Objective: The promotion of self-management support for people with LTCs is a health policy priority across the UK (LTCAS 2008; DoH 2012). Self-management support is designed to change and improve care for people with LTCs, who form an increasing proportion of the population requiring healthcare and treatment. For health organisations models of care, which support self-management, require greater emphasis on person-focused rather than disease-focused manifestations of health and represents a new model of care delivery requiring changes in practice. Current research demonstrates that health policies are increasingly complex, involve multiple organisations and often fail to translate into effective practice (Noyles et al. 2014). The deficit between what works and what happens in practice is referred to as the “implementation deficit” (Pressman and Wildasky 1984) and traditionally it has been difficult to breakaway from the idea that the policy process is best viewed from the top-down (Barett and Fudge 1981). However, there remains a need to understand the processes of implementation, which takes account of the variation, the multiple layers and interactions which takes place between policy-maker and -implementer as policy becomes practice (Hupe 2011). Implementation of self-management is a contemporary focus in UK health policy and this thesis explains what processes are used to implement self-management policy for people with LTCs into everyday practice in one health board. Methods: A case study approach was used to investigate the policy process with data collected using thirty-one semi-structured interviews with policy-makers and regional and local policy-implementers plus eight hours of observation of national and regional policy meetings. To provide context to the implementation process data also included thirteen policy documents. Data analysis used the retrospective application of NPT as a theoretical framework with which to explore the implementation processes. NPT is an emerging theory that is being promoted as a means of understanding implementation, embedding and integration of new ideas in healthcare (McEvoy et al. 2014). The application of NPT focuses on four mechanisms, termed work (May and Finch 2009: 547), which promote incorporation of new ideas in practice. These areas of work are coherence, cognitive participation, collective action and reflexive monitoring (Mair et al. 2012). Findings: The findings suggest that there are a number of important influences operating behind or as part of the policy implementation process. These included the need for a shared understanding, getting stakeholders involved to drive forward policy, work promoting collaboration and participation was the most detailed and important in the process of policy implementation; the course of policy was affected by factors which facilitated or inhibited stakeholders acceptance of self-management; and NPT fosters key analytical insights. Conclusion: Understanding the process of policy implementation in healthcare and how practice changes as a result of policy is subject to a wide range of influences. What emerges are five key recommendations relating to understanding policy implementation. (1) understanding the concept of self-management is important in promoting policy implementation. This understanding benefits from dialogue between policy-makers and -implementers. (2) stakeholder involvement supports implementation particularly the role of clinical leadership and leadership through existing networks but also value in establishing new organisational structures to create a receptive context. (3) develop participation and collaboration through use of the patient voice which helped simplify the policy message and motivate change. (4) other resources help policy implementation and where these are evident then policy is implemented and where they are absent then implementation is not embedded. Lack of evidence was a particular area of constraint. (5) NPT has shown that social context is important, and provides for this. But in addition there is evidence that historical perspectives and previous experience are also important influence on receptivity to implementation. This research contributes to the development of theory and practice in the area of implementation science. The exploration of the policy implementation has revealed the action and work which policy-makers and -implementers are engaged in while implementing policy. It has tested the utility of NPT in a real-life setting using all four mechanisms.

There is a consensus within the United Nations (UN), as well as various governmental entities, politicians, individuals, scholars, and academic communities, on the need to reform governmental performances. However, there is no unanimity among them pertaining to a specific reforming model that is valid for all contexts worldwide. Accordingly, many performance management processes and practical techniques have been put into practice, which aim at improving governmental institutions' performance. Hence, the purpose of this research is to develop, by studying the public health services that are provided by the government, an effective model, with the aim of improving governmental performance in the context of Bahrain. With regard to originality and values, the research discerns that among the many factors affecting governmental entities' performance, there are two dominant contextual factors, i.e. the sociocultural and political forces, both of which synergise with the so-called United Nations Development Programme (UNDP) Good Governance Approach. The study develops a new perspective on the Interactive Complex Intervention Model (ICIM), stemming from the Grounded Theory (GT) and Normalisation Process Theory/Model (NPT/M), as disclosed in practical terms by the outcomes of the data gathered and its analysis. In fact, although those elements influence all other factors, there are interactive correlative impacts among all factors. Despite these outcomes, the data obtained from the research cannot be generalised, as they are derived from the local context of Bahrain; certainly until now, they can allow other similar contexts in particular to implement the insights reported in this study. It is important to note that the most influencing factor enabling this research, which aims to develop the ICIM for reforming governmental entities' performance in Bahrain, is the salient points raised in Imam Ali's famous consultative letter to the Governor of Egypt, Malik Ashtar, which he wrote while he was the Caliph, as scholars regard this letter as a basic guide for the Islamic administration and the UNDP Good Governance Approach. Regarding the practical implications, the research has attempted to empirically understand the role of the aforementioned primary contributing forces, that are regarded as the critical prerequisite - the first step that allows the governments' decision makers, based on the underlying knowledge involved in the work, to forthwith provide them with several contextual practical insights towards adopting the ICIM in order to enhance and reform the government entities' performance.

A fundamental question in the neurobiological study of drug addiction concerns the mechanisms mediating the motivational effects of chronic drug withdrawal. According to one theory, drugs of abuse activate opposing motivational processes after both acute and chronic drug use. The negative experience of withdrawal is the opponent process of chronic drug use that drives relapse to drug-seeking and -taking, making the identification of the neurobiological substrates mediating withdrawal an issue of central importance in addiction research. In this thesis, I identify the involvement of the neurotransmitters dopamine (DA) and corticotropin-releasing factor (CRF) in the opponent motivational a- and b-processes occurring after acute and chronic nicotine administration. I report that acute nicotine stimulates an initial aversive a-process followed by a rewarding opponent b-process, and chronic nicotine stimulates a rewarding a-process followed by an aversive opponent b-process (withdrawal). These responses can be modeled using a place conditioning paradigm. I demonstrate that the acute nicotine a-process is mediated by phasic dopaminergic activity and the DA receptor subtype-1 (D1R) but not by tonic dopaminergic activity and the DA receptor subtype-2 (D2R) or CRF activity, and the opponent b-process is neither DA- nor CRF-mediated. I also demonstrate that the chronic nicotine a-process is DA- but not CRF-mediated, and that withdrawal from chronic nicotine (the b-process) decreases tonic but not phasic DA activity in the ventral tegmental area (VTA), an effect that is D2R- but not D1R-mediated. I show that a specific pattern of signaling at D1Rs and D2Rs mediates the motivational responses to acute nicotine and chronic nicotine withdrawal, respectively, by demonstrating that both increasing or decreasing signaling at these receptors prevents the expression of the conditioned motivational response. Furthermore, I report that the induction of nicotine dependence increases CRF mRNA in VTA DA neurons, and that blocking either the upregulation of CRF mRNA or the activation of VTA CRF receptors prevents the anxiogenic and aversive motivational responses to withdrawal from chronic nicotine. The results described in this thesis provide novel evidence of a VTA DA/CRF system, and demonstrate that both CRF and a specific pattern of tonic DA activity in the VTA are necessary for the aversive motivational experience of nicotine withdrawal.

BACKGROUND: Today’s societal changes, including high rate of change and increasing information flows, are increasing the demand on the individual mental capacity. It becomes increasingly difficult to analytically process all the different dilemmas and everyday decisions as individuals have a limited mental capacity available to make these decisions. Thus, it has been suggested that ego-depleted relies more heavily on intuition, which is less burdensome, when making decision. However little is known about to what extent intuitive decisions differ from analytic. Are ego-depleted individuals more or less likely to maximize outcome in moral dilemmas involving conflicting values? Do ego depleted individuals become more or less willing to cooperate? Do ego depleted individuals become more or less altruistic? Is our intuition more or less in accordance with Homo Economicus?AIM: Starting from a Dual Process perspective on decision-making the aim of this study is to examine how ego depletion affects moral judgment and pro-social decisions.METHOD: A laboratory experiment involving 115 subjects, using real monetary incentives, was conducted among students at Linköping University. Subjects were randomized into one of two treatments. Everything was identical across treatments except for the initial ego-depletion manipulation. Using a standard paradigm for ego-depletion subjects in treatment 1 were put under high cognitive load while subjects in treatment two were put under low cognitive load. Subjects faced 16 questions divided into four different decision tasks: Moral dilemmas, Public Goods game, two types of Dictator Game where the type of sacrifice subjects could make in order to contribute money to charity was varied.RESULTS: Subjects in the high cognitive load treatment made fewer consequentialists moral judgments compared to other subjects (p = 0.075). The effect is especially strong when looking only at high-conflict dilemmas such as Crying Baby. No difference between treatments was found for the public goods games. In the dictator game involving monetary sacrifice subjects donated less money to charity when put under high cognitive load. However the finding was not significant (p = 0.292). No difference was found in the dictator game involving effort as personal sacrifice since almost everyone chooses to donate to charity.CONCLUSION: According to The Dual Process perspective this essay shows that intuitive thinking does not evidently lead to that they makes decision that more or less is in accordance with Homo Economicus. The connection between ego depletion and pro-social decisions is more complex. Further research needs to investigate which different mental shortcuts that individuals uses in various types of pro-social decisions and why intuitive and analytical decision-making differ between different decisions. Further research within the area can identify potential mechanisms and policies that can support individuals’ capacity to make decisions in accordance with their own and society’s preferences.

A fundamental question in the neurobiological study of drug addiction concerns the mechanisms mediating the motivational effects of chronic drug withdrawal. According to one theory, drugs of abuse activate opposing motivational processes after both acute and chronic drug use. The negative experience of withdrawal is the opponent process of chronic drug use that drives relapse to drug-seeking and -taking, making the identification of the neurobiological substrates mediating withdrawal an issue of central importance in addiction research. In this thesis, I identify the involvement of the neurotransmitters dopamine (DA) and corticotropin-releasing factor (CRF) in the opponent motivational a- and b-processes occurring after acute and chronic nicotine administration. I report that acute nicotine stimulates an initial aversive a-process followed by a rewarding opponent b-process, and chronic nicotine stimulates a rewarding a-process followed by an aversive opponent b-process (withdrawal). These responses can be modeled using a place conditioning paradigm. I demonstrate that the acute nicotine a-process is mediated by phasic dopaminergic activity and the DA receptor subtype-1 (D1R) but not by tonic dopaminergic activity and the DA receptor subtype-2 (D2R) or CRF activity, and the opponent b-process is neither DA- nor CRF-mediated. I also demonstrate that the chronic nicotine a-process is DA- but not CRF-mediated, and that withdrawal from chronic nicotine (the b-process) decreases tonic but not phasic DA activity in the ventral tegmental area (VTA), an effect that is D2R- but not D1R-mediated. I show that a specific pattern of signaling at D1Rs and D2Rs mediates the motivational responses to acute nicotine and chronic nicotine withdrawal, respectively, by demonstrating that both increasing or decreasing signaling at these receptors prevents the expression of the conditioned motivational response. Furthermore, I report that the induction of nicotine dependence increases CRF mRNA in VTA DA neurons, and that blocking either the upregulation of CRF mRNA or the activation of VTA CRF receptors prevents the anxiogenic and aversive motivational responses to withdrawal from chronic nicotine. The results described in this thesis provide novel evidence of a VTA DA/CRF system, and demonstrate that both CRF and a specific pattern of tonic DA activity in the VTA are necessary for the aversive motivational experience of nicotine withdrawal.

Submitted by Rodrigo Miranda (rodmiranda02@gmail.com) on 2013-12-09T18:33:48Z No. of bitstreams: 1 Rodrigo Miranda.pdf: 612478 bytes, checksum: 71e496507dd2bce8ec290a067a967714 (MD5) / Approved for entry into archive by Suzinei Teles Garcia Garcia (suzinei.garcia@fgv.br) on 2013-12-10T17:29:52Z (GMT) No. of bitstreams: 1 Rodrigo Miranda.pdf: 612478 bytes, checksum: 71e496507dd2bce8ec290a067a967714 (MD5) / Made available in DSpace on 2013-12-10T17:31:55Z (GMT). No. of bitstreams: 1 Rodrigo Miranda.pdf: 612478 bytes, checksum: 71e496507dd2bce8ec290a067a967714 (MD5) Previous issue date: 2013-11-08 / The creative industries became to be focus of studies in the business field due to the interest awaken by the so called new economy, in the end of the 90’s. However, little has been explored about their forms of organization, in special the daily work of the people working in these companies. These people by lifestyle seek in the creative process your core activity. The notion of common sense one gets is that creative organizations are more flexible and dynamic than those of other sectors. Thus, studying how is the process of organizing and sense making in these organizations can bring practical and theoretical contributions on this perception. Considering this context, our goal in this thesis is to investigate the creation of meaning in the process of organizing companies in the creative industry in São Paulo. We surveyed 18 companies and four professional freelancers, adding up the total of 32 women working directly in the creative economy, in order to seek understanding about what they do, how they do and what meaning they attach to the creation and (re) creation their daily work and companies. This thesis greatly influenced by the ethnomethodological studies of the everyday life. Keeping this in view, we used the Process Theory and Ethnomethodology as foundations, which begins with the idea that the routine phenomenon and imperceptible day to day activities are fundamentals to understanding a larger temporal and spatial reality. It is in the everyday life that social relations are truly built. Following this guidance, this study sought to identify biographical elements of the participants of these companies and in the everyday life of creative industries, through non-participant observation, semi-structured interviews and document analysis. With this, we seek to establish an understanding of the process of organizing and sense making in this specific sector of the economy in order to contribute to the understanding of these organizations and the complexity of their dynamics. As a result, we could identify the sense making about the process of organizing in different occupational groups: professionals who work as managers move away from the creative process, artists deviate from the activities of management and organization, and managers seeking management activities for the development of organizations. We also observed that complex relationships are established in informal networks and new forms of labor exploitation that makes the sector is weak. Some organizations achieve stability because they are organized around networks of relationships, knowledge and action, so that the information and experiences circulate enabling reflections on what is made. Despite the perception that these organizations are flexible, the professionals themselves need much effort to keep the group together in the face of environmental uncertainties and difficulties. The organization, the people and the creative process remain uncertain and susceptible to changes that impact negatively in the maintenance of groups and social relations. / As indústrias criativas passaram a ser foco de estudos na área de Administração em virtude do interesse despertado pela chamada nova economia, no final dos anos 1990. No entanto, pouco foi explorado a respeito de suas formas de organização, em especial, o cotidiano do trabalho das pessoas que trabalham nessas empresas e que, por opção de vida, buscam no processo criativo sua atividade principal. A noção de senso comum que se tem é que as organizações criativas são mais flexíveis e dinâmicas do que aquelas de outros setores. Assim, estudar como se dá o processo de organizar e a criação de sentido nessas organizações pode trazer contribuições práticas e teóricas sobre essa percepção. Considerando esse contexto, nosso objetivo nesta tese é investigar a criação de sentido no processo de organizar em empresas da indústria criativa no município de São Paulo. Foram pesquisadas 18 empresas e quatro profissionais free-lancers, somando o total de 32 mulheres atuantes diretamente na economia criativa, com o intuito de buscar entendimento sobre o que fazem, como fazem e qual o sentido que atribuem ao à criação e (re)criação do seu cotidiano de trabalho. Esta tese teve grande influência dos estudos etnometodológicos sobre o cotidiano. Tendo isso em vista, utilizamos a Teoria do processo e a Etnometodologia como fundamentos, na qual se parte da ideia de que os fenômenos rotineiros e imperceptíveis do dia a dia são fundamentais para a compreensão de uma realidade espacial e temporal maior. É no cotidiano que as relações sociais são verdadeiramente construídas. Seguindo essa orientação, este estudo buscou a identificação de elementos biográficos dos participantes dessas empresas e do cotidiano das indústrias criativas, por meio de observação não participante, entrevistas semiestruturadas e análise documental. Com isso, buscamos estabelecer um entendimento sobre o processo de organizar e a criação de sentido nesse setor específico da economia, a fim de contribuir para o entendimento dessas organizações e da complexidade de sua dinâmica. Como resultados, podemos identificar a criação de sentidos no processo de organizar em grupos profissionais distintos: profissionais que trabalham como gestores se distanciam do processo criativo, artistas se afastam das atividades de gestão e organização, e gestores buscam atividades de gestão para o desenvolvimento das organizações. Observou-se também que relações complexas se estabelecem em redes de informalidade e de novas formas de exploração do trabalho que faz com que o setor se enfraqueça. Algumas organizações conseguem a estabilidade pelo fato de se organizarem em torno de redes de relacionamentos, de conhecimento e de ações, de modo que as informações e as experiências circulem possibilitando reflexões sobre o que se faz. Apesar da percepção de que essas organizações são flexíveis, os próprios profissionais necessitam de muito esforço para manter o grupo coeso frente às incertezas e dificuldades ambientais.

It is usually said that "A picture is worth a thousand words". It is then interesting to look into how students perceive their own writing process when they use drawing as an pre-writing strategy. Previous research have shown that drawings help young pupils in the beginning of their writing development. The study is a phenomenographic study and are built on interviews and observation as method. The aim of this study is to investigate pupils perception of using drawings as a pre-writing strategy for writing. The following questions where formulated: • How do the students experience the drawing as a preparation for writing their narrative text? • How do the students perceive their own writing process? • What is the students perception of the drawing as a possible support during the      writing process? • How do the students perceive the drawing as support during their own writing process? This study is based on interviews with four pre-school students in second grade. The result in the study shows that the students are positive to use drawing as preparation for writing. It also shows that the students had different perceptions about how the drawing was as a support for writing. The drawing was perceived as a support for the working memory, a support to describe details form the drawing in the text and make structure in the text. The result also shows that the student´s perception of the drawing as a support of writing are connected to the student's perception of their own writing process.

Behavioral adaptation and cognitive control are crucial for goal-reaching behaviors. Every creature is ubiquitously faced with choices between behavioral alternatives. Common sense suggests that errors are an important source of information in the regulation of such processes. Several theories exist regarding cognitive control and the processing of undesired outcomes. However, most of these models focus on the consequences of an error, and less attention has been paid to the mechanisms that underlie the commissioning of an error. In this article, we present an integrative review of neuro-cognitive models that detail the determinants of the occurrence of response errors. The factors that may determine the likelihood of committing errors are likely related to the stability of task-representations in prefrontal networks, attentional selection mechanisms and mechanisms of action selection in basal ganglia circuits. An important conclusion is that the likelihood of committing an error is not stable over time but rather changes depending on the interplay of different functional neuro-anatomical and neuro-biological systems. We describe factors that might determine the time-course of cognitive control and the need to adapt behavior following response errors. Finally, we outline the mechanisms that may proof useful for predicting the outcomes of cognitive control and the emergence of response errors in future research.

博士(心理学) / Doctor of Philosophy in Psychology / 同志社大学 / Doshisha University

This dissertation compares the work and life of secondary public-school teachers in Ontario with different labour contracts during a time of crisis. The COVID public health crisis along with neoliberalism, the defunding of public education, and a climate crisis have all influenced governmental policies and the labour process of public secondary teachers in Ontario. The influences that different contracts can have on the labour process of teachers, how they feel towards their union, and the impacts on their individual health and household wellbeing before and during the first year of the COVID pandemic is the focus of this dissertation. To help explore these contexts and the influences on the life and labour of public secondary teachers in Ontario with different contracts, I have used research from studies in Labour Process Theory, precarious work, and educational labour to inform my analysis. Along with those areas of discourse, I have also used insights from research into Critical Realism and Thematic Analysis to think through and discuss the differences between the teachers I interviewed and connect their experiences with work, their union, and their individual health and household well-being to larger systems, structures, and histories. The interviews conducted revealed three points of interest: that precarious labour contracts can function as a disciplinary device, that larger contexts outside the contract shaped how the contract was experienced, and that teachers’ unions can act as a source of solidarity and security during a crisis and when there are certain associations with its purpose. This exploratory research aims to open up future areas of research into educational labour and differences between the experiences of educators with different contracts. / Dissertation / Doctor of Philosophy (PhD) / This project explored the differences between public secondary teachers with different contracts in Ontario before and during the COVID pandemic. It involved an online survey to help recruit participants and interviews with 36 teachers who were recruited from the online survey. Of the 36 teachers, 13 had permanent contracts, 16 had long term occasional (LTO) contracts, and 7 had occasional teaching (OT) contracts. The interviews and analysis revealed three points of interest: that precarious labour contracts in a tiered relationship with secure contracts can function as a disciplinary device, that larger contexts outside the contract shaped how the contract was experienced, and that teachers’ unions can act as a source of solidarity and security during a crisis and when there are certain associations with its purpose. Teachers with different contracts had uniquely different experiences with their work, their union, and their individual health and household wellbeing before and during COVID.