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Due to the workload and lack of a critical mass of trained operational researchers within their ranks, health systems and programmes may not be able to dedicate sufficient time to conducting operational research (OR). Hence, they may need the technical support of operational researchers from research/academic organisations. Additionally, there is a knowledge gap regarding implementing differentiated tuberculosis (TB) care in programme settings. In this 'how we did it' paper, we share our experience of implementing a differentiated TB care model along with an inbuilt OR component in Tamil Nadu, a southern state in India. This was a health system initiative through a collaboration of the State TB cell with the Indian Council of Medical Research institutes and the World Health Organisation country office in India. The learnings are in the form of eleven tips: four broad principles (OR on priority areas and make it a health system initiative, implement simple and holistic ideas, embed OR within routine programme settings, aim for long-term engagement), four related to strategic planning (big team of investigators, joint leadership, decentralised decision-making, working in advance) and three about implementation planning (conducting pilots, smart use of e-tools and operational research publications at frequent intervals). These may act as a guide for other Indian states, high TB burden countries that want to implement differentiated care, and for operational researchers in providing technical assistance for strengthening implementation and conducting OR in health systems and programmes (TB or other health programmes). Following these tips may increase the chances of i) an enriching engagement, ii) policy/practice change, and iii) sustainable implementation. [ABSTRACT FROM AUTHOR]

Strategic sourcing, defined as a firm's key business process to identify, evaluate, configure, and negotiate purchases in important spend categories while managing long-term supplier relationships, is playing a significant role in sourcing strategies. The adoption of e-sourcing, defined as the use of business software (for example, using application service providers to conduct online procurement auctions) to automate or augment the aforementioned key business process, has been growing rapidly in recent years. One often-cited benefit of e-sourcing is the predicted savings, which is appealing, given the increasing pressure on cost competitiveness faced by firms. Using queuing techniques, this paper develops an economic model that captures fundamental trade-offs in a firm's e-sourcing business process as characterized by communication complexity, frequency of use, and cost of delay. This allows comparisons of two widely adopted structures for e-sourcing; the centralized structure versus the decentralized structure. Conditions under which the centralized structure is favored over the decentralized structure and vice versa are identified and illustrated with numerical examples and case evidence. These findings are robust in other settings. The paper concludes with a discussion of managerial implications. [ABSTRACT FROM AUTHOR]

To achieve Sustainable Development Goal 5 for gender equality by 2030, it is crucial for health and development professionals and governmental officials to understand how legal systems empower or oppress populations on the basis of gender worldwide, including opportunities and challenges of statutory provisions created by legal pluralism. Using Ethiopia as a case study, this paper examines how local laws applied in Sharia and Customary Dispute Resolution courts impact gender equality and the health of women and girls inspite of the inculcation of human rights statutes into national legislation, including the Constitution. We identify several key issues with the substantive law and its enforcement. First, laws which have been instituted at the national level to improve gender equally have been poorly enforced at the local level. Second, there is a sustained enforcement of laws that oppress women and that protect male perpetrators of gender-based violations. Third, local courts limit female representation and uphold patriarchy. To improve the health of women and girls, stakeholders must take into consideration the ways in which legal systems uphold harmful gender norms and obstruct and/or advance progress towards equal representation, opportunities, and constitutionally-mandated protections for all. [ABSTRACT FROM AUTHOR]

This paper explores the relationship between micro-economic business models, economic structure, and locally sustainable prosperity. In this respect, the paper takes as a premise the contention that sustainable mobility requires a sustainable industry to create the vehicles and business models to deliver that mobility. The interactions between locality and scale are explored within the context of the anti-globalisation discourse. Thereafter, the paper provides a brief outline of some business models from the automotive industry where alternatives to the monolithic and centralised structure of the mainstream industry have been proposed. [ABSTRACT FROM AUTHOR]

In India, the pressing concern in education is with bringing in at least 32 million children estimated to be out of school, to meet the goal of Universal Elementary Education (UEE). Support for decentralisation of public services is widespread because of the equity and efficiency benefits associated with it. In particular, decentralisation is seen to facilitate the matching of services with local preferences, thus increasing the chances for policy goals to be met. This proposition is examined in the context of research carried out in a village of Raichur district in India, where poor households' 'preferences' with reference to school timings are analysed with a view to reflecting on their implications for education policy and management. The paper attempts to address the following concerns: how homogeneous are local preferences? What if these run counter to policy interests? Can aspects of services be selectively decentralised, or does the 'production' of the sector as a whole require to be rethought? The paper concludes with some thoughts on the importance of processes of 'preference' articulation, and the need to recognise preferences implicit within policy intentions. [ABSTRACT FROM AUTHOR]

The primary objective of this study was to ascertain, through analysis of accessibility and development potential, which activity centres should be prioritised to support decentralisation of jobs, encourage better integration of transport and land use and ultimately aid the evaluation of a more compact, consolidation and connected city. In doing so, this study evaluated and compared the existing accessibility of different geographic units across the city, including the 34 activity centres identified by the Government of Australia, by the two most frequently use transport modes, namely – public transport and car. The analysis of this study has two parts. Firstly, an isochrone-based measure of accessibility was used for an accessibility modelling across the Perth Metropolitan Area in Western Australia. Secondly, using six node-place based indicators, this paper also endeavoured to prioritise the geographic units that are already better served by public transport, as indicated by the accessibility analysis. Multi-criteria weighed scoring method was applied to calculate a score out of 100 for each of the geographic units. The results of this analysis could help to identify activity centre(s) and other areas in Perth, if any, with higher potentials of being a Transit Oriented Development (TOD) supportive activity centre. [ABSTRACT FROM AUTHOR]

Examines the decentralization choices and trade-offs faced by Northern and Southern non-governmental development organizations (NGDO). Features of decentralization for different types of NGDO; Types of decentralization; Pressures of donor policy; Performance of NGDO.

In recent decades, many universities have been moving in the direction of a more hierarchical and centralised structure, with top-down planning and reduced local autonomy for departments. Yet, the management literature over this period has stressed the numerous benefits of flatter organisational structures, decentralisation and local autonomy for sections or departments. What might explain this paradox? And why have academics remained strangely quiet about this, meekly accepting their fate? This proposition paper critically examines the dangers of centralised top-down management, increasingly bureaucratic procedures, teaching to a prescribed formula, and research driven by assessment and performance targets, illustrating these with a number of specific examples. It discusses a number of possible forces driving these worrying developments, and concludes by asking whether academics may be in danger of suffering the fate of the boiled frog. [ABSTRACT FROM PUBLISHER]

This paper analyses Spanish infrastructure policy since the early 1700s: road building in the eighteenth century, railway creation and expansion in the nineteenth, motorway expansion in the twentieth, and high speed rail development in the twenty-first. The analysis reveals a long-term pattern, in which infrastructure policy in Spain has been driven not by the requirements of commerce and economic activity, but rather by the desire to centralise transportation around the country's political capital. As commerce has been unable to sustain the development of this policy, regulation and subsidies from the national budget have regularly been used to decide the priorities regarding infrastructure creation and to fund the development, maintenance, and operation of the networks. When high roads, bridges, canals, etc. are in this manner made and supported by the commerce which is carried on by means of them, they can be made only where that commerce requires them, and consequently where it is proper to make them. Their expense too, their grandeur and magnificence, must be suited to what that commerce can afford to pay. They must be made consequently as it is proper to make them. A magnificent high road cannot be made through a desert country where there is little or no commerce, or merely because it happens to lead to the country villa of the intendant of the province, or to that of some great lord to whom the intendant finds it convenient to make his court. Adam Smith, The wealth of nations (1776, vol. III.V.I, pp. 95-96) [ABSTRACT FROM AUTHOR]

Grounded in a historical analysis of the processes of managerialization in Israel between the 1950s and the 1970s, this paper explores the ways in which well-integrated U.S. experts, in collaboration with their Israeli counterparts, retheorized and disarmed the well-institutionalized and antimanagerialist Israeli version of workers' participation in management. It demonstrates how through the bricolage of the radical local alternative with the U.S.-originated promanagerialist version of workers' participation in management, foreign intervention opened the way for the formerly unwelcome professionalization of corporate control in the country. In so doing, the importance of translation and theorizing are stressed as mechanisms of reproduction of geopolitical domination of the world system center over the periphery. [ABSTRACT FROM AUTHOR]

This article explores the degree of coherence in the elements of organizational structures. Over the last twenty years of empirical studies on organizational structures, the assumption about the concept organizational structure as unitary and not resolvable into elements has been discarded. The present paper introduces the concept and some results of empirical studies on the degree of coherence of organizational structures and the practical implications of investigations performed from this viewpoint. If an organization is to attain its assumed goals, its members must cooperate, and the division of labor demands coordination and integration of their activities. If, however, the desired influence is to be exerted on parts of the organization in order to make the whole organization attain the assumed goals, it is indispensable to set up rules of mutual contingency and mutually assign the component parts of the organization. Intraorganizational order is established in the course of processes that eventually not only assign a place to each member of the organization but also determine permanent behavior patterns of individuals and groups of people who occupy different positions.

The present report is an attempt to explain the progress in a research project which has already been going on for many years and which is at present being reappraised. The objective has been and is at the moment to investigate, in ever greater depth and detail, the situation that has been briefly exposed in this paper. Collaborators are urgently sought to help with indepth studies of the problems of particular companies, the communication systems, and the development of relationships in the decision-making process between head office and the foreign subsidiary. [ABSTRACT FROM AUTHOR]

Tuberculosis (TB) is a major public health issue in Papua New Guinea, with incidence rates particularly high in the South Fly District of Western Province. We present three case studies, along with additional vignettes, that were derived from interviews and focus groups carried out between July 2019 and July 2020 of people living in rural areas of the remote South Fly District depicting their challenges accessing timely TB diagnosis and care; most services within the district are only offered offshore on Daru Island. The findings detail that rather than 'patient delay' attributed to poor health seeking behaviours and inadequate knowledge of TB symptoms, many people were actively trying to navigate structural barriers hindering access to and utilisation of limited local TB services. The findings highlight a fragile and fragmented health system, a lack of attention given to primary health services, and undue financial burdens placed on people living in rural and remote areas associated with costly transportation to access functioning health services. We conclude that a person-centred and effective decentralised model of TB care as outlined in health policies is imperative for equitable access to essential health care services in Papua New Guinea. [ABSTRACT FROM AUTHOR]

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Health facility governing committees (HFGCs) were established by lower and middle-income countries (LMICs) to facilitate community participation at the primary facility level to improve health system performance. However, empirical evidence on their effects under decentralization reform on the functionality of HFGCs is scant and inconclusive. This article reviews the effects of decentralization on the functionality of HFGCs in LMICs. A systematic literature review was conducted using various search engines to obtain a total number of 24 relevant articles from 14 countries published between 2000 and 2020. Inclusion criteria include studies must be on community health committees, carried out under decentralization, HFGCs operating at the individual facility, effects of HFGCs on health performance or health outcomes and peer-reviewed empirical studies conducted in LMICs. The study has found varied functionality of HFGCs under a decentralization context. The study has found many HFGCs to have very low functionality, while a few HFGCs in other LMICs countries are performing very well. The context and decentralization type, members' awareness of their roles, membership allowance and availability of resource to the facility in which HFGCs operate to produce the desired outcomes play a significant role in facilitating/limiting them to effectively carry out the devolved duties and responsibilities. Fiscal decentralization has largely been seen as important in making health committees more autonomous, even though it does not guarantee the performance of HFGCs. [ABSTRACT FROM AUTHOR]

Background: Health worker retention in rural and underserved areas remains a persisting problem in many low and middle income countries, and this directly affects the quality of health services offered. Objective: This paper explores the drivers of long-term retention and describes health worker coping mechanisms in rural Uganda. Methods: A descriptive qualitative study explored the factors that motivated health workers to stay, in three rural districts of Uganda: Kamuli, Pallisa, and Kibuku. In-depth interviews conducted among health workers who have been retained for at least 10 years explored factors motivating the health workers to stay within the district, opportunities, and the benefits of staying. Results: Twenty-one health workers participated. Ten of them male and 11 female with the age range of 33–51 years. The mean duration of stay among the participants was 13, 15, and 26 years for Kamuli, Kibuku, and Pallisa respectively. Long-term retention was related to personal factors, such as having family ties, community ties, and opportunities to invest. The decentralization policy and pension benefits also kept workers in place. Opportunities for promotion or leadership motivated long stay only if they came with financial benefits. Workload reportedly increased over the years, but staffing and emoluments had not increased. Multiple job, family support, and community support helped health workers cope with the costs of living, and holding a secure pensionable government job was valued more highly than seeking uncertain job opportunities elsewhere. Conclusion: The interplay between the costs of leaving and the benefit of staying is demonstrated. Family proximity, community ties, job security, and pension enhance staying, while higher costs of living and an unpredictable employment market make leaving risky. Health workers should be able to access investment opportunities in order to cope with inadequate remuneration. Promotions and leadership opportunities only motivate if accompanied by financial benefits. [ABSTRACT FROM PUBLISHER]

Since the 1978 reforms, China has experienced rapid economic and social development. GDP growth has been in the double digits on average yearly, creating the fastest sustained economic growth recorded by a major economy in history. Not only did this transform the economy and society at large, China reached important milestones in terms of reducing poverty and creating prosperity in a short period of time. This article uses the conceptual framework of new institutional economics to examine China's economic growth and how growth has been achieved largely by 'informal institutions' that are grounded in culture, customs, and private interactions that emerge spontaneously. The trajectory by which these informal institutions left their imprint on China's complex economic landscape and how they can constrain future economic growth are also of central importance. After examining decentralization and risk management practices, property rights, and the legal system, we emphasize the importance of creating formal institutions necessary for long-term growth, most importantly innovation. Preliminary evidence shows total factor productivity is tapering off which may reflect the constraints of China's institutional environment. This ought to be reversed if China is to enjoy long-term sustained growth. [ABSTRACT FROM AUTHOR]

In Tanzania only an estimated one-quarter of births are registered and certified. Birth registration uses a centralized system with geographic and cost barriers for families. A pilot decentralized birth registration system has been trialled in 11 of 26 regions, substantially increasing registration points, and enabling notification, registration and certification to occur in one step. This study compares completeness of birth registration and certification and achievement of key birth registration milestones in two districts where the birth registration system decentralized and two districts with the existing centralized system. Registration, notification, census and survey data were used to estimate birth registration completeness and quantify achievement of key registration milestones for births in 2012–16. These were compared between districts of Mbozi (decentralized in 2013) and Iringa (decentralized in 2016) and districts of Dodoma and Kibaha which remained centralized. For births that occurred from 2012 to 2016, completeness of birth registration/certification (by early 2017) was higher in districts that decentralized (Iringa 60%; Mbozi 52%) than remained centralized (Kibaha 36%; Dodoma 20%). Introduction of the decentralized system saw completeness for births registered within 12 months of occurrence increase in Iringa from 1% in 2014 to 67% in 2016, and in Mbozi from 15% in 2012 to 36% in 2013 before falling and subsequently increasing to 53% in 2016. In contrast, completeness in centralized districts did not increase. Although a higher proportion of births are notified in centralized than decentralized districts, registration and certification occurs for all notified births in decentralized districts but only one-third in centralized districts. Benefits of a decentralized system are more proximate registration points and the merging of notification, registration and certification steps. The findings, while demonstrating the immediate impact of the decentralized system on completeness, also show that continued efforts are necessary to sustain these improvements. [ABSTRACT FROM AUTHOR]

How does "self-governance" happen in Wikipedia? Through in-depth interviews with 20 individuals who have held a variety of responsibilities in the English-language Wikipedia, we obtained rich descriptions of how various forces produce and regulate social structures on the site. Although Wikipedia is sometimes portrayed as lacking oversight, our analysis describes Wikipedia as an organization with highly refined policies, norms, and a technological architecture that supports organizational ideals of consensus building and discussion. We describe how governance on the site is becoming increasingly decentralized as the community grows and how this is predicted by theories of commons-based governance developed in offline contexts. We also briefly examine local governance structures called WikiProjects through the example of WikiProject Military History, one of the oldest and most prolific projects on the site. [ABSTRACT FROM AUTHOR]

Background: Task sharing of TTE may improve capacity for heart failure diagnosis and management in patients in remote, low-resource settings but the impact on diagnostic accuracy and patient outcomes has not been studied. Objectives: Determine feasibility and impact of non-expert training in transthoracic echocardiography (TTE) to improve the diagnosis and outcomes of patients with suspected heart failure in Uganda. Methods: This two-part study examined an innovative training program to develop TTE competency among non-experts and used a pre-post design to determine the impact of decentralized TTE. Four of 8 non-experts (50%) passed a three-part training course. The training comprised of distance learning through a web-based curriculum, a 2-day hands-on workshop with cardiologists, and independent practice with remote mentorship. Continuous measures were compared (pre- vs. post-TTE) using t-tests or Wilcoxon rank-sum tests as distributionally appropriate and categorical variables assessed through chi-square testing. Sensitivity and specificity were calculated according to standard methodology comparing diagnosis pre- and post-TTE during phase 2. Results: Performance in the post-training phase showed good agreement with expert categorization (κ = 0.80) with diagnostic concordance in 421 of 454 studies (92.7%). TTE changed the preliminary diagnosis in 81% of patients, showing low specificity of clinical decision-making alone (14.2%; 95% CI 10.1–19.2%). Dilated cardiomyopathy, hypertensive heart disease with preserved systolic function, and right heart failure were the most underdiagnosed conditions prior to TTE while hypertensive heart disease with decreased systolic function was the most over-diagnosed condition. Conclusions: In conclusion, non-expert providers can achieve a high level of proficiency for the categorization of heart failure using handheld TTE in low-resource settings and use of telemedicine and remote mentorship may improve performance and feasibility. The addition of TTE resulted in substantial improvement in etiological specificity. Further study is needed to understand implications of this strategy on healthcare utilization, long-term patient outcomes, and cost. [ABSTRACT FROM AUTHOR]

Background: Decentralisation of antiretroviral therapy has been implemented to scale up HIV care provision for patients in resource-limited countries. Youth living with HIV demonstrate the poorest care outcomes, compared to other age groups. Objectives: To systematically evaluate evidence on the effects of decentralising facility-based HIV care on care outcomes for youth living with HIV in low- and middle-income countries. Methods: A systematic review was conducted through 12 electronic databases of peer-reviewed articles, conference abstracts, and grey literature; contacting relevant experts; and hand-searching references. Records were included if they were published after 1 January 1996 (advent of triple-drug ART) and reported health outcomes for decentralised and centralised care, separately, or evaluated the effect of decentralised care on care outcomes. Two authors independently screened search results. When age-disaggregated data (10–24 years old) were required for inclusion, we contacted study authors for data abstraction. Implementation fidelity of decentralisation, study quality, and risk of bias was assessed using the TIDieR checklist, CASP checklists, and ROBINS-I tool, respectively. Results: Of 11 potentially eligible studies, two studies from sub-Saharan Africa met inclusion criteria after data disaggregation by age. The studies and abstracted data were insufficiently homogenous in implementation and study design to justify meta-analysis. However, evidence suggests the potential for decentralised care to result in at least equivalent attrition-related outcomes (retention in care and mortality) for youth within decentralised HIV care. Limited sample size and significant selection and allocation bias confound clear, generalisable conclusions for youth living with HIV in resource-limited settings. Conclusions: There is a paucity of evidence for the effects of decentralising HIV care for youth living in resource-limited settings, particularly recent evidence reflective of the current HIV care landscape. Further work is required to rigorously analyse the effects of decentralising HIV care to inform policymakers and care providers, particularly as demand for HIV care in this population grows. [ABSTRACT FROM AUTHOR]

In this study an attempt has been made to solve a problematic phenomenon regarding how a decentralised environment mediates the effect on supply chain performance (SCP) - by taking various dimensions of knowledge management (KM) - specifically in the dairy sector of Lahore, Pakistan. This study also explores the relationship between KM practices and SCP in the presence of a general system theory; the theory claims that every system is has sub-parts, and every sub-part is surrounded by other sub-parts. Decentralisation has a mediating role which influences the relationship between KM practices and SCP in the dairy sector of Pakistan. A self-administered questionnaire was developed, and data were collected through a random sampling of 355 supply chain members of different dairy organisations in central Punjab. The data was analysed by AMOS software and through structure equation modelling (SEM). The underlying study reveals that the hypothesis is accepted, that decentralisation mediates the relationship between KM practices and SCP at a 1% level of significance; it also reveals that KM practices (with the exceptions of knowledge creation and knowledge sharing) have a direct relationship with SCP. Meanwhile, statistical analysis also indicates that KM practices (with the exception of knowledge creation) have a significant positive relationship with decentralisation at the 1% significance level. [ABSTRACT FROM AUTHOR]

We analyze the competitive and economic implications of information technology, the allocation of decision nights, and task bundling during business process reengineering. The popular reengineering literature advocates employee empowerment-decentralizing decision authority and consolidating tasks as complementary strategies. Our analysis reveals, however, that implementing these two changes simultaneously is suboptimal in many cases. Decentralization and consolidation decisions can occur separately or together; the optimal combination depends on the effectiveness of technology aimed at skill enhancement and the customers' sensitivity to time and quality. We identify those process parameters that can cause decentralization and consolidation to have opposite effects on process performance; we also point to other parameters, such as customer-to-customer variability, which can cause them to complement one another. Finally, we explain why, in a time-based competitive marketplace, firms are more likely to centralize their decision-making process while concentrating their information technology investments on enhancing productivity and intraorganizational communications. [ABSTRACT FROM AUTHOR]

To date, little research has been directed at the management infrastructure for end-user computing (EUC) from an organization design perspective. This study reports on the testing of a previously published contingency model in which two different structural forms are modeled for four states of EUC implementation: (1) an organic design (characterized by a decentralized, highly participatory form of decision making with loose controls), and (2) a mechanistic design (characterized by centralized decision making with a more tightly controlled form of management). Based on questionnaire data from 63 companies, statistical support is found for only the two states of EUC implementation for which a mechanistic design is modeled. Although only moderate support for this contingency model is found, the results of this study provide additional evidence for the effectiveness of a more controlled approach to EUC management under a low EUC growth objective at an early stage of implementation. This finding has important implications for other EUC management models and organization design options for assimilating new information technologies in general. The article concludes with recommendations for future empirical research, including a revised contingency model. [ABSTRACT FROM AUTHOR]

Despite the increasing pervasiveness of telecommunications technologies, very few studies have holistically attempted to examine their use in organizational contexts. This study approaches the use of these technologies from an innovation perspective. Literature on innovation is synthesized into a testable model and the results of a senior IS executive survey of 154 organizations is reported. Factors that enable initiation, adoption, and implementation of a set of 15 distinct telecommunications technologies are examined. Two factors in particular, environmental uncertainty and decentralization of decision making, show significant relationships with the usage of these technologies. The results provide useful insights into the usage of individual technologies and the contextual factors that enable diffusion of this important set of technologies in U.S. organizations. [ABSTRACT FROM AUTHOR]

Background: The past two decades have seen many countries, including a number in Southeast Asia, decentralising their health system with the expectation that this reform will improve their citizens' health. However, the consequences of this reform remain largely unknown. Objective: This study analyses the effects of fiscal decentralisation on child immunisation status in Indonesia. Design: We used multilevel logistic regression analysis to estimate these effects, and multilevel multiple imputation to manage missing data. The 2011 publication of Indonesia's national socio-economic survey (Susenas) is the source of household data, while the Podes village census survey from the same year provides village-level data. We supplement these with local government fiscal data from the Ministry of Finance. Results: The findings show that decentralising the fiscal allocation of responsibilities to local governments has a lack of association with child immunisation status and the results are robust. The results also suggest that increasing the number of village health centres (posyandu) per 1,000 population improves probability of children to receive full immunisation significantly, while increasing that of hospitals and health centres (puskesmas) has no significant effect. Conclusion: These findings suggest that merely decentralising the health system does not guarantee improvement in a country's immunisation coverage. Any successful decentralisation demands good capacity and capability of local governments. [ABSTRACT FROM AUTHOR]

Previous research has suggested that after 1996 devolution caused a reduction in regional disparities in Italy. However the analysis presented here suggests that the decline in regional disparities in Italy between 1996 and 2006 was driven by population dynamics and, to some extent, by the loss of competitiveness and consequent poor relative performance of northern regions. We conclude that links between devolution and the reduction of spatial disparities is unproven and its benefits are temporally and geographically uneven. [ABSTRACT FROM AUTHOR]

In this article, we present a comparative research project on municipal school policy in Sweden 1950-2010 which in our view contributes to the research fields of education policy and curriculum theory. Our project which started in 2014 links to a line of international research on education policy concerned with the tensions between decentralisation and globalisation and comparative research investigating transnational transfers of education policy ideas. In this article, we provide some preliminary findings which display municipal school policy dealing with national and transnational school initiatives and affecting local school actions. Most of the findings in this article concern the time period 1950-1975, during which the present two Swedish school forms, Grundskolan (a 9-year comprehensive school) and Gymnasieskolan (upper secondary school), were introduced and established.We compare local policy, through six interrelated indicators, in two municipalities with different structures and origins. On the basis of our findings, we conclude that municipal school policy research in a comparative and historical perspective is an important field of research as it reveals the complexity of school governance. Historical studies of municipal school policy and practice are crucial for exploring different dimensions of curriculum theory, including the transnational dimension. [ABSTRACT FROM AUTHOR]

This article seeks to explore the process whereby General Electric (GE) entered the computer industry during the mid-late 1950s. We explore the articulation of an internally contested business model through the study of the Product Scope Review (PSR) meeting which took place in October 1957. The article provides evidence of the difficulties surrounding the management of complex high technology industry in a large multi-divisional firm with competing calls on resources, and where a fundamental new technology disrupts established product lines. GE's attempt to manage the M-Form highlights the contradictions between decentralisation and a desire to retain vertical and horizontal economies. [ABSTRACT FROM PUBLISHER]

This study analyzes the relationships between organizational structure-namely, formalization, centralization, management style, and team solidarity-and the performance of technology start-ups (TSUs) in Israel. Employing a sample of 101 TSUs in Israel, the findings of regression analyses show that formalization, solidarity, and a laissez-faire management style can serve as predictors of TSU performance, controlling for TSU age, size, and industry. The research also reveals that the relationship between the level of formalization and TSU performance is nonlinear, with a negative slope at low and high levels of formalization. The laissez-faire style of management had the strongest positive effect on performance relative to other styles. These results point to dual managerial needs of the young TSU, seeking innovation and autonomy on the one hand, and needing some stable order on the other. The results of this study have the potential for wide generalization to TSUs in other countries and contexts. [ABSTRACT FROM AUTHOR]

This article examines how a shift toward decentralized and automobile-based patterns of American metropolitan development was a major aspect of the national defense buildup that took place just before Pearl Harbor. It suggests that the continuing and seemingly permanent clash between what are now standard contemporary suburban development practices and the ideas of architects about the design of cities and metropolitan areas can be traced back to that pivotal time. [ABSTRACT FROM AUTHOR]

Twenty-five million Americans play golf on the nation's 16,000 courses each year. These golf courses constitute a significant national landscape feature. Since 1878, when the game arrived in the United States, golf has filtered down the urban, economic, and social hierarchies to become accepted by and accessible to most Americans. During the ensuing thirteen decades the number, location, and layout of the nation's golf courses have responded to many of the same driving forces that impacted the nation, including decentralization, growth of the middle class, war, economic depression, suburbanization, and the increasing role of the federal government. Four epochs of golf-course growth and diffusion show the growing acceptance of the sport and depict where courses were most likely to be constructed as a result of the prevailing forces of each epoch. [ABSTRACT FROM AUTHOR]

The organization of R&D activities has a large impact on a company's ability to execute its business and technology strategy. Thus, managers face the challenging question, "What's the best structure for my company?" Recent studies have shown that R&D structures reflect companies' strategies for using technology to create value, but alignment with strategy is not enough to design a good R&D structure. There is also the need to evolve structures and orchestrate transitions that address the dynamics of a company's internal and external environments. A mismatched structure can defeat attempts to implement a good strategy. [ABSTRACT FROM PUBLISHER]

Discusses issues on community and lay control of public education from New York City, New York to Chicago, Illinois. Various meanings of the word community; Community school boards in New York City; School-based decentralization; Discrepancies between participatory promises and actual practices.

This article presents the findings of a research project on the concepts of centralization and decentralization in multinational firms. The research started by uncovering some myths and legends that surrounded the subject and inconsistent statements within a particular organization about its degree of centralization. A large quantity of empirical evidence has been considered in the light of the theories that have emerged and the methodologies that have been explored during the last twenty years. The author summarizes some of the information that has resulted.

The article investigates how the computer affects organizations and whether it can influence the development of industrial democracy. A substantial number of reports indicate that preplanned and formalized activities increase in number as a consequence of computerization, and this is borne out by the results of a Norwegian study. Computer technology procures better data faster -- and the data are also more relevant because the information is collected nearer to where the action takes place. This means tighter control of people, because the difference between planned and actual performance becomes more visible.

Families and friends who give care to people with mental disorders (MDs) are affected in a variety of ways and degrees. The interplay of caregiving consequences: poverty, discrimination and stigma, lack of support from others, diminished social relationships, depression, emotional trauma, and poor or interrupted sleep are associated caregiver burden. The burden of care on caregivers of people living with MDs was assessed in two districts located in the middle part of Ghana. Coping strategies and available support for caregivers of MDs were also assessed. A qualitative study was carried out involving 75 caregivers of participants with MDs registered within the Kintampo Health and Demographic Surveillance Systems. Data were gathered from caregivers about their experiences in providing care for their relations with MDs. Caregivers reported various degrees of burden, which included financial, social exclusion, emotional, depression, and inadequate time for other social responsibilities. Responsibilities around caregiving were mostly shared among close relatives but to a varying and limited extent. Religious prayers and the anticipation of cure were the main coping strategies adopted by caregivers, with expectation of new treatments being discovered. Emotional distress, stigma, financial burden, lack of support networks, social exclusion, health impact, and absence of decentralised mental health services were experienced by family caregivers. These findings highlight the need for interventions to support people with MDs and their caregivers. This might include policy development and implementation that will decentralise mental health care provision including psychosocial support for caregivers. This will ameliorate families' financial and emotional burden, facilitate early diagnosis and management, reduce travel time to seek care, and improve the quality of life of family caregivers of persons with MDs. [ABSTRACT FROM AUTHOR]

In Nigeria, the shortage of health workers is worst at the primary health care (PHC) level, especially in rural communities. And the responsibility for PHC – usually the only form of formal health service available in rural communities – is shared among the three tiers of government (federal, state, and local governments). In addition, the responsibility for community engagement in PHC is delegated to community health committees. This study examines how the decentralisation of health system governance influences retention of health workers in rural communities in Nigeria from the perspective of health managers, health workers, and people living in rural communities. The study adopted a qualitative approach, and data were collected using semi-structured in-depth interviews and focus group discussions. The multi-stakeholder data were analysed for themes related to health system decentralisation. The results showed that decentralisation influences the retention of rural health workers in two ways: 1) The salary of PHC workers is often delayed and irregular as a result of delays in transfer of funds from the national to sub-national governments and because one tier of government can blame failure on another tier of government. Further, the primary responsibility for PHC is often left to the weakest tier of government (local governments). And the result is that rural PHC workers are attracted to working at levels of care where salaries are higher and more regular – in secondary care (run by state governments) and tertiary care (run by the federal government), which are also usually in urban areas. 2) Through community health committees, rural communities influence the retention of health workers by working to increase the uptake of PHC services. Community efforts to retain health workers also include providing social, financial, and accommodation support to health workers. To encourage health workers to stay, communities also take the initiative to co-finance and co-manage PHC services in order to ensure that PHC facilities are functional. In Nigeria and other low- and middle-income countries with decentralised health systems, intervention to increase the retention of health workers in rural communities should seek to reform and strengthen governance mechanisms, using both top-down and bottom-up strategies to improve the remuneration and support for health workers in rural communities. [ABSTRACT FROM AUTHOR]