The purpose of this study was to explore the relationship between the formalization of inter-organizational partnerships and collaboration among staff members working together across primary care, mental health and addition organizations to provide services to adults with complex mental health and addiction needs. Phase I of the study provided an environmental scan of existing partnerships among Family Health Teams (FHTs) and Community Health Centres (CHCs), and the Mental Health and/or Addiction (MHA) organizations they partner with, in the province of Ontario (Canada). Phase II explored the relationship between formalization and a) administrative collaboration and b) and service delivery collaboration. The hypotheses proposed that staff members who are part of formalized partnerships would report higher levels of collaboration. Phase III explored how formal and informal partnerships and collaboration are experienced by the administrative and service provider staff members who work across FHTs, CHCs and MHAs organizations. Using a mixed methods approach, data were collected using electronic surveys and telephone interviews. The results of Phase I indicated that FHTs and CHCs in Ontario have between 1-3 partnerships with MHA organizations. Most are informal partnerships, have existed for less than 5 years, and most staff members (partners) interact on a monthly basis. The quantitative results of Phase II showed no significant relationship between formalization and either form of collaboration. The qualitative findings from Phase III provide two key contributions. First, the results of the interviews may help explain why collaboration was not higher in formalized partnerships, as demonstrated by the range of advantages and disadvantages experienced by administrators and service providers in both formal and informal partnerships. Second, the findings illuminate factors related to the process of creating and/or formalizing partnerships, suggesting that there may be other factors that mediate or have a direct impact on the relationship between formalization and collaboration. By bringing together the study findings, the study addresses a gap in the literature by proposing a pathway through which formalization may be associated with collaboration. The results of the study provide opportunities for future research to help improve the quality and accessibility of services to adults with complex mental health and addiction needs.

In Canada and internationally, policy makers are moving towards more comprehensive and integrated service delivery models for early learning that include parent involvement and support as integral to their design. The current study was part of an ongoing evaluation of the Best Start project in Peel Region, a municipality in the Greater Toronto Area (GTA). Best Start aims to integrate preschool, junior/senior kindergarten, child care, public health and parenting programs into a seamless, easily accessible early child development system. This study examined whether parents with kindergarten children enrolled in Best Start schools, where kindergarten and child care were co-located and service integration was underway, would report lower levels of parenting daily hassles compared to parents of children in demographically similar schools where there was no service integration. Parental perceptions about hassles specific to child care and early learning settings were measured using the Early Childhood-Parenting Daily Hassles Scale (EC-PDH) (Arimura, 2008). Three areas of parenting stress that could potentially be reduced through service integration were explored: (1) seamless day – seamless access to care, education and family support; (2) connectedness – parents feeling involved and connected to their child’s school; and (3) parenting capacity – parents feeling confident in their parenting role. The study also combined hassles scores from Best Start and comparison schools to examine all parents’ involvement in the early learning and care system and the hassles they may or may not face on a daily basis as a function of parent demographics and program usage. Parents from 369 families in 10 schools were included in this study. Although Best Start parents did not report lower levels of parenting daily hassles compared to comparison parents, qualitative analyses at Best Start sites where parents used child care suggested that parents were feeling supported and they were forging positive relationships with staff. The positive relationships reported among parents and ECEs or other staff were not as frequent between parents and kindergarten teachers. Combined data indicated that all parents seemed to be experiencing the greatest hassles in the parenting capacity domain. Results are discussed in terms of policy implications for parent involvement in integrated full-day early learning programs such as full-day kindergarten.

In Canada and internationally, policy makers are moving towards more comprehensive and integrated service delivery models for early learning that include parent involvement and support as integral to their design. The current study was part of an ongoing evaluation of the Best Start project in Peel Region, a municipality in the Greater Toronto Area (GTA). Best Start aims to integrate preschool, junior/senior kindergarten, child care, public health and parenting programs into a seamless, easily accessible early child development system. This study examined whether parents with kindergarten children enrolled in Best Start schools, where kindergarten and child care were co-located and service integration was underway, would report lower levels of parenting daily hassles compared to parents of children in demographically similar schools where there was no service integration. Parental perceptions about hassles specific to child care and early learning settings were measured using the Early Childhood-Parenting Daily Hassles Scale (EC-PDH) (Arimura, 2008). Three areas of parenting stress that could potentially be reduced through service integration were explored: (1) seamless day – seamless access to care, education and family support; (2) connectedness – parents feeling involved and connected to their child’s school; and (3) parenting capacity – parents feeling confident in their parenting role. The study also combined hassles scores from Best Start and comparison schools to examine all parents’ involvement in the early learning and care system and the hassles they may or may not face on a daily basis as a function of parent demographics and program usage. Parents from 369 families in 10 schools were included in this study. Although Best Start parents did not report lower levels of parenting daily hassles compared to comparison parents, qualitative analyses at Best Start sites where parents used child care suggested that parents were feeling supported and they were forging positive relationships with staff. The positive relationships reported among parents and ECEs or other staff were not as frequent between parents and kindergarten teachers. Combined data indicated that all parents seemed to be experiencing the greatest hassles in the parenting capacity domain. Results are discussed in terms of policy implications for parent involvement in integrated full-day early learning programs such as full-day kindergarten.

The purpose of this study was to explore the relationship between the formalization of inter-organizational partnerships and collaboration among staff members working together across primary care, mental health and addition organizations to provide services to adults with complex mental health and addiction needs. Phase I of the study provided an environmental scan of existing partnerships among Family Health Teams (FHTs) and Community Health Centres (CHCs), and the Mental Health and/or Addiction (MHA) organizations they partner with, in the province of Ontario (Canada). Phase II explored the relationship between formalization and a) administrative collaboration and b) and service delivery collaboration. The hypotheses proposed that staff members who are part of formalized partnerships would report higher levels of collaboration. Phase III explored how formal and informal partnerships and collaboration are experienced by the administrative and service provider staff members who work across FHTs, CHCs and MHAs organizations. Using a mixed methods approach, data were collected using electronic surveys and telephone interviews. The results of Phase I indicated that FHTs and CHCs in Ontario have between 1-3 partnerships with MHA organizations. Most are informal partnerships, have existed for less than 5 years, and most staff members (partners) interact on a monthly basis. The quantitative results of Phase II showed no significant relationship between formalization and either form of collaboration. The qualitative findings from Phase III provide two key contributions. First, the results of the interviews may help explain why collaboration was not higher in formalized partnerships, as demonstrated by the range of advantages and disadvantages experienced by administrators and service providers in both formal and informal partnerships. Second, the findings illuminate factors related to the process of creating and/or formalizing partnerships, suggesting that there may be other factors that mediate or have a direct impact on the relationship between formalization and collaboration. By bringing together the study findings, the study addresses a gap in the literature by proposing a pathway through which formalization may be associated with collaboration. The results of the study provide opportunities for future research to help improve the quality and accessibility of services to adults with complex mental health and addiction needs.

This qualitative study investigates the evolving role of Divisions of General Practice (Divisions) in linking general practitioners (GPs) and general practice with the wider health sector in Australia. The work draws on boundary role theory within organisations, integration theories, empirical research on service integration involving general practice, and structural interests theory to develop the conceptual framework on which the research was based. The data for the research came from both documentary and interview sources that gave voice to Divisions in the state of Victoria, Australia. The documents used represented the core working documents of Divisions, and the semi-structured interviews involved 30 key informants, these being leaders in all Victorian Divisions.

Esta dissertação propõe a elaboração de uma análise das consequências da combinação de produtos e serviços na gestão do processo de desenvolvimento de produtos. Atualmente, pode-se constatar que as empresas de manufatura têm aumentado o valor estratégico dos serviços em seus portfólios. Contudo, os serviços são desenvolvidos com processos empíricos ou, quando planejados junto ao processo de desenvolvimento de produtos, em geral, são pensados somente em suas fases finais. Embora possa se constatar que existe forte relação de interdependência entre os serviços e os produtos. Assim, a integração da gestão do processo de desenvolvimento de serviços ao processo de desenvolvimento de produtos é um desafio para as empresas. Com base em revisões de literatura e estudos de caso, foram desenvolvidos neste trabalho duas ferramentas e um framework para auxiliar as empresas na gestão integrada produto-serviço. O Sistema de Avaliação do Valor Estratégico (SAVE) mensura o valor estratégico dos itens do portfólio e a Matriz de Configuração Produto-Serviço (MCPS) revela as interdependências do portfólio e as características gerais do processo de desenvolvimento das empresas. Finalmente, o framework resultante orienta os gestores na operacionalização da gestão do Processo de Desenvolvimento Produto-Serviço (PDPS). / This dissertation proposes an analysis of the product-services integration consequences in the products development process management. As a result, the strategic value of services in manufacturing companies‘ portfolio was found in an increasing tendency. However, services are normally developed using empirical methods or planned exclusively in the final stages when designed within the product development process, even if there is a strong interdependence between the service and the product. Thus, the managerial integration of service and product development processes is a challenge for companies. Based on literature review and case studies, two tools and a framework are presented in order to help companies overcome this difficulty. The System for Evaluation of Strategic Value (SESV) measures the strategic value of the portfolio items and the Product-Service Configuration Matrix (PSCM) reveals the interdependencies of the portfolio and the general profile of company‘s development processes. This contribution is intended to guide the management of Product-Service Development Process (PSDP).

O objetivo do estudo foianalisar os processos de ensino-aprendizagem e o desenvolvimento de competências para o trabalho em serviços especializados odontológicos do Estágio Curricular Supervisionado II da Faculdade de Odontologia da UFRGS. Trata-se de um estudo de caso do tipo único e holístico que integrou análises quantitativas e qualitativas. Participaram da pesquisa 246 estagiários de um total de 329que realizaram o estágio entre os anos de 2013 a 2016. Os dados do estudo foram produzidos através de um questionário respondido de forma online e anônima. Foram disponibilizadas 26 perguntas fechadas (respostas numa escala do tipo likert em 6 escores) articuladas a possibilidades de respostas abertas. Compõem o questionário cinco blocos temáticos e organizados em duas grandes categorias de análise: Avaliação estrutural e pedagógica da experiência do estágio(identificação sóciodemográfica, campos de estágio, atividade de educação a distância e dinâmicas pedagógicas) e do Desenvolvimento de competências profissionais (desenvolvimento de ingredientes do agir em competência - protocolos, inserção na realidade, motivação para o trabalho, valores técnicos e trabalho em equipe). As respostas quantitativas foram exportadas para o Programa Statistical Package for the Social Sciences – SPSS para Windows, versão 16.0 e submetidos à análise descritiva. Para a análise das variáveis quantitativas na comparação entre as categorias nos diferentes semestres foi utilizado o teste qui-quadrado e quando necessário o test Z para comparação de proporções com ajuste de Bonferroni. Para a análise de comparação entre as médias foi utilizado o teste de análise de variância (ANOVA).Os dados qualitativos foram analisados buscando encontrar não apenas o conteúdo textual, mas seu sentido histórico e social. Os resultados demonstram que a experiência de estágio analisada está proporcionando aprendizagens significativas sobre o funcionamento da rede de atenção especializada em saúde bucal e o agir em competência de futuros cirurgiões-dentistas. Oportuniza o debate de valores e normas e o exercício de readaptações dos protocolos. Nas dinâmicas do estágio ocorrem oportunidades de estabelecimento de relações entre teoria e prática no cotidiano profissional dos serviços. A motivação para o trabalho foi um dos itens bem avaliado do agir em competência, enquanto que o trabalho em equipe apresentou respostas nos escores mais baixos da escala likert. Os estágios no campo de gestão e as atividades de educação à distância tiveram maior número de opiniões insatisfatórias devido ao seu caráter pedagógico inovador. / The objective of this study was to analyze the teaching-learning processes and the development of competencies for specialized dental services work of the Supervised Curricular Stage II of the School of Dentistry of UFRGS. It is an unique and holistic case study that integrated quantitative and qualitative analyzes. Two-hundred and forty six interns participated in the survey from a total of 329 who completed the internship between 2013 and 2016. The data used in the analyzes was captured through an anonymous online questionnaire. Twenty-six closed-ended questions (responses on a 6-point likert-type scale) were made available with the possibility of also being filled as open-ended answers. The questionnaire consists of five thematic blocks and organized into two broad categories of analysis: Structural and pedagogical evaluation of the internship experience (sociodemographic identification, area of study, distance learning activity and pedagogical dynamics) and the development of professional skills of acting in competence(protocols, hands-on experience, work-related motivation, technical values and teamwork). The quantitative responses were exported to the Statistical Package for the Social Sciences - SPSS for Windows, version 16.0 and subjected to descriptive analysis. For the analysis of the quantitative variables in the comparison between the categories in the different semesters the chi-square test was used and, when needed, the Z test to compare proportions with Bonferroni adjustment was used. The analysis of variance (ANOVA) was used to compare means. The qualitative data were analyzed to evaluate not only the textual content, but its historical and social sense. The results demonstrate that internship experience is providing significant learning about the functioning of the network of specialized attention in oral health and of acting in competence of future surgeons-dentists. It encourages the debate of values, norms and readaptations of the protocols. In the amplitude of the questions about the dynamics of the stage can be affirmed that it occurs mainly by the opportunities of establishing relationships between theory and practice in the work routine. Work-related motivation was one of the most well rated items of acting in competence, while teamworkpresented responses at the lowest scores on the likert scale. Internships in the field of management and distance education activities had the highest number of unsatisfactory opinionsdue to their innovative pedagogical character.

Les systèmes logiciels s'orientent vers des environnements de plus en plus hétérogènes et dynamiques. Cette évolution est induite par différents facteurs : explosion des dispositifs embarqués avec de fortes capacités de calcul, adoption rapide des services distants fournis par des tiers, mobilité des usagers et évolution du contexte associé, etc. Ces facteurs ouvrent de grandes possibilités pour la construction de nouveaux services numériques dans des domaines aussi divers que la santé, le divertissement, la domotique, ou encore le transport. Ces nouveaux domaines d'applications demandent la mise en œuvre des opérations d'intégration dans des contextes dynamiques et hétérogènes. Il est aujourd'hui admis que les approches à services facilitent l'intégration logicielle par la définition de protocoles standard de découverte et de liaison. La problématique d'intégration, au sens médiation, reste néanmoins entière. Le problème principal abordé par cette thèse est l'intégration de services dans des contextes hétérogènes et dynamiques. Plus précisément, nous avons conçu un modèle à composant spécifique à l'intégration logicielle, nommé CILIA. Ce modèle repose sur des composants, appelés médiateurs, et sur un langage d'assemblage de ces médiateurs. CILIA reprend les grands principes du Génie Logiciel tels que l'abstraction, la séparation de préoccupations et la modularité, et s'appuie sur des patrons d'intégration bien connus (Enterprise Integration Patterns). CILIA est implanté sous la forme d'un framework dynamique qui permet la mise à jour à l'exécution des solutions d'intégration. Ce framework CILIA est pleinement opérationnel et disponible en open source. Il est utilisé dans plusieurs projets collaboratifs. / Software systems are moving toward highly dynamic and heterogeneous environments. This dynamism is derived by several factors: the massive arrival of embedded devices with computing capabilities, the rapid adoption of newer distributed services provided by third parties, the user mobility and the constantly changing context, etc. These factors open up great opportunities for the construction of new and innovative services on several application domains, such as health-care systems, entertainment systems, home automation systems, transportation or traceability systems. These new application areas require the implementation of integration operations in dynamic and heterogeneous environments. It is well known that service-oriented computing eases the implementation of integrating systems by defining standard protocols to perform the discovery and the binding. However, some interoperability concerns, such as mediating, have been still unresolved. In this work we address the integration concern of service integration in dynamic and highly evolving environments. Specifically, we have developed an integration-specific component model called CILIA. This model is based on components, called mediators, and its assembly language. CILIA respects software engineering principles such as abstraction, separation of concerns, modularity, and anticipation of change and also it is influenced by the well-known enterprise integration patterns (EIP). CILIA has been developed as a dynamic framework that allows us to perform dynamic modifications at run-time on the integrated solutions. This framework is entirely developed and operational. It is available as an open source project and has been used by several collaborative projects.

O objetivo do estudo foianalisar os processos de ensino-aprendizagem e o desenvolvimento de competências para o trabalho em serviços especializados odontológicos do Estágio Curricular Supervisionado II da Faculdade de Odontologia da UFRGS. Trata-se de um estudo de caso do tipo único e holístico que integrou análises quantitativas e qualitativas. Participaram da pesquisa 246 estagiários de um total de 329que realizaram o estágio entre os anos de 2013 a 2016. Os dados do estudo foram produzidos através de um questionário respondido de forma online e anônima. Foram disponibilizadas 26 perguntas fechadas (respostas numa escala do tipo likert em 6 escores) articuladas a possibilidades de respostas abertas. Compõem o questionário cinco blocos temáticos e organizados em duas grandes categorias de análise: Avaliação estrutural e pedagógica da experiência do estágio(identificação sóciodemográfica, campos de estágio, atividade de educação a distância e dinâmicas pedagógicas) e do Desenvolvimento de competências profissionais (desenvolvimento de ingredientes do agir em competência - protocolos, inserção na realidade, motivação para o trabalho, valores técnicos e trabalho em equipe). As respostas quantitativas foram exportadas para o Programa Statistical Package for the Social Sciences – SPSS para Windows, versão 16.0 e submetidos à análise descritiva. Para a análise das variáveis quantitativas na comparação entre as categorias nos diferentes semestres foi utilizado o teste qui-quadrado e quando necessário o test Z para comparação de proporções com ajuste de Bonferroni. Para a análise de comparação entre as médias foi utilizado o teste de análise de variância (ANOVA).Os dados qualitativos foram analisados buscando encontrar não apenas o conteúdo textual, mas seu sentido histórico e social. Os resultados demonstram que a experiência de estágio analisada está proporcionando aprendizagens significativas sobre o funcionamento da rede de atenção especializada em saúde bucal e o agir em competência de futuros cirurgiões-dentistas. Oportuniza o debate de valores e normas e o exercício de readaptações dos protocolos. Nas dinâmicas do estágio ocorrem oportunidades de estabelecimento de relações entre teoria e prática no cotidiano profissional dos serviços. A motivação para o trabalho foi um dos itens bem avaliado do agir em competência, enquanto que o trabalho em equipe apresentou respostas nos escores mais baixos da escala likert. Os estágios no campo de gestão e as atividades de educação à distância tiveram maior número de opiniões insatisfatórias devido ao seu caráter pedagógico inovador. / The objective of this study was to analyze the teaching-learning processes and the development of competencies for specialized dental services work of the Supervised Curricular Stage II of the School of Dentistry of UFRGS. It is an unique and holistic case study that integrated quantitative and qualitative analyzes. Two-hundred and forty six interns participated in the survey from a total of 329 who completed the internship between 2013 and 2016. The data used in the analyzes was captured through an anonymous online questionnaire. Twenty-six closed-ended questions (responses on a 6-point likert-type scale) were made available with the possibility of also being filled as open-ended answers. The questionnaire consists of five thematic blocks and organized into two broad categories of analysis: Structural and pedagogical evaluation of the internship experience (sociodemographic identification, area of study, distance learning activity and pedagogical dynamics) and the development of professional skills of acting in competence(protocols, hands-on experience, work-related motivation, technical values and teamwork). The quantitative responses were exported to the Statistical Package for the Social Sciences - SPSS for Windows, version 16.0 and subjected to descriptive analysis. For the analysis of the quantitative variables in the comparison between the categories in the different semesters the chi-square test was used and, when needed, the Z test to compare proportions with Bonferroni adjustment was used. The analysis of variance (ANOVA) was used to compare means. The qualitative data were analyzed to evaluate not only the textual content, but its historical and social sense. The results demonstrate that internship experience is providing significant learning about the functioning of the network of specialized attention in oral health and of acting in competence of future surgeons-dentists. It encourages the debate of values, norms and readaptations of the protocols. In the amplitude of the questions about the dynamics of the stage can be affirmed that it occurs mainly by the opportunities of establishing relationships between theory and practice in the work routine. Work-related motivation was one of the most well rated items of acting in competence, while teamworkpresented responses at the lowest scores on the likert scale. Internships in the field of management and distance education activities had the highest number of unsatisfactory opinionsdue to their innovative pedagogical character.

Esta dissertação propõe a elaboração de uma análise das consequências da combinação de produtos e serviços na gestão do processo de desenvolvimento de produtos. Atualmente, pode-se constatar que as empresas de manufatura têm aumentado o valor estratégico dos serviços em seus portfólios. Contudo, os serviços são desenvolvidos com processos empíricos ou, quando planejados junto ao processo de desenvolvimento de produtos, em geral, são pensados somente em suas fases finais. Embora possa se constatar que existe forte relação de interdependência entre os serviços e os produtos. Assim, a integração da gestão do processo de desenvolvimento de serviços ao processo de desenvolvimento de produtos é um desafio para as empresas. Com base em revisões de literatura e estudos de caso, foram desenvolvidos neste trabalho duas ferramentas e um framework para auxiliar as empresas na gestão integrada produto-serviço. O Sistema de Avaliação do Valor Estratégico (SAVE) mensura o valor estratégico dos itens do portfólio e a Matriz de Configuração Produto-Serviço (MCPS) revela as interdependências do portfólio e as características gerais do processo de desenvolvimento das empresas. Finalmente, o framework resultante orienta os gestores na operacionalização da gestão do Processo de Desenvolvimento Produto-Serviço (PDPS). / This dissertation proposes an analysis of the product-services integration consequences in the products development process management. As a result, the strategic value of services in manufacturing companies‘ portfolio was found in an increasing tendency. However, services are normally developed using empirical methods or planned exclusively in the final stages when designed within the product development process, even if there is a strong interdependence between the service and the product. Thus, the managerial integration of service and product development processes is a challenge for companies. Based on literature review and case studies, two tools and a framework are presented in order to help companies overcome this difficulty. The System for Evaluation of Strategic Value (SESV) measures the strategic value of the portfolio items and the Product-Service Configuration Matrix (PSCM) reveals the interdependencies of the portfolio and the general profile of company‘s development processes. This contribution is intended to guide the management of Product-Service Development Process (PSDP).