Trial of the Primary Care Practice Improvement Tool: Building organisational performance in Australian general practice and primary health care

Objective: To nationally trial the Primary Care Practice Improvement Tool (PC-PIT), an organisational performance improvement tool previously co-created with Australian primary care practices to increase their focus on relevant quality improvement (QI) activities. Design: The study was conducted from March to December 2015 with volunteer general practices from a range of Australian primary care settings. We used a mixed-methods approach in two parts. Part 1 involved staff in Australian primary care practices assessing how they perceived their practice met (or did not meet) each of the 13 PC-PIT elements of high-performing practices, using a 1–5 Likert scale. In Part 2, two external raters conducted an independent practice visit to independently and objectively assess the subjective practice assessment from Part 1 against objective indicators for the 13 elements, using the same 1–5 Likert scale. Concordance between the raters was determined by comparing their ratings. In-depth interviews conducted during the independent practice visits explored practice managers’ experiences and perceived support and resource needs to undertake organisational improvement in practice. Results: Data were available for 34 general practices participating in Part 1. For Part 2, independent practice visits and the inter-rater comparison were conducted for a purposeful sample of 19 of the 34 practices. Overall concordance between the two raters for each of the assessed elements was excellent. Three practice types across a continuum of higher- to lower-scoring practices were identified, with each using the PC-PIT in a unique way. During the in-depth interviews, practice managers identified benefits of having additional QI tools that relate to the PC-PIT elements. Conclusions: The PC-PIT is an organisational performance tool that is acceptable, valid and relevant to our range of partners and the end users (general practices). Work is continuing with our partners and end users to embed the PC-PIT in existing organisational improvement programs.

Organisational Responses to Workplace Harassment: An Exploratory Study

Purpose – The aim of this paper is to explore what kind of measures personnel managers have taken to intervene in workplace harassment and to explore how organisational characteristics and the characteristics of the personnel manager affect the choice of response strategies. Design/methodology/approach – The study was exploratory and used a survey design. A web-based questionnaire was sent to the personnel managers of all Finnish municipalities and data on organisational responses and organisational characteristics were collected. Findings – The study showed that the organisations surveyed relied heavily on reconciliatory measures for responding to workplace harassment and that punitive measures were seldom used. Findings indicated that personnel manager gender, size of municipality, use of “sophisticated” human resource management practices and having provided information and training to increase awareness about harassment all influence the organisational responses chosen. Research limitations/implications – Only the effects of organisational and personnel manager characteristics on organisational responses were analysed. Future studies need to include perpetrator characteristics and harassment severity. Practical implications – The study informs both practitioners and policy makers about the measures that have been taken and that can be taken in order to stop harassment. It also questions the effectiveness of written anti-harassment policies for influencing organisational responses to harassment and draws attention to the role of gendered perceptions of harassment for choice of response strategy. Originality/value – This paper fills a gap in harassment research by reporting on the use of different response strategies and by providing initial insights into factors affecting choice of responses.

Bullying and organisational politics in competitive and rapidly changing work environments

This paper argues that workplace bullying can in some cases be a form of organisational politics, that is, a deliberate, competitive strategy from the perspective of the individual perpetrator. A cross-sectional study conducted among business professionals revealed that there was a correlation between a politicised and competitive climate and bullying. This finding implies that globalisation, increased pressures for efficiency, and restructuring, which limits the number of management positions and thereby contributes to increased internal competition, may lead to more bullying. The findings have important implications for management, since the possible political aspects of bullying must be taken into account in order to be able to undertake successful prevention and intervention measures.

Workplace Bullying among Business Professionals - Prevalence, Organisational Antecedents and Gender Differences (summary section only)

Workplace bullying can be defined as repeated and persistent negative acts that involve a power imbalance and create a hostile work environment. Partly because of the many negative consequences associated with the phenomenon, bullying has recently become the focus of many studies by contemporary organisational researchers. Drawing on a survey, this thesis provides information on the prevalence and forms of bullying among business professionals, a group of employees neglected in previous bullying research. The thesis follows a tradition among Nordic researchers that emphasises the role of the psychosocial work environment in bullying. In particular, it illustrates how high internal competition and a high degree of organisational politics in business life may lead employees to use bullying as a tactic to gain benefits over their colleagues. Furthermore, it explores the significance of gender in bullying in male-dominated work environments, with women tending to be subjected to more negative acts, tending to feel less capable to defend themselves in these situations, and tending to feel less reluctant to classify these experiences as bullying. In addition to the introductory essay, this thesis consists of a book chapter and four articles. These five papers address particular aspects of workplace bullying: the prevalence and forms of bullying, the significance of gender in bullying, and organisational antecedents of bullying.

The decline of malaria in Finland – the impact of the vector and social variables

Background: Malaria was prevalent in Finland in the 18th century. It declined slowly without deliberate counter-measures and the last indigenous case was reported in 1954. In the present analysis of indigenous malaria in Finland, an effort was made to construct a data set on annual malaria cases of maximum temporal length to be able to evaluate the significance of different factors assumed to affect malaria trends. Methods: To analyse the long-term trend malaria statistics were collected from 1750–2008. During that time, malaria frequency decreased from about 20,000 – 50,000 per 1,000,000 people to less than 1 per 1,000,000 people. To assess the cause of the decline, a correlation analysis was performed between malaria frequency per million people and temperature data, animal husbandry, consolidation of land by redistribution and household size. Results: Anopheles messeae and Anopheles beklemishevi exist only as larvae in June and most of July. The females seek an overwintering place in August. Those that overwinter together with humans may act as vectors. They have to stay in their overwintering place from September to May because of the cold climate. The temperatures between June and July determine the number of malaria cases during the following transmission season. This did not, however, have an impact on the longterm trend of malaria. The change in animal husbandry and reclamation of wetlands may also be excluded as a possible cause for the decline of malaria. The long-term social changes, such as land consolidation and decreasing household size, showed a strong correlation with the decline of Plasmodium. Conclusion: The indigenous malaria in Finland faded out evenly in the whole country during 200 years with limited or no counter-measures or medication. It appears that malaria in Finland was basically a social disease and that malaria trends were strongly linked to changes in human behaviour. Decreasing household size caused fewer interactions between families and accordingly decreasing recolonization possibilities for Plasmodium. The permanent drop of the household size was the precondition for a permanent eradication of malaria.

Optical studies of SN 2009jf: a Type Ib supernova with an extremely slow decline and aspherical signature

Optical UBVRI photometry and medium-resolution spectroscopy of the Type Ib supernova SN 2009jf, during the period from similar to -15 to +250 d, with respect to the B maximum are reported. The light curves are broad, with an extremely slow decline. The early post-maximum decline rate in the V band is similar to SN 2008D; however, the late-phase decline rate is slower than other Type Ib supernovae studied. With an absolute magnitude of M-V = -17.96 +/- 0.19 at peak, SN 2009jf is a normally bright supernova. The peak bolometric luminosity and the energy deposition rate via the 56Ni -> 56Co chain indicate that similar to 0.17+0.03(-0.03) M-circle dot of 56Ni was ejected during the explosion. The He i 5876 A line is clearly identified in the first spectrum of day similar to -15, at a velocity of similar to 16 000 km s-1. The O i] 6300-6364 A line seen in the nebular spectrum has a multipeaked and asymmetric emission profile, with the blue peak being stronger. The estimated flux in this line implies that greater than or similar to 1.34 M-circle dot oxygen was ejected. The slow evolution of the light curves of SN 2009jf indicates the presence of a massive ejecta. The high expansion velocity in the early phase and broader emission lines during the nebular phase suggest it to be an explosion with a large kinetic energy. A simple qualitative estimate leads to the ejecta mass of M-ej = 4-9 M-circle dot and kinetic energy E-K = 3-8 x 1051 erg. The ejected mass estimate is indicative of an initial main-sequence mass of greater than or similar to 20-25 M-circle dot.

Of plants and pikas: evidence for a climate-mediated decline in forage and cache quality

Background: Animals that hoard food to mediate seasonal deficits in resource availability might be particularly vulnerable to climate-mediated reductions in the quality and accessibility of food during the caching season. Central-place foragers might be additionally impacted by climatic constraints on their already restricted foraging range. Aims: We sought evidence for these patterns in a study of the American pika (Ochotona princeps), a territorial, central-place forager sensitive to climate. Methods: Pika food caches and available forage were re-sampled using historical methods at two long-term study sites, to quantify changes over two decades. Taxa that changed in availability or use were analysed for primary and secondary metabolites. Results: Both sites trended towards warmer summers, and snowmelt trended earlier at the lower latitude site. Graminoid cover increased at each site, and caching trends appeared to reflect available forage rather than primary metabolites. Pikas at the lower latitude site preferred species higher in secondary metabolites, known to provide higher-nutrient winter forage. However, caching of lower-nutrient graminoids increased in proportion with graminoid availability at that site. Conclusions: If our results represent trends in climate, cache quality and available forage, we predict that pikas at the lower latitude site will soon face nutritional deficiencies.