Stressful times call for team-based measures:psychiatric nursing in the UK National Health Service

Background: Team-based working is now an inherent part of effective health care delivery. Previous research has identified that team working is associated with positive mental health and well-being outcomes for individuals operating in an effective team environment. This is a particularly important topic in the health services context, although little empirical attention has been paid to mental-health services. Psychiatric nurses work on a day-to-day basis with a particularly stressful and demanding client group in an environment which is characterised by high demands, uncertainty, and limited resources. This paper specifically focuses on psychiatric nurses working in National Health Service (NHS) and casts some light on the ways in which effective team-based working can help to alleviate a number of occupational stressors and strains. Method: A questionnaire method (2005 NHS Staff Survey) was employed to collect data from 6655 psychiatric nurses from 64 different NHS Trusts. The hypotheses were concerned with four overall measures from the survey; effective team working, occupational stress, work pressure and social support. Hypothesis 1 stated that effective team working will have a significant negative relationship with occupational stress and work pressure. Further, Hypothesis 2 stated that social support from supervisors and co-workers will moderate this relationship. Findings: Data was treated with a series of regression analyses. For Hypothesis 1, working in a real team did have main effects on work pressure and accounted for 1.6 per cent of the variance. Using the Nagelkerke R square value, working in a real team also had main effects on occupational stress an accounted for approximately 2.8 per cent of the variance. Further, the Exp (B) value of 0.662 suggests that the odds of suffering from occupational stress are cut by 33.8 per cent when a psychiatric nurse works in a real team. Results failed to provide support for Hypothesis 2. The analysis then went on to adopt a unique approach for assessing the extent of real team-based working, distinguishing between real teams, and a number of pseudo team typologies, as well as the absence of teamwork all together. As was hypothesised, results demonstrated that psychiatric nurses working in real teams (ones with clear objectives, where-by team members work closely with one another to achieve team objectives and meet regularly to discuss team effectiveness and how it can be improved) experienced the lowest levels of stress and work pressure of the sample. However, contrary to prediction, results indicated that psychiatric nurses working in any type of pseudo team actually experienced significantly higher levels of stress and work pressure than those who did not report as working in a team at all. Discussion: These findings have serious implications for NHS Mental Health Trusts, which may not be implementing, structuring and managing their nursing teams adequately. Indeed, results suggest that poorly-structured team work may actually facilitate stress and pressure in the workplace. Conversely, well-structured real teams serve to reduce stress and work pressure, which in turn not only enhances the working lives and well-being of psychiatric nurses, but also greatly improves the service that the NHS provides to its users.

Diversifying into technical clothing manufacture:a situated learning theory perspective

An organisation’s ability to internalise external knowledge and learn from various sources in undertaking new product development and/or entering a new market is crucial to its competitive performance. Nevertheless, little attention has been paid to how growth-oriented small firms identify and exploit entrepreneurial opportunities, i.e. take entrepreneurial action, related to such methods of development, in a mature, contracting industry. The latter is particularly relevant to recent discussion and debate in academic and policy-making circles concerning the salvage of the clothing manufacture industry in developed industrialised countries, by intensifying efforts relating to diversification into high value manufacturing sectors. This paper, based on an instrumental case-firm, demonstrates analytically how learning as entrepreneurial action relating to diversifying into /technical clothing – i.e. a high value manufacturing/innovatory sector - takes place, drawing on situated learning theory. It is argued that learning relating to such entrepreneurial action is dynamic in nature and is founded on specific organising principles that foster both inter- and intracommunal learning.

"Comparing the incomparable":hospital costing and the art of medicine in post-war Britain

This paper examines the relationship between medical and hospital accounting discourses during the two decades after the 1946 National Health Service (NHS) Act for England and Wales. It argues that the departmental costing system introduced into the NHS in 1957 was concerned with the administrative aspects of hospital costliness as contemporary hospital accountants suggested that the perceived incomparability, immeasurability and uncontrollability of medical practice precluded the application of cost accounting to the clinical functions of hospitals. The paper links these suggestions to medical discourses which portrayed the practice of medicine as an intuitive and experience-based art and argues that post-war conceptions of clinical medicine represented this domain in a manner that was neither susceptible to the calculations of cost accountants nor to calculating and normalising intervention more generally. The paper concludes by suggesting that a closer engagement with medical discourses may enhance our understanding of historical as well as present day attempts to make medicine calculable.

Inward investment and the drivers of post recession recovery in Germany

This paper examines changes in the drivers of productivity in Germany over the period 1997-2012. We start by comparing the performance of German firms and inward investors before and during the recovery from the recent global financial crisis of 2008 across a range of sectors, and subsequently examine the channels through which different firms are able to generate productivity. Our results show that foreign investors are more productive than German MNEs and purely domestic firms, with the gap narrowing in the manufacturing sector, but growing in the service sector during the recovery period. We also contrast those firms for whom productivity growth is related to greater use of intangible assets, compared with those for whom productivity is linked to cash flow. Productivity of inward investors is driven by cash flow rather than intangible assets, these being limited to high-technology investors from the EU and the USA.

The construction and negotiation of identity and face in post observation feedback

Identity influences the practice of English language teachers and supervisors, their professional development and their ability to incorporate innovation and change. Talk during post observation feedback meetings provides participants with opportunities to articulate, construct, verify, contest and negotiate identities, processes which often engender issues of face. This study examines the construction and negotiation of identity and face in post observation feedback meetings between in-service English language teachers and supervisors at a tertiary institution in the United Arab Emirates. Within a linguistic ethnography framework, this study combined linguistic microanalysis of audio recorded feedback meetings with ethnographic data gathered from participant researcher knowledge, pre-analysis interviews and post-analysis participant interpretation interviews. Through a detailed, empirical description of situated ‘real life’ institutional talk, this study shows that supervisors construct identities involving authority, power, expertise, knowledge and experience while teachers index identities involving experience, knowledge and reflection. As well as these positive valued identities, other negative, disvalued identities are constructed. Identities are shown to be discursively claimed, verified, contested and negotiated through linguistic actions. This study also shows a link between identity and face. Analysis demonstrates that identity claims verified by an interactional partner can lead to face maintenance or support. However, a contested identity claim can lead to face threat which is usually managed by facework. Face, like identity, is found to be interactionally achieved and endogenous to situated discourse. Teachers and supervisors frequently risk face threat to protect their own identities, to contest their interactional partner’s identities or to achieve the feedback meeting goal i.e. improved teaching. Both identity and face are found to be consequential to feedback talk and therefore influence teacher development, teacher/supervisor relationships and the acceptance of feedback. Analysis highlights the evaluative and conforming nature of feedback in this context which may be hindering opportunities for teacher development.

Szolgáltatások ellátási láncának speciális menedzsment jellemzői = Specialties in managing service supply chains

Az elmúlt évtizedekben a gazdálkodástudomány kitüntetett figyelemmel kísért két - mind a makrogazdaság, mind az egyes vállalatok működésének sikere szempontjából meghatározó fontosságú - jelenséget, egyrészt a szolgáltatásoknak a hagyományos termeléssel szembeni egyre erőteljesebb térnyerését, másrészt a fogyasztói érték teremtése szempontjából növekvő jelentőségű ellátási láncoknak, illetve azok menedzsmentjének kérdéskörét. Ugyanakkor igen kevés elemzés, de kevés leíró jellegű munka is született a két jelenséget és menedzsment problémát összekapcsoló területről, azaz a szolgáltatások ellátási láncáról, ezen ellátási láncok kezelésének speciális problémáiról. Jelen műhelytanulmányban a szolgáltatások ellátási láncának és menedzsmentjének jellegzetességeit, a klasszikus terméket előállító ellátási láncokhoz viszonyított sajátosságait foglaltuk össze a nemzetközi szakirodalom alapján. Ennek során bemutattuk, hogy az ún. tiszta szolgáltatások széles körben ismert jellemzői hatással vannak a szolgáltatások előállítását és értékesítését végző ellátási láncok működésére is. Ezek a hatások és a specialitások megjelennek az ellátási lánc menedzsment irodalomban megjelenő mindhárom problémakörre, rányomják tehát bélyegüket mind az ellátási lánc felépítésére, struktúrájára, mind az ellátási láncban együttműködő partnerek kapcsolatának = In the last decades scholars have paid a lot of attention to both service operation and supply chain management. There is still limited research on the overlapping field of theses two management areas, on service supply chain specialties. This working paper gives a structured overview on the latest research results published in English. Doing so the paper would like to draw attention of the Hungarian researchers to this field and facilitate these empirical researches. As described in the paper traditional service specialties (intangibility, perishability, inseparability, heterogeneity and the importance of human capital) create special management problems concerning (i) the structure of these supply chains, (ii) their relationship management and (iii) the management of supply chain processes.

Pénzgazdálkodási szokások hatása a működőtőkére (The effect of financial management habits on operating capital. The example of the Hungarian Post Office)

A hálózatos iparágakban, ahogy a postai szolgáltatásoknál is, a forgalomban lévő készpénz nagyméretű működőtőkét jelenthet. A Magyar Posta a levél- és csomagkézbesítésen kívül jelentős készpénzforgalmat bonyolít le: nyugdíjakat, segélyeket és készpénz-átutalási megbízásokat továbbít. A forgalom napi ingadozása a vállalat likvideszköz-igényét jelentősen meghatározza. A posta esetében a postahivatalok készpénzgazdálkodása jól működő hüvelykujjszabályokon keresztül történik, ezek a szabályok döntési teret hagynak a hálózat heterogén egyedi szereplőinek. Az egyedi készletezési viselkedést a vállalati működőtőke meghatározásakor figyelembe kell venni. A tanulmány az egyedi készletezési szokások modellezésére új módszertant ajánl, majd a viselkedésmintákat csoportosítva a pénzkészletezésnek, a vállalati működőtőke szintjének és a vállalati likviditási pozíciónak a kapcsolatát elemzi. / === / The cash in circulation within network industries such as post-office services can repre-sent a sizeable quantity of operating capital. The Hungarian Post Office, besides han-dling mail, handles a significant amount of cash turnover, forwarding pensions, welfare benefits, and cash orders. Fluctuation in the daily volume of these is a strong factor in determining the company's liquidity requirements. The management of cash in post of-fices is governed by rules of thumb that operate well; the regulations leave decision-making scope for the diverse individual actors in the network. Attention has to be paid to individual cash holding when determining the corporate operating capital. The study suggests a new methodology for modelling the individual cash-holding habits, and goes on to group the behaviour patterns by analysing the connection between cash holding, level of corporate operating capital, and corporate liquidity position.

A New Approach Model in Post Graduate Training of Local Government Officers

In 2013-15 there was a new type of post graduate training elaborated and piloted in Hungary at the Institute of Executive Training and Continuing Education (VTKI) within the National University of Public Service (NKE). Although the pilot financed by the State Administration Reform Operative Program (ÁROP) had not lacked the previously established attempts to include interactivity in the training, it was the first to observe and apply the actual principles of the European Union 2020 expressed in the threefold criteria of economic growth: smartness, sustainability and inclusiveness. All of them are represented by a pillar of the program like e-learning, class training and field training with the inclusion of local society. According to the objectives of the program there were at least 10 thousand attendees from the civil service sphere set as project indicators, so it has been a large scale training program that took place in 2014 in Hungary. The following article shows the innovations included in this new approach model of post graduate training civil servants.

Perkins+Will Meeting Agendas and 15 Campus Plans

Meeting agenda and documents from Meeting # 5 between the memebers of Perkins+Will and the FIU-AHSCMP Executive Planning Committee. Includes plans and blueprints detailing facility goals and assumptions for the Academic Health Sciences facility over a 5, 10, and 20 year planning period, as well as future goals. Blueprints include a Campus Plan and 5, 10, and 20 year plans for the Program, Space, Service, and Access, as well as a Site Plan, and Perspective View of the facilities.

Defining failure in the nonprofit organization: The case of four human service agencies

Private nonprofit human service organizations provide a spectrum of services that aim to resolve societal problems. Their failure may leave needed and desired services unprovided or not provided sufficiently to meet public demand. However, the concept of organizational failure has not been examined for the nonprofit organization. This research addresses the deficiency in the literatures of organization failure and nonprofit organizations.^ An eight category typology, developed from a review of the current literature and findings from expert interviews, is initially presented to define nonprofit organization failure. A multiple case study design is used to test the typology in four nonprofit human service delivery agencies. The case analysis reduces the typology to five types salient to nonprofit organization failure: input failure, legitimacy failure, adaptive failure, management failure and leadership failure.^ The resulting five category typology is useful to both theory builders and nonprofit practitioners. For theory development, the interaction of the failure types extends the literature and lays a foundation for a theory of nonprofit organization failure that diffuses management and leadership across all of the failure types, highlights management and leadership failure as collective functions shared by paid staff and the volunteer board of directors, and emphasizes the importance of organization legitimacy.^ From a practical perspective, the typology provides a tool for diagnosing failure in the nonprofit organization. Using the management indicators developed for the typology, a checklist of the warning signals of potential failure, emphasizing the key types of management and leadership, offers nonprofit decision makers a priori examination of an organization's propensity for failure. ^

Teachers' perceptions of the usefulness of Individual Education Plans (IEP)

Since 1997 federal special education policy mandated that all classroom teachers take part in planning and implementation of Individualized Education Plans (IEP) for students with disabilities. This legislation has given teachers new responsibilities because it requires greater participation in the IEP process. The purpose of this study was to examine teachers' perceptions of the usefulness of Individualized Education Plans (IEP). ^ Eighty seven certified Miami-Dade County Public School teachers, 60 general education teachers and 27 special education teachers were surveyed using an updated version of Rheams' (1989) The Teacher Perceptions of the Usefulness of IEPs. Subjects completed a survey form containing a demographic cover page, 18 Likert-scale statements and 3 open ended questions. This study looked at differences in perceptions by teacher group affiliation (general and special), grade level taught (elementary and secondary), and years of experience (<=5 and >5 years). The dependent variables were teacher preparedness; feasibility of IEP implementation; relevancy of IP to classroom instruction; and legal, professional and personal accountability with regard to the IEP. ^ Results of the Multivariate Analysis of Variance (MANOVA) revealed that (a) special education teachers held a more positive perception of overall IEP usefulness than general education teachers, (b) special educators held more positive perceptions concerning issues of feasibility and preparedness, (c) elementary level teachers viewed the IEP more positively than secondary level teachers, specifically in the areas of preparedness and feasibility. ^ Findings of this study indicate that general and secondary educators have not embraced the legislation and incorporated it into their planning and instruction. These findings provide policymakers, institutions of higher education, and school administrators with insight as to how to better translate policy into classroom instructional practice. Consideration should be given to implementing (a) honest communication and shared decision making with regard to IEP directed curriculum and instruction, (b) updated pre and in-service IEP development and implementation training, and (c) opportunities for collaboration and increased plan time, especially on the secondary level. ^

Effects of service-learning on student attitudes toward academic engagement and civic responsibility

This empirical study explored the impact of service-learning participation on high school students' attitudes toward academic engagement and civic responsibility. This study focused whether a group of high school students who participated in a service-learning project had more positive attitudes toward academic engagement and civic responsibility than their high school peers who did not participate in a service learning project. ^ Data were collected from 67 volunteer students as participants in grades 9–12. A service-learning treatment group of 34 high school students was examined relative to a comparison group of 33 high school students with similar demographic and academic characteristics. The investigator used questionnaires, an oral history/service-learning project, and interviews with the teacher-coordinators of the project to collect the data. The two surveys, one investigating high school students' attitudes about academic engagement, the other investigating high school students' attitudes toward civic responsibility, were administered in a pre-treatment/post-treatment design. There were 90 days between the pre-treatment and post-treatment administrations. A factor analysis of the civic responsibility instrument and multivariate analysis of gain scores were used to compare the means of the total aggregate scores of the treatment and comparison groups. Factor analysis was performed on the academic engagement instrument but it was determined that only the total scores could be used in subsequent analyses. Results were used to determine the efficacy of service-learning as interpreted in student attitudes toward academic engagement and student attitudes toward civic responsibility. ^ The study found no significant difference between the academic engagement and the civic responsibility attitudes of a high school service-learning project group and a high school comparison group with comparable school and similar demographic characteristics. One of the implications for educational practice and policy from the study results is a need to design and implement more powerful studies, studies implemented at many sites rather than just at two sites that were the basis of this study, and studies that investigate the research questions over longer time periods. Although it was not a focus of the study, the investigator concluded that service learning projects such as this might be more effective if they were better aligned with Dewey's principles. ^

Recreational Food Service is Big Business

In the analysis - Recreational Food Service Is Big Business - by Gary Horvath, President, Recreational Foodservice Division, Service America Corporation and Mickey Warner, Associate Professor School of Hospitality Management at Florida International University, Horvath and Warner initially state: “Recreational food service is very different from routine food service management. The authors review the market and the management planning and challenges that create that difference.” Recreational food is loosely defined by the authors as food for special events. These can be one-time events, repeated events that are not on a fixed schedule [i.e. concerts], weekly events such as football-baseball-or basketball games, or other similar venues. Concessions are a large part of these fan based settings. “An anticipated 101,000 fans at a per capita spending of $5-6 [were expected]. A typical concessions menu of hot dogs, popcorn, soda, beer, snacks, novelty foods, candy, and tobacco products comprises this market segment,” say Horvath and Warner in reference to the Super-Bowl XXI football championship game, held in Rose Bowl stadium in Pasadena, California, on January 25, 1987. Some of the article is based upon that event. These food service efforts focus on the individual fan, but do extend to the corporate-organizational level as well. Your authors will have you know that catering is definitely a part of this equation. The monies spent and earned are phenomenal. “Special events of this type attract numerous corporate catering opportunities for companies entertaining VIP guest lists,” the authors inform. “Hospitality tents usually consist of a pregame cocktail party and buffet and a post-game celebration with musical entertainment held in lavishly decorated tents erected at the site. In this case a total of 5,000 covers, at a price of $200 each, for 12-15 separate parties were anticipated.” Horvath and Warner also want you to know that novelties and souvenirs make up an essential part of this, the recreational food service market. “Novelties and souvenirs are a primary market and source of revenue for every stadium food service operator,” say Horvath and Warner. The term, “per capita spending is the measurement used by the industry to evaluate sales potential per attendee at an event,” say the authors. Of course, with the solid revenue figures involved as well as the number of people anticipated for such events, planning is crucial, say Horvath and Warner. Training of staff, purchasing and supply, money and banking, facility access, and equipment, are a few of the elements to be negotiated. Through both graphs and text, Horvath and Warner do provide a fairly detailed outline of what a six-step event plan consists of.

Senior Savvy: Mature Diner's Restaurant Service Expectations

This article is a reflection of a study conducted with active mature consumers who enjoy dining out, traveling, and patronizing the service industry in general. The goal was to discover their restaurant service expectations in order to provide restaurateurs, hoteliers, educators, and students of hospitality management programs information about this important customer segment so that future plans for improving service would include considerations of their service needs.

The influence of neurocognitive impairment, alcohol and other drug (AOD) use, and psychosocial factors on antiretroviral treatment adherence, service utilization and viral load among HIV-seropositive adults

Among people living with HIV (PLWH), adherence to antiretroviral therapy (ART) can be affected by problems of neurocognitive (NC) impairment, stress, alcohol and other drug (AOD) abuse, and other barriers. The aims of this research were to: (1) examine factors associated with NC impairment, (2) explore relationships between psychosocial variables with ART adherence and viral load (VL), and (3) evaluate the efficacy of an evidence-based intervention in improving ART adherence, increasing service utilization, and decreasing VL. The first study (n=370) was cross sectional and used structural equation modeling to test whether AOD use, years living with HIV, and time from HIV diagnosis to seeking care were associated with poorer NC functioning. The second study (n=246) used similar methods to test the hypothesis that stress, barriers to adherence, NC impairment, poor social support, and AOD use were related to lower VL mediated by ART adherence. The third study (n=243) evaluated an evidence-based, eight-session program to improve ART adherence, reduce VL, and increase service utilization in a randomized controlled trial. Study participants were PLWH living in South Florida, 18 to 60 years old, with a history of alcohol abuse enrolled from January 2009 through November 2012. Secondary analysis of available data showed: (1) scores on interference with executive functioning increased by 0.32 for each day of marijuana use and 1.18 for each year living with HIV, but no association was found between alcohol use and NC functioning; (2) each barrier to adherence was associated with a 10% decrease in adherence to ART and a 0.42 unit increase in VL (log10) and the relationship between barriers and VL was partially mediated by ART adherence; (3) participants in the evidence-based program were more likely than the comparison group to report an undetectable VL (OR=2.25, p<0.01) at 6 months, but not 3 months, post-intervention. Psychosocial factors affect VL, but ART adherence is essential in achieving an undetectable VL in PLWH.