Magister Legum - LLM

This case study is a qualitative examination of a health promotion project conducted in collaboration with members of the mental health peer community. More specifically, it explores the community based participatory research (CBPR) implementation process used to conduct this health promotion project to gain a deeper understanding of the mechanisms at work in the implementation process. While there has been considerable attention to the principles that guide CBPR (Braun et al., 2012; Israel et al., 2008; LaVeaux & Christopher, 2009), there remains important work to be done in bridging these principles to implementation; what processes or mechanisms translate these principles to action. Four mechanisms were initially proposed by this writer, derived from extant literature in this area (Wallerstein & Duran, 2003). These provided the initial framework for analyzing the data gathered throughout the case study. The case report discusses the findings of how these initially proposed mechanisms have been transformed and redefined in the context of this case. The resultant mechanisms, knowledge sharing, power sharing, task sharing, resource sharing, and shared purpose (there are five, as one additional new mechanism emerged in the analysis), are described with examples of how they were reflected in this case. Implications for these findings for CBPR research, collaborative health promotion with the mental health peer community, and the social work profession are shared.

Permanent exclusion is a serious disciplinary measure and the Department for Children, Schools and Families (DCSF, 2008) advises that in most cases it is to be the last resort after a range of measures have been tried to improve a pupil’s behaviour. Following permanent exclusion the local authority (LA) takes responsibility for a pupil’s education and for most cases seeks to reintegrate the pupil into a new school. However the process of reintegration of permanently excluded pupils into mainstream school is regarded as difficult and research has shown that second permanent exclusions frequently occur fairly soon after entering a new school. In the last four years a ‘Hard To Place Pupil Protocol’ (HTPPP) has been published in all LAs as a statutory document. This seeks to encourage all schools to admit a fair share of excluded pupils in a timely manner. There has been no published research on this protocol to date. This study adopts a qualitative case study methodology, influenced by a social constructionist epistemological stance. The participants and methods utilised include interviews with reintegrating pupils, their parents and school staff supporting them, LA reintegration officers and headteachers. Additional methods included a focus group with members of the educational psychology team, a survey to secondary school staff, documentary evidence from pupil files and LA documents, educational psychologist (EP) case work evaluation and a reflexive research diary. This study includes analysis of the findings and presents pertinent themes emerging from the data. The results section indicates that the HTPPP has been effective in increasing the number of pupils being reintegrated. However there are some areas identified as being problematic. These include: decision making, perceived fairness of the protocol, the role of parents and the relationship between the protocol and permanent exclusion. The findings indicate that there are a number of factors that can facilitate or hinder a reintegration. These include: school support, communication, individual pupil attributes, sense of belonging, familial and societal factors and the impact of previous events including the original exclusion. The research findings indicate that EPs recognise their role in supporting the reintegration process through the application of psychological theory and knowledge, supporting complex cases, helping to change perspectives of the ‘problem’, working school staff and obtaining and championing the voice of the child. School staff consider the role of the EP as providing consultation around advice and strategies, it is also about providing a current assessment of a pupil’s educational needs, offering individual therapeutic work with the pupil, supporting home-school relations and enabling a third party perspective. The discussion relates the themes to previous literature and identifies some variation in terms of the factors that facilitate or hinder reintegration, and concluded by questioning the feasibility of establishing such factors. The evidence collected to determine effectiveness of the HTPPP is helpful to establish the way in which it might be adapted to operate in the future. By considering the role of an EP in supporting the process, it is anticipated that the research will contribute to evidence based practice in this area.

This study examines the changing context and implications for evaluation practice of social program and service delivery devolved to small nonprofit and grassroots organizations. The setting is explored through a critical reflection-on-practice of over twenty years experience conducting evaluation. Using a multiple case study approach, the dissertation examines nine broad themes through two broad composite scenarios and twenty-five detailed vignettes that portray the challenges of working as a consultant with and for small nonprofit and grassroots organizations as they grapple with growing demands for accountability through evaluation. The multiple case study analysis is complemented by an analysis of case studies in two broad areas of literature; one on the impacts of devolution in the nonprofit sector, and the other examining recent trends in evaluation conducted in challenging settings, including community-based and non-governmental organizations (NGOs). The five broad themes addressed through the case studies and literature on devolution are: 1) accountability, 2) capacity, 3) mandate drift, 4) competition, and 5) complexity. The four broad themes addressed through case studies and literature on evaluation are: 1) theory-based evaluation, 2) inclusiveness (participatory approaches), 3) the changing and multiple roles of evaluators, and 4) the use of dialogue, deliberative and democratic approaches in evaluation practice. The study contends that the ‘rough ground’ of nonprofit settings provides a useful lens for understanding broader challenges and trends in evaluation practice; that evaluators provide more than just technical skills and knowledge, but undertake important roles in linking communities, mediating among stakeholders, fostering dialogue and deliberation about programming, and mitigating some of the more egregious impacts of devolution experienced by nonprofit and grassroots organizations. By acknowledging and supporting the development of such roles and responsibilities, the profession and evaluators working in these settings can provide meaningful contributions to public discourse about the nature of accountability, the broad context of social programming, the complex capacity challenges being faced by nonprofit organizations, and the role of evaluation in exacerbating or potentially mitigating such effects. / Education, Faculty of / Graduate

Experiencing trauma in childhood can have a pervasive impact on child development. There is evidence to suggest that non verbal creative therapies aid the processing of traumatic memories and therefore present as a child centred treatment option for children who have experienced trauma. Art therapy is known to be an effective intervention for children who have experienced trauma however the outcomes of delivering art therapy interventions in specific contexts are not yet well researched. The present study sought to investigate the efficacy of school based art therapy as an intervention for children who have experienced psychological trauma. The study explores what areas of adjustment are achievable and how school based art therapy contributes to this adjustment. A multiple case study analysis was conducted to explore the experiences of three pupils who had attended art therapy interventions at their schools. Each case study used semi structured interviews, post intervention, to gather the views of the pupil, art therapist, a member of school staff and the pupil‘s parent / guardian. The data was analysed using thematic analysis and the results are presented as thematic network maps. The cross case synthesis revealed that after attending school based art therapy the pupils demonstrated positive adjustment in a range of areas. The thematic analysis suggested that the pupils had a greater understanding of themselves, increased resilience skills and a belief in a positive future. School based art therapy was found to be a wholly child centred therapeutic experience for the pupils, with the data suggesting that this child centred experience was facilitated by the process of the therapy, the non verbal creative art making and the context of delivery. This study provides the initial evidence to suggest that school based art therapy is an effective intervention for children who have experienced developmental trauma and presents avenues for future research.

This qualitative study explores how roles are constructed within interprofessional health care teams. It focuses on elucidating the different types of role boundaries, the influences on role construction and the implications for professionals and patients. A comparative case study was conducted with two interprofessional primary health care teams. The data collection included a total of 26 interviews (13 with each team) and non-participant observations of team meetings (2-3 meetings at each site). Thematic analysis was used to analyze the data and a model was developed to represent the emergent findings. The role boundaries are organized around interprofessional interactions (autonomous-collaborative boundaries) and the distribution of tasks (interchangeable-differentiated boundaries). Salient influences are categorized as structural, interpersonal and individual dynamics. The implications of role construction include professional satisfaction and more favourable wait times for patients. The elements in this conceptual model may be transferable to other interprofessional primary health care teams. It may benefit these teams by raising awareness of the potential impact of various within-team influences on role construction.

Small nonprofit organizations are faced with limited resources and budgets for setting and reaching their goals. Some are nevertheless able to mitigate these challenges and achieve success. This thesis examines how this can be done. Organizations with excellent public relations programs have been found to be successful in achieving their goals (Grunig et al., 2002). Through the lens of the excellence model, this thesis analyzes, using in depth, semi-structured interview data, how senior managers of seven successful small nonprofits account for their success and address challenges as well as how their practices reflect the excellence model. This thesis does not test the excellence model in the context of small nonprofits, but rather attempts to establish recommendations for communication and PR success for small nonprofits based on what is learned from a small group of successful organizations.

In the contemporary world, the fight against impunity has become a fundamental political claim, a social goal and a main concern for human rights movements. However, it is unclear how we can delimit this fight, what are its aims and, ultimately, the remedies it proposes to overcome impunity. The academic studies and human rights mechanisms referring to this issue are not sufficiently clarifying. They often lack clear theoretical distinctions and stable empirical observations. Moreover, in social discourses impunity is employed with extremely vague connotations. This research addresses this lacuna, offering a conceptualization and characterization of impunity from a socio-legal perspective. With this purpose in mind, this work develops an analysis of impunity through the study of a particular kind of criminality. The study of state crime provides a prolific perspective for the analysis of the phenomenon of impunity, allowing to visualize the constitution of different blockages against the autonomous operation of the criminal justice. Particularly, this research studies an event of enforced disappearance initiated at the siege of the Colombian Palace of Justice in 1985, through a reconstruction focused on the perspective of the victims using a combination of qualitative methods. This field work, alongside different explorations of the sociological, human rights and criminological state of art of impunity, provides a sociological reflection on the concept of impunity. In the end, taking into account the problematization of the concept and its uses in social discourses, this work proposes a conceptualization apt for overcoming the vagueness of the definition of impunity as well as allowing a delimitation of the fight against it, leaving space for possible innovations on the penal rationality and possibly reinforcing a human rights agenda, concerned with the escalation of repression through punishment and committed with the restoration of social links and the victims’ rights.

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.