Suchergebnisse

A "rational integration" model is proposed to explain why organizations, according to Allison (1971), tend to be mutually perceived as "rational actors" exhibiting goal consensus. It is suggested that the perception of rational action is attributable not merely to cognitive error but also to rational behaviors, performed both by elements of the perceived rational actor and by members of other organizations with which it transacts. The discussion addresses practical implications of rational integration, including problems and opportunities, and strategies for overcoming or exploiting them. The discussion also demonstrates how (1) the proposed model may enhance knowledge of organizations, and (2) research may contribute to this knowledge. Finally, by assigning causality to both "objective" social structure and the "subjective" perception of it, the proposed model can benefit social analysis in general by demonstrating an approach that integrates the structural and interpretive schools through a newly-proposed paradigm called "meta-structuralism. "

Aimed at final year undergraduate students, this is the first volume to publish in a new series of text covering core subjects in operational research in an accessible student-friendly format. This volume presents simulation paired with inventory control. The Operational Research Series aims to provide a new generation of European-originated texts of practical relevance to todays student. To guarantee accessibility, the texts are concise and have a non-mathematical orientation. These texts will provide students with the grounding in operational research theory they need to become the innovators of tomorrow

Motivated, competent Youth Development Workers (YDW's ) are essential to effective youth outreach programs. This study explores factors affecting job turnover among Youth Development Workers (YDW's) through detailed direct observation and interviews of six YDW's in four organizations and a group interview with eight different YDW's. YDW stressors included few resources, high need among youth, paperwork, excessive responsibilities, burnout/cynicism, miscommunication with supervisors, personal financial strain and lack of job security. Workers identified needs for appreciation, support from superiors, opportunities to advance, experienced mentors, resources and role definition. For programs to be effective and minimize turnover, YDW's require resources, mentorship, role definition and appreciation.

AbstractKnowledge is a source of competitive advantage but moves towards inter‐organizational collaboration mean that firms must give a high priority to knowledge management to ensure that they obtain maximum benefit from both internally generated and acquired knowledge. Knowledge transfer either to collaborators or internally is performed both on a person‐to‐person basis or more often by machine‐to‐person interaction. While knowledge management has been researched, there is little work that tries to model the fundamental interactions between repositories of knowledge or expertise and those seeking to acquire it. This paper introduces the concept of a knowledge management consultation system. The paper provides a characterization of the structure and functioning of such a system, in particular considering its necessary components, and distinguishes between knowledge, need and the carriers of these components. A model incorporating these components is proposed and an example is used to illustrate the scope and relationship of the components within the model. Implications of the model and its role in a research agenda for organizationally useful knowledge management systems are presented. Copyright © 2001 John Wiley & Sons, Ltd.

Purpose: To report on adults' recall of discussion by physicians and dentists about e-cigarettes. Design: A nationally representative cross-sectional survey (Internet and random digit dialing) in the United States. Participants: Adults who ever used e-cigarettes. Measures: Participant-reported discussion about the potential benefits and harms of e-cigarettes with their doctor, dentist, or child's doctor in the past 12 months. Analysis: Fisher exact test for the analysis between benefits and harms for each type of provider and for rates of advice between provider types. Results: Among the 3030 adults who completed the survey, 523 (17.2%) had ever used e-cigarettes. Of those who had seen their doctor, dentist, or child's doctor in the last year, 7.3%, 1.7%, and 10.1%, respectively, reported discussing potential harms of e-cigarettes. Conversely, 5.8%, 1.7%, and 9.3% of patients who had seen their doctor, dentist, or child's doctor in the last year reported that the clinician discussed the potential benefits of e-cigarettes. Each clinician type was as likely to discuss harms as benefits. Rates of advice were similar between doctors and child's doctors but lower for dentists. Rates were comparable when the analysis was limited to current e-cigarette users, participants with children, or those who reported using both e-cigarettes and combusted tobacco. Conclusions: Few physicians and dentists discuss either the harms or benefits of e-cigarettes with their patients. These data suggest an opportunity to educate, train, and provide resources for physicians and dentists about e-cigarettes and their use.

Purpose: To examine the relationship between several e-cigarette-related characteristics and daily e-cigarette use among adolescent current users. Design: Secondary analysis of 2016 National Youth Tobacco Survey data. Setting: United States middle schools and high schools. Sample: One thousand five hundred seventy-nine current e-cigarette users. Measures: Daily e-cigarette use and e-cigarette flavors, brands, device type, and acquisition were measured. Analysis: Logistic regression and Poisson regression models were built. Results: A total of 13.6% of current users reported daily use. Results indicated that daily users were at increased odds of using all flavor types (all P < .001), with the exception of menthol/mint, and using a higher number of flavors than nondaily users ( P < .001). Daily users were more likely to use Blu, eGo, Logic, Halo, NJOY, and another unlisted brand but less likely to report they did not know the brand used (all P ≤ .01). Daily users also reported using a higher number of brands than nondaily users ( P < .001). Daily users were at increased odds of using marijuana/tetrahydrocannabinol (THC) oil wax as device ingredients ( P < .001) and less likely to use only nicotine ( P < .001) or unknown ingredients ( P = .004). Daily users were more likely to acquire e-cigarettes from a vape shop, gas station/convenience store, Internet, mall/shopping center kiosk, drug store, grocery store, or other place (all P ≤ .01). Conclusion: Comprehensive efforts are needed to reduce e-cigarette use and nicotine addiction among adolescents.

Background English health-care commissioners from the NHS need information to commission effectively. In the light of new legislation in 2012, new 'external' organisations were created such as commissioning support units (CSUs), public health departments moved into local authorities and 'external' provider organisations such as commercial and not-for-profit agencies and freelance consultants were encouraged. The aim of this research from 2011 to 2014 was to study knowledge exchange between these external providers and health-care commissioners to learn about knowledge acquisition and transformation, the role of external providers and the benefits of contracts between external providers and health-care commissioners. Methods Using a case study design, we collected data from eight cases, where commercial and not-for-profit organisations were contracted. We conducted 92 interviews with external providers (n = 36), their clients (n = 47) and others (n = 9), observed 25 training events and meetings and collected various documentation including meeting minutes, reports and websites. Using constant comparison, data were analysed thematically using a coding framework and summaries of cases. Results In juggling competing agendas, commissioners pragmatically accessed and used information to build a cohesive, persuasive case to plot a course of action, convince others and justify decisions. Local data often trumped national or research-based information. Conversations and stories were fast, flexible and suited to the continually changing commissioning environment. Academic research evidence was occasionally explicitly sought, but usually came predigested via National Institute of Health and Care Excellence guidance, software tools and general practitioner clinical knowledge. Negative research evidence did not trigger discussions of disinvestment opportunities. Every commissioning organisation studied had its own unique blend of three types of commissioning models: clinical commissioning, integrated health and social care and commercial provider. Different types of information were privileged in each model. Commissioners regularly accessed information through five main conduits: (1) interpersonal relationships; (2) people placement (embedded staff); (3) governance (e.g. Department of Health directives); (4) 'copy, adapt and paste' (e.g. best practice elsewhere); and (5) product deployment (e.g. software tools). Interpersonal relationships appeared most crucial in influencing commissioning decisions. In transforming knowledge, commissioners undertook repeated, iterative processes of contextualisation using a local lens and engagement to refine the knowledge and ensure that the 'right people' were on board. Knowledge became transformed, reshaped and repackaged in the act of acquisition and through these processes as commissioners manoeuvred knowledge through the system. External providers were contracted for their skills and expertise in project management, forecast modelling, event management, pathway development and software tool development. Trust and usability influenced clients' views on the usefulness of external providers, for example the motivations of Public Health and CSUs were more trusted, but the usefulness of their output was variable. Among the commercial and not-for-profit agencies in this study, one was not very successful, as the NHS clients thought that the external provider added little of extra value. With another, the benefits were largely still notional and with a third views were largely positive, with some concerns about expense. Analysts often benefited more than those making commissioning decisions. Conclusions External providers who maximised their use of the different conduits and produced something of value beyond what was locally available appeared more successful. The long-standing schism between analysts and commissioners blunted the impact of some contracts on commissioners' decision-making. To capitalise on the expertise of external providers, wherever possible, contracts should include explicit skills development and knowledge transfer components. Funding The National Institute for Health Research Health Services and Delivery Research programme.

Tobacco use currently claims >5 million deaths per year worldwide and this number is projected to increase dramatically by 2030. The burden of death and disease is shifting to low- and middle-income countries. Tobacco control initiatives face numerous challenges including not being a high priority in many countries, government dependence upon immediate revenue from tobacco sales and production, and opposition of the tobacco industry. Tobacco leads to environmental harms, exploitation of workers in tobacco farming, and increased poverty. Children are especially vulnerable. Not only do they initiate tobacco use themselves, but also they are victimized by exposure to highly toxic secondhand smoke. Awareness of tobacco adverse health effects is often superficial even among health professionals. The tobacco industry continues to aggressively promote its products and recognizes that children are its future. The tools and knowledge exist, however, to dramatically reduce the global burden of tobacco. In 2003 the World Health Organization adopted the Framework Convention on Tobacco Control. Aggressive tobacco control initiatives have been undertaken not only in high-income countries but also in less-wealthy countries such as Uruguay and Thailand. Stakeholders must come together in coordinated efforts and there must be a broad and sustained investment in global tobacco control.