons learned, focusing on learning from such crises.

Good practice in sport science and medicine: perceptions of leaders on support and management of practitioners and teams

ABSTRACT The evaluation and delivery of good practice in the provision of Sport Science and Medicine (SSM) is clearly of interest and importance – with applied research, both anecdotal and empirical, that is burgeoning. However, no literature to date explores the role of the organisation and leader in supporting those striving to deliver good practice. The primary aim of this investigation is to explore the perceptions of experienced high-level leaders in the leadership, direction and operation of SSM practitioners and teams. A mixed methods modified Delphi technique, with three stages of investigation – a quantitative survey, individual interviews, and focus group discussions, was undertaken with 13 leaders of high-performance sport organisations in Europe and Australasia. This approach allowed expert consensus to be arrived at on a set of theoretically underpinned principles applicable to the pan regional support of good practice. A plethora of principles are offered relating to three core areas of support: organisational requirements; leadership; and practitioners´ skills and development. Importantly, a number of operational considerations for application are captured, including the impact of situational context in determining the focus and core elements of support required. Findings are particularly relevant for those leading SSM delivery – with a well led, organised and supported approach seemingly enabling good practice. In addition, results offer further empirical support to the importance of interdisciplinary teamwork, non-technical skill sets and relevant development opportunities for the practitioner. Overall, we hope the principles derived offer a practical starting point for those engaged in SSM provision.

Factors Facilitating and Inhibiting the Implementation of Telerehabilitation-A Scoping Review.

Due to the coronavirus pandemic, telerehabilitation has become increasingly important worldwide. While the effectiveness of telerehabilitation is considered proven for many indications, there is comparatively little knowledge about the implementation conditions. Therefore, this scoping review summarises the current state of facilitating and inhibiting factors that may influence the uptake of telerehabilitation. The review follows the JBI methodology for scoping reviews. The article search was carried out in five databases (MEDLINE, EMBASE, Web of Science, Cochrane and Psyndex) in May 2022, with an update in October 2023. Two independent researchers identified relevant studies according to the inclusion and exclusion criteria. The Consolidated Framework for Implementation Research served as the theoretical basis for the categorisation of the facilitating and inhibiting criteria in the organisational context. A total of 28 studies (timespan 2012 to 2023) have been included. The most relevant barriers identified are technical issues and a lack of technical skills. The factors considered most favourable for implementation are patients' motivation and the involvement of high-level leaders. The results provide clear indications of factors that inhibit and facilitate implementation, but also show that further research is needed.

Diversity of Backgrounds and Academic Accomplishments for Presidents Elected to Hip and Knee Arthroplasty Societies in the United States

BackgroundAcademic accomplishments and demographics for presidents of hip and knee arthroplasty societies are poorly understood. This study compares the characteristics of presidents nominated to serve the Hip Society, Knee Society, and American Association of Hip and Knee Surgeons. MethodsThis was a cross-sectional study of arthroplasty presidents in the United States (1990 to 2022). Curriculum vitae and academic websites were analyzed for demographic, training, bibliometric, and National Institutes of Health (NIH) funding data. Comparisons were made between organizations and time periods (1990 to 2005 versus 2006 to 2022). ResultsThere were 97 appointments of 78 unique arthroplasty presidents (80%). Most presidents were male (99%) and Caucasian (95%). There was 1 woman (1%) and 5 non-Caucasian presidents (2% Asian, 3% Hispanic). There were no differences in demographics between the 3 arthroplasty organizations and the 2 time periods (P > .05). Presidents were appointed at 55 ± 10 years old, which was on average 24 years after completion of residency training. Most presidents had arthroplasty fellowship training (68%), and the most common were the Hospital for Special Surgery (21%) and Massachusetts General Hospital (8%). The median h-index was 53 resulting from 191 peer-reviewed publications, which was similar between the 3 organizations (P > .05). There were 2 presidents who had NIH funding (2%), and there were no differences in NIH funding between the 3 organizations (P > .05). ConclusionsArthroplasty society presidents have diverse training pedigrees, high levels of scholarly output, and similar demographics. There may be future opportunities to promote diversity and inclusion among the highest levels of leadership in total joint arthroplasty.

Women in Anesthesiology and the Mid-Career Stall: Why They Are Not Advancing Into Senior Leadership.

Women anesthesiologists face many challenges when trying to advance their careers and find balance in personal and professional endeavors. In this article, we introduce the reader to several concepts central to understanding the challenges faced by mid-career women anesthesiologists and highlight why these challenges become particularly pronounced when women enter the mid-career stage. We describe how lack of constructive actionable feedback combined with lack of mentorship and sponsorship negatively affects women in the workplace. We also outline barriers and bias that mid-career women anesthesiologists face in high-level leadership roles along with the disproportionally high burden of nonpromotable work. We present a discussion of mistreatment and burnout, which are compounded by concurrent demands of parenthood and a professional career. We conclude with the impact that these barriers have on mid-career women anesthesiologists and recommendations for mitigating these challenges. They include a systematic increase in mentorship and sponsorship, an individualized professional development strategy, and an improved and comprehensive approach to promotion.

Navigating senior leadership in higher education: a case study of women in Cambodia

ABSTRACT Women are significantly underrepresented in leadership roles across sectors in Cambodia, and governmental policy is seeking to change this to promote gender equality in all high-level leadership. This qualitative research identified what factors supports Cambodian women to be successful in higher education senior leadership and the barriers they encounter in attaining and maintaining senior leadership roles. Eleven women in senior leadership roles from six prestigious higher education institutions in Phnom Penh were interviewed. Key findings revealed that self-efficacy, opportunities to learn, and support from the family, the workplace, and society were supportive factors for these Cambodian women to become senior leaders. Barriers faced by the women in this research included an overarching societal mind-set about women in society, constraints in the workplace, the pressures of family responsibilities, and their personally held expectations and values. Analysis using Bronfenbrenner’s ecological framework reveals that opportunities and challenges are embedded across levels – from the individual level to family, institutional, and societal levels. Change therefore requires intentional interventions targeting all levels, including individual beliefs, institutional norms, organizational culture, government policy, and ultimately, societal values. While this is a complex endeavor, this research provides insight into what is possible for women when they experience support across these levels.

Financialisation strategy of digital transformation: towards a people-centric, sustaining network leadership framework in an Arabic energy context

PurposeThis paper's purpose centres on advancing the current financialisation strategies within digital transformation (DT) through a rebalanced synthesis of both financialisation and people/centric, non-financialisation strategies of the DT field. Based on empirical data from Bahrain's energy sector, a new framework on People-centric, Sustaining Network Leadership is developed, capturing DT's human values deficit and proposing a new model on financialisation and non-financialisation strategies showing ‘how’ and ‘why’ DT is implemented in contemporary organisations.Design/methodology/approachThis study conducted a mixed methodology of narrative interviews, case studies and reviewed significant contributions from the DT, leadership and change management debates. A total of 26 operational and high-level leaders from Bahrain, 8 top energy companies and Braun and Clarke's 6-phase analysis were combined to form four empirical thematic bundles on ‘how’ and ‘why’ leaders adopted financialisation and non-financialisation strategies to resolve organisational sustainability issues in an Arabic context.FindingsFour sets of findings (bundles 1–4) highlight participants' financial and structural understanding when implementing DT initiatives, the different leadership styles ranging from authoritarian to network leadership, the socio-economic, political and cultural ramifications of their practices and the urgency of staff reskilling for organisational resilience and strategic sustainability. Based on the eight energy cases and interviews, a new values-driven, People-centric Sustaining Network Leadership Model is developed to show a more effective and efficient use of financial and non-financial resources when organisations implement DT initiatives in efforts to resolve global energy sustainability problems.Research limitations/implicationsLeadership, change management, DT, energy and environmental sustainability is a huge area of scholarship. While new studies emerge and contribute to this growing body of knowledge, this investigation has focused on those that significantly highlight how to make effective use of financialisation and non-financialisation resources. Therefore, all the literature on the topic has not been included. Although this study has filled the non-financialisation gap in current DT studies, a further rebalancing of the financialisation versus non-financialisation debates will be needed for theoreticians, practitioners and policy makers to continue addressing emerging and more complex socio-economic, political and cultural issues within and beyond organisations. Limitations are the study's focus on the Bahrain energy sector and the limited sample of 26 leaders.Practical implicationsThe study provides practitioners and policy makers with an approach for the successful implementation of DT initiatives in the oil and gas sector. For academics, this study provides empirically unique and interesting thematic bundles, insightful analyses into leadership, organisational change, digital transformation and network leadership theories to develop an innovative and creative People-centric, Sustaining Network Leadership Approach/Model on the practical barriers, implications/impacts of various leadership styles and potential solutions via a socio-cultural values-based alternative to the current financialisation discourse of DT.Originality/valueWhile there is a growing body of literature on DT, Leadership and Organisational Transformation and Change, there is a dearth of scholarship on the human-orientated strategies of DT implementation outside of western contexts. A contemporary and comprehensive, empirically evidenced analysis of the field has led to the development of this study's People-centric, Sustaining Network Leadership model which frames, captures, synthesises and extends the dominant cost-minimisation rhetoric of DT discourse to include a shared set of leadership practices, behaviours, intentions, perceptions and values. This helped to reveal the previously missing ‘how’ and ‘why’ of DT’s operational and strategic implementation.