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J Collins

Publications and source records attributed to J Collins.

504 records · Page 28Linked to original sources
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Turning goals into results: the power of catalytic mechanisms.

Most executives have a big, hairy, audacious goal. They write vision statements, formalize procedures, and develop complicated incentive programs--all in pursuit of that goal. In other words, with the best of intentions, they install layers of stultifying bureaucracy. But it doesn't have to be that way. In this article, Jim Collins introduces the catalytic mechanism, a simple yet powerful managerial tool that helps translate lofty aspirations into concrete reality. Catalytic mechanisms are the crucial link between objectives and performance; they are a galvanizing, nonbureaucratic means to turn one into the other. What's the difference between catalytic mechanisms and most traditional managerial controls? Catalytic mechanisms share five characteristics. First, they produce desired results in unpredictable ways. Second, they distribute power for the benefit of the overall system, often to the discomfort of those who traditionally hold power. Third, catalytic mechanisms have teeth. Fourth, they eject "viruses"--those people who don't share the company's core values. Finally, they produce an ongoing effect. Catalytic mechanisms are just as effective for reaching individual goals as they are for corporate ones. To illustrate how catalytic mechanisms work, the author draws on examples of individuals and organizations that have relied on such mechanisms to achieve their goals. The same catalytic mechanism that works in one organization, however, will not necessarily work in another. Catalytic mechanisms must be tailored to specific goals and situations. To help readers get started, the author offers some general principles that support the process of building catalytic mechanisms effectively.

Administrative Personnel↗
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Progress in efforts to prevent the spread of HIV infection among youth.

The Human Immunodeficiency Virus (HIV) that causes AIDS will continue to threaten public health for years to come. Despite some popular misperceptions, adolescents are at risk of infection. Twenty percent of persons reported with AIDS have been ages 20 through 29. Given the long incubation period between HIV infection and AIDS, some of these young adults probably were infected while they were teenagers. Young people must develop the skills they will need to avoid HIV infection and other related health problems. In 1987, the Centers for Disease Control (CDC) launched a national program to help schools and other agencies that serve youth across the nation provide effective health education to prevent the spread of HIV. CDC supports and works closely with national health and education organizations, State and local education agencies, colleges and universities, and local health departments to establish HIV prevention policies and programs, training and demonstration centers, information development and dissemination activities. The impact of these efforts are assessed through applied surveillance and evaluation research. Through this system, CDC is attempting to institutionalize the means for continuously providing educational programs that will be effective in preventing HIV infection and other important health problems.

Adolescent↗
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Tc-99m HMDP bone scintigraphic findings in association with concurrent serum osteocalcin measurements.

Osteocalcin is a noncollagenous bone protein produced by osteoblasts. Increase in serum osteocalcin level reflects osteoblast activity with acceleration of bone formation. To evaluate the correlation of Tc-HDP bone scintigraphic findings and concurrent serum osteocalcin, serum osteocalcin values of 40 consecutive patients were measured by radioimmunoassay at the time of initial referral for bone studies. These patients, all males aged 23-93, were studied for various disease entities, including prostate carcinoma. The results of the assay were categorized into three groups (gp) as follows: 17 at normal (1.8 to 6.6 ng/ml) level (gp 1), 21 low (gp 2), and two high (gp 3). Only one bronchogenic carcinoma patient with a high level had a right iliac lesion suggesting metastasis. The bone scans of nine patients with normal or low levels showed positive metastases. Two patients with stress fractures as shown on bone scans had normal levels. The images of patients with disparity between serum osteocalcin and positive bone lesions may be interpreted as follows: Instead of osteoblastic activity resulting in the synthesis and/or release of osteocalcin, area(s) of increased uptake in the bone scan may be predominantly reflecting increased regional blood flow and decreased sympathetic tone, resulting in an increase in bone-agent deposition.

Adult↗
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Are nurses less satisfied than other workers?

Are nurses less satisfied than other workers? In this study comparing job satisfaction of baccalaureate nurses with elementary teachers and accountants, the three groups rated many aspects of their jobs similarly. Nurses were not comparatively or pervasively less satisfied with their jobs than these other professionals except in the areas of salary, chance for administrative participation, and job security.

Adult↗
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The fat of the land.

Explore the source record for details and available documents.

Diet, Reducing↗
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The best available adjuvant treatments are within the framework of clinical trials. The International Breast Cancer Study Group.

The International Breast Cancer Study Group (IBCSG, formerly the Ludwig Group) is currently conducting several trials to improve available adjuvant therapies for operable breast cancer. Within the framework of clinical trials, treatment is available for several subpopulations of patients with operable disease. Two trials for patients with node-negative breast cancer question the efficacy of the combination of chemotherapy and endocrine manipulation. Four trials for patients with node-positive disease investigate questions of chemoendocrine therapy and of delayed reintroduction of chemotherapy after an initial cytotoxic treatment. One trial for elderly patients investigates the role of axillary lymph node dissection in terms of treatment outcome and quality of life. The ongoing trials are based on the results of past investigations by the Group: seven clinical trials, conducted since 1978, tested hypotheses of timing, duration, and the combined use of chemo- and endocrine therapies. Several ancillary studies were conducted using the database amassed from these trials, including pathological findings in node-negative disease, significance of micrometastases detected by serial sectioning of axillary nodes, importance of c-erbB-2 oncogene expression for prediction of treatment responsiveness, patterns of relapse, and assessing the impact of adjuvant treatment for breast cancer on the patients' quality of life. This report presents updated results of the seven IBCSG trials conducted from 1978 to 1993 and describes the trials currently open to patient accrual.

Aged↗
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School-based programs to reduce sexual risk behaviors: a review of effectiveness.

This review was undertaken in recognition of the mounting public health and social problems associated with adolescent sexual behavior and the importance of basing school-affiliated programs designed to reduce sexual risk-taking behavior on sound research. The authors were commissioned by the Division of Adolescent and School Health within the Centers for Disease Control and Prevention, Public Health Service, to review carefully the research on these programs and to assess their impact on behavior. The authors identified 23 studies of school-based programs that were published in professional journals and measured program impact on behavior. They then summarized the results of those studies, identifying the distinguishing characteristics of effective programs, and citing important research questions to be addressed in the future. Not all sex and AIDS education programs had significant effects on adolescent sexual risk-taking behavior, but specific programs did delay the initiation of intercourse, reduce the frequency of intercourse, reduce the number of sexual partners, or increase the use of condoms or other contraceptives. These effective programs have the potential to reduce exposure to unintended pregnancy and sexually transmitted disease, including HIV infection. These programs should be replicated widely in U.S. schools. Additional research is needed to improve the effectiveness of programs and to clarify the most important characteristics of effective programs.

Acquired Immunodeficiency Syndrome↗
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Guidelines for the management of Helicobacter pylori-related upper gastrointestinal diseases. Irish Helicobacter Pylori Study Group.

The discovery of H. pylori is the most important development in gastroduodenal disease this century. It has completely changed our understanding of conditions that occur in the upper gastrointestinal tract. Eradication of the bacterium will cure peptic ulcer disease, decrease the symptoms of non-ulcer dyspepsia and may prevent gastric cancer. There has been an exponential increase in the amount of research in this area in recent years and, consequently, there is considerable confusion as to how H. pylori-related conditions should be managed. It is hoped that these guidelines will clarify some of these issues.

Adult↗
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Effects of simvastatin and enalapril on serum lipoprotein concentrations and left ventricular mass in patients on dialysis. The Perfect Study Collaborative Group.

A randomised trial of simvastatin and enalapril in patients with chronic renal failure on dialysis: effects on serum lipoprotein concentrations and left ventricular mass. Left ventricular hypertrophy and abnormalities of lipoprotein metabolism are both possible contributors to the high risk of cardiovascular death in patients with chronic renal failure on dialysis. We investigated the effects of simvastatin on lipid and lipoprotein concentrations and the effects of enalapril on left ventricular mass in 107 patients receiving haemodialysis or continuous ambulatory peritoneal dialysis. Patients were randomised in a factorial design to receive simvastatin (10 mg daily) or placebo and enalapril (2.5-5 mg daily) or placebo. During follow-up, there was a significant excess of patients withdrawn from enalapril because of hypotension (2p = 0.002), and after 6 months only 55% of those assigned enalapril were still on treatment. From baseline to 6 months, there were no statistically significant differences in left ventricular mass or left ventricular dimensions between patients assigned enalapril and those assigned placebo. Among the patients assigned simvastatin, total cholesterol was reduced by 13% (2p = 0.001), LDL cholesterol was reduced by 17% (2p = 0.003) and apolipoprotein B was reduced by 12% (2p = 0.005) compared to patients assigned placebo. There were borderline significant (2p = 0.05 to 0.08) reductions in VLDL cholesterol, total triglyceride and VLDL triglycerides of 26%, 12% and 17% respectively. Large-scale trials are now required to determine whether reductions in lipid and lipoprotein concentrations confer a reduction in coronary heart disease morbidity and mortality in patients on dialysis.

Adolescent↗
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The use of condoms with other contraceptive methods among young men and women.

In a nationally representative sample of sexually experienced youths aged 14-22, 37% of young women and 52% of young men said the condom was the primary method used to prevent pregnancy at last intercourse; an additional 8% and 7%, respectively, said they used a condom at last intercourse; much of this represents dual use [corrected]. Condom use at last intercourse was reported by 25% of young men whose partner was using the pill. Significant independent predictors of condom use with the pill among men included younger age, black race, engaging in fewer nonsexual risk behaviors and having received instruction about HIV in school. Among young women, 21% of those relying on the pill reported also using a condom at last intercourse. For women, independent predictors of dual use included younger age, black race, older age at first sex, fewer nonsexual risk behaviors, having no partners in the previous three months and having talked to parents or other adult relatives about HIV.

Adolescent↗