The European experience

This mini‐review on European experiences with tackling the problem of organ shortage for transplantation was based on a literature review of predominantly European publications dealing with the issue of organ donation from deceased donors. The authors tried to identify the most significant factors that have demonstrated to impact on donation rates from deceased donors and subsequent transplant successes. These factors include legislative measures (national laws and European Directives), optimization of the donation process, use of expanded criteria donors, innovative preservation and surgical techniques, organizational efforts, and improved allocation algorithms.     

The psychological effects of organizational restructuring on nurses

AIM: This paper reports a comparison of nurses affected by the restructuring associated with healthcare organization mergers (1998-2000) in the United Kingdom and those of non-affected nurses in the UK. BACKGROUND: Restructuring, a feature of healthcare organizations for decades, has been associated internationally with negative outcomes for nurses. Despite this, no model to evaluate management of change factors and psychological stress processes has been operationalized and tested. METHOD: A sample of 351 Registered Nurses was recruited from southern England. Participants either worked in organizations that were within 6 months of merging or were not affected by mergers. On two occasions, 6 months apart, all were sent a questionnaire that had been formulated for the study. Questions related to the parts of the model being tested: restructuring initiatives (i.e. stressors) information and participation, coping action, and coping effectiveness (i.e. outcomes). The data were collected between 1998 and 2000. FINDINGS: Nurses affected by mergers reported statistically significantly higher restructuring initiatives before and after an event than non-affected nurses. Moreover, up to 12 months after an event some affected nurses reported lower information and participation, and lower coping effectiveness (i.e. higher job insecurity, job stress, job pressure, lower job satisfaction, physical, psychological, and environmental quality of life) than non-affected nurses, which was consistent with the model's proposals. However, there was no difference between affected and non-affected nurses' coping action. CONCLUSION: The psychological effects of restructuring are linked with perceptions of low information and participation, and with negative outcomes for nurses. Managers, therefore, need to communicate information and encourage staff to participate in decisions about restructuring events.     

Management's role in shaping organizational culture

AIM: The present study addresses the importance of the manager's role in the development and maintenance of organizational culture. It describes the types of cultures that exist and manager characteristics that are essential to facilitating a healthy workplace. BACKGROUND: While many managers do not deny the importance of organizational culture in employee satisfaction, few fail to realize the direct impact they have in shaping it. It is oftentimes believed that cultures are predetermined; however, this is a false assumption. It is crucial that managers at all levels are aware of their roles and responsibilities in upholding positive workplace environments that can increase employee satisfaction. Dissatisfaction is the major cause of turnover and can have detrimental cost and environmental effects on the agency. EVALUATION: Four critical components of culture (i.e. trust and trustworthiness, empowerment and delegation, consistency and mentorship) are discussed, as is the role of managers in turning these into positive cultural traits. The viewpoints of several authors, such as Stephen Covey, Mark McCormack and Charles Handy, are explored in relation to the development of organizational culture. Additional theories--Kanter's 'Theory of Organizational Empowerment', Locke's 'Goal-setting Theory' and the 'Social Exchange Theory'- supplement these viewpoints. CONCLUSIONS: Managers are always under the magnifying glass, with each action carefully scrutinized by subordinates. They must exercise caution when making decisions, ensuring that fairness and equitability exists among staff, and that ethical standards are upheld on a continual basis. The four cultural components, viewed as managerial traits of trust and trustworthiness, empowerment, consistency and mentorship coexist at all times regardless of the type of culture. Managers must put support systems and other mechanisms into place that allow employees the opportunity to empower themselves and to flourish, thus increasing their own effectiveness as well as that of the organization.     

Resource mobilization for health advocacy: Afro-Brazilian religious organizations and HIV prevention and control

Brazil’s national response to AIDS has been tied to the ability to mobilize resources from the World Bank, the World Health Organization, and a variety of donor agencies. The combination of favorable political economic opportunities and the bottom-up demands from civil society make Brazil a particularly interesting case. Despite the stabilization of the AIDS epidemic within the general Brazilian population, it continues to grow in pockets of poverty, especially among women and blacks. We use resource mobilization theories to examine the role of Afro-Brazilian religious organizations in reaching these marginalized populations. From December 2006 through November 2008, we conducted ethnographic research, including participant observation and oral histories with religious leaders (N = 18), officials from the National AIDS Program (N = 12), public health workers from Rio de Janeiro (N = 5), and non-governmental organization (NGO) activists who have worked with Afro-Brazilian religions (N = 5). The mobilization of resources from international donors, political opportunities (i.e., decentralization of the National AIDS Program), and cultural framings enabled local Afro-Brazilian religious groups to forge a national network. On the micro-level, in Rio de Janeiro, we observed how macro-level structures led to the proliferation of capacity-building and peer educator projects among these religious groups. We found that beyond funding assistance, the interrelation of religious ideologies, leadership, and networks linked to HIV can affect mobilization.     

People don’t live on the care cascade: The life of the HIV care cascade as an international AIDS policy and its implications

ABSTRACT

This article analyses how the HIV care cascade, an analytical tool, has become a policy practice that determines the direction and content of international AIDS policy. It traces the development of the cascade through from its emergence around 2011 to its position framing global AIDS policy by 2018. The article distinguishes between the cascade model as a mapping tool and the care cascade as a policy that aims to end the AIDS epidemic. It then argues that the move from an analytical to a policy tool has important implications, both for the scope of policies and for policy-relevant research. It concludes by considering its implications in determining policy direction. The qualitative research that informs the article is based on published care cascade research and policy documents, and observations of the presentations and discussions at the 2012 and 2018 International AIDS Conferences (IAS). The article uses textual analysis to develop its argument.