Purpose: As healthcare has become more scientifically based and far more sophisticated in terms of technology, it has become more fragmented in terms of care-giving, and less personal. The purpose of this paper is to discuss the challenging task of leading and managing in the gap between the existing and emerging cultures of healthcare.
Design/methodology/approach: This paper considers the literature on culture, how it exists at many levels and in multiple forms, and the impacts it has on the US healthcare system. Further, the paper explores foundations of the current healthcare culture and attempts to forecast features of the emerging culture, incorporating examples of advances in scientific knowledge and technology.
Findings: System change will continue to be problematic until leaders and change agents find ways to operate effectively in the gap between the existing cultural tenets and those emerging as the result of scientific and technological advancements.
Originality/value: Punctuated equilibrium theory serves as a main tenet for describing how changes will continue to push the USA towards a cultural tipping point. This paper contends that leaders and managers can succeed only by understanding and respecting both cultures and calls for improved theory development and research to help find creative ways to advance the new culture without trampling the old.
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http://dx.doi.org/10.1108/14777261211230826 | DOI Listing |
Sci Rep
January 2025
College of Water Conservancy and Hydropower Engineering, Hohai University, Nanjing, 210098, China.
Internal instability of embankment soils under seepage can occur in two distinct ways: suffusion and suffosion. Suffusion involves the removal of fine particles from the matrix without causing significant disturbance to the soil skeleton, while suffosion is characterized by the movement of fine particles accompanied by skeleton collapse or deformation. In terms of dam safety, suffosion poses a greater threat than suffusion.
View Article and Find Full Text PDFSci Rep
January 2025
Department of Chemistry, School of Advanced Sciences, Vellore Institute of Technology, Vellore, Tamil Nadu, 632014, India.
Hydroxyapatite (HA) is an important constituent of natural bone. The properties of HA can be enhanced with the help of various ionic substitutions in the crystal lattice of HA. Iron (Fe) is a vital element present in bones and teeth.
View Article and Find Full Text PDFJ Subst Use Addict Treat
January 2025
Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, 1070 Arastradero Road, Palo Alto, CA 94304, United States of America. Electronic address:
Background: Opioid-related overdoses increased substantially during the COVID-19 pandemic, eliciting an urgent demand for accessible treatment for individuals with opioid use disorder (OUD) and those who support them (support persons). Support persons can improve treatment initiation and retention in their individuals with OUD. Additionally, support persons may have their own mental health needs related to their loved one's OUD.
View Article and Find Full Text PDFPharmacol Ther
January 2025
Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran; Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran. Electronic address:
While benzodiazepines have been a mainstay of the pharmacotherapy of anxiety disorders, their short-term efficacy and risk of abuse have driven the exploration of alternative treatment approaches. The endocannabinoid (eCB) system has emerged as a key modulator of anxiety-related processes, with evidence suggesting dynamic interactions between the eCB system and the GABAergic system, the primary target of benzodiazepines. According to the existing literature, the activation of the cannabinoid receptors has been shown to exert anxiolytic effects, while their blockade or genetic deletion results in heightened anxiety-like responses.
View Article and Find Full Text PDFLancet Neurol
February 2025
Department of Clinical Neurological Sciences, University of Western Ontario, London, ON, Canada; Department of Cognitive Neurology, St Joseph's Health Care London, London, ON, Canada. Electronic address:
Background: No treatments exist for apathy in people with frontotemporal dementia. Previously, in a randomised double-blind, placebo-controlled, dose-finding study, intranasal oxytocin administration in people with frontotemporal dementia improved apathy ratings on the Neuropsychiatric Inventory over 1 week and, in a randomised, double-blind, placebo-controlled, crossover study, a single dose of 72 IU oxytocin increased blood-oxygen-level-dependent signal in limbic brain regions. We aimed to determine whether longer treatment with oxytocin improves apathy in people with frontotemporal dementia.
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