Anticipatory vigilance: A classic grounded theory of risk reduction and management in the perioperative setting

This research aimed to investigate the main concern facing nurses in minimising risk within the perioperative setting and to generate an explanatory substantive theory of how they resolve this through anticipatory vigilance. In the context of the perioperative setting, nurses encounter challenges in minimising risks for their patients on a continuous basis. Current explanations of minimising risk in the perioperative setting offers insights into how perioperative nurses undertake their work. Currently research in minimising risk is broadly related to dealing with errors as opposed to preventing them. To date, little is known about how perioperative nurses practice and maintain safety. This study was guided by the principles of classic grounded theory as described by Glaser (1978, 1998, 2001). Data was collected through individual unstructured interviews with thirty seven perioperative nurses (with varying lengths of experiences of working in the area) and thirty three hours of non-participant observation within eight different perioperative settings in the Republic of Ireland. Data was simultaneously collected and analysed. The theory of anticipatory vigilance emerged as the pattern of behaviour through which nurse’s deal with their main concern of minimising risk in a high risk setting. Anticipatory vigilance is enacted through orchestrating, routinising and momentary adapting within a spirit of trusting relations within the substantive area of the perioperative setting. This theory of offers an explanation on how nurses resolve their main concern of minimising risk within the perioperative setting. The theory of anticipatory vigilance will be useful to nurses in providing a comprehensive framework of explanation and understanding on how nurses deal with minimising risk in the perioperative setting. The theory links perioperative nursing, risk and vigilance together. Clinical improvements through understanding and awareness of the theory of anticipatory vigilance will result in an improved quality environment, leading to safe patient outcomes.

Lack of cross-scale linkages reduces robustness of community-based fisheries management.

Community-based management and the establishment of marine reserves have been advocated worldwide as means to overcome overexploitation of fisheries. Yet, researchers and managers are divided regarding the effectiveness of these measures. The "tragedy of the commons" model is often accepted as a universal paradigm, which assumes that unless managed by the State or privatized, common-pool resources are inevitably overexploited due to conflicts between the self-interest of individuals and the goals of a group as a whole. Under this paradigm, the emergence and maintenance of effective community-based efforts that include cooperative risky decisions as the establishment of marine reserves could not occur. In this paper, we question these assumptions and show that outcomes of commons dilemmas can be complex and scale-dependent. We studied the evolution and effectiveness of a community-based management effort to establish, monitor, and enforce a marine reserve network in the Gulf of California, Mexico. Our findings build on social and ecological research before (1997-2001), during (2002) and after (2003-2004) the establishment of marine reserves, which included participant observation in >100 fishing trips and meetings, interviews, as well as fishery dependent and independent monitoring. We found that locally crafted and enforced harvesting rules led to a rapid increase in resource abundance. Nevertheless, news about this increase spread quickly at a regional scale, resulting in poaching from outsiders and a subsequent rapid cascading effect on fishing resources and locally-designed rule compliance. We show that cooperation for management of common-pool fisheries, in which marine reserves form a core component of the system, can emerge, evolve rapidly, and be effective at a local scale even in recently organized fisheries. Stakeholder participation in monitoring, where there is a rapid feedback of the systems response, can play a key role in reinforcing cooperation. However, without cross-scale linkages with higher levels of governance, increase of local fishery stocks may attract outsiders who, if not restricted, will overharvest and threaten local governance. Fishers and fishing communities require incentives to maintain their management efforts. Rewarding local effective management with formal cross-scale governance recognition and support can generate these incentives.

The Oud Across Arabic Culture

This study is a compilation and compendium of information on the oud, the most important instrument in Arabic classical music. It has grown out of my own long-time involvement in studying and playing the oud, and in particular out of my interest in the lack of sources and knowledge available to the vast majority of oud players and researchers, as well as for the readers. My own path started from an intensive study of the oud, which included exposure to several treaties; some housed in museums around the globe, and some only available in the Arabic language. The study combines archival research (including Arabic poetry and pre-Islamic Era and medieval treaties), symbolism, new archaeological discoveries, field interviews, and analysis of existing scholarship, and draws on my professional performance experience for detailed stylistic analysis of the oud's performance practice and its historical development. The study consists of participant observation, personal performance, and interviews conducted in person, via telephone, and/or via e-mail, according to the choice of the performers. The performers have been selected from networks of musicians who perform regularly at lounges, concert halls, and private events. These performers have been chosen according to their musical knowledge, technical skill, experience, and activity in Arabic music and oud performance. Chapter one deals with the purpose of this study and the methods of investigation, as well as giving a brief overview of the history of the oud. In addition, there will be an introduction to the Arabic musical system (mâqâm), which is primarily based on the mechanics and sound production of the oud. Chapter two deals with the oud in Arabic sources: the first source is Arabic poetry in the pre-Islamic Era. The second source is Arabic poetry in the medieval era, in which I found a significant number of poets who allude to the oud, providing accurate descriptions of the player, singers, and the scenes within the contexts of oud performance. The third source is the Arab scholars' intensive treatises with meticulous accounts of the instrument's apparatii, including descriptions and measurements of the parts, strings, and tuning. While chapter three deals with the classification, the development of the oud, chapter four deals with topics such as: the symbolism of the oud and its relation to cosmology, astronomy, mathematics and anatomy. In most of the pertinent Arabic writings, philosophers mention a significant correlation between the oud and the other sciences. Chapter five deals with recreating the performance practice of the oud. A case study of the oud performers focuses on their style, technique, training, and personal experiences. Topics such as improvisation and ornamentation, the oud in the Arabic musical ensemble, the social uses and functions, and gender in musical performance practices will be included in detailed analysis. Other important topics will be analyzed such as traditional vs. modern technique, and the repertoire of the oud. Specifically, in regard to technique, the study outline the style of the music, the role of the oud in Arabic ensembles, the function of the oud in music composition, and the form of the ensembles in Arabic performance and practice.

FOLLOWING THE TRAIL OF THE SNAKE: A LIFE HISTORY OF COBRA MANSA "COBRINHA" MESTRE OF CAPOEIRA

This dissertation is a cultural biography of Mestre Cobra Mansa, a mestre of the Afro-Brazilian martial art of capoeira angola. The intention of this work is to track Mestre Cobrinha's life history and accomplishments from his beginning as an impoverished child in Rio to becoming a mestre of the tradition-its movements, music, history, ritual and philosophy. A highly skilled performer and researcher, he has become a cultural ambassador of the tradition in Brazil and abroad. Following the Trail of the Snake is an interdisciplinary work that integrates the research methods of ethnomusicology (oral history, interview, participant observation, musical and performance analysis and transcription) with a revised life history methodology to uncover the multiple cultures that inform the life of a mestre of capoeira. A reflexive auto-ethnography of the author opens a dialog between the experiences and developmental steps of both research partners' lives. Written in the intersection of ethnomusicology, studies of capoeira, social studies and music education, the academic dissertation format is performed as a roda of capoeira aiming to be respectful of the original context of performance. The result is a provocative ethnographic narrative that includes visual texts from the performative aspects of the tradition (music and movement), aural transcriptions of Mestre Cobra Mansa's storytelling and a myriad of writing techniques to accompany the reader in a multi-dimensional journey of multicultural understanding. The study follows Cinezio Feliciano Pe anha in his childhood struggle for survival as a street performer in Rio de Janeiro. Several key moves provided him with the opportunity to rebuild his life and to grow into a recognized mestre of the capoeira angola martial art as Mestre Cobra Mansa ("Tame Snake" in Portuguese). His dedicated work enabled him to contribute to the revival of the capoeira angola tradition during the 1980's in Bahia. After his move to the United States in the early 1990's, Mestre Cobrinha founded the International Capoeira Angola Foundation, which today has expanded to 28 groups around the world. Mestre Cobra returned home to Brazil to initiate projects that seek to develop a new sense of community from all that he has learned and been able to accomplish in his life through the performance and study of capoeira angola.

Reflexive learning in pre-service training of primary school teachers: from experience to assimilation of contents

This article presents an educational experiment carried out in the Primary School Teaching Degree at the University of Barcelona. Specifically, the article analyses the application of the “Work Corners” approach in a core subject. In a three-year action research process, trainers put into practice an innovation which enabled them to boost cooperative work and reflexive learning among trainees. Firstly, the theoretical model underpinning the project and guiding many of the actions carried out by the training team is presented. After providing detailed information on the practical development of the experiment, the data-gathering process and its results are shown. Various information-gathering strategies were used in assessing the project, such as a questionnaire, participant observation, and teachers’ diaries. The results demonstrate, amongst other things, that “work corners” offer viable and appropriate educational conditions for the articulation of theoretical and practical knowledge, for building professional knowledge, and therefore, the beginnings of a reflexive teaching practice.

Agitating for a design and regeneration agenda in a postconflict city: the case of Belfast

Introduction

Belfast has been a focus of academic attention for the last forty years with most interest centred on various aspects of ‘the Troubles’. Where there has been interest in the built environment, it has largely been about how the ‘security situation’ impacted directly on architecture and on the design and layout of social housing. This paper seeks to go beyond this to explore how the political- administrative culture of ‘the Troubles’ interacted with ‘normal’ market forces to shape the central area of the city, and to consider the responses of a recently formed activist group, known as the Forum for Alternative Belfast (hereafter referred to as the Forum). The paper is written by three of the directors of the Forum.1 Moreover, the empirical research presented here was undertaken by the Forum as part of a campaign to address issues relating to the design, layout and quality of Belfast’s built environment. In the longstanding tradition of participant observation working within an action-research paradigm, the participants have attempted to offer an account that is evidentially and purposefully selfcritical and reflective. It is of course recognised that while this approach offers many positive attributes, such as phenomenological access through immersion in the project, it also has the potential to bring compromise on research detachment and objectivity.2 To address the latter, the authors have attempted
to avoid polemical argument, and to support claims with primary or secondary research evidence. The authors also acknowledge that action-research has a chequered history; however, they would argue
that their approach is faithful to a concept that sees ‘research’ defined as understanding and ‘action’ defined as seeking change. The Forum’s very purpose is to seek change, but to do this requires evidence, collaboration and demonstration. And in this sense, it is a learning process for all participants, including the research activists, government officials, community organisations and students. The authors also recognise the complexity of factors that affect urban management and change, particularly in a city such as Belfast, which has had to cope with political violence for over thirty years. And they appreciate that in the context of conflict, governance is skewed to cope with political realities. Hamdi reminds us, however, that in practice there is an ‘important dialectic between top-down planning, with its formal and designed laws and structures, and bottom-up selforganizing collectivism—those “quantum and emergent systems” which Jane Jacobs argued long ago give cities their life and order.’3

‘Some Good Clean Fun’: Humour, Control and Subversion in an Advertising Agency

This article explores the relation between humour and control, drawing on participant observation in an organization in which humour was central to daily life. Keys is a leading advertising agency whose staff spent an unusually large amount of time sending humorous e-mails. Examining these e-mails in some depth, we unpack the role of humour in subverting various forms of control, including gender norms and managerial authority. We find the relation between humour, control and subversion to be ambiguous. Building upon current debates in organization studies, we develop the concept of humour based on our observations at Keys. Specifically, we argue that humour is always in excess of both control and subversion, a 'nicely impossible' object that cannot be captured. This article thus contributes to theoretical approaches on organizational humour, conceptualizing the concept of 'newness' through Judith Butler's re-reading of Derridean différance and the Lacanian Real. In addition, we contribute a novel empirical account of the study of e-mail list humour in a contemporary advertising firm. © 2012 Blackwell Publishing Ltd.

Using evidence in policy: The importance of mediating beliefs and practices

This article argues that to understand the use of evidence in policy, we need to examine how meanings and practices in the civil service shape what is accepted as knowledge, and how differences between the beliefs and values of the academy and the polity can impede the flow and transfer of knowledge. It considers the importance of social context and shared meanings in legitimating knowledge. Who counts as legitimate knowledge providers has expanded and here the role of stakeholder groups and experiential knowledge is of particular interest. How hierarchy, anonymity, and generalist knowledge within the civil service mediate the use of evidence in policy is examined. The difference in values and ideology of the civil service and the academy has implications for how academic research is interpreted and used to formulate policy and for its position in knowledge power struggles. There are particular issues about the social science nature of evidence to inform rural policy being mediated in a government department more used to dealing with natural science knowledge. This article is based on participant observation carried out in a UK Department of Agriculture and Rural Development. © 2013 The Author. Sociologia Ruralis © 2013 European Society for Rural Sociology.

Positioning Clinical Nurse Specialists and Nurse Practitioners as Change Champions to Implement a Pain Protocol in Long-Term Care

Pain management for older adults in long-term care (LTC) has been recognized as a problem internationally. The purpose of this study was to explore the role of a clinical nurse specialist (CNS) and nurse practitioner (NP) as change champions during the implementation of an evidence-based pain protocol in LTC. In this exploratory, multiple-case design study, we collected data from two LTC homes in Ontario, Canada. Three data sources were used: participant observation of an NP and a CNS for 18 hours each over a 3-week period; CNS and NP diaries recording strategies, barriers, and facilitators to the implementation process; and interviews with members of the interdisciplinary team to explore perceptions about the NP and CNS role in implementing the pain protocol. Data were analyzed using thematic content analysis. The NP and CNS used a variety of effective strategies to promote pain management changes in practice including educational outreach with team members, reminders to nursing staff to highlight the pain protocol and educate about practice changes, chart audits and feedback to the nursing staff, interdisciplinary working group meetings, ad hoc meetings with nursing staff, and resident assessment using advanced skills. The CNS and NP are ideal champions to implement pain management protocols and likely other quality improvement initiatives.

Developing management capability within a horizontal supply chain in performance measurement deployment and evolution: A Dynamic Capabilities and Goal Theory perspective

Complex collaboration in rapidly changing business environments create challenges for management capability in Utility Horizontal Supply Chains (UHSCs) involving the deploying and evolving of performance measures. The aim of the study is twofold. First, there is a need to explore how management capability can be developed and used to deploy and evolve Performance Measurement (PM), both across a UHSC and within its constituent organisations, drawing upon a theoretical nexus of Dynamic Capability (DC) theory and complementary Goal Theory. Second, to make a contribution to knowledge by empirically building theory using these constructs to show the management motivations and behaviours within PM-based DCs. The methodology uses an interpretive theory building, multiple case based approach (n=3) as part of a USHC. The data collection methods include, interviews (n=54), focus groups (n=10), document analysis and participant observation (reflective learning logs) over a five-year period giving longitudinal data. The empirical findings lead to the development of a conceptual framework showing that management capabilities in driving PM deployment and evolution can be represented as multilevel renewal and incremental Dynamic Capabilities, which can be further understood in terms of motivation and behaviour by Goal-Theoretic constructs. In addition three interrelated cross cutting themes of management capabilities in consensus building, goal setting and resource change were identified. These management capabilities require carefully planned development and nurturing within the UHSC. 

A realistic evaluation of track and trigger systems and acute care training for early recognition and treatment of deteriorating ward-based patients: research protocol.

Aim The aim of the study is to evaluate factors that enable or constrain the implementation and service delivery of early warnings systems or acute care training in practice. Background To date there is limited evidence to support the effectiveness of acute care initiatives (early warning systems, acute care training, outreach) in reducing the number of adverse events (cardiac arrest, death, unanticipated Intensive Care admission) through increased recognition and management of deteriorating ward based patients in hospital [1-3]. The reasons posited are that previous research primarily focused on measuring patient outcomes following the implementation of an intervention or programme without considering the social factors (the organisation, the people, external influences) which may have affected the process of implementation and hence measured end-points. Further research which considers the social processes is required in order to understand why a programme works, or does not work, in particular circumstances [4]. Method The design is a multiple case study approach of four general wards in two acute hospitals where Early Warning Systems (EWS) and Acute Life-threatening Events Recognition and Treatment (ALERT) course have been implemented. Various methods are being used to collect data about individual capacities, interpersonal relationships and institutional balance and infrastructures in order to understand the intended and unintended process outcomes of implementing EWS and ALERT in practice. This information will be gathered from individual and focus group interviews with key participants (ALERT facilitators, nursing and medical ALERT instructors, ward managers, doctors, ward nurses and health care assistants from each hospital); non-participant observation of ward organisation and structure; audit of patients' EWS charts and audit of the medical notes of patients who deteriorated during the study period to ascertain whether ALERT principles were followed. Discussion & progress to date This study commenced in January 2007. Ethical approval has been granted and data collection is ongoing with interviews being conducted with key stakeholders. The findings from this study will provide evidence for policy-makers to make informed decisions regarding the direction for strategic and service planning of acute care services to improve the level of care provided to acutely ill patients in hospital. References 1. Esmonde L, McDonnell A, Ball C, Waskett C, Morgan R, Rashidain A et al. Investigating the effectiveness of Critical Care Outreach Services: A systematic review. Intensive Care Medicine 2006; 32: 1713-1721 2. McGaughey J, Alderdice F, Fowler R, Kapila A, Mayhew A, Moutray M. Outreach and Early Warning Systems for the prevention of Intensive Care admission and death of critically ill patients on general hospital wards. Cochrane Database of Systematic Reviews 2007, Issue 3. www.thecochranelibrary.com 3. Winters BD, Pham JC, Hunt EA, Guallar E, Berenholtz S, Pronovost PJ (2007) Rapid Response Systems: A systematic review. Critical Care Medicine 2007; 35 (5): 1238-43 4. Pawson R and Tilley N. Realistic Evaluation. London; Sage: 1997

Reflexões Estratégicas de Desenvolvimento Local no Contexto da Preservação da Identidade de Penedos (Mértola)

Resumo O trabalho de investigação que está a decorrer, tem como objeto de estudo as questões da identidade e da memória de uma aldeia alentejana, enquanto território de partilha de uma comunidade rural, tendo em conta a participação estratégica dos atores locais. Estudaremos a partir daí, a sua relação com a terra, o quotidiano, a mudança, a organização social, a ruralidade, os fatores portadores de futuro e novas propostas de desenvolvimento local, para territórios de baixa densidade. Pretende-se encontrar formas contributivas para preservar a identidade da aldeia e concomitantemente encontrar conjuntamente com os atores locais territorializados, alternativas de desenvolvimento local, capazes de contrariar a tendência de despovoamento e empobrecimento territorial. Com este trabalho de investigação, que se insere no âmbito da Sociologia da Ação, será utilizada metodologicamente o MACTOR e a sua aplicabilidade na determinação da estratégia de atores e respetivas relações de forças com o território e o que a ele diz respeito e ainda a observação participante/método de pesquisa de terreno e consequentemente o inquérito por entrevista. Pretendendo-se aprofundar e conhecer os problemas da interioridade e abandono populacional, designadamente na aldeia de Penedos que se situa na margem direita do rio Guadiana, freguesia de S. Miguel do Pinheiro e concelho de Mértola, no Baixo Alentejo. Abstract The research that is taking place, has as its object of study the issues of identity and memory of an Alentejo village, while sharing the territory of a rural community, taking into account the strategic participation of local actors. We'll look from there, his relationship with the earth, the everyday, change, social organization, rurality, the factors bearing on the future and new proposals for local development to areas of low density. The aim is to find ways contributory to preserve the identity of the village and found concomitantly in conjunction with local stakeholders territorialized, alternative local development, able to counteract the trend of depopulation and impoverishment territorial. With this research work, which falls within the Sociology of Action, will be used to methodologically MACTOR and its applicability in determining the strategy of respective actors and power relations with the territory and that he has concerns and participant observation / method of field research and thus the survey interview. Intending to go deeper and understand the problems of interiority and abandoned population, particularly in the village of Penedos which lies on the right bank of the Guadiana River, parish of S. Miguel do Pinheiro, county of Mértola, in the Baixo Alentejo.

A educação no processo de interação entre o enfermeiro e a pessoa idosa/família na comunidade

Objetivo: Compreender a educação no processo de interação entre o enfermeiro e a pessoa idosa e família no domicílio. Estudo de natureza qualitativa, enquadrado nos principais pressupostos do Interacionismo Simbólico e da Grounded Theory, em quatro freguesias do Agrupamento de Centros de Saúde do Ave III, com um total de inscritos de 80285 e destes 9,81% eram pessoas idosas com idades iguais ou superiores a 65 anos. Na colheita dos dados recorremos: (i) à observação não participante das práticas de enfermagem às pessoas idosas e família no domicílio;(ii) 12 entrevistas às enfermeiras observadas e 4 entrevistas em grupo (pessoa idosa e família). Emergiram as categorias: organização estrutural dos cuidados no domicílio; avaliação em contexto e intervenção terapêutica em contexto. A categoria central foi a “Construção da relação no contexto do domicílio” pelo facto da relação da enfermeira com o idoso e a família ser central em todo o processo de cuidados. Os conhecimentos fornecidos pela teoria substantiva “Cuidar no Domicílio – um Processo de Interação” fundamentada nos dados e na sua análise, fornecem contributos válidos para a prática de enfermagem nesta área específica do cuidar a pessoa idosa e família no domicílio e no contexto em que foi desenvolvido o estudo; ABSTRACT: Education in the Interaction Process between nurse and Elderly person/family in the community Objective: Understanding education in the interaction process between nurse and elderly and their relatives at home. Qualitative study, framed on Symbolic Interactionism and Grounded Theory main assumptions, counting with 802825 members of four parishes of Agrupamento de Centros de Saúde do Ave III, which 9, 81% were elderly and had 65 or more years old. Data collection instruments used: (i) non-participant observation of nursing practices with elderly and families at home, (ii) interviews of 12 nurses practices observed and 4 group interviews (family and elderly person). Categories emerged: structural organization of home care; assessment and therapeutic intervention in context. The core category emerged was "Construction of the relationship in the context of the household" once the relationship between nurse, elderly and family seem be central to the whole process of care. The knowledge provided by substantive theory "Caring at Home - An Interaction Process" founded on data analysis provided valuable contributions to nursing practice in this specific area of care, elderly care and their relatives at home, in which context study was developed.

Turismo, turistas e eventos: o caso da Ilha da Madeira

A presente investigação, conducente à obtenção do grau de Doutor em Turismo na Universidade de Évora, aborda a temática dos eventos culturais no âmbito da actividade turística na Ilha da Madeira. Nesse sentido, e definido o objecto, o objectivo geral da pesquisa consistiu em analisar o contributo dos principais eventos turísticos - Festa da Flor, Festa do Vinho e Festa do Fim-de-Ano - na valorização das tradições culturais da Ilha e na promoção do destino Madeira. Para atingir os objectivos definidos, foi utilizada uma metodologia dual que consistiu num abordagem quantitativa e qualitativa, através da administração de um inquérito por questionário, um inquérito por entrevista e da utilização da observação directa e/ou participante, em triangulação que considerou o lado da procura e o lado da oferta. Foi possível concluir que os eventos analisados dão um contributo importante para a valorização das tradições, para a pertença e coesão social, e que enfatizam a interacção social entre turistas e anfitriões, ao mesmo tempo que consistem numa oferta singular e única; ABSTRACT: This dissertation was conceived to obtain the doctor degree in Tourism at the University of Évora. It approaches the theme of cultural events in the frame work of tourism activity in the island of Madeira. The main objective of the study was to analyze the contribution of the major tourist events (Flower Festival, Wine Festival and the Feast of the End-of-Year) on the value of cultural traditions of the island and the promotion of Madeira. The defined objectives were accomplished by the use of a dual methodology, through an approach of quantitative and qualitative orientation – by means of questionnaire to the tourists, interviews to the organisers and direct and participant observation by the researcher. We can conclude about the cultural importance of the three selected feasts (Flower Festival, Wine Festival and the Feast of the End-of-Year) as a major contribute to value the tradition, to emphasize the social cohesion, to identify the tourist experience and to evaluate social interaction between hosts and guests as an unique and singular offer.

Liderança e gestão das escolas em Portugal: o quotidiano do presidente do conselho executivo

O presente trabalho pretende apresentar uma investigação qualitativa que procurou conhecer o quotidiano de presidentes do conselho executivo de escolas secundárias públicas portuguesas. Esta investigação desenvolveu-se utilizando a metodologia de observação participante e de “shadowing” dos presidentes do conselho executivo que aceitaram participar no estudo. Para tal, acompanhámos 3 presidentes do conselho executivo de escolas secundárias públicas portuguesas durante algumas semanas de um ano lectivo, registando todos os elementos que compuseram o seu quotidiano e realizando entrevistas, quer com os presidentes, quer com outros elementos da equipa do conselho executivo. Os dados recolhidos foram analisados utilizando diversos enquadramentos teóricos de liderança e permitiram-nos caracterizar não só o quotidiano típico destes profissionais, mas também qual o seu papel na gestão e liderança da escola secundária pública em Portugal.