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One of the major challenges for managing human resources in the 1990s is to appropriately respond to employees having to manage the dual responsibilities of home and work (Paris, 1989). Balancing work and family has been considered a women's issue, with the question being whether women could handle both the home demands and the responsibilities of a paid job. Yet the entrance of women into the workforce has also required major role adjustments by their husbands. According to the traditional model of work, husbands prioritize work over family with the wife providing the necessary emotional and physical support to keep the husband in “good working order” (Pleck, 1977). In today's society, this model is no longer widely applicable, as men in dual earner families receive less emotional support than their single‐earner counterparts (Burke, & Weir, 1976; Keith, & Schafer, 1980) and tend to assume greater family responsibilities (Holahan, & Gilbert, 1979; Weingarten, 1978).

Recently, more and more North American women have been choosing to pursue careers in management and the professions. The invasion of women into these once exclusively masculine domains has been accompanied by a host of problems, many of which were unanticipated. In the articles presented here we examine the nature of these problems and provide some suggestions about what can be done to help resolve them.

Considers the modelling of dynamic systems using biased regression and spectral methods. Provides evidence on the power of transfer function modelling for unravelling the empirical connection between endogenous and exogenous (control) variables in both regression type and spectral input‐output systems. The Multiple Input Transfer Function Noise Model – of specific value when the input variables are collinear – has previously been used to demonstrate the connection between macroeconomic forces and stock market pricing on a thin security market. Compares the adequacy of representative time and frequency domain algorithms for modelling observed data series. The estimations are done with the combined Transfer Function and Cartesian ARIMA Search algorithm of Östermark and Höglund and the CAPM/APM programs of Östermark.

The linkage between internal and external satisfaction is an understudied topic in the service field. This study aims to address this gap by proposing an original research model, the service excellence chain (SEC), that connects the internal and external perspectives by conjoining performance-excellence models and the service-profit-chain approach. Theoretical assumptions and quantitative measures are proposed by using advanced statistical techniques.

The SEC is investigated through an empirical study in the healthcare sector, focusing on an Italian hospital and involving two of its core units. Qualitative and quantitative approaches were used. First, internal and external customer satisfaction were separately tested through structural equation modeling. The linkage between internal and external satisfaction is then proposed by mathematically defining a synthetic index, the internal and external customer satisfaction index (IEGSI), modeled through Bayesian networks (BNs) and object-oriented BNs to provide an overall measure able to predict organizational improvement.

The distinct measured models show good internal validity and adequate fit both for patients' and employees' perspectives. The IEGSI allows rigorously connecting internal and external satisfaction by developing conjoint scenarios for organizational improvement.

This study proposes the SEC model as an innovative way to connect internal and external satisfaction. The findings can be useful both for private and public organizations and may provide several useful insights for healthcare managers as well as for policy-makers in relation to developing strategies for improving service quality.

Evaluates an identification strategy, based on ridge regression, for multiple‐input models. The models are essentially the same as those of Edlund, but a far greater number of replications, 1,000, is used in each of the 21 cases tested. Furthermore, users actually identified and estimated ARIMA models of the residuals in the identification procedure of impulse response weights, unlike Edlund, who used only theoretical noise models in filtering the input and output series. A short discussion of the underlying theory was presented in Part I, Kybernetes, Vol. 22 No. 4, 1993, pp. 47–53. In Part II the procedures and results of the empirical testing are published together with some concluding remarks.

Evaluates an identification strategy, based on ridge regression, for mutliple‐input models. The corresponding computer algorithm was implemented on a VAX–8800 computer at the Computing Centre at A˚bo Akademi. The evaluation of the ridge‐regression method was carried out by simulations of different transfer‐function noise model structures. The models are essentially the same as those of Edlund, but a far greater number of replications, 1,000, is used in each of the 21 cases tested. Furthermore, uses actually identified and estimated ARIMA models of the residuals in the identification procedure of impulse response weights, unlike Edlund, who used only theoretical noise models in filtering the input and output series. A short discussion of the underlying theory is presented in Part I. The procedures and results of the empirical testing will be published in Part II in Kybernetes, Vol. 22 No. 7, 1993.

Here, this study aims to report a case study of the initial design and programme theory of an interdisciplinary work-focused relational group cognitive behaviour therapy (CBT) treatment programme for moderate-severe depression using realist methods.

This case study shows how the authors designed the intervention using component analysis of existing literature and focus groups of frontline practitioners and former service users and mind-mapping analysis to establish its operational logic and evaluated the theory underpinning the intervention using realist synthesis and evaluation to establish its conceptual logic.

An iterative hybrid approach of literature review, component analysis, focus group discussion and realist methods established the initial design and programme theory for the new intervention. The intervention focused on three areas of therapy, three inter-dependent outcomes, in a group format, with opportunities created for peer interaction. The main theoretical principles most likely to promote efficacy were to accelerate and optimise activation of one or more of six hypothesised mechanisms: realise, reflect, regulate, resolve, relate and retain/resume in the context of skilfully facilitated group psychotherapy.

This study outlines a methodological approach based on the layered ontology of critical realist philosophy, applied to a successful example, which will be useful during the early stages of the design and development of new group-based psychotherapeutic interventions.

By adopting the critical realist approach, the authors identified underlying mechanisms of change in relational group CBT. The theoretically integrated approach involving service users and practitioners from different professional backgrounds was unique and meant that the treatment programme was multi-modal rather than informed by a single therapeutic or theoretical approach.

Unlocking and transferring skills and capabilities in individuals to the teams they work within, and across, is the key to positive organisational development and improved patient care. Using the “deep smarts” model, the purpose of this paper is to examine these issues.

The “deep smarts” model is described, reviewed and proposed as a way of transferring knowledge and capabilities within healthcare organisations.

Effective healthcare delivery is achieved through, and continues to require, integrative care involving numerous, dispersed service providers. In the space of overlapping organisational boundaries, there is a need for “deep smarts” people who act as “boundary spanners”. These are critical integrative, networking roles employing clinical, organisational and people skills across multiple settings.

Studies evaluating the barriers and enablers to the application of the deep smarts model and 13 knowledge development strategies proposed are required. Such future research will empirically and contemporary ground our understanding of organisational development in modern complex healthcare settings.

An organisation with “deep smarts” people – in managerial, auxiliary and clinical positions – has a greater capacity for integration and achieving improved patient-centred care.

In total, 13 developmental strategies, to transfer individual capabilities into organisational capability, are proposed. These strategies are applicable to different contexts and challenges faced by individuals and teams in complex healthcare organisations.

Research has long focused on the notion of access and the trajectory towards a healthcare encounter but has neglected what happens to patients after these initial encounters. This paper focuses attention on what happens after an initial healthcare encounter leading to a more nuanced understanding of how patients from a diverse range of backgrounds make sense of medical advice, how they mix this knowledge with other forms of information and how they make decisions about what to do next.

Drawing on 160 in-depth interviews across four European countries the paper problematizes the notion of access; expands the definition of “decision partners”; and reframes the medical encounter as a journey, where one encounter leads to and informs the next.

This approach reveals the significant unseen, unrecognised and unacknowledged work that patients undertake to solve their health concerns.

De-centring the professional from the healthcare encounter allows us to understand why patients take particular pathways to care and how resources might be more appropriately leveraged to support both patients and professionals along this journey.

Despite general recognition of the benefits of talking openly about sexuality with children, parents encounter and/or create barriers to such communication. One of the key barriers is a desire to protect childhood innocence. The purpose of this paper is to explore parental interpretations of childhood innocence and the influence this has on their reported practices relating to sexuality-relevant communication with young children.

In all, 110 UK parents and carers of children aged between four and seven years were involved in focus group discussions. The discussions were transcribed and thematic network analysis was subsequently applied to the data. Following the reading and re-reading of the transcripts for meaning, context and content, individual comments and statements were identified within the data set and grouped to generate themes.

Childhood innocence was commonly equated with non-sexuality in children and sexual ignorance. Parents displayed ambiguity around the conceptualisation of non-innocence in children. Parents desire to prolong the state of childhood innocence led them to withhold certain sexual knowledge from their children; however, the majority also desired an open relationship whereby their child could approach them for information.

UK parents have a strong desire to maintain the social construction of their children as inherently innocent. This discourse is affecting the way in which they communicate about sexually relevant information with their children.