Describes a training strategy created by the American Association of Retired Persons to assist staff in the relocation of its Western headquarters. Programme was designed to provide stress management workshops and to initiate a new management development programme. Considers how to influence organisational culture and notes not a single employee left the organisation as a result of the relocation.
This paper investigates the integration of the home computer into the domestic sphere through a gender perspective on the notions of domesticity and domestication. The study is based on a series of interviews with seven British families in the late 1990s. The analysis is used to identify some of the characteristics that contribute to make the home computer domestic or undomestic, and to explore the processes of domestication. A focus on fears and anxieties around the computer as well as the emergence of myths and magical notions allows for deeper insights into the gender‐domestication “problématique”.
Working at the University of Liverpool alongside Julia Hallam and Lisa Shaw, and in the Department of Music, are Sara Cohen and Jacqueline Waldock. Both Sara and Jacky have led projects that engage with and support local organizations and communities, and examine music from the perspective of those involved. In fact, it was their shared interest in how ‘ordinary’ people engage with and experience music in everyday life that prompted them to join forces in 2014, and start working together on community engagement projects. At the same time, they have brought to these projects their own individual research interests and expertise. In this chapter, we discuss their recent collaboration on a project that explores the use of music to improve the wellbeing of older people in the UK, including people living with a dementia-related cognitive impairment and in nursing homes and health-care settings, and those who live independently but are cared for at day-care centres run by voluntary and community-based organizations. We situate this project within a selection of UK music initiatives or ‘interventions’ aimed at helping those living with dementia and age-related memory loss, and outline how specific projects informed our own approach and work.
The publication of the United Kingdom National Health Service (NHS) Information for Health Strategy heralded a new strategic focus for the provision of information systems…
The publication of the United Kingdom National Health Service (NHS) Information for Health Strategy heralded a new strategic focus for the provision of information systems (IS) support across the NHS. Key changes concerned the placement of much greater emphasis on clinical information needs by route of the Electronic Patient Record (EPR) and the Electronic Health Record (EHR). The last decade has seen unprecedented changes within the NHS due to government policies, political ideology, health‐care reform and pace of technological progress. This paper argues that this rate and scale of change has outstripped the ability of health‐care organisations to respond effectively in order to implement the key goals set by strategic policy makers. An historical review is combined with an analysis of recent empirical survey data to determine the evolution and progress of the NHS IM&T strategy over a period of ten years. The review and analysis is enabled by adopting techniques and theory derived from research within the field of Information Systems, whereby Information Systems maturity models are used as an heuristic to measure levels of sophistication of IT adoption and use. These models demonstrate that NHS hospitals are fairly immature in terms of the adoption and usage of information systems and technology; struggling to provide adequate foundations for systems integration (data, work and culture). Conclusions reflect on the current progress and ambition of the strategy and comment on its potential outcome given existing NHS knowledge of IT, skills, capability and infrastructure.
The focus of the paper is on the relationship between General Practitioners (GPs) and central government. This relationship dates from the introduction of national health…
The focus of the paper is on the relationship between General Practitioners (GPs) and central government. This relationship dates from the introduction of national health insurance in the UK. From the outset it had an impact on GPs’ medical role, their professional status and income. The structure created in 1911 meant that GPs operated as franchisees and, notwithstanding Labour’s policy objective of creating a salaried service, this role continued, effectively unchanged, after the creation of the National Health Service (NHS) in 1948. General Practice was also the poor relation in contrast to hospital medicine, a feature intensified by the priorities of the NHS. These forces meant that GPs had a dual role: that of clinician and gatekeeper to specialist hospital services, a role in which they exercised substantial clinical freedom: and running a small business, a feature which was exaggerated by the absence of grant aid to improve premises prior to the Family Doctor Charter of 1965. This structural relationship has been progressively transformed by changes in the 1980s and 1990s. On the one hand the emphasis on cost control has seen central government attempting to combine a financial with a clinical gatekeeping role. The crucial change in this respect is the creation of GP fundholding which, in turn, could be seen to have implications for the subordinate status of GPs within the medical profession. However, this has been combined with trends to greater measures of control over GPs. Of central importance in this respect were the changes introduced by the 1990 GP contract. The contract involved an attempt to substantially reduce clinical autonomy by building in much more detailed contractual duties with respect for example, to health promotion activities. This was combined with the use of financial incentives to reach, for example, immunization targets. Control over clinical autonomy has also involved constraints over prescribing and the shift from Family Practitioner Committees to Family Health Service Authorities. The rationale for this shift is the move from an administrative to a managerial body, acting as the agent of central government in enforcing the contract and imposing financial norms. GPs are thus to be made managerially accountable. The paper analyses the place of general practitioners in central government’s approach to health strategy and examines the tensions generated by the combination of conferring new powers on GPs and increasing controls over them. These tensions are related to current disputes over out‐of‐hours working and attempts by GPs to redefine a “core of service” approach to their job. The ambiguities of reliance on professionals combined with the desire to exert greater controls is traced in the recent policy statement by the Secretary of State Primary Care: The Future (1996). The paper thus aims to contribute to the critical discussion of the impact of central government managerialist initiative on key professional groups in the welfare state.
Purpose – The purpose of this chapter is to provide a comprehensive review of the literature on the importance of taxes as a determinant of FDI attraction.Approach – The…
Purpose – The purpose of this chapter is to provide a comprehensive review of the literature on the importance of taxes as a determinant of FDI attraction.
Approach – The chapter presents the fundamental elements of the conceptual background that explain how and under which circumstances taxation may be a significant factor underlying FDI decisions. Then it proceeds with an extensive review of the qualitative and quantitative literature on the topic. Finally, it draws several relevant conclusions on the main patterns that can be extracted from the evolution of the literature on this field.
Findings – In this chapter we arrive at three major findings concerning the effect of taxes on FDI, and we uncover one interesting puzzle worthy of further research.
First, from the literature review it becomes clear that both FDI and taxes are concepts covering heterogeneous phenomena, and therefore to compare studies, results or to make judgments on the relationship between taxes and FDI, the working definitions of FDI and taxes that are being used needs to be clearly established and understood.
Second, based on the review of the qualitative literature, it becomes clear that while taxes are an important aspect of FDI decisions among managers, they are probably not the main driver of the decision. Moreover, taxes may only play a ‘marginal’ role compared with other determinants of FDI.
Third, looking carefully at the quantitative literature as a whole, there is not a straight answer that permits to unequivocally say that lower taxes increase FDI attraction.
Finally, a puzzle emerges from the tension between what policy makers believe and what the studies show. The review in this chapter puts in evidence that while policy makers believe lowering taxes increases the attractiveness of their territories vis-à-vis FDI, the facts show that taxes appear only to play a marginal role compared with other determinants of FDI. So, why do policy makers put so much faith on tax policies as an FDI attraction tool?
Value – The value of this chapter is threefold. It presents a very complete and up to date review of the literature concerning the impact of taxation on FDI decisions, it analyses the literature's apparently disparate results and groups them into three clear emerging conclusions, and uncovers an interesting public policy puzzle.
This chapter explores how primary care physicians deliver mental health treatment for Medicaid patients in one county in the United States, and how treatment may have…
This chapter explores how primary care physicians deliver mental health treatment for Medicaid patients in one county in the United States, and how treatment may have changed after HMO enrollment with a mental health carve-out. We utilize Lipsky's theory of street-level bureaucracy to better understand how primary care physicians treat Medicaid patients for depression and what types of insurance arrangements support or inhibit that treatment. Exploratory interviews with 20 physicians revealed that the patient's status as a non-voluntary client, service system barriers and physicians’ commitment to treatment caused them to bear primary responsibility for the majority of depression care. Physicians were willing to act as advocates for their clients and viewed such advocacy as ethical given the lack of mental health parity. In general, primary care physicians were not familiar with new policies dictating mental health carve-outs for Medicaid patients, nor were they concerned with how mental health care was reimbursed for their patients. However, they were willing to provide mental health care even if they were not reimbursed. Physicians rely upon medication management to treat depression, and reimbursement plays a role in the amount of time spent with patients and in the coding used for the visit. Lipsky's (1980) theory of street-level bureaucracy provides a useful framework for understanding how physicians will act as advocates for their clients in the face of structural as well as resource constraints on health care.
The purpose of this study is to evaluate the extent and effectiveness of knowledge management (KM) in community service organisations (CSOs) in Australia. CSOs are…
The purpose of this study is to evaluate the extent and effectiveness of knowledge management (KM) in community service organisations (CSOs) in Australia. CSOs are focussed on support, care and encouragement, thereby improving the quality of life of many in the community. This study contributes to a wider acceptance and management of knowledge, from a national perspective, and assists CSOs to improve practice.
KM theory and practice is expanded through a national online survey from 89 Australian CSOs, represented by 538 employees. CSOs, as a subset of not-for-profit organisations, were selected because they contribute significantly to the economy. Existing research generally relies on case studies, offering scope for wider quantitative research to address the gap.
The extent and effectiveness of KM were moderate. KM was more extensive in CSOs with a formal KM policy. Face-to-face exchange of knowledge was the major transfer method. Recognition or other incentives are needed to encourage learning and disseminating new ideas.
Other CSOs and other countries could be included, along with very small CSOs.
Shortfalls in practice were discovered. Recommendations should improve client service by enhancing the appropriateness, consistency, quality and timely delivery of assistance. This will aid CSO sustainability by maximising limited resources. The challenge is to harness informal learning for organisation-wide learning and for hard outcomes, such as reducing costs and competing for government funding.
A synthesised large-scale survey integrates more elements of KM practice. Existing KM ideas are combined in new ways, applied in a fresh context, indicating elements of KM that are more significant in not-for-profit CSOs.