Aims: The aims of this thesis were focused on the social climate of inpatient forensic mental health settings. Firstly, the study reviewed the literature of qualitative studies of staff and patient experiences of social climate. Secondly, the utility of a case study methodology to examine innovations to practice in forensic mental health settings are discussed. Thirdly, a longitudinal case study aimed to examine the impact of a Mentalization based treatment (MBT) training and case consultation intervention on the functioning of a low secure ward. Method: A systematic review and qualitative synthesis of social climate in forensic mental health settings was completed using the ‘best-fit’ framework approach. Secondly, a critical analysis of case study methodology was presented based on key decision points. A longitudinal ward case study with staff (n=37) and patient (n=7) participants examined the impact of staff MBT training and MBT based case consultation sessions. MBT based case consultation sessions ran on the ward over an eight month period. Data was collected through a range of methods including questionnaires, semi-structured interviews, ward observations and routinely reported data. The case study data was tested through a pattern matching approach with reference to rival explanations. Results: The systematic review identified 20 papers that met the inclusion criteria. The framework synthesis identified 22 themes related to social climate, which were organised in a conceptual model. Ten themes were seen to represent the experience of social climate. Consideration of the applicability of the case study method to forensic settings found the method to be feasible and acceptable to staff though a limitation is that outcomes are tentative and open to rival explanations. Positive impacts of the training and case consultation intervention included an increase in enthusiasm for working with patients with a personality disorder diagnosis and evidence of some increased team cohesion. The main rival explanation identified was the impact of changes to the composition of the staff and patient group. Conclusions: The systematic review findings highlight that current quantitative measures of social climate may not fully represent the construct. The conceptual model developed allows for generation of potential interventions to improve social climate. In the case study, staff reported positive perspectives of both MBT training and the case consultation sessions. The intervention did not appear to impact on patient motivation, though patients reported positive changes in staff behaviour. The case study method was seen as applicable to forensic mental health settings and provided interpretable data useful for analytical generalisations, and clinically in considering innovations to practice.

This research examined which factors of influence contributed towards efficacious systemic leadership development, within case studies in the energy and military sectors, and identified and explained common underlying themes and factors which could help formulate future interventions, as well as enhance extant theoretical knowledge. The literature showed that key challenges exist in identifying what contribution leadership development makes to enhancing organisational leadership, and as such, social capital and systemic development. To focus the research, specific definitions were constructed, as to what sort of effective leadership positively impacts upon organisational leadership; which cardinal themes of leadership development traverse interventions, namely Delivery, Contextualisation, Performance, Impact and Values integration; and what constitutes systemic leadership development. A Social Constructivist position was adopted which explains the nature of the phenomena underlying systemic leadership development.

INTRODUCTION: Adolescent Idiopathic Scoliosis (AIS) is one of the most common spinal abnormalities in children, affecting 2% to 3% of adolescents in the United States. Its cause remains unclear. Many previous studies conclude that AIS may be caused by a combination of genetic and environmental factors, with very few consistencies. Severe scoliosis is usually treated with corrective surgery, and the etiology of post-surgical pain is even more unclear and has the opportunity to affect the patient well into adulthood. STUDY AIMS: By following a monozygotic twin pair with identical DNA, our retrospective case study can control for genetic disposition, and can look toward other possible causes for the pain the patients experienced. This study attempts to shed light on the complexities of AIS and pain with a focus on environmental and psychosocial factors. CASE PRESENTATION: We present a single pair of monozygotic twins treated for AIS with comparable spinal fusion surgeries performed at a large northeast urban children's hospital. Twin A and Twin B were initially treated with a brace for their scoliosis. Despite bracing, their curves progressed and warranted spinal fusion, with Twin A having a Cobb angle of 53°, and Twin B with 50°. The surgery was conducted simultaneously at the age of 13 by two different orthopedic surgeons. At age 7.5, Twin B was treated for Ebstein's anomaly of the tricuspid valve and significant dysrhythmias. METHODS: After the patients were discharged, a comprehensive retrospective chart review of the patients' pre-op, inpatient, and post-op pain and drug regiment was conducted. The patients were also asked to note their pain as they recovered after discharge. The patients and their mother completed self-report measures of multiple psychosocial variables both before and after surgery through REDCap. A Quantitative Sensory Test (QST) was also performed by the patients to assess their sensory sensitivity and pain thresholds. Mechanical, pressure, and thermal scores were obtained with the use of von Frey hairs, a pressure Algometer, and a Thermode. The QST was administered on the patients' palm/ thenar eminence (distant non-surgical site), and on their lower back (surgical site). The QST results were compared to a previous study's median cohort data, to discern if the patients presented hyper- or hyposensitivity for that particular test. RESULTS: Due to the limitations of case studies, the results presented here should be considered strictly preliminary. Twin B experienced more significant pain during both the acute and chronic recovery phases after surgery, and showed lower sensitivities during most pre-op QST trials. Twin B also scored markedly higher on a number of sub-variables in the psychosocial surveys. A notable correlation was the parent protective measure, indicating that the mother may have been more protective of Twin B. CONCLUSIONS: What is unique to this study is that age, gender, Cobb angle, fusion length, and genetic disposition are all controlled for, allowing us to analyze the patients based on other risk factors. Twin B shows consistently higher pain scores while in the hospital as well as while recovering at home. The parent self-report measures support these findings, showing a slight bias in favor of Twin B in regards to protectiveness, which also coincides with large-scale studies. Although preliminary, it is important not to underestimate the role environmental and psychosocial factors play in post-surgical pain.

Initiating the use of Computerised information systems (CISs) has become a global trend, including in Taiwan. Although CISs sound promising for improving clinical effectiveness and efficiency, evidence demonstrating their actual benefits is still limited. How CISs influence nursing practice and professionalism is not widely known, and the actual implementation process is not well understood. Hence, this study explores (1) the impact of CISs on the role of nurses and their practice, (2) the context of developing and implementing CISs, and (3) the practice politics underlying the use of information technologies in a Taiwanese hospital. A single, embedded, qualitative case study was conducted. Data collection used multiple methods, combining elite interviews with nurse managers (n=13) and informatics staff (n=3), five focus groups with front-line registered nurses (n=25) and 47 hours of non-participant observation in six wards in the case-study hospital. Data analysis followed a thematic approach, comparing and contrasting patterns among multiple perspectives. Four major themes emerged from the analysis. Firstly, the development of CISs was a result of negotiated order and relied upon interdisciplinary collaboration. Through interdisciplinary interactions of negotiations, covert negotiations and renegotiations, the exercise of power and power imbalances were recognised. Secondly, a top-down approach was adopted in the implementation process. In order to move computerisation forward, head nurses acted as change agents in gaining compliance from nurses. Front-line nurses showed generally positive attitudes towards computerisation. Being daily system users, front-line nurses were relatively powerless and were compliant with the top-down implementation; however, they grumbled at the same time. Thirdly, through system design strategies to structure clinical activities and increase information transparency, CISs became helpful tools in achieving standardised practice, tightening up managerial surveillance and control and clearly defining employees' accountabilities. Finally, whilst convenience and efficiency were perceived as the results of computerisation, hardware problems and the burdens of the computerisation process created hidden work in nursing practice, which required nurses to care for computers whilst caring for patients. Through the lens of several social theories, the study findings indicated that power in developing and implementing CISs was not in the hands of the nursing profession. The findings manifested the disciplinary power of computer technology and also suggest that computerisation may de-skill the nursing profession which may reignite the technology and skilling debate. Although generally believed to facilitate performance efficiency, this study found that computer technology created unfavourable consequences, for example hidden work, which seems to be unrecognised in the literature. Computers became the nurses 'co-client' and consequently took time away from patient care so computerisation may not be as efficient and effective as expected. Finally, a qualitative case study was found to be an appropriate methodology to explore this complex issue comprehensively and holistically. However, this small, single case study was conducted in one location in Taiwan. More research is needed to verify the findings which may have significant implications for management, policy and practice.

This Master thesis deals with socioeconomic and environmental aspects of life generally in the country, and with the regional context Strakonicka. In the important empiric part, I focus on to the appreciation changes of life in the small town Katovice, mainly in the period of the First Republic and nowadays. I used a combination of quantitative and qualitative methods to compare these. Specifically I used techniques of photo documentation, interviews with local witness and vice chief magistrate, analysis of statistical data and finally a small questionnaire too.

The professional identity of career practitioners in the UK has become increasingly challenged in recent decades due to the influence of government policy and the dominance of work-based qualifications. Privatisation, multi-professional working and workforce realignment have all contributed to a reshaping of the career guidance professional. This research examines the views of a group of practitioners all undertaking continuing professional development (CPD) in the form of a postgraduate award. The participants were all UK based practitioners working in a career related role; all were either currently on programme, had completed or stepped off with an interim award within a masters programme. The research explored practitioners’ views at a time of significant upheaval, of themselves as professionals, their professional identity and the extent to which postgraduate CPD contributed to this. The research utilised a case study approach employing document analysis, questionnaire, in-depth interviews and narrative biographies. These tools were specifically selected to enable sequential analysis of data allowing findings from each stage to be rigorously tested out by the next research tool. Applications from potential students were initially analysed helping to establish motivation for undertaking a programme of this type, an on-line survey explored practitioners views of themselves as professionals, motivation for postgraduate study and potential outcomes for themselves, their organisation and their profession. In-depth interviews and narrative biographies provided a voice allowing participants to explore their personal journey with their studies and how this engagement contributed to the establishment, maintenance or enhancement of their practitioner professional identity. Continuing professional development was classified as consisting of three types, operational, experiential and formal. Findings suggested participants predominantly valued formal CPD with operational being perceived as only meeting employer contractual compliance. Postgraduate level CPD contributed to professional identity through engagement with reflection, theory, policy and academic study. Ethics and client focus were central to the professional identity of the career practitioner. Postgraduate study was perceived to empower practitioners and to contribute to the professionalisation of the sector and give parity with other public sector professions. The research contributes to both the limited body of knowledge addressing professional identity within the career guidance context and discourse addressing professionalisation of new professions. It offers a shared professional perspective that can inform the evolving policy debate aiming to professionalise the career and allied workforces. The research offers a unique insight into a profession in transition and the voice of practitioners who have experienced successive waves of government policy, which has been often internalised as de-professionalisation.

Orientador: Orlando Fontes Lima Júnior / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Engenharia Civil, Arquitetura e Urbanismo / Made available in DSpace on 2018-08-17T14:12:02Z (GMT). No. of bitstreams: 1 Carvalho_CarolinaCorreade_M.pdf: 3829740 bytes, checksum: fac7bcc71791eaf9213b18db3929f42a (MD5) Previous issue date: 2010 / Resumo: O uso de plataformas logísticas no mundo vem crescendo consideravelmente, mas no Brasil tal prática ainda é incipiente. Face às particularidades locais, os projetos têm que ser bem adaptados para a realidade brasileira, existindo poucos estudos que auxiliem nesta direção. O objetivo deste trabalho é propor uma metodologia para análise de benchmarking de plataformas logísticas e aplicá-la em um caso na Região Metropolitana de Campinas, São Paulo, Brasil. Como base para o estudo foi selecionado vinte e nove plataformas logísticas espalhadas pelo mundo e, por meio de Análise Envoltória de Dados (DEA), foram identificadas as que constituíram benchmarking Mundial para o projeto da plataforma logística de Campinas (PLC). Para esta analise foi adotado o modelo DEA-BCC (Variable Return to Scale- VRS) com os seguintes indicadores de desempenho; áreas das plataformas logísticas, capital investido, número de empresas atraídas e movimentação anual de carga. Após a avaliação inicial das vinte e nove plataformas pelo DEA foram identificadas sete como benchmarks mundiais e deste conjunto três foram apontadas como referências de melhores práticas para a PLC (Atlantic Gateway-Halifax Logistics Park, Canadá; Raritan Center, USA; e Rickenbacker Global Logistics Park USA). Ao mesmo tempo um estudo qualitativo, utilizando o método de estudo de caso múltiplo, identificou outras cinco plataformas européias como referencias para o projeto; a PLAZA (Espanha); Distrito de Nola (Itália); Rugis (França); Bremen GVZ (Alemanha) e Dallas Logistic Hub (Estados Unidos). A partir de uma analise detalhada das plataformas selecionadas foi possível identificar sugestões de melhoria e diretrizes de concepção para a plataforma brasileira. Esta aplicação demonstrou que a estratégia proposta tem grande aplicabilidade e apresenta bons resultados para avaliação de projetos de concepção de plataformas logísticas / Abstract: The use of logistic Platform in the world has grown considerably, but in Brazil, this practice is still incipient. Given local circumstances, projects need to be well adapted to Brazilian reality, there are few studies that help in this direction. The aim of this paper is to suggest guidelines for strategic planning of the new logistics platform to be installed in Campinas, São Paulo. As a starting point of the study were selected twenty-nine logistics platforms around the world and, through Data Envelopment Analysis (DEA) have been identified that constitute the global benchmarking and were taken as the base platform design logistics of Campinas (PLC). For this analysis we adopted the DEA-BCC model (Variable Return to Scale-VRS) with the following performance indicators, areas of logistics platforms, the capital invested, number of businesses attracted and annual cargo handling. After the initial assessment of the twenty-nine platforms by DEA were identified seven as global benchmarks and this set three references have been identified as best practices for the PLC (Atlantic Gateway-Halifax Logistics Park, Canada, Raritan Center, USA; Rickenbacker Global Logistics Park and USA). At the same time a qualitative study, using the method of multiple case study, identified five more platforms PLAZA (Span), Distrito de Nola (Italy), Rugis (France) Bremen GVZ (German) e Dallas logistic Hub (USA) that could be included as references for the enterprise. From a detailed analysis of selected platforms were able to identify suggestions for improvements and design guidelines for the Brazilian platform. This application demonstrated that the proposed strategy has wide applicability and gives good results for project evaluation design of logistics platforms / Mestrado / Transportes / Mestre em Engenharia Civil

Demographic change as well as pressure from the European Union and national government are forcing organisations to change age-discriminatory Human Resource Management (HRM) approaches. Based on a qualitative analysis of eight British and German organisations, we found that commitment, scope, coverage and implementation of age management differ due to country-specific institutions, particularly government, in nudging employers and unions to preferred age practices. This confirms the path-dependency concept suggested by institutional theory. Nevertheless, we also found that industry-specific factors mediate the implementation of age management, leading to some convergence across countries. This indicates that organisations deviate from the institutional path to implement practices that they deem important. (authors' abstract)

In this study, we investigate how lead time is affected during development of a large-scale telecom product. We collected raw data from the product’s Gerrit repository which were later processed with statistical analysis. When we analysed the various areas, we concluded that a method to divide the lead time into different sequences would be the preferred method. We therefore chose to analyse lead time for different parts of the development. We found that on average lead time is roughly 3,4 days for the areas we investigate. The results indicated that lead time for reviewing increases with the years. The results also indicated that the lead time decreases for developers as they become more familiar with the product however the overall lead time for implementation did not. This can be as developers switch tasks internally or decides to change employment. The results also indicated that there is no relation between the amount of submitted LOC and lead time.

Context. Global Software Development is software work undertaken at geographically separated locations across national boundaries in a coordinated fashion involving real time or asynchronous interaction. Distributed Agile Development aims at the benefits of both Agile Software Development and Global Software Development aiding the distributed teams to overcome the challenges brought by the distribution. Objectives. In this study the author investigates whether a globally distributed company is prepared to be agile, determining hindrances for agile and providing recommendations to mitigate or overcome the detected hindrances. Methods. In this case study, surveys and interviews were used to study the hindrances for agile and literature was used to provide the recommendations towards the detected hindrances. Results. 4 hindrances were detected. Only 1 was justified as necessary for the good performance of the distributed company. Several recommendations to overcome the hindrances were proposed. Both hindrances and proposed solutions were validated by the company representative. Conclusions. We conclude that the studied individuals are willing to be agile. As agile is built bottom-up, the company is prepared to be agile. However, they will not be able to be agile until they overcome or mitigate the detected challenges. In the study, several solutions for it are proposed.