Whether and how top management create flexibility in mental healthcare organizations:COVID-19 as a test case

Purpose: Flexibility is essential for healthcare organizations to anticipate the increasing internal and external dynamics. Mental healthcare organizations in the Netherlands face major policy reforms made by the government, increasing involvement from municipalities and gradual replacement of clinical care with outpatient care. Top management plays an important strategic role in creating this flexibility because they make important choices, give direction and structure the organization. To create flexibility, managers have to deal with complexity and paradoxes. In this study, the authors aim to contribute to the knowledge on how healthcare managers can create flexibility in their organizations. Design/methodology/approach: This is a qualitative empirical field study. In total, 21 managers of mental healthcare organizations participated in open in-depth interviews. The authors explored flexibility on three perspectives: organizational direction, structure and operations. The COVID-19 pandemic has provided an opportunity to explore flexibility. The authors asked participants to reflect on their organization's response to the pandemic. Findings: Most mental healthcare organizations create flexibility in an implicit way. Flexibility and resilience are closely linked mechanisms. Flexibility ensures a quick response while resilience provides the counterforce and rebound needed to adapt. Adaption ensures that healthcare professionals learn from their experiences and do not return completely to the way things were done before. The primary urge to survive ensured rapid and adequate responses to the COVID-19 pandemic. Whether this is a manifestation of flexibility remains difficult to conclude. Practical implications: The complexity theory offers some guidance in creating a flexible organization without losing consistency. Flexibility and resilience are closely linked mechanisms that antagonize and protect each other. With this insight, managers in mental healthcare can utilize the qualities and balance them without falling into the various pitfalls. Originality/value: In this research, the authors are concerned with flexibility as a proactive attitude and capacity of organizations. By looking at the response of organizations to the COVID-19 crisis, the authors find out that responding to a disaster out of survival instinct is something else than flexibility. There is an interesting relationship between flexibility, resilience and adaptability, and they can balance each other

Dry-season retreat and dietary shift of the dart-poison frog Dendrobates tinctorius (Anura: Dendrobatidae)

A precipitação sazonal afeta a dinâmica das florestas tropicais e o comportamento das espécies que fazem parte desse ecossistema. A relação positiva entre os padrões de atividade dos anfíbios e a precipitação já foi demonstrada repetidas vezes. Os membros da família Dendrobatidae, um clado de saposvenenodeflecha neotropicais, são bemconhecidos por seu uso de hábitat e comportamento durante a estação chuvosa, mas seu comportamento durante a estação seca tem recebido pouca atenção. Estudamos o uso de hábitat e a dieta do dendrobatídeo Dendrobates tinctorius na Guiana Francesa durante as estações chuvosa e seca. Ao contrário de muitos outros dendrobatídeos, D. tinctorius não mantém territórios ao longo de toda a estação chuvosa. Ambos os sexos colonizam clareiras recentemente abertas e permanecem apenas poucas semanas nessas manchas, onde os animais consomem uma grande variedade de presas, principalmente formigas, besouros, vespas, larvas de insetos e ácaros. Durante a estação seca, os animais movem-se para locais de abrigo na floresta madura, como brácteas de palmeiras e ocos de árvores. Nesse período, são menos ativos e consomem um menor número de itens alimentares; consomem menos vespas e larvas de insetos e mais cupins. Formigas constituem a presa mais comum durante as duas estações. Discutimos os efeitos das mudanças sazonais no uso de hábitat sobre o comportamento territorial dos dendrobatídeos.Seasonal rainfall affects tropical forest dynamics and behavior of species that are part of these ecosystems. The positive correlation between amphibian activity patterns and rainfall has been demonstrated repeatedly. Members of Dendrobatidae, a clade of Neotropical dartpoison frogs, are well known for their habitat use and behavior during the rainy season, but their behavior during the dry season has received little attention. We studied habitat use and diet of the dendrobatid frog Dendrobates tinctorius in French Guiana during the rainy and dry seasons. Unlike many other dendrobatid frogs, D. tinctorius does not maintain territories for the entire rainy season. Both sexes colonize recently formed canopygaps and stay in these forest patches for only a few weeks. The frogs in these patches consume a great diversity of prey, consisting of ants, beetles, wasps, insect larvae, and mites. During the dry season, frogs move to retreat sites in mature forest, such as palm bracts and tree holes. The frogs are less active and consume fewer prey items in the dry season, and they consume fewer wasps and insect larvae, but more termites. Ants are the most common prey items during both the wet and dry seasons. We discuss the effects of shifts in seasonal habitat use on the territorial behavior of dendrobatid frogs

Movements of Individual Digits in Bimanual Prehension Are Coupled into a Grasping Component

The classic understanding of prehension is that of coordinated reaching and grasping. An alternative view is that the grasping in prehension emerges from independently controlled individual digit movements (the double-pointing model). The current study tested this latter model in bimanual prehension: participants had to grasp an object between their two index fingers. Right after the start of the movement, the future end position of one of the digits was perturbed. The perturbations resulted in expected changes in the kinematics of the perturbed digit but also in adjusted kinematics in the unperturbed digit. The latter effects showed up when the end position of the right index finger was perturbed, but not when the end position of the left index finger was perturbed. Because the absence of a coupling between the digits is the core assumption of the double-pointing model, finding any perturbation effects challenges this account of prehension; the double-pointing model predicts that the unperturbed digit would be unaffected by the perturbation. The authors conclude that the movement of the digits in prehension is coupled into a grasping component

Maternal Hypothyroxinemia During Pregnancy and Growth of the Fetal and Infant Head

Severe maternal thyroid dysfunction during pregnancy affects fetal brain growth and corticogenesis. This study focused on the effect of maternal hypothyroxinemia during early pregnancy on growth of the fetal and infant head. In a population-based birth cohort, we assessed thyroid status in early pregnancy (median 13.4, 90% range 10.8-17.2), in 4894 women, and measured the prenatal and postnatal head size of their children at 5 time points. Hypothyroxinemia was defined as normal thyroid-stimulating hormone levels and free thyroxine-4 concentrations below the 10th percentile. Statistical analysis was performed using linear generalized estimating equation. Maternal hypothyroxinemia was associated with larger fetal and infant head size (overall estimate beta: 1.38, 95% confidence interval 0.56; 2.19, P = .001). In conclusion, in the general population, even small variations in maternal thyroid function during pregnancy may affect the developing head of the young child

Maternal Hypothyroxinemia During Pregnancy and Growth of the Fetal and Infant Head

Severe maternal thyroid dysfunction during pregnancy affects fetal brain growth and corticogenesis. This study focused on the effect of maternal hypothyroxinemia during early pregnancy on growth of the fetal and infant head. In a population-based birth cohort, we assessed thyroid status in early pregnancy (median 13.4, 90% range 10.8-17.2), in 4894 women, and measured the prenatal and postnatal head size of their children at 5 time points. Hypothyroxinemia was defined as normal thyroid-stimulating hormone levels and free thyroxine-4 concentrations below the 10th percentile. Statistical analysis was performed using linear generalized estimating equation. Maternal hypothyroxinemia was associated with larger fetal and infant head size (overall estimate beta: 1.38, 95% confidence interval 0.56; 2.19, P = .001). In conclusion, in the general population, even small variations in maternal thyroid function during pregnancy may affect the developing head of the young child

Управление финансовой устойчивостью и рентабельностью предприятия

Целью статьи является изучение значения управления финансовой устойчивостью и рентабельностью предприятия в современных условиях хозяйствования

A line-of-sight electron cyclotron emission receiver for electron cyclotron resonance heating feedback control of tearing modes

An electron cyclotron emission (ECE) receiver inside the electron cyclotron resonance heating (ECRH) transmission line has been brought into operation. The ECE is extracted by placing a quartz plate acting as a Fabry¿Perot interferometer under an angle inside the electron cyclotron wave (ECW) beam. ECE measurements are obtained during high power ECRH operation. Thisdemonstrates the successful operation of the diagnostic and, in particular, a sufficient suppression of the gyrotron component preventing it from interfering with ECE measurements. When integratedinto a feedback system for the control of plasma instabilities this line-of-sight ECE diagnosticremoves the need to localize the instabilities in absolute coordinates