The reciprocal dynamics of organizing and sense‐making in the implementation of major public‐sector reforms

Abstract: Drawing on a longitudinal study from the early years of implementation of health‐care networks in Quebec, this article describes how public‐sector managers deal with complex challenges when both organizational structures and organizational strategies are radically transformed simultaneously. The new organizations studied had to completely re‐shuffle roles and responsibilities of their management teams while making sense of their new mandate of developing a population‐focused approach to health problems – all the time maintaining day‐to‐day operations. The four health‐care networks studied proceeded somewhat differently to meet these reciprocal challenges. The study reveals the importance of balancing organizing initiatives (focused on structures) with “sense‐making” initiatives (focused on strategies), of developing capacities for sense‐making through the creation of key “sense‐maker/sense‐giver” positions whose occupants are able to ensure that conceptual activities engage people working at different levels, even as organizational structures are in flux, and of mobilizing external constraints and influences as opportunities and resources in sense‐making and organizing. Sommaire : Se fondant sur une étude longitudinale des premières années de la mise en œuvre des réseaux de soins de santé au Québec, cet article décrit la manière dont les gestionnaires du secteur public font face à des défis complexes, alors que les structures et les stratégies organisationnelles sont radicalement transformées simultanément. Les nouveaux organismes étudiés ont dû complètement remanier les rôles et les responsabilités de leurs équipes de gestion et comprendre leur nouveau mandat d'élaborer une approche axée sur la population pour ce qui est des problèmes de santé, tout en maintenant leurs activités au jour le jour. Les quatre réseaux de soins de santéétudiés ont travailléà relever ces défis réciproques d'une manière assez différente. L'étude révèle l'importance de trouver un équilibre entre les initiatives consistant à organiser (axées sur les structures) et les initiatives consistant à interpréter les faits (axées sur les stratégies) ; de perfectionner les capacités à interpréter les faits grâce à la création de postes clés d'«interpréteurs de faits», dont les titulaires veilleraient à ce que des activités conceptuelles fassent intervenir les gens travaillant à différents niveaux même lorsque les structures organisationnelles fluctuent continuellement; et enfin de tirer parti des contraintes et influences externes comme autant d'occasions et de ressources pour interpréter et organiser les faits.     

Does Anger Towards the Partner Mediate and Moderate the Link Between Romantic Attachment and Intimate Violence?

The goal of this study is to evaluate a theoretical model of the link between attachment andcouple violence. The hypotheses state that experience and expression of anger towards the partner would mediate and moderate the association between an insecure attachment and couple psychologicaland physical violence. A sample of 316 couples representative of the French-speaking population ofQuebec filled out the Experiences in Close Relationships questionnaire, a couple version of the State-Trait Anger Inventory, and the Revised Conflict Tactics Scales. The mediator model revealed that experience and expression of anger in couples (state anger, trait anger, and anger-out) explained the association between an insecure attachment and intimate violence. The moderator model showed that significant interactions between male anxiety over abandonment and anger indicated that anger in couples (trait anger and anger control) moderates the strength and the direction of the association between attachment and intimate physical violence. Different outcomes were obtained when gender and type of violence were considered.     

Vertical Competition in Unitary States: The Case of Italy

In unitary states – states in whichconstitutional powers are owned by thecentral government – vertical competitioncan generate stable outcomes, that isoutcomes that do not unravel througharbitrary repossessions by the center.Stability is a product of institutionalcommitment devices. Through these ademocratic government, though it cannotbind successor governments, can effectivelyoblige them to respect some of thedecisions it has made. A number of suchcommitment devices exist in Italy; theymake possible stable vertical competitionbetween central and regional governments.     

Fatal Case of a 27‐Year‐Old Male After Taking Iboga in Withdrawal Treatment: GC‐MS/MS Determination of Ibogaine and Ibogamine in Iboga Roots and Postmortem Biological Material

We report the case of a man who died twelve hours after ingesting powdered iboga root, commonly taken for its stimulant and hallucinogenic properties. Ibogaine and ibogamine were quantified in the powder ingested and the victim's body fluids by GC‐MS/MS after liquid–liquid extraction (Toxi‐tubes A^®). The concentrations of ibogaine measured in the blood samples taken at the scene and in the peripheral blood, urine, and gastric fluid samples taken during the autopsy were 0.65, 1.27, 1.7, and 53.5 μg/mL, while the iboga content in the powder was 7.2%. Moreover, systematic toxicological analyses of biological samples showed the presence of diazepam and methadone in therapeutic concentrations. Death was attributed to the ingestion of a substantial quantity of iboga in the context of simultaneous methadone and diazepam consumption.     

Death From Butane Inhalation Abuse in Teenagers: Two New Case Studies and Review of the Literature

The ready availability of butane makes butane abuse frequent. Fatalities are rare. This study presents two cases of death by butane overdose. The postmortem analyses were carried out using headspace gas chromatography–mass spectrometry. It revealed femoral blood butane concentrations of 18 and 22 mg/L, respectively, as well as specific combinations of adjuvants in each victim. In one of the victims, brain and fatty tissue also contained butane, pointing to chronic consumption. The originality of this study is to show that the identification of specific combinations of adjuvants can be helpful for identifying the brand of deodorant used. Also, sampling the skin and mucosa can help identify the method of drug delivery. The histological examination documented both the direct toxic effect of the gas on the respiratory mucosa and signs of chronic abuse. Volatile substance intoxications should be systematically considered in case of sudden death in a teenager.     

Bureaucracy and state intervention: Parkinson's Law?

Abstract. Parkinson's Law is the popular idea that bureaucrats or administrators are bound to multiply. The basis for the Law was Parkinson's observation that, in some organizations, the number of administrators continued to increase even when the organization, as measured either by its output or the size of its direct labour force, was declining. This paper first considers two popular explanations of this phenomenon: the political monopoly model and the model of bureaucrats as budget maximizers. The authors show that neither of these theories is capable of providing a satisfactory explanation of Parkinson's observations. They then outline a new and more general theory of bureaucracy, in which bureaucrats maximize power, not by maximizing budgets, but by accumulating the loyalty of their subordinates and that of interest groups and the media. The paper then shows that this model does provide a consistent and indeed commonsense explanation of Parkinson's observations. All declining organizations might be expected to become top-heavy with administrators, as Parkinson predicted, but the process need have nothing to do with bureaucratic expansionism. The paper concludes by stressing the important policy implications of Parkinson's Law for the rational administration of government in an era of declining budgets. Sommaire. Selon une conception populaire, les bureaucrates ou les administrateurs sont régis par la loi de Parkinson: ils tendent à se multiplier. Cette loi découle de l'observation de Parkinson suivant laquelle, dans certaines organisations, le nombre des administrateurs continue à augmenter même lorsque la taille de l'organisation, mesurée par sa production ou par l'importance de sa main-d'oeuvre directe, diminue. Nous considérons deux explications populaires de ce phénomène: le modèle du monopole politique et celui des bureaucrates maximiscurs de budgets. Nous montrons que ni l'une ni l'autre de ces théories est capable d'expliquer de façon satisfaisante les observations de Parkinson. Nous offrons done une nouvelle théorie, plus générale, de la bureaucratic, d'après laquelle les bureaucrates maximisent le pouvoir et non les budgets, en accumulant la loyauté de leurs subordonnés, celle des groupes impliqués et celle des media. Nous démontrons ensuite que ce modèle fournit une explication cohérente et en fait logique, des observations de Parkinson. Nous nous attendons à ce que toutes les organisations en perte de vitesse aient une quantité disproportionnée d'administrateurs, comme l'a prédit Parkinson, mais ce processus n'a rien à voir avec l'expansionnisme bureaucratique. Nous concluons cet article en insistant sur les conséquences importantes de la loi de Parkinson pour l'administration rationnelle du gouvernement en période de restrictions budgétaires. ‘Work expands to fill the time available for its completion.’-C. N. Parkinson.     

Federalism and Decentralization: Ownership Rights and the Superiority of Federalism

The benefits and costs usually ascribed to federalism are benefitsand costs of decentralization; they are, therefore, presentin unitary states that are in fact all decentralized. The benefitsand costs specific to federalism pertain to ownership rightsin constitutional powers. Federalism is superior to confederalismand unitarianism because the ownership rights peculiar to thatsystem of government are such that they ensure the perduranceof competition when one or more competitors are unsuccessful.They do so because under federalism, powers cannot be repossessedunilaterally. Ownership rights have to be enforced; as a consequence,there are also costs that are specific to federalism.