Transparency in healthcare relates to formally reporting medical errors and disclosing bad outcomes to patients and families. Unfortunately, most physicians are not in the habit of communicating transparently, as many studies have shown the existence of a large medical error information gap. Research also shows that creating a culture of transparency would mutually support patient safety and risk management goals by concomitantly reducing medical errors and alleviating the malpractice crisis. Three predictor variables are used to represent the various dimensions of the context just described. Perfectionism represents the intrapersonal domain, socio-organizational climate represents the interpersonal and institutional domains, and medico-legal environment represents the societal domain. Chin and Benne’s normative re-educative strategy provides theoretical support for the notion that successful organizational change hinges upon addressing the structural and cultural barriers displayed by individuals and groups. The Physician Transparency Questionnaire was completed by 270 physicians who were drawn from a multi-site healthcare organization in Central Florida. Structural equation modeling was used to determine whether perfectionism, socio-organizational climate, and medico-legal environment significantly predict two transparency outcomes, namely, error reporting transparency and provider-patient transparency. Perfectionism and socio-organizational climate were found to be statistically significant predictors. Collectively, these variables accounted for nearly half of the variance in each transparency outcome. Within socio-organizational climate, policies had the greatest influence iv on transparency, followed by immunity and professional norms. Multiple group analysis showed that the covariance model developed in this study generalizes across gender, medical specialty, and occupation. In addition, group means comparisons tests revealed a number of interesting trends in error reporting and disclosure practices that provide insights about the behavioral and cognitive psychology behind transparent communication: 1) Physicians are more inclined to engage in provider-patient transparency compared to error reporting transparency, 2) physicians are more inclined to report serious errors compared to less serious errors, and 3) physicians are more inclined to express sympathy for bad outcomes than they are to apologize for a preventable error or be honest about the details surrounding bad outcomes. These results suggest that change efforts would need to be directed at medical education curricula and health provider organizations to ensure that current and future generations of physicians replace the pursuit for perfectionism with the pursuit for excellence. Also, a number of institutional changes are recommended, such as clearly communicating transparency policies and guidelines, promoting professional norms that encourage learning from mistakes rather than an aversion to error, and reassuring physicians that reporting and disclosure activities will not compromise their reputation. From the perspective of patient safety advocates and risk managers, the results are heartening because they emphasize a key principle in quality improvement - i.e., small changes can yield big results. From an ethical standpoint, this research suggests that healthcare organizations can inhibit (or facilitate) the emergence of professional virtues. Thus, although organizations cannot make a physician become virtuous, it is within their power to create conditions that encourage the physician to practice certain virtues. With respect to leadership styles, this research finds that v bottom-up, grassroots change efforts can elicit professional virtues, and that culture change in healthcare lies beyond the scope of the medico-legal system

This research provides insights into three aspects of social capital: the factors that influence its variability; its two-dimensional nature; and the relationship between social capital and membership in a YMCA. These insights have implications for social capital theory, for public policy, for organizational management and for individual well-being. Most social capital research treats the construct as a causal variable and analyzes the implications of different levels of social capital for certain aspects of individual and community well-being. This treatment implies that levels of social capital vary. Little research has been done to analyze the factors that cause social capital variability and therefore the understanding of social capital variability lacks insight. Before social capital variability can be explored, an intermediate issue must be addressed. Social capital is usually conceived of as a single-dimension construct. In fact social capital has two dimensions: the attitudes of social capital and the behaviors of social capital. Unidimensionality is sufficient when social capital is used exogenously but it is insufficiently nuanced when used for the purpose of recommending policies to increase it. This research analyzes the two-dimensional nature of social capital. Finally, a number of social capital behaviors have been studied but membership in the YMCA is not one of them. This research examines the relationship, ceteris paribus, between membership in the Central Florida YMCA and individual social capital. A survey questionnaire was mailed to 10,000 YMCA members in Central Florida and 21,000 residents who were demographically similar. There were 1,881 completed responses. The results were analyzed using structural equation modeling and were guided by social capital theory and the theory of reasoned action. iv The results of the study indicate that the two most influential factors of social capital variability are personal educational attainment and the average educational attainment of the community. The study also confirms that social capital is a two-dimensional construct and the two dimensions are iterative. The study results also revealed that members of the Central Florida YMCA had higher levels of social capital ceteris paribus. This study is significant in four areas: social capital theory, public policy, management of social capital-generating organizations and for individuals. At the theoretical level, insight has been gained into both the causes of social capital variability and the two-dimensional nature of social capital. Regarding public policy, this research provides clear evidence that education provides a greater role in building a community than simply creating human capital; it also creates social capital. Both educational institutions and those organizations that create social capital should be supported. Furthermore, social capital promulgation through public policy should target both dimensions of social capital to be most effective. For managers of social capital-generating organizations social capital can be used as a metric for measuring organizational effectiveness and community impact. For individuals, there is now an evidencebased approach for developing a life plan for creating personal social capital. This research is unique because it simultaneously brings insights into four distinct spheres of social capital.

Sustainability has been framed by the World Commission on Environment and Development as a fundamental concept in human society and by Fiorino (2010) as a critical conceptual focus for public administration over the next decade. A large number of U.S. local governments have implemented sustainability initiatives. Nevertheless, relatively few studies have comprehensively examined sustainability implementation by local governments. This study makes a concerted effort to examine sustainability implementation in U.S. local governments, which have taken the lead in many areas of sustainability. This study also develops a capacity building model to empirically evaluate how organizational strategies and capacities influence sustainability practices at the local level of government through a national survey of U.S. cities with populations over 50,000. The results show that cities are most successful in implementing sustainability initiatives if they develop proper technical, financial, and, particularly, managerial capacities and if they pursue primarily external, bottom-up, more participative, citizen or stakeholder driven strategies. These results suggest a public manager road map for sustainability implementation. From a theoretical perspective, the capacity building model adopted in this study provides a relatively powerful explanation of sustainability implementation, which demonstrates the value of a capacity building model in further studying sustainability implementation.

Research specific to gender and violent juvenile delinquency is sparse due to two factors: a substantially higher incidence of delinquent male violence and the cost associated with drawing adequate female samples is frequently prohibitive (Howell, 2003). Gender-differences are explored in a sample of arrested juveniles using an expanded measure of parental attachment [bond]. The dimensions of emotional attachment, supervision, and time-involvement with a selfreported caregiver are explored for between group differences and association with recognized risk factors for juvenile delinquency. Findings indicate that while statistically significant between-group differences are not found in the presentation of attachment, descriptive differences do exist. Females demonstrated a higher level of impairment in emotional attachment to a caregiver than their male counterparts; females arrested for a violent offense reported the highest level of problem in this area. Findings also indicate that the mechanism of attachment appears to function differently by gender group in terms of association with risk factors for delinquency. Time-involvement emerged as an important predictor for the full group and the female group, particularly in relationship with higher risk for antisocial peer involvement. Support for a gendered experience of parental attachment [social bond] is provided. Emotional attachment and time-involvement were found to be important predictors for the full group, while supervision was not indicated as important to any risk factor or to recidivism. The current research advances knowledge on gender-related differences within delinquency. Through enhancing the understanding of the complex gender-specific influences on juvenile crime, criminal justice and human service systems may better learn to address these needs thereby reducing both entrance rates into the juvenile justice system and recidivism.

In recent years, there has been increased reliance on the use of risk assessment in the juvenile justice system to predict and classify offenders based on their risk to reoffend. Over the years, the predictive validity of risk assessments has improved through the inclusion of actuarial assessment and dynamic risk factors. The predictive validity of certain assessments, such as the Youth Level of Service/Case Management Inventory (YLS/CMI), has been well established through numerous replication studies on different subgroups of the population. The validity of other instruments, such as the Positive Achievement Change Tool (PACT), is in its infancy having only been validated on the sample of the population for which it was created. The PACT, a relatively new juvenile risk assessment tool, was adapted from the Washington State Juvenile Court Assessment and validated on the Florida juvenile population. This study sought to demonstrate the predictive validity of the PACT risk assessment, analyze gender differences in juvenile recidivism, and determine the relative importance of individual-level, social-level, and community-level variables in the prediction of recidivism for a sample of juveniles in Tarrant County, Texas. The results of this research confirmed the predictive validity of the PACT for juveniles served by Tarrant County Juvenile Services (TCJS). Despite possessing adequate predictive validity for the entire population, gender-specific analyses revealed differences in the ability of the PACT to accurately classify female delinquents based on risk to reoffend. Not only did gender differences emerge in the predictive validity of the PACT, but males and female recidivism was also predicted by different social-level indicators. The results of this research provided further evidence for social-causation theories of crime and delinquency, with sociallevel indicators exerting the strongest relationship with recidivism when compared to individual- iii level and community-level predictors. The inability of community-level predictors to enhance the predictive accuracy of the assessment suggest broad application of the PACT across jurisdictions. TCJS has invested a considerable amount of time, resources, and funding in the implementation and maintenance of the PACT. The results of this study provided support and direction for the continued use of the PACT at TCJS. In addition, establishing the predictive validity of the PACT on the Tarrant County juvenile population satisfied the legislative requirement for a population specific validation of the risk assessment implemented in each county.

Nonprofit capacity building programs and program activities positively influence perceived organizational effectiveness. Being able to link nonprofit capacity building to organizational effectiveness is a paramount concern for both nonprofits seeking capacity building programming and those entities, be it foundations or government that fund capacity building initiatives and programs. Therefore being able to link nonprofit capacity building to organizational effectiveness and higher performance is crucial to ensure that both nonprofit organizations and funders continue to pursue and support capacity building programming. Through an examination of the developing hollow state and the resulting nonprofit capacity disparity this study demonstrates the purposeful need for the continuation of nonprofit capacity building programming and the support of such programming through outside private foundation and government funding. Using a conceptual model developed from the literature on organizational learning and change this study examines the impact of capacity building programming, programming activities, organizational learning theory and perceived organizational effectiveness. The influence of the type of capacity building programming, i.e. traditional workshop and traditional workshop plus technical and financial assistance is investigated through the use of quantitative and qualitative methods. Specifically the quantitative methods utilized were descriptive including bi-variate correlation analysis, paired and independent T-tests, ANOVA and multiple regression. The qualitative analysis including examining open-ended survey question responses from two pre-post capacity building intervention surveys and one post program survey and the analysis of comments made in 10 focus groups. The influence of capacity building programming iv activities, i.e. organizational development, organizational program development, organizational collaboration and organizational leadership is investigated through the use of multiple regression and qualitative analysis. This study uses pre-, post-test survey data from a total of 43 nonprofit organizations that participated in the Strengthening Communities Fund in Central Florida Program, managed by the Center for Public and Nonprofit Management at the University of Central Florida. The two year program was offered in two identical 10 month cycles. Pre- and post-test data were collected from 23 participant organizations in Cycle 1 and 20 in Cycle 2. This study sought to identify the nonprofit capacity building programming modality and programming activities that contributed most to perceived organizational effectiveness. According to the findings, nonprofit organizations seeking capacity building and funders looking to support capacity building programs should look to programs that offer activities that increase organizational leadership capacity and organizational program development. Increasing organizational leadership capacity and organizational program development contributes most to perceived organizational effectiveness. This study did not find support to recommend one particular capacity building training modality over another. Regardless of the method of capacity building program delivery, i.e. workshop and/or technical and financial assistance, programs which build organizational leadership capacity and organizational program development will greatly influence the perceived organizational effectiveness of the capacity building participant organizations.

With the rapid growth of juvenile offender diversion programs, which use many nontraditional sanctions, the effectiveness of sanction combinations in juvenile diversion programs and in each individual program needs to be evaluated. Those making sanctioning decisions currently do so based on intuition rather than using an evidence- or theory-based approach. Considerable research has examined the relationship between offender risk factors and recidivism (who is more likely to reoffend?) and between offender risk factors and sanctions (who is more likely to receive what sanctions?), but little is known about the relationship between sanctions and recidivism (which sanctions best reduce recidivism and for whom?). Furthermore, recidivism studies vary drastically in how they measure or quantify recidivism. This variability of approach makes comparing studies difficult and provides a less-than-complete picture of recidivism in general. The present study used data from one specific youth diversion program to test certain hypotheses of sanctioning by developing and testing a model for assigning sanction combinations to certain offenders on the basis of their individual characteristics. The study first developed measurement models for Offender Risk Propensity, Multiplicity of Sanctions, and Recidivism using structural equation modeling (SEM). Then predictive models were developed to test specific relationships. Understanding the effectiveness of certain sanction packages on certain offenders can form the basis for effective sanctioning in youth diversion programs. This study sought to answer three research questions: What is the best way to measure recidivism? Does completion of a restorative justice program reduce recidivism? Which sanctions, if any, reduce recidivism for specific offender types? To answer the first question: a iv multi-indicator latent construct of recidivism did a very good job of measuring variation in recidivism. Multiple indicators analyzed simultaneously produced a robust tool that can be used in other recidivism studies and help to reduce comparability issues between studies. The recidivism construct, when tested as a function of completion of the restorative justice program, was seen to produce a significant model having an overall good fit with the data. Thus to answer the second research question: offenders’ completion status for the restorative justice program was shown to be a significant predictor of the latent construct of recidivism at the 0.05 level (two-tailed), with those who failed to complete (or chose not to participate) having higher recidivism than did those who completed the program. To answer the third research question: the assignment of specific sanctions (both those suggested by research and theory and those traditionally assigned by this and similar programs) on the entire data set (and on various subsets) of this study have no statistically significant impact on recidivism at the 0.05 level (two-tailed). The findings suggest many policy implications. Consistency is all but nonexistent in recidivism measurements in the academic literature and in program review studies. A multiindicator latent construct of recidivism, such as the one proposed and proven effective in this study, provides a more complete picture than simply conceptualizing recidivism by one dummy variable. This recidivism model can be used as the endogenous variable to evaluate programs and their practices and could reduce the problem of study comparability. This could lead to a better understanding of program characteristics and their impact on offender success. This study also found that completion of the Neighborhood Restorative Justice Program was a significant predictor of recidivism, yet none of the eleven most commonly assigned v sanctions were seen to have a significant impact on recidivism for any subgroup. Proponents of restorative justice argue that it is the programs’ characteristics and not their specific activities that make the programs successful. Reintegrative Shaming Theory and Labeling Theory support this claim and suggest the best approach to address youth criminal behavior is to admonish the act and not the actor, have the offender and community agree on a plan to make the community whole after that criminal act, and prevent repeated interaction with the formal criminal justice system which encourages the youth to see themself as a deviant and engage in further deviant behavior. These characteristics should be further examined and widely employed if confirmed.

Emerging research suggests that childhood adversities may increase both the risk and symptomology of posttraumatic stress disorder (PTSD) in our veteran population. Over 40% of our reintegrating military veterans return with significant mental health issues led by combatrelated PTSD. PTSD impacts veterans in numerous areas including unemployment, increased criminal justice involvement, increased treatment costs, divorce, co-morbid mental illness, greater levels of domestic violence, homelessness, high college dropout rates, suicide, and long term health problems. The purpose of this study is to investigate the impact of childhood adversities (abuse, neglect, and poverty) upon the severity of combat-related PTSD in veteran populations. Specifically, the researcher examines the direct effects of: (1) childhood trauma; (2) childhood neglect; and (3) childhood poverty (as assessed based on socioeconomic status [SES]) upon the severity of combat-related PTSD. This study of student veterans (n=102) receiving services from a veteran service center at a major metropolitan university in Central Florida is a non-experimental, explanatory, retrospective survey design using structural equation modeling (SEM) to test the relationships among study variables. Findings strongly supported a relationship between childhood trauma and neglect and the severity of combat-related PTSD. Similarly, findings also supported that no relationship existed between childhood SES and the severity of combat-related PTSD. Both childhood trauma and neglect were significantly associated with combat-related PTSD at an even greater effect than that of combat exposure. SES was not found to be significant in the severity of combat-related PTSD. The findings iv suggest that preventive screening policies to reduce costs and severity of combat-related PTSD might be needed.

The purpose of this research study is to examine the effect of public information sources on an individual's satisfaction with the search process undertaken to select a physician. A quasiexperimental research design was adopted to randomly divide the medical staff of a large central Florida medical group into control and intervention groups of approximately 77 physicians each. The intervention involved insertion of the website address to online physician report cards on to each intervention group physician’s profile in the physician directory on the medical group's website. After two months, data were collected consisting of all individuals who had scheduled first-time appointments with one of the medical group's physicians during the two-month intervention period. A random sample of patients was drawn from each group and sample members were mailed a 62-item questionnaire along with a cover letter, summary of the research and postage-paid reply envelope. A total of 706 questionnaires were mailed and 61 completed questionnaires were returned, an 8.64% response rate. Intent-to-treat analysis was conducted using independent-samples t-tests to compare the research study’s continuous variables' mean scores for control and intervention group participants. The analysis revealed no significant difference in scores for control and intervention groups with the exceptions that the control group was somewhat more committed to conducting a search and selecting a new physician. The control group said the physician's communications skills influenced their satisfaction with the search and selection of a new physician quite a lot while the intervention group said physician communication skills somewhat influenced their satisfaction with search and selection. iv Results of the covariance structure analysis demonstrated that information use and level of commitment to search and select a new physician independently predict search satisfaction. As information use and search commitment increase, a patient's satisfaction with the search increases as well. Furthermore, as information use increases, the variety of information sources relied upon or used also increases. The findings support the alternative hypothesis that the positive or direct effect of physician report cards is demonstrated in the time and cost of patient search for a physician for both intervention and control groups. One other alternative hypothesis was partially supported, i.e., the effect of household income is confirmed in patient search and satisfaction in selecting a physician. The alternative hypotheses that proposed that physician report cards are more likely to be used to search for a medical specialist and that physician experience, office location and accepted insurance effect patient search and selection of a physician were not tested. Two other alternative hypotheses were rejected. The research findings also indicated that predictors of health care information search satisfaction vary based upon the environment and contextual factors in which the search is conducted.

Catastrophic disasters are different than routine disasters and managing them requires the mobilization of inter-organizational, inter-governmental, cross-sectoral and international humanitarian support. The role of the international community through International Nongovernmental Organizations (INGOs), and multi-lateral organizations such as the United Nations (UN) becomes imperative when the scale of the disaster is unprecedented and difficult for a country to manage on its own. The initial response and relief phase of managing disasters is one in which many agencies with different expertise, capacities, working mandates, resources, skills, working cultures and norms come together to coordinate and collaborate to provide timely response and relief services. Thus, the terrain of managing catastrophic disasters is complex and requires a deeper study to understand and delineate the factors shaping and facilitating collaborative response and relief efforts. This study examines the multi-level and multi-layered collaborative response networks present at the national-international level, provincial and district/local level of disaster response and interactions. In this research the nature and effectiveness of collaboration is being studied through a relevant case study of a catastrophic natural disaster, the 2010 Pakistan Floods. The phase of immediate response is explored primarily through Network Theory perspectives including supportive theoretical perspectives such as Social Capital, Resource Dependency, and Institutional Collective Action Theory perspectives that help to explain collaborative interactions in disaster response networks. This study explores and describes factors that influence (either facilitate or hinder) collaboration is disaster response networks. iv The key research questions for this study are: What factors facilitate and impede collaborative response to catastrophic disasters at the local, provincial, national and international levels? What are the differences and similarities in response systems at different levels? Additional questions address how leadership support (attributed to government and political leaders and organizations), institutional support (in the form of plans, international appeals of response, and development of relief funds to manage aid), network capacity of different organizations (programmatic and relational), nature of resource dependencies between responding agencies, and structural configurations of response systems impact the collaborative response in disasters. A case study method has been applied in this research. The 2010 Pakistan Floods response network/system is identified through content analysis of various newspapers, situation reports and after-action reports using the Social Network Analysis (SNA) method via UCINET Software 6.1. The actual response network is analyzed and compared with existing national disaster response plans to examine the effectiveness of collaborative response through centrality measures, clique analysis and visual display. This approach is supplemented with semistructured interviews of key institutional representatives that responded to the 2010 Floods. These organizations and institutions were primarily identified through the networks formulated via SNA. Findings and results from the analysis reflect that the response networks at each level of analysis differ both in structural aspects and also in functional aspects. The nature of the international-national response system is focused on mobilizing donor support and receiving and v managing aid, both in-kind and cash. Also a major role at the international and national level is to mobilize the UN cluster approach and focus on broader aims of response such as providing shelter and food to affected areas. Some of the factors identified as facilitating collaborative response were leadership of both national and international leaders, and availability of donor support and funds. At the provincial level of analysis, the Chief Minister of Punjab is playing a central and influential role and is partnering closely with the Armed Forces and local district administration. Interviews conducted of provincial level officials help to support the hypotheses concerning leadership support’s influence on collaborative response and also the role of institutional support in the form of creation of plans, and policies that help to mobilize quick funds and resources for relief. At the local level of response, networks are highly influenced by local conditions and local capacities of the district administration. Thus, there are diverse factors impacting each level of collaborative disaster response. All in all, leadership support, institutional support and network structural aspects are important variables that impact the effectiveness of collaborative response. Today policy makers are trying to figure out ways to collaborate successfully across sector boundaries for better and effective service delivery, both in the mundane operational tasks and in uncertain and complex situations such as disasters and catastrophic events. Thus, this research helps in expanding the literature on collaborative public management, collaborative emergency management, and network management. Also the frequency of natural disasters throughout the world demonstrate the need to study and examine factors that contribute to or hinder the effectiveness of inter-organizational response in disasters.