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Manuel Vallée

Purpose – This chapter has two central purposes. The first is to suggest that western, as well as non-western, illness categories are culture bound. The second is to…

Abstract

Purpose – This chapter has two central purposes. The first is to suggest that western, as well as non-western, illness categories are culture bound. The second is to elucidate the diagnostic and treatment implications associated with adopting a reductionistic diagnostic approach, including for psychiatric as well as nonpsychiatric illnesses.

Approach – A comparative approach is used to highlight the differences between American psychiatry's diagnostic system (i.e., DSM) and French child psychiatry's diagnostic system (CFTMEA). The analysis begins by identifying the overarching differences between the systems, then analyzes the differences between their respective versions of the Attention Deficit/Hyperactivity Disorder diagnostic category, and ends by tracing the diagnostic and treatment implications of those differences.

Findings – This analysis reveals that the systems differ in three significant ways: (1) theoretical orientation (biological vs. psychodynamic), (2) the view that symptoms should be counted as opposed to understood, and (3) the presence of symptom checklists versus their absence. Additionally, these differences encourage American clinicians to both administer the ADHD diagnosis to a greater number of symptomatic children and to treat these children with psychiatric medications.

Contributions to the field – The analysis makes three contributions to the field: (1) the comparative analysis highlights the limitations of the DSM's ADHD definition; (2) it strengthens the case for seeing western diagnostic categories in general, and the DSM categories in particular, as cultural artifacts; (3) it elucidates the profound relationship between diagnostic systems and both diagnostic rates and treatment practices.

Details

Sociology of Diagnosis
Type: Book
ISBN: 978-0-85724-575-5

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Article

Govinda R. Timilsina and Ram M. Shrestha

The purpose of this paper is to examine potential demand side management (DSM) programs in terms of their impacts to the overall economy in Thailand.

Abstract

Purpose

The purpose of this paper is to examine potential demand side management (DSM) programs in terms of their impacts to the overall economy in Thailand.

Design/methodology/approach

A multi‐sector computable general equilibrium (CGE) model of Thailand has been developed to accomplish the objectives of this study. The potential DSM program considered refers to replacement of less efficient electrical appliances with their efficient counterparts in the household sector in Thailand.

Findings

The study finds that the economy‐wide impacts of the DSM program (e.g., economic welfare, GDP, international trade) depend on three key factors: the project economics of the DSM option or the ratio of unit cost of electricity savings to price of electricity (CPR); the implementation strategy of the DSM option; and scale or size of the DSM option. This paper shows that the welfare impacts of the DSM programs would improve along with the project economics of the DSM programs. If the DSM program is implemented under the CDM, the welfare impacts would increase along with the price for certified emission reductions units. On the other hand, the welfare impacts would increase up to the optimal size or scale of the program, but would start to deteriorate if the size is increased further.

Research limitations/implications

The welfare function considered in this paper does not account for benefits of local air pollution reductions. The study provides crucial insights on designing DSM projects in Thailand to ensure that DSM programs are beneficial for the economy as a whole.

Originality/value

Analyses of DSM options under the CDM using CGE models are not available in the literature. This is the first paper in this area.

Details

International Journal of Energy Sector Management, vol. 2 no. 4
Type: Research Article
ISSN: 1750-6220

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Article

Maria Andersson Marchesoni, Karin Axelsson and Inger Lindberg

– The purpose of this paper is to describe staffs’ perceptions of digital support for medication administration (DSM) and out of the perceptions interpret underlying values.

Abstract

Purpose

The purpose of this paper is to describe staffs’ perceptions of digital support for medication administration (DSM) and out of the perceptions interpret underlying values.

Design/methodology/approach

In total, 22 persons working in elder care participated in the study. The study had a qualitative approach and focus group interviews were used to collect data. To analyze the manifest content a phenomenographic method was used. An interpretation of perceptions was then undertaken aimed at identifying underlying values.

Findings

Three descriptive categories, “utility,” “impact on working environment” and “economic impact” were the result of the manifest analysis. The values of having a “good working environment,” “benefits” and “good economy” were interpreted as guidance for staffs’ acceptance or rejection of the DSM.

Social implications

The care-giving process and its challenges from the perspective of the staffs need consideration. Staffs in this study sometimes expressed strong emotions as a sign of frustration for losing prerequisites to perform their work well. In big complex organizations where economy and effectiveness are often discussed, knowledge of power relations in innovation and implementation processes would be beneficial. Although moral distress is a well-known phenomenon, future research may be needed to find solutions that diminish this negative trend in more economic focussed organizations.

Originality/value

This study had a twofold approach with the intention of going beyond descriptions. To gain a deeper understanding a normative interpretation was completed. Ethical conflicts are frequently characterized as conflicts between at least two values. In this study staffs expressed fear of losing prerequisites needed to perform their work well. Prerequisites that were identified as values and these values were threatened by the DSM.

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Journal of Health Organization and Management, vol. 28 no. 3
Type: Research Article
ISSN: 1477-7266

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Article

Hugh Middleton

Consideration is given to the extent to which the DSM and ICD approach to psychiatric case definition and treatment supports clinical activity. Their validity as a way of…

Abstract

Consideration is given to the extent to which the DSM and ICD approach to psychiatric case definition and treatment supports clinical activity. Their validity as a way of defining ‘mental illness’ is found wanting and they do not, in themselves, usefully guide treatment. These conclusions are set in a critical realist approach to ‘mental illness’, which draws attention to the legitimacy of several differing perspectives, each reflecting their own sets of interests and allegiances. DSM‐V and ICD‐11 are due to be published in 2012 and 2014 respectively, and their architects are called upon to be clear about which of these constituencies they are representing.

Details

Mental Health Review Journal, vol. 13 no. 4
Type: Research Article
ISSN: 1361-9322

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Article

Alan Goldman

The aim of this paper is to assess highly toxic leaders and dysfunctional organizations as presented via management consulting and executive coaching assignments.

Abstract

Purpose

The aim of this paper is to assess highly toxic leaders and dysfunctional organizations as presented via management consulting and executive coaching assignments.

Design/methodology/approach

The paper employs an action research approach via two participant observer case studies incorporating the DSM IV‐TR: Diagnostic and Statistical Manual of Mental Disorders.

Findings

The paper finds that the nexus of dysfunctional organizational systems may be located in “pre‐existing” leadership pathologies.

Research limitations/implications

First, additional research will be needed to confirm and extend the findings of individual pathologies in leaders to dysfunctional organizational systems; second, a closer look is necessary at the applicability of the DSM IV‐TR to pathologies at the organizational level; third, due to the action research, case study approach utilized, there is somewhat limited generalizability; fourth, there are limitations re: the applicability of DSM IV‐TR as an assessment tool for management researchers due to the necessity of training in clinical psychology.

Practical implications

The importance of distinguishing personality disorders in leaders from toxic behaviors falling within a range of “normal pathology,” and the ability to assess individual leadership pathology within organizational systems via the clinically trained usage of the DSM IV‐TR; providing clinical assessment tools for reducing the number of misdiagnoses of leadership pathology in the workplace; encouraging collaboration between management and psychology researchers and practitioners.

Originality/value

This paper fills a gap in the toxic organizations research by identifying personality disorders in leaders and providing an action research agenda for incorporating the DSM IV‐TR as a means of extending the repertoire of assessment tools;

Details

Journal of Managerial Psychology, vol. 21 no. 5
Type: Research Article
ISSN: 0268-3946

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Article

Jessica Gullbrand

Large‐eddy simulation (LES) of a turbulent channel flow is performed using different subfilter‐scale (SFS) models and test filter functions. The SFS models used are the…

Abstract

Large‐eddy simulation (LES) of a turbulent channel flow is performed using different subfilter‐scale (SFS) models and test filter functions. The SFS models used are the dynamic Smagorinsky model (DSM) and the dynamic mixed model (DMM). The DMM is a linear combination between the scale‐similarity model and the DSM. The test filter functions investigated are the sharp cut‐off (in spectral space) and smooth filter that is commutative up to fourth‐order. The filters are applied either in the homogeneous directions or in all three spatial directions. The governing equations are discretized using a fourth‐order energy‐conserving finite‐difference scheme. The influence from the test filter function and the SFS model on the LES results are investigated and the effect of two‐dimensional versus three‐dimensional test filtering are investigated. The study shows that the combination of SFS model and filter function highly influences the computational results; even the effect on the zeroth‐order moment is large.

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International Journal of Numerical Methods for Heat & Fluid Flow, vol. 14 no. 4
Type: Research Article
ISSN: 0961-5539

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Article

P.T. Helo

Product configurator is a sales and production‐planning tool that helps to transform customer requirements into bills‐of‐materials, lists of features and cost estimations…

Abstract

Purpose

Product configurator is a sales and production‐planning tool that helps to transform customer requirements into bills‐of‐materials, lists of features and cost estimations. The purpose of this paper is to introduce a method of how to analyse sales configuration models by using a design structure matrix (DSM) tool. By applying the DSM techniques, the sales configuration managers may sequence the product configuration questions and organize the connection to production.

Design/methodology/approach

First, the paper explains a sales configuration system structure from published academic and non‐academic works. These sources employ both theoretical and practical views on the topic of computer‐based sales expert systems. Second, the paper demonstrates an application of using DSM for configuration modelling.

Findings

The current sales configuration approaches include constraint‐based, rules‐based, and object‐oriented approaches. Product description methods vary, but the general problem remains the same: the configuration process should be designed in such a way that customer selections do not affect the previous selections. From the user point of view, answering the questions should be smooth and fast. In turn this will lead to the growing importance of building more effective product configuration models. DSM offers a systematic way to organise customer interface in sales configuration systems.

Research limitations/implications

This paper analyses how DSM could help in planning product configuration modelling. Comparison of different sequences is presented. The examples used are hypothetical, but illustrate the suitability of DSM analysis. Companies are trying to establish easily configured product models, which are fast, flexible and cost‐effective for adjustments and modifications. Use of DSM may help in the roll‐out of sales configuration projects. DSM may also be used as a quick view to represent the complexity of product configurability. The future needs for configuration tools will be focused towards product model management from the technical limitations of different data storage approaches.

Practical implications

Configurator software creates product variants, which are logical descriptions of physical products. Variants have parameters which describe the customer‐made selections. The parameter selections may have interconnections between the choices. Some selections may affect further selections and some combinations may not be allowed for incompatibility, cost or safety reasons. There are several commercial software packages available for creating product configurations. Product description methods vary, but the general problem remains the same: the configuration process should be designed in such a way that customer selections do not affect the previous selections. Answering the questions should be smooth and fast. Configuration of complex products, for instance, airplanes, may include several sub‐systems and have various loops within the quotation process. The use of DSM may help in the roll‐out of sales configuration projects. DSM may also be used as a quick view to represent the complexity of product configurability.

Originality/value

The paper helps both researchers and practitioners to obtain a clearer view on the development of sales configuration systems and the potential of systematic DSM‐based product model analysis.

Details

Industrial Management & Data Systems, vol. 106 no. 7
Type: Research Article
ISSN: 0263-5577

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Book part

Karl Bryant

Purpose – The purpose of this chapter is to theorize the relationship between diagnosis and medicalization through an examination of the medicalization of childhood gender…

Abstract

Purpose – The purpose of this chapter is to theorize the relationship between diagnosis and medicalization through an examination of the medicalization of childhood gender variance and the Gender Identity Disorder of Childhood diagnosis.

Methodology/approach – The chapter examines textual data (published clinical and research literatures, and critiques of the diagnosis appearing in a range of venues) to track how childhood gender variance is medicalized over time and the role of diagnosis in that medicalization.

Findings – While diagnosis certainly plays a role in shoring up medicalization, this case study reveals the many ways in which diagnoses may also become key tools in attempts to curtail medicalization.

Research limitations/implications – As a case study, the findings are not generalizable to all diagnoses. As a study of an instance of the medicalization of deviance, these findings may be particularly applicable to analogous cases.

Social implications – These findings show the sometimes tenuous nature of medicalization processes, and the social uses of diagnoses in those processes.

Originality/value of paper – This chapter sheds light on a relationship that is often assumed to be unidirectional (e.g., that the formation of diagnosis results in increased medicalization), and answers calls for a more nuanced sociology of diagnosis, including greater attention to the relationship between diagnosis and medicalization.

Details

Sociology of Diagnosis
Type: Book
ISBN: 978-0-85724-575-5

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Book part

Manuel Vallée

Purpose – The DSM-III reflected American psychiatry's shift from a dynamic approach to a descriptive diagnostic approach. This chapter seeks to elucidate the implications…

Abstract

Purpose – The DSM-III reflected American psychiatry's shift from a dynamic approach to a descriptive diagnostic approach. This chapter seeks to elucidate the implications of this shift for the diagnosis and treatment of mental illness.

Methodology/approach – To shed light on this issue I analyze the diagnosis and treatment implications of this shift for Attention Deficit Disorder (ADD).

Findings – The transition to the diagnostic approach has had three consequences for the handling of ADD, and later Attention Deficit/Hyperactivity Disorder (ADHD): first, it increased the number of children diagnosed with the disorder; second, it encouraged clinicians to treat the disorder with psychostimulants; and third, it expanded the pool of clinicians who could prescribe stimulants.

Contribution to the field – Beyond illuminating the specific cases of ADD and ADHD, this analysis contributes to the medicalization literature by demonstrating that there is more to be studied than merely the expansion or contraction of diagnostic categories. Researchers also have to analyze the implicit assumptions within the diagnostic definitions, which have implications for the prevalence and treatment of illness.

Details

Understanding Emerging Epidemics: Social and Political Approaches
Type: Book
ISBN: 978-1-84855-080-3

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Book part

Sandra H. Sulzer, Gracie Jackson and Ashelee Yang

To examine how clinicians navigate providing treatment to Borderline Personality Disorder (BPD) in the context of the DSM 5, deinstitutionalization, and the biomedical model.

Abstract

Purpose

To examine how clinicians navigate providing treatment to Borderline Personality Disorder (BPD) in the context of the DSM 5, deinstitutionalization, and the biomedical model.

Methodology/approach

We conducted 39 interviews with mental health providers in the United States in a two-year period preceding and following the release of the DSM 5. Using Constructivist Grounded Theory, we analyzed the data for themes that emerged.

Findings

Clinicians faced pressures from insurance companies, the DSM categories, and their professional training to focus on biomedical treatments. These treatments, which emphasized pharmaceuticals and short courses of care, were ill-suited to BPD, which has a strong evidence base recommending long-term therapeutic interventions. We term this contradiction a “biomedical mismatch” and use Gidden’s concept of structuration to better understand how clinicians navigate the system of care. Providers ranged in their responses to the mismatch: some championed biomedicine, others were complicit, and a final group behaved as activists, challenging the paradigm. The sum of the strategies had downstream effects which included crisis reinstitutionalization and a discourse of untreatability. Ultimately, we discuss how social factors such as gender bias, stigma, and trauma are insufficiently represented in the biomedical model of care for BPD.

Originality/value

BPD fits poorly within the biomedical underpinnings of the current system. Accordingly, it illuminates the structuration of health care and where the rules of care break down. More precisely, deinstitutionalization was designed to remove patients from long courses of inpatient care. Many patients with BPD have failed to experience this outcome, with some patients now cycling through long courses of short-term crisis reinstitutionalization instead of having effective outpatient care over long periods. This unintended consequence of deinstitutionalization calls for a more biopsychosocial response to BPD.

Details

50 Years After Deinstitutionalization: Mental Illness in Contemporary Communities
Type: Book
ISBN: 978-1-78560-403-4

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