In this paper, we review the conventional analyses of management control systems, to conclude, first, that the illusion of control can mislead managers into believing that everything can be controlled and monitored, and, second, that no incentive system based only on extrinsic rewards can motivate individuals properly. Then, we investigate the philosophical foundations of the basic assumptions that, implicitly or explicitly, are made about the nature of the acting person. Based on personalist phenomenology, we show how the (...) development of technical and moral values is crucial to the long-run survival of organizations. We end by offering some guidelines as to what control systems should be like in order to be compatible with the nature of human persons. (shrink)

Management control systems include justice implicitly, as they believe that the market provides what is just or not through the market value. Psychological literature has deemed that people can perceive which procedures and decisions are just or not. In this paper, we argue that management control systems need to include justice criteria explicitly, beyond mere market value, in both their design (formal justice) and use (informal justice). This will increase the probability that organizational members will collaborate (...) to achieve organizational goals. (shrink)

Ethical aspects of management control systems are attracting increasing attention among scholars and practitioners. Much of the work centers on their aims. We complement this scholarship by applying the ethical principle of “no harm,” i.e., non-maleficence, to examine how those aims are achieved. We illustrate this approach by exploring the effects of four MCS designs on job-related stress drawing on the differentiation of stress into two dimensions: a challenge and a threat dimension. Results from a lagged field-survey with (...) 471 managers and employees from the UK and the U.S. support key predictions and offer first insights into designing MCS based on a “no harm” ethics. Our study highlights the benefits of interdisciplinary research in business ethics and hopefully encourages more work on MCS from a perspective based on the non-maleficence principle. (shrink)

Management control systems include justice implicitly, as they believe that the market provides what is just or not through the market value. Psychological literature has deemed that people can perceive which procedures and decisions are just or not. In this paper, we argue that management control systems need to include justice criteria explicitly, beyond mere market value, in both their design (formal justice) and use (informal justice). This will increase the probability that organizational members will collaborate (...) to achieve organizational goals. (shrink)

AbstractEnduring unethical behavior in trading has generated much research interest, and scholars disagree on the reasons for this situation. According to MacIntyre (2015), this has to do with the personal traits of traders, whereas Rocchi and Thunder (2019) argue this is due to permissive work environment that can potentially be changed to favoring ethical trading. We contribute to this debate by exploring how interactions between organizational culture and management control systems (MCSs) may affect the enduring unethical behaviors of (...) traders. We conceptualize this with the concepts of organized hypocrisy (Brunsson 1986, 1989, 1993) and decoupling (Meyer and Rowan 1977). An in-depth case study of fraud (Jerome Kerviel at Societe Generale), informs the empirical inquiry. We develop the concept of organized decoupling to characterize how the MCSs are articulated with the organizational culture favoring unethical behavior, while being used as a ‘safety mechanism’ to manage the legal and reputational risk of the bank. The analysis highlights three key features of the organized decoupling of MCS: physical distance, technical distance and social distance. The study contribution lies in showing that decoupling is not only emergent but might be intended and therefore organized. The findings also raise doubts on the role of MCSs in monitoring trading activities as presented by investment banking institutions and regulators, suggesting more organized hypocrisy, and raising significant concerns regarding the creation of tolerable work environment welcoming ethical behaviors in the investment banking sector. (shrink)

A growing number of companies are implementing proactive environmental strategies with the objective of gaining competitive advantage through an enhanced reputation, the reduction in production costs, and a first-mover advantage in the green product market. Yet according to the natural-resource-based view, the development and maintenance of unique and valuable environmental capabilities are the central elements allowing companies to gain financial benefit from their proactive environmental strategy. In this context, management control systems can contribute to the development of environmental (...) capabilities by focusing attention on strategic priorities and stimulating dialogue. Through a single case study, and building on Simons’ four levers of control, we propose a conceptual framework of management control levers that show how companies can enhance stakeholder integration capability through the joint use of belief, boundary, and diagnostic control systems; shared vision capability through the joint use of the belief and boundary systems; organizational learning capability through the use of interactive control systems and to a lesser extent diagnostic control systems; and continuous innovation capability through the use of interactive control systems, belief systems and to a lesser extent diagnostic control systems. (shrink)

Researchers have studied marketing ethics from several perspectives. Few studies, however, have analyzed supervisory reactions to unethical behavior by salespeople. The results of this study using a 2 × 3 factorial design showed that the performance level of the salesperson and the consequences of the salesperson's actions influenced some types of discipline used by a sample of 246 sales managers. The findings both support and contradict prior research on how sales managers respond to unethical sales force behavior.

The management control system aids administrators in guiding a business toward its organizational plans; as a result, management control is primarily concerned with the execution of the plan and plans. Financial and nonfinancial criteria are used to create management control systems. The financial element focuses on net income, earnings, and other financial metrics. The two components of leadership strategy in this study are cost and differentiation, which highlight the strategy of differentiation in attaining higher (...) quality due to the robust strategy’s attention on a particular area of the company. In this study, we presented a novel method named deep interaction neural network to predict the performance of the manufacturing companies based on their leading competitors using features cost leadership and differentiation strategies. Moreover, the management control system is classified into two financial and nonfinancial factors based on machine learning methods. Based on the results, the presented factors can accurately estimate the company’s performance based on management control criteria with a 93.48% R-square. Moreover, it can be seen that the DT method is presented with higher classification performance values. (shrink)

Researchers have studied marketing ethics from several perspectives. Few studies, however, have analyzed supervisory reactions to unethical behavior by salespeople. The results of this study using a 2 × 3 factorial design showed that the performance level of the salesperson and the consequences of the salesperson''s actions influenced some types of discipline used by a sample of 246 sales managers. The findings both support and contradict prior research on how sales managers respond to unethical sales force behavior.

This study examines the extent to which enabling and controlling uses of management control systems moderate the relationship between environmental innovation strategy and organizational performance. Partial least squares structural equation modeling is used to analyze survey data collected from top managers in 175 manufacturing and services sectors representing multinational and local organizations operating in Sri Lanka. We find that while the enabling use of MCS positively moderates the relationship between environmental innovation strategy and organizational performance, in contrast, the (...) controlling use of MCS negatively moderates the relationship. We compare the results for the manufacturing and services sectors. As predicted, we find a significant positive moderating impact of the enabling use of MCS in both manufacturing and services sectors. However, contrary to our expectations, we find no significant moderating impact for both sectors for the controlling use of MCS. We conclude that environmental innovation strategy per se does not lead to performance improvements; however, the extent to which organizations use enabling and controlling MCS determines the relationship. We provide theoretical insights and practical implications concerning the importance of strategic alignment between managerial controls, environmental innovation strategy, and organizational performance. (shrink)

In this study, we evaluate how individual virtues and inter-organizational management control systems influence buyer–supplier performance through relationship quality. Results from a sample of 232 firms confirm that virtues and IOMCS relate positively to relationship quality and performance, respectively. However, IOMCS lose their positive influence on relationship quality when considered along with virtues. That is, when both variables enter the regression model simultaneously, virtues win. This interesting finding has particular resonance at a time when research on ethics still (...) needs to reinforce its positive effects on the practice of management. (shrink)

In this study, we evaluate how individual virtues and inter-organizational management control systems influence buyer–supplier performance through relationship quality. Results from a sample of 232 firms confirm that virtues and IOMCS relate positively to relationship quality and performance, respectively. However, IOMCS lose their positive influence on relationship quality when considered along with virtues. That is, when both variables enter the regression model simultaneously, virtues win. This interesting finding has particular resonance at a time when research on ethics still (...) needs to reinforce its positive effects on the practice of management. (shrink)

In managing the Covid-16 pandemic, policy makers took actions which require the cooperation of individual citizens to succeed while the actions partially come at remarkable costs for individuals. The brief paper employs a thought experiment to identify factors which affect individuals’ propensity to cooperate in the public goods game. These factors reasonably comprise, for example, risk perception and attitude towards risk, embeddedness in a social network or the desire for social approval and may differ remarkably among the individuals of a (...) collective. The paper adopts a management control perspective which appears to be particularly helpful to identify how to implement policy makers’ actions with respect to the diverse individuals in a collective. In order to predict the overall outcome of “unpleasant” actions, an approach is required which allows to capture the heterogeneity of individuals within a collective which makes agent-based modelling a promising candidate. (shrink)

Managers vs. Owners: The Struggle for Corporate Control in American Democracy deals with a subject of profound importance: understanding the place of the modern corporation in a democratic society. This latest volume in the acclaimed Ruffin Series in Business Ethics describes how the balance between corporate power and government regulation has changed with the interests of society as a whole. The first section examines the debates over the rules that individuals or organized groups would agree to follow in their (...) interactions to accrue social advantages. The second section looks at management's point of view and tells how law promotes the need for managerial collective action and provides a vocabulary for articulating management as a profession. The authors conclude by looking at the impact of collective investor action - especially institutional investors - on the efforts by managers to preserve their autonomy. This examination of the inherent conflicts between the interests of corporate owners, the interests of the larger society, and the interests of managers who run corporations will be essential reading for students, scholars, and professionals concerned with the place of the large corporation in a democratic society. (shrink)

We examine the unique nature of agency problems within publicly traded family firms by investigating the earnings management decision of dominant family owners relative to non-family. To do so, we draw upon literature demonstrating that family owners are loss averse with respect to the family’s socioemotional wealth, or the affective endowment derived from firm ownership and control. Our theory and findings suggest that potential reputational consequences of earnings management lead family principals to engage in less of this (...) practice relative to non-family firms, and that founder family firms are less likely than non-founder family firms to use earnings management. Moreover, the family-firm effect varies with the firm size, the degree of CEO entrenchment, and the firm’s stock structure. We provide important insights regarding differences between family and non-family principals in the use of unethical accounting practices, thereby extending agency theory and advancing an underdeveloped research area. (shrink)

In recent years a series of developments in apparently loosely coupled domains have contributed to the development of new and vital perspectives on how to manage complex social systems such as corporations. These developments include improved communications technologies, increased awareness by constituencies of their potentials for influencing corporate behaviour, increased complexity and reduced transparency in large, heterogeneous organisations, a corresponding reduction in the capacity of traditional accounting and reporting systems to reflect organisational performance, new demands from employees as to their (...) work environments, from customers as to ecological and ethical sensitivity, from civil society and governments as to social and environmental accountability etc.A result is a major shift in the way organisations are choosing to observe themselves and to describe, measure, evaluate and report on their performance. From a focus on efficiency and control to a values-based perspective on management, corporate identity and success. And from a focus on legal compliance and financial performance to a focus on corporate social and ethical responsibility and accountability. (shrink)

There is a fundamental tension in business ethics between the apparent need to ensure ethical conduct through hierarchical control, and the encouragement of individuals' potential for autonomous moral judgement. In philosophical terms, these positions are consequentialist and Kantian, respectively. This paper assumes the former to be the dominant position in practice, and probably in theory also, but regards it as a misplaced extension of the more general managerial tendency to seek and maintain control over employees. While the functions (...) of such control are recognized, the arguments in favour of individuals' moral autonomy are pursued from both a Kantian and a social–theoretic perspective. Reference is made to Kohlberg's research on moral development that provides an insight into how individuals, through participation in debate with colleagues, might become more effective moral agents within organizational settings. This is contrasted with a managerial perspective, which pays lip service to individuals' right to such genuine involvement. The paper considers psychological manipulation and the legitimacy of managerial authority on matters of ethics, as opposed to in the purely technical context. The wider societal significance of such hierarchical power in organizations constitutes an important background to the paper. It is concluded that genuine, non‐manipulative, participation by employees (and others) is the way forward for the ethical management of business ethics. (shrink)

ABSTRACT Patient self‐management (SM) of chronic disease is an evolving movement, with some forms documented as yielding important outcomes. Potential benefits from proper preparation and maintenance of patient SM skills include quality care tailored to the patient's preferences and life goals, and increase in skills in problem solving, confidence and success, generalizable to other parts of the patient's life. Four central ethical issues can be identified: 1) insufficient patient/family access to preparation that will optimize their competence to SM without (...) harm to themselves, 2) lack of acknowledgement that an ethos of patient empowerment can mask transfer of responsibility beyond patient/family competency to handle that responsibility, 3) prevailing assumptions that preparation for SM cannot result in harm and that its main purpose is to deliver physician instructions, and 4) lack of standards for patient selection, which has the potential to exclude individuals who could benefit from learning to SM. Technology assessment offers one framework through which to examine available data about efficacy of patient SM and to answer the central question of what conditions must be put in place to optimize the benefits of SM while assuring that potential harms are controlled. (shrink)

Pharmacists, physicians, and other health care personnel practice within an integrated system of laws and regulations that influence many treatment modalities. Capitation, managed care, and other controls strain these relationships by mandating greater oversight of how health care is delivered. From a pharmacists’s perspective, any use of medication requites knowledge of three omnipresent factors: regulatory control, formularies, and economic decision making. My objective is to raise awareness of these issues as they relate to the prescription of pain medication and (...) to pain management generally.All practice-oriented drug law and regulation is based on the federal Controlled Substances Act of 1970. The Act, also known as Title II, is part of a much larger piece of legislation, the Comprehensive Drug Abuse Prevention and Control Act of 1970. CSA was enacted to regulate the manufacturing, distribution, dispensing, and delivery of drugs or substances that are subject to, or have the potential for, abuse or physical or psychological dependence. (shrink)

In response to numerous recent cases involving materially misstated financial information arising from fraudulent financial reporting, companies, auditors, and academics have increased their focus on strengthening internal controls as a means of deterring such unethical behaviors. However, prior research suggests that stronger controls may actually exacerbate the very opportunistic behavior the controls are intended to curb. The current study investigates whether the efficacy of an implemented control is conditioned on not only the strength of the control, but also (...) on how the firm frames the purpose for implementing the control. A monitoring purpose frames controls as reducing managers’ opportunities to engage in self-interested behavior, while a coordinating purpose frames controls as facilitating coordination between the firm and its managers. We posit that the efficacy of stronger controls to reduce unethical fraudulent reporting depends on the control frame. Using an experiment, this study investigates the interactive effect of control strength and control frame on managers’ fraudulent reporting decisions. As predicted, our results show that when controls are framed for monitoring purposes, stronger controls result in less fraudulent reporting than weaker controls. Conversely, when controls are framed for coordinating purposes, stronger controls result in more fraudulent reporting than weaker controls. Our results suggest that an inconsistency between the firm’s choice of the control strength and the control frame reduces the efficacy of the implemented control to curb unethical reporting behaviors. Furthermore, supplemental analysis shows that managers’ rationalization helps explain the interactive effect of control strength and communicated control purpose on fraudulent reporting. (shrink)

This paper describes the design of a control and management network (orderwire) for a mobile wireless Asynchronous Transfer Mode (ATM) network. This mobile wireless ATM network is part of the Rapidly Deployable Radio Network (RDRN). The orderwire system consists of a packet radio network which overlays the mobile wireless ATM network, each network element in this network uses Global Positioning System (GPS) information to control a beamforming antenna subsystem which provides for spatial reuse. This paper also proposes (...) a novel Virtual Network Configuration (VNC) algorithm for predictive network configuration. A mobile ATM Private Network-Network Interface (PNNI) based on VNC is also discussed. Finally, as a prelude to the system implementation, results of a Maisie simulation of the orderwire system are discussed. (shrink)

There is a fundamental tension in business ethics between the apparent need to ensure ethical conduct through hierarchical control, and the encouragement of individuals' potential for autonomous moral judgement. In philosophical terms, these positions are consequentialist and Kantian, respectively. This paper assumes the former to be the dominant position in practice, and probably in theory also, but regards it as a misplaced extension of the more general managerial tendency to seek and maintain control over employees. While the functions (...) of such control are recognized, the arguments in favour of individuals' moral autonomy are pursued from both a Kantian and a social–theoretic perspective. Reference is made to Kohlberg's research on moral development that provides an insight into how individuals, through participation in debate with colleagues, might become more effective moral agents within organizational settings. This is contrasted with a managerial perspective, which pays lip service to individuals' right to such genuine involvement. The paper considers psychological manipulation and the legitimacy of managerial authority on matters of ethics, as opposed to in the purely technical context. The wider societal significance of such hierarchical power in organizations constitutes an important background to the paper. It is concluded that genuine, non‐manipulative, participation by employees is the way forward for the ethical management of business ethics. (shrink)

Affective dynamics are discussed from the perspective of a view of origin and functions of affective valence based in control processes. This view posits that affect reflects the error signal of a feedback loop managing rate of progress at goal attainment or threat avoidance. Negative feelings signal doing poorly, demanding more effort. Positive feelings signal doing better than necessary, allowing coasting, which yields goal attainment without unnecessary resource expenditure. Given multiple simultaneous goals, these functions assist in moment-to-moment priority (...) class='Hi'>management, facilitating attainment of all. (shrink)

Management accounting and control seeks to provide information that substantiates decision-making at all firm levels and thus may also foster ethical decision-making. Against this background, this article presents a systematic literature review of research on management accounting and control and business ethics that has been published in the Journal of Business Ethics. Through this review, we intend to bring to the forefront a research topic that has been widely neglected in broader literature reviews on accounting ethics (...) research and that has been covered by a small number of articles published by traditional leading accounting journals only. Our systematic literature review is guided by a theoretical framework that integrates the decision-facilitating and decision-influencing roles of management accounting and control information and the stages of the ethical decision-making process. Through this theoretical lens, we analyze 64 management accounting and control articles published in the Journal of Business Ethics over more than three decades. Synthesizing and structuring this research, we discuss prior accomplishments and elaborate on avenues for future research. (shrink)

Rotter’s theory of internal-external locus of control evolved from Carl Jung’s work. In Psychological Types (1923), Jung defined two opposing tendencies in personality introversion and extroversion. While both tendencies are present in all individuals, one tends to dominate the other. The internal–external control construct was conceived as a generalized expectancy to perceive reinforcement either as contingent upon one’s own behaviors (internal control) or as the result of forces beyond one’s control, such as chance, fate, or powerful (...) others (external control) (Lefcourt, 1981, p. 15). Locus of control refers to those causes to which individuals attribute their successes and failures. Individuals are responsive to some external motivators (e.g. better jobs, promotions, higher salaries), but the more powerful are internal pressures (the desire for increased job satisfaction, self-esteem, and quality of life). Research indicates that an individual’s internal–external locus of control impacts their ethical behavior in an organization. Rotter’s I–E Scale (1966, Psychological Monographics 80(1), 1–28), a 29 item forced choice instrument, is the most widely used instrument to measure the degree of internality versus externality. Each respondent’s score for this scale had a potential range from 0 to 23. As there are six filler items used to mask the intent of the questionnaire a score of 23 being extremely external in nature and a score of zero being extremely internal in nature. The I Scale (Internal Scale) measures the extent to which people believe that they have control over their own lives; the E Scale (External Scale) measures the extent to which people believe that they do not have control over their own lives. This study utilized the I–E Scale. Jones (Unpublished Doctoral Dissertation) and Deflumeri (Unpublished Doctoral Dissertation) investigated the likelihood of an individual to engage in unethical behavior in an organization. This research suggests that when employees perceive that locus of control resides internally they themselves decide what is appropriate behavior, but with an external locus of control, employees will look at others to decide appropriate behavior. The researcher in this study investigated the relationship between managers’ locus of control and their moral reasoning. (shrink)

Pharmacists, physicians, and other health care personnel practice within an integrated system of laws and regulations that influence many treatment modalities. Capitation, managed care, and other controls strain these relationships by mandating greater oversight of how health care is delivered. From a pharmacists’s perspective, any use of medication requites knowledge of three omnipresent factors: regulatory control, formularies, and economic decision making. My objective is to raise awareness of these issues as they relate to the prescription of pain medication and (...) to pain management generally.All practice-oriented drug law and regulation is based on the federal Controlled Substances Act of 1970. The Act, also known as Title II, is part of a much larger piece of legislation, the Comprehensive Drug Abuse Prevention and Control Act of 1970. CSA was enacted to regulate the manufacturing, distribution, dispensing, and delivery of drugs or substances that are subject to, or have the potential for, abuse or physical or psychological dependence. (shrink)

The power of finance vis-à-vis the nonfinancial sector is changing. Macroeconomic developments and financial innovations have reduced financial actors’ exit options, thus diminishing exit-based structural power. At the same time, shareholdings have become more concentrated in the hands of large asset managers, thus increasing control-based power. This article documents these trends, before examining whether asset managers wield their power and why, despite being universal shareholders, they have not steered corporate behavior toward decarbonization. Rather than assuming orderly, good-faith interactions between (...) shareholders and managers, this article argues that in the United States today, political considerations govern the use of control-based power. Asset managers’ corporate governance policies are subservient to the—increasingly inconsistent—goals of maximizing assets under management while avoiding regulatory backlash. Unlike exit-based power, control-based power is constrained by being highly visible and, therefore, easily politicized. (shrink)

In the last thirty years, the USA and the UK have witnessed a profound change in the way in which we think about and respond to crime and social control. Crime has become part of everyday life as, for many citizens, has imprisonment. Managing Modernity brings together criminologists, social theorists, and philosophers to consider what explains these changes and what they tell us about ourselves and the way in which we live. The authors consider the pervasive, the obvious, and (...) the covert ways in which crime and social order have come to structure social discourses and social life, from mass imprisonment to zero tolerance, to on-the-spot fines. This volume was previously published as a special issue of the Critical Review of International Social and Political Philosophy (CRISPP). (shrink)

Suicide is a leading cause of death in the United States and in many other parts of the world. As such, suicide is frequently framed as a medical and public health problem for which solutions are best recommended by medical and public health authorities. While, medicalized suicide prevention strategies often resonate with traditional Christian commitments to preserve life and to discourage suicide, there is little evidence to date that medical approaches to suicide risk-reduction decrease population rates of suicide. Further, by (...) treating suicide as a phenomenon that can be eliminated through technical managerial control, modern suicide prevention efforts construe suffering persons as carriers of risk best managed by standardized and often dehumanizing environments of care. This emphasis on the medical management of risk also erodes the clinician–patient relationship and inappropriately centers medical (e.g., systematic health screenings) rather than non-medical (e.g., access to housing) forms of response. Although, medicalized suicide prevention efforts should not be dismantled, those working to prevent suicide would do well to prioritize a positive commitment to human dignity and worth and to engage social and political systems beyond medicine and public health, while drawing on specific contributions that clinicians can offer. (shrink)

This paper seeks to expand our appreciation of the gene editing tool, clustered regularly interspaced short palindromic repeats‐associated protein 9 (CRISPR‐Cas9), its function, its benefits and risks, and the challenges of regulating its use. I frame CRISPR's emergence and its current use in the context of 150 years of formal exploration of heredity and genetics. I describe CRISPR's structure and explain how it functions as a useful engineering tool. The contemporary international and domestic regulatory environment governing human genetic interventions is (...) reviewed and shown to be increasingly ineffective in its ability to restrain, guide, and optimize the emerging use of CRISPR. Several reasons for this lack of consensus are discussed. In conclusion, I suggest a number of public policy recommendations that might allow us to simultaneously embrace our most important moral values and manage the inevitable power CRISPR will come to have in our lives. (shrink)

In ‘Micromanagement and Poor Self-Control’, Chrisoula An-dreou argues that some cases of poor self-control are best understood as arising from poor self-management, in particular a kind of intrapersonal micromanagement. She argues that this furnishes us with a better understanding of those cases than the orthodox foreign force paradigm does (on which poor self-control amounts to diminished self-control). I argue that we cannot do without the foreign force paradigm to explain the cases that Andreou discusses. I (...) suggest a both/and approach on which poor self-management and diminished self-control together explain poor self-control. (shrink)

The Clinton administration's revised rules regulating but not prohibiting the common practice in managed care of linking physician compensation with cost cutting and control of services demonstrates the complexity of ethical issues in managed care. As originally proposed, the federal guidelines on payment for Medicare and Medicaid services would have precluded any interrelationship between payment to physicians and delivery of services. Such a restriction would have gutted the primary mechanism in managed care plans to curb the unacceptably high cost (...) of healthcare delivery: making physicians directly responsible for cost control by placing them at direct financial risk. At first blush such a linkage seems to involve an obvious and irreconcilable conflict of interest. How can a physician be responsible for the well-being of a patient while at the same time aware that a proportion of his or her income is linked to the provision of cost-conscious care? (shrink)

The Institute of Medicine has returned the problem of medical error to the top of the health-care agenda. Its report that 44,000 to 98,000 patients die each year as a result of medical errors in American hospitals has renewed scholarly interest in health system quality control. In To Err Is Human, the IOM provides a vivid picture of a health-care system riven with serious quality problems. It calls for systems-based error-reduction methods borrowed from other high-risk industries and forcefully argues (...) against the traditional tendency to assign accountability primarily to individual physicians. Most errors, the IOM argues, can be successfully addressed by engineering systemic fail-safe protections against the inevitable failings of human actors. (shrink)

The Institute of Medicine has returned the problem of medical error to the top of the health-care agenda. Its report that 44,000 to 98,000 patients die each year as a result of medical errors in American hospitals has renewed scholarly interest in health system quality control. In To Err Is Human, the IOM provides a vivid picture of a health-care system riven with serious quality problems. It calls for systems-based error-reduction methods borrowed from other high-risk industries and forcefully argues (...) against the traditional tendency to assign accountability primarily to individual physicians. Most errors, the IOM argues, can be successfully addressed by engineering systemic fail-safe protections against the inevitable failings of human actors. (shrink)

We propose an infrastructure for collaborative content management and version control for structured mathematical knowledge. This will enable multiple users to work jointly on mathematical theories with minimal interference. We describe the API and the functionality needed to realize a cvs-like version control and distribution model. This architecture extends the cvs architecture in two ways, motivated by the specific needs of distributed management of structured mathematical knowledge on the Internet. On the one hand the one-level client/server (...) model of cvs is generalized to a multi-level graph of client/server relations, and on the other hand the underlying change-detection tools take the math-specific structure of the data into account. (shrink)

Although it has disappeared as a clinical diagnosis, a Disability Studies perspective on Civil War nostalgia offers an opportunity to recover the process by which understanding around a medical event occurs. By incorporating and examining the interplay between and among participants in the conversation surrounding nostalgia as they operate within various site specific temporal and social contexts, this method of analysis offers an opportunity to arrive at an understanding not only of the factors that contribute to different perspectives on an (...) illness, but also into how some voices become ascendant in constructing medical understanding and why others become subordinate, dismissed, or disappear. (shrink)

ObjectiveTo confirm the effects of a transtheoretical model based on multidimensional life management on healthy behavior in patients with polycystic ovary syndrome.MethodsIn total, eighty eligible patients were recruited from March 2021 to June 2021 and randomly assigned to either the intervention or control groups. Outcome measures include health-promoting behavior, self-efficacy, anthropometrics, and the number of unplanned outpatient admissions. Data were collected at baseline, 3, and 6 months after the intervention. The chi-square test, rank-sum test, t-test, and repeated measurement (...) analysis of variance were used to analyze the data.ResultsIn total, sixty-six participants completed the study: 35 participants in the intervention group and 31 participants in the control group. After 6 months of intervention, the healthy behavior level of patients with PCOS increased from moderate [health-promoting lifestyle profile -II score of 105.37 ± 12.57] to good in the intervention group; and there was no change observed in the control group. In addition, the total self-efficacy score, PCOS-related unplanned outpatient admissions, waist circumference, and body mass index were found to have a significant difference in the intervention group at 6 months. Meanwhile, repeated measures analysis of variance showed a significantly greater improvement in health-promoting behavior and self-efficacy over time in the intervention group than in the control group.ConclusionThe transtheoretical model based on multidimensional life management positively affected healthy behavior, self-efficacy, the number of unplanned outpatient admissions, and anthropometrics in patients with PCOS.Clinical Trial Registrationwww.chictr.org.cn, ChiCTR2000034572. (shrink)

Various geoengineering technologies that would deliberately alter the climate system have been proposed as a way to alleviate risks of global warming. Technologies that would shield incoming sunlight to cool the planet, so called solar radiation management, are particularly controversial. Considering insights from social studies of simulation modeling and research on expectations in science and technology, I argue that climate modeling has a central role in producing visions of SRM. I draw upon an empirical analysis of scientific research on (...) SRM to examine how a creative play with technological ideas becomes possible through climate modeling. This enables scientists to project and study environmental impacts of speculative SRM methods in virtual experiments and to develop and refine ideas for adjusting sunlight. Hence, while climate models are used to improve scientific understandings of climate system behavior and to anticipate possible environmental impacts of SRM, they also become inventive tools, allowing scientists to envision novel ways of climate control and optimization. Given the importance of simulation studies to knowledge production on SRM, I critically reflect on the challenges that arise when visions about an engineered climate future are first and foremost produced in climate simulations. (shrink)

Osmoregulation in insects is an essential process whereby changes in hemolymph osmotic pressure induce the release of diuretic or antidiuretic hormones to recruit individual osmoregulatory responses in a manner that optimizes overall homeostasis. However, the mechanisms by which different osmoregulatory circuits interact with other homeostatic networks to implement the correct homeostatic program remain largely unexplored. Surprisingly, recent advances in insect genetics have revealed several important metabolic functions are regulated by classic osmoregulatory pathways, suggesting that internal cues related to osmotic and (...) metabolic perturbations are integrated by the same hormonal networks. Here, we review our current knowledge on the network mechanisms that underpin systemic osmoregulation and discuss the remarkable parallels between the hormonal networks that regulate body fluid balance and those involved in energy homeostasis to provide a framework for understanding the polymodal optimization of homeostasis in insects. (shrink)