Clinicians and hospital administrators are increasingly challenged to achieve efficient evidence-based care. Clinical decision support (CDS) tools are being introduced into the clinical setting to facilitate the bridging of knowledge gaps at the point of care. Order sets are one of the tools used to facilitate this knowledge translation. Using the realist review methodology and a focus group of interview participants, this thesis explored retrospectively some of the causal relationships that lead to effective and successful order set adoption. Findings demonstrate the need for in-depth and regular review of context and order set adoption. Technology can offer some enhancements in the form of delivery tools, but it also introduces new and complex challenges for development and implementation. Ongoing software development is needed to improve delivery formats as well as incorporate effective tools to allow for efficient continuous quality improvement supports. / Graduate / 0769 / 0566 / hallsm.77@gmail.com

This thesis highlights the significance of patriarchal structures and their reproduction in women&rsquo / s social position through the feminist perspective. Patriarchy is a dominant structure both on production and reproduction sphere. Patriarchy, which is a dominant structure in every sphere of social life has material basis and controls both women&rsquo / s labour and sexuality. With this framework some concepts such as the types of women&rsquo / s labour, paid and domestic labour, family, honour, violence and masculinity are used in order to understand patriarchy. Patriarchy is not a fixed structure / on the contrary it has been changed according to the different mode of production and different social and cultural structures in which it takes place. In the scope of this thesis, the examples of &lsquo / social realist&rsquo / and &lsquo / national cinema&rsquo / are analysed sociologically. The social, economic and political structure of Turkey in between 1960-70 has some special importance. In addition to that, the institution of cinema had some important changes at the same period. Meantime, it is important that not many studies were done in woman&rsquo / s subordination for this period in Turkey. Not only woman&rsquo / s subordination in the scope of patriarchy, but also mutual relations of men and the role of men in reproduction of patriarchy were analysed in the film analysis.

Connections between George Eliot and Immanuel Kant have been, for the most part, neglected. However, we have good reason to believe that Eliot not only read Kant (as well as many who were directly influenced by Kant), but substantially agreed with him on critical and moral issues. This thesis investigates one of the issues on which Kant and Eliot were most closely aligned, the need for duty in morality. Both the English novelist and the German philosopher upheld a vision of duty that could command absolutely while remaining consonant with human freedom and grounding a sense of moral dignity. This vision runs throughout the works of both writers, but is first developed and takes on a particular urgency in the works examined in this thesis, ranging from some of their early publications to Kant’s Critique of Practical Reason and Eliot’s Romola. The first chapter discusses duty in the wider context of debates about Divine Command Morality, in which the good is defined by its accord with the will or command of God, and which both Kant and Eliot resisted in formulating their own moral visions (while maintaining the language of law and command). This chapter also discusses evidence we have for Eliot’s familiarity with Kant and establishes critical context for this paper. The second chapter discusses religion – in particular, religious enthusiasm – as a necessary background for duty, which exists in the absence of theological certitude, even as it seeks to preserve something of religion’s capacity to command and its popular scope. Kant’s path to the first Critique led through works foundational for, but also sometimes at odds with the priorities and conclusions of critical science, and Eliot’s first novel was preceded by a critical career that paints a quite different picture of religion than the sympathetic portrait of Dinah Morris. The third chapter deals with three dimensions of duty in Kant and Eliot, autonomy, reflection and respect, primarily through Kant’s second Critique and The Mill on the Floss. In the conclusion, I turn to Romola to illustrate the conflict and indeterminative power inherent in this conception of duty.

Les expériences rares, qu’elles soient positives ou négatives, surprennent par leur avènement inopiné et brutal. Toutefois, le plus surprenant reste l’incapacité des organisations à en tirer des leçons appropriées. Les expériences rares challengent les approches traditionnelles de l’apprentissage organisationnel fondées sur la réplication et l’amélioration progressive. De plus, les expériences rares sont souvent complexes : elles sont composées d’une grande variété d’éléments qui interagissent de façon incertaine. De ce fait, elles sont marquées par un niveau élevé d’ambiguïté causale qui peut conduire à un apprentissage superstitieux. Dans ces conditions, la littérature souligne la nécessité de mettre en oeuvre un apprentissage délibéré fondé sur la codification des connaissances. Mais la codification est une arme à double tranchant, qui peut rigidifier l’organisation et la littérature reste assez silencieuse sur comment réaliser une « bonne codification ». Ce travail de thèse s’intéresse alors à la question suivante : comment développer et mettre en oeuvre une stratégie de codification appropriée pour faciliter un apprentissage organisationnel délibéré à partir d’une expérience rare et complexe ? Cette recherche menée au sein de l’Institut de Radioprotection et de Sûreté Nucléaire s’appuie sur étude de cas réaliste critique. Elle vise à étudier deux apprentissages délibérés mis en place au sein de l’institut pour apprendre de deux accidents nucléaires graves : l’accident Fukushima Daiichi et l’accident Three Mile Island. Les résultats obtenus identifient trois mécanismes générateurs clés du processus de codification, leurs modes d’activation et la façon dont ils se combinent. Ces mécanismes s’activent grâce à la fois au contexte environnemental et à l’apparition de structures dédiées à la codification, puis se combinent pour former différentes configurations qui supportent deux cycles distincts d’apprentissage. Ces deux cycles sont essentiels pour apprendre d’une expérience rare et complexe. / Rare experiences, whether they are positive or negative, surprise by their unexpected and brutal occurrence. However, more surprising is organizations’ incapability to draw lessons from such rare experiences. Indeed, these experiences challenge traditional approaches of organizational learning based on replication and incremental improvement. In addition, rare experiences are often complex: they are composed of a large variety of elements that interact in uncertain ways. As a result, rare experiences are characterized by a high level of causal ambiguity that can lead to superstitious learning. In these circumstances, the literature emphasizes the need to implement deliberate learning based on knowledge codification. However, codification is a double-edged sword, which can produce organizational rigidity. Besides, research remains quite silent on how to achieve a "well-performed codification”. This research addresses the following question: how to develop and implement an appropriate codification strategy to facilitate deliberate organizational learning from rare and complex experiences? This research is conducted in the Institute of Radioprotection and Nuclear Safety. It is based on a critical realist case study which aims to study two deliberate learning process implemented within the institute to learn from two serious nuclear accidents: Fukushima Daiichi accident and Three Mile Island accident. Our results identify three key generative mechanisms of the codification process, their activation modes and how they are combined. These mechanisms are activated by both the environmental context and the emergence of dedicated structures to codification. The combination of these mechanisms forms different configurations that support two distinct learning cycles which are essential for learning from a rare and complex experience.

What is morality’s place within realist theories of international politics? Often realism is disregarded for having little to offer on the matter. Whilst recent research suggests this is something of a misconception, seldom have realists themselves been asked if and where any moral philosophy belongs inside their perspectives, respectively, on world politics. This is probably unfair, and not a little strange, as several realists throughout the history of international political thought have in fact had much to say about what becomes of morality between states. This paper presents a small selection of those most important contributions to the realist literature, with a particular view towards what has been said on morality within them. Identified are a handful of instances where influential realists have indeed commented on what becomes of morality in international politics, with each example then taken to be useful in some way. Next is proposed something like a complement to them, by way of reading differently the origins of the classical realist tradition. This alternative reading requires first that we consider the ancient Greek sophist Protagoras as having had something important to say about morality and about human nature in Plato’s dialogue named after him. Second, we must ask whether Protagorean moral philosophy can at all be considered relevant to the development of realist theory. I argue that it can, and suggest that we ought therefore to revisit the realist tradition's ancient Greek origins, adding next to the name Thucydides that of his contemporary Protagoras as having been first to exemplify realist theory in the history of Western international political thought.

In many aspects, political theory forms a subjective structure of this abstract science. Perhaps, it is due to the fact that unlike natural sciences or mathematics, social sciences often lack the privilege of testing the theories in absolute and unadulterated conditions. Nonetheless, such nature of the science allows for a certain degree of flexibility, when applying political theories to real-world phenomena. Alliances and coalitions in international relations form the backbone of the theory, concerning IR scholars with two main questions: Why do alliances and coalitions form? And, what keeps alliances and coalitions together? As the core of my research, I examined NATO, as the most prominent and long-lasting alliance of our time, through the prism of alliance formation and cohesion theory introduced by George Liska. In particular, I explored the evolution of the North Atlantic Treaty Organization over the term of its existence, and sought to determine whether Liska's principles still apply to the contemporary situation, and in particular, how may the variables have altered the application of this scholar's theory to our future understanding of alliances. In its essence, this is a comparative study of the same alliance during the different stages of its existence. In particular, the comparison dissects such aspects of alliance theory as alignment, alliance formation, efficacy, and reasons for possible dissolution. As a result, the study led to a conclusion, that despite the permutations around and within NATO, the basic realist principles that may explain the mechanism of this alliance's formation and cohesion still apply to the contemporary organization.

This study investigated the role of different leadership styles within Iran and how such leadership changes influenced Iranian foreign policy. The study utilized event-data analysis of Iranian history and current events and discussed the role of realist and idealist to the development of Iran into the regional power it is today as well as how Western relations played a role in developing Iranian foreign policy, particularly with regard to its nuclear development. The main body of the study drew from the dynamics within Iran, its relations with the West, relations with Israel, and relations with other foreign powers. The event-data analysis also took into account the political and socioeconomic stability and conditions within Iran as it would readily influence the foreign policy-making within the nation. The first part of the study analyzed Iranian society under the Shah and the under the revolutionary guidance of the Ayatollah Khomeini; the second part analyzed the post-Khomeini period in Iran. In addition to reviewing the role of different revolutionary leadership styles within Iran, this study considers the role that Iranian-Western relations have played in Iranian policy-making. Further, this study considers the tumultuous role that nuclear development has had in Iran's foreign relations. Findings showed that there is a relationship between Western presence in the Middle East and growing aggression by Iranian leadership. Moreover, the study demonstrates that the role of revolutionary leadership styles is critical in accessing the manner in which foreign policy decisions are made. The study found that the role of Islam in Iranian politics has brought much contention but found that in the post-Khomeini years, it has not been the central reason for policy decisions. Recommendations were made for the continued study of the role of nuclear development in Iranian-Western relations as this study was able to find some evidence of it having some level of relevance. Additionally, recommendations were made that additional research be conducted with regard to the role of Islam in shaping Iranian foreign policy in the Post-Khomeini era.

The economic, demographic and social changes of the latter half of the C20th have influenced the experience of individuals now at 'midlife'. Arguably the impact of these changes has been more profound for women; specifically in the UK for those educated to be the wives, mothers and carers of industrial Britain (Newsom, 1963). Now around 50 years old this group of women are likely to experience a lengthy period of 'postmaternity' (Sheriff and Weatherall, 2009) extending to over thirty years in many cases. This research considers the experience of this metaphorically entitled 'telescopic' cohort (Goldstein and Schlag, 1999). The major corpus of age related research assumes a linear developmental progression of life stages (Erikson, 1951, 1968; Gould, 1978; Levinson, 1978; Levinson, 1996; Klohnen et al., 1996; Miner-Rubinio, 2004). Drawing on life course theory (Elder, 1995; Runyan, 1982; Super, 1980) enables this research to explore how women may have changed assumptions about themselves and their expectations as the social world has changed around them, moreover offers an alternative to the essentialist, linear, deterministic models of ageing. This feminist poststructuralist examination of the experience of women at 'midlife' is divided into two parts; firstly the 'lived life' which examines demographic changes, and drawing on material from 'Jackie' magazine, considers discourses of femininity and the expectations for, and of, girls. The 'told story' is then explored using narrative interview material. How women 'story' their lives and their understanding of 'self' at midlife is examined within the context of the changing world and their ageing bodies. The research revealed that the experience of 'midlife' for this cohort of women is narrated as a time of change in social circumstances with some 'gains' and some 'losses', however it is not storied as a time of inevitable 'crisis'. Moreover despite the plethora of literature portraying the menopause as problematic, this was not supported by the interview material.

Since the end of the Cold War, private military and security companies have gained a prominent place on the international battlefield. In an attempt to reduce monetary and political costs, states have not only outsourced some of the defense functions previously performed by uniformed personnel; they have also partly privatised the provision of security. Traditional accounts of the rise of private military and security companies have explained this evolution in terms of changing demand and supply of military force after the Cold War, in a neoliberal ideological environment. This rationalist account, however, overlooks the role of norms, which, as the constructivist research tradition has demonstrated, constrain state behaviour even in the domain of national security. From this constructivist point of view, the rise of private military and security companies is surprising given the existence of an anti-mercenary norm and a norm on the state monopoly on violence, both of which have precluded the private exercise of violence. How, then, should the rise of private military and security companies be understood in light of this hostile normative environment? Against a realist-constructivist background, this text draws upon models of norm change and epistemic communities to show that private military and security companies have used their pragmatic legitimacy and epistemic power to decisively shape the discursive construction of a new regulatory framework that legitimises the exercise of non-state violence.

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