a case study on management styles

Elon Musk’s ‘hardcore’ management style: a case study in what not to do

MBA Director & Assistant Professor of Organisational Behaviour, Bond Business School, Bond University

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As a case study in how to implement organisational change, Elon Musk’s actions at Twitter will go down as the gold standard in what not to do.

Among other things, the evidence shows successful organisational change requires: a clear, compelling vision that is communicated effectively; employee participation; and fairness in the way change is implemented. Trust in leaders is also crucial .

Musk, the world’s richest man, appears in a hurry to make Twitter into a money-spinner. But it takes time to understand the requirements for successful organisational change. Two in three such efforts fail, resulting in significant costs, a stressed workforce and loss of key talent.

Change management never quite goes to plan. It’s hard to figure out whether Musk even has a plan at all.

Musk’s ‘extremely hardcore’ style

Since taking over Twitter on October 27, Musk has stopped employees working from home, cancelled employee lunches, and laid off about 3,700 employees – roughly half of Twitter’s workforce. Many realised they had been sacked when they could no longer access their laptops .

Just days later it emerged that Musk had a team of snoopers comb through employees’ private messages on Slack, firing those who had criticised him.

Then, on Wednesday last week, Musk sent an ultimatum to staff to pledge commitment to a new “extremely hardcore” Twitter that “will mean working long hours at a high intensity”. Employees had until 5pm the next day to accept, or take a severance package.

About 500 staff reportedly wrote farewell messages .

Musk appears not to have anticipated this reaction. As the “hardcore” deadline approached, he started bringing key staff into meetings, trying to convince them to stay.

He also walked back his working-from-home ban, emailing staff that “all that is required for approval is that your manager takes responsibility for ensuring that you are making an excellent contribution”.

It was unsuccessful. So many employees decided to leave that on Friday Twitter locked all staff out of its office until Monday amid confusion as to who actually still worked there and should have access.

Layoffs and restructuring are common in organisational change. But the way they are managed has significant effects on those who are leaving, as well as those who remain. If you want employees to be committed and to respond to a crisis, telling them they are lazy and threatening them won’t help.

Read more: Thinking of breaking up with Twitter? Here’s the right way to do it

Choice matters

But what about SpaceX and Tesla – the companies on which Musk has built his fame and fortune? Doesn’t their success prove he is a good leader?

Not so fast. There is a big difference between a mission-driven company like SpaceX and a platform like Twitter.

When there is a common mission to achieve something extraordinary or which hasn’t been done before, employees will often willingly work extremely long hours in difficult situations.

They will choose to go above and beyond and work long hours if they feel aligned with the organisation’s purpose or that their work matters. But the key point here is that they choose.

As one Twitter employee tweeted after Musk’s “hardcore” email:

I didn’t want to work for someone who threatened us over email multiple times about only ‘exceptional tweeps should work here’ when I was already working 60-70 hours weekly.

Musk ignores the fundamentals

Both Tesla and SpaceX have many unhappy employees , with lawsuits filed over working conditions and Musk’s management style.

He has been commended for his thinking on iterative design and solving engineering problems. Challenging old models that may no longer be useful is important. But the fundamentals of leadership and organisational change are still essential – and on these, Musk falls woefully short.

Read more: What Elon Musk's destruction of Twitter tells us about the future of social media

While his employees – real people who aren’t billionaires and who have rent or mortgages to pay – were grappling with what being “hardcore” even means, and how that might impact their ability to have a life outside work, Musk was tweeting about his poll on whether former US president Donald Trump should be allowed back on the platform.

Then, after Trump declined to return, Musk tweeted the following:

The idea of any other chief executive sending such a message on social media almost defies belief.

Read more: Twitter and Elon Musk: why free speech absolutism threatens human rights

Some have suggested this whole debacle is an ego trip for Musk – a theory lent credence by his attempt to get out of the deal . His actions pose a significant risk to the business even if there are still enough employees around to keep it working.

Twitter’s former head of trust and safety, Yoel Roth, who resigned on November 10, wrote last week :

Almost immediately upon the acquisition’s close, a wave of racist and antisemitic trolling emerged on Twitter. Wary marketers, including those at General Mills, Audi and Pfizer, slowed down or paused ad spending on the platform, kicking off a crisis within the company to protect precious ad revenue.

But even more powerful than the advertisers, Roth noted, are the digital storefronts of Apple and Google:

Failure to adhere to Apple’s and Google’s guidelines would be catastrophic, risking Twitter’s expulsion from their app stores and making it more difficult for billions of potential users to get Twitter’s services.

Organisations are complex, interdependent systems, underpinned by a web of behavioural processes. Creating successful change requires aligning individual, work group and organisational goals.

Even if the little blue bird is still flying for now, the people-led systems that keep it aloft are under significant threat.

• Bad management
• organisational culture
• X (formerly Twitter)

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How to Make Different Business Leadership Styles Work (With Case Studies)

Several thought leaders have referred to 2020 as the year of great reset. But if you want to be really strict about it, most of the biggest business shifts started way back at the onset of the 21st century. 

Traditional business leaders who are banking on traditional business leadership styles in this new century needlessly risk losing their businesses to unhealthy age-old leadership practices.

The pandemic just helped reiterate the need for business leaders to change the way they approach business problems primarily due to the following reasons:

• New technologies
• Pace of change
• Changing demographics and employee expectations
• Changing customer expectations

Simon Sinek, in his influential book Start with Why: How Great Leaders Inspire Everyone to Take Action , proposes a powerful framework that emphasizes the importance of a leader’s ‘why’. Sinek argues that leaders who start with why, with their purpose, cause, or belief, are able to inspire and motivate others in a way that transcends simply outlining tasks and goals. This focus on purpose aligns well with the idea that effective leadership is about more than just giving orders; it’s about creating a shared vision and inspiring a team to achieve it.

The chart below gives you a better glimpse of the reasons why there is a difference in the requirements for the kind of leaders we need to have in this era. The data depicted is from Deloitte’s Human Capital Trends Survey .

What are these particular requirements? According to the same study by Deloitte, business leaders need to have the following abilities:

• lead through more complexity and ambiguity
• lead through influence
• manage on a remote basis
• manage a workforce with a combination of humans and machines
• lead more quickly

See this second figure below.

According to Forbes , there are three notable leadership skill shifts for 2021 and these are the following:

• Communication to Empathy 
• Emotional Intelligence to Emotional Agility 
• Time Management to Context Management

Leaders are expected to be effective communicators, but the shift is now focused on empathy as a priority for business leaders this year. The Management Research Group found empathy to be the leading positive leadership competency and one of the biggest predictors of senior executive effectiveness . This makes a lot of sense especially now that the recent challenges brought about by the pandemic have highlighted the value of caring while communicating.

Emotional intelligence to emotional agility is another important shift. Susan David , a psychologist and the author of the book “Emotional Agility: Get Unstuck, Embrace Change, and Thrive in Work and Life” describes emotionally agile people be the type of people who are not only aware of their feelings but also know how to navigate through them.

Now the shift from time management to context management gives emphasis on how the change in the context of how and where we work requires realignment in managing our time and designing our days around how we work. 

While there are several leadership styles and the specific strategies vary depending on the field or industry, the concepts are basically the same. Let’s take note of these leadership skill shifts mentioned earlier in studying how we can better tailor the different leadership styles to suit the changing times. 

The following are six of the different leadership styles we will tackle further:

• Autocratic Leadership Style
• Democratic Leadership Style
• Laissez-Faire Leadership Style
• Situational leadership style
• Transactional Leadership Style
• Transformational Leadership Style

First off, let’s start with the traditional business leadership styles.

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1. autocratic leadership style.

Case Study: Howell Raines of The New York Times

The New York Times under Howell Raines as the Executive Editor decided at one point to only put resources on the stories that he deemed as worth covering. While this led to The New York Times winning a record-breaking seven Pulitzer awards in a single year, several staff members got demoralized.

There is no known theorist behind autocratic leadership so it is considered as an organic leadership style that has developed over the course of time that it has been used. 

Basically, an autocratic leader is the type of leader who would make decisions without proper consultation. You may think that this leadership style is unacceptable for who decides on his own especially if the decision concerns an entire organization, right? 

But, Cleverism articulates three situations where the autocratic leadership style can be used and these are the following:

• The situation requires fast and immediate decision-making
• There is no clarity in the process of the procedure and pushing ahead might only lead people to danger
• There are more inexperienced people in the group and most of them are demotivated

The tendency of most businesses with an autocratic leader is that the subordinates will become passive and mediocre, or conflicts may arise.

In these situations where a business leader must step up and use the autocratic leadership style, it is important to take note of communicating openly and regarding others with respect the entire time.

2. Democratic Leadership Style

Case Study: Sergey Brin and Larry Page of Google

Founders Sergey Brin and Larry Page hired Eric Schmidt to jump-start the Internet search engine. Blending autocratic, laissez-faire and democratic leadership styles, they allowed someone knowledgeable and experienced into Google which would then lead to more democratic teams composed of experienced talent. 

Also known as the participative leadership style, the democratic leadership style in business management is often characterized as the style that encourages collaboration with fellow leaders and team members. In other words, everyone is allowed to participate in the decision-making process. 

While this style of leadership is very motivating for most people as compared to the autocratic leadership style, it works best for businesses that employ experts in their departments so little supervision is required. 

According to St. Thomas University , the following organizations can take advantage of this:

• Biotech R&D divisions
• Housing construction sites
• Universities
• Information technology companies

Furthermore, the university lists the following as the disadvantages of this leadership style:

• Business leaders may become too dependent on their subordinates
• Getting everyone’s input may take a lot of time 
• Missed deadlines are possible 
• Consulting with people who lack accurate data or sufficient knowledge
• Too much burden for business leaders to oversee collaboration

The democratic leadership style can bring forth massive business growth if business leaders are willing to take responsibility for the decisions made and provide support and expertise during collaborations.

Such requires highly productive leaders who know what they do and will take action.

3. Laissez-Faire Leadership Style

Case Study: Warren Buffett of Berkshire Hathaway

Warren Buffett is known for exemplifying the laissez-faire leadership style as he allows people he works with to do their jobs without his supervision or intervention. His great success over several years has been attributed to his style of leadership which allows a culture of motivation and confidence. He, however, sees to it that he only hires people he can trust to do their jobs.

The laissez-faire leadership style emerged from the French word laissez-faire which means “leave alone”. Also called the hands-off approach, this style is based on the concept that leaders can leave their employees or teams alone in coming up with ideas or decisions for the business departments they are part of. 

This used to be a very popular style before the 19th century, but as modernization started, more and more business leaders find the disadvantages of leading teams with no supervision to be detrimental. This is particularly possible for companies that lack expert talent.

What business leaders who employ this leadership style should note is that assuming that subordinates must be free from accountability. This only encourages the company’s people to be complacent.

The business leader must ensure that teams are composed of highly-skilled individuals who can be reliable in achieving business goals under their responsibility.

At this point, we’ve already discussed the three leadership styles that can be highly traditional unless approached with a fresh perspective that takes into account the new leadership needs and skill shifts.

How these three business leadership styles work is illustrated below.

Which leadership style can you resonate with the most?

We now have what we call modern leadership styles or approaches. These styles have emerged as a response to the traditional styles that do not allow much room for innovation. 

Although most of these new approaches are modified versions of the traditional leadership styles, they are identified mainly based on the following types of categories:

• Situational leadership
• Transactional leadership
• Transformational leadership
• Innovative leadership

4. Situational Leadership Style 

This leadership style follows the contingency-based leadership model when responding to situations or making decisions. Business leaders who employ this style are flexible and would normally use varying leadership strategies depending on the situation.

Goleman believes that a situational leader must be able to incorporate the six specific leadership styles given the right circumstances.

5. Transactional Leadership Style

Also known as managerial leadership, transactional leadership is a style that focuses on supervision, organization, and group performance.

Business leaders under this style use rewards and punishments to motivate subordinates in a given task.

According to Verywell Mind , the basic assumptions of transactional leadership are the following:

• When the chain of command is clear, your workforce performs their best
• Rewards and punishments are effective agents of motivation
• Obeying the leader is the most important goal of the subordinates
• Careful monitoring is a must

When giving assignments, the business leader must be clear when it comes to the instructions, rewards and consequences, as well as giving feedback. 

6. Transformational Leadership Style

Business leaders who subscribe to the transformational leadership style serve as inspirations to their subordinates.

They inspire as they lead by example and as they cultivate an environment that welcomes creativity and innovation. This suits employees who have entrepreneurial minds as transformational business leaders seek to inspire just the right amount of intellectual independence in the workplace.

In a roundup article, Harvard Business Review lists the following as the best examples of transformational leadership:

• Jeff Bezos , Amazon
• Reed Hastings , Netflix
• Jeff Boyd and Glenn Fogel , Priceline
• Steve Jobs and Tim Cook , Apple
• Mark Bertolini , Aetna
• Kent Thiry , DaVita
• Satya Nadella , Microsoft
• Emmanuel Faber , Danone
• Heinrich Hiesinger , ThyssenKrupp

The Harvard Business Review refers to this group as the Transformation 10 for exemplifying transformational leadership.

Strengthening Your Leadership Mindset

About 60% of the executives who participated in the 2021 Deloitte Global Human Capital Trends said that what prepared them for the unknown is leadership . This is the kind of leadership that takes into account the unpredictable and incorporates strategies surrounding that through coaching, teaming, and fostering.

But did you know that based on the research of the Corporate Executive Board , about 50%-70% of the new business executives or leaders fail within the first 18 months? Unless you have the right leadership mindset and you solidify that mindset, you will become part of this figure. 

Whenever a major business problem happens, you can either succumb to the pressure and give up, or find a solution to the problem . The most successful business leaders try their hardest to never give up.

Most business leaders would rather grind than get back to their regular jobs of 9-to-5.

In 1519, a Spanish explorer and conquistador Hernán Cortés pursued the treasures of the Aztecs with 11 ships and a crew of 100 sailors and 500 soldiers. His army was vastly outnumbered and some soldiers tried to escape. Cortés gave the order to burn the ships and left no choice but to fight until their last breath.

That wasn’t the end for everyone. Part of the army survived and they got a hold of the treasure.

At first, calmness is a myth. People are emotional by nature and react to any deviations from their plans. With time, those who choose to be in the captain’s spot until the end see problems that have to be solved and suppress the emotional part that is dragging them down.

The role of a business leader isn’t easy in the first place. Constant changes and surprises are not abnormal and at some point, they become a daily routine.

Plenty of problems appear to be critical, but in the end, they should be solved. You don’t run away from them. You step up as a business leader and inspire your teams to follow through.

The most effective leadership style for business is the leadership that inspires.

If being a business leader of a successful company is among your highest priorities, work on your leadership know-how, develop your management soft skills , and make it work for your people.

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Acknowledgments

The work was supported by Act 211 Government of the Russian Federation, contract № 02.A03.21.0011.

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Top 40 Most Popular Case Studies of 2017

We generated a list of the 40 most popular Yale School of Management case studies in 2017 by combining data from our publishers, Google analytics, and other measures of interest and adoption. In compiling the list, we gave additional weight to usage outside Yale

We generated a list of the 40 most popular Yale School of Management case studies in 2017 by combining data from our publishers, Google analytics, and other measures of interest and adoption. In compiling the list, we gave additional weight to usage outside Yale.

Case topics represented on the list vary widely, but a number are drawn from the case team’s focus on healthcare, asset management, and sustainability. The cases also draw on Yale’s continued emphasis on corporate governance, ethics, and the role of business in state and society. Of note, nearly half of the most popular cases feature a woman as either the main protagonist or, in the case of raw cases where multiple characters take the place of a single protagonist, a major leader within the focal organization. While nearly a fourth of the cases were written in the past year, some of the most popular, including Cadbury and Design at Mayo, date from the early years of our program over a decade ago. Nearly two-thirds of the most popular cases were “raw” cases - Yale’s novel, web-based template which allows for a combination of text, documents, spreadsheets, and videos in a single case website.

Read on to learn more about the top 10 most popular cases followed by a complete list of the top 40 cases of 2017.  A selection of the top 40 cases are available for purchase through our online store . 

#1 - Coffee 2016

Faculty Supervision: Todd Cort

Coffee 2016 asks students to consider the coffee supply chain and generate ideas for what can be done to equalize returns across various stakeholders. The case draws a parallel between coffee and wine. Both beverages encourage connoisseurship, but only wine growers reap a premium for their efforts to ensure quality.  The case describes the history of coffee production across the world, the rise of the “third wave” of coffee consumption in the developed world, the efforts of the Illy Company to help coffee growers, and the differences between “fair” trade and direct trade. Faculty have found the case provides a wide canvas to discuss supply chain issues, examine marketing practices, and encourage creative solutions to business problems. 

#2 - AXA: Creating New Corporate Responsibility Metrics

Faculty Supervision: Todd Cort and David Bach

The case describes AXA’s corporate responsibility (CR) function. The company, a global leader in insurance and asset management, had distinguished itself in CR since formally establishing a CR unit in 2008. As the case opens, AXA’s CR unit is being moved from the marketing function to the strategy group occasioning a thorough review as to how CR should fit into AXA’s operations and strategy. Students are asked to identify CR issues of particular concern to the company, examine how addressing these issues would add value to the company, and then create metrics that would capture a business unit’s success or failure in addressing the concerns.

#3 - IBM Corporate Service Corps

Faculty Supervision: David Bach in cooperation with University of Ghana Business School and EGADE

The case considers IBM’s Corporate Service Corps (CSC), a program that had become the largest pro bono consulting program in the world. The case describes the program’s triple-benefit: leadership training to the brightest young IBMers, brand recognition for IBM in emerging markets, and community improvement in the areas served by IBM’s host organizations. As the program entered its second decade in 2016, students are asked to consider how the program can be improved. The case allows faculty to lead a discussion about training, marketing in emerging economies, and various ways of providing social benefit. The case highlights the synergies as well as trade-offs between pursuing these triple benefits.

#4 - Cadbury: An Ethical Company Struggles to Insure the Integrity of Its Supply Chain

Faculty Supervision: Ira Millstein

The case describes revelations that the production of cocoa in the Côte d’Ivoire involved child slave labor. These stories hit Cadbury especially hard. Cadbury's culture had been deeply rooted in the religious traditions of the company's founders, and the organization had paid close attention to the welfare of its workers and its sourcing practices. The US Congress was considering legislation that would allow chocolate grown on certified plantations to be labeled “slave labor free,” painting the rest of the industry in a bad light. Chocolate producers had asked for time to rectify the situation, but the extension they negotiated was running out. Students are asked whether Cadbury should join with the industry to lobby for more time?  What else could Cadbury do to ensure its supply chain was ethically managed?

#5 - 360 State Real Options

Faculty Supervision: Matthew Spiegel

In 2010 developer Bruce Becker (SOM ‘85) completed 360 State Street, a major new construction project in downtown New Haven. Just west of the apartment building, a 6,000-square-foot pocket of land from the original parcel remained undeveloped. Becker had a number of alternatives to consider in regards to the site. He also had no obligation to build. He could bide his time. But Becker worried about losing out on rents should he wait too long. Students are asked under what set of circumstances and at what time would it be most advantageous to proceed?

#6 - Design at Mayo

Faculty Supervision: Rodrigo Canales and William Drentell

The case describes how the Mayo Clinic, one of the most prominent hospitals in the world, engaged designers and built a research institute, the Center for Innovation (CFI), to study the processes of healthcare provision. The case documents the many incremental innovations the designers were able to implement and the way designers learned to interact with physicians and vice-versa.

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This case is freely available to the public.

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• Original Article
• Open access
• Published: 19 December 2017

GOOGLE: a reflection of culture, leader, and management

• Sang Kim Tran 1 , 2  

International Journal of Corporate Social Responsibility volume  2 , Article number:  10 ( 2017 ) Cite this article

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This paper provides a viewpoint of the culture and subcultures at Google Inc., which is a famous global company, and has a huge engineering staff and many talented leaders. Through its history of development, it has had positive impacts on society; however; there have been management challenges. The Board of Directors (BoDs) developed and implemented a way to measure the abilities of their managers, which helped to identify problems. This paper will analyze the case study of Harvard Business Review, Oxygen Project, and clarify the management problem in Google’s organization. It will also compare Google with Zappos, a much smaller organization, and present how the BoDs of Zappos assesses its culture and subcultures. In this paper, we will recommend eight important points to building an organizational culture that is positive for stable growth of a company. We believe that much of what be learned could be useful to other business leaders, regardless of company scale.

Introduction

In a large society, each company is considered a miniature society (Mawere 2011 ). Similar to large societies with large cultures, small societies also need to build their own cultures. A culture is influenced by many factors and determines if it is a great culture. Corporate culture requires both the attention to the efficiency of production and business and to the relationship among people in the organization closely (Bhagat et al. 2012 ). Regardless if it is a large or a small organization, it must encounter issues of cooperation among individuals and groups. There are many factors leading to the success of business process re-engineering in higher education (BPR), the main four elements are culture, processes, structure, and technology. Culture is listed as number one (Ahmad et al. 2007 ). Hence, culture becomes the most important factor to the success of the development of a business. Organizational culture is the set of shared beliefs (Steiber and Alänge 2016 ), values, and norms that influence the way members think, feel, and behave. Culture is created by means of terminal and instrumental values, heroes, rites and rituals, and communication networks (Barman n.d. ). The primary methods of maintaining organizational culture are through the socialization process by which an individual learns the values, expected behaviors, and necessary social knowledge to assume their roles in the organization. In addition, (Gupta and Govindarajan 2000 ) and Fig.  1 in (Ismail Al-Alawi et al. 2007 ) illustrates that culture was established by six major factors, such as information systems, people, process, leadership, rewarding system, and organization structure. Therefore, there is a wide variety of combined and sophisticated cultures in the workplace, especially in big corporations like Google, Facebook, Proctor & Gamble, etc. Each organization tends to have a common goal, which is to create a culture that is different from other companies and to promote their teams to be creative in developing a distinctive culture (Stimpson and Farquharson 2014 ). Clearly, we can see that Google’s culture is different than others. What makes this company unique and different from others, as well as the dominant cultures and subcultures existing at this company? How do leadership behaviors impact the organizational culture? By operating a case study of a Harvard Business Review to analyze its organizational culture, subsequently, having compared it with Zappos’ culture, this paper will clarify the similarities and differences in managing organizational cultures between them and consider whether the solutions for the problems can be applied to other business models, and for tomorrow leaders or not?

Trends of using product by information searching

Company overview

This part shows how Google became famous in the world and its culture and subcultures made it a special case for others to take into consideration. Google is one of the few technology companies which continue to have one of the fastest growth rates in the world. It began by creating a search engine that combined PageRank system, developed by Larry Page (ranking the importance of websites based on external links), and Web search engine, created by Sergey Brin (accessing a website and recording its content), two co-founders of the company (Jarvis 2011 ; Downes 2007 ). Google’s achievements absolutely do not come from any luck. Google has made extra efforts in creating an index of a number of websites, which have been up to 25 billion websites. This also includes 17 million images and one billion messages to Usenet group (Downes 2007 ). Besides searching for websites, Google users are able to search for PDF files, PostScript, documents, as well as Microsoft, Lotus, PowerPoint and Shockwave files. Google processes nearly 50% of search queries all over the world. Moreover, it is the number one search option for web users and is one of the top five websites on the Internet, which have more than 380 million users and 28 billion visits every month, and more than 50% of access from countries outside the US (Desjardins 2017 ). Google’s technology is rather special: it can analyze millions of different variables of users and businesses who place advertisements. It then connects them with millions of potential advertisements and gives messages of advertisement, which is closest to objects in less than one second. Thus, Google has the higher rate of users clicking advertisements than its opponent Yahoo, from 50 to 100%, and it dominates over 70% market share of paid advertisements (Rosenberg 2016 ). Google’s self-stated mission: “to organize the world’s information and make it universally accessible and useful (Alves n.d. ).” Nowadays, it is believed that people in the world like “Google” with words “the useful-lively information storage”.

Predominant culture at Google

The dominant culture in the organization depends on the environment in which the company operates the organization’s objectives, the belief system of the employees, and the company’s management style. Therefore, there are many organizational cultures (Schein 2017 ). The Exhibit 3.1 at page 39 in (Schein 2009 ) provides what culture is about. For example, employee follows a standard procedure with a strict adherence to hierarchy and well-defined individual roles and responsibilities. Those in competitive environments, such as sales may forget strict hierarchies and follow a competitive culture where the focus is on maintaining strong relationships with external parties. In this instance, the strategy is to attain competitive advantages over the competition. The collaborative culture is yet another organizational way of life. This culture presents a decentralized workforce with integrated units working together to find solutions to problems or failure.

Why do many large companies buy its innovation? Because its dominant culture of 99% defect-free operational excellence squashes any attempts at innovation, just like a Sumo wrestler sitting on a small gymnast (Grossman-Kahn and Rosensweig 2012 ). They cannot accept failures. In fact, failure is a necessary part of innovation and Google took this change by Oxygen Project to measure the abilities of their multicultural managers. This means that Google itself possesses multiple different cultures (see Google’s clips). Like Zappos, Google had established a common, organizational culture for the whole offices that are distinctive from the others. The predominant culture aimed at Google is an open culture, where everybody and customer can freely contribute their ideas and opinions to create more comfortable and friendly working environment (Hsieh 2010a ).

The fig.  2 .1 in chapter two of (Schein 2009 ) and page 17 in part one of (Schein 2017 ) provide us three levels of culture which are Artifacts, Espoused values and Underlying assumptions helping us to understand the culture at Google. At page 84, in (Schein 2009 ), the “artifacts” are identified such as dress codes, level of formality in authority relationships, working hours, meeting (how often, how run, timing), how are decisions made, communication, social events, jargon, uniforms, identity symbols, rites and rituals, disagreements and conflicts, balance between work and family . It seems that Google is quite open in these artifacts by showing a respect for uniform and national culture of each staff individually and giving them the right to wear traditional clothes.

Ad Blocking Incidence

Working at Google, employees enjoy free food served throughout the day, a volleyball court, a swimming pool, a car wash, an oil change, a haircut, free health care, and many other benefits. The biggest benefit for the staff is to be picked up on the day of work. As assessed by many traffic experts, the system set up by Google is considered to be a great transport network. Tad Widby, a project manager and a traffic system researcher throughout the United States, said: “I have not seen any larger projects in the Bay Area as well as in urban areas across the country” (Helft 2007 ). Of course, it is impossible for Google to “cover up the sky”, so Yahoo also started implementing the bus project for employees in 2005. On peak days, Yahoo’s bus also took off. Pick up about 350 employees in San Francisco, as well as Berkeley, Oakland, etc. These buses run on biofuels and have Wi-Fi coverage. Yet, Danielle Bricker, the Yahoo bus coordinator of Yahoo, has also admitted that the program is “indirectly” inspired by Google’s initiative (Helft 2007 ). Along with that, eBay recently also piloted shuttle bus transfers at five points in San Francisco. Some other corporations are also emerging ideas for treatment of staff is equally unique. Facebook is an example, instead of facilitating employees far from the workplace; it helps people in the immediate neighborhood by offering an additional $10,000 for an employee to live close to the pillar within 10 miles, nearby the Palo Alto Department (Hall 2015 ).

When it comes to Google, people often ask what the formula for success is. The answer here is the employees of Google. They create their own unique workplace culture rules to create an effective work environment for their employees. And here are the most valuable things to learn from Google’s corporate culture (Scott 2008 ) that we should know:

Tolerate with mistakes and help staff correct

At Google, paying attention to how employees work and helping them correct mistakes is critical. Instead of pointing out the damage and blaming a person who caused the mistake, the company would be interested in what the cause of the problem was and how to fix it as quickly and efficiently as possible.

Also as its culture, we understand that if we want to make breakthroughs in the workplace, we need to have experimentation, failure and repeat the test. Therefore, mistakes and failures are not terrible there. We have the right to be wrong and have the opportunity to overcome failure in the support of our superiors and colleagues. Good ideas are always encouraged at Google. However, before it is accepted and put into use, there is a clear procedure to confirm whether it is a real new idea and practical or not?

Exponential thought

Google developed in the direction of a holding company - a company that does not directly produce products or provide services but simply invest in capital by buying back capital. In the company, the criteria for setting the ten exponential function in lieu of focusing only on the change in the general increase. This approach helps Google improve its technology and deliver great products to consumers continuously.

Of course, every company wants to hire talented people to work for them. However, being talented is an art in which there must be voluntary work and enthusiasm for the work of the devotees. At page 555 in (Saffold 1988 ) illustrated that distinctive cultures dramatically influencing performance do exist. Likewise, Google, Apple, Netflix, and Dell are 40% more productive than the average company which attracts top-tier employees and high performers (Vozza 2017 ). Recognizing this impact, Google created a distinctive corporate culture when the company attracted people from prestigious colleges around the world (West 2016 ; Lazear and Gibbs 2014 ).

Build a stimulating work environment

When it comes to the elements that create creativity and innovation, we can easily recognize that the working environment is one of the most important things. Google has succeeded in building an image of a creative working. Google offices are individually designed, not duplicated in any type of office. In fact, working environment at Google is so comfortable so that employees will not think of it as a working room, with a full area of ​​work, relaxation, exercise, reading, watching movies. Is the orientation of Google’s corporate culture to stimulate creativity and to show interest in the lives of employees so that volunteers contribute freely (Battelle 2011 )?

Subculture is also a culture, but for a smaller group or community in a big organization (Crosset and Beal 1997 ). Google, known as the global company with many more offices, so there are many subcultures created among groups of people who work together, from subcultures among work groups to subcultures among ethnic groups and nations, multi-national groups, as well as multiple occupations, functions, geographies, echelons in the hierarchy and product lines. For example, six years ago, when it bought 100 Huffys for employees to use around the sprawling campus, has since exploded into its own subculture. Google now has a seven-person staff of bicycle mechanics that maintains a fleet of about 1300 brightly-colored Google bikes. The company also encourages employees to cycle to work by providing locker rooms, showers and places to securely park bikes during working hours. And, for those who want to combine meetings with bike-riding, Googlers can use one of several seven-person (Crowley 2013 ).

Leadership influences on the culture at Google

From the definition of leadership and its influence on culture; so what does leader directly influence the culture existed? According to Schein, “culture and leadership are two sides of the same coin and one cannot understand one without the other”, page three in (Schein 2009 ). If one of us has never read the article “Google and the Quest to create a better boss” in the New York Times, it is listed in a priority reading. It breaks the notion that managers have no change. The manager really makes a difference (Axinn 1988 ; Carver 2011 ). In fact, a leader has a massive impact on the culture of the company, and Google is not an exception. The leaders of Google concerned more about the demands and abilities of each individual, the study of the nature of human being, an appreciation their employees as their customers. At Google, the founders thought they could create a company that people would want to work at when creating a home-like environment. It is real that they focus on the workplace brings the comfort to staff creatively and freely (Lebowitz 2013 ).

In my opinion, a successful business cannot be attributed solely from a single star; that needs the brightness of all employees. It depends very much on the capacity and ability to attract talented people. It is the way in which the leader manages these talents, is the cornerstone of corporate culture. One thing that no one can deny is that a good leader must be a creator of a corporate culture so that the employees can maximize capabilities themselves (Driscoll and McKee 2007 ; Kotter 2008 ).

To brief, through the view of Google’s culture, BoDs tended and designed to encourage loyalty and creativity, based on an unusual organizational culture because culture is not only able to create an environment, but it also adapts to diverse and changes circumstances (Bulygo 2013 ).

Company growth and its impact

“Rearrange information around the world, make them accessible everywhere and be useful.” This was one of the main purposes set by Larry Page and Sergey Brin when they first launched Google on September 4th, 1998, as a private company (Schmidt and Rosenberg 2014 ). Since then, Google has expanded its reach, stepped into the mobile operating system, provided mapping services and cloud computing applications, launched its own hardware, and prepared it to enter the wearable device market. However, no matter how varied and rich these products are, they are all about the one thing, the root of Google: online searching.

1998–2001: Focus on search

In its early years, Google.com was simply one with extreme iconic images: a colorful Google logo, a long text box in the middle of the screen, a button to execute. One button for searching and the other button are “I’m feeling lucky” to lead users to a random Google site. By May 2000, Google added ten additional languages to Google.com , including French, German, Italian, Swedish, Finnish, Spanish, Portuguese, Dutch, Norwegian and Danish, etc. This is one of the milestones in Google’s journey into the world. Google.com is available in over 150 languages (Scott 2008 ; Lee 2017 ).

2001–2007: Interface card

A very important event with Google around this time was the sale of shares to the public (IPO). In October 2003, Microsoft heard news of the IPO, so it quickly approached Google to discuss a buyout or business deal. Nevertheless, that intention was not materialized. In 2004, it was also the time when Google held a market share of 84.7% globally through collaboration with major Internet companies, such as Yahoo, AOL, and CNN. By February 2004, Yahoo stopped working with Google and separately stood out for engine search. This has led Google to lose some market share, but it has shown the importance and distinctness of Google. Nowadays, the term “Google” has been used as a verb just by visiting Google.com and doing an online search (Smith 2010 ). Not stopping at the homepage search, Google’s interface tag began to be brought to Gmail and Calendar with the links at the top of the page. Google homepage itself continues to use this style.

In 2006, Google also made an important acquisition to buy YouTube for $1.65 billion (Burgess and Green 2013 ). However, the company decided to keep YouTube as a separate brand and not to include it in Google Video search. Thanks to the backing of an Internet industry giant, YouTube has grown to become the world’s largest online video sharing service (Cha et al. 2007 ).

2007–2012: Navigation bar, Google menu, Google now

Google began to deploy a new navigation bar located at the edge of the screen. It includes links to a place where to look for photos, videos, news, maps, as well as buttons to switch to Gmail, Calendar, and other services developed by the company. In the upper left corner, Google added a box displaying Google + notifications and user accounts’ image. Google Now not only appeared on Android and it’s also brought to Chrome on a computer as well as iOS. All have the same operating principle, and the interface card still appears as Android it is.

2013–2014: Simplified interface

Google has moved all of the icons that lead to its other applications and services to an App Drawer button in the upper right hand, at the corner of the screen. In addition, Google.com also supports better voice search through the Chrome browser. Google has experimented with other markets, such as radio and print publications, and in selling advertisements from its advertisers within offline newspapers and magazines. As of November 2014, Google operates over 70 offices over 40 countries (Jarvis 2011 ; Vise 2007 ).

2014–2017: Chrome development and facing challenges

In 2015, Google would turn HTTPS into the default. The better website is, the more users will trust search engine. In 2016, Google announced Android version 7, introduced a new VR platform called Daydream, and its new virtual assistant, Google Assistant.

Most of Google’s revenue comes from advertising (Rosenberg 2016 ). However, this “golden” business is entering a difficult period with many warning signs of its future. Google Search is the dominant strength of Google and bringing great revenue for the company. Nonetheless, when Amazon surpassed Google to become the world’s leading product in the search engine in last December, this advantage began to wobble. This is considered a fatal blow to Google when iOS devices account for 75% of their mobile advertising revenue (Rosenberg 2016 ).

By 2016, the number of people installing software to block ads on phones has increased 102% from 2015. Figure  1 illustrates that by the year’s end, about 16% of smart phone users around the world blocked their ads whilst surfing the web. These were also two groups having the most time on the Internet, high-earners and young people; however, these people have disliked ads (see Fig. 1 ).

Figure  2 shows the young people have the highest ad blocking rates. It is drawing a gloomy picture for the sustainable development of the online advertising industry in general and Google in particular. Therefore, in early 2017, Google has strategies to build an ad blocking tool, built into the Chrome browser. This tool allows users to access ads that have passed the “Coalition for Better Ads” filter so as to limit the sense of discomfort (see Fig. 2 ).

For the company impact, the history shows that speedy development of Google creates both economic and social impacts to followers in a new way of people connection (Savitz 2013 ). In this modern world, it seems that people cannot spend a day without searching any information in Google (Chen et al. 2014 ; Fast and Campbell 2004 ), a tool serves human information seeking needs. Even though when addressing this paper, it is also in need the information from Google search and uses it as a supporting tool. Nobody can deny the convenience of Google as a fast and easy way to search (Schalkwyk et al. 2010 ; Jones 2001 ; Langville and Meyer 2011 ).

Research question and methodology

In order to get the most comprehensive data and information for this case analysis, a number of methods are used, including:

Research data and collect information were mostly from the Harvard Study (Project Oxygen), which has been selected because it is related to the purpose of our study.

Data collection and analysis has been taken from Google Scholar and various websites related researches. We look at the history of appearance, development, and recognize the impacts of this company, as well as the challenges and the way the Board of Directors measures the abilities of their manager when the problem is found.

Analyzing: It was begun by considering expectations from the Harvard Study. Subsequently, considering the smaller organization (Zappos) in comparison of how its cultures and subcultures are accessed as well. Since then, the paper has clarified the management problem that Google and Zappos confront and deal with it so as to help other businesses apply this theoretical practice and achieve its goal beyond expectations.

In our paper, we mainly use the inductive method approach by compiling and describing the other authors’ theories of corporate culture, especially Google and Zappos in merging and comparing, analyzing them and making our own results.

From the aspects of the research, the questions are suggested as below:

What is the most instrumental element found from the Harvard study?

Is there any difference and similarity between a huge company and a smaller enterprise in perspective of culture and subculture?

What makes Google different from others, the dominant cultures as well as subcultures existing? How do leadership behaviors impact on the organizational culture?

How organizational culture impacts on business achievements?

The Harvard study

Project oxygen summary.

This project began in 2009 known as “the manager project” with the People and Innovation Lab (PiLab) team researching questions, which helped the employee of Google become a better manager. The case study was conducted by Garvin (2013) about a behavior measurement to Google’s manager, why managers matter and what the best manager s do. In early days of Google, there are not many managers. In a flat structure, most employees are engineers and technical experts. In fact, in 2002 a few hundred engineers reported to only four managers. But over time and out of necessity, the number of managers increased. Then, in 2009, people and team culture at Google noticed a disturbing trend. Exit interview data cited low satisfaction with their manager as a reason for leaving Google. Because Google has accessed so much online data, Google’s statisticians are asked to analyze and identify the top attributes of a good manager mentioned with an unsolved question: “Do managers matter?” It always concerns all stakeholders at Google and requires a data-based survey project called Project Oxygen to clarify employees’ concern, to measure key management behaviors and cultivate staff through communication and training (Bryant 2011 ; Garvin et al. 2013 ). Research −1 Exit Interviews, ratings, and semiannual reviews. The purpose is to identify high-scoring managers and low-scoring managers resulted in the former, less turnover on their teams, and its connection (manager quality and employee’s happiness). As for “what the best managers do”, Research-2 is to interview high and low scoring managers and to review their performance. The findings with 8 key behaviors illustrated by the most effective managers.

The Oxygen Project mirrors the managers’ decision-making criteria, respects their needs for rigorous analysis, and makes it a priority to measure impact. In the case study, the findings prove that managers really have mattered. Google, initially, must figure out what the best manager is by asking high and low scoring managers such questions about communication, vision, etc. Its project identifies eight behaviors (Bulygo 2013 ; Garvin et al. 2013 ) of a good manager that considered as quite simple that the best manager at Google should have. In a case of management problem and solution, as well as discussing four- key theoretical concepts, they will be analyzed, including formal organizational training system, how culture influences behavior, the role of “flow” and building capacity for innovation, and the role of a leader and its difference from the manager.

Formal organizational training system to create a different culture: Ethical culture

If the organizational culture represents “how we do things around here,” the ethical culture represents “how we do things around here in relation to ethics and ethical behavior in the organization” (Key 1999 ). Alison Taylor (The Five Levels of an Ethical Culture, 2017) reported five levels of an ethical culture, from an individual, interpersonal, group, intergroup to inter-organizational (Taylor 2017 ). In (Nelson and Treviño 2004 ), ethical culture should be thought of in terms of a multi-system framework included formal and informal systems, which must be aligned to support ethical judgment and action. Leadership is essential to driving the ethical culture from a formal and informal perspective (Schwartz 2013 ; Trevino and Nelson 2011 ). Formally, a leader provides the resources to implement structures and programs that support ethics. More informally, through their own behaviors, leadership is a role model whose actions speak louder than their words, conveying “how we do things around here.” Other formal systems include selection systems, policies and codes, orientation and training programs, performance management systems, authority structures, and formal decision processes. On the informal side are the organization’s role models and heroes, the norms of daily behavior, organizational rituals that support or do not support ethical conduct, the stories people tell about the organization and their implications for conduct, and the language people use, etc. Is it okay to talk about ethics? Or is ethical fading the norm?

The formal and informal training is very important. The ethical context in organizations helps the organizational culture have a tendency to the positive or negative viewpoints (Treviño et al. 1998 ). The leader should focus on providing an understanding of the nature and reasons for the organization’s values and rules, on providing an opportunity for question and challenge values for sincerity/practicality, and on teaching ethical decision-making skills related to encountered issues commonly. The more specific and customized training, the more effective it is likely to be. Google seemed to apply this theory when addressed the Oxygen Project.

How culture influences behavior

Whenever we approach a new organization, there is no doubt that we will try to get more about the culture of that place, the way of thinking, working, as well as behavior. And it is likely that the more diverse culture of a place is, the more difficult for outsiders to assess its culture becomes (Mosakowski 2004 ).

Realizing culture in (Schein 2009 ) including artifacts, espoused valued and shared underlying assumptions. It is easier for outsiders to see the artifacts (visual objects) that a group uses as the symbol for a group; however, it does not express more about the espoused values, as well as tacit assumptions. In (Schein et al. 2010 ), the author stated: “For a culture assessment to be valuable, it must get to the assumptions level. If the client system does not get to assumptions, it cannot explain the discrepancies almost always surface between the espoused values and the observed behavioral artifacts” (Schein et al. 2010 ). Hence, in order to be able to assess other cultures well, it is necessary for us to learn each other’s languages, as well as adapt to a common language. Moreover, we also need to look at the context of working, the solution for shared problems because these will facilitate to understand the culture better.

According to the OCP (Organizational Culture Profile) framework (Saremi and Nejad 2013 ), an organization is with possessing the innovation of culture, flexible and adaptable with fresh ideas, which is figured by flat hierarchy and title. For instance, Gore-Tex is an innovative product of W. L. Gore & Associates Inc., considered as the company has the most impact on its innovative culture (Boudreau and Lakhani 2009 ). Looking at the examples of Fast Company, Genentech Inc., and Google, they also encourage their employees to take challenges or risks by allowing them to take 20% of their time to comprehend the projects of their own (Saremi and Nejad 2013 ). In (Aldrich n.d. ), it is recorded that 25%–55% of employees are fully encouraged and giving a maximum value.

The famous quote by Peter Drucker , “Culture eats strategy for Breakfast” at page 67 has created a lot of interest in (Manning and Bodine 2012 ; Coffman and Sorensen 2013 ; Bock 2015 ). Despite we all know how important culture is, we have successively failed to address it (O'Reilly et al. 1991 ). The organizational research change process from the view of Schein ( 2009 ); it is a fact that whenever an organization has the intention of changing the culture, it really takes time. As we all acknowledge, to build an organizational culture, both leader and subordinate spend most of their time on learning, relearning, experiencing, as well as considering the most appropriate features. Sometimes, some changes are inevitable in terms of economic, political, technological, legal and moral threats, as well as internal discomfort (Kavanagh and Ashkanasy 2006 ; Schein 1983 ). As the case in (Schein 2009 ), when a CEO would like to make an innovation which is proved no effective response, given that he did not get to know well about the tacit implications at the place he has just come. It is illustrated that whatsoever change should need time and a process to happen (Blog 2015 ; Makhlouk and Shevchuk 2008 ). In conclusion, a new culture can be learned (Schein 1984 ), but with an appropriate route and the profits for all stakeholders should be concerned by the change manager (Sathe 1983 ).

It is true that people’s behavior managed by their types of culture (Kollmuss and Agyeman 2002 ). All tacit assumptions of insiders are not easy for outsiders to grasp the meaning completely (Schein 2009 ). It is not also an exception at any organization. Google is an example of the multicultural organization coming from various regions of the world, and the national or regional cultures making this multicultural organization with an official culture for the whole company.

In this case, the organizational culture of Google has an influence on the behaviors of manager and employee. In addition, as for such a company specializes in information technology, all engineers prefer to work on everything with data-evidence to get them involved in the meaningful survey about manager (Davenport et al. 2010 ). Eventually, Google discovered 8 good behaviors of manager, which effect to the role of “flow” also (Bulygo 2013 ; Garvin et al. 2013 ).

The role of the “flow” and building capacity for innovation

More and more people are using the term of “patient flow”. This overview describes patient flow and links to theories about flow. Patient flow underpins many improvement tools and techniques. The term “flow” describes the progressive movement of products, information, and people through a sequence of the process. In simple terms, flow is about uninterrupted movement (Nave 2002 ), like driving steadily along the motorway without interruptions or being stuck in a traffic jam. In healthcare, flow is the movement of patients, information or equipment between departments, office groups or organizations as a part of a patient’s care pathway (Bessant and Maher 2009 ). In fact, flow plays a vital role in getting stakeholders involved in working creatively and innovatively (Adams 2005 ; Amabile 1997 ; Forest et al. 2011 ). An effective ethical leader must create flow in work before transfer it to employees for changing the best of their effort to maintain, keep and develop “flow” in an engineering job, which job be easier to get stress. Definitely, Google gets it done very well.

Acknowledgements

Thanks to the knowledge from my Master course, a credit of managing culture which helps me to write this paper. The author also gratefully acknowledges the helpful comments and suggestions of the reviewers and Associate Professor Khuong- Ho Van, who provided general technical help that all have improved the article.

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Center for Predoctoral Training, Vietnam National University–HCMC, Quarter 6, Linh Trung Ward, Thu Duc District, Ho Chi Minh, HCMC, Vietnam

Sang Kim Tran

Department of Research, Galaxy, 4/62 Nguyen Thi Minh Khai, Hoa Lan 1, Thuan Giao Ward, Binh Duong, 820000, Viet Nam

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Management Styles Analysis

Management Styles Management is a far-running subject and there are many definitions of management. From my point of view, management is described as a process to get something done in the business environment. It is the person called Manager who gets various jobs done by assign works to people working with him/her. How the Manager can get the things done effectively and efficiently is an important problem that should be researched. Robert Tannenbaum and Warren H.

Schmidt (1958, 1973), who argued that the style of leadership is dependent upon the prevailing circumstance, therefore leaders should exercise a range of management styles and deploy them as appropriate. In fact, a management style is an overall method of leadership used by a manager. Managers should be able to understand the concept of management styles which are characteristic ways relating to subordinates in different situations. In this essay, management styles and how they demonstrated in different cultures will be addressed.

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Also, the factors that affect the formation of such characteristic management styles will also be discussed. The aim of this essay is to provide some suggestions for managers in international companies with regard to the area of management in a foreign culture background.

There are two sharply contrasting styles: Autocratic and Permissive. Furthermore, these two categories are broken down into smaller subsets, which I will not discuss in detail in this essay. Each of the two styles has its own characteristics. Autocratic” means that Manager makes all decisions unilaterally, while “Permissive” means Manager permits subordinates to take part in decision making and also managers prefer to gives subordinates a considerable degree of autonomy in completing routine work activities. Although it may sound better to conduct a permissive manage style which might stimulate the employees to engage more into their job since they are also invited to take certain responsibility of the company’s fate.

However, that’s not always the case.

Therefore, in the fast development of economic globalization, how to properly utilize these different management styles according to local situations is a hot topic. Due to the various custom and belief in specific backgrounds, different management styles are required in different parts of the world. In my opinion, there are three key factors that influence management styles: culture, policy, and custom. How they affect the management styles are illustrated in this paragraph.

First of all, culture shapes both the individual and collective behavior in a society. Therefore, there is no doubt that management is closely associated with culture.

The management style and culture is closely related to each other. Diversity of cultures determines diversity of management. There are different cultures in different countries, different nationalities, and different societies, which means that there must be different management styles in order to deal with such specific situations. For instance, the two typical different management styles in Japan and the US both built on national cultures.

Then, management is also a culture itself. The leading ideologies, management theories and management styles are all important parts of the enterprise culture.

Management style varies from cultures. Therefore, it is crucial to study culture first and thereby decide which management style is suitable. Then, different policies and social rules are the other important factors which influence that influences management styles.

Economy cannot avoid laws, since any business operations in a country must obey the different policies announced by different countries. Different countries have different law systems and social rules and no matter what management styles should observe the law and rules. Only within the legal framework can a management style be applied.

In a word, law system directly influences management styles. For instance, managers can encourage his staffs to work overtime in some countries but it violates the labor law in some other countries. Apart from culture and law, different business customs also can influence management styles.

Business custom is part of a nation’s culture. It has been formed in a long time, maybe several decades, several countries, or even thousands years such as China and Japan. The custom includes how to manage enterprise, how to treat customers, how to get along with leaders and subordinates.

Different countries and economic systems have different answers and standards. For example, in China, “face issue” is important for individuals in traditional custom. And appreciation or encouragements should be made before any criticism.

If managers point out employees’ mistake in front of other workers directly, the employee might feel ashamed and reluctant to cooperate with the manager in future, which surely will bring barriers to management. There are also various customs in different regions, management styles are also changing according to such differences.

I would like to take Japan and the US as examples to discuss how these key factors, culture, policy, and customs influence management styles in specific circumstances. Obviously, Japan and the US display an obvious contrast in the aspect of culture, society and ideology, etc. I would like to discuss the features of Japan and the US at first.

First of all, the US is a nation with a large number of immigrants, which determines that its national culture is identified with individualism. As is known to all, the US is country with great freedom.

The enterprise culture in the US also grasps the core content of such freedom for individual employee. Certainly, this individualism is rather than selfishness, but emphasis on the independence, motility and personal achievement. As a result, the management in the US also encourages individualism and free development of personality.

They pay more attention to the efficiency of organization and production. They focus less on personal behaviors than what Japanese companies do. For example, employees in the US always prefer companies which give them certain personal time and space.

This trend also regulates the management styles to permissive. On the other hand, Japan is a very densely populated homogeneous country.

Their society is stable and uniform, so that Japan has a strong similarity in their behaviors. Japan, as an emerging capitalist country, it has much feudalistic remnants in enterprise culture and management. Because of paternalism in Japan, they respect authority and mastery. They accept hierarchical system and absolutely comply with the leaders and authorities. Then they have a form of familial capitalism.

In the company there is a dependence relation among the people according to how long they have been in the company.

There is a clear-cut personal relationship which is “Sennpai” and “Kouahai” (Senior and Junior). “Sennpai” should help, cultivate and responsible for “Kouahai” and “Kouahai” should respect “Sennpai” unconditionally. Most important, they value collectivism rather than individualism. They emphasize a sense of belonging to the team and loyal to enterprise. As the discussion above, management styles must be suitable for the place where the management is taking place.

Like, these two countries with distinctive cultural and social background, Japan and the US have quite different management styles.

In other words, enterprises want to explore oversea business, they should take different management styles in order to get most effective management. Apparently, autocratic management styles are suitable for regions where people respect collective value more, like the situation in Japan. In this management style, Manager can make decisions unilaterally and effectively without wasting time for a democratic decision.

This style can ensure a prompt decision thus master the business opportunities speedily and improve efficiency. Then while permissive should be more effective for the enterprises in the US, since the employees pay more attention to their individual value.

The manager should allow the employees to take part in decision-making: therefore everything is agreed by the majority and everyone can work with responsibility. In summary, management styles not only clearly exist in different regions of the world, it should arouse the special attention of managers and all the enterprises.

Meanwhile there is no management that remains unchanged for an international enterprise because they are running business in different cultures of the world. Management styles should be adjusted with the changing of the cultural background, specific law systems and traditional customs. Reference Abbott, Keith (2006), The impact of management style on the employment relations of different sized organizations, Australasian journal of business and social inquiry, vol. 4, no.

2, pp. 1-20 Deaton, D. (1985). Management style and large-scale survey evidence.

Industrial Relations Journal, 16, 2, 67–71. Edwards, 1993 P.

Edwards, A. Ferner and K. Sisson, People and the Process of management in the multinational company: A review with some illustrations, Industrial Relations Research Unit, Coventry (1993). Purcell, 1987 J. Purcell, Mapping management styles in employment relations.

Journal of Management Studies,  24 5 (1987), pp. 533–548. Wolf D. Reitsperger. (2007).

‘Japanese Management: Coping with British Industrial Relations’. Journal of Management Studies. : Wiley.

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Adapt Your Leadership Style to Your Situation

There’s not one leadership style that works for all contexts. For example, in some situations, it’ll make sense to tell people what to do, whereas asking open-ended questions will work better in others. You might need to adjust goals as new information emerges, or, under certain circumstances, stick exactly to the plan. You should adjust […]

There’s not one leadership style that works for all contexts. For example, in some situations, it’ll make sense to tell people what to do, whereas asking open-ended questions will work better in others. You might need to adjust goals as new information emerges, or, under certain circumstances, stick exactly to the plan. You should adjust your style based on the people you’re managing, the context in which you’re leading, and the outside pressures you’re under. To navigate tensions like these, you need a good deal of self-awareness. So understand your natural tendencies. What’s your default position? Do you tend to be more of a traditional leader, or do you align with a more adaptive, fluid style? If you’re not sure, get feedback from others. Then learn, adapt, practice. The goal is to develop a portfolio of micro-behaviors you can employ when the situation demands you use a different style. And look to your employees for signals on when it’s appropriate to favor one approach over another.

Source: This tip is adapted from “Every Leader Needs to Navigate These 7 Tensions,” by Jennifer Jordan, Michael Wade, and Elizabeth Teracino

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Change Management Case Study Examples: Lessons from Industry Giants

Explore some transformative journeys with efficient Change Management Case Study examples. Delve into case studies from Coca-Cola, Heinz, Intuit, and many more. Dive in to unearth the strategic wisdom and pivotal lessons gleaned from the experiences of these titans in the industry. Read to learn about and grasp the Change Management art!

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In the fast-paced world of business, staying ahead means being able to adapt. Have you ever wondered how some brands manage to thrive despite huge challenges? This blog dives into a collection of Change Management Case Studies, sharing wisdom from top companies that have faced and conquered adversity. These aren’t just stories; they’re success strategies.  

Each Change Management Case Study reveals the smart choices and creative fixes that helped companies navigate rough waters. How did they turn crises into chances to grow? What can we take away from their successes and mistakes? Keep reading to discover these inspiring stories and learn how they can reshape your approach to change in your own business. 

Table of Contents  

1) What is Change Management in Business? 

2) Top Examples of Case Studies on Change Management 

    a) Coca-Cola 

    b) Adobe 

    c) Heinz  

    d) Intuit  

    e) Kodak 

    f) Barclays Bank 

3) Conclusion

What is Change Management in Business?  

Change management in business refers to the structured process of planning, implementing, and managing changes within an organisation. It involves anticipating, navigating, and adapting to shifts in strategy, technology, processes, or culture to achieve desired outcomes and sustain competitiveness.  

Effective Change Management entails identifying the need for change, engaging stakeholders, communicating effectively, and mitigating resistance to ensure smooth transitions. By embracing Change Management principles, businesses can enhance agility, resilience, and innovation, driving growth and success in dynamic environments. 

Top Examples of Case Studies on Change Management  

Let's explore some transformative journeys of industry leaders through compelling case studies on Change Management: 

1) Coca-Cola  

Coca-Cola, the beverage titan, acknowledged the necessity to evolve with consumer tastes, market shifts, and regulatory changes. The rise of health-conscious consumers prompted Coca-Cola to revamp its offerings and business approach. The company’s proactive Change Management centred on innovation and diversification, leading to the launch of healthier options like Coca-Cola Zero Sugar.  

Strategic alliances and acquisitions broadened Coca-Cola’s market reach and variety. Notably, Coca-Cola introduced eco-friendly packaging like the PlantBottle and championed sustainability in its marketing, bolstering its brand image. 

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2) Adobe  

Adobe, with its global workforce and significant revenue, faced a shift due to technological advancements and competitive pressures. In 2011, Adobe transitioned from physical software sales to cloud-based services, offering free downloads or subscriptions.  

This shift necessitated a transformation in Adobe’s HR practices, moving from traditional roles to a more human-centric approach, aligning with the company’s innovative and millennial-driven culture. 

3) Heinz  

Berkshire Hathaway and 3G Capital’s acquisition of Heinz led to immediate, sweeping changes. The new management implemented cost-cutting measures and altered executive perks.  

Additionally, it introduced a more insular leadership style, contrasting with 3G’s young, mobile, and bonus-driven executive team. 

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4) Intuit  

Steve Bennett’s leadership at Intuit marked a significant shift. Adopting the McKinsey 7S Model, he restructured the organisation to enhance decision-making, align rewards with strategy, and foster a performance-driven culture. His changes resulted in a notable increase in operating profits. 

5) Kodak  

Kodak, the pioneer of the first digital and megapixel cameras in 1975 and 1986, faced bankruptcy in 2012. Initially, digital technology was costly and had subpar image quality, leading Kodak to predict a decade before it threatened their traditional business. Despite this accurate forecast, Kodak focused on enhancing film quality rather than digital innovation.  

Dominating the market in 1976 and peaking with £12,52,16 billion in sales in 1999, Kodak’s reluctance to adopt new technology led to a decline, with revenues falling to £4,85,11,90 billion in 2011.  

In contrast, Fuji, Kodak’s competitor, embraced digital transformation and diversified into new ventures. 

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6) Barclays Bank  

The financial sector, particularly hit by the 2008 mortgage crisis, saw Barclays Capital aiming for global leadership under Bob Diamond. However, the London Inter-bank Offered Rate (LIBOR) scandal led to fines and resignations, prompting a strategic overhaul by new CEO Antony Jenkins in 2012.  

Changes included rebranding, refocusing on core markets, altering the business model away from high-risk lending, fostering a customer-centric culture, downsizing, and embracing technology for efficiency. These reforms aimed to strengthen Barclays, improve shareholder returns, and restore trust. 

Conclusion  

The discussed Change Management Case Study examples serve as a testament to the transformative power of adept Change Management. Let these insights from industry leaders motivate and direct you as you navigate your organisation towards a path of continuous innovation and enduring prosperity. 

Enhance your team’s ability to manage uncertainty and achieve impactful results – sign up for our comprehensive Risk Management For Change Training now!  

Frequently Asked Questions

The five key elements of Change Management typically include communication, leadership, stakeholder engagement, training and development, and measurement and evaluation. These elements form the foundation for successfully navigating organisational change and ensuring its effectiveness. 

The seven steps of Change Management involve identifying the need for change, developing a Change Management plan, communicating the change vision, empowering employees, implementing change initiatives, celebrating milestones, and sustaining change through ongoing evaluation and adaptation. 

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The Knowledge Academy offers various Change Management Courses , including the Change Management Practitioner Course, Change Management Foundation Training, and Risk Management for Change Training. These courses cater to different skill levels, providing comprehensive insights into Change Management Metrics .   

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The impact of management styles on business decision making: exploring the different models of decision making, author (s): .

Alaegbu Anastecia Nkeiru & Barisua Fortune Nwinee

Decision-making is fundamentally a function of a company’s top members’ prerogative. Any success attributable to an organization depends wholly on the choice of its management styles and their grasp of administrative decisions and approaches to decision-making. Decision makers therefore, need to understand the concepts that ensure rationality and effectiveness in decisions; clarity in decision, time, work, and implementation and in follow-up evaluation needs to be taking into cognizance. Any style so adopted by management is seen to be the adhesive that binds diverse operations and functions together. It is the philosophy or set of principles by which the manager leverages on the workforce. Every organizations needs a better insight on the approach managers adopts in solving real life organization’s problems. This paper is a theoretical paper and accessed and explored related literature. The research demonstrated that there are series of management styles which influence decision making styles. Hence, the paper concluded that; management style suggestively affects the degree of decisions made by both individual employees and the management team in an organization.

Key words:  Management Style, Decision making, Rational Model, Situational Management Style, Collaborative Management Style.

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Alaegbu Anastecia Nkeiru & Barisua Fortune Nwinee (2019). The Impact of Management Styles on Business Decision Making: Exploring the Different Models of Decision Making. International Journal of Science and Business, 3(3), 210-229. doi: https://doi.org/10.5281/zenodo.2771707

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About Author (s)

Alaegbu Anastecia Nkeiru (Corresponding Author), Department of Marketing, Faculty of Management Sciences, University of Port Harcourt, Rivers State, Nigeria.

Prof. Barisua Fortune Nwinee, Dean, Faculty of Management Sciences, University of  Port Harcourt, Rivers State, Nigeria.

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DOI: https://doi.org/10.5281/zenodo.2771707

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• Published: 18 June 2024

Implications of cognitive and daily living capabilities on early type 2 diabetes management: a preliminary case–control study

• Romina Mahmoudi 1   na1 ,
• Farzin Kamari   ORCID: orcid.org/0000-0003-4774-5168 2   na1 ,
• Reza Naghdi Sadeh   ORCID: orcid.org/0000-0002-3541-812X 3 ,
• Amirreza Naseri   ORCID: orcid.org/0000-0001-9723-0109 4 , 5 &
• Vahideh Sadra   ORCID: orcid.org/0000-0003-3724-209X 1  

European Journal of Medical Research volume  29 , Article number:  337 ( 2024 ) Cite this article

Metrics details

Adherence to the transition from oral agents to insulin injections in Type 2 Diabetes Mellitus therapy varies among patients and is not uniformly successful, leading to suboptimal glycemic control in certain cases. This study aims to investigate the potential correlation between cognitive and daily functional capabilities and glycemic control in middle-aged to older adults (40–74 years old) diagnosed with Type 2 Diabetes Mellitus for less than 10 years, specifically those who have recently transitioned to insulin injections and have lower education levels within the context of a developing country.

A case–control study was conducted with 30 poorly controlled diabetes mellitus (PCDM) patients recognized by HbA1c levels > 8% compared to 30 fairly controlled diabetes mellitus (FCDM) patients with HbA1c levels ≤ 8%. Basic Montreal Cognitive Assessment (MoCA-B) score of less than 27 was investigated as the exposure among two groups. Additionally, intra- and inter-battery correlations were assessed among MoCA-B and Instrumental Activities of Daily Living (IADL) domains using Pearson’s r .

The primary outcomes showed no crude difference between MoCA-B scores in the two diabetic groups ( p -value = 0.82). However, after adjusting for age, education, and IADL scores, cognitive decline in the less-educated younger elderly with high IADL scores demonstrated an unexpected protective effect against PCDM ( p -value < 0.0001, OR 95% CI = 0–0.26). In linear regression analysis among MoCA-B and IADL scores, “delayed recall” and “orientation” domains from MoCA-B, and “managing medications” and “using the phone” from IADL were negatively associated with HbA1c levels ( p -values of < 0.01, 0.043, 0.015, and 0.023, respectively). Intra- and inter-battery correlations further illustrated a strong association between MoCA-B’s “orientation” with IADL’s “using the phone” and “managing medications” ( p -values < 0.0001).

Superior performance in certain cognitive domains is linked to better glycemic control. Still, since assessing cognitive domains may be timely in clinical routine, a potential rapid approach might be taken by assessing patients’ instrumental abilities to use cell phone or manage medications. Future studies including a larger sample size and a broader spectrum of psychosocial factors are needed to elaborate on our findings.

Diabetes mellitus (DM) is a group of metabolic syndromes that are characterized by high blood glucose levels resulting from deficits in insulin-related pathways [ 1 ]. In Type 2 DM (T2DM), which accounts for more than 90% of persons with diabetes, the resistance of the insulin receptors on hepatic and muscular cells is the main reason for increased blood levels of glucose [ 2 ]. In 2021, approximately 537 million adults had DM worldwide, and by projecting trends for overweight and obesity, it has been estimated that the global DM prevalence would upsurge by 783.2 million in 2045 [ 3 ]. Globally, DM is the ninth leading cause of death [ 4 ] and the first cause of new cases of vision loss among the 20–74 age interval [ 5 ]. DM is traditionally associated with a wide range of macro and microvascular complications, while a set of emerging complications, like DM-associated cognitive decline and functional disability, are drawing more attention in the recent literature [ 6 ]. The effects of DM on the cognitive decline are also well studied in the literature [ 7 , 8 , 9 ]; see a review in [ 6 ]. A gradual and chronic decline in cognitive function is commonly believed to occur which particularly accelerates with the aging process. In the large-scale cohort study of Whitehall II, it has been demonstrated that cognitive decline in the middle-aged to older adults with a recent diagnosis of T2DM (5 to 10 years) is negligible [ 10 ]. This highlights the importance of age in determining the extent of cognitive decline in individuals with T2DM. Besides age, maintaining tight control of glycemic levels is also crucial in preventing cognitive decline. In general, comprehensive treatment strategies are believed to be crucial in controlling the early- and late-onset complications, and the cognitive decline is of no exception.

Success in comprehensive management of DM is heavily dependent on the medication compliance and adherence of patients [ 11 ]. Patients demonstrate different levels of compliance with their anti-diabetes medications, and this might at some degree be related to their level of knowledge, education, cognition and alertness [ 12 ]. The core objective of our study arises from a recurring challenge observed in the endocrinological wards, where transitioning middle-aged to older patients from oral agents to insulin injections [ 13 ] results in deteriorating glycemic control due to a lesser degree of adherence. This necessitated our focus on middle-aged to older individuals with less than 10 years since the onset of T2DM, so-called recently diagnosed T2DM, a population wherein diabetes-related cognitive decline is improbable within the clinical and pathological contexts, as indicated by existing literature [ 10 ]. Although the level of education is plausibly a crucial factor in therapy compliance, studies which are examining the correlation between cognitive function, insulin adherence, and glycemic control, particularly in low education populations, are notably lacking in the literature. In this study, we aimed to investigate the potential correlation between cognitive and daily functional capabilities and glycemic control in middle-aged to older adults diagnosed with Type 2 Diabetes Mellitus for less than 10 years, specifically those who have recently transitioned to insulin injections and have lower education levels within the context of a developing country.

Study design

The current study was designed as a case–control investigation to examine the association between cognitive and instrumental abilities, and T2DM management in a minimally literate population. The cases were distinguished from the controls with an HbA1c of more than 8%. The variables under investigation among cases and controls were the Basic Montreal Cognitive Assessment (MoCA-B), Activities of Daily Living (ADL), and Instrumental Activities of Daily Living (IADL) scores. Age, gender, literacy, and other demographic factors were controlled as covariates. The data collection spanned 15 months starting from November 2019, with an 8-month pause due to the COVID-19 emergency, resulting in an effective recruitment period of 7 months. Sample size was derived from the variables of a similar study on Iranian population [ 14 ].

Study population

60 T2DM patients were recruited into the study, separated into two groups of 30 cases and 30 controls. The inclusion criteria were (1) the diagnosis criteria of T2DM according to the criteria established by the American Diabetes Association (ADA) [ 1 ]; (2) the age of patients to be ≥ 40 and < 75 years; (3) the duration of diagnosed T2DM less than 10 years; (4) a transition from oral agents to a regular insulin injection therapy in the past 3 to 6 months, i.e., recent transition. In other words, patients transitioned from oral agents to insulin injections with an indication due to antidiabetic agent failure, three to six months before recruitment in the study. Recruitment took place during a follow-up visit following the transition, at which point patients were categorized into cases and controls depending on their HbA1c levels at recruitment. The exclusion criteria were (1) drug or alcohol abuse or dependence; (2) cerebral stroke or other neurological conditions; (3) depression; (4) use of possible or known cognitive-impairing drugs in the previous month; (5) acute coronary syndrome; (6) decompensated heart failure; (7) severe renal dysfunction (serum creatinine > 2.5 mg/dL); (8) active malignancy; (9) active infection; (10) chronic liver failure; (11) body mass index (BMI) ≥ 35; (12) autoimmune diseases, and (13) any surgical procedure related to DM. It is to be noted that all included patients were middle-aged or younger at the time of their diagnosis. The cases entailed patients with an HbA1c measurement equal to or more than 8%, (183 mg/dL or 10.2 mmol/L). Controls were T2DM patients with the same criteria as above who had an HbA1c measurement equal to or less than 8%, i.e. fairly controlled T2DM [ 15 , 16 ]. Patients were recruited from the Imam-Reza University Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.

Cognitive and daily activity assessment

For the cognitive assessment, the standardized translated version of the MoCA-B battery [ 17 ] was performed on all patients via a specifically-trained and dedicated medical practitioner. The selection of MoCA-B among other cognitive screening tests [ 18 ] was due to its excellent sensitivity [ 19 ], availability of a validated translated version in Farsi [ 20 ], and our existing expertise in performing it during the clinical visits. Furthermore, to evaluate the extent of daily life activity and physical disabilities, ADL and IADL [ 21 ] batteries were performed by the same evaluator. Both ADL and IADL have been previously described as valuable assessment tools in the context of DM [ 22 , 23 ]. Patients with low scores of ADL or IADL due to non-cognitive etiologies, e.g., musculoskeletal restrictions, were subsequently excluded from the study. All tests were performed at once in a calm environment and the test results were concurrently documented in an Excel sheet.

Blood sampling and HbA1c measurement

Blood samples were collected on the next day of each interview. Serum separator tubes were used for creatinine level assessments, and Ethylenediaminetetraacetic acid (EDTA) tubes were used for complete blood count (CBC) and HbA1c measurements. The blood samples were obtained in the morning after an 8-h of continuous fasting. HbA1c was measured using immuno-turbidimetry methodology enhanced by latex particles, a test kit provided by ELITechGroup (Puteaux, France). A Selectra Pro XL device (Puteaux, France, 2016) at the Provincial Laboratory was used for the HbA1c measurements. All procedures were performed according to the manufacturer’s brochures and guidelines.

Linear regression analysis

First, a multiple linear regression model was established to predict HbA1c levels, incorporating covariates such as age, gender, education, BMI, past medical history of hypertension, current smoking status, and scores from ADL and IADL assessments. The multiple linear regression model can be formulated as Eq. ( 1 ):

in which \(Y\) is the level of HbA1c, \({\beta }_{0}\) is the intercept, \({\beta }_{1}\) to \({\beta }_{n}\) are coefficients, \({X}_{1}\) to \({X}_{n}\) are the covariates, and \(\varepsilon\) denotes the error term. Following the statistical elimination of non-significant covariates, individual domains of MoCA-B, ADL and IADL batteries were added to the model. After investigating interactions between domains and multicollinearity, a simplified model was derived as shown in Eq. ( 2 ):

where \(Y\) is the level of HbA1c, \({\beta }_{0}\) is the intercept, \({\beta }_{1}\) is the coefficient of the significant domain \(X\) .

Intra- and inter-battery correlation heatmaps

To propose a robust multiple linear regression model with battery domains as independent variables, multicollinearity of domains was investigated using heatmaps illustrating the intra- and inter-battery correlations. Redundant covariates were subsequently removed to reach Eq. ( 2 ). Also, as it is discussed in the next sections, the intra- and inter-battery correlations may provide useful information for clinicians regarding the redundancy of the MoCA-B and IADL domains. The correlation heatmaps were produced using Pearson’s r , as previously described for other battery correlations [ 24 ].

Statistical analysis

Narrative statistical analysis reports the mean ± standard deviation for normally distributed variables, and median (interquartile range) for skewed distributions. All frequencies are reported as percentages. The independency of cases and controls was investigated by statistical testing of overall demographic and clinical variables. Student’s t -test was performed for normally distributed variables with equal variances, while Welch’s test was preferred in the case of heteroscedasticity. To compare percentages, the chi-squared test of independence was chosen. All tests were done with a two-tailed assumption and an alpha of 0.05 with 95% confidence intervals (CI). The targeted power of tests was set to be 80%, and underpowered deviations identified through post hoc power calculations are separately reported in the respective legends. Odds ratio (OR) analyses were done in two-by-two tables with adjustments of covariates. All analyses were done in R statistical software (version 3.6.0) and RStudio (version 1.2.1335) using “EpiStats”, “dplyr”, and “plotly” packages [ 25 , 26 ].

Narrative characteristics of T2DM patients

60 T2DM patients were included based on the inclusion/exclusion criteria from whom one-half had a measurement of HbA1c more than 8%, i.e., cases, at the time of the study. The mean of HbA1c of cases was 10.12% and that of controls was 7.32%. The mean age ± SD of all 60 patients at the time of their T2DM diagnosis was 52.6 ± 8.5. Other characteristics of patients have been presented in Table  1 . The demographic characteristics of the two groups were similar, except for HbA1c which was the only criterion that distinguished the cases from the controls.

No unadjusted link between MoCA-B and HbA1c

First, we investigated the difference between MoCA-B scores in cases and controls. Both groups were balanced in size (n 1  = n 2  = 30), heteroscedastic (Bartlett’s test, p -value = 0.016), and non-normally distributed (Shapiro–Wilk normality test, p -value < 0.001). Kruskal–Wallis rank sum test revealed a p -value of 0.82. Similar result was obtained from primary analysis of unadjusted OR, which revealed no significant difference (OR = 0.64; 95% CI = 0.19–2.12) in risk for poorly controlled type 2 Diabetes Mellitus (PCDM), in individuals with an exposure of cognitive decline. Table 2 demonstrates the two-by-two table for more clarification of the patient distributions in four categories.

Odds ratio adjusted for age, education and IADL

Considering age as a covariate, adjusting for younger elderly patients (age > 60; n = 34) point estimate of age-adjusted OR is 0.09 (95% CI = 0–0.92; p -value = 0.015, see Table  3 ). However, in the middle-aged patients with age ≤ 60, no association was found between MoCA-B scores and HbA1c levels ( p -value = 0.24). Surprisingly, adjusting for age (> 60), education (≤ 7 years), and IADL (> 14) suggests a protective effect of cognitive decline in PCDM (n = 22; OR = 0.00; 95% CI = 0.00–0.26; p -value < 0.0001, see Table  4 ).

Linear regression analysis of specific domains

The linear regression analysis of cognitive domains revealed a significant association between the “delayed recall” domain of MoCA-B and the HbA1c measurement ( p -value < 0.01), represented by the regression model in Eq.  3 :

in which HbA1c is in the arbitrary unit of %, 11.26 is the intercept of the linear equation and the “delayed recall” variable has a coefficient of − 0.65, and \(\varepsilon\) is the error rate. The negative sign of the coefficient means that a higher score in the delayed recall domain would result in a lower expected/calculated HbA1c. Another significant association was seen in the domain of “orientation” with a negative coefficient and a p -value of 0.043. Nonetheless, multiple regression models were not significant involving any combination of MoCA-B, ADL, or IADL domains. Regarding IADL domains, two domains of “managing medications” and “using the phone” were revealed to be associated with the level of HbA1c with p -values of 0.015 and 0.023, respectively. The coefficients in both cases were negative, indicating an inverse relationship between these instrumental abilities and the HbA1c levels.

Additionally, we investigated Pearson’s correlations in domains of MoCA-B and IADL batteries. Figure  1 demonstrates a heatmap with color-coded Pearson’s r and denoted respective p -values within each cell. As illustrated, there was a considerable correlation between the “orientation” domain of MoCA-B and the “using the phone” domain of the IADL. Interestingly, the intra-battery analysis of IADL domains suggested a strong correlation between the two domains of “managing medications” and “using the phone”. Furthermore, we found a strong correlation between the “calculation” domain of MoCA-B, and “managing finances” and “fixing things in house” domains of the IADL. The latter was also correlated with the “abstraction” domain of MoCA-B. On the other hand, “visuoperception” and “naming” domains of MoCA-B seemed to be the least correlated with IADL domains, particularly with “housework”, “shopping”, and “driving”.

Inter-battery correlations of MoCA and IADL domains illustrated as a heatmap. Colors demonstrate the extent of correlation according to the color bar. p -values are written within each cell and asterisks refer to the level of significance. ****< 0.0001; ***< 0.001; **< 0.01; *< 0.05

The intra-battery analysis may further help identify the (semi)-redundant domains of the batteries, considering the specific context of our study. Figure  2 demonstrates to what extent MoCA-B and IADL batteries are redundant within their domains. These correlations suggested little evidence for general redundancy between any of two domains in each battery. However, as mentioned previously, there was a noticeable correlation between the “using the phone” and “managing medications” domains of IADL. Also, “managing finances” was correlated with “fixing things in house” and “using the phone”. Similarly, “doing housework” was moderately correlated with “shopping” and “cooking” domains. Unlike MoCA-B, the IADL battery demonstrated more redundancy within its domains. Interestingly, we could not find any significant correlation between “executive function” and “naming”, nor between “orientation” and “visuoperception”, nor for “executive function” and “calculation”. The associations between domains have been further discussed in the next section.

Intra-battery correlations of MoCA and IADL domains illustrated in two half-heatmaps. Colors demonstrate the extent of correlation according to the color bar. The diagonal red cells represent the correlations of identical domains. p -values are written within each cell and asterisks refer to the level of significance. ****< 0.0001; ***< 0.001; **< 0.01; *< 0.05

Like previously reported in the literature [ 10 , 27 ], we did not find any crude association between HbA1c levels and MoCA-B scores in minimally literate patients with a recent (< 10 years) diagnosis of T2DM who have also recently transitioned from oral agents to insulin injections. Evidently, this may not hold true in other populations, like elderly or patients with more than 10 years from initial diagnosis [ 28 ]. Similarly, we could not find any adjusted association between HbA1c levels and MoCA-B in middle-aged T2DM patients which is also aligned with the literature [ 29 , 30 ]. Nonetheless, the OR adjusted for younger elderly, less education and high IADL suggested a surprising protective effect against PCDM. We speculate that the support of caregivers and family members in insulin administration to this patient subpopulation was an important covariate which we did not control for in this preliminary case–control study. Numerous studies have reported that managing medications by cognitively declined elderly’s family members markedly enhance adherence in chronic diseases like T2DM [ 31 , 32 ]. However, other studies have reported a reversed effect of external caregivers, and not family members, on glycemic control in the elderly [ 33 , 34 ].

Based on our findings, even for patients with high ADL and IADL scores, the cognitive decline measured via MoCA-B was associated with glycemic control. This finding highlights the potential importance of MoCA-B screening in T2DM compliance, compared with a screening based on ADL and IADL, especially at the time of transition to insulin injections. According to the literature, deficits in general cognition are linked to missed clinical appointments and false blood glucose readings [ 33 , 35 ]. Although patients with satisfying IADL scores are well capable of administering their medications, their capability of adherence to medical visits starts to decline with cognitive deficits. Therefore, clinicians shall regardless of capability in daily activities consider cognitive function and family support in their treatment strategy. However, due to time constraints, it can be challenging for clinicians, and especially subspecialists, to screen every person with diabetes for cognitive functioning. The challenge arises when cognitive decline interferes with glycemic control, and subsequently, clinicians have to sort out the cognitive domains involved [ 36 ]. The intra-battery and inter-battery correlation analysis performed in this study helps such clinicians identify probable cognitive issues with a couple of simple questions. According to linear regression analyses, “delayed recall” and “orientation” are the most important among MoCA-B domains for good glycemic control in patients with T2DM. Among IADL domains, “managing medications” and “using the phone” are the most prominent. Based on our inter-battery analysis, “orientation” is highly correlated with “using the phone”. Also, “delayed recall” is moderately correlated with “using the phone”. Hence, it seems that a simple question of “can you work with your cellphone?” would provide the most relevant information of patient compliance in the least time. Besides, “managing medications” is highly correlated with “using the phone” according to the intra-battery Pearson’s correlation analysis of IADL. The “managing medications” domain demonstrates the second-highest relevance to MoCA-B’s “orientation” domain. This suggests that the second most crucial clinical question to assess patient compliance would be, “can you manage your medications?” While this study highlights the importance of the “delayed recall” domain in glycemic control, the “executive functioning” domain was previously demonstrated to be crucial in performing a complex insulin injection therapy [ 37 , 38 ].

Limitations

The primary limitation of the current study was the small sample size, derived from similar regional investigations [ 14 ], which led to some underpowered findings that could not be reported. The small sample size in this preliminary study underscores the need for cautious interpretation of the results and necessitates future studies to replicate our findings. Furthermore, while the investigated covariates in this study aligned with those in the literature [ 39 , 40 ], the absence of other potential confounding factors might have affected the inferred association between cognitive decline and PCDM. Access to covariates like family/care giver status, social support, mood, anxiety, psychosocial functioning, intelligence quotient (IQ), hypo- or hyperglycemia history and detailed medication history could well extend the results. Also, due to financial limitations, we could not include a broad spectrum of laboratory assays. Obviously, including the measurement of the pro-inflammatory factors and lipid status could provide a deeper view on the details of the association between the glycemic control and cognitive decline. It is recommended that future studies use a larger sample size and include more covariates in their analysis.

Conclusions

Aligned with the existing literature, this study does not find any association between MoCA-B scores and HbA1c levels in recently diagnosed middle-aged population. However, surprisingly, we found cognitive impairment results in improved glycemic control in less educated younger elderly. Limitations of the current study does not allow a concrete reasoning of this finding, leading to speculation about the potential significance of support from family members within this subpopulation. Future studies should include a larger sample size and a broad spectrum of psychosocial factors as covariates.

Moreover, within cognitive domains, we found the strongest associations between the “delayed recall” and “orientation” domains and HbA1c levels. Among IADL domains, “using the phone” and “managing medications” illustrated significant negative correlations with HbA1c levels. We further found that there is a significant correlation between MoCA-B’s “orientation” and IADL’s “using the phone” domains. Also, intra-battery analysis results revealed a strong correlation between “using the phone” and “managing medications” domains. These results suggest a potential rapid screening system in the clinics by asking about the ability of patient to use a cell phone or manage medications.

Availability of data and materials

The dataset generated and analyzed during the current study is available from the corresponding author on reasonable request.

Abbreviations

American Diabetes Association

Activities of daily living

Body mass index

Complete blood count

Confidence interval

• Diabetes mellitus

Fairly controlled diabetes mellitus

Hemoglobin A1c

• Instrumental activities of daily living

Multiple dose injections

Montreal cognitive assessment—basic

Poorly controlled diabetes mellitus

Single dose

Type 2 diabetes mellitus

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Acknowledgements

This study was presented as an M.D. thesis in Tabriz University of Medical Sciences. Authors are thankful to Mr. Behnam Akbarzadeh and Dr. Behzad Meili and those working at the Sheikh-ol-Raees Polyclinics, and Provincial Laboratory for their kind assistance during the COVID-19 crisis.

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Romina Mahmoudi and Farzin Kamari contributed equally to this work.

Authors and Affiliations

Endocrine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran

Romina Mahmoudi & Vahideh Sadra

Department of Neurophysiology, Institute of Physiology, Eberhard Karls University of Tübingen, Tübingen, Germany

Farzin Kamari

Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran

Reza Naghdi Sadeh

Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran

Amirreza Naseri

Research Center for Evidence-Based Medicine, Iranian EBM Center: A Joanna Briggs Institute Center of Excellence, Tabriz University of Medical Sciences, Tabriz, Iran

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Contributions

RM, FK, RNS and VS conceived and designed the study. RM performed the data gathering and executed the battery tests under the supervision of VS and RNS. FK performed the statistical analysis, produced the figures and contributed to the interpretation of the data. FK and RM wrote the initial draft. AN critically revised the manuscript draft. All authors read and approved the final manuscript.

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Correspondence to Vahideh Sadra .

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Ethics approval and consent to participate.

The study was approved on the 20th of July 2020, by the regional Ethical Committee (Approval ID: IR.TBZMED.REC.1399.420) at Tabriz University of Medical Sciences, Tabriz, Iran. All patients received detailed instructions about the study and participated voluntarily after actively signing the informed consent form.

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The authors declare that they have no competing interests.

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Mahmoudi, R., Kamari, F., Naghdi Sadeh, R. et al. Implications of cognitive and daily living capabilities on early type 2 diabetes management: a preliminary case–control study. Eur J Med Res 29 , 337 (2024). https://doi.org/10.1186/s40001-024-01925-1

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Received : 09 August 2023

Accepted : 06 June 2024

Published : 18 June 2024

DOI : https://doi.org/10.1186/s40001-024-01925-1

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