Physicians in leadership: the association between medical director involvement and staff-to-patient ratios

In a hospital environment that demands a careful balance between commercial and clinical interests, the extent to which physicians are involved in hospital leadership varies greatly. This paper assesses the influence of the extent of this involvement on staff-to-patient ratios. Using data gathered from 604 hospitals across Germany, this study evidences the positive relationship between a full-time medical director (MD) or heavily involved part-time MD and a higher staff-to-patient ratio. The data allows us to control for a range of confounding variables, such as size, rural/urban location, ownership structure, and case-mix. The results contribute to the sparse body of empirical research on the effect of clinical leadership on organizational outcomes.

Graduate education for leadership and organisational change in sustainable development

This paper reflects on the motivation, method and effectiveness of teaching leadership and organisational change to graduate engineers. Delivering progress towards sustainable development requires engineers who are aware of pressing global issues (such as resource depletion, climate change, social inequity and an interdependent economy) since it is they who deliver the goods and services that underpin society within these constraints. They also must understand how to implement change in the organisations within which they will work. In recognition of this fact the Cambridge University MPhil in Engineering for Sustainable Development has focussed on educating engineers to become effective change agents in their professional field with the confidence to challenge orthodoxy in adopting traditional engineering solutions. This paper reflects on ten years of delivering a special module to review how teaching change management and leadership aspects of the programme have evolved and progressed over that time. As the students who embark on this professional practice have often extensive experience as practising engineers and scientists, many have already learned the limitations of their technical background when solving complex problems. Students often join the course recognising their need to broaden their knowledge of relevant cross-disciplinary skills. The programme offers an opportunity for these early to mid-career engineers to explore an ethical and value-based approach to bringing about effective change in their particular sectors and organisations. This is achieved through action learning assignments in combination with reflections on the theory of change to enable students to equip themselves with tools that help them to be effective in making their professional and personal life choices. This paper draws on feedback gathered from students during their participation on the programme and augments this with alumni reflections gathered some years after their graduation. These professionals are able to look back on their experience of the taught components and reflect on how they have been able to apply this key learning in their subsequent careers. Copyright © 2012 September.

Leadership of healthcare commissioning networks in England: a mixed-methods study on clinical commissioning groups.

To explore the relational challenges for general practitioner (GP) leaders setting up new network-centric commissioning organisations in the recent health policy reform in England, we use innovation network theory to identify key network leadership practices that facilitate healthcare innovation.

The user-value of rural electrification: An analysis and adoption of existing models and theories

User-value is a determining factor for product acceptance in product design. Research on rural electrification to date, however, does not draw sufficient attention to the importance of user-value with regard to the overall success of a project. This is evident from the analysis of project reports and applicable indicators from agencies active in the sector. Learning from the design, psychology and sociology literatures, it is important that rural electrification projects incorporate the value perception of the end-user and extend their success beyond the commonly used criteria of financial value, the appropriateness of the technology, capacity building and technology uptake. Creating value for the end-user is particularly important for project acceptance and the sustainability of a scheme once it has been handed over to the local community. In this research paper, existing theories and models of value-theory are transposed and applied to community operated rural electrification schemes and a user-value framework is developed. Furthermore, the importance of value to the end-user is clarified. Current literature on product design reveals that user-value has different properties, many of which are applicable to rural electrification. Five value pillars and their sub-categories important for the users of rural electrification projects are identified, namely: functional; social significance; epistemic; emotional; and cultural values. These pillars provide the main structure for the conceptual framework developed in this research paper. It is proposed that by targeting the values of the end-user, the key factors of user-value applicable to rural electrification projects will be identified and the sustainability of the project will be better ensured. © 2014 The Authors.

CONTINUUM-THEORIES OF OPTICAL PHONONS AND POLARITONS IN SUPERLATTICES - A BRIEF CRITIQUE - COMMENT

The so-called hydrodynamic (HD) model on optical-phonon modes in superlattices is critically examined. Contrary to the HD model, a comparison between TM polaritons and the Fuchs-Kliewer-type interface modes has shown that the Fuchs-Kliewer interface modes do possess Frohlich potentials.

The generalized second law of thermodynamics in generalized gravity theories

We investigate the generalized second law of thermodynamics (GSL) in generalized theories of gravity. We examine the total entropy evolution with time including the horizon entropy, the non-equilibrium entropy production, and the entropy of all matter, field and energy components. We derive a universal condition to protect the generalized second law and study its validity in different gravity theories. In Einstein gravity (even in the phantom-dominated universe with a Schwarzschild black hole), Lovelock gravity and braneworld gravity, we show that the condition to keep the GSL can always be satisfied. In f ( R) gravity and scalar-tensor gravity, the condition to protect the GSL can also hold because the temperature should be positive, gravity is always attractive and the effective Newton constant should be an approximate constant satisfying the experimental bounds.

Dynamical horizon entropy and equilibrium thermodynamics of generalized gravity theories

We study the relation between the thermodynamics and field equations of generalized gravity theories on the dynamical trapping horizon with sphere symmetry. We assume the entropy of a dynamical horizon as the Noether charge associated with the Kodama vector and point out that it satisfies the second law when a Gibbs equation holds. We generalize two kinds of Gibbs equations to Gauss-Bonnet gravity on any trapping horizon. Based on the quasilocal gravitational energy found recently for f(R) gravity and scalar-tensor gravity in some special cases, we also build up the Gibbs equations, where the nonequilibrium entropy production, which is usually invoked to balance the energy conservation, is just absorbed into the modified Wald entropy in the Friedmann-Robertson-Walker spacetime with slowly varying horizon. Moreover, the equilibrium thermodynamic identity remains valid for f(R) gravity in a static spacetime. Our work provides an alternative treatment to reinterpret the nonequilibrium correction and supports the idea that the horizon thermodynamics is universal for generalized gravity theories.

工作幸福感的结构、测量及作用机制

With the emergence and development of positive psychology, happiness has been the focus of academia and business. However, there is no uniform measure of happiness, because of many different theories of happiness, which are not compatible with others. It bounds the further development of happiness theory. It is also the same with the research of work well-being, which refers to the emotional experience and quality of psychological functioning of employee in the workplace. Subjective well-being (SWB) and psychological well-being (PWB) are two major theories of happiness. Prior research has demonstrated the integration of these two theories theoretically, but still needs more empirical support. Besides, in line with the development of positive psychology, a body of knowledge about positive leadership is advocated. Transformational leadership is treated as one kind of positive leadership, since it emphasizes the leader’s motivational and elevating effect on followers. But the extent to which the transformational leadership can enhance work well-being, and what the mechanism is, these are the questions need to be explored. Based on the integration of SWB and PWB, this research tried to investigate the structure, measurement and mechanism of work well-being, and combining with the theory of transformational leadership, this study also tried to investigate the relationship between transformational leadership and work well-being. The structure and measurement of work well-being, the relationships between work well-being and job characteristics (including job resources and job demands), the relationships among transformational leadership, job resources, work well-being and corresponding outcomes, the relationships among transformational leadership, job demands, work well-being and corresponding outcomes, and the relationships among transformational leadership, group job characteristics, group work well-being and corresponding group outcomes were explored by using content analysis, Subject Matter Experts (SMEs) discussion, and structural questionnaire surveys. More than 7000 subjects were surveyed, and Explore Factor Analysis (EFA), Confirm Factor Analysis (CFA), Structural Equation Modeling (SEM), Hierarchical Linear Modeling (HLM) and other statistics methods were used. The following is the major conclusions. Firstly, work well-being is a two high-order factors structure, which includes affective well-being (AWB) and cognitive well-being (CWB). AWB is similar to SWB, and CWB is similar to PWB. Besides, the construct of AWB includes sub-dimensions of positive emotional experience and negative emotional experience. And the construct of CWB consists of work autonomy, personal growth, work competent, and work significance. Secondly, the relationships between job characteristics and AWB and CWB are different. On one hand job demands are directly related to AWB, and are indirectly related to CWB through the full mediation of AWB, on the other job resources are directly related to CWB, and are indirectly related to AWB through the full mediation of CWB, which means AWB and CWB reciprocally influences each other in the model of job demands-resources. These results were concluded as the process model of work well-being. Thirdly, AWB and CWB are positively related to many workplace outcomes, including job satisfaction, group satisfaction, organizational commitment, turnover intention, job performance, organizational citizenship behavior (OCB), and general psychological health and general physiological health. Fourthly, transformational leadership is indirectly related to CWB through the full mediation of job resources, and is related to AWB through the partial mediation of job demands. Meanwhile, transformational leadership is related to many workplace outcomes through the mediation of job characteristics and work well-being. These results implied that transformational leadership is indeed one kind of positive leadership. Fifthly, in the group level, transformational leadership is indirectly related to group CWB through the full mediation of group job resources, and is related to group AWB through the full mediation of group job demands. Group AWB has positive influence on group CWB, but not vice versa. Group job characteristics and group work well-being fully mediate the relationships between transformational leadership and intragroup cooperation and group performance.