A qualitative analysis of the lived experience of nursing staff developers in the process of changing to a new educational model

The purpose of this study was to document and critically analyze the lived experience of selected nursing staff developers in the process of moving toward a new model for hospital nursing education. Eleven respondents were drawn from a nation-wide population of about two hundred individuals involved in nursing staff development. These subjects were responsible for the implementation of the Performance Based Development System (PBDS) in their institutions.^ A purposive, criterion-based sampling technique was used with respondents being selected according to size of hospital, primary responsibility for orchestration of the change, influence over budgetary factors and managerial responsibility for PBDS. Data were gathered by the researcher through both in-person and telephone interviews. A semi-structured interview guide, designed by the researcher was used, and respondents were encouraged to amplify on their recollections as desired. Audiotapes were transcribed and resulting computer files were analyzed using the program "Martin". Answers to interview questions were compiled and reported across cases. The data was then reviewed a second time and interpreted for emerging themes and patterns.^ Two types of verification were used in the study. Internal verification was done through interview transcript review and feedback by respondents. External verification was done through review and feedback on data analysis by readers who were experienced in management of staff development departments.^ All respondents were female, so Gilligan's concept of the "ethic of care" was examined as a decision making strategy. Three levels of caring which influenced decision making were found. They were caring: (a) for the organization, (b) for the employee, and (c) for the patient. The four existentials of the lived experience, relationality, corporeality, temporality and spatiality were also examined to reveal the everydayness of making change. ^

Managerial work roles of health care executives in the changing environment of academic medical centers

The current U.S. health care system faces numerous environmental challenges. To compete and survive, health care organizations are developing strategies to lower costs and increase efficiency and quality. All of these strategies require rapid and precise decision making by top level managers. The purpose of this study is to determine the relationship between the environment, made up of unfavorable market conditions and limited resources, and the work roles of top level managers, specifically in the settings of academic medical centers. Managerial work roles are based on the ten work roles developed by Henry Mintzberg, in his book, The Nature of Managerial Work (1973). ^ This research utilized an integrated conceptual framework made up of systems theory in conjunction with role, attribution and contingency theories to illustrate that four most frequently performed Mintzberg's work roles are affected by the two environment dimensions. The study sample consisted of 108 chief executive officers in academic medical centers throughout the United States. The methods included qualitative methods in the form of key informants and case studies and quantitative in the form of a survey questionnaire. Research analysis involved descriptive statistics, reliability tests, correlation, principal component and multivariate analyses. ^ Results indicated that under the market condition of increased revenue based on capitation, the work roles increased. In addition, under the environment dimension of limited resources, the work roles increased when uncompensated care increased while Medicare and non-government funding decreased. ^ Based on these results, a typology of health care managers in academic medical centers was created. Managers could be typed as a strategy-formulator, relationship-builder or task delegator. Therefore, managers who ascertained their types would be able to use this knowledge to build their strengths and develop their weaknesses. Furthermore, organizations could use the typology to identify appropriate roles and responsibilities of managers for their specific needs. Consequently, this research is a valuable tool for understanding health care managerial behaviors that lead to improved decision making. At the same time, this could enhance satisfaction and performance and enable organizations to gain the competitive edge . ^

Development of operational performance models for truck-lane restrictions on freeway corridors

Highways are generally designed to serve a mixed traffic flow that consists of passenger cars, trucks, buses, recreational vehicles, etc. The fact that the impacts of these different vehicle types are not uniform creates problems in highway operations and safety. A common approach to reducing the impacts of truck traffic on freeways has been to restrict trucks to certain lane(s) to minimize the interaction between trucks and other vehicles and to compensate for their differences in operational characteristics. ^ The performance of different truck lane restriction alternatives differs under different traffic and geometric conditions. Thus, a good estimate of the operational performance of different truck lane restriction alternatives under prevailing conditions is needed to help make informed decisions on truck lane restriction alternatives. This study develops operational performance models that can be applied to help identify the most operationally efficient truck lane restriction alternative on a freeway under prevailing conditions. The operational performance measures examined in this study include average speed, throughput, speed difference, and lane changes. Prevailing conditions include number of lanes, interchange density, free-flow speeds, volumes, truck percentages, and ramp volumes. ^ Recognizing the difficulty of collecting sufficient data for an empirical modeling procedure that involves a high number of variables, the simulation approach was used to estimate the performance values for various truck lane restriction alternatives under various scenarios. Both the CORSIM and VISSIM simulation models were examined for their ability to model truck lane restrictions. Due to a major problem found in the CORSIM model for truck lane modeling, the VISSIM model was adopted as the simulator for this study. ^ The VISSIM model was calibrated mainly to replicate the capacity given in the 2000 Highway Capacity Manual (HCM) for various free-flow speeds under the ideal basic freeway section conditions. Non-linear regression models for average speed, throughput, average number of lane changes, and speed difference between the lane groups were developed. Based on the performance models developed, a simple decision procedure was recommended to select the desired truck lane restriction alternative for prevailing conditions. ^

Essays on the selection of securities: Decision on acquisition and issuance perspectives and decision rules

This dissertation is a discourse on the capital market and its interactive framework of acquisition and issuance of financial assets that drive the economy from both sides—investors/lenders and issuers/users of capital assets. My work consists of four essays in financial economics that offer a spectrum of revisions to this significant area of study. The first essay is a delineation of the capital market over the past half a century and major developments on capital markets on issues that pertain to the investor's opportunity set and the corporation's capital-raising availability set. This chapter should have merits on two counts: (i) a comprehensive account of capital markets and return-generating assets and (ii) a backdrop against which I present my findings in Chapters 2 through 4. ^ In Chapter 2, I rework on the Markowitz-Roy-Tobin structure of the efficient frontier and of the Separation Theorem. Starting off with a 2-asset portfolio and extending the paradigm to an n-asset portfolio, I bring out the optimal choice of assets for an investor under constrained utility maximization. In this chapter, I analyze the selection and revision-theoretic construct and bring out optimum choices. The effect of a change in perceived risk or return in the mind of an investor is ascertained on the portfolio composition. ^ Chapter 3 takes a look into corporations that issue market securities. The question of how a corporation decides what kinds of securities it should issue in the marketplace to raise funds brings out the classic value invariance proposition of Modigliani and Miller and fills the gap that existed in the literature for almost half a century. I question the general validity in the classic results of Modigliani and Miller and modify the existing literature on the celebrated value invariance proposition. ^ Chapter 4 takes the Modigliani-Miller regime to its correct prescription in the presence of corporate and personal taxes. I show that Modigliani-Miller's age-old proposition needs corrections and extensions, which I derive. ^ My dissertation overall brings all of these corrections and extensions to the existing literature as my findings, showing that capital markets are in an ever-changing state of necessary revision. ^