Breast cancer teams:the impact of constitution, new cancer workload and methods of operation on their effectiveness

National guidance and clinical guidelines recommended multidisciplinary teams (MDTs) for cancer services in order to bring specialists in relevant disciplines together, ensure clinical decisions are fully informed, and to coordinate care effectively. However, the effectiveness of cancer teams was not previously evaluated systematically. A random sample of 72 breast cancer teams in England was studied (548 members in six core disciplines), stratified by region and caseload. Information about team constitution, processes, effectiveness, clinical performance, and members' mental well-being was gathered using appropriate instruments. Two input variables, team workload (P=0.009) and the proportion of breast care nurses (P=0.003), positively predicted overall clinical performance in multivariate analysis using a two-stage regression model. There were significant correlations between individual team inputs, team composition variables, and clinical performance. Some disciplines consistently perceived their team's effectiveness differently from the mean. Teams with shared leadership of their clinical decision-making were most effective. The mental well-being of team members appeared significantly better than in previous studies of cancer clinicians, the NHS, and the general population. This study established that team composition, working methods, and workloads are related to measures of effectiveness, including the quality of clinical care. © 2003 Cancer Research UK.

Leadership clarity and team innovation in health care

The relationships among leadership clarity (i.e., team members' consensual perceptions of clarity of and no conflict over leadership of their teams), team processes, and innovation were examined in health care contexts. The sample comprised 3447 respondents from 98 primary health care teams (PHCTs), 113 community mental health teams (CMHTs), and 72 breast cancer care teams (BCTs). The results revealed that leadership clarity is associated with clear team objectives, high levels of participation, commitment to excellence, and support for innovation. Team processes consistently predicted team innovation across all three samples. Team leadership predicted innovation in the latter two samples, and there was some evidence that team processes partly mediated this relationship. The results imply the need for theory that incorporates clarity and not just style of leadership. For health care teams in particular, and teams in general, the results suggest a need to ensure leadership is clear in teams when innovation is a desirable team performance outcome. © 2003 Elsevier Inc. All rights reserved.

The Legitimation of authority in the European Union

The founding Treaties of the European Union (EU) provide the Commission with bureaucratic structures and functions, and the authority to take a political leadership role in the integration process. However, the legitimacy of the Commission's authority to act either as a bureaucracy or as a political institution is periodically contested, as is the authority and leadership of its President. Max Weber's theory of the legitimation of authority suggests itself in this context as a working tool for assessing the nature of institutional and individual authority and leadership in the Commission and the broader EU context. Weber's typology of authority offers both an understanding of the changes in the Commission's fortunes within the 'would-be polity' of the European institutions, and an appraisal of claims to authority at the individual level by the Commission President. When applied to two contrasting moments in the Commission's life during the presidency of Jacques Delors (the generating of the White Papers of 1985 and 1993), Weber's typology provides an explanation for the evolution of the legitimation of these forms of authority in terms of, first, the Union's imperfect provisions for legitimate claims to leadership authority on 'charismatic' grounds and, second, the absence in the Union of resources for leadership legitimacy based on 'traditional'-type authority, such as explicit, popular, or party political European-wide support for the project of European union. These are resources which, if present in the EU, would legitimise calls to reform the EU's institutions in the direction of more integration and a more federal polity. The case studies offer an appraisal of the functioning and malfunctioning of authority within the Union, as well as a critical assessment of the applicability of the Weberian model to the legitimation of authority in the EU.

State-of-the-art in lean design engineering:a literature review on white collar lean

Lean is usually associated with the ‘operations’ of a manufacturing enterprise; however, there is a growing awareness that these principles may be transferred readily to other functions and sectors. The application to knowledge-based activities such as engineering design is of particular relevance to UK plc. Hence, the purpose of this study has been to establish the state-of-the-art, in terms of the adoption of Lean in new product development, by carrying out a systematic review of the literature. The authors' findings confirm the view that Lean can be applied beneficially away from the factory; that an understanding and definition of value is key to success; that a set-based (or Toyota methodology) approach to design is favoured together with the strong leadership of a chief engineer; and that the successful implementation requires organization-wide changes to systems, practices, and behaviour. On this basis it is felt that this review paper provides a useful platform for further research in this topic.

Intergroup leadership in organizations:leading across group and organizational boundaries

Intergroup leadership-leadership of collaborative performance of different organizational groups or organizations-is associated with unique intergroup challenges that are not addressed by traditional leadership theories. To address this lacuna, we describe a theory of intergroup leadership. Firmly grounded in research on social identity and intergroup relations, the theory proposes that effective intergroup performance rests on the leader's ability to construct an intergroup relational identity. We describe key leadership actions to establish such an identity. © 2012 Academy of Management Review.

Embodying who we are:leader group prototypicality and leadership effectiveness

Leadership is a process enacted in the context of a shared group membership, and leadership effectiveness is contingent on followers' perceptions of the leader as a group member. Addressing this role of group membership, the social identity theory of leadership puts leader group prototypicality, the extent to which the leader is perceived to embody group identity, center-stage in leadership effectiveness. I review empirical research in leader group prototypicality, concluding there is a robust empirical basis for the key propositions of the social identity theory of leadership. I also identify newer developments that extend and enrich the social identity analysis of leadership, including attention to the roles of uncertainty, leader fairness, leader–follower relationship, leader self-perceived prototypicality, and leadership of creativity and innovation.

The continuing relevance of Germany's engine for CEE andthe EU

The article looks first into the nature of the relations between Germany and the CEE countries a decade since the accession of the CEE countries to the EU. The relations are characterized as normalised and intensive with diverse levels of closeness and co-operation reflecting of the conceptual and ideological compatibility/differences. Next, the article focuses on the German attitude to the euro zone crisis. Germany has become a hegemon in the rescue effort aimed at stabilisation and economic invigoration of the euro zone. However, German hegemony has developed by default, not by design: her leading position is linked with considerable political and financial costs. Germany moved central stage and took the position of a reluctant hegemon. However, German role is contested internationally (it has not the support of the French government in key areas) as well as internally (particularly by the Federal Constitutional Court and the Bundesbank).The article argues that the new situation makes the German-CEE relations increasingly relevant for both sides. The German leadership of the EU increasing split along the north-south divide requires backing by the Northern group countries to which the CEE in general belongs. Given a number of reasons the CEE countries implement three distinctive strategies of co-operation with Germany in European politics. Also military co-operation, which remained rather limited so far, may receive new impulses, given the financial austerity. © 2013 The Regents of the University of California.

Senior management leadership, social support, job design and stressor-to-strain relationships in hospital practice

Purpose: The purpose of this paper is to examine the effect of the quality of senior management leadership on social support and job design, whose main effects on strains, and moderating effects on work stressors-to-strains relationships were assessed. Design/methodology/approach: A survey involving distribution of questionnaires was carried out on a random sample of health care employees in acute hospital practice in the UK. The sample comprised 65,142 respondents. The work stressors tested were quantitative overload and hostile environment, whereas strains were measured through job satisfaction and turnover intentions. Structural equation modelling and moderated regression analyses were used in the analysis. Findings: Quality of senior management leadership explained 75 per cent and 94 per cent of the variance of social support and job design respectively, whereas work stressors explained 51 per cent of the variance of strains. Social support and job design predicted job satisfaction and turnover intentions, as well as moderated significantly the relationships between quantitative workload/hostility and job satisfaction/turnover intentions. Research limitations/implications: The findings are useful to management and to health employees working in acute/specialist hospitals. Further research could be done in other counties to take into account cultural differences and variations in health systems. The limitations included self-reported data and percept-percept bias due to same source data collection. Practical implications: The quality of senior management leaders in hospitals has an impact on the social environment, the support given to health employees, their job design, as well as work stressors and strains perceived. Originality/value: The study argues in favour of effective senior management leadership of hospitals, as well as ensuring adequate support structures and job design. The findings may be useful to health policy makers and human resources managers. © Emerald Group Publishing Limited.

Using the framework method for the analysis of qualitative data in multi-disciplinary health research

Background: The Framework Method is becoming an increasingly popular approach to the management and analysis of qualitative data in health research. However, there is confusion about its potential application and limitations. Discussion. The article discusses when it is appropriate to adopt the Framework Method and explains the procedure for using it in multi-disciplinary health research teams, or those that involve clinicians, patients and lay people. The stages of the method are illustrated using examples from a published study. Summary. Used effectively, with the leadership of an experienced qualitative researcher, the Framework Method is a systematic and flexible approach to analysing qualitative data and is appropriate for use in research teams even where not all members have previous experience of conducting qualitative research. © 2013 Gale et al.; licensee BioMed Central Ltd.

Leadership and the Labour Party:narrative and performance

The relationships between narrative and leadership, between rhetoric and performance, between doctrine and its voicing, are crucial to party politics and are underrated by both practising politicians and scholars. This study analyses the ‘performance of leadership’ in the UK Labour Party, and what this means for a new approach to understanding politics. The main focus of this study is the five-year leadership of Ed Miliband, 2010-2015. The fortunes of the party and the party leadership can be apprehended as a series of performed rhetorical events. A political leader’s persona is a construction that performs – rather like an actor – in the political space. The author identifies and analyses the architecture and the modalities of leadership persona construction and performance in contemporary politics.

Industrial relations in the road passenger transport industry-a political-economic analysis.

This thesis examines the British Bus and Tram Industry from 1889 to 1988. The first determinant of the pattern of industrial relations is the development of the labour-process. The labour process changes with the introduction of new technology (electrified trams and mechanised buses), the concentration and centralisation of ownership, the decline of competition, changing market position, municipal and state regulation, ownership and control. The tram industry, as a consequence of electrification, is almost wholly municipally owned and the history of the labour process from horse-trams to the decline of the industry is examined. The bus industry has a less unified structure and is examined by sector; London, Municipal, and Territorial/Provincial. The small independent sector is largely ignored. The labour process is examined from the horse-bus to the present day. The development of resistance in the labour process is discussed both as a theoretical problematic (the `Braverman Debate') and through the process of unionisation, the centralisation and bureaucratisation of the unions, the development of national bargaining structures (National Joint Industrial Council and the National Council for the Omnibus Industry), and the development of resistance to those processes. This resistance takes either a syndicalist form, or under Communist Party leadership the form of rank and file movements, or simply unofficial organisations of branch officials. The process of centralisation of the unions, bureaucratisation and the institutionalisation of bargaining and the relationship between this process and the role of the Unions in the Labour Party is examined. Neo-corporatism, that is the increasing integration of the leadership of the main Union, the T.G.W.U.with the Labour Party and with the State is discussed. In theoretical terms, this thesis considers the debate around the notion of `labour process', the relationship between labour process and labour politics and between labour process and labour history. These relationships are placed within a discussion of class consciousness.

Le groupe du Fer de Lance mélanésien face à ses défis

Cet article examine la complexité du processus d’intégration régionale en Océanie à travers le cas du groupe du Fer de Lance mélanésien (gflm). L’émergence de cette structure subrégionale en 1988 avait pour but d’affirmer la spécificité mélanésienne au cœur du Pacifique Sud. Or, en vingt-cinq années d’existence, le Fer de Lance ne semble pas avoir pleinement réalisé tous les objectifs qu’il s’était initialement fixés. Ses ambitions, politiques en particulier, ne sont qu’en partie réalisées. Quant à la récente présidence fidjienne du Fer de Lance, elle a tenté de donner une nouvelle stature régionale au groupe, mais y est-elle parvenue ? Cet article analyse les défis politiques, intérieurs et extérieurs, que le gflm rencontre depuis sa création et considère ceux qui lui restent à relever. This paper examines the complexities of regional integration in Oceania through the case study of the Melanesian Spearhead Group (MSG). The emergence of a new subregional structure in 1988 aimed to support the development of the Melanesian identity within the South Pacific. However, after twenty-five years of existence, the Spearhead Group does not seem to have reached all its initial objectives. Its political ambition has only partly been achieved. The recent Fijian leadership of the MSG has attempted to give a new regional dimension to the Melanesian group, but has it succeeded? This paper analyses how the subregional group has faced the challenges that emerged from its regional environment as well as from within its own structure. It fnally considers the new challenges ahead for the Melanesian group.

Protocol, image, and discourse in political leadership competition:the case of Prime Minister Lionel Jospin, 1997-2002

This article examines the relationship between Prime Minister Jospin and President Chirac in the period 1997 to 2002. It is concerned in particular with symbolism, discourse and protocol, and how these have mediated the political competition between Chirac and Jospin. We develop a framework of analysis with several main strands. We consider the effects of the institutions of the Fifth Republic upon the political conduct of Prime Minister and President. We observe the perceived character traits of the individuals concerned, as well as the character traits expected of the offices of President and Prime Minister. We investigate the influence of the past upon the behaviour of Chirac and Jospin in the present, both in terms of notions of regime crisis which configured the institutions in the first place, and in relation to the image of previous holders of the offices (especially Charles de Gaulle and Franois Mitterrand).

Dopamine, empathy and the neurobiology of leadership

Objectives: Organisational Psychologists have long sought after methods by which to train individuals to become more effective leaders. Indeed considerable sums of money are spent on the design of such training programs. Yet it is not clear whether or not leadership skills can be taught or whether they are innate. Social leadership is a varied construct consisting of many diverse aspects, yet the ability to empathise with subordinates is a core skill that underpins effective transformational leadership. This type of leadership consists of four characteristics which are labelled ‘idealized influence’, ‘inspirational motivation’, ‘intellectual stimulation’ and ‘individualized consideration’. This is distinct from the transactional style of leadership, which is based on offering contingent rewards for completion of specific tasks. By identifying a specific gene that mediates distinct leadership traits, more effective training regimes can be designed. Design: There are two likely candidate genes that may mediate empathic leadership. The first is catechol-O-methyltransferase (COMT) which is involved with dopamine synthesis, and the second is the serotonin transporter promoter gene (5-HTTLPR). Both these genes mostly appear in the general population in their heterozygotic form. Thus by comparing phenotypes in leadership traits a measure of base line differences can be examined. Methods: 115 volunteers completed the Multifactor Leadership questionnaire (MLQ), which is a standard 12-item leadership psychometric scale and also underwent buccal swab for subsequent genotyping. Results: Of the 115 subjects 37 were heterozygotic for the COMT gene and 47 heterozygotic for 5-HTTLPR. Of the 12 MLQ subscales, the scores for two of the subscales only differed between the two participant groups. Individuals who were heterozygotic for the COMT gene scored higher on the ‘Inspirational motivation’ t(84)=1.99, p=0.05 and ‘Intellectual stimulation’ t(82)=1.94, p=0.05 scales compared to the carriers for the heterozygotic 5HTPP gene. Conclusions: Given that the behaviours described by these two MLQ subscales require leaders to empathise with subordinates, the current results suggest that dopamine may play a role in this important social task. The fact that both heterozygotic carriers for COMT and 5HTPP were compared allows a comparison to be made between the genotypes most prevalent in the general population.