Our research paper looks at the sustainability challenge as an example of complexity in interrelated nested systems (or meta-problem) and we further explore the consequences of disruptive events induced by climate change (ie. Extreme Climate Events). Due to their potential effects on adaptive capacities of systems at all levels (macro, meso and micro) and the need for Strategic Sustainable Development (SSD) to develop meta-solutions (non-isolated, non-reinforcing) we focus on community-based interventions and participatory facilitation processes. Therefore, we enquire what might a process look like that supports a community’s psychological resilience and strategic sustainable development following a disruptive event. A way to reinforce a community’s adaptive capacities is through making meaning collaboratively and such a process can be supported by the use of stories and narrative. To this intent, we focus on the use of Collective Narrative Practices (CNP) within the implementation process (ABCD process) of the Framework for Strategic Sustainable Development (FSSD). CNP promote desired narratives and strengthen communities’ psychological resilience while the FSSD ensures the development of meta-solutions and their practical application (through the ABCD). Throughout a five-step exploration, we test their theoretical compatibility, interview FSSD and CNP practitioners, design an initial Process Prototype, test its validity by interviewing practitioners with expertise in both fields, and develop a final Process Prototype which embeds recommendations, guidelines and tools. Finally, our paper initiates the academic study of the linkage between FSSD and CNP and is aimed to guide practitioners of both fields to discern an effective way to facilitate the emergence of appropriate responses in a community, while maintaining or rebuilding its resilience and complying with SSD core principles.

This thesis investigates the performance of business model innovation (BMI) by incumbent power utility and clean-tech start-up firms influenced by the German Energiewende. It emphasises the factors that impact BMI from a managers’ perspective, examines success factors for managers to overcome BMI challenges, and addresses contingencies to perform BMI in a more structured way. The research is driven by the German Energiewende. It has been chosen as Germany is considered one of the world’s leading markets for renewable energies and a transformation of the power sector is currently underway. Therefore, established power utility firms face severe changes, which have the characteristics of a potential disruption to their business model (BM). At the same time, new players are challenging these incumbents with new BMs. The research is underpinned by the extant literature on BMs and BMI. The research approach is based on two case studies; the incumbent power utility and the clean-tech start-up sector. The qualitative study comprises of 24 semi-structured interviews conducted with top tier managers, from 18 firms, responsible for BMI within these firms. Key findings: This study extends our knowledge of BMI in both a start-up and an incumbent environment that is influenced by various contingent events. It portrays barriers to BMI and depicts critical success factors for BMI that point out solutions on how to overcome these barriers. It provides a structured BMI framework for established firms and illustrates future BM archetypes in this sector. It clearly documents the German Energiewende is regarded as a disruptive threat from the perspective of incumbent power utility managers. The theoretical contribution of this thesis is a process framework including all identified drivers and challenges for BMI in both established and start-up firms. Contributions to practice include critical success factors for BMI, recommendations to overcome barriers to BMI and future BM archetypes within the newly evolving Energiewende industry based on sustainable technologies.

Submitted by Filipe dos Santos (fsantos@pucsp.br) on 2018-06-15T12:33:39Z No. of bitstreams: 1 Marcelo Augusto Vieira Graglia.pdf: 15497008 bytes, checksum: f1fda85b7db5f6d79503250da9c5f3b3 (MD5) / Made available in DSpace on 2018-06-15T12:33:39Z (GMT). No. of bitstreams: 1 Marcelo Augusto Vieira Graglia.pdf: 15497008 bytes, checksum: f1fda85b7db5f6d79503250da9c5f3b3 (MD5) Previous issue date: 2018-03-22 / Fundação São Paulo - FUNDASP / This study analyzes the relationships between new technologies and disruptive innovations that stimulate the new wave of economic transformation and affect society as a whole. The goal is to investigate the mechanisms by which the jobs can be destroyed and understand the potential impacts on work, employment, and people / Este estudo analisa as relações entre novas tecnologias e inovações disruptivas que estimulam a nova onda de transformação econômica e afetam a sociedade como um todo. O objetivo é investigar os mecanismos pelos quais os empregos podem ser destruídos e compreender os impactos potenciais no trabalho, no emprego e nas pessoas

Evidências apontam para forte relação independente entre maus tratos na infância, comportamentos disruptivos e prejuízos em funções executivas. No entanto, ainda não é completamente compreendido como estes três fatores se relacionam entre si. Esta pesquisa avaliou a relação entre maus-tratos na infância e transtornos do comportamento disruptivo, testando desempenho em funções executivas como possível mediador e moderador desta relação. A presente pesquisa está inserida no estudo \"Coorte de escolares de alto risco para o desenvolvimento de psicopatologia e resiliência na infância e adolescência - projeto Prevenção\", projeto integrante do Instituto Nacional de Ciência e Tecnologia de Psiquiatria do Desenvolvimento para Infância e Adolescência (INCT-INPD), o qual incluiu 2500 crianças em idade escolar de São Paulo e Porto Alegre (Brasil). As crianças foram extensamente avaliadas com entrevistas diagnósticas, relatos de pais e da própria criança sobre maus tratos e com testes neuropsicológicos. Resultados indicam associação de maus tratos na infância e transtornos do comportamento disruptivo, porém não foi encontrada associação entre maus tratos e funções executivas. Crianças com transtornos do comportamento disruptivo apresentaram pior desempenho em teste específico para avaliação de flexibilidade cognitiva. Desempenho em funções executivas não agiu como mediador ou moderador da associação entre maus tratos e transtornos do comportamento disruptivo. Desta forma, os resultados indicam que a associação entre experiências de maus tratos e transtornos do comportamento disruptivo ocorre independentemente do desempenho em funções executivas. Futuros estudos longitudinais são fundamentais para confirmar estes resultados e elucidar os mecanismos cognitivos envolvidos nesta associação causal / Empirical evidences point to a strong independent relationship between maltreatment in childhood, disruptive behaviors and impairments in executive functions. However, how these three factors are interrelated it is not completed understood yet. This study evaluated the relationship between childhood maltreatment and disruptive behavior disorders, testing performance in executive functions as possible mediator and moderator factor in this relationship. This research is part of the study \"Cohort of high-risk students for the development of psychopathology and resilience in childhood and adolescence - Prevention Project\", a member project of the National Institute of Science and Developmental Psychiatry Technology for Children and Adolescents (INCT -INPD) in which is included 2,500 schoolchildren from São Paulo and Porto Alegre (Brazil). The children were evaluated with diagnostic interviews, reports of parents and children themselves about maltreatment and with neuropsychological tests, which included evaluation of inhibitory control, working memory, cognitive flexibility and planning. Results indicate association of childhood maltreatment and disruptive behavior disorder, but no association was found between maltreatment and executive functions. Children with Disruptive Behavior Disorders showed worse performance in specific task for assessment of cognitive flexibility. Performance in executive functions didn\'t work as a mediator or modifier variable in the association between childhood maltreatment and disruptive behavior disorder. Thus, the study results indicate that the association between experiences of maltreatment and disruptive behavior disorder occurs regardless of the performance in executive function in a community sample. Future longitudinal studies are essential to confirm these findings and elucidate the cognitive mechanisms involved on this causal association

Este trabalho enfoca o campo de atuação do marketing de serviços, setor cada vez mais representativo nas economias mundiais, em que a competitividade igualmente crescente demanda das empresas a capacidade de inovar e se diferenciar continuamente em prol da sobrevivência e crescimento. As características distintivas de marcas de serviços, sobretudo o caráter intangível da prestação, trazem para estas empresas o desafio da transformação dos serviços em benefícios concretos, buscando um posicionamento sólido junto aos consumidores e influenciando o processo de decisão de compra. Assim, é objetivo deste trabalho estudar como o posicionamento de marcas de serviços é gerido quando ocorre a introdução de uma inovação disruptiva, ou seja, quando a empresa decide pela introdução de uma tecnologia de ruptura, com uma proposição de valor consideravelmente diferente da tecnologia vigente. A metodologia adotada envolveu primeiramente a revisão de literatura nos temas de marketing de serviços, segmentação/posicionamento e aspectos da inovação disruptiva, buscando um entendimento da relação entre os construtos. De forma complementar, considerando-se a adequação com a questão de pesquisa, decidiu-se pela condução de um estudo de caso enfocando uma empresa do setor de serviços de telecomunicação móvel brasileiro, a Vivo S/A. A decisão pelo estudo de caso único foi motivada pelo caráter peculiar da situação estudada, representada pela introdução da tecnologia GSM pela empresa no período compreendido entre os anos 2006 e 2007, em caráter disruptivo. Estudou-se a forma como a empresa procedeu no tocante aos processos de segmentação, posicionamento e gestão do composto de marketing frente a este evento. Os resultados apontam para uma influência significativa da mudança tecnológica no posicionamento da marca, com maior impacto nos fatores relacionados a produto, promoção e pessoas, do composto de marketing de serviços. A pesquisa também revelou o poder de tecnologias emergentes em transformar as competências internas de uma empresa, muito além da tecnologia em si. Por fim, os resultados mostram como a empresa conseguiu resultados positivos nas dimensões de negócios e de marca, revertendo uma situação competitiva desfavorável, identificada no contexto que se pôde construir para o caso. / The following dissertation will address the theme of services marketing, a sector that has been increasingly representative in global economies, where competitiveness is constantly growing and demands that companies have the ability to continually innovate and differentiate in favor of their own survival and growth. The distinctive characteristics of service brands, especially the intangible characteristic, bring to these companies the challenge of transforming services into concrete benefits, seeking a solid position among consumers and influencing the purchase decision process. Thus, the objective of this project is to study how the positioning of services brands are managed when there\'s introduction of a disruptive innovation, ie, when the company decides to introduce a disruptive technology, with a value proposition considerably different from the current technology. The adopted methodology involved primarily a literature review in the areas of services marketing, segmentation / positioning and aspects of disruptive innovation, seeking to understand the relationship between the concepts. In a complementary way, considering the suitability to the research question, it was decided to conduct a case study focused on a mobile telecommunications company in Brazil, Vivo S/A. The decision for a single case study was motivated by the peculiar character of the studied situation, represented by the introduction of GSM technology by the company in the period between 2006 and 2007 in a disruptive character. The project sought to understand how the company proceeded regarding the processes of segmentation, positioning and management of the marketing mix, considering this event. The results point to a significant influence of technological change in brand positioning, with the greatest impact on factors related to product, promotion and people of the services marketing mix. The research also revealed the power of emerging technologies to transform the internal competencies of a company, beyond the technology itself. Finally, the results show how the company achieved positive results in the dimensions of business and brand, reversing a competitive disadvantage, identified in the context that could build into the case.

Made available in DSpace on 2015-04-22T22:10:27Z (GMT). No. of bitstreams: 1 edisandro.pdf: 1904738 bytes, checksum: 4110b3c3886c850238f6109003b3002c (MD5) Previous issue date: 2011-10-25 / The traditional innovation model widely adopted by organizations during the whole 20 century, also known as closed innovation model, where research and development activities are conducted entirely inside organization´s frontiers and controls, has given place in recent years to the open innovation model, where organizations have realized both importance and benefits of using external ideas and knowledge as main part of their innovative process (CHESBROUGH, 2003a). So, this research used an explanatory single case study with integrated units of analysis method (YIN, 2010) in order to analyze the current organizational practices adherence to open innovation concepts inside a R&D center located in the Industrial District of Manaus. As part of the methodology, the primary data were collected through participant observations as well as through the use of questionnaire and interviews instruments. The secondary data were collected through documental research by analyzing organizational procedures, work instructions and tools. The data analysis followed an analytical strategy that counted with theoretical propositions as well as both standard combination and construction of explanation specific techniques, as proposed by Yin (2010). The use of analytical strategy and specific techniques favored the organizational innovative process mapping, as well as the identification of practices related to the open innovation concepts established by this process. Through this data analysis it was also possible to identify improvements applicable to the innovative process in order increase the adherence to open innovation practices, as well as practices considered important to the organization that are not enough applied to the innovative process. As a result, it was pointed out that the initial proposition stating that current organizational practices were adherent to the open innovation concepts was not confirmed. Such conclusion is due to the lack of organizational practices related to the open innovation model. Besides that, it was also possible to establish a set of suggestions to the company aiming to increase the organizational practices adherence to the open innovation concepts. / O modelo de inovação tradicional largamente adotado pelas empresas durante o século XX, também conhecido como modelo de inovação fechada, consiste na realização das atividades de pesquisa e desenvolvimento (P&D) inteiramente dentro das fronteiras e controles organizacionais. Este conceito, no entanto, vem dando lugar nos últimos anos a um modelo de inovação aberta, onde as empresas têm percebido a importância e os benefícios de considerar ideias e conhecimentos externos como parte integrante do seu processo inovativo (CHESBROUGH, 2003a). Desta forma, esta pesquisa utilizou como método um estudo de caso único de finalidade explanatória e unidades de análise integradas (YIN, 2010), cujo objetivo foi analisar as práticas organizacionais vigentes quanto à aderência ao conceito de inovação aberta em um Instituto de P&D localizado no Polo Industrial de Manaus. Como parte da metodologia de pesquisa, foram coletados os dados primários, através da observação participante, bem como utilizados os instrumentos de questionário e entrevistas. Já a coleta dos dados secundários se deu através da pesquisa documental, analisando-se os procedimentos, instruções de trabalho e ferramentas organizacionais. Para análise dos dados seguiu-se a estratégia analítica geral de contar com as proposições teóricas bem como se utilizou as técnicas específicas de combinação padrão e construção da explanação, conforme proposto por Yin (2010). O uso da estratégia analítica e técnicas específicas permitiram o mapeamento do processo de inovação da organização, bem como a identificação de práticas ligadas à inovação aberta estabelecida por este processo. Ainda através da análise foi possível identificar pontos de melhoria no processo inovativo necessários a uma maior aderência às práticas da inovação aberta, assim como práticas consideradas importantes para a organização, mas que não são utilizadas de forma suficiente no processo inovativo. Como conclusão, esta pesquisa evidenciou que a proposição inicial de que as práticas organizacionais vigentes eram aderentes aos conceitos da inovação aberta não foi confirmada. Tal conclusão deve-se ao fato de que não foram encontrados certos aspectos chaves pertinentes ao modelo de inovação aberta em prática na organização. Além disso, foi possível estabelecer uma série de sugestões à organização visando tornar suas práticas aderentes ao modelo da inovação aberta.

O proposito deste estudo e avaliar o impacto psicologico da vivencia hospitalar de individuos que sofrem complicacoes pos-operatoria, partindo do pressuposto de que a intercorrencia agrava o quadro clinico com repercussoes na esfera psiquica destes pacientes. Teoricamente enfoca a evolucao do conceito de trauma na teoria freudiana, partindo do desamparo primordial (hilflosigkeit) ate a nova concepcao de angustia, levando em consideracao o fator economico, a nocao de a posteriori (nachträglichkeit) e a compulsao a repeticao. Com o intuito de ampliar a compreensao do fenomeno, o estudo percorre a etiologia do trauma para outros teoricos: Sandor Ferenczi, sobre o narcisismo da doenca; Donald W. Winnicott, que correlaciona o trauma a vivencia do fracasso do ambiente, a imprevisibilidade, ao excesso de tempo de exposicao a situacao desorganizadora, e a elevacao do nivel de dependencia. A constancia desta situacao leva ao que Maksud Khan nomeou de trauma cumulativo. A hipotese e a de que esta experiencia hospitalar pode promover um trauma psiquico, na medida em que o individuo se ve diante de uma situacao imprevisivel, que pode lhe causar transbordamento emocional pelo estado de desamparo, impotencia e risco da perda de sua integridade fisica -, que inibe uma elaboracao psiquica. Apos a alta hospitalar tais fatores podem, ainda, desencadear efeitos pos-traumaticos, acarretando-lhe, assim, uma dificuldade adaptativa. Para Moty Benyakar isto significa que o evento disruptivo pode promover um vivenciar traumatico dado a magnitude do impacto no psiquismo. Metodologicamente, para melhor compreensao do processo psiquico, faz-se um estudo longitudinal, de seis sujeitos, iniciando enquanto estes se encontram hospitalizados (situacao potencialmente traumatica), tres e seis meses apos a alta hospitalar. Na aplicacao do metodo qualitativo o estudo baseia-se na coleta de dados com entrevistas e na aplicacao reduzida da tecnica projetiva do TAT (Thematic Apperception Test). Pelo metodo quantitativo os pacientes sao submetidos a aplicacao da escala de avaliacao do transtorno de estresse pos-traumatico (CAPS Clinician Administred PTDS Scale). Esta pesquisa foi realizada em Hospital Escola de Universidade Publica, apos a aprovacao do Comite de Etica desta instituicao e do Comite de Etica para Seres Humanos do Instituto de Psicologia da Universidade de Sao Paulo. Atraves dos resultados obtidos na pesquisa pode-se constatar que ha uma relacao direta entre o evento e os seus efeitos no psiquismo. Pelo proprio carater disruptivo da instituicao hospitalar, dos encargos dos problemas de saude e do entorno (familiar, socioeconomico) o individuo vivencia uma vulnerabilidade fisica e psiquica. Contudo constatou-se que a dimensao da repercussao psiquica esta diretamente associada ao quadro clinico dos pesquisados, e ao tempo que ficam expostos a situacao potencialmente traumatica. Sendo este um fator fundamental na incidencia dos sintomas do Transtorno de Estresse Pos-traumatico. Com base neste estudo psicologico das complicacoes pos-operatorias, espera-se possibilitar aos profissionais de saude um novo olhar ao promover sua conscientizacao sobre problemas advindos desta experiencia, nao so aos individuos como, tambem, aos familiares, levantando a possibilidade de, se necessario, recorrerem a uma assistencia psicologica e/ou psiquiatrica / The objective of this study is to assess the psychological impact in subjects who stay in hospital after suffering from post-operative complications, on the assumption that the clinical picture gets worse causing troubles in the psychic area of these patients. Theoretically it focuses the evolution of the concept of trauma according to Freudian theory, since the primordial abandonment (hilflosigkeit) up to the new concept of distress, considering the economical situation, the concept of a posteriori (nachtraglichkeit) and the repetition compulsion. Aiming to offer a deeper understanding of the phenomenon, the study works with the etiology of trauma by other theorists: Sandor Ferenczi, about the narcissism of the disorder; Donald W. Winnicott, who relates the trauma to the experience of the environment failure, the unpredictability, the length of time facing a disordering situation, and the raising in dependence level. The constancy of this situation leads to what Maksud Khan called as cumulative trauma. The hypothesis is that in-hospital experience might provide a psychic trauma in so far as the subject has faced an unpredictable situation that might cause an overflow of emotions feeling abandoned, powerless and at the risk of losing physical integrity -, inhibiting a psychic elaboration. After having been discharged from hospital, such factors might also trigger post traumatic effects, implying into an adapting difficulty. According to Moty Benyakar, the disruptive event might provide a traumatic experience due to the great impact in the psychism. Methodologically for a better understanding of the psychic process, a longitudinal study has been made, with a number x of subjects, starting while they are in hospital (a potentially traumatic situation), from three to six months after they had been discharged from hospital. Applying the qualitative method the study has been based on the data collected through interviews and in the reduced application of the projective technique of TAT ( Thematic Apperception Test). Through the quantitative method the patients have been submitted to the application of the evaluation scale on the post-traumatic stress disorder (CAPS - Clinician Administered PTDS Scale). This research was carried out at the Hospital Escola da Universidade Publica, after the approval of the Comite de Etica ( Ethics Committee) of this institution and the Comite de Etica para Seres Humanos ( Ethics Committee for Human Beings) of the Instituto de Psicologia (Psychology Institute) of Universidade de Sao Paulo (USP). Through the results provided by the research, it was observed that there is a direct relation between the event and the effects in the psychism. For the own disruptive aspect in hospital, the burdens of health disorders and other surroundings ( familiar, socio- economic problems), the subject lives in a physical and psychic vulnerability. However it was pointed out that the dimension of the psychic repercussion is directly linked to the clinical picture of the six subjects who are studied, and the length of time that they have been exposed to the potentially traumatic situation. And this factor is extremely important in the incidence of the symptoms of the Post-Traumatic Stress Disorder. This psychological study of the post- traumatic surgery complications is meant to bring to health professionals much more awareness about the problems that come after this experience, not only for the subjects as well as to the relatives, who should be allowed to require, whenever necessary, some psychological and/or psychiatric treatment

<p>Za poremećaje iz grupe koja je u DSM-IV označena pod nazivom Deficit pažnje i poremećaji sa nasilničkim pona&scaron;anjem, a to su Deficit pažnje/Hiperaktivni poremećaj (ADHD), Poremećaj u vidu protivljenja i prkosa (ODD) i Poremećaj pona&scaron;anja (CD), može se reći da kao jedno od svojih osnovnih obeležja imaju i međusobni komorbiditet. I istraživačka praksa i iskustva kliničara ukazuju na to da je za ova tri poremećaja karakteristična tendencija da se javljaju mnogo če&scaron;će u kombinaciji, nego kao zasebni psihopatolo&scaron;ki entiteti.<br />Imajući u vidu čest komorbiditet, a uzimajući u obzir i činjenicu da među autoritetima na području bavljenja problematikom vezanom za poremećaje iz ove grupe ne postoji saglasnost po pitanju međusobnog odnosa ova tri poremećaja (ni u poslednjim izdanjima DSM i ICD klasifikacionih sistema ovi poremećaji ne tretiraju se na isti način), ovim istraživanjem nastojalo se utvrditi u kojoj meri su ADHD, ODD i CD zaista tri jedinstvena i nezavisna složaja pona&scaron;anja, ili se pre mogu tretirati kao jedan op&scaron;tiji psihopatolo&scaron;ki fenomen.<br />Na uzorku od 1471 deteta dve uzrasne kategorije, a prosečnog uzrasta od 9 godina i 4 meseca, primenjene su skale procene prisustva pona&scaron;anja karakterističnih za ADHD, Poremećaj u vidu protivljenja i prkosa i Poremećaj pona&scaron;anja. Skale su popunjavali učitelji dece. Od instrumenata je kori&scaron;ćena i skraćena forma treće revizije Konersove skale koju su popunjavali i učitelji, ali i deca iz starije grupe (sve tri skale kori&scaron;ćene u istraživanju visoke su kriterijumske validnosti). Na osnovu pravila za skorovanje, izdvojena je grupa od 373 dece koja manifestuju bihevioralne indikatore nekog od tri navedena psihopatolo&scaron;ka fenomena ili vi&scaron;e njih istovremeno. Na osnovu analize međusobnih preklapanja ispitivanih entiteta, može se zaključiti da je deficit pažnje, posmatran kao zasebna dimenzija, najmanje komorbidan od svih ispitivanih fenomena. Hiperaktivnost, posmatrana samostalno ili u kombinaciji sa deficitom pažnje, mnogo vi&scaron;e je povezana sa ostalim problemima, nego &scaron;to je to deficit pažnje. Poremećaj pona&scaron;anja i Poremećaj u vidu protivljenja i prkosa gotovo su uvek povezani, ili međusobno ili sa kombinovanim ADHD podtipom, odnosno sa izdvojenom dimenzijom hiperaktivnosti.<br />Rezultati konfirmatorne faktorske analize pokazali su da je model sa najboljim indeksima podesnosti bifaktorski model sa 4 faktora (deficit pažnje, hiperaktivnost, prkosno i suprotstavljajuće pona&scaron;anje i problemi u pona&scaron;anju), &scaron;to bi značilo da četiri izdvojena faktora predstavljaju fenomene koje karakteri&scaron;u pona&scaron;anja specifična za svaki od njih posebno, ali su ta pona&scaron;anja istovremeno i zajednički indikatori jednog generalnog faktora. Hiperaktivnost je u najvećoj meri zajednički fenomen sva tri poremećaja koja su predmet proučavanja u ovom radu, dok je nepažnja u najmanjoj meri zajednička svim poremećajima. U daljem toku statističke obrade podataka, primenjena je analiza latentnih profila. Rezultati ove analize saglasni su sa rezultatima dobijenim na osnovu analize komorbidnih stanja, kao i sa rezultatima konfirmatorne faktorske analize. Deficit pažnje, hiperaktivnost, prkosno i suprotstavljajuće pona&scaron;anje i problemi u pona&scaron;anju predstavljaju bihevioralne dimenzije koje su često povezane, pri čemu je komorbiditet svih navedenih problema zajedno posebno čest, kao i kombinacija hiperaktivnosti i deficita pažnje. Na osnovu svih sprovedenih analiza nameće se zaključak da ADHD, ODD i Poremećaj pona&scaron;anja pre predstavljaju različite dimenzije jednog generalnog psihopatolo&scaron;kog fenomena, nego &scaron;to ih možemo posmatrati kao entitete potpuno nezavisne jedan od drugog.<br />Suprotno postavljenoj hipotezi, uzrast se nije pokazao kao značajan faktor za manifestovanje pona&scaron;anja koja su tipična za Poremećaj u vidu protivljenja i prkosa i Poremećaj pona&scaron;anja. Potvrđena je pretpostavka o tome da deficit pažnje tokom vremena perzistira kod dece i ispoljava se u istoj meri, ali ne i pretpostavka o tome da dolazi do redukcije motornog nemira kako dete biva starije. Deca sa pona&scaron;anjima koja karakteri&scaron;u svaki od tri poremećaja imaju značajno slabije &scaron;kolsko postignuće u odnosu na kontrolnu grupu dece, pri čemu je saznanje o &scaron;kolskom uspehu deteta značajnije povezano sa učiteljskom procenom pona&scaron;anja dece nego sa samoprocenom samih učenika. Gradska sredina pokazala se kao značajan faktor za manifestovanje pona&scaron;anja karakterističnih samo za kombinovani ADHD podtip. Kao varijabla od značaja za ispoljavanje problematičnih pona&scaron;anja, pokazao se obrazovni nivo roditelja, i oca i majke. &Scaron;to su roditelji vi&scaron;eg obrazovnog nivoa, deca u manjoj meri manifestuju pona&scaron;anja koja su tipična za neki od tri poremećaja.<br />Rezultati dobijeni ovim istraživanjem jasno ukazuju na neophodnost posmatranja tri poremećaja iz grupe Deficit pažnje i poremećaji sa nasilničkim pona&scaron;anjem kroz drugačiju prizmu, a ne samo uzimajući u obzir kategorijalni pristup. U daljim istraživanjima problematike deficita pažnje i poremećaja sa nasilničkim pona&scaron;anjem u na&scaron;oj sredini, bilo bi poželjno uzorkom obuhvatiti decu iz vi&scaron;e od dve uzrasne kategorije, kao i decu iz velikih gradova, a svakako da bi uključivanje kliničkog uzorka dece u značajnoj meri doprinelo daljem rasvetljavanju međusobnog odnosa ADHD-a, Poremećaja u vidu protivljenja i prkosa i Poremećaja pona&scaron;anja.</p> / <p>One of the main features for the DSM-IV Attention Deficit and Disruptive Behavior Disorders (Attention Deficit/Hyperactivity Disorder, Conduct Disorder and Oppositional Defiant Disorder) is their mutual comorbidity. Both research and clinical practice showed that ADHD, ODD and CD typically occur in combination and that noncomorbid ODD, ADHD or CD are fairly rare. The overlap between those diagnosis is very well established. Regarding the frequent comorbidity, together with the fact that there is no consensus among authorities in the field (the specific criteria for diagnosing ADHD, ODD or CD vary between the guidelines adopted in the United States &ndash; DSM, and those used in Europe and in other international communities - ICD), one of the aims of this study was to determine whether ADHD, ODD and CD are really three unique and independent behavioral psychopathological entities, or those three can be treated as one more general psychopathological phenomenon.<br />The research was conducted on a convenience sample of N=1471 children (N=760 boys), with an average age of 9 years and 4 months. The presence of characteristics of ADHD, Oppositional Defiant Disorder and Conduct Disorder was measured with three scales &ndash; IVJER, CDRS-IV and ODDRS. These scales have been administrated to teachers. Third revision of the Conners Rating Scale (CRS) was also used in this study &ndash; both teacher report short form and self-report short form. Based on the rules for scoring the rating scales used in this research, a group of 373 children, who exhibit behavioral indicators of one of the three psychopathological phenomena listed above or several of them simultaneously are identified. On the basis of an analysis of the mutual overlapping of the examined entities, it can be concluded that the attention deficit, observed as a separate dimension, is the least comorbid of all the investigated phenomena. Hyperactivity, observed alone or in combination with attention deficit, is much more associate with other problems than attention deficit alone. Conduct Disorder and Oppositional Defiant Disorder are almost always in correlation, either with each other or with a combined ADHD subtype, or with a separate dimension of hyperactivity.<br />The results of the Confirmatory Factor Analysis (CFA) showed that the model with the best goodness-of-fit indices is the bifactor model with 4 factors (attention deficit, hyperactivity, defiant and oppositional behaviors and behavioral problems), which means that four separate factors represent phenomena which are characterized by behaviors specific to each of the factors, but, at the same time, these behaviors are the common indicators of the general factor. Hyperactivity is largely a common characteristic of all three disorders from the group, while attention deficit is at least common to all disorders. The results of the Latent Class Analysis (LCA) are consistent with the results obtained from the analysis of the mutual overlapping of the examined entities, as well as with the CFA results. Attention deficit, hyperactivity, defiant and oppositional behaviors and severe conduct problems are behavioral dimensions which are often in correlation, with the comorbidity of all these problems together being particularly common, along with the combination of hyperactivity and attention deficit. The research findings showed that ADHD, ODD and Conduct Disorder are more likeley to represent the different dimensions of a general psychopathological phenomenon, than being the entities completely independent of each other.<br />In contrast to the hypothesis, age did not prove to be a significant factor in the manifestation of behavior that is typical of Oppositional Defiant Disorder and Conduct Disorder. It is confirmed that attention deficit persists over time in children and is demonstrated to the same extent, but it is not confirmed that there is a reduction in hyperactivity as the child gets older. Children with behaviors that characterize each of the three disorders have significantly lower school achievement than the control group of children, whereby the knowledge about the child&rsquo;s school achievement is significantly more associate with the teacher&#39;s assessment of the child&rsquo;s behavior rather than with the self-evaluation of the students themselves. The urban environment proved to be a significant factor in the manifestation of behavior typical only of the combined ADHD subtype. As a variable of significance for the manifestation of problematic behaviors, the educational level of parents has been demonstrated. It is less likely for children to manifest behaviors that are typical of one of the three disorders, if the parents&rsquo; educational level is higher.<br />The research findings clearly point to the necessity of observing three disorders from the group Attention Deficit and Disruptive Behavior Disorders through a different prism, not just taking into account the categorical approach. The further research in the field of problem behaviors in our community, should include children from more than two age categories, as well as children from large cities. Clinical samples of children will significantly contribute to further clarification of the relation between ADHD, ODD and Conduct Disorder.</p>

Although the rapid growth of the music streaming industry has led to record levels of global music consumption, many leaders in the music streaming industry have not developed a financially sustainable business model for music streaming. This descriptive single case study focused on strategies that some global music streaming service leaders used to generate sustainable profits through their business models. Christensen's theory of disruptive innovation served as the conceptual framework for this study. Semistructured interviews with the chief executive officer and 4 senior managers of a leading music streaming service in southeastern Asia were analyzed to identify themes. Secondary data collected for this research included practitioner reports, government reports, company documentation, and peer-reviewed journal articles. During data analysis, I used method triangulation to generate insights regarding the key themes identified in the literature review. Analysis of the data revealed strategies that global music streaming leaders used to generate profits: (a) optimization of the firm's dynamic capabilities, (b) optimization of the subscription and freemium business models, and (c) a deliberate focus on the niche of local music. The findings of this study could be useful to music streaming service leaders who need to generate sustainable revenues and lack the strategies to do so on their own as well as to music streaming leaders who want their service to implement a disruptive innovation strategy. Additionally, the findings of this study might promote social change by generating awareness of proven strategies leading to sustainable profits for music streaming services and job security for artists who contribute to sustaining or increasing local economies cash flows and taxable incomes.

Recent changes in the Centers for Medicare and Medicaid Services (CMS) reimbursement programs resulted in $1 billion in payments to hospitals based on Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores. Approximately 50% of the 3,000 hospitals currently receiving Medicare supplements may receive increases in reimbursement payments while 50% will receive decreases in payments. This case study explored how one hospital team in North Texas achieved high HCAHPS scores. The primary provider theory, Deming's model of plan-do-study-act (PDSA), and disruptive innovation theory framed the study. The data collection process included administrator interviews (n = 7), hospital document analysis (n = 13), and observations of staff conducting care (n = 8). Through method triangulation, themes emerged on the constructs required to achieve high HCAHPS scores. Themes included caregiver-patient interactions, hospital services, hospital environment, hospital technology, and hospital governance. Although this was a single case study, other healthcare leaders may explore the findings to determine how the information contained within might transfer to other healthcare organizations. Improved patient outcomes resulting from education, communication, and technology in the continuum of care might enhance the patient experience and patients' overall health and wellness.