Re-Evaluating Professional Autonomy in Health Care

Professional autonomy, as the symbol of the traditional freedom ofdecision-making of medical professionals is criticized. This essayexamines the critique. It analyses the underlying assumption that theautonomy of health professionals is incompatible with the need fororganisation and management in order to control rising health carecosts. It is argued that the concept of professional autonomy should beredefined, not through restricting the decision-making freedom ofindividual health professionals, but through expanding the concept intothe sphere of management, so that managers will take responsibility forpatient care.     

Social identification and permeability of group boundaries

Two experiments were conducted to investigate some of the factors affecting social identification. In Experiment 1 ingroup identification was measured for subjects who were members of high or low status groups with either permeable or impermeable boundaries, and who received high, average or low ability feedback. The main results are that (1) members of high status groups show more ingroup identification than members of low status groups (2) members of low status groups with permeable boundaries identify less with their group than members of low status groups with impermeable boundaries and (3) in low status groups ingroup identification decreases as group members have higher individual ability. In Experiment 2, in addition to manipulating group status and individual ability, permeability was further differentiated into separate possibilities for upward and downward mobility. The most important results of Experiment 2 are that (1) members of high status groups show more ingroup identification than members of low status groups and (2) group members with high individual ability identify less with their group when upward mobility is possible than when upward mobility is not possible. These results are discussed in relation to social identity theory.     

Frequency effects in the processing of lexicalized and novel nominal compounds

The processing of lexicalized and novel noun-noun compounds of high interpretability was investigated. In Experiment 1, the familiarity of the lexicalized compounds had a significant effect on lexical decision times, but no frequency effects were observed for the constituent nouns. In Experiment 2, a frequency effect was found for the first noun of novel compounds, but not for the second noun. This result was replicated in Experiment 3 with different types of nonwords. A negative word frequency effect for the first noun was found in Experiment 4 in which the novel compounds functioned as nonwords. A frequency effect for the first noun was also observed in Experiment 5, in which a semantic classification task was used. Results point to a decomposition second model according to which access is initially based on the whole compound. If this is unsuccessful the compound will be decomposed and the constituent nouns will be processed separately. It is argued that in novel compounds, nouns are processed sequentially, and different orders of processing are discussed.     

Majorization as a tool for optimizing a class of matrix functions

The problem of minimizing a general matrix, trace function, possibly subject to certain constraints, is approached by means of majorizing this function by one having a simple quadratic shape and whose minimum is easily found. It is shown that the parameter set that minimizes the majorizing function also decreases the matrix trace function, which in turn provides a monotonically convergent algorithm for minimizing the matrix trace function iteratively. Three algorithms based on majorization for solving certain least squares problems are shown to be special cases. In addition, by means of several examples, it is noted how algorithms may be provided for a wide class of statistical optimization tasks for which no satisfactory algorithms seem available.The Netherlands organization for scientific research(NWO) is gratefully acknowledged for funding this project. This research was conducted while the author was supported by a PSYCHON-grant (560-267-011) from this organization. The author is obliged to Jos ten Berge, Willem Heiser, and Wim Krijnen for helpful comments on an earlier version of this paper.     

The analysis of multitrait-multimethod matrices via constrained components analysis

Multitrait-Multimethod (MTMM) matrices are often analyzed by means of confirmatory factor analysis (CFA). However, fitting MTMM models often leads to improper solutions, or non-convergence. In an attempt to overcome these problems, various alternative CFA models have been proposed, but with none of these the problem of finding improper solutions was solved completely. In the present paper, an approach is proposed where improper solutions are ruled out altogether and convergence is guaranteed. The approach is based on constrained variants of components analysis (CA). Besides the fact that these methods do not give improper solutions, they have the advantage that they provide component scores which can later on be used to relate the components to external variables. The new methods are illustrated by means of simulated data, as well as empirical data sets.This research has been made possible by a fellowship from the Royal Netherlands Academy of Arts and Sciences to the first author. The authors are obliged to three anonymous reviewers and an associate editor for constructive suggestions on the first version of this paper.     

Social comparison on two dimensions

In this experiment social comparison on two task dimensions has been studied. The subjects received bogus feedback on their performance on two tests, one allegedly measuring creativity, the other alertness. By means of this feedback four relative position conditions were induced: scoring high on both tests, scoring low on both tests, scoring high on creativity and low on alertness, and vice versa. Anticipating either a co-operative or a competitive game, the subjects indicated their preference for one or the other task dimension and also expressed their preference for a comparison person. It was found that, as predicted, the subjects preferred and valued comparison dimensions on which they occupied a favourable position. With respect to preference for a comparison person, compensatory choices were obtained: on the dimension on which the subject performed well, they preferred an inferior other. On the dimension on which they performed poorly, they preferred a superior other. This pattern of choices was found in co-operation as well as in competition. Finally, upward preference was stronger in co-operative than in competitive conditions, particularly on the dimension on which the subject's own score was low. These and other results were discussed in relation to theoretical social comparison notions.     

Knowledge management in strategic planning: The case of the dutch fourth report

This article examines the management and use of knowledge in a relatively complex planning and policy process, i.e., the preparation and implementation of the Fourth Report on Physical Planning in the Netherlands. Attention is given to the organization of this process; the manner in which research, policy design and plan negotiation were intertwined in the various phases of the process; and the solutions developed for the problem of obtaining sufficient knowledge without losing the impetus essential to policy-making. General conclusions are derived especially concerning the interrelationship between policy-making and the accretion and depletion of knowledge stocks. While his earlier publications were primarily concerned with the application of demographic research in spatial policy, he has more recently shifted his attention to knowledge utilization problems in general.     

An efficient algorithm for TUCKALS3 on data with large numbers of observation units

A modification of the TUCKALS3 algorithm is proposed that handles three-way arrays of order I × J × K for any I. When I is much larger than JK, the modified algorithm needs less work space to store the data during the iterative part of the algorithm than does the original algorithm. Because of this and the additional feature that execution speed is higher, the modified algorithm is highly suitable for use on personal computers. This research has been made possible by a fellowship from the Royal Netherlands Academy of Arts and Sciences to the first author.