Evaluation of job satisfaction of practice staff and general practitioners: an exploratory study

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From 'One Namibia, One Nation' towards 'Unity in Diversity? Shifting representations of culture and nationhood in Namibian Independence Day celebrations, 1990-2010

In 2010 Namibia celebrated its twentieth anniversary of independence from South African rule. The main celebrations in the country’s capital Windhoek became the stage for an impressively orchestrated demonstration of maturing nationhood, symbolically embracing postcolonial policy concepts such as ‘national reconciliation’, ‘unity’ and ‘diversity’. At the same time, nation building in post-apartheid Namibia is characterised by a high degree of social and political fragmentation that manifests itself in cultural and/or ethnic discourses of belonging. Taking the highly significant independence jubilee as our vantage point, we map out a shift of cultural representations of the nation in Independence Day celebrations since 1990, embodied by the two prominent slogans of ‘One Namibia, one Nation’ and ‘Unity in Diversity’. As we will argue, the difficult and at times highly fragile postcolonial disposition made it necessary for the SWAPO government, as primary nation builder, to accommodate the demands of regions and local communities in its policy frameworks. This negotiation of local identifications and national belonging in turn shaped, and continues to shape, the performative dimension of Independence Day celebrations in Namibia.Web of Scienc

Evaluating compulsory minimum volume standards in Germany: how many hospitals were compliant in 2004?

<p>Abstract</p> <p>Background</p> <p>Minimum hospital procedure volumes are discussed as an instrument for quality assurance. In 2004 Germany introduced such annual minimum volumes nationwide on five surgical procedures: kidney, liver, stem cell transplantation, complex oesophageal, and pancreatic interventions. The present investigation is the first part of a study evaluating the effects of these minimum volumes on health care provision. Research questions address how many hospitals and cases were affected by minimum volume regulations in 2004, how affected hospitals were distributed according to minimum volumes, and how many hospitals within the 16 German states complied with the standards set for 2004.</p> <p>Methods</p> <p>The evaluation is based on the mandatory hospital quality reports for 2004. In the reports, all hospitals are statutorily obliged to state the number of procedures performed for each minimum volume. The data were analyzed descriptively.</p> <p>Results</p> <p>In 2004, 485 out of 1710 German hospitals providing acute care and approximately 0.14% of all hospital cases were affected by minimum volume regulations. Liver, kidney, and stem cell transplantation affected from 23 to hospitals; complex oesophageal and pancreatic interventions affected from 297 to 455 hospitals. The inter-state comparison of the average hospital care area demonstrates large differences between city states and large area states and the eastern and western German states ranging from a minimum 51 km²up to a maximum 23.200 km², varying according to each procedure. A range of 9% – 16% of the transplantation hospitals did not comply with the standards affecting 1% – 2% of the patients whereas 29% and 18% of the hospitals treating complex oesophageal and pancreatic interventions failed the standards affecting 2% – 5% of the prevailing cases.</p> <p>Conclusion</p> <p>In 2004, the newly introduced minimum volume regulations affected only up to a quarter of German acute care hospitals and few cases. However, excluding the hospitals not meeting the minimum volume standards from providing the respective procedures deserves considering two aspects: the hospital health care provision concepts by the German states as being responsible and from a patient perspective the geographically equal access to hospital care.</p

The same but different: Understanding entrepreneurial behaviour in disadvantaged communities

While entrepreneurship is widely viewed as being equally accessible in all contexts, it could be questioned if potential or nascent entrepreneurs from minority and disadvantaged communities experience entrepreneurship in a similar manner to the mainstream population. This chapter examines immigrant, people with disability, youth, gay and unemployed communities to explore how their entrepreneurial behaviour might differ from the practices of mainstream entrepreneurs. What emerges is that marginalised communities can frequently find it difficult to divorce business from social living. This can have both positive and negative connotations for an entrepreneur, plus they face additional and distinctive challenges that mainstream entrepreneurs do not experience. The chapter concludes by proposing a novel ‘funnel approach’ that policymakers might adopt when seeking to introduce initiatives targeted at these disadvantaged communities

Working conditions and Work-Family Conflict in German hospital physicians: psychosocial and organisational predictors and consequences

<p>Abstract</p> <p>Background</p> <p>Germany currently experiences a situation of major physician attrition. The incompatibility between work and family has been discussed as one of the major reasons for the increasing departure of German physicians for non-clinical occupations or abroad. This study investigates predictors for one particular direction of Work-Family Conflict – namely work interfering with family conflict (WIF) – which are located within the psychosocial work environment or work organisation of hospital physicians. Furthermore, effects of WIF on the individual physicians' physical and mental health were examined. Analyses were performed with an emphasis on gender differences. Comparisons with the general German population were made.</p> <p>Methods</p> <p>Data were collected by questionnaires as part of a study on <it>Psychosocial work hazards and strains of German hospital physicians </it>during April–July 2005. Two hundred and ninety-six hospital physicians (response rate 38.9%) participated in the survey. The Copenhagen Psychosocial Questionnaire (COPSOQ), work interfering with family conflict scale (WIF), and hospital-specific single items on work organisation were used to assess WIF, its predictors, and consequences.</p> <p>Results</p> <p>German hospital physicians reported elevated levels of WIF (mean = 74) compared to the general German population (mean = 45, <it>p </it>< .01). No significant gender difference was found. Predictors for the WIF were lower age, high quantitative demands at work, elevated number of days at work despite own illness, and consequences of short-notice changes in the duty roster. Good sense of community at work was a protective factor. Compared to the general German population, we observed a significant higher level of quantitative work demands among hospital physicians (mean = 73 vs. mean = 57, <it>p </it>< .01). High values of WIF were significantly correlated to higher rates of personal burnout, behavioural and cognitive stress symptoms, and the intention to leave the job. In contrast, low levels of WIF predicted higher job satisfaction, better self-judged general health status, better work ability, and higher satisfaction with life in general. Compared to the German general population, physicians showed significantly higher levels of individual stress and quality of life as well as lower levels for well-being. This has to be judged as an alerting finding regarding the state of physicians' health.</p> <p>Conclusion</p> <p>In our study, work interfering with family conflict (WIF) as part of Work-Family Conflict (WFC) was highly prevalent among German hospital physicians. Factors of work organisation as well as factors of interpersonal relations at work were identified as significant predictors for WIF. Some of these predictors are accessible to alteration by improving work organisation in hospitals.</p

Doing Gender Im Technisch-Naturwissen-Schaftlichen Bereich

Für die Lösung des Nachwuchsproblems in den Technikwissenschaften spielt die Gewinnung von Frauen eine zentrale Rolle. Die in der Expertise dargestellten Befunde verdeutlichen dreierlei: (1) In den Natur- und Technikwissenschaften "verliert" man Frauen sehr früh im Lebensverlauf. (2) Wie beim Durchlauf eines Trichters (leaking pipeline) verringert sich mit jeder Bildungs- und Karrierestufe die Anzahl von Frauen in diesen Fächern und Berufen. (3) Die Erhöhung des Interesses für Technikwissenschaften von Mädchen und Frauen ist nicht nur "ein Problem" für das Bildungssystem, sondern ganz wesentlich auch des Arbeitsmarktes. Die Befunde der Expertise zeigen, dass es unbedingt notwendig ist, jungen Frauen, die in technischen Berufen gut ausgebildet sind, eine höhere Chance als bisher zu geben, (a) ihren Beruf aus dem Bereich Mathematik, Informatik, Naturwissenschaften, Technik (im Folgenden kurz: MINT) auszuüben und (b) dies auch mit den gleichen Gratifikationen wie Männer. Diese Herausforderung muss - und zwar unabhängig von der Nachfrage nach neuem Personal in technischen Berufen - schnell gemeistert werden, wenn Wirtschaft und Politik ein ernst gemeintes Interesse an "Frauen in MINT-Berufen" besitzen

Post-Socialist Culture and Entrepreneurship

In this paper it is argued that locus of control beliefs and preferences concerning state action negatively affect the formation of new firms in former socialist countries. For this purpose Kirzner's theory of costless entrepreneurship is reviewed and criticized. German reunification, in which the formerly Socialist East joined the Federal Republic of Germany, represents an intriguing natural experiment in which the formal institutional structure of one nation was almost fully transplanted into another. Traditional as well as psychological factors are examined. The results suggest that about one third of the east-west gap in new self-employment can be explained by inert informal institutions