No / This paper examines previous approaches to the identification and measurement of strategic flexibility and concludes that the use of quantitative methods alone cannot capture the essence of such a complex and intangible subject. It is reasoned that a holistic approach to research design should be adopted when carrying out particular categories of production management research. A research design used to investigate the concept of strategic flexibility in manufacturing industry is briefly outlined as an illustration. The role of the case study within this and the contribution it was able to make to the investigation is described.

Background: Preliminary evidence suggests there are differences in how older people and younger people with posttraumatic stress disorder (PTSD) present. However, currently little robust evidence exists relating to the presentation, assessment and intervention of PTSD in a rapidly ageing population. Faced with limited and conflicting evidence, clinical psychologists are reliant on their clinical expertise to make decisions in this context. Method: Eight studies reporting current prevalence of PTSD in older people were systematically reviewed. Semi-structured interviews with eight clinical psychologists with experience of assessment and intervention of post-traumatic stress symptomology in older people were analysed according to grounded theory methods. The analysis abstracted categories of data to construct a substantive theory of clinical decision making in this context. Results: Current and 12 month prevalence of PTSD ranged from 0.7% to 4.0% and 0.2% to 0.4% respectively. Partial PTSD was estimated at 1% to 10%. The quality of evidence limits the generalisability of the results. ‘Balancing complexity, resources and demand’ emerged from participants’ accounts as the core theoretical category, underpinning decision making in this context. Seven sub-categories comprise the model, ‘culture’; ‘NHS’; ‘clinician competencies’; “what the client brings”; ‘reconciling understanding’; ‘tailoring’ and ‘therapeutic relationship’. Conclusions: PTSD appears to be relatively rare among older people but more research is required to better understand the presentation and prevalence of full and partial PTSD. The theoretical model is broadly consistent with extant literature pertaining to the adaptation of psychological therapy for older people, offering further detail on implementation and the influence of treatment non-specific factors.

Bakgrund: Självskadebeteende är skador mot den egna kroppen genom att skära, rispa eller bränna sig utan avsikt att ta sitt liv. Det framkommer att personal känner bristande förståelse och frustration för patienter med självskadeproblem och att de inte vet hur man ska ta hand om dem. Syfte: Att beskriva hur sjuksköterskor inom psykiatrisk heldygnsvård upplever att vårda patienter med självskadebeteende. Metod: En kvalitativ metod användes och datainsamling skedde via intervjuer med sjuksköterskor inom den psykiatriska heldygnsvården (n=14). Materialet transkriberades och analyserades med innehållsanalys. Resultat: Analysen resulterade i ett tema, tre kategorier och sex underkategorier. Temat blev ”Vad göra”, de tre kategorierna blev ”En patientgrupp i nöd”, ”En patientgrupp som berör” och ”En behövande profession”. De sex underkategorierna blev ”Dåtidens brister”, ”I stridens hetta”, ”Mig som sjuksköterska”, ”Oss i personalgruppen”, ”I behov av stöd och vägledning” och ”I kunskapstörst”. Konklusion: Patienter med självskadebeteende berör den enskilda sjuksköterskan men också personalgruppen. Upplevelser vittnar om en patientgrupp i nödliknande situation både förr och idag. Förhoppningen är att med stöd, ökad kunskap och vägledning till verksamma sjuksköterskor förändra upplevelserna av att vårda patienter med självskadebeteende / Background: Self-harm is damage to the own body and includes cut, scratch or burn without intending to take one´s own life. It appears that staff feel lack of understanding and frustration for patients who self- harms and that they don´t know how to care for them. Aim: To describe nurses experiences of caring for patients who self- harm in psychiatric inpatient care. Methods: A qualitative approach was used and data collection was done through interviews with nurses in psychiatric inpatient care (n = 14). The interviews were transcribed and analyzed by content analysis. Results: The analysis resulted in one theme, three categories and six subcategories. The theme was "What to do", the three categories were "A population in need", "A population who affect" and "A profession in need". The six subcategories were "The inadequacies of yesterday”, "In the heat of battle," "Me as a nurse," "us in the personnel”, " "In need of support and guidance," and "In thirst for knowledge". Conclusion: Patients who self- harm affects the individual nurse but also the staff group. Experiences indicate a patient population with a situation in needs, both past and present. It is hoped that with the support, increased knowledge and guidance to the active nurses changing experiences of caring for patients with self-injurious behavior.

Cultural competency is theorized as the sensitivity of practitioners from the dominant culture towards the diverse cultural backgrounds of their patients. Less attention is placed on how communication between providers and patients can enable patients to share their health care beliefs. An evidence review of the literature around the conceptualization of cultural competency in health care was performed, and interviews were conducted aiming to understand what immigrant patients perceive as culturally competent care and its effect on the relationship between them and their providers. Definitions of cultural competence varied, and no conclusive studies linking cultural competence to improved health outcomes were found. Findings from the participant interviews helped to address gaps in the literature by confirming a preference for a patient-centred approach to culturally competent care, in addition to identifying pre-existing expectations for the health care encounter and patient-dependent factors as additional elements influencing the physician-patient relationship.

Induktiv intervjustudie med syfte att beskriva vilka erfarenheter sjuksköterskor verksamma inom somatisk vård har av att vårda personer med psykossjukdom. Resultatet visar att sjuksköterskor inom den somatiska vården har relativt mycket erfarenhet av att vårda personer med psykossjukdom. Den specifika psykiatriska kompetensen uppfattades otilräcklig och vårdandet innebar ofta känslosamma möten.

Research has shown that socially-focused partnerships that cross sectors (referred to as social partnerships within) are necessary in order to effectively address pressing societal issues such as poverty. Yet, in these complex organizational contexts, there is often variability within and between involved organizations as it relates to basic assumptions around work and the meanings given to practices at macro, meso and micro levels of analysis. Put differently, there are often a plurality of meaning systems at play in such multi-faceted organizational arrangements. Accordingly, the purpose of this dissertation was to understand to what extent multiple meaning systems exist in social partnerships focused on addressing multi-faceted societal challenges and, whether and how such differences in meaning systems are strategically negotiated over time. At a deeper theoretical level, this research was focused on illuminating the processes by which meaning systems are negotiated when organizational boundaries are blurred and when a plurality of meaning systems are at play, with a central focus on players that act as boundary spanners within these complex organizational contexts. To understand the complexities at play in social partnerships emanating from multiple meaning systems, I conducted a multi-site ethnographic study, involving in-depth interviews and participant observation, of the Greater Victoria Coalition to End Homelessness Society (Coalition) located in Victoria, British Columbia. In doing so, I utilized the principal literature streams that address multiple meaning systems at work: the culture literature in organization studies and the institutional logics perspective. As well, I incorporated other literatures based upon the emergent findings, namely organizational identity. Through this work I make a number of contributions within the area of sustainability, particularly the social partnership literature, as well as organizational theory. Empirically, I develop a process model that elucidates how players negotiate multiple meanings of organizational identity over time in a social partnership setting characterized by permeable boundaries and shared authority, at the group level of analysis. This is significant as we know little about how identity plays out in such multi-faceted organizational settings with continual blurred boundaries even as research has indicated that such arrangements are likely to surface identity issues among players (Maguire & Hardy, 2005). I also elucidate how individual players bridge across multiple meaning systems in a social partnership over time, answering the call for more research concerning the role of individuals and their interactions with organizations in the collaboration process over time (Manning & Roessler, 2014). To my knowledge, this work is one of the first of its kind to empirically explore tri-sector socially focused collaborations – involving players from the public, private and nonprofit sectors – that are more integrative and interconnected in nature (Austin & Seitanidi, 2012a) and that employs a process based perspective to understand how such collaborations unfold over time. In addition, I theoretically develop the link between institutional logics and organizational culture that emerged empirically via this study to guide future integrative work to holistically account for the multiplicity of meaning systems at work within and between such multi-faceted arrangements. / Graduate / 2020-04-01

Thesis advisor: Paul Gray / Thesis advisor: Paul Schervish / The current economic crisis resembles a type of "critical situation" wherein everyday assumptions and routines sustaining hegemonic ideologies and their corresponding forms of social power are prone to be disrupted (Giddens 1987). Such situations provide opportunities for the relative strength of such hegemonies, and how they are effectively restored and/or challenged, to be uncovered. In undertaking this study I sought to discover the social and economic implications and lessons MBA students associate with the current economic crisis and how they frame and rationalize such perceptions. In so doing, I further aimed to uncover specific ideological processes they perform in preserving and/or challenging conventional tenets of liberal capitalism. I reexamine the sociological concept of ideology in reference to the empirical data, and test the capacity of Giddens' (1979, 1984) and Mannheim's (1949) combined methodologies in uncovering interconnections of consciousness, ideology and agency. I conducted semi-structured interviews with 23 MBA students from five universities in Boston, and used a combination of grounded theory and theory testing to analyze the data. Findings reveal not only the specific content comprising hegemonic notions of what constitutes economic and social reality among respondents, but also reflect how ideology functions as a holistic process of social and self understanding and how it reproduces, and is reproduced by, the performance of agencies within particular corporate and educational structures. I argue that the tenets espoused and enacted by many respondents reveal a stark challenge to future social change. Even amid the current crisis -the largest since the Great Depression -most respondents acknowledge that this event had little impact on how they view their professional vocations or the macro economic system. This finding not only speak strongly to the rigidity of conventional tenets underscoring our liberal capitalist culture, but also implies the urgent need to reconsider how our educational institutions should play a greater role in challenging conventional notions of reality espoused so fervently by burgeoning business professionals. I further argue that critical, systematic evaluations of consciousness and ideology should take a more substantial role in the social sciences in determining the restraints and possibilities for social change. / Thesis (MA) — Boston College, 2010. / Submitted to: Boston College. Graduate School of Arts and Sciences. / Discipline: Sociology.

Thesis advisor: Michael G. Pratt / The psychology of ownership literature suggests that creation is one of the most powerful processes through which people may come to feel a sense of possession over ideas. Yet, because the task of making a new product is often too large for one individual, ideas are often transferred between, as well as discussed and shaped by, many different people across a range of departments during creative work. Thus, in organizations, shifts in responsibility over ideas are inevitable and the ability for ideas to be shaped by multiple people and successfully move from person to person is critical for organizations. However, we know relatively little about how people, particularly creative workers, respond to changes in responsibility over their ideas. To understand this phenomenon, I conducted an inductive, qualitative study of two teams at a video game design studio, using interviews, weekly diaries, and observations as my data sources. Through grounded theory analysis, I developed theory around how creative workers experience psychological ownership and how this experience is impacted when ideas are handed off between creative workers. Specifically, I describe task characteristics and individuals differences that impact ownership scope (exclusive or shared ownership) and strength. I also delimit outcomes associated with adopting a particular ownership scope for individual creative workers and the collective product. Then, I describe the key psychological conditions that impact how handoffs occur by describing 4 handoff scenarios and the ownership outcomes for both creative workers involved in each scenario. Together these scenarios demonstrate how ownership can be formed, maintained, and changed through social interactions via handoffs. I build on these findings to develop a relational model of ownership which highlights how psychological ownership impacts and is impacted by social interactions and interpersonal relationships. Practically, this research provides insights on how creative workers can experience and manage ownership over ideas in ways that facilitates engagement in creative work, as well as an organization's ability to benefit from the results of creative workers' labor. / Thesis (PhD) — Boston College, 2013. / Submitted to: Boston College. Carroll School of Management. / Discipline: Management and Organization.

A Região Amazônica é considerada área de alta endemicidade para hepatite B. No Estado do Acre e na capital Rio Branco caracteriza-se um quadro em que jovens e adultos jovens, em pleno período reprodutivo e produtivo para o trabalho e para o estudo, constituem população gravemente acometida pela doença. Assim, procurouse neste estudo a compreensão do modo de vida de pessoas portadoras do HBV, de ambos os sexos, entre 15 e 30 anos, para contribuir no enfrentamento da complexidade desse quadro, através de ações de saúde mais condizentes com as necessidades desses sujeitos. Os métodos qualitativos se mostraram mais apropriados, pois possibilitam a compreensão dos acontecimentos e da forma como os sujeitos vivenciam as experiências. Reconheceu-se no cotidiano, históricooriginal- significativo, uma oportunidade de se descobrir novos caminhos de entendimento para a realidade. Buscou-se os participantes a partir do Serviço de Assistência Especializada, valendo-se de instrumentos de pesquisa exclusivos, utilizados para obtenção de informações socioeconômicas e para nortear as entrevistas com os sujeitos. Foram realizadas doze entrevistas, duas das quais com familiares. Os depoimentos prestados, juntamente com as anotações de campo e os apontamentos da observação participante, além das informações colhidas pelos questionários iniciais, constituíram os registros analisados. A análise do material possibilitou as seguintes categorias: descoberta da doença, contemplando as situações que precipitaram o diagnóstico nos casos assintomáticos e sintomáticos, além das principais informações acerca da enfermidade; doença no cotidiano, abrangendo as percepções quanto aos efeitos adversos do tratamento, as restrições procedentes da doença e/ou do tratamento farmacológico e os cuidados profiláticos; modo de vida, apresentando as estratégias de enfrentamento à doença, modalidades através das quais os sujeitos confrontam-se com as implicações da hepatite B, quais sejam, a religiosidade, o apoio espiritual e familiar, e o planejamento para o futuro, além das relações afetivas no cotidiano, e por último, a categoria preconceito e estigma, realidade ainda presente no contexto de doenças infecciosas. Assinalam-se assim, as compreensões do modo de vida, a partir do cotidiano, de pessoas que vivem com o vírus B, para colaborar no maior entendimento de suas necessidades de saúde, podendo subsidiar estratégias de assistência mais equânimes, vislumbrando a atenção integral desses sujeitos / The Amazon region is considered an area of high endemicity for hep B. In the State of Acre, and in the city of Rio Branco, the reality of teens and young adults, on the heights of their reproductive and work/study productive period, constituting a population severely affected by the disease, is characteristic. Therefore, it\'s been aimed in this study, the comprehension of the way of life of the HBV affected people, both sexes, between 15 and 30 years, to contribute on the understanding of the complexity of this situation., through health actions more appropriate to the needs of these individuals. The qualitative methods were shown more suitable, because they allow the understanding of the events and the way those individuals lived their experiences. It\'s been recognized on the routine, \"historical-original-meaningful\", an opportunity of discovering new paths of understanding for reality. The participants were found on the Specialized Assistance Service, by the use of exclusive research tools, handled for obtaining socioeconomic informations and guiding the interviews with the individuals. Eleven interviews were made, two of them with relatives. The testimonies given, along with the field notes and the pointers of the participant observation, as well as the information gathered by the initial questionnaires, constituted the analyzed records. The material analysis permitted the following categories: disease discovery, covering the situations that hastened the diagnosis on the asymptomatic and symptomatic cases, as well as the main information about the disorder; everyday disease, covering the perceptions around the adverse effects of the treatment, the restrictions derived of the disease and/or farmacologic treatment and the prophylactic care; way of life, presenting the strategies of coping the disease, arrangements which the individuals confront with the implications of Hep B, whichever they are, religiosity, familiar and spiritual support, and planning for the future, as well as the affective relations on routine, and at last, the discrimination and stigma, reality still present on the context of infectious diseases. So, the comprehension of the way of life of people who live with the B virus, based on the routine, is pointed out to colaborate on the greater understanding of their health needs, enabling the allowance of fairer assistance strategies, glimpsing the full attention of these individuals

PURPOSE: To understand why adolescents who initiate the HPV vaccine series fail to complete all three shots. METHODS: Semi-structured interviews were performed with parents/guardians of 11-17 year old daughters and pediatric primary care providers in one inner-city public clinic and three private practices to determine why girls who received at least one dose of the HPV vaccine did or did not complete the series. The number of shots received was confirmed by electronic medical record review. Content analysis was used to identify themes related to series completion. RESULTS: 65 parents/guardians participated: 37 whose daughters received 1 or 2 doses of HPV vaccine and 28 whose daughters completed 3 doses. Most (n=24, 65%) parents/guardians failed to complete the series because they thought the clinics would remind them of subsequent doses. 9 (24%) cited logistical barriers. 4 (11%) decided to stop the vaccine series. 33 providers participated: 24 physicians, 3 nurse practitioners, and 6 registered nurses. 52% of providers told parents to schedule appointments, 41% scheduled the second dose at the time the first dose was given, and 7% tried to immunize patients when they returned for other appointments; providers confirmed that few parents chose to stop the series. No practice had a system in place to ensure series completion. CONCLUSIONS: Most failure to complete the HPV vaccine series occurred because providers expected parents to make appointments while parents expected to be reminded. Increased use of reminder/recall systems and clear communication of expectations regarding appointment scheduling could improve completion rates.