Randomized clinical trial of a brief and extensive dyadic intervention for advanced cancer patients and their family caregivers

Background Few intervention programs assist patients and their family caregivers to manage advanced cancer and maintain their quality of life (QOL). This study examined (i) whether patient–caregiver dyads (i.e., pairs) randomly assigned to a brief or extensive dyadic intervention (the FOCUS Program) had better outcomes than dyads randomly assigned to usual care and (ii) whether patients' risk for distress and other factors moderated the effect of the brief or extensive program on outcomes. Methods Advanced cancer patients and their caregivers ( N  = 484 dyads) were stratified by patients' baseline risk for distress (high versus low), cancer type (lung, colorectal, breast, or prostate), and research site and then randomly assigned to a brief (three‐session) or extensive (six‐session) intervention or control. The interventions offered dyads information and support. Intermediary outcomes were appraisals (i.e., appraisal of illness/caregiving, uncertainty, and hopelessness) and resources (i.e., coping, interpersonal relationships, and self‐efficacy). The primary outcome was QOL. Data were collected prior to intervention and post‐intervention (3 and 6 months from baseline). The final sample was 302 dyads. Repeated measures MANCOVA was used to evaluate outcomes. Results Significant group by time interactions showed that there was an improvement in dyads' coping ( p  < 0.05), self‐efficacy ( p  < 0.05), and social QOL ( p  < 0.01) and in caregivers' emotional QOL ( p  < 0.05). Effects varied by intervention dose. Most effects were found at 3 months only. Risk for distress accounted for very few moderation effects. Conclusions Both brief and extensive programs had positive outcomes for patient–caregiver dyads, but few sustained effects. Patient–caregiver dyads benefit when viewed as the ‘unit of care’. Copyright © 2012 John Wiley & Sons, Ltd.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/96760/1/pon3036.pd

Women take care and men take charge’: The case of leadership and gender in the Public and Commercial Services Union

This article presents the findings of a case study that aimed to understand the specific leadership styles that are valued by women and men lay representatives in the Public and Commercial Services (PCS) union and to determine the gendered implications for increasing women’s leadership and representation in trade unions. Survey responses from PCS lay representatives (reps) show the majority of women and men agreed that the leadership style they value, and makes a good union leader, is post-heroic (communal) leadership. This approach is associated with leadership characteristics such as being helpful, sensitive, and kind and are generally practised by women. This contrasts with male union leaders who are associated with a traditional, heroic (agentic) leadership style characterised by confidence, self-reliance, and decisiveness. Although some differences exist that highlight gender issues, both women and men lay reps have positive attitudes towards increasing women’s representation and participation in union leadership

Many quality measurements, but few quality measures assessing the quality of breast cancer care in women: A systematic review

BACKGROUND: Breast cancer in women is increasingly frequent, and care is complex, onerous and expensive, all of which lend urgency to improvements in care. Quality measurement is essential to monitor effectiveness and to guide improvements in healthcare. METHODS: Ten databases, including Medline, were searched electronically to identify measures assessing the quality of breast cancer care in women (diagnosis, treatment, followup, documentation of care). Eligible studies measured adherence to standards of breast cancer care in women diagnosed with, or in treatment for, any histological type of adenocarcinoma of the breast. Reference lists of studies, review articles, web sites, and files of experts were searched manually. Evidence appraisal entailed dual independent assessments of data (e.g., indicators used in quality measurement). The extent of each quality indicator's scientific validation as a measure was assessed. The American Society of Clinical Oncology (ASCO) was asked to contribute quality measures under development. RESULTS: Sixty relevant reports identified 58 studies with 143 indicators assessing adherence to quality breast cancer care. A paucity of validated indicators (n = 12), most of which assessed quality of life, only permitted a qualitative data synthesis. Most quality indicators evaluated processes of care. CONCLUSION: While some studies revealed patterns of under-use of care, all adherence data require confirmation using validated quality measures. ASCO's current development of a set of quality measures relating to breast cancer care may hold the key to conducting definitive studies

Trust into mistrust: the uncertain marriage between public and private sector practice for middle managers in education

The role of the middle manager has proved to be a difficult one to define due to the fluid nature of the tasks performed and the heterogeneity of understanding that exists for the term. This is further complicated by the differences associated with the context in which individual manager’s work. This research, which explores the drive towards neo-liberalism and the subsequent adoption of leadership and management practice from the private sector, makes a comparison between the roles of managers in English education with those in other settings. Using a questionnaire with 252 responses and interviews with 6 managers in the private and public sector, the role of middle managers was compared to identify the similarities and differences between organisations driven by social policy as opposed to profit. Participants surveyed were based in primary, secondary and further education and the interview respondents were employed in non-education contexts. The findings suggest that the initial reforms, which required higher levels of accountability through the introduction of key performance indicators, appear to be fully embedded within the education manager’s role and there is a high degree of convergence in relation to the expectation of managers at this level in all the settings. The findings also highlighted a fundamental difference in relation to how middle managers were expected to carry out their duties, the autonomy they had to do so and the authority that was bestowed upon them. © 2018 Association for Research in Post-Compulsory Education (ARPCE)

Leadership that facilitates the successful implementation of Lean Six Sigma

Researchers have identified leadership as a critical success factor for Lean Six Sigma implementation. It is essential to understand leadership behaviours that facilitate the use of Lean Six Sigma. This paper aims to identify leadership styles from the literature that can facilitate Lean Six Sigma implementation, which in turn broaden the current understanding of the suitable leadership styles. Also, the authors aim to explore how leadership styles can enhance Lean Six Sigma operations. The authors systematically reviewed the literature on leadership styles and Lean Six Sigma. The results determined the leadership styles that can enable the use of Lean Six Sigma successfully. These leadership styles are as follows: situational (task-oriented or relation-oriented behaviour), transformational, servant, authentic, empowering, and distributed leadership. The authors provide a better understanding for practitioners and researchers from existing literature on how leaders' behaviours can enhance Lean Six Sigma implementation. It is not clear which style is the most dominant and effective. There is a lack in interpreting how these leadership styles linked to Lean Six Sigma implementation. There is a lack of empirical evidence most of the studies depended on a theoretical base. Very few studies have focused on leadership styles and Six Sigma success; to the best of the authors' knowledge only one paper has studied this. Also, there is scarcity in papers that addressed leadership styles that facilitate Lean Six Sigma implementation. This paper initiates a call to study Lean Six Sigma rather than focus only on either Lean or Six Sigma. This proposition guides future research based on the view that Lean management can share underlying assumptions with Lean Six Sigma characteristics. However, the mean limitation of this review is the use of specific keywords and database to identify studies

Process to practice: The evolving role of the academic middle manager in English further education colleges

The English further education sector has undergone significant change since the Further and Higher Education Act (1992) encouraged a culture of entrepreneurship, competition and the use of what was seen as best practice from the commercial sector. This led to a cultural shift and the introduction of many new initiatives – a situation that still exists now. The implementation of these initiatives was often delegated to middle managers – a group of people who occupied the gap between the senior leaders and the lecturers in the classroom. Current austerity measures, restructuring and the shift towards the creation of larger organizations have resulted in reorganizations that could present opportunities for middle managers to participate in the strategic processes and leadership of the organization, further developing their role (Greatbatch and Tate, 2018). The purpose of this article is to investigate the leadership and management aspects of the middle-manager’s role within the context of further education in England. Although many managers in the sector are reluctant to identify as leaders (Briggs, 2006), our research shows that their role has evolved so that they are undertaking a range of activities that could be classified as leadership. We suggest that using ‘practice’ rather than ‘process’ as a descriptor of the role would reframe, identify and bring forward the leadership aspects of what they do. Encouraging a focus on a holistic, practice-based approach, rather than a succession of process-driven tasks, could help managers to perform their role more effectively. Findings taken from interviews with 32 participants and a questionnaire with 302 responses are used to illustrate our argument. © 2019 British Educational Leadership, Management & Administration Society (BELMAS)

Kepemimpinan Teori dan Praktik

25cm;xviii;431ha

Leadership : theory & practice

xxxii, 493 p. ; 21 cm