Collective Bargaining and Pay Inequity in the Public Sector - Essay Example In the United States at the moment majority of the states have passed legislations that permit workers to organise themselves and bargain collectively. This is because collective bargaining is a very important way through which employees can push for their rights considering the historical discrimination that has been witnessed in America’s public sector. The laws vary from state to state, for instance, only 12 states of all who have legalized collective recognise strikes are being legal. Those states not allowing strikes have outlined various processes for resolving issues in the workforce such as mediation and fact-finding. A good number of states use interest arbitration where neutral arbitrators listen to grievances raised, evaluate facts, and follow statutory criteria to come up with decisions as to the terms of collective bargaining agreements. Nonetheless, collective bargaining through unionisation has become a very popular practice in America and the world over. Unions represent members in many different ways which include and not limited to lobbying for favourable labor laws such as protection of employees from arbitrary discharge, educating and training members on their rights and most importantly negotiating compensation directly with employers on behalf of the membership. Collective bargaining agreements also address issues of discrimination in the work place based on gender, race and even class hence attempt to force employers apply the same standards to every individual. AFSCME for instance, which is mostly concerned with women has for the past few decades managed to lobby against pay inequity that is based on gender. One negative concern about trade unionism and collective bargaining agreements has been that they tend to indirectly further the inequality gap. In particularly comes about when covered employees are
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Schizophrenia: Risk Factors, Cognition and Structure John Rogers Schizophrenia: a review of risk factors, cognitive deficits, structural and function abnormalities. Introduction Occurring in about 1% of the world’s population, schizophrenia is a disorder of abnormal cognition encompassing oddities in perception, thinking, attention, learning, inhibition, memory, manner relating to and others (Cunningham Peters, 2014). Traditionally, schizophrenia has been broken down into several subtypes depending on the symptomology expressed (e.g. paranoid, disorganized, schizoaffective, catatonic). The symptomology of the disease is subdivided into both positive and negative classifications, as well as cognitive deficits. Positive symptoms implicated in the disease include delusion, hallucination, disorganized speech or clang associations, whereas negative symptoms include emotional flattening, asociality, anhedonia or avolition (Butcher, 2010).  This essay has four main aims. Firstly, while a definitive cause of schizophrenia still eludes us, an abundance of research has identified a wide array of biological and psychosocial risk factors and these aetiological factors will be outlined. Secondly, cognitive deficits associated with the disorder will be outlined. This section will highlight the widespread variety of cognitive deficits presented in patients and discuss some of the batteries of cognitive tests developed in assessing the extent of these shortfalls. Subsequently the structural abnormalities associated with the disease will be briefly revised, along with some of the confines of structural studies. Additionally the essay aims explore whether schizophrenia is a progressive disorder or solely a disorder of neurodevelopment based on structural analysis. Prior to concluding, the essay will review some findings from fMRI studies investigating the functional connectivity within the schizophrenic brain and how they relate to both the positive and negative symptoms presented in the illness. Furthermore, the limitations of fMRI studies, born out of a lack of precision of hemodynamic response measurements will be highlighted by analysing the results of an experiment examining activation during a working memory task. Aetiology The aetiology of schizophrenia is complex and cannot be reduced down to a single causal factor. This is evident when we consider the subtypes and indeed individual cases of the illness deviate massively in their presentation, responsiveness to treatment and illness trajectory (Moore, Kelleher Corvin, 2011). An abundance of research into the cause of the disorder suggests that a combination of predispositional physiological factors and a multitude of environmental risk factors result in brain pathways developing abnormally. Schizophrenia is a polygenic disease and thus cannot be explained by one mutated gene. Eyles, Feldon Meyer (2012) have identified 40 genes implicated in the development of the disease, signifying that it is a cocktail within a certain genotype that confers susceptibility to the illness. A study by Tinari et al. (2004) found that the genotype for higher risk in the illness only resulted in schizophrenia when an individual grew up in a dysfunctional vs. heathy family, suggesting that while biology provides the tinder, environment produces the spark. The dopamine hypothesis has stood out as the more proficient biological theory to date in investigating the causes of schizophrenia. While originally thought to be a functional excess of dopamine, research has indicated that it is actually increased receptor density and sensitivity, (particularly super-sensitivity at the D2 receptors; Wong et al. 1986) that may contribute to susceptibility of the disease (Butcher, 2010). Other successful biologically based studies into the aetiology of schizophrenia include the glutamate hypothesis, hormone studies and twin hereditary studies (see Cunningham Peters for review, 2014). Although the aforementioned studies and approaches are useful in understanding the illness, they all share a common limitation; they each ignore the environmental and developmental factors that may contribute more to the onset of the illness than genetics (Bagby Juhasz, 2013). Cannabis use has been closely related to the onset of schizophrenia, with young males who use being at significantly greater risk of developing the illness (Zammit et al., 2002). Moreover, 75% of individuals presenting with first-episode psychosis use the drug regularly (Archie et al., 2007) although some believe the correlation with high usage rates is due to self-medication (D’souza et al., 2005). Other well documented psychosocial risk factors include urban living, immigration, childhood experiences of trauma or neglect and immunological factors (for review see Cunningham and Peters, 2014) Cognitive deficits About 60-80% of schizophrenic patients display cognitive deficits (Lewis, 2004) across a multitude of domains including; attention, memory, processing speed, social cognition, reasoning and verbal learning (Keefe Harvey, 2012; Green et al. 2004). A study by Keefe et al., (2005) found that 98% of patients perform more poorly on cognitive tests than would be predicted by their parent’s education level. Additionally, a collection of studies have shown that cognitive impairment can reach two standard deviations below a healthy control mean (for review see Keefe Harvey, 2012). The MATRICS (measurement and treatment research in cognition in schizophrenia; Green et al., 2004) project has developed a battery of ten tests (MATRICS Consensus Cognitive battery; MCCB) in order to access cognitive functioning across these domains (see fig. 1) Fig 1. Shows the severity and profile of cognitive impairment in patients using the MCCB (Keefe et al. 2011a) This spread of cognitive deficits manifest itself across numerous domains from social to financial and occupational. For example, poor attention or attentive vigilance may result in an individual being unable to follow instructions or concentrate on a task in an occupational setting, or follow individual or group conversations in a social setting. Furthermore, schizophrenic individuals experience deficits in social cognition that create further difficulty within these settings such as theory-of-mind task performance (Tan et al., 2005) and perception of negative emotions, fear and facial affect in others (Penn et al, 1997). Research suggests that some of the cognitive deficits implicated in schizophrenia may develop prior to the onset of the disorder. A study by Jones Rodgers (1994) identified 30 individuals with schizophrenia from a random sample of 5000 individuals born in 1946. All subjects had been tested for non-verbal, verbal and reading abilities, arithmetic, and vocabulary, at ages 8, 11 and 15. Their progressively low scores in relation to heathy peers indicated a risk factor for the disease. These results should be approached with caution as a dysfunctional home environment may also affect both the academic ability in children as well as contribute to the onset of the illness. Nevertheless, other research has found similar results suggesting the cognitive deficit in a young person is a significant risk factor (Caspi et al., 2003; Erlenmeyer-Kimling et al. 2000). Although the impact of antipsychotic medications on neurocogniton provides minimal benefits to patients (Keefe Harvey, 2012), recent research has shown that patients who receive psychosocial support preform significantly better on several cognitive tasks than those who do not, suggesting that such interventions may be beneficial to those suffering with the disorder (Dalagdi et al., 2014). Structural abnormalities An abundance of research has aimed at identifying the structural deficits within schizophrenia. The most well documented deficits associated with the disorder are compromised white matter integrity (Kubicki et al., 2007) in addition to, a reduced grey matter volume across a range of neuroanatomical areas including the anterior cingulate, frontal and temporal lobes, hippocampus/amygdala and the thalamus (Shepard et al. 2002). Moreover, dorsolateral prefrontal cells have a simple dendritic organisation, indicating fewer synapses than a heathy individual (Kolb Whishaw, 2009) What remains a source of debate within the literature of the brain structure of schizophrenia is whether the disorder is progressive throughout the life-span or is strictly a neurodevelopmental disorder. While the lion’s share of the sMRI research posits that the illness progressively affects both grey and white matter (for meta-analysis see Olabi et al., 2011), others have suggested that the ‘progressive’ structural abnormalities observed could more be a consequence of numerous confounding variables (e.g. low physical activity, smoking, stress, alcohol, cannabis, anti-psychotic medication ; Zipursky, Reilly Murray, 2012). Furthermore, Zipursky et al. (2012) argue there is an absence of evidence of any toxic effect of psychosis on brain tissue. Zhang et al., (2014) used diffusion tensor imaging and a cross-sectional design in order to investigate whether schizophrenia produces progressive brain abnormalities. They found that schizophrenic patients showed lower fractional anisotropy (diffusion in the cells) values in the corpus callosum and corona radiate, and that these values were negatively correlated with the age of the patient. These researchers used a cross-sectional design and a majority of drug-naïve participants in an attempt to control for any medication effects, however, in doing this they open their results to scrutiny by drawing inferences about differences in two different brains. There are several limitations in structural studies in schizophrenia. Firstly, it’s very difficult to measure the effect of anti-psychotics on the brain without a control group of drug naïve patients. Given the debilitating nature of the illness, it’s difficult to find older patients that have not been medicated for long periods of time. Furthermore, if these patients are severely psychotic, it may prove impossible to test them, meaning some samples aren’t a true representation of the population. Secondly, there are causal problems in the structural studies. Consider, for example, an experiment using sMRI undertaken by Fornito et al., (2012). Their results showed schizophrenic patients have altered interregional connectivity and hypoactivation in the prefrontal cortex. What remains unclear is whether schizophrenic patients have these altered patterns of activation are a cause or are a consequence of the disorder. Functional abnormalities Schizophrenia is believed to be a disorder arising from disturbances in brain connectivity (Fornito et al., 2012) and that these disruptions prevent functionality in cognitive domains which often require communication between several distinct regions (Konrad Winterer, 2008). An analysis of resting functional connectivity of the disorder by Venkataraman et al. (2012) posits that patients display two distinct patterns when compared with healthy controls and that these patterns are correlated with the symptomology expressed. Abnormally increased connectivity between the medial parietal and frontal lobes was correlated with the presentation of positive symptoms, whereas decreased connectivity between medial parietal and temporal regions, and the temporal cortex, bilaterally corresponded with the presentation of negative symptoms (Venkataraman et al. 2012). Functional studies in schizophrenia typically use fMRI, which measures hemodynamic response related to changes in neural activity. While their usefulness in neuropsychology cannot be overstated, they are not without their limitations due to their precision. Consider for example the following experiment by Royer et al. (2009). This study found that even though schizophrenic individuals did not perform as well as the healthy groups in the working memory task (n-back), patients that did do well showed hyper-activation in the prefrontal and parietal lobes when compared to the control. Furthermore, fMRI showed increased activity in the superior frontal sulcus (self-awareness) and the posterior parietal cortex (planning of movement, attentional maintenance, response preparation/monitoring; Royer et al. (2009)) during successful trails. Here we run into a problem due to the lack of precision in the fMRI. While we can now observe frontal-parietal over-activation, we cannot distinguish whether this suggests either or both; (i) a compensatory mechanism allowing patients to perform well despite impaired cognitive functioning or, (ii) over-activation in the parietal areas corresponds to the BA 40 area (short term memory), suggesting improved effort (Royer et al., 2009). Conclusion Ultimately, schizophrenia is one of the most horrific examples of what can happen when the brain goes wrong. The disorder has a huge social and financial burden on sufferers, family members and healthcare systems. While there is no single cause of the disease, at least that we know of, research has shown the disorder to have a wide variety of risk factors in both biological and psychosocial domains. Schizophrenia presents itself in a wide variety of moderately to severely debilitating cognitive deficits although very recent research has shown that psychosocial interventions may at least curve the extent of these shortfalls (Dalagdi et al., 2014), at least in individuals whose positive or negative symptoms are not too extreme. Structurally, schizophrenia can be observed as disorder of compromised white matter integrity (Kubicki et al., 2007), reduced grey matter within the frontal and temporal lobes, hippocampus/amygdala and the thalamus (Shepard et al., 2002) and simple dendritic organisation within the dorsolateral prefrontal cells. The jury is out on whether schizophrenia is a progressive or neurodevelopmental disorder and this is primarily due to the difficulty in controlling for variables such as the effects of anti-psychotic medications, stress, and long term institutionalisation may have on brain structure. The positive or negative symptoms expressed in schizophrenia are related to the functional abnormalities in connectivity between the various brain regions (Venkataraman et al., 2012). While fMRI studies can provide us with valuable clues as to which brain regions are implicated in specific processes, there are issues with precision when comparing blood flow to activation is precise areas.
Impact of Emotional Intelligence on Manager Performance The impact of emotional intelligence on managers’ performance: Evidence from hospitals located in Tehran ABSTRACT Context: Most of the studies show that emotional intelligence (EI) is an important factor for effective leadership and team performance in organizations. Aims: This research paper aims to provide an exploratory analysis of EI in the hospitals managers located in Tehran, and examine its relation to their performance. Settings and Design: The present research was an analytical and cross-sectional study. Setting of the study was hospitals located in Tehran, Iran. Subjects and Methods: We conducted a cross-sectional study from a matched sample of 120 managers and 360 subordinates in hospitals located in Tehran. Cyberia shrink EI measure was used for assessing the EI of the participants. Moreover, a management performance Questionnaire is specifically developed for the present study. The total of 480 questionnaires analyzed throughout Kolmogorov–Smirnov, Mann–Whitney, and Kruskal–Wallis tests in SPSS. Results: The findings suggested a poor EI among hospital managers. As for EI subscales, social skills and self-motivation were in the highest and lowest levels respectively. Moreover, the results indicated that EI increases with experience. The results also showed there is no significant relationship between the components of EI and the performance of hospital managers. Conclusions: Present research indicated that higher levels of EI did not necessarily lead to better performance in hospital managers. Key words: Emotional intelligence, hospital managers, performance INTRODUCTION Emotional intelligence (EI) is the ability to identify, appraise, and handle one’s emotions.[1] Goleman and Sutherland[2] define EI as the ability to motivate oneself and persist in the face of frustration; to control impulses and delay gratification; to regulate one’s moods and keep distress from swapping the ability to think; to emphasize and to hope. As such Bar On,[3] defines EI as being concerned with understanding oneself and others, in relation with people and coping with the immediate surroundings in order to be more successful in dealing with environmental demands. Weisinger[4] sees EI as the intelligent use of feelings or making one’s emotions work to one’s advantage by using them to help guide behavior and thinking in beneficial ways. In this study, EI were defined as set of skills that contribute to the accurate appraisal and expression of emotion in oneself and in others, the impressive regulation of emotion, and the utilization of feelings to plan, persuade, and achieve in life.[5] Many studies have been conducted about EI that addressed both its concept and its measurement.[6] Some researchers believe in an ability model of EI,[5] while others claim that EI consists of both cognitive ability and personality aspects.[2,3] The ability model perceives EI as a form of pure intelligence, that is, EI is a cognitive ability. Salovey and Mayer’s model of EI is measured using the Mayer-Salovey-Caruso EI test, a performance measure which requires the participant to complete tasks associated with EI.[7] In contrast, the mix models of EI either emphasize how cognitive and personality factors influence general well-being[3] or focus on how cognitive and personality factors determine workplace success.[2] Bar On’s model is measured by using the emotion quotient inventory and Goleman’s model is measured by using the emotional competency inventory, the EI appraisal,[8] and the Work Profile Questionnaire.[9] Put it in perspective, research has shown that EI is an important factor in the workplace.[10-14] Researchers argue that EI is a critically important competency for effective leadership and team performance in organizations.[14-16] Some theorists claim that EI of managers can affect work output,[10,11] although evidence for this is not sufficient more.[17,18] EI has been reported to be positively associated with job satisfaction.[14] EI employees will be more capable of controlling their perception of the environment in which they work.[14] Leaders who are high on EI will be better able to take advantage of and use their positive moods and emotions to envision major improvements in their organizations’ functioning. They are also likely to have knowledge about the fact that their positive moods may cause them to be overly optimistic. Moreover, job performance is the aggregated value to the organization of the behavioral episodes performed by individuals over time that have positive or negative consequences for the organization.[19] Managers high on EI can foster their employees’ creativity through interaction with them and via the creation of a work climate supportive of creativity.[20,21] In addition, managers high on EI can create positive interactions between employees that leads to better cooperation,[22] coordination[23] and organizational behavior.[8,14] Furthermore managers high on EI help their employees in creating a good working climate and also reliable relationship with the customers.[24] Given the discussion above, EI plays a significant role in the manager-employee relationship and their performance. Though, the effects of EI on managers’ performance have not been assessed more in healthcare context. Considering the differences of the hospital environment in compare with other organizations, this study provides good evidence, with assessing the effect of EI on managers’ performance in hospitals environment for decision makers in health sector. SUBJECTS AND METHODS The present research was an analytical and cross-sectional study which were done in hospitals affiliated to three medical universities in Tehran (Tehran University of Medical Sciences, Iran University of Medical Sciences and Shahid Behshti University of Medical Sciences). For selecting the samples in this study, only managers who had a minimum of three subordinates were included. Finally 120 top, middle, and lower level managers of the hospitals were selected. Moreover, 360 individuals participated in this study to appraise performance of the managers; in that each three individuals evaluated the performance of their direct manager. Overall, 480 questionnaires were completed by the participants and data were analyzed by Kolmogorov–Smirnov, Mann–Whitney, and Kruskal–Wallis tests in Statistical Package for Social Sciences (SPSS Inc., Chicago, IL, USA), version 16. This study was approved by Iran University of Medical Sciences Ethics Committee. Participants in this study were informed that participating in this study is voluntary; which means if they don’t like to answer some questions they are free not to answer them and their biography will be treated as confidential and will not be disclosed. Furthermore participants provided informed consent for publication of this work. In this study, we followed Goleman’s model and examines five aspects of EI: self-awareness (the ability to recognize and understand personal moods and emotions, and their influence on postpone judgment and to think before acting), self-motivation (a passion to work for internal reasons that go beyond money and status), social awareness (the ability to understand the emotional makeup of other people), and social skills (the ability to manage relationships and build networks, and to find common ground and build rapport).[2] For this, Cyberia shrink EI questionnaire was used for assessing the EI of the participants. This questionnaire measures five subscales, namely self-awareness (seven items), self-regulation (four items), self-motivation (four items), empathy or social awareness (five items), and social skills (five items). [2] Moreover a management performance (MP) Questionnaire was specifically developed for the present study, which measures four major subscales: planning (8 items), organization (12 items), leadership (18 items), and control (12 items). Reliability and validity tests were conducted on Farsi version of the EI questionnaire and MP questionnaire with multivariate measure. To assess the acceptance of the questionnaires, 10 people involved at least 10 years in the field of academic managerial practice were invited to participate I order to revising parts of the questionnaires. At the end, all participants expressed high agreement to the appropriateness of the questionnaires. The questionnaires finalized after modifying some questions accordingly. Furthermore Cronbach’s alpha measured for the tools. The results showed that Cronbach’s alpha of Farsi version of EI questionnaire for all dimensions was as 0.89, and for MP questionnaire was as 0.88, which indicates strong reliability for our survey instruments. RESULTS Data showed 92 (76.6%) of samples were male and 28 (23.4%) were female. Participants’ age ranged from 23 to 57 (the majority of the managers belonged to the 40–50 years group) and the average age was 43.45 (standard deviation [SD] = 7.51). 45% of the managers had been >10 years of experience (mean = 14.24, SD = 7.14). The results show performance of male managers in public hospitals (mean 36 ± 13) was better that those in private hospitals (mean 35 ± 23). On the other hand, the performance of female managers in private hospitals (mean 38 ± 16) was significantly better that those in public hospitals (mean 36 ± 17). Emotional intelligence subscales scores of managers show that social skills have the highest rank and self-motivation has the lowest rank. In general, the EI score of hospital managers in this study was 56% [Table 1]. Moreover, there is no significant difference between the EI of men and women. Based on the result of this research, hospital managers in higher levels have a higher level of EI. Tough in some subscales of EI such as social awareness and social skills, middle managers have the highest score [Table 2]. The results of this study also showed, there is no significant relationship between education and the level of EI. However, this relationship is significant in social awareness. Moreover, the EI of the managers increased with experience, but this did not apply to all subscales of EI; as such in social awareness. Based on the results, a correlation was observed between the EI of hospital managers and their performance, although this correlation was not significant in any subscale of EI [Table 3]. DISCUSSION This study tried to assess the level EI of managers in hospitals located in Tehran and examine the relationship between the EI of hospital managers and the level of their performances. The result of this research shows there is a relation between EI of managers and their performances. However this relationship is not statistically significant. Most researches has shown that EI is positively associated with interview outcomes,[25] management analytical,[26] issues,[27] team working,[28] conceptual tasks[27] and (behavioral, job and employees) performance.[29-31] Studies have also depicted that emotional perception facilitates performance. Day and Carroll[17] showed that emotional perception was correlated with performance on a cognitive decision-making task. Newcombe and Ashkanasy[32] also showed evocation of positive expressed emotion through facial display has a significant and strong impact on follower and affect, the quality of the perceived leader-member relationship, which in turn with the result of present study. Langhorn[33] determined key areas of profit performance were correlated with the EI pattern of the general manager. Lyons and Schneider[34] examined the relationship of ability-based EI facets with performance under stress. They found that certain dimensions of EI were related to more challenge and enhanced performance. Hayashi and Ewert[35] reported a positive relationship between EI and successful leadership. Furthermore, Eicher[36] describe EI as a suitable basis in developing the staff’s executive programs. Offermann et al.[37] determined although both cognitive ability and emotional competence (intelligence) predict performance, cognitive ability accounts for more variance on individual tasks, whereas emotional competence accounts for more variance in team performance and attitudes. As such our study shows, performance of managers is multi-dimensional variable which can be affected by other factors like organizational factors, level of employees’ motivation than EI. Moreover the results of this study shows, there are no significant differences between EI of men and women. Although in those subscales associated with the social behavior (social awareness and social skills) women had higher scores than men. Generally, women are more aware of emotions, show more empathy, and have higher interpersonal communication skills.[3] As were discussed, in many of the previous studies, EI has been reported to be positively associated with performance. However, the results of the present research indicated that there is no significant relationship between the components of EI the performance of hospital managers. In other words, higher levels of EI did not lead to better performance in the hospital managers. CONCLUSIONS The current study shows managers in hospitals located in Tehran, had weak performance from their subordinates’ perspectives, and EI scores of managers were not in good condition. Moreover this research shows, unlike other related studies, there is no significant relationship between performance and EI of hospital managers. The effects of factors on the hospital managers’ performances should be assessed in more holistic point of view than considering EI as a determined factor on it.
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