A ‘movement for improvement’?: a qualitative study of the adoption of social movement strategies in the implementation of a quality improvement campaign

Given the difficulties of implementing ‘top-down’ quality improvements, health service leaders have turned to methods that empower clinicians to co-produce ‘bottom-up’ improvements. This has involved the adoption of strategies and activities associated with social movements, with clinicians encouraged to participate in collective action towards the shared goal of improvement. This paper examines the adoption of social movement methods by hospital managers as a strategy for implementing a quality improvement ‘campaign’. Our case study suggests that, despite the claim of empowering clinicians to develop ‘bottom-up’ improvements, the use of social movement methods is narrowly concerned with engaging clinicians in a pre-determined programme of ‘top-down’ change. It finds a prominent role for ‘hybrid’ clinical leaders and other staff representatives in the mobilisation of the campaign, especially for enrolling clinicians in change activities. The work of these ‘hybrids’ suggests some degree of creative mediation between clinical and managerial interests, but more often alignment with the aspirations of management. The study raises questions about the translation of social movements theories as a strategy for managing change and re-inventing professionalism

The Digital Life of Walkable Streets

Walkability has many health, environmental, and economic benefits. That is why web and mobile services have been offering ways of computing walkability scores of individual street segments. Those scores are generally computed from survey data and manual counting (of even trees). However, that is costly, owing to the high time, effort, and financial costs. To partly automate the computation of those scores, we explore the possibility of using the social media data of Flickr and Foursquare to automatically identify safe and walkable streets. We find that unsafe streets tend to be photographed during the day, while walkable streets are tagged with walkability-related keywords. These results open up practical opportunities (for, e.g., room booking services, urban route recommenders, and real-estate sites) and have theoretical implications for researchers who might resort to the use social media data to tackle previously unanswered questions in the area of walkability.Comment: 10 pages, 7 figures, Proceedings of International World Wide Web Conference (WWW 2015

Organizational and Leadership Implications for Transformational Development

Transformational development is a concept of change that originated in the Christian context but has now become generally used in the work of both secular and faith-based organizations. The growing use of the concept by organizations that are fundamentally different has naturally led to some confusion about what the concept means and what it takes to effectively implement it. In this article, we describe the key features of the concept and how they are important in determining the organizational requirements for its effective implementation. Drawing on a few cases, the paper highlights the centrality of faith in transformational development work

Polycomb Repressive Complex 2 (PRC2) Restricts Hematopoietic Stem Cell Activity

Polycomb group proteins are transcriptional repressors that play a central role in the establishment and maintenance of gene expression patterns during development. Using mice with an N-ethyl-N-nitrosourea (ENU)-induced mutation in Suppressor of Zeste 12 (Suz12), a core component of Polycomb Repressive Complex 2 (PRC2), we show here that loss of Suz12 function enhances hematopoietic stem cell (HSC) activity. In addition to these effects on a wild-type genetic background, mutations in Suz12 are sufficient to ameliorate the stem cell defect and thrombocytopenia present in mice that lack the thrombopoietin receptor (c-Mpl). To investigate the molecular targets of the PRC2 complex in the HSC compartment, we examined changes in global patterns of gene expression in cells deficient in Suz12. We identified a distinct set of genes that are regulated by Suz12 in hematopoietic cells, including eight genes that appear to be highly responsive to PRC2 function within this compartment. These data suggest that PRC2 is required to maintain a specific gene expression pattern in hematopoiesis that is indispensable to normal stem cell function

A qualitative study on healthcare professionals’ perceived barriers to insulin initiation in a multi-ethnic population

Background: Nationwide surveys have shown that the prevalence of diabetes rates in Malaysia have almost doubled in the past ten years; yet diabetes control remains poor and insulin therapy is underutilized. This study aimed to explore healthcare professionals’ views on barriers to starting insulin therapy in people with type 2 diabetes. Methods: Healthcare professionals consisting of general practitioners (n = 11), family medicine specialists (n = 10), medical officers (n = 8), government policy makers (n = 4), diabetes educators (n = 3) and endocrinologists (n = 2) were interviewed. A semi-structured topic guide was used to guide the interviews by trained facilitators. The interviews were transcribed verbatim and analysed using a thematic analysis approach. Results: Insulin initiation was found to be affected by patient, healthcare professional and system factors. Patients’ barriers include culture-specific barriers such as the religious purity of insulin, preferred use of complementary medication and perceived lethality of insulin therapy. Healthcare professionals’ barriers include negative attitudes towards insulin therapy and the ‘legacy effect’ of old insulin guidelines; whilst system barriers highlight the lack of resources, language and communication challenges. Conclusions: Tackling the issue of insulin initiation should not only happen during clinical consultations. It requires health education to emphasise the progressive nature of diabetes and the eventuality of insulin therapy at early stage of the illness. Healthcare professionals should be trained how to initiate insulin and communicate effectively with patients from various cultural and religious backgrounds

TQM and performance appraisal : complementary or incompatible?

Despite the scholarly interest in performance management as a key determinant of the effectiveness of enterprise process improvement methods such as total quality management (TQM) and its derivatives, few empirical studies have explicitly explored the practice of performance management systems in TQM‐focused organizations. In order to redress this imbalance, this study aims to describe how organizational and managerial forces led to a performance management systems failing to embrace the core principles of process improvement methods such as TQM. Using a qualitative study of six large UK‐based automobile and auto parts manufacturers, our results illustrate how manager‐controlled, individual‐focused, past‐oriented, long‐cycle, and narrowly defined performance appraisal (PA) systems can intervene to underline the ultimate potential of TQM. The paper concludes with the discussion of implications for theory and practice of TQM and human resource performance management

Between Power and Perception: Understanding youth perspectives in participatory monitoring and evaluation (PM&E) in Ghana

Participatory monitoring and evaluation (PM&E) approaches have been touted as an important concept for local participation in social interventions programmes. Utilizing a process analysis approaches, the PM&E data gathered through key informant interviews, formal surveys, and policy frameworks were analyzed. The study revealed three dominant power struggles between youth and programme implementers in three districts at the Greater Accra region, Ghana. The first and pervasive form of power dynamics involves the youth and programme implementers. The second involves a variety of arrangements with the government on one hand and implementers and youth on the other side. The third is who qualifies to be a beneficiary and for that matter participate in the PM&E. In these three forms of power struggles the paper reveals superior implementers control of who participate in the programme PM&E and at what stage in the process. The power imbalance between programme implementer and target beneficiaries impeded the level of beneficiaries’ participation in the PM&E