More of the Same? A Dual Case Study Approach to Examining Change Momentum in the Public Sector

Despite the significant amount of change experienced by the public sector, there has been relatively limited empirical examination of how change agendas affect public sector employees in Australia. This article presents a comparative analysis of two Australian public sector organisations that implemented the same positive work change agenda, but experienced very different outcomes. Using a critical realist approach, we draw on a mix of qualitative techniques to suggest that textbook notions of ‘successful change’, which are often derived from large private sector expectations, may fail to capture the complex nature of how public sector change initiatives may unfold. In particular, we demonstrate how political, temporal, contextual, and process factors interact to shift change momentum. Illustrative examples are provided throughout and the findings are discussed in terms of their implications for theory building, for change facilitation, and for future research.     

Acculturation Strategies and Mental Health in Gay,Lesbian, and Bisexual Youth

In this article, we examine the impact of acculturation strategies on minority stress and mental health in lesbian, gay, or bisexual (LGB) youth in Flanders, Belgium. Building on previous identity minority studies and on the social stress model, we investigate how LGB youth acculturate within both the LGB subculture and mainstream society and how this correlates with their mental health. Our sample is taken from an online survey and represents 561 LGB youth aged 14 through 21. The four traditional acculturation strategies are represented in this population (integration, separation, marginalization, assimilation). Bisexual boys are mostly absent from separation and integration strategies; gay and lesbian youth in middle adolescence are significantly more represented in the separation strategy compared to their late adolescence counterparts. Further, our findings suggest the relevance of identification with the LGB community, especially for internalized negative attitudes toward homosexuality. LGB youth who identify with the LGB community score significantly lower on this internalized homonegativity.     

Influenza A virus infection complicated by fatal myocarditis

Influenza virus typically causes a febrile respiratory illness, but it can present with a variety of other clinical manifestations. We report a fatal case of myocarditis associated with influenza A infection. A previously healthy 11-year-old girl had malaise and fever for approximately 1 week before a sudden, witnessed fatal collapse at home. Autopsy revealed a pericardial effusion, a mixed lymphocytic and neutrophilic myocarditis, a mild lymphocytic interstitial pneumonia, focal bronchial/bronchiolar mucosal necrosis, and histologic changes consistent with asthma. Infection with influenza A (H3N2) was confirmed by virus isolation from a postmortem nasopharyngeal swab. Attempts to isolate virus from heart and lung tissue were unsuccessful. Immunohistochemical tests directed against influenza A antigens and in situ hybridization for influenza A genetic material demonstrated positive staining in bronchial epithelial cells, whereas heart sections were negative. Sudden death is a rare complication of influenza and may be caused by myocarditis. Forensic pathologists should be aware that postmortem nasopharyngeal swabs for viral culture and immunohistochemical or in situ hybridization procedures on lung tissue might be necessary to achieve a diagnosis. Because neither culturable virus nor influenza viral antigen could be identified in heart tissue, the pathogenesis of influenza myocarditis in this case is unlikely to be the result of direct infection of myocardium by the virus. The risk factors for developing myocarditis during an influenza infection are unknown.