Hur barn förhåller sig till regler har belysts i forskning som visat att barnen lägger stor vikt vid moralrelaterade regler. Hur barnen accepterar konventionella regler beror på vilken funktion regeln upplevs fylla. Det som saknas i forskningen är ett dynamiskt perspektiv som tar hänsyn till interagerande aktörers ömsesidiga inflytande över varandra när förutsättningarna förändras och hur detta i sin tur skapar nya förutsättningar. För att belysa detta utgår studien från Giddens struktureringsteori som stipulerar att människors sociala handlingar både formar och formas av de strukturella förutsättningarna till skillnad från ett mer strukturalistiskt perspektiv där aktörerna ses som underkastade den struktur som de verkar inom. Struktureringsteorin möjliggör också för underordnade aktörer att utöva kontroll över de med mera makt. Datainsamlingen har genomförts genom deltagande observationer på en skola. Observationsobjektet har varit incidenter där eleverna agerat på ett sätt som inte är förenligt med verksamhetens konventioner. Fokus har legat på elevernas utnyttjande av resurser i form av material och lokaler. Resultatet visar att inbyggda motsättningar i de strukturella förutsättningarna öppnar en möjlighet för eleverna att ta kontroll över de resurser som personalen försöker reglera. När personalen försöker återta kontrollen resulterar det i oavsiktliga konsekvenser på grund av faktorer som inte uppmärksammats vilket i regel förskjuter problematiken och upprätthåller det olovliga resursutnyttjandet. / How children relate to rules has been highlighted in research in which children attach great importance to moral-related rules. How children accept conventional rules depends on what function the rule is perceived to fulfill. What is missing from the research is a dynamic perspective that considers how interacting actors influence each other when conditions change and how this in turn creates new conditions. To illuminate this, the study is based on Gidden's theory of structuration which stipulates that people's social actions both shape and are shaped by the structural conditions as opposed to a more structuralist perspective where the actors are seen as subjects to the structure in which they operate. The theory of structuration also enables subordinate actors to exercise control over those with more power. The data collection was carried out through participant observations at one school. The object of observation has been incidents where the students acted in a manner incompatible with the conventions of the school. The focus has been on students' utilization of resources in the form of materials and premises. The result shows that built-in contradictions in the structural conditions open opportunities for students to take control of the resources that the staff is trying to regulate. When staff try to regain control, it results in unintended consequences due to factors that have not been recognized, which usually offsets the problem and maintains the unwanted utilization of resources.

One of the key components of international development is to provide adequate shelter for citizens of developing countries. This is often accomplished by governmental, non- governmental, and private organizations that seek to lower the cost, increase the quality, and expand the availability of safe, sustainable housing through the use of innovative technologies. These new technologies can affect the social and/or economic structure within communities. This paper is a case study resulting from the construction of a seventy-one-home village, including infrastructure, near Yogyakarta, Indonesia by a foreign, aid-based non-governmental organization (NGO). The village was relocated less than two kilometers from its original site after a massive landslide, triggered by the 2006 earthquakes of Central Java, virtually destroyed the entire community. Four years after construction the researcher took an inductive inquiry approach through interviews with residents of the community and residents of neighboring communities to understand the social and economic impacts. The research project explored the unintended consequences to the community resulting from the NGO's use of innovative housing technologies (steel reinforced concrete domes and planned community development) without a thorough understanding of underlying community culture and interactions.

Unintended consequences of electronic health records represent undesired effects on individuals or systems, which may contradict initial goals and impact patient care. The purpose of this study was to determine the extent to which a new quantitative measure called the Carrington-Gephart Unintended Consequences of Electronic Health Record Questionnaire (CG-UCE-Q) was valid and reliable. Then, it was used to describe acute care nurses' experience with unintended consequences of electronic health records and relate them to the professional practice environment. Acceptable content validity was achieved for two rounds of surveys with nursing informatics experts (n = 5). Then, acute care nurses (n = 144) were recruited locally and nationally to complete the survey and describe the frequency with which they encounter unintended consequences in daily work. Principal component analysis with oblique rotation was applied to evaluate construct validity. Correlational analysis with measures of the professional practice environment and workarounds was used to evaluate convergent validity. Test-retest reliability was measured in the local sample (N = 68). Explanation for 63% of the variance across six subscales (patient safety, system design, workload issues, workarounds, technology barriers, and sociotechnical impact) supported construct validity. Relationships were significant between subscales for electronic health record-related threats to patient safety and low autonomy/leadership (P < .01), poor communication about patients (P < .01), and low control over practice (P < .01). The most frequent sources of unintended consequences were increased workload, interruptions that shifted tasks from the computer, altered workflow, and the need to duplicate data entry. Convergent validity of the CG-UCE-Q was moderately supported with both the context and processes of workarounds with strong relationships identified for when nurses perceived a block and altered process to work around it to subscales in the CG-UCE-Q for electronic health record system design (P < .01) and technological barriers (P < .01).

It is generally held that economic sanctions have an adverse effect on human rights in sanctioned countries, but what about the non-sanctioned countries? Previous research has found that human rights sanctions appear to have a deterring effect on non-sanctioned countries in Latin America which, in turn, led to human rights improvements. The assumption from these findings suggests that countries improve their human rights in fear of being sanctioned themselves. Utilising a difference-in-differences method with data from CIRI and PTS for the time period 1977-1996, the present quasi-experimental study attempts to test these findings on Africa and Asia by posing the hypothesis that economic sanctions improve the level of human rights protection in the non-sanctioned countries of the same geographical region. The results show that, while there appears to be a positive effect on some measures of human rights in non-sanctioned countries, these effects are weak. Moreover, the results also show that the improvements correspond with the number of years following a sanction, where 1 year displays the weakest human rights improvements, whilst 10 years displays the strongest. The conclusion is that there, in some cases, appears to be a modest effect which needs to be examined further, but that sanctions, nevertheless, do not improve human rights in neighbouring countries in a meaningful way.

Many of the sustainability challenges our society currently face have arisen as unanticipated side effects of our own modern developments. This thesis investigates if unintended consequences and perspectives are fully addressed by traditional methods for providing decision-making support within the sustainability domain. For that purpose, Systems Thinking is utilised in three cases: in the first, Systems Thinking is used to analyse sustainability issues relating to the current product design paradigm. In the second case, Systems Thinking is applied to two product systems – household washing machines and conventional passenger vehicles. The third case discusses different stakeholder perspectives in environmental decision-making and proposes a way to combine the ESA tools LCA, LCC and CBA in order to consider the different stakeholder perspectives. Results of the first case point out that the practices within the current design paradigm are focused on innovations and improvements in material and energy efficiency. These practices have led to the following unintended consequences: consumption rebound effects, increased waste, pollution, negative externalities, economic inequalities and other environmental and social negative impacts. These unintended consequences are represented in a Causal Loop Diagram (CLD). The diagram graphically illustrates how these unintended consequences influence one another and interact by means of cause-effect linkages and reinforcing feedback loops. A novel conceptual framework named Sustainability-Driven Systems-Oriented Design is proposed to work within broader system boundaries in order to address possible negative side effects that micro-level gains could have on macro-level losses. In the case of the two product systems, a CLD for household washing machines and conventional passenger vehicles is developed. The CLDs represent how selected variables interact by means of cause-effect associations to affect environmental impacts of the products. The CLD technique appears to be a useful way to connect quantitative assessment (from Life Cycle Assessment) with qualitative analysis (from Systems Thinking). In the third case it is argued that stakeholders tend to adopt different system boundaries and make assumptions according to their perspective when they use ESA tools in environmental decision-making. A way to combine ESA tools is suggested to facilitate the observation of the environmental decision from different viewpoints. It concludes, to some extent, that traditional methods for providing decision-making support can handle certain parameters that may result in unintended consequences. Systems Thinking may assist in the process of performing qualitative analyses of what is important to consider in order to strengthen the robustness of, and improve on the recommended actions from, quantitative detailed analyses. / <p>QC 201305330</p>

Introduction: En réponse aux exigences du gouvernement fédéral en ce qui concerne les temps d'attente pour les chirurgies électives d’hanche et du genou, les Organismes Canadiens de santé ont adopté des stratégies de gestion pour les listes d'attente. Cependant, il n'existe pas actuellement aucune information disponible concernant les effets imprévus, positive ou négative, de ces stratégies. Méthodologie: Un modèle qui a été construit est tombé en panne la gestion de la chirurgie d’hanche et du genou en différentes étapes, afin d'identifier les effets imprévus possibles pour chaque étape; le modèle a été validé auprès d'un panel d'experts. Cette étude a choisi quatre études de cas en fonction de leur durabilité: un cas qui a été durable, un cas qui a été modérément durable, et deux cas peu probable d'être durable. Dans cette étude qualitative, nous avons mené 31 entretiens semi-structurés entre Novembre 2010 et Juin 2011 avec les gestionnaires, les infirmières, les thérapeutes et les chirurgiens impliqués dans la gestion des stratégies du temps d’attente pour les chirurgies électives d’hanche et du genou. Les quatre cas ont été sélectionnés à partir de trois provinces / régions. Nous avons analysé les conséquences non intentionnelles aux niveaux systémique et organisationnelle en utilisant les stratégies dans chaque contexte. Enregistrements des entrevues ont été transcrits mot à mot et soumis à l'analyse du cadre. Résultats: Les effets négatifs sont la précarité des stratégies en raison du non-récurrente financement, l'anxiété chez les patients qui ne sont pas prêts pour la chirurgie, une redistribution du temps de chirurgie vers l’orthopédie au détriment des autres interventions chirurgicales, tensions entre les chirurgiens et entre les orthopédistes et anesthésistes, et la pression sur le personnel dans le bloc opératoire et postopératoire. Conclusion: La stratégie d’implémentation aux niveaux national et local devrait prendre en compte les conséquences potentielles, positives et négatives. Il y a des conséquences inattendues à chaque niveau de l'organisation des soins de santé. Individuellement et collectivement, ces conséquences peuvent positivement et négativement affecter les résultats. Par conséquent, la planification de la santé doit analyser et prendre en compte les conséquences inattendues en termes de bonnes résultats inattendues, compromis et les conséquences négatives afin d'améliorer les résultats. / Introduction: In response to federal government requirements regarding wait times for elective hip and knee surgeries, Canadian healthcare organizations have adopted wait list management strategies. However, there is currently no information available regarding the unanticipated effects, positive or negative, of these strategies. Methodology: A model was constructed that broke down the management of elective hip and knee surgery into different steps, in order to identify the unanticipated potential effects for each step; the model was validated with a panel of experts. This study chose four case studies based on their sustainability: one case that was sustainable, one case that was moderately sustainable, and two cases considered unlikely to be sustainable. In this qualitative study, we conducted 31 semi-structured interviews between November 2010 and June 2011 with managers, nurses, therapists and surgeons involved in wait time management strategies for hip and knee surgeries. The four cases were selected from three provinces/areas. We analyzed potential unintended consequences at the systemic and organizational levels of using these strategies in each setting. Interview recordings were transcribed verbatim and subjected to framework analysis. Results: Negative effects were the strategies’ precariousness due to non-recurrent funding, anxiety in patients not ready for surgery, a redistribution of surgical time toward orthopaedics at the expense of other surgeries, tensions between surgeons and between orthopaedic surgeons and anaesthesiologists, and significant pressure on personnel in the operating suite and in post-operative care. Conclusions: Strategy implementation at the national and local levels should take into consideration any potential consequences, positive and negative. There are unintended consequences at each level of healthcare organization. Individually and jointly, these consequences can positively and negatively affect outcomes. Therefore, health planning should analyze and take into account unintended consequences in terms of serendipities, trade-offs and negative consequences in order to improve results.

Introduction: En réponse aux exigences du gouvernement fédéral en ce qui concerne les temps d'attente pour les chirurgies électives d’hanche et du genou, les Organismes Canadiens de santé ont adopté des stratégies de gestion pour les listes d'attente. Cependant, il n'existe pas actuellement aucune information disponible concernant les effets imprévus, positive ou négative, de ces stratégies. Méthodologie: Un modèle qui a été construit est tombé en panne la gestion de la chirurgie d’hanche et du genou en différentes étapes, afin d'identifier les effets imprévus possibles pour chaque étape; le modèle a été validé auprès d'un panel d'experts. Cette étude a choisi quatre études de cas en fonction de leur durabilité: un cas qui a été durable, un cas qui a été modérément durable, et deux cas peu probable d'être durable. Dans cette étude qualitative, nous avons mené 31 entretiens semi-structurés entre Novembre 2010 et Juin 2011 avec les gestionnaires, les infirmières, les thérapeutes et les chirurgiens impliqués dans la gestion des stratégies du temps d’attente pour les chirurgies électives d’hanche et du genou. Les quatre cas ont été sélectionnés à partir de trois provinces / régions. Nous avons analysé les conséquences non intentionnelles aux niveaux systémique et organisationnelle en utilisant les stratégies dans chaque contexte. Enregistrements des entrevues ont été transcrits mot à mot et soumis à l'analyse du cadre. Résultats: Les effets négatifs sont la précarité des stratégies en raison du non-récurrente financement, l'anxiété chez les patients qui ne sont pas prêts pour la chirurgie, une redistribution du temps de chirurgie vers l’orthopédie au détriment des autres interventions chirurgicales, tensions entre les chirurgiens et entre les orthopédistes et anesthésistes, et la pression sur le personnel dans le bloc opératoire et postopératoire. Conclusion: La stratégie d’implémentation aux niveaux national et local devrait prendre en compte les conséquences potentielles, positives et négatives. Il y a des conséquences inattendues à chaque niveau de l'organisation des soins de santé. Individuellement et collectivement, ces conséquences peuvent positivement et négativement affecter les résultats. Par conséquent, la planification de la santé doit analyser et prendre en compte les conséquences inattendues en termes de bonnes résultats inattendues, compromis et les conséquences négatives afin d'améliorer les résultats. / Introduction: In response to federal government requirements regarding wait times for elective hip and knee surgeries, Canadian healthcare organizations have adopted wait list management strategies. However, there is currently no information available regarding the unanticipated effects, positive or negative, of these strategies. Methodology: A model was constructed that broke down the management of elective hip and knee surgery into different steps, in order to identify the unanticipated potential effects for each step; the model was validated with a panel of experts. This study chose four case studies based on their sustainability: one case that was sustainable, one case that was moderately sustainable, and two cases considered unlikely to be sustainable. In this qualitative study, we conducted 31 semi-structured interviews between November 2010 and June 2011 with managers, nurses, therapists and surgeons involved in wait time management strategies for hip and knee surgeries. The four cases were selected from three provinces/areas. We analyzed potential unintended consequences at the systemic and organizational levels of using these strategies in each setting. Interview recordings were transcribed verbatim and subjected to framework analysis. Results: Negative effects were the strategies’ precariousness due to non-recurrent funding, anxiety in patients not ready for surgery, a redistribution of surgical time toward orthopaedics at the expense of other surgeries, tensions between surgeons and between orthopaedic surgeons and anaesthesiologists, and significant pressure on personnel in the operating suite and in post-operative care. Conclusions: Strategy implementation at the national and local levels should take into consideration any potential consequences, positive and negative. There are unintended consequences at each level of healthcare organization. Individually and jointly, these consequences can positively and negatively affect outcomes. Therefore, health planning should analyze and take into account unintended consequences in terms of serendipities, trade-offs and negative consequences in order to improve results.

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Between 1980-2006, thousands of South African pension funds converted members from defined benefit to defined contribution structures. This research set out to answer the questions of why this phenomenon occurred and whether peculiar environmental circumstances influenced the outcome. The research framework identified various stakeholders in the retirement fund industry - government; regulator; pension fund adjudicator; ombudsman for long term insurance; trade unions; members; trustees; business; employers and service providers - and isolated the elements to be considered in the research. Industry experts were interviewed to obtain a macro view of the phenomenon and specific manifestations of the phenomenon were also considered in case studies. The purpose of the research was to develop a model for managers to assist them in dealing with environmental change. Qualitative research methodology was utilised and feedback from semi-structured interviews was categorised into several emergent themes. Within-case and cross-case analyses were conducted. Research results indicate that the conversion phenomenon occurred in two waves - one initiated in the 1980s and driven by the trade unions and a second in the 1990s, driven by employers, often at the advice of their consultants. Evidence of the start of a third wave also emerged. Results indicate that an environmental shock exerted a substantial influence on the course of events. Under these: &#61482; Various factors combined to drive organisational evolution (i.e. adaptation to the environment). &#61482; Adaptation speed was inappropriate and exceeded that which was required for sufficient thought. &#61482; Uncertainty and vacuum circumstances arose leading to consequences that require redress. &#61482; The power of the relative stakeholders changed and influenced the strategic outcome. &#61482; An imbalance in stakeholder interests arose and ethical factors became consequential. &#61482; Business acted to restore certainty for itself. Existing literature explained organisational behaviour in environments of competitive shock and high turbulence, but not in circumstances of environmental shock. A model emerged to assist managers to deal with environmental change, which was applied to an analysis of pension fund reform. It was also applied to the pension fund perspective on Broad-Based Black Economic Empowerment. This model may also be applied in analysis of land redistribution, sanctions and constitutional development. / Business Management / DBL

Between 1980-2006, thousands of South African pension funds converted members from defined benefit to defined contribution structures. This research set out to answer the questions of why this phenomenon occurred and whether peculiar environmental circumstances influenced the outcome. The research framework identified various stakeholders in the retirement fund industry - government; regulator; pension fund adjudicator; ombudsman for long term insurance; trade unions; members; trustees; business; employers and service providers - and isolated the elements to be considered in the research. Industry experts were interviewed to obtain a macro view of the phenomenon and specific manifestations of the phenomenon were also considered in case studies. The purpose of the research was to develop a model for managers to assist them in dealing with environmental change. Qualitative research methodology was utilised and feedback from semi-structured interviews was categorised into several emergent themes. Within-case and cross-case analyses were conducted. Research results indicate that the conversion phenomenon occurred in two waves - one initiated in the 1980s and driven by the trade unions and a second in the 1990s, driven by employers, often at the advice of their consultants. Evidence of the start of a third wave also emerged. Results indicate that an environmental shock exerted a substantial influence on the course of events. Under these: &#61482; Various factors combined to drive organisational evolution (i.e. adaptation to the environment). &#61482; Adaptation speed was inappropriate and exceeded that which was required for sufficient thought. &#61482; Uncertainty and vacuum circumstances arose leading to consequences that require redress. &#61482; The power of the relative stakeholders changed and influenced the strategic outcome. &#61482; An imbalance in stakeholder interests arose and ethical factors became consequential. &#61482; Business acted to restore certainty for itself. Existing literature explained organisational behaviour in environments of competitive shock and high turbulence, but not in circumstances of environmental shock. A model emerged to assist managers to deal with environmental change, which was applied to an analysis of pension fund reform. It was also applied to the pension fund perspective on Broad-Based Black Economic Empowerment. This model may also be applied in analysis of land redistribution, sanctions and constitutional development. / Business Management / DBL