Using qualitative mixed methods to study small health care organizations while maximising trustworthiness and authenticity

Background The primary health care sector delivers the majority of health care in western countries through small, community-based organizations. However, research into these healthcare organizations is limited by the time constraints and pressure facing them, and the concern by staff that research is peripheral to their work. We developed Q-RARA—Qualitative Rapid Appraisal, Rigorous Analysis—to study small, primary health care organizations in a way that is efficient, acceptable to participants and methodologically rigorous. Methods Q-RARA comprises a site visit, semi-structured interviews, structured and unstructured observations, photographs, floor plans, and social scanning data. Data were collected over the course of one day per site and the qualitative analysis was integrated and iterative. Results We found Q-RARA to be acceptable to participants and effective in collecting data on organizational function in multiple sites without disrupting the practice, while maintaining a balance between speed and trustworthiness. Conclusions The Q-RARA approach is capable of providing a richly textured, rigorous understanding of the processes of the primary care practice while also allowing researchers to develop an organizational perspective. For these reasons the approach is recommended for use in small-scale organizations both within and outside the primary health care sector.

Member perceptions of ESG investing through superannuation

Purpose Environmental, social and governance (ESG) risks have the potential to negatively impact financial returns, yet few superannuation funds integrate these considerations into their investment selection. The Cooper Review (2010) identified a lack of member demand as a key impediment to ESG investing by superannuation funds. Given this problem, the aim of this study is to explore superannuation fund members’ perceptions of ESG investing by their funds in order to identify reasons for the lack of demand. Design/methodology/approach An on-line survey was developed and distributed to assess possible reasons why members do not select ESG investment options. In total, 549 Australian superannuation fund members responded to the survey. Findings Results indicate that the majority of superannuation fund members are interested in ESG investing. Members lack awareness of their fund’s approach to ESG investing, and they do not perceive there to be a financial penalty from ESG investing. Finally, members show a preference for consideration of governance issues over both social and environmental issues. Research limitations Respondents are well educated and the majority did not choose their superannuation fund. There was no measure of financial literacy included in the research instrument. There is also a general limitation in surveying superannuation fund members when they lack knowledge about superannuation. Practical implications The results indicate that superannuation members are interested in both superannuation and ESG investing. Given the low take-up of ESG investment options, this finding raises the question of how effectively funds are engaging their members. Social implications The results should be of interest to superannuation funds and may lead to renewed interest in promoting ESG products. Originality/value This is the first study to examine superannuation members’ attitudes and behaviours towards ESG investing in the context of superannuation. The study also adds to our understanding of member decision making in the $1.8 trillion superannuation industry.

Tools, building blocks, and rewards : traditional media organizations learn to engage with productive audiences

This paper explores how traditional media organizations (such as magazines, music, film, books, and newspapers) develop routines for coping with an increasingly productive audience. While previous studies have reported on how such organizations have been affected by digital technologies, this study makes a contribution to this literature by being one of the first to show how organizational routines for engaging with an increasingly productive audience actually emerge and diffuse between industries. The paper explores to what extent routines employed by two traditional media organizations have been brought in from other organizational settings, specifically from so-called ‘software platform operators’. Data on routines for engaging with productive audiences have been collected from two information-rich cases in the music and the magazine industries, and from eight high-profile software platform operators. The paper concludes that the routines employed by the two traditional media organizations and by the software platform operators are based on the same set of principles: Provide the audience with (a) tools that allow them to easily generate cultural content; (b) building blocks which facilitate their creative activities; and (c) recognition and rewards based on both rationality and emotion.

Participation in Environmental Organizations

For decades, social scientists have searched for factors that shape pro-environmental behaviour. However, only a few studies have investigated the causes and consequences of participation in environmental organizations. This book fills the gap by analysing in detail the determinants of environmental participation and its consequences in different parts of the world. Benno Torgler, María A. García-Valinas and Alison Macintyre seek the answer to several questions regarding who is working towards positive outcomes for our environment, what sort of social and institutional context will assist voluntary participation, what sort of attitudes are related to positive environmental behavior, and which countries are active on the intergovernmental stage. By focusing on voluntary participation in environmental organizations, we are able to determine the level of willingness to work towards a solution for environmental problems. This allows an insight into the motivations and attitudes of individuals and nations and how these factors can affect environmental cooperation. Participation in Environmental Organizations sheds light on who is liable to participate and will help to see whose priorities and values are forwarded through voluntary activities and to what extent voluntary participation can become representative. Thus, the book provides a unique examination of citizens’ willingness to participate in environmental organizations. The book will be of interest to Economics students and researchers alike who seek a deeper understanding of the theory and practice of environmental participation.

The burden of cancer in member countries of the association of southeast asian nations (ASEAN)

This paper presents the most recent data on cancer rates and the burden of cancer in the ASEAN region. Epidemiological data were sourced from GLOBOCAN 2008 and disability adjusted life years (DALYs) lost were estimated using the standard methodology developed within the World Health Organization's Global Burden of Disease study. Overall, it was estimated there were over 700,000 new cases of cancer and 500,000 cancer deaths in ASEAN in the year 2008, leading to approximately 7.5 million DALYs lost in one year. The most commonly diagnosed cancers were lung (98,143), breast (86,842) and liver cancers (74,777). The most common causes of cancer death were lung cancer (85,772), liver cancer (69,115) and colorectal cancer (44,280). The burden of cancer in terms of DALYs lost was highest in Laos, Viet Nam and Myanmar and lowest in Brunei, Singapore and the Philippines. Significant differences in the patterns of cancer from country to country were observed. Another key finding was the major impact played by population age distribution on cancer incidence and mortality. Cancer rates in ASEAN are expected to increase with ageing of populations and changes in lifestyles associated with economic development. Therefore, ASEAN member countries are strongly encouraged to put in place cancer-control health carepolicies, focussed on strengthening the health systems to cope with projected increases in cancer prevention, treatment and management needs.

Assessment of the molecular structure of an intermediate member of the triplite-zwieselite mineral series: A raman and infrared study

The mineral series triplite-zwieselite with theoretical formula (Mn2+)2(PO4)(F)-(Fe2+)2(PO4)(F) from the El Criolo granitic pegmatite, located in the Eastern Pampean Ranges of Córdoba Province, was studied using electron microprobe, thermogravimetry, and Raman and infrared spectroscopy. The analysis of the mineral provided a formula of (Fe1.00, Mn0.85, Ca0.08, Mg0.06)∑2.00(PO4)1.00(F0.80, OH0.20)∑1.00. An intense Raman band at 981 cm−1 with a shoulder at 977 cm−1 is assigned to the ν1 symmetric stretching mode. The observation of two bands for the phosphate symmetric stretching mode offers support for the concept that the phosphate units in the structure of triplite-zwieselite are not equivalent. Low-intensity Raman bands at 1012, 1036, 1071, 1087, and 1127 cm−1 are assigned to the ν3 antisymmetric stretching modes. A set of Raman bands at 572, 604, 639, and 684 cm−1 are attributed to the ν4 out-of-plane bending modes. A single intense Raman band is found at 3508 cm−1 and is assigned to the stretching vibration of hydroxyl units. Infrared bands are observed at 3018, 3125, and 3358 cm−1 and are attributed to water stretching vibrations. Supplemental materials are available for this article. Go to the publisher's online edition of Spectroscopy Letters to view the supplemental file.

Is member-rated project success influenced by leadership team emotional intelligence?

Large complex projects often fail spectacularly in terms of cost overruns and delays; witness the London Olympics and the Airbus A380. In this project, we studied the emotional intelligence (EI) of leadership teams involved in such projects. We collected our data from 370 employees in 40 project teams working on large Australian defense contracts. We asked leadership team members to complete a scale measuring their EI, and project team members to rate the success of the projects. We found it was not the mean score, but the highest EI score in the leadership team that predicted members’ project success ratings.

Exploring university-community partnerships in arts-based service learning with Australian First Peoples and Arts Organizations

In this chapter we focus on the importance of partnerships in arts-based service learning with Australian First Peoples and community arts organizations. Drawing on six years of our own partnership and a wide body of literature, this chapter aims to act as a trigger for further reflection on ways to engage in meaningful partnerships with First Peoples and arts organizations. In particular, the continuum between transactional and transformational types of relationships provides a useful means for understanding our work and for positioning the various benefits and challenges associated with university-community partnerships more broadly.

Leaders' personal wisdom and leader-member exchange quality: The role of individualized consideration

Business scholars have recently proposed that the virtue of personal wisdom may predict leadership behaviors and the quality of leader–follower relationships. This study investigated relationships among leaders’ personal wisdom—defined as the integration of advanced cognitive, reflective, and affective personality characteristics (Ardelt, Hum Dev 47:257–285, 2004)—transformational leadership behaviors, and leader–member exchange (LMX) quality. It was hypothesized that leaders’ personal wisdom positively predicts LMX quality and that intellectual stimulation and individualized consideration, two dimensions of transformational leadership, mediate this relationship. Data came from 75 religious leaders and 1–3 employees of each leader (N = 158). Results showed that leaders’ personal wisdom had a positive indirect effect on follower ratings of LMX quality through individualized consideration, even after controlling for Big Five personality traits, emotional intelligence, and narcissism. In contrast, intellectual stimulation and the other two dimensions of transformational leadership (idealized influence and inspirational motivation) did not mediate the positive relationship between leaders’ personal wisdom and LMX quality. Implications for future research on personal wisdom and leadership are discussed, and some tentative suggestions for leadership development are outlined.

Establishing the next generation at work: Leader generativity as a moderator of the relationships between leader age, leader-member exchange, and leadership success

In this study, the authors investigated leader generativity as a moderator of the relationships between leader age, leader-member exchange, and three criteria of leadership success (follower perceptions of leader effectiveness, follower satisfaction with leader, and follower extra effort). Data came from 128 university professors paired with one research assistant each. Results showed positive relationships between leader age and leader generativity, and negative relationships between leader age and follower perceptions of leader effectiveness and follower extra effort. Consistent with expectations based on leadership categorization theory, leader generativity moderated the relationships between leader age and all three criteria of leadership success, such that leaders high in generativity were better able to maintain high levels of leadership success at higher ages than leaders low in generativity. Finally, results of mediated moderation analyses showed that leader-member exchange quality mediated these moderating effects. The findings suggest that, in combination, leader age and the age-related construct of generativity importantly influence leadership processes and outcomes. © 2011 American Psychological Association.

Disease Diplomacy

In the age of air travel and globalized trade, pathogens that once took months or even years to spread beyond their regions of origin can now circumnavigate the globe in a matter of hours. Amid growing concerns about such epidemics as Ebola, SARS, MERS, and H1N1, disease diplomacy has emerged as a key foreign and security policy concern as countries work to collectively strengthen the global systems of disease surveillance and control. The revision of the International Health Regulations (IHR), eventually adopted by the World Health Organization’s member states in 2005, was the foremost manifestation of this novel diplomacy. The new regulations heralded a profound shift in international norms surrounding global health security, significantly expanding what is expected of states in the face of public health emergencies and requiring them to improve their capacity to detect and contain outbreaks. Drawing on Martha Finnemore and Kathryn Sikkink’s "norm life cycle" framework and based on extensive documentary analysis and key informant interviews, Disease Diplomacy traces the emergence of these new norms of global health security, the extent to which they have been internalized by states, and the political and technical constraints governments confront in attempting to comply with their new international obligations. The authors also examine in detail the background, drafting, adoption, and implementation of the IHR while arguing that the very existence of these regulations reveals an important new understanding: that infectious disease outbreaks and their management are critical to national and international security. The book will be of great interest to academic researchers, postgraduate students, and advanced undergraduates in the fields of global public health, international relations, and public policy, as well as health professionals, diplomats, and practitioners with a professional interest in global health security.

Turing and the Trans-Pacific Partnership: Intellectual Property, Public Health, and Access to Essential Medicines

A recent controversy in the United States over drug pricing by Turing Pharmaceuticals AG has raised larger issues in respect of intellectual property, access to medicines, and the Trans-Pacific Partnership (TPP). In August 2015, Turing Pharmaceuticals AG – a private biopharmaceutical company with offices in New York, the United States, and Zug, Switzerland - acquired the exclusive marketing rights to Daraprim in the United States from Impax Laboratories Incorporated. Martin Shkreli, Turing’s Founder and Chief Executive Officer, maintained: “The acquisition of Daraprim and our toxoplasmosis research program are significant steps along Turing’s path of bringing novel medications to patients with serious disorders, some of whom often go undiagnosed and untreated.” He emphasised: “We intend to invest in the development of new drug candidates that we hope will yield an even better clinical profile, and also plan to launch an educational effort to help raise awareness and improve diagnosis for patients with toxoplasmosis.” In September 2015, there was much public controversy over the decision of Martin Shkreli to raise the price of a 62 year old drug, Daraprim, from $US13.50 to $US750 a pill. The drug is particularly useful in respect to the treatment and prevention of malaria, and in the treatment of infections in individuals with HIV/AIDS. Daraprim is listed on the World Health Organization’s (WHO) List of Essential Medicines. In the face of much criticism, Martin Shkreli has said that he will reduce the price of Daraprim. He observed: “We've agreed to lower the price on Daraprim to a point that is more affordable and is able to allow the company to make a profit, but a very small profit.” He maintained: “We think these changes will be welcomed.” However, he has been vague and ambiguous about the nature of the commitment. Notably, the lobby group, Pharmaceutical Research and Manufacturers of America (PhARMA), disassociated itself from the claims of Turing Pharmaceuticals. The group said: “PhRMA members have a long history of drug discovery and innovation that has led to increased longevity and improved lives for millions of patients.” The group noted: “Turing Pharmaceutical is not a member of PhRMA and we do not embrace either their recent actions or the conduct of their CEO.” The biotechnology peak body Biotechnology Industry Organization also sought to distance itself from Turing Pharmaceuticals. A hot topic: United States political debate about access to affordable medicines This controversy over Daraprim is unusual – given the age of drug concerned. Daraprim is not subject to patent protection. Nonetheless, there remains a monopoly in respect of the marketplace. Drug pricing is not an isolated problem. There have been many concerns about drug pricing – particularly in respect of essential medicines for HIV/AIDS, tuberculosis, and malaria. This recent controversy is part of a larger debate about access to affordable medicines. The dispute raises larger issues about healthcare, consumer rights, competition policy, and trade. The Daraprim controversy has provided impetus for law reform in the US. US Presidential Candidate Hillary Clinton commented: “Price gouging like this in this specialty drug market is outrageous.” In response to her comments, the Nasdaq Biotechnology Index fell sharply. Hillary Clinton has announced a prescription drug reform plan to protect consumers and promote innovation – while putting an end to profiteering. On her campaign site, she has emphasised that “affordable healthcare is a basic human right.” Her rival progressive candidate, Bernie Sanders, was also concerned about the price hike. He wrote a letter to Martin Shkreli, complaining about the price increase for the drug Daraprim. Sanders said: “The enormous, overnight price increase for Daraprim is just the latest in a long list of skyrocketing price increases for certain critical medications.” He has pushed for reforms to intellectual property to make medicines affordable. The TPP and intellectual property The Daraprim controversy and political debate raises further issues about the design of the TPP. The dispute highlights the dangers of extending the rights of pharmaceutical drug companies under intellectual property, investor-state dispute settlement, and drug administration. Recently, the civil society group Knowledge Ecology International published a leaked draft of the Intellectual Property Chapter of the TPP. Knowledge Ecology International Director, James Love, was concerned the text revealed that the US “continues to be the most aggressive supporter of expanded intellectual property rights for drug companies.” He was concerned that “the proposals contained in the TPP will harm consumers and in some cases block innovation.” James Love feared: “In countless ways, the Obama Administration has sought to expand and extend drug monopolies and raise drug prices.” He maintained: “The astonishing collection of proposals pandering to big drug companies make more difficult the task of ensuring access to drugs for the treatment of cancer and other diseases and conditions.” Love called for a different approach to intellectual property and trade: “Rather than focusing on more intellectual property rights for drug companies, and a death-inducing spiral of higher prices and access barriers, the trade agreement could seek new norms to expand the funding of medical research and development (R&D) as a public good, an area where the US has an admirable track record, such as the public funding of research at the National Institutes of Health (NIH) and other federal agencies.” In addition, there has been much concern about the Investment Chapter of the TPP. The investor-state dispute settlement regime would enable foreign investors to challenge government policy making, which affected their investments. In the context of healthcare, there is a worry that pharmaceutical drug companies will deploy their investor rights to challenge public health measures – such as, for instance, initiatives to curb drug pricing and profiteering. Such concerns are not merely theoretical. Eli Lilly has brought an investor action against the Canadian Government over the rejection of its drug patents under the investor-state dispute settlement regime of the North American Free Trade Agreement (NAFTA). The Health Annex to the TPP also raises worries that pharmaceutical drug companies will able to object to regulatory procedures in respect of healthcare. It is disappointing that the TPP – in the leaks that we have seen – has only limited recognition of the importance of access to essential medicines. There is a need to ensure that there are proper safeguards to provide access to essential medicines – particularly in respect of HIV/AIDs, malaria, and tuberculosis. Moreover, there must be protection against drug profiteering and price gouging in any trade agreement. There should be strong measures against the abuse of intellectual property rights. The dispute over Turing Pharmaceuticals AG and Daraprim is an important cautionary warning in respect of some of the dangers present in the secret negotiations in respect of the TPP. There is a need to preserve consumer rights, competition policy, and public health in trade negotiations over an agreement covering the Pacific Rim.

Relationship between quality certification and financial and non-financial performance of organizations

At present, many countries have either embraced ISO9001 or used it as the basis of their national quality certification systems. However, few studies have been conducted to examine the benefits companies’ gain from achieving and implementing ISO9001 standards (Chikuku et al. 2012; Psomas et al. 2013; Sampaio et al. 2011a,b). Analysis has brought much more confused and uneven results across the countries. Turning to the experience of Malaysia, this country has witnessed a spectacular growth at an average rate of 9.89% per annum of ISO certificates issued to companies operating within its borders (ISO Survey 2012). While many companies rush to be ISO 9001 certified whether this brings about better benefits (both the financial and the non-financial) is still an open question. In this study, the research problems were first formulated from the literature and then a questionnaire survey was conducted to test the hypotheses. A survey was administered to chief executives officers and managers across manufacturing and service organizations in Malaysia. Multivariate analysis and SPSS macro developed by Preacher and Hayes were used as statistical techniques to the financial and non-financial benefits of ISO9001 certification. The survey instrument was a two-page questionnaire comprising three sections. The first section of the questionnaire covered the company’s profile. The second section consisted of 25 items on internal benefits and third section consisted of 7 items on external benefits measured on 1–5 Likert scale to assess the benefits of ISO9001 certification. Total 201 valid responses were received. Results of the study indicate that there was no significant direct relationship between ISO9001 certification and organizational financial performance, while strong statistical evidence was found to support the direct relationship between ISO9001 certification and non-financial performance. The findings of the study discovered that financial performance is actually directly related to two non-financial measures, namely quality performance and local and international business performance, which are directly and significantly influenced by ISO9001 certification. Therefore non-financial performance measures are involved in the mediational process. The findings will assist practitioners in taking right courses of action that make the implementation of this standard more effective. For example, the study findings study suggests that companies should put emphasize on nonfinancial factors to improve their financial performance.

How can evaluative thinking and practice inform performance models for organizations and personnel

In the world today there are many ways in which we measure, count and determine whether something is worth the effort or not. In Australia and many other countries, new government legislation is requiring government-funded entities to become more transparent in their practice and to develop a more cohesive narrative about the worth, or impact, for the betterment of society. This places the executives of such entities in a position of needing evaluative thinking and practice to guide how they may build the narrative that documents and demonstrates this type of impact. In thinking about where to start, executives, project and program managers may consider this workshop as a professional development opportunity to explore both the intended and unintended consequences of performance models as tools of evaluation. This workshop will offer participants an opportunity to unpack the place of performance models as an evaluative tool through the following: · What shape does an ethical, sound and valid performance measure for an organization or personnel take? · What role does cultural specificity play in the design and development of a performance model for an organization or for personnel? · How are stakeholders able to identify risk during the design and development of such models? · When and where will dissemination strategies be required? · And so what? How can you determine that your performance model implementation has made a difference now or in the future?