Stroke is the primary cause of adult disability in the UK. Those who have experienced stroke have a higher risk of a subsequent stroke. Stroke recovery has physical, emotional and social dimensions and impacts on family caregivers as well as stroke survivors. Getting the right information at the right time is put forward as instrumental in supporting recovery and preventing further stroke. The research literature demonstrates persistent uncertainty about the best way to provide information to stroke survivors and carers in practice. The aim of this study was to explore the processes, motivations and perceptions of the impact of information exchange between stroke survivors, carers and health professionals. A qualitative case study strategy was utilised for the study as this provided a flexible framework to incorporate multiple perspectives upon information exchange in the practice context. A single setting in, Salford, Greater Manchester, was used to study the phenomenon of information exchange from the perspectives of stroke survivors, carers and health professionals. Data collection included interviews with participants, observations of communication and documentary analysis. Data was analysed using the Framework analysis approach in order to compare and contrast perspectives across the different respondent groups and so develop study propositions to explain the data. There was much common ground amongst respondents in the thematic categories identified from the data, but subtle differences in emphasis on different topics. The key findings from this research are in two areas. Firstly, the challenges of incorporating a self-management philosophy into information exchange post stroke are substantial. This is because patients experience a variable recovery trajectory and have insufficient contact time with the professionals who they perceive as valid information providers. Second, the research raises questions of what is meant by tailored information in practice: the timing of information was a critical issue for survivors and carers along with the desire for appropriate support to utilise information effectively. These findings suggest a need to shift the focus of research from information provision to information exchange post stroke; to examine not the best way of providing information, but rather the best way of assessing individual need, and pacing provision tailored to these specific needs. This would require debate and consensus among the stroke community about the core underlying principles of information exchange, a reassessment of key time-points for sharing information and a re-examination of professionals ongoing development needs in communication skills to underpin this.

In 2007 the Nursing and Midwifery Council (NMC) endorsed the use of simulation to replace up to three hundred hours of practice learning in the pre-registration nursing programme (NMC, 2007a). This decision was the impetus for this study as it raised questions regarding whether simulation could replace practice and whether simulated learning transferred to the practice setting. For the first time, the NMC proposal to replace practice hours with simulation has been critically analysed and the implications of this decision explored. A literature review demonstrated a lack of robust evidence to support the use of simulation in this way. This informed the development of this study’s research question and aims. A qualitative collective case study was chosen as the optimum research design to facilitate in-depth exploration of the use of simulation at a selected university in the North West of England. The in-depth qualitative case study incorporated multiple models of simulation, student cohorts, nurse educators and key informants which provided the most comprehensive analysis of viewpoints in any published research in the UK to date. Deeper understanding of the case arose from the use of multiple data collection methods: documentary analysis, participant observation and interviews which enabled findings to be triangulated and corroborated. Most importantly, because the simulation models used were comparable to those used by other education providers in the UK; there is a possibility of the transferability of findings which could be used to inform the development of simulation in the under-graduate nursing curriculum. This thesis develops an argument that there were three key assumptions made by the NMC when they endorsed the replacement of practice hours with simulation. The first is that there is a shared understanding in nursing regarding what simulation is. Secondly; that simulation is delivered in a ‘safe environment’ and finally that competence demonstrated in simulation transfers seamlessly to practice. This thesis has presented new knowledge and developed an argument for caution regarding the use of simulation in pre-registration nurse education. These findings challenge the assumptions made by the NMC and highlight issues for further consideration and exploration namely: the ambiguity regarding the concept of simulation, student safety during simulation, student perceptions of authenticity and finally the transfer of simulated learning to practice.

L'innovation managériale est le type d’innovation le plus adopté par les entreprises européennes. Certains auteurs soulignent que c’est ce type d’innovation qui confère l'avantage concurrentiel le plus durable. Pourtant, malgré un récent regain d’intérêt académique, l'innovation managériale reste beaucoup moins étudiée dans la littérature que l'innovation technologique. De plus, on remarque que cette littérature émergente sur l’innovation managériale ne s’est pas intéressée aux organisations à but non lucratif (OBNL). Or, le secteur à but non lucratif a connu une forte croissance et joue aujourd’hui un rôle économique incontournable. Pour accompagner cette croissance, les OBNL ont notamment adopté des innovations managériales. Les processus de production dans les OBNL reposent fortement sur des facteurs humains et intangibles difficilement substituables à du capital physique. L’innovation managériale, processus également basé sur des facteurs humains et intangibles, s’avère alors être un type d'innovation adapté aux OBNL. De plus, la distinction entre organisations à but lucratif et à but non lucratif a été explicitement présentée comme une grande opportunité pour le développement de la recherche sur le processus d’innovation. Les OBNL représentent en effet un cadre d’analyse spécifique. Ainsi, cette recherche vise à comprendre comment le processus d’innovation managériale est mis en place au sein de ces organisations particulières. La méthode qualitative de l’étude de cas unique enchâssée s’est avérée adaptée pour répondre à cette problématique. L’ONG Action Contre la Faim qui s’est engagée dans un vaste processus d’innovation managériale depuis 2008 a alors pu être investiguée. L’analyse et la discussion théorique de nos résultats nous ont permis de préciser en quoi la mise en place du processus d’innovation managériale est différente dans les OBNL. En effet, le processus d’innovation managériale dans une OBNL est caractérisé par des phases volontairement longues et un modèle mixte qui allie démarche bottom up et top down. Tout d’abord, l’OBNL prend tout le temps nécessaire pour créer collectivement une innovation managériale consensuelle, faiblement formalisée et évolutive. Ensuite, la grande plasticité de l’innovation managériale conduit à une longue phase d’implémentation non linéaire avec une mise en pratique constamment flexible et non routinisée. / The type of innovation mostly adopted by European companies is management innovation. Some authors point out that management innovation provides the most sustainable competitive advantage. However, despite a recent revival of academic interest, management innovation remains much less studied in the literature than technological innovation. In addition, this emerging literature on management innovation has not focused on nonprofit organizations (NPOs). Yet, the nonprofit sector has experienced a strong growth so that it plays now a major economic role. NPOs have adopted management innovations to support this growth. The production processes in NPOs are strongly based on human and intangible inputs that are difficult to substitute for physical capital. Thus, management innovation which is also a process based on human and intangible inputs, appears like a type of innovation appropriate for NPOs. Moreover, the distinction between forprofit and nonprofit organizations has been explicitly presented as a great opportunity for the theoretical development on the innovation process. NPOs represent indeed a specific analytical framework. Therefore, this research aims to understand how a management innovation process is put in place within these particular organizations. The qualitative method of the embedded single case study has been appropriate to address this issue. The NGO “Action Contre la Faim”, which has been involved in a vast process of management innovation since 2008, has been investigated. The analysis and theoretical discussion of our results allowed us to shed the light on the specificities of the management innovation process in NPOs. Indeed, the management innovation process in an NPO is characterized by deliberately long phases and a mixed model that combines a bottom-up and top-down approach. First of all, the NPO takes all the time necessary to collectively create a consensual, weakly formalized and evolving management innovation. Then, the great malleability of management innovation leads to a long and non-linear implementation with a constantly flexible implementation without routinization.

Cancer among Indigenous Peoples (First Nations, Inuit, and Métis) is disproportionately higher than the overall Canadian population. Many Indigenous Peoples have difficulty accessing care and do not receive culturally safe care due to a longstanding history of marginalization and colonization. The role of a nurse navigator (NN) was developed to improve continuity of care and overall health outcomes for Indigenous Peoples; however, limited research exists on what a NN does or how they are perceived. Using constructivist case study methodology, this thesis explored the experiences of a NN working in a large tertiary care hospital in Ontario, Canada, and the processes the NN used to support Indigenous cancer patients in a culturally safe manner. Six in-depth semi-structured interviews were performed with health care providers and managers, and shadowing of a NN occurred over two weeks allowing direct observations of the NN that was captured in field notes and reflective journaling. Interviews were audiotaped and transcribed; all data was entered into NVIVO 12 qualitative software and coded thematically. Analysis revealed the NN to be an important complement to clinical care and key resource to navigating the health care system, providing mechanisms for building trust, and raising awareness of Indigenous historical and cultural contexts. The NN practiced non-conventional, patient-centered approaches that included engaging with the land and arts, interpreting healthcare information, advocating for and aiding autonomy over healthcare. All participants felt the NN had a positive influence on health and wellbeing. Thesis results inform healthcare delivery and nursing practice to improve quality of care and outcomes for Indigenous cancer patients.

The current descriptions of bricolage largely present it as a behaviour in new businesses in richer contexts. Therefore, more diverse context-specific explanations are needed in order to deepen our understanding of bricolage. While Bricolage behaviour has been largely explained in new businesses, in extremely constrained environments, even established firms use bricolage to mobilise resources. This study set out to contribute to the understanding of bricolage by exploring it in an extremely constrained context. Using an interpretivist paradigm, empirical evidence from 8 case studies was collected through in-depth interviews and each is presented in a rich, ‘thick’ description. Through inductive coding, data-driven themes that highlight the nuances of bricolage when settings are extremely poor were derived. The study examines the idiosyncrasies of bricolage behaviour in small established firms, found in poor settings, it finds that, everything is a resource that can be bricolaged. It also finds that there is varied intensity with which underlying constructs of bricolage- making do, using resources at hand and recombining resources are manifested throughout the entrepreneurial process. In the starting phases, making do dominates, in the surviving phase, using resources at hand becomes more prominent, while in the growing phase, recombining resources is prioritised. This suggests that in poor contexts, bricolage manifests as a process that occurs throughout the life of the business. Additionally, the study highlights the sub-processes of bricolage,-scavenging, buttressing and refining. It explains how they interact by showing that scavenging precedes making do, buttressing precedes using resources at hand and refining precedes recombination of resources. Moreover different resources are used varyingly along the bricolage process. Furthermore, it integrates bricolage with two concepts of adaptive persistence and community embeddedness. Adaptive persistence is an active and dynamic experimentation to meet new challenges with the aim of finally solving them. It is exhibited as continuous adjustment to absorb emerging environmental shocks. On the other hand, community embeddedness highlights the firms’ close connection and interface with its local community on activities beyond its core role. In turn, the community becomes both an active advocate and a customer of the firm. These behaviours facilitate firm development. This work contributes to the understanding of bricolage behaviour by showing that the sub processes are more elaborate in poor settings and that established firms adopt these sub-processes varyingly as they develop. / Thesis (PhD)--University of Pretoria, 2018. / Gordon Institute of Business Science (GIBS) / PhD / Unrestricted

The thesis will conduct qualitative content analysis, with the help of theories like electoral democracy and Dahl's theory of polyarchal democracy, the thesis will be able to investigate the grade of democracy in the Democratic Republic of Congo. Throughout the research process, I will analyse these theories to measure the grade of democracy in the country. The focus of this thesis is to determine whether the Democratic Republic of the Congo is indeed related to democratic principles. In addition, I introduced previous reports, documents and theories to measure the grade of democracy in the Democratic Republic of Congo. I analysed the views on these reports and documents by identifying the elements that describe democratic countries and using them to measure the democratic hierarchy of the Democratic Republic of the Congo. Elements such as freedom of expression, fair and free election and many others. These elements are studied to give a conclusion on the measurement of democracy in the Democratic Republic of Congo. Finally, I conclude my research by presenting measures related to country ́s democracy. However, the Democratic Republic of Congo have failed to establish contact with democratic principles which has led to a lower grade of democracy.

Background: Rooming house residents have high rates of morbidity and mortality, yet little is known about why this disparity in health exists. Research Question: How are rooming houses linked to health? Case: Social exclusion of rooming house residents in downtown Ottawa, bounded by the neighborhood, and Ottawa’s political policies at the time of data collection (September 2019-June 2020). Methodology: A single embedded descriptive case study was informed by multiple sources of evidence, and involved a community advisory group (CAG). Rooming house residents took photos, participated in a community walk-about with participant observations and attended a focus group. Two additional focus groups were conducted; one with fellow rooming house residents, another with the CAG. Interviews with rooming house front-line service providers and a secondary data set of homeless service measures also informed the case. Findings: 1. Rooming house residents (n=10) took 112 photos, and (n=8) took part in a focus group where two broad themes emerged: Housing is health care, and just managing today. 2. Interviews with front-line service providers (n=11) focused on two themes: There are many costs to living in a rooming house, and rooming house front-line service providers wear many hats. 3. Between a sample of sheltered homeless (n = 60) and rooming house residents (n=52), there was no difference found for several health indicators, including frequency of care received in the emergency room, hospitalization as an inpatient, and if substance use made it difficult to stay or afford housing. Focus groups with rooming house residents who did not take photos (n=10) and the GAG (n=6) contributed to persona co-creation revealing financial and contextual factors affecting the health of rooming house residents. Conclusion: The shared spaces of rooming houses create a tension between offering community and creating a risk environment. The negative health consequences to living in a rooming house are mitigated by the many roles that rooming house front-line service providers play in filling gaps. This study suggests the need to definitively position rooming house residents on the housing continuum in order to ensure equitable distribution of resources to optimize the health of this vulnerable population.

No description available.

The problem of this study was to provide a more comprehensive and accurate profile of various aspects of selective mutism—family atmosphere/dynamics, aetiology and manifestations of mutism, usages and outcomes of therapeutic approaches, and a profile of the affected child—and to provide a more comprehensive and consistent basis to guide effective treatment strategies and facilitate additional research. A content analysis of case studies of selective mute children completed from 1929-1994 was used to educe this data.

El objetivo de la investigación fue evaluar la participación de los niños que asisten a los talleres de vacaciones de una ONG. Se trabajó con el modelo teórico de Bisquerra (2013), quien realizó estudios relacionados a la emoción y la educación emocional. En referencia al método utilizado es cualitativa y se definió un estudio de caso. La población estuvo conformada por 15 niños, cuyas edades oscilan de 6 a 9 años de un curso de vacaciones organizado por una ONG. El instrumento utilizado fue la observación y registros antes y después del taller “Mis emociones y yo”. Los resultados que se obtuvieron, muestran que los participantes al culminar el programa presencian cambios con respecto a su educación emocional, logrando un reconocimiento y aceptación de ellos. Por lo tanto, se llegó a la conclusión de que el taller favorece en el desarrollo de la Inteligencia Emocional de los niños, que así obtienen competencias que se relacionen en la percepción, apreciación y discernimiento de sus emociones. / The objective of the research was to evaluate the participation of children who attend NGO holiday workshops. We worked with the theoretical model of Bisquerra (2013), who carried out studies related to emotion and emotional education. In reference to the method used, it is qualitative and a case study was defined. The population consisted of 15 children, whose ages range from 6 to 9 years of a vacation course organized by an NGO. The instrument used was observation and records before and after the "My Emotions and Me" workshop. The results obtained show that the participants at the end of the program witness changes regarding their emotional education, achieving recognition and acceptance of them. Therefore, it was concluded that the workshop favors the development of the Emotional Intelligence of children, who thus obtain competences that are related in the perception, appreciation and discernment of their emotions. / Trabajo de investigación