Community participation in bureaucratic organizations: Principles and strategies

The present paper points out that there are tasks that primary groups perform better than bureaucracies and those that bureaucracies perform better than primary groups. Both types of tasks are very interdependent so that sometimes primary group tasks must be performed within the boundaries of the bureaucratic organization. The argument is made that when primary groups intervene in bureaucracies, they can do so directly in non-expert tasks without lowering the effectiveness of the bureaucratic organization. When they intervene in expert aspects, they should do so indirectly through an expert advocate. However, in all intervention the primary group must take into account that its structure is contradictory to that of the bureaucracy and, therefore, it must keep as much distance as possible—consistent with its ability to intervene. From this analysis we derive a series of hypotheses suggesting when the community might ideally use the bureaucracy's own experts, when the community must hire its own experts, when the community should use mass media, strikes, indigenous workers, etc. It is suggested that the multitudinous possibilities for linkages can all be derived from a few basic underlying dimensions of the situation. Cet article montre qu'il existe certaines tâches que les groupes primaires accomplissent mieux que les bureaucraties, et certaines autres qu'accomplissent mieux les bureaucraties. Les deux sortes de tâches sont interdépendentes; donc parfois les tâches des groupes primaires doivent s'accomplir parmi les organisations bureaucratiques. Les auteurs soutiennent que les groupes primaires peuvent intervenir dans les bureaucraties en complétant les tâches non-expertes sans réduire l'efficacité de l'organisation bureaucratique. Quands ils participent à certains sujets experts, ils devraient se munir d'un agent expert. Mais dans toute intervention le groupe primaire doit se rendre compte que sa structure contredit celle de la bureaucratie et que, par conséquent, il doit se tenir autant à distance que possible par rapport à sa compétence d'intervention. De cette analyse proviennent des hypothèses qui indiquent quand une communauté peut se servir le mieux du personnel expert d'une bureaucratie, quand la communauté doit engager des experts, quand la communauté doit se servir des mass média, des grèves, des ouvriers indigènes, etc. Les nombreuses possibilités de liaisons proviennent toutes de quelques dimensions fondamentales de la situation.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/42934/1/10780_2005_Article_BF02214879.pd

Community Mental Health Centers as Human Service Organizations

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/67333/2/10.1177_000276428502800506.pd

Nucleophilic Functionalization of the Calix[6]arene Para- and Meta-Position via p‑Bromodienone Route

It is here demonstrated that the p-bromodienone route, previously reported for calix[4]arenes, is also effective for the functionalization of the calix[6]arene macrocycle. Thus, alcoholic O-nucleophiles can be introduced at the calix[6]arene exo rim. In addition, the reaction of a calix[6]arene p-bromodienone derivative with an actived aromatic substrate, such as resorcinol, led to the first example of a meta-functionalized, inherently chiral calix[6]arene derivativ

Parental health limitations, caregiving and loneliness among women with widowed parents: longitudinal eveidence from France

We investigate how daughters’ feelings of loneliness are impacted when widowed parents develop health limitations, and when daughters take on personal care tasks in response. Using longitudinal data from daughters of widowed parents drawn from the French Family and Intergenerational Relationships Study (ERFI, 1485 observations nested in 557 daughters), we assess (a) whether health limitations of widowed parents are associated with daughters’ feelings of loneliness regardless of whether or not daughters provide personal care and (b) whether there is an effect of care provision on loneliness that cannot be explained by parental health limitations. Fixed effect regression analyses show that widowed parents’ health limitations were associated with raised feelings of loneliness among their daughters. No significant additional effect of providing personal care to a widowed parent was found. Prior research on the impact of health limitations of older parents on the lives of their adult–children has focused mostly on issues related to informal caregiving. Our findings suggest that more attention to the psychosocial impact of parental health limitations—net of actual caregiving—on adult children’s lives is warranted

The Emergence of Hospital Federations: An Integration of Perspectives from Organizational Theory

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68464/2/10.1177_107755878704400206.pd

Integration in primary community care networks (PCCNs): examination of governance, clinical, marketing, financial, and information infrastructures in a national demonstration project in Taiwan

Background. Taiwan's primary community care network (PCCN) demonstration project, funded by the Bureau of National Health Insurance on March 2003, was established to discourage hospital shopping behavior of people and drive the traditional fragmented health care providers into cooperate care models. Between 2003 and 2005, 268 PCCNs were established. This study profiled the individual members in the PCCNs to study the nature and extent to which their network infrastructures have been integrated among the members (clinics and hospitals) within individual PCCNs. Methods. The thorough questionnaire items, covering the network working infrastructures - governance, clinical, marketing, financial, and information integration in PCCNs, were developed with validity and reliability confirmed. One thousand five hundred and fifty-seven clinics that had belonged to PCCNs for more than one year, based on the 2003-2005 Taiwan Primary Community Care Network List, were surveyed by mail. Nine hundred and twenty-eight clinic members responded to the surveys giving a 59.6 % response rate. Results. Overall, the PCCNs' members had higher involvement in the governance infrastructure, which was usually viewed as the most important for establishment of core values in PCCNs' organization design and management at the early integration stage. In addition, it found that there existed a higher extent of integration of clinical, marketing, and information infrastructures among the hospital-clinic member relationship than those among clinic members within individual PCCNs. The financial infrastructure was shown the least integrated relative to other functional infrastructures at the early stage of PCCN formation. Conclusion. There was still room for better integrated partnerships, as evidenced by the great variety of relationships and differences in extent of integration in this study. In addition to provide how the network members have done for their initial work at the early stage of network forming in this study, the detailed surveyed items, the concepts proposed by the managerial and theoretical professionals, could be a guide for those health care providers who have willingness to turn their business into multi-organizations. © 2007 Lin; licensee BioMed Central Ltd.published_or_final_versio

Prevalence of diabetes complications in people with type 2 diabetes mellitus and its association with baseline characteristics in the multinational A1chieve study

BACKGROUND: Current International Diabetes Federation guidelines recommend a target HbA(1c) <7.0%, but many people with diabetes worldwide find this difficult to achieve, increasing their risk of developing complications. This publication examines the prevalence of diabetes complications and its association with baseline characteristics in people with type 2 diabetes who participated in the A(1)chieve study. METHODS: A(1)chieve was a 24-week, multinational, open-label, observational study of 66,726 people with type 2 diabetes who had begun using biphasic insulin aspart 30, insulin aspart, or insulin detemir in routine clinical care. Participants were enrolled from 28 countries across four continents (Asia, Africa, Europe and South America). Baseline measurements of disease characteristics included: glycated haemoglobin (HbA(1c)), fasting (FPG) and post-prandial plasma glucose (PPG), high- and low-density lipoprotein cholesterol (H- or LDL-C), systolic blood pressure (SBP), and body mass index (BMI). Data on complications and use of vascular disease preventative drugs were collected. RESULTS: Complication rates were high (27.2% had macrovascular complications and 53.5% had microvascular complications), particularly in Russia, and use of vascular disease preventative drugs was lower than expected. Age, BMI, diabetes duration, LDL-C, and SBP were positively associated, and HDL-C negatively associated, with macro- and microvascular complications (all p < 0.05). HbA(1c) and FPG were negatively associated with macrovascular complications (both p < 0.05), which may be linked to the cross-sectional study design. CONCLUSIONS: These results suggest a worldwide failure to achieve glycaemic targets. Better diabetes management with earlier initiation and optimisation of insulin regimens (e.g., with insulin analogues in the A(1)chieve population) may reduce the prevalence of vascular complications, improve the lives of people with diabetes and reduce the burden on healthcare systems